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Sinonasal teratocarcinosarcoma (SNTCS) is one of the rarest and most highly invasive malignant neoplasms often found in the nasal cavity and paranasal sinuses. SNTCS is often misdiagnosed because of its morphological heterogeneity. Due to its rarity, clinical characteristics and optimal therapy have not been well-established. Here, we present a case of SNTCS with orbital and intracranial extensions. A 48-year-old male patient presented with left-side nasal obstruction for 3 years. He appeared with visual and neurological symptoms 2 months ago. On radiographic examination, a mass was observed in the left paranasal sinuses with orbital and intracranial extension involvement. The mass was surgically resected. In the future, knowledge of this entity may assist in the accurate diagnosis and proper management of SNTCS.

It is yet unknown if the ApneaGraph200 system can replace the Polysomnography system (PSG), which is now the gold standard for obstructive sleep apnea (OSA) diagnosis. We performed a meta-analysis to evaluate the difference in apnea hypopnea index and lowest oxygen saturation levels between the AG200 system and PSG system.Utilizing PubMed, Elsevier, Wanfang, and China National Knowledge Internet (CNKI), a thorough literature search was carried out. Eligible studies contrasting the AG200 system and the PSG system were found by two separate researchers. Review Manager (version 5.3) was adopted for data synthesis.The meta-analysis A pooled the comparison of AHI between the AG and PSG groups, and included seven studies involving a total of 419 participants, which revealed that there was a significant difference in AHI between the above two diagnostic methods (standard mean difference (SMD) = - 0.19, 95% confidence interval (CI) = - 0.32 to - 0.05, P = 0.008). As a supplementary, meta-analysis B pooled the comparison of lowest oxygen saturation between the AG and PSG groups and included five studies involving a total of 224 participants. It revealed that there was no significant difference between the AG group and the PSG group (SMD = 0.09, 95% CI - 0.24 to 0.43, P = 0.58).The ApneaGraph200 system can be used for the initial screening of OSA patients, but it is not a complete alternative to polysomnography for the diagnosis and severity of the OSA condition.

OBJECTIVE Recent studies have investigated the mechanism by which refluxed gastric materials reach the middle ear, to establish otitis media with effusion (OME) causal relation between them in both children and adults. Therefore, the relationship between OME and gastro-esophageal reflux disease (GERD) should be further studied extensively. METHODS To identify eligible original articles, we searched a range of computerized databases, including Medline via PubMed, EMBASE, CNKI, and Web of Science with a systematic searching strategy. Subgroup analysis was performed to analyze heterogeneity and Egger and Begg funnel plot to assess the publication bias of the included articles. RESULTS The meta-analysis had an overall sample size of 1961. We identified a significant relationship between OME and GERD, with a pooled odds ratio (OR) of 4.52 (95% confidence interval [CI]: 2.42-8.44; p

The pathogenesis of cardiovascular disease (CVD) in patients with obstructive sleep apnea (OSA) is unclear. Several studies have suggested that CVD may be caused by oxidative stress from chronic intermittent hypoxia and associated vascular endothelial dysfunction. Oxidative stress in patients with OSA can induce endothelial cell apoptosis, aggravate vascular endothelial damage, and promote the expression of redox-sensitive genes and adhesion molecules. No meta-analysis has explored whether or not OSA is related to nitric oxide (NO). To assess the association between serum/plasma NO levels and OSA, we performed a meta-analysis of the literature on the subject to grade the strength of evidence. OSA was significantly related to decreased serum or plasma NO levels (WMD = − 11.66, 95% CI − 17.21 to − 6.11; P

Ameloblastoma (AM) is a rare epithelium-derived odontogenic tumor, mostly involving the mandible and less often the maxilla. Most AMs are benign and characterized by indolence and local invasiveness, with a high recurrence rate. Herein, we present a case of maxillary AM in a 42-year-old female suffering from left nasal congestion and facial swelling for almost one month after endoscopic surgery at a local hospital. The mass was completely resected by a transnasal functional endoscopic sinus surgery based on radiographic examination. Subsequently, postsurgical histopathological examinations were conducted, and she was diagnosed with a plexiform AM pattern. Immunohistochemical staining revealed that the tumor was positive for PCK, P63, CK5/6, and CK14 but negative for S100, ER, and Ki67. Based on these findings, the patient was diagnosed with maxillary AM.

Obstructive sleep apnea (OSA) as an independent cardiovascular risk factor has been proposed, but the mechanisms underlying cardiovascular disease is far from being completely elucidated. Leptin, an inflammatory cytokine produced by adipocytes, contributes to the modulation of metabolism, respiratory control, and inflammation, which are factors associated with cardiovascular disease. Serum levels of leptin in children with OSA have shown conflicting results in previous studies.We performed a meta-analysis to clarify the correlation between leptin expression of the OSA patients following the PRISMA. PubMed, Embase, and Web of Science were systematically searched for relevant studies, and then independently screened by two researchers, and analyzed the data through STATA version 12.0.In a total of 5 articles including 469 participants, the data analysis showed that serum leptin levels were elevated in children with OSA (MD, 6.36; 95% CI, 0.24-12.49, P .001), compared to the control group. Subgroup analysis were performed based on body mass index. The results of subgroup analysis demonstrated that the serum leptin concentration was correlated with body mass index in children with OSA (MD, 9.70; 95% CI, 0.22-11.18, P .001).The serum leptin levels were elevated in children with OSA, compared to the control group. It could add to our developing understanding of the pathogenesis and potential treatments for children with OSA, and help us to recognize the relevance of OSA in determining cardiovascular issues among children.

Epstein-Barr virus-positive anaplastic plasmacytoma in the sinonasal tract is uncommon. Herein, we present the case of a 40-year-old male patient with a right sinonasal tract filled with a soft tissue mass, as shown on CT. Apart from frequent nosebleeds, he did not report any specific sinonasal symptoms, such as nasal obstruction, discharge, or loss of smell. The patient underwent functional endoscopic sinus surgery under general anesthesia. The diagnosis of Epstein-Barr virus-positive anaplastic plasmacytoma was confirmed by lesion biopsy, subsequent immunohistochemical staining, and in situ hybridization.

N-acetyl-cysteine (NAC) is an efficacious treatment for sensorineural hearing loss in animal models, such as noise-induced hearing loss (NIHL), however previous research into the effect of NAC on patients with hearing loss produced contradictory results. In this study, we investigated the effect of NAC treatment on sensorineural hearing loss. PubMed, Web of Science and Embase databases were searched in their entirety using the key words: hearing loss, NAC, N-acetylcysteine, and sensorineural hearing loss. Studies which included assessment of hearing loss with pure-tone threshold (PTA) data were selected. Eligible studies regarding the effects of NAC treatment on patients with hearing loss were collected by two independent reviewers. A total of 1197 individuals were included from seven published studies. Two studies reported data for a sudden idiopathic sensorineural hearing loss (SISNHL) group. Three studies reported data for a NIHL group. Other studies reported data for drug-induced hearing loss. The meta-analysis demonstrated that the overall effect of NAC treatment on sensorineural hearing loss was invalid. However, NAC treatment was linked with improved patient outcomes of hearing tests in cases of sudden hearing loss, but did not prevent hearing loss induced by noise or ototoxicity. However, there is a need for better-designed studies with larger samples to further prove the correlation between the effect of NAC and hearing loss.

We introduce a green and facile method to compatibilize hydrophobic polylactide (PLA) with hydrophilic cellulose nanofibers (CNF) by using ionic liquid ([DBNH][OAc]) welding with a cosolvent system (gamma-valerolactone). Such welding affords strong (230 MPa tensile strength), flexible (13% elongation at break), transparent (90%) and defect-free CNF/PLA films. The films are biodegradable in marine environments (70% degradation in 7 weeks), facilitating the otherwise slow PLA decomposition. Physical, chemical and structural features of the films before and after welding are compared and factored in the trends observed for degradation in seawater. The results point to the possibility of PLA-based films forming a co-continuous system with nanocellulose to achieve an improved performance. The role of film morphology, hydrophobicity, and crystallinity is discussed to add to the prospects for packaging materials that simultaneously display accelerated degradability in marine environments.

Background: The association between obstructive sleep apnea-hypopnea syndrome (OSAHS) and plasma/serum ghrelin levels remains controversial. We performed a meta-analysis to evaluate the difference in plasma/serum ghrelin levels between OSAHS patients and controls. Methods: Database of PubMed, SCI, and Elsevier were searched entirely. Two independents identified eligible studies of ghrelin levels in OSAHS patients. ReviewManager (version 5.3) was adopted for data synthesis. Results: The meta-analysis A pooled the comparison of ghrelin concentrations in OSAHS patients and controls, which included 7 studies and involving 446 participants. The result of the meta-analysis A indicated that plasma/serum ghrelin levels were no significant differences between the OSAHS group and the control group (standard mean difference (SMD) = 0.08, 95% confidence interval (CI) = −0.12 to 0.28, P = .43). As a supplementary, meta-analysis B pooled the comparison of plasma/serum ghrelin levels in OSAHS patients before and after continuous positive airway pressure (CPAP) therapy, which included 155 participants from 4 studies, it revealed that plasma/serum ghrelin levels were no significant differences between before and after CPAP therapy (SMD = 0.12, 95%CI = −0.07 to 0.31, P = .22). Conclusion: The meta-analysis A demonstrated that plasma/serum ghrelin levels were no significant differences between the OSAHS group and the control group. The meta-analysis B showed plasma/serum ghrelin levels have no significant changes after CPAP therapy in OSAHS patients.

Background An increasing number of COVID‐19 patients worldwide will probably need tracheostomy in an emergency or at the recovering stage of COVID‐19. We explored the safe and effective management of tracheostomy in COVID‐19 patients, to benefit patients and protect health care workers at the same time. Methods We retrospectively analyzed 11 hospitalized COVID‐19 patients undergoing tracheostomy. Clinical features of patients, ventilator withdrawal after tracheostomy, surgical complications, and nosocomial infection of the health care workers associated with the tracheostomy were analyzed. Results The tracheostomy of all the 11 cases (100%) was performed successfully, including percutaneous tracheostomy of 6 cases (54.5%) and conventional open tracheostomy of 5 cases (45.5%). No severe postoperative complications occurred, and no health care workers associated with the tracheostomy are confirmed to be infected by SARS‐CoV‐2. Conclusion Comprehensive evaluation before tracheostomy, optimized procedures during tracheostomy, and special care after tracheostomy can make the tracheostomy safe and beneficial in COVID‐19 patients.

Objective Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, various digestive symptoms have been frequently reported in patients infected with the virus. In this study, we aimed to further investigate the prevalence and outcomes of COVID-19 patients with digestive symptoms. Methods In this descriptive, cross-sectional, multicenter study, we enrolled confirmed patients with COVID-19 who presented to 3 hospitals from January 18, 2020, to February 28, 2020. All patients were confirmed by real-time polymerase chain reaction and were analyzed for clinical characteristics, laboratory data, and treatment. Data were followed up until March 18, 2020. Results In the present study, 204 patients with COVID-19 and full laboratory, imaging, and historical data were analyzed. The average age was 52.9 years (SD ± 16), including 107 men and 97 women. Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases). If lack of appetite is excluded from the analysis (because it is less specific for the gastrointestinal tract), there were 38 total cases (18.6%) where patients presented with a gastrointestinal-specific symptom, including diarrhea, vomiting, or abdominal pain. Patients with digestive symptoms had a significantly longer time from onset to admission than patients without digestive symptoms (9.0 days vs 7.3 days). In 6 cases, there were digestive symptoms, but no respiratory symptoms. As the severity of the disease increased, digestive symptoms became more pronounced. Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms. Discussion We found that digestive symptoms are common in patients with COVID-19. Moreover, these patients have a longer time from onset to admission, evidence of longer coagulation, and higher liver enzyme levels. Clinicians should recognize that digestive symptoms, such as diarrhea, are commonly among the presenting features of COVID-19 and that the index of suspicion may need to be raised earlier in at-risk patients presenting with digestive symptoms. However, further large sample studies are needed to confirm these findings.

Background: Head and neck squamous cell carcinoma (HNSCC) is a malignant tumor of the head and neck. Although it one of the most prevalent heterogeneous diseases, the role of tumor-related immune cells in HNSCC is not well understood, particularly in the current immunotherapy. Method: We explored TME, TMB in HNSCC to evaluate 22 subsets of TIICs, using GEO and TCGA database, to deduce the relationship of immune subpopulation, survival of patients, function and expression difference to reveal potential targets and biomarkers for immunotherapy. Results: GSE6631 database containing 22 HNSCC samples and 22 normal samples and TCGA database containing 111 HNSCC and 12 normal tissues were downloaded. M0 macrophages and resting memory CD4 +T cells were differentially expressed between tumor and normal cells, and therefore may plays an important role in regulating progression of cancer (PT. There were on average 78 Variation per HNSCC tumor. Top 10 mutated genes related to TMB were TP53, TTN, FAT1, MUC16, CDKN2A, CSMD3, SYNE1, LRP1B, NOTCH1 and PIK3CA. Conclusion: There is an intricate connection between TIIC, TMB and genomic alterations. Our findings offer the basis for future research on enhanced tumor immunotherapy.

BACKGROUND This study aimed to elucidate the possible activity of the mitochondrial-mediated apoptotic pathway (MMAP) in obstructive sleep apnea-hypopnea syndrome (OSAHS). MATERIAL AND METHODS A control group, a mild OSAHS group, a moderate OSAHS group, and a severe OSAHS group were included. Masson staining, hematoxylin and eosin staining, and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay were performed to assess collagen fiber hyperplasia, pathological morphology, and cell apoptosis, respectively, in muscle samples. RESULTS In the OSAHS groups, the palatopharyngeal muscle fibers were larger, with apparent hypertrophy and increased elastic fiber content. The proportions of type I fibers were markedly higher in the control group than in the moderate and severe OSAHS groups (P0.05). Moreover, apoptosis was significantly enhanced in the muscle cells of the OSAHS groups. The Bax expression levels gradually increased across the 4 groups (lowest in the control group and highest in the severe OSAHS group) (P0.05); conversely, the p38 and p62 expression levels did not significantly differ among groups (P0.05). CONCLUSIONS A decrease in the proportion of the different fiber types can result in collapse of the upper airway. The pathogenesis of OSAHS appears to involve muscle cell apoptosis via MMAP.

Although mixed sleep apnea (MSA) is one of the three types of sleep apnea, it is not considered a separate disease entity. It is generally seen as a part of obstructive sleep apnea-hypopnea syndrome (OSAHS), but its implications are often ignored. In this study, we examined its features and the potential impact on OSAHS patients. Subjects diagnosed with OSAHS by polysomnography (PSG) were enrolled. All participants underwent physical checkups and tests of blood biochemistry. They were anthropometrically, clinically, and polysomnographically studied. MSA events were common in patients with severe OSAHS patients. There were significant differences between the pure OSAHS group and its mixed counterpart in apnea-hypopnea indices during REM (AHIREM) and non-REM (AHINREM) and in percentages of N2 or N3 sleep. Logistic regression analysis showed that, after adjustment of other parameters, patients with MSA events were mostly male, had higher body mass index (BMI), higher scores on Epworth Sleepiness Scales (ESS), higher triglyceride (TG) levels, and higher apnea-hypopnea index (AHI). The combined predictive probability of the aforementioned variables was 0.766 (95% CI = 0.725~0.806; sensitivity 61.6%, specificity 82.1%). Our study suggested that MSA was related to the stability of the ventilatory control in OSAHS patients. MSA events occur more frequently in patients with severe OSAHS, and male gender, obesity, daytime sleepiness, and elevated TG levels were risk factors for the mixed OSAHS.

An energy-efficient method has been developed to prepare 3-5 nm-wide carboxyl-functionalized cellulose nanofibers (CNFs) from pulp fiber by a simple one-pot swelling followed by esterification process. Tetrabutylammonium acetate (TBAA)/dimethyl sulfoxide (DMSO) binary solvent is used as the swelling agent and the esterification medium admixed with maleic anhydride. All steps are performed at room temperature and no post-mechanical treatment is needed. The highly efficient defibrillation of pulp fiber to CNFs is thought to be due to two factors: 1) swelling in TBAA/DMSO effectively loosens the structure of cellulose supermolecules by breaking the intra- and intermolecular hydrogen bonds between cellulose chains; and 2) the carboxyl groups grafted onto the cellulose molecules by esterification prohibit the reformulation of hydrogen bonds between cellulose chains and therefore stabilize the disperse CNFs with uniform diameter in solution. Other than acid anhydride, no catalyst is added for the esterification, which facilitates the recycling and reuse of the binary solvent. This energy-efficient one-pot method could facilitate the large-scale manufacture of bio-based nanomaterials.

Objective This meta-analysis was performed to assess the difference in the serum level of advanced glycation end products (AGEs) between patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) and controls. Methods A systematic literature search was performed using PubMed, Elsevier, SCI, Wanfang, Weipu, and China National Knowledge Internet. Eligible studies that reported the serum AGE level in patients with OSAHS were identified by two reviewers. Review Manager version 5.2 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) and R version 3.10 ( www.r-project.org ) were employed for data synthesis. Results Five studies involving 670 subjects were identified. The meta-analysis showed that the mean serum AGE level in the OSAHS group was 0.98 mmol/L higher than those in the control group (95% confidence interval, 0.69–1.27). Conclusions This meta-analysis showed that the serum AGE level was elevated in patients with OSAHS. This finding suggests that AGEs may play an important role in insulin resistance in OSAHS and serve as a biomarker for patients with OSAHS with a high risk of type 2 diabetes mellitus.

Background : Head and neck squamous cell carcinoma (HNSCC), a basic malignant tumor of the head and neck distinct. As a famous heterogeneous disease, the jobs of immune cells inside the tumor-related as yet missing for HNSCC, particularly in current immunotherapy. Method: We explored the TME, TMB and evaluate the 22 TIICs subsets of immune response based on GEO and TCGA database of HNSCC to explore its relationship with atomic subpopulation, survival, function and expression difference and reveal potential targets and biomarkers for immunotherapy. Results: Observing the download of GSE6631 database contained 22 HNSCC samples and 22 normal samples and TCGA database contained 111 HNSCC and 12 normal tissues. The results suggested that the expression of macrophages M0 and T cells CD4 memory resting was significant difference and may plays an important role in regulate cancer progression ( P T, the variants per sample median was 78 in HNSCC patients. Top 10 mutated genes that related to TMB was TP53, TTN, FAT1, MUC16, CDKN2A, CSMD3, SYNE1, LRP1B, NOTCH1 and PIK3CA. We portrayed the immune scene in detail, uncovering the awesome immune infiltration styles of various subtypes in HNSCC. Conclusion: The intricate connection between TIIC, TMB and genomic alterations was additionally set up. Our paintings advance the information of immune response and offers significant assets for research to enhance immunotherapy.

The pathogenesis of cardiovascular disease (CVD) in patients with obstructive sleep apnea (OSA) is unclear. Several studies have suggested that CVD may be caused by oxidative stress from chronic intermittent hypoxia and associated vascular endothelial dysfunction. Oxidative stress in patients with OSA can induce endothelial cell apoptosis, aggravate vascular endothelial damage, and promote the expression of redox-sensitive genes and adhesion molecules. No meta-analysis has explored whether or not OSA is related to nitric oxide (NO).To assess the association between serum/plasma NO levels and OSA, we performed a meta-analysis of the literature on the subject to grade the strength of evidence.OSA was significantly related to decreased serum or plasma NO levels (WMD = - 11.66, 95% CI - 17.21 to - 6.11; P 0.01). Among the studies analyzed, there was high degree of heterogeneity (IThis meta-analysis suggests a strong correlation between OSA and serum or plasma NO levels which may explain the link between intermittent hypoxia of OSA and risk of CVD. The strength of this finding may spur further basic and clinical research into vascular endothelial dysfunction in patients with OSA.

Purpose The polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder, clinically characterized by oligo-ovulation/chronic anovulation, menstrual irregularities, hyperandrogenism (such as hirsutism, acne), hyperinsulinemia, and obesity. Prostatic-specific antigen (PSA) has been identified as a potential new marker in PCOS women. Although the precise role of PSA in PCOS patients still remains undetermined, PSA might serve as a useful clinical marker and might even represent a new diagnostic criterion of hyperandrogenemia in females of PCOS. Methods A meta-analysis was performed in the study to identify the association between the polycystic ovary syndrome and prostatic-specific antigen. To identify eligible original articles, we searched a range of computerized databases, including Medline via PubMed, EMBASE, CNKI and Web of Science with a systematic searching strategy. The characteristics of each study and standard mean differences (SMD) with corresponding confidence intervals (CIs) were calculated and subgroup analysis was performed to analyze heterogeneity. Results A total of 532 patients from seven articles were included in the meta-analysis. We identified a significant relationship between polycystic ovary syndrome and prostatic-specific antigen, with a pooled SMD of 0.81 (95% CI: 0.58 to 1.04; P Conclusions The meta-analysis suggested that there was a significant association between the polycystic ovary syndrome and prostatic-specific antigen and we should not ignore the role of PSA in the PCOS patients in clinical.

A silica-supported peroxycarboxylic acid oxidant, 2-percarboxyethyl silica (SiO2@(CH2)2COOOH), was successfully prepared and used for the epoxidation of fatty acid methyl esters (FAMEs) and vegetable oils. Among the oxidants prepared under different conditions, C-SiO2@(CH2)2COOOH (TEOS:CTES = 2:1) had the highest surface area, pore volume, and peroxide value. It also exhibited the highest activity for the epoxidation reactions. For methyl linoleate, 92.76% yield of epoxidized product was obtained at room temperature. Other unsaturated FAMEs with 1 and 3 double bonds were also efficiently converted to their epoxides. Moreover, the oxidant was also successfully applied to the epoxidation of vegetable oils, olive oil, and linseed oil with high product yield at room temperature. Finally, the used oxidant was regenerated through a simple oxidation process with H2O2 and recycled at least 5 times without much drop in the reactivity.

Pediatric early warning scores in an emergency department may be used in routine patient evaluation of illness severity and resource allocation, thereby positively impacting quality and safety in pediatric care. This prospective nursing study assessed the feasibility and reliability of pediatric early warning scores in a busy, inner-city, level 1 trauma center pediatric emergency department. The pediatric early warning scores demonstrated high interrater reliability (degree of agreement among scorers) (intraclass correlation coefficient = 0.91) and intrarater reliability (multiple repetitions by a single scorer) (intraclass correlation coefficient = 0.90).

Porous silica ceramic substrates were coated with silica sols via dip coating to obtain waterproof performance. Silica sols were prepared through acid-catalyzed hydrolysis and condensation of tetraethyl orthosilicate. The gelation temperature, ratio of ethanol/TEOS, times of coating, and sintering temperature have been studied. The sample with the best waterproof effect was prepared by 5 times of repeated coating using a sol prepared at 25 oC with an ethanol/TEOS ratio of 7 and sintering at 550 °C.

Thyroid cancer (TC) is the most well-known endocrine neoplasia as well as a common malignant tumor in the head and neck. Our study was designed to assess the prognostic meaningful of TNFRSF12A expression in TC dependent on data acquired from TCGA and so as to increase further knowledge into the biological pathways involved in TC pathogenesis related TNFRSF12A.Information on gene expression and comparing clinical data were identified and downloaded from TCGA. Gene set enrichment analysis (GSEA) created an arranged list of all genes indicated by their connection with TNFRSF12A expression.Our study cohort included 370 (73.1%) female and 136 (26.9%) male patients. The scatter plot and paired plot showed the difference of TNFRSF12A expression between normal and tumor samples (P < .01). The univariate analysis suggested that TNFRSF12A-low associated essentially with age (HR: 1.15; 95%CI: 1.08-1.22; P < .01), stage (HR: 2.79; 95%CI: 1.43-5.46; I vs IV; P = .003) and tumor stage (HR: 2.39; 95%CI: 1.08-5.30; P = .031). The GSEA results show that type II diabetes mellitus, pantothenate and CoA biosynthesis, adipocytokine signaling pathway, PPAR signaling pathway, mTOR signaling pathway, insulin signaling pathway, are enriched in TNFRSF12A low expression phenotype.TNFRSF12A expression may be a potential useful prognostic molecular biomarker of bad survival in thyroid cancer, in addition, PPAR signaling pathway, insulin signaling pathway, mTOR signaling pathway may be the key pathway controlled by TNFRSF12A in thyroid cancer. Further experimental ought to be performed to demonstrate the biologic effect of TNFRSF12A.

This work investigates multifunctional composite films synthesized with cellulose nanofibers (CNFs) and poly(vinyl alcohol) (PVA). First, TEMPO-oxidized CNFs were modified in the heterogeneous phase with benzophenone, diisocyanate, and epoxidized soybean oil via esterification reactions. A thorough characterization was carried out via elemental analysis as well as FT-IR and X-ray photoelectron spectroscopies and solid-state NMR. Following, the surface-modified CNFs were combined with PVA to endow composite films with UV-absorbing capabilities while increasing their thermomechanical strength and maintaining a high light transmittance. Compared to neat PVF films, the tensile strength, Young modulus, and elongation of the films underwent dramatic increases upon addition of the reinforcing phase (maximum values of ∼96 MPa, ∼ 714 MPa, and ∼350%, respectively). A high UV blocking performance, especially in the UVB region, was observed for the introduced multifunctional PVA films at CNF loadings below 5 wt %. The trade-off between modified nanofibril function as interfacial reinforcement and aggregation leads to an optimum loading. The results indicate promising applications, for example, in active packaging.

Post-tonsillectomy hemorrhage (PTH) remains a significant complication. There are no guidelines for Pediatric Emergency Department (PED) disposition of children with secondary PTH.To describe the incidence, clinical characteristics and interventions required by children presenting to a PED with secondary PTH. To identify patient and clinical characteristics associated with need for operative/inpatient intervention.Retrospective chart review of healthy children 1-18 years with secondary PTH from 2005 to 2012. Demographics, clinical and oropharynx findings, laboratory data, intervention type and ED disposition were recorded.We encountered 181 children with 193 episodes of PTH. One hundred and twenty one patients were included in the final analysis. Secondary PTH rate was 2.3%. Only a minority of patients were hypotensive (3.3%) or had hemoglobin10g/dl (9.5%) at presentation. 65.3% Children had positive oropharyngeal exam: clot 39 (49.4%) patients; ooze 17 (21.5%) patients; ooze+clot in 5 (6.3%) patients or active bleeder in 18 (22.8%) patients. Eighty seven (71.9%) patients were admitted; 74 (61.1%) patients required active intervention: medical 14.8%, surgical 74.4% or both 10.8%. Thirty seven children needed immediate operative intervention. Only positive oropharyngeal exam and age ≥6 years were significantly associated with need for intervention. None of the patients with a confirmed normal oropharyngeal exam at the initial visit required any intervention either medical or surgical. The rate of return visit for recurrent PTH was found to be similar for both the admitted and the discharged group. No patient returned with a life threatening hemorrhage.Majority of children with secondary PTH were admitted and nearly 3/5th of them required an intervention. Our data suggests that healthy children6 years with a confirmed normal oropharyngeal exam are less likely to require an intervention and may be candidates for safe discharge from the ED provided reliability of return for recurrence can be assured.

Cellulose nanofiber (CNF) was modified by rosin and used as a reinforcement filler within a polylactic acid (PLA) matrix. The resulting film was then coated with chitosan (CHT) to prepare a two-layer composite film for antimicrobial food packaging. The FT-IR spectra of rosin modified CNF (R-CNF) displayed a clear peak at 1730cm-1, which confirmed the successful esterification of CNF by rosin. The R-CNF showed a better dispersion in PLA matrix than CNF and the loading of R-CNF had a significant effect on the mechanical properties of the resulting film. A percolation network was formed when the R-CNF loading was 8%, where the composite film displayed optimum mechanical properties. The antimicrobial test showed that the R-CNF/PLA/CHT composite film exhibited excellent antimicrobial performance against E. coli and B. subtilis, which could be attributed to the synergistic antimicrobial effect of CHT and rosin.

In this paper, the glass was coated by silica film using sol-gel method. The influence of preparation conditions (such as the ratio of water to silica, aging time of the sol and the drying time of the film) on the film cracking was studied. Results show that when the ratio of water to silica is 1, aging time 72 h and drying time 6 h, the obtained film is crack-free. The film consists of nanoparticles distributed in silica gel. The thickness is about 45~60 nm. The visible light spectra measurements indicate that the coated film increase the transparency of the glass substrate. After the acid treatment and a scratching of 50 times, the spectra remain unchanged, suggesting a good acid and abrasion resistance of the prepared film.

Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea hypopnea syndrome (OSAHS), but previous studies assessing the effect of CPAP on homocysteine (HCY) in patients with OSAHS yielded conflicting results. In this study, we conducted a meta-analysis to determine whether CPAP therapy could reduce plasma HCY levels.Searches of PUBMED, SCI, and Elsevier databases were completed. Studies of adult patients with OSAHS who reported HCY levels pre- and post-CPAP treatment were collected by two independent reviewers. RevMan (version 5.2) and STATA (version 12.0) were used to perform data synthesis.A total of 6 studies involving 206 participants were included. Meta-analysis showed that the total weighted mean difference (WMD) for HCY levels was -0.62 units (95% confidence interval (CI) -1.21 to -0.04, P0.05) post- and pre-CPAP therapy. Subgroup analysis showed that HCY was decreased nonsignificantly within 3 months after the therapy (WMD, -0.07, 95% CI -0.88 to 0.74, P0.05), but it was significantly reduced after 3 months therapy (WMD, -1.22, 95% CI -2.07 to -0.38, P0.05).This meta-analysis suggests that HCY levels were significantly reduced by CPAP therapy in patients with OSAHS and the HCY levels may be clinically recognized as a valuable indicator for OSAHS treatment, but the clinical significance of this finding as it relates to cardiovascular risk reduction in OSAHS patients warrants further study.

The new progress of ground-based long-wave infrared remote sensing is presented, which describes the windowing spatial and temporal modulation Fourier spectroscopy imaging in details. The prototype forms the interference fringes based on the corner-cube of spatial modulation of Michelson interferometer, using cooled long-wave infrared photovoltaic staring FPA (focal plane array) detector. The LWIR hyperspectral imaging is achieved by the process of collection, reorganization, correction, apodization, FFT etc. from data cube. Noise equivalent spectral radiance (NESR), which is the sensitivity index of CHIPED-1 LWIR hyperspectral imaging prototype, can reach 5.6 x 10⁻⁸ W · (cm⁻¹ · sr · cm²)⁻¹ at single sampling. The data is the same as commercial temporal modulation hyperspectral imaging spectrometer. It can prove the advantage of this technique. This technique still has space to be improved. For instance, spectral response range of CHIPED-1 LWIR hyperspectral imaging prototype can reach 11. 5 µm by testing the transmission curve of polypropylene film. In this article, choosing the results of outdoor high-rise and diethyl ether gas experiment as an example, the authors research on the detecting method of 2D distribution chemical gas VOC by infrared hyperspectral imaging. There is no observed diethyl ether gas from the infrared spectral slice of the same wave number in complicated background and low concentration. By doing the difference spectrum, the authors can see the space distribution of diethyl ether gas clearly. Hyperspectral imaging is used in the field of organic gas VOC infrared detection. Relative to wide band infrared imaging, it has some advantages. Such as, it has high sensitivity, the strong anti-interference ability, identify the variety, and so on.

The goal of the research is to reconstruct the unknown cost (objective) function(s) presumably used by the neural controller for sharing the total force among individual fingers in multifinger prehension. The cost function was determined from experimental data by applying the recently developed Analytical Inverse Optimization (ANIO) method (Terekhov et al. 2010). The core of the ANIO method is the Theorem of Uniqueness that specifies conditions for unique (with some restrictions) estimation of the objective functions. In the experiment, subjects (n = 8) grasped an instrumented handle and maintained it at rest in the air with various external torques, loads, and target grasping forces applied to the object. The experimental data recorded from 80 trials showed a tendency to lie on a 2-dimensional hyperplane in the 4-dimensional finger-force space. Because the constraints in each trial were different, such a propensity is a manifestation of a neural mechanism (not the task mechanics). In agreement with the Lagrange principle for the inverse optimization, the plane of experimental observations was close to the plane resulting from the direct optimization. The latter plane was determined using the ANIO method. The unknown cost function was reconstructed successfully for each performer, as well as for the group data. The cost functions were found to be quadratic with nonzero linear terms. The cost functions obtained with the ANIO method yielded more accurate results than other optimization methods. The ANIO method has an evident potential for addressing the problem of optimization in motor control.

BACKGROUND Gastroesophageal reflux disease (GERD) is believed to be associated with various manifestations in the otorhinolaryngology and has been found to be an additional risk factor for adenoid hypertrophy, but the causal relation between them is under controversial. We thus performed a meta-analysis to grade the strength of evidence and systematically explore whether adenoid hypertrophy correlates with GERD in the literature. METHODS A systematic literature search was performed using Medline via PubMed, Embase, CNKI, and Web of Science. Studies reporting the adenoid hypertrophy and GERD were identified for inclusion. RESULTS There were 6 studies that matched the selection criteria, and the total sample size of these studies was 548 cases. We identified a significant relationship between adenoid hypertrophy and GERD, with a pooled odds ratio of 4.12 (95% confidence interval [CI]: 1.32-12.93; P .05) under the fixed-effects model. And the results was significant in Helicobacter pylori subgroup analysis, with a corresponding value of 2.39 (95% CI: 0.39-14.55, P

The study addresses three main questions: (1) Does the magnitude of the grasping force affect the pre- hension synergies, i.e., conjoint changes of finger forces and moments? (2) Do individual finger forces scale with the total grasping forces ('scale-invariance hypothesis')? (3) How specification of the grasping force magnitude affects the inverse optimization of digit forces. Subjects (n = 7) grasped with minimal force an instrumented han- dle and maintained it at rest in the air. Then, the subjects doubled the initial grasping force. The forces and moments exerted by individual digits were recorded with six-com- ponent sensors. External torques that the subjects should resist (9 in total) varied among the trials from 0 to 0.46 Nm both in clockwise and counterclockwise directions. After the force doubling, the moments of the normal forces (M n ) increased in the pronation effort tasks (PR-tasks) and decreased in the supination effort tasks (SU-tasks). The changes in the moments of the tangential forces (M t ) were opposite to the M n changes; the moments increased in the SU-tasks and decreased in the PR-tasks. The opposite effects of force doubling on the M t s in the SU-tasks and PR-tasks were a consequence of the unidirectional changes of the thumb tangential forces: in all the tasks the contri- bution of the thumb tangential force to the total tangential force increased after the grasping force doubling (and the total contribution of the four fingers decreased). The decrease of the virtual finger (VF) tangential force was mainly due to the decrease of the index finger force (VF is an imagined finger that exerts the same force and moment as all the fingers together). In the non-zero torque tasks the individual finger forces did not scale proportionally with the grasping force, the sharing percentage of the individual finger forces in the VF normal force changed with the grasping force increase. The root mean square differences between the actual finger sharing percentages in the VF force and the sharing percentages predicted from optimi- zation procedures in which different cost functions were used were in all cases smaller after the doubling than before the doubling. Hence the answers to the three ques- tions formulated above are: (1) the alteration of the grasping force magnitude induces complex coordinated changes of all digit forces and moments; (2) the scale invariance hypothesis is confirmed only for the zero-torque tasks and rejected for the non-zero tasks, and (3) the specification of the grasping force magnitude at the level of twice the initial grasping force—which essentially restricts the control task to the object tilt prevention—improves the accuracy of the employed optimization procedures.

We used transcranial magnetic stimulation (TMS) to explore the stability of the three constituents of the multi-finger prehension synergy. Patterns of co-variation between mechanical variables produced by individual digits were used as indices of the prehension synergy. We tested hypotheses that TMS would violate these patterns and that different components of the prehension synergy would take different times to restore. Subjects held an instrumented handle with one of the three external load and one of the seven external torques statically in the air. Single-pulse TMS was applied unexpectedly over the hand projection in the contralateral hemisphere. The normal forces showed a quick TMS-induced increase that was proportional to the background force magnitude. This was also true for the tangential forces produced by the thumb, middle and ring fingers but not by the index and little fingers. The total moment of force changed proportionally to its background value with predominance of supination responses. During the quick force response to TMS, patterns of digit force co-variation stabilizing the total tangential force and total moment of force were violated. Two stages of synergy restoration were identified taking approximately 0.3 s and 1.5 s. These times differed among the three synergy components. The results support the idea of a prehension synergy as a neural mechanism that facilitates conjoint changes in forces produced by individual digits with the purpose to stabilize the hand action on the hand-held object. The data also support applicability of the principle of superposition to the human hand action.

The RAS association domain family protein 1a (RASSF1A), a tumor suppressor gene at 3p21.3, plays a very important role in various cancers, including the head and neck squamous cell carcinoma (HNSCC). Hypermethylation of CpG islands in the RASSF1A promoter region contribute to epigenetic inactivation. However, the association between RASSF1A promoter methylation and HNSCC remains unclear and controversial. Therefore, a meta-analysis was performed in the study to identify the association. We identified the eligible studies through searching PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI) databases with a systematic searching strategy. The information on characteristics of each study and prevalence of RASSF1A methylation were collected. Pooled odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated. Meta-regression was performed to analyze heterogeneity and funnel plots were applied to evaluate publication bias. A total of 550 HNSCC patients and 404 controls from twelve eligible studies were included in the meta-analysis. Overall, a significant association was observed between RASSF1A methylation status and HNSCC risk under a random-effects model (OR = 2.93, 95% CI: 1.58–5.46). There was no significant publication bias observed. The meta-analysis suggested that there was a significant association between aberrant RASSF1A methylation and HNSCC.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a serious health issue, which can impact the hormone secretion. The aim of this study is to analyze the relationship between serum sex hormone concentrations and different severity degree of OSAHS, and to evaluate the influence of OSAHS on sex hormone levels. We enrolled 116 subjects who were subjected to polysomnography (PSG). They were divided into three groups: control group (n=10) [apnea hypopnea index (AHI)5/h], mild-moderate OSAHS group (n=15) (5≤AHI30/h), and severe OSAHS group (n=91) (AHI≥30/h). The patients in OSAHS group were subdivided into obesity and non-obesity subgroups. The parameters such as AHI, body mass index (BMI), lowest oxygen saturation (LSaO2), and mean oxygen saturation (MSaO2) were recorded. Serum levels of testosterone, polactin, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined in the morning immediately after waking up. Mean levels of hormones were compared among groups. The correlation between hormone levels and sleep-breathing parameters was analyzed. No significant differences in serum sex hormone levels were found among control, mild-moderate OSAHS, and severe OSAHS groups (P0.05). There was no correlation between AHI and sex hormone levels (P0.05). Testosterone was significantly negatively correlated with BMI (P0.05). These results suggested that BMI might have a direct effect on testosterone level, and it might be an important factor affecting testosterone level in male OSAHS patients, and there may be no correlation between severity of OSAHS and sex hormones levels.

Spinal cord injury (SCI) results in significant impairments in function and ankle joint spasticity is a common secondary complication. Various interventions have been trialed to improve function and reduce spasticity after SCI, with variable results. We investigated the effects of a pharmacological (an anti-spastic medication - tizanidine) and a physical intervention (robotic-assisted locomotor training - Lokomat) on function in people with incomplete SCI over 4-week of training. The outcome measures were walking speed, endurance and mobility. Subjects were randomized into one of three groups; no intervention (control), Lokomat (Lok) and tizanidine (Tiz). To account for variability, we used growth mixture modelling (GMM) to class subjects based on their recovery patterns. GMM identified two classes of recovery: high and low function. Significant improvements were seen in walking speed and mobility in high and low functioning subjects in the Lok group, and in walking endurance in high functioning subjects in the Tiz group. However, changes with training were clinically important only for approximately 10% of subjects, who achieved a minimal important difference (MID) in functional outcomes as a result of the training. We used mixed model ANOVAs to compare the group effects. Improvements with training were seen in both classes, however no differences between interventions were found. The GMM had classed all subjects that achieved the MID as high functioning. GMM can be used to successfully class subjects; however larger subject numbers and longer interventions are required to fully utilize this technique. Our results demonstrate that both interventions have potential to improve walking capacity, but more intense training for a longer period may need to achieve MID.

The effects of surface friction at the digit-object interface on digit forces were studied when subjects (n=8) statically held an object in a five-digit grasp. The friction conditions were SS (all surfaces are sandpaper), RR (all are rayon), SR (S for the thumb and R for the four fingers), and RS (the reverse of SR). The interaction effects of surface friction and external torque were also examined using five torques (–0.5, –0.25, 0, +0.25, +0.5 Nm). Forces and moments exerted by the digits on a handle were recorded. At zero torque conditions, in the SS and RR (symmetric) tasks the normal forces of the thumb and virtual finger (VF, an imagined finger with the mechanical effect equal to that of the four fingers) were larger for the RR than the SS conditions. In the SR and RS (asymmetric) tasks, the normal forces were between the RR and SS conditions. Tangential forces were smaller at the more slippery side than at the less slippery side. According to the mathematical optimization analysis decreasing the tangential forces at the more slippery sides decreases the cost function values. The difference between the thumb and VF tangential forces, ΔF t, generated a moment of the tangential forces (friction-induced moment). At non-zero torque conditions the friction-induced moment and the moment counterbalancing the external torque (equilibrium-necessitated moment) could be in same or in opposite directions. When the two moments were in the same direction, the contribution of the moment of tangential forces to the total moment was large, and the normal forces were relatively low. In contrast, when the two moments were in opposite directions, the contribution of the moment of tangential forces to the total moment markedly decreased, which was compensated by an increase in the moment of normal forces. The apparently complicated results were explained as the result of summation of the friction-related (elemental) and torque-related (synergy) components of the central commands to the individual digits.

Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea hypopnea syndrome (OSAHS), but previous studies assessing the effect of CPAP on leptin in patients with OSAHS yielded conflicting results. In this study, we conducted a meta-analysis to determine whether CPAP therapy could reduce serum leptin levels.Databases of PubMed, Elsevier, and SCI were thoroughly searched by 2 independent reviewers.RevMan (version 5.2) was used for data synthesis. Weighted mean difference (WMD) before and after CPAP therapy was calculated to estimate the effects of CPAP therapy.A total of 11 studies involving 413 participants were included. Meta-analysis showed that the total WMD for leptin levels was 1.44 units (95% confidence interval: 1.11-1.77, P.01) before and after CPAP therapy. Subgroup analysis exhibited that leptin was decreased within 3 days after the therapy, and it was further reduced within 1 to 3 months and beyond.The results of our meta-analysis showed that CPAP could significantly reduce leptin levels in OSAHS patients without concomitant weight loss.

The concept of high-throughput imaging Fourier transform spectrometer is introduced. Starting from the principle of the lateral shearing interferometer, it analyses the decline reason for the signal modulation efficiency and theoretically analyses the several aspects of the surface errors of the plane mirror, the beamsplitter properties change and the incident light angle influence the modulation efficiency. Based on analysis results, some expressions of modulation efficiency are provided. Furthermore, the relationship between modulation efficiency and performance parameters is pointed out. The reasons for the interferometer signal modulation efficiency decline can contain the following several aspects: (1) the influence of the surface errors of the plane mirror, (2) the polarization state change because of the influence of the reflection and the transmission in the light incident process makes the signal modulation efficiency decline, (3) the influence of the incident light angle. The results show that: this class of system is inherently optomechanics robust, no-moving part system, simple and compact structure, easy assembly and adjustment, strong vibration resistance as well as high resolution and high-throughput. Our results will provide a theoretical and practical guide for studying, developing and engineering Michelson lateral shearing interference imaging spectrometers. It can be widely used in the long-wave infrared (LWIR) imaging spectrometer system for thermal infrared remote sensing community.

Signal-to-noise Ratio of hyper-spectral imaging FTIR interferometer system plays a decisive role on the performance of the instrument. It is necessary to analyze them in the development process. Based on the simplified target/background model, the energy transfer model of the LWIR hyper-spectral imaging interferometer has been discussed. The noise equivalent spectral radiance (NESR) and its influencing factors of the interferometer system was analyzed, and the signal-to-noise（SNR） was calculated by using the properties of NESR and incident radiance. In a typical application environment, using standard atmospheric model of USA(1976 COESA) as a background, and set a reasonable target/background temperature difference, and take Michelson spatial modulation Fourier Transform interferometer as an example, the paper had calculated the NESR and the SNR of the interferometer system which using the commercially LWIR cooled FPA and UFPA detector. The system noise sources of the instrument were also analyzed in the paper. The results of those analyses can be used to optimize and pre-estimate the performance of the interferometer system, and analysis the applicable conditions of use different detectors. It has important guiding significance for the LWIR interferometer spectrometer design.

Previous attempts to investigate the effects of antispastic medications are limited to clinical studies using that use clinical evaluations to assess. Since these measures are neither objective nor quantitative, the therapeutic effects of such medications on neuromuscular properties have not been fully evaluated. In this study, as a first attempt, we examined the effect of tizanidine, an anti-spastic medication, on modification of the neuromuscular properties of patients with chronic incomplete spinal cord injury (SCI). Each patient was administered 2 mg of tizanidine four times per day for four weeks. The spastic ankle of each patient was evaluated at baseline (prior to any medication, and then 1, 2, and 4 weeks after the start of medication. The ankle was perturbed with a small-amplitude Pseudo-Random Binary Sequence (PRBS) perturbation at various positions over the ankle range-of-motion. A parallel-cascade system identification technique, which provides an objective and quantitative measure of neuromuscular properties, was used to calculate the intrinsic and reflex stiffness. The stiffness vs. joint angle trends were then calculated for each evaluation; these curves were compared across the intervention time to determine the recovery pattern (i.e. change over time) due to the tizanidine intervention. All patients exhibited decreases in reflex stiffness (which abnormally increase after SCI) due to the medication; however, patients were observed to exhibit multiple recovery patterns. For some patients, the reflex stiffness continuously reduced over the four-week intervention period, while for other patients, the decrease during the first week (i.e. between the baseline and 1-Week evaluations) was most pronounced. Also, some patients presented a significant decrease with time, while others presented no improvement in the intrinsic stiffness. These findings suggest that tizanidine may be effective in reducing not only reflex stiffness, but also the subject's intrinsic stiffness for certain patients. Future work remains to identify predictors which can objectively determine which patients are likely to exhibit maximal benefit from the tizanidine prior to being prescribed with the medication.

In this study, the effect of the LOKOMAT, a robotic-assisted locomotor training system, on the reduction of neuromuscular abnormalities associated with spasticity was examined, for the first time in the spinal cord injury (SCI) population. Twenty-three individuals with chronic incomplete SCI received 1-hour training sessions in the LOKOMAT three times per week, with up to 45 minutes of training per session; matched control group received no intervention. The neuromuscular properties of the spastic ankle were then evaluated prior to training and after 1, 2, and 4 weeks of training. A parallel-cascade system identification technique was used to determine the reflex and intrinsic stiffness of the ankle joint as a function of ankle position at each time point. The slope of the stiffness vs. joint angle curve, i.e. the modulation of stiffness with joint position, was then calculated and tracked over the four-week period. Growth Mixture Modeling (GMM), an advanced statistical method, was then used to classify subjects into subgroups based on similar trends in recovery pattern of slope over time, and Random Coefficient Regression (RCR) was used to model the recovery patterns within each subgroup. All groups showed significant reductions in both reflex and intrinsic slope over time, but subjects in classes with higher baseline values of the slope showed larger improvements over the four weeks of training. These findings suggest that LOKOMAT training may also be useful for reducing the abnormal modulation of neuromuscular properties that arises as secondary effects after SCI. This can advise clinicians as to which patients can benefit the most from LOKOMAT training prior to beginning the training. Further, this study shows that system identification and GMM/RCR can serve as powerful tools to quantify and track spasticity over time in the SCI population.

The objective of this study was to help assess complex neural and muscular changes induced by stroke using power spectral analysis of surface electromyogram (EMG) signals.Fourteen stroke subjects participated in the study. They were instructed to perform isometric voluntary contractions by abducting the index finger. Surface EMG signals were collected from the paretic and contralateral first dorsal interosseous (FDI) muscles with forces ranging from 30% to 70% maximum voluntary contraction (MVC) of the paretic muscle. Power spectral analysis was performed to characterize features of the surface EMG in paretic and contralateral muscles at matched forces. A Linear Mixed Model was applied to identify the spectral changes in the hemiparetic muscle and to examine the relation between spectral parameters and contraction levels. Regression analysis was performed to examine the correlations between spectral characteristics and clinical features.Differences in power spectrum distribution patterns were observed in paretic muscles when compared with their contralateral pairs. Nine subjects showed increased mean power frequency (MPF) in the contralateral side (15 Hz). No evident spectrum difference was observed in 3 subjects. Only 2 subjects had higher MPF in the paretic muscle than the contralateral muscle. Pooling all subjects' data, there was a significant reduction of MPF in the paretic muscle compared with the contralateral muscle (paretic: 168.7 ± 7.6 Hz, contralateral: 186.1 ± 8.7 Hz, mean ± standard error, F=36.56, p0.001). Examination of force factor on the surface EMG power spectrum did not confirm a significant correlation between the MPF and contraction force in either hand (F=0.7, p0.5). There was no correlation between spectrum difference and Fugl-Meyer or Chedoke scores, or ratio of paretic and contralateral MVC (p0.2).There appears to be complex muscular and neural processes at work post stroke that may impact the surface EMG power spectrum. The majority of the tested stroke subjects had lower MPF in the paretic muscle than in the contralateral muscle at matched isometric contraction force. The reduced MPF of paretic muscles can be attributed to different factors such as increased motor unit synchronization, impairments in motor unit control properties, loss of large motor units, and atrophy of muscle fibers.Surface EMG power spectral analysis can serve as a useful tool to indicate complex neural and muscular changes after stroke.