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Cognitive intervention includes cognitive stimulation, cognitive training, and cognitive rehabilitation. This systematic review was performed to re-assess the efficacy of cognitive intervention for the patients with Alzheimer’s disease (AD). Twenty studies (2012 participants) were eventually included. For global cognitive function, the combined mean difference (MD) in eight studies was 1.67 (95% Confidence Interval: 0.45, 2.89, p = 0.007; Q = 33.28, df = 8, p

BackgroundThe association between coffee and caffeine consumption and the risk of renal cell carcinoma was inconsistent among observational studies, and whether these observed associations were causal remained unclear. Therefore, we performed two-sample Mendelian randomization (MR) study to assess the causal nature of the association.Materials and methodsIn this study, 12 and two independent single nucleotide polymorphisms (SNPs) related to coffee and caffeine consumption at a genome-wide significance level of p < 5 × 10–8 were used as instrumental variables (IVs), respectively. Summary-level data for renal cell carcinoma were taken from the FinnGen consortium with up to 174,977 individuals, and the International Agency for Research on Cancer (IARC) with 13,230 individuals. We used inverse-variance weighted (IVW) as the main method, followed by the weighted median method, the MR-Egger regression method, and the MR robust adjusted profile score method. Outlier and pleiotropic variants were assessed by the MR Pleiotropy RESidual Sum and Outlier test and MR-Egger regression. We used meta-analysis methods in fixed-effects to combine the estimates from the two sources.ResultsThe genetically predicted coffee consumption was not associated with the risk of renal cell carcinoma in the FinnGen consortium, and the relationship was consistent in the IARC consortium. The pooled odds ratio (OR) per 50% increase of coffee consumption was 0.752 [95% confidence interval (CI), 0.512–1.105; p = 0.147]. In addition, complementary analyses that separated the coffee-related SNPs according to their relationship with blood levels of caffeine metabolites (higher, lower, or unrelated) found no relationship with renal cell carcinoma. The results were consistent after excluding eight SNPs due to potential risk factors at genome-wide significance (p < 5 × 10–8). Moreover, genetically predicted per 80-mg increase in caffeine consumption was not associated with the risk of renal cell carcinoma (pooled OR = 0.872, 95% CI: 0.676–1.125, p = 0.292).ConclusionOur MR study provided no convincing evidence for a causal effect between coffee and caffeine consumption and the risk of renal cell carcinoma. The associations for renal cell carcinoma need to be verified in well-powered studies.

Background Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers. Methods This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured. Results Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms. Conclusion The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.

Non-muscle invasive bladder cancer (NMIBC) is a major type of bladder cancer with a high incidence worldwide, resulting in a great disease burden. Treatment and surveillance are the most important part of NIMBC management. In 2018, we issued "Treatment and surveillance for non-muscle-invasive bladder cancer in China: an evidence-based clinical practice guideline". Since then, various studies on the treatment and surveillance of NMIBC have been published. There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China. Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated. We formed a working group of clinical experts and methodologists. Through questionnaire investigation of clinicians including primary medical institutions, 24 clinically concerned issues, involving transurethral resection of bladder tumor (TURBT), intravesical chemotherapy and intravesical immunotherapy of NMIBC, and follow-up and surveillance of the NMIBC patients, were determined for this guideline. Researches and recommendations on the management of NMIBC in databases, guideline development professional societies and monographs were referred to, and the European Association of Urology was used to assess the certainty of generated recommendations. Finally, we issued 29 statements, among which 22 were strong recommendations, and 7 were weak recommendations. These recommendations cover the topics of TURBT, postoperative chemotherapy after TURBT, Bacillus Calmette-Guérin (BCG) immunotherapy after TURBT, combination treatment of BCG and chemotherapy after TURBT, treatment of carcinoma in situ, radical cystectomy, treatment of NMIBC recurrence, and follow-up and surveillance. We hope these recommendations can help promote the treatment and surveillance of NMIBC in China, especially for the primary medical institutions.

BackgroundNon-muscle-invasive bladder cancer (NMIBC) still poses a heavy load for resulting in many new cases which contribute significantly to medical costs. Although many NMIBC guidelines have been developed, their implementation remains deficient.ObjectiveThis study was conducted in order to analyze the knowledge of and compliance with the guidelines for NMIBC of Chinese urologists and to identify associated factors.MethodsWe conducted an online survey between August 2019 and January 2021. Respondents who were more than 65 years old or did not give informed consent were excluded. Linear/logistic regressions were performed to identify factors associated with the knowledge of and compliance with the guidelines of urologists, respectively. McNemar’s tests were used to explore the divergence between knowledge and compliance.ResultsA total of 814 responses were received, and 98.77% of urologists acknowledged the positive effects of high-quality guidelines. The average knowledge score was 6.10 ± 1.28 (out of a full score of 9), and it was positively associated with educational level and the number of guidelines consulted. Only 1.61% and 39.36% of the respondents realized that the guidelines did not recommend further chemotherapy or BCG infusion for low-risk patients. There were 38.87% and 51.84% respondents “often” or more frequently utilizing BCG therapy for intermediate- and high-risk NMIBC patients, respectively. Divergence between knowledge and compliance in performing a second TURBT after incomplete initial resection reached statistical significance (p < 0.001).ConclusionsAlthough the vast majority of urologists acknowledged the positive effects of guidelines, knowledge of and compliance with some recommendations of NMIBC guidelines are still inadequate. Factors associated with guidelines, individual professionals, patients, organizations, and the environment jointly contributed to the non-compliance.

On 6 February 2020, our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infection, and this guideline provided our experience and make well reference for fighting against this pandemic worldwide. However, the coronavirus disease 2019 (COVID-19) is a new disease, our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience; hence, the strategies of diagnosis and treatment are also continually updated. In this letter, we answered one comment on our guideline and provided the newest diagnostic criteria of “suspected case” and “confirmed case” according to the latest Diagnosis and Treatment Guidelines for COVID-19 (seventh version) that issued by the National Health Committee of the People’s Republic of China.

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named “2019 novel coronavirus (2019-nCoV)” by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

Objective To summarize and evaluate the evidence of guidelines and systematic reviews (SRs) of nonpharmacological interventions for mild cognitive impairment (MCI) to support the development of future guidelines and clinical decisions for MCI patients. Methods Scottish Intercollegiate Guideline Network (SIGN), National Institute for Health and Clinical Excellence (NICE), American Academy of Neurology (AAN), Registered Nurses Association of Ontario (RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews (AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of outcomes. Results Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions (including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4 (13%), low for 10 (32%), and moderate for 17 (55%). Conclusions Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.

Background Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia. Methods A total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software. Results A total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26–2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75–6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30–2.64; periodontitis: OR = 4.83, 95% CI: 2.57–9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22–2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04–4.53), and there was a higher risk in the group with a prostate volume greater than 60 g. Conclusion Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.

Background: The morbidity and mortality of coronavirus disease 2019 (COVID-19) are still increasing. This study aimed to assess the quality of relevant COVID-19 clinical practice guidelines (CPGs) and to compare the similarities and differences between recommendations.Methods: A comprehensive search was conducted using electronic databases (PubMed, Embase, and Web of Science) and representative guidelines repositories from December 1, 2019, to August 11, 2020 (updated to April 5, 2021), to obtain eligible CPGs. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the quality of CPGs. Four authors extracted relevant information and completed data extraction forms. All data were analyzed using R version 3.6.0 software.Results: In total, 39 CPGs were identified and the quality was not encouragingly high. The median score (interquartile range, IQR) of every domain from AGREE II for evidence-based CPGs (EB-CPGs) versus (vs.) consensus-based CPG (CB-CPGs) was 81.94% (75.00–84.72) vs. 58.33% (52.78–68.06) in scope and purpose, 59.72% (38.89–75.00) vs. 36.11% (33.33–36.11) in stakeholder involvement, 64.58% (32.29–71.88) vs. 22.92% (16.67–26.56) in rigor of development, 75.00% (52.78–86.81) vs. 52.78% (50.00–63.89) in clarity of presentation, 40.63% (22.40–62.50) vs. 20.83% (13.54–25.00) in applicability, and 58.33% (50.00–100.00) vs. 50.00% (50.00–77.08) in editorial independence, respectively. The methodological quality of EB-CPGs were significantly superior to the CB-CPGs in the majority of domains (P < 0.05). There was no agreement on diagnosis criteria of COVID-19. But a few guidelines show Remdesivir may be beneficial for the patients, hydroxychloroquine +/– azithromycin may not, and there were more consistent suggestions regarding discharge management. For instance, after discharge, isolation management and health status monitoring may be continued.Conclusions: In general, the methodological quality of EB-CPGs is greater than CB-CPGs. However, it is still required to be further improved. Besides, the consistency of COVID-19 recommendations on topics such as diagnosis criteria is different. Of them, hydroxychloroquine +/– azithromycin may be not beneficial to treat patients with COVID-19, but remdesivir may be a favorable risk-benefit in severe COVID-19 infection; isolation management and health status monitoring after discharge may be still necessary. Chemoprophylaxis, including SARS-CoV 2 vaccines and antiviral drugs of COVID-19, still require more trials to confirm this.

Objective: Understanding gender differences in responses of health-care workers (HCWs) to COVID-19 outbreak is an effective way to promote customized supports.Methods: During February 2020, 103 HCWs infected with COVID-19 (64 females and 39 males) and 535 uninfected HCWs (383 females and 152 males) were recruited in a cross-sectional study. Level of attention, six emotional status, and self-evaluation of eight protective measures were recorded. Multivariable Firth's logistic regressions were applied to explored independent effect of gender.Results: During early outbreak, female HCWs were more likely to give greater attention, adjusted OR:1.92 (95%CI 1.14–3.23) in total HCWs. Higher proportion of anxiety was observed in female HCWs, adjusted OR:3.14 (95%CI 1.98–4.99) for total HCWs, 4.32(95%CI 1.32–14.15) for infected HCWs and 2.97 (1.78, 4.95) for uninfected HCWs. Proportion of pessimism, fear, full of fighting spirit, and optimism were low, and no gender differences were observed. During a later outbreak, a majority of HCWs reported being very familiar with eight protective measures. After training, a proportion of high self-evaluation in hand hygiene, wearing gloves, and surgical masks increased independently in female HCWs, and adjusted ORs were 3.07 (95% CI 1.57–5.99), 2.37 (95% CI 1.26–4.49), and 1.92 (95% CI 1.02–3.62), respectively. Infection status amplified gender difference in anxiety, hand hygiene, and glove wearing.Conclusion: Female HCWs perceived the outbreak seriously, effective emotional and psychological well-ness should be targeted at female HCWs preferentially, and male HCWs should be encouraged to express their feelings and be further trained.

To evaluate the association between anthropometric parameter of obesity and newly diagnosed hyperuricemia (HUA) in a general Chinese population.A population- based cross-sectional survey included 9 615 participants (3777 men and 5838 women) aged 35-74 years in 2006 and 2009 in Qingdao, China. The multivariate linear regression was used to assess the linear associations between anthropometric parameter of obesity [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and serum uric acid. The logistic regression model was performed to estimate the associations between BMI, WC, WHR and newly diagnosed HUA.The prevalence of newly diagnosed HUA was higher in men than in women (19.46% vs 11.34%, p0.05). Multivariate liner regression showed that BMI, WC and WHR were positively correlated with serum uric acid. Multivariate logistic regression revealed that being overweight [men, odds ratios (OR): 1.69, 95% confidence intervals (95% CI): 1.37-2.08; women, OR: 1.67, 95% CI: 1.34-2.09] and obese (men, OR: 3.01, 95% CI: 2.38-3.79; women, OR: 2.91, 95% CI: 2.31-3.67) were significantly associated with a higher risk of newly diagnosed HUA. Abdominal obesity (WC: men, OR: 2.26, 95% CI: 1.88-2.73; women, OR: 1.96, 95% CI: 1.61-2.39; WHR: men, OR: 1.91, 95% CI: 1.61-2.26; women, OR: 1.39, 95% CI: 1.16-1.67) were associated with an increased risk of newly diagnosed HUA.This study demonstrated that BMI, WC and WHR were positively correlated with serum uric acid in both genders. Meanwhile, overweight, obese and abdominal obesity were associated with increased risk of newly diagnosed HUA.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, coronavirus disease 2019 (COVID-19), affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage, we have issued “A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)”; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas: chemoprophylaxis, diagnosis, treatments, and discharge management. We searched the literature for direct evidence on the management of COVID-19, and assessed its certainty generated recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. Finally, we issued 34 statements. Among them, 6 were strong recommendations for, 14 were weak recommendations for, 3 were weak recommendations against and 11 were ungraded consensus-based statement. They covered topics of chemoprophylaxis (including agents and Traditional Chinese Medicine (TCM) agents), diagnosis (including clinical manifestations, reverse transcription-polymerase chain reaction (RT-PCR), respiratory tract specimens, IgM and IgG antibody tests, chest computed tomography, chest x-ray, and CT features of asymptomatic infections), treatments (including lopinavir-ritonavir, umifenovir, favipiravir, interferon, remdesivir, combination of antiviral drugs, hydroxychloroquine/chloroquine, interleukin-6 inhibitors, interleukin-1 inhibitors, glucocorticoid, qingfei paidu decoction, lianhua qingwen granules/capsules, convalescent plasma, lung transplantation, invasive or noninvasive ventilation, and extracorporeal membrane oxygenation (ECMO)), and discharge management (including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge). We also created two figures of these recommendations for the implementation purpose. We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Objective: The quality and rationality of many recently registered clinical studies related to coronavirus disease 2019 (COVID-19) needs to be assessed. Hence, this study aims to evaluate the current status of COVID-19 related registered clinical trial. Methods: We did an electronic search of COVID-19 related clinical studies registered between December 1, 2019 and February 21, 2020 (updated to May 28, 2020) from the ClinicalTrials.gov, and collected registration information, study details, recruitment status, characteristics of the subjects, and relevant information about the trial implementation process. Results: A total of 1,706 studies were included 10.0% of which (n=171) were from France, 943 (55.3%) used an interventional design, and 600 (35.2%) used an observational design. Most of studies (73.6%) aimed to recruit fewer than 500 people. Interferon was the main prevention program, and antiviral drugs were the main treatment program. Hydroxychloroquine and chloroquine (230/943, 24.4%) were widely studied. Some registered clinical trials are incomplete in content, and 37.4% of the 1,706 studies may have had insufficient sample size. Conclusion: The quality of COVID-19 related studies needs to be improved by strengthening the registration process and improving the quality of clinical study protocols so that these clinical studies can provide high-quality clinical evidence related to COVID-19.

BACKGROUND: This study aims to observe the effects of the intracoronary and peripheral venous administration of nicorandil for the postoperative myocardial microcirculation and short-term prognosis of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) treatment. METHODS: A total of 140 STEMI patients were divided into three groups according to different patterns of administration: sequential nicorandil group, intracoronary nicorandil group and control group. The main observation indexes included coronary blood flow and myocardial perfusion immediately after PPCI, while the secondary observation indexes included major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) during the period of hospitalization. RESULTS: After PPCI, the difference in the proportion of patients with thrombolysis in myocardial infarction (TIMI) flow grade 3 among the three groups was statistically significant (P=0.036), where this proportion was higher in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.022 and P=0.047); The difference in corrected TIMI frame count (CTFC) among the three groups was statistically significant (P=0.022), where CTFC was lower in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.010, P=0.031); The differences in the proportion of patients with complete ST resolution (STR) and advancing of enzyme peak time to within 12 h between each two groups were statistically significant (P

Background Clinical practice guidelines have become increasingly widely used to guide quality improvement of clinical practice. Qualitative research may be a useful way to improve the quality and implementation of guidelines. The methodology for qualitative evidence used in guidelines development is worthy of further research. Methods A comprehensive search was made of WHO, NICE, SIGN, NGC, RNAO, PubMed, Embase, Web of Science, CNKI, Wanfang, CBM, and VIP from January 1, 2011 to February 25, 2020. Guidelines which met IOM criteria and were focused on clinical questions using qualitative research or qualitative evidence, were included. Four authors extracted significant information and entered this onto data extraction forms. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the guidelines’ quality. The data were analyzed using SPSS version 17.0 and R version 3.3.2. Results Sixty four guidelines were identified. The overall quality of the guidelines was high (almost over 60%). Domain 1 (Scope and Purpose) was ranked the highest with a median score of 83% (IQ 78–83). Domain 2 (Stakeholder involvement) and Domain 5 (Applicability) were ranked the lowest with median scores of 67% (IQ 67–78) and 67% (IQ 63–73) respectively. 20% guidelines used qualitative research to identify clinical questions. 86% guidelines used qualitative evidence to support recommendations (mainly based on primary studies, a few on qualitative evidence synthesis). 19% guidelines applied qualitative evidence when considering facilitators and barriers to recommendations’ implementation. 52% guideline developers evaluated the quality of the primary qualitative research study using the CASP tool or NICE checklist for qualitative studies. No guidelines evaluated the quality of qualitative evidence synthesis to formulate recommendations. 17% guidelines presented the level of qualitative research using the grade criteria of evidence and recommendation in different forms such as I, III, IV, very low. 28% guidelines described the grades of the recommendations supported by qualitative and quantitative evidence. No guidelines described the grade of recommendations only supported by qualitative evidence. Conclusions The majority of the included guidelines were high-quality. Qualitative evidence was mainly used to identify clinical questions, support recommendations, and consider facilitators and barriers to implementation of recommendations’. However, more attention needs to be paid to the methodology. For example, no experts proficient in qualitative research were involved in guideline development groups, no assessment of the quality of qualitative evidence synthesis was included and there was lack of details reported on the level of qualitative evidence or grade of recommendations.

Background: The effects of acupuncture on Alzheimer's disease (AD) outcomes remain controversial. The aim of this review was to evaluate the effectiveness and safety of acupuncture for the treatment of AD.Methods: PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang Data were searched to identify relevant randomized controlled trials from inception to January 19, 2019. Data were extracted and evaluated by two authors independently. The data analysis was conducted using R (version 3.6.0) and RStudio (version 1.2.1335) software.Results: Thirty trials involving 2,045 patients were included. Acupuncture plus drug therapy may have been more beneficial for general cognitive function in AD patients than drug therapy alone (short-term treatment: MD, mean difference = 1.94, 95% CI: 1.11, 2.77; p < 0.01; medium-term treatment: MD = 4.41, 95% CI: 1.83, 7.00; p < 0.01). People who received acupuncture plus drug therapy attained higher ADL (Activities of Daily Living) scores than patients who received drug therapy alone for medium-term treatment duration (MD = −2.14; 95% CI: −3.69, −0.59; p < 0.01). However, there is no statistically significant difference in subgroup effect on MMSE (Mini-mental Status Examination) and ADLs (p > 0.05) when comparing acupuncture treatment with drug therapy (such as Donepezil hydrochloride, Nimodipine, or Yizhijiannao), or acupuncture plus drug therapy (such as Donepezil hydrochloride, Dangguishaoyaosan, or Jiannaosan) with drug therapy alone. There was also no significant difference in general cognitive function, ADLs, or incidence of adverse events between acupuncture treatment and drug therapy (p > 0.05).Conclusions: This review indicates that acupuncture plus drug therapy may have a more beneficial effect for AD patients than drug therapy alone on general cognitive function in the short and medium term and on ADLs in the medium term. Acupuncture alone may not have superior effects compared with drug therapy on global cognitive function, ADLs, and incidence of adverse events. Duration of treatment may not modify the effect of acupuncture in comparison with drug therapy. Additional large-scale and high-quality clinical trials are needed.

The objective of this study was to compare the efficacy and safety of 10 different surgical treatments for benign prostatic hyperplasia (BPH) with volume >60 mL. A systematic literature review and network meta-analysis of randomized controlled trials (RCTs) within a Bayesian framework was performed. A total of 52 parallel-group RCTs included, reporting on 6,947 participants, comparing open prostatectomy (OP), monopolar/bipolar transurethral resection of prostate (monopolar/ bipolar TURP), thulium, holmium and diode laser enucleation of prostate (LEP), bipolar enucleation of prostate, potassium titanyl phosphate laser vaporization of prostate (KTP LVP), bipolar vaporization of prostate (bipolar VP), and laparoscopic simple prostatectomy (laparoscope SP). Compared with OP, laparoscope SP identified better maximal flow rate (Qmax; mean differences [MDs] = 2.89 mL/s) at the 24th month, but bipolar VP demonstrated worse Qmax (MD = −3.20 mL/s) and International Prostate Symptom Score (IPSS; MD = 2.60) at the 12th month. Holmium LEP (MD = 1.37) demonstrated better International Index of Erectile Function–5 at the 12th month compared with OP. However, compared with OP, KTP LVP demonstrated worse postvoid residual volume (PVR) at the sixth (MD = 10.42 mL) and 12th month (MD = 5.89 mL) and monopolar TURP (MD = 6.9 mL) demonstrated worse PVR at the 12th month. Eight new surgical methods for BPH with volume >60 mL appeared to be superior in safety compared with OP and monopolar TURP due to fewer complications. Bipolar VP and KTP LVP maybe not suitable for prostates more than 60 mL due to short- and middle-term worse Qmax, IPSS, and PVR than OP.

Methodological quality (risk of bias) assessment is an important step before study initiation usage. Therefore, accurately judging study type is the first priority, and the choosing proper tool is also important. In this review, we introduced methodological quality assessment tools for randomized controlled trial (including individual and cluster), animal study, non-randomized interventional studies (including follow-up study, controlled before-and-after study, before-after/ pre-post study, uncontrolled longitudinal study, interrupted time series study), cohort study, case-control study, cross-sectional study (including analytical and descriptive), observational case series and case reports, comparative effectiveness research, diagnostic study, health economic evaluation, prediction study (including predictor finding study, prediction model impact study, prognostic prediction model study), qualitative study, outcome measurement instruments (including patient - reported outcome measure development, content validity, structural validity, internal consistency, cross-cultural validity/ measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity, and responsiveness), systematic review and meta-analysis, and clinical practice guideline. The readers of our review can distinguish the types of medical studies and choose appropriate tools. In one word, comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.

Aim To appraise the quality of current nursing clinical practice guidelines (N-CPGs) in China and explore the methodology for N-CPGs development. Background Implementation of quality improvement projects based on N-CPGs has becoming an hot topic for nursing with proliferation in the number of N-CPGs in China in recent years. The methodology for developing N-CPGs is worthy of exploration. Methods A systematic literature search was performed using PubMed, CINAHL, Web of Science, CNKI, Wanfang, VIP and CBM and relevant representative guidelines repositories from inception to July 31, 2019. Two authors independently selected eligible guidelines and performed data extraction. Four appraisers independently assessed the quality of the N-CPGs using the AGREE II tool. Results 20 N-CPGs were eventually included in this review. After AGREE II appraisal, the final domain scores ranged between 0.00 and 83.33%. When comparing the total domain scores, "Scope and purpose" and "Clarity of presentation" scored highest with a total of 63.89 (59.37-69.79) (%, median, interquartile range (IQR)), and 63.89 (58.33-75.70) (%), respectively. "Editorial independence" obtained the lowest ranking with a total score of 0 (0-81.25) (%). The total scores of "Stakeholder involvement", "Rigour of development", "applicability" and "editorial independence" were lower than 50%. Conclusion The quality of N-CPGs in China is not very high and the process of guideline development still needs to improve. Implications for nursing management N-CPGs are important documents used to guide nursing quality improvement. High quality N-CPGs are beneficial for nursing management.

Background Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies. Methods A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers. Results Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42, 85.42%); stakeholder involvement 41.67% (30.56, 75.00%); rigour of development 48.96% (27.08, 65.63%); clarity and presentation 80.56% (75.00, 86.11%); applicability 34.38% (22.92, 40.63%) and editorial independence 70.83% (35.42, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses. Conclusions The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details.

Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is one of the major adverse outcomes affecting the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). Ischemic postconditioning prior to PCI (pre-PCI) in patients with STEMI is hypothesized to be protective against CIN after PCI.A total of 251 patients with STEMI were randomized into two groups: ischemic postconditioning group (n = 123, age, 61.1 ± 12.5 years) who underwent ischemic postconditioning prior to PCI; control group (n = 128; age, 64.1 ± 12.1 years) who underwent only PCI. Ischemic postconditioning was administered by three cycles of deflation and inflation of the balloon (1-min ischemia and 1-min reperfusion) starting 1 min after infarct-related artery (IRA) opening. Diagnostic criterion for CIN was: increase in serum creatinine level by ≥0.5 mg/dL or by ≥25% increase from preoperative level within 48 h of surgery. All patients were followed for 1 year for incidence of major cardiovascular events (MACE).The incidence of postoperative CIN in the ischemic postconditioning group was 5.69% as compared to 14.06% in the control group (p0.05). At one year, the MACE incidence in the ischemic postconditioning group was 7.32% as compared to 15.63% in the control group (p0.05).Pre-PCI ischemic postconditioning in STEMI patients significantly reduces the post-PCI incidence of CIN and improves long-term prognosis.

High heterogeneity has been reported among epidemiological studies exploring the relationship between metformin and the risk of gastric cancer. Immortal time bias might be one of the vital factors causing heterogeneity because of its widespread existence in pharmacological observational studies and it could severely exaggerate the drug's effectiveness. Immortal time bias could occur in an observational study if exposure status is determined based on a measurement or event that occurs after baseline. In this study, we aimed to assess whether immortal time bias is responsible for the false assumption that metformin reduces the risk of gastric cancer. We searched PubMed, Embase, Web of Science and Cochrane Library databases for relevant studies from the inception to August 9, 2020. The strength of the relationship was assessed using pooled relative risks (RRs) with corresponding 95% confidence intervals (95% CIs). Statistical analyses were carried out using a random-effects model. Pooled RR from 6 cohort studies with immortal time bias found a clear 33% reduced risk associated with metformin use (RR = 0.67, 95% CI = 0.59, 0.77; P < 0.001; I2 = 48.5%). However, pooled RR from 8 cohort studies without immortal time bias indicated no association between the use of metformin and gastric cancer risk (RR = 0.95, 95% CI = 0.85, 1.05; P = 0.317; I2 = 64.5%). From a univariate meta-regression model, the presence of immortal time bias was associated with a significant reduction of 29% in the effect estimate of metformin on gastric cancer risk (ratio of RR = 0.71, 95% CI = 0.58, 0.86; P = 0.002). This meta-analysis indicates that metformin use has no protective effect on gastric cancer risk. The relationship between metformin use and gastric cancer risk has been exaggerated as a result of the presence of immortal time bias. Further studies are required to confirm the results by controlling for immortal time bias based on appropriate study designs and statistical methods.

Emotion is the external way to express human’s inner thoughts, which has a significant influence on human behaviors. It is an important prerequisite for studying the intrinsic affect mechanism of emotions on behaviors certain. In this article, drivers’ emotional induction experiment, actual and virtual driving experiments are designed to obtain the multi-source dynamic data of human–vehicle–environment under the condition of different emotions. The influences of emotions’ changes on car movement characteristics of different types of drivers are explored. Changing law of car movement characteristics under the condition of different emotions can be obtained finally. The research can provide theoretical basis for the future research of driver assistance system, which is of great significance to realize active vehicle safety warning and unmanned driving in the future.

Most quantum error-correcting codes constructed are stabilizer codes which are potentially more efficient and significant.Under the concept of graph states theory, we focused on 7-qubit graph states characteristics of stabilizer codes, by calculating and analyzing the entanglement properties of graphical codes. For the instance of code ((7,1,3)) with 16 inequitable graphs, the figure of entanglement properties can be measured.And we analyzed 7-qubit graph characteristics of stabilizers codes and calculated the entanglement measures by iterative algorithm.

With the fast development of clean energy in China, the conflict between limited peak load regulation capability and the increasing installed wind power capacity became more and more obvious. Two different wind power integration dispatching modes were proposed in this paper, meanwhile, the wind power integration capacity and system economy under different scenarios, which have different wind power penetration and energy storage system (ESS) capacity, were also analyzed. As indicated in the example analysis, the ESS can significantly enhance the wind power integration capacity; and the economical wind power integration dispatching mode is the most suitable choice for the power grid in wind-rich area.

Indefinite kernel support vector machine (IKSVM) has recently attracted increasing attentions in machine learning. Different from traditional SVMs, IKSVM essentially is a non-convex optimization problem. Some algorithms directly change the spectrum of the indefinite kernel matrix at the cost of losing some valuable information involved in the kernels so as to transform the non-convex problem into a convex one. Other algorithms aim to solve the dual form of IKSVM, but suffer from the dual gap between the primal and dual problems in the case of indefinite kernels. In this paper, we directly focus on the non-convex primal form of IKSVM and propose a novel algorithm termed as IKSVM-DC. According to the characteristics of the spectrum for the indefinite kernel matrix, IKSVM-DC decomposes the objective function into the subtraction of two convex functions and thus reformulates the primal problem as a difference of convex functions (DC) programming which can be optimized by the DC algorithm (DCA). In order to accelerate convergence rate, IKSVM-DC further combines the classical DCA with a line search step along the descent direction at each iteration. A theoretical analysis is then presented to validate that IKSVM-DC can converge to a local minimum. Systematical experiments on real-world datasets demonstrate the superiority of IKSVM-DC compared to state-of-the-art IKSVM related algorithms.

Three novel rare earth complexes [N(CH3)4][Ln(NF)4]6H2O(Ln=Nd(III)(1), Sm(III)(2), Ho(III)(3)) were synthesized using hydrothermal method from norfloxacin HNF=1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinoline carboxylic acid, C16H18FN3O3), imidazole and rare earth nitrates. The complexes were characterized by elemental analysis, FT-IR, TG-DTG and X-ray single crystal diffraction. Each rare earth ion was eight-coordinated with carboxyl-O atoms and keto-O atoms from norfloxacin. Four of the norfloxacin ions acted as bidentate chelate group took part in the coordination with rare earth ion. The structures of complexes were tetragonal system with space group I41/acd, which were allomerism. The interaction between complex 1 and DNA was studied by electronic absorption spectra and fluorescence spectroscopy. The binding interaction between the complex 1 and bovine serum albumin (BSA) was studied by fluorescence spectroscopy. The complex 1 bound to DNA by the mode of partial intercalation. Complex 1 had a strong ability to quench the fluorescence from BSA. The complex interaction was mainly a static quenching process with BSA together with formation of two binding sites.

This paper designs a type of small artificial blood vessel in a composite structure, which the nano cellulose coating is attached to the tube blank. The properties of this type of artificial blood vessel - radical and axial tensile property, area of aperture gaps - are observed by an electron microscopy and analyzed to prepare for the further experiments.

Three novel norcantharidin acylamide acids (L1N-thiadiazole norcantharidin acylamide acid, C10H11N3O4S; L2N-thiazole norcantharidin acylamide acid, C11H12N2O4S and L3N-benzothiazole norcantharidin acylamide acid, C15H14N2O4S) were synthesized by the reactions of norcantharidin (NCTD7-oxabicyclo[2,2,1]heptane-2,3-dicarboxylic acid anhydride, C8H8O4) with 2-amino-1,3,4-thiadiazole (C2H3N3S), 2-aminothiazole (C3H4N2S) and 2-aminobenzothiazole (C7H6N2S), respectively. Their structures were characterized by elemental analysis, IR, and NMR. The inhibition rates of L3 was much higher than those of L1 and L2 against human hepatoma cells SMMC7721 cell lines in vitro. The interaction between the compounds and DNA was studied by means of fluorescence quenching studies and viscosity measurements. The emission intensities decreased obviously with increasing concentration of the compounds in the fluorescence quenching experiments. The linear Stern-Volmer quenching constant Ksq values were 0.62 (L1), 0.55 (L2) and 1.08 (L3), respectively. The binding abilities followed the trend from high to low were L3, L1 and L2, respectively. The results of viscosity measurements showed that L1 and L2 might bind to DNA via partial intercalation, while L3 bound mainly in intercalation.

In a previous study, we reported water-soluble light-emitting nanoparticles with distinct interchain aggregation states of the constituent conjugated polymers. These interchain states usually result in strong self-quenching, dramatically reducing the quantum efficiency of fluorescence. In the work reported in the present study, we developed new water-soluble fluorescent nanoparticles without distinct aggregation of the conjugated polymer chains, which demonstrated distinctive morphologies and optical properties. ‘Strawberry’ morphologies of the nanoparticles were directly observed using transmission electron microscopy. The conjugated polymers were dispersed in the individual cores of the nanoparticles and the majority of the core diameters were in the range 8–12 nm. The primary optical properties of the conjugated polymers in tetrahydrofuran still remained in the nanoparticles. The results suggest that the conjugated polymer chains formed a possible unimolecular structure without distinct aggregation in the nanoparticles. Copyright © 2010 Society of Chemical Industry

Here we report a case of cervical spondylosis misdiagnosed as cerebral infarction. The patient was a 55-year-old man with a one-day history of weakness in his right extremities. Brain magnetic resonance imaging (MRI) showed no acute abnormality, cerevical MRI showed that cervical spondylisis, C4/5, C5/6 disc herniation, spinal canal stenosis and compression of the spinal cord. Then the patient was transferred to the Department of Orthopaedics and underwent surgical treatment of cervical spondylosis. Followed-up for six months, the weakness of his right extremities returned to normal.

The caustic method is applied to compressive shear experiment and used to detect the stress intensity factors of cracks prefabricated on plexiglass sample. Loading, friction of crack planes and influence among cracks are not needed to know as they are combined and transformed into the caustic shadow used in detecting the stress intensity factor. Even boundary condition is not necessary. Therefore it is effective to determine the stress intensity factor of compressive shear crack.

Based on the phenomena that the deformation gap was observed before the great Tangshang earthquake, this paper discusses the strain gap according to test and theory. The (strain) patterns were recorded photographically by realtime holographic interferometry and shadow optical method of caustics, as soon as the loading process started. In the meantime, the AE (acoustic emission) signals were recorded by a micro crack information storage-analysis system. According to damage theory and location of micro fracture, we have studied the stain gap and gained: a) It is necessary that strain gap appears under the condition of linear elasticity theory, and its situation is relatively stable, corresponding to stress concentration. b) Micro fractures, which appear initially at area of high stress, occur rarely at the strain gap, and their locations are finally in the zone between the stress concentration area and the strain gap, which indicate the clusters or groups. However, the major macro fracture (final rupture) started from the shadow areas, and then grew quickly towards the strain gaps, which resulted in failure of sample.

Using a plexiglass sample and by means of real-time holographic interferometry and shadow optical method of caustics, the different features of dynamic variation in stress (strain) field, plastic area and nucleation zone (shadow area) when the sample fractures during loading (loading-fracture) and unloading (unloading-fracture) are studied visually. The results show that the strain nuclei (zones with dense fringes) appear first at the tips of prefabricated cracks at low stress, and then the shadow areas of caustics form with the increase of load. These nuclei and shadow areas can become larger, or smaller, when the process of loading, or unloading, goes on. When the stress is kept within a certain range, the shadow areas of caustics can become larger and smaller alternatively with repeated loading and unloading (cyclic loading). However, when loading and unloading at high stress, in particular when the macrofracture is about to appear, the variations of the shadow areas of caustics are irreversible and quite different. The shadow areas of caustics expand rapidly at an increasing speed when loading-fracture appears. In contrast, the shadow areas of caustics expand at a lower speed when unloading-fracture appears; besides, there is a circular shadow in front of the sharp-angle shaped area.

Rock experiment results indicate that the load/unload response ratio (LURR) of rocks expressed via strain energy may have singular or negative value after the stress in the rock reaches its maximum before rock failure or when the rock goes into the strain-weakening phase. The universality of this phenomenon is discussed. Expressed via strain or strain energy and the travel time of P wave, the variation form of the reciprocal of LURR during the process of rock failure preparation is derived. The results show that after a sharp decrease the reciprocal of LURR reaches its minimum when the main fracture of the rock is about to appear. This feature can be taken as an indication that the rock main fracture is impending.

The purposes of the present study were to investigate the inhibitory effect of quercetin (QUE) preconditioning on endoplasmic reticulum stress (ERS) inducer tunicamycin (TM)-induced apoptosis in RAW264.7 macrophages and the underlying molecular mechanisms. RAW264.7 cells were pretreated with different concentrations (20, 40, and 80 μmol/L) of QUE for 30 min and then treated with TM (5 mg/L) for 12 h. Cell viability and apoptosis were determined using MTT assay and Annexin V-FITC apoptosis detection kit, respectively. The nuclear translocation of activating transcription factor 6 (ATF6) in cells was detected by immunofluorescence analysis and Western blot. Protein and mRNA expressions of C/EBP homologous protein (CHOP) and Bcl-2 were examined by Western blot and real-time PCR, respectively. The results showed that TM reduced cell viability and induced apoptosis in RAW264.7 macrophages. The cytotoxic effects of TM were significantly inhibited by QUE pretreatment at the concentrations of 40 and 80 μmol/L. Interestingly, we found that QUE also significantly suppressed the TM-induced translocation of ATF6, an ERS sensor, from the cytoplasm to the nucleus. In addition, exposure of RAW264.7 macrophages to TM resulted in a significant increase of the expression of CHOP, a transcription factor regulated by ATF6 under conditions of ERS, as well as a decrease of Bcl-2 at transcript and protein levels. QUE blocked these effects in a dose-dependent manner. These data indicate that QUE can protect RAW264.7 cells from TM-induced apoptosis and that the mechanism at least partially involves its ability to inhibit the ATF6-CHOP signaling pathway.

Noroviruses (NoVs) are a leading cause of epidemic acute gastroenteritis affecting millions of people worldwide. Understanding of NoV remains limited due to the lack of a cell culture system and small animal models. Currently, there are no available vaccines or antivirals against NoVs. In this study, an approach for large-scale production of anti-NoV antibodies for use as a potential treatment for NoV disease using passive immunization was evaluated. NoV-specific immunoglobulins (IgY) were produced by immunizing chickens with NoV P particles. The birds continuously produced high titers of antibodies in their eggs for at least 3 months, in which NoV-specific antibody levels reached 4.7-9.2 mg/egg yolk. The egg yolk antibodies strongly reacted with NoV P particles by both ELISA and Western blot and blocked NoV virus-like particle (VLP) and P particle binding to the histo-blood group antigen (HBGA) receptors with a BT50 of about 1:800. The blocking activity of the chicken IgY remained after an incubation at 70°C for 30 min or treatment at pH 4 to 9 for 3 h. These data suggested that chicken IgY could be a practical strategy for large-scale production of anti-NoV antibodies for potential use as passive immunization against NoV infection, as well as for diagnostic purposes.

Among the new norcantharidin acylamide acids synthesized, compound (VII) shows the highest antiproliferative activities against human hepatoma cells SMMC7721 in vitro.

Two new La(III) and Sm(III) complexes with enrofloxacin (HER, 1-cyclopropyl-7-(4-ethyl-1-piperazinyl)-6-fluoro-1,4-dihydro-4-oxo-3-quinoline carboxylic acid, C19H21FN3O3), [La2(ER)6(H2O)2]·14H2O(1) and [Sm2(ER)6(H2O)2]·14H2O(2) have been synthesized and characterized by elemental analysis, FT-IR, TG-DTG and X-ray single crystal diffraction. Both of the complexes are triclinic system with space group Pī. The structure of the complexes show that each rare earth atom in both complexes was nine-coordinated. Two of the enrofloxacin ions acted as tridentate chelate and bridging ligands, while the others as bidentate chelate ligands. The binding reaction between the complexes and bovine serum albumin (BSA) was studied by UV-vis absorption spectra and fluorescence spectroscopy. The results indicated that the two complexes had a quite strong ability to quench the fluorescence from BSA and the binding reaction was mainly a static quenching process. The binding constants K A /(L·mol−1) were 1.46 × 105(1) and 8.59 × 106(2) and one binding site was formed. The synchronous spectroscopy suggested that tryptophan residues were placed in BSA. It was also found that the two complexes exhibited greater antimicrobial activity than enrofloxacin at given concentrations.

In the crystal structure of the title compound, [Ni(C8H8O5)(H2O)2]n, the NiII cation is in a Jahn–Teller-distorted octahedral coordination environment binding to two O atoms from water molecules, the bridging O atom of the bicycloheptane unit, two carboxylate O atoms from different carboxylate groups and one carboxylate O atom from a symmetry-related bridging ligand. The crystal structure is made up from layers propagating parallel to the bc plane.

In the crystal structure of the title compound {systematic name: diaquabis[1-cyclopropyl-6-fluoro-4-oxo-7-(piperazin-1-yl)-1,4-dihydroquinoline-3-carboxylato]manganese(II) 2,2′-bipyridine solvate tetrahydrate}, [Mn(C17H17FN3O3)2(H2O)2]·C10H8N2·4H2O, the pyridone O and one carboxylate O atom of the two ciprofloxacin ligands are bound to the MnII ion and occupy the equatorial positions, while the two aqua O atoms lie in the apical positions resulting in a distorted octahedral geometry. The crystal packing is stabilized by N–H...O and O–H...O hydrogen bonding interactions.

In the crystal structure of the title compound, [Cu(C8H8O5)(H2O)2]n, the Cu(II) cation is in a Jahn–Teller distorted six-coordination by two O atoms from water molecules, by the bridging O atom from the bicyclo moiety, by two carboxylate O atoms from two different carboxylate groups and by one carboxylate O atom from a symmetry-related bridging ligand.The polymeric structure is made up from double-strands propagating parallel to the c axis that are held together via intermolecular O—H...O hydrogen bonds.

Three novel complexes [Nd(L)(NO3)(H2O)2].NO(3).2H2O (HL1 = N-pyrimidine norcantharidin acylamide acid, C12H13N3O4; HL2 = N-pyridine norcantharidin acylamide acid, C13H14N2O4; HL3 = N-phenyl norcantharidin acylamide acid, C14H15NO4) were synthesized. HL1, HL2 and HL3 are the ligand of complex(1), complex(2) and complex(3), respectively. Their structures were characterized by elemental analysis, conductivity measurement, infrared spectra and thermogravimetric analysis. The DNA-binding properties of the complexes have been investigated by fluorescence spectroscopy and viscosity measurements. The results suggest that the complexes can bind to DNA by partial intercalation. The liner Stern-Volmer quenching constant Ksq values are 3.3(+/-0.21)(1), 1.7(+/-0.19)(2) and 0.9(+/-0.04)(3), respectively. Complex (1) and (2) have been found to cleave pBR322 plasmid DNA at physiological pH and temperature. The test of antiproliferation activity indicates that complex(1) has strong antiproliferative ability against the SMMC7721 (IC50 = 131.7 +/- 23.4 micromol x L(-1)) and A549 (IC50 = 128.4 +/- 19.9 micromol x L(-1)) cell lines. The inhibition rates of complex(2) (IC50 = 86.3 +/- 11.3 micromol x L(-1)) are much higher than that of NCTD (IC50 = 115.5 +/- 9.5 micromol x L(-1)) and HL2 (111.0 +/- 5.7 micromol x L(-1)) against SMMC7721 cell lines.

On a plexiglass sample, a penetrating crack was prefabricated by laser. The crack is inclined towards the major principal stress (σ1 (σ y ,) at an angle of about 30o. Using this sample and by means of shadow optical method of caustics and microcrack location, the process zone, nucleation zone and plastic area of earthquakes were studied experimentally, and the strain variation in the shadow area was monitored. From the result, we comprehend the following. When the stress σ y , was increased to a certain value, shadow areas were formed around the prefabricated crack and at its tips, with that at the tips being larger. These shadow areas become larger with the increase of load and smaller with unloading. In the shadow area the strain was inhomogeneous: it was very large in some places but very small in others. When the shadow area reached a critical state, microcracks appeared at the tips of the prefabricated crack. Microcracks appeared on one side of the prefabricated crack where the strain and the shadow were both smaller. The zone with concentrated microcracks, or the process zone, was always located at the crack tip; this zone together with a half length of the original crack formed the nucleation zone which fell into the shadow area but was smaller than it. The shadow optical area of caustics bears a certain quantitative relation with the plastic area. Therefore, if an appropriate method is available to obtain the shadow optical area of caustics, it would be possible to detect the area with strong differential deformation change, and hence to determine the zone where strong fracture (an earthquake) would take place.

Novel noncovalently connected water-soluble nanoparticles containing hydroxyl-capped polyfluorene (PFOH) and poly(acrylic acid) (PAA) were obtained and characterized. These nanoparticles were quite...