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BACKGROUND: To investigate the relationship between fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH), hemodynamics, and functional outcome in atherosclerotic middle cerebral artery (MCA) stenosis using a computational fluid dynamics (CFD) model based on magnetic resonance angiography (MRA), according to a modified Rankin Scale (mRS) at 3 months. METHODS: A total of 120 patients with 50–99% atherosclerotic MCA stenosis were included. The training and internal validation groups were composed of 99 participants and 21 participants, respectively. Demographic, imaging data, and functional outcome (mRS at 3 months) were collected. Hemodynamic parameters were obtained from the CFD model. The FVH score was based on the number of territories where FVH is positive, according to the spatial distribution in the Alberta Stroke Program Early Computed Tomography Score (ASPECTS). The prediction models were constructed according to clinical and hemodynamic parameters using multivariate logistic analysis. The DeLong test compared areas under the curves (AUCs) of the models. RESULTS: The multivariable logistic regression analysis showed that the National Institute of Health Stroke Scale (NIHSS) at admission, hypertension, hyperlipidemia, the ratio of wall shear stress before treatment (WSSR(before)), and difference in the ratio of wall shear stress (WSSR) were independently associated with functional outcome (all P

ObjectiveTo test the hypothesis that cerebral blood flow (CBF) assessed with arterial spin labelling (ASL) MRI is increased and standardised neurological examination is altered in infants with neonatal opioid withdrawal syndrome (NOWS) compared with those without.DesignProspective cohort study.SettingLevel IV neonatal intensive care unit and outpatient primary care centre.ParticipantsInfants with NOWS receiving pharmacological treatment and unexposed controls matched for gestational age at birth and post-menstrual age at MRI.Main outcomesCBF assessed by ASL on non-sedated 3-Tesla MRI and standardised Hammersmith Neonatal Neurological Examination (HNNE) within 14 days of birth.ResultsThirty infants with NOWS and 31 control infants were enrolled and included in the final analysis. Global CBF across the brain was higher in the NOWS group compared with controls (14.2 mL/100 g/min±5.5 vs 10.7 mL/100 g/min±4.3, mean±SD, Cohen’s d=0.72). HNNE total optimality score was lower in the NOWS group compared with controls (25.9±3.6 vs 28.4±2.4, mean±SD, Cohen’s d=0.81). A penalised logistic regression model including both CBF and HNNE items discriminated best between the two groups.ConclusionsIncreased cerebral perfusion and neurological examination abnormalities characterise infants with NOWS compared with those without intrauterine drug exposure and suggest prenatal substance exposure affects fetal brain development. Identifying neurological and neuroimaging characteristics of infants with NOWS can contribute to understanding mechanisms underlying later outcomes and to designing potential new treatments.

Objective To evaluate the outcomes of cervical spondylotic radiculopathy secondary to bony foraminal stenosis treated with anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) assisted by High‐Definition 3‐Dimensional Exoscope. Methods In this retrospective study, a total of 19 consecutive patients (12 males and seven females, with an average of 49.2 years, range from 40 to 59 years) with spondylotic radiculopathy caused by bony foraminal stenosis underwent ACDF combined with ACF assisted by High‐Definition 3‐Dimensional Exoscope in our hospital between January 2019 and December 2019 were included in this study. All patients signed the consent form before the surgery. The patient baseline information such as gender, age, body mass index (BMI), surgery time, blood loss, hospital stay, lesion segment, side, follow‐up time and postoperative complications were recorded. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) were measured and compared before surgery, 1 months and final follow‐up after surgery. The radiographic outcomes were evaluated using the C2‐C7 angel, disc height, foraminal height, superior diagonal distance, inferior diagonal distance, and foraminal area. Results The involved levels included C4‐C5 (six cases), C5‐C6 (10 cases), C6‐C7 (three cases). The mean duration of the surgery, mean blood loss, mean hospital stay, and mean follow‐up were 100 ± 11.10 min, 19.4 ± 7.05 mL, 7.1 ± 0.99 days, and 12.1 ± 2.25 months, respectively. The average preoperative JOA score was 11.9 ± 1.31, then improved to 15.7 ± 0.73 (t = −13.45, P, ACDF combined with ACF assisted by High‐Definition 3‐Dimensional Exoscope is an effective and safe for the treatment of CSR caused by secondary to bony foraminal stenosis. In addition to sufficient decompression, this technique can also significantly reduce intraoperative bleeding.

Background: How the extracellular matrix (ECM) microenvironment modulates the contractile phenotype of vascular smooth muscle cells (VSMCs) and confers vascular homeostasis remains elusive. Methods: To explore the key ECM proteins in the maintenance of the contractile phenotype of VSMCs, we applied protein-protein interaction network analysis to explore novel ECM proteins associated with the VSMC phenotype. By combining in vitro and in vivo genetic mice vascular injury models, we identified nidogen-2, a basement membrane glycoprotein, as a key ECM protein for maintenance of vascular smooth muscle cell identity. Results: We collected a VSMC phenotype–related gene dataset by using Gene Ontology annotation combined with a literature search. A computational analysis of protein-protein interactions between ECM protein genes and the genes from the VSMC phenotype–related gene dataset revealed the candidate gene nidogen-2, a basement membrane glycoprotein involved in regulation of the VSMC phenotype. Indeed, nidogen-2–deficient VSMCs exhibited loss of contractile phenotype in vitro, and compared with wild-type mice, nidogen-2 –/ – mice showed aggravated post–wire injury neointima formation of carotid arteries. Further bioinformatics analysis, coimmunoprecipitation assays, and luciferase assays revealed that nidogen-2 specifically interacted with Jagged1, a conventional Notch ligand. Nidogen-2 maintained the VSMC contractile phenotype via Jagged1-Notch3 signaling but not Notch1 or Notch2 signaling. Nidogen-2 enhanced Jagged1 and Notch3 interaction and subsequent Notch3 activation. Reciprocally, Jagged1 and Notch3 interaction, signaling activation, and Jagged1-triggered VSMC differentiation were significantly repressed in nidogen-2–deficient VSMCs. In accordance, the suppressive effect of Jagged1 overexpression on neointima formation was attenuated in nidogen-2 –/– mice compared with wild-type mice. Conclusions: Nidogen-2 maintains the contractile phenotype of VSMCs through Jagged1-Notch3 signaling in vitro and in vivo. Nidogen-2 is required for Jagged1-Notch3 signaling.

Edaravone (Eda) is a free radical scavenger used in clinical trials for the treatment of ischemic stroke and amyotrophic lateral sclerosis. However, how Eda exerts its neuroprotective effects remains to be elucidated. We investigated the neuroprotective effects of Eda in cultured hippocampal neurons and in a mouse model of AlCl3/D-galactose-induced cognitive impairment. Eda protected hippocampal neurons by eliminating H2O2 or glutamate-induced toxicity, leading to decreased cell viability and neurite shortening. Consistently, Eda restored impaired levels of BDNF, FGF2 and their associated signaling axes (including TrkB, p-Akt and Bcl-2) to attenuate neuronal death. In a mouse model of chemically-induced cognitive impairment, Eda restored the levels of BDNF, FGF2 and TrkB/Akt signaling axis to attenuate neuronal apoptosis, thereby ameliorating cognitive impairment. Meanwhile, the pro-inflammation was eliminated due to the restoration of pro-inflammatory factors such as TNF-α, IL-6, IL-1β, and NOS2. In summary, Eda is an effective drug for protecting neurons from neurotoxic injury. BDNF, FGF2, and their regulated pathways may be potential therapeutic targets for neuroprotection.

Background Absolute monocyte count (AMC) is often used to be assessed in cancer follow‐up, which has regained interest as a potential prognostic indicator in many solid tumors, though not consistently or comprehensively. In the present study, we set out to perform a comprehensive meta‐analysis of all available data regarding the prognostic significance of AMC in solid tumors. We also evaluated the association between AMC and clinical features in solid tumors. Methods A hazard ratio (HR) and corresponding 95% confidence interval (CI) or a p value (p) from eligible studies were extracted and subsequently pooled analyzed. Subgroup analyses and meta‐regression analyses were conducted according to the confounders of included studies. In addition, the relationships between AMC and clinical characteristics were also explored in the meta‐analysis. Results Overall, ninety‐three articles comprising 104 studies with 32229 patients were finally included. The results showed that elevated AMC was associated with worse overall survival (OS) (HR = 1.615; 95% CI: 1.475‐1.768; p, Elevated AMC indicates poor long‐term outcomes in solid tumors, which could be applied in the prognosis assessment.

Aims The progression of myocardial infarction (MI) involves multiple metabolic disorders. Bile acid metabolites have been increasingly recognized as pleiotropic signaling molecules that regulate multiple cardiovascular functions. G protein-coupled bile acid receptor (TGR5) is one of the receptors sensing bile acids to mediate their biological functions. In this study, we aimed to elucidate the effects of bile acids-TGR5 signaling pathways in myocardial infarction (MI). Methods and results Blood samples of AMI patients or control subjects were collected and plasma was used for bile acid metabolism analysis. We discovered that bile acid levels were altered and deoxycholic acid (DCA) was substantially reduced in the plasma of AMI patients. Mice underwent either the LAD ligation model of MI or sham operation. Both MI and sham mice were gavaged with 10 mg/kg/d DCA or vehicle control since 3-day before the operation. Cardiac function was assessed by ultrasound echocardiography, infarct area was evaluated by TTC staining and Masson trichrome staining. Administration of DCA improved cardiac function and reduced ischemic injury at the 7th-day post-MI. The effects of DCA were dependent on binding to its receptor TGR5. Tgr5−/− mice underwent the same MI model. Cardiac function deteriorated and infarct size was increased at the 7th-day post-MI, which were not savaged by DCA administration. Moreover, DCA inhibited interleukin (IL)-1β expression in the infarcted hearts, and ameliorated IL-1β activation at 1-day post-MI. DCA inhibited NF-κB signaling and further IL-1β expression in cultured neonatal mouse cardiomyocytes under hypoxia as well as cardio-fibroblasts with the treatment of LPS. Conclusions DCA-TGR5 signaling pathway activation decreases inflammation and ameliorates heart function post-infarction. Strategies that control bile acid metabolism and TGR5 signaling to ameliorate the inflammatory responses may provide beneficial effects in patients with myocardial infarction.

Purpose The present systematic review aimed to examine the relationship between lung neoplasm and human chorionic gonadotropin (HCG). Especially, women with lung neoplasm mimicking as ectopic pregnancy were explored. Methods A rare case of lung neoplasm with high serum β-HCG, which was initially thought to be ectopic pregnancy, was reported. A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2020. Results Studies assessed lung neoplasm patients with positive HCG were included. Twenty studies, including 24 patients, were included. These cases illustrate the importance of considering the possibility of paraneoplastic secretion of β-HCG in patients who have a positive pregnancy test. This may prevent a delay in the diagnosis and treatment of malignancy in young women. Of the 24 cases, only 7 (29.17%) were managed surgically; others were managed conservatively or with chemotherapy or radiation. Conclusion The present systematic review shows the need to re-awaken awareness and high index of suspicion to lung neoplasm diagnosis in patients with positive pregnancy test.

Feature extraction is known to be an effective way in both reducing computational complexity and increasing accuracy in hyperspectral imagery (HSI) classification. In this article, we propose a novel HSI feature extraction based on joint adaptive structure density (JASD), which can make full use of the texture feature of feature level and effectively utilize the spatial structure feature of pixel level. Specifically, the proposed JASD method considers two weak assumptions when exploiting the structure information contained in the HSI: 1) close pixels in spectral space have the same label and 2) all the pixels in a subregion belong to the same class. The JASD method consists of the following steps. First, a principal component analysis method is applied to the original high-dimensional HSI to obtain low-dimensional features in order to promote the separability of pixels between different classes and improve the execution efficiency of the proposed method. Then, the local density peak-assisted $k$ nearest neighbor idea is introduced into oversegmentation-based regions to define the structural spatial information of the HSI and overcome the aforementioned weak assumptions. Meanwhile, recursive filtering in the transform domain is applied to the above low-dimensional HSI to preserve global edge details. Next, the global edge details and the local spatial structure feature are fused based on the stacking method. Finally, the composite hyperspectral feature is fed into the supervised classifier to obtain the classification results. Experimental results on three widely used real HSI data sets demonstrated that the proposed JASD method is superior to several comparative classification methods in terms of classification accuracy and computational burden.

Acute lymphoblastic leukemia (ALL) is one of the most common malignancies in children. Our aim was to identify a novel miRNA that can predict prognosis of childhood ALL patients and explore its potential mechanism.The miRNA expression profiles of childhood ALL were analyzed using GEO database and HiSeq instruments. The expression of miR-155 was examined by RT-PCR in 42 ALL patients. To investigate the role of miR-155 in ALL, four ALL cell lines (CEM-C1, Jurkat, MOLT-3 and MOLT-4) were transfected with miR-155 mimics, miR-155 inhibitors or corresponding controls. Dual-luciferase reporter system was applied to confirm the miR-155 target ZNF238. Moreover, proliferation and apoptosis were evaluated by MTT and flow cytometry.Dataset GSE56489 and GSE23024 demonstrated that miR-155 was up-regulated and ZNF238 was down-regulated at diagnosis status of ALL. High miR-155 expression was associated with poor outcome. Overexpressed miR-155 promoted ALL cell proliferation and inhibited apoptosis. Dual-luciferase reporter result showed that miR-155 directly regulated ZNF238. Silencing ZNF238 promoted cell proliferation in ALL cells.Our research indicating that miR-155 might possess potential value as a biomarker for predicting the prognosis of individuals. However, the role of ZNF238 in childhood ALL remain unknown. In the present study, we found the possible role of ZNF238 as a new tumor suppressor in ALL, which might be necessary for the antiproliferative functions of normal cells to counteract ALL formation.Our results propose that miR-155 is in association with poor prognosis of childhood ALL. Furthermore, miR-155 could promote cell proliferation targeting ZNF238.

An ultraviolet curable glue (UCG)-filled microprobe Fabry–Perot fiber temperature sensor, which based on the two-beam interference principle, is proposed and fabricated. In the range of 25.7–250 °C, the average sensitivity and average linear correlation coefficient of the sensor are −41.69 pm/°C and 0.98558, respectively. Under the same temperature, the maximum fluctuation (0.56 pm) of the trough’s wavelength and the standard error (0.0023 ± 0.04%) are obtained. The proposed interferometer exhibits excellent stability and has a potential application in the field of temperature monitoring.

BACKGROUND/AIM It is crucial that dentists who treat traumatic dental injuries rule out concomitant brain injuries. Despite anatomic proximity, controversy exists regarding association between facial trauma and head injury. The aim of this study was to examine the association between dento-alveolar trauma (DAT) and traumatic brain injuries (TBI) using a national dataset of emergency department (ED) visits. MATERIAL AND METHODS Nationwide Emergency Department Sample (NEDS) data, one of the Healthcare Cost and Utilization Project (HCUP) datasets, were analyzed. Encounters of patients age 0-18 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes associated with DAT and TBI in the 2010-2014 NEDS were identified. Data were analyzed using descriptive statistics, chi-square test, and logistic regression models to investigate the association between DAT and TBI and factors associated with TBI in DAT-positive patients. RESULTS During the study period, 6 281 658 ED visits were associated with traumatic injuries. DAT was recorded in 93 408 (1.5%) and TBI was recorded in 996 334 (15.9%) of these traumatic injury visits. Within the group of DAT-positive encounters, 7035 (7.5%) had codes associated with TBI. Of trauma encounters where a DAT was not involved (6 188 250 encounters), 989 299 (16%) had an associated TBI code. Patients with DAT had 0.20 odds of having TBI (95% CI, 0.19-0.20, P

Background Ankylosing spondylitis with Andersson lesions is not rare, but its potential pathogenesis and natural course remain unclear. Case description We describe a case of CT image changes in ankylosing spondylitis from fracture to Andersson lesions. A 40-year-old man with a 23-year history of ankylosing spondylitis presented with acute back pain after a slight fall, and the CT showed a T12 fracture; the patient refused surgery for 12 months. The process from fracture to Andersson lesions was characterized by CT, including the subsequent interbody bone graft with internal fixation and successful bone fusion at the last follow-up. Histopathologic analysis showed degenerative fibrocartilage tissue calcification, necrotic intervertebral disc tissue, fibrovascular hyperplasia, and focal accumulation of inflammatory cells. Conclusion Aseptic inflammation and persistent instability caused by a fracture contributed in the course from fracture to Andersson lesions in ankylosing spondylitis. CT can accurately track the pathological process, and interbody fusion via the posterior pedicle lateral approach can achieve satisfactory effectiveness, good fusion and kyphosis correction.

Installation time of ground support in many caverns excavation is mainly based on analytical and empirical method, instead of the robust numerical simulations. A novel graph method is proposed to determine the installation time of the support upon finite difference method (FDM) simulation. A three dimensional numerical model for the diversion tunnel of Guandi hydropower station is developed. The curve d-r between the convergence d and the excavation unloading rate r is built up upon one-step excavation simulation. Meanwhile, the curve d-l between d and the distance from the tunnel face l, is established via the step-by-step simulation. Using the dimensionless convergence λ instead of d in both curve d-r and curve d-l, curve λ-r and curve λ-l can be yielded to achieve the composite graph r-λ-l. When r = r0, l can be chose as l0 along the identical λ in the comprehensive graph r-λ-l, where r is the excavation unloading rate at the critical plastic state and l0 is the distance from the tunnel face to the support installation location. The proposed graph method is demonstrated to meet well with common sense upon the diversion tunnel of Guandi hydropower station and can be conveniently realized in other engineering practice.

The authors examined time to need new treatment of primary second molars in very young children treated under general anesthesia (GA).During this retrospective chart review, the authors examined patients aged 2 through 4 years with severe early childhood caries (ECC) who received dental treatment under GA. Primary second molars were tracked in periodic recall visits after GA for 6 through 89 months. Using a random-effects Cox proportional hazards model, the authors compared hazards of teeth requiring new treatment based on treatments received at GA.Of 3,166 primary second molars included in the study, 367 (12%) were not erupted, 77 (2%) received topical fluoride only, 873 (28%) received a pit and fissure sealant, 242 (8%) received a composite restoration, and 1,607 (50%) received a stainless steel crown (SSC) at GA. SSCs had a survival probability of 98% by 84 months after GA, significantly higher than all other groups (P .0001). The second molars that were not erupted at GA had the highest hazard, especially within the first 24 months after GA. Teeth that received sealant had longer time to need new treatment than nonsealed teeth; however, at 84 months after GA, only 33% of the sealed teeth did not require additional treatment.Preventive or restorative treatments other than SSCs resulted in need for new treatment in a substantial number of teeth. SSCs had the highest success in this population with severe ECC treated under GA and should be chosen over other restorative options to reduce risk of undergoing repeat dental treatment.Aggressive treatment with SCC should be considered for young children with severe ECC especially those who are treated under GA at a young age.

An optical fiber dual Fabry-Perot interferometric carbon monoxide gas sensor based on PANI/Co3O4/GO (PCG) sensing membrane coated on the end face of the optical fiber is proposed and fabricated. One end face of photonic crystal fiber (PCF) without cut-off wavelength is fused with a single-mode fiber (SMF), and the other end face of the PCF is coated with PCG sensing membrane. The collapsed layer formed during the air hole fusion of PCF is used as the first reflector, the interface between PCF and sensing membrane is used as the second reflector, and the interface between the sensing membrane and the air is used as the third reflector, thus the dual Fabry-Perot structure sensor is formed. The results show that the sensor has excellent sensitivity and selectivity to carbon monoxide. With the increasing concentration of carbon monoxide gas in the range of 0−60 ppm, the intensity of interference spectrum decreases. The sensitivity of the sensor is 0.3473 dB m/ppm, and its linearity is good. The response time and recovery time are 68 s and 106 s, respectively. The sensor has the advantages of the compact size, low cost, high sensitivity, strong selectivity and simple structure. It is suitable for the sensing detection of low concentration carbon monoxide gas.

Few studies have reported on the detail of the mass production process of nanofiltration (NF) membranes and modules due to technical confidentiality. This work presents a procedure of fabrication of NF membranes and modules on the pilot scale. Thin film composite (TFC) NF flat-sheet membranes of 300 mm width were continuously fabricated via custom-designed equipment. The fabrication parameters and their effects on NF performance were systematically investigated. The optimized conditions parameters were achieved for excellent NF modules’ performance. The modules show over 75 L m−2 h−1 flux at 6 bar and over 95% MgSO4 rejection. This study may provide insightful guidelines for the scale-up of NF membranes for water treatment and other applications.

To explore FGF1 and miR-143-3p expression in hepatocellular carcinoma (HCC) cells and its related mechanisms. Eighty-two HCC patients treated at our hospital from January 2018 to January 2019 were enrolled as Group A, while further 80 healthy people undergoing physical examinations during the same time period were enrolled as Group B. HCC cells and normal human liver cells were purchased, with HepG2 and SMMC-7721 cells transfected with pcDNA3.1-FGF1, si-FGF1, NC, miR-143-3p-inhibitor and miR-143-3p-mimics. FGF1 and miR-143-3p expression was detected by qRT-PCR. The expression of N-cadherin, vimentin, Snail, Slug, E-cadherin and γ-catenin was detected by Western Blotting (WB). Cell proliferation was detected by MTT assay. Cell invasion was detected by Transwell. Cell apoptosis was detected by flow cytometry (FCM). FGF1 was highly expressed but miR-143-3p was poorly expressed in HCC cells. Areas under the curves (AUCs) of the two indicators were > 0.8. The indicators were correlated with the age, gender, tumor invasion, degree of differentiation, tumor location and TNM staging of the patients. Silencing FGF1 and overexpressing miR-143-3p could promote cell apoptosis, inhibit cell growth, cell epithelial-mesenchymal transition (EMT) and the expression of N-cadherin, vimentin, Snail and Slug, and increase the expression of E-cadherin and γ-catenin. Dual luciferase reporter gene assay (DLRGA) confirmed that FGF1 and miR-143-3p had a targeted relationship. The rescue experiment showed that the proliferation, invasion and apoptosis of HepG2 and SMMC-7721 cells in the miR-143-3p-mimics+pcDNA3.1-FGF1 and miR-143-3p-inhibitor+Si-FGF1 groups were not different from those in the miR-NC group. Inhibiting FGF1 can upregulate miR-143-3p-mediated Hedgehog signaling pathway, and affect cells’ EMT, proliferation and invasion, so FGF1 is expected to become a potential therapeutic target for HCC.

Objective To examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes. Methods A community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher’s exact tests, logistic regression models, general linear models and the Cox proportional hazard model. Results The fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55–801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90–23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1–3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12–3.25) pattern had a higher risk of spontaneous miscarriage. Conclusion Three unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women’s fecundability and birth outcomes.

Purpose The aim of this study was to find the most useful marker of endometriosis-related infertility and evaluate predictive and diagnostic values of systemic inflammatory response markers (preoperative white blood-cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 levels in endometriosis patients. Methods This study comprised 662 women who had undergone laparoscopic surgery and been pathologically confirmed as having endometriosis and 83 patients pathologically confirmed with benign ovarian tumors. Related inflammatory factors in endometriosis complicated by infertility were analyzed via logistic regression analysis. Diagnostic values of the inflammatory response markers were obtained by receiver operating-characteristic analysis. Results We firstly identified that lower NLR level was an independent risk factor of infertility. Serum lymphocytes were significantly higher in endometriosis patients, while serum CA125, NLR, MLR, and PLR were elevated. For differentiating endometriosis from other benign ovarian tumors, the combination of NLR and CA125 achieved greater sensitivity than CA125 alone. In addition, both CA125 and NLR were positively correlated with stage, oviduct adhesion, and diameter of ovarian ectopic cysts. Conclusion NLR may be used as a simple and easily obtained predictive marker for endometriosis with infertility. Moreover, NLR can be a neoadjuvant biomarker for serum CA125 to diagnose endometriosis.

Objective: The purpose of this study was to evaluate the efficiency and safety of different treatment modalities for heterotopic pregnancy (HP) in vitro fertilization-embryo transfer (IVF-ET) cycles to avoid influence on intrauterine pregnancy (IUP). Materials and methods: Cases of HP (n = 90) were from the IVF/ICSI registry database at the Reproductive Hospital Affiliated to Shandong University. An additional 360 women were randomly selected as controls. The primary outcome to examine the risk factors, diagnostic modalities and the impact of different treatment modalities for HP. Results: Our results showed that surgical treatment had a certain effect on improving the live-birth rate, although the effect was not statistically significant (87.9% vs. 70.8%, P = 0.055). The risk factors for HP included previous tubal surgery and hydrosalpinx. Fourteen days after embryo transfer, the serum levels of β-human chorionic gonadotropin (β-hCG) and estradiol (E2) were lower in the HP group than in the IUP group (P

Summary Two-dimensional (2D) non-covalent and covalent networks are interesting because their tailorable architectures offer fresh applications in sensing, catalysis, gas storage, and topological structures. So far, rational design of these networks has been explored exclusively involving organic molecules based on the concept of modular assembly. Here, we demonstrate that, by using molecular-beam epitaxy, we can isolate inorganic blocks to form a 2D porous gold-phosphorus network (AuPhoN), wherein blue phosphorene (blueP) subunits are linked by gold atoms on an Au surface. We provide evidence that such metal-phosphorus networks are tunable in their chemical functionalities and electronic properties by simply altering the linkers and subunits. Our work provides insights to tailor low-dimension architectures of inorganic networks that maintain good long-range order and are stable over a wide temperature range.

Developing a computational method for recognizing preterm delivery is important for timely diagnosis and treatment of preterm delivery. The main aim of this study was to evaluate electrohysterogram (EHG) signals recorded at different gestational weeks for recognizing the preterm delivery using random forest (RF). EHG signals from 300 pregnant women were divided into two groups depending on when the signals were recorded: i) preterm and term delivery with EHG recorded before the 26th week of gestation (denoted by PE and TE group), and ii) preterm and term delivery with EHG recorded during or after the 26th week of gestation (denoted by PL and TL group). 31 linear features and nonlinear features were derived from each EHG signal, and then compared comprehensively within PE and TE group, and PL and TL group. After employing the adaptive synthetic sampling approach and six-fold cross-validation, the accuracy (ACC), sensitivity, specificity and area under the curve (AUC) were applied to evaluate RF classification. For PL and TL group, RF achieved the ACC of 0.93, sensitivity of 0.89, specificity of 0.97, and AUC of 0.80. Similarly, their corresponding values were 0.92, 0.88, 0.96 and 0.88 for PE and TE group, indicating that RF could be used to recognize preterm delivery effectively with EHG signals recorded before the 26th week of gestation.

Aiming at the problems existing in the Chinese-Khmer parallel corpus, such as single field, small scale, and poor timeliness, a method of Chinese-Khmer parallel fragment extraction from comparable corpus based on Dirichlet process is proposed. The method firstly obtains the topic distribution of bilingual comparable corpus through bilingual topic model, then uses Poisson distribution to randomly divide the bilingual texts, sets up a threshold to initially filter parallel fragment of comparable corpus, and then obtains the matching probability between parallel fragments by Dirichlet process. Obtaining the final parallel fragments by Gibbs sampling. From the comparison experiments, the method of parallel fragment extraction from bilingual comparable corpus based on Dirichlet process can obtain higher quality parallel fragments without providing any parallel data, which is more suitable for languages where bilingual resources are low.

Recently, it has been proven that noisy label is a pivotal problem to be solved for hyperspectral image (HSI) classification. In this article, we propose a new noisy label detection method for HSI classification that is based on the class-dependent collaborative representation (CDCR) algorithm. First, a Tikhonov regularization-based weight matrix among the training samples is calculated, which can estimate the differences among the training samples. Then, the residual of each training sample can be obtained by the CDCR method. Specifically, the larger the residual is, the greater probability belonging to a mislabeled sample will be. Finally, the noisy labels are detected by the defined decision function. Experiments based on the different real hyperspectral datasets demonstrate the effectiveness of the proposed method in detecting noisy labels and improving classification performance of HSI.

Purpose To compare twenty-two machine learning (ML) models against logistic regression on survival prediction in severe traumatic brain injury (STBI) patients in a single center study. Materials and methods Data was collected from STBI patients admitted to the Sichuan Provincial People's Hospital between December 2009 and November 2011. Twenty-two machine learning (ML) models were tested, and their predictive performance compared with logistic regression (LR) model. Receiver operating characteristics (ROC), area under curve (AUC), accuracy, F-score, precision, recall and Decision Curve Analysis (DCA) were used as performance metrics. Results A total of 117 patients were enrolled. AUC of all ML models ranged from 86.3% to 94%. AUC of LR was 83%, and accuracy was 88%. The AUC of Cubic SVM, Quadratic SVM and Linear SVM were higher than that of LR. The precision ratio of LR was 95% and recall ratio was 91%, both were lower than most ML models. The F-Score of LR was 0.93, which was only slightly better than that of Linear Discriminant and Quadratic Discriminant. Conclusions The twenty-two ML models selected have capabilities comparable to classical LR model for outcome prediction in STBI patients. Of these, Cubic SVM, Quadratic SVM, Linear SVM performed significantly better than LR.

As an effective means of solving collision problems caused by the limited perspective on board, the cooperative roadside system is gaining popularity. To improve the vehicle detection abilities in such online safety systems, in this paper, we propose a novel multi-sensor multi-level enhanced convolutional network model, called multi-sensor multi-level enhanced convolutional network architecture (MME-YOLO), with consideration of hybrid realistic scene of scales, illumination, and occlusion. MME-YOLO consists of two tightly coupled structures, i.e., the enhanced inference head and the LiDAR-Image composite module. More specifically, the enhanced inference head preliminarily equips the network with stronger inference abilities for redundant visual cues by attention-guided feature selection blocks and anchor-based/anchor-free ensemble head. Furthermore, the LiDAR-Image composite module cascades the multi-level feature maps from the LiDAR subnet to the image subnet, which strengthens the generalization of the detector in complex scenarios. Compared with YOLOv3, the enhanced inference head achieves a 5.83% and 4.88% mAP improvement on visual dataset LVSH and UA-DETRAC, respectively. Integrated with the composite module, the overall architecture gains 91.63% mAP in the collected Road-side Dataset. Experiments show that even under the abnormal lightings and the inconsistent scales at evening rush hours, the proposed MME-YOLO maintains reliable recognition accuracy and robust detection performance.

BackgroundHepatocellular carcinoma (HCC) is one of the malignant tumors with high morbidity and mortality worldwide. Immunotherapy has emerged as an increasingly important cancer treatment modality. However, the potential relationship between immune genes and HCC still needs to be explored. The purpose of this study is to construct a new prognostic risk signature to predict the prognosis of HCC patients based on the expression of immune-related genes (IRGs) and explore its potential mechanism.MethodsWe analyzed the gene expression data of 332 HCC patient samples and 46 adjacent normal tissues samples (Solid Tissue Normal including cirrhotic tissue) in The Cancer Genome Atlas (TCGA) database and clinical characteristics. We analyzed the gene expression data, identified differentially expressed IRGs in HCC tissues, filtered IRGs with prognostic value to construct an IRG signature, and classified patients into high and low gene expression groups based on the expression of IRGs in their tumor tissues. We also investigated the potential molecular mechanisms of IRGs through a bioinformatics approach using Protein-Protein Interaction (PPI) network, Kyoto Encyclopedia of Genes and Genomes (KEGG) database analysis and Gene Ontology (GO) database analysis. Differentially expressed IRGs associated with significant clinical outcomes (SIRGs) were identified by univariate Cox regression analysis. An immune-related risk score model (IRRSM) was established based on Lasso Cox regression analysis and multivariate Cox regression analysis. Based on the IRRSM, the immune score of the patients was calculated, and the patients were divided into high-risk and low-risk patients according to the median score, and the differences in survival between the two groups were compared. Then, the correlation analysis between the IRRSM and clinical characteristics was performed, and the IRRSM was validated using the International Cancer Genome Consortium (ICGC) database.ResultsThe IRRSM was eventually constructed and confirmed to be an independent prognostic model for HCC patients. The IRRSM was shown to be positively correlated with the infiltration of four types of immune cells.ConclusionOur results showed that some SIRGs have potential value for predicting the prognosis and clinical outcomes of HCC patients. IRGs affect the prognosis of HCC patients by regulating the tumor immune microenvironment (TIME). This study provides a new insight for immune research and treatment strategies in HCC patients.

Inflammation in the epididymis and testis contributes significantly to male infertility. Alternative therapeutic avenues treating epididymitis and orchitis are expected since current therapies using antibiotics have limitations associated to side effects and are commonly ineffective for inflammation due to nonbacterial causes. Here, we demonstrated that type 1 parathyroid hormone receptor (PTH1R) and its endogenous agonists, parathyroid hormone (PTH) and PTH-related protein (PTHrP), were mainly expressed in the Leydig cells of testis as well as epididymal epithelial cells. Screening the secretin family G protein–coupled receptor identified that PTH1R in the epididymis and testis was down-regulated in mumps virus (MuV)- or lipopolysaccharide (LPS)-induced inflammation. Remarkably, activation of PTH1R by abaloparatide (ABL), a Food and Drug Administration–approved treatment for postmenopausal osteoporosis, alleviated MuV- or LPS-induced inflammatory responses in both testis and epididymis and significantly improved sperm functions in both mouse model and human samples. The anti-inflammatory effects of ABL were shown to be regulated mainly through the Gq and β-arrestin-1 pathway downstream of PTH1R as supported by the application of ABL in Gnaq(±) and Arrb1(−/−) mouse models. Taken together, our results identified an important immunoregulatory role for PTH1R signaling in the epididymis and testis. Targeting to PTH1R might have a therapeutic effect for the treatment of epididymitis and orchitis or other inflammatory disease in the male reproductive system.

Journal of translational medicine 19(1), 415 (2021). doi:10.1186/s12967-021-03073-0, Published by BioMed Central, London

BackgroundHNSCC is a heterogeneous disease, which arises from distinct anatomic subsites, associates with various risk factors and possesses diverse molecular pathological features. Generally, HNSCC is considered as an immunosuppressive disease, characterized by abnormal tumor immune microenvironment. The TNF family plays a crucial role in the survival, proliferation, differentiation, and effector functions in both immune and non-immune cells. However, the expression patterns of TNF in HNSCC remains to be systematically analyzed.MethodsWe downloaded transcriptional profile data of HNSCC from TCGA and GEO datasets. Unsupervised clustering methods were used to identify different TNF patterns and classify patients for further analysis. PCA was conducted to construct a TNF relevant score, which we called risk score.ResultsIn this study, we systematically evaluated the patterns of TNF family and tumor immune microenvironment characteristics of HNSCC patients by clustering the expression of 46 members of TNF family. We identified two subtypes with distinct clinical and immune characteristics in HNSCC and constructed a risk scoring system based on the expression profile of TNF family genes.ConclusionRisk score serves as a reliable predictor of overall survival, clinical characteristics, and immune cell infiltration, which has the potential to be applied as a valuable biomarker for HNSCC immunotherapy.

Aims We aimed to assess the comparative efficiency and safety of the use of glyburide, metformin, and insulin in gestational diabetes mellitus (GDM). Methods We searched for randomized controlled trials that compared glyburide, metformin, and insulin in GDM. Data regarding glycemic control and neonatal safety were collected and analyzed in pairwise and network meta-analyses. Results A total of 4533 individuals from 23 trials were included. Compared with glyburide, metformin reduced 2-h postprandial blood glucose (2HPG) to a greater extent (standard mean difference (SMD) 0.18; 95% credible interval (CI) 0.01, 0.34). There were significantly lower prevalence of neonatal hypoglycemia (risk difference (RD) − 0.07; 95%CI − 0.11, − 0.02) and preeclampsia (RD − 0.03; 95%CI − 0.06, 0) in the metformin group than in the insulin group. The metformin group had significantly lower birth weight (SMD − 0.17; 95%CI − 0.25, − 0.08) and maternal weight gain (SMD − 0.61; 95%CI − 0.86,− 0.35) compared with the insulin group. Network meta-analysis suggested that metformin had the highest probability of successfully controlling glycemia and preventing neonatal complications. Conclusions The present meta-analysis suggests that metformin may be as effective as insulin for glycemic control and is the most promising drug for the prevention of neonatal and maternal complications.

Objective To determine the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of upper gastrointestinal submucosal lesions (SMLs). Methods This was a retrospective study involving patients diagnosed with SMLs using EUS and confirmed by histopathology from November 2014 to December 2020 at The Third Xiangya Hospital of Central South University. Results A total of 231 patients with SMLs were examined by EUS. Histologically, 107 lesions were stromal tumors, and 75 lesions were leiomyomas. Stromal tumors were mainly located in the stomach (89.7%), and leiomyomas were predominantly seen in the esophagus (69.3%). The diagnostic accuracy of EUS for stromal tumors and leiomyomas was 80.4% and 68.0%, respectively. The diagnostic accuracy was highest for lesions located in the muscularis mucosa. The mean diameter of stromal tumors measured using EUS was significantly larger than that of leiomyomas (21.89 mm vs. 12.35 mm, p 3 cm (p p Conclusions EUS has good diagnostic value for the diagnosis of upper gastrointestinal SMLs based on the lesion size and the muscle layer of origin. The diagnostic accuracy of EUS lesions is related to the origin, and the diagnostic accuracy is greatest in the mucosal muscularis layer. Stromal tumors > 3 cm and a surface ulcer on EUS are likely to be intermediate or high risk for invasion.

BackgroundBrain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC).MethodsBetween 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received.ResultsA total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1–60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS.ConclusionsBrain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.

Background: Diaphyseal and metaphyseal modeling defects lead to severe changes in bone mass and shape, which are common features in osteoporosis that linked to non-vertebral fractures. Original mechanism of diaphyseal and metaphyseal modeling defects has proved elusive. Studying rare syndromes can elucidate mechanisms of common disorders and identify potential therapeutic targets.Methods: We evaluated a family pedigree with craniometadiaphyseal dysplasia (CRMDD, OMIM 269300), a genetic disorder that is characterized by cortical-bone thinning, limb deformity, and absent of normal metaphyseal flaring and diaphyseal constriction. Systemic radiographic examination and serum hormone test were made for this rare disease. One patient and her two normal parents were examined by means of whole-exome sequencing (WES) to identify the candidate pathogenic gene and rule out mucopolysaccharidosis and Prader–Willi Syndrome by means of Sanger sequencing.Results: There are several conspicuous radiographic characteristics: (1) bullet-shaped phalanges, (2) long and narrow pelvic inlet, absent of supra-acetabular constriction, (3) round rod-shaped long tubular bones, (4) prominent aiploic mastoid, (5) bending-shaped limb, genua varus and genu varum, and (6) congenital dislocation of elbow. Here, we did not find any wormian bones, and there are several typical clinical characteristics: (1) macrocephaly and wide jaw, (2) Avatar elf-shaped ears, pointed and protruding ears, (3) hypertrophy of limbs, (4) flat feet and giant hand phenomenon, (5) nail dystrophy, (6) limb deformity, (7) high-arched palate, (8) superficial hemangiomas, (9) tall stature, and intellectual disability. In this patient, we found biallelic frameshift deletion mutations in WRAP53, and those two mutations were transmitted from her parents respectively.Conclusions: We describe her clinical and radiological findings and presented a new subtype without wormian bones and with a tall stature. Our study showed that craniometadiaphyseal dysplasia was caused by a deficiency of WRAP53 with autosomal recessive inheritance.

Background Whether neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) against primary debulking surgery (PDS) has a differential effect on prognosis due to Breast Cancer Susceptibility Genes (BRCA)1/2 mutations has not been confirmed by current studies. Methods All patients included in this retrospective study were admitted to Qilu Hospital of Shandong University between January 2009 and June 2020, and germline BRCA1/2 mutation were tested. Patients in stage IIIB, IIIC, and IV, re-staged by International Federation of Gynecology and Obstetrics (FIGO) 2014, were selected for analysis. All patients with NAC received 1–3 cycles of platinum-containing (carboplatin, cisplatin, or nedaplatin) chemotherapy. Patients who received maintenance therapy after chemotherapy were not eligible for this study. All relevant medical records were collected. Results A total of 308 patients were enrolled in the study, including 108 patients with BRCA1/2 mutations (BRCAmut), and 200 patients with BRCA1/2 wild-type (BRCAwt). In the two groups, 36 BRCAmut patients (33.3%) and 59 BRCAwt patients (29.5%) received neoadjuvant chemotherapy. The progression-free survival (PFS) of BRCAmut patients was significantly reduced after NAC (median: 15.0 vs. 19.0 months, HR = 0.59; p = 0.03); however, there was no statistical difference in overall survival (OS) (median: 75.1 vs. 68.5 months, HR = 0.90; p = 0.72). Whether BRCAwt patients received NAC had no significant effect on PFS (median: 13.5 vs. 14.6 months, HR = 1.02; p = 0.90) or OS (median: 54.0 vs. 56.4 months, HR = 1.23; p = 0.34). Multivariate analyses showed that the independent predictors of prolonged survival were PDS (p = 0.003), the absence of residual tumor after surgery (p = 0.010), and FIGO III stage (p = 0.011). Conclusions For advanced-stage ovarian cancer patients treated with NAC followed by IDS, PFS and OS were not significantly affected in BRCAwt patients. In BRCAmut patients, NAC-IDS resulted in a shortened PFS, but had no further effect on overall survival.

Background: To explore the best pretreatment method of colorectal cancer tissue samples for metabolomics research based on solid-phase nuclear magnetic resonance. Method: Taking mucosal tissues of colorectal cancer and divide it into 5 groups of 0.2cm*0.2cm*0.2cm. Pretreatment was performed as follows: I. Liquid nitrogen storage; II. Transfer to the -80℃ refrigerator after storing in liquid nitrogen for 10 minutes; III. Transfer to the -80℃ refrigerator after storing in liquid nitrogen for 20 minutes; IV. Transfer to the -80℃ refrigerator after storing in liquid nitrogen for 30 minutes; V. -80℃ refrigerator storage. The interval between tumor sample separation to pretreatment is less than 30 minutes. The tissue sample testing process is carried out on Bruker AVII-600 Spectrometer equipped with a high-resolution probe having a 1H/13C magical angle rotation. The tissue samples were put into the NMR which run at a speed of 5000Hz for 10 minutes. NMR signals were collected and analyzed by Fourier transform, partial least squares discrimination analysis (PLS-DA). Corresponding metabolites and metabolic pathways were found in Human Metabolome Database (HMDB) according to the ppms with variable importance of projection (VIP) ＞1. Results: The content of pelargonic acid, stearic acid, D-Ribose, heptadecanoic acid, pyruvic acid, succinate, sarcosine, glycine, creatine, and L-lactate in liquid nitrogen storage group were significantly lower than the other groups (PConclusion: Liquid nitrogen storage can slow down the glucose and choline phospholipid metabolism process of colorectal cancer tissue samples in vitro; liquid nitrogen can preserve tissue sample’s metabolic state in the body. It is therefore the better way to store tissue sample than the other methods. clinical trial registry website: http://www.chictr.org.cn/index.aspx. Trial number: ChiCTR1900024640

Atherosclerosis-associated cardiovascular disease is one of the main causes of death and disability among patients with diabetes mellitus. However, little is known about the impact of S-nitrosylation in diabetes-accelerated atherosclerosis. Here, we show increased levels of S-nitrosylation of guanine nucleotide-binding protein G(i) subunit alpha-2 (SNO-GNAI2) at Cysteine 66 in coronary artery samples from diabetic patients with atherosclerosis, consistently with results from mice. Mechanistically, SNO-GNAI2 acted by coupling with CXCR5 to dephosphorylate the Hippo pathway kinase LATS1, thereby leading to nuclear translocation of YAP and promoting an inflammatory response in endothelial cells. Furthermore, Cys-mutant GNAI2 refractory to S-nitrosylation abrogated GNAI2-CXCR5 coupling, alleviated atherosclerosis in diabetic mice, restored Hippo activity, and reduced endothelial inflammation. In addition, we showed that melatonin treatment restored endothelial function and protected against diabetes-accelerated atherosclerosis by preventing GNAI2 S-nitrosylation. In conclusion, SNO-GNAI2 drives diabetes-accelerated atherosclerosis by coupling with CXCR5 and activating YAP-dependent endothelial inflammation, and reducing SNO-GNAI2 is an efficient strategy for alleviating diabetes-accelerated atherosclerosis., S-nitrosylation can influence many pathophysiological processes. Here the authors show that the coupling efficiency of GNAI2 with CXCR5 is enhanced by S-nitrosylation of GNAI2, leading to Hippo-YAP dysfunction in endothelium, and plays a role in diabetes-accelerated atherosclerosis.

Background: Triple-negative breast cancer lacks significant expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. It is the more aggressive and malignant kind of breast cancers and is currently without any effective targeted therapies.Methods: We have screened for genes in the ubiquitin-proteasome system that are essential for the proliferation and survival of TNBC cells via CRISPR/Cas9-mediated gene editing. Growth of TNBC cells were assayed using cell and tumor xenograft models to validate the vital role of USP28. We employed cell biology and biochemical methods to uncover the mechanisms underlying the requirement of USP28 for the proliferation of TNBC cells.Results: USP28, a deubiquitin enzyme, is an essential gene for TNBC cells in vitro and in vivo. Compromising the function of USP28 causes TNBC cells to arrest in S/G2 phases with DNA damage checkpoint activation. We show that RecQ family helicases are regulated by USP28, which is more important in TNBC cells than in other breast cancer cells. We further showed that a small molecule inhibitor of USP28 displayed anti-tumor activities against xenografts derived from TNBC cells.Conclusion: Our data establish a critical role played by USP28 in supporting the proliferation and viability of triple negative breast cancer cells through stabilizing RecQ family helicases and support USP28 as a therapeutic target for TNBC.

Objective To prospectively establish an early diagnosis model of acute colon cancerous bowel obstruction by applying nuclear magnetic resonance hydrogen spectroscopy(1H-NMR) technology based metabolomics methods, combined with machine learning. Methods In this study, serum samples of 71 patients with acute bowel obstruction requiring emergency surgery who were admitted to the Emergency Department of Sichuan Provincial People's Hospital from December 2018 to November 2020 were collected within 2 hours after admission, and NMR spectroscopy data was taken after pretreatment. After postoperative pathological confirmation, they were divided into colon cancerous bowel obstruction (CBO) group and adhesive bowel obstruction (ABO) control group. Used MestReNova software to extract the two sets of spectra bins, and used the MetaboAnalyst5.0 website to perform partial least square discrimination (PLS-DA), combining the human metabolome database (HMDB) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) to find possible different Metabolites and related metabolic pathways. Results 22 patients were classified as CBO group and 30 were classified as ABO control group. Compared with ABO group, the level of Xanthurenic acid, 3-Hydroxyanthranilic acid, Gentisic acid, Salicyluric acid, Ferulic acid, Kynuric acid, CDP, Mandelic acid, NADPH, FAD, Phenylpyruvate, Allyl isothiocyanate, and Vanillylmandelic acid increased in the CBO group; while the lecel of L-Tryptophan and Bilirubin decreased (all P

Clinical studies have shown that dexmedetomidine (DEX) reduces mortality and inflammation in patients with sepsis, and ameliorates cognitive decline in both postoperative and critical care patients. This study aims to explain the neuroprotective effects provided by DEX in mice with cecal ligation and puncture (CLP)-induced polymicrobial sepsis. Mice were treated with DEX intraperitoneally three times every two hours after CLP. The survival rate, body weight, and clinical scores were recorded each day. Morris water maze (MWM) and fear conditioning tests were used to evaluate cognitive function. Blood brain barrier (BBB) permeability, hippocampal inflammation, hippocampal neural apoptosis, and T helper (Th) cell subgroups were assessed. Furthermore, Atipamezole was used to verify that the potential neuroprotective effects in the sepsis-associated encephalopathy (SAE) were mediated by DEX. Compared with the Sham group, CLP mice showed significant cognitive impairment, BBB interruption, excessive neuroinflammation, and neuronal apoptosis. These detrimental effects of CLP were attenuated by DEX. Furthermore, we found that DEX corrects peripheral Th1/Th2/Th17 shift and reduces proinflammatory cytokines in the hippocampus. Additionally, atipamezole prevented DEX's protective effect. Taken together, DEX alleviates cognitive impairments by reducing blood-brain barrier interruption and neuroinflammation by regulating Th1/Th2/Th17 polarization.

Background: Although percutaneous osteoplasty (POP) has been widely accepted and is now being performed for the treatment of painful bone metastases outside the spine, there are only scarced reports regarding osteoplasty in painful sternal metastases.Case presentation: The paper reported four patients with painful sternal metastasis who underwent POP under fluoroscopic and cone-beam CT guidance. The patients were three men and one woman (mean age, 66.25 years). Primary tumor location in lung is 3 cases, in thyroid is 1 case. In these cases, Pain was measured using a numerical rating scale (NRS), with scores ranging from 0 (no pain) to 10 (worst pain imaginable). The scores on the NRS in the four patients before POP were 9, 8, 8, and 9. After POP, the NRS scores decreased to 2, 3, 2, and 2, respectively, in follow-up at 6 months. Conclusions: POP is a safe and effective treatment for pain caused by metastatic bone tumors in the sternum. However, care and at tention should be paid to the insertion of a needle and cement distribution for better treatment effect

Jin Peng,1 Ruiying Dong,1 Jianfen Jiao,1 Min Liu,1 Xi Zhang,1 Hualei Bu,1 Ping Dong,2 Shasha Zhao,3 Naidong Xing,4 Shuai Feng,5 Xingsheng Yang,1 Beihua Kong1 1Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 3Department of Clinical Nutrition, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 4Department of Urology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 5Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of ChinaCorrespondence: Xingsheng YangDepartment of Obstetrics and Gynecology, Qilu Hospital, Shandong University, No. 107 West Wenhua Road, Jinan, 250001, People’s Republic of ChinaEmail xingshengyang@sdu.edu.cnObjective: Enhanced recovery after surgery (ERAS) protocol has widely gained acceptance in gynecological surgery. Its safety and efficacy should be evaluated fully via well-designed, randomized, control trials. The main objective of our study is to compare the ERAS protocol with the conventional perioperative care program after gynecological oncology. Furthermore, the secondary objectives of our study are the identification of markers that allow us to evaluate the effectiveness of the application of ERAS elements in the modulation of the body’s response to surgical stress.Methods: Patients with gynecological tumors indicated for surgery were randomly assigned to either the ERAS group or the conventional group. The ERAS protocol included short fasting time, fluid restriction, early oral feeding, reduced opioid consumption and immediate mobilization after surgery. The primary endpoint was the reduction of hospital stay in the ERAS group. The day of first flatus, postoperative nausea and vomiting (PONV), maximum pain score by the visual analogue scale (VAS) and complication, readmission rate, reoperation rate, postoperative mortality, total hospital cost and systemic inflammatory response (SIR) were secondary endpoints.Results: A total of 130 patients in gynecological tumor surgery were enrolled (ERAS = 65, conventional = 65). The ERAS group had faster bowel function recovery, significantly less pain, less PONV, shorter hospital stay, and less total hospital costs. SIR markers were estimated and screened out that postoperative platelet, neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) were significantly lower in ERAS groups compared to conventional groups.Conclusion: The implementation of ERAS protocol is safe and enhances postoperative recovery after gynecological oncology surgery. We firstly reveal the beneficial effect of ERAS protocols on the alleviation of postoperative SIR, which is a reflection of the magnitude of surgical trauma. Postoperative platelet, NLR or PLR could be the novel and inexpensive markers to assess how ERAS protocols modulate gynecological oncology surgery.Trial Registration: The trial was registered in ClinicalTrials.gov (NCT03629626).Keywords: ERAS, enhanced recovery after surgery, systemic inflammatory response, gynecological oncology surgery, NLR, neutrophil-lymphocyte-ratio, PLR, platelet-lymphocyte-ratio

Network optimization is a branch of mathematical programming studying how to plan, optimize, and manage the network to improve its performance, which has been widely investigated and practiced in t...

Objective: Examine the effect of driving time on follow-up visit attendance for children hospitalized with a traumatic brain injury (TBI). We hypothesized that families who lived further from the hospital would show poorer follow-up attendance.Participants: 368 children admitted to the hospital with TBI.Design & Outcome Measures: Using a retrospective chart review, we calculated driving time from patients' homes. The primary outcome was attendance at the first appointment post-discharge. We used logistic regression to examine the effect of driving time on attendance, including an analysis of the effects of injury and sociodemographic covariates on the model.Results: Majority of children attended their first appointment. Patients living 30-60 min from the hospital were most likely to attend, and those living 15 min away were least likely to attend. After adjusting for patient characteristics, families with driving time of 30-60 min had significantly higher odds of returning for follow-up than those with driving time