The effects of Previously Fermented Juice （PFJ） on the fermentative quality and changes in chemical composition during fermentation of rice straw silage were investigated. The results showed that the PFJ and diluted...The effects of Previously Fermented Juice （PFJ） on the fermentative quality and changes in chemical composition during fermentation of rice straw silage were investigated. The results showed that the PFJ and diluted the PFJ （dPFJ） treated silages had significantly （p〈0.05） lower pH and ammonia-nitrogen content, while significantly higher lactic acid content compared with treatments. This study confirmed that the applying of the PFJ and the dPFJ improved fermentation quality of silage.展开更多
Salvage liver transplantation (LT) has been performed for recurred hepatocellular carcinoma(HCC) or for deterioration of liver function after resection of HCC. Controversies arise, howeverover the technical feasibilit...Salvage liver transplantation (LT) has been performed for recurred hepatocellular carcinoma(HCC) or for deterioration of liver function after resection of HCC. Controversies arise, howeverover the technical feasibility of salvage LT in patientswho underwent liver surgery,展开更多
Dear Editor,We read with great interest article titled'Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia'by Chen et al[1].The authors have analysed subjects with previ...Dear Editor,We read with great interest article titled'Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia'by Chen et al[1].The authors have analysed subjects with previously untreated anisometropic amblyopia and found a significant correlation between high degree of anisometropia and deep amblyopia,worse contrast sensitivity,fusion and stereopsis functions.We commend the authors in addressing a very important problem and agree with the authors in the notation that children with anisometropia are usually detected later owing to lack of noticeable physical abnormalities.展开更多
The "cascade static lens （CSL） gauge" has a high sensitivity（S） because the emitted electrons repeat the go and back oscillation before they are received by the electrodes. (S=18.6 Pa<sup>-1</su...The "cascade static lens （CSL） gauge" has a high sensitivity（S） because the emitted electrons repeat the go and back oscillation before they are received by the electrodes. (S=18.6 Pa<sup>-1</sup> (2480 Torr<sup>-1</sup> in a展开更多
Background: Erlotinib has been reported to be effective for the treatment of non-small cell lung cancer (NSCLC). To evaluate the efficacy and safety of erlotinib under conditions similar to daily clinical practice, a ...Background: Erlotinib has been reported to be effective for the treatment of non-small cell lung cancer (NSCLC). To evaluate the efficacy and safety of erlotinib under conditions similar to daily clinical practice, a phase II trial was conducted in Japanese patients with previously treated NSCLC. Methods: The eligibility criteria were stage IIIB/IV NSCLC, a performance status (PS) of 0 - 2, and previous treatment with 1 - 2 non-EGFR-TKI regimens. Patients received erlotinib (150 mg/day) orally until disease progression or intolerable toxicity occurred. The primary endpoint was the objective response rate (ORR). In addition, the disease control rate (DCR), progression-free survival (PFS), overall survival (OS), safety, and EGFR gene mutation status were evaluated. Results: Thirty-eight patients were enrolled, and 37 patients were evaluated. The median age was 69 years (range, 50 - 80 years). Patient characteristics were as follows: 26 were male and 11 were female;12 had a PS of 0, 20 had a PS of 1, and 5 had a PS of 2;and 26 had adenocarcinoma, and 11 had non-adenocarcinoma histology. The ORR and DCR were 21.6% (95% confidence interval [CI], 11.4% - 37.2%) and 54.1% (95% CI, 35.9% - 66.6%), respectively. Twenty-seven patients could be evaluated for EGFR gene status (12, mutated;15, wild-type). The ORR for EGFR-mutated patients was 41.7%, while that for patients with wild-type EGFR was 13.3%. The median PFS was evaluated as 4.4 months (95% CI, 2.2 - 10.7 months). The median OS was 14.9 months (95% CI, 9.2 months - not reached). Common adverse events were tolerable skin toxicities, diarrhea, and stomatitis. In addition, interstitial lung disease occurred in 8.1% of patients. Conclusion: As efficacy and safety were similar to previous studies, erlotinib was found to be effective for Japanese patients with previously treated NSCLC in clinical practice.展开更多
Memory enables organisms to encode,store,and retrieve information essential for interacting with and adapting to a dynamic environment.As an internal representation of the external world,memory serves as a crucial bri...Memory enables organisms to encode,store,and retrieve information essential for interacting with and adapting to a dynamic environment.As an internal representation of the external world,memory serves as a crucial bridge between past experiences and future behaviors.However,the brain continuously forms new memories,raising the question of how new memories are integrated without disrupting previously formed ones.展开更多
BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)inc...BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)includes multiple procedures,and the no studies have examined the clinical value of individual laparoscopic procedures.AIM To evaluate the safety and feasibility of each rLH procedure for hepatolithiasisa in patients with a history of biliary surgery.METHODS Patients with previous biliary surgery who underwent reoperative hepatectomy for hepatolithiasis were studied.Liver resection procedures were divided into three categories:(1)Laparoscopic/open left lateral sectionectomy[reoperative laparoscopic left lateral sectionectomy(rLLLS)/reoperative open left lateral sectionectomy(rOLLS)];(2)Laparoscopic/open left hemihepatectomy[reoperative laparoscopic left hemihepatectomy(rLLH)/reoperative open left hemihepatectomy(rOLH)];and(3)Laparoscopic/open complex hepatectomy[reoperative laparoscopic complex hepatectomy(rLCH)/reoperative open complex hepate ctomy(rOCH)].The clinical outcomes were compared between the rLLLS,rLLH,and rLCH groups,and subgroup analyses were performed for the rLLLS/rOLLS,rLLH/rOLH,and rLCH/rOCH subgroups.RESULTS A total of 185 patients were studied,including 101 rLH patients(40 rLLLS,50 rLLH,and 11 rLCH)and 84 reoperative open hepatectomy(40 rOLLS,33 rOLH,and 11 rOCH).Among the three types of rLH procedure,rLLLS required the shortest operation time(240.0 minutes vs 325.0 minutes vs 350.0 minutes,P=0.001)and the lowest blood transfusion rate(10.0%vs 22.0%vs 54.5%,P=0.005),followed by rLLH.The rLCH had the highest conversion rate(P<0.05)and postoperative intensive care unit stay rate(P=0.001).Most clinical outcomes in rLLLS and rLLH were superior or similar to those in the corresponding open surgery,while there were no differences in all outcomes between the rLCH and rOCH subgroups.CONCLUSION The rLH is safe for hepatolithiasis patients with a history of biliary surgery.The rLLLS and rLLH can be recommended for these patients,whereas rLCH should be applied with caution.展开更多
With the support by the National Natural Science Foundation of China,an international collaborative study led by Prof.Daniel Rosenfeld(The Hebrew University of Jerusalem),Dr.Zhu YanNian(Meteorological Institute of Sha...With the support by the National Natural Science Foundation of China,an international collaborative study led by Prof.Daniel Rosenfeld(The Hebrew University of Jerusalem),Dr.Zhu YanNian(Meteorological Institute of Shaanxi Province).Prof.Wang MingHuai(Nanjing University).展开更多
Background:Recurrent,previously stented basilar trunk aneurysms pose significant challenges to either microsurgical clipping or traditional endovascular treatment.We here presented an intriguing case that was successf...Background:Recurrent,previously stented basilar trunk aneurysms pose significant challenges to either microsurgical clipping or traditional endovascular treatment.We here presented an intriguing case that was successfully treated by the pipeline embolization device(PED;ev3/Covidien Neurovascular,Irvine,California,USA).Case presentation:A 62-year-old male found a recurrent aneurysm,which had been treated with coiling and stentassisted coiling before.The patient came to our center seeking for a third treatment.In our center,a single PED and additional coils were used to treat this refractory aneurysm.The whole length of the PED was delicately implanted in the previous Enterprise stent(Cordis Corporation,Miami FL,USA),which resembled the double-layer flow diverter FRED(Microvention,Tustin,California,USA).The inflow zone of the aneurysmal sac was further coiled considering that this aneurysm had ruptured.No procedure-related complications occurred.Follow-up angiogram at 6 months indicated that the intractable aneurysm was completely occluded and the patient was free from any neurologic deficit.Conclusions:This is a case that adds knowledge to improve the poor performance of flow diverters in previously stented aneurysms.However,future studies with larger group of patients are needed to further test the safety and efficacy of this technique.展开更多
Subject Code:E02With the support of the National Natural Science Foundation of China,a collaborative team led by Profs.Zhao Zhisheng(赵智胜)and Tian Yongjun(田永君)from the State Key Laboratory of Metastable Materials...Subject Code:E02With the support of the National Natural Science Foundation of China,a collaborative team led by Profs.Zhao Zhisheng(赵智胜)and Tian Yongjun(田永君)from the State Key Laboratory of Metastable Materials Science and Technology,Yanshan University demonstrates a new form of carbon with展开更多
Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:...Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.展开更多
In this editorial,we discussed the apparent discrepancy between the findings described by Colapietro et al,in their case report and data found in the literature.Colapietro et al reported a case of hepatitis B virus(HB...In this editorial,we discussed the apparent discrepancy between the findings described by Colapietro et al,in their case report and data found in the literature.Colapietro et al reported a case of hepatitis B virus(HBV)-related hepatic decompensation in a patient with chronic myeloid leukemia and a previously resolved HBV infection who was receiving Bruton’s tyrosine kinase(BTK)inhibitor therapy.First of all,we recapitulated the main aspects of the immune system involved in the response to HBV infection in order to underline the role of the innate and adaptive response,focusing our attention on the protective role of anti-HBs.We then carefully analyzed literature data on the risk of HBV reactivation(HBVr)in patients with previous HBV infection who were treated with either tyrosine kinase inhibitors or BTK inhibitors for their hematologic malignancies.Based on literature data,we suggested that several factors may contribute to the different risks of HBVr:The type of hematologic malignancy;the type of therapy(BTK inhibitors,especially second-generation,seem to be at a higher risk of HBVr than those with tyrosine kinase inhibitors);previous exposure to an anti-CD20 as first-line therapy;and ethnicity and HBV genotype.Therefore,the warning regarding HBVr in the specific setting of patients with hematologic malignancies requires further investigation.展开更多
In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of pr...In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of previous hepatitis B(PHB)and a source for reactivation of HBV.The prevalence of PHB is underestimated due to the lack of population testing programs.However,this condition not only com-plicate anticancer treatment,but may be responsible for the development of other diseases,like cancer or autoimmune disorders.Here we unveil possible mecha-nisms responsible for realization of these processes and suggest practical approa-ches for diagnosis and treatment.展开更多
Previous Particle Boundary(PPB),as the detrimental structure in Powder Metallurgy(PM)components,should be eliminated by subsequent hot process to improve the mechanical properties.The objective is to investigate the D...Previous Particle Boundary(PPB),as the detrimental structure in Powder Metallurgy(PM)components,should be eliminated by subsequent hot process to improve the mechanical properties.The objective is to investigate the Dynamic Recrystallization(DRX)nucleation mechanisms and grain growth behavior of the 3rd-generation PM superalloy with PPB structure.Microstructure observation reveals that PPB decorated with(Ti,Ta,Nb)C carbides belongs to the discontinuous chain-like structure.The elimination of PPB networks can be achieved effectively via hot deformation due to the occurrence of DRX.Four different DRX nucleation mechanisms were proposed and discussed in detail according to the special microstructure characteristics of the PM superalloy.Firstly,local lattice rotations can be detected in the vicinity of(Ti,Ta,Nb)C carbides during hot deformation and thus PPB structure serves as the preferential nucleation sites for DRX grains via Particle-Stimulated Nucleation(PSN).Then,Discontinuous-DRX(DDRX)characterized by grain boundary bulging dominates the microstructure refinement and Continuous-DRX(CDRX)operated by subgrain rotation can be regarded as an important assistant mechanism.At last,the initial Σ3 boundaries would lose their twin characteristics owing to the crystal rotation and then transform into the general High Angle Grain Boundaries(HAGBs).The distorted twins provide additional DRX nucleation sites,viz.,twin-assisted nucleation.Particular attention was focused on the grain growth behavior of the PM superalloy in subsequent annealing process.The recrystallization temperature was determined to be about 1110.C and 1140.C can be considered as the critical temperature for grain growth.The findings would provide theoretical support for microstructure refinement of the 3rd-generation PM superalloy,which is of pivotal significance for improving the mechanical properties of aviation components.展开更多
Oculocutaneous albinism（OCA） is an autosomal recessive disorder characterized by hypopigmentation in eyes,hair and skin,accompanied with vision loss.Currently,six genes have been identified as causative genes for no...Oculocutaneous albinism（OCA） is an autosomal recessive disorder characterized by hypopigmentation in eyes,hair and skin,accompanied with vision loss.Currently,six genes have been identified as causative genes for non-syndromic OCA（OCA-1w4,6,7）,and ten genes for syndromic OCA（HPS-1e9,CHS-1）.Genetic counseling of 51 Chinese OCA families（39 OCA-1 with mutations in the TYR gene,6 OCA-2 with mutations in the OCA2 gene,4 OCA-4 with mutations in the SLC45A2 gene,1 HPS-1（Hermanskye Pudlak syndrome-1） with mutation in the HPS1 gene,and 1 mixed OCA-1 and OCA-4） led us to perform the prenatal genetic testing of OCA using amniotic fluid cells through the implementation of our optimized strategy.In our cohort,eleven previously unidentified alleles（PUAs）（5 in TYR,2 in OCA2,and 4 in SLC45A2） were found.Three missense PUAs（p.C112 R,p.H363 R and p.G379 V of TYR） and one in-frame deletional PUA（p.S222 del of SLC24A5） led to fetuses with OCA when co-inherited with other disease causative alleles.Three PUAs（p.P152 H and p.W272 X of TYR,p.A486 T of SLC24A5） identified in the OCA probands did not co-transmit with known pathological alleles and thus gave rise to unaffected fetuses.Four PUAs（p.Q83 X and p.A658 T of TYR,p.G161 R and p.G366 R of SLC24A5） did not transmit to the unaffected fetuses.In addition,the in vitro transfection assays showed that the p.S192 Y variant of TYR produced less pigment compared to the wild-type allele.A fetus with a digenic carrier of OCA-1 and OCA-4 was unaffected.In combination with functional assays,the family inheritance pattern is useful for the evaluation of pathogenicity of PUAs and genetic counseling of OCA.展开更多
Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous ca...Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.展开更多
BACKGROUND The etiology of pancreatic cancer remains unclear. This limits the possibility of prevention and effective treatment. Hepatitis B virus(HBV) is responsible for the development of different types of cancer, ...BACKGROUND The etiology of pancreatic cancer remains unclear. This limits the possibility of prevention and effective treatment. Hepatitis B virus(HBV) is responsible for the development of different types of cancer, but its role in pancreatic cancer is still being discussed.AIM To assess the prevalence of previous HBV infection and to identify viral biomarkers in patients with pancreatic ductal adenocarcinoma(PDAC) to support the role of the virus in etiology of this cancer.METHODS The data of 130 hepatitis B surface antigen-negative subjects were available for the final analysis,including 60 patients with PDAC confirmed by cytology or histology and 70 sex-and age-matched controls. All the participants were tested for HBV biomarkers in blood [antibody to hepatitis B core antigen(anti-HBc), antibody to hepatitis B surface antigen(anti-HBs) and HBV DNA], and for those with PDAC, biomarkers in resected pancreatic tissues were tested(HBV DNA, HBV pregenomic RNA and covalently closed circular DNA). We performed immunohistochemistry staining of pancreatic tissues for hepatitis B virus X antigen and Ki-67 protein. Non-parametric statistics were used for the analysis.RESULTS Anti-HBc was detected in 18/60(30%) patients with PDAC and in 9/70(13%) participants in the control group(P = 0.029). Accordingly, the odds of PDAC in anti-HBc-positive subjects were higher compared to those with no previous HBV infection(odds ratio: 2.905, 95% confidence interval: 1.191-7.084, standard error 0.455). HBV DNA was detected in 8 cases of PDAC and in 6 of them in the pancreatic tumor tissue samples only(all patients were anti-HBc positive). Blood HBV DNA was negative in all subjects of the control group with positive results of the serum anti-HBc test. Among 9 patients with PDAC, 5 revealed signs of replicative competence of the virus(covalently closed circular DNA with or without pregenomic RNA) in the pancreatic tumor tissue samples. Hepatitis B virus X antigen expression and active cell proliferation was revealed by immunohistochemistry in 4 patients with PDAC in the pancreatic tumor tissue samples.CONCLUSION We found significantly higher risks of PDAC in anti-HBc-positive patients. Detection of viral replication and hepatitis B virus X protein expression in the tumor tissue prove involvement of HBV infection in pancreatic cancer development.展开更多
· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·...· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·METHODS: Sixty cases(63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included32 patients(32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients(12eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case(1 eye, 1 canaliculus)of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.· RESULTS: UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2(2 eyes, 2canaliculi) of the 9 patients(12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14patients(14 eyes, 14 canaliculi).·CONCLUSION: UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.展开更多
AIM:To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS:A broad literature search was performed with the terms"col...AIM:To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS:A broad literature search was performed with the terms"colorectal","colectomy","PAOS","previous surgery"and"PAOS".Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS,whether descriptive or comparative.Endpoints of interest were conversion rates,inadvertent enterotomy and morbidity.Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS:From a total of 394 citations,13 full-texts achieved selection criteria to be included in the study.Twelve of them compared patients with and without PAOS.All studies were retrospective and comparative and two were case-matched.The selected studies comprised a total of 5005 patients,1865 with PAOS.Among the later,only 294(16%)had history of a midline incision for previous gastrointestinal surgery.Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopywas more prevalent in 3 of 5 studies that disclosed this event.Morbidity was similar in the majority of studies.A quantitative analysis(meta-analysis)could not be performed due to heterogeneity of the studies.CONCLUSION:Conversion rates were slightly higher in PAOS groups,although not statistical significant in most studies.History of PAOS did not implicate in higher morbidity rates.展开更多
High-pressure phase transitions of cubic Y_2O_3 are investigated using in situ synchrotron x-ray diffraction in a diamond anvil cell up to 36.3 GPa. The pressure-induced phase transitions of cubic Y_2O_3, which displa...High-pressure phase transitions of cubic Y_2O_3 are investigated using in situ synchrotron x-ray diffraction in a diamond anvil cell up to 36.3 GPa. The pressure-induced phase transitions of cubic Y_2O_3, which display apparent inconsistencies in previous studies, are verified to be from a cubic phase to a monoclinic phase and further to a hexagonal phase at 11.7 and 21.6 GPa, respectively. The hexagonal Y_2O_3 displays noticeable anisotropic compressibility due to its layered structure and it is stable up to the highest pressure in the present study. A third-order Birch–Murnaghan fit based on the observed pressure-volume data yields zero pressure bulk moduli of180(3), 196(7) and 177(7) GPa for cubic, monoclinic and hexagonal phases, respectively.展开更多
基金Supported by the Scientific Research of Anhui Educational Committee (KJ2010B053)
文摘The effects of Previously Fermented Juice （PFJ） on the fermentative quality and changes in chemical composition during fermentation of rice straw silage were investigated. The results showed that the PFJ and diluted the PFJ （dPFJ） treated silages had significantly （p〈0.05） lower pH and ammonia-nitrogen content, while significantly higher lactic acid content compared with treatments. This study confirmed that the applying of the PFJ and the dPFJ improved fermentation quality of silage.
文摘Salvage liver transplantation (LT) has been performed for recurred hepatocellular carcinoma(HCC) or for deterioration of liver function after resection of HCC. Controversies arise, howeverover the technical feasibility of salvage LT in patientswho underwent liver surgery,
文摘Dear Editor,We read with great interest article titled'Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia'by Chen et al[1].The authors have analysed subjects with previously untreated anisometropic amblyopia and found a significant correlation between high degree of anisometropia and deep amblyopia,worse contrast sensitivity,fusion and stereopsis functions.We commend the authors in addressing a very important problem and agree with the authors in the notation that children with anisometropia are usually detected later owing to lack of noticeable physical abnormalities.
文摘The "cascade static lens （CSL） gauge" has a high sensitivity（S） because the emitted electrons repeat the go and back oscillation before they are received by the electrodes. (S=18.6 Pa<sup>-1</sup> (2480 Torr<sup>-1</sup> in a
文摘Background: Erlotinib has been reported to be effective for the treatment of non-small cell lung cancer (NSCLC). To evaluate the efficacy and safety of erlotinib under conditions similar to daily clinical practice, a phase II trial was conducted in Japanese patients with previously treated NSCLC. Methods: The eligibility criteria were stage IIIB/IV NSCLC, a performance status (PS) of 0 - 2, and previous treatment with 1 - 2 non-EGFR-TKI regimens. Patients received erlotinib (150 mg/day) orally until disease progression or intolerable toxicity occurred. The primary endpoint was the objective response rate (ORR). In addition, the disease control rate (DCR), progression-free survival (PFS), overall survival (OS), safety, and EGFR gene mutation status were evaluated. Results: Thirty-eight patients were enrolled, and 37 patients were evaluated. The median age was 69 years (range, 50 - 80 years). Patient characteristics were as follows: 26 were male and 11 were female;12 had a PS of 0, 20 had a PS of 1, and 5 had a PS of 2;and 26 had adenocarcinoma, and 11 had non-adenocarcinoma histology. The ORR and DCR were 21.6% (95% confidence interval [CI], 11.4% - 37.2%) and 54.1% (95% CI, 35.9% - 66.6%), respectively. Twenty-seven patients could be evaluated for EGFR gene status (12, mutated;15, wild-type). The ORR for EGFR-mutated patients was 41.7%, while that for patients with wild-type EGFR was 13.3%. The median PFS was evaluated as 4.4 months (95% CI, 2.2 - 10.7 months). The median OS was 14.9 months (95% CI, 9.2 months - not reached). Common adverse events were tolerable skin toxicities, diarrhea, and stomatitis. In addition, interstitial lung disease occurred in 8.1% of patients. Conclusion: As efficacy and safety were similar to previous studies, erlotinib was found to be effective for Japanese patients with previously treated NSCLC in clinical practice.
文摘Memory enables organisms to encode,store,and retrieve information essential for interacting with and adapting to a dynamic environment.As an internal representation of the external world,memory serves as a crucial bridge between past experiences and future behaviors.However,the brain continuously forms new memories,raising the question of how new memories are integrated without disrupting previously formed ones.
基金Supported by The Key Research and Development Program of Anhui Province of China,No.1804h08020273The Key Research Project of Health Commission of Anhui Province of China,No.AHWJ2022a016.
文摘BACKGROUND Laparoscopic hepatectomy(LH)has been applied in the treatment of hepatolithiasisa in patients with a history of biliary surgery and has already achieved good clinical outcomes.However,reoperative LH(rLH)includes multiple procedures,and the no studies have examined the clinical value of individual laparoscopic procedures.AIM To evaluate the safety and feasibility of each rLH procedure for hepatolithiasisa in patients with a history of biliary surgery.METHODS Patients with previous biliary surgery who underwent reoperative hepatectomy for hepatolithiasis were studied.Liver resection procedures were divided into three categories:(1)Laparoscopic/open left lateral sectionectomy[reoperative laparoscopic left lateral sectionectomy(rLLLS)/reoperative open left lateral sectionectomy(rOLLS)];(2)Laparoscopic/open left hemihepatectomy[reoperative laparoscopic left hemihepatectomy(rLLH)/reoperative open left hemihepatectomy(rOLH)];and(3)Laparoscopic/open complex hepatectomy[reoperative laparoscopic complex hepatectomy(rLCH)/reoperative open complex hepate ctomy(rOCH)].The clinical outcomes were compared between the rLLLS,rLLH,and rLCH groups,and subgroup analyses were performed for the rLLLS/rOLLS,rLLH/rOLH,and rLCH/rOCH subgroups.RESULTS A total of 185 patients were studied,including 101 rLH patients(40 rLLLS,50 rLLH,and 11 rLCH)and 84 reoperative open hepatectomy(40 rOLLS,33 rOLH,and 11 rOCH).Among the three types of rLH procedure,rLLLS required the shortest operation time(240.0 minutes vs 325.0 minutes vs 350.0 minutes,P=0.001)and the lowest blood transfusion rate(10.0%vs 22.0%vs 54.5%,P=0.005),followed by rLLH.The rLCH had the highest conversion rate(P<0.05)and postoperative intensive care unit stay rate(P=0.001).Most clinical outcomes in rLLLS and rLLH were superior or similar to those in the corresponding open surgery,while there were no differences in all outcomes between the rLCH and rOCH subgroups.CONCLUSION The rLH is safe for hepatolithiasis patients with a history of biliary surgery.The rLLLS and rLLH can be recommended for these patients,whereas rLCH should be applied with caution.
文摘With the support by the National Natural Science Foundation of China,an international collaborative study led by Prof.Daniel Rosenfeld(The Hebrew University of Jerusalem),Dr.Zhu YanNian(Meteorological Institute of Shaanxi Province).Prof.Wang MingHuai(Nanjing University).
基金the National Natural Science Foundation of China(grant no.81371314)the High-level Personnel Training Program of Beijing Health system(grant no.2013-2-016).
文摘Background:Recurrent,previously stented basilar trunk aneurysms pose significant challenges to either microsurgical clipping or traditional endovascular treatment.We here presented an intriguing case that was successfully treated by the pipeline embolization device(PED;ev3/Covidien Neurovascular,Irvine,California,USA).Case presentation:A 62-year-old male found a recurrent aneurysm,which had been treated with coiling and stentassisted coiling before.The patient came to our center seeking for a third treatment.In our center,a single PED and additional coils were used to treat this refractory aneurysm.The whole length of the PED was delicately implanted in the previous Enterprise stent(Cordis Corporation,Miami FL,USA),which resembled the double-layer flow diverter FRED(Microvention,Tustin,California,USA).The inflow zone of the aneurysmal sac was further coiled considering that this aneurysm had ruptured.No procedure-related complications occurred.Follow-up angiogram at 6 months indicated that the intractable aneurysm was completely occluded and the patient was free from any neurologic deficit.Conclusions:This is a case that adds knowledge to improve the poor performance of flow diverters in previously stented aneurysms.However,future studies with larger group of patients are needed to further test the safety and efficacy of this technique.
文摘Subject Code:E02With the support of the National Natural Science Foundation of China,a collaborative team led by Profs.Zhao Zhisheng(赵智胜)and Tian Yongjun(田永君)from the State Key Laboratory of Metastable Materials Science and Technology,Yanshan University demonstrates a new form of carbon with
文摘Background:Patients presenting with large surface area burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.
文摘In this editorial,we discussed the apparent discrepancy between the findings described by Colapietro et al,in their case report and data found in the literature.Colapietro et al reported a case of hepatitis B virus(HBV)-related hepatic decompensation in a patient with chronic myeloid leukemia and a previously resolved HBV infection who was receiving Bruton’s tyrosine kinase(BTK)inhibitor therapy.First of all,we recapitulated the main aspects of the immune system involved in the response to HBV infection in order to underline the role of the innate and adaptive response,focusing our attention on the protective role of anti-HBs.We then carefully analyzed literature data on the risk of HBV reactivation(HBVr)in patients with previous HBV infection who were treated with either tyrosine kinase inhibitors or BTK inhibitors for their hematologic malignancies.Based on literature data,we suggested that several factors may contribute to the different risks of HBVr:The type of hematologic malignancy;the type of therapy(BTK inhibitors,especially second-generation,seem to be at a higher risk of HBVr than those with tyrosine kinase inhibitors);previous exposure to an anti-CD20 as first-line therapy;and ethnicity and HBV genotype.Therefore,the warning regarding HBVr in the specific setting of patients with hematologic malignancies requires further investigation.
基金Supported by Ministry of Science and Higher education of Russia,No.FGMF-2022-0005Moscow Healthcare Department,No.123040700014-4.
文摘In this editorial we comment on the article published in the recent issue of the W orld Journal of Gastroenterology.We focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of previous hepatitis B(PHB)and a source for reactivation of HBV.The prevalence of PHB is underestimated due to the lack of population testing programs.However,this condition not only com-plicate anticancer treatment,but may be responsible for the development of other diseases,like cancer or autoimmune disorders.Here we unveil possible mecha-nisms responsible for realization of these processes and suggest practical approa-ches for diagnosis and treatment.
基金supported by the National Natural Science Foundation of China(No.52175363)the National Key Research and Development Program,China(Nos.XXXXKF2019-8-1,XX-XX-0015-0087)。
文摘Previous Particle Boundary(PPB),as the detrimental structure in Powder Metallurgy(PM)components,should be eliminated by subsequent hot process to improve the mechanical properties.The objective is to investigate the Dynamic Recrystallization(DRX)nucleation mechanisms and grain growth behavior of the 3rd-generation PM superalloy with PPB structure.Microstructure observation reveals that PPB decorated with(Ti,Ta,Nb)C carbides belongs to the discontinuous chain-like structure.The elimination of PPB networks can be achieved effectively via hot deformation due to the occurrence of DRX.Four different DRX nucleation mechanisms were proposed and discussed in detail according to the special microstructure characteristics of the PM superalloy.Firstly,local lattice rotations can be detected in the vicinity of(Ti,Ta,Nb)C carbides during hot deformation and thus PPB structure serves as the preferential nucleation sites for DRX grains via Particle-Stimulated Nucleation(PSN).Then,Discontinuous-DRX(DDRX)characterized by grain boundary bulging dominates the microstructure refinement and Continuous-DRX(CDRX)operated by subgrain rotation can be regarded as an important assistant mechanism.At last,the initial Σ3 boundaries would lose their twin characteristics owing to the crystal rotation and then transform into the general High Angle Grain Boundaries(HAGBs).The distorted twins provide additional DRX nucleation sites,viz.,twin-assisted nucleation.Particular attention was focused on the grain growth behavior of the PM superalloy in subsequent annealing process.The recrystallization temperature was determined to be about 1110.C and 1140.C can be considered as the critical temperature for grain growth.The findings would provide theoretical support for microstructure refinement of the 3rd-generation PM superalloy,which is of pivotal significance for improving the mechanical properties of aviation components.
基金partially supported by grants from the National Natural Science Foundation of China(Nos.81472871 and31230046)the Natural Science Foundation of Beijing(No.7132073)the State Key Laboratory of Molecular Developmental Biology of China(No.2013-MDB-KF-03)
文摘Oculocutaneous albinism（OCA） is an autosomal recessive disorder characterized by hypopigmentation in eyes,hair and skin,accompanied with vision loss.Currently,six genes have been identified as causative genes for non-syndromic OCA（OCA-1w4,6,7）,and ten genes for syndromic OCA（HPS-1e9,CHS-1）.Genetic counseling of 51 Chinese OCA families（39 OCA-1 with mutations in the TYR gene,6 OCA-2 with mutations in the OCA2 gene,4 OCA-4 with mutations in the SLC45A2 gene,1 HPS-1（Hermanskye Pudlak syndrome-1） with mutation in the HPS1 gene,and 1 mixed OCA-1 and OCA-4） led us to perform the prenatal genetic testing of OCA using amniotic fluid cells through the implementation of our optimized strategy.In our cohort,eleven previously unidentified alleles（PUAs）（5 in TYR,2 in OCA2,and 4 in SLC45A2） were found.Three missense PUAs（p.C112 R,p.H363 R and p.G379 V of TYR） and one in-frame deletional PUA（p.S222 del of SLC24A5） led to fetuses with OCA when co-inherited with other disease causative alleles.Three PUAs（p.P152 H and p.W272 X of TYR,p.A486 T of SLC24A5） identified in the OCA probands did not co-transmit with known pathological alleles and thus gave rise to unaffected fetuses.Four PUAs（p.Q83 X and p.A658 T of TYR,p.G161 R and p.G366 R of SLC24A5） did not transmit to the unaffected fetuses.In addition,the in vitro transfection assays showed that the p.S192 Y variant of TYR produced less pigment compared to the wild-type allele.A fetus with a digenic carrier of OCA-1 and OCA-4 was unaffected.In combination with functional assays,the family inheritance pattern is useful for the evaluation of pathogenicity of PUAs and genetic counseling of OCA.
基金Supported by Beijing Clinical Study(Z111107058811025)Beijing Government Excellent Person Sponsor Program
文摘Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.
基金Supported by Ministry of Science and Higher Education of Russian Federation,No. FGMF-2022-0005Russian Science Foundation,No. 20-15-00373Moscow Healthcare Department,No. AAAA-A18-118021590196-1。
文摘BACKGROUND The etiology of pancreatic cancer remains unclear. This limits the possibility of prevention and effective treatment. Hepatitis B virus(HBV) is responsible for the development of different types of cancer, but its role in pancreatic cancer is still being discussed.AIM To assess the prevalence of previous HBV infection and to identify viral biomarkers in patients with pancreatic ductal adenocarcinoma(PDAC) to support the role of the virus in etiology of this cancer.METHODS The data of 130 hepatitis B surface antigen-negative subjects were available for the final analysis,including 60 patients with PDAC confirmed by cytology or histology and 70 sex-and age-matched controls. All the participants were tested for HBV biomarkers in blood [antibody to hepatitis B core antigen(anti-HBc), antibody to hepatitis B surface antigen(anti-HBs) and HBV DNA], and for those with PDAC, biomarkers in resected pancreatic tissues were tested(HBV DNA, HBV pregenomic RNA and covalently closed circular DNA). We performed immunohistochemistry staining of pancreatic tissues for hepatitis B virus X antigen and Ki-67 protein. Non-parametric statistics were used for the analysis.RESULTS Anti-HBc was detected in 18/60(30%) patients with PDAC and in 9/70(13%) participants in the control group(P = 0.029). Accordingly, the odds of PDAC in anti-HBc-positive subjects were higher compared to those with no previous HBV infection(odds ratio: 2.905, 95% confidence interval: 1.191-7.084, standard error 0.455). HBV DNA was detected in 8 cases of PDAC and in 6 of them in the pancreatic tumor tissue samples only(all patients were anti-HBc positive). Blood HBV DNA was negative in all subjects of the control group with positive results of the serum anti-HBc test. Among 9 patients with PDAC, 5 revealed signs of replicative competence of the virus(covalently closed circular DNA with or without pregenomic RNA) in the pancreatic tumor tissue samples. Hepatitis B virus X antigen expression and active cell proliferation was revealed by immunohistochemistry in 4 patients with PDAC in the pancreatic tumor tissue samples.CONCLUSION We found significantly higher risks of PDAC in anti-HBc-positive patients. Detection of viral replication and hepatitis B virus X protein expression in the tumor tissue prove involvement of HBV infection in pancreatic cancer development.
文摘· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·METHODS: Sixty cases(63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included32 patients(32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients(12eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case(1 eye, 1 canaliculus)of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.· RESULTS: UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2(2 eyes, 2canaliculi) of the 9 patients(12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14patients(14 eyes, 14 canaliculi).·CONCLUSION: UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.
文摘AIM:To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS:A broad literature search was performed with the terms"colorectal","colectomy","PAOS","previous surgery"and"PAOS".Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS,whether descriptive or comparative.Endpoints of interest were conversion rates,inadvertent enterotomy and morbidity.Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS:From a total of 394 citations,13 full-texts achieved selection criteria to be included in the study.Twelve of them compared patients with and without PAOS.All studies were retrospective and comparative and two were case-matched.The selected studies comprised a total of 5005 patients,1865 with PAOS.Among the later,only 294(16%)had history of a midline incision for previous gastrointestinal surgery.Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopywas more prevalent in 3 of 5 studies that disclosed this event.Morbidity was similar in the majority of studies.A quantitative analysis(meta-analysis)could not be performed due to heterogeneity of the studies.CONCLUSION:Conversion rates were slightly higher in PAOS groups,although not statistical significant in most studies.History of PAOS did not implicate in higher morbidity rates.
基金the National Natural Science Foundation of China under Grant Nos 11775292,11104307 and U1530134the Natural Science Foundation of Shanghai under Grant No 18ZR1448100the Shanghai Sailing Program under Grant No 17YF1423600
文摘High-pressure phase transitions of cubic Y_2O_3 are investigated using in situ synchrotron x-ray diffraction in a diamond anvil cell up to 36.3 GPa. The pressure-induced phase transitions of cubic Y_2O_3, which display apparent inconsistencies in previous studies, are verified to be from a cubic phase to a monoclinic phase and further to a hexagonal phase at 11.7 and 21.6 GPa, respectively. The hexagonal Y_2O_3 displays noticeable anisotropic compressibility due to its layered structure and it is stable up to the highest pressure in the present study. A third-order Birch–Murnaghan fit based on the observed pressure-volume data yields zero pressure bulk moduli of180(3), 196(7) and 177(7) GPa for cubic, monoclinic and hexagonal phases, respectively.
