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Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) remains controversial, especially for tumors larger than 5 cm. We compared the short- and long-term outcomes of laparoscopic and open liver resection (OLR) for large HCC.Patients with large HCC after curative hepatectomy were enrolled. To compare the short-term outcomes, propensity score matching (PSM) and inverse probability treatment weighting (IPTW) were performed to reduce the effect of confounding factors, respectively. Subsequently, Cox-regression analyses were conducted to identify the independent risk factors associated with decreased recurrence-free survival (RFS) and poor overall survival (OS).There were 265 patients enrolled in the final analysis: 146 who underwent OLR and 119 who underwent LLR. There was no significant difference between the OLR and LLR groups according to PSM and IPTW analysis (all P 0.05). Multivariable analysis revealed that LLR was not independently associated with poorer OS (HR 1.15, 95% CI 0.80-1.67, P = 0.448) or RFS (HR 1.22, 95% CI 0.88-1.70, P = 0.238).There were no significant differences in perioperative complications or long-term prognosis between LLR and OLR for large HCC, which provides evidence for standard laparoscopic surgical practice with adequate surgeon experience and careful patient selection.

Taking the upper sub-member of Sha 4 in Well Fanye 1 and Well Niuye 1 in Dongying Sag, Jiyang Depression, Bohai Bay Basin as a typical example, this paper adopts the method of combining macro and micro laminar characterization and complementing each other. The characteristics of laminar development are studied by means of fine description of rock thin sections by cores and electron microscopic observation Reconstruction of the Bohai Bay Basin in sand four period of ancient sedimentary environment, it is concluded that the sand on the four period of development of four complete filling sedimentary cycle. Using Milankovitch cycles method, reveals the ancient climate control mechanism of lithofacies, formed by organic laminae under hot and humid climate and a small amount of calcite laminated lithofacies, in hot and humid climate, the lithofacies is mainly composed of organic lamina and a small amount of calcite lamina, while in cold and dry climate, the lithofacies is mainly composed of calcite lamina, and the lithofacies is mainly composed of organic lamina, silty lamina and gypsum lamina. Micro-laminar research is an important scientific issue in unconventional oil and gas eology. It can provide basic data for unconventional oil and gas exploration, such as the types, distribution and extension of laminar, especially the determination of sampling targets. Different laboratory samples can be analyzed according to the laminar types.

The initial tacrolimus dose regimen in paediatric lung transplant recipients is unknown. The present study optimized the initial tacrolimus dose regimen for paediatric lung transplant recipients.This study was based on a published population pharmacokinetic model of tacrolimus in lung transplant recipients and used Monte Carlo simulations to recommend an initial dose regimen of tacrolimus in paediatric lung transplant recipients.Without voriconazole, the tacrolimus doses recommended for paediatric lung transplant recipients who were not CYP3A5*1 carriers were 0.02, 0.03, and 0.04 mg/kg/day, split into two doses, for weights of 10-16, 16-30, and 30-40 kg, respectively. For paediatric lung transplant recipients who were CYP3A5*1 carriers, the tacrolimus doses of 0.03, 0.04, 0.05, and 0.06 mg/kg/day, split into two doses, were recommended for weights of 10-16, 16-25, 25-30, and 30-40 kg, respectively. With voriconazole, the tacrolimus dose recommended for paediatric lung transplant recipients who were not CYP3A5*1 carriers was 0.02 mg/kg/day, split into two doses, for weights of 10-40 kg. For paediatric lung transplant recipients who were CYP3A5*1 carriers, tacrolimus doses of 0.02 and 0.03 mg/kg/day, split and two doses, were recommended for weights of 10-24 and 24-40 kg, respectively.This study developed tacrolimus dose regimens for the first time for paediatric lung transplant recipients using Monte Carlo simulation and optimized initial dosage in paediatric lung transplant recipients.

Background and Aims Preoperative prediction of microvascular invasion (MVI) using a noninvasive method remain unresolved, especially in HBV-related in intrahepatic cholangiocarcinoma (ICC). This study aimed to build and validate a preoperative prediction model for MVI in HBV-related ICC.Methods Patients with HBV-associated ICC undergoing curative surgical resection were identified. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors of MVI in the training cohort. Then, a prediction model was built by enrolling the independent risk factors. The predictive performance was validated by receiver operator characteristic curve (ROC) and calibration in the validation cohort.Results Consecutive 626 patients were identified and randomly divided into the training (418, 67%) and validation (208, 33%) cohorts. Multivariate analysis showed that TBIL, CA19-9, tumor size, tumor number, and preoperative image lymph node metastasis were independently associated with MVI. Then, a model was built by enrolling former fiver risk factors. In the validation cohort, the performance of this model showed good calibration. The area under the curve was 0.874 (95% CI: 0.765–0.894) and 0.729 (95%CI: 0.706–0.751) in the training and validation cohort, respectively. Decision curve analysis showed an obvious net benefit from the model.Conclusion Based on clinical data, an easy model was built for the preoperative prediction of MVI, which can assist clinicians in surgical decision-making and adjuvant therapy.

Aims. The present study is aimed at exploring the effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on weight in type 2 diabetes mellitus (T2DM) and therapeutic regimen recommendations. Methods. 20,019 patients with T2DM were enrolled. The maximal effect ( E max ) models, whose evaluation index was change rate of body weight from baseline value, were used to analyze data using nonlinear mixed effect modeling (NONMEM). Results. For SGLT-2 inhibitors, canagliflozin, empagliflozin, ertugliflozin, ipragliflozin, luseogliflozin and tofogliflozin, the E max , and treatment duration to reach half of the maximal effects (ET50) were -3.72% and 3.35 weeks, -5.59% and 16.8 weeks, -2.84% and 3.42 weeks, -3.43% and 3.09 weeks, -3.04% and 4.38 weeks, and -2.45% and 3.16 weeks, respectively. In addition, for T2DM patients, 100 mg/day canagliflozin needs to be taken 13.4 weeks for the plateau of effect on weight; 10 mg/day empagliflozin needs to be taken 67.2 weeks for the plateau of effect on weight; 5 mg/day ertugliflozin needs to be taken 13.68 weeks for the plateau of effect on weight; 50 mg/day ipragliflozin needs to be taken 12.36 weeks for the plateau of effect on weight; 2.5 mg/day luseogliflozin needs to be taken 17.52 weeks for the plateau of effect on weight; 20 mg/day tofogliflozin needs to be taken 12.64 weeks for the plateau of effect on weight. Conclusions. This was the first study to explore effects of SGLT-2 inhibitors on weight in T2DM; meanwhile, the optimum dosages and treatment durations on weight from canagliflozin, empagliflozin, ertugliflozin, ipragliflozin, luseogliflozin, and tofogliflozin were recommended, respectively.

Accumulating evidence indicates that long noncoding RNAs (lncRNAs) act as tumor promoters or suppressors in various types of cancer. Previous investigations suggest that ceramide synthase 6 (CERS6) antisense RNA 1 (CERS6-AS1) acts as an oncogene in breast cancer; however, its role in colorectal cancer is unknown. This study aimed to explore the molecular mechanism of CERS6-AS1 in colorectal cancer. Gene expression in colorectal cancer was examined using reverse transcription-quantitative polymerase chain reaction and western blot analyses. The viability and proliferation of colorectal cancer cells were measured by Cell Counting Kit-8 assays and colony formation assays. The migratory and invasive capacities of the colorectal cancer cells were assessed by Transwell assay. Cell stemness was examined by sphere-formation assay. Mechanistically, RNA pull-down assays, RNA immunoprecipitation assays, and luciferase reporter assays were performed to explore the relationship among CERS6-AS1, miR-15b-5p and spectrin beta, non-erythrocytic 2 (SPTBN2). Moreover, a xenograft tumor model was established to investigate the role of CERS6-AS1 in vivo. We found that CERS6-AS1 and SPTBN2 were highly expressed in colorectal cancer tissues and cells. CERS6-AS1 depletion inhibited cell viability, proliferation, migration, and invasion; the epithelial-mesenchymal transition process and stemness. It suppressed xenograft tumor growth in colorectal cancer. Moreover, SPTBN2 levels were positively regulated by CERS6-AS1 and negatively regulated by miR-15b-5p in colorectal cancer cells. Rescue assays revealed that SPTBN2 reversed the inhibitory effect of CERS6-AS1 deficiency on the malignant behaviors of colorectal cancer cells. Overall, the lncRNA CERS6-AS1 facilitates malignant phenotypes of colorectal cancer cells by targeting miR-15b-5p to upregulate SPTBN2.

PurposeThe COVID-19 epidemic is still spreading globally and will not be completely over in a short time. Wearing a mask is an effective means to combat the spread of COVID-19. However, whether the public wear a mask for epidemic prevention and control will be affected by stochastic factors such as vaccination, cultural differences and irrational emotions, which bring a high degree of uncertainty to the prevention and control of the epidemic. The purpose of this study is to explore and analyze the epidemic prevention and control strategies of the public in an uncertain environment.Design/methodology/approachBased on the stochastic evolutionary game model of the Moran process, the study discusses the epidemic prevention and control strategies of the public under the conditions of the dominance of stochastic factors, expected benefits and super-expected benefits.FindingsThe research shows that the strategic evolution of the public mainly depends on stochastic factors, cost-benefit and the number of the public. When the stochastic factors are dominant, the greater the perceived benefit, the lower the cost and the greater the penalty for not wearing masks, the public will choose to wear a mask. Under the dominance of expected benefits and super-expected benefits, when the number of the public is greater than a certain threshold, the mask-wearing strategy will become an evolutionary stable strategy. From the evolutionary process, the government’s punishment measures will slow down the speed of the public choosing the strategy of not wearing masks. The speed of the public evolving to the stable strategy under the dominance of super-expected benefits is faster than that under the dominance of expected benefits.Practical implicationsThe study considers the impact of stochastic factors on public prevention and control strategies and provides decision-making support and theoretical guidance for the scientific prevention of the normalized public.Originality/valueTo the best of the authors’ knowledge, no research has considered the impact of different stochastic interference intensities on public prevention and control strategies. Therefore, this paper can be seen as a valuable resource in this field.

Background Evidence suggests that pediatric tuina, a modality of traditional Chinese medicine (TCM), might have beneficial effects on the symptoms of attention deficit hyperactivity disorder (ADHD), such as overall improvements in concentration, flexibility, mood, sleep quality, and social functioning. This study was conducted to understand the facilitators and barriers in the delivery of pediatric tuina by parents to children with ADHD symptoms. Methods This is a focus group interview embedded in a pilot randomized controlled trial on parent-administered pediatric tuina for ADHD in preschool children. Purposive sampling was employed to invite 15 parents who attended our pediatric tuina training program to participate voluntarily in three focus group interviews. The interviews were audio-recorded and transcribed verbatim. The data were analyzed through template analysis. Results Two themes were identified: (1) facilitators of intervention implementation and (2) barriers to intervention implementation. The theme of the facilitators of intervention implementation included the subthemes of (a) perceived benefits to children and parents, (b) acceptability to children and parents, (c) professional support, and (d) parental expectations of the long-term effects of the intervention. The theme of barriers to intervention implementation included the subthemes of (a) limited benefits for children’s inattention symptoms, (b) manipulation management difficulties, and (c) limitations of TCM pattern identification. Conclusion Perceived beneficial effects on the children’s sleep quality and appetite and parent–child relationships, as well as timely and professional support, mainly facilitated the implementation of parent-administered pediatric tuina. Slow improvements in the children’s inattention symptoms and the possible inaccuracies of online diagnosis were the dominant barriers of the intervention. Parents have high expectations for the provision of long-term professional support during their practice of pediatric tuina. The intervention presented here can be feasibly used by parents.

Dapagliflozin has been used to treat patients with type 1 diabetes mellitus; however, the actual drug efficacy of dapagliflozin on glycated hemoglobin (HbA1c) and whether there is a rebound from dapagliflozin efficacy on HbA1c remain unknown. The present study aimed to explore the actual therapeutic effect and rebound situation of dapagliflozin on HbA1c in type 1 diabetes mellitus patients. A total of 1,594 type 1 diabetes mellitus patients were enrolled for analysis using a non-linear mixed effect model from randomized controlled trials from published literature works including two 5 mg/day dapagliflozin dosage groups and three 10 mg/day dapagliflozin dosage groups. The change rate of HbA1c from a baseline value was chosen as a dapagliflozin pharmacodynamic evaluation index. After deducting control group effects, the therapeutic effect of 5 and 10 mg/day dapagliflozin on HbA1c in type 1 diabetes mellitus patients had no significant difference. In addition, the actual maximal efficacy (AEmax) of dapagliflozin on HbA1c was -6.24% at week 9. When it reached the AEmax, the dapagliflozin pharmacodynamic rebound on HbA1c occurred, and when the treatment was continued for 0.5 and 1 year, the actual efficacies were -4.70% (75% AEmax) and -3.27% (52% AEmax), respectively. This was the first time to clarify the actual therapeutic effect and rebound situation of dapagliflozin on HbA1c in type 1 diabetes mellitus patients, providing a reference value for clinical practices.

Although anatomical hepatectomy (AH) is widely used in the treatment of hepatocellular carcinoma (HCC), the prognosis is still unsatisfactory. The present study aimed to evaluate the survival benefit of adjuvant transcatheter arterial chemoembolization (TACE) for patients with HCC after AH. A total of 832 patients were stratified into with adjuvant TACE (443, 53.2%) and without adjuvant TACE group (389, 46.8%) AH. Propensity score matching (PSM) was performed to control for confounding factors, and multivariable Cox regression was performed to determine the independent risk factors. After PSM, the results showed that the adjuvant TACE group had better overall survival (OS) and recurrence-free survival (RFS). Among the patients with tumor recurrence, adjuvant TACE was associated with a high rate of early-stage tumor at recurrence, a lower recurrence rate around the frontal margin and extrahepatic metastases, and a higher rate of receiving curative treatment. Multivariable Cox regression analysis showed that adjuvant TACE was an independent prognostic factor for OS (HR 0.673, P = 0.001) and RFS (HR 0.650, P = 0.001). Patients with HCC after AH can benefit from postoperative adjuvant TACE. Therefore, adjuvant TACE should be considered for patients with a high risk of recurrence.

Background Evidence suggests that pediatric tuina, which is a modality of traditional Chinese medicine (TCM), might have beneficial effects on attention deficit hyperactivity disorder (ADHD) symptoms. Therefore, we designed and conducted a pilot randomized controlled trial (RCT) on parent-administered pediatric tuina for ADHD in preschool children. This paper reported focus group interview data as a part of a process evaluation embedded with the outcome evaluation of the RCT. To understand the parents’ facilitators and barriers of delivering pediatric tuina to their children with ADHD symptoms. Methods Purposive sampling were employed to invite 15 parents who attended our pediatric tuina training program to voluntarily participate in three focus group interviews. The interviews were audio-recorded and transcribed verbatim. The data was analyzed with template analysis. Results Two themes were identified. Under the theme of the facilitators to the intervention implementation, subthemes included (a) perceived benefits on children and parents, (b) acceptability of children and parents, (c) professional supports, and (d) parents’ expectations on long-term effects of the intervention. Under the theme of the intervention implementation barriers, subthemes included (a) limited benefits on children’s inattention symptoms, (b) manipulation management difficulties, and (c) limitations of TCM pattern identification. Conclusion Parents mainly focused on the health effects and safety of pediatric tuina intervention, especially the effects on children’s sleep quality and appetite. Parents could master and conduct the manipulations well if appropriate support and guidance are provided. Besides, parents need long-term support for persisting this intervention.

COVID-19 has caused huge losses to countries around the world, and it will not end in a short time. The lack of motivation for international joint prevention and control is one of the important reasons for the global pandemic of COVID-19. How to improve the efforts and level of international joint prevention and control has become an urgent problem to be solved. Considering the long-term and dynamic nature of international joint prevention and control, the differential game method is used to compare and analyze the optimal decisions of countries in the three scenarios of spontaneous governance, external subsidies and internal cost sharing. The results show that the optimal prevention and control efforts of countries are negatively correlated with discount rates, prevention and control cost coefficients, decay rate and risk factors. It is positively correlated with the impact degree of social benefits, the impact degree of prevention and control efforts on the level of joint prevention and control, the distribution ratio of social benefits, and the impact degree of prevention and control level on social benefits. The prevention and control efforts, joint prevention and control level, social benefits and system benefits under spontaneous governance are the lowest and highest under the internal cost sharing. The internal cost sharing will only be carried out when social benefits distribution ratio obtained reach a certain threshold. This study provides decision-making support for the joint prevention and control of countries to defeat COVID-19 under the normalization of the epidemic.

The present study aimed to explore the effect of carnitine supplementation on body weight in patients with polycystic ovary syndrome (PCOS) and predict an appropriate dosage schedule using a machine-learning approach. Data were obtained from literature mining and the rates of body weight change from the initial values were selected as the therapeutic index. The maximal effect (Emax) model was built up as the machine-learning model. A total of 242 patients with PCOS were included for analysis. In the machine-learning model, the Emax of carnitine supplementation on body weight was −3.92%, the ET50 was 3.6 weeks, and the treatment times to realize 25%, 50%, 75%, and 80% (plateau) Emax of carnitine supplementation on body weight were 1.2, 3.6, 10.8, and 14.4 weeks, respectively. In addition, no significant relationship of dose-response was found in the dosage range of carnitine supplementation used in the present study, indicating the lower limit of carnitine supplementation dosage, 250 mg/day, could be used as a suitable dosage. The present study first explored the effect of carnitine supplementation on body weight in patients with PCOS, and in order to realize the optimal therapeutic effect, carnitine supplementation needs 250 mg/day for at least 14.4 weeks.

Chlorantraniliprole (CAP) is an insecticide widely used to control the small white butterfly (SWB), Pieris rapae. Exposure to CAP can cause oxidative injury in SWB; however, it is unclear if antioxidant enzymes are involved in the defense process. In this study, a thioredoxin peroxidase (PrTPX1) gene was identified from SWB by using a homology search method. The gene encoded a 195 amino-acid PrTPX1 protein. Sequence characteristics and phylogenetic analysis indicated that PrTPX1 was a typical "2-Cys" TPX, and the PrTPX1 gene consisted of four exons and three introns. Reverse transcription-quantitative polymerase chain reaction analysis indicated that the messenger RNA levels of PrTPX1 were highest in third-, fourth- and fifth-instar larval stages and in the larval midgut. Treatment with sublethal doses (LD

Background and aimsRecently, the effectiveness of “textbook outcomes (TO)” in the evaluation of surgical quality has been recognized by more and more scholars. This study tended to examine the association between preoperative albumin–bilirubin (ALBI) grades and the incidence of achieving or not achieving TO (non-TO) in patients with hepatocellular carcinoma (HCC) undergoing laparoscopic hepatectomy.MethodsThe patients were stratified into two groups: ALBI grade 1 (ALBI ≤ -2.60) and ALBI grade 2/3 (ALBI > -2.60). The characteristics of patients and the incidence of non-TO were compared. Multivariate analyses were performed to determine whether ALBI grade was independently associated with TO.ResultsIn total, 378 patients were enrolled, including 194 patients (51.3%) in the ALBI grade 1 group and 184 patients (48.7%) in the ALBI grade 2/3 group. In the whole cohort, 198 patients (52.4%) did not achieve TO, and the incidence of non-TO in the ALBI grade 2/3 group was obviously higher than that in the ALBI grade 1 group (n = 112, 60.9% vs. n = 86, 44.3%, P = 0.001). The multivariate analyses showed that ALBI grade 2/3 was an independent risk factor for non-TO (OR: 1.95, 95%CI: 1.30–2.94, P = 0.023).ConclusionsMore than half (52.4%) of the patients with hepatocellular carcinoma did not achieve TO after laparoscopic hepatectomy, and preoperative ALBI grade 2/3 was significantly associated with non-TO. Improving the liver function reserve of patients before operation, thereby reducing the ALBI grade, may increase the probability for patients to reach TO and enable patients to benefit more from surgery.

The agricultural non-point source pollution (ANPSP) load in Guangdong province is very large and has a serious impact on the regional ecological environment. Inventory analysis was used to assess and analyze the temporal and spatial variation characteristics of the ANPSP load of Guangdong province during 1999-2019, and the sources of ANPSP were discussed, as well as the relationship between them. The results showed that, during the past 20 years, the total ANPSP pollution loads of Guangdong province decreased by 6.08%, and the pollution loads of chemical oxygen demand (COD), total nitrogen (TN), and total phosphorus (TP) increased by -11.88%, 4.99%, and 26.17%, respectively. The input intensity of chemical fertilizers and pesticides increased by 112.19% and 60.38%, respectively. The Pearl River Delta had the highest ANPSP loads in Guangdong province, followed by those in northern, western, and eastern Guangdong. Livestock and poultry breeding were the main sources of COD, the total percent fertilizers and livestock and poultry breeding were the main sources of TN, and livestock and poultry breeding and aquaculture were the main sources of TP. In addition, the contribution of pollutants discharged from aquaculture showed an obvious increasing trend. There were certain differences in the pollution sources in different regions. In western Guangdong, northern Guangdong, and eastern Guangdong, livestock and poultry breeding were the main sources of COD and TP, and fertilizer was the main source of TN; by contrast in the Pearl River Delta, aquaculture had become the main source of TN and TP pollution loads. The correlation results showed that the decline in the total ANPSP in Guangdong province was mainly due to the increase in high urbanization rate and the decrease in the proportion of rural population. In general, there were stage changes in the time and differences in spatial characteristics and sources of ANPSP in Guangdong province. A combination of comprehensive treatment and targeted pollution treatment should be adopted, and fertilizer reduction measures and pollution treatment in the aquaculture should be strengthened in an all-around way, focusing on strengthening the treatment of pollution from aquaculture in the Pearl River Delta region and the treatment of rural life pollution in northern Guangdong.

This study aimed to explore the quantitative efficacy of L-carnitine supplementation on glycemic control in type 2 diabetes mellitus patients using model-based meta-analysis (MBMA).Literatures were retrieved from the public database and data from these trials were extracted. The quantitative efficacy of L-carnitine on fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) in type 2 diabetes mellitus patients were evaluated by maximal effect (EIn the model of FPG, EIt was the first time to provide valuable quantitative information for efficacy of L-carnitine supplementation on glycemic control in type 2 diabetes mellitus patients.

Ferroelectric materials are promising for solar energy conversion due to the unique spontaneous polarization effect, leading to effective control of electron-hole recombination and potentially high power conversion efficiency of perovskite solar cells. Herein, the ultrathin ferroelectric hafnia alumina (HfAlO) films were obtained by atomic layer deposition and applied to modify the electron transport layer of PSCs. The XPS and AFM characterizations indicate that the Hf0.39Al0.10O films feature smooth, dense, and compact surface morphology. For the devices incorporating the ultrathin HfAlO films, the oriented ferroelectric effect-induced spontaneous polarization and internal electric field are crucial factors to enhance the charge separation during charge transfer. Accordingly, the short circuit current, open-circuit voltage, and power conversion efficiency (PCE) are increased by 11.8%, 9.0%, and 29.8%, respectively. Moreover, the HfAlO incorporating devices retained ~ 80% of the original PCE after 500 h ageing, much better than that of the pristine devices showing the retention of only ~ 50% of the original PCE.

In order to optimize the application of Al electrodes in pyrochemical reprocessing of spent nuclear fuel, the feasibility of porous Al electrodes to separate actinides-lanthanides (An-Ln) in LiCl-KCl eutectic melt was explored. The separation efficiencies and rates of U and lanthanides (La, Ce, Sm) on Al electrodes with regular and irregular and without pores were compared. U was selectively recovered in the form of U-Al alloys by controlling the potential (−1.2 V) on both Al rod and porous Al electrodes. X-ray diffraction (XRD) and scanning electron microscopy (SEM)-energy dispersive spectroscopy (EDS) showed that the obtained granular alloys were mainly Al3U and Al4U, and inductive coupled plasma optical emission spectrometry (ICP-OES) indicated that there was almost no Ln in the electrolysis products. Positively, the required separation time was greatly shortened, and the separation rate was effectively improved when porous Al electrodes were used. In addition, the Al honeycomb electrode with regular pores has better kinetic performance compared with Al foam electrodes with irregular pores. The results indicate that the specially designed porous Al electrodes may have a good application prospect for the separation of An-Ln in the pyrochemical reprocessing of spent nuclear fuel.

A chemical investigation of Sigesbeckia glabrescens Makino identified four compounds. On the basis of spectroscopic data, they were determined to be ent-pimarane-type diterpenoids and their analogu...

Objective To analyze the risk factors of traumatic subdural effusion (TSE) transforming into chronic subdural hematoma (CSDH). Methods A totalof75 patients with TSE after traumatic brain injury (TBI) were included from December 2017 to July 2019. CT or MRI reexamination during treatment and follow⁃up were performed to observe whether CSDH was transformed and relevant influencing factors were analyzed. Univariate and multivariate Logistic regression analyses were performed to screen the risk factors for the transformation of TSE into CSDH. Results Logistic regression analysis showed that the higher effusion density (OR =6.021, 95%CI: 1.047-34.631; P =0.044), subdural effusion increases for a long time (OR = 1.253, 95%CI: 1.002-1.568; P = 0.048), the thicker effusion (OR = 2.080, 95%CI: 1.267-3.414; P =0.004) and brain atrophy (OR =35.392, 95%CI: 1.397-896.474; P =0.031) were risk factors for the transformation of TSE into CSDH. Conclusions The subdural effusion increases for a long time, higher effusion density, thicker effusion and brain atrophy are the risk factors associated with the transformation of TSE into CSDH. DOI：10.3969/j.issn.1672⁃6731.2020.07.008

Approximately 10% of bone fractures do not heal satisfactorily, leading to significant clinical and socioeconomic implications. Recently, the role of macrophages in regulating bone marrow stem cell (BMSC) differentiation through the osteogenic pathway during fracture healing has attracted much attention. Methods: The tibial monocortical defect model was employed to determine the critical role of macrophage scavenger receptor 1 (MSR1) during intramembranous ossification (IO) in vivo. The potential functions and mechanisms of MSR1 were explored in a co-culture system of bone marrow-derived macrophages (BMDMs), RAW264.7 cells, and BMSCs using qPCR, Western blotting, immunofluorescence, and RNA sequencing. Results: In this study, using the tibial monocortical defect model, we observed delayed IO in MSR1 knockout (KO) mice compared to MSR1 wild-type (WT) mice. Furthermore, macrophage MSR1 mediated PI3K/AKT/GSK3β/β-catenin signaling increased ability to promote osteogenic differentiation of BMSCs in the co-culture system. We also identified proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) as the target gene for macrophage MSR1-activated PI3K/AKT/GSK3β/β-catenin pathway in the co-culture system that facilitated M2-like polarization by enhancing mitochondrial oxidative phosphorylation. Conclusion: Our findings revealed a previously unrecognized function of MSR1 in macrophages during fracture repair. Targeting MSR1 might, therefore, be a new therapeutic strategy for fracture repair.

A new biflavone (philonotisflavone-3′′′-methyl ether), three diterpenes (lupulin G, lupulin H, lupulin I), a new ecdysteroid (ajugasterone E), and four known compounds were isolated from the whole plant of Ajuga lupulina Maxim. Their structures were determined by spectroscopic analysis, including MS, NMR and ECD spectral data. Compounds 1-3 has DPPH radical scavenging ability, and compound 1 has stronger activity than vitamin C. Compounds 2, 3, 7 and 8 have potential cytotoxic activity against Hela, with IC50 values less than 20.0 μM. Abietane diterpenes 2, 3, 7 and 8 are also found to have NO inhibitory effects with IC50 values less than 40.0 μM.

Objectives. The purpose of this study was to explore the effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on urine albumin to creatinine ratio (UACR) in type 2 diabetes mellitus (T2DM) patients and to recommend appropriate medication care scheme. Methods. 8371 T2DM patients from four dapagliflozin studies and two canagliflozin studies were collected for analyzing with nonlinear mixed effect model (NONMEM). The change rates of UACR from baseline were intended to be evaluation indicators. Results. In the present study, there was no significant difference in the effects on UACR using dapagliflozin or canagliflozin treatment in T2DM patients. The maximal effect ( E max ) and the treatment duration of reaching half of E max (ET50) from SGLT-2 inhibitors on UACR in T2DM patients were -19.2% and 0.448 weeks, respectively. Further, the treatment duration to reach 25%, 50%, 75%, and 80% E max was 0.150 weeks, 0.448 weeks, 1.344 weeks, and 1.792 weeks, respectively. Namely, for achieving the plateau period (80% of E max ) of SGLT-2 inhibitors on UACR in T2DM patients, 10 mg/day dapagliflozin (or 100 mg/day canagliflozin) should be taken for at least 1.792 weeks. Conclusions. To our knowledge, the present study explored the effects of SGLT-2 inhibitors on UACR in T2DM patients, meanwhile, recommended appropriate medication care scheme for the first time.

The layer-by-layer assembly technique was used to synthesize novel multiwalled carbon nanotubes (MWCNTs) on magnetic carbon (Fe

In this case, the acupuncture treatment for open-angle glaucoma patient achieved a significant result. The acupoints Jīngming (睛明BL1), Qiuhou (球后Extra), Fēngchi (风池GB20), and Taichōng (太冲LR3) were used as the main ones plus some symptomatic acupoints. After one course of treatment, the left eye pressure decreased by 12 mmHg compared with that before treatment, the left eye vision improved, and the fundus oozing was significantly reduced. After two courses of treatment, the left eye pressure was below 20 mmHg, left eye vision obviously improved, and the fundus oozing completely disappeared.

Purpose: The study aimed to explore the effects of l-carnitine, acetyl-l-carnitine, and propionyl-l-carnitine on Body Mass in type 2 diabetes mellitus (T2DM) patients.Methods: Randomized controlled trial (RCT) studies of l-carnitine, acetyl-l-carnitine, and propionyl-l-carnitine in T2DM patients were searched. The change rates of Body Mass index (BMI) from baseline values were used as an evaluation indicator. The maximal effect (Emax) model by non-linear mixed-effect modeling (NONMEM) was used as the evaluation method.Results: A total of 10 RCT studies, 1239 T2DM patients were included for analysis, including eight studies of l-carnitine, one study of acetyl-l-carnitine, and one study of propionyl-l-carnitine. The study found that l-carnitine could reduce the Body Mass of T2DM patients. Based on only one study each for acetyl-l-carnitine and propionyl-l-carnitine, no significant effects were found in acetyl-l-carnitine or propionyl-l-carnitine. In addition, in order to achieve a plateau of efficacy (80% Emax), 2 g/day l-carnitine was required for at least 2 weeks.Conclusions: Two g/day l-carnitine was required for at least 2 weeks to affect Body Mass in T2DM patients, and no significant effects were found in acetyl-l-carnitine or propionyl-l-carnitine.

WHAT IS KNOWN AND OBJECTIVES Dapagliflozin was the first oral treatment approved in type 1 diabetes mellitus (T1DM) patients, simultaneously improving body weight. However, the time course and dose effect of dapagliflozin on loss of weight in T1DM patients was still unknown. The present study aimed to investigate quantitative relationship between dapagliflozin and loss of weight in T1DM patients based on Model-based Meta-analysis. METHODS Five dapagliflozin dosage groups, two of them were 5 mg/day and three of them were 10 mg/day, 1612 T1DM patients were analysed with maximal effect (Emax ) model, and evaluation index was change rate of body weight from baseline value. RESULTS In these T1DM patients, dosages were not incorporated into model, indicating no significant dose-response relationship between 5 and 10 mg/day affecting loss of weight. Emax and the treatment duration to reach half of the maximal effects (ET50 ) of dapagliflozin influencing loss of weight in T1DM patients were -4.9% and 10.4 weeks, and the duration to achieve 25%, 50%, 75%, and 80% (plateau) of Emax were 3.5, 10.4, 31.2, and 41.6 weeks. WHAT IS NEW AND CONCLUSIONS It was the first time to explore quantitative relationship between dapagliflozin and loss of weight in T1DM patients. To achieve the plateau period in loss of weight, 5 mg/day dapagliflozin was required for at least 41.6 weeks.

Beneficial effects of parent-administered pediatric tuina on ADHD in children have been reported in previous studies, but no rigorously designed randomized controlled trials (RCTs) have been conducted on it.To assess the feasibility and preliminary effects of parent-administered pediatric tuina for ADHD symptoms in preschoolers.This project was a two-arm, parallel, open-label, pilot RCT. Sixty-four participants were randomized into two groups at a 1:1 ratio. Parents in the parent-administered tuina group (n = 32) attended an online training program on pediatric tuina for ADHD and conduct this intervention on their children at home. Parents in the parent-child interaction group (n = 32) attended an online training about progressive muscle relaxation exercise and carried out parent-child interactive physical activities with their children at home. Both interventions were carried out every other day during a two-month intervention period, with each manipulation for at least 20 min. Feasibility outcomes included recruitment rate, consent rate, participants' adherence, retention rate, and adverse event. Outcomes were assessed at baseline, week 4, and week 8. The primary outcome measure was the Swanson, Nolan, and Pelham parent scale (SNAP); the secondary outcomes included preschool anxiety scale, children's sleep habits questionnaire, and parental stress scale. A mixed-method process evaluation embedded within the outcome evaluation was performed.The recruitment rate was 12.8 per month. The consent rate was 98.5%. Good adherence was shown from the parent logbook. Four participants withdraw from the study. No severe adverse event was reported. For the SNAP total score, both groups showed improvement with moderate within-group effect size (Cohen's d0.5, all p0.001) and the between-group effect size was minimal (dThe study design and the parent-administered pediatric tuina intervention were feasible. Parent-administered pediatric tuina provided beneficial effects on improving core hyperactivity/impulsivity symptoms in preschool children. Parents perceived improvements on children's appetite and sleep quality. Further large-scale are warranted.

Objective: This study aimed to detect the association between P-selectin autoantibody positive and response to steroid treatment in newly diagnosed immune thrombocytopenia (ITP) patients. Methods: The data from 105 newly diagnosed adult ITP patients administered with first-line of steroid treatment from October 2016 to May 2021 were retrospectively analyzed. Treatment responses were evaluated within 3 months after the onset of treatment. Results: Among the 105 patients, 80.00% (84/105) of patients presented with platelet glycoprotein-specific antibody positive; 44.76% (47/105) patients were anti-P-selectin positive, while 35.24% (37/105) were anti-P-selectin negative. No significant difference in overall response was observed between patients who were anti-P-selectin positive and those who were anti-P-selectin negative (74.47% vs. 89.19, χ2 = 2.910, p = 0.088). But patients who were anti-P-selectin negative had significantly higher complete response rate, compared to those who were anti-P-selectin positive (72.97% vs. 48.94%, χ2 = 4,965, p = 0.026). Logistic regression analysis revealed that anti-GP IIb/IIIa positive (OR = 3.114, p = 0.010, 95% CI: 1.313–7.388) and anti-P-selectin positive (OR = 0.309, p = 0.036, 95% CI: 0.127–0.753) were two factors that could affect patients’ response. Conclusions: Our study found that ITP patients with anti-GP IIb/IIIa may have a higher response to steroid treatment, but anti-P-selectin-mediated-ITP might be less responsive to steroid treatment. In adults with ITP, the presence of anti-P-selectin autoantibodies is a predictive factor for poor response to steroid treatment.

The green peach aphid, Myzus persicae (Sulzer), is a serious agricultural pest with a worldwide distribution. Catalase (CAT), which is encoded by the catalase (Cat) gene, is an extremely important antioxidant enzyme that plays a pivotal role in protecting cells against the toxic effects of hydrogen peroxide. The Cat gene has not been characterized in M. persicae; therefore, this study describes the identification of the Cat (MpCat) gene from M. persicae. MpCat contains an open reading frame of 1515 bp and encodes a MpCAT protein consisting of 504 amino-acid residues. MpCAT possesses features typical of other insect catalases, including 7 conserved amino acids involved in binding heme and 15 involved in binding nicotinamide adenine dinucleotide phosphate. Phylogenetic analysis showed that MpCAT was closely related to orthologs from other aphid species. MpCat consisted of nine exons and eight introns, and the number and insertion sites of introns are consistent with those of Cat genes from Acyrthosiphon pisum (Harris) and Aphis gossypii Glover. The mRNA transcripts of MpCat were detected at all tested developmental stages, with the highest mRNA level in alate adults. The expression of MpCat was significantly upregulated when M. persicae was exposed to low and high temperatures, ultraviolet radiation, Beauveria bassiana, and permethrin. The transcription of MpCat and the activity of catalase were suppressed by RNA interference, and knockdown of MpCat significantly reduced the survival rate in M. persicae under heat stress. The results provide valuable information for further study on the physiological functions of MpCat.

6061 aluminium was treated by Plasma electrolytic oxidation (PEO) where a new experimental method was introduced: the applied voltage of the PEO process was quickly increased to 486 V by different ...

Various plasma electrolytic oxidation (PEO) ceramic coatings were fabricated on aluminum in the electrolytes with different concentrations of Na2SiO3·9H2O. The morphology of fractured cross-section and coating/substrate (C/S) interface, phase compositions, and corrosion behavior of these ceramic coatings were characterized employing field emission scanning electron microscopy (SEM) equipped with energy dispersive X-ray spectroscopy (EDS), X-ray diffractometer (XRD), potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) measurements. The results showed that adding Na2SiO3·9H2O in the electrolyte could reduce the decrease amplitude of the voltage-time curve, and it can affect the types of the anodic film before the beginning of plasma discharges. A novel phenomenon was recorded as PEO treatment was carried out in the electrolyte with 1.85 g l−1 Na2SiO3·9H2O that the substrate was first covered by a barrier-type anodic film, and then a porous-type anodic film appeared after the barrier-type anodic film was broken down. The anodic film continued to grow for a long duration in the PEO process after being broken down. Characteristics of PEO ceramic coatings with a similar thickness acquired in various electrolytes were also evaluated. XRD results indicated that these ceramic coatings of similar thickness were mainly composed of α-Al2O3 and γ-Al2O3, and the α-Al2O3 proportion decreased with increasing Na2SiO3·9H2O concentration. The electrochemical data showed that the corrosion resistance of these PEO ceramic coatings of similar thickness decreased by adding Na2SiO3·9H2O in the electrolyte.

Plasma electrolytic oxidation (PEO) of Al was carried out in dilute alkaline sodium tripolyphosphate (Na5P3O10) electrolyte. Surface and cross-section morphologies, elemental and phase compositions were characterized by scanning electron microscopy (SEM) equipped with energy dispersive X-ray spectroscopy (EDS) and X-ray diffractometer (XRD). The results revealed that a severe thinning of the anodic film resulted in the voltage decrease at the initial stage of the PEO process. Porous-type anodic film with uniform pore diameter were fabricated at the initial stage of PEO process. Subsequently, detachments and cracks took place on the anodic films, and served as weak regions occurring dielectric breakdown preferentially due to the concentration of electric current at these sites. Two origins of PEO coatings, the transformation of anodic films and the normal generation of PEO coatings through the plasma discharges, were proposed. The results also indicated that P element mainly participated in the anodic oxidation and existed as amorphous phase in the inner side areas of anodic films except the barrier layer. Based on the analyses of the microstructure evolution and the chemical composition, a schematic of coating growth mechanism was proposed in the end.

A plasma electrolytic oxidation (PEO) coating was fabricated on AA1060 alloy in an alkaline sodium hexametaphosphate ((NaPO3)6) electrolyte. The growth characteristic of the PEO coating was investigated by means of a substrate-detachment technique, Scanning electron microscope (SEM) equipped with energy dispersive spectrometry (EDS), X-ray photoelectron spectrometer (XPS), X-ray diffractometer (XRD) and Mott-Schottky analysis. The results showed that an ordered and porous anodic aluminum oxide (AAO) film was formed at the anodic oxidation stage by the influence of (NaPO3)6 in the electrolyte, and the microstructure of the AAO film induced the plasma discharge events to initiate inside the AAO film. The Mott-Schottky analysis showed that the PEO coated samples were all represented n-type semiconducting behavior. The microstructures of detached coatings showed that the coating/substrate interfaces formed at the anodic oxidation stage and sparking stage consist of numerous hemispherical cap structures, but with different sizes. It was also revealed that the inward growth of the hemispherical cap structures is dependent on the diffusion of oxygen from the electrolyte or plasma gases to substrate, and P atoms mainly exist in the amorphous phase of the PEO coating.

Plasma electrolytic oxidation (PEO) coatings were prepared on AA1060 alloy substrate by a galvanostatic regime in an alkaline sodium hexametaphosphate ((NaPO3)6) electrolyte, and the influences of ...