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Apoptosis repressor with caspase recruitment domain (ARC) is a highly potent and multifunctional suppressor of various types of programmed cell death (PCD) (e.g. apoptosis, necroptosis, and pyroptosis) and plays a key role in determining cell fate. Under physiological conditions, ARC is predominantly expressed in terminally differentiated cells, such as cardiomyocytes and skeletal muscle cells. Its expression and activity are tightly controlled by a complicated system consisting of transcription factor (TF), non-coding RNA (ncRNA), and post-translational modification (PTM). ARC dysregulation has been shown to be closely associated with many chronic diseases, including cardiovascular disease, cancer, diabetes, and neurodegenerative disease. However, the detailed mechanisms of ARC involved in the progression of these diseases remain unclear to a large extent. In this review, we mainly focus on the regulatory mechanisms of ARC expression and activity and its role in PCD. We also discuss the underlying mechanisms of ARC in health and disease and highlight the potential implications of ARC in the clinical treatment of patients with chronic diseases. This information may assist in developing ARC-based therapeutic strategies for patients with chronic diseases and expand researchers’ understanding of ARC.

There are more and more uncertain factors affecting the power supply and demand situation in China. Studying and judging the power supply and demand situation in 2021 is of great significance to ensure the stable and healthy development of China's economy and society. Therefore, this paper combed the main factors affecting China's power demand and power supply in 2021, and analyzed the impact on power supply and demand from the aspects of international economy, domestic economy, key industries, climate and temperature, and power substitution. The economic trend, power demand and power supply of China in 2021 were forecasted, and on this basis, the national and regional power supply and demand situation were comprehensively studied and judged. It is estimated that the power consumption of the whole society in China will reach 8.22 trillion kW·h in 2021, and the growth rate will rebound significantly. By the end of 2021, the installed capacity of power generation in China is expected to reach 2.37 billion kW, of which the installed capacity of new energy is expected to account for more than 1/4. Moreover, the power supply and demand situation of China will be generally balanced in 2021, and there may be power supply and demand tension during peak hours in Central China and other regions.

Permeable pavement (PP) can be used to decrease urban surface runoff. However, few studies have been conducted to explore the runoff reduction effect of various structures of PP in the carriageway. In this study, several structures of PP used in the carriageway of sponge cities in China were investigated and divided into three types: surface drainage, base course storage and drainage, and fully permeable. Then, the runoff models were developed by Storm Water Management Model to simulate the effect of the three types under various rainfall recurrence periods. Results show that rainfall recurrence period, structure and thickness of the permeable layer were identified as the most influential factors in PP runoff reduction. The surface drainage can reduce total runoff depth and coefficient by more than 14%, and also delay runoff start time and duration by more than 40 minutes. Surface runoff in the base course storage and drainage can only be generated when recurrence period is 50 years. The fully permeable does not generate any runoff under all recurrence periods. Based on simulation results, a series of runoff coefficient values for PP were recommended to help the design and implementation of PP in mitigating urban waterlogging problems.

Gastric cancer (GC) is one of the most common malignant tumors of digestive systems worldwide, with high recurrence and mortality. Chemotherapy is still the standard treatment option for GC and can effectively improve the survival and life quality of GC patients. However, with the emergence of drug resistance, the clinical application of chemotherapeutic agents has been seriously restricted in GC patients. Although the mechanisms of drug resistance have been broadly investigated, they are still largely unknown. MicroRNAs (miRNAs) are a large group of small non-coding RNAs (ncRNAs) widely involved in the occurrence and progression of many cancer types, including GC. An increasing amount of evidence suggests that miRNAs may play crucial roles in the development of drug resistance by regulating some drug resistance-related proteins as well as gene expression. Some also exhibit great potential as novel biomarkers for predicting drug response to chemotherapy and therapeutic targets for GC patients. In this review, we systematically summarize recent advances in miRNAs and focus on their molecular mechanisms in the development of drug resistance in GC progression. We also highlight the potential of drug resistance-related miRNAs as biomarkers and therapeutic targets for GC patients.

Traditional outage model for the power equipment usually focus on the behavior of the equipment under random factors, and the availability of the power equipment in system analysis is usually confined to the steady value. However, this model may be inaccurate in the short term analysis, where the transient process of availability has not ended yet. Furthermore, the power equipment in the short term analysis might be influenced by both random factors and deterministic factors, yet the impact of deterministic factors cannot be completely reflected in the traditional outage model. Based on the above issues, a Markov-based transient outage model is proposed in this paper, which describes the deterioration and repair process of an equipment. Both the corrective maintenance and preventive maintenance are concerned in the model. The preventive maintenance in the model is considered as deterministic event, in which the start time and duration are both scheduled. Meanwhile the corrective maintenance and the unexpected failure are modeled as random events. The transient state probability and availability of equipment under preventive maintenance is derived. The effect of deterministic events on the availability of equipment is analyzed on numerical tests. The proposed model can be used in the short-term reliability assessment and maintenance scheduling in actual systems.

Osteoarthritis (OA) is characterized by symptoms such as abnormal lubrication function of synovial fluid and heightened friction on the cartilage surface in its early stages, prior to evident cartilage damage. Current early intervention strategies employing lubricated hydrogels to shield cartilage from friction often overlook the significance of hydrogel-cartilage adhesion and enhancement of the cartilage extracellular matrix (ECM). Herein, we constructed a hydrogel based on dihydrazide-modified hyaluronic acid (HA) (AHA) and catechol-conjugated aldehyde-modified HA (CHA), which not only adheres to the cartilage surface as an effective lubricant but also improves the extracellular environment of chondrocytes in OA. Material characterization experiments on AHA/CHA hydrogels with varying concentrations validated their exceptional self-healing capabilities, superior injectability and viscoelasticity, sustained adhesion strength to cartilage, and a low friction coefficient. Chondrocytes exhibited robust adhesion and proliferation on the AHA/CHA hydrogel surface, with the upregulation of cartilage matrix protein expression. Intra-articular injection of AHA/CHA hydrogels was performed following destabilization of the medial meniscus (DMM) surgery in mice to assess its protective effect on cartilage. The AHA/CHA hydrogel effectively attenuated the degree of cartilage wear, facilitated chondrocytes' anabolic metabolism, and restored the ECM of cartilage. Therefore, the AHA/CHA hydrogel emerges as a promising therapeutic approach in clinical practices of OA treatment.

Water electrolysis via alkaline hydrogen evolution reaction (HER) is a promising approach for large-scale production of high-purity hydrogen at a low cost, utilizing renewable and clean energy. However, the sluggish kinetics derived from the high energy barrier of water dissociation impedes seriously its practical application. Herein, a series of hybrid Pt nanoclusters/Ru nanowires (Pt/Ru NWs) catalysts are demonstrated to accelerate alkaline HER. And the optimized Pt/Ru NWs (10 ​% wt Pt) exhibits exceptional performance with an ultralow overpotential (24 ​mV at 10 ​mA ​cm−2), a small Tafel slope (26.3 ​mV dec−1), and long-term stability, outperforming the benchmark commercial Pt/C-JM-20 ​% wt catalyst. This amazing performance also occurred in the alkaline anion-exchange membrane water electrolysis devices, where it delivered a cell voltage of about 1.9 ​V at 1 ​A ​cm−2 and an outstanding stability (more than 100 ​h). The calculations have revealed such a superior performance exhibited by Pt/Ru NWs stems from the formed heterointerfaces, which significantly reduce the energy barrier of the decisive rate step of water dissociation via cooperative-action between Pt cluster and Ru substance. This work provides valuable perspectives for designing advanced materials toward alkaline HER and beyond.

Objective The electronic medical records (EMRs) corpus for cerebral palsy rehabilitation and its application in downstream tasks, such as named entity recognition (NER), requires further revision and testing to enhance its effectiveness and reliability. Methods We have devised an annotation principle and have developed an EMRs corpus for cerebral palsy rehabilitation. The introduction of test-retest reliability was employed for the first time to ensure consistency of each annotator. Additionally, we established a baseline NER model using the proposed EMRs corpus. The NER model leveraged Chinese clinical BERT and adversarial training as the embedding layer, and incorporated multi-head attention mechanism and rotary position embedding in the encoder layer. For multi-label decoding, we employed the span matrix of global pointer along with softmax and cross-entropy. Results The corpus consisted of 1405 EMRs, containing a total of 127,523 entities across six different entity types, with 24,424 unique entities after de-duplication. The inter-annotator agreement of two annotators was 97.57%, the intra-annotator agreement of each annotator exceeded 98%. Our proposed baseline NER model demonstrates impressive performance, achieving a F1-score of 93.59% for flat entities and 90.15% for nested entities in this corpus. Conclusions We believe that the proposed annotation principle, corpus, and baseline model are highly effective and hold great potential as tools for cerebral palsy rehabilitation scenarios.

[Objective] Large-scale integrated transportation hub structure is a vital component in urban layout, characterized by significant investment, extensive construction scale, and diverse functionalities. Ensuring the resilience of such buildings to seismic forces, preventing damage while preserving functionality, and providing sufficient safety and comfort under the influence of complex multidimensional traffic are engineering challenges of practical significance. Thus, it is necessary to sort through and summarize relevant literature research on this subject. [Method] The environmental vibration issues caused by various traffic loads along routes and buildings are reviewed. Additionally, the research status of vibration/seismic isolation devices commonly used in transportation hub structures is explored. The research achievements of scholars in China and worldwide in vibration response measurement, vibration prediction simulation, and vibration propagation laws are summarized. Based on the limitations of existing researches, the future research directions in environmental vibration control for transportation hub structure s are discussed. [Result & Conclusion] There is relatively limited research on three-dimensional composite vibration/seismic isolation globally, with a main focus on metro vibration isolation along rail transit lines or superstructures. Research primarily concentrates on experimental studies of the mechanical performance of the proposed vibration/seismic isolation device and vibration/seismic isolation effects. Currently, theoretical and technical research on three-dimensional composite vibration/seismic isolation is not deep enough, and its application is not yet widely adopted or developed into a system approach. Key issues, such as the development of related devices, vibration reduction mechanisms, mechanical performance, theoretical models, remain crucial problems that urgently need resolution.

Abstract Objectives To explore the prevalence and associated factors of obesity in Tibetan adults in Qinghai, China, and to determine the association between the FTO (rs1121980 and rs17817449) and MC4R gene (rs17782313 and rs12970134) polymorphisms with obesity. Methods A cross-sectional survey was conducted in 2015 in Qinghai to selected Tibetan adults aged 20 to 80 years. Prevalence of obesity (BMI ≥ 28 kg/m2) and overweight (BMI 24 ~ 27.9 kg/m2) were evaluated. Multivariable logistic models were used to determine the associated factors. Pair-matched subjects of obesity cases and normal-weight controls were selected for the gene polymorphism analyses. Conditional logistic models were used to assess the association between gene polymorphisms with obesity. Additive and multiplicative gene-environment interactions were tested. Results A total of 1741 Tibetan adults were enrolled. The age- and sex- standardized prevalence of obesity and overweight was 18.09% and 31.71%, respectively. Male sex, older age, heavy level of leisure-time exercise, current smoke, and heavy level of occupational physical activity were associated with both obesity and overweight. MC4R gene polymorphisms were associated with obesity in Tibetan adults. No significant gene-environment interaction was detected. Conclusion The prevalence of obesity and overweight in Tibetan adults was high. Both environmental and genetic factors contributed to the obesity prevalent.

ObjectiveTo investigate the technical feasibility of applying a simple suture guide device to close the annulus fibrosus (AF) of the intervertebral discs (IVD).Methods30 sheep functional discal units (FDUs) were obtained and subjected to mock discectomy. Mock sutures were performed using 3–0 non-absorbable sutures under a novel AF suture device following a suture procedure. The FDUs were compressed under axial loading at 1.8 mm/min and evaluated for Failure load (N).ResultsThe failure loads of the hand stitching group (Group H) and suture device stitching group (Group S) were significantly higher than those of the control group (Group C) (p = 0.033; p < 0.001).ConclusionThis study provides reasonable reasons to believe that the simple suture guide device described here is technically feasible for AF defect closure. It thus constitutes an encouraging proof of concept for the proposed device; however, it does not constitute a complete demonstration of the device’s feasibility in the clinical setting considering that the annulus closure operation is performed ex vivo on functional spinal units, as opposed to within an environment that mimics the clinical setting. To this end, confirmatory experiments will be conducted such as more multiaxial or dynamic mechanical testing, and notably performing the surgery on sheep models instead of on ex vivo functional spinal units.

ObjectiveUltrasound-guided techniques have become popular in severe humeral lateral condylar fractures (HLCFs). This study compared the results of ultrasound-guided closed reduction and percutaneous pinning (UG-CRPP) for Song types 4 and 5 and dislocation type of HLCFs.MethodsThis retrospective study was conducted in patients with HLCFs treated between January 2021 and October 2022 at three hospitals. The patients were divided into three groups according to Song's classification and elbow dislocation. The surgical time, reduction failure rate, and outcomes of the three groups were compared.ResultsThe mean surgical time of the 94 patients across the three groups (Song 4 group, 42 cases; Song 5 group, 38 cases; and dislocation group, 14 cases) was the longest for Song 4 (66.14 ± 23.05 min), followed by the dislocation group (59.71 ± 21.07 min) and Song 5 (52.16 ± 14.94 min) (for all, P = 0.009). The failure rate decreased in the following order: dislocation group (5/14), Song 4 group (7/42), and Song 5 group (2/38). The failure rate of closed reduction in Song 4 was 3.2-fold higher than that in Song 5, and for the dislocation group, it was 7.6-fold higher than that in Song 5. Significant differences were observed between the Song 4, Song 5, and dislocation groups in terms of shaft-condylar angle and supination (P = 0.015, P = 0.043). No significant differences (P > 0.05) were observed in the carry angle, flexion, extension, or pronation of the three groups. Two cases of delayed healing, four cases of superficial infection, one case of trochlear necrosis, and 39 cases of lateral spur in the Song 4 group were observed. In the Song 5 group, five had a superficial infection, one had re-displacement, and 26 had a lateral spur. In the dislocation group, there were two cases of superficial infection and 10 of lateral spurs.ConclusionsSong 4 HLCFs require longer surgical time and present more postoperative complications than Song 5 and dislocation-type HLCFs and can easily lead to lateral spurs. The failure rates of closed reduction in Song 4 and the dislocation type were higher than those in Song 5. Thus, UG-CRPP can be used to treat patients with unstable HLCFs.

ObjectiveThe association between intestinal microbiota and lipids has garnered significant scholarly interest. This study analyzes pertinent literature on intestinal microbiota and lipids to offer scientific guidance for future advancements and research directions.MethodsArticles focusing on intestinal microbiota and lipids were obtained from the Web of Science Core Collection (WoSCC). Following a rigorous screening process, 12,693 articles were included in the study. The collected data was processed comprehensively and visually analyzed using various academic tools such as CiteSpace, VOSviewer, R software, and Scimago Graphica.ResultsThe field of intestinal microbiota and its relationship with major lipids has witnessed a significant surge in scholarly attention, as indicated by the upward trend observed in related articles. Among countries, China had emerged as the leading contributor in publication output, with Chinese Acad Sci being the most prolific institution in this field. Notably, Nutrients and Nature were the prominent journals that published many articles and garnered the highest number of co-citations. Scholars have widely recognized Patrice D Cani's notable contributions in this field. Current research endeavors have focused on obesity, insulin resistance, metabolism, growth performance, the gut-brain axis, and others.ConclusionsOur analysis identified four primary research trends: “biochemical pathways,” “exploration of diseases,” “intervention and effect,” and “health and diet.” Future scholars must devote more attention to intestinal microbiota and major lipids to advance our understanding of human health.

Abstract Background Spinal subdural hematoma (SSH) is a rare cause of compression of the neutral elements of the spinal cord. However, little is known about the presentation of acute SSH after lumbar spine surgery. The reason for this may be that symptomatic SSH occurs rarely and is not given enough attention by spine surgeons. Currently, the decision to perform MRI postoperatively is more dependent on surgeon preference; therefore, no high-quality studies have been published. Our team reports our experience in the diagnosis and management of SSH after lumbar decompression and fusion surgery. Methods We retrospectively studied 215 patients who underwent routine MRI following minimal invasive transforaminal lumbar interbody fusion (MI-TLIF) between 2020-01-01 and 2022-06-30. The patients were divided into SSH group (17 cases) and non-SSH group (198 cases) according to the occurrence of SSH. Univariate analysis and multivariate logistic regression analysis were performed to identify relevant risk factors that increase the risk of SSH postoperatively. Results None of the patients presented with serious neurologic symptoms, such as lower extremity paralysis or cauda equina syndrome that required emergency hematoma debridement. SSH was found in 17 (7.9%) patients and non-SSH in 198 (92.1%). Factors affecting SSH were presence of hypertension, presence of diabetes and postoperative anticoagulant therapy. The significantly independent risk factor of postoperative SSH were diabetes (P = 0.008, OR: 6.988) and postoperative anticoagulant therapy (P = 0.003, OR: 8.808). Conclusions SSH after MI-TLIF is not a rare condition, with generally no requirement of emergency evacuation. Comprehensive anti-symptomatic treatment could achieve satisfactory results. Diabetes mellitus and postoperative anticoagulant therapy are independent risk factors for SSH. Spine surgeons should hold applicability of the use of anticoagulants after lumbar surgery.

Abstract Background Clinical practice of aerosol delivery in conjunction with respiratory support devices for critically ill adult patients remains a topic of controversy due to the complexity of the clinical scenarios and limited clinical evidence. Objectives To reach a consensus for guiding the clinical practice of aerosol delivery in patients receiving respiratory support (invasive and noninvasive) and identifying areas for future research. Methods A modified Delphi method was adopted to achieve a consensus on technical aspects of aerosol delivery for adult critically ill patients receiving various forms of respiratory support, including mechanical ventilation, noninvasive ventilation, and high-flow nasal cannula. A thorough search and review of the literature were conducted, and 17 international participants with considerable research involvement and publications on aerosol therapy, comprised a multi-professional panel that evaluated the evidence, reviewed, revised, and voted on recommendations to establish this consensus. Results We present a comprehensive document with 20 statements, reviewing the evidence, efficacy, and safety of delivering inhaled agents to adults needing respiratory support, and providing guidance for healthcare workers. Most recommendations were based on in-vitro or experimental studies (low-level evidence), emphasizing the need for randomized clinical trials. The panel reached a consensus after 3 rounds anonymous questionnaires and 2 online meetings. Conclusions We offer a multinational expert consensus that provides guidance on the optimal aerosol delivery techniques for patients receiving respiratory support in various real-world clinical scenarios.

Objective The suitability of in situ cast fixation for treating Gartland IIA humeral supracondylar fractures has remained controversial due to concerns regarding loss of elbow flexion. This study aimed to assess the instant loss of elbow flexion after Gartland IIA humeral supracondylar fractures based on the relationship between the anterior marginal line of the humerus and capitellum in the lateral view. Methods This simulation study was conducted with normal radiographs using Adobe Photoshop 14.0, followed by verification using clinical cases. Standard lateral views of normal elbows of children were collected from January 2008 to February 2020. Adobe Photoshop was used to simulate Gartland IIA supracondylar fractures with different degrees of angulation in the sagittal plane. A formula was deduced to assess flexion loss, and this method was verified in three cases. The data were grouped by age, and the relationship between elbow flexion loss and age, as well as the angulation of the fracture, was analyzed using a one‐way or multivariate ANOVA. Results There was a flexion loss of 19° (11–30°) when the anterior margin line of the humerus was tangential to the capitellum. This loss increased with age at injury (r = 0.731, P = 0.000). Moreover, the difference in angulation in the sagittal plane also influenced the extent of elbow flexion loss (r = −0.739, P = 0.000). The more horizontal the fracture line in the lateral view, the greater the loss of elbow flexion. Conclusion Instant elbow flexion loss after Gartland IIA humeral supracondylar fractures increases with age at the time of injury and decreases with angulation in the sagittal plane. When the anterior margin of the humerus is tangential to the capitellum, there will be an average loss of 19° in elbow flexion. These findings provide a quantitative reference for clinical decision‐making in the treatment of Gartland IIA supracondylar fractures.

BackgroundInterventions using ultrasound-guided closed reduction and percutaneous pinning (UG-CRPP) of humeral lateral condylar fractures (HLCFs) have been increasingly applied; however, their effectiveness for unstable HLCFs and the criteria for ultrasound outcomes remain unclear. This study assessed the outcomes of UG-CRPP for HLCFs and evaluated the success criteria in children.MethodsData were retrospectively collected from 106 patients with unstable HLCFs admitted to three hospitals between January 2021 and August 2022. Fifty-five cases were left-sided and 51 cases were right-sided: 74 male patients and 32 female patients were included. Perioperative data, elbow function, complications, and criteria for UG-CRPP were analyzed.ResultsThe mean rate of UG-CRPP was 88%. The mean surgical time was 54.56 ± 21.07 min, and the mean fluoroscopy frequency was 9.25 ± 2.93 times. At the last follow-up, there were significant differences in elbow flexion between the affected side (135.82° ± 6.92°) and the unaffected side (140.58° ± 5.85°) (p = 0.01). The Mayo score of the affected side was 90.28° ± 4.97°, the Baumann angle was 71.4° ± 5.4°, condylar shaft angle was 39.9° ± 6.4°, and the carrying angle was 8.4° ± 3.6°. Seventy patients presented mild lateral spurs and 16 patients exhibited moderate spurs. Fourteen patients presented with pin infection, and one patient exhibited postoperative re-displacement. There was no premature physeal closure, varus, or valgus elbow deformity, delayed union, or non-union. Successful ultrasound-based outcome criteria for UG-CRPP were defined as follows: (i) absent or less than a cartilage thickness step on the cartilage hinge on coronal plane parallel articular surface scanning, (ii) no lateral displacement and intact distal end of the condylar and capitellum on coronal plane vertical articular surface scanning, (iii) no anteroposterior displacement and absent or less than a cartilage thickness step on sagittal plane vertical articular surface scanning, and (iv) intact posterior fracture line or less than a cortex step on posterolateral sagittal plane vertical articular surface scanning.ConclusionUG-CRPP is a procedure with minimal blood loss, less invasive, cosmetic, and no radiation exposure. It yielded good outcomes in unstable HLCFs. The successful criteria make it suitable for clinical application.

Abstract A common practice adopted for the pseudorange bias estimation and calibration assumes that Global Navigation Satellite System satellite-dependent pseudorange biases vary gently over time. Whereupon satellite pseudorange biases are routinely estimated and provided as the products with low temporal resolution, e.g., hourly or daily, by the agencies. The story sounds unquestionably perfect under the acquainted assumption. To validate the inadequacy of the above hypothesis we herein present an approach to the estimate the BeiDou Navigation Satellite System (BDS) pseudorange biases with high temporal resolution. Its feasibility, affecting factors, and necessity are discussed. Concretely, the Geometry-Free function models are first constructed to retrieve the linear combination of the pseudorange biases; then the pseudorange Observable-specific Signal Bias (OSB) values with respect to baseline frequencies (e.g., BDS C2I/C6I) are estimated along with the ionosphere modeling; subsequently, all multi-frequency pseudorange OSBs are determined by using the ionospheric information with constraint conditions; finally, the possible Differential Code Bias sets are attainable with the estimated pseudorange OSBs. Using the observation data of four months when the estimated BDS pseudorange biases are stable, their reliability is demonstrated with the stability at the level of sub-nanosecond and the BeiDou-3 Navigation Satellite System (BDS-3) values more stable than that of BeiDou-2 Navigation Satellite System (BDS-2). The comparison between the estimated pseudorange biases and the Chinese Academy of Sciences products reveals that the accuracy of the estimated pseudorange biases is 0.2–0.4 ns. Moreover, the large magnitude of the short-term pseudorange bias variation in the tens of nanoseconds for the BDS-2 and BDS-3 are found in years 2021 and 2022, which are affected by two types of the satellite flex power for the BDS-2 and BDS-3, respectively. We stress that it’s necessary to estimate the BDS pseudorange biases with high temporal resolution in the case of the satellite flex power and the products currently provided by the agencies cannot reflect the true quantity under the circumstance.

Abstract Purpose Percutaneous vertebroplasty(PVP) has been widely used in treating symptomatic Schmorl’s nodes(SNs). However, there were still some patients with poor pain relief. At present, there is a lack of research to analyze the reasons for poor efficacy. Methods Review the SNs patients treated with PVP in our hospital from November 2019 to June 2022, collect their baseline data. Reverse reconstruction software was used to calculate the filling rate of bone edema ring(Rf). NRS score was used to evaluate pain and ODI to evaluate function. The patients were divided into remission group(RG) and non remission group(n-RG) according to symptom. In addition, according to the Rf, they were divided into excellent, good and poor groups. Differences between groups were investigated. Results A total of 26 vertebrae were included in 24 patients. When grouped according to symptoms, patients in n-RG were older, and surgical segments were tend to locate in lower lumbar spine. The proportion of Poor distribution was significantly higher. When grouped according to the cement distribution, the preoperative NRS and ODI of the three groups were comparable, but the NRS and ODI of Poor group were significantly worse than the Excellent and Good groups postoperatively and at the last follow-up. Conclusions The cement distribution may significantly affect the efficacy of PVP in treating symptomatic SNs. We suggest that the bone edema ring should be filled as fully as possible to ensure the efficacy. In addition, advanced age and low lumbar lesions are also adverse factors for clinical outcomes.

The intervertebral disc (IVD) is a load-bearing, avascular tissue that cushions pressure and increases flexibility in the spine. Under the influence of obesity, injury, and reduced nutrient supply, it develops pathological changes such as fibular annulus (AF) injury, disc herniation, and inflammation, eventually leading to intervertebral disc degeneration (IDD). Lower back pain (LBP) caused by IDD is a severe chronic disorder that severely affects patients’ quality of life and has a substantial socioeconomic impact. Patients may consider surgical treatment after conservative treatment has failed. However, the broken AF cannot be repaired after surgery, and the incidence of re-protrusion and reoccurring pain is high, possibly leading to a degeneration of the adjacent vertebrae. Therefore, effective treatment strategies must be explored to repair and prevent IDD. This paper systematically reviews recent advances in repairing IVD, describes its advantages and shortcomings, and explores the future direction of repair technology.

Abstract Objective The incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF. Methods One hundred seventy-one patients with Wilkins type III flexion-type SCHF from January 2012 to December 2021 were retrospectively enrolled in a tertiary paediatric hospital. Patients were divided into ORIF group versus closed reduction and internal fixation (CRIF) group. Then, patients data of age, sex, injury side, obesity, deviation of displacement, fracture level, rotation, nerve injury, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios (OR) of ORIF. Results Overall, 171 children with type III flexion-type SCHF were analyzed (average aged 7.9 ± 2.8 years). Displacement was lateral in 151 cases, medial in 20. 20 cases had combined ulnar nerve injury. The failed closed reduction rate was 20%. Univariate analysis indicated age, distal fracture fragment rotation, and ulnar nerve injury were significantly associated with ORIF. (P = 0.047, P = 0.009, and P = 0.001, respectively). Multivariate logistic regression analysis showed that distal fracture fragment rotation (OR, 3.3; 95%CI:1.1–9.5; P = 0.028) and ulnar nerve injury (OR, 6.4; 95%CI:2.3–18.3; P = 0.001) were independent risk factors; however, the age was not an independent one (OR, 1.5; 95%CI:0.6–3.5; P = 0.397) for ORIF in the Wilkins type III flexion-type SCHF. Conclusion Distal fracture fragment malrotation on initial x-rays and ulnar nerve injury were significant risk factors for ORIF in Wilkins type III flexion-type SCHF. Surgeons should prepare tourniquets or other open reduction instruments when treating these types of fractures. Level of evidence Level IV

Objective For pediatric lateral condylar fractures (LCFs) of the humerus, it is often hard to determine the stability of the fracture based on the Song classification, especially for those categorized as Song stages 2 and 3. This study aims to define the characteristics of cartilage injury and assess the stability of LCFs classified as Song stages 2 and 3 on post‐traumatic magnetic resonance imaging (MRI). Methods This was a retrospective study based on imaging data, conducted with a short follow‐up period. From January 2016 to May 2019, data of all patients with Song 2 and Song 3 LCFs treated at two institutions were collected. Based on the inclusion criteria, a total of 62 patients with Song stage 2/3 LCF were included. All radiographs were selected for observation and classification for comparison by two observers, both experienced pediatric orthopedic surgeons. MRIs scans for comparison were analyzed in three consecutive coronal sections and cross‐sections. Patients were treated conservatively with casting or surgically with closed reduction and percutaneous pinning (CRPP). Results Altogether 62 cases between 1.5 to 9 years old were included. Reliability analysis revealed poor, moderate, or good agreement between the two observers (range, 0.149–0.633). Both observers showed moderate or good consistency (range, 0.413–0.611). Among the 62 patients diagnosed with Song stages 2 and 3 fractures on initial radiographs, only two patients (3%) had complete fractures with complete disruption of the cartilage hinge as seen on MRI. The hinge was generally located in the posterior‐inferior region of the distal humeral cartilage as indicated on MRI. There was no significant difference between Song stages 2 and 3 with regard to ratio of hinge to total values in any cross‐sections, nor was there any significant difference in the completeness of the coronal sections (P > 0.05). Of the 62 patients treated, 50 were managed conservatively with casting and 12 underwent CRPP. Forty‐nine of the remaining 60 patients (97%) with incomplete fractures were managed conservatively, while the remaining 11 patients were managed with CRPP. All patients with incomplete fractures showed bone healing and no evidence of lateral condyle displacement on follow‐up radiographs. Conclusions The Song stage 2 or 3 classification is not entirely accurate and is inadequate at guiding treatment outcomes. The cartilage hinge was most likely located posteroinferiorly within the distal humeral epiphysis. According to our findings, conservative treatment with an effective cast or splint may be sufficient for bone healing in case of incomplete cartilage fractures.

Cancer vaccines have gained widespread attention in recent years as an emerging treatment for tumors. However, most therapeutic cancer vaccines have failed in phase III clinical trials due to faint clinical benefits. In this study, we funded that a specific synbiotic composing Lactobacillus rhamnosus GG (LGG) and jujube powder significantly enhanced the therapeutic effects of whole cells cancer vaccine in MC38 cancer cells bearing-mouse. The utilization of LGG increased the abundance of Muribaculaceae, which is conductive to an enhanced anti-tumor effect, but reduced microbial α-diversity. The use of jujube nursed probiotic microorganisms in Lachnospiaceae and enriched microbial diversity, as indicated by increased Shannon and Chao index. The reshaped gut microbiota by this synbiotic improved lipid metabolism conductive to intensified infiltration of CD8+ T cells in the tumor microenvironment and enhanced the potency of above-mentioned cancer vaccine. These encouraging findings are helpful for further efforts towards enhancing the therapeutic effects of cancer vaccines through nutritional intervention.

Abstract The cerebellum is involved in encoding balance, posture, speed, and gravity during locomotion. However, most studies are carried out on flat surfaces, and little is known about cerebellar activity during free ambulation on slopes. Here, it has been imaged the neuronal activity of cerebellar molecular interneurons (MLIs) and Purkinje cells (PCs) using a miniaturized microscope while a mouse is walking on a slope. It has been found that the neuronal activity of vermal MLIs specifically enhanced during uphill and downhill locomotion. In addition, a subset of MLIs is activated during entire uphill or downhill positions on the slope and is modulated by the slope inclines. In contrast, PCs showed counter‐balanced neuronal activity to MLIs, which reduced activity at the ramp peak. So, PCs may represent the ramp environment at the population level. In addition, chemogenetic inactivation of lobule V of the vermis impaired uphill locomotion. These results revealed a novel micro‐circuit in the vermal cerebellum that regulates ambulatory behavior in 3D terrains.

BackgroundRotation of the distal fragment often occurs in flexion-type supracondylar humerus fractures (SCHFs), potentially leading to ulnar nerve injury (UNI) and open reduction. We analyzed the correlation between the rotations and UNI or open reduction and then assessed the risk factors associated with these rotations.MethodsData of Wilkins type III lateral flexion SCHFs were collected over a 10-year time period (1 January 2012 to 31 December 2021) in Children's Hospital of Fudan University Anhui Hospital. We defined the rotation of the distal fragment on the coordinate axis as two types, IIIA (X-axis rotation) and IIIB (the rotation of both X- and Y-axes) on X-ray radiography. Demographic data, the incidence of the two-type rotation, odds ratios (ORs) of UNI and open reduction, and risk factors of the rotation of both X- and Y-axes were analyzed.ResultsTotally, 152 patients were found (50 with IIIA vs. 102 IIIB). The UNI rate was 13%, and the open reduction rate was 22%. The UNI rate of the IIIB was five-fold higher than that of the IIIA [OR, 5.143; 95% confidence interval (CI), 1.414–23.125; p = 0.019], and the open reduction rate of the IIIB was nearly five-fold higher than that of the IIIA (OR, 4.729, 95%CI, 1.584–14.495; p = 0.003). In these two types, patients with UNI had a higher risk of open reduction than those without UNI (OR, 9.816; 95%CI, 3.503–27.508; p = 0.001). In the multiple regression analysis, a high level of fracture was identified as a risk factor for the rotation of both X- and Y-axes.ConclusionType IIIB lateral flexion-type SCHFs have higher rates of UNI and open reduction, and a high level of fracture is a risk factor associated with this type.

Abstract Study design A retrospective cohort study. Objective To investigate the radiological and clinical outcomes of patients with or without pedicle-screw rod fixation (PSRF) in OLIF surgery. Methods Between June 2017 and December 2019, 66 consecutive patients who underwent OLIF surgery at two centers were divided into stand-alone and combined groups according to whether or not PSRF was used. Imaging and clinical data were collected preoperatively, postoperatively, 3 and 6 months postoperatively, and at the last follow-up. Related coefficient and multiple linear regression analysis was used to detect the influencing factors of cage subsidence (CS). Results There was a lower baseline BMD in the combined group (p = 0.005). The combined group showed superior VAS score at 3 months postoperatively, although there was no difference in long-term VAS and ODI scores between the two groups. The foraminal height (FH) of the two groups was comparable at preoperatively, postoperatively, and 3 months postoperatively, but the combined group showed better maintenance of FH at 6 months postoperatively (p = 0.049) and last follow-up (p = 0.019). The total CS (tCS) of the combined group was lower than that of the stand-alone group during the whole follow-up period (all p ≤ 0.001). Multiple linear regression suggested that lower BMD was the risk factor for main CS, and PSRF could significantly reduce the BMD threshold for severe CS (−4.77 vs −1.38). Conclusions OLIF combined with PSRF can effectively avoid foraminal height loss and prevent severe CS, which may be more suitable for patients with osteoporosis or osteopenia and improve clinical outcomes.

While recent years have witnessed ever-growing evidence on the prebiotic attributes of anthocyanins for treatment of microbiota-associated diseases, the complex interplay between anthocyanin uptake, the gut microbiota, and the intestinal mucosal immune system remains poorly understood. Here, we investigate the effects of bilberry anthocyanins on the gut microbiota composition and metabolism, and the intestinal mucosal immune system of mice. We observed an increased proportion of IgA-producing plasma cells in the mesenteric lymph nodes (MLNs) and an enhanced secretion of secretory immunoglobulin A (sIgA) and antimicrobial peptides in the small intestine. Small intestine transcriptome analysis further suggested that anthocyanins influenced IgA production. We found that oral administration of anthocyanins altered the gut microbiota through maintaining the anaerobic intestinal environment, promoting the secretion of sIgA and antimicrobial peptides, and downregulating cell motility and mobile genetic elements of commensal bacteria. These observations suggest that the oral administration of anthocyanins helps in maintaining intestinal homeostasis and thus it may find applications in immunotherapy and related fields.

Abstract Background Our study aimed to explore the prevalence and risk factors of refractive error (RE) in Han and Tibetan population aged 50–79 years in Xining and surrounding areas in Qinghai Province on Qinghai-Tibet Plateau. Methods As part of the China National Health Survey, our cross-sectional study compared the age-adjusted prevalence of RE in Han and Tibetan older adults aged 50–79 years in Xining and surrounding areas. A multivariate logistic regression model was used to identify risk factors for myopia and hyperopia. Results Among 769 Han participants and 476 Tibetan participants, the age-adjusted prevalence of myopia (spherical equivalent (SE) + 0.5D), high myopia (SE = 0.5D) is 28.56, 22.82, 2.80, and 69.38%. Han participants have higher age-adjusted prevalence of myopia (32.93% vs 21.64%, p

Abstract Background While anthocyanins are proven to be effective in inhibiting tumour cell proliferation, the underlying mechanisms remain unclear. This research aims to explore the glycosylation of anthocyanins in the tumour inhibitory effects and the potential mechanism. Methods The tumour inhibitory effect on mouse colon cancer cells (MC38) was examined by MTT and flow cytometric analyses. The inhibitory pathway of anthocyanin was explored by assessment of tumour cell mitochondrial membrane potential (MMP), the caspase-3 and caspase-9 activity, as well as the cell energy metabolism in terms of the glucose uptake, the NAD+/NADH ratio and the ATP level. Results We found that 500 μM bilberry anthocyanins extract (BAE) induced 48.1% mitochondrial damage, activated the downstream caspase cascade to form apoptotic bodies (caspase-3 activity increased by 169%, caspase-9 activity increased by 186%), and inhibited cell proliferation (survival rate: 55.97%, 24 h). In contrast, the same concentration of anthocyanidin (cyanidin) led to marginal mitochondrial damage (only 9.85%) and resulted in little inhibition of MC38 cells (survival rate: 86.84%, 24 h). For cells incubated with 500 μM BAE, reactive oxygen species (ROS) decreased by 53.8%, but the ratio of NAD+/NADH increased to 3.67, demonstrating that the mitochondrial damage was induced by blocking energy metabolism. Furthermore, cell energy metabolism is related to glucose uptake since the presence of 200 μM GLUT1 inhibitor substantially enhanced the inhibitory effects of cyanidin-3-O-glucoside (Cy-3-Glu) at 500 μM (survival rate: 51.08%, 24 h). Conclusions The study suggested that the glycosides of anthocyanins might handicap glucose transport and inhibit energy metabolism, which, in turn, led to mitochondrial damage and apoptosis of tumour cells.

Abstract The production of GWs during preheating in the Starobinsky model with a nonminimally coupled auxiliary scalar field is studied through the lattice simulation in this paper. We find that the GW spectrum $$\Omega _{\mathrm{gw}}$$ Ωgw grows fast with the increase of the absolute value of coupling parameter $$\xi $$ ξ . This is because the resonant bands become broad with the increase of $$|\xi |$$ |ξ| . When $$\xi 0$$ ξ>0 . $$\Omega _{\mathrm{gw}}$$ Ωgw reaches the maximum at $$\xi =-20$$ ξ=-20 ($$\xi =42$$ ξ=42 for the case $$\xi >0$$ ξ>0 ) and then decreases with slight oscillation. Furthermore we find that the GWs produced in the era of preheating satisfy the limits from the Planck and next-generation CMB experiments.