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ثراء شينجيانغ
يعتبر ظهور الأدوات البرونزية قفزة مهمة في تاريخ الحضارة الإنسانية. وعلي الرغم من أن العصر البرونزي في الصين لم يكن الأول في تاريخ البشرية، ولكن الأدوات البرونزية في الصين القديمة قد احتلت مكانة فريدة في تاريخ الحضارة العالمية اعتمادا علي أنواعها المتنوعة وأنماطها الغنية وعملية السبك الدقيقة والدلالة التاريخية والثقافية العميقة التي يحملها كل عمل برونزي في الصين القديمة. وهذا الكتاب الذي بين يدي القارئ الكريم يعرفن بلغة واضحة وحية وبالشرح والصور على أحد اوجه الثقافة والفنون الصينية الشهيرة والتي هي ثقافة البرونز الرائعة في الصين القديمة ، فمن خلال قطعة من القطع البرونزية الثمينة يمكننا أن نستمع إلي صوت العصر البرونزي من أماكن بعيدة وتجربة أسلوب فريد من نوعه في ذلك العصر الذي مازالت أسراره بعيدة عن متناول القارئ العربي والتي نحاول من خلال هذا الكتاب أن نقدمها بشكل موجز وواضح لننقل للقارئ الكريم وجها جديدا عليه من أوجه الحضارة الصينية المتميزة.
Book
Risk of post-polypectomy bleeding and thromboembolic events during colonoscopy in patients on continued or interrupted antiplatelet therapy: a pooled analysis
It remains uncertain whether antiplatelet therapy is associated with an increased risk of bleeding in patients undergoing colonoscopic post-polypectomy. Our objective was to compare the incidence of post-polypectomy bleeding and thromboembolic events among patients receiving uninterrupted and interrupted antiplatelet therapy.
We conducted a comprehensive search of PubMed, MEDLINE, and Cochrane library databases up until March 2024 to identify relevant studies. The primary outcome was the incidence of bleeding events in patients undergoing colonoscopy with polypectomy while continuing or interrupting antiplatelet therapy. Additionally, we assessed the occurrence rate of thromboembolic events as a secondary outcome measure.
Twenty two studies, encompassing 95,107 patients receiving antiplatelet therapy, met the inclusion criteria. Overall, the pooled incidence of colonoscopic post-polypectomy bleeding were 2.40% for patients on uninterrupted clopidogrel, and 2.20% for those on interrupted clopidogrel therapy. Subgroup analysis revealed that older patients on clopidogrel therapy had a higher risk in both uninterrupted (4.60% vs. 1.40%) and interrupted (3.00% vs. 1.50%) treatment regimens compared to younger patients. The incidence of post-procedural bleeding for continued and interrupted aspirin was 1.70% and 1.40%, respectively. Similarly, older individuals on uninterrupted aspirin therapy exhibited a higher risk of bleeding with an incidence rate of 2.50% compared to younger individuals with an incidence rate of l.00%. Among all the regions, the European population on uninterrupted aspirin therapy demonstrated the highest bleeding incidence at 7.20%. Furthermore, thromboembolic events were more prevalent in patients on interrupted clopidogrel than those did not interrupt clopidogrel therapy.
Uninterrupted antiplatelet therapy in elderly patients increases the risk of post-polypectomy bleeding, while the potential elevated risk of thromboembolic events resulting from discontinuation should not be ignored. Especially for high-risk patients, endoscopists must carefully weigh the risk of bleeding and adverse cardiovascular events when deciding whether to interrupt or continue antiplatelet therapy.
Journal Article
Effectiveness and Safety of Aspirin Versus Other Antithrombotics for VTE After Total Hip and Knee Arthroplasty in Real-World Setting
BackgroundVenous thromboembolism (VTE) is a potentially life-threatening complication in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Multiple antithrombotic agents are routinely used to prevent VTE after THA and TKA. However, it remains unclear which anticoagulant is optimal in real-world clinical practice. This study aimed to assess the effectiveness and safety of aspirin and other antithrombotic agents for VTE prophylaxis following THA and TKA.MethodsSeveral electronic databases, including PubMed, Embase, and the Cochrane Library, were systematically searched from inception to January 13th, 2025. The search identified real-world studies assessing the efficacy or safety of aspirin versus other anticoagulants for VTE prophylaxis after THA or TKA. The pooled rate of thromboembolic and bleeding events was estimated using a random-effects model. Two reviewers independently screened the literature and extracted data. Subgroup analyses were conducted based on study type, dose regimen and geographic region.ResultsA total of 41 studies were identified for inclusion. The overall incidence of VTE after THA and TKA with low-molecular-weight heparin (LMWH) was 1.20% (95% CI: 0.90%-1.60%). The incidence of VTE for aspirin, warfarin and direct oral anticoagulants (DOACs) was 0.80%, 0.9% and 0.90%, respectively. The pooled incidence of major bleeding for aspirin (1.90%, 95% CI: 0.00%-4.60%) was statistically significantly different from that in patients receiving LMWH (3.50%, 95% CI: 0.00%-7.80%) and DOACs (3.10%, 95% CI: 1.20%- 5.00%). When analyzing regional subgroups among several antithrombotic agents, VTE rate was significantly higher in Asia (LMWH: 21.80%, aspirin: 2.40%, DOACs: 9.40%) compared to other regions. In terms of major bleeding, the higher rate associated with DOACs (5.00%, 95% CI: 0.90%-9.20%) was found in North America compared to other regions, especially among patients treated with rivaroxaban (4.10%, 95% CI: 1.20%-7.00%).ConclusionTo date, this study provides the most comprehensive real-world evidence regarding antithrombotic agents for VTE prophylaxis after THA and TKA. Aspirin appears to be as effective as other antithrombotic agents for VTE prophylaxis following THA and TKA. Furthermore, its use is associated with a significantly lower risk of bleeding. Nevertheless, these findings should be interpreted carefully.
Journal Article
Factors Influencing the Interruption of Nursing Document Writing in the Intensive Care Unit: A Cross-Sectional Survey
To explore the current status of interruption events in nursing document writing in the intensive care unit (ICU) using a cross-sectional survey.
Between May and October 2021, the convenience sampling method was used to observe the interruption events in nursing document writing in the ICU. A total of 54 nurses and 7 indicators were observed: the start time, end time, interruption period, source, type, duration and outcome of interruption events.
A total of 438 interruption events in nursing document writing occurred in 85.955 hours, with a frequency of 5.093 times/hour and a duration of 4787.00 (1152.00, 13,109.00) seconds. The frequency of interruption events in nursing document writing was the highest (11 times/hour) and the duration was the longest (9581.50 seconds) from 08:00 to 12:00. The main sources of interruptions for nurses with 10 or more years of service or with the professional title of nurse are nurses themselves and their colleagues. The main sources of interruptions for nurses who have been in charge for 10 years or over are the working environment and doctors. This intervention in work continuity occurs unexpectedly; however, if adjustments are made to nursing procedures, the interruption can be terminated rapidly or adverse consequences can be avoided. Years of working experience, seniority level, interruption time periods and professional titles were independent factors influencing the number of interruption events, and they were all positively correlated. The results of this study show that there were statistically significant differences in the incidence of negative outcomes among ICU nurses with varying years of working experience and professional titles.
Interruptions in nursing document writing have high frequency, complex sources and multiple types. For senior nurses, the outcome was predominantly positive, while for junior nurses, it was predominantly negative.
Journal Article
Adaptive NN-based distributed consensus control for nonlinear multi-agent systems under direct graphs
This paper is mainly concerned with the leaderless consensus problem for nonlinear multi-agent systems (MAS) with unknown mismatched nonlinear dynamics and external disturbances. First, a novel adaptive controller is designed to achieve bounded consensus with a linear feedback term, the RBF neural network (RBFNN) adaptive approximation term, a discontinuous feedback term, and a state constraint term. Furthermore, on this basis, an observer-based robust uniform control scheme against disturbance is proposed to achieve the leaderless consensus of MAS with unmeasurable states under the directed graph. Compared with the previous works, the proposed controller is less conservative. Finally, two simulation-based examples are provided to verify the effectiveness of the proposed control scheme.
Journal Article
Genomics Approach Reveals That Aroma Production in Apple Is Controlled by Ethylene Predominantly at the Final Step in Each Biosynthetic Pathway
Ethylene is the major effector of ripening in many fleshy fruits. In apples (Malus x domestica) the addition of ethylene causes a climacteric burst of respiration, an increase in aroma, and softening of the flesh. We have generated a transgenic line of 'Royal Gala' apple that produces no detectable levels of ethylene using antisense ACC OXIDASE, resulting in apples with no ethylene-induced ripening attributes. In response to external ethylene these antisense fruits undergo a normal climacteric burst and produced increasing concentrations of ester, polypropanoid, and terpene volatile compounds over an 8-d period. A total of 186 candidate genes that might be involved in the production of these compounds were mined from expressed sequence tags databases and full sequence obtained. Expression patterns of 179 of these were assessed using a 15,720 oligonucleotide apple microarray. Based on sequence similarity and gene expression patterns we identified 17 candidate genes that are likely to be ethylene control points for aroma production in apple. While many of the biosynthetic steps in these pathways were represented by gene families containing two or more genes, expression patterns revealed that only a single member is typically regulated by ethylene. Only certain points within the aroma biosynthesis pathways were regulated by ethylene. Often the first step, and in all pathways the last steps, contained enzymes that were ethylene regulated. This analysis suggests that the initial and final enzymatic steps with the biosynthetic pathways are important transcriptional regulation points for aroma production in apple.
Journal Article
Identification and fine mapping of AvrPi15, a novel avirulence gene of Magnaporthe grisea
Avirulence of Magnaporthe grisea isolate CHL346 on rice cultivar GA25 was studied with 242 ascospore progenies derived from the cross CHL346 x CHL42. Segregation analysis of the avirulence in the progeny population was in agreement with the existence of a single avirulence (Avr) gene, designated as AvrPi15. For mapping the Avr gene, we developed a total of 121 microsatellite DNA markers [simple sequence repeat (SSR)], which evenly distributed in the whole-genome of M. grisea through bioinformatics analysis (BIA) using the publicly available sequence. Linkage analysis of the AvrPi15 gene with these SSR markers showed that six markers on chromosome 6, MS6-1, MS6-2, MS6-3, MS6-7, MS6-8 and MS6-10, were linked to the AvrPi15 locus. To further define the chromosomal location of the AvrPi15 locus, two additional markers, MS6-17 and STS6-6, which were developed based on the sequences of telomeric region 11 (TEL11), were subjected to linkage analysis. The results showed that MS6-17 and STS6-6 were associated with the locus by 3.3 and 0.8 cM, respectively. To finely map the Avr gene, two additional candidate avirulence gene (CAG) markers, CAG6-1 and CAG6-2, were developed based on the gene annotation of the sequence of TEL 11. Linkage analysis of the Avr gene with these two markers revealed that both of them completely cosegregated with the AvrPi15 locus. Finally, this locus was physically mapped into approximately 7.2-kb interval of the TEL11 by BIA using these sequence-ready markers. This is the key step toward positional cloning of the AvrPi15 gene.
Journal Article
Grain Refinement of Pure Al by Inoculation and Rotating Magnetic Field
This study aims to understand the grain refinement behavior of commercial purity Al under the influences of inoculation and rotating magnetic field (RMF). Effects of RMF with magnetic flux density of 6mT on the refinement potency of Al-5Ti-1B were investigated. The experimental results indicate fading effect is obvious after adding 0.2 wt.% Al-5Ti-1B into Al with the holding time of 20 min. However, the fading effect can be eliminated to a great extent when RMF was applied to the inoculated Al until the temperature decreased to 662 °C. Meanwhile, the grain size can be further reduced. Compared to the grain size of pure Al under RMF until the temperature decreased to 662 °C, the grain size is coarser when applying RMF to the inoculated Al until solidification, which can be ascribed to the Joule heat produced by RMF.
Journal Article