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Background Nondiabetic kidney disease (NDKD), which is prevalent among patients with diabetes mellitus (DM), is considerably different from diabetic kidney disease (DKD) in terms of the pathological features, treatment strategy and prognosis. Although renal biopsy is the current gold-standard diagnostic method, it cannot be routinely performed due to a range of risks. The aim of this study was to explore the predictors for differentiating NDKD from DKD to meet the urgent medical needs of patients who cannot afford kidney biopsy. Methods This is a retrospective study conducted by reviewing the medical records of patients with type 2 DM who underwent percutaneous renal biopsy at the Affiliated Hospital of Guizhou Medical University between January 2017 and May 2021. The demographic data, clinical data, blood test results, and pathological examination results of the patients were obtained from their medical records. Multivariate regression analysis was performed to evaluate the predictive factors for NDKD. Results A total of 244 patients were analyzed. The median age at biopsy was 55 (46, 62) years. Patients diagnosed with true DKD, those diagnosed with NDKD and those diagnosed with NDKD superimposed DKD represented 48.36% (118/244), 45.9% (112/244) and 5.74% (14/244), respectively, of the patient population. Immunoglobulin A nephropathy was the most common type of lesion in those with NDKD (59, 52.68%) and NDKD superimposed DKD (10, 71.43%). Independent predictive indicators for diagnosing NDKD included a DM duration of less than 5 years (odds ratio [OR] = 4.476; 95% confidence interval [CI]: 2.257–8.877; P P P = 0.003), and a negative of urinary glucose excretion test result (OR = 2.985; 95% CI: 1.474–6.044; P = 0.002).. Conclusions A DM duration less than 5 years, an absence of retinopathy, a high RBC count and an absence of urinary glucose excretion were independent indicators for the diagnosis of NDKD, suggesting that patients with NDKD may require a different treatment regimen than those with DKD.

To compare the thoracic magnetic resonance imaging (TMRI) features between peripheral lung cancer (PLC) and progressive massive fibrosis (PMF) of coal silicosis (CS), and to excavate information of differential diagnostic value. 68 patients with PLC (68 lesions) were selected as lung cancer group (LCG), and 50 patients with PMF of CS (78 lesions) were selected as coal silicosis group (CSG). TMRI was performed in both groups, and T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and Spectral pre-saturated inversion recovery (SPIR) were used. The differences and characteristics of TMRI between the two groups were analyzed. 55 cases of pulmonary masses (PM) in LCG showed iso-signal intensity on T1WI (80.9%), and 63 cases showed high-signal intensity on T2WI and SPIR (92.6%); 65 cases of PMF in CSG showed iso-signal intensity on T1WI (83.5%), and high-signal intensity on T2WI and SPIR was found in 4 cases (5.1%), but 67 cases showed low-signal intensity (85.9%). PMF in CSG with high-signal intensity on T2WI and SPIR were significantly lower than PM in LCG(P < 0.1). Compared with TMRI of PLC showed high-signal intensity on T2WI and SPIR, PMF in CS showed low-signal intensity on T2WI and SPIR. This feature is of important significance in differential diagnosis.

ObjectivesThe aim of our study was to investigate the association between serum albumin concentration and the risk of cardiac arrest in critically ill patients with end-stage renal disease in the intensive care unit (ICU).DesignThis was a secondary analysis.SettingThe Phillip electronic-ICU collaborative database from 2014 to 2015.ParticipantsThis study included 4990 critically ill patients diagnosed with end-stage renal disease.Primary and secondary outcome measuresThe exposure of interest was serum albumin concentration. The outcome variable was cardiac arrest.ResultsA non-linear relationship was observed between serum albumin concentration and risk of cardiac arrest, with an inflection point of 3.26 g/dL after adjusting for potential confounders. The effect sizes and the CIs on the left and right sides of the inflection point were 0.88 (0.65 to 1.19) and 0.32 (0.16 to 0.64), respectively.ConclusionsWithin an albumin range of 3.26–5.6 g/dL, each 1 g/dL increase in serum levels is associated with a 68% decrease of the risk of cardiac arrest in critically ill patients with end-stage renal disease.

Xiaoqinglong decoction (XQLD), a classic prescription of Traditional Chinese Medicine, has already been used clinically to cure acute lung injury (ALI), but its mechanism remains unclear. This subject aimed to explore the preventive role of XQLD in septic ALI rats besides its effects on angiotensin-converting enzyme (ACE)2 and its downstream factors. After, respectively, administrated with different concentrations of XQLD (6.25 g/kg/d, 12.5 g/kg/d, 25 g/kg/d) for 5 days and dexamethasone (DEX, 1 mg/kg) for 0.5 h, the rat models of ALI were established by intraperitoneal injection of lipopolysaccharide (LPS, 5 mg/kg) for 24 h. All rats were evaluated by lung function test, arterial blood gas analysis, morphological observation, lung wet/dry (W/D) ratio, and the lung injury score. The levels of malonaldehyde (MDA), superoxide dismutase (SOD), interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and angiotensin (Ang) (1–7) in the lung were measured through biochemical and ELISA kits. The expressions of angiotensin-converting enzyme (ACE)2, mitochondrial assembly receptor (MasR), and nuclear factor (NF)-κB in lung tissue were detected by qRT-PCR and western blotting. Positive reaction cells of MasR were observed by immunohistochemistry. The results show that XQLD significantly ameliorated septic lung injury including edema and hemorrhage, as well as improved pulmonary function and arterial blood gas. Furthermore, XQLD markedly decreased the levels of IL-1β, TNF-α, MDA, and NF-κB while increased the levels of SOD, Ang (1–7), ACE2, and MasR in septic ALI rats. Pearson correlation showed that the expressions of ACE2 were inversely related to IL-1β, TNF-α, MDA, and NF-κB and positively correlated with SOD contents. Our data indicated that XQLD pretreatment alleviated inflammation and oxidative damage in septic ALI rats, which might be related to the up-regulation of ACE2-Ang (1–7)-MasR axis and inhibition of the NF-κB pathway.

Due to high mortality rates and poor prognosis, liver injury remains one of the leading causes of mortality worldwide. Amounting evidence suggested that the activation of the nucleotide-binding oligomerization domain (NOD)-like receptor containing pyrin domain 3 (NLRP3) inflammasome, which promotes pro-interleukin-1β (pro-IL-1β) and pro-interleukin-18 (pro-IL-18) cleavage and maturation play a vital role in the occurrence and development of liver injury and liver disease. Mitochondrial dysfunction is a common co-occurring event in liver injury. Abnormal mitochondrial function has also been shown to be closely related to NLRP3 inflammasome activation. Currently, natural products have attracted the attention of researchers as potential therapeutic agents for liver injury and liver disease due to their less toxicity and multi-targeting advantages. A number of natural products have been discovered to prevent and treat liver injury by modulating the activation of NLRP3 inflammasome. In this review, we highlight the mechanisms involved in the regulation of NLRP3 inflammasome activation by mitochondria during liver injury and natural products that target mitochondrial function processes to prevent or treat liver injury. Our paper may shed insight into novel viewpoint and target for prevention and treatment of liver injury based on NLRP3 inflammasome.

Data Envelopment Analysis (DEA) cross-efficiency has been used to replace the self-evaluation system, which requires decision-makers to rank a series of decision-making units (DMUs) according to cross-efficiency scores, and finally determine the order of each DMU, so as to provide decision-making basis for decision-makers. However, this method has certain deficiencies: one is that the cross-efficiency value is not unique; the other one is that the cross-efficiency evaluation uses the same weight to aggregate cross-efficiency. In this paper, Technique for order performance by similarity to ideal solution (TOPSIS) and The Best Worst Method (BWM) methods are used to aggregate the aggressive cross-efficiency values and benevolent cross-efficiency values. Besides, the high consistency of the BWM method improves the shortcomings of the TOPSIS method. The result of TOPSIS method is not necessarily close to the ideal solution, and far away from the negative ideal solution. At the same time, the distance measured by the TOPSIS method replaces the preference of the BWM method, which makes BWM method more objective. Finally, a numerical example is given to verify the feasibility and effectiveness of the method.

Through collecting the relevant provisions and medical cases of梳理古医籍中针灸治疗痿病相关条文、医案，从辨经、辨病、辨证3个层面整体分析针灸治疗全身型重症肌无力诊疗取穴思路。辨经论治主要依据经脉循行、经脉病候特点取穴；辨病论治根据痿病病因病机、传变阶段取穴；辨证论治根据证型不同分别立以治法而取穴。现代临床治疗全身型重症肌无力当以古代文献为根，努力形成针灸治疗全身型重症肌无力的标准化诊疗方案。.

The pollution of heavy metals and organic compounds has received increased attention in recent years. In the current study, a novel biochar-based iron oxide composite (FeYBC) was successfully synthesized using pomelo peel and ferric chloride solution through one-step process at moderate temperature. Results clearly demonstrate that FeYBC exhibited more efficient removal of Cr(VI) and/or phenol compared with the pristine biochar, and the maximum adsorption amounts of Cr(VI) and phenol by FeYBC could reach 24.37 and 39.32 mg g−1, respectively. A series of characterization data suggests that several iron oxides such as Fe2O3, Fe0, FeOOH and Fe3O4 were formed on the FeYBC surface as well as oxygen-containing groups. Thermodynamics study indicates that Cr(VI) and phenol adsorption by FeYBC were endothermic and exothermic processes, respectively. Langmuir adsorption isotherm and pseudo-second order models could better explain the Cr(VI) and phenol adsorption behaviors over FeYBC. The Cr(VI) adsorption might be primarily achieved through the ion exchange and surface complexation and reduction, whereas the π–π interaction and electron donor–acceptor complex mainly contributed to phenol adsorption. The findings indicate that the biochar-based iron oxide composites material was an efficient adsorbent for the remediation of industrial effluents containing Cr(VI) and phenol.

The addition of graphene oxide (GO) to cement paste significantly increases its toughness, however its fluidity is adversely affected. GO was first reacted with vinyltrimethoxysilane to produce a silane-modified graphene oxide (S-GO), which was then copolymerized with acrylic acid and a water reducing agent, isobutaenol polyoxyethylene ether (molecular mass 2400), to obtain a silane and copolymer-modified GO (P-S-GO) which acted as a water-reducing agent of the cement paste. A copolymer without GO was prepared under the same conditions for comparison. The structure, elemental composition and dispersibility of GO, S-GO and P-S-GO in a simulated cement environment (saturated lime water) were investigated by FTIR, XRD and a sedimentation test. The fluidity and rheology of the cement pastes with added GO, copolymer or P-S-GO were investigated. Results showed that vinyltrimethoxysilane reacted with the -OH group on the GO sheets to form an ether bond and the copolymer was grafted onto a vinyl group of S-GO by an addition reaction to produce the P-S-GO. The P-S-GO has a better dispersibility in saturated lime water with a negligible amount of aggregation compared to GO and a significant agglomeration occurs for GO. The addition of the P-S-GO to the cement pastes improves the fluidity and rheological properties compared with GO, offsetting the negative impact of GO and increasing the toughness of the resulting cements.

Blending polylactide (PLA) with flexible polymers is usually capable of reducing its inherent brittleness, which, however, is accompanied with a substantial decrease in tensile strength. Here, considering the integration of flexibility and rigidity, 1,4-butanediol and dodecanedioic acid with flexible alkyl chains as well as isosorbide with a rigid cyclic sugar structure is used to synthesize a new bio-based copolyester. By virtue of interfacial compatibilization between PLA and the copolyester via dicumyl peroxide-induced dynamic vulcanization, well balanced mechanical properties are achieved for resulting blends, that is, elongation at break and notched impact strength are increased to 298.4% and 578.0 J/m that represent 37- and 24-fold increases, while tensile strength maintains at 59.5 MPa that decreases by only ~15% compared with that of neat PLA. Massive shear yielding of PLA matrix triggered by internal micro-voids accounts for the toughening mechanism. Given the high mechanical strength and supertoughness, the PLA-based materials have potential applications in different areas.

Summary Hepatocellular carcinoma (HCC) has high relapse and low 5-year survival rates. Single-cell profiling in relapsed HCC may aid in the design of effective anticancer therapies, including immunotherapies. We profiled the transcriptomes of ∼17,000 cells from 18 primary or early-relapse HCC cases. Early-relapse tumors have reduced levels of regulatory T cells, increased dendritic cells (DCs), and increased infiltrated CD8+ T cells, compared with primary tumors, in two independent cohorts. Remarkably, CD8+ T cells in recurrent tumors overexpressed KLRB1 (CD161) and displayed an innate-like low cytotoxic state, with low clonal expansion, unlike the classical exhausted state observed in primary HCC. The enrichment of these cells was associated with a worse prognosis. Differential gene expression and interaction analyses revealed potential immune evasion mechanisms in recurrent tumor cells that dampen DC antigen presentation and recruit innate-like CD8+ T cells. Our comprehensive picture of the HCC ecosystem provides deeper insights into immune evasion mechanisms associated with tumor relapse.

Objective To analyse the traditional MRI signs, diffusion weighted imaging (DWI), perfusion weighted imaging (PWI), and hydrogen proton magnetic resonance spectroscopy (1H-MRS) of intracranial primary central nervous system lymphoma in immunocompetent people. To explore its diagnostic value. Methods The paper retrospectively analysed the MRI signs of 12 patients with primary central nervous system lymphoma confirmed by surgery and pathology. Results Twelve patients were all B-cell lymphoma. A total of 13 nodules were detected, 11 were single and 1 was multiple. Lesions T1WI showed low or equal signal shadows, T2WI showed equal, slightly higher, high signal shadows, DWI showed high and low signal shadows; the boundaries of the lesions were clearer, and mild to moderate enema was visible around them; most of the lesions showed obvious uniform enhancement and "gap" Signs "and" spike signs "; 1H-MRS showed a moderate decrease in N-acetyl aspartate (NAA) peak, an increase in choline (Cho) peak, and a slight decrease in creatine (Cr) peak, which can be seen Huge lipid peak. Perfusion-weighted imaging suggested that the lesions were hypoperfusion nodules. Conclusion The combined application of traditional magnetic resonance imaging, diffusion weighted imaging, perfusion weighted imaging, and 1H-MRS can improve the diagnosis rate of primary central nervous system lymphoma.

Hepatocellular carcinoma (HCC) has a high relapse rate and low 5-year survival rate. We generated > 20,000 full-length single-cell transcriptomes from 19 primary or relapsed HCC patients, determining unique features of the tumor microenvironment in relapsed as compared to primary HCC. Relapsed tumors have reduced regulatory T cells, and increased dendritic cells (DCs) and infiltrated CD8+ T cells. CD8+ T cells from relapsed tumors show group 2 innate lymphoid cell like state, with high naive, low cytotoxic and exhausted signals. The abundance of distinct DC subtypes is associated with good prognosis in primary or relapsed HCC, while FCN1+ monocytes are associated with poor prognosis only in relapsed HCC. Differentially expressed genes and interactions analyses reveal potential mechanisms driving immune evasion and tumor survival in relapsed and primary HCC. Together these results provide a compressive understanding of the ecosystem in primary and relapsed tumors, guiding future immune therapy strategies in HCC.

A chelation-directed self-sorting synthesis of a series of cationic heterometallic coordination cages (HCCs) with tunable sizes is described. Two complexation modes were found in the cage-forming process. Metal-anchoring host-guest behavior and size-selective in-cage catalytic activities were found for the HCCs.

Mercury is harmful to the environment, which has gradually become one of the research hotspots. Sediments, as a main repository of pollutants, have an important impact on water quality and the internal organisms, which deserves our research. In this paper, we focused on Hefei landscape water sediment and tried to investigate the status of inorganic mercury and methylmercury pollutions in the sediment. To study the conversion process from inorganic mercury to methylmercury and their enrichment levels and mechanism, we established the ecological chain of "sediment-water-grass-fish" through analog microcosm examination. The results were as follows: from ten water and sediment samples in Hefei landscape water sediment, we found that the contents of inorganic mercury and methylmercury ranged 11.74-13.12 µg · kg⁻¹ and 0.37-2.23 µg · kg⁻¹, respectively. The microcosm examination showed that: with increasing culture time, inorganic mercury in sediments gradually decreased. There was a phenomenon that the content of methylmercury increased at first and then decreased to reach the balance later. Both the inorganic mercury and methylmercury in water change showed an increasing trend. The enrichment contents of inorganic mercury in Egeria densa Planch, and golden mandarin fish (Siniperca scherzeri Steindachner) were low while their enrichment of methylmercury could he great. In addition, we found that both the bioaccumulation ability and the enrichment coefficient of methylmercury in the body of golden mandarin fish were the maximum during the same period.

The tower-blade interaction is one of key reasons that would seriously affect the wind turbine aerodynamic performance. Simulation of tower shadow effect for a three-bladed, upwind offshore wind turbine using STAR-CCM+ software is researched. The model of national renewable energy laboratory (NREL) 5 MW baseline wind turbine is used in this simulation by computational fluid dynamics (CFD) method. Based on the reynolds averaged navier-stokes (RANS) equations and the shear-stress transport (SST) k - ω turbulence model, aerodynamic simulations for NREL 5 MW turbine have been studied. Model validation and grid-independence verification are conducted in order to have more accurate results. The aerodynamic simulations of wind turbine model with tower and rotor model without tower are carried out separately. The impacts of tower shadow effect on aerodynamic performance are obtained by comparison of two models. The method of blade element momentum (BEM) is also used to study tower shadow effect, and two research methods are compared. Simulation results demonstrate that the tower shadow effect is remarkable. Mutation caused by tower shadow effect of aerodynamic performance is emerged and it will cause some adverse results for blades and tower. Impact of tower shadow effect on average value of wind turbine aerodynamic load is not significant. As is shown by simulation results, average thrust of wind turbine is declined by 0.46% and average power is declined by 0.87%. This paper could also provide some references for further research about the influence of tower shadow effect on aerodynamic performance.