This study aimed to clarify the incidence of hepatitis B virus (HBV) reactivation and its significance on long-term survival after partial hepatectomy in patients with HBV-related hepatocellular ...carcinoma (HCC), who had preoperative low HBV-DNA level of less than 2000 IU/mL.
HBV reactivation is a frequent complication of systemic chemotherapy in hepatitis B surface antigen-positive patients. Surgery and anesthesia result in a generalized state of immunosuppression in the immediate postoperative period. Data on HBV reactivation and its significance after partial hepatectomy are unclear.
Consecutive patients from January 2006 to December 2007 were retrospectively studied.
HBV reactivation happened in 19.1% of patients in 1 year. There were 28 patients whose HBV reactivation was detected after the diagnosis of HCC recurrence. On multivariate analysis, hepatitis B e antigen (HBeAg) positivity, preoperative HBV-DNA above the lower limit of quantification (≥200 IU/mL), Ishak inflammation score of greater than 3, preoperative transarterial chemoembolization (TACE), operation time of more than 180 minutes, blood transfusion, and without prophylactic antiviral therapy were significantly associated with an increased risk of HBV reactivation. HBV reactivation negatively influenced postoperative hepatic functions. The posthepatectomy liver failure rate in patients with HBV reactivation was significantly higher than in those without reactivation (11.8% vs 6.4%; P = 0.002). The 3-year disease-free survival (DFS) rate and overall survival (OS) rates after resection in patients with HBV reactivation were significantly lower than those without reactivation (34.1% vs 46.0%; P = 0.009, and 51.6% vs 67.2%; P < 0.001, respectively). HBeAg positivity, detectable preoperative HBV-DNA level, high Ishak inflammation score, preoperative TACE, long operation time, and blood transfusion were independent risk factors for HBV reactivation, whereas prophylactic antiviral therapy was a protective factor. HBV reactivation, HBeAg positivity, HBV-DNA level of 200 IU/mL or more, tumor diameter greater than 5 cm, presence of satellite nodules, presence of portal vein tumor thrombus, blood transfusion, and resection margin less than 1.0 cm were independent risk factors for DFS. A HBV-DNA level of 200 IU/mL or more, an Ishak fibrosis score of 4 or greater, a tumor diameter greater than 5 cm, the presence of satellite nodules, the presence of portal vein tumor thrombus, a resection margin less than 1.0 cm, no prophylactic antiviral therapy, and HBV reactivation were independent risk factors for OS.
HBV reactivation was common after partial hepatectomy for HBV-related HCC with a preoperative low HBV-DNA level of less than 2000 IU/mL. Routine prophylactic antiviral treatment should be given before partial hepatectomy.
The scale of ground-to-air confrontation task assignments is large and needs to deal with many concurrent task assignments and random events. Aiming at the problems where existing task assignment ...methods are applied to ground-to-air confrontation, there is low efficiency in dealing with complex tasks, and there are interactive conflicts in multiagent systems. This study proposes a multiagent architecture based on a one-general agent with multiple narrow agents (OGMN) to reduce task assignment conflicts. Considering the slow speed of traditional dynamic task assignment algorithms, this paper proposes the proximal policy optimization for task assignment of general and narrow agents (PPO-TAGNA) algorithm. The algorithm based on the idea of the optimal assignment strategy algorithm and combined with the training framework of deep reinforcement learning (DRL) adds a multihead attention mechanism and a stage reward mechanism to the bilateral band clipping PPO algorithm to solve the problem of low training efficiency. Finally, simulation experiments are carried out in the digital battlefield. The multiagent architecture based on OGMN combined with the PPO-TAGNA algorithm can obtain higher rewards faster and has a higher win ratio. By analyzing agent behavior, the efficiency, superiority and rationality of resource utilization of this method are verified.
X-ray flares are frequently detected in the X-ray afterglow light curves and are highly correlated with the prompt emission of gamma-ray bursts (GRBs). We compile a comprehensive sample of X-ray ...flares up to 2021 April, comprising 697 flares. We classify the total sample into four types: early flares (tp≤103 s), late flares (tp>103 s), long gamma-ray burst (LGRB) flares and short gamma-ray burst (SGRB) flares, and analyze the distributions and relationships of the flare parameters. It is found that the early flares have a higher frequency, shorter duration, and more asymmetrical structure. In addition, the distributions of the morphological parameters of the SGRB flares are similar to those of the LGRB flares. We also find that the durations and rising (decay) times of the early flares are positively correlated with the peak times, but the late flares follow the different dependent relations. There is a strong anti-correlation between the peak luminosities (LX,P) and the peak times of the flares, e.g., LX,p∝tp,z−1.45 for the LGRB flares, and LX,p∝tp,z−1.27 for the SGRB flares, respectively. Furthermore, the peak luminosity is highly dependent on the isotropic energy (EX,iso) for the early LGRB flares, the best fit is LX,p∝EX,iso1.06(r=0.89). We also find a tight three-parameter correlation, LX,p∝tp,z−1.03EX,iso0.92(r=0.96). All the late flares fall into the 3σ confidence region defined by the early flares. In terms of the point of kinematic arguments, both the SGRB and LGRB flares support a common scheme of internal origin. The SGRB flares have similar properties to the LGRB flares, suggesting that both of them share a similar physical mechanism from the late-time activity of central engine.
Ferroptosis, a newly discovered type of regulated cell death, has been implicated in numerous human diseases. Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal interstitial ...lung disease with poor prognosis and limited treatment options. Emerging evidence has linked ferroptosis and glutamate-determined cell fate which is considered a new light on the etiology of pulmonary fibrosis. Here, we observed that N-methyl d-aspartate receptor (NMDAR) activation promoted cell damage and iron deposition in MLE-12 cells in a dose-, time-, and receptor-dependent manner. This mediated substantial Ca2+ influx, upregulated the expression levels of nNOS and IRP1, and affected intracellular iron homeostasis by regulating the expression of iron transport-related proteins (i.e., TFR1, DMT1, and FPN). Excessive iron load promoted the continuous accumulation of total intracellular and mitochondrial reactive oxygen species, which ultimately led to ferroptosis. NMDAR inhibition reduced lung injury and pulmonary fibrosis in bleomycin-induced mice. Bleomycin stimulation upregulated the expression of NMDAR1, nNOS, and IRP1 in mouse lung tissues, which ultimately led to iron deposition via regulation of the expression of various iron metabolism-related genes. NMDAR activation initiated the pulmonary fibrosis process by inducing iron deposition in lung tissues and ferroptosis of alveolar type II cells. Our data suggest that NMDAR activation regulates the expression of iron metabolism-related genes by promoting calcium influx, increasing nNOS and IRP1 expression, and increasing iron deposition by affecting cellular iron homeostasis, ultimately leading to mitochondrial damage, mitochondrial dysfunction, and ferroptosis. NMDAR activation-induced ferroptosis of alveolar type II cells might be a key event to the initiation of pulmonary fibrosis.
•NMDAR activation promoted iron deposition and mitochondrial dysfunction.•NMDAR activation is involved in the occurrence of iron metabolism disorders in the lungs and ferroptosis of ATII cells.•NMDAR activation promotes the occurrence and development of pulmonary fibrosis via induced ATII cell ferroptosis.
The phytochemical investigation of the roots of Croton crassifolius led to the isolation of 16 new halimane furanoditerpenoids, crohalifuranes A–P (1–16), along with 15 known analogues, 17–31. The ...new structures including their absolute configurations were elucidated by NMR and MS data analysis, comparison of experimental and calculated electronic circular dichroism data, single-crystal X-ray diffraction data, and chemical methods. Crohalifuranes A (1) and B (2) are tetranor- and 19-nor-halimane diterpenoids featuring a rare decahydroacenaphthene core, respectively, which might be derived from the accompanying crassifoliusin A by loss of the furan ring or the C-19 substituent. Crohalifurane C (3) represents the first example of a 20-nor-halimane diterpenoid, and crohalifurane D (4) is characterized by an unusual 6,20-δ-lactone moiety. All compounds were examined for their inhibitory effects on nitric oxide (NO) production induced by lipopolysaccharide in RAW264.7 cells, and 2 and 23 exhibited moderate inhibition on NO production with IC50 values of 17.2 ± 1.3 and 23.7 ± 1.4 μM, respectively.
To explore the hot compression behavior and microstructural evolution, fine-grained Al−1.88Mg−0.18Sc− 0.084Er (wt.%) aluminum alloy wires were fabricated with Castex (continuous casting−extrusion) ...and ECAP-Conform, and their hot compression behavior was investigated at temperatures of 673−793 K and strain rates of 0.001−10 s−1; the microstructures were characterized by optical microscope, X-ray diffractometer, transmission electron microscope, and electron backscattered diffractometer, and the flow stresses were obtained by thermal compression simulator. Microstructural evolution and flow curves reveal that dynamic recovery is the dominant softening mechanism. Continuous dynamic recrystallization followed by dynamic grain growth takes place at a temperature of 773 K and a strain rate of 0.001 s−1; the yielding drop phenomenon was discovered. Hyperbolic sine constitutive equation incorporating dislocation variables was presented, and a power law constitutive equation was established. The stress exponent is 3.262, and the activation energy for deformation is 154.465 kJ/mol, indicating that dislocation viscous glide is the dominant deformation mechanism.
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•PCA-GA-SVM is used for identification of typical toxic red tide algae.•Dominant algal species in mixed red tide are identified in Qinhuangdao sea area.•The classification of typical ...toxic red tide algae in Qinhuangdao.•Such a procedure is green and environment-friendly.
Red tides occur every year in the Qinhuangdao sea area of China, including a variety of toxic algae and non-toxic algae. Toxic red tide algae have caused great damage to the marine aquaculture industry in China and seriously endangered human health, but most of non-toxic algae are important bait for marine plankton. Therefore, it is very important to identify the type of mixed red tide algae in Qinhuangdao sea area. In this paper, three-dimensional fluorescence spectroscopy and chemometrics were applied to the identification of typical toxic mixed red tide algae in Qinhuangdao. Firstly, the three-dimensional fluorescence spectrum data of typical mixed red tide algae in Qinhuangdao sea area were measured by f-7000 fluorescence spectrometer, and the contour map of algae samples was obtained. Secondly, the contour spectrum analysis is carried out to find the excitation wavelength of the peak position of the three-dimensional fluorescence spectrum and form the new three-dimensional fluorescence spectrum data selected by the feature interval. Then, the new three-dimensional fluorescence spectrum data are extracted by principal component analysis (PCA). Finally, the feature extraction data and the data without feature extraction are used as the input of the genetic optimization support vector machine (GA-SVM) and particle swarm optimization support vector machine (PSO-SVM) classification models, respectively, to obtain the classification model of mixed red tide algae, and the two feature extraction analysis methods and two classification algorithms are compared. The results show that the classification accuracy of the test set using the principal component feature extraction and GA-SVM classification method is 92.97 %, when the excitation wavelengths are 420 nm, 440 nm, 480 nm, 500 nm and 580 nm, and the emission wavelengths are 650–750 nm. Therefore, it is feasible and effective to apply the three-dimensional fluorescence spectrum characteristics and genetic optimization support vector machine classification method to the identification of toxic mixed red tide algae in Qinhuangdao sea area.
Background: Renal hyperparathyroidism can be effectively treated with parathyroidectomy. However, managing persistence or recurrence after the initial surgery is still challenging. Understanding the ...anatomical patterns observed in reoperative parathyroidectomies can help localize the disease during initial and subsequent surgeries. Aim: This study aimed to identify the patterns of persistence and recurrence following parathyroidectomy for renal hyperparathyroidism and assess the performance of various localization studies. Methods: A retrospective cohort study was conducted on dialysis patients who underwent reoperative parathyroidectomy at a single center. Patient demographics, laboratory test results, localization study findings, surgical details, and postoperative outcomes were obtained through the chart reviews. Persistence was defined as an intact parathyroid hormone level ＞300 pg/mL within 6 months after the primary surgery; otherwise, recurrence was defined as ＞ 6 months. Results: Among 377 patients who underwent parathyroidectomies, 20 (5.3%) required reoperations. Supernumerary glands were the primary cause of persistence (70%) and recurrence (50%), predominantly located posteriorly within the tracheoesophageal groove. Besides, overgrowth of the forearm graft accounted for 30% of recurrences. Neck ultrasound (US) showed 6 out of 19 false negatives (68% sensitivity and 100% specificity), whereas ^(99m)Tc-sestamibi scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) had one false negative (95% sensitivity and 100% specificity). CT scans accurately localized the disease in cases where US and sestamibi scintigraphy yielded discordant results. Conclusion: Supernumerary glands frequently contribute to the persistence and recurrence of renal hyperparathyroidism after parathyroidectomy. In the reoperative context, sestamibi SPECT/CT and CT scans detect affected parathyroid tissue in the neck and mediastinum more effectively than neck USs.
In this work, we experimentally confirmed an effective Lamb-wave guiding method, which utilizes a localized phononic cavity mode in a 2D phononic crystal. The phononic crystal is created by a ...periodic distribution of solid pillars built on an elastic plate, while the cavity mode is induced by replacing part of the pillars by the hollow pillars. In the experiments, transmission characteristics of the Lamb-waves within the waveguides are studied comprehensively. Elastic field distributions of the cavity mode are mapped in the deep-subwavelength regime. In geometrical shapes, both a straight waveguide and a bended one are made for practical measurement, demonstrating visually that the elastic energies are well localized around the hollow pillars and can be transported around the bends.
As one type of spatially offset Raman spectroscopy (SORS), inverse SORS is particularly suited to
in vivo
biomedical measurements due to its ring-shaped illumination scheme. To explain inhomogeneous ...Raman scattering during
in vivo
inverse SORS measurements, the light–tissue interactions when excitation and regenerated Raman photons propagate in skin tissue were studied using Monte Carlo simulation. An eight-layered skin model was first built based on the latest transmission parameters. Then, an open-source platform, Monte Carlo eXtreme (MCX), was adapted to study the distribution of 785 nm excitation photons inside the model with an inverse spatially shifted annular beam. The excitation photons were converted to emission photons by an inverse distribution method based on excitation flux with spatial offsets Δ
s
of 1 mm, 2 mm, 3 mm and 5 mm. The intrinsic Raman spectra from separated skin layers were measured by continuous linear scanning to improve the simulation accuracy. The obtained results explain why the spectral detection depth gradually increases with increasing spatial offset, and address how the intrinsic Raman spectrum from deep skin layers is distorted by the reabsorption and scattering of the superficial tissue constituents. Meanwhile, it is demonstrated that the spectral contribution from subcutaneous fat will be improved when the offset increases to 5 mm, and the highest detection efficiency for dermal layer spectral detection could be achieved when Δ
s
= 2 mm. Reasonably good matching between the calculated spectrum and the measured
in vivo
inverse SORS was achieved, thus demonstrating great utility of our modeling method and an approach to help understand the clinical measurements.
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