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Efficacy and safety of clarithromycin for patients with sepsis or septic shock:a systematic review and meta-analysis

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Emergency and Critical Care Medicine 2024年第2期4卷 90-96页

作者： Pengyue Zhao Renqi yao Jiaqi Yang Wei Wen yongming yao Xiaohui Du Department of General Surgery First Medical Center of the Chinese PLA General HospitalBeijingChina Translational Medicine Research Center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General HospitalBeijingChina Department of Burn Surgery the First Affiliated Hospital of Naval Medical UniversityShanghaiChina Department of General Surgery Hainan Hospital of Chinese PLA General HospitalSanyaHainanChina.

Background:Clarithromycin exerts an immunomodulatory role in several human diseases.However,whether this effect improves the prognosis in patients with sepsis remains controversial,and higher levels of clinical evidence are urgently needed.To the best of our knowledge,no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in sepsis.Methods:A comprehensive literature search of PubMed,EMBASE,and the Cochrane Library was conducted up to December 31,2022.Only randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were included.Data were pooled by applying a fixed-effects model and a relative risk(RR)estimate with 95%confidence intervals(CIs)using Review Manager(version 5.3;Cochrane Collaboration,Copenhagen,Denmark).Results:Three randomized controlled trials involving a total of 910 patients were included.The pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome(RR:1.51;95%CI:1.02-2.25;P=0.04;I^(2)=0%),28-day mortality(RR:1.09;95%CI:0.87-1.36;P=0.46;I^(2)=0%),and 90-day mortality(RR:0.86;95%CI:0.71-1.03;P=0.10;I^(2)=81%)in patients with sepsis or septic shock.Moreover,there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group(RR:1.02;95%CI:0.87-1.19;P=0.83;I^(2)=18%).Conclusion:Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with clarithromycin.However,administration of clarithromycin did not increase the risk of adverse events.

关键词： Clarithromycin Meta-analysis Outcomes Sepsis Septic shock

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Reinforcement learning based adaptive control for uncertain mechanical systems with asymptotic tracking

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Defence Technology（防务技术） 2024年第4期34卷 19-28页

作者： Xiang-long Liang Zhi-kai yao yao-wen Ge Jian-yong yao School of Mechanical Engineering Nanjing University of Science and TechnologyNanjing210094China College of Automation&College of Artificial Intelligence Nanjing University of Post and TelecommunicationNanjing210023China

This paper mainly focuses on the development of a learning-based controller for a class of uncertain mechanical systems modeled by the Euler-Lagrange formulation.The considered system can depict the behavior of a large class of engineering systems,such as vehicular systems,robot manipulators and satellites.All these systems are often characterized by highly nonlinear characteristics,heavy modeling uncertainties and unknown perturbations,therefore,accurate-model-based nonlinear control approaches become unavailable.Motivated by the challenge,a reinforcement learning(RL)adaptive control methodology based on the actor-critic framework is investigated to compensate the uncertain mechanical dynamics.The approximation inaccuracies caused by RL and the exogenous unknown disturbances are circumvented via a continuous robust integral of the sign of the error(RISE)control approach.Different from a classical RISE control law,a tanh(·)function is utilized instead of a sign(·)function to acquire a more smooth control signal.The developed controller requires very little prior knowledge of the dynamic model,is robust to unknown dynamics and exogenous disturbances,and can achieve asymptotic output tracking.Eventually,co-simulations through ADAMS and MATLAB/Simulink on a three degrees-of-freedom(3-DOF)manipulator and experiments on a real-time electromechanical servo system are performed to verify the performance of the proposed approach.

关键词： Adaptive control Reinforcement learning Uncertain mechanical systems Asymptotic tracking

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Optimal strategy for treatment of sepsis based on the host inflammatory reaction and immune response

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Journal of Intensive Medicine 2024年第2期4卷 175-180页

作者： Hui Zhang Ning Dong yongming yao Translational Medicine Research Center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General HospitalBeijingChina

Introduction Sepsis is a common complication following infections,burns,trauma,and major operations and has become the main cause of death in non-coronary intensive care units.It was the most common reason for hospitalization(except in live born infants)in 2017,with 48.9 million cases reported worldwide.[1]A study found that sepsis led to 11.0 million deaths(which represented 19.7%of all global deaths)and has required the expenditure of 38.2 billion dollars for medical care.

关键词： dollar operations treatment

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Uniqueness on Difference Operators of Meromorphic Functions of Infinite Order

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Acta Mathematica Sinica,English Series 2024年第2期40卷 511-527页

作者： Hui LI ming Liang FANG Xiao yao School of Science China University of Mining and TechnologyBeijing 100083P.R.China Institute of Mathematics Academy of Mathematics and System SciencesChinese Academy of SciencesBeijing 100190P.R.China School of Sciences Hangzhou Dianzi UniversityHangzhou 310012P.R.China School of Mathematical sciences and LPMC Nankai UniversityTianjin 300071P.R.China

We investigate the uniqueness problems of meromorphic functions and their difference operators by using a new method.It is proved that if a non-constant meromorphic function f shares a non-zero constant and ∞ counting multiplicities with its difference operators Δcf(z) and Δ_(c)^(2)f(z), thenΔcf(z)≡Δ_(c)^(2)f(z).In particular,we give a difference analogue of a result of Jank-Mues-Volkmann.Our method has two distinct features:(ⅰ) It converts the relations between functions into the corresponding vectors.This makes it possible to deal with the uniqueness problem by linear algebra and combinatorics.(ⅱ) It circumvents the obstacle of the difference logarithmic derivative lemma for meromorphic functions of infinite order,since this method does not depend on the growth of the functions.Furthermore,the idea in this paper can also be applied to the case for several variables.

关键词： Uniqueness meromorphic functions difference operators infinite order

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Elastic three-dimensional phononic topological insulators with Dirac hierarchy

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Science China(Physics,Mechanics & Astronomy) 2024年第5期67卷 54-62页

作者： Shao-yong Huo Qiu-Shuang Yang Jiu-Jiu Chen Hong-Kang Li Long-Chao yao Fu-Chun He Chun-ming Fu College of Mechanical Engineering University of South ChinaHengyang 421001China State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body College of Mechanical and Vehicle EngineeringHunan UniversityChangsha 410082China

Three-dimensional(3D)phononic topological insulators(TIs)featuring two-dimensional(2D)surface states and one-dimensional(1D)hinge states have opened up a new route for multi-dimensional robust wave transport,providing unprecedented methods for integrated acoustic sensors and energy harvesting devices.However,aiming at the elastic 3D phononic TI with gapless surface states and hinge states,the realization of elastic 3D phononic TIs with gapless surface states and hinge states is a significant challenge due to the complicated multi-mode polarization of elastic waves in 3D structures.In this study,we demonstrate an elastic 3D phononic TI with a Dirac hierarchy by elaborately operating the corresponding spatial symmetries of the chiral honeycomb lattice.First,a 3D double Dirac cone of elastic wave can be achieved by doubling the lattice along the outof-plane direction to fold two iso-frequency Weyl points.The topological phase transitions and 2D gapless two-fold Dirac surface states of elastic wave are realized by breaking the half-lattice spatial translation symmetry.Subsequently,based on the Brillouin zone folding along the in-plane direction,the 2D gapless two-fold surface Dirac cones are folded into four-fold surface Dirac cones.Finally,by inducing the relative radius of adjacent holes to break the in-plane spatial inversion symmetry,the fourfold surface Dirac cones are gapped and associated with a surface state inversion,in which the gapless 1D hinge Dirac dispersion is achieved.This research offers a route for engineering the hierarchies of TIs in 3D elastic wave systems and provides new possibilities for designing 3D ultrasonic devices with unconventional functions.

关键词： Dirac topological hierarchy

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Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 4-13页

作者： Ji-yao Sheng Zi-Fan Meng Qiao Li yong-Sheng Yang Department of Hepatobiliary and Pancreatic Surgery the Second Hospital of Jilin UniversityChangchun 130041China Jilin Engineering Laboratory for Translational Medicine of Hepatobiliary and Pancreatic Diseases the Second Hospital of Jilin UniversityChangchun 130041China

Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related contraindications.With recent advances in precision medicine,precise drug treatment provides better treatment efficacy.Data sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May 2022.Information on clinical trials was obtained from https://clinicaltrials.gov/and http://***/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs.According to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and others.All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.Conclusions:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.

关键词： Cirrhotic portal hypertension Target drug Primary prevention Bleeding

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Dynamic interwell connectivity analysis of multi-layer waterflooding reservoirs based on an improved graph neural network

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Petroleum Science 2024年第2期21卷 1062-1080页

作者： Zhao-Qin Huang Zhao-Xu Wang Hui-Fang Hu Shi-ming Zhang yong-Xing Liang Qi Guo Jun yao School of Petroleum Engineering China University of Petroleum(East China)Qingdao266580ShandongChina Exploration and Development Research Institute Shengli OilfieldSINOPECDongying257015ShandongChina

The analysis of interwell connectivity plays an important role in the formulation of oilfield development plans and the description of residual oil distribution. In fact, sandstone reservoirs in China's onshore oilfields generally have the characteristics of thin and many layers, so multi-layer joint production is usually adopted. It remains a challenge to ensure the accuracy of splitting and dynamic connectivity in each layer of the injection-production wells with limited field data. The three-dimensional well pattern of multi-layer reservoir and the relationship between injection-production wells can be equivalent to a directional heterogeneous graph. In this paper, an improved graph neural network is proposed to construct an interacting process mimics the real interwell flow regularity. In detail, this method is used to split injection and production rates by combining permeability, porosity and effective thickness, and to invert the dynamic connectivity in each layer of the injection-production wells by attention mechanism.Based on the material balance and physical information, the overall connectivity from the injection wells,through the water injection layers to the production layers and the output of final production wells is established. Meanwhile, the change of well pattern caused by perforation, plugging and switching of wells at different times is achieved by updated graph structure in spatial and temporal ways. The effectiveness of the method is verified by a combination of reservoir numerical simulation examples and field example. The method corresponds to the actual situation of the reservoir, has wide adaptability and low cost, has good practical value, and provides a reference for adjusting the injection-production relationship of the reservoir and the development of the remaining oil.

关键词： Graph neural network Dynamic interwell connectivity Production-injection splitting Attention mechanism Multi-layer reservoir

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Skin Microbiota and the Skin Barrier

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International Journal of Dermatology And Venereology 2024年第1期07卷 18-26页

作者： Wu ming-Yang yao Xu Department of Allergy and Rheumatology Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Hospital for Skin Diseases (Institute of Dermatology) Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing Jiangsu 210042 China

The skin constitutes the primary barrier between the human body and the external environment. The skin microbiome plays an important role in the microecosystem on the skin surface and mediates multiple facets of the skin barrier function, including physical, chemical, microbial, and immune barriers. In this review, we discuss the host–microbiota interactions in barrier maintenance and disruption, implications for skin disorders such as atopic dermatitis, psoriasis, and rosacea, and the latest strategies for targeting the skin microbiota to improve the skin barrier.

关键词： skin barrier microbiota immune atopic dermatitis Staphylococcus aureus

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Beyond microbial carbon use efficiency

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National Science Review 2024年第4期11卷 33-35页

作者： Ke-Qing Xiao Chao Liang Zimeng Wang Jingjing Peng yao Zhao ming Zhang mingyu Zhao Shuiqing Chen yong-Guan Zhu Caroline L.Peacock State Key Lab of Urban and Regional Ecology Research Center for Eco-Environmental SciencesChinese Academy of Sciences University of Chinese Academy of Sciences Institute of Applied Ecology Chinese Academy of Sciences Department of Environmental Science and Engineering Fudan University College of Resources and Environmental Sciences China Agricultural University State Key Laboratory of Environmental Criteria and Risk Assessment Chinese Research Academy of Environmental Sciences State Key Laboratory of Agricultural Microbiology College of Resources and Environment Huazhong Agricultural University Key Laboratory of Cenozoic Geology and Environment Institute of Geology and Geophysics Chinese Academy of Sciences School of Earth and Environment University of Leeds

Microbial carbon use efficiency (CUE)is defined as the proportion of microbial biomass growth C versus substrate C uptake, and thus provides a useful measure of microbially driven accumulation and loss of soil organic carbon (SOC)[1]. In a recent study published in Nature [2],the authors used a data-driven machinelearning approach to conclude that CUE promotes global SOC storage based on a positive correlation between CUE and SOC content and that, based on sensitivity analysis, CUE is at least four times as important as six other evaluated factors,namely plant C inputs, C input allocation, non-microbial C transfer, substrate decomposability, environmental modifications and vertical transport.

关键词： SOIL-CARBON ORGANIC-MATTER

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Neuropathological characteristics of abnormal white matter functional signaling in adolescents with major depression

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World Journal of Psychiatry 2024年第2期14卷 276-286页

作者： Xin-Lin Huang Ju Gao yong-ming Wang Feng Zhu Jing Qin Qian-Nan yao Xiao-Bin Zhang Hong-Yan Sun Imaging and Nuclear Medicine Jiamusi UniversityJiamusi 154000Heilongjiang ProvinceChina Department of Psychiatry The Affiliated Guangji Hospital of Soochow UniversitySuzhou 215137Jiangsu ProvinceChina School of Biology&Basic Medical Sciences Medical College of Soochow UniversitySuzhou 215137Jiangsu ProvinceChina Department of Radiology Shanghai Anting HospitalShanghai 20000China Department of Radiology The Affiliated Guangji Hospital of Soochow UniversitySuzhou 215137Jiangsu ProvinceChina

BACKGROUND Major depression disorder(MDD)constitutes a significant mental health concern.Epidemiological surveys indicate that the lifetime prevalence of depression in adolescents is much higher than that in adults,with a corresponding increased risk of suicide.In studying brain dysfunction associated with MDD in adolescents,research on brain white matter(WM)is sparse.Some researchers even mistakenly regard the signals generated by the WM as noise points.In fact,studies have shown that WM exhibits similar blood oxygen level-dependent signal fluctuations.The alterations in WM signals and their relationship with disease severity in adolescents with MDD remain unclear.AIM To explore potential abnormalities in WM functional signals in adolescents with MDD.METHODS This study involved 48 adolescent patients with MDD and 31 healthy controls(HC).All participants were assessed using the Patient Health Questionnaire-9 Scale and the mini international neuropsychiatric interview(MINI)suicide inventory.In addition,a Siemens Skyra 3.0T magnetic resonance scanner was used to obtain the subjects'image data.The DPABI software was utilized to calculate the WM signal of the fractional amplitude of low frequency fluctuations(fALFF)and regional homogeneity,followed by a two-sample t-test between the MDD and HC groups.Independent component analysis(ICA)was also used to evaluate the WM functional signal.Pearson’s correlation was performed to assess the relationship between statistical test results and clinical scales.RESULTS Compared to HC,individuals with MDD demonstrated a decrease in the fALFF of WM in the corpus callosum body,left posterior limb of the internal capsule,right superior corona radiata,and bilateral posterior corona radiata[P<0.001,family-wise error(FWE)voxel correction].The regional homogeneity of WM increased in the right posterior limb of internal capsule and left superior corona radiata,and decreased in the left superior longitudinal fasciculus(P<0.001,FWE voxel correction).The ICA results of WM overlapped with tho

关键词： White matter Regional homogeneity The fractional amplitude of low-frequency fluctuations Independent component analysis Adolescents Major depression disorders

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