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The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma (LUAD). The Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 LUAD patients without epidermal growth factor receptor (EGFR) mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing LUAD. According to the PG-SGA, 63 (16·3 %), 174 (44·7 %) and 78 (20·1 %) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36·2 %) patients based on the NRS 2002. The average LOS for tumour patients in Northern China was 12·5 d. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P < 0·001), NRS 2002 (P < 0·001) and latest weight loss (P < 0·001) predicted the longer LOS. LOS was related to nutritional status and hospitalisation expenses (P < 0·001). LUAD patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P < 0·001). In Northern Chinese patients with LUAD, a risk for undernutrition evaluated by the PG-SGA, the NRS 2002 and recent weight loss, but not BMI, could predict a longer LOS.

Objectives Recently, the Gram-negative bacterium Klebsiella oxytoca has been identified as an emerging pathogen. Here we report the draft genome of a 2,3-butanediol-producing strain, K. oxytoca CCTCC M207023, isolated from soil in Nanjing, China. The tetracycline-resistant phenotype and the high yield of 2,3-butanediol was demonstrated. Methods The draft genome of K. oxytoca CCTCC M207023 was determined using an Illumina NovaSeq™ 6000 next-generation DNA sequencing platform. Clean sequencing data were subsequently assembled using SOAPdenovo. Results The draft genome of K. oxytoca CCTCC M207023, comprising 5 658 144 bp and with a GC content of 56.50%, was assembled into 5262 open-reading frames (ORFs). Antimicrobial resistance genes were also annotated. Conclusions The draft genome sequence of K. oxytoca CCTCC M207023 reported here will be a reference for comparative analysis with the antimicrobial resistance mechanisms for the safety of 2,3-butanediol industrial production.

Background The relationship between dental caries and periodontal disease is still controversial. The objective of this study was to explore the relationship between different types of caries and periodontal disease severity in middle-aged and elderly people in China. Methods The study population consisted of 4407 middle-aged and 4117 elderly subjects. Caries were divided into the following three types: type A, crown caries; type B, lesions involving both the crown and root, representing mixed-type caries; and type C, root caries. These three types together represent the overall caries situation, which we call type ABC. Caries were quantitated by decayed and filled teeth (DFT index). Periodontitis was evaluated by clinical attachment loss. Results Middle-aged people with periodontitis had a significant association with DFT type B (OR: 1.21, 95% CI 1.17–1.25) and type C (OR: 1.40, 95% CI 1.24–1.56). Elderly people with periodontitis had a significant association with DFT type C (OR: 1.28, 95% CI 1.21–1.35). Conclusions In China, caries types B/C were positively correlated with periodontitis in the middle-aged group, and only caries type C was positively correlated with periodontitis in the elderly group.

The accumulation of reactive oxygen species (ROS) can induce oxidative damage which can be detrimental to microbial biomass and product yields. In this study, we used intermittent hypoxic stress (IHS) to eliminate the main source of ROS during the production of arachidonic acid (ARA)-rich lipids by Mortierella alpina. Biomass, lipid- and ARA concentration simultaneously reached their peak values, and the ARA yield increased by about 20% along with a lower level of ROS concentration. Under these conditions, more NADPH, substrate and energy may be available for lipid biosynthesis. The efficacy of this strategy was also confirmed in a bioreactor, with similar results. Interestingly, the total power required for stirring fell by about 4%, which may be of practical value for energy savings. This work offers new insights into the control of ROS generation in M. alpina and might be applicable to other microbial PUFAs producers.

Background The financial burden of oral diseases is a growing concern as the medical expenses rise worldwide. The aim of this study was to investigate the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of the inequality for Chinese adults. Methods A secondary analysis used the data of 13,464 adults from the 4th National Oral Health Epidemiological Survey (NOHES) in China was undertaken. The dental expenditure was collected and divided into out-of-pocket and health insurance payments. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. The decomposition model of the concentration index was set up to explore the associated socioeconomic determinants. Results The results showed that a mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval-CI: 18.83,22.26). Among those who actually used dental service, the cost was $100.95 (95%CI: 93.22,108.68). Over 90% of dental spending was due to out-of-pocket expenses. For self-reported oral health, the horizontal inequality index was − 0.1391 and for the decayed tooth (DT), it was − 0.2252. For out-of-pocket payment, the Kakwani index was − 0.3154 and for health insurance payment it was − 0.1598. Income, residential location, educational attainment, oral hygiene practice, self-reported oral health, age difference were the main contributors to the inequality of dental expenditure. Conclusion Dental expenditure for Chinese adults was at a lower level due to underutilization. The ratio of payments of dental expenditure and utilization was disproportional, whether it was out-of-pocket or insurance payment. Individuals who were more in need of oral care showed less demand for service or not required service in time. For future policy making on oral health, it is worth the effort to further promote the awareness of the importance of oral health and utilization of dental service.

Cement-fly ash mixture has been commonly used for the foundation treatment projects in the fly ash stratum, as it is effective in improving foundation bearing capacity and reducing settlement of stratum. In order to figure out the effect of dynamic and static load on the mechanical properties exhibited by the cement-fly ash and the reaction mechanism of cement-fly ash, a combination of the unconfined compressive test, impact test, scanning electron microscopy (SEM), and X-ray diffraction (XRD) method was adopted in this study to investigate the cement-fly ash test samples. As demonstrated by the results, the observed growth rate of 0–60 days (d) is higher than that in the later stages and the typical stress-strain curve can be divided into six sections under the unconfined compressive test. At the gas pressure of 0.2 MPa, the cement-fly ash samples exhibited obvious plastic properties in early curing time (0–60 d), and brittle failure was observed in the final stage (90 d). It is obvious that the value of dynamic compressive strength (DCS) is higher than that of unconfined compressive strength (UCS). The analysis of XRD has revealed that the hydration products are primarily derived from the hydration reaction of cement in the early stage and the pozzolanic reaction in the late stage. The pores of cement-fly ash are found to be filled with the hydration products, despite the presence of a mass of pores in the interior.

In recent years, eukaryotic microorganisms have been widely applied to offer many solutions for everyday life and have come to play important roles in agriculture, food, health care, and the fine-chemicals industry. However, the complex genetic background and low homologous recombination efficiency have hampered the implementation of large-scale and high-throughput gene editing in many eukaryotic microorganisms. The low efficiency of homologous recombination (HR) not only makes the modification process labor-intensive but also completely precludes the application of many otherwise very useful genome editing techniques. Thus, increasing the efficiency of HR is clearly an enabling technology for basic research and gene editing in eukaryotic microorganisms. In this review, we summarize the current strategies for enhancing the efficiency of HR in eukaryotic microorganisms (particularly yeasts and filamentous fungi), list some small molecules and candidate genes associated with homologous and non-homologous recombination, and briefly discuss the further development prospects of these strategies.

The treatment of industrial wastewater containing complex foulants demands high efficiency yet cost-effective separation process. The composite hollow fiber nanofiltration membranes suffer from tedious fabrication procedures, impeding the large volume fabrication and application. Herein, we reveal a very simplified designing strategy by polyelectrolyte modification of the co-extruded polyimide/polyethersulphone dual-layer hollow fibers with hierarchical structure and chemistry. The active layer's thickness of the dual-layer hollow fiber substrate is only 800 nm, the thinnest in literature. Compared to integral active single layer hollow fiber, the ultrathin active layer not only leads to over 4 times increase in mechanical flexibility and tenfold reduction in material cost but also enables fully chemical transition from imide to cross-linked polyamide, minimizing the intrinsic hydrolysis tendency of active material. The optimized membranes with a well-defined pore radius of 0.23 nm have 93–95% rejection to Mg2+ and Ca2+ and PWP of 9.1 LMH/bar. Moreover, the composite membranes exhibit backwash ability and stability in the heated feed solutions, which meets the demand for direct treatment of industrial effluents. This work paves the way for the large volume fabrication and application of hollow fiber nanofiltration membranes for treating municipal water, industrial wastewater, and other applications.

The hollow fiber organic solvent nanofiltration (OSN) membranes have drawn increasing interest for the refining of high value-added products such as nutraceuticals, pharmaceuticals and fine chemicals. The hollow fiber OSN membranes with defined pore size, reliable stability and durability in various harsh solvents are in urgent demand. Herein, for the first time, braid reinforced hollow fiber (BRHF) OSN membranes with defined pore size, robust mechanical strength, and excellent solvent stability were fabricated and used for the recovery of pharmaceuticals. The BRHF nanofiltration membranes can endure an operation pressure over 3 times larger than that of the cross-linked polyimide hollow fiber OSN membranes in aprotic solvents with a DMF flux of 37.9 LMH and a methanol flux of 70.3 LMH at 15 ​bar. The membranes show over 98.8% rejection to the Tetracycline, Chlortetracycline hydrochloride and Vitamin B12. After immersion in DMF for 360 ​h, the membranes maintain over 98% rejection to Chlortetracycline hydrochloride. Moreover, the BRHFs eliminate the risk of module leakage caused by breakage of hollow fibers and surmount the swelling tendency of polymeric OSN membranes in harsh solvents which enables the scaling-up of high-performance hollow fiber OSN membrane modules. The BRHF OSN membranes with robust stability and durability exhibit very promising application prospects in the pharmaceutical and fine chemical industry.

Fly ash and lime have been frequently employed to reduce the swelling potential of expansive soils. Laboratory experiments, scanning electron microscopy (SEM), and X-ray diffraction (XRD) were used in this study to investigate the stabilizing effect of fly ash and lime on expansive soils in the Jianghuai undulating plain area. The comparison was drawn between the variation laws of physical parameters, mechanical properties, microstructure, and mineral composition of expansive soil before and after being stabilized. Experimental results suggest that, after 5% lime is added based on fly ash, the plasticity index of the expansive soil decreases by 64.9%, the free swelling ratio is reduced to about 10%, the unloading swelling ratio is reduced to nearly 4%, and the stabilized soil no longer exhibits the expansive property. The unconfined compressive and tensile strengths of the stabilized soil increase first and then decrease with the rising in fly ash content. After the addition of 5% lime, both the unconfined compressive and tensile strengths increase significantly. The optimum modifier mixture ratio is obtained as 10% fly ash + 5% lime. The SEM images reveal that the microstructures of the stabilized expansive soil vary from an irregular flake-like and flocculent structures to blocky structures, and the soil samples compactness is enhanced. XRD results indicate that quartz is the main component of the stabilized soil. These are the underlying causes of the rise in the strength. The conclusions of this study can be referenced for the engineering design and construction of expansive soil in Jianghuai undulating plain area.

To probe into the dynamic mechanical properties of expansive soil stabilized by fly ash and lime under impact load, the split-Hopkinson pressure bar (SHPB) test was carried out in this study. An analysis was made on the dynamic mechanical property and final fracture morphology of stabilized soil, and the failure mechanism was also explored from the perspective of energy dissipation. According to the test results, under the impact pressure of 0.2 MPa, plain soil and pure fly ash-stabilized soil exhibit strong plasticity. After the addition of lime, the stabilized soil shows obvious brittle failure. The dynamic compressive strength and absorbed energy of stabilized soil first increase and then decrease with the change of mix proportions. Both the dynamic compressive strength and the absorbed energy reach the peak value at the content of 20% fly ash and 5% lime (20% F + 5% L). In the process of the test, most of the incident energy is reflected back to the incident bar. The absorbed energy of stabilized soil increases linearly with the rise of dynamic compressive strength, while the absorbed energy is negatively correlated with the fractal dimension. The fractal dimension of pore morphology of the plain soil is lower than that of the fly ash-lime combined stabilized soil when it comes to the two different magnification ratios. The test results indicate that the modifier content of 20% F + 5% L can significantly improve the dynamic mechanical properties of the expansive soil.

This study aims at introducing a method for individual agreement evaluation to identify the discordant raters from the experts’ group. We exclude those experts and decide the best experts selection method, so as to improve the reliability of the constructed tongue image database based on experts’ opinions. Fifty experienced experts from the TCM diagnostic field all over China were invited to give ratings for 300 randomly selected tongue images. Gwet’s AC1 (first-order agreement coefficient) was used to calculate the interrater and intrarater agreement. The optimization of the interrater agreement and the disagreement score were put forward to evaluate the external consistency for individual expert. The proposed method could successfully optimize the interrater agreement. By comparing three experts’ selection methods, the interrater agreement was, respectively, increased from 0.53 [0.32-0.75] for original one to 0.64 [0.39-0.80] using method A (inclusion of experts whose intrarater agreement>0.6), 0.69 [0.63-0.81] using method B (inclusion of experts whose disagreement score=“0”), and 0.76 [0.67-0.83] using method C (inclusion of experts whose intrarater agreement>0.6& disagreement score=“0”). In this study, we provide an estimate of external consistency for individual expert, and the comprehensive consideration of both the internal consistency and the external consistency for each expert would be superior to either one in the tongue image construction based on expert opinions.

on the basis of the data from the previous box-behnken central composite design, an Artificial Neural Network (ANN) model was constructed for the prediction of outputs of carotenoids. GA (genetic algorithm) was used to search for the optimal culture medium for Rhodospirillum Rubrum S1:citric acid 3.678g/L, Beef extract 3.407 g/L, MgSO4 0.524g/L, FeSO40.023g/L. In the optimal culture medium, it was predicted that the outputs of the carotenoids were13.85 mg/ L.After three verification experiments, the outputs of the carotenoids were 13.72mg/L, the error between the expected value and the experimental value was 0.93%.

BACKGROUND Cerebral ischemia-reperfusion/hypoxia-reoxygenation insult triggers lots of pathophysiological and biochemical events that separately affect the evolution of cerebral damage. Accordingly, all known effective neuroprotective measures should be taken to get the optimal efficacy of therapy. This study was undertaken to investigate whether diazoxide (DZ) preconditioning combined with the following hypothermia could contribute to synergistic neuroprotection compared with either hypothermia or DZ preconditioning alone. METHODS Cultured for 9-10 days in vitro, the hippocampal neurons of SD rats were preconditioned with DZ 0 micromol/L or DZ 250 micromol/L for 1 hour per day and this treatment lasted for 3 days. Subsequently, neurons were subjected to deprivation of oxygen for 4 hours at 37 degrees C, 34 degrees C, 30 degrees C and 22 degrees C, respectively. This experiment consisted of 8 groups (4 temperature groups and 4 combination groups) and each group contained 12-well or 2-dish cells. Survival rate, expression of Bcl-2, fluorescence magnitude of intracellular calcium, and concentration of malondialdehyde (MDA) were determined at 24 hours after reoxygenation. RESULTS The survival rate and expression of Bcl-2 were both increased in individually hypothermic conditions compared with those at 37 degrees C (P < 0.05), whereas intracellular calcium and MDA did the opposite exhibition simultaneously (P < 0.05). 22 degrees C contributed to a higher survival rate and greater expression of Bcl-2 in comparison with other hypothermia (P < 0.05). Preceding administration of 250 micromol/L DZ took the similar effects on the neurons like hypothermia. Moreover, compared with individual hypothermia or DZ preconditioning, the neuronal survival rate and expression of Bcl-2 in the combination group were increased significantly (P < 0.05), whereas the calcium fluorescence density and concentration of MDA were reduced further (P < 0.05). 250 micromol/L DZ preconditioning combined with 22 degrees C provided a maximal neuroprotection. CONCLUSIONS Compared with either individual hypothermia or DZ preconditioning, the combination of both treatments conferred synergistic protection for cultured hippocampal neurons in vitro against hypoxia-reoxygenation insult.

To observe the alleviative effects of preconditioning with diazoxide (DZ), a mitochondrial ATP-sensitive potassium channel opener, combined with subsequent hypothermia on anoxia-re-oxygenation injury.Hippocampal neurons of new-born SD rat were cultured. DZ of the concentration of 250 micromol/L was added into the culture fluid. The group of preconditioned cultured neurons were re-divided into 4 subgroups to be treated by hypothermia of different levels: 37 degrees C, 34 degrees C, 30 degrees C, and 22 degrees C, and then were derived of oxygen for 4 hours. The group of neurons without addition of DZ was re-divided into 4 subgroup too to be exposed to different temperatures and then underwent anoxia-re-oxygenation as described above. Thus the experiment was performed on 8 subgroups in total. Twenty-four hours after re-oxygenation the neurons were stained with dimethyl sulfoxide and their levels of absorptivity were measured so as to calculate the survival rate. Modified thiobarbital method was used to detect the concentration of malondialdehyde (MDA) in the culture fluid. Fluorescence probe Fluo-3-AM was added to detect the Ca(2+) concentration in the neurons.The survival rates of the DZ-preconditioned neurons of the 22 degrees C, 30 degrees C, and 34 degrees C subgroups were (94 +/- 8)%, (73 +/- 9)%, (67 +/- 8)% respectively, all significantly higher than that of the 37 degrees C subgroup (57 +/- 6%, all P0.01), with significant differences between the 22 degrees C subgroup and the 30 degrees C and 34 degrees C subgroups (both P0.01). The survival rates of the non-DZ-preconditioned neurons of the 22 degrees C, 30 degrees C, and 34 degrees C subgroups were 66 +/- 10%, 52 +/- 910%, 48 +/- 9% respectively, all significantly higher than that of the 37 degrees C subgroup (41% +/- 7%, all P0.01), with significant differences between the 22 degrees C subgroup and the 30 degrees C and 34 degrees C subgroups (both P0.01). The survival rates at different temperatures in the DZ-preconditioned group were all significantly higher than those in the corresponding non-preconditioned subgroups (all P0.01). The MDA concentration in the culture fluid of the 22 degrees C subgroup was significantly lower than those of the 30 degrees C, 34 degrees C, and 37 degrees C subgroups in both the DZ-preconditioned and non-preconditioned groups (all P0.01). The MDA concentrations of the preconditioned subgroups at different temperatures were all significantly lower than those of the corresponding non-preconditioned subgroups (all P0.01). The fluorescent value of the intracellular Ca(2+) of the 22 degrees C subgroup was significantly lower than those of the 30 degrees C, 34 degrees C, and 37 degrees C subgroups in both the DZ-preconditioned and non-preconditioned groups (all P0.01). The fluorescent value of the intracellular Ca(2+) of the preconditioned subgroups at different temperatures were all significantly lower than those of the corresponding non-preconditioned subgroups (all P0.01).Hypothermia alleviates the anoxia-re-oxygenation injury: DZ preconditioning enhances the neuroprotection by hypothermia.

A two‐step double ion‐exchange process is employed to produce dual‐core waveguides in glass. First, potassium ion exchange is carried out at 400 °C. Then, silver ion exchange is performed at 300 °C. The fabricated waveguides have low losses, large single‐mode regions, and more symmetrical profiles than single ion‐exchanged waveguides. Etched gratings are also made in dual‐core waveguides. Very high efficiencies are demonstrated in these waveguides.

The first fabrication of ion-exchanged waveguides in erbium doped phosphate glasses is reported. Singlemode channel waveguides are fabricated into a new erbium doped phosphate glass by a dry silver-film ion exchange technique. Mode profiles, transmission and fluorescence spectra of the fabricated waveguides are presented.