Search

Detecting circularly polarized light (CPL) signals is the key technique in many advanced sensing technologies. Over recent decades, many efforts have been devoted to both the material design and the device engineering of CPL photodetectors. CPL detectors with different sensing wavelengths have distinct applications in bio-imaging, drug discovery, and information encryption. In this review, we first introduce the working principle of state-of-the-art CPL photodetectors followed by a general material design strategy. We then systematically summarize the recent progress on the chiral materials developed for CPL detection, including inorganic metamaterials, organics, hybridized materials, etc. We compare and analyse the photocurrent dissymmetry factors of these systems and provide perspectives on strategies to improve the dissymmetry factors and extend the detection wavelength. We believe that the information we include in this review would attract broader interest from researchers working on different aspects of organic and hybridized semiconductor materials and devices.

The prevalence of location-based big data has opened a new research frontier for estimating origin–destination commuting matrices for cities where granular flow data are not yet available from official sources. However, investigations into estimation errors and potential correction methods have been rare in the literature. To address the research gap, this paper first compares the performance of two estimated commuting matrices for Shanghai, derived by two distinct matrix estimation methods, namely a big-data approach using mobile phone signalling data and a discrete choice model for simulating the residential location of commuters. The empirical results indicate an outstanding analytical complementarity of the two approaches. A novel method is then proposed for mitigating the errors associated with the big-data approach. The proposed method features a selective blending of the big-data based flow estimation and the model-based estimation. By comparing the blended flow estimation with benchmark travel statistics, we find that the proposed method would significantly reduce the estimation errors and hence improve the robustness of the estimated matrix. It is expected that the proposed method will set a new standard for correcting potential errors in big-data based flow estimation.

OBJECTIVES The purpose of this study was to observe the effect of subcutaneous stimulation of the peripheral nerve on acute or subacute zoster occurring in trigeminal nerve branches, and to evaluate the preventive effect of prior temporary implant of a peripheral stimulation electrode in the acute or subacute phase of herpes zoster (HZ) (from 30 to 90 d after zoster onset) before postherpetic neuralgia (PHN) presents. METHODS AND MATERIALS A total of 26 patients' medical records were analyzed. All of patients had received temporary subcutaneous peripheral nerve stimulation (PNS). The clinical efficacy of treatment was evaluated on a visual analog scale (VAS), and dosages of pain medication were recorded before and at 1 to 6 months after the temporary stimulation. The rate of PHN was reevaluated at a 6 months follow-up. RESULTS There was a significant decrease in VAS values after PNS. Medication doses decreased significantly after TPNS. The rate of clinically meaningful PHN (VAS >3) dropped below 4%. DISCUSSION This study revealed that PNS is an effective treatment for trigeminal herpetic neuralgia following acute or subacute HZ. As a extend neuromodulation method, subcutaneous peripheral nerve-field stimulation might be a useful option to reduce the progression of neuropathic changes caused by persistent transmission of pain signals in the trigeminal nerve branches after the acute or subacute phase of HZ.

Treatment of neuropathic pain (NP) resulting from nerve injury is one of the most complicated and challenging in modern practice. Pharmacological treatments for NP are not fully effectively and novel approaches are requisite. Recently, transplantation of bone mesenchymal stem cells (BMSCs) has represented a promising approach for pain relief and neural repair, but how it produces beneficial effects on resiniferatoxin (RTX) induced nerve injury is still unclear. Here, we identified the BMSCs' analgesic effects and their potential mechanisms of microglial cells activation on RTX induced neuralgia. Immunostaining, biochemical studies demonstrated that microglia rather than astrocyte cells activation involved in RTX induced mechanical hyperalgesia, whereas the GFP-labeled BMSCs alleviated this mechanical hyperalgesia. Moreover, pain-related TRPA1, PKCδ, CaMKIIɑ (Calcium/calmodulin dependent protein kinase II), P38/MAPK (mitogen-activated protein kinase), p-P65 activation and expression in the spinal cord were significantly inhibited after BMSC administration. In addition, BMSCs treated RTX mice displayed a lower density of mushroom dendritic spines. Our research suggested that activation of PKCδ-CaMKIIɑ-P38/MAPK-p-P65 pathway and mushroom dendritic spines abnormal increase in the spinal cord is the main mechanism of RTX induced neuropathic pain, and transplant of BMSCs to the damaged nerve may offer promising approach for neuropathic pain.

Although defined as a lymphoid surface marker, CD7 is aberrantly expressed on a subtype of acute myeloid leukemia cells and appears to be associated with an inferior response to chemotherapy. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative modality but no data has been reported in CD7-positive AML patients. We performed a retrospective analysis involving 141 AML patients who underwent allo-HCT in first morphological complete remission (CR1). The results showed that CD7-positive AML patients had a poor 2-year overall survival (64.5% vs 82.0%, P = 0.040), relapse-free survival (RFS) (56.5% vs 79.4%, P = 0.005), and higher cumulative incidence of relapse (27.0% vs 9.7%, P = 0.003) post-HCT. In addition, expression of CD7 was related to RAS and RUNX1 mutation, and high residual disease level pre-HCT. Multivariate analyses showed CD7 expression at diagnosis was an independent risk factor for RFS (P = 0.016, HR = 0.418) and relapse (P = 0.014, HR = 0.307). We concluded that for AML patients in CR1, CD7 is a negative predictor for allo-transplant outcomes.

Objective This research aims to develop a laboratory model that can accurately distinguish pneumonia from nonpneumonia in patients with COVID-19 and to identify potential protective factors against lung infection. Methods We recruited 50 patients diagnosed with COVID-19 infection with or without pneumonia. We selected candidate predictors through group comparison and punitive least absolute shrinkage and selection operator (LASSO) analysis. A stepwise logistic regression model was used to distinguish patients with and without pneumonia. Finally, we used a decision-tree method and randomly selected 50% of the patients 1000 times from the same specimen to verify the effectiveness of the model. Results We found that the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine had better discriminatory power than other factors. Age and underlying diseases were not significant for discrimination. The model correctly discriminated 77.1% of patients. In the final validation step, we observed that the model had an overall predictive rate of 81.3%. Conclusion We developed a laboratory model for COVID-19 pneumonia in patients with mild to moderate symptoms. In the clinical setting, the model will be able to predict and differentiate pneumonia vs nonpneumonia before any lung computed tomography findings. In addition, the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine were considered protective factors against lung infection in patients without pneumonia.

Background It has been demonstrated that ischemic preconditioning (IPC), and ischemic postconditioning (IPost) have a significant protective effect on myocardial ischemia/reperfusion (MI/R) injury by alleviating oxidative stress and mitochondrial disturbances, although the underlying molecular mechanisms are not clear. To demonstrate that cardioprotection against anoxia/reoxygenation (A/R) injury is transduced via the Notch1/Hes1/VDAC1 signaling pathway. Methods Using proteomics techniques, liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) and tandem affinity purification (TAP), to screen for differentially expressed proteins associated with Hes1, followed by standard bioinformatics analysis. The co-immunoprecipitation (Co-IP) assay confirmed an interaction between Hes1 and VDAC1 proteins. H9c2 cells were transfected with Hes1 adenoviral N-terminal TAP vector (AD-NTAP/Hes1) and Hes1-short hairpin RNA adenoviral vector (AD-Hes1-shRNA) to establish A/R injury, ischemic preconditioning (IPC), and ischemic postconditioning (IPost) models, respectively. The expression of Hes1 and VDAC1 proteins were measured by western blotting, while the levels of intracellular reactive oxygen species (ROS), mitochondrial membrane potential (ΔΨm), and apoptosis were evaluated by flow cytometry. Results AD-NTAP/Hes1 can activate the exogenous protein expression of Hes1, thus decreasing creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) activity and promoting cell viability. The study found that VDAC1 was a potential target protein for Hes1 and the overexpression of Hes1 protein expression downregulated protein expression levels of VDAC1, reduced ROS production, stabilized ΔΨm, and inhibited apoptosis in H9c2 cells. Additionally, downregulation of Hes1 protein expression also upregulated VDAC1 protein expression, increased ROS production, imbalanced ΔΨm, promoted cell apoptosis, and attenuated the cardioprotection afforded by IPC and IPost. Conclusions The Notch1/Hes1 signaling pathway activated by IPC/IPost can directly downregulate the protein expression of VDAC1 and consequently relieve A/R injury.

Objective To explore the efficacy and safety of rituximab (RTX) in the treatment of autoimmune nephropathy manifested as refractory nephrotic syndrome (RNS). Methods A single-center prospective cohort study was conducted on RNS patients treated with RTX between March 2017 and December 2019. The subjects were divided into the primary nephropathy (PN) group and the secondary nephropathy (SN) group. Based on the estimated glomerular filtration rate (eGFR) before RTX treatment, the SN group was then divided into the SN-1 group (eGFR ≥ 30 ml/min) and the SN-2 group (eGFR Results Fifty-four patients were followed up for at least 6 months. The overall remission rates were 65%, 66.7%, 27.3% in the PN, SN-1, and SN-2 groups, respectively (P = 0.022). Kaplan–Meier analysis showed a significant difference of the renal survival among the three subgroups (P Conclusions RTX may be a promising option in RNS patients with eGFR ≥ 30 ml/min/1.73m2. However, it has little effect on prognosis in patients with secondary RNS with eGFR 2, but with a high risk of severe infection.

Polyhedral CaMoO4 microcrystallites with excitation-induced tunable luminescent characteristics were successfully synthesized by a hydrothermal method. Polyhedral morphologies with different shapes and exposed facets were observed for the samples prepared at different temperatures. Sharp-vertex polyhedron was obtained at 140 °C due to the increase of (001) surface energy and the sample exhibited the strongest PL emission intensity due to its regular polyhedron morphology. Green and blue light emissions were observed separately under different excitation wavelengths in single CaMoO4 microcrystallites, which can be attributed to the charge transfer transitions within the [MoO4]2− complex and the shallow defects in the bandgap, respectively. The excitation-induced tunable luminescent characteristics make it to be a promising inorganic single-emitting component for optical applications.

In large-scale structured scenes, efficient and reliable global localization is hard to achieve for mobile robots due to the substantial increase in the search space. This article addresses this issue by proposing an optimized branch and bound (BnB) based global localization using multiscale/resolution maps, which can efficiently find the global optimal initial pose with a high success rate. Multiscale feature maps (MSFMs) are first constructed to reflect the explicit point/line information of the structured scene. Then, to narrow the position space, robust features are extracted from LiDAR data at different scales and matched with MSFMs instantaneously using the hash function. Utilizing the attitude and heading reference system, a yaw angle estimation considering environmental interference is achieved to reduce the orientation space and improve the localization reliability in ambiguous environments. Besides, with the optimal resolution level and sparse point cloud sampled from interval filtering, an optimized BnB-based search is presented by using multiresolution maps. Finally, the effectiveness of the proposed method is verified by mobile robot real-world and simulated experiments in large-scale structured environments.

The interface material is an indispensable part of perovskite solar cells (PSCs) because of its special functions. In this work, a conjugated polyelectrolyte, PTPADT-SO3Na, was synthesized and intr...

Purpose To determine the spectrum of critical incidents in postanesthesia care unit (PACU) and the possible prediction and prevention of the worse scenario–associated critical incidents. Design A retrospective observational study. Methods The critical incidents in PACU comprising 92,136 patients were recorded. The incidents included the following disorders: delayed recovery, pain, bleeding, hypothermia, unplanned transfer to intensive care unit, shivering, agitation, nausea and vomiting, and respiratory or cardiovascular-related critical incidents. We then performed descriptive analyses and t test or χ2 test on the collected data. Findings A total of 1,760 critical incidents were recorded in 1,417 patients among 92,136 patients. Most critical incidents were associated with the patients after general anesthesia and general or gynecologic surgery. The most common critical incidents noted in the present study were pain, followed by cardiovascular-related and respiratory-related incidents. The average length of stay in PACU was 61.50 ± 44.40 minutes for the patients with critical incidents and 28.50 ± 19.40 minutes for the patients without critical incidents. Conclusions Critical incidents lead to longer length of stay in the PACU. Regular inspection and immediate response for critical incidents in the PACU is essential for the maintenance of the quality of the immediate postoperative care.

Stanford type A acute aortic dissection (AAD) is a life-threatening illness that presents with chest pain and hemodynamic instability. AAD prompt and accurate evaluation and management are critical for survival as it is a cardiac surgical emergency. The initial treatment of AAD mandates strict blood pressure stabilization with intravenous antihypertensive medications. The progressive nature of the disease will increase the mortality as time elapses between diagnosis and surgical intervention. In addition, the patient’s blood pressure control is challenged in the presence of renal failure requiring hemodialysis. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or named 2019-nCoV) pneumonia was a newly underrecognized illness (COVID-19 [coronavirus disease 2019]). COVID-19 can cause severe acute respiratory distress syndrome, acute kidney injury, heart injury, and liver dysfunction, which would aggravate the progress of aortic dissection. In this article, we report the successful anesthesia management in a pneumonia patient with AAD complicated with renal failure during the COVID-19 epidemic period, who underwent emergency surgery and deep hypothermic circulatory arrest repair.

Background Reliable and timely determination of second-line drug resistance is essential for early initiation effective anti-tubercular treatment among multi-drug resistant (MDR) patients and blocking the spread of MDR and extensively drug-resistant tuberculosis. Molecular methods have the potency to provide accurate and rapid drug susceptibility results. We aimed to establish and evaluate the accuracy of a reverse dot blot hybridization (RDBH) assay to simultaneously detect the resistance of fluoroquinolones (FQs), kanamycin (KN), amikacin (AMK), capreomycin (CPM) and second-line injectable drugs (SLIDs) in Mycobacterium tuberculosis. Methods We established and evaluated the accuracy of the RDBH assay by comparing to the phenotypic drug susceptibility testing (DST) and sequencing in 170 M. tuberculosis, of which 94 and 27 were respectively resistant to ofloxacin (OFX) and SLIDs. Results The results show that, compared to phenotypic DST, the sensitivity and specificity of the RDBH assay for resistance detection were 63.8% and 100.0% for OFX, 60.0% and 100.0% for KN, 61.5% and 98.1% for AMK, 50.0% and 99.3% for CPM, and 55.6% and 100% for SLIDs, respectively; compared to sequencing, the sensitivity and specificity of the RDBH assay were 95.2% and 100.0% for OFX, 93.8% and 100.0% for SLIDs or KN (both based on mutations in rrs 1400 region and eis promoter), and 91.6% and 100.0% for AMK or CPM (both based on mutations in rrs 1400 region), respectively. The turnaround time of the RDBH assay was 7 h for testing 42 samples. Conclusion Our data suggested that compared to sequencing, the RDBH assay could serve as a rapid and reliable method for testing the resistance of M. tuberculosis against OFX and SLIDs, enabling early administration of appropriate treatment regimens among MDR tuberculosis patients.

Although type 2 diabetes mellitus (T2DM) patients with coronavirus disease 2019 (COVID-19) develop a more severe condition compared to those without diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment with antihyperglycemic drugs and glucocorticoids is unclear.From 1584 COVID-19 patients, 364 severe/critical COVID-19 patients with clinical outcome were enrolled for the final analysis, and patients without preexisting T2DM but elevated glucose levels were excluded. Epidemiological data were obtained and clinical status evaluation carried out to assess the impact of T2DM and its management on clinical outcomes.Of 364 enrolled severe COVID-19 inpatients, 114 (31.3%) had a history of T2DM. Twenty-seven (23.7%) T2DM patients died, who had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury compared with non-DM patients. In severe COVID-19 patients with T2DM, we demonstrated a higher risk of all-cause fatality with glucocorticoid treatment (adjusted hazard ratio [HR], 3.61; 95% CI, 1.14-11.46; P = .029) and severe hyperglycemia (fasting plasma glucose ≥11.1 mmol/L; adjusted HR, 11.86; 95% CI, 1.21-116.44; P = .034).T2DM status aggravated the clinical condition of COVID-19 patients and increased their critical illness risk. Poor fasting blood glucose (≥ 11.1 mmol/L) and glucocorticoid treatment are associated with poor prognosis for T2DM patients with severe COVID-19.背景: 虽然2019冠状病毒病(COVID-19)合并2型糖尿病(T2DM)患者比未患糖尿病的患者病情更加严重, 但其发病机制尚不清楚。此外, 降糖药和糖皮质激素治疗对COVID-19的影响尚不清楚。 方法: 对我院1584例COVID-19住院患者的临床资料进行回顾性分析。我们排除了既往无T2DM但血糖升高的患者, 得到364例重型/危重型COVID-19患者作为最终分析对象, 收集其流行病学资料和临床转归, 以评估T2DM及其治疗对COVID-19临床预后的影响。 结果: 在364例重型/危重型COVID-19住院患者中, 114例(31.3%)有T2DM病史。27例(23.7%)T2DM患者死亡, 这些患者比非糖尿病患者具有更严重的炎症反应、凝血激活、心肌损伤、肝损伤和肾损伤。在T2DM合并COVID-19重症患者中, 糖皮质激素治疗(校正HR, 3.61；95%CI, 1.14-11.46；P=0.029)和严重高血糖(空腹血糖≥11.1 mmol/L；校正HR, 11.86；95%CI, 1.21-116.44；P=0.034)的全因死亡风险更高。 结论: T2DM加重COVID-19病情并增加其危重症风险。空腹血糖不良(≥11.1mmol/L)和糖皮质激素治疗与重症COVID-19患者预后不良相关。.

Circularly polarized (CP) electroluminescence has been demonstrated as a strategy to improve the performance of organic light emitting diode (OLED) displays. CP emission can be generated from both small molecule and polymer OLEDs (SM-OLEDs and PLEDs), but to date, these devices suffer from low dissymmetry factors (g-factor

It was widely recognized that the procedure of ultrasound-guided lumbar and sacral plexus block is required to be performed in a lateral decubitus position that patients' hips and knees were bended. It is difficult, however, for patients with hip fractures to change position because of severe pain and confined movements. We here reported a new modified combination of ultrasound-guided lumbosacral plexus block with anterior quadratus lumborum block in supine position that had been successfully applied in one elderly patient who underwent hip surgery.

Intractable scratching is the characteristic of chronic itch, which represents a great challenge in clinical practice. However, the mechanism underlying chronic itch development is largely unknown. In the present study, we investigated the role of NMDA receptor in acute itch and in development of chronic itch. A mouse model was developed by painting DNFB to induce allergic contact dermatitis (ACD). We found that the expression of pNR1, which is a subunit of NMDA receptor, was significantly increased in the dorsal root ganglion in the DNFB model. The DNFB-evoked spontaneous scratching was blocked by the NMDA antagonist D-AP-5, the calcium-calmodulin-dependent protein kinase (CaMK) inhibitor KN-93, a CaMKIIα siRNA and the PKC inhibitor LY317615. Moreover, activation of PKC did not reverse the CaMKIIα knockdown-induced decrease in scratching, suggesting that PKC functions upstream of CaMKIIα. Thus, our study indicates that modulation of NR1 receptor by CaMKIIα plays an important role in the development of chronic itch.

Gastric ulcer is a common digestive system disease, which leads to the serious decline in the life quality and effective therapies are in urgent need. Midnightmidday ebb flow acupunctures including Najia and Nazi acupunctures have been applied in clinics in China for more than one thousand years and the acupoints are selected according to the time rhythm. Najia acupuncture, namely day-prescription of acupoints, divides ten days (one cycle) into 120 two-hour periods and each period is coordinated with a meridian. Meanwhile, Nazi acupuncture, namely hour-prescription of acupoints, divides a day(one cycle) into 12 two-hour periods and each period is coordinated with a meridian. When there is a disease in a certain meridian, the relevant acupoints are operated in the corresponding time. However, the comparative efficacies of Najia and Nazi acupunctures on promoting the healing of gastric ulcer are still unknown. In this study, gastric ulcer rats were induced by acetic acid and were randomly divided into four groups: non-acupuncture group, normal acupuncture group, Najia acupuncture group and Nazi acupuncture group. After different treatments for continuous 10 days, the gained weight, gastric ulcer area and the thickness of gastric mucosa were measured and analyzed. Decreased ulcer area, increased mucosa thickness and dense scar tissue occurred in the Najia group and Nazi group compared to that in the non-acupuncture group (P0.05). Thickness of gastric mucosa in Nazi acupuncture group increased significantly compared to normal acupuncture group (P

Hole transporting materials (HTMs) play a critical role in ameliorating the performance of perovskite solar cells (PSCs). Dedicated HTMs can improve not only the hole extraction and efficiency but also the stability. Herein, PFDT-COOH and its fluorinated derivative, PFDT-2F-COOH, are introduced as dopant-free HTMs for inverted PSCs. Compared to PFDT-COOH, PFDT-2F-COOH exhibits a deeper highest occupied molecular orbital (HOMO) level, a higher work function on indium tin oxide electrodes, and an elevated built-in potential in the device. The PFDT-COOH device based on FA1−xMAxPbI3 mixed-cation perovskite exhibits a champion power conversion efficiency (PCE) of 20.64%, while the PFDT-2F-COOH device exhibits a champion PCE of 21.68%, which is close to the highest value (21.7%) attained in inverted single-junction PSCs. The elevated efficiency is attributed to reduction of carrier recombination and enhancement of carrier extraction via the fluorination strategy. In addition, the two devices also show excellent operational and thermal stabilities. Therefore, our work offers a feasible strategy for preparing high efficiency and stable inverted PSCs.

Backgroundː Reintubation after planned extubation (RAP) is a serious adverse event. This study aimed to determine the rate and impact of RAP on postoperative course and hospitalization outcomes.Methodsː Of the 121,965 patients in the PACU, 14 patients with RAP were included in this retrospective, single-center, 1:2 matched cohort study in China from January 1, 2017 to December 31, 2019. Duration of PACU stay, postoperative time in the hospital, inpatient healthcare costs, and outcome of hospitalization were compared between the RAP and matched groups.Resultsː The rate of RAP occurrence was 0.0115%. After propensity score matching, there were no statistically significant differences in age, sex, body mass index, emergency operation, surgical classification, American Society of Anesthesiologists physical status, and the durations of anesthesia and the procedure between the two groups. Duration of PACU stay, length of postoperative stay, and inpatient healthcare costs significantly differed between the RAP and matched groups (P < 0.01 for all). The percentage of patients in whom discharge from the PACU was prolonged was significantly higher in the RAP group than in the matched group (92.86% vs.714%), with an odds ratio of 29.87 (95% CI = 14.00 to 2040.54; P < 0.001) after matching.Conclusionsː RAP in the PACU had low incidence but was associated with life-threatening and serious complications, increased incidence of prolonged discharge, prolonged PACU and postoperative hospital stay, increased inpatient healthcare costs, and unanticipated intensive care unit admission. Hypoxemia, airway obstruction, dyspnea, respiratory depression, confusion, asthma, chest tightness, pain, hemorrhage, or agitation could be the risk factor for RAP. The appropriate time for tracheal extubation and monitoring in PACU can effectively prevent the occurrence of reintubation and improve the prognosis of patients.

We report a case of 39-year-old female patient with paraneoplastic pemphigus ( PNP ) associated with thymoma treated with Rituximab plus corticosteroids and methotrexate. After Rituximab therapy for 8 weeks, oral ulcerations had cured, lesions on the trunk and limbs improved. Rituximab may be useful for PNP therapy, but further studies are necessary to confirm this hypothesis. This article is protected by copyright. All rights reserved.

Background Compared with singleton pregnancy, twin gestation is featured by a greater increase in cardiac output. Therefore, norepinephrine might be more suitable than phenylephrine for maintaining blood pressure during cesarean section for twins, as phenylephrine causes reflex bradycardia and a resultant decrease in cardiac output. This study was to determine whether norepinephrine was superior to phenylephrine in maintaining maternal hemodynamics during cesarean section for twins. Methods Informed consent was obtained from all the patients before enrollment. In this double-blinded, randomized clinical trial, 100 parturients with twin gestation undergoing cesarean section with spinal anesthesia were randomized to receive prophylactic norepinephrine (3.2 μg/min) or phenylephrine infusion (40 μg/min). The primary outcome was the change of heart rate and blood pressure during the study period. The secondary outcomes were to compare maternal complications, neonatal outcomes, Apgar scores and umbilical blood acid-base status between the two vasopressors. Results There was no significant difference observed for the change of heart rate between two vasopressors. The mean standardized area under the curve of heart rate was 78 ± 12 with norepinephrine vs. 74 ± 11 beats/min with phenylephrine (mean difference 4.4, 95%CI − 0.1 to 9.0; P = .0567). The mean standardized area under the curve of systolic blood pressure (SBP) was significantly lower in parturients with norepinephrine, as the mean of differences in standardized AUC of SBP was 6 mmHg, with a 95% CI from 2 to 9 mmHg (P = .0013). However, requirements of physician interventions for correcting maternal hemodynamical abnormalities (temporary cessation of vasopressor infusion for reactive hypertension, rescuing vasopressor bolus for hypotension and atropine for heart rate less Conclusion Infusion of norepinephrine was not associated with less overall decrease in heart rate during cesarean section for twins, compared with phenylephrine. Trial registration Chinese Clinical Trial Registry (ChiCTR1900021281).

Aortic dissection (AD) is a catastrophic cardiovascular emergency with a poor prognosis, and little preceding symptoms. Abnormal lipid metabolism is closely related to the pathogenesis of AD. However, comprehensive lipid alterations related to AD pathogenesis remain unclear. Moreover, there is an urgent need for new or better biomarkers for improved risk assessment and surveillance of AD. Therefore, an untargeted lipidomic approach based on ultra-high-performance liquid chromatograph-mass spectrometry was employed to unveil plasma lipidomic alterations and potential biomarkers for AD patients in this study. We found that 278 of 439 identified lipid species were significantly altered in AD patients (n = 35) compared to normal controls (n = 32). Notably, most lipid species, including fatty acids, acylcarnitines, cholesteryl ester, ceramides, hexosylceramides, sphingomyelins, lysophosphatidylcholines, lysophosphatidylethanolamines, phosphatidylcholines, phosphatidylinositols, diacylglycerols, and triacylglycerols with total acyl chain carbon number ≥54 and/or total double bond number ≥4 were decreased, whereas phosphatidylethanolamines and triacylglycerols with total double bond number

Background Multiple chronic diseases (MCDs) and social isolation are independent risk factors related to stroke and disability, but it is unknown whether the combination of these two conditions resulted from aging-related to functional disability in stroke patients. This study aimed to probe the relationship between the combination of MCDs, social isolation, and functional disability after stroke in elderly patients. Methods A multicenter and cross-sectional study was conducted in the Departments of Rehabilitation of 103 hospitals located in 23 cities across China. Stroke patients aged 60–90 years were selected for analysis. Demographic characteristics, lifestyles, and clinical information were investigated by questionnaires and medical records. MCDs (hypertension/ diabetes/ hyperlipidemia/heart disease/kidney disease) were categorized into three levels: 0, 1, and ≥ 2. Functional disability was assessed by the Barthel Index and categorized into four groups: no, mild, moderate, and severe disability. The multi-nominal logistic regression model was used to explore the independent and combined association of MCDs and social isolation with functional disability. Results A total of 4046 elderly stroke patients (55 % males) were included in the final analysis. The prevalence of social isolation, MCDs ≥ 2, and severe disability increased with aging. In the fully adjusted model, patients with social isolation or MCDs had a higher risk of functional disability significantly than those without. Patients with social isolation combined MCDs ≥ 2 were 35 times (95 % CI: 18.89–64.69) more likely to suffer severe disability after stroke, and 8 times (95 % CI: 18.89–64.69) for moderate disability than those without social isolation and MCDs. Conclusions MCDs, social isolation, and their combination were associated with a higher risk of functional disability after stroke in Chinese elderly patients. The elderly population should be encouraged to participate in more social activities, particularly in those with MCDs. Future secondary prevention and rehabilitation treatments to the functional ability of elderly stroke patients should underscore both social activity and the combined treatments of MCDs. Trial registration NO: ChiCTR2000034067.

What is known and objective: Every prescriber knows that patients often do not take their medicines as prescribed. Hippocrates, the wise man of Kos, knew over two millennia ago. Our objective is to comment on the types of studies aimed at understanding and optimizing drug usage and to draw attention to the need to seek approval before using or citing the Morisky adherence scale. Comment: The study of prescribing and how patients use their medicines is important. As part of this effort, the results of investigations of how patients adhere to drug prescriptions can be informative. However, the results are meaningful only if the methods used for doing the measurements are valid and made explicit. We were surprised when a team of our authors were threatened with legal action for citing the Morisky Adherence Scale and explaining how some authors had obtained their adherence scores. Adherence studies are but one facet of the study of prescribing aimed at improving clinical outcomes. Other aspects include investigating the quality of prescribing, and how unnecessary medicines can be deprescribed to improve the quality of care and reduce the risk of adverse effects. What is new and conclusion: The study of optimal prescribing is an important endeavour and adherence studies are but one aspect. We report that using and citing the Morisky Adherence scale in any detail is a risky business. Prior approval is required unless one is prepared to pay up, retrospectively. We require all authors to certify they have no conflicts of interest with respect to the scale.

Recognition of insect pests in the wild plays a key role in crop protection. Large-scale pest recognition in natural scenes is extremely challenging due to significant intra-class variation and small inter-class variation within sub-categories. Existing works typically use state-of-the-art convolutional neural networks (CNNs) to extract global features directly for pest classification, while neglecting the effectiveness of fine-grained features for identifying visually similar pest categories under a specific super-category. In this paper, we propose a saliency guided discriminative learning network (SGDL-Net) to tackle these problems. The proposed SGDL-Net simultaneously mines global features and fine-grained features in a multi-task learning manner. We design two branches with shared parameters for pest datasets with a hierarchical structure: the raw branch and the fine-grained branch. The raw branch is utilized to extract coarse-grained features, i.e., global features, and the fine-grained branch mines fine-grained features through a fine-grained feature mining module (FFMM) as a way to constrain feature learning in the raw branch. In particular, we leverage a salient object location module (SOLM) to locate the salient object in the image and feed it to the fine-grained branch. Finally, through the co-training of the two branches, SGDL-Net is able to learn coarse-grained and fine-grained combined discriminative features via a single CNN. Experimental results show that SGDL-Net achieves state-of-the-art performance on the benchmark dataset IP102 used for insect pest recognition. Meanwhile, ablative studies demonstrate the promise of its application on other hierarchically structured datasets (e.g., CIFAR-100).

Xiao Ran,1 Qin Zhang,2 Shaoping Li,1 Zhen Yu,1 Li Wan,2 Bin Wu,3 Rongxue Wu,4 Shusheng Li1 1Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China; 2Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China; 3Laboratory of Platelet and Endothelium Biology, Department of Transfusion Medicine, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No.1 Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China; 4Department of Biological Sciences Division/Cardiology, University of Chicago, Chicago, IL, 60637, USACorrespondence: Qin Zhang Email qzhang8@tjh.tjmu.cnShusheng Li Email Shushengli16@sina.comAim: Sepsis, an acute, life-threatening dysregulated response to infection, affects practically all aspects of endothelial function. Tissue kallikrein (TK) is a key enzyme in the kallikrein–kinin system (KKS) which has been implicated in endothelial permeability. Thus, we aimed to establish a potentially novel association among TK, endothelial permeability, and sepsis demonstrated by clinical investigation and in vitro studies.Methods: We performed a clinical investigation with the participation of a total of 76 controls, 42 systemic inflammatory response syndrome (SIRS) patients, and 150 patients with sepsis, who were followed-up for 28 days. Circulating TK levels were measured with an enzyme-linked immunosorbent assay. Then, the effect of TK on sepsis-induced endothelial hyperpermeability was evaluated by in vitro study.Results: Data showed a gradual increase in TK level among controls and the patients with SIRS, sepsis, and septic shock (0.288± 0.097 mg/l vs 0.335± 0.149 vs 0.495± 0.170 vs 0.531± 0.188 mg/l, respectively, P < 0.001). Further analysis revealed that plasma TK level was positively associated with the severity and mortality of sepsis and negatively associated with event-free survival during 28 days of follow-up (relative risk, 3.333; 95% CI, 2.255– 4.925; p < 0.001). With a septic model of TK and kallistatin in vitro, we found that TK exacerbated sepsis-induced endothelial hyperpermeability by downregulating zonula occluden-1 (ZO-1) and vascular endothelial (VE)-cadherin, and these could be reversed by kallistatin, an inhibitor of TK.Conclusion: TK can be used in the diagnosis of sepsis and assessment of severity and prognosis of disease. Inhibition of TK may be a novel therapeutic target for sepsis through increasing ZO-1 and VE-cadherin, as well as downregulating endothelial permeability.Keywords: tissue kallikrein, sepsis, mortality, endothelial permeability, junction protein

BACKGROUND For initial respiratory management, continuous positive airway pressure (CPAP) is increasingly used for preterm infants, especially for gestational age less than 32 weeks. However, neonatologists are concerned about the potential risks of CPAP support failure. OBJECTIVES To examine the association between different initial respiratory support modalities and the outcomes of preterm infants at

Background Ability in the activities of daily life is often impaired in the older adults with a neurological disease. The Barthel Index is an instrument used worldwide to assess such ability. The Longshi Scale is a picture-based alternative, but its effectiveness has not been evaluated with older adult subjects. This study was to determine whether the Longshi Scale can effectively quantify the ability of older adults in the activities of daily living by comparing its ratings with those using the Barthel Index. Methods A multi-center cross-sectional study was conducted among patients over 65 years. A total of 2438 patients were divided into three groups, including bedridden, domestic, or community group based on their ability to go out of bed, move outdoors, and return indoors. Their ability in the activities of daily living among three groups was evaluated using both the Longshi Scale and the Barthel Index, and the results were compared. Results There was a significant difference in the average Barthel Index scores of three groups classified using the Longshi Scale. The average Longshi Scale scores also showed significant differences between the four groups classified using the Barthel Index. Spearman correlation coefficients showed strong correlation(>0.83) between the Longshi Scale and Barthel Index scores. Conclusions The Longshi Scale can efficiently distinguish the ability in the activities of daily living of people with a neurological disease. Its rating correlate well with those using the Barthel Index.

Besides high quality perovskites, a precisely designed interface is always necessary to achieve top performance perovskite solar cells. However, this inevitably introduces complexity for fabricatio...

The emission of circularly polarized light is central to many applications, including data storage, optical quantum computation, biosensing, environmental monitoring, and display technologies. An emerging method to induce (chiral) circularly polarized (CP) electroluminescence from the active layer of polymer light-emitting diodes (polymer OLEDs; PLEDs) involves blending achiral polymers with chiral small-molecule additives, where the handedness/sign of the CP light is controlled by the absolute stereochemistry of the small molecule. Through the in-depth study of such a system we report an interesting chiroptical property: the ability to tune the sign of CP light as a function of active layer thickness for a fixed enantiomer of the chiral additive. We demonstrate that it is possible to achieve both efficient (4.0 cd/A) and bright (8000 cd/m2) CP-PLEDs, with high dissymmetry of emission of both left-handed (LH) and right-handed (RH) light, depending on thickness (thin films, 110 nm: gEL = 0.51, thick films, 160 nm: gEL = -1.05, with the terms "thick" and "thin" representing the upper and lower limits of the thickness regime studied), for the same additive enantiomer. We propose that this arises due to an interplay between localized CP emission originating from molecular chirality and CP light amplification or inversion through a chiral medium. We link morphological, spectroscopic, and electronic characterization in thin films and devices with theoretical studies in an effort to determine the factors that underpin these observations. Through the control of active layer thickness and device architecture, this study provides insights into the mechanisms that result in CP luminescence and high performance from CP-PLEDs, as well as demonstrating new opportunities in CP photonic device design.

Background: Diabetic peripheral neuropathy (DPN) affects nearly 50% of the diabetic population. Advanced glycation end products, measured through skin autofluorescence (SAF), play an important role in the diagnosis and prevention of DPN. To date, however, no relevant study has discussed the relationship between SAF and the Chinese population. Objective: We conducted this study to evaluate the association between DPN and SAF among the Chinese population. Methods: In this cross-sectional study, we recruited a total of 820 patients with type 2 diabetes. All of the patients underwent SAF measurements and a nerve conduction study (NCS). Post-SAF characterization, the patients were divided into three groups according to the first and third quartiles of their SAF values (AU) (SAF ≤ 2.2; 2.2 2.7). Based on the results of the NCS, patients were divided into two groups: DPN and non-DPN. Results: When compared with the non-DPN group (n = 275) with the DNP group. The latter had higher SAF values (2.72 ± 0.55 AU vs. 2.17 ± 0.71 AU, P 2.57 ng/mL predicts a threefold increased risk of DPN (p

Background Previous studies have demonstrated that dexmedetomidine improves the quality of postoperative analgesia. In the present study, we performed a meta-analysis of randomized controlled trials to quantify the effect of dexmedetomidine as an adjuvant to sufentanil for postoperative patient-controlled analgesia (PCA). Methods PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched for randomized controlled trials in which dexmedetomidine was used as an adjuvant for PCA with sufentanil. In the retrieved studies, we quantitatively analyzed pain intensity, sufentanil consumption, and drug-related side effects. Results Nine studies with 907 patients were included in this meta-analysis. Compared with sufentanil alone, dexmedetomidine-sufentanil for postoperative intravenous PCA reduced pain intensity at 24 h (mean difference (MD) = − 0.70points; 95% confidence interval (CI): − 1.01, − 0.39; P

Central poststroke pain (CPSP) is a neuropathic pain syndrome arising after a lesion of the central nervous system owing to cerebrovascular insult. Impaired daily activities and reduced quality of life in people suffering from CPSP justify the need for improved treatment. The detailed mechanism of CPSP is not well understood, but central disinhibition has been suggested. Recent reports indicated that epoxyeicosatrienoic acids (EETs), the cytochrome P450 metabolites of arachidonic acid, promoted neuronal survival after stroke, displayed antinociception in peripheral inflammatory pain, and reduced neuronal excitability in seizure model. Here, we tested the hypothesis that 14,15-EET may attenuate CPSP by suppressing thalamic disinhibition through neurosteroids-δ-subunit-containing gamma-aminobutyric acid A receptors (δGABAAR) signaling. In this study, we used a rat model of thalamic hemorrhagic stroke to induce CPSP. Pain behavioral tests revealed that CPSP rats exhibited mechanical allodynia, starting at day 7 postlesion and lasting at least 4 weeks. Analysis of the perithalamic lesion tissue from the brain of CPSP rats demonstrated a decrease of 14,15-EET content, steroidogenic acute regulatory protein expression, and allopregnanolone (AP) production. This was accompanied by reduced δGABAAR expression in the medial thalamus at 4 weeks postlesion. Intrathalamic injection of exogenous 14,15-EET into the ventral posterior lateral nucleus attenuated mechanical allodynia, induced a marked increase in the abundance of the steroidogenic acute regulatory protein and AP along the lesion site and a concomitant increase in δGABAAR expression in the medial thalamus under CPSP condition. However, this antinociceptive effect could be eliminated by the 5α-reductase inhibitor finasteride or dutasteride or GABAAR antagonist bicuculline. Moreover, compared with the current first-line drug gabapentin for central neuropathic pain, an early treatment of EET showed greater efficacy in the secondary prevention of CPSP. Taken together, this study provided a proof of concept that EETs may have anti-CPSP effect by reserving normal thalamic inhibition through AP-δGABAAR signaling. PERSPECTIVE: Agents targeting EETs may serve as potential therapeutic options for stroke, the use of which at the initial period could not only block further nerve damage but also prevent the occurrence of CPSP.

Hypnosis has a therapeutic effect on substance dependence. However, its neural basis remains unclear, which impedes its further clinical applications. This study investigated the mechanisms of smoking treatment based on hypnosis from two perspectives: immediate and follow-up effects. Twenty-four smokers screened from 132 volunteers underwent hypnosis suggestion and performed a smoking-related cue task twice during functional magnetic resonance imaging (fMRI) scanning (in normal and hypnotic states). The number of cigarettes smoked per day was recorded at follow-up visits. The smokers reported decreased craving after hypnosis. The activations in the right dorsal lateral prefrontal cortex (rDLPFC), the left insula and the right middle frontal gyrus (rMFG), and the functional connectivity between the rDLPFC and the left insula were increased in the hypnotic state. The reduced craving was related to the DLPFC-insula network, which reflected the immediate mechanism of hypnosis on smoking. The number of cigarette use at the 1-week and 1 month follow-up was correlated with the rMFG activation which reflecting hypnotic depth, suggesting the follow-up effect of hypnosis on smoking depended on the trait of smokers. We identified two different mechanisms of hypnosis effect on smoking, which have important implications for design and optimization of hypnotic treatments on mental disorders.

The natural images have self-similarities which can be used to improve the image reconstruction. However, the existing video reconstruction algorithms pay more attention to modeling and ignore the importance of priors in the reconstruction. In this paper, the self-similarities are involved in the modeling when the video is reconstructed from temporally compressed video measurements. The proposed reconstruction model includes two parts: First, the video tensor sparsity model is formulated by using a spatial–temporal tensor sparse penalty for similar patches. The Intrinsic Tensor Sparsity (ITS) measure is used as the sparsity measure, which encodes both sparsity insights delivered by the Tucker and CANDECOMP/PARAFAC (CP) decomposition for tensors. Second, 3D video patches are modeled as the Gaussian Joint Sparsity (GJS) by exploiting the temporal similarity to obtain an initial image which has distinct direction structure. GJS is a combination of statistical distribution and joint sparsity model. The experimental results show that both the reconstruction models based on ITS and GJS contribute to improving the quality of the video reconstruction.

Novel small-molecules, B2T and B2F, based on benzobis(thiadiazole) have been designed and synthesized as electron transporting materials for perovskite solar cells (PSCs). Benefiting from the high electron affinity of benzobis(thiadiazole) unit, both B2T and B2F exhibited an efficient electron transporting ability in CH3NH3PbI3-xClx planar-heterojunction (PHJ) PSCs. The device based on B2T exhibited an optimal power-conversion efficiency (PCE) of 13.0%, while that of B2F was 15.0% with a relatively low hysteresis. Compared to B2T device, the higher efficiency of B2F device was mainly due to the impressive increase in short-circuit current density (JSC), from 19.36 mA cm−2 to 22.13 mA cm−2. By comprehensive analysis of the energy level and photoluminescence spectra of the devices, we inferred that the higher JSC was resulted from the lower highest occupied molecular orbital (HOMO) energy level of B2F than B2T, which induced a more efficient hole-blocking and less recombination of charge carriers. Through the molecular design (from thiophene to fluorene), we developed a highly efficient electron transporting material, this strategy may provide a new building block to develop novel efficient interface materials for PSCs.

Post-stroke survivors exhibited cognitive deficits and performed emotional impairment. However, the effect of global cerebral ischemia on standard behavioral measures of emotionality and underlying mechanism remain largely unknown. Our previous work identified that down-regulation of Cdh1 contributed to ischemic neuronal death in rat, thus we hypothesized that Cdh1 exerts a role in emotionality after cerebral ischemia, and we investigated the effect of Cdh1 overexpression on neurogenic behaviors and possible mechanisms in transient global cerebral ischemia reperfusion (tGCI/R) rats. A series of behavioral tests were used to evaluate emotion and cognitive related behaviors, and molecular biological techniques were employed to investigate hippocampal neuroplasticity. The results showed that tGCI/R rats displayed anxiety- and depression-like behaviors and a certain degree of cognitive impairment, and these abnormal behaviors accompanied with a loss of hippocampal synapses and dendritic spines, disruption of dendrite arborization and decline in the level of GAP-43, synaptophysin, synapsin and PSD-95. However, Cdh1 overexpression improved negative emotionality, ameliorated cognitive deficits, rescued hippocampal synapses loss, prevented dendritic network disorganization, and increased the level of synaptic-associated proteins after tGCI/R. Taken together, these findings suggest that Cdh1 overexpression exerts a neuroprotective effect by regulating hippocampal neuroplasticity thus improving negative emotionality and cognitive deficits after tGCI/R.

Nanostructures have proved to be advantageous in light harvesting, improving the power conversion efficiency (PCE) of photovoltaic devices. However, the reported light-harvesting nanostructures all require extra processing beyond that for device fabrication, with multiple steps for nano-patterned structures or plasmonic nano-particles. Here we synthesized a conjugated polymer PFPDI which could simply form a nanostructured film on perovskite by spin coating. PFPDI possesses a perylene diimide-based backbone and phosphite ester pendants, which makes it a robust electron-transporting material (ETM) in perovskite solar cells. Furthermore, the perovskite solar cells with PFPDI as the electron-transporting layer (ETL) exhibited a higher light-harvesting efficiency compared to the standard phenyl-C61-butyric acid methyl ester (PCBM) devices. The JSC of the PFPDI device was enhanced from 19.71 mA cm-2 to 23.43 mA cm-2. SEM images and reflectance spectra confirmed that the PFPDI formed ditch-like nanostructures on perovskite film and induced a better light-harvesting efficiency. Further research indicated that the interaction of P[double bond, length as m-dash]O with Pb was essential to the formation of the nanostructures of PFPDI on perovskite. Therefore, our work not only offers an efficient organic ETM, but also opens up new horizons for simply constructing nanostructures with light-harvesting ability in photovoltaic devices.

AgBiS2 nanorod arrays are grown directly on a substrate by a simple in situ preparation method in this work. TEM characterization shows that a single nanorod is 50 nm in diameter and 180 nm in length. Additionally, the nanostructured AgBiS2 film has a useful band gap (∼1.0 eV) with a very high absorption coefficient (105 cm−1). By applying these nanorods to photovoltaic devices, an efficiency of 1.4% is achieved. This simple preparation method provides a new route for the synthesis of nanostructured materials.

Accurate fetal weight estimation is important for both fetuses and their mothers. The low birth weight (LBW, birth weight

Spiro-OMeTAD is a commonly used hole transport material (HTM) in regular device structures. However, a complex and uncontrollable oxygen doping process is necessary. To avoid the drawbacks of dopants, a polyelectrolyte (P3CT-BN) is introduced as a dopant-free HTM. The CO group on P3CT-BN could interact with bare Pb at the perovskite surface, which facilitates hole transfer at the perovskite/HTL interface. The P3CT-BN layer could reduce interfacial recombination and exhibits outstanding film-forming properties. Thus the efficiency of the best device is improved from 18.26% to 19.05% when replacing Spiro-OMeTAD with P3CT-BN. Moreover, devices based on P3CT-BN exhibit outstanding stability, retaining 80% of their original performance after storage in the atmosphere (30–40% relative humidity) for 1800 h without encapsulation. These results indicate that P3CT-BN can be an effective HTM to realize high efficiency and stable PSCs.

Malignant tumors are a key factor that threatens human health. With the continuous development of molecular biology, immunology and oncology, tumor immunodrugs have gradually become an effective means to suppress malignant tumors after surgery, radiotherapy and chemotherapy. The United States, as a leading country in the development of tumor immunodrugs, has rich clinical trial practice experience and comprehensive clinical trial considerations. Therefore, this article intends to explore the progress of clinical trials of tumor immunodrugs in the United States in terms of the alternative endpoints of clinical trials, clinical trials of adolescent tumor patients, and the design of a single clinical trial main plan for multiple drugs and/or multiple tumor subgroups, thereby providing a reference for optimizing the design of clinical trials in China, expanding the application scope of tumor immunodrugs, and speeding up the process of marketing new drugs.

The trisaccharide, 2'-fucosyllactose (Fucα1-2Galβ1-4Glc; 2'-FL), is the most abundant oligosaccharide in human milk. It has numerous significant biological properties including prebiotics, antibacterial, antiviral, and immunomodulating effects, and has been approved as "generally recognized as safe" (GRAS) by the Food and Drug Administration (FDA) and as a novel food (NF) by the European Food Safety Authority (EFSA). 2'-FL not only serves as a food ingredient added in infant formula, but also as a dietary supplement and medical food material in food bioprocesses. There is considerable commercial interest in 2'-FL for its irreplaceable nutritional applications. This review aims at systematically elaborating key functional properties of 2'-FL as well as its applications. In addition, several approaches for 2'-FL production are described in this review, including chemical, chemo-enzymatical, and cell factory approaches, and the pivotal research results also have been summarized. With the rapid development of metabolic engineering and synthetic biology strategies, using the engineered cell factory for 2'-FL large-scale production might be a promising approach. From an economic and safety point of view, microbial selection for cell factory engineering in 2'-FL bioprocess also should be taken into consideration.

The brain and the spinal cord together make up the central nervous system (CNS). The functions of the human brain have been the focus of neuroscience research for a long time. However, the spinal cord is largely ignored, and the functional interaction of these two parts of the CNS is only partly understood. This study developed a novel method to simultaneously record spinal cord electrophysiology (SCE) and electroencephalography (EEG) signals and validated its performance using a classical resting-state study design with two experimental conditions: eyes-closed (EC) and eyes-open (EO). We recruited nine postherpetic neuralgia patients implanted with a spinal cord stimulator, which was modified to record SCE signals simultaneously with EEG signals. For both EEG and SCE, similar differences were found in delta- and alpha-band oscillations between the EC and EO conditions, and the spectral power of these frequency bands was able to predict EC/EO behaviors. Moreover, causal connectivity analysis suggested a top-down regulation in delta-band oscillations from the brain to the spinal cord. Altogether, this study demonstrates the validity of simultaneous SCE-EEG recording and shows that the novel method is a valuable tool to investigate the brain-spinal interaction. With this method, we can better unite knowledge about the brain and the spinal cord for a deeper understanding of the functions of the whole CNS.

BackgroundMultiple chronic diseases (MCDs) and social isolation are independent risk factors related with stroke and disability, but it is unknown whether the combination of these two conditions resulted from ageing related to functional disability in stroke patients. The purpose of this study was to probe the relationship between combination of MCDs, social isolation and functional disability in elderly stroke patients.MethodsA multicentre and cross-sectional study was conducted in the Departments of Rehabilitation Medicine of 103 hospitals located in 23 cities across China. Stroke patients aged over 60 years were selected as participants. Demographic characteristics, lifestyles and clinical information were investigated by questionnaire and medical records. Multi-nominal logistic regression model was used to explore the association of MCDs, social isolation and their combination with functional disability assessed by Barthel Index Scale.ResultsA total of 4281 elderly stroke patients were included in the final analysis. The proportion of social isolation and MCDs (>1) increased by the severity of functional disability. Social isolation was associated with increased risks for mild (33%), moderate (175%), and severe (833%) functional disability significantly in their comparisons with those without social isolation and MCDs. The intragroup odds ratio (OR) of MCDs increased by its number and the intergroup of OR increased by the severity of functional disability significantly. Social isolation and ≥3 MCDs associated the highest risk for severe (OR= 38.24, 95%CI: 14.76-99.07) and moderate (OR = 9.74, 95%CI: 3.62-26.22) functional disability, but not significant for mild group.ConclusionsMCDs, social isolation, and their combination were associated with functional disability in Chinese elderly stroke patients. Future secondary prevention and rehabilitation for functional disability in this population should underscore both social activity and the combined treatments of MCDs.Clinical Trial Registration NOChiCTR2000034067.

Objective The aim of this study was to evaluate the safety and efficacy of laparoscopy in the treatment of hepatic alveolar echinococcosis (AE). Methods Between January 2018 and December 2019, 213 hepatic AE patients were admitted to the authors' institution. Among them, 165 patients (77.46%, 165/213) underwent surgery. Of 13 patients who underwent laparoscopic treatment, two required conversion to open surgery. The remaining 11 patients (group 1) were analyzed. During the same period, 154 patients underwent open surgery, but only 14 records were compatible with the criteria for the laparoscopic approach and were reviewed retrospectively (group 2). Results Conversion to open surgery occurred in two cases. Both groups were basically consistent in terms of detailed demographic data, characteristics of the lesions, and surgical strategy (P > 0.05). The laparoscopic group not only achieved the same R0 resection as the open group, but the results were also significantly superior to those of the open group in terms of postoperative complications, postoperative catheterization time, and postoperative hospital stay (P = 0.042, P = 0.046, and P = 0.045, respectively). No recurrences were observed in either group during this period. Conclusions Laparoscopic surgery provides a safe and efficacious approach for hepatic AE in selected patients. Large, prospective, randomized trials are needed to confirm its superiority.

Background The lack of knowledge regarding the pathogenesis and host immune response during SARS-CoV-2 infection has limited the development of effective treatments. Thus, we longitudinally investigated the dynamic changes in peripheral blood lymphocyte subsets and parallel changes in cytokine levels in COVID-19 patients with different disease severities to further address disease pathogenesis. Methods A total of 67 patients (10 moderate, 38 severe and 19 critical cases) with COVID-19 admitted to a tertiary care hospital in Wuhan from February 8th to April 6th, 2020 were retrospectively studied. Dynamic data of lymphocyte subsets and inflammatory cytokines were collected. Results On admission, compared with moderate cases, severe and critical cases showed significantly decreased levels of total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells, B cells and NK cells. IL-6 and IL-10 were significantly higher in the critical group. During the following hospitalization period, most of the lymphocyte subsets in the critical group began to recover to levels comparable to those in the severe group from the fourth week after illness onset, except for NK cells, which recovered after the sixth week. A sustained decrease in the lymphocyte subsets and an increase in IL-6 and IL-10 were observed in the nonsurvivors until death. There was a strong negative correlation between IL-6 and IL-10 and total lymphocytes, T lymphocytes, CD4+ T cells, CD8+ T cells and NK cells. Conclusions A sustained decrease in lymphocyte subsets, especially CD4+ T cells and NK cells, interacting with proinflammatory cytokine storms was associated with severe disease and poor prognosis in COVID-19.