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BACKGROUND: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis, yet there are fewer studies about predictors of PVT recanalization. We aimed to further explore the predictors of recanalization in cirrhotic PVT to facilitate accurate prediction of patients' clinical status and timely initiation of appropriate treatment and interventions. To further investigate the benefits and risks of anticoagulant therapy in cirrhotic PVT patients. METHODS: A retrospective cohort study of patients with cirrhotic PVT in our hospital between January 2016 and December 2022, The primary endpoint was to analyze predictors of PVT recanalization by COX regression. Others included bleeding rate, liver function, and mortality. RESULTS: This study included a total of 82 patients, with 30 in the recanalization group and 52 in the non-recanalization group. Anticoagulation therapy was the only independent protective factor for portal vein thrombosis recanalization and the independent risk factors included massive ascites, history of splenectomy, Child-Pugh B/C class, and main trunk width of the portal vein. Anticoagulation therapy was associated with a significantly higher rate of PVT recanalization (75.9% vs. 20%, log-rank P < 0.001) and a lower rate of PVT progression (6.9% vs. 54.7%, log-rank P = 0.002). There was no significant difference between different anticoagulation regimens for PVT recanalization. Anticoagulation therapy did not increase the incidence of bleeding complications(P = 0.407). At the end of the study follow-up, Child-Pugh classification, MELD score, and albumin level were better in the anticoagulation group than in the non-anticoagulation group. There was no significant difference in 2-year survival between the two groups. CONCLUSION: Anticoagulation, massive ascites, history of splenectomy, Child-Pugh B/C class, and main portal vein width were associated with portal vein thrombosis recanalization. Anticoagulation may increase the rate of PVT recanalization and decrease the rate of PVT progression without increasing the rate of bleeding. Anticoagulation may be beneficial in improving liver function in patients with PVT in cirrhosis.
Assuntos
Anticoagulantes , Cirrose Hepática , Veia Porta , Trombose Venosa , Humanos , Cirrose Hepática/complicações , Masculino , Feminino , Estudos Retrospectivos , Trombose Venosa/etiologia , Trombose Venosa/tratamento farmacológico , Pessoa de Meia-Idade , Anticoagulantes/uso terapêutico , Fatores de Risco , Ascite/etiologia , Idoso , Progressão da Doença , Adulto , EsplenectomiaRESUMO
The hierarchical porous SiOC ceramics (HPSCs) have been prepared by the pyrolysis of precursors (the mixture of dimethicone and KH-570) and polyacrylonitrile nanofibers (porous template). The HPSCs possess hierarchical porous structure with a BET surface area of 51.4 m2/g and have a good anti-oxidation property (only 5.1 wt.% weight loss). Owing to the porous structure, the HPSCs deliver an optimal reflection loss value of - 47.9 dB at 12.24 GHz and an effective absorption bandwidth of 4.56 GHz with a thickness of 2.3 mm. The amorphous SiOC, SiOx, and free carbon components within SiOC make contributions to enhancing dipolar polarization. Besides, the abundant interfaces between SiOC and carbon nanofibers (CNFs) are favorable for improving interfacial polarization. The conductive loss arisen from cross-linked CNFs can also boost the microwave absorption performance.
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Two dimensional materials have been widely identified as promising microwave absorbers, owing to their large surface area and abundant interfaces. Here, a novel laminated and magnetic composite derived from Mxene was designed and successfully synthesized via facile hydrothermal oxidization of nickel ion intercalated Ti3C2. Highly disordered carbon sheets were obtained by low temperature hydrothermal oxidization, and the in-situ produced TiO2 and NiO nanoparticles embedded closely between them. This layered hybrid exhibits excellent microwave absorbing performance with an effective absorbing bandwidth as high as 11.1 GHz (6.9-18 GHz) and 9 GHz (9-18 GHz) when the thickness is 3 and 2 mm, respectively. Besides the high dielectric loss, magnetic loss and ohmic loss of the composite, the amorphous nature of obtained carbon sheets and multi-reflections between them are believed to play a decisive role in achieving such superior microwave absorbing performance.
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Multi-functional carbon fiber (CF) based composites have great potential as new-type microwave absorption materials (MAMs). However, it was still a huge challenge to integrate antioxidation and MA properties into CF based composites. Herein, the SiOC ceramics coating modified carbon fibers (SiOC/CFs) were prepared by a polymer precursor pyrolysis method. The X-ray photoelectron spectroscopy (XPS) revealed that the SiOC coating was composed of SiOC, SiO2, and amorphous carbon phases. The SiOC ceramics as dual-functional coating not only heightened the oxidation temperature from 415 °C to 890 °C, but also highly improved the microwave absorbing ability from -12.60 dB to -47.50 dB. The enhanced MA performance could be attributed to multiple reflections in the cross-linked structure, various polarization relaxation processes, and the favorable impedance matching effect. The SiOC ceramics coating as a semiconductor could suppress the skin effect originating from the cross-linked CF network, thus leading to a favorable impedance matching behavior.
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Lithium-sulfur (Li-S) batteries have attracted more and more attention because they represent one of the most promising candidates to satisfy emerging energy storage demands. The biggest challenge regarding the application of the Li-S battery is to suppress the polysulfide shuttle while maintaining a high sulfur loading mass. Here, a dual polysulfide confinement strategy is designed by confinement of sulfur in polydopamine-coated MXene nanosheets (denoted as S@Mxe@PDA) that performs as a high-performance cathode for Li-S cells owing to their inherently high underlying metallic conductivity and chemical bonding and strong chemical adsorption to lithium polysulfides (LPs). This dual LPs confinement strategy is supported by the results of density functional theory calculations. It is demonstrated that the S@Mxe@PDA cathode exhibits outstanding electrochemical properties, including high reversible capacity (1044 mAh g-1 after 150 cycles at 0.2 C), superior rate capability (624 mAh g-1 at 6 C) and excellent cycling stability (556 mAh g-1 after 330 cycles at 0.5 C with 4.4 mg cm-2 sulfur loading). This work offers a facile and effective method for boosting Li-S batteries into practical applications.
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In this work, we demonstrate the enhancement of microwave attenuation capability of Ti3C2 enabled microwave absorbing materials (MAMs) within a frequency range of 2-18 GHz. Ti3C2 nano-sheet/paraffin composites exhibit enhanced microwave absorbing performance with an effective absorbing bandwidth of 6.8 GHz (11.2-18 GHz) at 2 mm and an optimal reflection loss of -40 dB at 7.8 GHz. Moreover, mechanisms for the dielectric responses of the Ti3C2 MXene nanosheets are intensively discussed. Three typical electric polarizations of Ti3C2 are illustrated with the Cole-Cole diagram. The enhanced microwave absorbing properties can be ascribed to the high dielectric loss accompanied with the strong multi-reflections between MXene layers.