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Objective. To explore the application of touching combined with intelligent interaction of voice and rhythm in the nursing of neonatal feeding intolerance and its effect on the quality of life. Methods. A total of 140 newborns with feeding intolerance treated in our hospital from April 2019 to April 2021 were selected. The patients were randomly divided into two groups: the control group and the study group. The control group received touch nursing and the study group received touch combined with intelligent interactive nursing mode of voice, music, and rhythm. The general data, feeding performance, feeding process, growth and development, feeding intolerance, total intestinal feeding, jaundice duration, hospital stay, and quality of life scores were compared between the two groups. Results. First of all, we compared the general data of the two groups. There was no significant difference in gestational age, sex, mode of delivery, birth weight, head circumference, body length, Apgar score, and other general data between the two groups. Second, we compared the feeding performance of the two groups. Before nursing, there was no significant difference between the two groups ( P > 0.05 ). After nursing, the feeding rate, milk intake ratio, and proficiency of the two groups increased, and the comparison between the two groups. The feeding rate, milk intake ratio, and proficiency of the study group were better than those of the control group. In terms of the feeding process of the two groups, the days of oral feeding, complete import feeding, feeding conversion, and indwelling gastric tube in the study group were lower than those in the control group ( P < 0.05 ). In terms of the growth and development of the two groups, the recovery time of birth weight in the study group was lower than that in the control group, and the growth of body weight, length, and head circumference at 14 days in the study group was higher than those in the control group. The feeding intolerance, the duration of jaundice, and the days of hospitalization in the study group were lower than those in the control group ( P < 0.05 ). Moreover, the feeding intolerance, the duration of jaundice, and the days of hospitalization in the study group were lower than those in the control group ( P < 0.05 ). Finally, we compared the scores of qualities of life between the two groups. The physiological function, psychological function, and social function of the study group were lower than those of the control group ( P < 0.05 ). The physiological function, psychological function, and social function of the study group were lower than those of the control group ( P < 0.05 ). Conclusion. The application of touching combined with phonetic rhythm intelligent interaction technology in the nursing of neonatal feeding intolerance can promote the faster development and maturity of neonatal gastrointestinal function, improve gastrointestinal motility, shorten the time of parenteral nutrition in newborns, achieve total enteral feeding faster, and promote neonatal growth and development, so as to shorten the duration of hospitalization, improve the tolerance of neonatal gastrointestinal feeding, and improve the quality of life.

Mei-Yu Lv, Li-Xia Qiang, Bao-Cai Wang, Yue-Peng Zhang, Zhi-Heng Li, Xiang-Shun Li, Ling-Ling Jin, Shou-De Jin Department of Respiratory Medicine, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of ChinaCorrespondence: Shou-De Jin, Department of Respiratory Medicine, The Fourth Affiliated Hospital of Harbin Medical University, No. 37 Yiyuan Street, Nangang District, Harbin, 150001, People’s Republic of China, Tel/Fax +86 0451-85939123, Email jinshoude@163.comPurpose: Pulmonary surfactant proteins A (SP-A) and D (SP-D) are lectins, involved in host defense and regulation of pulmonary inflammatory response. However, studies on the assessment of COPD progress are limited.Patients and Methods: Pulmonary surfactant proteins were obtained from the COPD mouse model induced by cigarette and lipopolysaccharide, and the specimens of peripheral blood and bronchoalveolar lavage (BALF) in COPD populations. H&E staining and RT-PCR were performed to demonstrate the successfully established of the mouse model. The expression of SP-A and SP-D in mice was detected by Western Blot and immunohistochemistry, while the proteins in human samples were measured by ELISA. Pulmonary function test, inflammatory factors (CRP, WBC, NLR, PCT, EOS, PLT), dyspnea index score (mMRC and CAT), length of hospital stay, incidence of complications and ventilator use were collected to assess airway remodeling and progression of COPD.Results: COPD model mice with emphysema and airway wall thickening were more prone to have decreased SP-A, SP-D and increased TNF-α, TGF-β, and NF-kb in lung tissue. In humans, SP-A and SP-D decreased in BALF, but increased in serum. The serum SP-A and SP-D were negatively correlated with FVC, FEV1, FEV1/FVC, and positively correlated with CRP, WBC, NLR, mMRC and CAT scores (P < 0.05, respectively). The lower the SP-A and SP-D in BALF, the worse the lung function and the increased probability of complications and ventilator use. Moreover, the same trend emerged in COPD patients grouped according to GOLD severity grade (Gold 1– 2 group vs Gold 3– 4 group). The worse the patient’s condition, the more pronounced the change.Conclusion: This study suggests that SP-A and SP-D may be related to the progression and prognostic evaluation of COPD in terms of airway remodeling, inflammatory response and clinical symptoms, and emphasizes the necessity of future studies of surfactant protein markers in COPD.Keywords: COPD, pulmonary surfactant protein A and D, airway remodeling

The cerebral ischemia-reperfusion (I/R) model is crucial for the study of cerebral stroke. Chrysophanol (Chry) can protect nerve damage of mice in cerebral ischemia-reperfusion injury. This study aimed at investigating the neuroprotective effects of chrysophanol through mitochondrial autophagy in mice with ischemia-reperfusion injury.Adult mice were stochastically divided into five groups: sham, I/R (solvent), I/R+Chry (dose, 10.0ml/kg), I/R+Chry (dose, 1.0ml/kg), and I/R+Chry (dose, 0.1ml/kg). The cerebral ischemia-reperfusion model was made in I/R and I/R+Chry groups. The changes in hippocampal formation were observed by hematoxylin and eosin (HE) staining. The expressions of LC3B-II and LC3B-I protein in hippocampus were demonstrated by western blot (WB). The fluorescence intensities of NIX, LC3B, and mitochondria were detected by immunohistochemistry fluorescent (IF).Comparing with the I/R group, the I/R+Chry groups showed improvements in reducing the damage on the hippocampus, indicated by the reduced ratio of LC3B-II and LC3B-I protein, decreased fluorescence intensity of NIX and LC3B, and increased intensity of mitochondrial fluorescence.Our study showed that chrysophanol may regulate mitochondrial autophagy through NIX protein and alleviate the damage of hippocampus through decreasing the level of mitochondrial autophagy.

Treatment of late-stage lung cancer has witnessed limited advances. In contrast to the tremendous efforts toward improving adaptive immunity, approaches to modulating innate immunity are relatively immature. As important innate immune cells, tumor-associated macrophages (TAMs) account for a substantial fraction of tumor-infiltrating lymphocytes, which not only reverses the immune-suppressive tumor microenvironment but also facilitates an adaptive immune response. In this study, we developed a tumor-specific MMP-2-responsive CD47 blockage (TMCB) strategy to enable effective cancer immunotherapy. Briefly, the matrix metalloproteinase-2 (MMP-2)-responsive self-assembly peptide specifically recognizes CD47, which is highly expressed in lung tumor cells. Second, the MMP-2-responsive self-assembly peptide is efficiently cleaved by MMP-2, which is overexpressed in the tumor microenvironment. Finally, the generated residual peptide naturally self-assembles into peptide-based nanofibers. The in situ constructed nanofibers inhibit the canonical CD47 "Do not eat me" signal expressed on tumor cells to promote phagocytosis of tumor cells by macrophages, which further induces effective antigen presentation and initiates T cell-mediated adaptive immune responses to inhibit tumor growth. Thus, we described a peptide-based TMCB strategy that induces both innate and adaptive immune systems to inhibit tumor growth.

East Asians treated with potent P2Y12 inhibitors (prasugrel or ticagrelor) generally experience more intense platelet inhibitory responses resulting in an increased risk of major bleeding. Whether a half-dose de-escalation strategy improves the net clinical benefit in Korean patients with acute coronary syndrome (ACS) remains uncertain. A total of 120 patients were pragmatically randomized to either prasugrel (n = 39, 60 mg loading dose (LD)/10 mg maintenance dose (MD)), ticagrelor (n = 40, 180 mg LD/90 mg MD), or clopidogrel (n = 41, 600 mg LD/75 mg MD) followed by a half-dose reduction at 1 month, or conventional dose 75 mg clopidogrel. The primary endpoint was the incidence of optimal platelet reactivity (OPR), defined as a P2Y12 reaction unit (PRU) value between 85 and 208 (by VerifyNow) at 3 months. Ticagrelor treatment achieved a significantly lower PRU compared with prasugrel and clopidogrel (31.0 ± 34.5 vs. 93.2 ± 57.1 vs. 153.1 ± 69.4), resulting in the lowest rate of OPR (12.5% vs. 48.7% vs. 63.4%). At 9 months, the minor bleeding was significantly higher with potent P2Y12 inhibitors than with clopidogrel (31.6% vs. 12.2%, HR, 2.93, 95% CI, 1.12–7.75). Only a few patients experienced ischemic complications. In Korean ACS patients, a de-escalation strategy with half-dose ticagrelor and prasugrel from standard dose increased the OPR rate significantly. Half-dose ticagrelor had a lower OPR rate and greater platelet inhibition compared with half-dose prasugrel as well as conventional-dose clopidogrel. Optimal dose reduction strategies for potent P2Y12 inhibitors require further investigation to balance safety and efficacy.

Graphical abstract Abbreviation: SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; COVID-19: Coronavirus Disease 2019., Highlights • TCM could reduce the all-cause mortality in COVID-19 patients. • TCM could inhibit virus replication and transcription of SARS-CoV-2. • TCM can attenuate the cytokine storm and immune deficiency caused by the SARS-CoV-2., Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third coronavirus causing serious human disease to spread across the world in the past 20 years, after SARS and Middle East respiratory syndrome. As of mid-September 2020, more than 200 countries and territories have reported 30 million cases of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, including 950,000 deaths. Supportive treatment remains the mainstay of therapy for COVID-19. The World Health Organization reported that four candidate drugs, including remdesivir, are ineffective or have little effect on COVID-19. According to China News, 90 % of Chinese patients with COVID-19 use traditional Chinese medicine (TCM), with an effectiveness rate of 80 %, and no deterioration in patient condition. We have compiled the direct evidence of TCM treatment for COVID-19 as of December 31, 2020. We describe the advantages of TCM in the treatment of COVID-19 based on clinical evidence and the required methods for its clinical use. TCM can inhibit virus replication and transcription, prevent the combination of SARS-CoV-2 and the host, and attenuate the cytokine storm and immune deficiency caused by the virus infection. The cooperation of many countries is required to establish international guidelines regarding the use of TCM in patients with severe COVID-19 from other regions and of different ethnicities. Studies on the psychological abnormalities in patients with COVID-19, and medical staff, is lacking; it is necessary to provide a complete chain of evidence to determine the efficacy of TCM in the related prevention, treatment, and recovery. This study aims to provide a reference for the rational use of TCM in the treatment of COVID-19.

Background: East Asian patients receiving treatment with the potent P2Y12 inhibitors prasugrel or ticagrelor experience more potent platelet inhibition than with clopidogrel. Methods: This study investigated differences in OPR rates with reduced doses of prasugrel (n = 38) or ticagrelor (n = 40) for maintenance therapy in 118 Korean ACS patients who had undergone PCI, in comparison to conventional-dose clopidogrel (n = 40). We assessed drug responses at one- and three-months post-PCI with VerifyNow and multiple electrode aggregometry assays. Results: At the one-month period, patients receiving standard-dose prasugrel or ticagrelor had lower platelet reactivity as determined by the three assays than those receiving the conventional dose of clopidogrel (VN: p = 0.000; MEA: p = 0.000; LTA: p = 0.000). At the 3-month point, platelet reactivity was lower in those receiving reduced-dose prasugrel or ticagrelor than the clopidogrel-treated patients (VN: p = 0.000; MEA: p = 0.012; LTA: p = 0.002). Prasugrel resulted in significantly lower platelet inhibition than ticagrelor as determined by VN and LTA (VN: p = 0.000; LTA: p = 0.003). At three months, there was a significant overall difference in OPR among the three groups when measured by VN (p < 0.001), but not when measured by MEA (p = 0.596). OPR in the reduced-dose prasugrel group was not significantly different to the clopidogrel group at three months (VN: p = 0.180; MEA: p = 0.711). OPR in the reduced-dose ticagrelor group was similar to clopidogrel as determined by MEA at three months, but was different when assessed by VN (VN: p = 0.000; MEA: p = 0.540). Compared to standard-dose, the reduced-dose prasugrel OPR rate was significantly increased (VN: p = 0.008; MEA: p = 0.020). Conclusions: OPR values for reduced-dose prasugrel and conventional-dose clopidogrel at three months were similar but higher than for reduced-dose ticagrelor as determined by VN, but no differences were noted by MEA. The MEA assay might have less sensitivity and consistency than the VN assay. Further studies are needed to explore this discrepancy.

Traditional Chinese medicine (TCM) has played a significant role in the treatment of coronavirus disease 2019 (COVID-19) in Wuhan City. During the epidemic, Academician Tong Xiaolin suggested a close association of COVID-19 with cold-dampness, an etiological factor in TCM, by summarizing the characteristics of the COVID-19 patients in Wuhan. and the theory of Cold-dampness Plague was proposed. Based on the Cold-dampness Plague theory, a series of TCM drugs, such as Huoxiang Zhengqi Dropping Pills, Lianhua Qingwen Granules Hanshiyi Formula, and Tongzhi Granule were developed for the different stages, namely mild, moderate, severe, recovery, of the COVID-19. In addition, clinical evidences were obtained through randomized clinical trials or retrospective cohort studies. The Anti-SARS-CoV-2 mechanism of the TCM prescriptions were then summarized from the four aspects: targeting the ACE2 and 3CLPro, targeting cytokines, targeting acute immune responses to SARS-CoV-2, and targeting pulmonary fibrosis. Despite the clinical efficacy and therapeutic pharmacology speculation, more studies such as large-scale randomized clinical trials, cell and animal experiments are needed to further verify the theory of the Cold-dampness Plague in COVID-19 patients.

Background Globally, although the jellyfish population has increased in recent years, ocular jellyfish stings remain an uncommon ophthalmic emergency, and have been rarely reported. According to a few previous reports, ocular jellyfish stings may cause anterior segment disorders, and most of these injuries were self-limited and spontaneously resolved within 24 to 48 h. Case summary A brother and sister both presented with severe fundus complications several years after ocular jellyfish stings and both had prolonged blurred vision. To our knowledge, such fundus lesions induced by jellyfish stings have not been reported previously. Conclusion The fundus status of patients following ocular jellyfish stings should be carefully monitored in cases of irreversible ocular damage.

BACKGROUND: Cutaneous epithelioid angiomatous nodules (CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confused with benign and malignant vascular tumors. However, the etiology of CEAN remains unclear, and no association with infection, trauma, or immunosuppression has been described. This case study indicated that CEAN is closely related to the patient’s impaired immune status and may be induced by cyclosporine. CASE SUMMARY: A 19-year-old boy with nephrotic syndrome (NS) developed large CEAN on the left foot during treatment for NS. He had repeated relapses of edema in the past 6 years and different types of immunosuppressants were administered including methylprednisolone, mycophenolate mofetil, tacrolimus and cyclosporine; the dosages of these drugs were frequently adjusted. The patient had been receiving cyclosporine and methylprednisolone for 7 mo before he developed CEAN. Cyclosporine was discontinued due to its side effects on skin. After cessation of cyclosporine and 16 mo follow-up, the nodules gradually disappeared without any other treatment for the CEAN. CONCLUSION: Impaired immune status is proposed to be a risk factor for CEAN, which may be induced by cyclosporine.

Background: Panax notoginseng, a Chinese herbal medicine, has been widely used to treat vascular diseases. Diabetic retinopathy (DR) is one of the complications of diabetic microangiopathy. According to recent studies, the application of Panax notoginseng extract and related Chinese patent medicine preparations can significantly improve DR. However, the pharmacological mechanisms remain unclear. Therefore, the purpose of this study was to decipher the potential mechanism of Panax notoginseng treatment of DR using network pharmacology. Methods: We evaluated and screened the active compounds of Panax notoginseng using the Traditional Chinese Medicine Systems Pharmacology database and collected potential targets of the compounds by target fishing. A multi-source database was also used to organize targets of DR. The potential targets as the treatment of DR with Panax notoginseng were then obtained by matching the compound targets with the DR targets. Using protein-protein interaction networks and topological analysis, interactions between potential targets were identified. In addition, we also performed gene ontology-biological process and pathway enrichment analysis for the potential targets by using the Biological Information Annotation Database. Results: Eight active ingredients of Panax notoginseng and 31 potential targets for the treatment of DR were identified. The screening and enrichment analysis revealed that the treatment of DR using Panax notoginseng primarily involved 28 biological processes and 10 related pathways. Further analyses indicated that angiogenesis, inflammatory reactions, and apoptosis may be the main processes involved in the treatment of DR with Panax notoginseng. In addition, we determined that the mechanism of intervention of Panax notoginseng in treating DR may involve five core targets, VEGFA, MMP-9, MMP-2, FGF2, and COX-2. Conclusion: Panax notoginseng may treat diabetic retinopathy through the mechanism of network pharmacological analysis. The underlying molecular mechanisms were closely related to the intervention of angiogenesis, inflammation, and apoptosis with VEGFA, MMP-9, MMP-2, FGF2, and COX-2 being possible targets.

Aim Early interventions in prediabetes can prevent or delay the incidence of type 2 diabetes mellitus (T2DM). The aim of this review was to assess the efficacy and safety of traditional Chinese patent medicine (TCPM) on the prevention of T2DM. Methods Seven electronic databases were searched to identify eligible trials published until June 1, 2016. Randomized controlled trials (RCTs) that compared TCPM plus lifestyle modification (LM) versus LM alone were included for in the. RCTs that used TCPM plus LM compared with placebo plus LM were also included. Methodological quality was assessed using the Cochrane Collaboration Risk of Bias tool. A random- or fixed-effect model was used to analyze outcomes that were expressed as risk ratios (RRs) or mean differences (MD), and the I2 statistic was used to assess heterogeneity. Results Twenty-six trials with a total of 4169 participants met the inclusion criteria. Subgroup analysis confirmed that, compared with LM alone, TCPM and LM together were significantly better at reducing diabetes (RR, 0.47; 95% CI, 0.38–0.59) and normalizing blood glucose (RR, 0.76; 95% CI, 0.69–0.85). They also caused a greater reduction in fasting plasma glucose (FBG) (MD, −0.37; 95% CI, −0.62 to −0.13), 2-h plasma glucose (2 h PG) (MD, −0.91; 95% CI, −1.35 to −0.47) and body mass index (BMI) (MD, −0.45; 95% CI, −0.76 to −0.14). Compared with placebo plus LM, TCPM plus LM was superior at reducing diabetes (RR, 0.55; 95% CI, 0.45–0.68) and normalizing blood glucose (RR, 0.62; 95% CI, 0.50–0.76). The interventions were also associated with a decline in FBG levels (MD, −0.68; 95% CI, −1.25 to −0.11) and 2 h PG levels (MD, −1.07; 95% CI, −1.85 to −0.29). There were no significant differences in adverse events in either group. Subgroup and sensitivity analyses found no significant difference in overall effects among all study characteristics, indicating that the overall effects were stable. Generally, the quality of evidence was low for the effect of TCPM on the incidence of diabetes and normalization of blood glucose, and was very low for the effects of TCPM on FBG, 2 h PG, and BMI. Conclusions Based on this systematic review, TCPM may reduce the risk of progression to T2DM and increase the possibility of regression toward normoglycemia. As a result of the methodological drawbacks of the included studies, more rigorously designed RCTs are required to more reliably assess the efficacy of TCPM and long-term follow-up is needed before TCPM can be recommended for prediabetic patients.

To evaluate the feasibility of a double-acquisition coronary CT angiography (CCTA) protocol in the presence and absence of an intravenous (IV) vasodilator infusion for detecting vasospastic angina. Twenty patients with a high clinical probability of vasospastic angina were enrolled. All subjects underwent baseline CCTA without a vasodilator in the early morning followed by a catheterized coronary angiography with ergonovine provocation test. Within 3 days, all subjects underwent repeat CCTA during a continuous IV infusion of nitrate. Vasospastic angina as detected by CCTA was defined as significant stenosis (≥50 %) with negative remodelling without definite plaques or diffuse small diameter (

Background: Total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH) is more complex than the normal hip, with large replacement risks and many complications. Although nonosteotomy THA is convenient to perform, femoral osteotomy shortening can avoid blood vessel and nerve traction injuries. This study aimed to compare osteotomy THA with nonosteotomy to determine reasonable options for operative management of DDH. Methods: Data on 48 DDH patients who underwent THA were analyzed retrospectively. The patients were divided into two groups: Group A 29 cases (nonosteotomy), and group B 19 cases (osteotomy). Harris and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, limb length discrepancy (LLD), radiological data on the hip, and claudication were evaluated. Data were analyzed by using paired-sample Student's t-test, independent-sample Student's t-test, and Pearson's Chi-square test; the test level was α =0.05. Results: Postoperative Harris (90.7 ± 5.1) and WOMAC scores (88.0 ± 10.6) were significantly improved compared with preoperative Harris (44.8 ± 5.7) and WOMAC scores (42.0 ± 5.3) in group A (P < 0.05). Postoperative Harris (90.4 ± 2.8) and WOMAC scores (88.2 ± 5.9) were significantly improved compared with preoperative Harris (44.4 ± 4.2) and WOMAC scores (43.2 ± 4.3) in group B (P < 0.05). One case of dislocation occurred in group A; after closed reduction, dislocation did not recur. In group A, 2 patients developed cutaneous branch injury of the femoral nerve, which spontaneously recovered without treatment. Postoperative LLD >2 cm was seen in one case in group A and five cases in group B. Postoperative claudication showed no significant difference between the two groups (P > 0.05). No patients developed infection; postoperative X-rays showed that the location of the prosthesis was satisfactory, and the surrounding bone was not dissolved. Conclusions: THA is effective and safe for DDH. For unilateral high dislocation DDH patients with limb lengthening ≤4 cm and good tissue conditions, THA without femoral osteotomy may be considered.

BACKGROUND Tianqi Jiangtang Capsule is a commonly used Chinese patent medicine for the treatment of type 2 diabetes mellitus (T2DM) in China. The purpose of this study is to systematically evaluate the clinical efficacy and safety of Tianqi Jiangtang Capsule in the treatment of type 2 diabetes mellitus. METHODS Randomized controlled trials (RCTs) of Tianqi Jiangtang Capsule in the treatment of type 2 diabetes mellitus were retrieved. According to the requirements of Cochrane Manual, the included literature was assessed and meta-analyzed with RevMan 5.3 software. RESULTS (1) Meta-analysis included 8 RCTs and 1029 participants.(2) There were two studies on adverse reactions.(3) Meta-analysis showed that Tianqi Jiangtang Capsule could significantly reduce HbA1c (n = 1029; MD, -0.31; 95% CI, [-0.43 to -0.19]; P

Based on the background of Dalian subway running through bridge pile foundation, a 3d numerical model is built by the finite element software MIDAS/GTS in order to research the laws of the internal force and the displacement of the pile and soil during the Construction process. The outcome reflects that the sedimentation value of the top of the pile is bigger than others. Because the bigger thrust about the shield machine, the horizontal displacement of the pile is increasing at first and decreasing at last from a positive into a negative. Because of the loss of the soil, the soil beside the pile collapses and causes strong friction force. The surface sedimentation value which is near the central line of the tunnel is bigger than other place. This paper is of good reference roles in the similar underground engineering in Dalian.

BACKGROUND There is insufficient data on the efficacy of prasugrel and ticagrelor in Korean patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS I n the current double-blind, prospective pilot study, 39 patients with STEMI undergoing primary percutaneous coronary intervention were randomized to receive prasugrel 60 mg loading dose (LD) followed by 10 mg daily maintenance dose (n=19), or ticagrelor 180 mg LD followed by 90 mg twice daily maintenance dose (n=20). We assessed platelet reactivity with the VerifyNow and Vasodilator-Stimulated Phosphoprotein (VASP) P2Y12 assays. Compared to baseline platelet reactivity, both prasugrel and ticagrelor groups achieved similar and significantly lower P2Y12 reaction units (PRU) (259 [IQR: 230 to 281] vs. 28 [12 to 55] for prasugrel; 261 [196 to 286] vs. 43 [11 to 61] for ticagrelor), and platelet reactivity indexes (PRI) (51.2% [39.3 to 61.3] vs. 8.1% [6.1 to 14.7] for prasugrel; 47.5% [38.4 to 50.4] vs. 11.2% [7.1 to 15.5] for ticagrelor, all P values

Based on the problem of tunnel running through bridge pile foundation, a 3d numerical model is built by the finite element software MIDAS/GTS in order to research the internal force and the displacement of the pile and soil during the Construction process. The sedimentation value of the top of the pile is bigger than others. Because the bigger thrust about the Shield machine, the horizontal displacement of the pile is increasing at first and decreasing at last from a positive into a negative. Because of the loss of the soil, the soil beside the pile collapses and causes strong friction force. The surface sedimentation value which is near the central line of the tunnel is bigger than other place. This paper is of good reference roles in the similar underground engineering in Dalian.

Perfluorinated compounds (PFCs) have received increasing attention worldwide recently because of potential risk to aquatic environment and living organisms. Herein, occurrence and spatial distributions of 17 selected PFCs were investigated in surface water adjacent to potential industrial emission categories in Shanghai. The results showed the distributions of PFCs in the ambient rivers were greatly affected by those industrial sources. Perfluorooctanoic acid (PFOA) and other short-chain PFCs such as perfluoropentanoic acid (PFPeA) and perfluorooctanesulfonate (PFBS) were detected as the predominant species in all samples. Specifically, the total concentrations of PFCs (∑PFCs) near the airport ranged from 142 to 264ngL-1, with PFOA, PFPeA, and PFBS as most prevalent. While near the fluorochemical plant and metal plating, concentrations of ∑PFCs ranged from 200 to 2143ngL-1 and 211ngL-1 to 705ngL-1; and PFOA was the predominant individual PFCs, with the highest concentration of 1985ngL-1. However, concentrations of PFOS were found at relatively low level, which ranged from < 0.06 to 4.44ngL-1. The Spearman correlation analysis of concentration of individual PFCs showed that PFOA and perfluorohexanoic acid (PFHxA) was positive, while the correlation between PFOA and perfluorohexansulfonate (PFHxS) was negative near the airport, indicating PFOA and PFHxA may share common sources. Preliminary ecological risk evaluation of PFCs in adjacent water of the industrial emission areas suggested these emission categories posed higher risks than other area, although the risk level was still relatively safe.

The dynamic viscoelasticity of the outer and inner part of bamboo with different ages was investigated using Dynamic Mechanical Thermal Analyzer (DMA). The results showed that,storage modulus (E’) and loss modulus (E’’) of both outer and inner part of bamboo were increased at temperature between 25-250°Cas the bamboo ages increasing. In addition, E’ and E’’ of the outer part of bamboo were higher of the inner part with the same bamboo age. Also a significant loss peak in E’’~T curves between 190-210°C was found. The peak values of E’’~ T curves of the outer part only shown slight variation with bamboo age increasing. However, significantly different of peak values was found in the inner part. This was caused by the difference of the chemical composition in outer and inner part of bamboo with different ages. The width of E’’ peak varied slightly in outer bamboo of different ages, but in the inner part , it was increased as the age increasing. This revealed that in the outer part of different ages, the chemical composition of the molecular values was closer, In the inner bamboo, it was increased as the age increasing..

Using mechanism design and dynamic analysis software, the simulation is conducted about grasping operation and moving objects for multi redundant manipulator on the basis of mechanism design and theoretical research, as well as the snake crawling motion simulation. The simulation results validate the correctness of theory analysis. The each joint driving torque data and curve provided the effective data basis for the design and development of a prototype.

In this paper, the behavior of composite stub columns under different loading conditions is studied using the finite element method. The accuracy of the theoretical method is validated by comparing with the experimental results. The behavior of specimen under different loading conditions is analyzed. Then, based on the finite element method, the comparison of mechanical behavior under three typical loading conditions is studied. The results show that the difference on bearing capacity will become larger with the increase of steel area to concrete area ratio. For the core concrete loaded specimen with lower steel area-to-concrete area ratio, whose bearing capacity is the lowest, but its ductility is very good. With the increase of the steel yield strength, the bearing capacity will increase evidently for specimen loaded simultaneously. While for the specimen with only core concrete loaded, the steel yield strength has little influence except increase of ductility.

This paper discusses the pole placement with low-order controllers, e.g., PID type controllers and phase lead/lag compensators, using parameter space approach. The damping ratio sector region and the relative stability region in s-plane, which form a trapezoid region in the left-half of s-plane, are mapped into the controller parameters space. Thus, the corresponding controller parameters can place all the closed-loop poles in a specified trapezoid region, and guarantee the performances of the closed-loop systems. The advantage of the proposed method is that it is simple and can be applied to time-delay systems. A simulation example is given to illustrate the effectiveness of the design.

Dynamic mechanical properties of radial curtain plybamboo and its constitution unit-radial bamboo strip were studied using dynamic mechanical analysis (DMA). The results showed: experimental temperature had great effect on dynamic mechanical properties, the shape and alignment of radial bamboo strips were closely related the dynamic mechanical properties of radial curtain plybamboo.

The acoustic performance of sound-isolating and decoupled tiles is studied from macroscopic and microscopic. First, the sound absorption and reverse sound insulation performance of sound-isolating and decoupled tiles is studied based on laminated media; then the acoustic decoupling materials influence on acoustic radiation of double cylindrical shell underwater is studied, using a double-layer cylindrical structure of large-scale as experimental model .There are large amount of operating modes designed in this experiment, such as all laying, partial laying, laying and so on. The results show that sound-isolating and decoupled tiles not only have the effect of weakening the absorption of reflections, but also have reverse sound insulation effect, which increases as frequency increases; for single point mechanical vibration, the tiles can effectively inhibit vibration and sound radiation of high frequency in the double shell.

This paper discusses the parameters tuning of fractional-order controller satisfying the desired gain-margin and phase-margin specifications in terms of a stability equation method applicable to fractional-delay systems. The tuning procedure is then applied to the level control of double water tank, which is modeled as a second-order transfer function with time-delay. The Matlab simulations and the experiments on the water tank device show the effectiveness of the tuning and the benefits of using fractional-order controllers.

It is necessary and valuable to build the transferring relationship between test bed datum and ship datum for satisfying the boundary requirements of exciting forces in ship’s vibration-acoustic analysis. Principle of the force transferring technique for machineries with multiple supporting points is introduced first, and then the measurement method for free velocities of machineries is given. A method for transferring test bed datum to ship datum of machinery force characteristics is discussed and applied to deal with a practical problem, in which the numerical simulation is used for predicting admittance of ship mounting seat absenting reality. Experimental results show that the proposed method is valid.

Finite cylindrical shells with stiffened ribs are major structure of cabin on the submerged or underwater vehicles. This paper aims to probe into the feasibility of sound radiation simulation of underwater structure based on ABAQUS. ABAQUS is used to compute and analysis the underwater sound radiation rule of double cylindrical shell structure. And the computation data agrees with the experimental data basically. Adopting boundary impedance technique and acoustics IEM technique to simulation infinite flow field is feasible, and adopting acoustics IEM technique has much better performance. Boundary impedance technique is promoted for the concerning of accuracy. The results indicate that ABAQUS is appropriate to solve underwater sound radiation problem and it can satisfy the requirement of project application, which provides a new analysis method.

With the SMA (Shape Memory Alloy) banner model, the effect of pre-stressing and displacement, stiffness and length to the energy dissipation ratio is studied. The two equations, which are of pre-stressing and displacement to the energy dissipation ratio are proposed. The method are put forward to confirm the stiffness and length of SMA . Based on the above analysis, a new pull-press SMA damper is designed. The simulation analysis on seismic response of five-floor frame with SMA damper shows that the displacement and acceleration of the top floor are reduced by 50﹪at least. It verifies that this kind of SMA damper can availably suppress the seismic response of structure.

We wished to elucidate a potential role of the tumor necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible molecule 14 (Fn14) axis in myocardial fibrosis. Stimulation of neonatal rat cardiac fibroblasts (CFs) with TWEAK could increase CFs numbers and collagen synthesis. Conversely, when CFs were pretreated with siRNA against Fn14, induction of cell proliferation and collagen synthesis by TWEAK were inhibited. Pretreatment with TWEAK on CFs induced activation of the nuclear factor-kappaB (NF-кB) pathway and subsequently increased the production of metalloproteinase-9 (MMP-9). Cell treatment with siRNA against Fn14 led to inhibition of the NF-кB pathway. Additionally, after stimulation of cell with ammonium pyrrolidine dithiocarbamate, cell proliferation and collagen synthesis induced by NF-кB and the upregulation of MMP-9 production were inhibited. The present study suggested that the TWEAK/Fn14 axis increased cell proliferation and collagen synthesis by activating the NF-кB pathway and increasing MMP-9 activity. This axis may be important for regulating myocardial fibrosis.

Redox effector factor (Ref-1) is a sensitive marker for oxidative cellular injury. The aim of this study was to investigate the effects of acupuncture on hippocampal Ref-1 expression in cerebral multi-infarction rats. The rats with reference memory impairment were randomly allocated to three groups: impaired group, acupuncture group and placebo acupuncture group. Moreover, normal group and sham-operated group were set as control groups. Morris water maze test showed that cerebral multi-infarction rats did not present significant changes in spatial working memory performance. Further investigation by immunohistochemistry revealed that acupunctural treatment significantly increased the expression of Ref-1 in the hippocampus of the impaired rats. These findings suggested that the spatial working memory was unaffected in the cerebral multi-infarction rats although spatial reference memory deficits were detected in our previous study; in addition, acupuncture could increase the Ref-1 expression, consequently exerting the anti-oxidant effects.

Objective To assess hard major adverse clinical events (HMACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO). Background There are limited data regarding long-term HMACE risks based on PCI-CTO success. Methods First-time PCI was performed in 438 consecutive patients with 473 target CTO lesions. Patients after procedural success (n = 355; 378 CTO lesions) and failure (n = 83; 95 CTO lesions) were followed for an average 40 months (7–77 months range). We compared HMACE (composite of cardiac death, non-fatal myocardial infarction (MI), and stroke) dependent on the success of PCI. Results The incidence of HMACE was low, with a total of 16 events, and did not differ {6% vs.3.1%, HR = 0.47; CI [0.16–1.35; p = 0.162} dependent on the success of PCI-CTO. There were less cardiac deaths {0.3% vs. 1.2%, RR = 0.22; CI [0.01–3.50];p = 0.283}, non fatal MI {1.1% vs.3.6%, RR = 0.27; CI [0.06–1.22], p = 0.089}, but more strokes {1.7% vs.1.2%, RR = 1.32; CI [0.16–10.99], p = 0.795} after successful PCI-CTO. Conclusions The risks of HMACE after PCI-CTO over long-term follow-up were minimal, and do not depend on the procedure success. This unexpected finding somewhat challenge the aggressive interventional approach, and should be confirmed in the adequately powered randomized trial.

The feed drive system model of NC precision sphere grinding machine (MD6040) is constructed. Although a large number of researchers pay more attention on advanced controllers, most high performance machine tools still adopt PID (Proportion Integration Differentiation) controller today. In this paper, PDF (Pseudo-Derivative Feedback) controller and PDFF (Pseudo-Derivative Control with feedforward Gain) controller which evolved from PID controller are studied. The performance of PID controller, PDF controller and PDFF controller is investigated by simulation and experiment. Both simulation results and experiment results showed that PID controller has severe overshoot and less rise time, PDF controller has strong robustness and long rise time and PDFF controller possesses the advantages of the other two controllers. PDFF controller is more suitable for NC precision sphere grinding machine feed drive system.

It is much valuable to find a method for predicting the middle and high acoustic characteristics of big and complex structures such as ships and airplanes. Impact of the ring frequency and the damping on the vibration transmission is discussed firstly. Then the feasibility of the model simplification method for big and complex structures whose acoustic characteristics will be predicted is analyzed. At last, the simplification method was applied to predict the middle and high frequency sound radiation of the double complex cylindrical structures. Numerical results showed that the proposed method has the same accuracy as the conventional finite element method and boundary element method, and can be applied to deal with engineering problems.

Streptococcus pneumoniae is a major cause of invasive infection in young infants and older adults. There are currently 90 capsular serotypes identified and 23 serotypes (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F) are responsible for about 90% of invasive disease. Among the more than 90 different S. pneumoniae serotypes, serotype 19A is globally very prevalent. A simplified purification procedure including adjustment of cell lysate pH to 4.5, fractionation with 50- 80% ethanol, and dialysis rendered capsular polysaccharide (CPS) in a yield of 31.32 +/- 3.11 mg from 1 l culture (75% recovery after lyses). The product contained only 69.6 microng of protein (99.78% purity) and 0.8 mg (sum of the precipitants from 50~60%, 60~70%, and 70~80%) of nucleic acid (97.45% purity). The purified CPS was conjugated with bovine serum albumin; the product size ranged from 100 to 180 kDa.

The different age pleioblastus amarus particle were taken as the raw materials, and the wet-process bamboo powder-boards were made from the laccase-treated powder by hot pressing. The raw material chemical constituents were analyzed. The reactive oxygen species free radicals produced from the laccase-treated bamboo were detected by electron spin resonance. The physical and mechanical properties of the bamboo particleboards were measured. In order to provide some theoretical basis for producing bamboo particleboard by laccase activation, the relations between physical and mechanical properties of bamboo particle boards and chemical constituents, the reactive oxygen species free radicals were researched.

Three kinds of particles which produced by the processing of bamboo flooring were taken as the raw materials and analyzed of chemical constituents. Cellulose crystallinity and the reactive oxygen species (ROS) free radicals produced from laccase-treated bamboo were examined by X-ray Diffraction (XRD) and Electron Spin Resonance (ESR), respectively. Physical and mechanical properties of laccase treated bamboo particle boards which made from surplus materials of bamboo flooring process were investigated. In order to provide some theoretical basis for producing particle board with the surplus materials of bamboo flooring process by using laccase, the relations between physical properties and chemical constituents, cellulose crystallinity or the ROS free radicals of bamboo particle boards were researched.

Plybamboo is commonly made using chordwise bamboo strips. Previous studies have indicated that the bamboo utilization rate and the processing efficiency are low in manufacturing chordwise curtain Plybamboo. This paper presents a study on the manufacturing technology of radial curtain plybamboo form. Radial strips cut from bamboo were glued on the radial faces. The results showed: (1) the bamboo utilization rate of radial cutting strips was 15-20% higher than chordwise cutting strips, and the resin consumption was only approximately 50% of chordwise bamboo strips; (2) however, radial bamboo strips were more subject to lengthwise bending deformation than chordwise strips during drying. This lengthwise bending deformation can be effectively reduced or prevented by placing a hollow rigidity axle in the radial bamboo curtain rolls when using the bound drying method; (3) the hot pressing time of the radial curtain plybamboo form was approximately 50% of the chordwise composite plastic curtain plybamboo.

In adult mammalian brain, microvessels may produce a special microenvironment and then influence the characteristics of neural stem cells (NSCs). This work aims to compare the effects of cerebral microvascular endothelial cells (CMECs) and vascular endothelial growth factor (VEGF) on the behaviors of NSCs. An in vitro model with co-cultured CMECs and NSCs was established by using transwell co-culture system. The expression of nestin and NF in the early stage of the co-culture, and NF in the later stage were explored by immunostaining. Results demonstrate that both CMECs and VEGF stimulate the proliferation of NSCs and inhibit the differentiation. After removing CMECs or VEGF from the co-culture system, a further culture in medium for the differentiation of NSCs was performed. The percentage of NF-positive cells in the CMECs co-culture group is the highest, suggesting the improved neuronal differentiation of NSCs by CMECs.

Alkyl glucosides were synthesized by the reaction of Leuconostoc mesenteroides dextransucrase with sucrose and various alcohols. Alkyl alpha-D-glucosides were obtained with a yield of 30% (mol/mol) with primary alcohols, but secondary alcohols or tertiary alcohols gave yields below 5%. The optimal yield was 50% using 1-butyl alpha-D-glucoside with 0.9 M 1-butanol. The acceptor products of methanol or ethanol were confirmed as methyl alpha-D-glucopyranoside and ethyl alpha-D: -glucopyranoside via MALDI-TOF MS and NMR analysis. Thus, methyl or ethyl alpha-D-glucoside constituted half the emulsification activities of Triton X-100 as commercially available surfactants.

This paper deals with an on-line mismachining error measurement for curve grinding based on digital image processing. Using CCD camera, the contour of the workpiece’s finished surface is captured and the image is preprocessed for denoising and edge detecting. The worktable is guided by the image of the finished workpiece to follow the path of the finished contour and then the real curve of the finished workpiece is measured by fitting a curve according to the moving path of the worktable. Finally, the machining error is obtained by comparing the measured curve with the theoretical curve of the workpiece. This method is applied to a CNC curve grinding machine MD9040. A measurement experiment is given. The experiment results show that the measurement method offers high detection precision and can be used in wide fields, especially for measuring the parts with complex curve.

In this paper, firstly the Lorenz chaotic equation was taken as an example to produce a nonlinear time series, and we discussed the applicability of delay time algorithm to the presence of noise at different time series length. The study shows that the C-C algorithm of delay time is robust, and the Fraser et al's mutual information algorithm and auto-correlation function algorithm are affected by presence of noise and variations of time series length and the Libert et al's mutual information algorithm can not calculate the delay time. Based on the above studies, we characterized the gas/liquid two phase flow patterns based on the chaotic analysis of conductance fluctuating signals. The results indicate that at a low superficial water velocity, with increasing superficial gas velocity, the dynamic characteristic of bubble and churn flows becomes more complex, and the slug flow is affected by the liquid superficial velocity; whereas at high superficial water velocity, with increasing superficial gas velocity, the dynamic characteristic of gas/liquid two phase flow becomes simpler while the flow pattern changes from bubble flow to slug flow, and the dynamic characteristic of slug flow shows unsteady fluctuating phenomena due to liquid phase turbulence interaction, and the dynamic characteristic of two phase flow becomes more and more complex while the flow pattern changes from slug to churn flow. The study shows that we can characterize the flow pattern variations of gas/liquid two phase flows based on the chaotic analysis of conductance signals, it is a useful tool to understand flow pattern transition mechanism and its dynamic evolution characteristic.

The aim of this study is to evaluate if mitomycin C (MMC), applied topically at the site of maxillary antrostomy in experimentally inflamed maxillary sinuses, may reduce postoperative ostial stenosis without any harmful effect. Twenty-four rabbits with experimentally induced maxillary sinusitis underwent maxillary antrostomy bilaterally. MMC at a concentration of 0.4 or 1 mg/ml was applied at the site of antrostomy on the right whilst the antrostomy site on the left served as the control. Half of each MMC concentration group of animals were killed after 3 weeks, and the remaining half after 6 weeks. For every rabbit, the areas of antrostomies were measured and mucosal specimens around the ostia were obtained for microscopic evaluation at the time of antrostomy and killing. Within each MMC concentration group, MMC-treated antrostomies were significantly wider than those of the controls (P0.05), even after 6 weeks. However, comparison of the areas of MMC-treated antrostomies between the two MMC concentration groups did not show any significant difference (P0.05). No systemic side effect or permanent mucosal damage was detected. These results suggest that postoperative topical MMC at a concentration of 0.4 mg/ml can be used to prolong the patency of maxillary antrostomy in an inflammed sinus.

The novel antiplatelet agent ticagrelor has been demonstrated to exert a faster and more powerful inhibition of platelet aggregation in comparison to clopidogrel in coronary artery disease patients. However, a ticagrelor dose of 90 mg twice daily might not be suitable for patients of East Asian ethnicity, and has not been fully investigated. The aim of this study was to assess the effects of low loading doses (LD, 90 mg) and maintenance doses (MD, 90 mg daily) of ticagrelor in comparison to clopidogrel (600 mg LD, 75 mg daily MD) in healthy Korean volunteers. Twelve subjects were randomized into two groups, receiving either clopidogrel (600 mg LD, followed by 75 mg MD daily for 5 days) or ticagrelor (90 mg LD, followed by 90 mg MD daily for 5 days). Following a 2-week washout period, the treatments were switched between the groups. Three platelet function assessment methods which included light transmission aggregometry (LTA), the VerifyNow assay and multiple electrode platelet aggregometry (MEA) were then used to serially measure platelet function at various time points (baseline, 0.5, 2, 6, 24, 26, 120 and 122 h). The mean IPA to 10 µM ADP in the ticagrelor group was significantly higher than that for the clopidogrel group at the 0.5, 2, 6, 26 and 122 h time points (p ≤ 0.001). However, there was no significant difference between the two groups at the 24- and 120-hour time points (p > 0.05). The assay results produced by the other two platelet function tests (VerifyNow and MEA) were similar to those obtained by LTA. The low loading and maintenance doses of ticagrelor (90 mg LD, 90 mg daily MD) cause a more rapid and potent inhibition of platelet function when compared to clopidogrel (600 mg LD and 75 mg MD). Additionally, at the lowest value of platelet inhibition strength, oral once-daily administration of ticagrelor was no less efficacious than clopidogrel at the 24- and 120-hour time points. Due to a large diurnal variation occurring with a single daily dose, a lower dose twice-daily could be a better option for patients of East Asian ethnicity.

Numerous studies have investigated association of interleukin-13 (IL-13) G+2044A polymorphism with COPD susceptibility; however, the results were inconsistent and inconclusive. To evaluate the association between the IL-13 G+2044A polymorphism and susceptibility to COPD, a meta-analysis of published case–control studies was performed. Based on PubMed and Chinese database, this research selected studies that examined the association of the IL-13 G+2044A polymorphism with COPD. A genetic model-free approach was used to assess whether the combined data showed this association. Then a subgroup analysis was also performed, with stratifications for race, study design, and sample size. Six studies (total 1,213 COPD patients and 801 control subjects) for the IL-13 G+2044A polymorphism with COPD were included in the meta-analysis (G- vs A-allele: OR 1.12, 95 % CI 0.96–1.32, P = 0.15; genotypes GG+GA vs genotype AA: OR 0.99, 95 % CI 0.49–2.00, P = 0.98; genotype GG vs genotypes GA+AA: OR 1.18, 95 % CI 0.97–1.44, P = 0.09; genotype GA vs genotypes GG+AA: OR 0.85, 95 % CI 0.70–1.04, P = 0.11). This meta-analysis demonstrates that the IL-13 G+2044A polymorphism does not confer susceptibility to COPD. More detailed data about individual and environment, larger sample sizes with unbiased genotyping methods and matched controls in different populations are required.

The chemoenzymatic process involving biocatalytic resolution of rac-2-carboxyethyl-3-cyano-5-methylhexanoic acid ethyl ester (CNDE, 1) has been the most competitive and attractive route for pregabalin. A new esterase-producing strain ZJB-09203, which exhibited high hydrolytic activity, excellent enantioselectivity, and diastereoselectivity towards CNDE, has been successfully isolated from soil samples with a pH indicator agar plate method. The isolate was identified as Morgarella morganii by the ATB system (ID 32 GN) and the 16S rDNA sequence. In order to suppress product inhibition during enzymatic hydrolysis of CNDE, an adsorptive biocatalytic process was developed by utilizing anion-exchange resin D201 as adsorbent for selective removal of (3S)-2-carboxyethyl-3-cyano-5-methylhexanoic acid (2) from the reaction medium. This approach allowed the substrate loading to be increased up to 1.5 M and the chiral intermediate 2 was produced in 682 mM, 45.3 % conversion, and 95 % ee. These results imply that M. morganii ZJB-09203 esterase is a promising biocatalyst in the development of chemenzymatic manufacturing process for pregabalin.