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Objective: To establish a standardized framework encompassing the precise locations, manipulations, functions and indications of specific acupoints in the field of paediatric Tuina., Methods: The development of consensus involved three distinct stages. Initially, a list of paediatric Tuina specific acupoints was compiled based on an extensive literature review, which was subsequently supplemented through expert interviews. In the second stage, the Delphi method was employed to assess the significance of acupoint locations, manipulations, functions, and indications. In situations where the questionnaire survey failed to yield agreement or when the experts held reservations, the nominal group approach was utilized during the expert consensus meeting. The final version of the technical standardized material was ultimately determined during an expert consensus conference. After undergoing external peer review and evaluation, the completed draft was prepared for public dissemination RESULTS: The comprehensive list identified a total of 66 specific acupoints. The location and manipulation questionnaire consisted of 156 items based on the literature database, while the function and indication questionnaire contained 116 items. Two rounds of Delphi surveys were conducted for the location and manipulation category, and another two rounds of Delphi surveys were conducted for the function and indication category. During the experts consensus meeting The panel of experts conducted in-depth discussions on 61 questions, resulting in the formulation of technical guidelines for the locations, manipulations, functions, and indications of 64 paediatric Tuina acupoints. Subsequently, the research team compiled and edited the draft of the technical guidelines for acupoints of paediatric Tuina, which was finalized after external review and feedback., Conclusion: This study successfully established the recognized technical standards for practitioners of paediatric Tuina, thereby standardizing clinical practices and providing a foundation setting the framework for future research. The guidelines offer theoretical insights and recommendations for conducting clinical studies comparing different acupoint sites, as well as modifying or enhancing treatment regimens.

Objective: To analyze the characteristics of deliberate drug ingestion in adolescents and its related influencing factors., Method: This was a retrospective study. A total of 158 cases of deliberate drug ingestion as observation group and 160 cases of other diseases in adolescents as control group were treated in the Emergency Department of Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from January 2020 to December 2022. The clinical characteristics of adolescents who engaged in deliberate drug ingestion were analyzed, and various factors that could potentially influence deliberate drug ingestion in adolescents were subjected to both univariate and multivariate analysis., Result: There was a progressive increase in the number of patients presenting with mental health issues year by year. Univariate analysis showed that family type, guardian's education level, place of residence, whether they were only children, parents' knowledge of medication, awareness of medication safety, depression/anxiety, negative life events, and social support were risk factors for deliberate drug ingestion in adolescents (all p<0.05). Logistic regression analysis showed that family type, parents' knowledge of medication, awareness of medication safety, whether they were depressed/anxious, negative life events, and social support were independent risk factors for deliberate drug ingestion in adolescents (p<0.05)., Conclusion: The incidence of deliberate drug ingestion in adolescents is increasing year by year, and their behavior is influenced by multiple factors. Interventions should be targeted at controllable influencing factors to prevent or reduce deliberate drug ingestion in adolescents., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

There is a rapid growth in the volume of data in the cancer field and fine-grained classification is in high demand especially for interdisciplinary and collaborative research. There is thus a need to establish a multi-label classifier with higher resolution to reduce the burden of screening articles for clinical relevance. This research trains a multi-label classifier with scalability for classifying literature on cancer research directly at the publication level. Firstly, a corpus was divided into a training set and a testing set at a ratio of 7:3. Secondly, we compared the performance of classifiers developed by "PubMedBERT + TextRNN" and "BioBERT + TextRNN" with ICRP CT. Finally, the classifier was obtained based on the optimal combination "PubMedBERT + TextRNN", with P= 0.952014, R=0.936696, F1=0.931664. The quantitative comparisons demonstrate that the resulting classifier is fit for high-resolution classification of cancer literature at the publication level to support accurate retrieving and academic statistics.

Purpose: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is defined as a congenital visceral myopathy with genetic mutations. However, the etiology and pathophysiology are not fully understood. We aimed to generate a gene leiomodin-1a (lmod1a) modification technique to establish a zebrafish model of MMIHS., Methods: We targeted lmod1a in zebrafish using CRISPR/Cas9. After confirming the genotype, we measured the expression levels of the target gene and protein associated with MMIHS. A gut transit assay and spatiotemporal mapping were conducted to analyze the intestinal function., Results: Genetic confirmation showed a 5-base-pair deletion in exon 1 of lmod1a, which caused a premature stop codon. We observed significant mRNA downregulation of lmod1a, myh11, myod1, and acta2 and the protein expression of Lmod1 and Acta2 in the mutant group. A functional analysis of the lmod1a mutant zebrafish showed that its intestinal peristalsis was fewer, slower, and shorter in comparison to the wild type., Conclusion: This study showed that targeted deletion of lmod1a in zebrafish resulted in depletion of MMIHS-related genes and proteins, resulting in intestinal hypoperistalsis. This model may have the potential to be utilized in future therapeutic approaches, such as drug discovery screening and gene repair therapy for MMIHS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To investigate the prognostic factors and outcomes in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) in Southern China., Methods: A retrospective analysis of medical records of patients with ANCA-GN admitted to Shenzhen Hospital of Southern Medical University and Nanfang Hospital of Southern Medical University between September 2011 and September 2021 was performed. The clinical presentation, biological, and renal pathology were collected. In addition, the risk factors for end-stage renal disease (ESRD) and short-term overall survival in patients with ANCA-GN were analyzed., Results: A total of 93 patients with ANCA-GN were included in the study. Of them, 91.4%, were perinuclear anti-neutrophil cytoplasmic antibodies (MPO-pANCA)-positive. Approximately one-quarter (24.7%) of patients had progressed to ESRD, and 7.5% died within six months. Most patients presented with hematuria (94.6%), proteinuria (78.5%), elevated serum creatinine (86.0%), anemia (90.3%), and increased erythrocyte sedimentation rate (ESR) (44.1%). The majority (94.6%) of patients presented with crescent formations at histopathological examination. Serum creatinine, hemoglobin, and Birmingham vasculitis activity score (BVAS) were all independent factors for ESRD (P<0.05). Moreover, while ANCA renal risk score (ARRS) has an impact on prognosis of nephropathy, it did not influence ESRD independently (P>0.05). The effect of Berden's histopathologic classification on ESRD has not been confirmed. Age at onset, ESR and cardiovascular involvement were all independent factors affecting short-term overall survival of patients with ANCA-GN (P<0.05)., Conclusions: Serum creatinine, hemoglobin, and BVAS were all independent risk factors of ESRD, while ARRS and Berden's histopathologic classification were not. Age at onset, ESR, and cardiovascular involvement were independent risk factors for the overall six-month survival rate in patients with ANCA-GN., (Copyright: © Pakistan Journal of Medical Sciences.)

Sarcopenia can lead to more postoperative complications and poorer prognosis in patients with colorectal cancer; however there is limited research exploring the incidence and influencing factors of different stages of sarcopenia in patients with colorectal cancer. We investigated 312 patients with colorectal cancer. Sarcopenia was determined by measuring muscle mass, grip strength, and gait speed. According to the European Working Group on Sarcopenia in Older People (EWGSOP) 2010, patients were classified into four groups: nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. The incidence of sarcopenia and severe sarcopenia was 10.3% and 8.7%, respectively. Multivariate logistic regression analysis showed that age, TNM stage smoking history, total protein, upper arm circumference, waist circumference, and Patient-Generated Subjective Global Assessment (PG-SGA) score were independently associated with sarcopenia at different stages. This study suggests that routine data should be used to provide targeted care during hospitalization for patients with colorectal cancer in order to reduce the incidence of sarcopenia and improve prognosis., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Society of Gastroenterology Nurses and Associates.)

Objective: To investigate the correlation of serum osteopontin levels with disease severity and prognosis in patients with acute cerebral infarction., Methods: This retrospective analysis included forty patients with acute cerebral infarction (ACI) admitted to the Department of Neurology of Baoding Children's Hospital from May, 2019 to May, 2022 within 24 hours of onset were selected as the observation group, while 40 healthy subjects in our hospital during the same period were selected as the control group. The correlation between serum Osteopontin (OPN) levels and risk factors on one day, seven days and 14 days was analyzed. Patients in the observation group were subdivided into the good prognosis group and the poor prognosis group according to mRS score, and the serum OPN levels of the two groups were compared. The correlation between serum OPN and disease severity and prognosis of patients with ACI was analyzed., Results: The serum OPN levels in the observation group were significantly higher than those in control group (P< 0.05), and its level was positively correlated with NIHSS score and infarct size. The proportion of patients with hyperlipidemia, smoking, drinking, hypertension and OPN level on seven day in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The OPN level > 8.720 ng/ml on seven days was an independent risk factor for poor prognosis of cerebral infarction., Conclusion: OPN is involved in the entire pathophysiological process of ACI, and its level can predict the severity of the disease in patients with ACI, and can be used as an important indicator for evaluating their clinical prognosis., Competing Interests: Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Adenosine triphosphate (ATP) is a small molecule that is released to the urine from bladder urothelial cells and the bladder mucosal band of the human body. In certain cases, ATP can serve as a biomarker in bladder disease. For the practical applicability of luminescent sensors for ATP in urine, it is significant to find a new strategy for making the detection progress simple and available for in-field urine analysis. Here, a novel luminescent lanthanide coordination polymer (Tb-BPA) was designed and synthesized for quick and sensitive detection of ATP through luminescence quenching with a quenching constant of 4.90 × 10 3 M -1 and a detection limit of 0.55 × 10 -6 M. Besides, Tb-BPA has excellent anti-interference ability and can detect ATP in simulated urine with a small relative standard deviation (<4%). Moreover, the luminescent polyacrylonitrile nanofiber films modified by Tb-BPA were prepared by electrospinning and were used for ATP visual detection. Notably, this film is easy to recover and reuse, and maintains good detection performance after at least 7 cycles.

To assess the effect of telemedicine on stoma-related complications in adults with enterostomy, we conducted a meta-analysis to evaluate the effects of the telemedicine group compared to the usual group. Literature searches were performed in PubMed, Embase, Web of Science, The Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang and VIP databases from their inception up to October 2023. Two authors independently screened and extracted data from the included and excluded literature according to predetermined criteria. Data collected were subjected to meta-analysis using Review Manager 5.3 software. The final analysis included a total of 22 articles, encompassing 2237 patients (telemedicine group: 1125 patients, usual group: 1112 patients). The meta-analysis results demonstrated that, compared to the usual group, the telemedicine group significantly reduced the overall occurrence of stoma-related complications, with an odds ratio (OR) of 0.22 (95% CI = 0.15-0.32, p < 0.00001). Furthermore, it resulted in a decrease in stoma complications (OR = 0.27, 95% CI = 0.15-0.47, p < 0.00001) and peristomal complications (OR = 0.25, 95% CI = 0.19-0.34, p < 0.00001). Therefore, the existing evidence suggests that the application of telemedicine can reduce the incidence of stoma and peristomal complications, making it a valuable clinical recommendation., (© 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Drug resistance is one of the main challenges in cancer treatment. Long non coding RNAs (lncRNAs) play a complex and precise regulatory role in regulating drug resistance of cancer. The common ways of lncRNA regulating drug resistance of cancer involve ATP binding transporter overexpression, abnormal DNA damage response, tumor cell apoptosis, accumulation of epithelial mesenchymal transformation and cancer stem cell formation. Moreover, studies on exosomal lncRNAs regulating cancer drug resistance are developed in recent years. Further study on the role and mechanism of lncRNAs drug resistance in cancer will help clinical cancer treatment program and explore new treatment methods. This paper reviews recent advances in lncRNAs regulating drug resistance of cancer, especially the role of exosomal lncRNAs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

In order to study the torsional performance of steel tube concrete after reinforcement with a carbon-fiber-reinforced polymer (CFRP), the mechanical properties of 18 specimens were studied from both experimental and finite element perspectives. The T - θ curve and τ - γ curve of the specimen were measured in the experiment, and the failure mode of the specimen was analyzed. Subsequently, a reasonable finite element model was established using ABAQUS software, and the variation in various parameters surrounding the performance of the specimen was analyzed. Based on the experimental and finite element results, a formula for calculating the bearing capacity of the specimen was established. According to both the experimental and numerical results, the torsional bearing capacity of C-CF-CFRP-ST, defined as the torque endured by the specimen with maximum shear strain, was determined to be 15,000 με, together with its corresponding calculation formula. After the test, it was demonstrated that the main components of the concrete-filled CFRP-steel tube composite material-the steel tube and the concrete-could be used as reusable resources.

Objective: To explore the mechanism by which Qinghua decoction regulates neuroendocrine inflammation in chronic nonbacterial prostatitis (CNP) model rats and provide an experimental basis for clinical treatment., Methods: The rats were randomly divided into six groups: normal control, model, Qianlie Tongyu capsule, low-dose Qinghua decoction, medium-dose Qinghua decoction, and high-dose Qinghua decoction group with six rats in each group. Rats in each group were sacrificed on the 29th day of treatment, and blood and prostate tissues were collected. Serum levels of tumor necrosis factor-alpha and interleukins 1-beta, 6, 8, and 10 (TNF-α and IL-1β, -6, -8, and -10, respectively) were measured using enzyme-linked immunosorbent assay. The pathological changes in the rat prostate tissue in each group were observed under a light microscope. The expression levels of chromogranin A (CgA), nerve growth factor (NGF), and tyrosine kinase A (TrkA) were detected using reverse transcription quantitative polymerase chain reaction. Western blotting was used to detect protein expression of CgA, NGF, and TrkA., Results: In the model group, the prostate capsule membrane and stroma were significantly dilated with more inflammatory cells infiltrating the stroma and perivessels. TNF-α, IL-1β, -6, and -8, CgA, NGF, and TrkA levels increased, whereas the content of IL-10 decreased, which was statistically significant compared to that in the normal control group ( < 0.05). Prostate tissue cells in the high-dose group were neatly arranged with no obvious inflammatory cell infiltration. When compared with the model group, the high-dose Qinghua decoction group showed a significant improvement in these indices ( < 0.05)., Conclusion: Qinghua decoction led to inhibition of pathological changes in the prostate tissue of rats with CNP, regulation of inflammatory cytokine expression, and inhibition in the expression of CgA, NGF, and TrkA. This mechanism may be primarily related to regulation of the CgA/NGF/TrkA signaling pathway mediated by various inflammatory factors.

Objective: This study aims to explore the difference between 11 C-methyl-N-2β-carbomethoxy-3β-(4-fluorophenyl)-tropanel ( 11 C-CFT) positron emission tomography (PET) imaging in the early-onset Parkinson's disease (EOPD) and late-onset Parkinson's disease (LOPD), and to analyze the correlation between 11 C-CFT PET imaging and disease duration, Hoehn & Yahr (H&Y) stage, motor symptoms, and non-motor symptoms in patients with idiopathic Parkinson's disease (PD), so as to explore its application value in assessing the severity of Parkinson's disease., Materials and Methods: A total of 113 patients with idiopathic PD were included in this study. The patients were divided into EOPD and LOPD groups according to the age of 60 years, of which 58 were early-onset and 55 were late-onset. All patients underwent 11 C-CFT PET imaging and manually sketched regions of interest (ROI) to delineate the caudate nucleus, anterior putamen, and posterior putamen ROI layer-by-layer, and the corresponding values were recorded. Clinical data [age of onset, disease duration, H&Y stage, total Unified Parkinson's Disease Rating Scale (UPDRS) score, UPDRS III score, tremor score, postural instability/gait difficulty (PIGD) score, rigidity score, bradykinesia score, and Montreal Cognitive Assessment (MoCA) score] were collected from all patients. The differences in striatal 11 C-CFT uptake between patients with EOPD and LOPD were compared, and the correlation between striatal 11 C-CFT uptake and the clinical data of patients with idiopathic PD was evaluated., Results: The caudate nucleus 11 C-CFT uptake was higher in EOPD than in the LOPD group ( t  = 3.002, p  = 0.003). 11 C-CFT uptake in the caudate nucleus in patients with PD was negatively correlated with the age of onset, H&Y stage, disease duration, total UPDRS score, UPDRS III score, rigidity score, and bradykinesia score ( p  < 0.05). The anterior and posterior putamen 11 C-CFT uptake was negatively correlated with H&Y stage, disease duration, total UPDRS score, UPDRS III score, PIGD score, rigidity score, and bradykinesia score ( p  < 0.05)., Conclusion: 11 C-CFT PET provides an objective molecular imaging basis for the difference in disease progression rates between patients with EOPD and LOPD. Secondly, 11 C-CFT PET can be used as an important objective indicator to assess disease severity and monitor disease progression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kangli, Hongguang, Yinghua, Xiaoxiao, Yuyin, Lulu, Yi, Zhihui and Ying.)

Aim: To examine the status quo and influencing factors of sleep quality and work engagement of nurses participating in COVID-19 during the post-epidemic era and to study the relationship between them., Design: We conducted a cross-sectional survey and correlational and predictive logic to determine the association between sleep quality and work engagement among nurses in Shanghai during the post-epidemic era., Methods: This design involved 1060 frontline nurses in Shanghai. The Pittsburgh Sleep Quality Index questionnaire and the Utrecht Work Engagement Scale-9 scales were used for data collection., Results: This study found that the sleep quality of frontline nurses was impaired and the nurses with poor sleep accounted for 48.20% during the post-epidemic era. The work engagement of frontline nurses was at the medium level. Factors affecting nurses' sleep quality were the number of nurse night shifts, family support and nurse health. The factors affecting the nurse work engagement were monthly income, profession title, family support and self-health status. There was a positive correlation between nurses' sleep quality and work engagement., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Objective: Evaluation of the correlation between 18 F-fluorodeoxyglucose-positron emission tomography ( 18 F-FDG PET) and cognitive function in first-diagnosed and untreated Parkinson's disease (PD) patients., Materials and Method: This cross-sectional study included 84 first diagnosed and untreated PD patients. The individuals were diagnosed by movement disorder experts based on the 2015 MDS Parkinson's disease diagnostic criteria. The patients also underwent 18 F-FDG PET scans and clinical feature assessments including the Montreal Cognitive Assessment (MoCA) scale. Glucose metabolism rates were measured in 26 brain regions using region of interest (ROI) and pixel-wise analyses with displayed Z scores. The cognitive function was assessed by professionals using the MoCA scale, which covers five cognitive domains. Spearman's linear correlation and linear regression models were used to compare the correlations between 18 F-FDG metabolism in each brain region and cognitive domain, using SPSS 25.0 software., Result: The results indicated a positive correlation between executive function and glucose metabolism in the lateral prefrontal cortex of the left hemisphere ( p  = 0.041). Additionally, a positive correlation between memory function and glucose metabolism in the right precuneus ( p  = 0.014), right lateral occipital cortex ( p  = 0.017), left lateral occipital cortex ( p  = 0.031), left primary visual cortex ( p  = 0.008), and right medial temporal cortex ( p  = 0.046). Further regression analysis showed that for every one-point decrease in the memory score, the glucose metabolism in the right precuneus would decrease by 0.3 ( B  = 0.30, p  = 0.005), the glucose metabolism in the left primary visual cortex would decrease by 0.25 ( B  = 0.25, p  = 0.040), the glucose metabolism in the right lateral occipital cortex would decrease by 0.38 ( B  = 0.38, p  = 0.012), and the glucose metabolism in the left lateral occipital cortex would decrease by 0.32 ( B  = 0.32, p  = 0.045)., Conclusion: This study indicated that cognitive impairment in PD patients mainly manifests as changes in executive function, visual-spatial function and memory functions, while glucose metabolism mainly decreases in the frontal and posterior cortex. Further analysis shows that executive function is related to glucose metabolism in the left lateral prefrontal cortex. On the other hand, memory ability involves changes in glucose metabolism in a more extensive brain region. This suggests that cognitive function assessment can indirectly reflect the level of glucose metabolism in the relevant brain regions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhihui, Yinghua, Hongguang, Yuyin, Xiaoxiao, Lulu, Yi, Kangli and Ying.)

Background The presence of cervical lymph node (LN) metastases (LNMs) affects clinical staging and prognosis of thyroid cancer, but the role of conventional B-mode US is limited for preoperative diagnosis of LNMs. The diagnostic value of lymphatic contrast-enhanced US (LCEUS) in thyroid cancer is still being explored. Purpose To explore the diagnostic performance of LCEUS by means of thyroidal injection of contrast agent in comparison with US in detecting LNMs of suspected thyroid cancer. Materials and Methods In this single-center prospective study conducted from November 2020 to January 2021, consecutive participants with suspected thyroid cancer underwent B-mode US and LCEUS of cervical LNs before biopsy. LNMs were confirmed with fine-needle aspiration cytologic examination, thyroglobulin washout assessment, or histopathologic examination after surgery. The diagnostic performance of LCEUS for cervical LNs was compared with that of conventional B-mode US, and its association with LN size and location was evaluated. Results The final data set included 64 participants (mean age, 45 years ± 12 [SD]; 52 women) with 76 LNs. The sensitivity, specificity, and accuracy of LCEUS for LNM were 97%, 90%, and 93%, respectively, whereas they were 81%, 80%, and 80%, respectively, for LNM at conventional B-mode US. Compared with US, LCEUS had better diagnostic accuracy for the LNs smaller than 1 cm (82% vs 95%; P = .03) and for central neck LNs (level VI) (83% vs 96%; P = .04). Conclusion Lymphatic contrast-enhanced US had better diagnostic performance than conventional B-mode US for detecting cervical LN metastases in suspected thyroid cancer before surgery, especially for LNs smaller than 1 cm and central neck LNs. © RSNA, 2023 See also the editorial by Grant and Kwon in this issue.

Backgrounds: Kidney stone also known as urolithiasis or nephrolithiasis, is one of the oldest diseases known to medicine, however, the gene expression changes and related kidney injury remains unclear., Methods: A calculi rat model was developed via ethylene glycol- and ammonium chloride-induction. Integrated proteomic and transcriptomic analysis was performed to characterize the distinct gene expression profiles in the kidney of calculi rat. Differential expressed genes (DEGs) were sub-clustered into distinct groups according to the consistency of transcriptome and proteome. Gene Ontology and KEGG pathway enrichment was performed to analyze the functions of each sub-group of DEGs. Immunohistochemistry was performed to validated the expression of identified proteins., Results: Five thousand eight hundred ninety-seven genes were quantified at both transcriptome and proteome levels, and six distinct gene clusters were identified, of which 14 genes were consistently dysregulated. Functional enrichment analysis showed that the calculi rat kidney was increased expression of injured & apoptotic markers and immune-molecules, and decreased expression of solute carriers & transporters and many metabolic related factors., Conclusions: The present proteotranscriptomic study provided a data resource and new insights for better understanding of the pathogenesis of nephrolithiasis, will hopefully facilitate the future development of new strategies for the recurrence prevention and treatment in patients with kidney stone disease., (© 2023. The Author(s).)

Background: Prolapse is a common complication following enterostomy; the defect and consequences of a prolapse significantly affect health-related quality of life. Creative techniques must be employed to manage the prolapse., Cases: This article describes management of 3 neonates with stoma prolapse., Conclusion: Management of stoma prolapse should be individualized, employing successful nonoperative techniques rather than more difficult operative procedures to prevent recurrent prolapse., (Copyright © 2023 by the Wound, Ostomy and Continence Nurses Society.)

Electroplating sludge was a hazardous waste comprised of heavy metals and other Fe/Al/Ca/Si impurities, and produced massively in surface treatment industry. In the past, it was commonly purified via hydrometallurgy, chlorination and reduction calcination routes, but also blended as additive in rotary kiln, to stabilize the heavy metals in geopolymer. Herein, an alternative strategy was developed to treat a real electroplating sludge for recycling magnetic Zn-rich spinel and stabilizing Zn in calcium metasilicate glass via a facile pyrometallurgy route with the blending of emulsion mud and coal ash. The sludge contained 35.6% Zn and 0.54% Cr and then was blended with 50% emulsion mud. After calcination at 1200 °C, the product was highly dispersed, whilst octahedral ZnAlFeO 4 spinel with Zn content of 40.0% were formed and separated by using magnet, in accordance with the recycling efficiency of 51.2% Zn from the electroplating sludge. But after calcination at 1400 °C, the gypsum in emulsion mud was decomposed as CaO and accelerated the dissolution of Si-bearing substance as calcium metasilicate glass for covering ZnAlFeO 4 spinel, resulting in the Zn leaching of 1568 mg/L. By adding 50% Si-rich coal ash in the calcination system, more calcium metasilicate glass were generated, and then the Zn concentration in the toxic leaching test was only 12.09 mg/L. During the calcination, Cr showed similar performance to Al/Fe and involved in the spinel formation. This provided a new route to recycle Zn from Zn-rich electroplating sludge and to solidify heavy metals via calcium metasilicate glass route., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Objectives: Neuronal intranuclear inclusion body disease (NIID) is a neurodegenerative disease with highly heterogeneous clinical manifestations. The present study aimed to characterize clinical features and propose a classification system based on a large cohort of NIID in China., Methods: The Chinese NIID registry was launched from 2017, and participants' demographics and clinical features were recorded. Brain MRI, skin pathologies, and the number of GGC repeat expansions in the 5' untranslated region of the NOTCH2NLC gene were evaluated in all patients., Results: In total, 223 patients (64.6% female) were recruited; the mean (SD) onset age was 56.7 (10.3) years. The most common manifestations were cognitive impairment (78.5%) and autonomic dysfunction (70.9%), followed by episodic symptoms (51.1%), movement disorders (50.7%), and muscle weakness (25.6%). Imaging markers included hyperintensity signals along the corticomedullary junction on diffusion-weighted imaging (96.6%), white matter lesions (98.1%), paravermis (55.0%), and focal cortical lesions (10.1%). The median size of the expanded GGC repeats in these patients was 115 (range, 70-525), with 2 patients carrying >300 GGC repeats. A larger number of GGC repeats was associated with younger age at onset ( r = -0.329, p < 0.0001). According to the proposed clinical classification based on the most prominent manifestations, the patients were designated into 5 distinct types: cognitive impairment-dominant type (34.1%, n = 76), episodic neurogenic event-dominant type (32.3%, n = 72), movement disorder-dominant type (17.5%, n = 39), autonomic dysfunction-dominant type (8.5%, n = 19), and neuromuscular disease-dominant type (7.6%, n = 17). Notably, 32.3% of the episodic neurogenic event-dominant type of NIID has characteristic focal cortical lesions on brain MRI presenting localized cortical edema or atrophy. The mean onset age of the neuromuscular disease-dominant type was 47.2 (17.6) years, younger than the other types ( p < 0.001). There was no significant difference in the sizes of GGC repeats among the patients in the 5 types ( p = 0.547, Kruskal-Wallis test)., Discussion: This observational study of NIID establishes an overall picture of the disease regarding clinical, imaging, and genetic characteristics. The proposed clinical classification of NIID based on the most prominent manifestation divides patients into 5 types., Competing Interests: The authors report no disclosures relevant to the manuscript. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/NG., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Background: Patients with hemorrhagic stroke have high mortality and disability rates. Nevertheless, early rehabilitation interventions can improve their outcomes. We aimed to apply capsaicin atomization as early intervention to patients with hemorrhagic stroke and explore improvements in cough and swallowing functions., Method: Patients with hemorrhagic stroke were randomly divided into the control group, which received routine care, and the intervention group, which underwent the capsaicin solution nebulization scheme in addition to routine care. Differences in the presence/absence of cough reflex and number of coughs in response to capsaicin, the presence/absence of swallowing reflex in response to water, the presence/absence of postswallow residue, substance P (SP) concentration, and pulmonary inflammation between the two groups were determined before and after the intervention., Results: A total of 53 patients with hemorrhagic stroke were included. Results showed no statistically significant difference in cough reflex in both groups after the intervention ( p > .05). The degree of cough in the intervention group was stronger than that in the control group ( p = .046). No statistically significant difference was observed in the number of patients with swallowing reflex in response to water between the groups ( p > .05). The presence/absence of postswallow residue of the intervention group was stronger than that of the control group ( p = .032). No statistically significant difference was observed between the Glasgow Coma Scale scores of the groups after the intervention ( p > .05). SP in the intervention group was significantly increased ( p = .031). The Clinical Pulmonary Infection Score was significantly lower in the control group, and the difference was statistically significant ( p = .028)., Conclusions: Capsaicin nebulization can help enhance the number of coughs in response to capsaicin, reduce postswallow residue, and increase the level of SP in patients with hemorrhagic stroke and has a positive effect on pulmonary inflammation. This study provides intervention points for cough and swallowing rehabilitation after a hemorrhagic stroke., Supplemental Material: https://doi.org/10.23641/asha.21956903.

Objective: To explore the pharmacological basis and mechanism of Buxue Yimu pills (BYP) in the treatment of anaemia in women from the perspective of metabolomics and network analysis. Materials and Methods: Forty-six women of reproductive age with haemoglobin 70-110 g/L were recruited. Blood samples were collected before and after 4 weeks of oral BYP treatment to assess the changes in haemoglobin, coagulation function, and iron metabolism indices. An integrated analysis of metabolomics (liquid chromatography mass spectrometry) and network analysis was performed to identify the potential pharmacodynamic mechanisms of BYP. Results: After BYP treatment, the haemoglobin level of patients significantly increased from 93.67 ± 9.77 g/L to 109.28 ± 12.62 g/L ( p < 0.01), while no significant changes were found in iron metabolism and coagulation-related indicators. A total of 22 differential metabolites were identified after metabolomics analysis, which were mainly related to the inhibition of inflammation and oxidative stress. Integrating pharmacodynamics and metabolomics, a network of drug-active components-targets-metabolic pathways-metabolomics was established. Acetylcholinesterase, phospholipase A2 group IIA, and phospholipase A2 group IVA may be the most promising therapeutic targets. Conclusion: BYP can inhibit inflammation and oxidative stress as well as promote haematopoiesis, potentially improving anaemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ying-ying, Yan-fang, Yan, Su-ying, Dong, Bin, Xue, Miao, Rui-lin, Xiao-hui, Yu-pei and Ai-jun.)

Fe/S-bearing erdite flocculant has been proven to be effective in the precipitation of heavy metals from real electroplating wastewater, with the only drawback being the huge production of sludge. This sludge was rich in Fe/S/Zn/Cu/Ni and refractory to be recycled due to the extractant pollution by free Fe and the dissolution of sulphide. Herein, a multistep separation method was developed to dissolve sulphide and separate Fe prior to Zn/Cu/Ni. Results showed that more than 92% sludge was dissolved as Fe/Zn/Cu/Ni-rich leachate after the sludge was leached by nitric acid, with the rest of the remaining undissolved elemental sulphurs. When the leachate was directly extracted by using commercially extractant Acorga M5640 and Di-(2-ethylhexyl) phosphoric acid (P204), Fe was complexed by the phosphate group of the extractant. The Fe was effectively removed prior to Zn/Cu/Ni to avoid the extractant pollution. The Fe removal efficiency was only 38.34% without sucrose, but it rose to 99.94% with the addition of 0.5 g sucrose. The added sucrose reacted with nitrate to consume H + , which showed a similar rate to the H + release from Fe hydrolysis. Thereafter, the Fe hydrolysis was continued to remove, the Fe at a high level. The removed Fe was in the form of high-purified hematite nanorod with a diameter and length of 300-600 nm and 0.5-2.5 μm, respectively. After Fe removal, Cu/Zn/Ni was extracted by using Acorga M5640 and P204 to form three halite, including a mixture of copper sulphate hydrate and bonattite (96.8% CuSO 4 ·H 2 O/CuSO 4 ·3H 2 O), gunningite (97.5% ZnSO 4 ·H 2 O) and dwornikite (97.9% NiSO 4 ·H 2 O). The rest of the solution was neutralised by lime water to remove sulphate as gypsum (95.9% CaSO 4 ) to meet the discharge standard of the electroplating industry. In summary, the recycling efficiency of Fe/Cu/Zn/Ni from the sludge reached 94.4%, 92.6%, 94.7% and 95.3%, which provided an alternative strategy to resource utilise Fe/S-bearing solid waste., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Although exposure to ambient air pollution has been associated with mental disorder, little is known about its potential effects on children and adolescents, especially in Chinese population. We aimed to reveal the relationship of air pollutants with hospital outpatient visits for child and adolescence psychiatry (HOVCAP) in Shenzhen., Methods: A case-crossover study based on time-series data was applied, and a distributed lag non-linear model (DLNM) was used to evaluate the non-linear and delayed effects of 4 major air pollutants (NO 2 , PM 2.5 , SO 2 and O 3 ) on HOVCAP. Least absolute shrinkage and selection operator (LASSO) regression was used to control the multicollinearity between covariates and to filter variables., Result: A total of 94,660 cases aged 3-18 were collected from 2014 to 2019 in the Mental Health Center of Shenzhen. Results of pollutants at mode value (M 0 ) showed that in the single lag effect result, when the average daily concentration of NO 2 at 24 μg/m 3 , there was a significant effect on HOVCAP over lag 1, lag 4 and lag 5, respectively. The cumulative RR of NO 2 M 0 value to the outpatient visits were 1.438 (1.137-1.818) over lag 0-2, 1.454 (1.120-1.887) over lag 0-3, 1.466 (1.084-1.982) over lag 0-4, 1.680 (1.199-2.354) over lag 0-5, 1.993 (1.369-2.903) over lag 0-6, and 2.069 (1.372-3.119) over lag 0-7. However, PM 2.5 , SO 2 , O 3 were not associated with HOVCAP over neither single lag effects nor cumulative effects. The RR values both shown an increase either when NO 2 increases by 10 units or when the maximum concentration of NO 2 is reached., Conclusion: Our study suggests that exposure to the normal air quality of NO2 in Shenzhen may associated with the risk of HOVCAP. However, PM2.5, SO2, O3 were not associated with HOVCAP., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: To illustrate the accurate location of Poly-ADP-ribose polymerase inhibitor (PARPi) as the first-line maintenance therapy in advanced ovarian cancer (AOC)., Methods: Search for eligible studies and calculate clinical outcomes., Results: PARPi as a first-line maintenance treatment significantly prolonged the BRCAmut population and the homologous recombination deficiency (HRD) positive population., Conclusion: PARPi as first-line maintenance therapy significantly improves the progression-free survival in AOC, especially in the BRCAmut and HRD positive populations. PARPi has been becoming the standard first-line maintenance therapy for AOC.

Pulmonary fibrosis (PF) is characterized by oxidative injury and excessive collagen synthesis in lung fibroblasts, causing impaired pulmonary function and chronic lung injury. Piceatannol, a dietary polyphenol, possesses vital pharmacological effects in metabolic disorders, cancers, cardiovascular disease and infectious disease; however, its role in PF is still not completely elucidated. Mice (8 to 10 weeks old) were administered bleomycin (BLM) intratracheally (2 U/kg) to establish an in vivo PF model. Murine primary lung fibroblasts were isolated and stimulated with TGF-β (10 ng/mL) for 48 h to induce its activation. Meanwhile, mice or primary lung fibroblasts were treated with different doses of piceatannol to observe its protective roles. Pulmonary function and arterial blood gas were detected to assess pulmonary physiological status. Collagen deposition and the mRNA levels of profibrotic genes were determined by H&E staining and RT-PCR. Meanwhile, the protein and mRNA markers, as well as end-product of oxidative stress were detected in vivo and in vitro. The results showed that pulmonary function was significantly impaired in BLM-induced mice, accompanied by elevated oxidative stress and excessive collagen synthesis. Piceatannol significantly improved pulmonary function and decreased oxidative injury as well as collagen synthesis in mice with PF. Mechanically, piceatannol treatment significantly inhibited the activation of JAK2/STAT3 signaling pathway in BLM-induced mice and TGF-β-induced lung fibroblasts. Additional findings also demonstrated that coumermycin A1 (C-A1), an agonist of JAK2, could abolish the effects of piceatannol on TGF-β-induced lung fibroblasts and reactivated the phosphorylation STAT3. Taken together, our study demonstrated that piceatannol could protect against oxidative injury and collagen synthesis during PF in a JAK2/STAT3 signaling pathway-dependent manner., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

Objective: To explore biomarkers of Pien Tze Huang that ameliorated the symptoms of hepatic fibrosis., Methods: Two groups of carbon tetrachloride-induced hepatic fibrosis (HF) mice model were constructed in our study: one group received PZH treatment and another group received no treatment. We performed this study to investigate the role of PZH in the regulation process of hepatic fibrosis., Results: We identified 31 down-regulated and 39 up-regulated miRNAs using small RNA-seq analysis. Combining RNA-Seq data analysis, our study revealed 7 significant target genes (Sp4, Slc2a6, Tln2, Hmga2, Ank3, Pax9, Fgf9). The results of real-time quantitative polymerase chain reaction analysis suggested that the expression level of 6 genes (Sp4, Tln2, Hmga2, Ank3, Pax9, Fgf9) were down-regulated compared to control group. On the other hand, the expression level of Slc2a6 appeared to be up-regulated. The protein mass spectrometry showed that PZH group had lower protein expression of Tln2 compared to control group., Conclusion: We identified 7 genes that were significantly related to PZH response in HF mice using multiple conjoint analysis methods. These genes could participate in underlying regulation mechanism of hepatic fibrosis during PZH treatment.

Due to its calcium-rich and diverse multimineral profile, Aquamin (derived from the red seaweed Lithothamnion sp.) is used globally as a dietary food supplement. Published reports on the genetic and prenatal developmental toxicity of Lithothamnion sp. do not exist. In accordance with the standardized protocols set by the Ministry of Health of the People's Republic of China (GB-15193), the following studies were performed: the Ames test, the mammalian erythrocyte micronucleus test, the mammalian spermatocyte chromosome test, and prenatal developmental toxicity testing. The results showed that Lithothamnion sp. did not induce a significant increase in the following: revertant colony numbers for Salmonella typhimurium strains TA 97, 98, 100, 102 and 1535; frequency of micronucleated polychromatic erythrocytes (MNPCE); spermatocyte chromosomal aberration rate. In the prenatal developmental toxicity study, no mortality, no abnormal changes in behavior and activities, and the absence of toxic symptoms and abnormalities in macroscopic autopsy were observed in each dam/all pups. Compared to the negative control group, Lithothamnion sp. at all tested doses had no effects on body weight gain, number of corpora lutea and implantations, fetal body weight and length, external, visceral and skeletal malformations. In conclusion, Lithothamnion sp. did not cause genetic toxicity. Furthermore, the prenatal developmental toxicity no observed adverse effect level (NOAEL) was determined to be greater than 2000  mg/kg.bw.

Background and Objectives: Brain arteriovenous malformation (bAVM) is a congenital disorder and a leading cause of hemorrhagic stroke. Germline genetic variants play an essential role in the pathogenesis of bAVM. However, the biological relevance of disease-associated genes identified in previous studies is elusive. In this study, we aim to systematically investigate the contribution of germline variants to bAVM and explore the critical molecular pathways underlying the pathogenesis of bAVM., Methods: Probands with sporadic bAVM were consecutively recruited into this study from November 2015 to November 2018 and underwent exome sequencing. The controls were aggregated from individuals who were not known to have vascular malformation and underwent exome sequencing for clinical or research purposes. The retained control dataset included 4,609 individuals, including 251 individuals with parental samples sequenced. We first analyzed de novo variants in cases and controls and performed a pathway enrichment analysis. A gene-based rare variant association analysis was then performed to identify genes whose variants were significantly enriched in cases., Results: We collected an exome-sequenced bAVM cohort consisting of 152 trios and 40 singletons. By first focusing on de novo variants, we observed a significant mutational burden of likely gene-disrupting variants in cases vs controls. By performing a pathway enrichment analysis of all nonsynonymous de novo variants identified in cases, we found the angiopoietin-like protein 8 (ANGPTL8) regulatory pathway to be significantly enriched in patients with bAVM. Through an exome-wide rare variant association analysis utilizing 4,394 in-house exome data as controls, we identified SLC19A3 as a disease-associated gene for bAVM. In addition, we found that the SLC19A3 variants in cases are preferably located at the N' side of the SLC19A3 protein. These findings implicate a phenotypic expansion of SLC19A3 -related disorders with a domain-specific effect., Discussion: This study provides insights into the biological basis of bAVM by identifying novel molecular pathways and candidate genes., (© 2022 American Academy of Neurology.)

Cr/Fe-bearing sludge is a hazardous solid waste, produced at mass production in smelting, plating and surface finishing industries. Such waste is commonly treated by chemical detoxification and safety landfill, whereas only a few Cr-rich sludge is recycled as a tanning reagent. In this study, a novel route was developed to recycle Cr/Fe-bearing sludge as erdite-bearing flocculant for wastewater treatment. Results showed that two sludges were irregular aggregates, one of which contained 1.6 wt.% Cr (short for LS) and the other contained 4.2 wt.% Cr (HS). After hydrothermal treatment, stable Cr(III)/S-bearing product was formed from the Cr(VI) reduction in the sludges. Conversely, erdite was generated in nanorod form with diameter and length of 200 nm and 0.5-1 μm from LS, respectively, whereas grew radially to 1.5-2.5 μm for HS. The two erdite-bearing products were spontaneously hydrolysed to Fe/S-bearing flocs and showed similar performance in the treatment of real electroplating effluent with 91.55, 1.94 and 0.25 mg/L of Zn, Ni and Cr, respectively. For instance, by adding 1 g/L product of LS, the release of Cr from the products did not occur, and the residual Zn, Ni and Cr in the effluent was 0.25, 0.65 and 0.17 mg/L, respectively, which met the discharge standard of the electroplating industry. With the two converted products, the residual Zn/Ni/Cr concentrations were apparently lower than those of the raw sludges and other common reagents (e.g. polymeric ferric sulphate, activated carbon and diatomite). Thus, such erdite-bearing products could serve as a flocculant and then be applied in electroplating wastewater treatment., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022.)

The management of acquired reactive perforating collagenosis (ARPC) is challenging. Here, we shared two cases of ARPC combined with elderly atopic dermatitis (AD) that did not respond well to conventional treatment but responded well to the monotherapy of dupilumab, which suggests that dupilumab may be an alternative option for the treatment., (© 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

Background and Purpose: This study tests whether patients with unruptured intracranial aneurysm who underwent stent placement benefitted from platelet function monitoring-guided adjustment of antiplatelet therapy., Methods: We conducted a randomized, open-label, parallel group, assessor-blinded trial. Patients with unruptured intracranial aneurysm who underwent stent placement were assigned in a 1:1 ratio to receive either drug adjustment (patients who had high on-treatment platelet reactivity to antiplatelet therapy on the basis of platelet function monitoring [monitoring group]) or conventional therapy (without monitoring and drug adjustment [conventional group]). The second monitoring was performed 14 days after randomization in patients with drug adjustment. The primary outcome was the composite frequency of ischemic stroke, transient ischemic attack, stent thrombosis, urgent revascularization, and cerebrovascular death within 7 days after stent implantation. The safety outcome was the composite frequency of major, minor, or minimal bleeding within 1 month after stent implantation., Results: In total, 314 patients were included (n=157 per group). The primary combined outcome occurred in 19 patients (12.1%) in the conventional group and 8 patients (5.1%) in the monitoring group (hazard ratio, 0.39 [95% CI, 0.17-0.92]; P =0.03). Ischemic stroke occurred at a lower frequency in the monitoring group compared with that in the conventional group (4.5% versus 12.1%; hazard ratio, 0.34 [95% CI, 0.14-0.83]; P =0.01), which drove the overall primary combined outcome. The safety outcome occurred in the monitoring group (7.0%) and in the conventional group (1.9%; hazard ratio, 3.87 [95% CI, 1.06-14.14]; P =0.03). A significant difference was observed in the frequency of minor or minimal bleeding events between the two groups (monitoring group versus conventional group, 6.4% versus 1.3%; P =0.02) but not in the frequency of major bleeding events between the two groups., Conclusions: Platelet function monitoring-guided antiplatelet therapy reduces thromboembolic events in patients with unruptured intracranial aneurysm after stent placement, significantly enhancing minor or minimal bleeding events but not major bleeding events. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03989557.

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Background: Polyunsaturated fatty acid (PUFA) is important for the development of the fetal brain, and the retina. Gestational diabetes mellitus (GDM) may influence maternal and fetal fatty acid metabolism, in turn affecting fetal growth and development. In several studies, maternal and fetal PUFA metabolic differences have been reported between mothers with and without GDM, but not in other studies. Thus, the aim of this meta-analysis (registration number: CRD42020220448) was to compare levels of linoleic acid (LA), α-linolenic acid (ALA), arachidonic acid (AA), docosahexaenoic acid (DHA), and total n-3 and n-6 PUFA between mothers with and without GMD and their fetuses., Methods: We performed a meta-analysis of observational studies on maternal and fetal fatty acid metabolism, published until May 2021. In addition, we performed subgroup analysis depending on the analyzed tissues (plasma/serum, erythrocyte membrane, or placenta) and the expression modes of fatty acids (concentration or percentage)., Results: We included 24 observational studies involving 4335 maternal datasets and 12 studies involving 1675 fetal datasets in the meta-analysis. Levels of AA, DHA, and n-6 and n-3 PUFA were lower in the cord blood of mothers with GDM than in controls (P  <  0.05). Compared to that in controls, in erythrocyte membranes, the percentages of AA, DHA, and n-6 and n-3 PUFA in total fatty acid were lower in mothers with GDM (P  <  0.05), but in plasma/serum, the percentages of AA, DHA, and n-6 PUFA in total fatty acid were higher in mothers with GDM (P  <  0.05)., Conclusions: GDM appears to influence the transfer of PUFAs from mothers to fetuses. The percentage of PUFAs in maternal plasma/serum was higher, and that in erythrocyte membranes was lower in mothers with GDM compared to those with normal glucose tolerance., (Copyright © 2021. Published by Elsevier Ltd.)

In this paper, the process of crack propagation is investigated using the extended finite element method at the mesoscale to study the drill pipe fracture mechanism. Firstly, the property of the S135 drill pipe was analyzed through physical and chemical experiments and the scanning electron microscope method. After that, a grain distribution model of the drill pipe material at the mesoscale was established by the Python scripting language on ABAQUS platform. Furthermore, the extended finite element method was applied to study crack dynamic propagation. And the distribution of stress and strain during the crack propagation were obtained at the mesoscale grain model. Finally, by the mesomechanics "homogenization" method, the stress and strain of the crack propagation model at different times were analyzed, and the influence of crack propagation on drill pipe material was obtained. Simulation results show that, although drill pipe material at the macroscopic scale is in the elastic stage, plastic zone and micro-crack propagation may also exist at the mesoscale. The proposed method in this paper studied the stress distribution in the crack tip during the propagation, which is a benefit for exploring the fracture mechanism of drill pipe.

The thread connection's root fillet radius of 0.038″ size is the greatest weakness of the API NC type joints and thread. During the slimehole drilling, especially in the deep and ultra-deep gas well, its stress concentration factor and notch sensitivity factor are very high A novel thread connection design (TM) of a drilling tool is proposed to decrease the fatigue failure of the slimehole drilling tool in the deep and the ultra-deep gas well in the Tarim oilfield China. The novelty in the TM thread structure is, reducing the threads per inch, extending the distance from the last engaged thread to the external shoulder of the pin and adding three threads to the conventional connection. The novel thread connection will improve the slimehole drilling tool's anti-fatigue life due to its improved elasticity and rigidity. Furthermore, the TM can transfer the maximum stress at the connection root to the loaded surface, which can effectively lower the fatigue notch's sensitivity coefficient. In this paper, the finite element method (FEM) is applied to carry out the detailed comparative analysis of the TM with existing thread connection NC38, TX60 and TH90. The TM has the lowest stress concentration factor and fatigue notch sensitivity coefficient, so its anti-fatigue life is the highest. In addition, TM is manufactured and is tested at Tarim oilfield in China.

Background: Aesthetic surgical reconstruction of auricular keloids is still a conundrum. This study introduces our experiences in analyzing the anatomic morphological features of auricular keloids, and devising optimized surgical procedures accordingly., Methods: A total of 129 ears with auricular keloids were classified and operated. All patients were followed up for at least 12 months., Results: According to their anatomic positions, auricular keloids were divided into 3 Groups (A, B, and C). The morphological features of keloids were further interpreted according to Chang-Park classification of earlobe keloids. The authors optimized surgical procedures according to the anatomic morphological features from a range of surgical techniques. The recurrence rate of Group C was statistically higher than Group A and B. There was no significant difference in recurrence rate between keloids treated with "primary suture" and "filleted flaps.", Conclusions: According to the anatomic positions and morphological features of auricular keloids, we could conveniently devise optimized surgical strategies to obtain aesthetic reconstruction of auricular keloids., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

Aramid nanofibers (ANFs) represent the most promising nanoscale building blocks for high-performance nanocomposites. But their applications are mostly limited to those polymers containing -OH or -NH 2 groups that can interact with ANFs through hydrogen bonding or others. In this paper, allyl and benzyl modified ANFs were successfully fabricated using a metallization method followed by functionalization with allyl and benzyl bromide. A series of modified aramid nanomaterials (ANMs) with different degrees of modification were prepared and their morphologies studied. The modified ANFs were added to polystyrene (PS) films as reinforcements. The mechanical properties of the resulting composite PS films including Young's modulus, toughness and yield strength were dramatically improved compared to those of pure PS film. These new types of reinforcement additives for non-polar polymer materials are presented in this paper., (Copyright © 2020 Peng, Yaoqin, Congcong, Changmei, Rongjun, Chunnuan, Ying and Ying.)

Introduction: The aim of this study was to define the subsuperior bronchus (B*) and reestablish the bronchial anatomy of the right lower lobe (RLL) by assessment of atypical bronchi., Materials and Methods: Chest computed tomography (CT) scans of 500 consecutive patients were retrospectively evaluated. All CT scans were acquired with 64-slice scanners. Atypical bronchi in the RLL were classified on the basis of running direction and shape: lateral (Lat), posterolateral (PL), posterior (Post), Lat + PL, and PL + Post. We classified an atypical bronchus in the basal segmental bronchus (BSB) stem running posteriorly or posterolaterally as B* and a para-lateral bronchus running laterally as Para-B8. The B* posts running posteriorly were named P1, and those running medially P2., Results: Atypical BSB bronchi Lat, PL, and Post arose from B8, B9, and B10, respectively. All Lat + PL bronchi arose from B8 or B9, and all PL + Post from B9 or B10. When an atypical bronchus arose from one of the BSB pair, none arose from the other. Atypical bronchi forming B* and Para-B8 arose from the stem spreading the connatural BSBs. The P2 post coexisted with another atypical stem bronchus originating from B8, 9, 10, or higher., Conclusions: The first subsegmental bronchi of B8, B9, and B10 are Lat, PL, and Post, respectively. Lat + PL and PL + Post bronchi at the BSB level could result from fusion of an atypical bronchus during downward migration. The stem B* and Para-B8 could result from arrested downward migration of atypical bronchi. This information is useful for RLL segmentectomy., (© 2020 Wiley Periodicals, Inc.)

As a representative foreign medicinal material, olibanum(Ruxiang) was imported to China since the Qin and Han Dynasties. Olibanum was first described as a medicinal by the name &quot;Xunluxiang&quot; in Miscellaneous Records of Famous Physicians(Ming Yi Bie Lu). This study investigated historical records on olibanum and conducted the herbalogical study. It was found that olibanum came from the resin mainly obtained from the bark of Pistacia lenticus before the Tang Dynasty. With the prosperity of the Maritime Silk Road, instead, the resin obtained from the bark of Boswellia carterii was mainly used as olibanum. In ancient time, the oleo-gum-resin secreted from the cut bark was collected in spring and summer, and the quality was judged based on transparency and shape. The processing methods of olibanum went through many evolutions, which changed from simple methods such as grinding and frying to complex methods such as levigating and grinding with wine, and now to frying and processing with vinegar. The usage of olibanum included alchemy, folk and religious incense, bathing, cosmetic and medicinal since ancient times. From the Song Dynasty, olibanum had been mainly used as medicinal because of its good effect to treat wounds. In traditional Chinese medicine, olibanum unblocks menstruation, relieves pain and reduces swelling and generated muscles. The medicinal efficacy of olibanum is not much different from ancient to modern. Only the efficacy of replenishing energy and promoting the movement of Qi was rarely mentioned in modern reference. In this article, the historical evolutions of olibanum about original plants, processing and medicinal efficacy were sorted out. The results could provide historical basis for the further development and clinical utilization of olibanum.

As a most important Chinese materia medica, Aconiti Lateralis Radix Praeparata(Fuzi) had been widely used in China for thousands of years. This herbalogical study was systematically performed based on variation characteristics of the naming, habitat, harvesting, processing and properties. The sharp toxicity of Fuzi had been well known since the spring and autumn period in the history, which was much earlier than that its medical properties was understood and applied. Sichuan province was regarded as the geo-authentic region of Fuzi all along, where the best quality goods could be provided for clinic use. The study showed the harvesting time of Fuzi was changing in different periods, and the possible effects were of climate change and artificial planting. The perishable characteris-tics of Fuzi severely limited its storage period; therefore, different kinds of storage methods were effectively used since Tang Dynasty. For thousands of years, Fuzi had been processed with various accessories to reduce toxicity, while simultaneously the study on processing mechanism was on going all the time. Fuzi was widely used in clinical practice to cure Yang depletion syndrome, which was based on its function of enhancing Yang and removing cold. Along with the further study on quality evaluation standard, Fuzi will probably get a much wider range of applications.

The chemical fingerprints of American ginseng were established by high performance liquid chromatography(HPLC) coupled with similarity evaluation system for chromatographic fingerprint of traditionanl Chinese medicine. The results were analyzed with use of stoichiometry methods(cluster analysis, principal component analysis, and orthogonal partial least squares discriminant analysis), and meanwhile, a preliminary study on the antioxidant and anti-proliferation activity of colorectal cancer cells was conducted. By comparing the fingerprints of American ginseng before and after processing, the contents of five components in the eight ginseno-sides quantified in this paper increased, including ginsenoside Rc, Rg&#95;2, Rb&#95;2, Rb&#95;3 and Rd, respectively, and a new component was produced after steaming. The activity study showed that steamed American ginseng had better antioxidant activity and anti-proliferation activity of colorectal cancer cells than raw American ginseng. The research results show that the steaming method of American ginseng used in this experiment has good stability and reproducibility, and the steaming of American ginseng produces similar changes as artificial red ginseng, which provides a certain reference for expanding the application range of American ginseng.

What is already known on this topic?, Following 110 days of no new confirmed cases of COVID-19 in Tianjin Municipality, a case was confirmed on June 17, 2020. A total of 136 local cases had been reported previously., What is added by this report?, The 137 th case was found in a dishwasher working in the western dining room of a hotel in Tianjin. Epidemiological investigations and laboratory research indicated that this case was likely transmitted from an asymptomatic individual that had recently visited several public places in Beijing Municipality and was working as a chef in the same workplace as the patient. Sequencing and analysis found that the COVID-19 virus genome found in the 137 th case was 100% identical to sequences from the recent outbreak in Beijing's Xinfadi Agricultural Product Wholesale Market., What are the implications for public health practice?, A combination of meticulous epidemiological investigation and detailed laboratory research can promptly identify the source of COVID-19., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2020.)

Chemoresistance is still a major obstacle for lung cancer treatment. Increasing studies have demonstrated that microRNAs (miRNAs) are essential meditators of chemoresistance during cancer progression. MiR-451a is reported to be a tumor suppressor during cancer development. However, its effects on lung cancer and drug resistance in lung cancer are still unclear. In the study, the results showed that miR-451a exhibited a significant role in suppressing the drug resistance in lung cancer cells when treated with doxorubicin (DOX) through alleviating epithelialmesenchymal transition (EMT), as evidenced by the markedly reduced expression of N-cadherin and Vimentin, while the enhanced expression of E-cadherin. In addition, miR-451a over-expression markedly promoted the sensitivity of lung cancer cells to DOX treatments, and also disrupted the EMT of lung cancer cells. Mechanistically, miR-451a was found to directly target c-Myc to affect the EMT and drug resistance in lung cancer cells in response to DOX incubation. Furthermore, c-Myc knockdown markedly elevated the sensitivity of lung cancer cells to DOX, whereas over-expressing c-Myc markedly reversed the anti-tumor role of DOX, which was slightly diminished by miR-451a mimic. The in vivo experiments confirmed that miR-451a promoted the sensitivity of lung cancer cells-derived tumors to DOX treatment by reducing c-Myc. Therefore, our results revealed a new insight into DOX resistance of lung cancer cells and miR-451a could be considered as a potential therapeutic target to overcome drug resistance in lung cancer., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020. Published by Elsevier Masson SAS.)

Traditionally, statistical methods for futility analysis are developed based on a single study. To establish a drug's effectiveness, usually at least two adequate and well-controlled studies need to demonstrate convincing evidence on its own. Therefore, in a standard clinical development program in chronic diseases, two independent studies are generally conducted for drug registration. This paper proposes a statistical method to combine interim data from two independent and similar studies for interim futility analysis and shows that the conditional power approach based on combined interim data has better operating characteristics compared to the approach based on single-trial interim data, even with small to moderate heterogeneity on the treatment effects between the two studies.