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BackgroundIn elderly patients with calculous acute cholecystitis, the risk of emergency surgery is high, and percutaneous cholecystostomy tube drainage (PC) combined with delayed laparoscopic cholecystectomy (DLC) may be a good choice. We retrospectively compared laparoscopic cholecystectomy (LC) to DLC after PC to determine which is the better treatment strategy.MethodWe performed a retrospective cohort analysis of 752 patients with acute calculous cholecystitis. Patients with the following conditions were included: (1) age > 65 years old; (2) patients with a grade 2 or 3 severity of cholecystitis according to the 2013 Tokyo Guidelines (TG13); (3) the surgeons who performed the LC were professors or associate professors and (4) the DLC was performed in our hospital after PC. Patients who missed their 30-day follow-up; were diagnosed with bile duct stones, cholangitis or gallstone pancreatitis or were pregnant were excluded from the study. A total of 51 of 314 patients who underwent LC and 73 of 438 patients who underwent PC + DLC were assessed. PC + DLC and LC patients were matched by cholecystitis severity grade according to the TG13, and the National Surgical Quality Improvement Program (NSQIP) calculator was used to predict mortality (n = 21/group). Preoperative characteristics and postoperative outcomes were analysed.ResultsCompared to the matched LC group, the DLC group had less intraoperative bleeding (42.2 vs 75.3 mL, p = 0.014), shorter hospital stays (4.9 vs 7.4 days, p = 0.010) and lower rates of type A bile duct injury (4.8% vs 14.3%, p = 0.035) and type D (0 vs 9.5%, p = 0.002) according to Strasberg classification, residual stones (4.8 vs 14.3%, p = 0.035) and gastrointestinal organ injury (0 vs 3.6%, p < 0.001). Patients in the DLC group had lower incidences of ICU admission and death and a significantly lower incidence of repeat surgery.ConclusionIn elderly patients treated for acute calculous cholecystitis, the 30-day mortality and complication rates were lower for PC + DLC than for LC. However, the total hospitalisation time was significantly prolonged and the costs were significantly higher for PC + DLC.

Background Hepatocellular carcinoma (HCC) is a common abdominal cancer with dissatisfactory therapeutic effects. The discovery of cuproptosis lights on new approach for cancer treatment and assessment. So far, there is extremely limited research investigating the roles of cuproptosis-related (CR) genes in cancers. Methods A novel CR risk signature was constructed using the Lasso regression analysis. Its prognostic value was assessed via a series of survival analyses and validated in three GEO cohorts. The effects of CR risk signature on tumor immune microenvironment (TIM) were explored through CIBERSORT, ESTIMATE, and ssGSEA algorithms. Using GESA, we investigated its impacts on various metabolism process. The somatic mutation features of CR signature genes were also explored via cBioPortal database. Using tumor mutation burden, expressions of immune checkpoints, TIDE score, IMvigor 210 cohort, and GSE109211 dataset, we explored the potential associations of CR risk score with the efficacy of immune checkpoint inhibitors (ICIs) and sorafenib. Finally, the biofunctions of DLAT in HCC cells were ascertained through qPCR, immunohistochemistry, colony formation, and Transwell assays. Results FDX1, DLAT, CDKN2A and GLS constituted the CR risk signature. CR risk signature possessed high prognostic value and was also applicable to three validation cohorts. Meanwhile, it could improve the accuracy and clinical making-decision benefit of traditional prognostic model. Moreover, high CR risk was indicative of unfavorable anti-tumor immune response and active metabolisms of glycolysis and nucleotide. As for therapeutic correlation, CR risk score was a potential biomarker for predicting the efficacy of ICIs and sorafenib. Through qPCR and immunohistochemistry detection in clinical samples, we reconfirmed DLAT was significantly upregulated in HCC samples. Overexpression of DLAT could promote the proliferation, migration, and invasion of HepG2 and HuH-7 cells. Conclusions The novel CR risk signature greatly contributed to the clinical assessment of HCC. Cuproptosis regulatory gene DLAT possessed cancer-promoting capacities and was expected to be a promising therapeutic target for HCC.

In this paper, we consider the existence and nonexistence of sign-changing solutions for fractional Kirchhoff equation with cubic growth in bounded domains. By the nodal Nehari manifold method, the quantitative deformation lemma and variational techniques, we obtain a least energy sign-changing solution u b for the given problem. Moreover, we give a convergence property of u b as b → 0 , where b is regarded as a positive parameter.

In order to study the geochemical characteristics of fine-grained sedimentary rocks and clarify its relationship with the tight oil reservoir, the Chang7 Member of Triassic Yanchang Formation in Longdong area was taken as an example to be studied by rock pyrolysis, isotopic determination, maceral analysis, gas chromatography and gas chromatography–mass spectrometry. Lacustrine organic-rich fine-grained sedimentary rocks can be divided into organic-rich shale and organic-rich mudstone according to their lithology and texture. The results show that the organic-rich shale was deposited in a quiet and anoxic deep lacustrine environment, the organic matter was of high abundance and mainly sourced from plankton and benthic algae (type I–II1). Organic-rich mudstone mainly deposited in the semi-deep lacustrine environment, where the water was relatively shallow and the salinity was low, the organic matter was of low abundance and came from the mixed source of plankton and terrestrial clastic (type II1–II2). The Chang7 tight oil is widely distributed in the turbidite sand bodies, and it was mainly sourced from the Chang7 organic-rich shale.

To systematically analyze the damage caused by bedrock and overburden layer slope under seismic action, a set of large-scale shaking table test was designed and completed. Interpolation of the acceleration amplification coefficient, Hilbert–Huang transform and transfer function was adopted. The damage mechanisms of the bedrock and overburden layer slopes under seismic action are systematically summarized in terms of slope displacement, acceleration field, vibration amplitude, energy, vibration frequency, and damage level. The results show a significant acceleration amplification effect within the slope under seismic action and a localized amplification effect at the top and trailing edges of the slope. With an increase in the input seismic intensity, the difference in the vibration amplitude between the overburden layer and bedrock increased, low-frequency energy of the overburden layer was higher than that of the bedrock, and the vibration frequency of the overburden layer was smaller than that of the bedrock. These differences cause the interface to experience cyclic loading continuously, resulting in the damage degree of the overburden layer at the interface being larger than that of the bedrock, reduction of the shear strength, and eventual formation of landslides. The displacement in the middle of the overburden is always greater than that at the top. Therefore, under the action of an earthquake and gravity, the damage mode of the bedrock and overburden layer slope is such that the leading edge of the critical part pulls and slides at the trailing edge, and multiple tensile cracks are formed on the slope surface.

Vibratory rollers are generally used in the process of highway subgrade compaction. In the paper, the vibratory roller—subgrade finite element model was established to simulate the field construction by using ABAQUS. We used Hilbert–Huang Transform to analyze the compaction in the field test from the time–frequency domain. By changing the parameters of the vibratory roller and the filler, the comprehensive influence of the parameters such as the elastic modulus of the filler, rolling speed, excitation force, vibration frequency and thickness of the filler on the compaction quality of the subgrade was investigated. We studied the propagation pattern of vibration waves in three-dimensional space. The study shows that the signals of different frequency bands in the Hilbert spectrum represent the compaction degrees of fillers in different zones. The peak acceleration generally decreases with the increase of horizontal and vertical distance, but there is an increase at the boundary of the vibration field. There is an optimal combination of the excitation force, vibration frequency and thickness of the filler. The vibration waves propagate in the form of an ellipsoid in three dimensions, and the amplitude decreases with distance.

How Cooper pairs form and condense has been the main challenge in the physics of copper-oxide high-temperature superconductors. Great efforts have been made in the ‘underdoped’ region of the phase diagram, through doping a Mott insulator or cooling a strange metal. However, there is still no consensus on how superconductivity emerges when electron-electron correlations dominate and the Fermi surface is missing. To address this issue, here we carry out high-resolution resonant inelastic X-ray scattering and scanning tunneling microscopy studies on prototype cuprates Bi 2 Sr 2 Ca 0.6 Dy 0.4 Cu 2 O 8+ δ near the onset of superconductivity, combining bulk and surface, momentum- and real-space information. We show that an incipient charge order exists in the antiferromagnetic regime down to 0.04 holes per CuO 2 unit, entangled with a particle-hole asymmetric pseudogap. The charge order induces an intensity anomaly in the bond-buckling phonon branch, which exhibits an abrupt increase once the system enters the superconducting dome. Our results suggest that the Cooper pairs grow out of a charge-ordered insulating state, and then condense accompanied by an enhanced interplay between charge excitations and electron-phonon coupling. A major mystery in cuprate superconductors is how Cooper pairs form and condense. Here, the authors use RIXS and STM techniques to reveal that a charge-ordered insulating phase and enhanced bond-buckling phonons play important roles in this process.

A large-scale shaking table test of an anti-dip rock slope at the tunnel entrance with retaining structures was designed and conducted, and the dynamic responses of the slope and the surrounding rock were analyzed. To investigate the damage evolution law in the surrounding rock, dynamic parameters of the rock mass and marginal spectra were used to study the dissipation law of seismic energy and the distribution characteristics of seismic energy across different frequency bands, respectively. The research findings indicate that the retaining structure effectively inhibits toppling failure at the tunnel entrance; however, considerable toppling deformation persists in the slope, and a through-going crack has developed at the invert section of the tunnel lining. The acceleration amplification effect in the shallow buried section of the tunnel is stronger than that in the deep buried section. Under vertical seismic action, the acceleration amplification effect at the tunnel entrance is significant. The damage analysis based on dynamic parameter changes shows that, with increasing input acceleration, the damaged area is mainly concentrated in the surrounding rock at the lower part of the lining and gradually extends deeper into the slope. Marginal spectrum analysis shows that, under vertical seismic action, the damage to the surrounding rock at the lower part of the lining can be identified according to the energy distribution characteristics in the 9–12 Hz frequency band. The failure state of the lining can be effectively identified through changes in the dynamic parameters and attenuation of the marginal spectrum amplitude of the surrounding rock. For the seismic design of anti-dip rock slopes at tunnel entrances, the seismic performance of the inverted arch in the lining should be improved, and reinforcement measures for the surrounding rock beneath the lining should be intensified. Greater attention should be given to the low-frequency components of vertical seismic waves.

Background The triglyceride-glucose (TyG) index is highly correlated with cardiovascular diseases, but the relationship between TyG index changes and hypertrophic cardiomyopathy (HCM) has rarely been reported. We aimed to investigate whether the level and the change of the TyG index were associated with HCM. Methods The study retrospectively collected socio-demographic, medical, anthropometric, and laboratory data from patients with HCM who were continuously admitted to Beijing Anzhen Hospital between January 1, 2018, and December 31, 2022. Logistic regressions were used to determine the relationship between the TyG index, other HCM factors, and the incidence of atrial fibrillation (AF). After stratifying patients by TyG index, we compared inter-group characteristics and evaluated the association between the TyG index and AF using logistic regression, followed by subgroup analyses to examine the consistency of this association. Results For the total HCM population, the prevalence of AF was 285/1284(22.20%). Patients with AF had greater age (61.8 ± 10.6 vs. 54.0 ± 14.2 years, P < 0.001), lower body mass index (BMI) (25.59 ± 3.27 vs. 26.47 ± 4.03, P < 0.001), larger left atrial diameter (LAD) (46.86 ± 7.11 vs. 40.39 ± 5.98, P < 0.001), and more moderate or severe mitral regurgitation (MR) (82.5% vs. 67.0%, P < 0.001). Patients with AF had significantly greater free fatty acids (FFA) level (0.50 ± 0.26 vs. 0.44 ± 0.22, P = 0.004), although their triglycerides (TG) (1.45 ± 0.95 vs. 1.77 ± 1.05, P < 0.001), TyG index (8.64 ± 0.64 VS. 8.84 ± 0.64, P < 0.001), total cholesterol (TC) (4.21 ± 1.07 vs. 4.53 ± 1.07, P < 0.001), and low-density lipoprotein cholesterol (LDL-C) (2.55 ± 0.91 vs. 2.75 ± 0.88, P = 0.001) levels were much lower. In the multivariate logistic regression model, we discovered that age, LAD, left ventricular ejection fraction (LVEF), and TyG index were independently linked with the occurrence of AF. Subgroup analysis of the study population showed no interaction between all subgroups after adjusting for confounders. Conclusion In conclusion, our study demonstrates that a higher TyG index is inversely associated with key adverse features in HCM, including LAD, and the prevalence of AF and moderate-to-severe MR. Further investigations are warranted to elucidate the mechanisms underlying these associations and their impact on the long-term prognosis of HCM.

Salmonella enterica serotype Mbandaka has emerged as a significant foodborne pathogen in poultry, posing increasing public health risks through its zoonotic transmission from poultry sources to humans, yet critical gaps remain in understanding its transmission inter-host transmission and antimicrobial resistance (AMR) mechanisms within the poultry industry. In this study, we addressed these knowledge gaps by conducting a comprehensive genomic analysis of 1813 S. Mbandaka genomes, including genotyping, phylogenetic reconstruction, and pangenome analysis. The results revealed that S. Mbandaka exhibits a global distribution pattern, with sequence type 413 (ST413) representing the dominant lineage. Phylogenetic analysis revealed frequent close genomic relatedness between human and poultry-derived strains (SNP ≤ 10), suggesting poultry as a potential major zoonotic reservoir for human S. Mbandaka infection. Furthermore, close genetic relationship was also detected among the human-derived strains, suggesting the potential community spread. In addition, genomic analysis indicated an increase over time in the number of antimicrobial resistance genes (ARGs) detected per genome, frequently associated with plasmids and insertion sequences (ISs). Notably, the ARGs significantly enriched in Chinese strains were primarily associated with the Col(pHAD28) plasmid. Comparative analysis demonstrated that the ARG profiles of S. Mbandaka were similar to those of other Salmonella serovars, suggesting the potential for cross-species transmission. In conclusion, these findings represent a large-scale retrospective genomic analysis of publicly available whole-genome sequences and elucidate the transmission dynamics and AMR mechanisms of S. Mbandaka in poultry, providing insights into its risks to poultry production and public health while guiding the development of targeted prevention strategies for the poultry sector.