Search

Although cigarette smoking is an independent risk factor for cardiovascular disease, inconsistent results have been published in the literature on its impacts on the cardiovascular health of patients after coronary revascularization with a percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). We performed a comprehensive electronic database search through July 2018. Studies reporting the risk estimates of all-cause mortality and cardiovascular outcomes in patients after coronary revascularization with PCI or CABG on the basis of smoking status were selected. Multivariate-adjusted relative risks (RRs) and 95% confidence intervals (CIs) were pooled using random-effects models with inverse variance weighting. Data from 37 records including 126 901 participants were finally collected. Overall, the pooled RR (95% CI) associated with cigarette smoking was 1.26 (95% CI: 1.09-1.47) for all-cause mortality, 1.08 (95% CI: 0.92-1.28) for major adverse cardiovascular events, 0.96 (95% CI: 0.69-1.35) for cardiovascular mortality and 1.15 (95% CI: 0.81-1.64) for myocardial infarction. The increased risk of all-cause mortality was also observed in former smokers compared with those who had never smoked (RR: 1.19; 95% CI: 1.03-1.38). Furthermore, the negative effects of cigarette smoking on all-cause mortality were also observed in most subgroups. Cigarette smoking has been shown to increase the likelihood of all-cause mortality in patients after coronary revascularization with PCI or CABG. Smoking cessation is essential for PCI or CABG patients to manage their coronary artery disease.

Sustainable feeding of the growing population in China without ecological destabilization is a grand challenge. In this populous country where agriculture is dominated by smallholder farming, developing innovative technology and translating scientific knowledge into action for smallholder farmers is a crucial step in addressing this challenge. Here, we present a novel approach for technology innovation and dissemination to achieve sustainable intensification in the fields of smallholder farmers. The Science and Technology Backyard (STB) is a hub in a rural area that links knowledge with practices to promote technology innovation and exchange. In this study, the framework and functions of STB are introduced, and the key implications for sustainable intensification across millions of smallholder farmers are explicitly stated: (i) develop innovative technology based on stated demands of farmers; (ii) disseminate technology by innovative social service models though combined top-down approaches with bottom-up measures to enable smallholders in rural areas. This paper provides a perspective on transformation of small-scale agriculture toward sustainable intensification in China and useful knowledge applicable to other developing countries.

Increasing plant density is an effective and important way to reduce maize yield gaps in Northeast China. However, the fact is that a significant plant density gap exists between optimum plant density and actual plant density in farmers' fields. To quantify the density gap between planned planting density and final harvest plant density (HPD), we studied 60 farmers' fields on three types of soil for three crop seasons from 2015 to 2017 by measuring their plant-plant distance, actual seedlings density (ASD), final HPD and yield. We also explored the potential causes of density loss by digging the places where the seedlings were missing for two consecutive years in 2016–2017. Results show that the three-year average HPD in farmers' fields was 59 699 plants ha−1, which was significantly lower than the planned density, including both the machine setting density (MSD; 67 962 plants ha−1) and theoretical plant density (TPD; 67 467 plants ha−1). No significant difference was found in HPD between years and soil types. However, for MSD and TPD, the average value in 2015 was significantly higher than that in 2016 and 2017. No significant difference between soil types was observed. Furthermore, the results from 2016 till 2017 indicated that a lack of seeds in the soil, a failure to germinate due to low-quality seeds, and a lack of seedlings breaking out of the soil due to environmental problems explained approximately 60.88, 10.33 and 28.80% of density loss, respectively. According to our survey, 63% of farmers did not know their own TPD and HPD, and 54% of farmers did not know the density loss. Therefore, we argue that farmers' limited knowledge of density and density loss is an urgent problem that needs to be solved in maize production. These observations will be useful for determining best management practices for maize production and for providing helpful suggestions for machine improvement.

North China Plain (NCP) is the primary winter wheat production region in China, characterized by smallholder farming systems. Whereas the winter wheat average yield of smallholder farmers is currently low, the yield potential and limiting factors driving the current yield gap remain unclear. Therefore, increasing the wheat yield in NCP is essential for the national food security. This study monitored wheat yield, management practices and soil nutrient data in 132 farmers' fields of Xushui County, Baoding City, Hebei Province during 2014–2016. These data were analyzed using variance and path analysis to determine the yield gap and the contribution of yield components (i.e., spikes per hectare, grain number per spike and 1000-grain weight) to wheat yield. Then, the limiting factors of yield components and the optimizing strategies were identified by a boundary line approach. The results showed that the attainable potential yield for winter wheat was 10 514 kg ha−1. The yield gaps varied strongly between three yield groups (i.e., high, middle and low), which were divided by yield level and contained 44 farmers in each group, and amounted to 2493, 1636 and 814 kg ha−1, respectively. For the three yield components, only spikes per hectare was significantly different (P6.598 × 06 ha−1), the seeding rate should range from 210–300 kg ha−1, seeding date should range from 3th to 8th October, and basal N input should range from 90–180 kg ha−1. Compared to these reasonable ranges of management measures, most of the farmers' practices were not suitable, and both lower and higher levels of management existed. It is concluded that the strategies for optimizing yield components could be achieved by improving wheat seeding quality and optimizing farmers' nutrient management practices in the NCP.

The impairment of mitochondrial bioenergetics, often coupled with exaggerated reactive oxygen species (ROS) production, is a fundamental disease mechanism in organs with a high demand for energy, including the heart. Building a more robust and safer cellular powerhouse holds the promise for protecting these organs in stressful conditions. Here, we demonstrate that NADH:ubiquinone oxidoreductase subunit AB1 (NDUFAB1), also known as mitochondrial acyl carrier protein, acts as a powerful cardio-protector by conferring greater capacity and efficiency of mitochondrial energy metabolism. In particular, NDUFAB1 not only serves as a complex I subunit, but also coordinates the assembly of respiratory complexes I, II, and III, and supercomplexes, through regulating iron-sulfur biosynthesis and complex I subunit stability. Cardiac-specific deletion of Ndufab1 in mice caused defective bioenergetics and elevated ROS levels, leading to progressive dilated cardiomyopathy and eventual heart failure and sudden death. Overexpression of Ndufab1 effectively enhanced mitochondrial bioenergetics while limiting ROS production and protected the heart against ischemia-reperfusion injury. Together, our findings identify that NDUFAB1 is a crucial regulator of mitochondrial energy and ROS metabolism through coordinating the assembly of respiratory complexes and supercomplexes, and thus provide a potential therapeutic target for the prevention and treatment of heart failure.

The resistance variations of Aerosol-Jet printed silver lines in a current-voltage measurement with linear increased voltages are studied. There are four kinds of curves obtained due to the different initial average sheet resistances. The most typical device has both current leap and drop in the whole voltage sweep, and divides the current-voltage characteristics into three regions. The results, which show that Joule heating plays a key role, can be explained using electric sintering and electromigration failure. Characteristics of other devices were also explained subsequently to confirm the findings. All of the fused printed Ag-NPs have similar average sheet resistances, which may be a balanced state between electrical sintering and electromigration. This investigation opens up a better method for understanding the current carrying capacity of Aerosol-Jet printed conductive line with rough surface, narrow width, and high sheet resistance.

In this paper, we develop a more general framework of block-structured Markov processes in the queueing study of blockchain systems, which can provide analysis both for the stationary performance measures and for the sojourn times of any transaction and block. Note that an original aim of this paper is to generalize the two-stage batch-service queueing model studied in Li et al. \cite{Li:2018} both ``from exponential to phase-type" service times and ``from Poisson to MAP" transaction arrivals. In general, the MAP transaction arrivals and the two stages of PH service times make our blockchain queue more suitable to various practical conditions of blockchain systems with crucial random factors, for example, the mining processes, the block-generations, the blockchain-building and so forth. For such a more general blockchain queueing model, we focus on two basic research aspects: (1) By using the matrix-geometric solution, we first obtain a sufficient stable condition of the blockchain system. Then we provide simple expressions for the average number of transactions in the queueing waiting room, and the average number of transactions in the block. (2) However, comparing with Li et al. \cite{Li:2018}, analysis of the transaction-confirmation time becomes very difficult and challenging due to the complicated blockchain structure. To overcome the difficulties, we develop a computational technique of the first passage times by means of both the PH distributions of infinite sizes and the $RG$-factorizations. Finally, we hope that the methodology and results given in this paper will open a new avenue to queueing analysis of more general blockchain systems in practice, and can motivate a series of promising future research on development of lockchain technologies., 38 pages, 4 figures

Objective: To study the diagnostic value of color doppler ultrasound in children with thyroid nodules and thyroid cancer. Methods: A total of sixty children with thyroid nodules treated in our hospital from March 2017 to March 2018 were selected for study. All patients underwent color Doppler ultrasound diagnosis. According to the diagnostic data, benign thyroid nodules and thyroid cancer were analyzed. The nodule nature was grouped into benign nodules group and malignant nodules group. The aspect ratio and boundary of the two groups were compared in blurring, calcification, blood flow signal classification, etc. Results: A total of 95 nodules were diagnosed by color doppler ultrasonography in 60 cases of thyroid nodules. 49 cases were benign nodules. There were 80 nodules, accounting for 82.11%, 11 cases of thyroid cancer, and 15 nodules. Accounted for 15.79%. Biopsy puncture pathology confirmed 77 benign nodules and 18 malignant nodules. The pathological results were gold standard. The specificity of color Doppler ultrasound was 90%, the sensitivity was 66.67%, and the accuracy of ultrasound diagnosis was 86.32%.The two nodules were statistically significant in terms of boundary, aspect ratio, calcification, echo, and resistance index (P0.05).Conclusion: Color Doppler ultrasound has the advantages of simple operation, high accuracy, non-invasive and painless, and reproducible detection. The high-frequency probe can clearly display changes such as minute lesions, blood flow signals, echoes, calcifications, etc., and can diagnose thyroid cancer in time. It provides a favorable basis for clinical treatment and has important clinical warning value, especially for children with thyroid examination.

BACKGROUND This study aimed to compare the application value of intraoperative fluorescence navigation technology (FNT) and intraoperative ultrasound (IOUS) in primary liver cancer surgery. MATERIAL AND METHODS Fifty consecutive patients with primary liver cancer scheduled to receive surgical treatment were divided into FNT group and IOUS group. FNT and IOUS were separately used to guide tumor resection and detect new cancerous lesions in the 2 groups. The complete tumor resection rate (R0) resection rate, length of the tumor distance from cutting edge, the diagnostic efficacy of cancerous nodules and the fluorescence imaging characteristics of different types tumors were recorded. RESULTS The R0 resection rate was 100% (25 out of 25 patients) in the FNT group and 96% (24 out of 25 patients) in the IOUS group. In the FNT group, 1 case (4%, 1 out of 25 patients) had cancer tissue that was less than 1 cm from the cutting edge, compared to 7 cases (28%, 7 out of 25 patients) in the IOUS group (P=0.049), which was a significant difference. In the remaining livers of 50 consecutive patients, FNT found 5 new cancerous nodules with a sensitivity of 71.4%, a specificity of 11.1%, and a false-positive rate of 88.9%; for IOUS the results were 42.9%, 88.9%, 11.1%. The fluorescence imaging characteristics of all well-differentiated hepatocellular carcinomas were tumor tissue imaging, but all other types of tumors were ring imaging around the tumor. CONCLUSIONS FNT can improve the R0 resection rate, ensure a safe distance between tumor and cutting edge and can identify more new cancerous nodules compared to IOUS. Thus, FNT could improve the surgical treatment effect for primary liver cancer and hopefully further improve the prognosis of patients.

Danggui Buxue Tang (DBT) is a famous Chinese medicinal decoction. Mechanism of DBT action is wide ranging and unclear. Exploring new ways of treatment with DBT is useful. Sprague-Dawley(SD) rats were randomly divided into 3 groups including control (NC, Saline), the DBT (at a dose of 8.10 g-1), and blood deficiency(BD) (Cyclophosphamide (APH)-andCyclophosphamide(CTX)-induced anaemia). A metabolomics approach using Liquid Chromatography-Quadrupole-Time-of-Flight/Mass Spectrometry (LC/Q-TOFMS) was developed to perform the plasma metabolic profiling analysis and differential metaboliteswerescreened according to the multivariate statistical analysiscomparing the NC and BD groups, andthe hub metabolites were outliers with high scores of the centrality indices. Anaemia disease-related protein target and compound of DBT databases were constructed. The TCMSP, ChemMapper and STITCH databases were used to predict the protein targets of DBT. Using the Cytoscape 3.2.1 to establish a phytochemical component-target protein interaction network and establish a component, protein and hub metabolite protein-protein interaction (PPI) network and merging the three PPI networks basing on BisoGenet. The gene enrichment analysis was used to analyse the relationship between proteins based on the relevant genetic similarity by ClueGO. The results shown DBT effectively treated anaemia in vivo. 11 metabolic pathways are involved in the therapeutic effect of DBT in vivo; S-adenosyl-l-methionine, glycine, l-cysteine, arachidonic acid (AA) and phosphatidylcholine(PC) were screened as hub metabolites in APH-and CTX-induced anaemia. A total of 288 targets were identified as major candidates for anaemia progression. The gene-set enrichment analysis revealed that the targets are involved in iron ion binding, haemopoiesis, reactive oxygen species production, inflammation and apoptosis. The results also showed that these targets were associated with iron ion binding, haemopoiesis, ROS production, apoptosis, inflammation and related signalling pathways. DBT can promote iron ion binding and haemopoiesis activities, restrain inflammation, production of reactive oxygen, block apoptosis, and contribute significantly to the DBT treat anaemia.

To determine and evaluate the value of shadowing and the twinkling artifact (TA) for the diagnosis of ureteral stones.Related ultrasound images from 117 patients with suspected ureteral stones were consecutively collected with optimized machine settings, confirmed by computed tomography and then retrospectively reviewed by 12 physicians who were classified into 3 groups according to their experience levels: elementary, intermediate, and advanced. The shadowing/TA grades were separately evaluated by all the participating physicians in a blinded manner, and the consistency was verified using Kendall's coefficient of concordance (Kendall's W). Furthermore, the diagnostic performance was compared among the groups stratified by physicians' clinical experience levels and ureteral stone sizes.Using shadowing/TA as indicators for ureteral stones, Kendall's W for the TA evaluation was higher than that for shadowing among all the participating physicians and subgroups (P.05). Furthermore, with no difference in specificity at 100%, the sensitivity of the isolated TA was superior to that of shadowing in groups stratified by the physicians' clinical experience levels and stone sizes, respectively (P.05). However, for the respective comparisons of shadowing and the TA among groups stratified by stone sizes, as ureteral stones became larger, the detection sensitivities all significantly increased (P ≤.001).Among physicians, subjective evaluation of the TA is more consistent and has better diagnostic sensitivity than that of shadowing for the diagnosis of ureteral stones, and the stone size may play an important role in the detection sensitivity of these 2 indicators.

To develop an optimal prophylactic regimen among Chinese patients who accept transrectal prostate biopsy. We enrolled 420 patients who accepted transrectal prostate biopsy. They were randomly classified into three groups (n = 140 for each): Group A received a single 500-mg tablet of levofloxacin without enema; group B received a single 500-mg tablet of levofloxacin plus enema; group C received 3-day levofloxacin orally plus enema. Patients were assessed if they had a febrile urinary tract infection (FUTI). The incidence of FUTI was compared among groups. Subgroup analysis was performed between patients at high and low risk of infection in each group. There were 15 cases developed FUTI: 7 (5%), 6 (4.3%), and 2 (1.4%), respectively, in groups A, B, and C. Of the 15 patients who developed FUTI, Escherichia coli was detected in blood culture in two cases. Urine culture results were all negative. FUTI patients (73.3% (11/15)) had at least one high risk factor. Subgroup analysis showed that the incidence of FUTI in group A was significantly higher than that in group C among high-risk patients. There was no statistical difference between group A and group B among both high- and low-risk patients. A single 500-mg dose of levofloxacin without enema represents excellent prophylaxis for transrectal prostate biopsy in Chinese patients at low risk of infection. For those at high risk, 3-day levofloxacin prophylaxis is the optimal regimen. Prebiopsy enema provides no clinically significant outcome advantage and is unnecessary.

This research investigated the use of sodium carboxymethyl cellulose (CMC) as a reinforcement to improve mechanical properties of loess soil found in northwestern China. The mechanical properties of loess were determined by unconfined compressive strength and split tensile strength tests. Three different contents of CMC were adopted: 0.5%, 1.0%, and 1.5%. The results showed that utilizing CMC reduced the maximum dry density of the loess. The compressive strength, tensile strength, and Young’s modulus are enough to construct low-rise buildings when the CMC content exceeds 1.0%, based on existing standards. This research thus provides a prospective sustainability method for loess stabilization.

In order to research on the issue of high-pressure gas blasting fracture deeply, a high-pressure gas blasting cracking experimental system was established; the effects of gas pressure and gas volume on the morphology of crack growth were studied; the p-t curve of pressure in the blasting process with time was obtained; and the mechanism of high-pressure gas blasting cracking was analyzed in this paper. The conclusion has shown that the stage of effect of high-pressure gas blasting on the test block includes three stages: the gas jet impact stage, the crack initiation and development stage, and the perforation fracture stage. In the design of gas pressure of 5 MPa, the experimental block only produces one longitudinal main crack. As the gas pressure increases to 7.5 MPa and 10 MPa, besides forming one longitudinal main crack, a transverse main crack is formed with further expanded 4–6 secondary cracks. In the same design of gas pressure regardless of volume size, each pressure variation stage has the same length, and the experimental block of the cracking pressure is basically the same. With the higher design pressure, the cracking pressure and the fracture pressure are higher. In the same design of gas pressure, with the larger gas volume, the fracture pressure required for the experimental block is smaller.

Endothelial cell dysfunction and diabetic vascular complications are intrinsically linked. Although BDNF plays a protective role in cerebral microvascular complications caused by diabetes, the mechanisms of this activity are not fully clear. In this study, we investigated the role of BDNF in the hyperglycemic injury of BMECs and its associated intracellular signal transduction pathways. BMECs were treated with 33 mM glucose to imitate the endothelium under hyperglycemic conditions. The high-glucose treatment caused cell dysfunction, as evaluated by oxidative stress and cell apoptosis, which could be alleviated by BDNF. In addition, BDNF preserved mitochondrial function as assessed by mPTP opening, mitochondrial membrane potential, calcium content, and mitochondrial biogenesis markers. Western blot analysis of LC3-II, p62, and TOMM20 and the detection of mRFP-GFP-LC3 adenovirus for autophagy flux revealed that BDNF enhanced autophagy flux. Furthermore, BDNF activated mitophagy, which was confirmed by the observed colocalization of LC3-II with BNIP3 and from transmission electron microscopy observations. The HIF-1α/BNIP3 signaling pathway was associated with BDNF/TrkB-induced mitophagy. In addition, BDNF-induced mitophagy played a protective role against BMEC damage under hyperglycemia. Thus, the results of this study suggest that BDNF/TrkB/HIF-1α/BNIP3-mediated mitophagy protects BMECs from hyperglycemia.

Objective. The aim of this study was to investigate the difference of efficacy between conventional moxibustion (CM) and smoke-free moxibustion (SM) for patients with osteoarthritis of the knee (KOA). Methods. This is a multicentre, randomized, single blinded, parallel-group clinical trial. Patients with KOA were randomly allocated to CM group (69) and SM group (69) in 7 hospitals of China. Moxibustion treatment in 12 sessions over 4 weeks was administrated at 3 acupuncture points (EX-LE4, ST35, and ST36). Patients completed standard questionnaires at baseline and after 2 weeks, 4 weeks, 8 weeks, and 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) from the baseline to 4 weeks. The secondary outcomes include Visual Analogue Scale (VAS) and Patient Global Assessment score (PGA). Results. Analyses showed that the WOMAC score improved in pain (95% CI,-0.1[-1.2 to 0.9], p=0.76), stiffness (95% CI,-0.1 [-0.5 to 0.3], p=0.71), and function (95% CI, 2.2 [-1.3 to 5.8], p=0.22) compared between the two groups at 4 weeks, as well as the VAS score (95% CI,0.1 [-0.3 to 0.6], p=0.60). Similar results presented at 8 and 12 weeks. No statistically significant difference was observed between CM and SM groups for outcome measurements. Conclusions. It suggested that smoke generated during moxibustion treatment does not affect the efficacy of moxibustion in the treatment of KOA, which should be taken into account to be removed for the sake of reducing environmental pollution or moxa smoke exposure of acupuncturists or patients. This trial is registered with Clinical Trials.gov, NCT02772055.

A crucial feature of differentiated cells is the rapid activation of enhancer-driven transcriptional programs in response to signals. The potential contributions of physicochemical properties of enhancer assembly in signaling events remain poorly understood. Here we report that in human breast cancer cells, the acute 17β-estradiol-dependent activation of functional enhancers requires assembly of an enhancer RNA-dependent ribonucleoprotein (eRNP) complex exhibiting properties of phase-separated condensates. Unexpectedly, while acute ligand-dependent assembly of eRNPs resulted in enhancer activation sensitive to chemical disruption of phase separation, chronically activated enhancers proved resistant to such disruption, with progressive maturation of eRNPs to a more gel-like state. Acute, but not chronic, stimulation resulted in ligand-induced, condensin-dependent changes in spatial chromatin conformation based on homotypic enhancer association, resulting in cooperative enhancer-activation events. Thus, distinct physicochemical properties of eRNP condensates on enhancers serve as determinants of rapid ligand-dependent alterations in chromosomal architecture and cooperative enhancer activation.

Gastric cancer is the third most common cause of cancer-related deaths and is the fifth highest incidence of cancer worldwide, especially in Eastern Asia, Central and Eastern Europe, and South America. Currently, surgery is the only curative treatment for gastric cancer; however, digestive tract reconstruction after distal gastrectomy for gastric cancer is controversial due to the postoperative complications such as reflux gastritis. There is an increasing trend toward laparoscopic uncut Roux-en-Y (URY) for radical gastrectomy. However, evidence on the feasibility of this procedure in patients undergoing laparoscopic radical distal gastrectomy is still absent. Thus, a prospective randomized trial is warranted. This is a prospective, multicenter, two-arm randomized controlled trial in which 210 patients will be randomly assigned to two groups: laparoscopic URY (n=105) and laparoscopic Billroth II plus Braun anastomosis (n=105). Each participant must be pathologically diagnosed with gastric cancer and undergo laparoscopic radical gastrectomy at Xijing Hospital and other four hospitals. The laparoscopic URY procedure is based on the Billroth II gastrojejunostomy plus Braun anastomosis, and then blocked the jejunum input loop at the stump-jejunal anastomosis. The patients' demographic and pathological characteristics will be recorded. The total and oral nutritional intake, general data, total serum protein, serum albumin, blood glucose, and temperature will be recorded before surgery and at the time of hospitalization. Postoperative adverse events will also be recorded, as well as at follow-up appointments at three months and six months after surgery. The rate of reflux gastritis will represent the primary endpoint, and other secondary endpoints, which are all recorded.

Doctor-blade coating (DBC) is a roll-to-roll compatible high-throughput thin film fabrication route with little solution wastage and is considered as a more scalable method for the fabrication of organic solar cells (OSCs) than spin coating (SC). Since wet film drying is much slower during DBC than during SC, the interfacial connection within the films might be different, which could remarkably influence the device performance of OSCs. In this work, we demonstrated that the device performance, reproducibility, and long-term stability are more sensitive to the ZnO morphology in doctor-blade (DB)-coated cells than in spin-coated cells in both fullerene (PTB7-Th:PC71BM) and non-fullerene (PBDB-TF:IT-4F) systems. Such an influence is more significant in large-area cells. We ascribe this enormous difference between the spin-coated and DB-coated devices to different interfacial contacts, which were caused by different spreading forces and drying kinetics during the thin film formation process. A smooth ZnO cathode buffer layer from methanol-dispersed inks was more suitable for DBC, and with this layer, a high power conversion efficiency of 12.88% and 9.22% was achieved for the 0.12 and 1.04 cm2 DB-coated PBDB-TF:IT-4F OSCs, respectively.

Mitochondrial abnormalities have long been observed in the development of vascular calcification. Metformin, a member of the biguanide class of antidiabetic drugs, has recently received attention owing to new findings regarding its protective role in cardiovascular disease. Since the precise control of mitochondrial quantity and quality is critical for the survival and function of vascular smooth muscle cells (VSMCs), maintaining mitochondrial homeostasis may be a potential protective factor for VSMCs against osteoblast-like phenotypic transition. However, limited studies have been reported in this area. Here, we investigated the role of metformin in the phenotypic transformation of VSMCs, as well as its intracellular signal transduction pathways. We demonstrated that supplementation with metformin restored the β-glycerophosphate (β-GP)-mediated impairment of mitochondrial biogenesis in VSMCs, as evidenced by an increased mitochondrial DNA copy number, a restored mitochondrial membrane potential (MMP), and upregulated mitochondrial biogenesis-related gene expression, whereas the AMP-activated protein kinase (AMPK) inhibitor compound C suppressed these effects. We also observed that overexpression of pyruvate dehydrogenase kinase 4 (PDK4), an important mitochondrial matrix enzyme in cellular energy metabolism, exacerbated β-GP-induced oxidative stress and subsequent apoptosis in VSMCs but that these effects were suppressed by dichloroacetate, a widely reported PDK4 inhibitor. More importantly, enhanced mitochondrial biogenesis attenuated the β-GP-induced phenotypic transformation of VSMCs into an osteogenic phenotype through inhibition of the PDK4/oxidative stress-mediated apoptosis pathway, whereas disruption of mitochondrial biogenesis by zidovudine aggravated β-GP-induced apoptosis in VSMCs. In addition, inhibition of autophagy by small interfering RNA targeting Atg5 reduced mitochondrial biogenesis in VSMCs. In summary, we uncovered a novel mechanism by which metformin attenuates the phenotypic transformation of VSMCs into an osteogenic phenotype via inhibition of the PDK4/oxidative stress-mediated apoptosis pathway, and mitochondrial homeostasis is involved in this process.

High efficiency and performance stability are the two key challenges for polymer solar cells before their commercialization. With the development of high-performance conjugated polymer donors and small-molecule acceptors, the power conversion efficiency (PCE) of polymer solar cells now reaches 17%. A method that can improve the PCE while keeping the high device stability of polymer solar cells is therefore strongly needed. In this paper, we report the use of piperazine as a molecular dopant in the blends of the well-investigated polymer–fullerene solar cell systems, including P3HT:PC61BM, PTB7-Th:PC61BM and PffBT4T-2OD:PC61BM. The results indicate that both the efficiency and stability of these polymer solar cells are improved simultaneously after such a molecular doping process. The electron mobility of the piperazine-doped P3HT:PC61BM film (1.68 × 10−3 cm2 V−1 s−1) was found to be enhanced by almost 10 times in comparison with that of the pristine P3HT:PC61BM film (2.0 × 10−4 cm2 V−1 s−1) by measuring the injection-charge extraction by linearly increasing voltage (i-CELIV) in a metal-insulator-semiconductor (MIS) diode, which is due to the intermolecular electron transfer between piperazine and PC61BM, as confirmed by the dark electron spin resonance (ESR) measurement. In addition, piperazine molecules are able to reduce oxidized P3HT, yielding neutral P3HT, which is considered as the second reason for the performance enhancement. Photon-induced charge transfer between PC61BM and piperazine was confirmed by light electron spin resonance (LESR) measurements. Such a charge transfer process leads to the quenching of PC61BM excitons by piperazine, which decreases the PC61BM dimerization rate and consequently suppresses the “burn-in” degradation of polymer solar cells. The current work provides an effective method that can simultaneously improve the efficiency and stability of polymer–fullerene solar cells.

Background Paroxetine is one of the selective serotonin reuptake inhibitors (SSRIs) used in the treatment of premature ejaculation (PE). However, this use is not approved in many countries. The purpose of this systematic review and meta-analysis is to review the efficacy and safety of paroxetine for PE patients. Methods We searched relevant randomized, controlled trials through May 2018, using PubMed, Embase and Cochrane Central Register. The main endpoint included intra-vaginal ejaculatory latency time (IELT) and side effects in the treatment of PE. Cochrane Collaboration’s Revman software, version 5.3, was used for statistical analysis. Results Out of 493 unique articles, a total of 19 randomized, controlled trials (RCTs) were reviewed. Quite a few RCTs were considered to have unclear risk of bias because of limited information. Pooled outcomes suggested that paroxetine was more effective than placebo, fluoxetine and escitalopram at increasing IELT (all p

Combined with the Internet of Vehicles, some intelligent systems for connected health can make medical vehicles transport medical supplies more safely and timely in response to catastrophic natural disasters or serious accidents. However, in an urban scenario, the crisscrossing of roads and the uneven distribution of vehicles exist, which lead to problems such as the high mobility of vehicles and the attachment of data. These have become important contributors to the low stability of the vehicle community and the high distortion of the data among medical vehicles. Focusing on the above problems, this paper proposes a prediction-based multirole classification community clustering method (PMRC) for the vehicular ad hoc network (VANET). The experimental results show that the method can effectively improve the stability of the community in VANET and reduce the probability of data distortion.

Sinularin, a soft corals-derived natural product, exerts anti-tumorigenic activity in various types of human cancer cells. However, the action of Sinularin and its mechanism in renal carcinoma is not well understood. In the current study, we demonstrated that Sinularin inhibited the viability of human renal cancer cells 786-O and ACHN in a dose- and time-dependent manner, but did not show significant toxicity against non-malignant HRCEpic cells. Cell cycle analysis revealed that Sinularin induced G2/M arrest significantly. In addition, Sinularin could induce apoptosis in cells along with caspase-3/-9 activation, release of mitochondrial proteins, up-regulation of pro-apoptotic Bcl-2 family proteins and inhibition of anti-apoptotic Bcl-2 family proteins. Sinularin could also repress the activation of PI3K/Akt/mTOR signaling pathway. Moreover, Sinularin triggered the activation of MAPKs and p38 activation was essential for the anti-tumor effect of Sinularin. The generation of ROS (reactive oxygen species) was critical for Sinularin-induced apoptosis since ROS scavenger NAC (N-acetyl cysteine) could block the Sinularin-triggered apoptosis. In conclusion, all the results indicated that Sinularin may be applied as a therapeutic natural agent for human renal cancer.

Metal/covalent-organic framework (MOF/COF) membranes have attracted increasing research interest and have been considered as state-of-the-art platforms applied in various environment- and energy-related separation/transportation processes. To break the trade-off between permeability and selectivity to achieve ultimate separation, recent studies have been oriented towards how to design and exploit ultrathin MOF/COF membranes (i.e. sub-1 μm-thick). Given great advances made in the past five years, it is valuable to timely and systematically summarize the recent development and shed light on the future trend in this multidisciplinary field. In this review, we first present the advanced strategies in fabricating ultrathin defect-free MOF/COF membranes such as in situ growth, contra-diffusion method, layer-by-layer (LBL) assembly, metal-based precursor as the pre-functionalized layer, interface-assisted strategy, and laminated assembly of MOF/COF nanosheets. Then, the recent progress in some emerging applications of ultrathin MOF/COF membranes beyond gas separation is highlighted, including water treatment and seawater desalination, organic solvent nanofiltration, and energy-related separation/transportation (i.e. lithium ion separation and proton conductivity). Finally, some unsolved scientific and technical challenges associated with future perspectives in this field are discussed, inspiring the development of next-generation separation membranes.

HA modified by bisphosphonate (BP) (HA-BP) was synthesized by chemical reaction and possessed promising properties such as self-healing, injection ability, and strong adhesion. The main aim of this study was to confirm its role in promoting osteogenic differentiation in vitro and bone regeneration in vivo.The cell biocompatibility of this material was determined using the CCK-8 assay. Alkaline phosphatase (ALP), osteocalcin (OT), vascular endothelial growth factor (VEGF), and collagen I were assessed by quantitative real-time polymerase chain reaction (Q-PCR) in the treated group. The number and density of calcium nodules and ALP were evaluated by Alizarin Red staining and ALP staining. We have successfully developed an animal model simulating osteonecrosis of the femoral head (ONFH). Utilizing this animal model, the impact of HA-BP/CaP on bone formation was assessed. The amount of bone regeneration at 1 and 2 months after HA-BP/CaP injection was estimated by micro-computed tomography (micro-CT) analysis and HE, collagen I, and periostin staining.The number of cells gradually increased in the experimental group over time and was close to that of the blank control group. ALP, collagen I, and VEGF expression was significantly higher in the experimental group than in the blank group (VEGF, ALP, both **p 0.01; collagen I, ***p0.001). In addition, the number and density of calcium nodules and ALP was clearly greater in the material group than in the control group. The quantification analysis showed that the mineral contents of regenerated bone at 1 and 2 months after HA-BP/CaP injection were significantly greater than those in the control group, according to micro-CT evaluation (**p0.01). The amount of organic components in the HA-BP/CaP group was greater than that in the control group after decalcification and HE staining. In addition, collagen I and periostin staining further confirmed the results of HE staining.This material can boost proliferation and osteogenic differentiation of MC3T3-E1 cells in vitro. It can intensely accelerate bone regeneration in vivo, which is a promising strategy for tissue engineering.

A water circulation system with the almost same element composition and socket type was adopted in coral Acropora culture under different seawater pH value conditions and the data of the relationship between boron isotopic compositions of coral and seawater pH value by thermoelectric ionization mass spectrometer were obtained. According to the correlations between αcarb-3 of coral and the pH value of cultured seawater, αcarb-3 was not a constant but related to pH value, indicating that B(OH)3 also incorporated carbonate. Therefore, the theoretical formula could not be used to calculate the seawater pH value from the δ11Bcarb value of the measured marine biological carbonate. The empirical equations obtained experimentally would be an alternative method to calculate the seawater pH value. In addition, the mixed precipitation of CaCO3 and Mg(OH)2 was found in aquaculture tanks with high pH value, and the δ11B of the solid was significantly higher than that of cultured seawater. The result indicated that the presence of Mg(OH)2 had a significant effect on the boron isotope fractionation, which deserved our attention.

Millet color is an important index for consumers to assess foxtail millet quality. The yellow color of millet is mainly because of the accumulation of carotenoids, which are essential for human nutrition. However, the discoloration of millet during storage due to carotenoid degradation seriously reduces the nutritional and commercial value of millet products. The essential quality traits of millet discoloration during storage were analyzed using two foxtail millet varieties, namely 9806-1 and Baomihunzi. We observed that the millet discoloration was caused by carotenoid degradation during storage, and different genotypes exhibited different discoloration rates. The carotenoid reduction rate in 9806-1 (32.2%) was higher than that in Baomihunzi (10.5%). The positive correlation between carotenoid reduction and the expression of SiLOX protein indicated that SiLOX from foxtail millet played a major role in carotenoid reduction during storage. The expression profiles of the SiLOX gene family were analyzed at different grain maturing stages, from S1 to S3, in these two varieties to determine the key SiLOX genes responsive to millet discoloration in foxtail millet. The consecutively low expression of SiLOX2, SiLOX3, and SiLOX4 contributed to the low level of SiLOX protein in Baomihunzi. Furthermore, the undetectable expression of SiLOX4 in the later stage of maturation in Baomihunzi was associated with low discoloration, indicating that SiLOX4 might be a key gene in regulating the discoloration of millet. This study provided critical information on the mechanism of carotenoid degradation during millet storage and laid the foundation for further understanding of carotenoid metabolism in foxtail millet.

Multiple roadways are opened to solve the difficulties in gas control in the high seam working face of high gassy mines, resulting in a large width of coal pillars between roadway groups. Moreover, recovering coal pillars is challenging during stoping, which causes serious resource waste. While the size of coal pillars is optimized, the reasonable horizon layout of roadway groups is performed to ensure a fine recovery rate of coal resources, mine safety, and efficient production. Theoretical analysis was applied to calculate the stress distribution of surrounding rocks around coal pillars based on the engineering practice of the W2302 working face in the Sihe Coal Mine. The MathCAD software Prime 2.0 combined with the on-site measured stress was used to draw the stress distribution under different coal pillar widths, which can derive the stress distribution data of the floor. The vertical stress concentration factors tended to be consistent at 10 m below the coal pillars and about 12 m from the centerline of coal pillars under different coal pillar widths, this area was suitable for the layout of floor rock roadways with a stress concentration factor of about 1. Numerical simulations were used to compare the stress distributions of the roadway floor and the deformation features of surrounding rocks under different coal pillar widths. The coal pillar width was finally determined to be 45 m, which optimized the size of coal pillars. The return air roadways were arranged at 9.8 m below the coal seam combined with the strata distribution on-site. According to the industrial test on-site, the return air roadways were available during the service period, which showed reliable theoretical analysis and simulation results. A reasonable horizon layout of return air roadways can provide a scientific basis and reference for similar projects.

Zinc oxide (ZnO) is one of the most extensively used electron-transporting layers (ETLs) in organic solar cells. However, owing to numerous surface defects and mismatched energy bands with the photoactive layer, light-soaking process is usually required to achieve a high device performance for the ZnO-based cells. Herein, we reported the synthesis of N,S-doped carbon quantum dots (N,S-CQDs) by a simple hydrothermal treatment using ascorbic acid and ammonium persulfate as reagents. As characterized by high-resolution transmission electron microscopy and X-ray diffraction, the synthesized CQDs were found to be 2-7 nm in dimensions, having a graphite-structured core and amorphous carbon on the shell. Fourier transform infrared and X-ray photoelectron spectroscopy analyses confirmed that these CQDs are highly nitrogen- and sulfur-doped, which leads to efficient (with a quantum yield of 33%) downconversion and excitation-dependent photoluminescence character. Application of these N,S-CQDs as surface modifier for ZnO layer in inverted organic solar cells was investigated. Results indicate that the cells with N,S-CQDs-decorated ZnO ETL showed higher power conversion efficiency without S-shaped kink in the current density-voltage curves. The performance improvement and the elimination of light-soaking effect for ZnO:N,S-CQDs cells are attributed to the ZnO surface defect passivation by N,S-CQDs, as confirmed by fluorescence spectroscopy and scanning Kelvin probe microscopy. The cells with N,S-CQDs-modified ZnO ETL showed a high power conversion efficiency of 9.31%, which is higher than the reference ZnO cells. The current work provides a feasible way to achieve shell element-doped CQDs for specific application in organic electronic devices.

Six Co(II) complexes were synthesized from CoCl2 with positional isomeric ligands: 3-(pyridine-3-yl)-5-(2-methoxyphenol-6-yl)-1H-1,2,4-triazole (3-H2pmpt) and 4-(pyridine-3-yl)-5-(2-methoxyphenol-6-yl)-1H-1,2,4-triazole (4-H2pmpt), namely, {[Co3(3-pmpt)2Cl2(DMF)2]·(DMF)2}n (1), {[Co3(4-pmpt)2Cl2(DMF)2]·(DMF)}n (2), [Co3(3-pmpt)2Cl2(DMF)2]n (3), [Co3(4-pmpt)2Cl2(DMF)2]n (4), {[Co5(3-pmpt)4(HCO2)2(DMF)2]·(H2O)4}n (5), {[Co5(4-pmpt)4(HCO2)2(H2O)2]·(H2O)6}n (6). Structural analysis reveals that pmpt isomers display different coordination modes to manage Co(II) ions to form [Co3] subunits in 1–4, and [Co5] subunits in 5–6, respectively. Which are further extended via different pyridine ring N-orientation to build the 1-D chains (for 1, 5 and 6) and 2-D layers (for 2, 3 and 4). Structural analysis indicate that 3/4-pmpt is an excellent multi-connect linker with pyridine ring at different angles, has an important effect on the structural topologies of such Co(II) complexes. Magnetic susceptibilities reveal weak ferromagnetic and antiferromagnetic exchange interactions between the adjacent metal centers in 5 and 6.

The ecological environment is closely related to the growth and quality of authentic medicinal materials. Ginseng is very strict with its natural environment and grows mostly in the damp valleys of forests, and the appearance and chemical composition of ginseng under different growth environments are very different. This article reviews the effects of different ecological factors(including light, temperature, altitude, moisture, soil factors, etc.)on the appearance and chemical composition(mainly ginsenosides) of ginseng. Through systematic review, it is found that soil physical factors are the most important ecological factors that affect the appea-rance of ginseng, and soil bulk density plays a key role; temperature affects ginsenosides in ginseng medicinal materials The dominant ecological factors for the accumulation of chemical ingredents; strong light, high altitude, high soil moisture, low soil nutrient and strong acid soil can influence the accumulation of secondary metabolites in ginseng. Environmental stress can also stimulate the formation and accumulation of secondary metabolites in medicinal plants. Appropriate low temperature stress, high or low water stress, acid or alkali stress can also promote the accumulation of ginsenosides. This article systematically reviews the ecological factors that affect the appearance and chemical composition of ginseng, and clarifies the dominant ecological factors and limiting factors for the formation of ginseng's appearance and quality, as well as beneficial environmental stress factors, in order to provide a theoretical basis for ginseng ecological planting and ginseng quality improvement.

We report on a case of metastatic urothelial bladder carcinoma (mUBC) treated with anlotinib combined with sintilimab. A 69-year-old male was diagnosed with non-muscle invasive bladder cancer (NMIBC). He received transurethral resection of bladder tumor (TURBT) and intravesical gemcitabine chemotherapy. After the patients’ cancer progressed to mUBC, cisplatin-based chemotherapy (gemcitabine combined with cisplatin, GC) was performed to this patient as first line therapy for four cycles. However, the disease progressed again within 6 months. Local radiotherapy was performed on the metastatic lesions, and after radiotherapy, the patient received anti-PD-1 antibody (sintilimab 200 mg, q3w)combined with Albumin-bound (Nab)-paclitaxel (100 mg, qw) as the second-line therapy, but the patient’s cancer was still observed to be progressing. Molecular characterization confirmed the presence of FGFR3 mutations in the patient. Anlotinib was recommended to this patient. After the patient was fully informed and he was aware of off-label use of the drug, then, Nab-paclitaxel was replaced by anlotinib (10 mg D1–14, q3w) and sintilimab infusions were maintained for every 3 weeks. Partial response (PR) was observed through imaging examinations and stable disease (SD) was observed for more than 11 months; the patient’s quality of life also improved. This case suggested that anlotinib combined with sintilimab may be a safe and effective choice in the treatment of mUBC in patients with FGFR3 mutations.

Background B lymphocyte activating factor (BAFF) is a growth factor regulating B lymphocytes survival and maturation. Serum BAFF levels were elevated in patients affected with autoimmune thyroid diseases (AITD), including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). The aim of this study is to explore the association of expression levels of BAFF and its receptors with AITD. Methods Fifty-two GD patients, 39 Hashimoto’s thyroiditis (HT) patients and 23 healthy controls (HC) were recruited in this study. Serum BAFF levels were measured by ELISA. Expression of BAFF receptors, including BAFF receptor 3 (BR3) and transmembrane activator and calcium-modulating and cyclophilin ligand interactor (TACI), on B lymphocytes were analyzed by flowcytometry. Effects of steroids on serum BAFF levels and expression of BR3 and TACI were also observed in 10 patients with Graves’ orbitopathy (GO) receiving steroids therapy. Results Serum BAFF levels were significantly elevated from 0.93 ± 0.24 ng/ml in HC to 1.18 ± 0.33 ng/ml in GD (P = 0.0027) and 1.02 ± 0.24 ng/ml in HT (P = 0.0331). BR3 expression on peripheral B lymphocytes were elevated in GD (mean MFI: 4.52 ± 2.06 in GD vs. 3.00 ± 0.87 in HC, P = 0.0015), while TACI expression on peripheral B lymphocytes were decreased in GD without significance (mean MFI: 7.96 ± 4.06 in GD vs. 9.10 ± 3.37 in HC, P = 0.1285). Expression of BR3 and TACI was not changed significantly in HT patients. Steroids significantly suppressed serum BAFF concentrations (from 1.18 ± 0.27 ng/ml to 0.97 ± 0.10 ng/ml, P = 0.0364) and BR3 expression in GO patients (mean MFI from 6.26 ± 4.91 to 4.05 ± 1.58, P = 0.0083). Conclusions Altered expression of BAFF and its receptor may mediate the autoimmunity in GD. Restoring the normal expression profile of receptors for BAFF could be a new strategy to treat GD.

The uncontrolled inflammatory response caused by a disorder in inflammation resolution is one of the reasons for acute respiratory distress syndrome (ARDS). The macrophage pool markedly expands when inflammatory monocytes, known as recruited macrophages, migrate from the circulation to the lung. The persistent presence of recruited macrophages leads to chronic inflammation in the resolution phase of inflammation. On the contrary, elimination of the recruited macrophages at the injury site leads to the rapid resolution of inflammation. Resolvin D1 (RvD1) is an endogenous lipid mediator derived from docosahexaenoic acid. Mice were administered RvD1 via the tail vein 3 and 4 days after stimulation with lipopolysaccharide. RvD1 reduced the levels of the inflammatory factors in the lung tissue, promoted the anti-inflammatory M2 phenotype, and enhanced the phagocytic function of recruited macrophages to alleviate acute lung injury. We also found that the number of macrophages was decreased in BAL fluid after treatment with RvD1. RvD1 increased the apoptosis of recruited macrophages partly via the FasL-FasR/caspase-3 signaling pathway, and this effect could be blocked by Boc-2, an ALX/PRP2 inhibitor. Taken together, our findings reinforce the concept of therapeutic targeting leading to the apoptosis of recruited macrophages. Thus, RvD1 may provide a new therapy for the resolution of ARDS.

For the inverted organic solar cells (OSCs), the interface contacts between the ZnO electron transporting layer and the organic active layer play an important role in the device performance and stability. Since the solution-processed ZnO surface always contains some base or zinc salt contaminants, we explored how the surface pH conditions influence the performance and stability of the nonfullerene acceptor (NFA) cells. A tight relationship between the surface pH condition and the device performance and stability was established. Specifically, device performance and stability were improved by treating the ZnO films with acid solutions but worsened after base treatment. The large number of hydroxyl groups on the surface of the solution-processed ZnO films was proved to be the main reason for the surface pH condition-related performance, which caused oxygen-deficient defects and unfavorable vertical phase separation in the blend films, hindered the photogenerated charge transfer and collection, and consequently resulted in low short-circuit current density and power conversion efficiency (PCE). The surface -OH groups also boosted the photocatalytic activity and led to fast degradation of the nonfullerene acceptor. Removal of the surface -OH groups can alleviate such problems. Different acid solutions, ZrAcac, 2-phenylethylmercaptan (PET), and glutamic acid (GC), were used to treat the ZnO films, and PET treatment was the most effective treatment for performance improvement. An efficiency of 16.46% was achieved for the PM6:Y6 cells and the long-term stability under continuous illumination conditions was significantly improved with a

Background: Pneumatic tourniquets are widely used in total knee arthroplasty (TKA). Some surgeons prefer a uniform tourniquet inflation pressure (UTIP)for all patients; others use personalized tourniquet inflation pressures (PTIP) based on systolic blood pressure (SBP) and limb occlusion pressure(LOP). However, no consensus exists regarding the optimal mode of inflation pressure during TKA. This review aimed to appraise if personalized tourniquet inflation pressures are better than uniform tourniquet inflation. Methods: The databases (Web of Science，Embase，PubMed，Cochrane Controlled Trials Register,、Cochrane Library、Highwire、CBM、CNKI、VIP、Wanfang) were searched on March 2021 to systematically identify and screen the literature for randomized controlled trials (RCTs) involving PTIP and UTIP during total knee arthroplasty.Results: Thirteen randomized controlled trials, involving 1204 TKAs (1201 patients) were included in the systematic review. The meta-analysis identified a trend toward less Visual Analogue Scale (VAS) score at rest with PTIP group at one day（P=0.002），2-3day（P=0.01）, and less VAS score at activity 1day (P＜0.0001 ),2-3 days after the operation (P＜0.00001 )and discharge (P＜0.0001). No significant difference was found between the groups in terms of VAS score at rest when discharge (P=1.0). We also found no significant difference in terms of intraoperative blood loss（P=0.48）, total blood loss（P=0.15）, lower limb vein thrombosis （P=0.42）and thigh bullae（P=0.17）. However, in the PTIP group, we found a significant higher Hospital for Special Surgery (HSS) score （P=0.007）,broader knee Range of motion(ROM)（P=0.02）,less rate of thigh ecchymosis（P=0.00001）and shorter thigh circumference at one day(P=0.006), 2-3day (P=0.0005), and discharge(P=0.02).Conclusion: PTIP provides a similar bloodless surgical field compared with the conventional UTIP. Furthermore, PTIP provides less pain intensity, thigh circumference, rate of thigh ecchymosis, higher HSS and better initial recovery of knee flexion in total knee arthroplasty. Therefore, we recommend using a PTIP method during TKA. More adequately powered and better-designed randomized controlled trials （RCTs）studies with long-term follow-up are required to produce evidence-based guidelines regarding the PTIP method.

Background Currently, the surgical approach to adenocarcinomas of esophago-gastric junction (AEG) remains controversial. Function-preserving gastric surgeries are becoming more popular, with proximal gastrectomy with double-tract anastomosis being one of the most important for AEG. Meanwhile, with the increasing use of laparoscopic techniques in the treatment of gastric cancer, the safety and effectiveness of laparoscopic-assisted proximal gastrectomy with double-tract anastomosis for Siewert type II-III AEG need to be further clarified. Methods Data of patients with Siewert type II/III AEG was collected at our center from October 2010 to December 2019 were retrospectively analyzed. 61 patients underwent open proximal gastrectomy with double-tract anastomosis (OPG-DT group) and 52 underwent laparoscopic-assisted proximal gastrectomy with double-tract anastomosis (LAPG-DT group). The clinical features, surgery, and short-term outcomes of patients in these 2 groups were collected to assess the safety and feasibility of LAPG-DT. Results A total of 113 patients were analyzed, there were 98 males and 15 females. No death during the operation. The differences in the number of lymph nodes, time to first flatus time to first eating, postoperative hospital stay, Additional analgesics were not statistically significant between two groups. Although the operative duration of LAPG-DT group was significantly longer than that of the OPG-DT group [(217±61) vs. (161±14) min, P=0.000), while less blood loss and less stress in LAPG-DT group. Early and late postoperative complications were similar between two groups. Conclusions Although laparoscopic-assisted proximal gastrectomy with double-tract anastomosis requires long operative time, it is associated with less bleeding and milder stress. Therefore, it is a safe and feasible surgical method.

BackgroundCement mantle penetration and the cement–bone interface strength were critical to a successful primary total knee arthroplasty (TKA). It remained unclear whether decreased blood and fat in the cancellous bone achieved with the use of a tourniquet increases tibial cement mantle penetration in different zones on AP and lateral view in TKA according to criteria defined by the Knee Society Scoring System (KSS). The purpose of this study was to determine whether tourniquet use influences tibial cement mantle penetration in different zones on AP and lateral view in TKA according to KSS.MethodsWe conducted a meta-analysis to identify studies involving the impact of tourniquet use and no tourniquet use on tibial bone cement penetration in primary TKA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, VIP, Wanfang database, up to January 2021. Finally, we identified 1231 patients (1231 knees) assessed in twelve studies.ResultsTourniquet use increases the cumulative cement mantle penetration (P< 0.00001), mean cement mantle penetration (P= 0.004), and cement mantle in zone 3(P< 0.0001) on AP view. However, there were no significant differences in cement mantle in zone 1(P= 0.5), zone 2(P=0 .54), zone 4(P= 0.07) on AP view, and zone 1(P= 0.32), zone 2(P= 0.38) on lateral view between two groups. There were also no significant differences in length of surgery(P= 0.7), change in hemoglobin(P= 0.4), transfusion rates(P= 0.47), and complications such as muscular calf vein thrombosis(P= 0.21), superficial infection (P= 0.72), and deep vein thrombosis (P= 0.66) between two groups.ConclusionThe application of a tourniquet increases the thickness of the tibial bone cement penetration—the increase in the thickness of bone cement penetration mainly located in zone 3 on the anteroposterior (AP) view.

BACKGROUND: To investigate the safety and merits of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). METHODS: Retrospective analysis of the clinical data of 100 consecutive patients with Siewert II and III AEG treated at the Affiliated Tumor Hospital of Zhengzhou University from October 2010 to October 2019 was performed. Out of these patients, 69 underwent open proximal gastrectomy with double-tract reconstruction (OPG-DT), while 31 underwent LPG-DT. The clinicopathological characteristics, perioperative data, and short-term outcomes of the two groups were compared. A P value