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Abstract Background Stress response always occurs in cardiac valve replacement patients undergoing cardiopulmonary bypass (CPB). Methods 60 patients undergoing cardiac valve replacement were recruited and randomized into control and Dex groups. Dex group received 1.0 μg·kg-1 of Dex for 10 min intravenously before anesthesia, followed by 0.5 μg·kg-1·h-1 of Dex, steadily administered throughout the procedure. And controlled group received the identical velocity of saline as Dex group. Plasma level of cortisol (Cor), epinephrine (E), norepinephrine (NE), and serotonin (5-HT) were evaluated at four timepoints: Before administration (T0), sawn sternum (T1), end of extracorporeal circulation (T2), and 24 h post operation (T3). General data of operation and recovery such as heart rate (HR), mean arterial pressure (MAP), intraoperative bispectral index (BIS), and hospitalization time in the intensive care unit (ICU) were also compared. Results Increase of Cor, E, NE, and 5-HT for the Dex group was significant lesser than that in the control group (P

High-finesse fiber Bragg gratings (FBGs) Fabry-Perot interferometers (FPIs) have shown great promise as sensitive ultrasonic sensors. However, the fabrication process of the sensors usually introduces birefringence to the fiber, which makes the sensor operation sensitive to the polarization of the probe laser. Here, we theoretically study the effect of laser polarization on the sensitivity of the sensor with birefringence. We show that, to maintain the sensitivity above half of its maximum of a high-finesse FBG-FPI sensor, the spectral notch separation caused by sensor birefringence should be less than ~61% of the spectral notch width of the sensor. We fabricate an FBG-FPI sensor with negligible overall birefringence by rotating the fiber by 90° between the fabrication of the two FBGs. As a result, the birefringence introduced during the fabrication of the two FBGs cancels out each other. For comparison, a regular FBG-FPI fabricated without fiber rotation was also tested. While the regular FBG-FPI exhibited large variations in detection sensitivity with laser polarization, the polarization-insensitive showed little changes. As a result, no control on the laser polarization is needed during the operation of the polarization-insensitive FBG-FPI for ultrasonic detection, an important attribute required in many practical applications of the sensor.

A multi-objective trajectory planning method for redundantly actuated parallel manipulator under hybrid force and position control is proposed considering the coordination of its driving forces. Combining inverse kinematics analysis, the driving force coordination of the manipulator is analyzed using the virtual work principle. On this basis, the B-spline curve is used to plan the motion trajectory of the end-effector of the manipulator in the Cartesian space. Subsequently, the driving force coordination, total motion time, and maximum absolute value of the jerk impulse of the actuator are defined as objective functions, and a multi-objective optimization problem is solved using the multi-objective particle swarm algorithm (MOPSO). Finally, the potential optimal solution is selected by constructing a comprehensive optimal evaluation function. The trajectory simulation results verify that the trajectory planning method is effective and universal.

In order to find the “sweet spots” of unconventional oil and gas from the Pinghu Formation in the Pinghu Tectonic Belt, we are committed to clarifying the development and distribution rules of coal-measure source rocks and tight reservoirs as well as the controlling factors. Using 3D seismic and logging data, combined with logging constraints of target lithology and pyrolysis experiments of source rock, "source and reservoir" research of uncoventional oil and gas was carried out in the Pinghu Tectonic Belt. The results show that two stages of regression and one stage of transgression occurred in the Pinghu Formation, resulting in river-controlled and wave-controlled delta-neritic facies dominated by sedimentary facies, source rocks developed in interdistributary bay and swamp microfacies, and tight sandstones in point bar and distributary channel microfacies are developed. The accumulation of coalbed methane and shale gas is controlled by the sedimentary facies and the degree of thermal evolution under the factors of burial depth. The accumulation of tight sandstone is closely related to the dominantly sedimentary facies and diagenetic modification of physical properties and faults. It is concluded that the structural type, type and distribution of faults, and depositional environment of the Pinghu Tectonic Belt in the Xihu Sag are the key factors controlling the development and accumulation of coal-measure source rocks and tight sandstone reservoirs. This understanding provides a clear direction for the deep exploration of unconventional oil and gas in the sag and provides a reference for finding reservoir “sweet spots.”

Due to the worldwide scarcity of fresh water, seawater becomes an alternative base fluid in hydraulic fracturing for oil and gas production. However, the injection of seawater that contains high concentration of sulfate will induce the scale formation and thus reduce hydrocarbon production. One of the most effective ways to solve this problem is to remove sulfate ions from seawater before fracturing application. The objective of this study is to develop an effective and environment-friendly approach to remove sulfate ions from seawater based on coprecipitation of SO42− with NaAlO2 and CaO as ettringite (Ca6Al2(SO4)3(OH)12·26H2O). Residual sulfate concentration in treated seawater was determined when NaAlO2 and CaO dosed at different molar ratios to sulfate. Results showed the efficiency of sulfate removal was more than 90% (4290 ppm to ∼400 ppm) when Al : Ca : S = 2 : 6 : 1. It was found the sulfate precipitation completed in 15 mins with stirring under an alkaline condition (pH ≈ 12) and was not affected by temperature (15°C to 45°C). Increasing the Na+ concentration from 0 to 25,000 ppm in waters resulted in the increment of residual sulfate concentration from 250 to ∼600 ppm, decreasing the removal efficiency. Besides, the analysis of Ca2+ and Mg2+ in treated seawater showed the Ca2+ concentrations were on the similar level as that before the treatment and Mg2+ was removed in the precipitation process, which is beneficial to the application of the treated seawater. The morphology and element analysis of the collected precipitates showed that the ettringites were in a layered shape with composition between Ca6Al2(SO4)3(OH)12 and Ca4Al2(SO4)(OH)12 at the optimized chemical dosage; therefore, the developed ettringite precipitation method could effectively remove sulfate from seawater without toxic chemicals involved, which benefits seawater hydraulic fracturing in an economic way, and this contributes to water sustainability.

This study aimed to compare the in-vivo kinematics and articular contact status between medial-pivot total knee arthroplasty (MP-TKA) and posterior stabilized (PS) TKA during weight-bearing single-leg lunge. 16 MP-TKA and 12 PS-TKA patients performed bilateral single-leg lunges under dual fluoroscopy surveillance to determine the in-vivo six degrees-of-freedom knee kinematics. The closest point between the surface models of the femoral condyle and the polyethylene insert was used to determine the contact position and area. The nonparametric statistics analysis was performed to test the symmetry of the kinematics between MP-TKA and PS-TKA. PS-TKA demonstrated a significantly greater range of AP translation than MP-TKA during high flexion (p = 0.0002). Both groups showed a significantly greater range of lateral compartment posterior translation with medial pivot rotation. The contact points of PS-TKA were located significantly more posterior than MP-TKA in both medial (10°–100°) and lateral (5°–40°, 55°–100°) compartments (p < 0.0500). MP-TKA had a significantly larger contact area in the medial compartment than in the lateral compartment. In contrast, no significant differences were observed in PS-TKA. The present study revealed no significant differences in clinical outcomes between the MP and PS groups. The PS-TKA demonstrated significantly more posterior translations than MP-TKA at high flexion. The contact points are located more posteriorly in PS-TKA compared with MP-TKA. A larger contact area and medial pivot pattern during high flexion in MP-TKA indicated that MP-TKA provides enhanced medial pivot rotation.

Goblet cell adenocarcinoma (GCA) is a rare amphicrine tumor and difficult to diagnose. GCA is traditionally found in the appendix, but extra-appendiceal GCA may be underestimated. Intestinal adenocarcinoma with signet ring cell component is also very rare, and some signet ring cell carcinomas are well cohesive, having some similar morphological features to GCAs. It is necessary to differentiate GCA from intestinal adenocarcinomas with cohesive signet ring cell component (IACSRCC). The goal of this study is to find occurrence of extra-appendiceal GCA and characterize the histological, immunohistochemical, transcriptional, and immune landscape of GCA. We collected 12 cases of GCAs and 10 IACSRCCs and reviewed the clinicopathologic characters of these cases. Immunohistochemical stains were performed with synaptophysin, chromogranin A, CD56, somatostatin receptor (SSTR) 2, and Ki-67. Whole transcriptome RNA-sequencing was performed, and data were used to analyze differential gene expression and predict immune cell infiltration levels in GCA and IACSRCC. RNA-sequencing data for colorectal adenocarcinoma were gathered from TCGA data portal. Of the 12 patients with GCA, there were 4 women and 8 men. There were three appendiceal cases and nine extra-appendiceal cases. GCAs were immunohistochemically different from IACSRCC. GCA also had different levels of B-cell and CD8+ T-cell infiltration compared to both colorectal adenocarcinoma and cohesive IACSRCCs. Differential gene expression analysis showed distinct gene expression patterns in GCA compared to colorectal adenocarcinoma, with a number of cancer-related differentially expressed genes, including upregulation of TMEM14A, GOLT1A, DSCC1, and HSD17B8, and downregulation of KCNQ1OT1 and MXRA5. GCA also had several differentially expressed genes compared to IACSRCCs, including upregulation of PRSS21, EPPIN, RPRM, TNFRSF12A, and BZRAP1, and downregulation of HIST1H2BE, TCN1, AC069363.1, RP11-538I12.2, and REG4. In summary, the number of extra-appendiceal GCA was underestimated in Chinese patients. GCA can be seen as a distinct morphological, immunohistochemical, transcriptomic, and immunological entity. The classic low-grade component of GCA and the immunoreactivity for neuroendocrine markers are the key points to diagnosing GCA.

Introduction The associated mortality and morbidity in hip fracture patients pose a major healthcare burden for ageing populations worldwide. We aim to analyse how an individual’s comorbidity profile based on age-adjusted Charlson Comorbidity Index (CCI) may impact on functional outcomes and 90-day readmission rates after hip fracture surgery. Materials and Methods Surgically treated hip fracture patients between 2013 and 2016 were followed up for 1-year and assessed using Parker Mobility Score (PMS), EuroQol-5D (EQ-5D) and Physical and Mental Component Scores (PCS and MCS, respectively) of Short Form-36 (SF-36). Statistical analysis was done by categorising 444 patients into three groups based on their CCI: (1) CCI 0–3, (2) CCI 4–5 and (3) CCI ≥ 6. Results PMS, EQ-5D and SF-36 PCS were significantly different amongst the CCI groups pre-operatively and post-operatively at 3, 6 and 12 months (all P < 0.05), with CCI ≥ 6 predicting for poorer outcomes. In terms of 90-day readmission rates, patients who have been readmitted have poorer outcome scores. Multivariate analysis showed that high CCI scores and 90-day readmission rate both remained independent predictors of worse outcomes for SF-36 PCS, PMS and EQ-5D. Discussion CCI scores ≥6 predict for higher 90-day readmission rates, poorer quality of life and show poor potential for functional recovery 1-year post-operation in hip fracture patients. 90-day readmission rates are also independently associated with poorer functional outcomes. Peri-operatively, surgical teams should liaise with medical specialists to optimise patients’ comorbidities and ensure their comorbidities remain well managed beyond hospital discharge to reduce readmission rates. With earlier identification of patient groups at risk of poorer functional outcomes, more planning can be directed towards appropriate management and subsequent rehabilitation. Conclusion Further research should focus on development of a stratified, peri-operative multidisciplinary, hip-fracture care pathway treatment regime based on CCI scores to determine its effectiveness in improving functional outcomes.

Objective We aimed to compare the efficacy and risks of proton pump inhibitor (PPI) versus histamine-2 receptor blocker (H2B) use for stress ulcer prophylaxis (SUP) in critically ill patients with sepsis and risk factors for gastrointestinal bleeding (GIB). Methods In this retrospective cohort study, we used the Medical Information Mart for Intensive Care III Clinical Database to identify critically ill adult patients with sepsis who had at least one risk factor for GIB and received either an H2B or PPI for ≥48 hours. Propensity score matching (PSM) was conducted to balance baseline characteristics. The primary outcome was in-hospital mortality. Results After 1:1 PSM, 1056 patients were included in the H2B and PPI groups. The PPI group had higher in-hospital mortality (23.8% vs. 17.5%), GIB (8.9% vs. 1.6%), and pneumonia (49.6% vs. 41.6%) rates than the H2B group. After adjusting for risk factors of GIB and pneumonia, PPI use was associated with a 1.28-times increased risk of in-hospital mortality, 5.89-times increased risk of GIB, and 1.32-times increased risk of pneumonia. Conclusions Among critically ill adult patients with sepsis at risk for GIB, SUP with PPIs was associated with higher in-hospital mortality and higher risk of GIB and pneumonia than H2Bs.

Abstract Background Fibrous hamartoma of infancy(FHI) is a rare benign lesion most frequently occurring within the first year of life. So far, just over 200 cases have been reported in the English literature, in which the radiologic findings of FHI have not been fully described. Herein, 2 adult cases of FHI receiving treatment in our hospital and the published cases searched on PubMed are reviewed, with the emphasis on the discussion of the spectrum of MR findings and their histologic correlation. Case presentation We present two adult cases who aged 47 years and 19 years with slow growing masses beginning from their childhood in the posterior craniocervical area. On CT and MR imaging, the tumours showed as the superficially located lesions with ill-defined margins that involved the subcutaneous layer and its underlying muscles. The size of the lesions were 21.3 × 16.7 × 16 cm in case 1 and 20.2 × 19.3 × 13.6 cm in case 2. The tumours demonstrated heterogeneous intensities/signals with the adipose tissue presenting as the disperse strands or small focus of fatty intensity/signal. Parallel or whirling appearance, and dilated vessels were delineated in the cases. Contrast enhancement was administered in case 1 and marked enhancement was found. Conclusions The usually observed manifestation of FHI on CT and/or MR imaging is the strands of adipose/fibrous intensities traversing the lesions, with the characteristic parallel or whirling appearance in some cases. The tumours with ill-defined margins have the tendency to involve the underlying muscles. Some fibroblastic and adipocytic tumours should be ruled out in differential diagnosis.

BackgroundWhile in vitro wear simulation of unicompartmental knee arthroplasty (UKA) showed outstanding long-term wear performance, studies reported that polyethylene (PE) wear was responsible for 12% fixed-bearing (FB) UKA failure. This paper aimed to quantify the in vivo 6-degrees-of-freedom (6-DOF) knee kinematics and contact positions of FB UKA during daily activities and compare with the previous results of in vitro wear simulator.MethodsFourteen patients following unilateral medial FB UKA received a CT scan and dual fluoroscopic imaging during level walking, single-leg deep lunge, and sit-to-stand motion for evaluating in vivo 6-DOF FB UKA kinematics. The closest point between surface models of the femoral condyle and PE insert was determined to locate the medial compartmental articular contact positions, which were normalized relative to the PE insert length. The in vivo contact area was compared with the in vitro wear region in previous simulator studies.ResultsThe in vivo contact positions during daily activities were more anterior than those in the previous in vitro wear simulator studies (p < 0.001). Significant differences in the femoral anteroposterior translation and tibial internal rotation during the stance phase were observed and compared with those in lunge and sit-to-stand motions (p < 0.05). The in vivo contact position located anteriorly and medially by 5.2 ± 2.7 and 1.8 ± 1.6 mm on average for the stance phase, 1.0 ± 2.4 and 0.9 ± 1.5 mm for the lunge, and 2.1 ± 3.3 and 1.4 ± 1.4 mm for sit-to-stand motion. The in vivo contact position was in the more anterior part during the stance phase (p < 0.05).ConclusionThe current study revealed that the contact position of FB UKA was located anteriorly and medially on the PE insert during in vivo weight-bearing activities and different from previous findings of the in vitro wear simulator. We should take in vivo 6-DOF knee kinematics and contact patterns of FB UKA into account to reproduce realistic wear performance for in vitro wear simulator and to improve implant design.

Purpose: Shorter length of stay (LOS) after total knee arthroplasty (TKA) is cost-effective. Straight leg raise (SLR) is a common exercise prescribed after TKA, but the significance of early postoperative SLR is unknown. The primary aim of this study is to evaluate the association between early postoperative SLR and LOS. Secondary aims are to explore associations among early postoperative SLR, time to ambulation, and time to stairs climbing and identify factors related to postoperative SLR. Methods: 888 TKAs (888 knees, 865 patients) performed at a tertiary hospital in 2016 were included for this retrospective study. All TKAs were performed with medial parapatellar approach and tourniquet. Time to events (SLR, ambulation, stair climbing), LOS and factors influencing these events were analysed using a multivariate Poisson regression model and logistic regression. Results: Patients who performed SLR on postoperative day 1 (POD1) had shorter LOS than those who did not (adjusted Mean Ratio (aMR) = 0.846, p < 0.001), with estimated mean LOS being 3.5 days and 4.1 days, respectively. Performing SLR on POD1 was also associated with shorter time to ambulation (aMR = 0.789; p < 0.001) and stair climbing (aMR = 0.811, p < 0.001). Female gender and higher rest pain on POD1 were associated with delayed postoperative SLR. Conclusion: Performing SLR on POD1 after TKA is associated with shorter LOS, time to ambulation, and time to stair climbing. Early postoperative SLR can prognosticate early recovery and discharge. Optimization of preoperative muscle strength and postoperative pain may be important in early recovery after TKA.

Improving the load-to-weight ratio of robots is an essential issue in the field of construction robots. In the present study, a method for analyzing the mobility of the typical multi-loop coupled mechanism is proposed, which combines the iterative replacement of generalized kinematic pairs with the screw theory. Then, the driving force/torque, driving power, and total power of actuators are considered as the evaluation indices, and the influence of different drive layouts on the mechanism is analyzed. Obtained results show that the driving force of the moving pair in the drive layout S1 or S3 changes smoothly compared with that in the drive layout S2, and the peak values of the driving force and the driving torque reduce by 49% and 12%, respectively. This demonstrates that the drive layout S1 effectively reduces the quality of the actuators. Finally, the coupled mechanism with the drive layout is applied in a high-altitude curtain wall installation robot, and the prototype of the robot is developed based on the coupled mechanism. Performed experiments show that the load-to-weight ratio in the proposed robot is about 13%.

In the installation process of large-scale external cladding, the labor intensity is high, and it is dangerous and hard to guarantee good construction quality. In view of these issues, this study designs a construction robot for external cladding installation, as a better solution. First, the advantages and disadvantages of the current building external cladding hanging process are discussed. The components, suitable for automatic installation, are selected to develop an automatic installation process for the building external cladding. According to the process steps and installation action flow, the installation robot is first adjusted. After the design of a step-by-step workflow of positioning and installation, a robot with a six-degree-of-freedom string-mixing mechanism is designed. Finally, a prototype of the proposed external cladding installation robot is developed, and the system is experimentally verified under simulation conditions and real operation. The test results show that the external cladding installation robot system has a strong theoretical basis. The series-parallel hybrid six-degree-of-freedom structure is reasonable, design wise. It helps to complete the automatic installation of the building external cladding and improve the automation level of large-scale plate installations.

Background: Non-alcoholic fatty liver disease (NAFLD), which often accompanied by metabolic syndrome, such as obesity, diabetes and dyslipidemia, has become a global health problem. Our previous results show that HCV core protein binding protein 6 (HCBP6) could maintain the triglyceride homeostasis in liver cells. However, the role of HCBP6 in NAFLD and its associated metabolic disorders remains incompletely understood. Methods: Hepatic HCBP6 expression was determined by qRT-PCR, Western blot and immunohistochemistry analysis. HCBP6 knockout (HCBP6-KO) mice were constructed and fed a high-fat diet (HFD) to induce NAFLD. The effects of HCBP6 on glucose and lipid metabolism were measured by HE staining, qRT-PCR, Western blot and GTT. Wild-type and HCBP6-KO mice kept on a HFD were treated with ginsenosides Rh2, and HE staining and GTT were used to study the function of Rh2 in metabolism disorders. Results: HCBP6 is reduced in HFD-fed mice. HCBP6 deficiency increased the body weight, aggravated fatty liver and deteriorated lipid homeostasis as well as glucose homeostasis in HFD-induced mouse model of NAFLD. Moreover, HCBP6-KO mice failed to maintain body temperature upon cold challenge. Mechanistically, HCBP6 could regulate lipolysis and fatty acid oxidation via activation of AMKP in vivo. In addition, HCBP6 expression was upregulated by ginsenosides Rh2. Accordingly, ginsenosides Rh2 administrations improved HFD-induced fatty liver and glucose tolerance. Conclusions: These findings indicated that HCBP6 is essential in maintaining lipid and glucose homeostasis and body temperature. HCBP6 augmented by ginsenosides Rh2 may be a promising therapeutic strategy for the treatment of metabolic disorders in NAFLD mice.

Abstract:. On February 8, 2020, Singapore raised its Disease Outbreak Response System Condition (DORSCON) level to Orange, indicating that coronavirus 2019 (COVID-19) was a severe disease with high human transmissibility. Using lessons learned from the severe acute respiratory syndrome (SARS) outbreak in 2003, the orthopaedic surgery department at Singapore General Hospital, a tertiary-level referral center, was prepared to handle this pandemic through business-continuity planning. The business that we are referring to is the “business” of orthopaedic surgery, encompassing clinical care, education, research, and administration. There is a lack of literature detailing business-continuity plans of surgical departments during pandemics, with new guidelines being developed. A large proportion of orthopaedic work, such as cases of fracture and infection, cannot be postponed. Even elective surgeries cannot be postponed indefinitely as it could result in detriment to the quality of life of patients. The aim of this article is to detail the business-continuity plans at our institution that allowed the delivery of essential musculoskeletal care through personnel segregation measures during the COVID-19 pandemic. Strategies to ensure the provision of timely medical intelligence, the reduction of nonessential ambulatory visits and surgical procedures, ensuring the safety and morale of staff, and continuing education and research efforts were paramount. As the COVID-19 pandemic unfolds, our posture needs to constantly evolve to meet new challenges that may come our way. Our existing business-continuity plan is not perfect and may not be applicable to smaller hospitals. There is conflict between envisioned normalcy, remaining economically viable as an orthopaedic department, and fulfilling training requirements, and educating the next generation of orthopaedic surgeons on the one hand and the need for segregation, workload reduction, virtual education, and social distancing on the other. Orthopaedic surgeons need to strike a balance between business continuity and adopting sustainable precautions against COVID-19. We hope that our experience will aid other orthopaedic surgery departments in adapting to this new norm, protecting their staff and patients, managing staff morale, and allowing the continuation of musculoskeletal care during the COVID-19 pandemic.

Background: Metaphyseal sleeves have been used as metaphyseal filling implants to address bone loss during revision total knee replacements (TKRs). This study aims to compare the 2-year clinical and radiological outcomes of constraint implant with bone defect and constraint implant without or minimal bone defect in revisions TKR with preoperative coronal plane instability. Materials and Methods: Seventeen cases of constraint implants with metaphyseal sleeve matched paired with 34 cases of constrained condylar knee (CCK) prosthesis. Age, gender, body mass index and aetiology for revision surgery were recorded. Clinical outcome measures included Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), Oxford Knee Score (OKS), physical component summary (PCS) and mental component summary (MCS). Radiological outcome measures included joint line changes, hip–knee–ankle angle (HKA), coronal femoral angle (CFA) and coronal tibial angle (CTA). Result: Patients in sleeve group showed significant improvement in KSKS, KSFS and OKS (38 ± 7, 35 ± 6 and 20 ± 2 points, respectively, p < 0.001), while they were 19 ± 3 and 6 ± 2 points for PCS and MCS, respectively ( p < 0.001 and p = 0.021). These postoperative scores after surgery were similar between the two groups at 6 months and 2 years. The sleeve provides comparable result in joint line restoration; the postoperative HKA, CFA and CTA were all comparable between the two groups. Conclusion: Metaphyseal sleeve with constraint implant is a viable option for revision TKR with preoperative coronal plane instability and significant bone defect. It is able to achieve similar clinical outcomes and joint line restoration compared to CCK prosthesis at 2-year follow-up.

Background: Ischemia-reperfusion injury (IRI) has been considered an inevitable event in organ transplantation since the first successful kidney transplant was performed in 1954. To avoid IRI, we have established a novel procedure called ischemia-free organ transplantation. Here, we describe the first case of ischemia-free kidney transplantation (IFKT).Materials and Methods: The kidney graft was donated by a 19-year-old brain-dead donor. The recipient was a 47-year-old man with end-stage diabetic nephropathy. The graft was procured, preserved, and implanted without cessation of blood supply using normothermic machine perfusion.Results: The graft appearance, perfusion flow, and urine production suggested that the kidney was functioning well-during the whole procedure. The creatinine dropped rapidly to normal range within 3 days post-transplantation. The levels of serum renal injury markers were low post-transplantation. No rejection or vascular or infectious complications occurred. The patient had an uneventful recovery.Conclusion: This paper marks the first case of IFKT in humans. This innovation may offer a unique solution to optimizing transplant outcomes in kidney transplantation.

Recent studies have shown the effect of microRNAs on HSC activation and transformation, which is essential for the pathogenesis of liver fibrosis. In our study, we explored the role of miR-185 in liver fibrosis. Plasma miR-185 was detected in hepatitis B virus-related liver fibrosis patients (S2/3, n = 10) by Illumina HiSeq sequencing, and healthy volunteers were selected (n = 8) as the control group. We found that the plasma miR-185 level in fibrosis patients was significantly downregulated. CCl4-induced fibrosis tissues in mouse livers and TGF-β1-activated HSCs also presented downregulated miR-185 concomitant with an increased expression of RHEB and RICTOR. To explore the correlations, LX-2 cells were transiently transfected with miR-185 mimics. The expression levels of α-SMA, collagen I, and collagen III were decreased as well as RHEB and RICTOR. Inhibition of endogenous miR-185 increased fibrogenic activity. Furthermore, dual-luciferase reporter assays indicated that miR-185 inhibited the expression of RHEB and RICTOR by directly targeting their 3′ UTRs. Moreover, silencing RHEB and RICTOR suppressed α-SMA and collagen expression levels. In conclusion, miR-185 prevents liver fibrogenesis by inhibiting HSC activation via inhibition of RHEB and RICTOR. These results provide new insights into the mechanisms behind the anti-fibrotic effect of miR-185.

A single-channel fiber-optic bolometer system based on a high-finesse silicon Fabry–Pérot interferometer (FPI) was previously reported, intended to measure plasma radiation from the magnetically confined fusion chamber. Recently, we developed a multichannel fiber-optic bolometer system with five bolometers multiplexed using a coarse wavelength division multiplexer (CWDM) and interrogated with a white-light system involving a superluminescent light-emission diode source and a high-speed spectrometer. One of the bolometers was used as the reference bolometer to compensate for the ambient temperature variations, and the other four bolometers were used for radiation measurement. The bolometers have a simple structure with a silicon pillar at the end of the single-mode fiber and a gold disk on the other side of the silicon pillar. They are also easy to fabricate without stringent requirements on the optical alignment. Analysis of the system optimization was performed to improve the noise performance and to mitigate the vibration effect that may present in the practical application. The system had a significantly enhanced measurement range compared to the previous high-finesse FPI bolometer system for measuring radiation. Test results performed in air using a 405 nm laser as the radiation source showed that the temperature resolution and the noise-equivalent power density of the sensing bolometers connected to each channel of the CWDM were, respectively, ~0.4 mK and ~0.1 W/m2, with a time constant of ~220 ms, which is comparable to the previous more complicated fiber-optic bolometer systems based on high-finesse FPIs that were interrogated using wavelength-scanning lasers.

Abstract Background Recent studies have indicated that microRNA-223 (miR-223) plays a role in the tissue-protective effect of mesenchymal stem cells (MSCs). NLR family-pyrin domain containing 3 (NLRP3) was reported to affect a renal ischemia/reperfusion (I/R) injury by exerting a direct effect on the renal tubular epithelium. Therefore, we investigated how miR-223 and NLRP3 might function in kidneys exposed to conditions of ischemia and subsequent reperfusion. Methods Hypoxia/reoxygenation (H/R) murine renal tubular epithelial cells (RTECs) were cocultured with either MSCs or hypoxia-pretreated MSCs (htMSCs), after which the RTECs were examined for their viability and evidence of apoptosis. Next, miR-223 expression in the MSCs was downregulated to verify that MSCs protected RTECs via the transport of miR-223. Kidney I/R KM/NIH mouse models were created and used for in vivo studies. Results The results showed that coculture with MSCs significantly increased the viability of RTECs and decreased their rates of apoptosis. The levels of hepatocyte growth factor (HGF), insulin-like growth factor-1 (IGF-1), transforming growth factor beta (TGF-β), and vascular endothelial growth factor (VEGF) in samples of coculture supernatants were higher than those in samples of non-coculture supernatants. A bioinformatics analysis revealed a targeting relationship between miR-223 and NLRP3. A dual luciferase assay showed that miR-223 inhibited NLRP3 expression. The htMSCs displayed a protective function associated with an upregulation of miR-223 as induced by Notch1 and the downregulation of NLRP3. Conversely, inhibition of miR-223 impeded the protective effect of MSCs. In the I/R mouse models, injection of either MSCs or htMSCs ameliorated the damage to kidney tissue, while suppression of miR-223 expression in MSCs reduced their protective effect on mouse kidneys. Conclusions Our results demonstrate that miR-223 and NLRP3 play important roles in the treatment of renal tissue injuries with transplanted MSCs.

Conductive colloidal chains are promising for electronics but difficult to synthesize outside of a liquid environment. Here, the authors use field-directed assembly and capillary effects to pull conductive particle chains out of a suspension, which remain held together by flexible liquid bridges even after the external field is turned off.

Background/Aims: The aim of this study was to elucidate how high-mobility group box 1 (HMGB1) exacerbates renal ischemic-reperfusion injury (IRI) by inflammatory and immune responses through the toll-like receptor 4 (TLR4) signaling pathway. Methods: A total of 30 wild-type (WT) mice and 30 TLR4 knockout (TLR4-/-) mice were selected and then randomly assigned to the Sham, I/R or HMGB1 groups. The serum and kidney tissues of all mice were collected 24 h after the perfusion. The fully automatic biochemical detector and ELISA were applied to determine the blood urea nitrogen (BUN) and serum creatinine (Scr) levels, and TNF-α, IL-1β, IL-6, IFN-γ and IL-10 levels, respectively. HE staining was used to evaluate kidney tissue damage, immunofluorescence and immunohistochemical staining were performed to observe CD68 and MPO cell infiltration, and flow cytometry was applied to detect immune cells. qRT-PCR and Western blotting were used to detect the expressions of TLR signaling pathway-related genes and proteins, respectively. Results: Compared with the Sham group, the levels of BUN, Scr, TNF-α, IL-1β, IL-6, IFN-γ and IL-10, kidney tissue damage score, CD68 and MPO cell infiltration, the numbers of immune cells, and the expressions of TLR signaling pathway-related genes and proteins in the I/R and HMGB1 groups were significantly up-regulated. In the I/R and HMGB1 groups, the levels of BUN and Scr, TNF-α, IL-1β, IL-6 and IFN-γ, kidney tissue damage score, CD68 and MPO cell infiltration, immune cell numbers, and TLR signaling pathway-related gene and protein expressions in the WT mice were all higher than those in the TLR4-/- mice, but IL-10 level was significantly lower. Similarly, all aforementioned indexes but IL-10 level in the WT and TLR4-/- mice were higher in the HMGB1 group than in the I/R group. Conclusion: Our study indicated that the up-regulation of HMGB1 could exacerbate renal IRI by stimulating inflammatory and immune responses through the TLR4 signaling pathway.c

Background and objective Bronchial tuberculosis is a common complication of pulmonary tuberculosis. The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis, when the drug and endoscopic treatment were no effect. Methods Reviewed the clinical-pathological records documenting the surgical outcomes in 36 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 2000 and February 2016. Pneumonectomy in 8 cases, lobectomy in 23 cases, sleeve resection in 5 cases. Results No intraoperative or early postoperative death occurred. Six patients developed complications. All 6 cases recovered well after treatment. Conclusion Surgical treatment is still the recommended treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its good results. It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed.

Introduction: Reduction in neuroforaminal height (FH) may diminish the indirect decompression benefit that lateral access surgery (LAS) provides. However, the relationship between postoperative FH reduction in LAS and health-related quality-of-life (HRQoL) outcomes remains unclear. Objectives: To determine whether FH reduction affects HRQoL outcomes at 2-year follow-up. Methods: A retrospective review of 45 patients who underwent LAS for degenerative lumbar spine conditions was performed. The cohort was divided into two groups: maintenance (A) and reduction (B) in FH. Outcome measures included numerical pain rating scale (NPRS back and leg pain), Oswestry Disability Index (ODI), Short Form 36 Health Survey (SF-36), North American Spine Society (NASS) score for neurogenic symptoms (NS), patient satisfaction, and expectation fulfilment for surgery. Mean disc height (DH), FH, and fusion were evaluated on plain radiographs. Radiological fusion was assessed with the Bridwell fusion classification. Unpaired student’s t -test was used to compare between groups and one-way ANOVA with Bonferroni post hoc correction was used to determine differences between time intervals within each group. Results: The average pre-op mean FH was 16.9 ± 3.5 mm. Group A had 25 patients showing postoperative maintenance of FH (19.4 ± 3.3 mm to 20.2 ± 3.2 mm; 4% increase) at 2-year postsurgery while group B had 20 patients showing decrease in FH (21.1 ± 3.3 mm to 18.7 ± 3.5 mm; 11% decrease). Group A mean DH improved from 7.0 ± 2.0 mm to 10.3 ± 1.6 mm (47% increase). Group B mean DH improved from 6.8 ± 2.3 mm to 11.0 ± 3.0 mm (62% increase). There were no significant differences in NPRS, ODI, NASS, SF-36, and SF-36 MCS/PCS between groups at 2 years ( p > 0.05); 92% of group A and 85% of group B patients reported good satisfaction and fulfilment of expectations ( p > 0.05). Conclusion: Despite an initial increase in FH after LAS surgery, 45% of patients had FH reduction at 2 years. However, FH reduction up to 11% did not affect short-term HRQoL outcomes.

In an ultrasonic sensor system based on π phase-shifted fiber Bragg gratings (πFBGsÞ, a cost-effective way for sensor demodulation is to set the laser wavelength at the center of the steep spectral slope of the πFBG refection spectrum. Frequency noise of the laser source ultimately limits the signal-to-noise ratio (SNR) of the sensor system. Here, we demonstrate a noise cancelation method based on a pair of πFBGs, which is capable of improving the SNR of system beyond the limitation set by the laser frequency noise. In this method, one of the gratings is used as the sensor to detect the acoustic signal, and the other grating, isolated from the signal, is used as a reference that gives the noise information. Employing a data postprocessing method, the noise is subtracted from the original detected signal. We show that the SNR of the sensor system can be improved by up to 20 dB using this method.

Category: Bunion Introduction/Purpose: Patients with hallux valgus (HV) often experience concurrent second toe metatarsalgia due to altered forefoot biomechanics. Additional second toe Weil osteotomy has been performed to reduce transfer metatarsalgia as some studies have highlighted the presence of second toe pain after isolated HV correction. 1, 2 There is a paucity of literature evaluating residual second toe pain after these procedures . We hypothesize that combined Scarf/Weil osteotomy will result in less residual second toe pain while achieving good functioning outcome. The aim of this study was to evaluate the presence of second toe pain after isolated scarf osteotomy versus combined Scarf/Weil osteotomy. Methods: Between January 2007 and June 2012, 439 patients underwent a scarf osteotomy for symptomatic hallux valgus at a tertiary hospital. Patients who underwent isolated scarf osteotomy were matched 1:1 to patients who had both Scarf and second toe Weil osteotomy. The following functional outcome scores were prospectively collected preoperatively and postoperatively at 6 and 24 months: American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal (MTP-IP) Scale, Visual Analog Scale (VAS), SF36-Physical Component Score (PCS) and Mental Component Score (MCS). Radiological outcomes such as the Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) were measured. Statistical analysis was performed using SPSS® 20.0 and significance was defined as a p-value = 0.05. The Student’s unpaired t-test was used to compare the radiological and functional outcomes between the two groups of patients, while the paired t-test was used to analyze improvement in pre- and postoperative outcomes within each group. Results: 94.4% of the patients were female and no difference in BMI. In the Scarf/Weil group, the HVA and IMA improved by 21.2 ± 10.2 and 8.2 ± 4.7 degrees respectively (both P

Category: Bunion Introduction/Purpose: Men are recognized to possess higher pain thresholds, report less pain and have a greater tolerance for pain. With increasing numbers of males seeking hallux valgus (HV) surgery, there is a paucity of literature comparing health-related quality-of-life (HRQoL) outcomes and satisfaction between males and females undergoing HV surgery. Methods: Prospectively collected registry data of 439 patients who underwent HV surgery at a single institution from 2007-2015 were reviewed. Propensity scores generated using logistic regression was used to match males (n=26) to females (n=52) in a 1:2 ratio. Hallux visual analogue scale (VAS) scores, American Orthopaedic Foot and Ankle Society scores (AOFAS), proportion attaining AOFAS minimal clinically important difference (MCID), Short-form 36 (SF-36), satisfaction and expectation scores were analyzed. Hallux valgus (HVA) and inter-metatarsal (IMA) angles were recorded pre- and postoperatively. Results: Before PSM, there were significant differences in age (49.8±17.4 vs 55.2±11.8, p=0.03) and SF-36 role-physical (37.5±43.7 vs 59.2±42.6, p=0.01)(Table 1). After PSM, there were no significant pre-operative differences in hallux VAS, AOFAS and SF-36 HRQoL scores between groups (Table 1). At two-years, males had significantly lower SF-36 general health scores (68.7±20.6 vs 79.3±17.8, p=0.02) (Table 2). In addition, lower proportion of males reported good/excellent satisfaction (73.1% vs 78.8%) and expectation fulfilment (80.8% vs 94.2%) at two-years (Table 3). Similar proportion of males attained MCID for AOFAS (53.8% vs 46.2%, p=0.63) (Table 4). Males and females presented with similar pre-operative HVA (29.3±8.4 vs 28.2±9.3, p=0.63) and IMA (14.4±3.2 vs 13.9±3.4, p=0.53), with successful correction of HVA (14.7±6.5 vs 12.5±7.8, p=0.25) and IMA (9.4±3.3 vs 8.3±3.1, p=0.17) post-operatively (Table 5). Conclusion: Our findings suggest that males may experience lower expectation fulfilment when compared to females after HV surgery, despite resolution of hallux pain, satisfactory radiological correction and attainment of similar proportion of MCID in AOFAS scores. These findings highlight that males may possess higher expectations towards hallux valgus surgery. Future research should focus on factors affecting expectation fulfilment in males undergoing HV surgery.

The effects of shot peening treatments on the microstructure and fatigue behavior of the teeth root in wet copper-based powder metallurgy friction plates were investigated and an efficient method for selecting optimal shot peening parameters for friction plates was proposed. Different experimental processes including microscopy observation, microhardness, roughness and X-ray diffraction measurements have been performed to characterize the treated surface of specimens. It is found that fatigue life of friction plates firstly increases and then decreases with the increase of Almen intensity, and the optimal fatigue life has improved over 55%. It is considered that both surface grain refinement and high residual compressive stress are the main ingredients responsible for the improved fatigue life. With further increase of Almen intensity, surface roughness of the teeth root gradually increases to a critical point, where rough peened surface may induce crack initiation due to stress concentration, and finally lead fatigue deteriorate.

Water scarcity is the most critical constraint for sustainable cotton production in Xinjiang Province, northwest China. Drip irrigation under mulch is a major water-saving irrigation method that has been widely practiced for cotton production in Xinjiang. The performance of such an irrigation system should be evaluated for proper design and management. Therefore, a field experiment and a simulation study were conducted to (1) determine a modeling approach that can be applied to manage drip irrigation under mulch for cotton production in this region; and (2) examine the effects of irrigation amount and mulch on soil water distribution and root zone water balance components. In the experiment, four irrigation treatments were used: T1, 166.5 m3; T2, 140.4 m3; T3, 115.4 m3; and T4: 102.3 m3. The HYDRUS-2D model was calibrated, validated, and applied with the data obtained in this experiment. Soil water balance in the 0–70 cm soil profile was simulated. Results indicate that the observed soil water content and the simulated results obtained with HYDRUS-2D are in good agreement. The radius of the wetting pattern, root water uptake, and evaporation decreased as the amount of irrigation was reduced from T1 to T4, while a lot of stored soil water in the root zone was utilized and a huge amount of water was recharged from the layer below 70 cm to compensate for the decrease in irrigation amount. Mulch significantly reduced evaporation by 11.7 mm and increased root water uptake by 11.2 mm. Our simulation study suggests that this model can be applied to provide assistance in designing drip irrigation systems and developing irrigation strategies.

In this study, we aimed to explore new downstream effectors of TWIST1/2 in inducing epithelial-to-mesenchymal transition in gastric cancer. Bioinformatic data mining was performed using data in The Cancer Genome Atlas Stomach Adenocarcinoma. Survival curves were generated using Kaplan–Meier plotter. Gastric cancer cell lines (AGS and SGC-7901) were used as in vitro cell model to investigate the regulative effect of TWIST1/2 on epithelial membrane protein 3 expression and the progression of epithelial-to-mesenchymal transition. Results showed that TWIST1 and TWIST2 are usually co-upregulated in patients with primary gastric cancer. High TWIST1 expression is associated with worse overall survival (hazard ratio = 1.26; 95% confidence interval = 1.06–1.49; p = 0.007) and also worse first progression-free survival (hazard ratio = 1.47; 95% confidence interval = 1.18–1.82; p

Studies have demonstrated that microRNA 185 may be a promising therapeutic target in liver cancer. However, its role in hepatocellular carcinoma is largely unknown. In this study, the proliferation of human HepG2 cells was inhibited by transfection of microRNA 185 mimics. Cell-cycle analysis revealed arrest at the G0/G1 phase. Transfection of HepG2 cells with microRNA 185 mimics significantly induced apoptosis. These data confirmed microRNA 185 as a potent cancer suppressor. We demonstrated that microRNA 185 was a compelling inducer of autophagy, for the first time. When cell autophagy was inhibited by chloroquine or 3-methyladenine, microRNA 185 induced more cell apoptosis. MicroRNA 185 acted as a cancer suppressor by regulating AKT1 expression and phosphorylation. Dual-luciferase reporter assays indicated that microRNA 185 suppressed the expression of target genes including RHEB , RICTOR , and AKT1 by directly interacting with their 3′-untranslated regions. Binding site mutations eliminated microRNA 185 responsiveness. Our findings demonstrate a new role of microRNA 185 as a key regulator of hepatocellular carcinoma via autophagy by dysregulation of AKT1 pathway.

The groundwater level in the Big Sunflower River Watershed (BSRW) in the U.S. has declined significantly in the past 30 years. Therefore, it is imperative to assess surface water resources (SWR) availability in BSRW to mitigate groundwater use for irrigation. This research applied the coupled Soil and Water Assessment Tool–Modular Groundwater Flow model (SWAT–MODFLOW) to assess SWR in BSRW. This study aimed at: (1) Assessing the reliability of SWAT–MODFLOW in BSRW, (2) analyzing temporal and spatial variations of SWR, and (3) assessing the potential availability of SWR in BSRW. Calibration and validation results showed that SWAT–MODFLOW can well simulate streamflow and groundwater levels in BSRW. Our results showed that BSRW had lower average monthly total stream resources (MSR = 8.8 × 107 m3) in growing seasons than in non-growing seasons (MSR = 11.0 × 107 m3), and monthly pond resources (MPR from 30,418 to 30,494 m3) varied less than stream resources. The proportion of sub-basins in BSRW with stream water resources greater than 700 mm was 21% in dry years (229 to 994 mm), while this increased to 35% in normal years (296 to 1141 mm) and 57% in wet years (554 to 991 mm). The Water Stress Index (WSI) ranged from 0.4 to 2.1, revealing that most of the sub-basins in BSRW have net SWR available for irrigation. Our results suggested that surface water resources might be supplementary irrigation sources to mitigate the water resources scarcity in this region.

We present a compact and highly-sensitive fiber-optic refractometer based on a high-Q p-phase-shifted fiber-Bragg-grating (pFBG) that is chemically etched to the core of the fiber. Due to the p phase-shift, a strong pFBG forms a high-Q optical resonator and the reflection spectrum features an extremely narrow notch that can be used for highly sensitivity refractive index measurement. The etched pFBG demonstrated here has a diameter of ~9.3 μm and a length of only 7 mm, leading to a refractive index responsivity of 2.9 nm/RIU (RIU: refractive index unit) at an ambient refractive index of 1.318. The reflection spectrum of the etched pFBG features an extremely narrow notch with a linewidth of only 2.1 pm in water centered at ~1,550 nm, corresponding to a Q-factor of 7.4 ´ 105, which allows for potentially significantly improved sensitivity over refractometers based on regular fiber Bragg gratings.

Purpose. To compare the outcome following total knee arthroplasty (TKA) in obese and non-obese Asian patients. Methods. 27 obese patients were compared with 27 non-obese controls matched for age, gender, diagnosis (osteoarthritis), prosthesis, preoperative Knee Society knee and function scores, preoperative Oxford Knee Score, and follow-up duration. All TKAs were performed by a single surgeon. Patients were assessed at 6 months and 2 years for the range of motion, Knee Society knee and function scores, Oxford Knee Score, and Short Form-36 Health Survey (SF-36). Results. The obese and non-obese groups did not differ significantly in pre- and post-operative variables: range of motion, Knee Society knee and function scores, Oxford Knee Score, and SF-36 score. Using revision as an end-point, implant survival was 100%. There were no intra- or post-operative complications in either group. Conclusion. Obese and non-obese Asian patients achieved a comparable outcome following TKA.