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Objective: Yiqi Fumai Lyophilized Injection (YQFM), a Chinese medicine injection, has been widely used for the treatment of cardiovascular diseases, especially heart failure (HF). However, bioactive compounds and underlying mechanisms of YQFM in treating HF remain poorly understood. Materials and Methods: Network pharmacology was employed to investigate the bioactive compounds and mechanisms of YQFM. A compound-target network was constructed to screen bioactive compounds based on contribution index calculation. Then, an adriamycin-induced HF rat model was established to evaluate the cardio-protective effects of YQFM by hematoxylin and eosin staining and enzyme-linked immunosorbent assays. Results: Network pharmacology indicated that YQFM may alleviate HF through 36 compounds and 109 targets. Particularly, ginsenosides Rb1, Rg1, Re, Rf, Rb2, Rh1, schisandrin, and ginsenoside Rc were indicated as the top contributors of YQFM in treating HF. YQFM was predicted to act on multiple targets such as vascular endothelial growth factor A, interleukin-2 (IL-2), IL-6, and IL-1β, as well as to regulate signaling pathways such as hypoxia-inducible factor 1, tumor necrosis factor, VEGF, and PI3K-Akt. The pharmacological study suggested that YQFM could attenuate cardiac injury and up-regulate plasma concentrations of VEGFR-1 and NO in HF rats. Ginsenoside Rb1, as the major contributor from network pharmacology analysis, also showed a cardioprotective effect and up-regulation of VEGFR-1 in plasma. Conclusions: Ginsenosides and schisandrin were predicted as the most important contributors to the cardioprotective effect of YQMF. Ginsenoside Rb1 was proved to alleviate HF and increase the plasma concentration of VEGFR-1.

Abstract Recycling of molybdenum isotopes in continental subduction zones remains debated. In this contribution, we re‐visit the Mo isotope compositions of the Sailipu post‐collisional ultrapotassic rocks in the Himalaya‐southern Tibet orogen. These ultrapotassic rocks have very varying δ98/95Mo values of −0.66 to −0.07‰ and Mo/Ce ratios of 0.0008–0.005, which are lower than those of mid‐ocean ridge basalts (MORB; δ98/95Mo = −0.20 ± 0.06‰, and Mo/Ce = 0.03) and oceanic subduction‐related (i.e., mantle source involving fluids, residual slab, or oceanic sediments) magmatic rocks (e.g., modern arc lavas, Cenozoic OIB‐type basalts in eastern China and the central Mariana Trough basalts in the back‐arc basin, syn‐collisional andesitic rocks in southern Tibet). Combined with the light Mo isotopes of the Himalayan schists and gneisses, we suggest that the light Mo isotopic signature of the Sailipu ultrapotassic rocks is derived from subducted Indian continental crust. This is consistent with the extremely low δ11B (−17.4 to −9.7‰) and B/Nb (0.16–1) values and enriched Sr‐Nd‐Pb isotopes of the Sailipu ultrapotassic rocks. Thus, this study reveals the recycling of light Mo‐B isotopes during continental subduction and demonstrates that Mo‐B isotopes can effectively distinguish between continental and oceanic subduction.

Abstract The origins of Cenozoic granites in the Himalaya are key to understanding the evolution of the Himalayan orogen. However, it is unclear whether these granites represent primary melts, and the nature of their magma source is controversial. Here, we present a systematic element and Sr–Nd–B–Mo isotope study of Cenozoic granites from the Yardoi area in the eastern Tethyan Himalaya, China. These granites can be divided into two groups: mid‐Eocene porphyritic two‐mica granites with low SiO2 contents (65.9−69.6 wt.%) and adakitic geochemical signatures, and mid‐Eocene to Miocene equigranular granites with high SiO2 contents (71.6−75.5 wt.%). The high‐SiO2 granites (HSG) have similar Sr−Nd isotope compositions to the low‐SiO2 granites (LSG), but they have distinct δ11B values of −19.4‰ to −11.4‰ and −10.6‰ to −6.89‰. This indicates that the two groups have different sources, with the LSG derived by partial melting dominantly of metamafic rocks at thickened lower crustal conditions, and the HSG generated by partial melting of the mid‐crust metasedimentary rocks with less enriched Nd isotope compositions. The δ98/95Mo of the LSG and HSG are highly variable with values of −0.68‰ to 0.12‰ and −1.13‰ to 0.46‰, respectively. δ11B values of the HSG correlate positively with δ98/95Mo and Sr/Y values and correlate negatively with K2O, Rb, Zr, and Rb/Sr, reflecting the addition of external metamorphic fluids during anatexis of the metapelites. The B–Mo isotope data robustly suggest source‐controlled compositional diversity of the Himalayan granites, which could provide clues to the physical and geochemical responses during the evolution of a large orogen.

Spurs have played an important role in the radiation of the genus Aquilegia, but little is known about how the spurless state arose in A. ecalcarata. Here we aim to characterize the genetic divergence within A. ecalcarata and gain insights into the origin of this species. A total of 19 populations from A. ecalcarata and 23 populations from three of its closest relatives (Aquilegia kansuensis, Aquilegia rockii and Aquilegia yabeana) were sampled in this study. We sequenced fifteen nuclear gene fragments across the genome and three chloroplast loci to conduct phylogenetic, PCoA and STRUCTURE analyses.Our analyses indicate that A. ecalcarata may not be monophyletic and can be divided into two distinct lineages (A. ecalcarata I and A. ecalcarata II). A. ecalcarata I is genetically close to A. kansuensis, whereas A. ecalcarata II is close to A. rockii. Isolation-with-migration analysis suggested that historical gene flow was low between A. ecalcarata I and A. rockii, as well as between A. ecalcarata II and A. kansuensis. The two distinct lineages of A. ecalcarata show significant divergence in 13 floral traits and also have distinct distributions. In addition, both A. ecalcarata I and II are adapted to a stony environment that differs from that of their closest relatives, indicating a habitat shift may have driven new adaptations. Our findings enrich the understanding of how floral evolution contributes to species diversification.

AIM:To investigate the changes of Notch receptors and interleukin(IL)-22 expression in patients with Vogt-Koyanagi-Harada(VKH)syndrome, and to assess the regulatory activity of Notch signaling to IL-22 production by CD4+ T cells in patients with VKH syndrome.METHODS: Thirty-five patients with VKH syndrome(including fifteen active VKH and twenty inactive VKH)and twelve healthy controls were enrolled. Plasma was isolated, and CD4+T cells were purified. Notch receptors were investigated by qRT-PCR and Western blot. Plasma IL-22 expression was measured by ELISA. The percentage of Th17 and Th22 cells was investigated by flow cytometry. CD4+T cells, which were purified from active VKH patients, were stimulated with Notch signaling inhibitor DAPT. mRNA expression of transcription factor in CD4+T cells as well as IL-22 secretion by CD4+T cells was investigated.RESULTS: Notch1-Notch3 in CD4+T cells from active VKH syndrome patients was significantly elevated in comparison with inactive VKH and healthy controls. Plasma IL-22 expression and percentage of Th17 and Th22 was notably increased in active VKH syndrome in comparison with inactive VKH and controls. DAPT stimulation inhibited Notch signaling pathway in CD4+T cells, leading to the down-regulation of AhR mRNA and IL-22 secretion.CONCLUSION:Notch-AhR-IL-22 signaling pathway might take part in the pathogenesis of VKH syndrome.

AIM: To compare the effectiveness between multiple intravitreal injections of ganciclovir alone and combined with foscarnet as initial treatment for patients with newly-onset cytomegalovirus retinitis (CMVR). METHODS: The retrospective study observed 37 patients (58 eyes) who suffered from CMVR onset between 2013 and 2015. Among them, 35 eyes underwent 4 weekly intravitreal injections of 3.0 mg ganciclovir, and 23 eyes underwent 4 weekly injections of 3.0 mg ganciclovir combined with 2.4 mg foscarnet. Visual acuity, intraocular pressure and viral load of cytomegalovirus (CMV) in aqueous humor measured by real-time polymerase chain reaction were compared before and after each injection. RESULTS: CMV-DNA copies in aqueous humor decreased remarkably in both groups. The average of CMV-DNA copies in patients’ aqueous decreased from 38.3×104 copies/mL at baseline to 2.2×104 copies/mL after the 4th injection in patients who were treated with ganciclovir monotherapy, and decreased from 76.9×104 copies/mL to 11.3×104 copies/mL after 4 continuous injections of ganciclovir combined with foscarnet. No significant difference was found in reduction of viral load, change of visual acuities or intraocular pressures between monotherapy or combined therapy. CONCLUSION: Results of this study show that the initial effectiveness of treating CMVR after 4 weekly intravitreal injections is not significantly different from ganciclovir alone or combined with foscarnet. Continuous injection of ganciclovir alone is sufficient in treating immunosuppressive patients with newly-onset CMVR.

AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract. METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease, and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time(BUT), corneal fluorescein staining score(FL), tear secretion test(SⅠt)and conjunctival epithelium goblet cell density(CIC)was compared between two groups before operation and at 1wk, 1 and 3mo after operation. RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group(P>0.05). At 1wk, 1mo after operation, data of the observation group was significantly higher than that of the control group and before operation, with statistical significance(PP>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance(PPPP>0.05), and the postoperative SⅠt scores of the observation group at 1wk, 1 and 3mo postoperatively was evidently lower than that of the control group and before operation(PPCONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion, impair conjunctival epithelium goblet cell.

Two rare guanidine-type alkaloids, Buthutin A (1) and Buthutin B (2), along with two other compounds (3, 4), were isolated from Buthus martensii Karsch, and determined using extensive spectroscopic data analysis and high resolution-mass spectrometry. Compound 1 showed the most potent inhibition on AChE and BChE with IC50 values of 7.83 ± 0.06 and 47.44 ± 0.95 μM, respectively. Kinetic characterization of compound 1 confirmed a mixed-type of AChE inhibition mechanism in accordance with the docking results, which shows its interaction with both catalytic active (CAS) and peripheral anionic (PAS) sites. The specific binding of compound 1 to PAS domain of AChE was also confirmed experimentally. Moreover, compounds 1 and 3 exhibited satisfactory biometal binding abilities toward Cu2+, Fe2+, Zn2+ and Al3+ ions. These results provide a new evidence for further development and utilization of B. martensii in health and pharmaceutical products.

Thyroid cancer is common in China. Thyroid adenocarcinoma metastases can be local or distal metastasis. Local metastasis presents as a hard and fixed lymph node in the neck, while distant metastases are found in the lung, skull, vertebrae, and pelvis. However, thyroid follicular carcinomas are mostly observed in hematogenous metastases. The thyroid adenocarcinoma and follicular carcinoma of the thyroid gland are often misdiagnosed. Here, we report the case of a 53-year-old female patient. More than 2 years after her initial diagnosis, her left chest wall was physically examined. The results revealed a progressive enlargement that had a hard quality, poor activity, unclear boundary, pressure pain, and percussion pain. Thyroid follicular cell carcinoma was subsequently diagnosed and treated surgically. The thyroid carcinoma had multiple bone metastases, and the thyroid follicular carcinoma had spread to the chest wall through the blood vessels. Thus, preoperative procedures and follow-up should be strengthened because early pathological thyroid follicular carcinoma and thyroid adenoma can easily be misdiagnosed. Pathologic consultation and follow-ups should be strengthened to prevent misdiagnosis.

In the title complex, [Ni(C9H5O6)2(C11H10N4)2]·8H2O, the NiII ion exhibits site symmetry 2. It has a distorted octahedral coordination defined by two N atoms from two symmetry-related 1-[(1H-benzimidazol-1-yl)methyl]-1H-imidazole ligands and four O atoms from two symmetry-related 3,5-dicarboxybenzoate anions. In the crystal, the complex molecules and solvent water molecules are linked via O—H...O, O—H...N and N—H...O hydrogen bonds, forming a three-dimensional structure. There are also a number of C—H...O interactions present.

Cervical orthoses, vital for neck immobilization in medical care and sports, often struggle to provide adequate support due to individual neck shape and size variations. This study addresses this issue by developing a specific computer-aided orthosis design software tailored for creating customized 3D-printed cervical orthoses. The self-developed software embedded anatomical and rehabilitation knowledge into the orthosis design process, ensuring consistency and reducing manual modification. Finite element analysis of cervical orthoses determined that a minimum thickness of 5 mm PLA (polylactic acid) material is necessary to meet safety requirements. This study highlights the automation potential of customized computer-aided orthosis design and underscores the potential to revolutionize orthopedic care. We also applied easy-to-access 3D printing technology to fabricate well-fitting and immobilized cervical orthoses. These customized cervical orthoses offer a promising future with the advantages of being cost-effective, lightweight, immobility, comfortable, easy to wear, and minimal accessories to meet clinical needs, enhancing patient comfort and compliance and providing reassurance about the economic benefits of the technology.

In order to explore glucose uptake and elucidate the underlying mechanism of insulin resistance (IR) in human liver cancer cell (HepG2) upon the intervention of soluble dietary fiber (SDF) from fermented soybean dregs, HepG2 cell model with insulin resistance (HepG2/IR) was established to measure the cell viability and glucose uptake by cholecystokinin (CCK) 8 and glucose oxidase (GOD) kits upon SDF intervention. Meanwhile, protein expression of insulin receptor substrate 1 (IRS-1) and protein kinase B (Akt) in HepG2/IR cells treated with SDF was evaluated by Western blot. Moreover, protein expression of Mfn2 and Drpl associated with mitochondrial dynamics in HepG2/IR cells exposed to SDF was detected. Our results revealed that SDF increased glucose uptake in HepG2/IR cells, with evidences of up-regulated p-IRS, Akt, p-adenosine, 5 '-monophosphate-activated protein kinase (AMPK), silent information regulator 1 (SIRT1) and irisin. Furthermore, SDF restored the balance of mitochondrial dynamics via upregulating Mfn2, and down-regulating PGC-la and Drpl in insulin-resistant HepG2 cells. In contrast, after blocking SIRT1 by EX527, the glucose uptake of HepG2/IR cells could not be rescued when treated with SDF. Therefore, SDF can mitigate or rescue insulin resistance to improve glucose uptake via regulating AMPK/SIRT1 signal pathway. [ABSTRACT FROM AUTHOR]

We present an angular stable dual-band frequency selective surface (FSS) in this paper. By placing anchor-shaped elements with different structural parameters along x-axis alternately within hexagonal wire grid, the proposed FSS can provide two closely spaced passbands. And the resonant frequency ratios are only 1.16 and 1.19 for TE and TM polarizations, respectively. In addition, the proposed FSS has stable frequency response under oblique incidence, and resonant frequency deviation is below 0.5% within 60° incident angle. An FSS prototype is fabricated and measured for further verification, and good agreements between the simulated and measured results can be observed. [ABSTRACT FROM AUTHOR]

Computer-aided surgical planning has been widely used to increase the safety and predictability of surgery. The validation of the target of surgical planning to surgical outcomes on a patient-specific model is an important issue. The aim of this research was to develop a robust superposition method to assess the deviation of planning and outcome by using the symmetrical characteristic of the affected target. The optimal symmetry plane (OSP) of an object is usually used to evaluate the degree of symmetry of an object. We proposed a refined OSP-based contouring method to transfer a complex three-dimensional superposition operation into two dimensions. We compared the typical iterative closest point (ICP) algorithm with the refined OSP-based contouring method and examined the differences between them. The results using the OSP-based method were much better than the traditional method. As for processing time, the OSP-based contouring method was 11 times faster than the ICP method overall. The proposed method was not affected by the metallic artifacts from medical imaging or geometric changes due to surgical intervention. This technique can be applied for post-operative assessment, such as quantifying the differences between surgical targets and outcomes as well as performing long-term medical follow-up.

A compact miniaturized frequency selective surface (FSS) with stable resonant frequency is proposed in this letter. The proposed FSS is composed of four spiral triangles connected in the middle of the unit cell, symmetrically. Simulated results show that the dimension of the element is only 0.0558λ0 ×0.0558λ0, and reduction in FSS size is up to 97.7% with respect to conventional cross-dipole FSS operating at the same frequency of 2.7GHz. Also, the proposed FSS has great angular stability, and the resonant frequency deviation keeps below 0.4% for both TM and TE polarizations of 60° incident angle. [ABSTRACT FROM AUTHOR]

Plaster casting has been effective in fracture rehabilitation due to its immobility capability. Thermoplastic casting gains some efficiency and convenience from clinical processing but fitting and immobility are two major tradeoffs. Three-dimensional (3D)-printed braces have demonstrated improvements in innovation, customization, and appearance, but one may question their effectiveness in rehabilitation. Via a science-based data-centric approach, we evaluated the feasibility of customizing 3D-printed braces for wrist fractures after surgery. First, we established a framework for determining a proper timeframe for reliable pressure measurement for plaster casts, devised a method to evaluate the immobilization capability of the plaster casts and customized braces, and assessed changes in immobilization capability due to the clearance adjustment of customized braces. Second, we compared the customized wrist braces and plaster casts in immobilization capability and functional effectiveness in clinical trials. Thirty-three patients were recruited (9, control; 24, experimental). Both the Disability of Arm, Shoulder, and Head, and the Manual Ability Measure surveys showed significant differences between the control and experimental groups after brace wearing time frames of 2, 4, 8, and 12 weeks, and 6 and 12 months. We found that customized braces can match plaster casts in immobilization ability and can promote effective functional recovery.

Background: To explore the homogenized management method of infection prevention and control in medical resident under COVID-19 epidemic situation. Methods: Overall, 268 members in Ningbo Medical Group which was participating in the management of novel coronavirus pneumonia in Wuhan, China were managed homogeneously in terms of personal cleaning and disinfection of articles, prevention and control of infection in life, training and assessment of relevant infection knowledge in hospitals. Results: In the epidemic situation, the homogenization management of infection prevention and control in the resident of medical team is an important measure to block the transmission link. Conclusion: 1. Conduct homogenization management on the training of hospital infection knowledge for medical staff. 2. Conduct homogeneous management of effective assessment of training knowledge. 3. Conduct homogenization management from personal cleaning and disinfection, as well as infection prevention and control in daily life.

Abstract Objective Atlantoaxial fixation is technically demanding and challenging, especially in cases with anatomical abnormality. The purpose of this study is to report the effectiveness of the three-dimensional (3D)-customized guiding template for placement of C1 and C2 screws in cases with abnormalities. Method Two patients with anatomical abnormality and one without were included. The preoperative computed tomography (CT) image was analyzed using our software. The entry point, trajectory, and depth of the screws were designed based on these images. Templates with screw guiding cylinders and cervical spine model were created. In operation, guiding templates were applied directly to the laminae. Drilling, tapping, and screwing were performed through the cylinders. To evaluate the accuracy, deviation of the screw axis from the preplanned trajectory was measured on postoperative CT. A classification system was taking to evaluate the pedicle screw insertion. Results In complex cases, one of C2 screws has grade 2 deviation, and two has grade 1. There was no deviation in screws of C1. All patients achieved symptoms free after 6 months follow-up. Conclusion Although 3D-printed template for atlantoaxial fixation still has limitation in complex cases, it has been proved usefulness and makes the most difficult and dangerous spinal posterior fixation easy to achieve.

Objective We assessed our results of short-segment decompression and fixation for osteoporotic thoracolumbar fractures with neurological deficits. Methods We evaluated 20 elderly patients (age, 60–89 years; mean, 73.2 years) with osteoporotic thoracolumbar fractures and neurological deficits. They underwent short-segment decompression and fixation and followed up for 40.6 (range, 24–68) months. A visual analog scale (VAS) and the Oswestry Disability Index (ODI) were used to measure back pain and disability. We also analyzed patients’ radiologic findings and neurological status. Perioperative and postoperative complications were recorded. Results At the latest follow-up, the average VAS score for back pain and ODI scores had significantly improved. The radiologic assessment showed significant improvements in local kyphosis, anterior vertebral height, and the vertebral wedge angle compared with the original measures. Neurological function also improved in 18 of 20 patients. No major complications occurred perioperatively. Our techniques included preservation of the posterior ligament complex, decortication of facet joints for fusion, no tapping to increase the screw insertional torque, pre-contouring of the rods according to the “adaptive” curve obtained from postural reduction, and postoperative spinal bracing. Conclusions Posterior short-segment decompression and fixation could be an effective surgical option for osteoporotic thoracolumbar burst fractures with neurological deficits.

With the advent of microsurgery, composite defect in the mandible can be repaired with various forms of osteocutaneous free flaps. However, it is difficult to accurately reconstruct a large defect in the mandible when not enough mandibular reference blueprints remain. This case report describes a large ameloblastoma at the left lower molar region and ascending ramus of the mandible in a 53-year-old male patient. Before surgery, spiral computed tomography scanning of the whole skull of the patient was performed. Using three-dimensional reconstruction and mirror imaging coupled with laser stereolithographic technique, a complete mandibular biomodel with idealized shape was fabricated. A titanium reconstruction plate was made using the biomodel as a guide. The tumor mass together with the left mandible from the second premolar to the condylar head area was resected en bloc. The large mandibular defect was then reconstructed with the precontoured titanium plate and three segments of vascularized fibular bone graft fixed along the plate. The temporomandibular joint was restored with temporalis muscle as an interpositional disc replacement. The complex defect in the mandible was thus repaired with satisfactory functioning and esthetic result. We suggest that with the help of mirror imaging coupled with laser stereolithographic technique, a precontoured titanium plate can be made for the reconstruction of large mandibular defects. [J Formos Med Assoc 2007;106(3):244-250]