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Xu-Lin Wang,1,&ast; Ling-Ling Dai,2,&ast; Yan-Na Li,1 Jian-Wen Zhang,1 Ming-Cui Qu,1 Yao-Yao Zhou,1 Na Xing1 1Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Respiration, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Na Xing, Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou, People’s Republic of China, Tel +8613949095172, Email 16427485@qq.comPurpose: This study aimed to compare the efficacy of remimazolam and propofol regarding postoperative anesthesia satisfaction in patients undergoing outpatient gynecological surgery.Patients and Methods: This was a single-center, open-label, non-inferiority, randomized clinical trial. Patients aged ≥ 18 years who underwent outpatient gynecological surgery with sedation were enrolled. Participants were randomly assigned to be sedated with remimazolam or propofol. The primary endpoint was the immediate postoperative anesthesia satisfaction score, evaluated through the Iowa Satisfaction with Anesthesia Scale (ISAS).Results: 168 patients were randomly allocated to either the remimazolam group (n = 84) or the propofol group (n = 84). The mean (standard deviation) ISAS scores immediately after surgery were 1.7 (0.6) for the remimazolam group and 2.0 (0.7) for the propofol group (difference, – 0.2; 97.5% confidence interval [CI]: – 0.5 to – 0.0; p = 0.02), indicating non-inferiority. The length of post-anesthesia care unit (PACU) stay was longer in the remimazolam group than in the propofol group (27.6 [9.1] min vs 22.4 [7.0] min; difference, 5.2 [95% CI: 2.7 to 7.6] min; p < 0.001). High-intensity injection pain was less frequently observed in the remimazolam group than in the propofol group (3.6% vs 45.2%; difference, – 41.7% [95% CI: – 54.2% to – 29.1%]; p < 0.001). The nausea score was higher in the remimazolam group immediately after surgery than in the propofol group. Pain, nausea, sleep quality, anxiety, and depression scores were higher in the remimazolam group than in the propofol group on postoperative day 1. The incidence of adverse events and other secondary endpoints was comparable between the two groups.Conclusion: Remimazolam was non-inferior to propofol regarding postoperative anesthesia satisfaction in patients undergoing outpatient gynecological surgery. Therefore, it should be considered as a new sedation alternative in such procedures.Keywords: remimazolam, propofol, patient satisfaction, outpatient gynecological surgery, sedation

Background: The aim of this study is to confirm the association among oral health behaviors, periodontitis, and preeclampsia in Korean women. Methods: This study is designed as a case-control study. Sixteen women with preeclampsia and 48 without preeclampsia post-delivery were included in this study from November 2007 to January 2010. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may influence the periodontal condition and preeclampsia. Full-mouth periodontal probing was conducted by one trained examiner (KHB). Localized periodontitis was defined as periodontal clinical attachment loss (AL) ≥3.5 mm on two or three sites not on the same tooth. In addition, generalized periodontitis was defined as clinical AL ≥3.5 mm on ≥4 sites not on the same tooth. Gingival crevicular flui was collected using a sterilized paper point for quantitative analysis of Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia (Pi), and Tannerella forsythia (previously T. forsythensis). Results: After adjusting for confounders, the adjusted odds ratio (OR) was 4.79 (95% confidence interval [CI]: 1.02 to 29.72) for localized periodontitis and 6.60 (95% CI: 1.25 to 41.61) for generalized periodontitis. In addition, the proportion of floss or interdental brush users in women with preeclampsia was lower than that in women without (adjusted OR: 0.21; 95% CI: 0.02 to 0.93). Pi was significantly more prevalent in women with preeclampsia (P= 0.028). Conclusion: These results indicate that preeclampsia could be associated with the maternal periodontal condition and interdental cleaning. [ABSTRACT FROM AUTHOR]

Exocyst, a protein complex, plays a crucial role in various cellular functions, including cell polarization, migration, invasion, cytokinesis, and autophagy. Sec3, known as Exoc1, is a key subunit of the Exocyst complex and can be involved in cell survival and apoptosis. In this study, two subtypes of Sec3 were isolated from Epinephelus coioides, an important marine fish in China. The role of E. coioides Sec3 was explored during Singapore grouper iridovirus (SGIV) infection, an important pathogen of marine fish which could induce 90 % mortality. E. coioides Sec3 sequences showed a high similarity with that from other species, indicating the presence of a conserved Sec3 superfamily domain. E. coioides Sec3 mRNA could be detected in all examined tissues, albeit at varying expression levels. SGIV infection could upregulate E. coioides Sec3 mRNA. Upregulated Sec3 significantly promoted SGIV-induced CPE, and the expressions of viral key genes. E. coioides Sec3 could inhibit the activation of NF-κB and AP-1, as well as SGIV-induced cell apoptosis. The results illustrated that E. coioides Sec3 promotes SGIV infection by regulating the innate immune response., (Copyright © 2024. Published by Elsevier Ltd.)

Blastocystis spp. and Giardia duodenalis are two prevalent zoonotic intestinal parasites that can cause severe diarrhea and intestinal diseases in humans and many animals. Black goat ( Capra hircus ) farming is increasingly important in China due to the remarkable adaptability, high reproductive performance, rapid growth rate, and significant economic value of black goats. A number of studies have indicated that black goats are the potential reservoir of multiple zoonotic protozoans in China; however, the prevalence and zoonotic status of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province is still unknown. Thus, a total of 1200 fecal samples of black goats were collected from several representative regions at different altitudes in Shanxi Province and were examined for the presence and genotypes of G. duodenallis and Blastocystis spp. by amplifying the beta-giardin ( bg ), glutamate dehydrogenase ( gdh ), and triosephosphate isomerase ( tpi ) loci of G. duodenalis and SSU rRNA of Blastocystis spp. using PCR and sequence analysis methods, respectively. The overall prevalence of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province were 7.5% and 3.5%, respectively. Two assemblages (B and E) of G. duodenalis and four subtypes (ST5, ST10, ST14, and ST30) of Blastocystis spp. were identified, with assemblage E and ST10 as the prevalent genotype and subtype in black goats, respectively. One novel multilocus genotype (MLG) was identified in MLG-E and was designated as MLG-E12. For both G. duodenalis and Blastocystis spp., the prevalence was significantly related to the region and age groups ( p < 0.05). This is the first report on the prevalence of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province. These results not only provide baseline data for the prevention and control of both parasites in black goats in Shanxi Province, but also enhance our understanding of the genetic composition and zoonotic potential of these two parasites.

Objective： To explore the effect of psychological nursing on the prognosis of male patients with urethral riding injury treated by ureteroscopic urethral catheter implantation (UCI)., Methods: This study included 63 male patients with urethral straddle injury treated in the General Hospital of Southern Theater Command from February 2020 to March 2023. We divided the patients into a control (n = 29) and an experimental group (n = 34) according to the odd- or even-numbered days of admission and treated them by ureteroscopic UCI. Meanwhile those of the former group received routine nursing care and the latter underwent psychological nursing intervention in addition. We obtained the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of the patients, recorded their postoperative pain scores, catheter-removal time, hospitalization days, postoperative complications and overall recovery status, and compared the data collected between the two groups., Results: At 3 days after surgery, both the SAS and SDS scores were significantly lower in the experimental group than in the control (SAS: 45.2 ± 2.9 vs 50.4 ± 3.6, P< 0.05; SDS: 41.9 ± 2.5 vs 48.3 ± 4.0, P< 0.05), and so were the pain scores at 24 hours (6.2 ± 0.6 vs 6.8 ± 0.9, P< 0.05), 48 hours (4.9 ± 0.7 vs 6.1 ± 0.8, P< 0.05) and 72 hours after surgery (2.5 ± 0.6 vs 3.9 ± 0.9, P< 0.05). The hospitalization time was remarkably shorter in the experimental than in the control group (［14.1 ± 2.9］ vs ［16.1 ± 3.4］ d, P< 0.05), but there was no statistically significant difference in the time of postoperative catheterization between the two groups of patients (［19.3 ± 3.7］ vs ［19.6 ± 4.4］ d, P > 0.05). A 30-day postoperative follow-up found 2 cases of difficult urination in the control group but no complications in the experimental group., Conclusion: Ureteroscopic UCI is a safe, effective and minimally invasive treatment method for male urethral riding injury, and psychological nursing helps not only shorten the time of catheterization and hospitalization but also avoid postoperative complications.

CRISPR/Cas9 gene editing technology, as a highly efficient genome editing method, has been extensively employed in the realm of animal husbandry for genetic improvement. With its remarkable efficiency and precision, this technology has revolutionized the field of animal husbandry. Currently, CRISPR/Cas9-based gene knockout, gene knock-in and gene modification techniques are widely employed to achieve precise enhancements in crucial production traits of livestock and poultry species. In this review, we summarize the operational principle and development history of CRISPR/Cas9 technology. Additionally, we highlight the research advancements utilizing this technology in muscle growth and development, fiber growth, milk quality composition, disease resistance breeding, and animal welfare within the livestock and poultry sectors. Our aim is to provide a more comprehensive understanding of the application of CRISPR/Cas9 technology in gene editing for livestock and poultry.

Background: BRII-196 and BRII-198 are two recombinant human immunoglobulin (Ig) G1 monoclonal antibodies (mAbs) that non-competitively target distinct epitope regions within the receptor-binding domain (RBD) of the coronavirus spike glycoproteins. These antibodies are derived directly from human B cells of individuals who recovered from COVID-19., Objective: To analyze the efficacy of BRII-196/BRII-198 in the treatment of coronavirus disease 2019 (COVID-19) vaccine breakthrough infections., Methods: COVID-19 patients at high risk of progressing to severe and critical illness, with an initial SARS-CoV-2 immunoglobulin (Ig) G antibody level < 1.0 S/CO (detected within 24-48 hours post COVID-19 diagnosis), were treated with BRII-196/BRII-198 within three days of symptom onset. Treatment continued until the antibody level exceeded 1.0 S/CO. Patients whose absolute lymphocyte count (ALC) at first detection (within 24-48 h post-diagnosis) was < 0.8 × 10 9 /L received thymalfasin therapy within three days of symptom onset, continuing until the ALC level surpassed 0.8 × 10 9 /L. We determined the correlation of SARS-CoV-2 IgG antibody level and ALC with the condition of COVID-19 patients. Additionally, we analyzed the effects of BRII-196/BRII-198 on SARS-CoV-2 nucleic acid (NA) negative conversion, lymphocyte count recovery, and the change in SARS-CoV-2 IgG antibody level from the first positive NA test for SARS-CoV-2 to negative conversion in COVID-19 patients., Results: A total of 61 cases of breakthrough infections were observed, classified as 10 mild cases, 31 ordinary cases, and 20 severe cases. Among these, 20%, 48.4% and 75% of the patients with mild, ordinary, and severe COVID-19, respectively, had initial SARS-CoV-2 IgG antibody level < 1.0 S/CO. Additionally, 0%, 35% and 70% had initial ALC < 0.8 × 10 9 /L, respectively. Fifteen ordinary and 15 severe COVID-19 patients were treated with BRII-196/BRII-198. In severely infected patients, BRII-196/BRII-198 treatment showed statistically significant differences in NA negative conversion time and changes in SARS-CoV-2 IgG antibody levels ( P < 0.05). However, in patients classified with ordinary severity, BRII-196/BRII-198 treatment did not lead to notable differences in NA negative conversion time or changes in SARS-CoV-2 IgG antibody level ( P > 0.05). BRII-196/BRII-198 therapy was not associated with lymphocyte count recovery time in patients with either ordinary and/or severe COVID-19 ( P > 0.05)., Conclusions: The initial levels of SARS-CoV-2 IgG antibody and lymphocytes in fully vaccinated patients with breakthrough infections are inversely correlated with the severity of the disease. Early treatment with BRII-196/BRII-198 can shorten NA negative conversion time in severe COVID-19 patients and increase in vivo neutralizing antibody levels post-conversion, providing lasting protection. However, BRII-196/BRII-198 does not influence lymphocyte count recovery in patients with either ordinary and/or severe COVID-19., Competing Interests: None., (AJTR Copyright © 2024.)

In order to explore the status of soil heavy metal pollution and environmental quality in west Hunan, relevant areas of Phoenix County were selected as the study area. Using data from 440 soil samples collected in the study area from June to August 2022, the pH value of the soil and contents of eight heavy metal elements, namely, As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, were analyzed. The PMF model was used for traceability analysis and geochemical evaluation of soil environmental quality. The results showed that the average values of soil heavy metals ω (Zn), ω (Cr), ω (Pb), ω (Ni), ω (Cu), ω (As) , ω (Cd), and ω (Hg) were 81.02, 64.67, 31.63, 29.27, 25.52, 9.93, 0.28, and 0.13 mg·kg -1 , respectively. The soil in the study area was mainly weakly acidic, and the contents of the Cd and Hg elements were relatively high compared to the national soil background values and were highly variable. The contents of the Hg and Cd elements in forest land were higher than that in other land uses. The PMF model results showed that the contribution rates of heavy metal pollution sources in the study area were mining sources (37.4%), atmospheric sedimentation sources (7.7%), natural sources (41.1%), and agricultural activity sources (13.8%) and provided suggestions on pollution control measures according to the spatial distribution of the four types of pollution sources. Through the comprehensive assessment of soil environmental geochemistry, the study area was divided into three types of plots, namely, non-risk areas (94.27 km 2 ), accounting for 76.38%; risk-controllable areas (27.45 km 2 ), accounting for 22.24%; and high-risk areas (1.7 km 2 ), accounting for 1.38%. This study provided data support for the prevention and control measures of land pollution in the research area, as well as the delineation of the prevention and control scope.

The dual-specificity phosphatase (DUSP) family plays key roles in the maintenance of cellular homeostasis and apoptosis etc. In this study, the DUSP member DUSP1 of Epinephelus coioides was characterized: the length was 2371 bp including 281 bp 5' UTR, 911 bp 3' UTR, and a 1125 bp open reading frame encoding 374 amino acids. E. coioides DUSP1 has two conserved domains, a ROHD and DSPc along with a p38 MAPK phosphorylation site, localized at Ser308. E. coioides DUSP1 mRNA can be detected in all of the tissues examined, and the subcellular localization showed that DUSP1 was mainly distributed in the nucleus. Singapore grouper iridovirus (SGIV) infection could induce the differential expression of E. coioides DUSP1. Overexpression of DUSP1 could inhibit SGIV-induced cytopathic effect (CPE), the expressions of SGIV key genes, and the viral titers. Overexpression of DUSP1 could also regulate SGIV-induced apoptosis, and the expression of apoptosis-related factor caspase 3. The results would be helpful to further study the role of DUSP1 in viral infection., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Comparison of clinical efficacy between transurethral holmium laser prostate enucleation (two-way rendezvous and trenching method) and transurethral plasma enucleation., Methods: A total of 483 patients with benign prostatic hyperplasia who were admitted to our hospital from December 2019 to December 2022 were randomly divided into an observation group (245 cases) and a control group (238 cases) using a random number table method. The observation group underwent transurethral holmium laser prostatectomy, while the control group underwent transurethral plasma prostatectomy,evaluate the efficacy of two surgical methods., Result: The IPSS symptom score, quality of life (QOL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and other indicators were significantly improved in both groups after 6 months of surgery compared to before (P<0.05), and there was no statistically significant difference between the two groups (P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). There was no statistically significant difference in sexual function and retrograde ejaculation between the two groups of patients(P>0.05)., Conclusion: Both surgical methods have good surgical efficacy, but compared with prostate plasma resection, holmium laser prostatectomy can reduce intraoperative bleeding in patients with BPH, effectively shorten catheter retention time, patient hospitalization time, and postoperative bladder flushing time, resulting in higher quality of life and safety.

Background: Lomatogonium rotatum (LR) is traditionally used in Mongolian folk medicine as a hypoglycemic agent, but its evidence-based pharmacological effects and me-chanisms of action have not been fully elucidated., Aim: To emphasize the hypoglycemic action mechanism of LR in a type 2 diabetic rat model and examine potential biomarkers to obtain mechanistic understanding regarding serum metabolite modifications., Methods: A high-fat, high-sugar diet and streptozotocin injection-induced type 2 diabetic rat model was established. The chemical composition of the LR was identified by high performance liquid chromatography. LR extract administrated as oral gavage at 0.5 g/kg, 2.5 g/kg, and 5 g/kg for 4 wk. Anti-diabetic effects of LR extract were evaluated based on histopathological examination as well as the measurement of blood glucose, insulin, glucagon-like peptide 1 (GLP-1), and lipid levels. Serum metabolites were analyzed using an untargeted metabolomics approach., Results: According to a chemical analysis, swertiamarin, sweroside, hesperetin, coumarin, 1.7-dihydroxy-3,8-dimethoxyl xanthone, and 1-hydroxy-2,3,5 trimethoxanone are the principal active ingredients in LR. An anti-diabetic experiment revealed that the LR treatment significantly increased plasma insulin and GLP-1 levels while effectively lowering blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and oral glucose tolerance test compared to the model group. Furthermore, untargeted metabolomic analysis of serum samples detected 236 metabolites, among which 86 were differentially expressed between the model and the LR group. It was also found that LR considerably altered the levels of metabolites such as vitamin B6, mevalonate-5P, D-proline, L-lysine, and taurine, which are involved in the regulation of the vitamin B6 metabolic pathway, selenium amino acid metabolic pathway, pyrimidine metabolic pathway, and arginine and proline metabolic pathways., Conclusion: These findings indicated that LR may have a hypoglycemic impact and that its role may be related to changes in the serum metabolites and to facilitate the release of insulin and GLP-1, which lower blood glucose and lipid profiles., Competing Interests: Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

The naturally high background value region of Cd derived from the weathering of carbonate has received wide attention. Due to the significant difference in soil physicochemical properties, soil Cd content, and bioavailability of different parent materials in the karst area, there are certain limitations in using the total soil Cd content to classify the environmental quality of cultivated land. In this study, surface soil and maize samples of eluvium and alluvial parent material in typical karst areas were collected systematically; the contents of maize Cd, soil Cd, pH, and oxides were analyzed, the Cd geochemical characteristics of different parent soils and the influencing factors of their bioavailability were revealed, and scientific and effective arable land use zoning suggestions based on the prediction model were suggested. The results showed that the physicochemical properties of different parent material soils in the karst area were obviously different. The alluvial parent material soil had low Cd content but high bioavailability, and the maize Cd exceeding rate was high. The maize Cd bioaccumulation factor was significantly negatively correlated with soil CaO, pH, Mn, and TC, and the correlation coefficients were -0.385, -0.620, -0.484, and -0.384, respectively. Compared with the multiple linear regression prediction model, using the random forest model to predict the maize Cd enrichment coefficient had higher accuracy and precision. Furthermore, a new scheme for the safe utilization of cultivated land at the plot scale based on soil Cd and predicted crop Cd content was proposed in this study, making full use of arable land resources to ensure crop safety.

Objective: To investigate the efficacy of sacubitril/valsartan in peritoneal dialysis (PD) patients with heart failure with preserved ejection fraction (HFpEF) and its effect on residual renal function. Methods: PD patients with HFpEF in Ningbo First Hospital from March 2018 to August 2021 were retrospectively enrolled and divided into study group with sacubitril/valsartan and control group with valsartan. The clinical baseline data before treatment and clinical indicators during follow-up (6 and 12 months after treatment) were collected and compared between the two groups, and the adverse reactions were also recorded. Results: A total of 99 patients were included in the study. There were 61 patients in the study group, including 44 males and 17 females, with a mean age of (52±13) years. Meanwhile, there were 38 patients in the control group, including 23 males and 15 females, with a mean age of (57±14) years. There was no statistically significant difference in clinical baseline data between the two groups (e.g., age, sex, body mass index, duration of dialysis) (all P >0.05). The N-terminal pro-B-type natriuretic peptide (NT-proBNP) and left ventricular end-systolic dimension (LVDs) were lower, but the left ventricular ejection fraction (LVEF) was higher in the study group than those in the control group at 6 and 12 months after treatment (all P <0.05). The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were lower than baseline values at 6 and 12 months after treatment respectively, with statistically significant differences (all P <0.05). However, there were no statistically significant differences in the decreases of SBP and DBP between the two groups at 6 and 12 months after treatment (all P >0.05). The decrease extents in residual estimated glomerular filtration rate (eGFR) [0.52 (-0.05, 1.19) vs 1.72 (0.97, 2.39) ml·min -1 ·(1.73 m 2 ) -1 , P <0.001]and 24-h residual urine volume [200 (-100, 300) vs 300 (137, 400) ml, P =0.018] at 12 months after treatment were lower in the study group than those in the control group. During the follow-up period, hyperkalemia occurred in 16 cases (26.2%) and 13 cases (34.2%) in the study group and the control group, and hypotension occurred in 3 cases (4.9%) and 1 case (2.6%) in the study group and the control group, respectively. There were no adverse reactions such as cough and angioneurotic edema in the two groups. Conclusions: Sacubitril/valsartan can safely and effectively improve cardiac function and lower blood pressure in PD patients with HFpEF. Compared with valsartan, sacubitril/valsartan may be more beneficial to delay the loss of residual renal function in PD patients with HFpEF.

Objective: To evaluate the prediction and effect of fibrinogen-to-albumin ratio (FAR) on active, severe active, and poor prognosis of systemic lupus erythematosus (SLE)., Methods: One hundred and sixty-eight patients with SLE who were treated in our hospital were enrolled, the clinical data, laboratory indexes, and disease prognosis of all patients were collected and analyzed., Results: Triglyceride (TG), FAR, ESR, and anti-dsDNA (+) were the influencing factors, while complement 3 (C3) was the protective factor of active SLE, the odds ratio (OR) values were 2.968, 3.698, 2.114, 2.727, and 0.652, respectively (p < 0.05). FAR, ESR, and anti-dsDNA (+) were the influencing factors, while C3 was the protective factor of severe active SLE, the OR values were 3.791, 1.953, 2.187, and 0.742, respectively (p < 0.05). SLE disease activity index (SLEDAI), TG, FAR, and anti-dsDNA (+) were the influencing factors, while C3 was the protective factor of poor prognosis SLE, the OR values were 3.024, 2.293, 3.012, 2.323, and 0.801, respectively (p < 0.05). FAR and FIB were positively correlated with SLEDAI, while ALB was negatively correlated with SLEDAI, the related coefficient (r) were 0.398, 0.267, -0.270, respectively. The receiver operating curve (ROC) analysis showed that the predictive values of FAR for active, severe active and poor prognosis SLE were 0.769, 0.769, and 0.734, respectively, were significant higher than FIB and ALB (p < 0.05)., Conclusion: Fibrinogen-to-albumin ratio was an influencing factor of active, severe active, and poor prognosis SLE had higher predictive value than FIB and ALB for the activity and prognosis of SLE., (© 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Objective: To investigate the nutritional risk, malnutrition, severe malnutrition, and malnutrition prevalence of different stages in chronic kidney disease (CKD) patients with and without diabetes mellitus using the Global Leadership Initiative on Malnutrition (GLIM), and to analyze the causes of malnutrition and to improve the clinical outcomes of patients for early intervention., Methods: A total of 683 patients with CKD who were hospitalized in our hospital from January 2020 to January 2021 were enrolled and divided into subgroups 1 to 5 according to whether they were complicated with diabetes and glomerular filtration rate. Using the second step of the malnutrition (GLIM) diagnostic tool and 2 previously commonly used malnutrition assessment methods (body mass index <18.5 kg/m 2 with poor general condition, 3 points for nutritional deficiency in nutritional risk screening), combined with clinical research on the main causes of malnutrition, the intervention measures were discussed., Results: The prevalence of malnutrition was 16.7% (114/683) in the patients included in the survey using the diagnostic criteria of malnutrition (GLIM) (excluding whole body muscle mass index). The prevalence of malnutrition in CKD patients with and without diabetes was 23.7% and 12.6%, respectively. The overall prevalence rate of severe malnutrition was 14.2%, and the prevalence rates of those with and without diabetes were 19.0% and 11.4%, respectively; the results of the two methods of malnutrition assessment showed that the prevalence of malnutrition in CKD patients with diabetes was higher than that in the uncombined group. There was no severe malnutrition in patients with CKD stages 1 and 2. From CKD stage 3 onwards, the severe malnutrition in the diabetic group was significantly higher than that in the uncombined group., Conclusion: With the progression of CKD, the incidence of malnutrition also gradually increased, indicating that malnutrition is related to primary diseases and concomitant diseases. Attention should be paid to the malnutrition of CKD patients with diabetes, and clinical medical staff need to pay early attention to various diseases that lead to the progression of CKD, such as diabetes, primary nephropathy, and other factors, to prevent complications and delay the progression of CKD., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Li-Li Dai et al.)

We report a narrow bandwidth spatiotemporal mode-locked (STML) ytterbium-doped fiber laser, based on a homemade carbon nanotube/polyvinyl alcohol composite film and the multimode interference filtering effect. The wavelength-tunable narrow bandwidth STML operations combined with different pulse states are achieved, including single pulse, multiple pulses, and harmonics. The 3-dB bandwidth at the single-pulse state is 103 pm, while at the harmonic state, it is as narrow as 26 pm. To give an insight into the generation of the narrow bandwidth STML pulses, numerical simulations are performed. Such a laser has a wide range of potential applications in fields of optical communication and optical measurement, as well as provides a favorable platform for studying the evolution dynamics of multimode solitons.

Backgroud: Root caries in aging population was prevalent worldwide. Due to the absence of enamel and specific structure of dentine, bacteria are able to penetrate further into dentine at an earlier stage of lesion development. The aim of this study was to investigate the effect of adding of a strontium-doped bioactive glass-ceramic (HX-BGC) to a fluoride-free toothpaste on prevention of formation of artificial dentine caries., Methods: Thirty-six human tooth specimens were allocated to three groups (n = 12 per group). Group 1 treated with slurry containing a fluoride-free toothpaste and 5% HX-BGC, Group 2 was treated with fluoride-free toothpaste slurry, and Group 3 received deionized water as a negative control. The specimens were subjected to four cycles (15 h demineralization and 8 h remineralization for one cycle) of biochemical cycling. A mixed suspension of five bacteria species (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Actinomyces naeslundii) were prepared in brain heart infusion broth with 5% sucrose and used as acidic challenge in biochemical cycling. Subsequently, surface morphology of the dentine lesion was assessed by scanning electron microscopy, while the lesion depths and mineral loss were assessed by micro-computed tomography., Results: The mean lesion depths in dentine in Groups 1 to 3 were 87.79 ± 16.99 μm, 101.06 ± 10.04 μm and 113.60 ± 16.36 μm, respectively (p = 0.002). The mean amounts of mineral loss in Groups 1 to 3 were 0.82 ± 0.10 g/cm 3 , 0.89 ± 0.09 g/cm 3 and 0.96 ± 0.11 g/cm 3 , respectively (p = 0.016). No obvious differences in the surface morphology were seen among the groups., Conclusion: Addition of strontium-doped bioactive glass-ceramic to fluoride-free toothpaste has potential to reduce formation of dentine lesions., (© 2022. The Author(s).)

Background: Previous studies have suggested that pregnant women with pulmonary hypertension (PH) have high maternal mortality. However, indexes or factors that can predict maternal death are lacking., Methods: We retrospectively reviewed pregnant women with PH admitted for delivery from 2012 to 2020 and followed them for over 6 months. The patients were divided into two groups according to 10-day survival status after delivery. Predictive models and predictors for maternal death were identified using four machine learning algorithms: naïve Bayes, random forest, gradient boosting decision tree (GBDT), and support vector machine., Results: A total of 299 patients were included. The most frequent PH classifications were Group 1 PH (73.9%) and Group 2 PH (23.7%). The mortality within 10 days after delivery was 9.4% and higher in Group 1 PH than in the other PH groups (11.7 vs. 2.6%, P = 0.016). We identified 17 predictors, each with a P -value < 0.05 by univariable analysis, that were associated with an increased risk of death, and the most notable were pulmonary artery systolic pressure (PASP), platelet count, red cell distribution width, N-terminal brain natriuretic peptide (NT-proBNP), and albumin (all P < 0.01). Four prediction models were established using the candidate variables, and the GBDT model showed the best performance (F1-score = 66.7%, area under the curve = 0.93). Feature importance showed that the three most important predictors were NT-proBNP, PASP, and albumin., Conclusion: Mortality remained high, particularly in Group 1 PH. Our study shows that NT-proBNP, PASP, and albumin are the most important predictors of maternal death in the GBDT model. These findings may help clinicians provide better advice regarding fertility for women with PH., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dai, Jiang, Li, Shao, Wang, Wang, Jia, Liu, An, Jing and Cheng.)

The growth, biomass, nutrient content and accumulation as well as the vertical distribution of nutrient accumulation in Cunninghamia lanceolata plantation across densities of 1800, 3000, 4500 trees·hm -2 were stu-died in order to provide scientific basis for efficient cultivation of C. lanceolata plantation. The total amounts of nutrients accumulated in C. lanceolata plantation with 1800, 3000, 4500 trees·hm -2 were 1311.57, 2531.55 and 2307.33 kg·hm -2 , respectively. There were significant variations among different densities. Under the same density, the order of nutrient content and accumulation in C. lanceolata plantation was total N > total K > total Ca > total Mg > total P. Moreover, the amount of nutrients in trunk and bark decreased with the increases of tree height. The amount of nutrient accumulation in persistent withered branch and leaf were allocated from middle to the upper part of tree, while the opposite was observed for fresh branch and leaf. N accumulation increased with the increases of stand densities, while the other nutrients first increased then decreased. The order of the amount of nutrient accumulation in trunk, bark, root, persistent withered branch, persistent withered leaf and litter among different densities was 4500 > 3000 > 1800 trees·hm -2 , and was 3000 > 1800 > 4500 trees·hm -2 in fresh branch and leaf, and 1800 > 3000 > 4500 trees·hm -2 in understory. Under the densities of 1800 and 4500 trees·hm -2 , the nutrient distribution ratio in bark was the largest, accounting for 21.6% and 19.4%. In 3000 trees·hm -2 , the distribution ratio of fresh leaves reached its maximum, accounting for about 22.9%, and the next was fresh branches, which had a distribution ratio of about 17.8%. 3000 trees·hm -2 was the most appropriate density for nutrient accumulation and distribution in C. lanceolata plantation.

Ground-level ozone pollution(O 3 ) and climate change have become key global problems threatening the environment and sustainable development of urban forests. At present, various studies have assessed the O 3 impacts on trees; however, it is difficult to accurately evaluate the complex ecological effects caused by multiple factors on the natural urban environment. In this paper, the interactions between O 3 and carbon dioxide(CO 2 ), drought, nitrogen deposition, and warming, as well as the effects of the physiology, biochemistry, and growth of urban trees in China were reviewed. Elevated CO 2 could alleviate the negative effects of elevated O 3 on the photosynthetic metabolism, antioxidant system, and growth of trees. There is a complex interaction between O 3 and drought, which may synergistically aggravate, alleviate, or have no effect on trees. However, there was no correlation between O 3 and N deposition, only a significant interaction between elevated temperatures and O 3 , which slowed down the adverse effects of O 3 on tree growth and photosynthesis. Finally, suggestions are put forward to manage and sustainable develop urban forests in China under future climate change and air pollution.

Background: The most recent international guidelines recommended support training of chest compression (CC) using feedback devices. This study aimed to compare the training efficacy of a simplified feedback trainer with the traditional cardiopulmonary resuscitation (CPR) simulator in CPR training. Methods: A total of 60 soldiers were randomly allocated into three groups equally, trained with a simplified external cardiac massage (ECM) trainer named Soul Sheath TM (SS) (SS group), a Resusci Anne manikin (RA group), or traditional simulation training with instructor feedback, respectively. After 7 days of training, the CPR skills were tested blindly in a 2-min assessment session. The primary outcome was the proportion of effective CC, and the secondary outcome included CC rate, depth, compression position, and extent of the release. Results: The percentage of effective CC achieved in the SS group was comparable with the RA group (77.0 ± 15.52 vs. 77.5 ± 10.73%, p = 0.922), and significantly higher than that in the control group (77.0 ± 15.52 vs. 66.8 ± 16.87%, p = 0.037). Both the SS and RA groups showed better CC performance than the control group in terms of CC rate (SS group vs. control group, P = 0.032 and RA group vs. control group, P = 0.026), the proportion of shallow CC (SS group vs. control group, P = 0.011 and RA group vs. control group, P = 0.017). No difference between the SS group and RA group was found in all the CC parameters. Conclusions: The simplified ECM trainer (SS) provides a similar efficacy to the traditional manikin simulator with feedback in CC training to improve the quality of CPR skills., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Meng, You, Dai, Yin, Xu and Wang.)

Objectives: This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures., Methods: A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined., Results: Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant ( P <0.05), and vertical root fracture was the most common type. Palatal and buccal roots were commonly fractured at the mesiodistal and buccal-palatal directions, respectively., Conclusions: This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

This study investigated the effect of strontium-doped bioactive glass (SBAG) on the formation of dental demineralized lesions., Materials and Methods: The study materials were 48 sound human tooth specimens with both dentine and enamel, divided equally into four groups: Group 1 (SBAG), Group 2 (SBAG+Fluoride), Group 3 (Fluoride), and Group 4 (Water as control). After 14 days of pH cycling, the surface morphology of the specimens was observed by scanning electron microscopy. Crystal characteristics of the precipitates were assessed by X-ray diffraction (XRD). Micro-CT was used to measure the mineral loss and the depths of the demineralized lesions formed., Results: Exposure of collagen in inter-tubular areas in dentine was seen in the control group (Group 4) but not in Groups 1 to 3. In Group 2, there were obvious granular particles on the surface of the dentine. XRD revealed precipitation of apatites on the surface of the tooth specimens in Groups 1 to 3. The mean lesion depths in dentine were 81.80 μm, 30.68 μm, 39.04 μm, and 146.36 μm in Groups 1 to 4, respectively ( p < 0.001). Lesions in enamel were only found in the control group. The mean mineral loss values in the dentine lesions were 1.25 g/cm 3 , 0.88 g/cm 3 , 0.87 g/cm 3 , and 1.65 g/cm 3 , in Groups 1 to 4, respectively ( p < 0.001)., Conclusion: Strontium-doped bioactive glass has a preventive effect on the formation of demineralized lesions in enamel and dentine.

A plasma radiation measurement system for a wide spectral range, based on compact Absolute eXtreme UltraViolet (AXUV) silicon photodiodes, has been implemented on the newly constructed ENN XuanLong-50 (EXL-50) spherical tokamak. The system consists of two 16-channel AXUV16ELG arrays and one AXUV63HS1 single-cell detector mounted on ceramic sockets. The two arrays, facing toward the EXL-50 slim central post from two locations inside a top and a side ConFlat 400 port, have 32 view chords covering the interested plasma region in a poloidal cross section at toroidal 330°. The single-cell detector, seated on a retractable feedthrough, could be arranged flexibly with the help of an ultra-high vacuum compatible gate valve. The design details together with considerations on the EXL-50 specific engineering realities and physics requirements are described. Preliminary results from the EXL-50 2020 experimental campaign are presented.

Objective: To assess the efficacy and safety of PNS on antiplatelet therapy in the treatment of AIS., Methods: We searched 7 literature databases and 2 clinical studies databases for randomized controlled studies (RCTs) evaluating PNS as an adjuvant therapy for AIS. Relevant studies were retrieved and screened, and data were extracted independently by two reviewers. The quality of the included studies was assessed using the Cochrane Risk Assessment Tool. Meta-analysis was carried out with the Rev Man 5.4 software., Results: Of 8267 records identified, 43 RCTs met our inclusion criteria ( n  = 4170 patients). Patients assigned to PNS with conventional treatments (CTs) had improved functional independence at 90 days compared with those assigned to CTs alone ( RR  = 1.87, 95% CI  = 1.37, to 2.55, P < 0.0001). Patients who received PNS combined with CTs showed significantly high improvements in neurological function among individuals with AIS on the neurologic deficit score (NDS) ( MD CSS  = -5.71, 95% CI  = -9.55 to -1.87, P =0.004; MD NIHSS  = -3.94, 95% CI  = -5.65 to -2.23, P < 0.00001). The results also showed PNS contributed to a betterment in activities of daily living (ADL) on the Barthel index ( MD day 10 BI  = 4.86, 95% CI  = 2.18, to 7.54, P < 0.00001; MD day 14 BI  = 13.92, 95% CI  = 11.46 to 16.38, P < 0.00001; MD day 28 BI  = 7.16, 95% CI  = 0.60, to 13.72, P < 0.00001). In addition, PNS, compared with CTs alone, could significantly improve overall response rate (ORR) ( RR NIHSS  = 1.20, 95% CI  = 1.16, to 1.24, P < 0.00001; RR CSS  = 1.15, 95% CI  = 1.08, to 1.24, P < 0.0001), hemorheological parameters, maximum platelet aggregation rate (MPAR) ( MD  = -6.82, 95% CI  = -9.62 to -4.02, P < 0.00001), platelet parameters ( MD PLT  = 4.85, 95% CI  = 1.82 to 7.84, P =0.002; MD MPV  = -0.79, 95% CI  = -1.09 to -0.48, P < 0.00001), and serum CD62P ( MD  = -0.21, 95% CI  = -0.29 to -0.13, P < 0.00001). The incidence of adverse reactions in PNS was lower than that in the control group ( RR  = 0.62, 95% CI  = 0.39 to 0.97, P =0.04). Adverse reactions in the PNS were mild adverse reactions., Conclusion: PNS may be effective and safe in treating AIS on ameliorating neurological deficit, improving activities of daily living function, and enhancing antiplatelet effects. However, more high-quality evidence is needed before it can be recommended for routine antiplatelet therapy in patients with AIS., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Liu-ding Wang et al.)

To systematically search and sort out the clinical randomized controlled trial(RCT) on the prevention and treatment of acute cerebral infarction with traditional Chinese medicine(TCM) by using the method of evidence map, and to understand the evidence distribution of related studies. CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were retrieved from January 2016 to September 2020, and literatures related to the prevention and treatment of acute cerebral infarction with traditional Chinese medicine were included. Text description combined with table and bubble chart were used to analyze the distribution characteristics of evidence. A total of 1 102 clinical articles in recent five years were retrieved. The annual trend of clinical study publication, study size, TCM therapy category and main scheme, and study literature quality were analyzed. We find that TCM treatment of acute cerebral infarction has become a hot topic of clinical research, the number of literature showed a trend of increased year by year, various means of intervention of TCM in the treatment of the advantages of increasingly highlight. Follow-up clinical research should highlight the characteristics of TCM: in the analysis of outcome indicators; increase the neuropsychological patients after stroke and cognitive ability, and the theory of combined treatment of TCM disease when thoughts; At the same time, the quality of clinical research needs to be improved. At present, there is still a lack of unified standards for the production of evidence map. This study is the first to explore the application of evidence map to summarize and display the clinical research status of TCM treatment of acute cerebral infarction, and combine it with the setting of priority areas of TCM clinical research, so as to provide a reference basis for determining the priority topic selection of TCM treatment optimization research.

To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction. CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P. notoginseng saponins in the treatment of acute cerebral infarction. The retrieval time was from the time of database establishment to January 2021. After two researchers independently screened out the literature and extracted the data, AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews, GRADE system was used to grade the quality of evidences of the outcome indicators, and the efficacy evaluation was summarized. A total of 5 systematic reviews were included. AMSTAR-2 evaluation results showed that 3 items were relatively complete, while 4 items had a poor overall quality. P. notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function, enhancement of the total effective rate in clinic, and improvement of activities of daily living. GRADE evaluation results showed that the quality of evidence was from low quality to very low quality. In conclusion, in the treatment of acute cerebral infarction, P. notoginseng saponins can improve the clinical efficacy, with a good safety but a not high methodological quality and a low evidence quality. It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P. notoginseng saponins in the treatment of acute cerebral infarction.

There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.

To analyze the use of outcome indicators of randomized controlled trial(RCT) of acupuncture in the treatment of acute ischemic stroke in recent three years, so as to provide a basis for building a study on the core outcome indicators for the treatment of acute ischemic stroke with acupuncture. The RCTs of acupuncture treatment for acute ischemic stroke in recent three years were collec-ted through computer retrieval of eight Chinese and English databases and two clinical trial registries at home and abroad. Literature was screened out, and data was extracted. Risk of assessment bias tool Cochrane 6.1 was used for bias risk assessment, outcome indicators were summarized and analyzed. A total of 47 RCTs were included, and 3 studies were trials registration scheme. Outcome indicators were divided into 6 categories according to functional attributes, namely physical symptoms/signs, physical and chemical examination, quality of life, traditional Chinese medicine symptoms/syndromes, safety events and long-term prognosis. The study found that in addition to the common problems in previous studies covered by the status quo of outcome indicators selection of RCT of acupuncture in the treatment of acute ischemic stroke, there were also the other problems as follows: emphasis on macroscopic efficacy indicators but neglect of acupuncture specific indicators, lack of characteristic indicators and economic indicators of traditional Chinese medicine therapy, and unification of indicators measurement tool and measurement time point. In the future, the outcome indicators set for the treatment of acute ischemic stroke with acupuncture shall be established, and the core outcome indicators set shall be in line with the characteristics of traditional Chinese medicine treatment.

A toroidal soft x-ray array system for spectrum and intensity measurements on the EXL-50 spherical tokamak is described. Silicon drift detectors and digital multichannel analyzers are adopted for all 21 channels of the array, and an average energy resolution of 147 eV at 5.89 keV has been achieved at count rates over 500 kcps. In total, 20 channels of the array are symmetrically observed in both co- and counter-current directions on the EXL-50 mid-plane with a spatial resolution of around 10 cm, and the remaining one serves as a background reference channel. Tungsten emissions from tungsten coating of the limiters on the central post are observed. The influence of hard x rays on measured soft x-ray spectra and system operation is discussed.

Objective: To investigate the remineralizing effect of a strontium-doped bioactive glass (HX-BGC) and fluoride on demineralized enamel and dentine., Materials: Sixty demineralized human tooth specimens were allocated to four groups. Group 1 received 5% HX-BGC, Group 2 received 5% HX-BGC and 1450 ppm fluoride, Group 3 received 1450 ppm fluoride, and Group 4 received deionized water as negative control. The specimens were subjected to pH cycling for 14 days. The surface morphology, lesion depths, crystal characteristics and collagen matrix degradation of the specimens were assessed by scanning electron microscopy (SEM), micro-computed tomography (mico-CT), X-ray diffraction (XRD), and spectrophotometry with a hydroxyproline (HYP) assay, respectively., Results: SEM images showed the enamel surface was smooth with regularly arranged enamel rods in Groups 1-3. Granular grains were observed in both inter-tubular and intra-tubular dentine in Groups 1-3. The mean lesion depths in enamel were 80.8 μm, 50.6 μm, 72.7 μm and 130.7 μm in Groups 1-4, respectively (p < 0.001), and those in dentine were 152.6 μm, 140.9 μm, 165.4 μm and 214.1 μm, respectively (p < 0.001). The differences in mean mineral loss in enamel and in dentine between the four study groups follow the same pattern as that of the differences in lesion depth. XRD illustrated apatite formation in each group. There were no significant differences in the HYP concentrations among the four groups (p = 0.261)., Conclusion: Combined use of HX-BGC and fluoride can reduce mineral loss and promote remineralization of demineralized enamel and dentine through the precipitation of newly formed apatite., Clinical Significance: Adjunctive use of HX-BGC may enhance the remineralization effect of fluoride in the management of early dental caries lesions., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Sulongga-4 (SL-4) is a herbal formula used in traditional Mongolian medical clinics for the treatment of peptic ulcers and gastroenteritis, even though its pharmacological mechanism has not been well characterized., Aim: To evaluate the protective effect and identify the mechanisms of action of SL-4 on gastroduodenal ulcer induced by pyloric ligation (PL) in rats., Methods: PL was performed to induce gastric and duodenal ulcers in rats, which were then treated with oral SL-4 (1.3, 2.6, or 3.9 g/kg per day) for 15 d. PL-induced gastroduodenal ulceration. Therapeutic effects were characterized by pathological and histological evaluations and inflammatory indicators were analyzed by enzyme-linked immunosorbent assay. Microarray analyses were conducted to identify gene expression profiles of gastroduodenal tissue in PL rats with or without SL-4 treatment. The candidate target genes were selected and verified by quantitative reverse transcription polymerase chain reaction (qRT-PCR)., Results: SL-4 decreased histopathological features in the PL-induced ulcerated rats. SL-4 significantly ( P < 0.05) decreased expression of tumor necrosis factor-α, interleukin (IL)-1β, IL-6, endotoxin, platelet-activating factor, and increased prostaglandin E2 and epidermal growth factor in ulcer tissue. Microarray analysis was used to identify a panel of candidate target genes for SL-4 acting on PL-induced ulceration. Genes included some complement and coagulation cascade and retinol metabolism pathways that are closely associated with inflammatory responses and gastric mucosal protective mechanisms. qRT-PCR showed that altered expression of the selected genes, such as CYP2b2 , UGT2b1 , A2m , and MASP1 was consistent with the microarray results., Conclusion: SL-4 exerts protective effects against PL-induced gastroduodenal ulcers via reducing inflammatory cytokines and elevating expression of gastric acid inhibitory factors. Downregulation of CYP2b2 and UGT2b1 genes in retinol metabolism and upregulation of A2m and MASP1 genes in the complement and coagulation cascades pathways are possibly involved in SL-4-mediated protection against gastroduodenal ulcer., Competing Interests: Conflict-of-interest statement: The authors declare that they have no competing interests., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To study the effect of Tai Chi (TC) and resistance training (RT) with different intensity on the cancer-related fatigue (CRF) and quality of life (QoL) of middle-aged and elderly cancer patients., Methods: Totally 120 cancer patients were enrolled and randomly assigned to 4 groups by a random number table, including TC group, high-intensity 60% one repetition maximum (1-RM) RT group (HIRT), low-intensity (30% 1-RM) RT group (LIRT) and control group, 30 patients in each group. Participants in the TC group received 24-form simplified Yang-style TC training at a frequency of 40 min per day, 3 days per week for 12 weeks. Patients in the two RT groups received 10 sessions, 6 designated movements per day, 3 days per week for 12 weeks. The 1-RM of 6 muscle groups, fat mass (FM), lean body mass (LBM), along with the scores of Brief Fatigue Inventory (BFI), QoL questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI) were measured before and after training. The adverse effect was also observed., Results: After 12-week intervention, patients in both TC and RT groups showed significant improvements in CRF and QLQ-CCC compared to pre-treatment (P<0.05). Compared with the LIRT and TC groups, patients in the HIRT group improved more significantly in increasing muscle strength and LBM, and reducing in FM (P<0.05). Patients in the TC group significantly increased in lower limb muscle strength compared with the LIRT group (P<0.05). In addition, patients in the TC group showed more significant improvements in scores of GAD-7, PHQ-9 and PSQI than 2 RT groups (P<0.05)., Conclusions: TC and RT, both low- and high-intensity training, can significantly increase muscle strength, reduce CRF and improve QoL in the middle-aged and elderly cancer patients. TC has a better effect than RT in terms of sleep quality and mental health. The long-term application is needed to substantiate the effect of TC as an alternative exercise in cancer patients.

A tangential hard x-ray (HXR) diagnostic on the newly constructed ENN XuanLong-50 (EXL-50) spherical tokamak for fast electron emission studies is presented. The HXR detection system consists of a symmetrical CdZnTe semiconductor detector array with a spectral sensitivity range of 20-300 keV. 25 channels have been designed on the 270° horizontal vacuum port with 12 sight lines to observe the forward emission, 12 sight lines to observe the backward emission of fast electrons, and 1 for viewing the central. Currently, ten channels have been in operation in the EXL-50 experiments. The systems are designed to measure the x-ray spectra for the estimation of fast electron temperature and electron velocity distribution in the EXL-50 experiment, which will be useful for understanding the dynamics of fast electrons generated by electron cyclotron resonance heating, for plasma instability and transport studies and for the analysis of plasma heating efficiency.

As both host and pathogen require iron for survival, iron is an important regulator of host-pathogen interactions. However, the molecular mechanism by which how the availability of iron modulates host innate immunity against bacterial infections remains largely unknown. Using the metazoan Caenorhabditis elegans as a model, we demonstrate that infection with a pathogenic bacterium Salmonella enterica serovar Typhimurium induces autophagy by inactivating the target of rapamycin (TOR). Although the transcripts of ftn-1 and ftn-2 encoding two H-ferritin subunits are upregulated upon S. Typhimurium infection, the ferritin protein is kept at a low level due to its degradation mediated by autophagy. Autophagy, but not ferritin, is required for defense against S. Typhimurium infection under normal circumstances. Increased abundance of iron suppresses autophagy by activating TOR, leading to an increase in the ferritin protein level. Iron sequestration, but not autophagy, becomes pivotal to protect the host from S. Typhimurium infection in the presence of exogenous iron. Our results show that TOR acts as a regulator linking iron availability with host defense against bacterial infection., Competing Interests: The authors declare no conflict of interest.

Objectives: This study investigated the effects of a new strontium-doped bioactive glass and fluoride on hydroxyapatite crystallization., Methods: We designed an in vitro experiment with calcium phosphate (CaCl 2 ·2H 2 O + K 2 HPO 4 in buffer solution) with different concentrations of strontium-doped bioactive glass (1 mg/mL or 5 mg/mL), and different concentrations of fluoride (0 ppm, 1 ppm or 5 ppm). Tris-buffered saline served as negative control. After incubation at 37 ℃ for 48 h, the shape and organization of crystals were examined by transmission electron microscopy (TEM) and electron diffraction. Structure of the crystals was assessed by powder X-ray diffraction (P-XRD) and unit cell parameters were calculated. Characterization of the crystals were performed by Raman spectroscopy and Fourier Transform Infrared Spectroscopy (FTIR)., Results: TEM and selected-area electron diffraction revealed that the precipitates in all experimental groups were crystalline apatite. There was an interaction between strontium and fluoride with different concentrations on crystal thickness (p = 0.008). P-XRD indicated the formation of strontium-substituted-fluorohydroxyapatite and strontium-substituted-hydroxyapatite in the groups with both bioactive glass and fluoride. Expansion or contraction of crystal unit cell was influenced by the concentrations of strontium and fluoride. Raman spectra showed strong phosphate band at 960 cm -1 in all experimental groups and displayed no obvious shift. FTIR results confirmed the formation of apatite., Conclusions: The results of this study suggest that strontium-doped bioactive glass and fluoride have synergistic effects on hydroxyapatite crystallization., Clinical Significance: Strontium-doped bioactive glass and fluoride have synergistic effects on hydroxyapatite crystallization by producing strontium-substituted-hydroxyapatite and strontium-substituted-fluorohydroxyapatite with enhanced bioactivity and reduced solubility which could be beneficial for caries management., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Asian leaf-litter toads of the genus Leptobrachella represent charismatic anuran diversification with 80 species, of which 25 are from China. Recent new discoveries suggest that the diversity of this genus is underestimated. Here, we describe a new species of Leptobrachella , Leptobrachella bashaensis sp. nov. from the Basha Nature Reserve, Congjiang County, Guizhou Province, China. The new species is distinguished from its congeners by the following suite of morphological traits: small body size (SVL 22.9-25.6 mm in six adult males and 27.1 mm in one adult female); head longer than wide; dorsal skin slightly shagreened with small tubercles; creamy-white chest and belly with irregular black spots; distinct ventrolateral glands forming a white line; finger webbing and fringes absent; toe webbing rudimentary and lateral fringes narrow; iris bicolored with bright orange in upper half and silver in lower half; dorsal surface of tadpole head dark brown with small, brown, irregular spot, air sac-shaped bulges on both sides of body. The new species differs from all known congeners by an uncorrected p -distance of >5.3% of the 16S rRNA gene fragment examined, and the phylogenetic analysis clusters the new species with L. maoershanensis and L. laui . At present, the new species is only known from a small range of montane evergreen secondary forests in Basha Nature Reserve approximately 900 m elevation. Its natural history and conservation status are discussed., (Jing-Cai Lyu, Liang-Liang Dai, Ping-Fan Wei, Yan-Hong He, Zhi-Yong Yuan, Wen-Li Shi, Sheng-lun Zhou, Si-yu Ran, Zhong-Fan Kuang, Xuan Guo, Gang Wei, Guo Yuan.)

Background: Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs., Methods: We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%., Results: At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group., Conclusions: The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure., Trial Registration: ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx., (Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Objectives: To investigate the antibacterial effect of a new bioactive glasses on cariogenic bacteria., Methods and Materials: A newly developed bioactive glass named Huaxi bioactive glass-ceramic (HX-BGC) and its antibacterial effects were investigated. 3 M™ Specialty Glass 19933 (SG) was used as the positive control while deionized water was used as a negative control. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of HX-BGC and SG against four cariogenic bacteria (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilius, Lactobacillus rhamnosus) were determined by a microdilution method. Subsequently, bacterial growth and acid production were assessed by co-culturing the four cariogenic bacteria species with HX-BGC or SG at different concentrations anaerobically at 37 °C. Optical density (at 660 nm) was assessed by a microplate reader and the acidity of the supernatant was measured by a pH electrode at 6, 12, 24, and 48 h. Microbial kinetics, morphology and viability were evaluated by counting colony forming units (CFU), scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), respectively., Results: The MBC of HX-BGC againstS.mutans, S.sobrinus, L.acidophilus and L.rhamnosus were 15.63 mg/mL, 15.63 mg/mL, 7.81 mg/mL and 62.5 mg/mL, respectively. The optical density (7.8 mg/mL) value of the bacterial suspensions did not change during the 48 h of culture. The acidity of bacterial suspension kept steady at around pH 8.8. Results from counting the CFU indicated that HX-BGC had stronger antibacterial effect when compare to SG, which is consistent with the SEM and CLSM results., Conclusions: HX-BGC inhibits acid production and growth of cariogenic bacteria., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Fangcang shelter hospitals were established in China during the coronavirus disease 2019 (COVID-19) pandemic as a countermeasure to stop the spread of the disease. To our knowledge, no research has been conducted on mental health problems among patients in Fangcang shelter hospitals. This study aimed to determine the prevalence and major influencing factors of anxiety and depressive symptoms among COVID-19 patients admitted to Fangcang shelter hospitals. From February 23, 2020, to February 26, 2020, we obtained sociodemographic and clinical characteristics information of COVID-19 patients in Jianghan Fangcang Shelter Hospital (Wuhan, China) and assessed their mental health status and sleep quality. Data were obtained with an online questionnaire. The questionnaire consisted of a set of items on demographic characteristics, a set of items on clinical characteristics, the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Pittsburgh Sleep Quality Index. Three hundred seven COVID-19 patients who were admitted to Jianghan Fangcang Shelter Hospital participated in this study. The prevalence of anxiety and depressive symptoms were 18.6% and 13.4%, respectively. Poor sleep quality and having ≥ two current physical symptoms were independent risk factors for anxiety symptoms. Female sex, having a family member with confirmed COVID-19, and having ≥ two current physical symptoms were independent risk factors for depressive symptoms. Anxiety and depressive symptoms were found to be common among COVID-19 patients in Fangcang Shelter Hospital, with some patients being at high risk., Competing Interests: The authors have declared that no competing interests exist.

As an aggressive subtype of squamous cell carcinoma, basaloid squamous cell carcinoma (BSCC) rarely occurs in the oral and maxillofacial region. The gingiva is an unusual site of BSCC. This study reported a 78-year-old male who presented with left maxillary pain. Clinical examination revealed a gingival mass in the left maxilla. Under microscope, the lesion showed typical comedo necrosis and peripheral palisading. Areas of glandular-like structures were also observed. Immunohistochemistry results revealed that the Ki-67 score of BSCC in this case was 28%, and S-100 was positive in some areas. However, P16 and CK7 were negative. Finally, a diagnosis of BSCC was made based on the pathological and immunohistochemical characteristics. The patient underwent subtotal maxillectomy. After 12 months later, the patient was alive with no evidence of disease. Combined with relevant literature, this article analyzed the clinicopathological features, differential diagnosis, diagnosis, treatment, and prognosis of BSCC. Although surgery remains the main treatment in the head and neck region, radiation-chemotherapy should be considered in some human papilloma virus-positive cases.