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Rheumatoid arthritis (RA) is an autoimmune disease characterized by the accumulation of leukocytes and inflammatory mediators within the synovial tissue. Leukocyte counts are proposed to play a role in the pathogenesis of RA. However, the causality remains unclear. To investigate the causal relationship between various leukocytes and RA by implementing two-sample univariable Mendelian Randomization (MR) and multivariable MR. MR analysis was performed using respective genome-wide association study (GWAS) summary statistics for the exposure traits (eosinophil counts, neutrophil counts, lymphocyte counts, monocyte counts, basophil counts, and white blood cell counts) and outcome trait (RA). Summary statistics for leukocytes were extracted from the Blood Cell Consortium meta-analysis and INTERVAL studies. Public GWAS information for RA included 14,361 cases and 43,923 controls. Inverse variance weighted, weighted median, MR-Egger regression, MR pleiotropy residual sum and outlier, and multivariable MR analyses were performed in MR analysis. Univariable MR found elevated eosinophil counts (OR 1.580, 95% CI 1.389-2.681, p = 1.30 × 10 -7 ) significantly increased the risk of RA. Multivariable MR further confirmed that eosinophil counts were a risk factor for RA. Increased eosinophils were associated with higher risk of RA. Further elucidations of the causality and mechanisms underlying are likely to identify feasible interventions to promote RA prevention., (© 2023. The Author(s).)

Background: Although various endoscopic surgery robots developed in previous studies are versatile and have high lesion accessibility, they have limitations in terms of reaching the target lesion through the curved path in the large intestine and providing a stable tasking environment for the operator., Methods: An endoscopic surgery robot was developed for performing surgery in the large intestine. The robot was easily inserted into the target lesion in the curved colon through the mounted soft actuator and demonstrated high structural stiffness through the insertion of the sigmoidal auxiliary tendons., Results: The robot was able to access the target lesion in the curved colon through teleoperation alone. Further, it was confirmed that the high structural stiffness overtube improved the overall task performance in the user test., Conclusions: The proposed robotic system demonstrated the possibility and potential of performing advanced endoscopic surgery in the large intestine., (© 2022 John Wiley & Sons Ltd.)

A highly stretchable and tissue-adhesive multifunctional sensor based on structurally engineered islets embedded in ultra-soft hydrogel is reported for monitoring of bladder activity in overactive bladder (OAB) induced rat and anesthetized pig. The use of hydrogel yielded a much lower sensor modulus (1 kPa) compared to that of the bladder (300 kPa), while the strong adhesiveness of the hydrogel (adhesive strength: 260.86 N/m) allowed firm attachment onto the bladder. The change in resistance of printed liquid metal particle thin-film lines under strain were used to detect bladder inflation and deflation; due to the high stretchability and reliability of the lines, surface strains of 200% could be measured repeatedly. Au electrodes coated with Platinum black were used to detect electromyography (EMG). These electrodes were placed on structurally engineered rigid islets so that no interfacial fracture occurs under high strains associated with bladder expansion. On the OAB induced rat, stronger signals (change in resistance and EMG root-mean-square) were detected near intra-bladder pressure maxima, thus showing correlation to bladder activity. Moreover, using robot-assisted laparoscopic surgery, the sensor was placed onto the bladder of an anesthetized pig. Under voiding and filling, bladder strain and EMG were once again monitored. These results confirm that our proposed sensor is a highly feasible, clinically relevant implantable device for continuous monitoring OAB for diagnosis and treatment., 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.)

The overtube of an endoscopic surgery robot is fixed when performing tasks, unlike those of commercial endoscopes, and this overtube should have high structural stiffness after reaching the target lesion so that sufficient tension can be applied to the lesion tissue with the surgical tool and there are fewer changes in the field of view of the endoscopic camera from this reaction force. Various methods have been proposed to reinforce the structural stiffnesses of hyper-redundant manipulators. However, the safety, rapid response, space efficiency, and cost-effectiveness of these methods should be considered for use in actual clinical environments, such as the gastrointestinal tract. This study proposed a method to minimize the positional changes of the overtube end tip due to external forces using only auxiliary tendons in the optimized path without additional mechanical structures. Overall, the proposed method involved moving the overtube to the target lesion through the main driving tendon and applying tension to the auxiliary tendons to reinforce the structural stiffness. The complete system was analyzed in terms of energy, and the sigmoidal auxiliary tendons were verified to effectively reinforce the structural stiffness of the overtube consisting of rolling joints. In addition, the design guidelines of the overtube for actual endoscopic surgery were proposed considering hollowness, retroflexion, and high structural stiffness. The positional changes due to external forces were confirmed to be reduced by 60% over the entire workspace.

Tetrabromobisphenol A (TBBPA), a hazardous and persistent flame retardant, has been widely detected in the natural aquatic system. The acceleration of reductive debromination (rate-limiting process) is vital during the decomposition and detoxification of TBBPA. This study achieved superior TBBPA electrochemical reductive debromination performance by nano Pd doped Ni foam electrode (4.8 times higher than Ni foam electrode). The optimal TBBPA reductive debromination performance was obtained under -1.2 V of cathode potential, 1.2 wt% of Pd loading, 10 mg L -1 of TBBPA and 100 mM of Na 2 SO 4 as the electrolyte solution. UPLC-QTOF-MS verified that Br atoms in TBBPA were removed sequentially to form bisphenol A as the major product. Most TBBPA was reductively debrominated by atomic H* through indirect hydrodebromination, evidenced by the atomic H* quenching test. The higher solution conductivity and appropriate TBBPA concentration would contribute to the debromination efficiency. Excessive H 2 generation whether by over negative potential or H atom richness electrolyte largely disturbed the reaction process and restricted the debromination. The improved generation of reductant (H*) ads Pd was the most significant, while excessive Pd loading would make aggregation and limit the debromination efficiency. The study confirmed the optimization strategies of conditions for Pd/Ni foam electrode and revealed the related function mechanism for stimulating TBBPA electrochemical reduction, giving suggestions for the efficient removal of TBBPA in the aquatic environment., 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 B.V. All rights reserved.)

Understanding prostate cancer onset and progression in order to rationally treat this disease has been critically limited by a dire lack of relevant pre-clinical animal models. We have generated a set of genetically engineered mice that mimic human prostate cancer, initiated from the gland epithelia. We chose driver gene mutations that are specifically relevant to cancers of young men, where aggressive disease poses accentuated survival risks. An outstanding advantage of our models are their intact repertoires of immune cells. These mice provide invaluable insight into the importance of immune responses in prostate cancer and offer scope for studying treatments, including immunotherapies. Our prostate cancer models strongly support the role of tumour suppressor p53 in functioning to critically restrain the emergence of cancer pathways that drive cell cycle progression; alter metabolism and vasculature to fuel tumour growth; and mediate epithelial to mesenchymal-transition, as vital to invasion. Importantly, we also discovered that the type of p53 alteration dictates the specific immune cell profiles most significantly disrupted, in a temporal manner, with ramifications for disease progression. These new orthotopic mouse models demonstrate that each of the isogenic hotspot p53 amino acid mutations studied (R172H and R245W, the mouse equivalents of human R175H and R248W respectively), drive unique cellular changes affecting pathways of proliferation and immunity. Our findings support the hypothesis that individual p53 mutations confer their own particular oncogenic gain of function in prostate cancer., (© 2022. The Author(s).)

This study was designed to identify the pathogen causing soft rot of Pinellia ternata in Qianjiang of Hubei province and screen out the effective bactericides, so as to provide a theoretical basis for the control of soft rot of P. ternata. In this study, the pathogen was identified based on molecular biology and physiological biochemistry, followed by the detection of pathogenicity and pathogenicity spectrum via plant tissue inoculation in vitro and the indoor toxicity determination using the inhibition zone method to screen out bactericide with good antibacterial effects. The control effect of the bactericide against P. ternata soft rot was verified by the leave and tuber inoculation in vitro. The phylogenetic tree was constructed based on the 16 S rDNA, dnaX gene, and recA gene sequences, respectively, and the result showed that the pathogen belonged to the same branch as the type strain Dickeya fangzhongdai JS5. The physiological and biochemical tests showed that the pathogen was identical to D. fangzhongdai, which proved that the pathogen was D. fangzhongdai. The pathogenicity test indicated that the pathogen could obviously infect leaves at 24 h and tubers in 3 d. As revealed by the indoor toxicity test, 0.3% tetramycin, 5% allicin, and 80% ethylicin had good antibacterial activities, with EC_(50) values all less than 50 mg·L~(-1). Tests in tissues in vitro showed that 5% allicin exhibited the best control effect, followed by 0.3% tetramycin and 10% zhongshengmycin oligosaccharide, and their preventive effects were better than curative effects. Therefore, 5% allicin can be used as the preferred agent for the control of P. ternata soft rot, and 0.3% tetramycin and 10% zhongshengmycin oligosaccharide as the alternatives. This study has provided a certain theoretical basis for the control of P. ternata soft rot.

Objective: To compare clinical efficacy of minimally invasive locking plate and anatomic locking plate in treating intra-articular calcaneal fractures via sinus tarsi approach., Methods: A retrospective analysis was conducted of 48 patients with intra-articular calcaneal fractures treated with surgery via sinus tarsi approach from July 2016 to June 2017. According to differernt methods of internal fixation, the patients were divided into minimally invasive locking plate group and anatomic locking plate group. In minimally invasive locking plate group, there were 14 males and 10 females, aged from 27 to 46 years old with an average age of (38.70±5.58) years old, 18 patients were typeⅡand 6 patients were type Ⅲ according to Sanders classification. In anatomic locking plate group, there were 17 males and 7 females, aged from 26 to 46 years old with an average age of (37.10±6.44) years old, 16 patients were typeⅡ and 8 patients were type Ⅲ according to Sanders classification. Operative time, visual analogue scale (VAS), postoperative complications between two groups were compared, and Böhler angle, Gissane angal, calcaneal width and height were recorded and compared between two groups at 1 week after operation and final follow up. The functional effect was assessed according to Maryland foot function score at final follow up., Results: All patients were followed up for (14.10±1.94) months (ranged 12 to 18 months). All patients were obtained bone union from 8 to 16 weeks with an average of (10.60±2.25) weeks. Operation time, VAS score and complication rate in minimally invasive locking plate group were (69.50±7.51) min, (2.80±1.07) and 2 cases respectively, and (77.50±7.15) min, (3.80±1.09) and 8 cases in anatomic locking plate group respectively, there were statistical difference between two groups ( P <0.05). However, there were no statistically differences in Maryland foot function score, Böhler angle, Gissane angle, calcaneal width and height at 1 week after opertaion and final follow-up between two groups ( P >0.05)., Conclusion: Compare with anatomic locking plate, minimally invasive locking plate via sinus tarsi approach for Sanders typeⅡ and Ⅲ intra-articular calcaneal fractures could obtain similar reliable fixation and functional recovery with more simple operation, shorter operative time, lighter postoperative pain and less complications.

Exosomes were found to exert a therapeutic effect in the treatment of osteonecrosis of the femoral head (ONFH), while miR-135b was shown to play an important role in the development of ONFH. In this study, we investigated the effects of concomitant administration of exosomes and miR-135b on the treatment of ONFH. A rat mode of ONFH was established. TEM, Western blotting and nanoparticle analysis were used to characterize the exosomes collected from human-induced pluripotent stem cell-derived mesenchymal stem cells (hiPS-MSC-Exos). Micro-CT was used to observe the trabecular bone structure of the femoral head. Real-time PCR, Western blot analysis, IHC assay, TUNEL assay, MTT assay and flow cytometry were performed to detect the effect of hiPS-MSC-Exos and miR-135b on cell apoptosis and the expression of PDCD4/caspase-3/OCN. Moreover, computational analysis and luciferase assay were conducted to identify the regulatory relationship between PDCD4 mRNA and miR-135b. The hiPS-MSC-Exos collected in this study displayed a spheroidal morphology with sizes ranging from 20 to 100 nm and a mean concentration of 1 × 10 12 particles/mL. During the treatment of ONFH, the administration of hiPS-MSC-Exos and miR-135b alleviated the magnitude of bone loss. Furthermore, the treatment of MG-63 and U-2 cells with hiPS-MSC-Exos and miR-135b could promote cell proliferation and inhibit cell apoptosis. Moreover, PDCD4 mRNA was identified as a virtual target gene of miR-135b. HiPS-MSC-Exos exerted positive effects during the treatment of ONFH, and the administration of miR-135b could reinforce the effect of hiPS-MSC-Exos by inhibiting the expression of PDCD4., (© 2020 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)

Soil microorganisms are one of the important biological indictors of soil quality and can reflct the comprehensive ecological environment characteristics of the soil. The research of soil microbial diversity is the key to know the ecological functions and balance with soil. In this paper, high-throughput sequencing on PCR-amplified 16 S rRNA gene V3-V4 fragments was used to determine the bacterial diversity in rhizosphere soil of A. macrocephala under the treatment with BZJN1 or streptoprofen. The results showed that there were no significant differences of the bacteria in A. macrocephala rhizosphere soil of the streptoprofen treatment group and the biocontrol BZJN1 treatment group. All the soil bacteria was classified into 25 categories,67 classes, 108 orders, 167 families and 271 generas, except some unidentified bacteria. Proteobacteria(30.7%-34.8%) was the dominant phylum, of which Alphaproteobacteria(16.8%-18.5%) was the dominant subgroup. Compared with the control group, the relative abundance of multiple phylums bacteria in the rhizosphere soil of A. macrocephala was significantly changed in the streptoprofen treatment group and the biocontrol BZJN1 treatment group. In addition, RDA analysis showed that there was connection with different environmental factors and microbial communities. The abundance of the three genera in the rhizosphere soil of A. macrocephala was significantly positively correlated with Invertase, Urease and AP. PICRUSt function prediction results showed that BZNJ1 could enhance some bacterial functions and promote the plant growth. Biocontrol is a new type of green and safety control pest method. BZNJ1 significantly enhances some bacterial functions on the basis of effectively preventing root rot of A. macrocephala and promoting plant growth, and has no significant effect on the soil bacterial community structure. All the results can provide theoretical support for popularization of BZNJ1.

Two new metal-organic frameworks (MOFs), namely, three-dimensional poly[diaquabis{μ 2 -1,4-bis[(2-methyl-1H-imidazol-1-yl)methyl]benzene}bis(μ 2 -glutarato)dinickel(II)] monohydrate], {[Ni 2 (C 5 H 6 O 4 ) 2 (C 16 H 18 N 4 ) 2 (H 2 O) 2 ]·H 2 O} n or {[Ni 2 (Glu) 2 (1,4-mbix) 2 (H 2 O) 2 ]·H 2 O} n , (I), and two-dimensional poly[[{μ 2 -1,4-bis[(2-methyl-1H-imidazol-1-yl)methyl]benzene}(μ 2 -glutarato)zinc(II)] tetrahydrate], {[Zn(C 5 H 6 O 4 )(C 16 H 18 N 4 )]·4H 2 O} n or {[Zn(Glu)(1,4-mbix)]·4H 2 O} n (II), have been synthesized hydrothermally using glutarate (Glu 2- ) mixed with 1,4-bis[(2-methyl-1H-imidazol-1-yl)methyl]benzene (1,4-mbix), and characterized by single-crystal X-ray diffraction, IR and UV-Vis spectroscopy, powder X-ray diffraction, and thermogravimetric and photoluminescence analyses. Ni II MOF (I) shows a 4-connected 3D framework with point symbol 6 6 , but is not a typical dia network. Zn II MOF (II) displays a two-dimensional 4 4 -sql network with one-dimensional water chains penetrating the grids along the c direction. The solid-state photoluminescence analysis of (II) was performed at room temperature and the MOF exhibits highly selective sensing toward Fe 3+ and Cr 2 O 7 2- ions in aqueous solution.

Background: The tendon-sheath mechanism provides flexibility but degrades the task performance of the flexible endoscopic robot because of the inherent backlash hysteresis problem. Previous studies have only focused on reducing backlash hysteresis. The goal of this study is to identify the backlash hysteresis criteria of surgical tool bending joints to maintain efficient surgical performance., Methods: A test platform for a surgical tool has been developed that has initial backlash hysteresis under 5° and can adjust the backlash hysteresis intentionally. Performance variation has been investigated in three bench-top endoscopic tasks in which various backlash hysteresis conditions were intentionally adjusted., Results: A clear drop-off in task performance has been observed when the backlash hysteresis of the bending joints was greater than 10° regardless of the type of task and link length., Conclusions: The backlash hysteresis of surgical tool bending joints should be reduced to at least 10° to maintain efficient performance in robotic endoscopic surgery., (© 2019 John Wiley & Sons, Ltd.)

Aim: To compare the diagnostic performance of total counts of metastatic lymph nodes (LN-sum) and conventional multidetector (MD) computed tomography (CT) staging in the nodal evaluation of advanced gastric cancer (AGC) patients., Materials and Methods: In total, 127 consecutive patients who underwent preoperative MDCT and gastrectomy for AGC were identified. Metastatic LNs on MDCT were defined as LNs with a short axis ≥8 mm, marked or heterogeneous enhancement, and morphological features (central necrosis, round shape, clustering). The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of the N-stage using LN-sum and conventional MDCT staging were generated and compared. In addition, metastatic LN counts between the MDCT and the histopathological examinations and correlation between LN-sum and histopathological nodal status were analysed., Results: The total counts of metastatic LNs on MDCT was significantly smaller than those detected in histopathological assessments (p<0.0001). LN-sum showed significant correlation with the pathological N stage and the number of metastatic LNs (rho=0.69, 0.73, p<0.0001). The areas under the receiver operating characteristic curve were 0.896, and 0.835, for N stage ≥N2 and N3, with cut-off values of 12.5 and 23.5 mm, respectively. LN-sum provided better diagnostic performance than conventional MDCT staging for discriminating N0-2 versus N3; sensitivity, accuracy, PPV and NPV of LN-sum were significantly higher (80.4 versus 52.2%, 81.1 versus 68.5%, 71.2 versus 57.1%, and 88 versus 74.1%)., Conclusion: LN-sum may be sufficiently useful in assessing the N3 stage of AGC and may help to plan appropriate therapy for AGC patients., (Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Through investigation,it was found that the main disease of leaves was grey mold on Dendrobium officinale in Hubei province,which has a great impact on the yield and quality of D. officinale. The identification of morphological and molecular biological was used to prove that the pathogen was Botrytis cinerea. Through test the effect of 5 plant source fungicides and 4 antibiotic fungicides on mycelial growth of strain HS1,which proved 0. 3% eugenol had the best inhibitory effect,EC50 was 0. 29 mg·L -1 ,the second was1% osthol and EC50 was 1. 12 mg·L -1 ,the EC50 of 0. 5% matrine was 9. 16 mg·L -1 ,the EC50 of the other six fungicides was higher than 10 mg·L -1 . The field control effect test proved that 0. 3% eugenol had the best control effect,reaching 89. 44%,secondly for 1%osthole,which was 77. 17%,0. 5% matrine was in the third place with 62. 37% of effective rate. However,the control effect of the other fungicides was less than 60%. The three plant-derived fungicides were safe for the produce of D. officinale and showed no phytotoxicity. The effect of these fungicides on the growth of D. candidum was tested,and proved that all the fungicides were safe and harmless to D. candidum. This study provides a research basis for the safe and effective prevention and control gray mold of D. officinale.

Alanyl-glutamine (Ala-Gln), a highly soluble and stable glutamine dipeptide, is known to improve gut integrity and function. The aim of this study was to evaluate whether dietary Ala-Gln supplementation could improve growth performance, intestinal development and digestive-absorption function in weaned piglets. A total of 100 purebred Yorkshire piglets weaned at 21 days of age were assigned randomly to four dietary treatment groups and fed a basal diet (control group) or a basal diet containing 0.15%, 0.30% and 0.45% Ala-Gln, respectively. Compared with the control group, piglets fed the Ala-Gln diets had higher average daily gain and lower feed : gain and diarrhea rate (P < 0.05). Moreover, dietary Ala-Gln supplementation increased villous height and villous height : crypt depth ratio in duodenum and jejunum (P < 0.05), as well as the activities of maltase and lysozyme in jejunum mucosa (P < 0.05). In addition, a decrease in serum diamine oxidase activity and crypt depth in duodenum and jejunum was observed in piglets fed the Ala-Gln diets (P < 0.05). Serum cytosolic phospholipase A2 (cPLA2) concentration and gene expression of cPLA2, Na+-dependent glucose transporter 1, glucose transporter 2 and peptide transporter 1 in jejunum were increased by feeding Ala-Gln diets relative to control diet (P < 0.05). These results indicated that feeding Ala-Gln diet has beneficial effects on the growth performance of weaned piglets, which associated with maintaining intestinal morphology and digestive-absorption function.

Objective: To compare clinical effect of minimally invasive surgery and conventional open plating for acute displaced midshaft clavicle fracture based on 3D-print., Methods: From July 2016 and December 2016, 40 patients with acute displaced midshaft clavicle fractures were retrospectively analyzed. The patients were divided into 3D minimally invasive surgery group (group A) and conventional open plating group (group B) according to different surgical incisions and whether to use 3D printing. In group A, including 11 males and 9 female, aged from 19 to 57 years old with an average of(37.2±9.3)years old; type 2A2 were 4 patients, type 2B1 were 9 patients and type 2B2 were 7 patients according to Robinson classification. In group B, including 13 males and 7 female, aged from 17 to 54 years old with an average of(35.1±9.5) years old; type 2A2 were 5 patients, type 2B1 were 8 patients and type 2B2 were 7 patients according to Robinson classification. Operative time, blood loss, length of incision, fracture healing time, complications were observed and compared between two groups, DASH score and Constant score of shoulder joint were evaluated at 12 months after operation., Results: Forty patients were followed up from 12 to 18 months with an average of(15.1±2.0) months. All fractures were healed, healing time in group A ranged from 12 to 18 months with an average of (14.3±1.7) months, in group B ranged from 11 to 18 months with an average of (14.4±1.9) months, while there was no statistical differences between two groups( P >0.05). No differences in blood loss between two groups( P >0.05). Operative time, length of incision in group A was less than that of group B ( P <0.05). There were no significant differences in DASH score and Constant score at 12 months between two groups( P >0.05). One patient in group A occurred complication, and 6 patients in group B occurred compilations, and has statistical differences between two groups( P <0.05)., Conclusions: Minimally invasive technique based on 3D-print could resolve some difficulties of minimally invasive surgery effectively and achieve fracture healing and functional recovery similar to traditional open reduction with more beautiful incision, less complication, shorter operation time., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© 2019 by the China Journal of Orthopaedics and Traumatology Press.)

A glucose/oxygen biofuel cell (BFC) that can operate continuously under oxygen-free conditions is described. The oxygen-deficit limitations of metabolite/oxygen enzymatic BFCs have been addressed by using an oxygen-rich cathode binder material, polychlorotrifluoroethylene (PCTFE), which provides an internal oxygen supply for the BFC reduction reaction. This oxygen-rich cathode component mitigates the potential power loss in oxygen-free medium or during external oxygen fluctuations through internal supply of oxygen, while the bioanode employs glucose oxidase-mediated reactions. The internal oxygen supply leads to a prolonged energy-harvesting in oxygen-free solutions, e.g., maintaining over 90% and 70% of its initial power during 10- and 24-h operations, respectively, in the absence of oxygen. The new strategy holds considerable promise for energy-harvesting and self-powered biosensing applications in oxygen-deficient conditions., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Anterior chest wall numbness after plate fixation of clavicular shaft fractures is a common complication. This is usually related to damage of the branches of the supraclavicular nerve in conventional open plating. We investigated whether the use of minimally invasive plate osteosynthesis could reduce the incidence of post-operative numbness and improve patients' satisfaction compared to open plating., Methods: Between August 2012 and October 2015, 73 patients with acute clavicle shaft fracture (Robinson classification 2A2-2B2) were treated with plate fixation at our institution. Thirty-eight patients underwent minimally invasive plate osteosynthesis (MIPO), and the other 35 patients received conventional open reduction and internal fixation (ORIF). The incidence of anterior chest wall numbness, numbness area, and patient satisfaction were evaluated at 2 weeks, 3 months and 1 year after the operation by questionnaires. Shoulder joint function was evaluated using the Constant-Murley score and the Disability of the Arm, Shoulder and Hand (DASH) score, and pain was measured using a Visual Analogue Scale (VAS)., Results: The patients in the MIPO group had a lower incidence and smaller area of anterior chest wall numbness than the ORIF group at each follow-up interval. The patients who underwent MIPO reported higher satisfaction with the operation. There was no significant difference in the Constant-Murley score, DASH score and VAS of the 2 groups at 1-year follow-up., Conclusion: The MIPO technique for clavicle shaft fractures is an effective way to reduce post-operative numbness and improve patients' satisfaction compare to conventional open plating. Surgeons could consider using this technique as an alternative procedure to prevent iatrogenic supraclavicular nerve damage and subsequent anterior chest wall numbness., (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

In this study， an endophytic bacteria strain BZJN1 was isolated from Atractylodes macrocephala， and identified as Bacillus subtilis by physiological and biochemical tests and molecular identification. Strain BZJN1 could inhibit the growth of mycelia of Ceratobasidium sp. significantly， and the inhibition rate was more than 70%. The mycelium growth deformity with bulge as spherical and partially exhaustible in apex or central with microscopic observation. The inhibitory rates under 3% and 6% concentrations of the cell free fermentation were 22.7% and 38.7% expectively. The field test proved that the control efficacy of treatment of 1×10⁸ cfu·mL⁻¹ is 75.27% and 72.37% after 10 and 20 days. All the treatments of strain BZJN1 was able to promote the growth of A. macrocephala， the treatment of 1×10⁸ cfu·mL⁻¹ could able to increase the yield to 14.1%., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Printing techniques could offer a scalable approach to fabricate thermoelectric (TE) devices on flexible substrates for power generation used in wearable devices and personalized thermo-regulation. However, typical printing processes need a large concentration of binder additives, which often render a detrimental effect on electrical transport of the printed TE layers. Here, we report scalable screen-printing of TE layers on flexible fiber glass fabrics, by rationally optimizing the printing inks consisting of TE particles (p-type Bi 0.5 Sb 1.5 Te 3 or n-type Bi 2 Te 2.7 Se 0.3 ), binders, and organic solvents. We identified a suitable binder additive, methyl cellulose, which offers suitable viscosity for printability at a very small concentration (0.45-0.60 wt.%), thus minimizing its negative impact on electrical transport. Following printing, the binders were subsequently burnt off via sintering and hot pressing. We found that the nanoscale defects left behind after the binder burnt off became effective phonon scattering centers, leading to low lattice thermal conductivity in the printed n-type material. With the high electrical conductivity and low thermal conductivity, the screen-printed TE layers showed high room-temperature ZT values of 0.65 and 0.81 for p-type and n-type, respectively.

Highly stretchable textile-based biofuel cells (BFCs), acting as effective self-powered sensors, have been fabricated using screen-printing of customized stress-enduring inks. Due to synergistic effects of nanomaterial-based engineered inks and the serpentine designs, these printable bioelectronic devices endure severe mechanical deformations, e.g., stretching, indentation, or torsional twisting. Glucose and lactate BFCs with the single enzyme and membrane-free configurations generated the maximum power density of 160 and 250 µW cm -2 with the open circuit voltages of 0.44 and 0.46 V, respectively. The textile-BFCs were able to withstand repeated severe mechanical deformations with minimal impact on its structural integrity, as was indicated from their stable power output after 100 cycles of 100% stretching. By providing power signals proportional to the sweat fuel concentration, these stretchable devices act as highly selective and stable self-powered textile sensors. Applicability to sock-based BFC and self-powered biosensor and mechanically compliant operations was demonstrated on human subjects. These stretchable skin-worn "scavenge-sense-display" devices are expected to contribute to the development of skin-worn energy harvesting systems, advanced non-invasive self-powered sensors and wearable electronics on a stretchable garment.

Zn aqueous batteries typically suffer from poor cycle life because water soluble zincate ions are formed during the oxidation of Zn. When Zn is oxidized, most of the Zn 2+ ions detach from the current collector and become electrochemically inactive, leaving the battery non-rechargeable. Numerous reports demonstrate the use of Bi 2 O 3 as an electrode additive to enhance electrochemical performance and they attribute this phenomenon to the improvement in electrical conductivity. However, conductivity does not have an effect on the intrinsic solubility of the zincate ion. We conduct a series of characterizations to provide a comprehensive mechanistic role of Bi 2 O 3 in the Zn electrode. We find that upon oxidation, zincate ions are formed but they relax into ZnO on the surface of the bismuth species. This work proposes that the reason for the prolonged cycle life is due to the deposition of ZnO through relaxation and this prevents losing electrochemically active materials. This finding paves the way for further improving the cycle life and understanding the mechanism of the Zn based rechargeable aqueous batteries and possibly other conversion types of rechargeable batteries.

Purpose: To investigate the expression of differentiated embryo-chondrocyte expressed gene l（DEC1）in oral squamous cell carcinoma（OSCC）and its clinical significance., Methods: Detection of the protein expression of DEC1 in tissue specimens from 80 primary OSCC patients and 30 cases of normal oral mucosa were performed using immunohistochemistry. SPSS10.0 software package was uses for statistical analysis., Results: The result of immunohistochemistry showed that positive expression rate of DEC1 in OSCC tissues was 92.50%, 5.00% in normal oral mucosa tissue. The difference was statistically significant (P<0.05). In OSCC tissues, the difference in expression of DEC1 was statistically significant (P<0.05) between highly differentiated group and lowly differentiated group, between patients with lymph node metastasis and patients without lymph node metastasis., Conclusions: The significantly increased DEC1 gene may be associated with the tumorigenesis and development of OSCC.

We present the first example of an all-printed, inexpensive, highly stretchable CNT-based electrochemical sensor and biofuel cell array. The synergistic effect of utilizing specially tailored screen printable stretchable inks that combine the attractive electrical and mechanical properties of CNTs with the elastomeric properties of polyurethane as a binder along with a judiciously designed free-standing serpentine pattern enables the printed device to possess two degrees of stretchability. Owing to these synergistic design and nanomaterial-based ink effects, the device withstands extremely large levels of strains (up to 500% strain) with negligible effect on its structural integrity and performance. This represents the highest stretchability offered by a printed device reported to date. Extensive electrochemical characterization of the printed device reveal that repeated stretching, torsional twisting, and indenting stress has negligible impact on its electrochemical properties. The wide-range applicability of this platform to realize highly stretchable CNT-based electrochemical sensors and biofuel cells has been demonstrated by fabricating and characterizing potentiometric ammonium sensor, amperometric enzyme-based glucose sensor, enzymatic glucose biofuel cell, and self-powered biosensor. Highly stretchable printable multianalyte sensor, multifuel biofuel cell, or any combination thereof can thus be realized using the printed CNT array. Such combination of intrinsically stretchable printed nanomaterial-based electrodes and strain-enduring design patterns holds considerable promise for creating an attractive class of inexpensive multifunctional, highly stretchable printed devices that satisfy the requirements of diverse healthcare and energy fields wherein resilience toward extreme mechanical deformations is mandatory.

Background: The association between chemotherapy-induced ovarian dysfunction (CIOD) and response to neoadjuvant chemotherapy (NAC) is not known. We therefore investigated the impact of CIOD on response to NAC in breast cancer patients according to estrogen receptor (ER) status., Methods: In total, 343 premenopausal breast cancer patients treated with NAC between 2006 and 2010 were analyzed. Clinical responses were determined based on changes in tumor size measured using breast MRI. Patients with complete response or partial response were considered to have clinical response., Results: After completion of NAC, 264 of 343 patients (76.9 %) developed CIOD. The clinical response rate was significantly higher in patients with CIOD than those without CIOD (65.2 vs. 51.9 %; p = 0.033). Additionally, the mean follicle-stimulating hormone (FSH) level after NAC was significantly higher in patients with clinical response (FSH 68.7 ± 34.5 vs. 59.8 ± 34.3 IU/L; p = 0.021). Multivariate analysis showed an independent association of CIOD to clinical response (OR 0.523, 95 % CI 0.297-0.918; p = 0.024). However, we observed no differences in the pathologic complete response (pCR) rate between patients with and without CIOD (8.7 vs. 6.3 %; p = 0.497). Subgroup analysis according to ER status showed that the association between CIOD and clinical response was significant in ER-positive but not ER-negative breast cancer (p = 0.025 and 0.818, respectively)., Conclusions: CIOD during NAC is significantly associated with clinical response, but not pCR. Moreover, this association is only observed in ER-positive breast cancer, suggesting that the moderate difference in response to NAC is possibly a hormonal effect of chemotherapy-induced ovarian dysfunction.

Purpose: T lymphoma invasion and metastasis inducing factor 1 (TIAM1) overexpression has been reported in a variety of human cancers. However, the investigation of TIAM1 in oral squamous cell carcinoma (OSCC) was extremely rare. The aim of the study was to assess TIAM1 expression and explore its role in OSCC., Methods: Immunohistochemistry staining was performed in 80 primary OSCC patients and 20 normal oral mucosa samples. The expression of TIAM1 and its association with clinicopathological parameters were analyzed using SPSS19.0 software package., Results: TIAM1 expression was significantly stronger in OSCC tissues (91.25%) compared with normal oral mucosa (10.00%); TIAM1 overexpression was significantly correlated with histological grade (P=0.019), clinical stage (P<0.001) and lymph node metastasis (P=0.004), but not significantly correlated with sex or age., Conclusions: TIAM1 may play an important role in the occurrence, development and metastasis of OSCC, which may be a potentially therapeutic target in the future.

A novel biosensor for the determination of hydrogen peroxide and glucose was developed based on EGN-TDZ-Pd, as an electrocatalyst. The preparation of graphene oxide (GO) nanosheets was functionalized by combining it with 5-amino-1,3,4-thiadiazole-2-thiol (TDZ) and by covalently bonding it to palladium (Pd) nanoparticles (GO-TDZ-Pd). In the electrochemical investigation, EGN-TDZ-Pd was characterized via scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and electrochemical impedance spectroscopy (EIS). Cyclic voltammetry (CV) and chronoamperometry (CA) were used to characterize the performance of EGN-TDZ-Pd. The proposed H2O2 biosensor exhibited a wide linear range from 10 µM to 6.5 mM. Also, a glucose biosensor was prepared using glucose oxidase and EGN-TDZ-Pd placed onto a glassy carbon electrode (GCE). The GOx/EGN-TDZ-Pd/GCE was easily prepared using a rapid and simple procedure, and it was utilized for highly sensitive glucose determination.

Poly(3,4-ethylenedioxythiophene)-(PEDOT)-functionalized reduced graphene oxide (rGO) with MnO2 nanoparticles (MnO2/PEDOT/rGO) was prepared using electrochemical methods. The MnO2/ PEDOT/rGO was obtained through the electrochemical reduction of PEDOT/GO and under electrochemical treatment in KMnO4. The PEDOT/rGO and MnO2/PEDOT/rGO were characterized by several instrumental and electrochemical methods. The electrocatalytic 02 reduction for both electrodes was investigated via cyclic and hydrodynamic voltammetry in 0.1 M KOH aqueous solutions. The kinetic analysis in comparison to PEDOT/rGO a significant enhancement was found for the MnO2/PEDOT/rGO. The proposed main path in the oxygen reduction reaction (ORR) mechanism on the MnO2/PEDOT/rGO was the direct four-electron transfer process with faster transfer kinetic rate. The better ORR kinetics were obtained due to the excellent composite formation and well attachment of MnO2 NPs within oxide form. The PEDOT/rGO was less stable for long term use than MnO2/PEDOT/rGO.

Objective: To study the dry matter accumulation and nutrient uptake of Shiyao Angelica sinensis, in order to provide theoretical basis for reasonable fertilization., Methods: The aerial part(stems and leaves) and root were collected in different growth periods, and the fresh weight, dry weight and contents of nitrogen, phosphorus and potassium were measured., Results: The dry matter accumulation and nutrient uptake were well fitted a Logistic equation with the increase of the number of days after sowing. In the early stage of Shiyao Angelica sinensis growth, the dry matter accumulation and nutrient uptake were very slow. Beginning in late July, the dry matter accumulation and nutrient uptake of stems and leaves sped up. Starting from the occurrence peak in August, the roots of nutrient uptake sped up. In late September, the dry matter accumulation of root reached a peak. In early October, the dry matter accumulation and nutrient uptake slowed down significantly. The middle of October was the harvest time., Conclusion: Some phosphorus should be applied as base fertilizer in the plantation of Shiyao Angelica sinensis, and nitrogen should be applied as top fertilizer in different growth periods.

Purpose: The aim of this study was to investigate whether the observed changes over time in the survival rates vary according to the intrinsic subtypes of breast cancer diagnosed., Methods: Data from 46,320 breast cancer patients in the Korean Breast Cancer Registry who underwent surgery between 1999 and 2006 were reviewed. Among them, results from 25,887 patients with available data about the status of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) were analyzed. Patients were classified into two cohorts according to the year in which they underwent surgery: 1999-2002 and 2003-2006., Results: The patients treated in the latter time period showed significantly better overall survival (OS) compared with those in the former period when adjusted for follow-up duration. The proportion of hormone receptor+/HER2-subtype and stage I breast cancer were significantly higher in the latter period (47.4% vs. 54.6%, p<0.001; 31.0% vs. 39.6%, p<0.001, respectively). Improvement in OS between the former and latter periods was seen in all subtypes of breast cancer, including triple-negative cancers (all p-values <0.001 in univariate and multivariate analyses)., Conclusion: Improvement in survival in Korean breast cancer patients over the study years is being observed in all subtypes of breast cancer, implying that increases in both early-stage detection and the proportion of less aggressive cancers contribute to this improvement.

Orange II, an azo dye, is sometimes illegally used as a red dye in food products despite its adverse health effects if consumed. Therefore, the determination of low concentrations of Orange II is an important target. An Orange II sensor was prepared using electrochemically reduced graphene oxide grafted with 5-amino-1,3,4-thiadiazole-2-thiol-Pt nanoparticles (denoted as ERGO-ATDT-Pt) onto a glassy carbon electrode (GCE) and investigated for Orange II detection in 0.1M acetate buffer solution (ABS at pH 4.5) with prominent reversible redox peaks. A wide linear range of 1×10(-)(8)-6×10(-)(7)M with a low detection limit of 3.4×10(-)(10)M (s/n=3) was found for Orange II detection. This developed ERGO-ATDT-Pt/GCE sensor showed good selectivity, excellent stability and better response to the real sample analysis with excellent recovery., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Rhizoma paridis is a perennial, traditional Chinese medicinal herb. In May 2013, a disease was observed in an approximately 10 ha cultivated field in Enshi, Hubei Province, China. Approximately 80% of plants in the field were affected. Symptoms were visible on the basal leaves of affected plants. Chlorosis followed by necrosis started at the leaf tips and margins and gradually spread inward until the entire leaf was necrotic. Thick, gray mycelium and conidia were visible on both sides surface of leaves under wet, humid conditions. The leading edge of the chlorotic leaves was excised from 20 plant samples surface disinfested with 1% NaOCl solution for 1 min, rinsed in sterile water, air dried, and placed on potato dextrose agar (PDA). Plates were incubated at 22°C in the dark. Mycelia were initially hyaline and white, and became dark gray after 72 h. Mycelia were septate with dark branched conidiophores. Conidia were smooth, hyaline, ovoid, aseptate, and ranged from 8 to 14.5 × 7 to 8.5 μm. Numerous hard, small, irregular, and black sclerotia that were 1 to 3 × 2 to 5 mm were visible on PDA plates after 12 days. The fungus was identified as Botrytis cinerea on the basis of these characters (1). The internal transcribed spacer (ITS) region of rDNA was amplified using the ITS1 and ITS4 primer and sequenced (GenBank Accession No. KF265499). BLAST analysis of the PCR product showed 99% identity to Botryotinia fuckeliana (perfect stage of B. cinerea) (EF207415.1, EF207414.1). The pathogen was further identified to the species level as B. cinerea using gene sequences from glyceraldehyde-3-phosphate dehydrogenase (G3PDH), heat-shock protein 60 (HSP60), and DNA-dependent RNA polymerase subunit II (RPB2) (2) (KJ638600, KJ638602, and KJ638601). Pathogenicity was tested by spraying the foliage of 40 two-year-old plants with a suspension of 10 6 conidia per ml of sterile distilled water. Each plant received 30 ml of the inoculum. Ten healthy potted plants were inoculated with sterilized water as control. All plants were covered with plastic bags for 5 days after inoculation to maintain high relative humidity and were placed in a growth chamber at 22°C. The first foliar lesions developed on leaves 7 days after inoculation and were similar to those observed in the field. No symptoms developed on the control plants. B. cinerea was consistently re-isolated from all artificially inoculated plants. The pathogenicity test was completed twice. To our knowledge, this is the first report of gray mold of R. paridis caused by B. cinerea in China. The root of R. paridis is the most commonly used Chinese herbal medicine to treat viper bites. In recent years, cultivation of this herb has increased in China because of its high value. Consequently, the economic importance of this disease is likely to increase with the greater prevalence of this host species. References: (1) H. L. Barnett and B. B. Hunter. Illustrated Genera of Imperfect Fungi. Burgess Publishing Company, Minneapolis, MN, 1972. (2) M. Staats et al. Mol. Biol. Evol. 22:333, 2005.

A simple, eco-friendly and efficient harmless chemical approach has been developed for the simultaneous nitrogen (N) doping and reduction of graphene oxide (GO) by cost free human urine using simple refluxing. Large-scale preparation of graphene has been hindered largely by several issues, such as highly toxic reducing agents that are harmful to human health and environment, complicated reduction process and costly chemicals. Human urine is a natural precursor of urea with no cost. In this process, the NH3 has acted as not only reducing but also doping agent that produced via thermal decomposition of urea, while the N doping level of ~11.1 at% is achieved. For the first time we have used urine as a reductant and doping agent in such a high class chemical technology. The simultaneous reduction and N-doping of GO using urine (denoted as UNG) have confirmed by X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy, and UV-vis spectroscopy. The resultant UNG has demonstrated to show remarkable electrocatalytic activity toward oxygen reduction reaction (ORR) with better fuel selectivity, and stability than that of the commercially available 20 wt% Pt/C electrode using cyclic voltammetry (CV) and chronoamperometry.

Objective: To compare transverse abdominis (TrA) contractility in stroke patients with hemiparesis and healthy adults using musculoskeletal ultrasonography., Methods: Forty-seven stroke patients with hemiparesis and 25 age-matched healthy control subjects participated in this study. Stroke patients were divided into three groups on the basis of their degree of ambulation. Group A consisted of 9 patients with wheelchair ambulation, group B of 23 patients with assisted ambulation, and group C of 15 patients with independent ambulation. Inter-rater reliability regarding ultrasonographic measurement of abdominal muscle thickness in the control group was assessed by two examiners. The TrA contraction ratio (TrA contracted thickness/TrA resting thickness) was measured during abdominal drawing-in maneuver and was compared between the patients and the control group and between the ambulation groups., Results: The inter-rater reliability ranged from 0.900 to 0.947. The TrA contraction ratio was higher in the non-paretic side than in the paretic side (1.40±0.62 vs. 1.14±0.35, p<0.01). The TrA contraction ratio of the patient group was lower in the non-paretic side as well as in the paretic side than that of the control group (right 1.85±0.29, left 1.92±0.42; p<0.001). No difference was found between the ambulation regarding the TrA contraction ratio., Conclusion: The TrA contractility in hemiparetic stroke patients is significantly decreased in the non-paretic side as well as in the paretic side compared with that of healthy adults. Ultrasonographic measurement can be clinically used in the evaluation of deep abdominal muscles in stroke patients.

Purpose: We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography., Methods: We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as those lesions detected by breast MRI that were previously undetected by mammography and ultrasonography and which would otherwise have not been identified., Results: Among the 1,038 cases, 228 additional lesions (22.0%) and 30 additional malignancies (2.9%) were detected by breast MRI. Of these 228 lesions, 109 were suspected to be malignant (Breast Imaging-Reporting and Data System category 4 or 5) on breast MRI and second-look ultrasonography and 30 were pathologically confirmed to be malignant (13.2%). Of these 30 lesions, 21 were ipsilateral to the main lesion and nine were contralateral. Fourteen lesions were in situ carcinomas and 16 were invasive carcinomas. The positive predictive value of breast MRI was 27.5% (30/109). No clinicopathological factors were significantly associated with additional malignant foci., Conclusion: Breast MRI was useful in detecting additional malignancy in a small number of patients who underwent ultrasonography and mammography.

A simple method has adapted to prepare MWCNT grafted Poly(lactic acid) (MWCNT-g-PLA) by intercalative polymerization of poly(lactic acid) in the presence of multi-wall carbon nanotubes (MWCNT) functionalized with hydroxyl groups. The functionalized MWCNT has obtained from the treatment of methylene diphenyl diisocyanate (MDI) with MWCNT, and then the reaction with 1,4-butanediol (BD) to create functional hydroxyl groups. MWCNT-g-PLA-Pd and MWCNT-g-PLA-Pt have prepared from the MWCNT-g-PLA and metal precursors. The synthesized materials have characterized by 1H-NMR, Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM). The MWCNT-g-PLA-Pd is possibilities for employing to electrochemical detection of hydrogen peroxide. Electrocatalytic activities are verified from cyclic voltammetry (CV) and amperometric response in 0.1 M phosphate buffer solution (PBS). The biosensor provided good stability and selectivity towards interferences such as UA, AA, and glucose.

In this paper, an efficient method was successfully established by the combination of macroporous resin (MR) and high-speed counter-current chromatography (HSCCC) for rapid enrichment and separation of aloe-emodin 8-O-β-D-glucoside, emodin 1-O-β-D-glucoside, emodin 8-O-β-D-glucoside and piceatannol 4'-O-β-D-(6″-O-gallate)-glucoside. Six kinds of macroporous resins were investigated in the first step and X-5 macroporous resin was selected for the enrichment of the target compounds. The recoveries of the target compounds reached 89.0, 85.9, 82.3 and 84.9% respectively after 40% ethanol elution. In the second step, the target compounds were separated by HSCCC with a two-phase solvent system composed of chloroform/ethyl acetate/methanol/water (8:1:6:5, v/v). The established method will be helpful for further characterization and utilization of Rheum tanguticum. The results demonstrate that MR coupled with HSCCC is a powerful technique for separation of bioactive compounds from natural products., (Copyright © 2014 Elsevier B.V. All rights reserved.)

In two-dimensional interfacial assemblies, there is an interplay between molecular ordering and interface geometry, which determines the final morphology and order of entire systems. Here we present the interfacial phenomenon of spontaneous facet formation in a water droplet driven by designed peptide assembly. The identified peptides can flatten the rounded top of a hemispherical droplet into a plane by forming a macroscopic two-dimensional crystal structure. Such ordering is driven by the folding geometry of the peptide, interactions of tyrosine and crosslinked stabilization by cysteine. We discover the key sequence motifs and folding structures and study their sequence-specific assembly. The well-ordered, densely packed, redox-active tyrosine units in the YYACAYY (H-Tyr-Tyr-Ala-Cys-Ala-Tyr-Tyr-OH) film can trigger or enhance chemical/electrochemical reactions, and can potentially serve as a platform to fabricate a molecularly tunable, self-repairable, flat peptide or hybrid film.

Objective: To explore clinical effectiveness of internal fixation and semi-shoulder arthroplasty in treating proximal humerus comminuted fractures in elderly., Methods: From October 2009 and October 2011, 32 patients aged over 60 years old with three and four-part fractures of proximal humeral were treated with internal fixation (20 cases) and semi-shoulder arthroplasty (12 cases). In internal fixation group, there were 6 males and 14 females aged from 63 to 82 years old (ranged, 71.50 +/- 5.45), 8 cases with three-part fracture and 12 cases with four-part fracture, and treated with open reduction and locking plate internal fixation. While in semi-shoulder arthroplasty group, there were 4 males and 8 females aged from 61 to 85 years old (ranged, 72.80 +/- 6.80), 5 cases with three-part fracture and 7 cases with four-part fracture, and treated with semi-shoulder arthroplasty. Postoperative complications were observed, EQ-5D was used to evaluate quality of life, and Constant-Murley score was used to assess functional outcomes., Results: All patients were followed up from 12 to 24 months with an average of 18 months. All injuries were healed at stage I . Two cases in internal fixation group occurred severe complications, including 1 case with screw fracture, 1 case with avascular necrosis of humeral head. EQ-5D in interal fixation group and semi-shoulder arthroplasty group were respectively 0.65 +/- 0.12, 0.67 +/- 0.12, Constant-Murley score respectively was 63.20 +/- 11.35 and 66.80 +/- 11.96, and with no statistical meaning between two goups (P>0.05)., Conclusion: There is no difference in qulity of life and functional recovery for the treatment of proximal humerus comminuted fractures by open reduction and internal fixation and semi-shoulder arthroplasty. However, the complication rate in semi-shoulder arthroplasty was lower than that of internal fixation group.

Objective: To observe the changes in protein expression induced by botulinum toxin A (BoNT-A) injection and to characterize the molecular and cellular action of mechanisms of BoNT-A injection on skeletal muscles using proteomic elements as biomarkers., Methods: BoNT-A was injected into left gastrocnemius muscles of 12 Sprague-Dawley rats (2 months of age) at a dosage of 5 units/kg body weight. For the controls same volume of normal saline was injected to right gastrocnemius muscle of each rat. Muscle samples were obtained at 4 time points (3 rats per time point): 3, 7, 14, and 56 day post-injection. To reveal the alterations in muscle protein, we performed 2-dimensional electrophoresis (2DE) and compared Botox group and normal saline group at each time point. Altered protein spots in 2DE were identified using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometer (MALDI-TOF MS) proteomics analysis., Results: Compared with normal saline group, 46 protein spots showed changed protein expression. Twelve protein spots demonstrated increased volume and 34 protein spots demonstrated decreased volume. Among spots of decreased volume, 17 spots showed statistically significant differences. Thirty-eight identified proteins were associated with alterations in energy metabolism, muscle contractile function, transcription, translation, cell proliferation, and cellular stress response., Conclusion: BoNT-A gives influences on muscle contractile function and energy metabolism directly or indirectly besides neurotoxic effects. Proteomic expression provides better understanding about the effect of BoNT-A on skeletal muscle.

Tissue polypeptide-specific antigen (TPS), a specific epitope structure of a peptide in serum associated with human cytokeratin 18, is linked to the proliferative activity of tumors. Here, we aimed to identify the association between the preoperative serum TPS level and outcome in breast cancer patients. We assayed preoperative serum TPS levels in 1,477 breast cancer patients treated between June 2000 and December 2006. The TPS level was measured with a one-step solid phase radiometric sandwich assay detecting the M3 epitope on cytokeratin 18 fragments. The cutoff value was 80 U/L. Among the 1,477 breast cancer patients examined, preoperative serum TPS level was elevated (>80 U/L) in 290 patients (19.6%). Age (>45 years), tumor size (>2 cm), nodal metastasis, negative progesterone receptor and human epidermal growth factor receptor 2 were associated with elevated TPS. Evidence of recurrence was observed in 229 patients (15.6%). Elevated TPS was associated with poor disease-free survival (p < 0.001) and overall survival (p < 0.001). In a multivariate analysis using the Cox proportional regression model, elevated TPS was an independent prognostic factor for disease-free survival (p = 0.001) and overall survival (p = 0.026). Furthermore, in subgroup analysis based on molecular subtype, the prognostic effect of preoperative TPS on survival (OS: HR 2.614, p = 0.003; DFS: HR 1.895, p = 0.001) was identified only in the luminal A subtype. Elevated preoperative serum TPS level is associated with poor breast cancer outcomes. Based on these findings, we conclude that preoperative TPS is a valuable biomarker for clinical use in predicting outcomes in breast cancer patients., (Copyright © 2012 UICC.)

Atractylodes macrocephala is a perennial herbaceous plant (family Asteraceae) native to China. The biennial root, Largehead Atractylodes Rhizome (LAR), is the most commonly used Chinese herbal medicine to prevent early pregnancy loss due to miscarriage. From summer 2010 to spring 2012, symptoms of root rot were observed on LAR in Xianfeng county, Enshi city, Hubei Province, China. White mold on the root of LAR could be observed at an early growth stage in the field and the white mold spread over the entire plant after 10 days, which differs from root rot of LAR caused by Fusarium oxysporum and Rhizoctonia solani, neither of which are characterized as having mycelium spreading over the whole plant (4). Where root rot symptoms were present, rhizome yield was reduced by 15% on average, with up to 40% yield loss in some fields. Under humid conditions in mid-June, the disease in the field spread quickly and the rhizomes of LAR were completely rotted. After rainfall and increasing temperature from 16 to 35°C, white mycelium appeared and plants withered within a few weeks. In April 2011 and 2012, a fungus was consistently recovered from symptomatic rhizome samples after they were surface sterilized with 0.1% mercuric chloride solution and plated onto potato dextrose agar (PDA). Pale gray colonies with short aerial mycelia and brown sclerotia formed on PDA after 7 days incubation at 28°C. Binucleate cells were observed using light microscopy and the characteristics were matched with morphological characteristics of a Ceratobasidium sp (3). Genomic DNA of the culture was extracted, and the rDNA-internal transcribed spacer sequence (GenBank Accession No. JQ926741) showed 99% identity to Ceratobasidium sp (GenBank No. H269825.1). Mycelial plugs of the culture taken from PDA were inoculated onto 40 rhizomes of 1-year-old seedlings and plants were incubated with a 16-h photoperiod at 28°C and 90% relative humidity in an artificial climate chamber where they developed typical disease symptoms after 2 days. Ten rhizomes of 1-year-old seedlings and were treated with PDA plugs only. All seedlings inoculated with the pathogen were withered and the rhizomes were completely covered with gray mycelium 2 days after inoculation, which was similar to the symptoms observed in the field. After 7 days, the symptoms were more severe than those observed in the field, with seedlings rotted completely. The main stalk of all inoculated plants was covered with gray mycelia in 4 days, and the stalk became withered, which was similar to the symptoms observed in the field. No symptoms were observed on control seedlings and plants. Koch's postulates were fulfilled by successful reisolation of Ceratobasidium sp. from diseased seedlings. The pathogenicity tests were carried out twice. Ceratobasidium sp. has been reported to cause root rot of canola in Washington (2). It has also been observed on Rehmannia in China (1). To our knowledge, this is the first report of Ceratobasidium sp. causing root rot on LAR. References: (1) B. B. Chen et al. Chin. J. Chin. Material Medica (In Chinese) 9:1137, 2011. (2) K. L. Schroeder et al. Plant Dis. 96:591, 2012. (3) B. Sneh et al. Page 39 in: Identification of Rhizoctonia Species. The American Phytopathological Society, 1991. (4) S. X. Zang et al. J. Agric. Univ. Hebei (In Chinese) 28:73, 2005.

Pd nanoparticle catalysts supported by thiolated graphene oxide (tGO) on a glassy carbon electrode (GCE), and denoted as tGO-Pd/GCE, are used in this study for the electrochemical determination of hydroxylamine and hydrazine. The physicochemical properties of tGO-Pd were characterized by transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS) and electrochemical impedance spectroscopy (EIS). They showed strong catalytic activity toward the oxidation of hydroxylamine and hydrazine. Cyclic voltammetry (CV) and amperometry were used to characterize the sensors' performances. The detection limits of hydroxylamine and hydrazine by tGO-Pd/GCE were 0.31 and 0.25 microM (s/n = 3), respectively. The sensors' sensitivity, selectivity, and stability were also investigated.

Purpose: The need for surgical excision in patients with ultrasound-guided core needle biopsy (CNB)-diagnosed atypical ductal hyperplasia (ADH) remains an issue of debate. The present study sought to validate a scoring system (the U score, for underestimation) that we have previously developed for predicting malignancy in CNB-diagnosed ADH., Methods: The study prospectively enrolled 85 female patients with CNB-diagnosed ADH who underwent subsequent surgical excision. Underestimation was defined as a surgical specimen having malignant foci., Results: The overall underestimation rate was 37% (31/85). Multivariate analysis showed that a clinically palpable mass, microcalcification on imaging, size >15 mm and a patient age of ≥50 years were independently associated with underestimation. When applied to the scoring system, the validation score was significant (p<0.001; area under the curve, 0.852). No patient with a U score <3.5 had an underestimated lesion., Conclusion: The present study successfully validated the efficacy of our scoring system for predicting malignancy in CNB-diagnosed ADH. A U score of ≤3.5 indicates that surgical excision may not be necessary.

Objectives: The present study tried to identify factors predictive of upstaging from ultrasound-guided core needle biopsy (CNB)-diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision., Materials and Methods: We enrolled 506 female CNB-diagnosed DCIS patients who underwent subsequent surgical excision between January 2000 and February 2011. A retrospective analysis of patients undergone core needle biopsy and subsequent surgical excision was performed. Ultrasonography guided CNB was performed using either an 8-, 11-gauge vacuum-assisted method, or a 14-gauge needle automated gun method., Results: The overall upstaging rate was 42.7% (216/506). Multivariate analysis found that a palpable lesion, a lesion size >20 mm, a high grade lesion, and use of the 14-gauge needle method were independently associated with upstaging (p < 0.05 for all variables). We designed a scoring system to predict lymph node positivity in these patients, and the subsequent ROC curve showed an AUC value of 0.746 (p < 0.001, 95% CI: 0.66-0.82). Patient with a non-high grade lesion that was ≤20 mm in size carried no risk of lymph node positivity., Conclusion: Upstaging was associated with lesions that were large, palpable or high grade. It was also associated with use of the 14-gauge needle method. Our scoring system might be helpful to identify patients who do not require sentinel lymph node biopsy., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Purpose: To assess the technical success rate and safety of radiofrequency perforation guidewire (RF) technology for the recanalization of refractory chronic central venous occlusions in symptomatic hemodialysis patients with failed conventional endovascular methods., Methods: This single center retrospective cohort of hemodialysis patients comprised of six men (mean age 67 years, range 55 to 80) with autogenous fistulae, who had already undergone failed conventional endovascular methods. These patients underwent the RF perforation technique from December 2006 to January 2010., Results: Three patients were successfully treated using the RF perforation technique, after which they had PTFE stent grafts placed at the site of occlusion. There was no recurrence of clinical symptoms. In the remaining three patients, the procedure was terminated after multiple unsuccessful attempts. There were no complications., Conclusions: The RF perforation technique is a potential alternative technology for recanalization of refractory chronic central venous occlusions in hemodialysis patients in the setting of failed conventional endovascular recanalization techniques.

Background: Our aim was to compare the accuracy of magnetic resonance imaging (MRI) and ultrasonography (US) in measuring the size of invasive breast cancer (IBC) and carcinoma in situ (CIS). We also examined the utility of routinely performing MRI in addition to US before breast-conserving surgery (BCS)., Patients and Methods: Data from 1558 consecutive patients diagnosed with IBC and/or CIS between 2003 and 2005 were reviewed. For comparing the accuracy of US and MRI, paired t test was done comparing pathologic and imaging (US and MRI) tumor size in 821 patients who received both breast US and MRI. In instance of attempted BCS (n = 794), operative approach, resection margins, and clinical outcomes of non-MRI and MRI groups were compared., Results: For CIS, IBC without CIS, and IBC with CIS, MRI was more accurate in estimating tumor size than US. When BCS was attempted (n = 794), the rate of tumor involvement in initial resection margins did not differ between non-MRI and MRI groups (23.0% and 23.4%, P = .926). Similarly, rates of re-excision (13.1% vs 17.5%, P = .130) and conversion to mastectomy (2.3% vs 2.1%, P = .893) were comparable, as were ipsilateral breast tumor recurrence, locoregional recurrence, and disease-free survival (log rank P = .284, .950, and .955, respectively)., Conclusions: Breast MRI provided more accurate estimates of tumor size, correlating better with pathologic tumor size than US for both IBC and CIS. However, no clear benefit in terms of lower re-excision rate, higher breast conservation success, or reduced recurrence emerged for routine use of breast MRI before BCS.

Introduction: Anti-estrogen therapy has been shown to reduce mammographic breast density (MD). We hypothesized that a short-term change in breast density may be a surrogate biomarker predicting response to adjuvant endocrine therapy (ET) in breast cancer., Methods: We analyzed data for 1,065 estrogen receptor (ER)-positive breast cancer patients who underwent surgery between 2003 and 2006 and received at least 2 years of ET, including tamoxifen and aromatase inhibitors. MD was measured using Cumulus software 4.0 and expressed as a percentage. MD reduction (MDR) was defined as the absolute difference in MD of mammograms taken preoperatively and 8-20 months after the start of ET., Results: At a median follow-up of 68.8 months, the overall breast cancer recurrence rate was 7.5% (80/1065). Mean MDR was 5.9% (range, -17.2% to 36.9%). Logistic regression analysis showed that age < 50 years, high preoperative MD, and long interval between start of ET to follow-up mammogram were significantly associated with larger MDR (p < 0.05). In a survival analysis, tumor size, lymph node positivity, high Ki-67 (≥ 10%), and low MDR were independent factors significantly associated with recurrence-free survival (p < 0.05). Compared with the group showing the greatest MDR (≥ 10%), the hazard ratios for MDRs of 5-10%, 0-5%, and < 0% were 1.33, 1.92, and 2.26, respectively., Conclusions: MD change during short-term use of adjuvant ET was a significant predictor of long-term recurrence in women with ER-positive breast cancer. Effective treatment strategies are urgently needed in patients with low MDR despite about 1 year of ET.

A sensitive and selective method using 2-(7H-dibenzo[a,g]carbazol-7-yl)ethyl 4-methylbenzenesulfonate (DBCETS) as a new fluorescent labeling reagent has been proposed for simultaneously detecting BA and FFA by HPLC with fluorescence detector. The developed method offered the low detection limits of 0.42-0.70 and 0.28-0.57 ng/mL for BA and FFA, respectively. Compared with the reported methods, the proposed method here is capable of offering higher detection sensitivity and selectivity, with less cost and lower volume of sample preparation. This method was validated to ensure high accuracy and precision, and the reliability of its results. When applied to the serum samples of healthy volunteers and patients with hepatic carcinoma, it showed excellent applicability., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The electrocatalytic reduction of hydrogen peroxide on thioalted graphene oxide (t-GO) covalent bonded to palladium nanoparticles was used as the basis of an H2O2 biosensor. Poly (diallydimethylammonium chloride)-coated t-GO-Pd on glassy carbon electrodes was easily and quickly prepared and gave sensitive measurements of H2O2 concentration. The Pd nanoparticles covalently bonded to the thiolated graphene oxide were characterized by transmission electron microscopy, X-ray photoelectron spectroscopy, and energy dispersive X-ray spectroscopy. Comparable results for H2O2 determination were obtained from cyclic voltammetric and amperometric measurements. The proposed H2O2 biosensor exhibited a wide linear range of 10 microM to 10 mM, and a low detection limit of 0.22 microM (S/N = 3), at an applied potential of -0.1 V by the amperometric method.