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OBJECTIVE To determine the risk for pulmonary embolism (PE) and explore the relationship between the site of thrombosis and PE in patients with acute lower extremity deep vein thrombosis (DVT). METHODS 1585 hospitalized patients first diagnosed with acute lower extremity DVT were investigated retrospectively. The patients were divided into two groups: the non-PE group (Group 1) and the PE group (Group 2). Then, Group 2 was divided into two subgroups: asymptomatic pulmonary embolism (asPE, Group 2a) and symptomatic pulmonary embolism (sPE, Group 2b). Kaplan-Meier curves and logistic regression analysis were used to explore the relevant risk factors for PE. RESULTS Among 1585 patients, 458 patients suffered from PE, accounting for 28.9%. 102 (22.3%) of them had the typical clinical manifestations of PE and were defined as sPE, and the remaining 356 (77.7%) patients were classified as asPE. Patients with proximal lower extremity DVT were significantly more predominant in the PE group than in the non-PE group (92.8% vs. 86.2%, p

Heat stress is known to negatively impact the reproductive process of livestock, which inevitably leads to a decline in animal fertility. Nuclear factor E2-related factor 2 (Nrf2) is an inducible transcription factor, which is essential for maintaining redox signal transmission against oxidative stress. However, there is no reliable research on the response mechanism of Sertoli Cells (SCs) against heat stress and the activation of Nrf2 when SCs are exposed to heat stress. Here, we used primary mouse SCs and SCs line TM4, along with Nrf2 specific inhibitor to determine the reaction mechanism of SCs to maintain intracellular redox homeostasis and self-survival by activating Nrf2. We found that acute heat stress only affected the vitality of SCs and the expression of functional molecules (tight junction-associated proteins and lactate dehydrogenase A [LDHA]) but did not cause cell apoptosis. When Nrf2 was inhibited, more cell death occurred in TM4 cells post heat stress treatment, along with a greater decrease in cell viability and a significant increase in intracellular ROS levels. Our study clarified for the first time the protective effect of Nrf2 activation on heat stress-induced SCs damage. It explained the possible reasons or mechanisms involved in the survival of SCs, the critical protective cells in the testis, which were not affected by heat stress. This study further improved the response mechanism of SCs in the reproductive injury caused by a high-temperature environment.

In this study, a new approach is presented to determine the stress and displacement field of a shallow buried circular tunnel subject to gravity and arbitrary lateral stress based on the complex variable method. The soil mass and lining are conformally mapped onto two ring regions. A more effective method than the power series method is used to solve the undetermined coefficients of complex potential functions. The interaction mechanism between the lining and the soil mass is fully considered. The boundary conditions along the inner boundary of the lining and the ground surface and the stress and displacement continuity conditions along the excavation line are used in the analytical derivation. In the verification, the stress and displacement distributions obtained in the semi-analytical solution agree with the numerical results and satisfy the boundary and continuity conditions. Using examples, the stress distributions along the inner boundary of the lining and interface are presented to examine the influence of key parameters including the Young's modulus and buried depth. The effect of the lining in reducing stress concentration and restricting tunnel convergence is quantitatively analyzed.

Gastric cancer is one of the common malignant tumors in the gastrointestinal tract, and surgery is currently an important treatment for progressive gastric cancer. With the development of technology, the simultaneous maturation of artificial intelligence (AI), fifth-generation (5G) telecommunication networks and the internet of things (IOT) has brought significant efficacy and new opportunities for the surgical treatment of gastric malignancies. The combination of 5G network and remote surgical robotic system is the future trend of radical gastric cancer surgery, and the "unmanned" treatment mode of fully automated robotic gastric cancer radical surgery will be realized soon.

Objective To evaluate the quality of Arnebiae Radix (AR) and Dictamni Cortex (DC) and study the efficacy of herbal extracts of these two herbs on the treatment of allergic contact dermatitis (ACD). Methods Qualitative and quantitative analysis of effective components was performed using High Performance Thin Layer Chromatography (HPTLC), High Performance Liquid Chromatography (HPLC), and HPLC-Quadrupole Time of Flight-Mass Spectrometry (HPLC-QTOF-MS). In vitro allergic ACD 3D model was established by incubating 3D reconstructed human epidermis (RHE) with skin sensitizer, potassium dichromate. A total of 65 gene expression that were associated with ACD, which included 24 antioxidant responsive element (ARE) and 41 SENS-IS genes were quantified by qRT-PCR. More than or equal to 10 ARE genes and 18 SENN-IS genes were induced by 1.3-fold, demonstrating the successful establishment of in vitro ACD model. Oil extracts of AR and DC were applied on the in vitro ACD model to study the efficacy. Results Batch 3 of AR and batch 2 of DC showed presence of all active ingredients with the highest concentrations. Active ingredients of the herbs were extracted using a special oil and formulated into herbal oil extracts. The herbal oil extracts were able to down regulate the induced genes in the in-vitro ACD skin model, bringing the tissue back to homeostatic status. Conclusion The oil extracts showed the potent efficacy of using AR and DC in ACD treatment. The combination study will be done to optimize the formulation ratio which will be developed into a topical cream.

A new analytical approach is presented for gravity-induced stresses in elastic half plane with a slope. The half plane is mapped onto the unit circle in ζ plane by conformal transformations. The mapping function proposed by Schwarz-Christoffel is irrational and difficult to be applied to the problem in the paper. Therefore, the explicit expression of the mapping function, which is easy to use and has high precision, is proposed through power series approximation. Based on the complex potentials with body force, a simple method for solving gravity-induced stresses which do not involve analytic continuation and Cauchy integral is established. The analytic functions are expressed as power series. Through the stress boundary condition on the ground surface, a set of linear equations with the coefficients of the power series can be directly constructed and solved. The stress results obtained by the presented analytical method agree well with the numerical solution. The stress distributions under different Poisson’s ratio and slope angle are studied.

(Zr53Al11.6Ni11.7Cu23.7)1–x(Fe77.1C22.9)x (x=0−2.2, at.%) bulk metallic glasses (BMGs) were prepared by copper mold suction casting method. Their glass forming ability and physical and chemical properties were systematically investigated. The glass forming ability is firstly improved with increasing x, and then decreased when x exceeds 0.44 at.%. Both glass transition temperature and crystallization temperature are increased, while the supercooled liquid region is narrowed, with Fe–C micro-alloying. The hardness, yielding and fracture strength, and plasticity firstly increase and then decrease when x reaches up to 1.32 at.%. The plasticity of the BMG (x=1.32 at.%) is six times that of the Fe-free and C-free BMG. In addition, by the Fe–C micro-alloying, the corrosion potential is slightly decreased, while the corrosion current density increases. The pitting corrosion becomes increasingly serious with the increase of Fe and C content.

Amorphous solid dispersions (ASD) are one of most commonly used supersaturating drug delivery systems (SDDS) to formulate insoluble active pharmaceutical ingredients. However, the development of polymer-guided stabilization of ASD systems faces many obstacles. To overcome these shortcomings, co-amorphous supersaturable formulations have emerged as an alternative formulation strategy for poorly soluble compounds. Noteworthily, current researches around co-amorphous system (CAS) are mostly focused on preparation and characterization of these systems, but more detailed investigations of their supersaturation (“spring-parachute“ process), stability, in vivo bioavailability and molecular mechanisms are inadequate and need to be clarified. In present study, we chose pharmacological relevant BCS II drugs to fabricate and characterize “felodipine-indomethacin” CAS. To enrich the current inadequate but key knowledge on CAS studies, we carried out following highlighted investigations including dissolution/solubility, semi-continuous “spring-parachute” process, long-term stability profile of amorphous state, in vivo bioavailability and underlying molecular mechanisms (molecular interaction, molecular miscibility and crystallization inhibition). Generally, the research provides some key information in the field of current “drug-drug” CAS supersaturable formulations.

Few studies have examined the long-term prognosis of Chinese patients with intracerebral hemorrhage (ICH). This study assessed the clinical characteristics and predictors of vascular events occurring within 5 years after ICH. We included consecutive patients diagnosed with first-ever ICH between June 2013 and December 2014. Based on follow-up data (collected until December 2019), we used multivariable logistic regression to examine the clinical characteristics and long-term predictors of vascular events (including recurrent ICH, ischemic stroke, and acute coronary syndrome) in patients who survived more than 30 days after ICH. Across the 307 patients in our analysis, the 5-year mortality rate was 28.01%. Within 5 years after ICH, major vascular events were observed in 62 patients (17.82%, 95% CI 13.78–21.82%). We observed high incidence of recurrent ICH (8.91%) and ischemic stroke (10.06%), but low incidence of acute coronary syndrome (1.15%). Most cases of recurrent ICH (80.65%) occurred within 3 years after ICH. Age ≥56 years and history of ischemic stroke or transient ischemic attack (TIA) were identified as predictors of cardiovascular and cerebrovascular events. ICH survivors are at high risk of both cardiovascular and cerebrovascular events, especially older patients (≥56 years) and those who experienced ischemic stroke or TIA prior to their first ICH. Recurrent ICH is more likely to occur within the first three years after first ICH than at later times. Clinicians should monitor patients closely for adverse events, particularly during the first three years after initial ICH.

Ultra-low wear or non-wear of moving parts is highly desirable because wear limits the service life and reliability of components, particularly under high temperatures. In this study, VN/Ag composites were prepared using vacuum hot-pressing sintering, and their microstructure and high-temperature tribological behaviour were studied. The results demonstrated that the tribological properties of VN ceramics remarkably improved because of metallic Ag. In particular, negative wear was detected in the VN/Ag composites at 700 °C. During the high-temperature tribology process, the evolution of Ag, V2O5, Ag3VO4, and AgVO3 caused by Ag and VN on the worn surface played a significant role in lubrication. In addition, the cell volumes of AgVO3 and Ag3VO4, which were produced via the expansive tribochemical reaction, were 75% and 103% larger than the sum of the cell volumes of VN and Ag. The cell volume expansion compensated for the mechanical damage caused by the wear, possessed an excellent role in wear reduction, and thus contributed to the improvement of high-temperature lubricating materials with high reliability and long service lives.

BACKGROUND: Trimethylamine N-oxide (TMAO), a diet-derived, gut microbial-host cometabolite, has been linked to cardiometabolic diseases. However, the relations remain unclear between diet, TMAO, and cardiometabolic health in general populations from different regions and ethnicities. OBJECTIVES: To examine associations of circulating TMAO with dietary and cardiometabolic factors in a pooled analysis of 16 population-based studies from the United States, Europe, and Asia. METHODS: Included were 32,166 adults (16,269 white, 13,293 Asian, 1247 Hispanic/Latino, 1236 black, and 121 others) without cardiovascular disease, cancer, chronic kidney disease, or inflammatory bowel disease. Linear regression coefficients (β) were computed for standardized TMAO with harmonized variables. Study-specific results were combined by random-effects meta-analysis. A false discovery rate

BACKGROUND: Few population-based studies have evaluated the influence of long-term diet on the gut microbiome, and data among Asian populations are lacking. OBJECTIVE: We examined the association of long-term diet quality, comprising 8 food groups (fruit, vegetables, dairy, fish/seafood, nuts/legumes, refined grains, red meat, and processed meat), with gut microbiome among Chinese adults. METHODS: Included were 1920 men and women, enrolled in 2 prospective cohorts (baseline 1996–2006), who remained free of cardiovascular diseases, diabetes, and cancer at stool collection (2015–2018) and had no diarrhea or antibiotic use in the last 7 d before stool collection. Microbiome was profiled by 16S rRNA sequencing. Long-term diet was assessed by repeated surveys at baseline and follow-ups (1996–2011), with intervals of 5.2 to 20.5 y between dietary surveys and stool collection. Associations of dietary variables with microbiome diversity and composition were evaluated by linear or negative binomial hurdle models, adjusting for potential confounders. False discovery rate (FDR)

A viscous fluid confined in a closed channel has two flow patterns, namely a laminar flow and a turbulent flow. Although already the onset and properties of each pattern have extensively been explored in various geometric fluid systems, very little is known about the flow pattern of a discrete medium. Thus, herein, we reported an experimental study on the type of flow in a vertically vibrated, annular, and granular system. It was found that the system presents either a laminar granular flow or a turbulent granular flow in different vibration modes. With the help of the Reynolds numbers of the granular system, the flow patterns were explained and identified. Finally, our results revealed a property peculiar to the granular flow which is similar to, albeit at the same time different from, viscous fluids.

The previous analytical methods mainly focused on the determination of the plastic region with only one circular hole in an infinite domain. However, there is no exact analytical method for the plastic regions when there are two circular holes. In this paper, the conformal transformation in the complex variable method is proposed to solve the elastoplastic problem of an infinite medium containing two equal circular holes. The research is based on the following preconditions: the two plastic regions formed are disconnected with each other, and each plastic region can completely surround each hole. Initially, the unknown elastic region in the physical plane is mapped onto an annular region in the image plane using the conformal transformation. Subsequently, the nonlinear equations containing the mapping function coefficients are established according to the stress continuity conditions along the two elastoplastic interfaces. The coefficients are set as the design variables and solved effectively by the differential-evolution algorithm. The presented solution is verified by comparing to the Finite Element analysis of ABAQUS software. Finally, the influences of the separation distance between the two holes and the loads on the plastic regions are analyzed.

Objective To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication. Methods A total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hedĭng (EX-LE2鹤顶), Neixīyan (内膝眼EX-LE4), Dubi (犊鼻ST35), Xuehai (血海SP10), Liangqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment. Results (1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P Conclusion The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.

Background The androgen receptor (AR) is increasingly considered as a potential biomarker for breast cancer. Nevertheless, the prognostic value of AR expression in patients with triple-negative breast cancer (TNBC) remains controversial. Therefore, in this meta-analysis we investigated AR expression and its impact on survival outcome. Methods PubMed, Embase, the Cochrane Library, and references of articles were searched to identify relevant studies in which investigated the association between AR expression and prognosis in patients diagnosed with TNBC were published between 1946 and May 2019. The hazard ratio (HR) and confidence interval (CI) of disease-free survival (DFS), overall survival (OS), Distant disease-free survival (DDFS), and Recurrence free survival (RFS) were weighted and pooled by using the fixed-effect or random-effect model based on the heterogeneity of included studies. Results A total of 27 studies, including 4914 TNBC patients were included. AR was expressed in 27.96% (1315/4703) of TNBC patients. In addition, AR expression in TNBC was not associated with disease free survival (DFS) (HR 0.923, 95% CI= 0.671-1.271, p=0.634)), overall survival (OS) (HR 0.910, 95% CI=0.678-1.222, p=0.531), Distant disease-free survival (DDFS) (HR 1.02, 95% CI=0.96-1.08, p=0.489) and Recurrence free survival (RFS) (HR 0.957, 95% CI =0.462-1.982, p=0.906) in TNBC, regardless of confounding factors and heterogeneity existed among included studies. Conclusion In TNBC patients, AR expression is not associated with prognosis.

This paper considers the approach proposed by Zou et al. for determining the plastic zone around a shallow circular tunnel in an elasto-plastic semi-infinite space that incorporates the gravitational effect based on the bipolar coordinate system. The paper aims to analyze the correctness of the analytic expressions for elastic and plastic stress, as well as the reasonableness of the procedure building for solving the elasto-plastic interface. Finally, a promising way of solving this problem more exactly is presented.

Objective To explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease. Methods Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yīfēng (翳风 TE17) and Qiānzheng (牵正 EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House–Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side. Results After 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56±4.25, 34.13±4.28, and 7.46±1.53 respectively, significantly increased in comparing with 11.69±2.45, 12.98±3.34, and 2.62±1.41 respectively before treatment (all P Conclusion Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.