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BACKGROUND Glycated hemoglobin (Hb) (HbA1c) is an indicator that is used to diagnose and monitor the treatment of diabetes. Many factors can affect the detection of HbA1c. One of the most important of these factors is the Hb variant. Here, we report a rare Hb variant and evaluate its effect on HbA1c. CASE SUMMARY A 35-year-old man was suspected of harboring an Hb variant following the measurement of HbA1c with the Variant II Turbo 2.0 Hb detection system during a routine examination. Subsequently, we used the Arkray HA-8160 and ARCHITECT c4000 system to reanalyze HbA1c. Finally, the Hb variant was detected with a Capillary2FP analyzer that operates on the principle of capillary electrophoresis. We also used gene sequencing to investigate the mutation site. The value of HbA1c detected with the Variant II Turbo 2.0 system was 52.7%. However, the Arkray HA-8160 system did not display a result while the ARCHITECT c16000 system showed a result of 5.4%. The Capillary2FP analyzer did not reveal any abnormal Hb zones. However, gene sequencing identified the presence of a mutation in the Hb β2 chain [CD2(CAC>TAC), His>Tyr, HBB: c.7C>T]; the genotype was Hb Fukuoka. CONCLUSION Hb variants could cause abnormal HbA1c results. For patients with Hb variants, different methods should be used to detect HbA1c.

BACKGROUND Co-morbidity of SRY gene turner syndrome (TS) with positive SRY gene and non-classical congenital adrenal hyperplasia (NCAH) is extremely rare and has never been reported to date. CASE SUMMARY In this article, we present a 14-year-old girl who was referred to our hospital with short stature (weight of 43 kg and height of 143 cm, < -2 SD) with no secondary sexual characteristics (labia minora dysplasia). Laboratory tests indicated hypergonadotropic hypogonadism with significantly increased androstenedione and 17-hydroxyprogesterone (17-OHP) levels. This was accompanied by the thickening of the extremity of the left adrenal medial limb. The patient’s karyotype was 45,X/46,X, +mar, and cytogenetic analysis using multiplex ligation-dependent probe amplification and high-throughput sequencing indicated that the SRY gene was positive with compound heterozygous mutations in CYP21A2 as the causative gene for congenital adrenal hyperplasia. The sites of the suspected candidate mutations were amplified and verified using Sanger sequencing. The patient was finally diagnosed as having SRY positive TS with NCAH. The patient and her family initially refused medical treatment. At her most recent follow-up visit (age = 15 years old), the patient presented facial hair, height increase to 148 cm, and weight of 52 kg, while androstenedione and 17-OHP levels remained high. The patient was finally willing to take small doses of hydrocortisone (10 mg/d). CONCLUSION In conclusion, upon evaluation of the patient mentioned in the report, we feel that 17-OHP measurement and cytogenetic analysis are necessary for TS patients even in the absence of significant virilization signs. This will play a significant role in guiding diagnosis and treatment.

Paeonia lutea is a wild peony (an endangered flowering plant species) found in China. Seed abortion (endosperm and embryo development failure) is linked to several endangered plant species. Therefore, it is of interest to complete a comparative analysis of transcriptome between the normal active seeds (Population A) and the endangered abortion seeds (Population H). Data from GO assignments of differentially expressed genes (DEGs) shows that "metabolic process", "binding", "cellular process", "catalytic activity", "cell" and "cell part" are commonly prevalent in these popuations. DEGs between the populations are found to be connected with metabolic pathways, biosynthesis of secondary metabolites, purine metabolism and ribosome. We used quantitative RT-PCR to validate 16 DEGs associated with these populations. It is found that histone genes and proline-rich extensin genes are predominant in the common groups. Histone genes (H2A, H2B, H3, H4 and linker histone H1) show 3 to 4 folds log2FC higher expession in population A than in population H in stage I unlike in stage II and III. Increased activity of proline-rich extensin genes in population A than in population H corresponding to seed abortion in the later population is implied. These preliminary data from the transcriptome analysis of the wild type plant species Paeonia lutea provide valuable insights on seed abortion.

Sterility plays an important role in plant adaptation and evolution and has contributed to the development of high yielding crop hybrids. We used the widely targeted metabolomics profiling to survey the metabolites and biological pathways associated with male sterility in Prunus mira by comparing flowers from fertile and sterile trees. Male sterile flowers displayed abnormal stamen, uncolored anthers, and distorted and shrunken pollen grains with an apparent lack of turgidity. We report 566 metabolites in six flower samples and 140 differentially accumulated metabolites (DAMs) between both flower types. Most of the DAMs belong to the phenyl propanoid biosynthesis pathway, particularly flavonoid, flavone and flavonol biosynthesis pathways, implying that alterations in these key pathways link to male sterility in P. mira. The known link between low levels of flavonoid metabolites, weak expression levels of several structural genes from the phenyl propanoid biosynthesis pathway and hyper accumulation of reactive oxygen species were highlighted for understanding the underlying mechanism leading to the abnormal or aborted pollen grains observed in the sterile flowers. Data on the molecular mechanism of male sterility in Prunus mira will facilitate further in-depth investigations on this important agronomic and ecological trait.

Although there is a large literature demonstrating rapid and accurate enumeration of small sets of simultaneously presented items (i.e., subitizing), it is unclear whether this small numerosity advantage (SNA) can also manifest in sequential enumeration. The present study thus has two aims: to establish a robust processing advantage for small numerosities during sequential enumeration using a rapid serial visual presentation (RSVP) paradigm, and to examine the underlying mechanism for a SNA in sequential enumeration. The results indicate that a small set of items presented in fast sequences can be enumerated accurately with a high precision and a SOA (stimulus onset asynchrony)-sensitive capacity limit, essentially generalizing the large literature on small numerosity advantage from spatial domain to temporal domain. A resource competition hypothesis was proposed and confirmed in further experiments. Specifically, sequential enumeration and other cognitive process, such as visual working memory (VWM), compete for a shared resource of object individuation by which items are segregated as individual entities. These results implied that the limited resource of object individuation can be allocated within time windows of flexible temporal scales during simultaneous and sequential enumerations. Taken together, the present study calls for attention to the dynamic aspect of the enumeration process and highlights the pivotal role of object individuation in underlying a wide range of mental operations, such as enumeration and VWM.

Introduction: The incidence of postoperative sepsis is continually increased, while few studies have specifically focused on the risk factors and clinical outcomes associated with the development of sepsis after surgical procedures. The present study aimed to develop a mathematical model for predicting the in-hospital mortality among patients with postoperative sepsis. Materials and Methods: Surgical patients in Medical Information Mart for Intensive Care (MIMIC-III) database who simultaneously fulfilled Sepsis 3.0 and Agency for Healthcare Research and Quality (AHRQ) criteria at ICU admission were incorporated. We employed both extreme gradient boosting (XGBoost) and stepwise logistic regression model to predict the in-hospital mortality among patients with postoperative sepsis. Consequently, the model performance was assessed from the angles of discrimination and calibration. Results: We included 3,713 patients who fulfilled our inclusion criteria, in which 397 (10.7%) patients died during hospitalization, and 3,316 (89.3%) patients survived through discharge. Fluid-electrolyte disturbance, coagulopathy, renal replacement therapy (RRT), urine output, and cardiovascular surgery were important features related to the in-hospital mortality. The XGBoost model had a better performance in both discriminatory ability (c-statistics, 0.835 vs. 0.737 and 0.621, respectively; AUPRC, 0.418 vs. 0.280 and 0.237, respectively) and goodness of fit (visualized by calibration curve) compared to the stepwise logistic regression model and baseline model. Conclusion: XGBoost model has a better performance in predicting hospital mortality among patients with postoperative sepsis in comparison to the stepwise logistic regression model. Machine learning-based algorithm might have significant application in the development of early warning system for septic patients following major operations.

Background Infected abdominal aortic aneurysms (iAAAs) are rare but life-threatening diseases. The purpose of the present study was to report our experience of extra-anatomic prosthesis bypass in the retroperitoneum as a treatment for iAAAs. Methods Data of 8 consecutive patients diagnosed with iAAAs and treated by an extra-anatomic prosthesis bypass in the retroperitoneum were retrospectively collected. Operative details were as follows: one side of the retroperitoneal space was selected to build a track, and a bifurcated expanded polytetrafluoroethylene prosthesis was placed through the track. The proximal end of the prosthesis was sutured with the normal segment of abdominal aorta proximal to the infected aneurysm by end-to-end anostomosis. The 2 distal ends of the prosthesis were, respectively, sutured with the external iliac artery distal to the aneurysm. The anastomoses were then consolidated with the nearby connective tissue. After the closure of the retroperitoneum, the infected aneurysm was incised, and the infected tissue was debrided. Drainage tubes were placed in the aneurysm sac, which was packed with an omentum flap. All patients received perioperative antibiotic therapy for a period of time. All 8 patients were regularly followed up by outpatient observation. Results Eight patients with iAAAs underwent an extra-anatomic prosthesis bypass in the retroperitoneum and debridement of the infected aneurysm. An emergency operation was performed for 1 patient who underwent concomitant gastrointestinal procedures for aortoduodenal fistula. All 8 patients were definitively diagnosed by one or more sequential computed tomography scans combined with other methods. The blood or tissue cultures of all cases were positive in the perioperative period, with Salmonella (5 cases) being the most common pathogens. Other pathogens included Burkholderia pseudomallei (2 cases) and Escherichia coli (1 case). All patients survived and were discharged in 4–5 weeks after their operations. All patients were free from graft infection during the follow-up period. Conclusions The extra-anatomic prosthesis bypass in the retroperitoneum for treating iAAAs was safe and effective. Our experience with the procedure may provide a new approach for the treatment of this disease.

Acute lung injury (ALI) and respiratory distress syndrome are common, potentially lethal injuries that predominantly occur following chest trauma. Circular RNAs (circRNAs) are stable conserved non-coding RNAs that are widely expressed in different organs. To the best of our knowledge, no previous studies have shown whether circRNAs are involved in traumatic lung injury (TLI). The aim of the present study was to identify highly expressed circRNAs in plasma samples from patients with TLI and explore their potential functions in the pathogenesis of TLI. A high-throughput circRNA microarray was used to investigate the expression profile of circRNAs in plasma samples from five patients with TLI and paired control samples. Subsequently, a total of five abnormally expressed circRNAs were investigated using reverse transcription-quantitative PCR (RT-qPCR). A bioinformatics analysis was performed to predict a competitive endogenous RNA (ceRNA) network. In addition, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to identify the main biological processes and pathways. Finally, additional samples were tested to identify the expression profiles of the selected circRNAs. Among the 310 circRNAs that were highly expressed in the microarray analysis, 60 were upregulated and 250 were downregulated in patients with TLI. RT-qPCR results indicated that two downregulated circRNAs (circ_102927 and circ_100562) and one upregulated circRNA (circ_101523) matched the microarray results. The bioinformatics analysis constructed a targeting network based on the three validated circRNAs. GO and KEGG analyses identified the top ten enriched annotations. The expression of homo sapiens circular RNA 102927 (hsa_circRNA_102927) in the plasma of patients with TLI was 0.34-fold compared with the control group in expanded size validation. The results of the present study identified the differentially expressed circRNAs in the plasma of patients with TLI and provided evidence that highly expressed circRNAs involved in the ceRNA network may serve a role in the pathophysiology of TLI.

In peach orchards, birds severely damage flowers during blossom season, decreasing the fruit yield potential. However, the wild peach species Prunus mira shows intraspecific variations of bird damage, indicating that some of the wild trees have developed strategies to avert bird foraging. Motivated by this observation, we formulated the present study to identify the potential flower metabolites mediating the bird’s selective feeding behavior in P. mira flowers. The birds’ preferred (FG) and avoided (BFT) flowers were collected from wild P. mira trees at three different locations, and their metabolite contents were detected, quantified, and compared. The widely-targeted metabolomics approach was employed to detect a diverse set of 603 compounds, predominantly, organic acids, amino acid derivatives, nucleotide and its derivatives, and flavones. By quantitatively comparing the metabolite contents between FG and BFT, three candidate metabolites, including Eriodictiol 6-C-hexoside 8-C-hexoside-O-hexoside, Luteolin O-hexosyl-O-hexosyl-O-hexoside, and Salvianolic acid A, were differentially accumulated and showed the same pattern across the three sampling locations. Distinctly, Salvianolic acid A was abundantly accumulated in FG but absent in BFT, implying that it may be the potential metabolite attracting birds in some P. mira flowers. Overall, this study sheds light on the diversity of the floral metabolome in P. mira and suggests that the bird’s selective feeding behavior may be mediated by variations in floral metabolite contents.

Background Acute abdominal pain is often caused by intestinal obstruction, with high morbidity, and mortality, so that the early diagnosis is particularly important. Currently, both spiral CT and ultrasound are common imaging diagnostic methods. However, the accuracy and practicality of the diagnosis are controversial. Therefore, the purpose of this study is to systematically evaluate the accuracy and practicality of spiral CT and ultrasound in the diagnosis of intestinal obstruction. Methods Retrieval of English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (CNKI, WAN FANG, VIP, CBMDISC) by computers. From the establishment of the database to October 2020, a diagnostic experimental study on the diagnosis of intestinal obstruction by ultrasound and spiral CT was conducted. Two researchers independently conducted data extraction and quality evaluation of literature on the included studies, and Meta Disc1.4 and RevMan5.3 were used for meta-analysis on the included literature. Results Sensitivity, specificity, po-sitive Likelihood ratio, NE-Gative likelihood ratio, diagnostic odds ratio and other indicators were used to determine the diagnostic efficacy of ultrasound and helical CT. Conclusion This study is aimed at providing an evidence-based basis for clinicians to choose an appropriate or optimal diagnostic method by comparison of the accuracy and practicality between spiral CT and ultrasound in the diagnosis of intestinal obstruction. Ethics and dissemination The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. Osf registration number DOI 10.17605/ OSF.IO / Q5RNS.

A growing body of evidence suggested that time can be represented separately either on the lateral, sagittal or vertical axis. However, it is still not clear whether these mental time lines from different origins could co-exist, or compete with each other such that if one is selected, the others are inhibited? The present study addressed this question using a multi-dimensional free-choice paradigm with Mandarin speakers in three experiments. The results showed that significant spatial-temporal congruency effects were found both on the lateral and sagittal/vertical axes in the horizontal/coronal plane either in a temporal judgment relevant or irrelevant task. By contrast, the spatial-temporal congruency effects did not appear at the same time on the sagittal and vertical axes in the sagittal plane. These results supported that lateral mental time line could co-exist with the other two, while sagittal and vertical mental time lines could not co-exist with each other. This finding implied that the space-time mapping mechanism is different between the lateral axis and the sagittal and vertical axes, whereas it is the same for the latter two axes.

ObjectivesWe employed a comprehensive systematic review and meta-analysis to assess benefits and risks of a threshold of haemoglobin level below 7 g/dL versus liberal transfusion strategy among critically ill patients, and even patients with septic shock.DesignSystematic review and meta-analysis.Data sourcesWe performed systematical searches for relevant randomised controlled trials (RCTs) in the Cochrane Library, EMBASE and PubMed databases up to 1 September 2019.Eligibility criteriaRCTs among adult intensive care unit (ICU) patients comparing 7 g/dL as restrictive strategy with liberal transfusion were incorporated.Data extraction and synthesisThe clinical outcomes, including short-term mortality, length of hospital stay, length of ICU stay, myocardial infarction (MI) and ischaemic events, were screened and analysed after data collection. We applied odds ratios (ORs) to analyse dichotomous outcomes and standardised mean differences (SMDs) to analyse continuous outcomes with fixed or random effects models based on heterogeneity evaluation for each outcome.ResultsEight RCTs with 3415 patients were included. Compared with a more liberal threshold, a red blood cell (RBC) transfusion threshold 2=53%), length of hospital stay (SMD: −0.11, 95% CI: −0.30 to 0.07, p=0.24, I2=71%), length of ICU stay (SMD: −0.03, 95% CI: −0.14 to 0.08, p=0.54, I2=0%) or ischaemic events (OR: 0.80, 95% CI: 0.43 to 1.48, p=0.48, I2=51%). However, we found that the incidence of MI (OR: 0.54, 95% CI: 0.30 to 0.98, p=0.04, I2=0%) was lower in the group with the threshold ConclusionsAn RBC transfusion threshold

Forming process of TC4 titanium alloy laser weld joint during superplastic deformation is simulated. The stress and strain curve, which is obtained in the simulation, is compared with that obtained by hot tensile experiments. The simulation results provides a basis for subsequent laser welding / superplastic forming technology, and proposes outlook to the analyze problems for laser welding / superplastic forming (LBW / SPF) technology.

Forming process of TC4 titanium alloy laser weld joint during superplastic deformation is simulated. The stress and strain curve, which is obtained in the simulation, is compared with that obtained by hot tensile experiments. The simulation results provides a basis for subsequent laser welding / superplastic forming technology, and proposes outlook to the analyze problems for laser welding / superplastic forming (LBW / SPF) technology.

The article employs the subgrade-reaction theory, leading-out the buckling stability equation of the pile with gravitational stress and frictional resistance which’s top bomb embedded but bottom fixed,and provide the solution ,by using the minimum potential principle.And to consider the pile gravitational stress factors on the influence of the pile buckling load in different embedment ratio cases.

Rock deformation and unstable failure of slope is controlled by weak structural plane whose identification and evaluation is greatly influenced by deformation failure prediction of slope and design treatment. Based on the propagation characteristics of acoustic wave in shaft lining strata, attenuation of stoneley wave and inherent attenuation of strata are analyzed and permeability relationship among shaft lining strata is researched. The relationship between reflected stoneley-wave intensity and the width and filling ability of strata crack is studied. By application example of landslide investigation, attribute parameters and characteristics of acoustic wave are discussed. Strata division, the practicability and accuracy of recognition for fracture and holes evaluation and mechanic characteristics of rock mass also are studied.

As Turing (1936, Proceedings of the London Mathematical Society) noted, a fundamental process in human cognition is to effect chained sequential operations in which the second operation requires an input from the preceding one. Although a great deal is known about the costs associated with 'independent' (unrelated) operations, e. g., from the classic psychological refractory period paradigm, far less is known about those operations to which Turing referred. We present the results of two behavioural experiments, where participants were required to perform two speeded sequential tasks that were either chained or independent. Both experiments reveal the reaction time cost of chaining, over and above classical dual-task serial costs. Moreover, the chaining operation significantly altered the distribution of reaction times relative to the Independent condition in terms of an increased mean and variance. These results are discussed in terms of the cognitive architecture underlying the serial chaining of cognitive operations. © 2011 Springer-Verlag. Fil: Fan, Zhao. Huazhong Normal University; China Fil: Singh, Krish. Cardiff University; Reino Unido Fil: Muthukumaraswamy, Suresh. Cardiff University; Reino Unido Fil: Sigman, Mariano. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; Argentina Fil: Dehaene, Stanislas. College de France; Francia Fil: Shapiro, Kimron. Bangor University; Reino Unido

Interleukin- (IL-) 37 is a novel anti-inflammatory cytokine that suppresses immune response and inflammation. This study was performed to determine whether IL-37 was elevated in patients with rheumatoid arthritis (RA) and investigate the correlation between IL-37 level and disease activity and the concentration of Th1/Th2/Th17-related cytokines. Clinical parameters of disease activity, including the 28-joint disease activity score (DAS28) and C-reactive protein (CRP), were collected in 34 RA patients and 34 age- and sex-matched healthy controls. Plasma IL-37 was measured by ELISA. Plasma levels of TNF-α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, G-CSF, GM-CSF, IFN-γ, MCP-1, and MIP-1βwere analyzed using the Bio-Plex suspension array system. It was found that IL-37 levels were elevated markedly in RA patients and almost undetectable in healthy controls. In addition, IL-37 levels in patients with active RA were significantly enhanced as compared with those in patients of remission. More importantly, IL-37 showed a significant correlation with disease activity (DAS28) and IL-4, IL-7, IL-10, IL-12, and IL-13 concentrations in RA patients. These findings suggest that IL-37 plays an important role in the pathogenesis of RA and may prove to be a potential biomarker of active RA.

Seismic data obtained from an about 210km long Baiyan-Jianghong deep seismic sounding profile, which was completed in the Leiqiong area in 1984 and 1985, were processed by means of finite difference tomography, time term inversion and 2-D dynamic ray tracing methods. And 2-D inhomogeneous crustal structure images along the Baiyan-Jianghong seismic line were determined. The results show that the crustal thickness in northern Hainan province and Leizhou Peninsula is about 25~26km. In northern Hainan Island embossment of the southern part of Qiongzhou Channel, the average crustal velocity is about 6.16km·s–1 and 5.70km·s–1 in the Leiqiong Depression area of northern segment of Qiongzhou Channel. The crustal velocity is particularly low and especially obvious in lower crust where it is only about 6.3~6.5km·s–1. The crystalline basement presents a velocity gradient belt, the thickness of which is about 2~4km and the velocity is approximately 5.5~6.0km·s–1. Moho, the velocities of which on its two sides are 6.5km·s–1 and 8.05km·s–1 respectively, shows one-order velocity discontinuity, and there is no obvious crust-mantle transitional zone to be found. Because the Baiyan-Jianghong seismic line lies in the Leiqiong Depression area with basalt covering of the Pleistocene Period, it is suggested that the thinner crust and lower velocity in this area mainly reflect the multi-erupting of volcanic magma from the Cenozoic till the late Quaternary as well as the underplating and delaminating of hot mantle to the crustal bottom which are interrelated with the crust being still in a comparatively hot state.

Using the teleseismic waveform data recorded by 19 PASSCAL broadband mobile seismic stations which worked nearly one year in the Changbaishan volcanic area and other 14 stations with portable broadband digital seismographs deployed about three months in the Jingpohu volcanic region, totally 423 high quality receiver functions were extracted. Through stacking these receiver functions in terms of midpoint stacks of P converted to S waves, the discontinuity distributions along with their patterns were obtained. The results show that beneath the studied area, 410km, 520km and 660km discontinuities exist. Both the 410km and the 660km discontinuities are relatively continuous and present positively correlative characteristics. The 410km discontinuity is a local uplift beneath the Changbaishan volcano, and 660km discontinuity is of the complex multi-interface. The thickness of the transition zone between 410km and 660km is about 250km and approaches the whole world average value. The 660km discontinuity descends beneath the Huichun deep earthquake area and above the 660km discontinuity in the stack profiles, where there are some phases which are not continuous on the two sides of the Huichun deep earthquake area. We infer that the west Pacific plate has already subducted into the upper mantle transition zone beneath the Eurasia plate. We consider that the local uplift of 410km discontinuity and the complex multi-interface characteristics of the 600km discontinuity as well as the occurrence of the Huichun deep earthquakes are all due to the slab activities in the transition zone. Because of the strong resistance from the 660km discontinuity, the subduction slab may become nearly horizontal and continue to subduct toward west. And beneath the Eurasia plate, the front part of the west Pacific plate possibly has been split into several segments rather than remaining a whole.

This study was made to evaluate the effect of SB203580, a specific p38 MAP kinase inhibitor, on burn-induced hepatic injury as well as the activation of nuclear factor (NF)-kappaB in severely burned rats. Sprague-Dawley rats were divided into three groups: (1) sham group, rats underwent sham burn; (2) burn group, rats given third-degree burns over 30% total body surface area (TBSA) and treated with vehicle plus lactated Ringer solution for resuscitation 4 ml/(kg% TBSA); and (3) burn plus SB203580 group, rats given burn injury and fluid resuscitation plus SB203580 (10 mg/kg i.v., 15 min and 12 h after burn). Hepatocellular injury (measured by serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT)) and hepatocellular function (determined by the indocyanine green dye retention rate (ICG R15)) were assessed at 24 h post-burn. Liver histologic changes were also analyzed. Burn trauma resulted in increased serum aminotransferases concentrations, decreased ICG R15, elevated serum tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta levels and hepatic TNF-alpha and IL-1beta mRNA expressions, and worsen histologic condition. The level of Nuclear Factor (kappa) inhibitor (IkappaBalpha) in liver was decreased and DNA-binding activity of Nuclear Factor-kappaB (NF-kappaB) was increased after thermal injury. p38 MAP kinase was more significantly activated in liver harvested from burn rats than from shams. SB203580 inhibited the activation of p38 MAP kinase, reduced the levels of TNF-alpha and IL-1beta, and prevented burn-mediated liver injury. Both the IkappaBalpha level and NF-kappaB activity in the liver following burns was not affected by administration with SB203580. These findings suggest that (1) p38 MAP kinase activation is one important aspect of the signaling event that may mediate the release of TNF-alpha and IL-1beta and contributes to burn-induced liver injury and (2) p38 MAP kinase does not influence the activation of NF-kappaB directly in the liver of severely burned rats.

We have obtained 34 receiver functions from 71 teleseismic waveforms recorded by 34 stations that were installed in Changbaishan-Jingpohu volcanic area. Through inversing receiver function of 34 seismic stations, we obtain S wave velocity structures beneath the stations. The results revealed that the Moho depth is about 32-33km along Shenyang-Dunhua direction and becomes deeper toward its west side. In Changchun area, the Moho thickness reaches about 36km and under the crater of Changbaishan-Tianchi volcano, the depth of Moho reaches about 38km while beneath Jingpohu volcanic area, Moho depth is about 39km. Overall, the crustal thickness of studied area is thick in north and thin in south. We found an anomalous layer with obvious low Swave velocity beneath Changbaishan-Tianchi crater at about 10km depth. Beneath Jingpohu volcanic area there is also possibly a low S-wave velocity anomalous body at about 30km depth. The results show that the S-wave velocity gradients at Moho are obviously different between near crater and far apart from the crater. S-wave velocity gradient of Moho near crater is clearly smaller than that in area without volcano, which suggests that Moho structures beneath volcano are different from general Moho structures in other areas. The crust thickness on the two sides along Shenyang-Dunhua direction has a comparatively great changes and its location is almost the same as Dunhua-Mishan fault at near surface. Therefore, Dunhua-Mishan fault is a very important geological structure zone in the studied area.

A growing body of evidence suggested that elapsing time is tightly associated with space in a specific way (e.g., Spatial Temporal Association of Response Codes or STARC effect). However, existing findings cannot justify a hypothesis that elapsing time is recoded directly into a spatial linear representation in working memory. The present study addresses this fundamental question by using three modified STARC-related working memory paradigms. In different experiments, participants were asked to give order judgment, order-irrelevant STM recognition judgment, or motor-related free-choice judgment, immediately after successive presentation of a set of disparate stimuli. Results show that responses to early stimuli were faster or more often with the left key and responses to late stimuli were faster or more often with the right key. These findings clearly support the hypothesis that elapsing time is directly and automatically recoded into a spatial linear representation in working memory.

Background Accurate estimation of a burned area is crucial to decisions about fluid resuscitation, surgical options, nutritional support, and prognosis. Widely used clinical methods to estimate a burn area are two-dimensional. They do not consider age, sex, body mass, physical deformities, or other relevant factors. Computer-aided methods have improved the accuracy of estimating burned areas by including data analysis and reducing subjective differences. Three-dimensional (3D) scanning allows us to determine body dimensions rapidly and reproducibly. We describe an individualized, cost-efficient, portable 3D scanning system, BurnCalc, that can create an individual 3D model and then calculate body surface area (BSA) and the burn area accurately and quickly. Methods The BurnCalc system was validated by verifying the accuracy and stability of BSA calculation. We measured 10 regular objects in experiment 1, using Student’s t-test and the intraclass correlation coefficient (ICC) in the analysis. In experiment 2, artificial paper patches of known dimensions were attached to various parts of the body of 40 volunteers. Their sizes were then calculated using BurnCalc. The BurnCalc data were compared to actually measured values to verify accuracy and stability. Total BSAs of these 40 volunteers were also calculated by BurnCalc and compared to those derived from an accepted formula. In experiment 3, four experts using Chinese Rule-of-Nines or Rule-of-Palms methods calculated the percentages of the total BSA in 17 volunteers. Student’s t-test and ICC, respectively, were used to compare the results obtained with the BurnCalc technique. Results Statistically, in experiment 1, p = 0.834 and ICC = 0.999, demonstrating that there was no difference between the BurnCalc and real measurements. Also, the hypothesis of null difference among measures (experiment 2) was true because p > 0.05 and ICC = 0.999, indicating that calculations of the total BSA and the burn area were more accurate using the BurnCalc technology. The reliability of the BurnCalc program was 99.9%. In experiment 3, only the BurnCalc method exhibited values of p > 0.05 (p = 0.774) and ICC = 0.999. Conclusions BurnCalc technology produced stable, accurate readings, suggesting that BurnCalc could be regarded as a new standard clinical method.

Trichloroethylene (TCE) is a common groundwater contaminant of toxic and carcinogenic concern. Aerobic co-metabolic processes are the predominant pathways for TCE complete degradation. In this study, Pseudomonas fluorescens was studied as the active microorganism to degrade TCE under aerobic condition by co-metabolic degradation using phenol and gasoline as growth substrates. Operating conditions influencing TCE degradation efficiency were optimized. TCE co-metabolic degradation rate reached the maximum of 80% under the optimized conditions of degradation time of 3 days, initial OD600 of microorganism culture of 0.14 (1.26 × 107 cell/mL), initial phenol concentration of 100 mg/L, initial TCE concentration of 0.1 mg/L, pH of 6.0, and salinity of 0.1%. The modified transformation capacity and transformation yield were 20 μg (TCE)/mg (biomass) and 5.1 μg (TCE)/mg (phenol), respectively. Addition of nutrient broth promoted TCE degradation with phenol as growth substrate. It was revealed that catechol 1,2-dioxygenase played an important role in TCE co-metabolism. The dechlorination of TCE was complete, and less chlorinated products were not detected at the end of the experiment. TCE could also be co-metabolized in the presence of gasoline; however, the degradation rate was not high (28%). When phenol was introduced into the system of TCE and gasoline, TCE and gasoline could be removed at substantial rates (up to 59% and 69%, respectively). This study provides a promising approach for the removal of combined pollution of TCE and gasoline.

Cutaneous burn trauma causes functional inhibition of the heart, but the mechanism is unclear. Using a high dissociation constant (K(D)) calcium indicator TF-BAPTA and 19F MR spectroscopy, the relationship between the changes of cytosolic free calcium and cardiac function after burn trauma was examined. Sprague-Dawley rats received scald (43% TBSA) or sham burns. Twenty-four hours later, the hearts were excised and perfused by the Langendorff method with a modified phosphate-free Krebs-Henseleit bicarbonate buffer. Left ventricular developed pressure (LVDP) was recorded through a catheter attached to an intraventricular balloon. At the same time, 31P and 19F nuclear magnetic resonance (NMR) spectroscopy was perforined before and after TF-BAPTA loading. LVDP of the heart from burned rats was 40% less than in sham burn rats (65+/-6 vs 110+/-12 mmHg, P0.01). Cytosolic free calcium increased about four-fold in those hearts from the burn group compared to the sham burn group (0.807+/-0.192 vs 3.891+/-0.929 microM). Loading TF-BAPTA in those hearts only caused about a 15-20% decrease in LVDP. PCr/Pi ratio also decreased significantly with this loading, but ATP signals were not affected. In conclusion, the inhibition of cardiac contractility caused by burn trauma correlated with the overload of cytosolic free calcium in the heart.

Magnetostratigraphy of the Lower Triassic Liujiagou and Heshanggou Groups have been established by detailed studies of samples collected from Shuiyuguan, Jiaocheng, Shanxi, China. The magnetic polarities column has a mixed polarity characteristics. The Early Triassic period commences with normal polarity magnetisation. The normal and reversed polarity combination in Liujiagou Formation is basically the same as in the previous results from Ordos. The VGP positions (longitude/latitude) of the Liujiagou Group are 348°/69°, in general agreement with the previous results of 348°/62° reported from Taiyuan, North China.

The quorum sensing commonly exists in procaryote kingdom,regulating various biologic functions.Recently similar phenomenon was also found in fungi world,which affecting both biofilm formation and dimorphism.In this article,we focus on the recent progress on quorum sensing of pathogenic fungi and discuss the possibility of taking quorum sensing molecule as a potential target for antifungl therapy.

The age of the lacustrine Nihewan Group has been a matter of dispute for decades. An initial Early Pleistocene age was extended to Late Pleistocene based on palaeolithic evidence and mammal fossils. The presence of a short reversed polarity zone proposed to represent the Blake geomagnetic excursion (0.117Ma B.P) apparently confirmed this age[1]. We report on a new, high-resolution paleomagnetic record from two parallel sections at Xujiayao revealing a Normal polarity zone at the middle-upper section and an extensive reversed polarity zone within the middle-lower part of the section. K-A ages (0.45±0.08 B.P and 0:38±0:07Ma B.P) of basalt underlying the lacustrine sediments nearby whose horizon can be correlated to the layer with normal polarity at the paleolithic section suggest the normal and reversed polarities should be Brunhes and Matuyama Chron. The Blake reversed excursion was denied. The Nihewan Group at Xujiayao and the paleolithic layers within the lacustrine sediments must hence be much older than Late Pleistocene.

Introduction Early diagnosis and treatment for thermal injury with septic complications continue to be a serious clinical problem. In this study, plasma biomarkers of rats in the burn and/or septic models were investigated with a metabolomic method. Methods Rat plasma samples were analyzed by ultra-performance liquid chromatography–quadrupole time-of-flight mass spectrometry (UPLC–Q-TOF-MS). Multivariate analysis, the principal components analysis (PCA), was used to validate metabolic changes. In addition, another multivariate method, the orthogonal partial least-squares analysis (OPLS), was used to profile potential biomarkers in models. Results Nine characteristic metabolites, including hypoxanthine, indoxyl sufate, glucuronic acid, gluconic acid, proline, uracil, nitrotyrosine, uric acid, and trihydroxy cholanoic acid were identified in models of thermal injury and/or sepsis. Conclusion These biomarkers were mainly involved in oxidative stress and tissue damage, and might supply evidence for distinguishing burned septic patients from non-septic ones.

The aim of the present study is to analyze the changes of cure rate and the main causes of death in the last 40 years, and to summarize our experience in the treatment of extensive full-thickness burn patients. The clinical characteristics, cure rate and main causes of death of 73 cases with total burned area more than 90% TBSA and full-thickness burn area more than 70% TBSA were analyzed retrospectively. Among them, 21 cases (28.8%) were cured and 52 cases (71.2%) died. The cure rate increased significantly in the recent years, and the main causes of death changed from shock and sepsis in the time period 1959-1978 to sepsis and MODS in the past two decades. Due to the improvement of early comprehensive management of burn shock, aggressive surgical approach to full-thickness burn wound and potent systemic supporting measures, the survival rate increased significantly.

Modified Heller's myotomy is still the first choice for achalasia and the assessment of surgical outcomes is usually made based on the subjective sensation of patients. This study was to objectively assess the long-term outcomes of esophageal myotomy for achalasia using esophageal manometry, 24-hour pH monitoring, esophageal scintigraphy and fiberoptic esophagoscopy.From February 1979 to October 2000, 176 patients with achalasia underwent modified Heller's myotomy, including esophageal myotomy alone in 146 patients, myotomy in combination with Gallone or Dor antireflux procedure in 22 and 8 patients, respectively. Clinical score, pressure of the lower esophageal sphincter (LES), esophageal clearance rate and gastroesophageal reflux were determined before and 1 to 22 years after surgery.After a median follow-up of 14 years, 84.5% of patients had a good or excellent relief of symptoms, and clinical scores as well as resting pressures of the esophageal body and LES were reduced compared with preoperative values (P0.001). However, there was no significant difference in DeMeester score between pre- and postoperative patients (P=0.51). Esophageal transit was improved in postoperative patients, but still slower than that in normal controls. The incidence of gastroesophageal reflux in patients who underwent esophageal myotomy alone was 63.6% compared to 27.3% in those who underwent myotomy and antireflux procedure (P=0.087). Three (1.7%) patients were complicated with esophageal cancer after surgery.Esophageal myotomy for achalasia can reduce the resting pressures of the esophageal body and LES and improve esophageal transit and dysphagia. Myotomy in combination with antireflux procedure can prevent gastroesophageal reflux to a certain extent, but further randomized studies should be carried out to demonstrate its efficacy.

This study was designed to investigate the role of p38 mitogen-activated protein (MAP) kinase on Kupffer cells (KCs) secretion of proinflammatory cytokines such as tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta and hepatic injury following burn trauma. Sprague-Dawley rats were randomized into four groups: (1) sham burn rats given vehicle, (2) sham burn rats given the p38 MAP kinase inhibitor SB203580 (10mg/kg i.v., 15min and 12h after sham burn), (3) rats given a 30% total body surface area (TBSA) full-thickness burn and fluid resuscitation plus vehicle, and (4) burn rats given injury and fluid resuscitation plus SB203580. Rats from each group were killed at 24h post-burn to examine plasma aspartate transaminase (AST) and alanine transaminase (ALT) and KCs were isolated. The KCs secretion of TNF-alpha and IL-1beta and p38 MAP kinase activity (by Western blot analysis) were also examined. These studies showed by more significant activation of p38 MAP kinase in KCs harvested from burn rats than from shams. Burn trauma resulted in hepatic dysfunction and promoted KCs secretion of TNF-alpha and IL-1beta. SB203580 inhibited p38 MAP kinase activity, reduced KCs secretion of proinflammatory cytokines, and alleviated burn-mediated hepatic dysfunction. These data suggest p38 MAP kinase activation is one important aspect of the signaling event that may mediate the KCs secretion of proinflammatory cytokines TNF-alpha and IL-1beta following burn trauma.

AIM: To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients, and propose practicable guidelines for the prevention and treatment of gastrointestinal (GI) dysfunction. METHODS: From 1980 to 2007, a total of 219 patients with large area and extraordinarily large area burns (LAB) were admitted, who were classified into three stages according the therapeutic protocols used at the time: Stage 1 from 1980 to 1989, stage 2 from 1990 to 1995, and stage 3 from 1996 to 2007. The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed. RESULTS: The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1, which was significantly lower than that in stage 1 (P < 0.05). No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3. The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%, 21.4% and 28.5%, respectively, which were significantly lower than those in stage 1 patients (P < 0.05 or P < 0.01), and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients (P < 0.05). CONCLUSION: Comprehensive fluid resuscitation, early excision of necrotic tissue, staged food ingestion, and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients.

A nanostructured surface layer was fabricated on 35# type carbon steel plate by using ultrasonic impact treatment (UIT) technique. The micro-structural features of the surface layer produced by UIT were characterized by optical microscopy (OM) observations, X-ray diffraction (XRD) and transmission electron microscopy (TEM), and hardness measurement was carried out in order to examine the hardness variation along the depth. Experimental results showed that the thickness of the plastic deformation layer varies from a few to about 100μm depending on the duration of UIT. Obvious grain refinement was observed and the gain size was about 10nm in the top surface layer. After UIT, the micro-hardness of the surface layer was enhanced significantly compared with that of the original sample, and the hardness increased when the duration of UIT increased.

OBJECTIVEThe authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era.METHODSA retrospective review of a single-institution endonasal endoscopic patient database (April 2010–April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades. The series was divided into 2 epochs based on implementation of a strict perioperative antibiotic protocol and more liberal use of permanent and/or temporary buttresses; repair failure rates and postoperative meningitis rates were assessed for the 2 epochs and compared.RESULTSIn total, 551 operations were performed in 509 patients for parasellar pathology, including pituitary adenoma (66%), Rathke’s cleft cyst (7%), meningioma (6%), craniopharyngioma (4%), and other (17%). Extended approaches were used in 41% of cases. There were 9 postoperative CSF leaks (1.6%) and 6 cases of meningitis (1.1%). Postoperative leak rates for all 551 operations by grade 0, 1, 2, and 3 were 0%, 1.9%, 3.1%, and 4.8%, respectively. Fat grafts were used in 33%, 84%, 97%, and 100% of grade 0, 1, 2, and 3 leaks, respectively. Pedicled mucosal flaps (78 total) were used in 2.6% of grade 0–2 leaks (combined) and 79.5% of grade 3 leaks (60 nasoseptal and 6 middle turbinate flaps). Nasoseptal flap usage was highest for craniopharyngioma operations (80%) and lowest for pituitary adenoma operations (2%). Two (3%) nasoseptal flaps failed. Contributing factors for the 9 repair failures were BMI ≥ 30 (7/9), lack of buttress (4/9), grade 3 leak (4/9), and postoperative vomiting (4/9). Comparison of the epochs showed that grade 1–3 repair failures decreased from 6/143 (4.1%) to 3/141 (2.1%) and grade 1–3 meningitis rates decreased from 5 (3.5%) to 1 (0.7%) (p = 0.08). Prophylactic lumbar CSF drainage was used in only 4 cases (< 1%), was associated with a higher meningitis rate in grades 1–3 (25% vs 2%), and was discontinued in 2012. Comparison of the 2 epochs showed increase buttress use in the second, with use of a permanent buttress in grade 1 and 3 leaks increasing from 13% to 55% and 32% to 76%, respectively (p < 0.001), and use of autologous septal/keel bone as a permanent buttress in grade 1, 2, and 3 leaks increasing from 15% to 51% (p < 0.001).CONCLUSIONSA graded approach to skull base repair after endonasal surgery remains valid in the endoscopic era. However, the technique has evolved significantly, with further reduction of postoperative CSF leak rates. These data suggest that buttresses are beneficial for repair of most grade 1 and 2 leaks and all grade 3 leaks. Similarly, pedicled flaps appear advantageous for grade 3 leaks, while CSF diversion may be unnecessary and a risk factor for meningitis. High BMI should prompt an aggressive multilayered repair strategy. Achieving repair failure and meningitis rates lower than 1% is a reasonable goal in endoscopic skull base tumor surgery.