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Objective: To strengthen preoperative preparation management and reduce preoperative preparation defects. Methods: We set up a special medical care management team to investigate the preoperative preparation in surgical departments, analyze the causes of the shortcomings in preoperative preparation, and propose countermeasures. The medical staff jointly formulated plans related to preoperative preparation management including clear outline of responsibilities, strengthening of training, integrated medical care, timely feedback, and continuous improvement. Besides, the preoperative preparation of patients before and after the improvement measures were compared using statistical analysis. Results: The rate of inadequate preoperative preparation was 11.14 per thousand before the integrated management model was implemented. After the implementation of the integrated management model, the rate of inadequate preoperative preparation decreased to 2.99 per thousand, and the difference was statistically (P < 0.05). Conclusion: The integrated management of preoperative preparation can help reduce the rate of preoperative complications and ensure the safety of surgery.

Haiyan Yang,1 Deliang Liu,1 Lin Zeng,1,2 Siping Peng,1 Huiling Liu1 1Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China; 2Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of ChinaCorrespondence: Deliang Liu, Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, No. 1 Fuhua Road, Futian District, Shenzhen, Guangdong, 518034, People’s Republic of China, Email ldl2580@gzucm.edu.cnPurpose: Inpatients undergoing colonoscopy may be at increased risk of hypoglycemia. However, few high-quality studies have examined the relationship between hypoglycemia and colonoscopy in patients with type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 1016 patients from a large tertiary hospital were enrolled in this retrospective study. We collected demographic information, laboratory indices, colonoscopy information and hypoglycemia information from the enrolled patients during hospitalization. Logistic regression analysis was adopted to estimate the adjusted odds ratios to determine the association between hypoglycemia and colonoscopy.Results: Hypoglycemia occurred in 80 of 788 (10.1%) patients without colonoscopy exposure and 37 of 228 (16.2%) patients with colonoscopy exposure. 25 patients (67.6%) had hypoglycemic events from 3 hours to 68 hours after the end of colonoscopy. Adjusting for demographic and clinical covariates, the risk of hypoglycemia was 1.99 times higher in those who underwent colonoscopy than in those who did not (OR 1.99, 95% CI 1.25– 3.19). The association was consistent in subgroups of females, the elderly, the overweight patients, patients with long duration of disease or patients with suboptimal glycemic control.Conclusion: A strong association between colonoscopy and an increased risk of hypoglycemia is observed in patients with T2DM. When performing a colonoscopy for diabetics, the risk of hypoglycemia should be considered even within 68 hours after colonoscopy.Keywords: hypoglycemia, colonoscopy, type 2 diabetes mellitus, retrospective study, fasting

The purpose of this systematic review was to assess potential gender differences in prevalence and clinical relevance of insulin-related lipohypertrophy (LH).Five electronic databases (PubMed, Embase, CNKI, Wanfang and VIP) were systematically searched for studies, from inception to 1st Sep 2022, on the prevalence of insulin-related LH. The eligibility of articles was independently screened, and the included studies were evaluated using standardized quality assessment tools.A total of 22 studies mentioned the LH prevalence in different genders, of which two are about gestational diabetes; therefore, 20 studies were eventually included, providing data on 6238 patients. The prevalence of LH varied from 30.26% to 72.54%. Ten studies (4392 patients) were conducted with the adult diabetes patients of different genders over the age of 18, the total prevalence rate of LH was 51.73%, the LH prevalence in male gender was from 41.94% to 68.57% and the rate of the total population was 54.89% (2046 patients); The LH prevalence in female gender was from 33.18% to 70% and the rate of the total population was 48.98% (2346 patients), and the prevalence of LH was significantly different between male and female gender (The evidence shows that the results of gender differences in the LH prevalence are inconsistent with different types of DM. Probably, there is no gender differences in the LH prevalence in adult patients with T1DM, but it has a gender difference between male and female in T2DM. More strictly designed clinical studies are needed to further verify and reveal the underlying mechanisms.

Erythromycin fermentation residue (EFR) after spray drying could be reused as a soil amendment. However, the effects of spray-dried EFR on antibiotic resistance genes (ARGs), nitrogen cycling, and microbial community structure in soil are rarely reported. In this study, a pot experiment was conducted by adding spray-dried EFR to soil. For the application of 1.0% spray-dried EFR, the residual erythromycin (ERY) could be rapidly removed with the half-life of 22.2 d; the total relative abundance of ARGs increased at first, but decreased to the initial level of the control group in the end; genes related to ammonium assimilation (glnA, gltB, gltD), ammonification (gdhA, gudB, cynT, cynS, ncd2), denitrification (narI, narG, narH), assimilatory nitrate reduction (nirA, nasA), and dissimilatory nitrate reduction (nirD) were enriched; soil microbial community structure presented temporary variation. Network analysis showed significant negative correlations between ARGs and nitrogen cycling genes. The addition of 6.0% spray-dried EFR resulted in the amplification of ARGs and inhibition of nitrogen cycling. This work provides new insights into the effects of spray-dried EFR on ARGs, nitrogen cycling, and microbial community structure within the fertilized soil.

This paper focuses on the impact of trade in environmentally sound technologies (green trade) on the environment. Using a panel of 277 Chinese cities from 2004 to 2013 and the instrumental variables (IV) strategy, we find that green trade can decrease the pollution level, though total trade openness is far less favorable to the environment. We also find that green imports and green exports are both conducive to the Chinese environment while green ordinary trade performs better than green processing trade. Nevertheless, the effects of green trade are restricted by a city’s purchasing power and absorptive capacity as well as the classifications of environmental goods. Further, green trade mainly improves the local green technological innovation to benefit the environment.

A novel hexaazatrinaphthylene-based (HATN) azo polymer (PAH) was synthesized from a newly designed tri-nitro compound trinitrodiquinoxalino[2,3-a:2',3'

Prestressed rebars are usually used to apply vertical prestress to concrete to prevent web cracking. The reduction of working stress will affect the durability of the structure. However, the existing working stress detection methods for prestressed rebars still need to be improved. To monitor the working stress of rebars, a magnetic resonance sensor was introduced to carry out experimental research. The correlation between rebar stress and the sensor’s induced voltage was theoretically analyzed using the magnetoelastic effect and magnetic resonance theory. A working stress monitoring method for prestressed rebars based on magnetic resonance was proposed. Working stress monitoring experiments were carried out for 16 mm, 18 mm, and 20 mm diameter rebars. The results showed that the induced voltage peak-to-peak value and the rebar prestress were nonlinearly correlated under different working conditions. Correlations between the characteristic indicators and the rebar working stress were obtained using nonlinear and linear fit. The cubic polynomial segmented fit outperformed the gradient overall linear fit, with the goodness of fit R2 greater than 0.96. The average relative error values of working stress monitoring were less than 5% under different working conditions. This provides a new method for working stress measurement of vertical prestressed rebars.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and has a poor prognosis. Pituitary tumor transforming gene 1 (PTTG1) is highly expressed in HCC, suggesting it could play an important role in hepatocellular carcinogenesis. Here, we evaluated the impact of PTTG1 deficiency on HCC development using a diethylnitrosamine (DEN)-induced HCC mouse model and a hepatitis B virus regulatory X protein (HBx)-induced spontaneous HCC mouse model. PTTG1 deficiency significantly suppressed DEN- and HBx-induced hepatocellular carcinogenesis. Mechanistically, PTTG1 promoted asparagine synthetase (ASNS) transcription by binding to its promoter, and asparagine levels were correspondingly increased. The elevated levels of asparagine subsequently activated the mTOR pathway to facilitate HCC progression. In addition, asparaginase treatment reversed the proliferation induced by PTTG1 overexpression. Furthermore, HBx promoted ASNS and asparagine metabolism by upregulating PTTG1 expression. Overall, PTTG1 is involved in the reprogramming of asparagine metabolism to promote HCC progression and may serve as a therapeutic and diagnostic target for HCC.

Intestinal barrier defect is a hallmark of inflammatory bowel disease (IBD). Mitochondrial dysfunction results in energy deficiency and oxidative stress, which contribute to the pathogenesis of IBD. Arrestin beta 1 (ARRB1) is a negative regulator that promotes G protein-coupled receptors (GPCRs)desensitization, endocytosis, and degradation. Our previous study indicated that ARRB1 was involved in mucosal protection in colitis; however, its role in maintaining the intestinal barrier is still unclear. In the present study, we demonstrated that ARRB1 protected the intestinal tight junction barrier against experimental colitis in vivo. ARRB1 deficiency was accompanied by abnormal mitochondrial morphology, lower ATP production, and severe oxidative stress. In vitro, the knockdown of ARRB1 reduced ATP levels and mitochondrial membrane potential while increasing reactive oxygen species levels and oxidative stress. Upon ARRB1 ablation, mitophagy was inhibited, accompanied by decreased LC3BII, phosphatase and tension homologue induced protein kinase1 (PINK1) and parkin, but increased p62 expression. Mitophagy inhibition via PINK1 siRNA or mitochondrial division inhibitor 1 (Mdivi-1) impaired ARRB1-mediated tight junction protection. Mitofusin2 is a critical ubiquitinated substrate for parkin accumulation in mitochondria. Co-immunoprecipitation and luciferase assays indicated that the interaction of ARRB1 with E2F1 activated mitophagy by enhancing the transcription of mitofusin2. Thus, our results suggest that ARRB1 is critical to maintaining the intestinal tight junction barrier by modulating mitophagy. This finding indicates that ARRB1 might be a potential therapeutic target to prevent IBD progression by maintaining mitochondrial homeostasis.

Radar emitter identification (REI) aims to extract the fingerprint of an emitter and determine the individual to which it belongs. Although many methods have used deep neural networks (DNNs) for an end-to-end REI, most of them only focus on a single view of signals, such as spectrogram, bi-spectrum, signal waveforms, and so on. When the electromagnetic environment varies, the performance of DNN will be significantly degraded. In this paper, a multi-view adaptive fusion network (MAFN) is proposed by simultaneously exploring the signal waveform and ambiguity function (AF). First, the original waveform and ambiguity function of the radar signals are used separately for feature extraction. Then, a multi-scale feature-level fusion module is constructed for the fusion of multi-view features from waveforms and AF, via the Atrous Spatial Pyramid Pooling (ASPP) structure. Next, the class probability is modeled as Dirichlet distribution to perform adaptive decision-level fusion via evidence theory. Extensive experiments are conducted on two datasets, and the results show that the proposed MAFN can achieve accurate classification of radar emitters and is more robust than its counterparts.

A fluorescent sensing platform based on the “off–on” mode is proposed for the detection of low concentrations of Ag+ and S2O32−.

Social recommendation systems can improve recommendation quality in cases of sparse user–item interaction data, which has attracted the industry’s attention. In reality, social recommendation systems mostly mine real user preferences from social networks. However, trust relationships in social networks are complex and it is difficult to extract valuable user preference information, which worsens recommendation performance. To address this problem, this paper proposes a social recommendation algorithm based on multi-graph contrastive learning. To ensure the reliability of user preferences, the algorithm builds multiple enhanced user relationship views of the user’s social network and encodes multi-view high-order relationship learning node representations using graph and hypergraph convolutional networks. Considering the effect of the long-tail phenomenon, graph-augmentation-free self-supervised learning is used as an auxiliary task to contrastively enhance node representations by adding uniform noise to each layer of encoder embeddings. Three open datasets were used to evaluate the algorithm, and it was compared to well-known recommendation systems. The experimental studies demonstrated the superiority of the algorithm.

Arsenical compound lewisite was developed to be a potent chemical warfare agent in the blister agent class and was abandoned in the war areas. Exposure to lewisite can cause serious damage to human’s skin, eyes and respiratory tract. Therefore, it is essential for scientific researchers to design materials that can detect and remove the abandoned lewisite efficiently. In the present work, the potential of transition metals doped (TM = Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu and Zn) graphene (TM/G) to eliminate lewisite is investigated by the first-principles calculations based on density functional theory. The adsorption geometry, adsorption energy, charge transfer, density of states and UV spectra of adsorption system of lewisite on TM/G (L@TM/G)are calculated and analyzed. Computational results demonstrate that there is a strong chemical interaction between TM/G substrate and lewisite molecule. More importantly, the adsorption of lewisite on TM/G can be regulated by introducing an electric field with proper direction and intensity, and therefore the reversible adsorption/desorption can be achieved. In addition, the electronic and optical properties of TM/G change significantly after lewisite adsorption, making TM/G promising to detect lewisite agent. The work predicts that TM/G is a potential sensor and renewable adsorbent for lewisite.

Traditional non-resorbable bone wax has been used in clinical surgery for more than 100 years. However, residual bone wax has been proven to cause numerous complications. In this study, a novel resorbable bone wax was designed to overcome the disadvantages of traditional non-resorbable bone wax. Alkylene oxide copolymers were used as the main component of resorbable bone wax; additionally, β-tricalcium phosphate and starch microspheres were added to enhance bone regeneration and hemostatic ability. This novel resorbable bone wax has a high potential for clinical translation and is expected to be developed as a substitute for traditional bone wax.

Abnormal levels of autophagy have been implicated in the pathogenesis of multiple diseases, including cancer. However, little is known about the role of autophagy-related genes (ARGs) in low-grade gliomas (LGG). Accordingly, the aims of this study were to assess the prognostic values of ARGs and to establish a genetic signature for LGG prognosis. Expression profile data from patients with and without primary LGG were obtained from The Cancer Genome Atlas (TCGA) and Genome Tissue Expression databases, respectively, and consensus clustering was used to identify clusters of patients with distinct prognoses. Nineteen differentially expressed ARGs were selected with threshold values of FDR < 0.05 and |log2 fold change (FC)| ≥ 2, and functional analysis revealed that these genes were associated with autophagy processes as expected. An autophagy-related signature was established using a Cox regression model of six ARGs that separated patients from TCGA training cohort into high- and low-risk groups. Univariate and multivariate Cox regression analysis indicated that the signature-based risk score was an independent prognostic factor. The signature was successfully validated using the TCGA testing, TCGA entire, and Chinese Glioma Genome Atlas cohorts. Stratified analyses demonstrated that the signature was associated with clinical features and prognosis, and gene set enrichment analysis revealed that autophagy- and cancer-related pathways were more enriched in high-risk patients than in low-risk patients. The prognostic value and expression of the six signature-related genes were also investigated. Thus, the present study constructed and validated an autophagy-related prognostic signature that could optimize individualized survival prediction in LGG patients.

The future sixth generation (6G) is going to face the significant challenges of massive connections and green communication. Recently, reconfigurable intelligent surfaces (RIS) and non-orthogonal multiple access (NOMA) have been proposed as two key technologies to address the above problems. Motivated by this fact, we consider a downlink RIS-aided NOMA system, where the base station seeks to communicate with two NOMA users with the aid of a RIS. Considering future network supporting real-time service, we investigate the system performance with the view of effective capacity (EC), which is an important evaluation metric of sensitive to delay sensitive system. Based on this basis, we derive the analytical expressions of the EC of the near and far users. To obtain more useful insights, we deduce the analytical approximation expressions of the EC in the low signal-to-noise-ratio (SNR) approximation by utilizing Taylor expansion. In order to compare, we provide the results of orthogonal multiple access (OMA). It is found that 1) The number of RIS components and the transmission power of the base station have important effects on the performance of the considered system model. 2) Compared with OMA, NOMA system has higher effective capacity due to the short transmission time.

BackgroundExcessive alcohol intake with hepatitis B virus (HBV) infection accelerates chronic liver disease progression and patients with HBV infection are more susceptible to alcohol-induced liver disease. Hepatitis B virus X protein (HBx) plays a crucial role in disease pathogenesis, while its specific role in alcoholic liver disease (ALD) progression has not yet been elucidated. Here, we studied the role of HBx on the development of ALD.MethodsHBx-transgenic (HBx-Tg) mice and their wild-type littermates were exposed to chronic plus binge alcohol feeding. Primary hepatocytes, cell lines, and human samples were used to investigate the interaction between HBx and acetaldehyde dehydrogenase 2 (ALDH2). Lipid profiles in mouse livers and cells were assessed by using liquid chromatography–mass spectrometry.ResultsWe identified that HBx significantly aggravated alcohol-induced steatohepatitis, oxidative stress, and lipid peroxidation in mice. In addition, HBx induced worse lipid profiles with high lysophospholipids generation in alcoholic steatohepatitis, as shown by using lipidomic analysis. Importantly, serum and liver acetaldehyde were markedly higher in alcohol-fed HBx-Tg mice. Acetaldehyde induced lysophospholipids generation through oxidative stress in hepatocytes. Mechanistically, HBx directly bound to mitochondrial ALDH2 to induce its ubiquitin–proteasome degradation, resulting in acetaldehyde accumulation. More importantly, we also identified that patients with HBV infection reduced ALDH2 protein levels in the liver.ConclusionsOur study demonstrated that HBx-induced ubiquitin-dependent degradation of mitochondrial ALDH2 aggravates alcoholic steatohepatitis.

Over 200 synthetic cannabinoid receptor agonists (SCRAs) have been identified as new psychoactive substances. Effective monitoring and characterization of SCRAs are hindered by the rapid pace of structural evolution. Ahead of possible appearance on the illicit drug market, new SCRAs were synthesized to complete a systematic library of cumyl-indole- (

Objective: To analyze the application of the Mini-Mental State Examination (MMSE) scale in cognitive assessment of elderly patients in a general ward. Methods: Elderly patients who underwent nephrosurgery and thoracic surgery between July 2015 to June 2019 were eligible for the study. A total of 713 patients enrolled and data were collected for the assessment of cognitive status. We analyzed the relationship between cognitive impairment, degree of cognitive impairment, age, and gender. Result: In the 713 cases of cognitive ability assessment by the MMSE, there was cognitive impairment in 21 (4.04%) male patients, and 10 (5.18%) female patients. In addition, the analysis of the correlation between cognitive impairment and gender showed a P value of 0.51, which was not statistically significant. In the participants age research, the average age of the patients in the cognitive normal group was 72.30±6.50 years old, and the average age of the patients in the cognitive impairment group was 78.61±6.90 years old. Their p value was

Among 2D materials (Xenes) which are at the forefront of research activities, borophene, is an exciting new entry due to its uniquely varied optical, electronic, and chemical properties in many polymorphic forms with widely varying band gaps including the lightest 2D metallic phase. In this paper, we used a simple selective chemical etching to prepare borophene with a strong near IR light-induced photothermal effect. The photothermal efficiency is similar to plasmonic Au nanoparticles, with the added benefit of borophene being degradable due to electron deficiency of boron. We introduce this selective chemical etching process to obtain ultrathin and large borophene nanosheets (thickness of ~4 nm and lateral size up to ~600 nm) from the precursor of AlB2. We also report first-time observation of a selective Acid etching behavior showing HCl etching of Al to form a residual B lattice, while HF selectively etches B to yield an Al lattice. We demonstrate that through surface modification with polydopamine (PDA), a biocompatible smart delivery nanoplatform of B@PDA can respond to a tumor environment, exhibiting an enhanced cellular uptake efficiency. We demonstrate that borophene can be more suitable for safe photothermal theranostic of thick tumor using deep penetrating near IR light compared to gold nanoparticles which are not degradable, thus posing long-term toxicity concerns. With about 40 kinds of borides, we hope that our work will open door to more discoveries of this top-down selective etching approach for generating borophene structures with rich unexplored thermal, electronic, and optical properties for many other technological applications.

Hydrolysis plays an imperative role in the abiotic transformation process of antibiotics in aqueous solutions. However, little information is available on the hydrolysis process of spectinomycin (an aminocyclitol antibiotic). This study systematically investigated the spectinomycin hydrolysis kinetics and mechanisms under different pH via experiments and density functional theory (DFT) computation. Hydrolysis was first conducted in a pure water system under pH of 4.0-9.0 and temperature of 25 °C, 50 °C and 70 °C, respectively. Results showed that hydrolysis was highly dependent on pH and temperature. When pH 6.0, spectinomycin hydrolysis was accelerated by the catalysis of OH

With gestational diabetes (GDM), women have a higher risk for future type 2 diabetes, and risk factors for diabetes for it are amplified. Whether this phenomenon is affected by traditional puerperal or postpartum practices among Chinese women who develop gestational diabetes is unclear. This has been explored in a Cantonese cultural setting to enable relevant risk management.Some 138 women were followed before, during and after pregnancy in accordance with Cantonese Puerperal Practices (CPP), and occurrence of GDM and exclusive breast-feeding. Body compositional and cardiometabolic information were collected. These included glucose tolerance and insulin resistance.During a median postpartum follow-up of 60.4 days, women with a typical CPP had a greater body weight and weight retention. With artificial feeding, women with a typical CPP had greater OGTT glycemic responses and more insulin resistance. With exclusive breast-feeding, however, no differences in postpartum cardiometabolic measurements were observed, except for a higher early-phase insulin response.Traditional CPP is associated with early postpartum cardiometabolic impairment in gestational diabetes, but this is avoided with breast-feeding.

To explore the influence of different densities of Sinonovacula constricta on the composition of easily degradable organic matter and related functional bacteria, four experimental ecosystems were established: three polyculture systems (PMB1, PMB2, and PMB3) of Portunus trituberculatus and Marsupenaeus japonicus with different stocking densities of S. constricta (11.6, 23.1, and 34.7×104 ind./hm2, respectively) and a polyculture system with only P. trituberculatus and M. japonicus (PM). Among the easily degradable organic components in all aquaculture systems, protein content was the highest (0.74%~0.86%), followed by carbohydrates (0.16%~0.21%) and lipids (0.06%~0.13%). In the high-density (34.7×104 ind./hm2) S. constricta mixed culture system, the contents of carbohydrates, lipids, and proteins in the sediment were significantly lower than those of the other polyculture systems. The number of cellulose-decomposing bacteria in PMB3 was 3.79×106 cfu/g, which was significantly higher than that in the other systems. The number of starch-degrading bacteria and glutin-degrading bacteria was the lowest in PMB3, 1.26×104 cfu/g, and 160.00 cfu/g, respectively. The number of lipid-degrading bacteria in PMB3 was 0.77×104 cfu/g, which was significantly lower than that in the other systems. The easily degradable organics content in sediment was significantly positively correlated with the corresponding functional bacteria. The results showed that mixed culture of S. constricta could reduce the content of easily degradable organics in the sediment of mariculture ponds and change the number of functional bacteria in the sediment and the availability of degradable organic sediments may determine the abundance of corresponding degradable bacteria.