Search

Objective: The purpose of the present study was to evaluate whether intravenous immunoglobulin (IVIG) increases live birth rates and improves neonatal results in patients with antiphospholipid antibodies (aPL) at high-risk for miscarriage. Background: Positivity of aPL in pregnant women is a high-risk factor for miscarriage, and IVIG treatment has emerged as a potential intervention. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was employed to search multiple electronic databases for articles published until August 20, 2023, including PubMed, Web of Science, Embase, Scopus and Medline. The inclusion criteria encompassed studies assessing the efficacy of IVIG in aPL-positive patients with a high risk of miscarriage. Relevant articles were assessed for the quality and data were extracted for analysis. Two independent reviewers performed study selection, data extraction, and quality assessments. The risk of bias was evaluated according to the Cochrane risk of bias tool. All analyses were conducted using Review Manager 5.3. Results: This systematic review included nine randomized controlled trials, with 366 aPL-positive women at high risk of miscarriage. These studies included in this review were randomized controlled trials. The primary outcome measures were successful pregnancy outcomes and live birth rates. The secondary outcomes included obstetric complications, and neonatal outcomes (such as birth weight and live-birth rate). The comparison between the intervention and control groups revealed no significant differences in terms of obstetric complications and neonatal outcomes. The group receiving IVIG treatment had a higher prevalence of preterm deliveries than controls (OR = 2.05, I2 = 46%, 95% CI [0.58–5.24]), but also exhibited a partial improvement in live birth rates (OR = 2.86, I2 = 52%, 95% CI [1.04–7.90]), because it reduced the number of miscarriages (OR = 0.35, I2 = 52%, 95% CI [0.13–0.96]). Conclusion: Based on the available evidence, IVIG intervention appears to be a potentially effective approach for managing of aPL-positive pregnant women with high risk of miscarriage. While IVIG shows significant potential in tripling the chances of having a live-born child, further large-scale randomized controlled trials are necessary, preferably comparing IVIG with hydroxychloroquine or lifestyle and dietary interventions, to refine treatment protocols and ensure the most effective application. [ABSTRACT FROM AUTHOR]

Low back pain is a common clinical symptom of intervertebral disc degeneration (IVDD), which seriously affects the quality of life of the patients. The abnormal apoptosis and senescence of nucleus pulposus cells (NPCs) play important roles in the pathogenesis of IVDD. PHLDA2 is an imprinted gene related to cell apoptosis and tumour progression. However, its role in NPC degeneration is not yet clear. Therefore, this study was set to explore the effects of PHLDA2 on NPC senescence and apoptosis and the underlying mechanisms. The expression of PHLDA2 was examined in human nucleus pulposus (NP) tissues and NPCs. Immunohistochemical staining, magnetic resonance imaging imaging and western blot were performed to evaluate the phenotypes of intervertebral discs. Senescence and apoptosis of NPCs were assessed by SA‐β‐galactosidase, flow cytometry and western blot. Mitochondrial function was investigated by JC‐1 staining and transmission electron microscopy. It was found that the expression level of PHLDA2 was abnormally elevated in degenerated human NP tissues and NPCs. Furthermore, knockdown of PHLDA2 can significantly inhibit senescence and apoptosis of NPCs, whereas overexpression of PHLDA2 can reverse senescence and apoptosis of NPCs in vitro. In vivo experiment further confirmed that PHLDA2 knockdown could alleviate IVDD in rats. Knockdown of PHLDA2 could also reverse senescence and apoptosis in IL‐1β‐treated NPCs. JC‐1 staining indicated PHLDA2's knockdown impaired disruption of the mitochondrial membrane potential and also ameliorated superstructural destruction of NPCs as showed by transmission electron microscopy. Finally, we found the PHLDA2 knockdown promoted Collagen‐II expression and suppressed MMP3 expression in NPCs by repressing wnt/β‐catenin pathway. In conclusion, the results of the present study showed that PHLDA2 promotes IL‐1β‐induced apoptosis and senescence of NP cells via mitochondrial route by activating the Wnt/β‐catenin pathway, and suggested that therapy targeting PHLDA2 may provide valuable insights into possible IVDD therapies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Central South University is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Two dinuclear and centrosymmetric silver-containing complexes, namely [Ag2(3,5-dmpz)2(3,5-dmpz methanol)2(tbtc)] (1) and [Ag2(3,5-dmpz)2(3,5-dmpz methanol)2(dbtc)] (2) (3,5-dmpz: dimethylpyrazole; 3,5-dmpz methanol: 3,5-dimethylpyrazole methanol; H2tbtc: tetrabromoterephthalic acid; H2dbtc: 2,5-dibromoterephthalic acid), were prepared and characterized. X-ray crystallographic data of 1 and 2 revealed that trigonal environment of the Ag ions has a "compressed Y's" geometry. The antimicrobial activity of 1 and 2 was tested against the Gram-positive, Gram-negative bacteria and fungus, displaying the better inhibiting activity than the individual AgNO3 and 3,5-dimethylpyrazole, especially for Candida albicans (IC50 2.5 ± 0.1 mg mL −1 and 2.8 ± 0.2 mg mL−1). The quantified IC50 values displayed that complexes 1 and 2 were more effective against fungus than the Gram-negative bacteria and Gram-positive bacteria. [ABSTRACT FROM AUTHOR]

The experiment was to explore the effect of different energy level diets on growth performance, serum biochemical index, rumen fermentation parameters and rumen microflora of Gobi Short-tail pregnant ewe. Sixty healthy Gobi Short-tail pregnant ewes with similar age, body condition and weight (43.64 ± 2.19) kg were selected and randomly divided into three groups, with four replicates in each group and five ewes in each replicate. Ewes in each group were fed diets with different energy levels. The metabolic energy of control group was 7.98 MJ/kg. Metabolic energy of test group 1 was 6.37 MJ/kg. The metabolic energy of test group 2 was 4.77 MJ/kg. The pre trial period was 15 d, and the trial period was 45 d. The results showed that the final weight and average daily gain of ewes in test group 2 were extremely lower than those in other two groups (P<0.01). The serum ALB content of ewes in test group 1 and test group 2 was significantly lower than that in control group (P<0.05), the serum BUN content was extremely lower than that in control group (P<0.01), and ALT activity of ewes in test group 2 was significantly higher than that in other groups (P<0.05). The rumen ammonia nitrogen content of ewes in test group 1 and test group 2 was extremely lower than that in control group (P<0.01). The relative abundances of Bacteroides, Verrucomicrobiota and Rikenellaceae in rumen of test group 1 and test group 2 were extremely higher than those in control group (P<0.01), the relative abundances of Erysipelotrichaceae UCG-002 were extremely lower than those in control group (P<0.01), and the relative abundances of Firmicutes and Prevotella were significantly lower than those in control group (P<0.05). Rumen Bacteroides of ewes in test group 1 were extremely lower than those in other two groups (P<0.01). The study indicates that proper reduction of dietary energy level can ensure the normal life activities of pregnant ewes, reduce the feeding cost of shed feeding in winter and spring, improve the breeding efficiency of farmers and herdsmen, excessive reduction of dietary energy level will have a negative impact on pregnant ewes to some extent. [ABSTRACT FROM AUTHOR]

Background: Nucleus pulposus mesenchymal stem cells (NPMSCs) transplantation is a promising treatment for intervertebral disc degeneration (IVDD). However, the transplanted NPMSCs exhibited weak cell proliferation, high cell apoptosis, and a low ability to resist the harsh microenvironment of the degenerated intervertebral disc. There is an urgent need to explore feasible methods to enhance the therapeutic efficacy of NPMSCs transplantation. Objective: To identify the optimal concentration for NPMSCs pretreatment with hydrogen peroxide (H2O2) and explore the therapeutic efficacy of NPMSCs transplantation using H2O2 pretreatment in IVDD. Methods: Rat NPMSCs were pretreated with different concentrations (range from 25 to 300 μM) of H2O2. The proliferation, reactive oxygen species (ROS) level, and apoptosis of NPMSCs were detected by cell counting kit-8 (CCK-8) assay, 5-ethynyl-2′-deoxyuridine (EdU) staining, and flow cytometry in vitro. The underlying signalling pathways were explored utilizing Western blotting. A rat needle puncture-stimulated IVDD model was established. X-ray, histological staining, and a multimode small animal live imaging system were used to evaluate the therapeutic effect of H2O2-pretreated NPMSCs in vivo. Results: NPMSCs pretreated with 75 μM H2O2 demonstrated the strongest elevated cell proliferation by inhibiting the Hippo pathway (P < 0.01). Meanwhile, 75 μM H2O2-pretreated NPMSCs exhibited significantly enhanced antioxidative stress ability (P < 0.01), which is related to downregulated Brd4 and Keap1 and upregulated Nrf2. NPMSCs pretreated with 75 μM H2O2 also exhibited distinctly decreased apoptosis (P < 0.01). In vivo experiments verified that 75 μM H2O2-pretreated NPMSCs-transplanted rats exhibited an enhanced disc height index (DHI% = 90.00 ± 4.55, P < 0.01) and better histological morphology (histological score = 13.5 ± 0.5, P < 0.01), which means 75 μM H2O2-pretreated NPMSCs can better adapt to the environment of degenerative intervertebral discs and promote the repair of IVDD. Conclusions: Pretreatment with 75 μM H2O2 was the optimal concentration to improve the proliferation, antioxidative stress, and antiapoptotic ability of transplanted NPMSCs, which is expected to provide a new feasible method to improve the stem cell therapy efficacy of IVDD. [ABSTRACT FROM AUTHOR]

Preconditioning has a powerful protective potential against myocardial ischemia-reperfusion injury (I/R). Our prior work demonstrated that baicalein, a flavonoid derived from the root of Scatellaria baicalensis Georgi (also known as Huangqin), confers this preconditioning protection. This study further explored the mechanisms of baicalein preconditioning (BC-PC) in mouse cardiomyocytes. Cells were treated with baicalein (10 μM) for a brief period of time (10 min) prior to simulated ischemia 90 min/reperfusion for 180 min. Baicalein triggered an induction of a small amount of mitochondrial reactive oxygen species (ROS) prior to the initiation of ischemia, assessed by 6-carboxy-2′, 7′-dichlorodihydrofluorescein diacetate (6-carboxy-H2DCFDA). It also significantly increased cell viability measured by propidium iodide (PI) and lactate dehydrogenase and preserved mitochondrial membrane potential assessed by TMRM fluorescence intensity. Myxothiazol, a mitochondrial electron transport chain complex III inhibitor, partially blocked ROS generation induced by BC-PC and reduced cell viability. BC-PC increased phosphorylation of Akt (Thr308 and Ser473) and eNOS Ser1177, and nitric oxide (NO) production measured using 4,5-diaminofluorescein diacetate (DAF-2 DA, 1 μM). Akt inhibitor API-2 abolished Akt phosphorylation and reduced DAF-2 production and cell viability. In addition, BC-PC decreased phosphorylation of pyruvate dehydrogenase (PDH) reflecting upregulated PDH activity, and increased ATP production at 30 min during reperfusion. Taken together, baicalein preconditioning-induced cardioprotection involves pro-oxidant generation, activates survival signaling Akt/eNOS/NO, and improves metabolic recovery after I/R injury. Our work provides new perspectives on the effect of baicalein on cardiac preconditioning against I/R injury. [ABSTRACT FROM AUTHOR]

As two mathematical tools for dealing with uncertainty, the covering rough set theory and the evidence theory have close relationships with each other. Different covering rough set models are characterized by evidence theory. The purpose of this paper is to interpret belief functions with two pairs of covering approximation operators. The two pairs of covering approximation operators are equivalent to a pair of relation approximation operators. Then, based on a necessary and sufficient condition for a belief structure to be the belief structure induced by the pair of relation approximation operators, necessary and sufficient conditions for a belief structure to be the belief structure induced by the covering approximation operators are presented. Moreover, two kinds of covering reductions in covering information systems defined from the two pairs of covering approximation operators are characterized by the belief and plausibility functions. [ABSTRACT FROM AUTHOR]

Background: Pedicle screw placement in patients with osteoporosis is a serious clinical challenge. The bone mineral density (BMD) of the screw trajectory has been positively correlated with the screw pull-out force, while the computer tomography (CT) value has been linearly correlated with the BMD. The purpose of this study was to establish an in vitro osteoporosis model and verify the accuracy and effectiveness of automated pedicle screw planning software based on CT values in this model.Methods: Ten vertebrae (L1-L5) of normal adult pigs were randomly divided into decalcification and control groups. In the decalcification group, the vertebral bodies were decalcified with Ethylenediaminetetraacetic acid (EDTA) to construct an in vitro osteoporosis model. In the decalcification group, automatic planning (AP) and conventional manual planning (MP) were used to plan the pedicle screw trajectory on the left and right sides of the pedicle, respectively, and MP was used on both sides of the control group. CT values of trajectories obtained by the two methods were measured and compared. Then, 3D-printed guide plates were designed to assist pedicle screw placement. Finally, the pull-out force of the trajectory obtained by the two methods was measured.Results: After decalcification, the BMD of the vertebra decreased from - 0.03 ± 1.03 to - 3.03 ± 0.29 (P < 0.05). In the decalcification group, the MP trajectory CT value was 2167.28 ± 65.62 Hu, the AP trajectory CT value was 2723.96 ± 165.83 Hu, and the MP trajectory CT value in the control group was 2242.94 ± 25.80 Hu (P < 0.05). In the decalcified vertebrae, the screw pull-out force of the MP group was 48.6% lower than that of the control group (P < 0.05). The pull-out force of the AP trajectory was 44.7% higher than that of the MP trajectory (P < 0.05) and reached 97.4% of the MP trajectory in the control group (P > 0.05).Conclusion: Automatic planning of the pedicle screw trajectory based on the CT value can obtain a higher screw pull-out force, which is a valuable new method of pedicle screw placement in osteoporotic vertebre. [ABSTRACT FROM AUTHOR]

Background: Although previous studies have suggested that navigation can improve the accuracy of pedicle screw placement, few studies have compared navigation-assisted transforaminal lumbar interbody fusion (TLIF) and navigation-assisted minimally invasive TLIF (MIS-TLIF). The entry point of pedicle screw insertion in navigation-assisted MIS-TLIF (NM-TLIF) may deviate from the planned entry point due to an uneven bone surface, which may result in misplacement. The purpose of this study was to explore the pedicle screw accuracy and clinical consequences of MIS-TLIF and TLIF, both under O-arm navigation, to determine which surgical method is better.Methods: A retrospective study of 54 patients who underwent single-segment NM-TLIF or navigation-assisted TLIF (N-TLIF) was conducted. In addition to the patients' demographic characteristics, intraoperative indicators and complications, the Oswestry Disability Index (ODI) and visual analog scale (VAS) score were recorded and analyzed preoperatively and at the 1-, 6-, and 12-month and final postoperative follow-ups. The clinical qualitative accuracy and absolute quantitative accuracy of pedicle screw placement were assessed by postoperative CT. Multifidus muscle injury was evaluated by T2-weighted MRI.Results: Compared with N-TLIF, NM-TLIF was more advantageous in terms of the incision length, intraoperative blood loss, drainage volume, time to ambulation, length of hospital stay, blood transfusion rate and analgesia rate (P < 0.05). The ODI and VAS scores for low back pain were better than those of N-TLIF at 1 month and 6 months post-surgery (P < 0.05). There was no significant difference in the clinical qualitative screw placement accuracy (97.3% vs. 96.2%, P > 0.05). The absolute quantitative accuracy results showed that the axial translational error, sagittal translational error, and sagittal angle error in the NM-TLIF group were significantly greater than those in the N-TLIF group (P < 0.05). The mean T2-weighted signal intensity of the multifidus muscle in the NM-TLIF group was significantly lower than that in the N-TLIF group (P < 0.05).Conclusions: Compared with N-TLIF, NM-TLIF has the advantages of being less invasive, yielding similar or better screw placement accuracy and achieving better symptom relief in the midterm postoperative recovery period. However, more attention should be given to real-time adjustment for pedicle insertion in NM-TLIF rather than just following the entry point and trajectory of the intraoperative plan. [ABSTRACT FROM AUTHOR]

A proper lattice structure consisting of homogeneous material is designed in this paper to investigate the maximum bandwidth of perfect lattice structures and tunable property of waveguide with linear geometric defect by means of selecting optimal geometric lattice cell. A simulation model based on finite element method is used to calculate dispersion curves and transmission spectrums of lattice structures with different geometric parameters. Meanwhile, a simplified theoretical model of unit cell, which considers the mass of grid bar and stiffness of node area, is applied to validate the accuracy of simulation result and may provide an effective approach for prediction of band gap lower boundary. Then, the validated numerical results show different orders of widest band gap that can be realized by different optimal geometric structures. Moreover, waveguide property can be effectively controlled and manipulated by changing defect parameters. The present study may establish theoretical and simulation foundation to control and manipulate band structures and other acoustic propagation characteristics of waveguide devices. [ABSTRACT FROM AUTHOR]

Background: Liver disease is associated with increased bleeding risk. The efficacy and safety of direct oral anticoagulants (DOACs) is a subject of contention in atrial fibrillation (AF) patients with liver disease. Methods: Electronic databases (PubMed, Embase, and Cochrane Library) were searched to retrieve studies on the efficacy and safety of DOACs versus warfarin in AF patients with liver disease from January 1980 to April 2020. A meta-analysis was conducted using a random-effects model. Results: Six studies involving 41,859 patients were included. Compared with warfarin, DOACs demonstrated significant reduction in ischemic stroke (HR, 0.68; 95% CI (0.54–0.86)), major bleeding (0.74 (0.59–0.92)), and intracranial hemorrhage (ICH) (0.48 (0.40–0.58)), with no significant effect on gastrointestinal bleeding (P = 0.893) in AF patients with liver disease. Similar results were observed in regular-dose, reduced-dose, and active liver disease subgroups, albeit Asian patients had a slight reduction in major bleeding (P = 0.055). Furthermore, the pooled estimates of individual DOAC subgroups indicated that dabigatran and apixaban led to greater safety in major bleeding (P < 0.001), ICH (P < 0.001), and gastrointestinal bleeding (P < 0.005) in these patients. The same trends were observed in AF patients with cirrhosis. Conclusions: Our findings suggest that DOACs significantly reduce the risk of ischemic stroke, major bleeding, and ICH, with no significant effect on the risk of gastrointestinal bleeding in AF patients with liver disease compared with warfarin. [ABSTRACT FROM AUTHOR]

The rough set theory and the evidence theory are two important methods used to deal with uncertainty. The relationships between the rough set theory and the evidence theory have been discussed. In covering rough set theory, several pairs of covering approximation operators are characterized by belief and plausibility functions. The purpose of this paper is to review and examine interpretations of belief functions in covering approximation operators. Firstly, properties of the belief structures induced by two pairs of covering approximation operators are presented. Then, for a belief structure with the properties, there exists a probability space with a covering such that the belief and plausibility functions defined by the given belief structure are, respectively, the belief and plausibility functions induced by one of the two pairs of covering approximation operators. Moreover, two necessary and sufficient conditions for a belief structure to be the belief structure induced by one of the two pairs of covering approximation operators are presented. [ABSTRACT FROM AUTHOR]

Background: Despite the wide use of intraoperative neurophysiological monitoring (IONM) in spinal surgeries, the efficacy of IONM during percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) surgery in detecting postoperative neurological deficits has not been well characterized.Methods: MIONM data from 113 consecutive patients who underwent PE-TLIF surgeries between June 2018 and April 2020 were retrospectively reviewed. Postoperative neurological deficits were documented and analyzed, and the efficacy and specificity of various IONM techniques were compared.Results: Of the 113 consecutive patients, 12 (10.6%) with IONM alerts were identified. The MIONM sensitivity and specificity were 100 and 96.2%, respectively. The frequency of neurological complications, including minor deficits, was 6.2% (n = 7); all of the neurological complications were temporary. The ability of single IONM modalities to detect neurological complications varied between 25.0 and 66.6%, whereas that of all modalities was 100%.Conclusions: MIONM is more effective and accurate than unimodal monitoring in assessing nerve root function during PE-TLIF surgeries, reducing both neurological complications and false-negative findings. We recommend MIONM in PE-TLIF surgeries. [ABSTRACT FROM AUTHOR]

The reductions of covering information systems in terms of covering approximation operators are one of the most important applications of covering rough set theory. Based on the connections between the theory of topology and the covering rough set theory, two kinds of topological reductions of covering information systems are discussed in this paper, which are characterized by the belief and plausibility functions from the evidence theory. The topological spaces by two pairs of covering approximation operators in covering information systems are pseudo-discrete, which deduce partitions. Then, using plausibility function values of the sets in the partitions, the definitions of significance and relative significance of coverings are presented. Hence, topological reduction algorithms based on the evidence theory are proposed in covering information systems, and an example is adopted to illustrate the validity of the algorithms. [ABSTRACT FROM AUTHOR]

Background: Cumulative evidence suggests that neuronal death including autophagy, apoptosis, and necrosis is closely related to the occurrence and development of cerebral ischemia–reperfusion (I/R) injury. Moreover, vagal nerve stimulation (VNS) is involved in many different neuroprotective and neuroplasticity pathways. Thus, VNS may be a novel approach for treating various neurodegenerative diseases. The present study aims to determine whether VNS protects against cerebral I/R injury in rats by inhibiting autophagy and apoptosis. Methods: Cerebral I/R injury is induced by middle cerebral artery occlusion (MCAO) and VNS is carried out. Infarct volume, neurological deficit, autophagy, and apoptosis are examined 24 h after reperfusion. Results: Vagal nerve stimulation decreases infarct volume and suppresses neurological deficit. Moreover, obvious autophagy and apoptosis are detected in rats that have undergone I/R, and VNS inhibits autophagy and apoptosis. Conclusion: Vagal nerve stimulation exerts neuroprotective effects following I/R injury by inhibiting autophagy and apoptosis. [ABSTRACT FROM AUTHOR]

Spinal fusion serves an important role in the reconstruction of spinal stability via restoration of the normal spinal sequence and relief of pain. Studies have demonstrated that the fusion rate is mainly associated with the osteogenic capacity of the implanted graft. Mesenchymal stem cells (MSCs) have been successfully isolated from human degenerated cartilage endplate (CEP) and designated as CEP-derived stem cells (CESCs). Previous studies have suggested that CESCs possesses in vitro and in vivo chondrogenic potential superior to that of bone marrow (BM)-MSCs. In addition, CESCs have shown a stronger in vitro osteogenic ability. The present study aimed to further determine the in vivo three-dimensional osteogenesis efficacy of CESCs for spinal fusion. Tissue-engineered bone grafts were transplanted into a rabbit model of posterolateral lumbar intertransverse process fusion using CESCs and BM-MSCs as seed cells composited with porous hydroxyapatite (PHA). The results of manual palpation and computed tomography (CT) scan reconstruction indicated that the CESCs/PHA group had a higher fusion rate than the BM-MSCs/PHA group, although the difference was not observed to be statistically significant. In addition, RT-qPCR results revealed that the in vitro CESCs/PHA composite expressed significantly higher levels of osteogenic-specific mRNA compared with the BM-MSCs/PHA composite. Finally, micro-CT and semi-quantitative histological analysis further demonstrated that the newly formed bone quality of the CESCs/PHA group was significantly higher than that of the BM-MSCs/PHA group in the intertransverse process fusion model. Therefore, the study indicated that CESCs possess superior in vivo osteogenesis capacity compared with BM-MSCs, and might serve as an important alternative seed cell source for bone tissue engineering. These results may provide the foundation for a biological solution to spinal fusion or other bone defect issues. [ABSTRACT FROM AUTHOR]

Background and Aim: The effect of real‐time analysis of needle‐based confocal laser endomicroscopy (nCLE) for gastric subepithelial lesions (SELs) on the diagnostic value is unclear. The study aimed to investigate the diagnostic efficacy of real‐time nCLE for gastric SELs and to assess the technical aspects and safety of real‐time nCLE. Methods: Consecutive patients with gastric SELs ≥ 1 cm were prospectively investigated by endoscopic ultrasound (EUS), followed by nCLE. During EUS‐nCLE, real‐time nCLE diagnosis was made by an expert endoscopist. The procedure‐relative adverse events were assessed and recorded. One‐month washout period later, nCLE videos were reviewed off‐line by the same endoscopist. The nCLE diagnoses were compared with corresponding pathological results. Additionally, image quality and interobserver agreements for the criteria were evaluated by three experienced endomicroscopists. Results: Except for one failing to be punctured, 60 patients completed EUS‐nCLE procedures successfully. Real‐time nCLE had high diagnostic accuracies of ≥ 88.3% for gastric SELs. There were no significant differences between real‐time and off‐line nCLE diagnoses for gastric SELs (P > 0.05). The overall accuracy of real‐time nCLE for diagnosis of gastric SELs was 86.7%. There were no procedure‐relative adverse events occurred. In addition, the mean image quality score was 3.6 (1 = poor and 5 = excellent). The interobserver agreement was "almost perfect" for ectopic pancreas and "substantial" for gastrointestinal stromal tumor, leiomyoma, and carcinoma. Conclusions: Endoscopic ultrasound‐nCLE could provide in vivo real‐time diagnostic imaging with a high diagnostic accuracy. Meanwhile, real‐time nCLE was feasible and had a satisfactory safety profile. [ABSTRACT FROM AUTHOR]

(*, IBS-D FSN vs. control FSN in BDNF+/- mice; #, IBS-D FSN in BDNF+/+ mice vs. in BDNF+/- mice; †control FSN in BDNF+/+ mice vs. in BDNF+/- mice). (B) TrkB/Fc significantly suppressed the effect of IBS-D FSN at 30, 45 and 60 mmHg (*, IBS-D FSN vs. control; #, IBS-D FSN vs. [Extracted from the article]

Baicalein is a natural flavonoid with anti-oxidant activities protecting against ischemia/reperfusion (I/R) injury. Previous studies suggest that oxidative burst early after reperfusion accelerates cell death. We therefore investigated the critical therapeutic window of baicalein by examining the timing of baicalein treatment in relation to its oxidant modulating and cytoprotective effects. Using an established chick cardiomyocyte model of I/R, we administered baicalein at various time points after reperfusion and assessed cell viability and the profiles of reactive oxygen species (ROS), nitric oxide (NO), and Akt phosphorylation. Baicalein administered at the onset of reperfusion resulted in a concentration-dependent reduction of cell death (25  μ M 4 8. 2 ± 1. 9 %, 50 μ M 4 3. 8 ± 1. 5 %, 100 μ M 3 6. 6 ± 2. 1 %, vs. I/R control 5 7. 3 ± 1. 4 %, all p < 0. 0 5). Baicalein (100 μ M) timely and effectively scavenged ROS burst and enhanced NO production in the early reperfusion phase. Cotreatment with NO synthase (NOS) inhibitor l-NAME (200 μ M) partially abrogated the cytoprotective effect. Baicalein (100 μ M) given after reperfusion lost protective effect in a time-dependent manner with cytoprotection completely lost if > 6 0 min. Even with only 15-min delay after reperfusion, the ROS scavenging effect was abolished and the NO enhancing effect markedly reduced. The phosphorylation of Akt, an upstream regulator of eNOS, also diminished as the delay lengthened. In conclusion, baicalein treatment after reperfusion confers cardioprotection in a concentration- and time-dependent manner. The critical therapeutic window lies in the early reperfusion phase, during which ROS scavenging and Akt-eNOS mediated NO signaling are most effective. [ABSTRACT FROM AUTHOR]

Granular computing is an emerging computing paradigm of information processing. Rough set theory is a kind of models of granular computing and is used to deal with the vagueness and granularity in information systems. Covering-based rough set theory is one of the most important extensions of the classical Pawlak rough set theory. In the covering-based rough set theory, the covering lower and upper approximation operators are two basic concepts. The axiomatic characterizations of covering-based approximation operators guarantee the existence of coverings reproducing the operators, so the rough set axiomatic system is the foundation of the covering-based rough set theory. In this paper, we present a new covering upper approximation operator and explore the basic properties of the covering upper approximation operator to find an axiomatic set for characterizing the covering upper approximation operator. We also discuss the relationships between the covering upper approximation operator and three other covering upper approximation operators, compare the covering upper approximation operator with the other covering upper approximation operators by defining precision degrees and rough degrees, and present the necessary and sufficient conditions for the covering upper approximation operators to be identical. The results not only are beneficial to enrich the kinds of the covering rough sets, but also have theoretical and actual significance to covering rough sets. [ABSTRACT FROM AUTHOR]

Background: The diagnostic yield of current techniques for gastric subepithelial tumors (SETs) is suboptimal. This prospective study aimed to develop diagnostic criteria for needle-based confocal laser endomicroscopy (nCLE) of gastric SETs, and to evaluate the diagnostic efficacy, feasibility, and safety of endoscopic ultrasound-guided nCLE (EUS-nCLE).Methods: Eligible patients were prospectively recruited to undergo EUS-nCLE. Four unblinded investigators evaluated nCLE videos and corresponding histopathology to develop the nCLE criteria. The recorded nCLE videos were reviewed off-line by one endoscopist 3 months later. Image quality (five-point scale, 1 = poor and 5 = very good) and the interobserver agreements were assessed.Results: All 33 patients underwent successful EUS-nCLE procedures. The nCLE criteria for gastric SETs were established. Overall accuracy of off-line nCLE was significantly higher than that of EUS alone (87.9 % vs. 63.6 %; P = 0.02). The mean image quality score was 3.9. The kappa values of the interobserver agreements were 0.66 for gastrointestinal stromal tumor, 0.89 for ectopic pancreas, 0.58 for leiomyoma, and 0.72 for carcinoma.Conclusions: EUS-nCLE was feasible and safe to accurately diagnose gastric SETs. [ABSTRACT FROM AUTHOR]

Stem cell therapies for intervertebral disc degeneration have been demonstrated as a promising strategy. Previous studies have shown that human nucleus pulposus cell- (NPC-) derived exosomes can induce the differentiation of mesenchymal stem cells (MSCs) into NP-like cells in vitro. However, the mechanism of MSC differentiation into NP-like cells with the induction of NPC exosomes is still unclear. Here, we verified the induction effects of NPC exosomes on the differentiation of MSCs into NP-like cells. In addition, the Notch1 pathway was downregulated in this process. Then, DAPT and soluble Jagged1 (SJAG) were applied to inhibit or enhance the expression of the Notch1 pathway, respectively, resulting in the upregulation or downregulation of collagen II, aggrecan, and Sox9 in MSCs. Knocking down of Notch1 protein facilitated the effects of NPC exosomes on the differentiation of MSCs into NP-like cells. NPC exosomes were more effective than an indirect coculture system in terms of the differentiation of MSCs into NP-like cells. Inhibition of NPC exosome secretion with Rab27a siRNA prevented the induction effects of an indirect coculture system on the differentiation of MSCs into NP-like cells. Transwell migration assays revealed that NPC exosomes could promote the migration of MSCs. Taken together, the Notch1 pathway was negatively associated with the differentiation of MSCs into NP-like cells with the treatments of NPC exosomes. Inhibition of the Notch1 pathway facilitates NPC exosome-induced differentiation of MSCs into NP-like cells in vitro. NPC exosomes play a key role in the differentiation of MSCs into NP-like cells in an indirect coculture system of NPCs and MSCs. [ABSTRACT FROM AUTHOR]

Objective To observe characteristics of resting-state functional magnetic resonance imaging (rs-fMRI) in patients with major depression and explore the possible pathogenesis. Methods A total of 24 major depression patients and 26 sex-, age- and education-matched healthy controls were scanned with rs-fMRI based on amplitude of low-frequency fluctuation (ALFF). The correlation between mALFF values of brain regions and Hamilton Depression Rating Scale-17 (HAMD-17) score was analyzed by Spearman rank correlation analysis. Results Compared with control group, mALFF values in bilateral dorsolateral prefrontal cortex (DLPFC), right orbital superior frontal gyrus, right inferior temporal gyrus, left operculum inferior frontal gyrus, left medial superior frontal gyrus and left gyrus rectus in major depression group were significantly increased (P < 0.05, for all; AlphaSim correction), while mALFF values in bilateral supplementary motor area (SMA), right posterior cingulate gyrus, right precuneus and left lingual gyrus were significantly reduced (P < 0.05, for all; AlphaSim correction). Spearman rank correlation analysis showed mALFF values of brain regions in major depression patients was not significantly correlated with HAMD-17 score (P > 0.05, for all). Conclusions Abnormal brain spontaneous activity within default mode network (DMN) and limbic system could emerge in major depression patients during resting-state, which may be neurobiological substrate of major depression. [ABSTRACT FROM AUTHOR]

Objective: Celiac disease is a chronic inflammatory enteropathy with a symptom spectrum similar to that of irritable bowel syndrome (IBS). It is a common but largely undiagnosed condition in the Western countries. However, it is extremely rare among Chinese individuals, and few studies have investigated its prevalence in China. The aim was to determine the prevalence of celiac disease in patients with IBS who were diagnosed using the Rome III criteria in a single center of northern China. Methods: This was a single‐center, prospective, controlled cohort study performed in Qilu Hospital involving 246 patients with IBS and 246 healthy controls. Blood samples were drawn to assess serum tissue transglutaminase immunoglobulin A (tTg‐IgA). Patients with a positive or equivocal tTg‐IgA (≥15 U/mL) were subjected to probe‐based confocal laser endomicroscopy (pCLE) and duodenal biopsy to confirm celiac disease. Results: Altogether 12 (4.9%) patients with IBS and two (0.8%) healthy controls were positive or equivocal for serum tTg‐IgA. Of these, five patients with IBS underwent pCLE and a targeted biopsy; all were histopathologically found to have celiac disease, although one was eventually diagnosed with lymphoma. After implementation of a gluten‐free diet, seven patients serologically positive for IBS showed clinical improvement, thus our study illustrated a minimum prevalence of 2.85% of celiac disease among patients with IBS in our center. Conclusions: Celiac disease is not rare in Chinese individuals, particularly among those with IBS. Therefore, it should receive higher attention in clinical practice in China. [ABSTRACT FROM AUTHOR]

Background and study aims Owing to the indistinctive endoscopic appearance of gastric intestinal metaplasia (GIM), gastric intraepithelial neoplasia (GIN), and early gastric cancer (EGC), a significant number of such lesions may be missed during surveillance endoscopy. The aim of this clinical trial was to assess the value of combined computed virtual chromoendoscopy (flexible spectral imaging color enhancement [FICE]) and probe-based confocal laser endomicroscopy (pCLE) for in vivo detection of GIM, GIN, and EGC. Patients and methods This was a multicenter, randomized controlled trial performed in 238 patients at four tertiary centers. Patients were randomized to FICE-guided pCLE with targeted biopsies (group A) or FICE with standard biopsies (group B). The diagnostic yield of GIM, GIN, or EGC was compared between the two groups. Results On a per-patient assessment, the diagnostic yield for GIM/GIN/EGC was 73.3 % (88/120) in group A and 63.6 % (75/118) in group B (P = 0.09). On a per-biopsy analysis, FICE-guided pCLE with targeted biopsies significantly increased the diagnostic yield of GIM/GIN/EGC vs. FICE with standard biopsies, from 31.5 % (252/800) to 75.1 % (313/417) (P < 0.001). In addition, pCLE-guided targeted biopsies led to a significant 48.5 % decrease in the number of biopsies per patient vs. FICE with standard biopsies (P < 0.001). Conclusions Real-time pCLE and targeted biopsies after FICE improved the diagnostic yield for the detection of GIM, GIN, and EGC, and only required about half the number of biopsies vs. FICE with standard biopsies. This may allow a better regimen for endoscopic surveillance and subsequent treatment of patients with premalignant and malignant gastric abnormalities.Trial registered at ClinicalTrials.gov (NCT02515721). [ABSTRACT FROM AUTHOR]

Chaotic vibrations, stability and synchronization are important topics in nonlinear dynamics, and thus are studied in this paper for a new chaotic system with quadratic and cubic nonlinearly. The modified Duffing-Rayleigh system with piecewise quadratic function is presented firstly. Then, by taking the Melnikov function method, necessary conditions for chaotic motion of the modified Duffing-Rayleigh system are given. Fractional modified Duffing-Rayleigh oscillator is also discussed, and results of computer simulation demonstrate the chaotic dynamic behaviors of the fractional-order modified Duffing-Rayleigh system with order less than 2. Furthermore, generalized projective synchronization of two fractional modified Duffing-Rayleigh oscillators is explored by the active control technology. Adaptive synchronization and parameter identification of a fractional modified Duffing-Rayleigh oscillator with unknown parameters are also investigated. Numerical results validate the effectiveness and applicability of the proposed synchronization schemes. [ABSTRACT FROM AUTHOR]

Introduction: Several types of stem cells have been successfully demonstrated to exist in the human degenerated intervertebral disc (IVD), which is composed of annulus fibrosus (AF), nucleus pulposus (NP) and cartilage endplate (CEP). However, the differences in the biological characteristics among these and bone marrow derived mesenchymal stem cells (BM-MSCs) remain unclear.Materials and Methods: To investigate this issue, cells were harvested from human AF, NP, CEP, and bone marrow, respectively; passage 2 cells were selected using the agarose suspension culture system to obtain stem cell clones. Following expansion in vitro, stem cells from different anatomical regions were compared regarding the morphology, proliferation ability, immunophenotypic expression, and multi-lineage differentiation capacity. In addition, stem cell-alginate bead compositions were constructed for the comparison of DNA and sGAG content.Results: There were subtle differences regarding cell morphology, but no significant differences in proliferation ability among the four types of stem cells. For the immunophenotypic analysis, all stem cells basically fulfilled the criteria for mesenchymal stem cells (MSCs), which have been published by the International Society for Cellular Therapy (ISCT), with a significant difference in CD105 expression. A comparison of the osteogenic capacities indicated: cartilage endplate-derived stem cells (CESCs) > annulus fibrosus-derived stem cells (AFSCs) > BM-MSCs > nucleus pulposus-derived stem cells (NPSCs). The chondrogenesis difference was similar to osteogenesis. For adipogenesis: BM-MSCs >NPSCs >CESCs >AFSCs. In the stem cell/alginate composition, the CESCs consistently showed the superior chondrogenic potential among all those cell types.Conclusions: Our data indicated that all the four types of stem cells shared some similar biological properties (regarding shape, proliferation ability and immunophenotypic expression). CESCs, which had the strongest osteogenic and chondrogenic potentials, may serve as excellent seed cells for NP/cartilage or bone tissue engineering. [ABSTRACT FROM AUTHOR]

The macerals, including fusinitic coal containing 72.20% inertinite and xyloid coal containing 91.43% huminite, were separated from Shengli lignite using an optical microscope, and their combustion reactivity was examined by thermogravimetric analysis. Several combustion parameters, including ignition and burnout indices, were analyzed, and the combustion kinetics of the samples were calculated by regression. Fusinitic coal presented a porous structure, while xyloid coal presented a compact structure. The specific surface area of fusinitic coal was 2.5 times larger than that of xyloid coal, and the light-off temperature of the former was higher than that of the latter. However, the overall combustion reactivity of fusinitic coal was better than that of xyloid coal. The combustion processes of fusinitic and xyloid coals can be accurately described by both the homogeneous model and the shrinking core model. The features of xyloid coal agree with the shrinking core model when its conversion rate is 10%–90%. The activation energy of fusinitic coal during combustion can be divided into three phases, with the middle phase featuring the highest energy. The activation energy of xyloid coal is lower than that of fusinitic coal in the light-off phase, which may explain the low light-off temperature of this coal. [ABSTRACT FROM AUTHOR]

The over-expressed colonic brain-derived neurotrophic factor (BDNF) has been reported to be associated with abdominal pain in patients with irritable bowel syndrome (IBS). However, the neuropathological mechanism is unclear. We here investigated the involvement of enteroglial cells (EGCs) and enteric nerves in IBS-like visceral hypersensitivity. We showed that glial fibrillary acidic protein (GFAP), tyrosine receptor kinase B (TrkB) and substance P (SP) were significantly increased in the colonic mucosa of IBS patients. The upregulation of those proteins was also observed in the colon of mice with visceral hypersensitivity, but not in the colon of BDNF+/− mice. Functionally, TrkB or EGC inhibitors, or BDNF knockdown significantly suppressed visceral hypersensitivity in mice. Using the EGC cell line, we found that recombinant human BDNF (r-HuBDNF) could directly activate EGCs via the TrkB-phospholipase Cγ1 pathway, thereby inducing a significant upregulation of SP. Moreover, supernatants from r-HuBDNF-activated EGC culture medium, rather than r-HuBDNF alone, triggered markedly augmented discharges in isolated intestinal mesenteric afferent nerves. r-HuBDNF alone could cause mesenteric afferent mechanical hypersensitivity independently and this effect was synergistically enhanced by activated EGCs. We conclude that EGC-enteric nerve unit may be involved in IBS-like visceral hypersensitivity and this process is likely initiated by BDNF-TrkB pathway activation. [ABSTRACT FROM AUTHOR]

In this study, articles in English and Chinese were selected from available electronic databases prior to September 2014. The metabolic concentrations and patterns of N-acetylaspartic acid (NAA), Choline (Cho), Creatine (Cr), NAA/Cr, NAA/Cho, and Cho/Cr ratios in radiotherapy-induced radiation encephalopathy by proton magnetic resonance spectroscopy were extracted. A meta-analysis was performed to quantitatively synthesize findings of these studies. Weighted mean difference (WMD) and 95% confidence intervals (95%CIs) were calculated using random or fixed effective models. Heterogeneity between studies was assessed using the Cochrane Q test and I2 statistics. The results indicated that a total of 4 researches involving 214 patients met inclusion criteria. Depending on methodologies of selected studies, control groups were referred to as healthy subjects. The combined analysis revealed that there was no significant difference in value of Cr between radiotherapy group and healthy control group (WMD = −1.483, 95% CI: −67.185–64.219, p=0.965). However, there were significant difference in values of NAA (WMD = −18.227, 95%CI: −36.317–−0.137, p=0.048), Cho (WMD = 38.003, 95%CI: 5.155–70.851, p=0.023), NAA/Cr (WMD = −1.175, 95%CI: −1.563–−0.787, p=0.000), NAA/Cho (WMD = −1.108, 95%CI: −2.003–0.213, p=0.015), and Cho/Cr (WMD = −0.773, 95%CI: 0.239–1.307, p=0.005). In conclusion, MRS can be regarded as an effective and feasible imaging test for radiotherapy-induced radiation encephalopathy in NPC patients. [ABSTRACT FROM AUTHOR]

Stroke causes devastating and irreversible losses of neurological function with subsequent slow and incomplete recovery of lost brain functions, because of the brain's limited capacity for brain plasticity. Growth arrest and DNA-damage-inducible protein 45 beta (Gadd45b) has recently been demonstrated as a candidate plasticity-related gene, making it an excellent candidate molecule that has therapeutic potential. Here, we examine whether in vivo blockage of Gadd45b affects axonal plasticity and subsequent functional recovery after focal brain infarction. Adult male Sprague-Dawley rats were subjected to cerebral ischemia by middle cerebral artery occlusion (MCAO). We adopted RNA interference (RNAi) mediated by a lentiviral vector (LV) as a means of suppressing the expression of Gadd45b. Functional recovery was assessed with a battery of tests that measured skilled forelimb reaching and forelimb balance controlling. Axonal reorganization at the level of the red nucleus was revealed by anatomical studies. Axonal regeneration was measured by elevated expression of growth-associated protein 43 (GAP-43). The levels of brain-derived neurotrophic factor (BDNF), cyclic AMP (cAMP), protein kinase A (PKA), and Rho-kinase (ROCK) were determined. Gadd45b-RNAi significantly inhibited axonal plasticity (axonal regeneration and axonal reorganization) after MCAO. This inhibition was paralleled by worse functional recovery performance on several behavioral measures. Gadd45b-RNAi also significantly decreased the expression levels of both BDNF and cAMP/PKA/phosphorylated cAMP response element-binding protein (pCREB) pathway and promoted ROCK expression. We conclude that Gadd45b stimulates recovery after stroke by enhancing axonal plasticity required for brain repair. Pharmacological targeting of Gadd45b provides new opportunities for stroke treatment. [ABSTRACT FROM AUTHOR]

China has entered a new phase in blood safety and availability through persistent efforts in the past decades. Based on national data from 2008 to 2012, we present a comprehensive review on the blood services ranging from policy and organization, supply, donors, screening and processing, and clinical use to government response in contemporary China. Current evidence suggests that the Chinese blood industries, after continual efforts in reforms on the legal framework and national management system, have been in a relatively steady but bottleneck stage. Although the blood industries have had an impressive track record on management and resolving problems, such as low availability, limited donors, deficient laboratory tests, shortage of blood products, and unnecessary clinical usage of blood still exist nationwide. While medical technology and services have seen a rapid increase in progress in recent years, they have not coordinated with the development of the national health care system. This article presents an analysis with detailed data, rich contents, and recent response from the Chinese government, allowing readers to appreciate how China, a country with more than 19.13% of the world's population, has long endeavored to improve safety and availability of blood. Meantime, the article sincerely welcomes the guidance on policymaking and technical assistance from the international community. Data in this article do not include those of Hong Kong, Macao, or Taiwan. [ABSTRACT FROM AUTHOR]

Objectives Confocal laser endomicroscopy ( CLE) consists of endoscope-based CLE ( eCLE) and probe-based CLE ( pCLE). This study aimed to compare e CLE and pCLE in their diagnostic yield in different parts of the gastrointestinal ( GI) tract. Methods Consecutive patients were scheduled for CLE examination due to GI symptoms. All patients were randomly assigned to eCLE or pCLE group and underwent a programmed procedure using one type of CLE. Differences in procedure time, complication rate, CLE image quality and image acquisition feasibility between these two types of CLE for esophagogastroduodenoscopy (EGD) and colonoscopy were calculated. Results Altogether 513 CLE procedures were performed, including 324 EGD and 189 colonoscopy. The procedure time of pCLE was significantly shorter than that of eCLE both in EGD and colonoscopy (16.78 min vs 18.13 min for EGD, P = 0.027; 32.48 min vs 39.89 min for colonoscopy, P < 0.001). No significant difference was found between these two types of CLE in diagnostic utility, including the detection and prediction of histopathological results of the lesions. The CLE image quality of both e CLE and p CLE were comparable in the stomach and colon, but eCLE seemed to be superior to pCLE in examining the esophagus. Colonoscopy using pCLE had a higher complete rate than that of eCLE, although the difference was not statistically significant ( P = 0.065). Conclusions pCLE is more flexible in diagnosing GI diseases with a shorter procedure time than eCLE regardless of comparable diagnostic yields, except the diagnosis of esophageal diseases in which eCLE provides better image quality. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this article is to evaluate the efficacy and the safety of the percutaneous vertebroplasty (PVP) versus percutaneous kyphoplasty (PKP) in dealing with the osteoporotic vertebral compression fracture (OVCF). Methods: In July 2014, a comprehensive systematic computer-based online search was performed by using the databases of PubMed, EMBASE, Cochrane Library, Web of Science, Wan Fang, and the China Biological Medicine. Only prospective comparative trials (PCT) and randomized controlled trials (RCT) that compared PVP with PKP were included. Trials were screened based on the inclusion and exclusion criteria previously formed. The Cochrane collaboration guidelines were also used to assess the quality of these included studies. The primary data of these studies [volume of the cement, postoperative vertebral height, visual analog scale (VAS) score and Oswestry Disability Index (ODI) score after the surgery, and so on] were carefully abstracted and processed by Revman 5.2.0 software The publication bias of the main results (cement leakage and adjacent-level fracture) were examined by Stata 12.0 (Begg and Egger test). Furthermore, the stability of the main results were also detected by sensitivity and cumulative analyses. Results: Six RCT and 14 PCT studies involving 1,429 patients met our criteria and were included finally. Comparing these two methods, the PKP group took more operation time [SMD = 0.66, 95 % CI (0.28, 1.03), p = 0.0006] with higher anterior vertebral body height [SMD = 1.40, 95 % CI (0.49, 2.32), p = 0.003], greatly reduced Cobb angle in the long run [SMD = −0.61, 95 % CI (−1.04, −0.19), p = 0.005] and had lower risk of cement leakage. However, in VAS scores and ODI scores after the surgery whether for the short-term efficacy (no more than 1 week after the surgery) or long-term efficacy (more than six months), Cobb angle in the short run and new fracture in the adjacent level, no statistically differences were found between the two groups. Conclusions: Based on current evidence, PVP takes less time in the operation, while it has greater risk of cement leakage, was inferior in reducing Cobb angle in the long term and results in lower anterior vertebral body height after the surgery. For pain relief, which is the main desire of the patients, both procedures provide significant improvement in VAS and ODI pain scores. PVP is still an effective procedure. [ABSTRACT FROM AUTHOR]

Using the daily data for 38 companies during the period of 2009–2013, this article examines the long-run equilibrium between the stock prices of firms dual listed on A-share market in China and H-share market in Hong Kong, and exploits the arbitrage opportunity for investors. We propose a simple self-financing trading strategy which is derived from the short-run disequilibrium price path. Our results demonstrate that cointegration and error-correction mechanism exist between the A-share and the H-share. In addition, our proposed trading strategy actually beats the markets and provides superior performance in terms of Sharp Ratio and value at risk statistics. Further analysis on international asset pricing model demonstrates that our trading strategy yields an average annualized excess return of about 17.6% when adjusted for the systematic risk. [ABSTRACT FROM AUTHOR]

Background: Confocal laser endomicroscopy (CLE) can provide in vivo subcellular resolution images of esophageal lesions. However, the learning curve in interpreting CLE images of precancerous or early-stage esophageal squamous cancer is unknown. The goal of this study is to evaluate the diagnostic accuracy and inter-observer agreement for differentiating esophageal lesions in CLE images among experienced and inexperienced observers and to assess the learning curve. Method: After a short training, 8 experienced and 14 inexperienced endoscopists evaluated in sequence 4 sets of high-quality CLE images. Their diagnoses were corrected and discussed after each set. For each image, the diagnostic results, confidence in diagnosis, quality and time to evaluate were recorded. Results: Overall, diagnostic accuracy was greater for the second, third, fourth set of images as compared with the initial set (odds ratio [OR] 2.01, 95% CI 1.22–3.31; 7.95, 3.74–16.87; and 6.45, 3.14–13.27), respectively, with no difference between the third and fourth sets in accuracy (p = 0.67). Previous experience affected the diagnostic accuracy only in the first set of images (OR 3.70, 1.87–7.29, p<0.001). Inter-observer agreement was higher for experienced than inexperienced endoscopists (0.732 vs. 0.666, p<0.01) Conclusion: CLE is a promising technology that can be quickly learned after a short training period; previous experience is associated with diagnostic accuracy only at the initial stage of learning. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to compare the safety and efficacy of minimally invasive discectomy (MID) with standard discectomy (SD) and determine whether the use of the MID technique could decrease the recurrence of lumbar disc herniation (LDH) after the surgery. Methods: In February 2014, a comprehensive search was performed in PubMed, EMBASE, Web of Science, Cochrane Library and the Chinese Biological Medicine Database. Only randomised controlled trials (RCT) that compared MID with SD for the surgical management of LDH were included. These trials were carefully picked out following the inclusion and exclusion criteria. Using the Cochrane Collaboration guidelines, two authors independently extracted data and assessed these trials' quality. The age of the patients, size of incision, surgical time, blood loss, visual analogue scale (VAS) score after the surgery, hospital stay, disc herniation recurrence, X-ray exposure and surgical costs in these studies were abstracted and synthesised by a meta-analysis with RevMan 5.2.0 software, and the main results (VAS score after the surgery and disc herniation recurrence) of publication bias were examined by Stata 12.0. Results: Overall, 16 trials involving 2,139 patients meeting our criteria were included and analysed. Comparing MID and SD, the former was more likely to increase disc herniation recurrence [relative risk (RR) = 1.95, 95 % confidence interval (CI) 1.19-3.19, p = 0.008], and it involved a smaller size of incision [mean difference (MD) = −1.91, 95 % CI −3.33 to −0.50, p = 0.008], shorter hospital stay, longer operating time (MD = 11.03, 95 %C I 6.62-15.44, p < 0.00001) and less blood loss (MD = −13.56, 95 % CI −22.26 to −4.87, p = 0.002), while no statistical difference appeared with regard to the age of the patients, VAS score after the surgery, X-ray exposure, hospital stay and surgical costs. Conclusions: Based on available evidence, MID results in less suffering for patients during the hospital course with a similar clinical efficacy compared to SD. This makes MID a promising procedure for patients with LDH; however, to popularise it greater effort is required to reduce disc herniation recurrence. [ABSTRACT FROM AUTHOR]

This article examines the relevance of cash dividend from the theoretical and empirical perspective by taking market liquidity into account. We construct an economic model that demonstrates that the effect of cash dividend on firm valuation depends on the status of market liquidity. The hypotheses derived from our model are strongly supported by data from A- and B-share markets in China. Our results from the dynamic panel regression demonstrate that the price premium of B-share relative to A-share is positively correlated to the level of cash dividend, and this relationship becomes even stronger when the relative liquidity of B-share is in a low status. In addition, this price premium is positively affected by the relative liquidity and firm profitability. The results are robust under alternate liquidity and dividend measures. The subsequent analysis based on the event study approach further reveals a more positive (negative) response to the announcement of cash dividend initiation (omission) in the B-share market. In particular, this positive response on the initiation is negatively correlated with the relative liquidity. [ABSTRACT FROM AUTHOR]

Background and Aims Three different confocal laser endomicroscopy ( CLE) diagnostic systems including Maiz, Sanduleanu, and Qilu had been developed to differentiate between benign and neoplastic colorectal lesions. This study was designed to compare and evaluate these three diagnostic systems by different levels of expertise. Methods Thirty-nine patients with 50 colorectal polyps, including 23 hyperplastic polyps and 27 adenomas diagnosed by histopathology, were recruited. Four confocal images (two superficial images and two deeper images) and one conventional white-light endoscopic image were selected from each of the 50 lesions in this study by an experienced endomicroscopist. Selected images were evaluated by three experienced CLE investigators and three non-experienced ones. The accuracy and interobserver agreement between experienced and non-experienced investigators for prediction of colorectal neoplasia were determined. Results The diagnostic accuracy was 84%, 81%, and 87%, respectively, using the Maiz, Sanduleanu, and Qilu diagnostic system, while the sensitivity was 85%, 79%, and 85%, the specificity was 83%, 84%, and 89%, respectively. There is no significant difference on diagnostic accuracy between experienced and non-experienced investigators. In addition, there is a short learning curve for non-experienced CLE investigators identified in this study. Conclusions The three diagnostic systems for the prediction of colorectal hyperplastic polyp or adenoma have a high accuracy, sensitivity, and specificity. The diagnostic accuracy was not significantly influenced by the expertise in CLE. [ABSTRACT FROM AUTHOR]