Background
Acupuncture is used to treat chronic functional constipation (CFC) in China, despite limited evidence. We aim to assess the effectiveness and safety of acupuncture in managing CFC.
Methods
...A multicenter randomized controlled trial was performed involving 684 patients with CFC; the patients were randomly allocated to receive He acupuncture (n = 172), Shu‐mu acupuncture (n = 171), He‐shu‐mu acupuncture (n = 171), or oral administration of mosapride (n = 170). Sixteen sessions of acupuncture were given in the treatment duration of 4 weeks. The primary outcome was the change in spontaneous bowel movements (SBMs) at week 4 (at the end of treatment) compared to baseline. The secondary outcomes included stool consistency (Bristol scale), the degree of straining during defecation, and adverse events.
Key Results
The SBMs increased in all the four groups at week 4, and the magnitude of increase was equivalent in the four groups (He acupuncture, 2.7 95% CI, 2.3‐3.1; Shu‐mu acupuncture, 2.7 95% CI, 2.3‐3.0; He‐shu‐mu acupuncture, 2.2 95% CI, 1.9‐2.5; and mosapride, 2.4 95% CI, 2.0‐2.9; P = .226). However, the change in SBMs at week 8 was significantly smaller in mosapride group (1.4 95% CI, 1.0‐1.8) than the three acupuncture groups (2.4 95% CI, 2.1‐2.7, 2.3 95% CI, 1.9‐2.7, 2.1 95% CI, 1.7‐2.5 in He, Shu‐mu, and He‐shu‐mu group, respectively, P = .005).
Conclusions & Interferences
The three acupuncture treatments were as effective as mosapride in improving stool frequency and stool consistency in CFC, but the magnitude of the treatment effect is unknown due to the lack of sham acupuncture control.
The effectiveness of acupuncture in the treatment of chronic functional constipation is unknown. Our study result showed that acupuncture treatments are as effective as mosapride in improving stool frequency and stool consistency.
The explosion process of the flake aluminum powder–air two-phase flow is experimentally studied in a large-scale long straight horizontal tube with a length of 32.4 m and an inner diameter of ...0.199 m. The deflagration-to-detonation transition (DDT) of the aluminum powder–air mixture is analyzed after being ignited by a 40-J electric spark, and the DDT of the mixture at different mass concentrations is compared. The results show that self-sustained detonation can be achieved in the range of 286–532 g/m
3
of the flake aluminum powder concentration, and the DDT process of the aluminum powder–air mixture at the concentration of aluminum particles 409 g/m
3
(optimal concentration) is analyzed in detail. The detonation velocity and detonation pressure at the optimal concentration are 1690 m/s and 58 bar, respectively. During the self-sustained detonation stage, the detonation overpressure of the multiphase fuel–air mixture exhibits a typical constant oscillation characteristic, while the detonation velocity remains stable. In addition, a double-headed mode helical detonation phenomenon is observed in the detonation wave front of the aluminum powder–air mixture. The structure of the detonation wave, the flow field parameters, and the interaction between the shock wave and the three-wave point trajectory are analyzed. The detonation cell size at the optimal concentration is approximately 486 mm.
The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10
electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV ...energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays
. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref.
). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane
, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.
We present a novel surface-enhanced Raman scattering (SERS) substrate based on graphene oxide/silver nanoparticles/silicon pyramid arrays structure (GO/Ag/PSi). The SERS behaviors are discussed and ...compared by the detection of R6G. Based on the contrast experiments with PSi, GO/PSi, Ag/PSi and GO/AgA/PSi as SERS substrate, the perfect bio-compatibility, good homogeneity and chemical stability were confirmed. We also calculated the electric field distributions using Finite-difference time-domain (FDTD) analysis to further understand the GO/Ag/PSi structure as a perfect SERS platform. These experimental and theoretical results imply that the GO/Ag/PSi with regular pyramids array is expected to be an effective substrate for label-free sensitive SERS detections in areas of medicine, food safety and biotechnology.
The global climate system experienced a series of drastic changes during the Cenozoic. In Asia, these include the climate transformation from a zonal pattern to a monsoon-dominated pattern, the ...disappearance of typical subtropical aridity, and the onset of inland deserts. Despite major advances in the last two decades in characterizing and understanding these climate phenomena, disagreements persist relative to the timing, behaviors and underlying causes. This paper addresses these issues mainly based on two lines of evidence. First, we compiled newly collected data from geological indicators of the Cenozoic environment in China as paleoenvironmental maps of ten intervals. In confirming the earlier observation that a zonal climate pattern was transformed into a monsoonal one, the maps within the Miocene indicate that this change was achieved by the early Miocene, roughly consistent with the onset of loess deposition in China. Although a monsoon-like regime would have existed in the Eocene, it was restricted to tropical-subtropical regions. The latitudinal oscillations of the climate zones during the Paleogene are likely attributable to the imbalance in evolution of polar ice-sheets between the two hemispheres. Secondly, we examine the relevant depositional and soil forming processes of the Miocene loess-soil sequences to determine the circulation characteristics with emphasis on the early Miocene. Continuous eolian deposition in the middle reaches of the Yellow River since the early Miocene firmly indicates the formation of inland deserts, which have been constantly maintained during the past 22 Ma. Grain-size gradients between loess sections indicate northerly dust-carrying winds from northern sources, a clear indication of an Asian winter monsoon system. Meanwhile, well-developed Luvisols show evidence that moisture from the oceans reached northern China. This evidence shows the coexistence of two kinds of circulations, one from the ocean carrying moisture and another from the inland deserts transporting dust. The formation of the early Miocene paleosols resulted from interactive soil forming and dust deposition processes in these two seasonally alternating monsoonal circulations. The much stronger development of the early Miocene soils compared to those in the Quaternary loess indicates that summer monsoons were either significantly stronger, more persistent through the year, or both. These lines of evidence indicate a joint change in circulation and inland aridity by the early Miocene and suggest a dynamic linkage of them. Our recent sensitivity tests with a general circulation model, along with relevant geological data, suggest that the onset of these contrasting wet/dry responses, as well as the change from the "planetary" subtropical aridity pattern to the "inland" aridity pattern, resulted from the combined effects of Tibetan uplift and withdrawal of the Paratethys seaway in central Asia, as suggested by earlier experiments. The spreading of South China Sea also helped to enhance the south-north contrast of humidity. The Miocene loess record provides a vital insight that these tectonic factors had evolved by the early Miocene to a threshold sufficient to cause this major climate reorganization in Asia.
Summary
Background
Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.
Objectives
This study aimed to clarify the ...current epidemiological characteristics and pathogen spectrum of tinea capitis in China.
Methods
A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. When necessary, the pathogens were further identified by morphology or molecular sequencing in the central laboratory.
Results
Among all enrolled patients, 74·1% of the cases were in patients aged 2–8 years. The children with tinea capitis were mainly boys (56·2%) and were more likely than adults to have a history of animal contact (57·4% vs. 35·3%, P = 0·012) and zoophilic dermatophyte infection (73·5% vs. 47%). The adults were mainly female (83%) and were more likely than children to have anthropophilic agent infection (53% vs. 23·9%). The most common pathogen was zoophilic Microsporum canis (354, 65·2%), followed by anthropophilic Trichophyton violaceum (74, 13·6%). In contrast to the eastern, western and northeastern regions, where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69%, P < 0·001), where the patients had the most tinea at other sites (20%) and dermatophytosis contact (26%) but the least animal contact (39%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang province.
Conclusions
Boys aged approximately 5 years were the most commonly affected group. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.
What is already known about this topic?
Tinea capitis is an infection of the scalp and hair caused by dermatophytes and is still common in developing countries. Prepubertal children are mainly affected.
The pathogen spectrum of tinea capitis varies across different geographical areas and changes over time.
Nationwide prospective epidemiological surveys of tinea capitis in China are rare and out of date.
What does this study add?
This study provides data concerning the epidemiological characteristics and pathogen spectrum of tinea capitis in contemporary China.
Boys aged approximately 5 years were most commonly affected and were more likely than adults to have zoophilic dermatophyte infection.
The main pathogens of tinea capitis in China are zoophilic dermatophytes, mainly Microsporum canis. In contrast to the other regions, the predominant pathogens in central China are anthropophilic dermatophytes.
Plain language summary available online
Dysbiotic oral microbiota has been associated with multiple sclerosis. However, the role and mechanism of oral microbiota in the development of multiple sclerosis are still elusive. Here, we ...demonstrated that ligature-induced periodontitis (LIP) aggravated experimental autoimmune encephalomyelitis (EAE) in mice, and this was likely dependent on the expansion of T helper 17 (Th17) cells. LIP increased the splenic richness of Enterobacter sp., which was able to induce the expansion of splenic Th17 cells and aggravate EAE in mice. LIP also led to enrichment of Erysipelotrichaceae sp. in the gut and increased Th17 cells in the large intestinal lamina propria of EAE mice. Fecal microbiota transplantation from EAE mice with LIP also promoted EAE symptoms. In conclusion, periodontitis exacerbates EAE, likely through ectopic colonization of oral pathobionts and expansion of Th17 cells.
Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the ...efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC.
Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib 50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle). The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety.
A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028. The median PFS was 18.0 months in the toripalimab–axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab–axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab–axitinib group and 58.6% of patients in the sunitinib group.
In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile
ClinicalTrials.gov NCT04394975
•Toripalimab plus axitinib provided significantly better PFS than sunitinib as a first-line treatment for advanced RCC.•A significantly higher ORR was found in patients who received toripalimab plus axitinib than those who received sunitinib.•The combination of toripalimab plus axitinib was generally well tolerated.•No new safety signals were identified in the combination outside the known safety profile of toripalimab or axitinib.
Abstract
Bulk Bi
0.5
Sr
0.5
Fe
0.5
Cr
0.5
O
3
(BSFCO) is a new compound comprising the
R3c
structure. The structural, magnetic property and exchange bias (EB) details are investigated. The material ...was in the super-paramagnetic (SP) state at room temperature. Exchange bias usually occurs at the boundary between different magnetic states after field cooling (
H
FC
) acts on the sample. Here the result shows that changing
H
FC
from 1 to 6 T reduces the
H
EB
value by 16% at 2 K at the same time. Meanwhile,
H
EB
diminishes as the ferromagnetic layer thickness increases. The variation of (the thickness of ferromagnetic layer)
t
FM
with the change of
H
FC
leads to the tuning of
H
EB
by
H
FC
in BSFCO bulk. These effects are obviously different from the phenomenon seen in other oxide types.
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