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Early prediction and prevention of infected pancreatic necrosis

World Journal of Gastroenterology 2024年第9期30卷 1005-1010页

作者： Cheng Lv Zi-Xiong Zhang lu ke Department of Critical Care Medicine Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210000Jiangsu ProvinceChina Research Institute of Critical Care Medicine and Emergency Rescue Nanjing UniversityNanjing 210000Jiangsu ProvinceChina

Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.

关键词： Acute pancreatitis Infected pancreatic necrosis Biomarker Scoring system Nutrition therapy Selective digestive decontamination Probiotics Antibiotics Immune enhancement therapy

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Early systemic anticoagulation reduces hospital readmission in acute necrotizing pancreatitis patients:A retrospective cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 77-82页

作者： Wen-Jian Mao Jing Zhou Guo-Fu Zhang Fa-Xi Chen Jing-Zhu Zhang Bai-Qiang Li lu ke Wei-Qin Li Department of Critical Care Medicine Jinling HospitalNanjing Medical UniversityNanjing 210002China Department of Critical Care Medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China National Institute of Healthcare Data Science Nanjing UniversityNanjing 210010China

Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,Plusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.

关键词： Anticoagulation Splanchnic venous thrombosis Acute necrotizing pancreatitis Readmission Long-term outcomes

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Multi-Perspective Data Fusion Framework Based on Hierarchical BERT: Provide Visual Predictions of Business Processes

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Computers, Materials & Continua 2024年第1期78卷 1227-1252页

作者： Yongwang Yuan Xiangwei Liu ke lu School of Mathematics and Big Data Anhui University of Science and TechnologyHuainan232001China School of Economics and Management Anhui University of Science and TechnologyHuainan232001China The key Laboratory of Embedded System and Service Computing Ministry of Education Tongji UniversityShanghai201804China

Predictive Business Process Monitoring(PBPM)is a significant research area in Business Process Management(BPM)aimed at accurately forecasting future behavioral events.At present,deep learning methods are widely cited in PBPM research,but no method has been effective in fusing data information into the control flow for multi-perspective process prediction.Therefore,this paper proposes a process prediction method based on the hierarchical BERT and multi-perspective data fusion.Firstly,the first layer BERT network learns the correlations between different category attribute data.Then,the attribute data is integrated into a weighted event-level feature vector and input into the second layer BERT network to learn the impact and priority relationship of each event on future predicted events.Next,the multi-head attention mechanism within the framework is visualized for analysis,helping to understand the decision-making logic of the framework and providing visual predictions.Finally,experimental results show that the predictive accuracy of the framework surpasses the current state-of-the-art research methods and significantly enhances the predictive performance of BPM.

关键词： Business process prediction monitoring deep learning attention mechanism BERT multi-perspective

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Simultaneous acceleration of sulfur reduction and oxidation on bifunctional electrocatalytic electrodes for quasi-solid-state Zn–S batteries

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Science China Chemistry 2024年第5期67卷 1531-1538页

作者： Mingli Wang Hong Zhang Tianhang Ding Fangjun Wu Lin Fu Bin Song Pengfei Cao ke lu Institutes of Physical Science and Information Technology School of Materials Science and EngineeringKey Laboratory of Structure and Functional Regulation of Hybrid Materials of Ministry of EducationAnhui UniversityHefei 230601China Hefei National Laboratory for Physical Sciences at the Microscale University of Science and Technology of ChinaHefei 230026China School of Chemistry and Chemical Engineering Harbin Institute of TechnologyHarbin 150001China School of Chemistry and Chemical Engineering Guizhou UniversityGuiyang 550025China Institute of Functional Nano&Soft Materials(FUNSOM) Soochow UniversitySuzhou 215123China State key Lab of Organic-Inorganic Composites Beijing University of Chemical TechnologyBeijing 100029China

The incomplete sulfur reduction and high ZnS re-oxidation energy barrier along with severe side reactions during the battery cycling compromise the practical application of Zn–S electrochemistry. Herein, a bifunctional electrocatalytic sulfur matrix that simultaneously accelerates the sulfur reduction and ZnS oxidation is proposed to realize a highly-efficient Zn–S cell. It is revealed that the N-heteroatom hotspots are more favorable for facilitating the conversion of S to ZnS while the CoO nanocrystal substantially lowers the ZnS activation energy barrier thereby suppressing the formation of disproportionation species(e.g.,SO_(4)^(2-)) and accumulation of inactive ZnS. Accordingly, the Co O anchored on the N-doped carbon-supported sulfur cathode delivers a high Zn^(2+)storage capacity of 1,172 m Ahg^(-1)and outstanding cycling stability with a capacity retention of 71.6% after500 cycles with a high average Coulombic efficiency of 97.8%. Simultaneously, the stable cycling of solid-state Zn–S pouch cells with an energy density of 585 Whkg^(-1)sulfuris also demonstrated. Moreover, the postmortem analysis reveals that the degradation of Zn–S cells is mainly attributed to the limited reversibility of Zn anodes rather than the ZnS decomposition and/or accumulation. The approach to the bidirectional catalysis manipulated the sulfur redox provides a new perspective to realize the theoretical potentials of Zn–S cells.

关键词： Zn–S battery bifunctional catalysts solid-state battery sulfur redox degradation mechanism

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Aggressive versus controlled fluid resuscitation in acute pancreatitis: A systematic review and meta-analysis of randomized controlled trials

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Chinese Medical Journal 2023年第10期136卷 1166-1173页

作者： Kun He Lin Gao Zihan Yang Yuelun Zhang Tianrui Hua Wenmo Hu Dong Wu lu ke Department of Gastroenterology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Critical Care Medicine Center of Severe Acute Pancreatitis(CSAP)Jinling HospitalMedical School of Nanjing UniversityNanjingJiangsu 210010China Department of Internal Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Medical Research Center State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China National Institute of Healthcare Data Science Nanjing UniversityNanjingJiangsu 210010China

Background:Early fluid resuscitation is one of the fundamental treatments for acute pancreatitis(AP),but there is no consensus on the optimal fluid rate.This systematic review and meta-analysis aimed to compare the efficacy and safety of aggressive vs.controlled fluid resuscitation(CFR)in AP.Methods:The Cochrane Central Register of Controlled Trials(CENTRAL),MEDLINE,Embase,and Web of Science databases were searched up to September 30,2022,for randomized controlled trials(RCTs)comparing aggressive with controlled rates of early fluid resuscitation in AP patients without organ failure on admission.The following keywords were used in the search strategy:"pancreatitis,""fluid therapy,""fluid resuscitation,"and"randomized controlled trial."There was no language restriction.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)framework was used to assess the certainty of evidence.Trial sequential analysis(TSA)was used to control the risk of random errors and assess the conclusions.Results:A total of five RCTs,involving 481 participants,were included in this study.For primary outcomes,there was no significant difference in the development of severe AP(relative risk[RR]:1.87,95%confidence interval[CI]0.95-3.68;P=0.07;n=437;moderate quality of evidence)or hypovolemia(RR:0.98,95%CI:0.32-2.97;P=0.97;n=437;moderate quality of evidence)between the aggressive and CFR groups.A significantly higher risk of fluid overload(RR:3.25,95%CI:1.53-6.93;Pluid resuscitation(AFR)group than the controlled group.Additionally,the risk of intensive care unit admission(P=0.02)and the length of hospital stay(Plusions.Conclusion:For AP patients without organ failure on admission,CFR may be superior to AFR with respect to both efficacy and safety outcomes.Registration:PROSPERO;https://www.***.york.***.uk/PROSPERO/;CRD 42022363945.

关键词： Acute pancreatitis Aggressive fluid resuscitation Controlled fluid resuscitation Efficacy Safety Systemic review

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Early versus delayed intervention in necrotizing acute pancreatitis complicated by persistent organ failure

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 63-68页

作者： He Zhang Lin Gao Wen-Jian Mao Jie Yang Jing Zhou Zhi-Hui Tong lu ke Wei-Qin Li Medical School of Southeast University 87 DingjiaqiaoNanjing 210009China Center of Severe Acute Pancreatitis(CSAP) Department of General SurgeryJinling HospitalMedical School of Southeast UniversityNo.305 Zhongshan East RoadNanjing 210002China

Background:Current guidelines for the treatment of patients with necrotizing acute pancreatitis(NAP)recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming“walled-off”.However,for patients showing signs of clinical deterioration,especially those with persistent organ failure(POF),it is controversial whether this delayed approach should always be adopted.In this study,we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF.Methods:All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion.They were divided into two groups based on the timing of initial interven-tion(within 4 weeks and beyond 4 weeks).All the data were extracted from a prospectively collected database.Results:Overall,131 patients were included for analysis.Among them,100(76.3%)patients were in-tervened within 4 weeks and 31(23.7%)underwent delayed interventions.As for organ failure prior to intervention,the incidences of respiratory failure,renal failure and cardiovascular failure were not signifi-cantly different between the two groups(P>0.05).The mortality was not significantly different between the two groups(35.0%vs.32.3%,P=0.83).The incidences of new-onset multiple organ failure(8.0%vs.6.5%,P=1.00),gastrointestinal fistula(29.0%vs.12.9%,P=0.10)and bleeding(35.0%vs.35.5%,P=1.00),and length of ICU(30.0 vs.22.0 days,P=0.61)and hospital stay(42.5 vs.40.0 days,P=0.96)were com-parable between the two groups.Conclusion:Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients compli-cated by POF.

关键词： Necrotizing acute pancreatitis Persistent organ failure Early intervention Delayed intervention Clinical outcomes

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An approach of dynamic response analysis of nonlinear structures based on least square Volterra kernel function identification

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Transportation Safety and Environment 2023年第2期5卷 1-13页

作者： Zhenhao Zhang Jun Xiong Zhenpeng Zhao Fuming Wang Yi Zeng Bing Zhao lu ke School of Civil Engineering Changsha University of Science and TechnologyChangsha 410114HunanChina Guangxi key Laboratory of Disaster Prevention and Engineering Safety Guangxi UniversityNanning 530004GuangxiChina College of Civil engineering and Architecture Guangxi UniversityNanning 530004GuangxiChina

Analysis of the dynamic response of a complex nonlinear system is always a difficult problem.By using Volterra functional series to describe a nonlinear system,its response analysis can be similar to using Fourier/Laplace transform and linear transfer function method to analyse a linear system’s response.In this paper,a dynamic response analysis method for nonlinear systems based on Volterra series is developed.Firstly,the recursive formula of the least square method is established to solve the Volterra kernel function vector,and the corresponding MATLAB programme is compiled.Then,the Volterra kernel vector corresponding to the nonlinear response of a structure under seismic excitation is identified,and the accuracy and applicability of using the kernel vector to predict the response of a nonlinear structure are analysed.The results show that the Volterra kernel function identified by the derived recursive formula can accurately describe the nonlinear response characteristics of a structure under an excitation.For a general nonlinear system,the first three order Volterra kernel function can relatively accurately express its nonlinear response characteristics.In addition,the obtained Volterra kernel function can be used to accurately predict the nonlinear response of a structure under the similar type of dynamic load.

关键词： nonlinear system Volterra series kernel function dynamic response least square method

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Analysis of Narrative Strategies in Colum McCann’s Short Story“Sisters”

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Journal of Literature and Art Studies 2023年第1期13卷 7-12页

作者： lu ke Wuhan University of Technology WuhanChina

As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the times.From the perspective of narratology,this paper considers that the writer uses narrative techniques such as non-linear narration and embedded structure to express multi-level narrative voices through a first-person narrator,Sheona.These narrative techniques help to fully reflect the theme of the work and endow the work with great aesthetic and ideological value.

关键词： Colum McCann sisters narrative structure narrative voice

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Interpretation,Narrative and Study of“Disaster”Scenarios in Western Literature

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Journal of Literature and Art Studies 2023年第2期13卷 68-75页

作者： lu ke School of Foreign Languages Wuhan University of TechnologyWuhanChina

Disaster runs through the whole process of human development.As a common topic faced by mankind anywhere and anytime,disaster has become the object of consideration and writing by writers in every country.This paper first identifies the etymological meaning of“disaster”in Western language and culture,and then examines the main representations of Western“disaster”literature in terms of literary genre,developing trajectory and thematic characteristics.Finally,the paper summarizes the researches of Western“disaster”literature,and provide references for worldwide study of“disaster”literature.

关键词： disaster “disaster”literature interpretation narrative study

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Structural Evolution of an FeMoSiB Alloy during Ball Milling

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Journal of Materials Science & Technology 1998年第3期14卷 281-285页

作者： Guo, Faqiang lu, ke Acad Sinica Inst Met Res State Key Lab RSA Shenyang 110015 Peoples R China

Ball milling induced microstructure evolution in an FeMoSiB alloy with three kinds of different phase constitutions (bcc alpha -Fe solid solution and various borides) was investigated by means of X-ray diffraction and transmission electron microscopy. Experimental evidences indicate that a same final product of bcc alpha -Fe solid solution is formed upon milling for all samples. During the transformation, the XRD peaks of alpha -Fe phase shift to lower diffraction angles, and those of borides disappear in turn, first the metastable Fe//3B and Fe//2//3B//6 and then the stable Fe//2B. The observed structural evolution might originate from the transformation of ordered Fe//2B phase into disordered alpha -Fe solid solution. (Edited author abstract) 8 Refs.

关键词： Iron alloys

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