Obstructive sleep apnea(OSA)and coronary artery disease(CAD)frequently coexist,forming a bidirectional pathophysiological loop that amplifies cardiovascular risk.Intermittent hypoxemia in OSA patients promotes endothe...Obstructive sleep apnea(OSA)and coronary artery disease(CAD)frequently coexist,forming a bidirectional pathophysiological loop that amplifies cardiovascular risk.Intermittent hypoxemia in OSA patients promotes endothelial dysfunction,systemic inflammation,oxidative stress,and sympathetic activation,thereby accelerating atherogenesis,whereas myocardial ischemia and ventricular dysfunction in CAD patients can further destabilize upper-airway patency and exacerbate OSA.Continuous positive airway pressure(CPAP)is the standard therapy for OSA and reliably restores sleep architecture;however,large randomized trials have reported inconsistent effects on major adverse cardiovascular events,particularly in patients with established CAD.This mini review synthesizes contemporary data on CPAP across diverse OSA–CAD clinical scenarios,delineates patient phenotypes most likely to achieve cardiovascular benefit and identifies contexts in which CPAP provides limited protection.On the basis of these findings,we propose pragmatic recommendations for patient selection,adherence monitoring and optimization of CPAP therapy and highlight key research priorities,including extended follow-up,adherence-enhancing strategies and multimodal interventions.Clarifying the circumstances under which CPAP is cardioprotective will enable more precise management of patients with OSA,with or without concomitant CAD.展开更多
Large-volume presses(LVPs)are widely utilized in diverse research fields—including high-pressure physics,chemistry,materials science,and Earth and planetary sciences—to investigate the physical and chemical properti...Large-volume presses(LVPs)are widely utilized in diverse research fields—including high-pressure physics,chemistry,materials science,and Earth and planetary sciences—to investigate the physical and chemical properties of materials under extreme high-pressure and hightemperature conditions.A prerequisite for achieving reproducible property measurements is the determination and control of pressure within experimental setups.However,the lack of precise pressure calibration in LVPs hinders the broader application of such devices in ultrahigh-pressure studies.This study employs a suite of standard phase transition-based pressure markers—comprising metallic conductors,semiconductors,and minerals—through both in situ and ex situ identification approaches,to establish pressure calibration curves ranging from 0.4 to>30 GPa for various types of LVP installed at the Center for High Pressure Science and Technology Advanced Research(HPSTAR),Beijing,including piston–cylinder,cubic,and multi-anvil presses.The results provide a unified and traceable pressure reference for highpressure experiments conducted at HPSTAR,while also offering technical guidance and calibration standards for other researchers utilizing similar LVP systems,thereby enabling more consistent comparison between different laboratories.This work facilitates the advancement of LVP research toward broader applications in higher-pressure regimes.展开更多
While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the assoc...While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.展开更多
The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence...The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence is still lacking.To validate this framework,here we employ a programmable robotic platform,where a single light-controlled wheeled robot travels in an activity landscape.Our experiments quantitatively demonstrate that the intrinsic pressure difference across the activity interface is balanced by the emerged polarization force.This result unambiguously confirms the theoretical predictions,thus validating the intrinsic pressure framework and laying the experimental foundation for the intrinsic pressure-based mechanical description of dry active matter.展开更多
Wearable sensors integrated with deep learning techniques have the potential to revolutionize seamless human-machine interfaces for real-time health monitoring,clinical diagnosis,and robotic applications.Nevertheless,...Wearable sensors integrated with deep learning techniques have the potential to revolutionize seamless human-machine interfaces for real-time health monitoring,clinical diagnosis,and robotic applications.Nevertheless,it remains a critical challenge to simultaneously achieve desirable mechanical and electrical performance along with biocompatibility,adhesion,self-healing,and environmental robustness with excellent sensing metrics.Herein,we report a multifunctional,anti-freezing,selfadhesive,and self-healable organogel pressure sensor composed of cobalt nanoparticle encapsulated nitrogen-doped carbon nanotubes(CoN CNT)embedded in a polyvinyl alcohol-gelatin(PVA/GLE)matrix.Fabricated using a binary solvent system of water and ethylene glycol(EG),the CoN CNT/PVA/GLE organogel exhibits excellent flexibility,biocompatibility,and temperature tolerance with remarkable environmental stability.Electrochemical impedance spectroscopy confirms near-stable performance across a broad humidity range(40%-95%RH).Freeze-tolerant conductivity under sub-zero conditions(-20℃)is attributed to the synergistic role of CoN CNT and EG,preserving mobility and network integrity.The Co N CNT/PVA/GLE organogel sensor exhibits high sensitivity of 5.75 k Pa^(-1)in the detection range from 0 to 20 k Pa,ideal for subtle biomechanical motion detection.A smart human-machine interface for English letter recognition using deep learning achieved 98%accuracy.The organogel sensor utility was extended to detect human gestures like finger bending,wrist motion,and throat vibration during speech.展开更多
Improving device efficiency is fundamental for advancing energy harvesting technology,particularly in systems designed to convert light energy into electrical output.In our previous studies,we developed a basic struct...Improving device efficiency is fundamental for advancing energy harvesting technology,particularly in systems designed to convert light energy into electrical output.In our previous studies,we developed a basic structure light pressure electric generator(Basic-LPEG),which utilized a layered configuration of Ag/Pb(Zr,Ti)O_(3)(PZT)/Pt/GaAs to generate electricity based on light-induced pressure on the PZT.In this study,we sought to enhance the performance of this Basic-LPEG by introducing Ag nanoparticles/graphene oxide(AgNPs/GO)composite units(NP-LPEG),creating upgraded harvesting device.Specifically,by depositing the AgNPs/GO units twice onto the Basic-LPEG,we observed an increase in output voltage and current from 241 mV and 3.1μA to 310 mV and 9.3μA,respectively,under a solar simulator.The increase in electrical output directly correlated with the intensity of the light pressure impacting the PZT,as well as matched the Raman measurements,finite-difference time-domain simulations,and COMSOL Multiphysics Simulation.Experimental data revealed that the enhancement in electrical output was proportional to the number of hot spots generated between Ag nanoparticles,where the electric field experienced substantial amplification.These results underline the effectiveness of AgNPs/GO units in boosting the light-induced electric generation capacity,thereby providing a promising pathway for high-efficiency energy harvesting devices.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both co...BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both conditions markedly reduce survival and increase therapeutic complexity.Recently,hepatic artery infusion chemotherapy(HAIC)in combination with targeted immunotherapy has shown promise for advanced HCC.CASE SUMMARY We report a 47-year-old male with advanced HCC complicated by PVTT and OJ,who was admitted with marked jaundice of the skin and sclera.Imaging revealed a large hepatic mass(14.5 cm×11.3 cm)in the right lobe with associated portal vein tumor thrombus.The tertiary bile duct was only mildly dilated,making percutaneous transhepatic cholangiography drainage infeasible.The patient underwent reduced-dose HAIC,which resulted in significant tumor shrinkage and marked reduction in serum bilirubin.This improvement enabled sequential treatment with lenvatinib and camrelizumab.After six cycles,both liver function and alphafetoprotein levels improved.The patient achieved a progression-free survival of 20 months and an overall survival of 29 months.CONCLUSION HAIC can treat high-bilirubin HCC with PVTT and OJ,allowing for subsequent targeted immunotherapy.展开更多
Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabo...Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.展开更多
Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low...Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low-dose curcumin(50 mg/kg),high-dose curcumin(200 mg/kg),high-dose curcumin plus a scrambled control antagomir,or high-dose curcumin plus anti-miR-29b treatments.Cardiac function was assessed by echocardiography.Fibrosis was evaluated by histology,collagen volume fraction,and hydroxyproline content.Expression of miR-29b,HDAC4,and fibrosis-related markers(Col1a1,Col3a1,TGF-β1)was measured by quantitative RT-PCR and Western blotting assays.Myocardial procollagen type I carboxy-terminal propeptide was determined by ELISA,and HDAC4-specific enzymatic activity was assayed using a fluorogenic kit.Results:Curcumin improved cardiac function,reduced fibrosis,restored miR-29b expression,and suppressed HDAC4 expression and activity in a dose-dependent manner.Furthermore,curcumin decreased myocardial procollagen type I carboxy-terminal propeptide levels,confirming reduced collagen synthesis.Anti-miR-29b administration partially abrogated the antifibrotic and cardioprotective effects of curcumin.Conclusions:Curcumin attenuates pressure overload-induced cardiac fibrosis and dysfunction in a TAC mouse model via modulation of the miR-29b/HDAC4 axis and suppression of collagen synthesis.展开更多
The magnetic properties and Kondo effect in Ce3TiBi5 with a quasi-one-dimensional structure were investigated using in situ high-pressure resistivity measurements up to 48 GPa.At ambient pressure,Ce_(3)TiBi_(5) underg...The magnetic properties and Kondo effect in Ce3TiBi5 with a quasi-one-dimensional structure were investigated using in situ high-pressure resistivity measurements up to 48 GPa.At ambient pressure,Ce_(3)TiBi_(5) undergoes an antiferromagnetic(AFM)transition at T_(N)∼5 K.Under high pressures within 8.9 GPa,we find that Kondo scattering contributes differently to the high-temperature resistance,R(T),depending on the applied current direction,demonstrating a significantly anisotropic Kondo effect.The complete P–T phase diagram has been constructed,in which the pressure dependence of T_(N) exhibits a dome-like shape.The AFM order remains robust under pressure,even when the coherence temperature T^(*) far exceeds 300 K.We attribute the observed anisotropic Kondo effect and the robust AFM to the underlying anisotropy in electronic hybridization under high pressure.展开更多
Luminescent metal-organic frameworks(MOFs)have garnered significant attention due to their structural tunability and potential applications in solid-state lighting,bioimaging,sensing,anticounterfeiting,and other field...Luminescent metal-organic frameworks(MOFs)have garnered significant attention due to their structural tunability and potential applications in solid-state lighting,bioimaging,sensing,anticounterfeiting,and other fields.Nevertheless,due to the tendency of1,4-benzenedicarboxylic acid(BDC)to rotate within the framework,MOFs composed of it exhibit significant non-radiative energy dissipation and thus impair the emissive properties.In this study,efficient luminescence of MIL-140A nanocrystals(NCs)with BDC rotors as ligands is achieved by pressure treatment strategy.Pressure treatment effectively modulates the pore structure of the framework,enhancing the interactions between the N,N-dimethylformamide vip molecules and the BDC ligands.The enhanced host-vip interaction contributes to the structural rigidity of the MOF,thereby suppressing the rotation-induced excited-state energy loss.As a result,the pressure-treated MIL-140A NCs displayed bright blue-light emission,with the photoluminescence quantum yield increasing from an initial 6.8%to 69.2%.This study developed an effective strategy to improve the luminescence performance of rotor ligand MOFs,offers a new avenue for the rational design and synthesis of MOFs with superior luminescent properties.展开更多
In order to investigate the effect of die wall thickness on morphologies of defect band,a stepped mold with a wall thickness of 5 mm,4 mm,3 mm,2 mm,and 1 mm was designed to carry out high pressure die casting experime...In order to investigate the effect of die wall thickness on morphologies of defect band,a stepped mold with a wall thickness of 5 mm,4 mm,3 mm,2 mm,and 1 mm was designed to carry out high pressure die casting experiments with AlSi10 MgMn alloy.For castings with wall thickness of 2-4 mm,the ratio of the mean defect band width(w)and mean grain size(d)in the defect band(w/d)ranges 7-18,while it increases to 24.47 for the 5 mm-thick casting.This difference is related with the filling speed and the distribution of externally solidified crystals(ESCs).The mold flow analysis indicates that the filling speed decreases from 25.41 m·s^(-1)to 11.07 m·s^(-1)when wall thickness increases from 2 mm to 5 mm.Due to the decreasing filling speed along the wall thickness,ESCs gradually diffuse from the center to the defect band,which keep the shear strength in the defect band at a high-level during filling.Meanwhile,the shear strength generated during the filling also decreases as the shear rate drops.Finally,the defect bands in the 5 mm-thick region become widen and indistinct,and the porosity is as high as 5.25%.展开更多
The functional properties of glasses are governed by their formation history and the complex relaxation processes they undergo.However,under extreme conditions,glass behaviors are still elusive.In this study,we employ...The functional properties of glasses are governed by their formation history and the complex relaxation processes they undergo.However,under extreme conditions,glass behaviors are still elusive.In this study,we employ simulations with varied protocols to evaluate the effectiveness of different descriptors in predicting mechanical properties across both low-and high-pressure regimes.Our findings demonstrate that conventional structural and configurational descriptors fail to correlate with the mechanical response following pressure release,whereas the activation energy descriptor exhibits robust linearity with shear modulus after correcting for pressure effects.Notably,the soft mode parameter emerges as an ideal and computationally efficient alternative for capturing this mechanical behavior.These findings provide critical insights into the influence of pressure on glassy properties,integrating the distinct features of compressed glasses into a unified theoretical framework.展开更多
This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native th...This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.展开更多
Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of tr...Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.展开更多
Hydraulic stimulation technology is widely employed to enhance the permeability of geothermal reservoirs.Nevertheless,accurately predicting hydraulic fracture propagation in complex geological conditions remains chall...Hydraulic stimulation technology is widely employed to enhance the permeability of geothermal reservoirs.Nevertheless,accurately predicting hydraulic fracture propagation in complex geological conditions remains challenging,thereby hindering the effective utilization of existing natural fractures.In this study,a phase field model was developed utilizing the finite element method to examine the influence of fluid presence,stress conditions,and natural fractures on the initiation and propagation of hydraulic fractures.The model employs Biot's poroelasticity theory to establish the coupling between the displacement field and the fluid field,while the phase field theory is applied to simulate fracture behavior.The results show that whenσ_(x0)/σ_(y0)<3 or qf<20 kg/(m^(3)·s),the presence of natural fractures can alter the original propagation direction of hydraulic fractures.Conversely,in the absence of these conditions,the propagation path of natural fractures is predominantly influenced by the initial stress field.Furthermore,based on the analysis of breakdown pressure and damage area,the optimal intersection angle between natural fractures and hydraulic fractures is determined to range from 45°to 60°.Finally,once a dominant channel forms,initiating and propagating hydraulic fractures in other directions becomes increasingly difficult,even in highly fractured areas.This method tackles the challenges of initiating and propagating hydraulic fractures in complex geological conditions,providing a theoretical basis for optimizing Enhanced Geothermal System(EGS)projects.展开更多
BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To...BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for CPAP.Liver fibrosis and steatosis were assessed using TE.Before and after 6 mo of CPAP therapy,serum markers and TE were assessed for all patients.The mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP therapy.Univariate analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT level.In multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT levels.Meanwhile,no significant changes in TE data or serum fibrosis markers were seen.CONCLUSION Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW changes.In those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.展开更多
Background:Obstructive sleep apnea(OSA)is highly common in patients with coronary artery disease(CAD)and it is a strong predictor of subsequent cardiovascular events.However,whether treatment with continuous positive ...Background:Obstructive sleep apnea(OSA)is highly common in patients with coronary artery disease(CAD)and it is a strong predictor of subsequent cardiovascular events.However,whether treatment with continuous positive airway pressure(CPAP)can decrease this risk remains controversial.Methods:PubMed,EMBASE,the Cochrane Library,and ClinicalTrials.gov were systematically searched to identify randomized clinical trials reporting cardiovascular events from database inception to February 12,2022.Results:Four trials with 3043 participants were included.The median follow-up duration ranged from 3 to 4.75 years.Compared with usual care alone,CPAP was not associated with decreased MACCE risk(RR 0.96,95%CI 0.77–1.21,P=0.75),and the results were consistent regardless of CPAP adherence(≥4 hours/night vs.<4 hours/night,RR 0.48,95%CI 0.20–1.16).Similarly,no significant differences were observed between groups in the risks of all-cause death(RR 0.81,95%CI 0.52–1.26),cardiovascular death(RR 0.70,95%CI 0.36–1.33),myocardial infarction(RR 1.08,95%CI 0.73–1.60),revascularization(RR 1.03,95%CI 0.77–1.38),and cerebrovascular events(RR 0.77,95%CI 0.23–2.61).Conclusion:Existing evidence does not support an association between CPAP treatment and decreased risk of recur-rent cardiovascular events in patients with CAD and OSA,regardless of adherence to CPAP.展开更多
Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditi...Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditions such as skin disorders. Methods: To investigate whether such a leak affects FiO2 supplied to the alveoli, we simulated a patient with chronic obstructive pulmonary disorder during NPPV in HMV. In addition, FiO2 was measured in the portion assumed to be the mouth and lungs while setting the flow of the oxygen concentrator and leak amount based on a previous study. Results: FiO2 supplied to the lungs increased statistically significantly upon increasing the amount of leak (P Conclusions: We observed that FiO2 supplied to alveoli can be reduced by a leak in the NPPV mask. Because our results differ from those previously reported, we believe that further studies should reassess the selection of respirators and oxygen concentrators.展开更多
Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic ki...Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.展开更多
文摘Obstructive sleep apnea(OSA)and coronary artery disease(CAD)frequently coexist,forming a bidirectional pathophysiological loop that amplifies cardiovascular risk.Intermittent hypoxemia in OSA patients promotes endothelial dysfunction,systemic inflammation,oxidative stress,and sympathetic activation,thereby accelerating atherogenesis,whereas myocardial ischemia and ventricular dysfunction in CAD patients can further destabilize upper-airway patency and exacerbate OSA.Continuous positive airway pressure(CPAP)is the standard therapy for OSA and reliably restores sleep architecture;however,large randomized trials have reported inconsistent effects on major adverse cardiovascular events,particularly in patients with established CAD.This mini review synthesizes contemporary data on CPAP across diverse OSA–CAD clinical scenarios,delineates patient phenotypes most likely to achieve cardiovascular benefit and identifies contexts in which CPAP provides limited protection.On the basis of these findings,we propose pragmatic recommendations for patient selection,adherence monitoring and optimization of CPAP therapy and highlight key research priorities,including extended follow-up,adherence-enhancing strategies and multimodal interventions.Clarifying the circumstances under which CPAP is cardioprotective will enable more precise management of patients with OSA,with or without concomitant CAD.
基金supported by the National Science Foundation of China(Grant Nos.U1530402 and U1930401).
文摘Large-volume presses(LVPs)are widely utilized in diverse research fields—including high-pressure physics,chemistry,materials science,and Earth and planetary sciences—to investigate the physical and chemical properties of materials under extreme high-pressure and hightemperature conditions.A prerequisite for achieving reproducible property measurements is the determination and control of pressure within experimental setups.However,the lack of precise pressure calibration in LVPs hinders the broader application of such devices in ultrahigh-pressure studies.This study employs a suite of standard phase transition-based pressure markers—comprising metallic conductors,semiconductors,and minerals—through both in situ and ex situ identification approaches,to establish pressure calibration curves ranging from 0.4 to>30 GPa for various types of LVP installed at the Center for High Pressure Science and Technology Advanced Research(HPSTAR),Beijing,including piston–cylinder,cubic,and multi-anvil presses.The results provide a unified and traceable pressure reference for highpressure experiments conducted at HPSTAR,while also offering technical guidance and calibration standards for other researchers utilizing similar LVP systems,thereby enabling more consistent comparison between different laboratories.This work facilitates the advancement of LVP research toward broader applications in higher-pressure regimes.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82192900,82192901,82192904,81390540,and 91846303 to L.L.)the National Key Research and Development Program of China(Grant No.2016YFC0900500 to Y.G.)the Kadoorie Charitable Foundation in Hong Kong,and the Wellcome Trust in the UK(Grant/Award Nos.088158/Z/09/Z,104085/Z/14/Z,and 202922/Z/16/Z to Z.C.).
文摘While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.
基金supported by the National Natural Science Foundation of China (Grant Nos.T2325027,12274448,T2350007,12404239,12174041,12325405,12090054,and T2221001)the National Key R&D Program of China (Grant No.2022YFF0503504)。
文摘The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence is still lacking.To validate this framework,here we employ a programmable robotic platform,where a single light-controlled wheeled robot travels in an activity landscape.Our experiments quantitatively demonstrate that the intrinsic pressure difference across the activity interface is balanced by the emerged polarization force.This result unambiguously confirms the theoretical predictions,thus validating the intrinsic pressure framework and laying the experimental foundation for the intrinsic pressure-based mechanical description of dry active matter.
基金supported by the Basic Science Research Program(2023R1A2C3004336,RS-202300243807)&Regional Leading Research Center(RS-202400405278)through the National Research Foundation of Korea(NRF)grant funded by the Korea Government(MSIT)。
文摘Wearable sensors integrated with deep learning techniques have the potential to revolutionize seamless human-machine interfaces for real-time health monitoring,clinical diagnosis,and robotic applications.Nevertheless,it remains a critical challenge to simultaneously achieve desirable mechanical and electrical performance along with biocompatibility,adhesion,self-healing,and environmental robustness with excellent sensing metrics.Herein,we report a multifunctional,anti-freezing,selfadhesive,and self-healable organogel pressure sensor composed of cobalt nanoparticle encapsulated nitrogen-doped carbon nanotubes(CoN CNT)embedded in a polyvinyl alcohol-gelatin(PVA/GLE)matrix.Fabricated using a binary solvent system of water and ethylene glycol(EG),the CoN CNT/PVA/GLE organogel exhibits excellent flexibility,biocompatibility,and temperature tolerance with remarkable environmental stability.Electrochemical impedance spectroscopy confirms near-stable performance across a broad humidity range(40%-95%RH).Freeze-tolerant conductivity under sub-zero conditions(-20℃)is attributed to the synergistic role of CoN CNT and EG,preserving mobility and network integrity.The Co N CNT/PVA/GLE organogel sensor exhibits high sensitivity of 5.75 k Pa^(-1)in the detection range from 0 to 20 k Pa,ideal for subtle biomechanical motion detection.A smart human-machine interface for English letter recognition using deep learning achieved 98%accuracy.The organogel sensor utility was extended to detect human gestures like finger bending,wrist motion,and throat vibration during speech.
基金supported by Korea Evaluation Institute of Industrial Technology(KEIT)grant funded by the Korea Government(MOTIE)(RS-2022-00154720,Technology Innovation Program Development of next-generation power semiconductor based on Si-on-SiC structure)the National Research Foundation of Korea(NRF)by the Korea government(RS-2023-NR076826)Global-Learning&Academic Research Institution for Master's·PhD students,and Postdocs(LAMP)Program of the National Research Foundation of Korea(NRF)by the Ministry of Education(No.RS-2024-00443714).
文摘Improving device efficiency is fundamental for advancing energy harvesting technology,particularly in systems designed to convert light energy into electrical output.In our previous studies,we developed a basic structure light pressure electric generator(Basic-LPEG),which utilized a layered configuration of Ag/Pb(Zr,Ti)O_(3)(PZT)/Pt/GaAs to generate electricity based on light-induced pressure on the PZT.In this study,we sought to enhance the performance of this Basic-LPEG by introducing Ag nanoparticles/graphene oxide(AgNPs/GO)composite units(NP-LPEG),creating upgraded harvesting device.Specifically,by depositing the AgNPs/GO units twice onto the Basic-LPEG,we observed an increase in output voltage and current from 241 mV and 3.1μA to 310 mV and 9.3μA,respectively,under a solar simulator.The increase in electrical output directly correlated with the intensity of the light pressure impacting the PZT,as well as matched the Raman measurements,finite-difference time-domain simulations,and COMSOL Multiphysics Simulation.Experimental data revealed that the enhancement in electrical output was proportional to the number of hot spots generated between Ag nanoparticles,where the electric field experienced substantial amplification.These results underline the effectiveness of AgNPs/GO units in boosting the light-induced electric generation capacity,thereby providing a promising pathway for high-efficiency energy harvesting devices.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both conditions markedly reduce survival and increase therapeutic complexity.Recently,hepatic artery infusion chemotherapy(HAIC)in combination with targeted immunotherapy has shown promise for advanced HCC.CASE SUMMARY We report a 47-year-old male with advanced HCC complicated by PVTT and OJ,who was admitted with marked jaundice of the skin and sclera.Imaging revealed a large hepatic mass(14.5 cm×11.3 cm)in the right lobe with associated portal vein tumor thrombus.The tertiary bile duct was only mildly dilated,making percutaneous transhepatic cholangiography drainage infeasible.The patient underwent reduced-dose HAIC,which resulted in significant tumor shrinkage and marked reduction in serum bilirubin.This improvement enabled sequential treatment with lenvatinib and camrelizumab.After six cycles,both liver function and alphafetoprotein levels improved.The patient achieved a progression-free survival of 20 months and an overall survival of 29 months.CONCLUSION HAIC can treat high-bilirubin HCC with PVTT and OJ,allowing for subsequent targeted immunotherapy.
基金supported by the National Science and Technology Major Program for Noncommunicable Chronic Diseases(2023ZD0503500)the National Natural Science Foundation of China(82030102,12126602,91857118)+1 种基金the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSP-GG-2)。
文摘Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.
基金supported by China International Medical Foundation(Z-2019-42-1908-4)Natural Science Basic Research Program of Shaanxi Province(2019JM-440).
文摘Objective:To investigate the antifibrotic effects of curcumin in a transverse aortic constriction(TAC)mouse model and elucidate its molecular mechanisms.Methods:Male C57BL/6 mice underwent TAC and received vehicle,low-dose curcumin(50 mg/kg),high-dose curcumin(200 mg/kg),high-dose curcumin plus a scrambled control antagomir,or high-dose curcumin plus anti-miR-29b treatments.Cardiac function was assessed by echocardiography.Fibrosis was evaluated by histology,collagen volume fraction,and hydroxyproline content.Expression of miR-29b,HDAC4,and fibrosis-related markers(Col1a1,Col3a1,TGF-β1)was measured by quantitative RT-PCR and Western blotting assays.Myocardial procollagen type I carboxy-terminal propeptide was determined by ELISA,and HDAC4-specific enzymatic activity was assayed using a fluorogenic kit.Results:Curcumin improved cardiac function,reduced fibrosis,restored miR-29b expression,and suppressed HDAC4 expression and activity in a dose-dependent manner.Furthermore,curcumin decreased myocardial procollagen type I carboxy-terminal propeptide levels,confirming reduced collagen synthesis.Anti-miR-29b administration partially abrogated the antifibrotic and cardioprotective effects of curcumin.Conclusions:Curcumin attenuates pressure overload-induced cardiac fibrosis and dysfunction in a TAC mouse model via modulation of the miR-29b/HDAC4 axis and suppression of collagen synthesis.
基金supported by the National Key Research and Development Program of Chinathe National Natural Science Foundation of China (Grant Nos.2024YFA1408000,12474097,and2023YFA1406001)+2 种基金the Guangdong Provincial Quantum Science Strategic Initiative (Grant No.GDZX2201001)the Center for Computational Science and Engineering at Southern University of Science and Technology,the Major Science and Technology Infrastructure Project of Material Genome Big-science Facilities Platform supported by Municipal Development and Reform Commission of Shenzhen(for J.L.Z.and Y.L.)the Chinese funding sources applied via HPSTAR。
文摘The magnetic properties and Kondo effect in Ce3TiBi5 with a quasi-one-dimensional structure were investigated using in situ high-pressure resistivity measurements up to 48 GPa.At ambient pressure,Ce_(3)TiBi_(5) undergoes an antiferromagnetic(AFM)transition at T_(N)∼5 K.Under high pressures within 8.9 GPa,we find that Kondo scattering contributes differently to the high-temperature resistance,R(T),depending on the applied current direction,demonstrating a significantly anisotropic Kondo effect.The complete P–T phase diagram has been constructed,in which the pressure dependence of T_(N) exhibits a dome-like shape.The AFM order remains robust under pressure,even when the coherence temperature T^(*) far exceeds 300 K.We attribute the observed anisotropic Kondo effect and the robust AFM to the underlying anisotropy in electronic hybridization under high pressure.
基金supported by the National Key R&D Program of China(Grant No.2023YFA1406200)the National Natural Science Foundation of China(No.12274177 and 12304261)the China Postdoctoral Science Foundation(No.2024M751076)。
文摘Luminescent metal-organic frameworks(MOFs)have garnered significant attention due to their structural tunability and potential applications in solid-state lighting,bioimaging,sensing,anticounterfeiting,and other fields.Nevertheless,due to the tendency of1,4-benzenedicarboxylic acid(BDC)to rotate within the framework,MOFs composed of it exhibit significant non-radiative energy dissipation and thus impair the emissive properties.In this study,efficient luminescence of MIL-140A nanocrystals(NCs)with BDC rotors as ligands is achieved by pressure treatment strategy.Pressure treatment effectively modulates the pore structure of the framework,enhancing the interactions between the N,N-dimethylformamide vip molecules and the BDC ligands.The enhanced host-vip interaction contributes to the structural rigidity of the MOF,thereby suppressing the rotation-induced excited-state energy loss.As a result,the pressure-treated MIL-140A NCs displayed bright blue-light emission,with the photoluminescence quantum yield increasing from an initial 6.8%to 69.2%.This study developed an effective strategy to improve the luminescence performance of rotor ligand MOFs,offers a new avenue for the rational design and synthesis of MOFs with superior luminescent properties.
基金supported by the National Natural Science Foundation of China(No.52474396 and 52175284)the National Key Research and Development Program of China(Grant No.2022YFB3404201)。
文摘In order to investigate the effect of die wall thickness on morphologies of defect band,a stepped mold with a wall thickness of 5 mm,4 mm,3 mm,2 mm,and 1 mm was designed to carry out high pressure die casting experiments with AlSi10 MgMn alloy.For castings with wall thickness of 2-4 mm,the ratio of the mean defect band width(w)and mean grain size(d)in the defect band(w/d)ranges 7-18,while it increases to 24.47 for the 5 mm-thick casting.This difference is related with the filling speed and the distribution of externally solidified crystals(ESCs).The mold flow analysis indicates that the filling speed decreases from 25.41 m·s^(-1)to 11.07 m·s^(-1)when wall thickness increases from 2 mm to 5 mm.Due to the decreasing filling speed along the wall thickness,ESCs gradually diffuse from the center to the defect band,which keep the shear strength in the defect band at a high-level during filling.Meanwhile,the shear strength generated during the filling also decreases as the shear rate drops.Finally,the defect bands in the 5 mm-thick region become widen and indistinct,and the porosity is as high as 5.25%.
基金supported by the National Natural Science Foundation of China (Grant Nos.T2325004 and 52161160330)the National Natural Science Foundation of China (Grants No.12504233)+2 种基金Advanced MaterialsNational Science and Technology Major Project (Grant No.2024ZD0606900)the Talent Hub for “AI+New Materials” Basic Researchthe Key Research and Development Program of Ningbo (Grant No.2025Z088)。
文摘The functional properties of glasses are governed by their formation history and the complex relaxation processes they undergo.However,under extreme conditions,glass behaviors are still elusive.In this study,we employ simulations with varied protocols to evaluate the effectiveness of different descriptors in predicting mechanical properties across both low-and high-pressure regimes.Our findings demonstrate that conventional structural and configurational descriptors fail to correlate with the mechanical response following pressure release,whereas the activation energy descriptor exhibits robust linearity with shear modulus after correcting for pressure effects.Notably,the soft mode parameter emerges as an ideal and computationally efficient alternative for capturing this mechanical behavior.These findings provide critical insights into the influence of pressure on glassy properties,integrating the distinct features of compressed glasses into a unified theoretical framework.
文摘This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.
文摘Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.
基金supported by the National Key Research and Development Program(2021YFB150740401)National Natural Science Foundation of China(42202336)the CAS Pioneer Hundred Talents Program in China(Y826031C01)。
文摘Hydraulic stimulation technology is widely employed to enhance the permeability of geothermal reservoirs.Nevertheless,accurately predicting hydraulic fracture propagation in complex geological conditions remains challenging,thereby hindering the effective utilization of existing natural fractures.In this study,a phase field model was developed utilizing the finite element method to examine the influence of fluid presence,stress conditions,and natural fractures on the initiation and propagation of hydraulic fractures.The model employs Biot's poroelasticity theory to establish the coupling between the displacement field and the fluid field,while the phase field theory is applied to simulate fracture behavior.The results show that whenσ_(x0)/σ_(y0)<3 or qf<20 kg/(m^(3)·s),the presence of natural fractures can alter the original propagation direction of hydraulic fractures.Conversely,in the absence of these conditions,the propagation path of natural fractures is predominantly influenced by the initial stress field.Furthermore,based on the analysis of breakdown pressure and damage area,the optimal intersection angle between natural fractures and hydraulic fractures is determined to range from 45°to 60°.Finally,once a dominant channel forms,initiating and propagating hydraulic fractures in other directions becomes increasingly difficult,even in highly fractured areas.This method tackles the challenges of initiating and propagating hydraulic fractures in complex geological conditions,providing a theoretical basis for optimizing Enhanced Geothermal System(EGS)projects.
基金the Japan Society for the Promotion of Science,No.JP16K09564.
文摘BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for CPAP.Liver fibrosis and steatosis were assessed using TE.Before and after 6 mo of CPAP therapy,serum markers and TE were assessed for all patients.The mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP therapy.Univariate analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT level.In multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT levels.Meanwhile,no significant changes in TE data or serum fibrosis markers were seen.CONCLUSION Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW changes.In those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.
基金funded by grants from National Key R&D Program of China(2022YFC2505600)the Training Program for Outstanding Young Scholars in Beijing Anzhen Hospital,Capital Medical University(AZ2023-YQ-03).
文摘Background:Obstructive sleep apnea(OSA)is highly common in patients with coronary artery disease(CAD)and it is a strong predictor of subsequent cardiovascular events.However,whether treatment with continuous positive airway pressure(CPAP)can decrease this risk remains controversial.Methods:PubMed,EMBASE,the Cochrane Library,and ClinicalTrials.gov were systematically searched to identify randomized clinical trials reporting cardiovascular events from database inception to February 12,2022.Results:Four trials with 3043 participants were included.The median follow-up duration ranged from 3 to 4.75 years.Compared with usual care alone,CPAP was not associated with decreased MACCE risk(RR 0.96,95%CI 0.77–1.21,P=0.75),and the results were consistent regardless of CPAP adherence(≥4 hours/night vs.<4 hours/night,RR 0.48,95%CI 0.20–1.16).Similarly,no significant differences were observed between groups in the risks of all-cause death(RR 0.81,95%CI 0.52–1.26),cardiovascular death(RR 0.70,95%CI 0.36–1.33),myocardial infarction(RR 1.08,95%CI 0.73–1.60),revascularization(RR 1.03,95%CI 0.77–1.38),and cerebrovascular events(RR 0.77,95%CI 0.23–2.61).Conclusion:Existing evidence does not support an association between CPAP treatment and decreased risk of recur-rent cardiovascular events in patients with CAD and OSA,regardless of adherence to CPAP.
文摘Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditions such as skin disorders. Methods: To investigate whether such a leak affects FiO2 supplied to the alveoli, we simulated a patient with chronic obstructive pulmonary disorder during NPPV in HMV. In addition, FiO2 was measured in the portion assumed to be the mouth and lungs while setting the flow of the oxygen concentrator and leak amount based on a previous study. Results: FiO2 supplied to the lungs increased statistically significantly upon increasing the amount of leak (P Conclusions: We observed that FiO2 supplied to alveoli can be reduced by a leak in the NPPV mask. Because our results differ from those previously reported, we believe that further studies should reassess the selection of respirators and oxygen concentrators.
文摘Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.
