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Evaluation of the efficacy and safety of endoscopic band ligation in the treatment of bleeding from mild to moderate gastric varices type 1

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World Journal of Gastroenterology 2024年第5期30卷 440-449页

作者： Yue Deng Ya Jiang tong Jiang Ling Chen Hai-jun Mou Bi-Guang Tuo Guo-Qing shi Department of Gastroenterology Digestive Disease HospitalThe Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Gastroenterology Guizhou Hospital of the First Affiliated HospitalSun Yat-sen UniversityGuiyang 550000Guizhou ProvinceChina Department of Gastroenterology Yinjiang Autonomous County People’s HospitalTongren 554300Guizhou ProvinceChina

BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONC

关键词： Gastric varices Type 1 gastric variceal hemorrhage Endoscopic band ligation Tissue adhesive injection

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Global research trends in cardiac arrest research:a visual analysis of the literature based on CiteSpace

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World Journal of Emergency Medicine 2022年第4期13卷 290-296页

作者： shi-jiao Yan Mei Chen Jing Wen Wen-ning Fu Xing-yue Song Huan-jun Chen Ri-xing Wang Mei-ling Chen Xiao-tong Han Chuan-zhu Lyu School of Public Health Hainan Medical UniversityHaikou 570100China Research Unit of Island Emergency Medicine Chinese Academy of Medical Sciences(No.2019RU013)Hainan Medical UniversityHaikou 570100China Guizhou Center for Disease Control and Prevention Guiyang 550004China School of Nursing Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430000China Key Laboratory of Emergency and Trauma Ministry of EducationCollege of Emergency and TraumaHainan Medical UniversityHaikou 571199China Department of Emergency Hainan Clinical Research Center for Acute and Critical Diseasesthe Second Affiliated Hospital of Hainan Medical UniversityHaikou 570100China Emergency and Trauma College Hainan Medical UniversityHaikou 570100China Department of Emergency Medicine Hunan Provincial Institute of Emergency MedicineHunan Provincial Key Laboratory of Emergency and Critical Care MetabolomicsHunan Provincial People's Hospital/the First Affiliated HospitalHunan Normal UniversityChangsha 410000China Emergency Medicine Center Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610072China

BACKGROUND:The high morbidity,high mortality and low survival rate of cardiac arrest(CA)cause a heavy global burden.We aimed to analyze the changes in scientific output related to CA over the past two decades.METHODS:We analyzed the scientific output related to CA from 2000 to 2020 via the Web of Science.The data were analyzed using CiteSpace software.RESULTS:In total,28,312 articles relating to CA were identified in the Web of Science.The volume of scientific research output in the field of global CA research was mainly distributed in the Americas,Europe and Asia,covering a wide range.Of the 28,312 articles,the research content of the highly cited literature mainly focused on CA,mild hypothermia treatment,and prognosis of CA patients.CONCLUSION:Various scientific methods were applied to reveal scientific productivity,collaboration,and research hotspots in the CA research field.Cardiopulmonary resuscitation(CPR),extracorporeal membrane oxygenation(ECMO),survival and target temperature management are research hotspots.Future research on CA will continue to focus on its treatment and prognosis to improve the survival rate of CA patients.

关键词： Cardiac arrest Bibliometrics CiteSpace Research hotspots Cardiopulmonary resuscitation

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医学就是善的吗?

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医学争鸣 2016年第2期37卷 15-19页

作者：时统君徐州医学院社会科学部江苏徐州221004

医学是随着人类对疾病痛苦的最初表达并在减轻或驱除这种疾病痛苦的美好愿望中形成和发展起来的,由此决定了医学在本质上是善的。然而,现实中与医学本质善相对应的恶的、不道德的医学在医学领域却是客观存在的。为此,重视和加强对医学... 详细信息

医学是随着人类对疾病痛苦的最初表达并在减轻或驱除这种疾病痛苦的美好愿望中形成和发展起来的,由此决定了医学在本质上是善的。然而,现实中与医学本质善相对应的恶的、不道德的医学在医学领域却是客观存在的。为此,重视和加强对医学进行整体的善恶审视和道德评价,充分实现医学伦理道德的扬善抑恶功能,从而纠正医学领域的恶的因素,彰显和维护医学的善的本质,既是医学伦理学必须承担的重要学科使命,亦是医学伦理学赖以安身立命的合法性依据之所在。

关键词：医学善与恶医学伦理

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EPR Effect of Amphiphilic Copolymer Micelles Observed by Fluorescent Imaging

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Chemical Research in Chinese Universities 2011年第4期27卷 628-634页

作者： LIU tong-jun LIU shi HU Xiu-li SHENG shi-hou HUANG Yu-bin JING Xia-bin Department of Colorectal and Anal Surgery China-Japan Union Hospital of Jilin University Changehun 130033 P. R. China State Key Laboratory of Polymer Physics and Chemistry Changchun Institue of Applied Chemistry Chinese Academy of Sciences Changchun 130022 P.R. China

Enhanced permeation and retention（EPR） targeting effect of rhodamine B labeled PEG-b-P（LA-co-DHP） [PEG：poly（ethylene glycol）;LA：L-lactide;DHP：2,2-dihydroxylmethyl-propylene carbonate] micelles（RhB-micelles） was observed in H22 liver cancer bearing mice.The RhB-micelles were prepared by conjugating rhodamine B with the DHP units of amphiphilic block copolymer PEG-b-P（LA-co-DHP） followed by subsequent self-assembling of the conjugate.The parent copolymer PEG-b-P（LA-co-DHP） was synthesized by ring-opening copolymerization of LA and DHP with PEG as macroinitiator and diethyl zinc（ZnEt2） as catalyst.The micelles have a spherical shape and the average diameter is ca.50 nm by TEM（transmission electron microscope） or 80 nm by DLS（dynamic light scattering）.Their in vitro cell uptake experiment by CLSM（confocal laser scanning microscopy） and flow cytometry showed preferential internalization of micelles by MCF-7 human breast cancer cells to free RhB.The in vivo tests by live animal imaging and ex vivo excised organ imaging showed that after vena tail injection,free RhB molecules were distributed in the whole body through the circulation system and then gradually metabolized and excreted and there was no preferential partition in tumor bed from the beginning to the end.But the RhB-micelles were preferentially distributed to the tumor bed so that their concentration（fluorescent intensity） in tumor bed got the level of the liver at a certain time point between 1 and 6 h and reached a maximum relative intensity at around 12 h,indicating an obvious EPR effect of RhB-micelles in H22 liver cancer.

关键词： Enhanced permeability and retention（EPR） effect Fluorescent imaging Micelle Passive targeting

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Hybrid solid electrolyte enabled dendrite-free Li anodes for high-performance quasi-solid-state lithium-oxygen batteries

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National Science Review 2021年第2期8卷 123-133页

作者： Jin Wang Gang Huang jun-Min Yan Jin-Ling Ma tong Liu Miao-Miao shi Yue Yu Miao-Miao Zhang Ji-Lin Tang Xin-Bo Zhang Key Laboratory of Automobile Materials Ministry of EducationDepartment of Materials Science and EngineeringJilin University State Key Laboratory of Rare Earth Resource Utilization Changchun Institute of Applied ChemistryChinese Academy of Sciences Materials Science and Engineering Physical Science and Engineering DivisionKing Abdullah University of Science and Technology State Key Laboratory of Electroanalytical Chemistry Changchun Institute of Applied ChemistryChinese Academy of Sciences

The dendrite growth of Li anodes severely degrades the performance of lithium-oxygen(Li-O2) batteries.Recently, hybrid solid electrolyte(HSE) has been regarded as one of the most promising routes to tackle this problem. However, before this is realized, the HSE needs to simultaneously satisfy contradictory requirements of high modulus and even, flexible contact with Li anode, while ensuring uniform Li+distribution. To tackle this complex dilemma, here, an HSE with rigid Li1.5Al0.5Ge1.5(PO4)3(LAGP)core@ultrathin flexible poly(vinylidene fluoride-hexafluoropropylene)(PVDF-HFP) shell interface has been developed. The introduced large amount of nanometer-sized LAGP cores can not only act as structural enhancer to achieve high Young’s modulus but can also construct Li+diffusion network to homogenize Li+distribution. The ultrathin flexible PVDF-HFP shell provides soft and stable contact between the rigid core and Li metal without affecting the Li+distribution, meanwhile suppressing the reduction of LAGP induced by direct contact with Li metal. Thanks to these advantages, this ingenious HSE with ultra-high Young’s modulus of 25 GPa endows dendrite-free Li deposition even at a deposition capacity of 23.6 m Ah.Moreover, with the successful inhibition of Li dendrites, the HSE-based quasi-solid-state Li-O2battery delivers a long cycling stability of 146 cycles, which is more than three times that of gel polymer electrolyte-based Li-O2battery. This new insight may serve as a starting point for further designing of HSE in Li-O2batteries, and can also be extended to various battery systems such as sodium-oxygen batteries.

关键词： lithium-oxygen batteries dendrite suppression Li anodes hybrid solid electrolyte LAGP PVDF-HFP

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生命、关怀与超越——医学人文教育的意义表达

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医学争鸣 2015年第3期6卷 13-16页

作者：时统君徐州医学院社会科学部江苏徐州221004

本文以哲学诠释学为方法依据,全面阐释了医学人文教育的多维意义。认为生命、关怀与超越是蕴涵于医学人文教育的应有之义。只有在实践中充分地表达与彰显医学人文教育的生命、关怀与超越意义,医学人文教育才能为医学的发展与进步提供源... 详细信息

本文以哲学诠释学为方法依据,全面阐释了医学人文教育的多维意义。认为生命、关怀与超越是蕴涵于医学人文教育的应有之义。只有在实践中充分地表达与彰显医学人文教育的生命、关怀与超越意义,医学人文教育才能为医学的发展与进步提供源源不断的善的精神支撑力。

关键词：医学人文教育生命关怀超越

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悖离与重建:走向意义关怀的医学人文教育

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医学与哲学（A） 2015年第2期36卷 16-19页

作者：时统君徐州医学院社会科学部江苏徐州221004

人是一种意义存在,因而彰显意义关怀,使医学生在接受医学人文教育的同时既能感受到自身生命存在的意义,又能明了医学人文教育对医学、对其自身存在的意义理当是医学人文教育的固有使命。然而,当下的医学人文教育在践履其使命的过程中却... 详细信息

人是一种意义存在,因而彰显意义关怀,使医学生在接受医学人文教育的同时既能感受到自身生命存在的意义,又能明了医学人文教育对医学、对其自身存在的意义理当是医学人文教育的固有使命。然而,当下的医学人文教育在践履其使命的过程中却陷入了困境。当下医学人文教育困境的形成原因固然纷繁复杂,但就哲学层面而言,因科学主义思潮强势张扬、工具性医学教育理念以及医学人文教育知识化倾向导致的意义关怀的失落无疑是其重要成因。就此而言,走向意义关怀并采取相应举措显然是医学人文教育摆脱当下困境、实现自身使命的应然诉求。

关键词：医学人文教育医学生意义关怀

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Evaluation of sea level rise in Bohai Bay and associated responses

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Advances in Climate Change Research 2017年第1期8卷 48-56页

作者： LIU Ke-Xiu WANG Hui FU shi-Jie GAO Zhi-Gang DONG jun-Xing FENG Jian-Long GAO tong National Marine Data and Information Service Tianjin 300171 China

Tide gauge data from 1950 to 2015 are used to analyze sea level change, tidal change, return levels, and design tide levels under rising sea level scenarios in Bohai Bay. Results show the following: 1) Since 1950 sea levels in Bohai Bay show a significant rising trend of 3.3 mm per year. The speed has been particularly rapid in 1980e2015 at a rate of 4.7 mm per year. 2) Astronomical tides showed a clear long-term trend in 1950e2015. The amplitude and phase lag of the M2 tide constituent decreased at a rate of 0.21 cm per year and 0.11 per year, respectively and the phase lag of K1 decreased at a rate of 0.09 per year, whereas there was little change in its amplitude. The mean high and low tides increased at a rate of 0.08 and 0.52 cm per year, respectively, whereas the mean tidal range decreased at a rate of 0.44 cm per year. Results from numerical experiments show that local sea level rise plays an important role in the tidal dynamics change in Bohai Bay. 3) It is considered that the sea level return periods will decrease owing to the influence of sea level rise and land subsidence, therefore design tide level will change in relation

关键词： Bohai Bay Sea level rise Astronomical tide Design tide level Land subsidence

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Preparation and Properties of High-performance Polyimide Copolymer Fibers Derived from 5-Amino-2-(2-hydroxy-5-aminobenzene)-benzoxazole

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Chinese Journal of Polymer Science 2019年第5期37卷 478-492页

作者： Xue-Min Dai Hong Gao Ran Zhang Zhi-jun Du tong-Fei shi Xiang-Ling Ji Xue-Peng Qiu Yong-Feng Men State Key Laboratory of Polymer Physics and Chemistry Changchun Institute of Applied ChemistryChinese Academy of Sciences Polymer Composites Engineering Laboratory Changchun Institute of Applied ChemistryChinese Academy of Sciences University of Chinese Academy of Sciences China Academy of Space Technology

A series of polyamic acid copolymers(co-PAAs) with para-hydroxyl groups was synthesized using two diamine monomers,namely p-phenylenediamine(p-PDA) and 5-amino-2-(2-hydroxy-5-aminobenzene)-benzoxazole(m-pHBOA), of different molar ratios through copolymerization with 3,3′,4,4′-biphenyltetracarboxylic dianhydride(BPDA) in N,N-dimethyacetamine(DMAc). The co-PAA solutions were used to fabricate fibers by dry-jet wet spinning, and thermal imidization was conducted to obtain polyimide copolymer(coPI) fibers. The effects of the m-pHBOA moiety on molecular packing and physical properties of the prepared fibers were investigated.Fourier transform infrared(FTIR) spectroscopic results confirmed that intra/intermolecular hydrogen bonds originated from the hydroxyl group and the nitrogen atom of the benzoxazole group and/or the hydroxyl group and the oxygen atom of the carbonyl group of cyclic imide. As-prepared PI fibers displayed homogenous and smooth surface and uniform diameter. The glass transition temperatures(Tgs) of PI fibers were within 311-337 °C. The polyimide fibers showed 5% weight loss temperature(T5%) at above 510 °C in air. Twodimensional wide-angle X-ray diffraction(WXRD) patterns indicated that the homo-PI and co-PI fibers presented regularly arranged polymer chains along the fiber axial direction. The ordered molecular packing along the transversal direction was destroyed by introducing the m-pHBOA moiety. Moreover, the crystallinity and orientation factors increased with increasing draw ratio. Small-angle X-ray scattering(SAXS) results showed that it is beneficial to reduce defects in the fibers by increasing the draw ratio. The resultant PI fibers exhibited excellent mechanical properties with fracture strength and initial modulus of 2.48 and 89.73 GPa, respectively, when the molar ratio of p-PDA/m-pHBOA was 5/5 and the draw ratio was 3.0.

关键词： Polyimide fiber Phenylenebenzoxazole Hydroxyl group Hydrogen bonding

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Designing a toroidal crystal for monochromatic X-ray imaging of a laser-produced He-like plasma

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High Power Laser Science and Engineering 2022年第6期10卷 20-30页

作者： Miao Li tong Yao Zuhua Yang jun shi Feng Wang Guohong Yang Minxi Wei Ao Sun Yang Li College of Optoelectronic Engineering Chongqing University of Posts and TelecommunicationsChongqingChina Research Center of Laser Fusion China Academy of Engineering PhysicsMianyangChina Key Laboratory of Optoelectronic Technology and Systems Ministry of EducationChongqing UniversityChongqingChina

In this study,a toroidal quartz(2023)crystal is designed for monochromatic X-ray imaging at 72.3◦.The designed crystal produces excellent images of a laser-produced plasma emitting He-like Ti X-rays at 4.75 keV.Based on the simulations,the imaging resolutions of the spherical and toroidal crystals in the sagittal direction are found to be 15 and 5μm,respectively.Moreover,the simulation results show that a higher resolution image of the source can be obtained by using a toroidal crystal.An X-ray backlight imaging experiment is conducted using 4.75 keV He-like Ti X-rays,a 3×3 metal grid,an imaging plate and a toroidal quartz crystal with a lattice constant of 2d=0.2749 nm.The meridional and sagittal radii of the toroidalα-quartz crystal are 295.6 and 268.5 mm,respectively.A highly resolved image of the microgrid,with a spatial resolution of 10μm,is obtained in the experiment.By using similar toroidal crystal designs,the application of a spatially resolved spectrometer with high-resolution X-ray imaging ability is capable of providing imaging data with the same magnification ratio in the sagittal and meridional planes.

关键词： dynamic diffraction monochromatic X-ray imaging resolution toroidal quartz crystal

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