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Min Yu,1– 3 Zeliang Hao,1– 3 Liyue Xu,4 Long Zhao,4 Yongfei Wen,4 Fang Han,4,&ast; Xuemei Gao1– 3,&ast; 1Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China; 2Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, People’s Republic of China; 3National Center for Stomatology, Beijing, 100081, People’s Republic of China; 4Sleep Division, Peking University People’s Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fang Han, Sleep Division, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People’s Republic of China, Tel +86-010-88324204, Email hanfang1@hotmail.com Xuemei Gao, Department of Orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People’s Republic of China, Tel/Fax +86-010-82195350, Email xmgao@263.netPurpose: Catathrenia is a rare sleeping disorder characterized by repetitive nocturnal groaning during prolonged expirations. Patients with catathrenia had heterogeneous polysomnographic, comorbidity, craniofacial characteristics, and responses to treatment. Identifying phenotypes of catathrenia might benefit the exploration of etiology and personalized therapy.Patients and Methods: Sixty-six patients diagnosed with catathrenia by full-night audio/video polysomnography seeking treatment with mandibular advancement devices (MAD) or continuous positive airway pressure (CPAP) were included in the cohort. Polysomnographic characteristics including sleep architecture, respiratory, groaning, and arousal events were analyzed. Three-dimensional (3D) and 2D craniofacial hard tissue and upper airway structures were evaluated with cone-beam computed tomography and lateral cephalometry. Phenotypes of catathrenia were identified by K-mean cluster analysis, and inter-group comparisons were assessed.Results: Two distinct clusters of catathrenia were identified: cluster 1 (n=17) was characterized to have more males (71%), a longer average duration of groaning events (18.5± 4.8 and 12.8± 5.7s, p=0.005), and broader upper airway (volume 41,386± 10,543 and 26,661± 6700 mm3, p< 0.001); cluster 2 (n=49) was characterized to have more females (73%), higher respiratory disturbance index (RDI) (median 1.0 [0.3, 2.0] and 5.2 [1.2, 13.3]/h, p=0.009), more respiratory effort-related arousals (RERA)(1 [1, 109] and 32 [13, 57)], p=0.005), smaller upper airway (cross-sectional area of velopharynx 512± 87 and 339± 84 mm2, p< 0.001) and better response to treatment (41.2% and 82.6%, p=0.004).Conclusion: Two distinct phenotypes were identified in patients with catathrenia, primary catathrenia, and catathrenia associated with upper airway obstruction, suggesting respiratory events and upper airway structures might be related to the etiology of catathrenia, with implications for its treatment.Keywords: subtype, groaning, upper airway, treatment, OSA, sleep-disordered breathing

Wei Li, Jun Zhao, Ruiping Hao, Shujuan Wang, Ming Chen, Huijun Liu, Le Qi, Zaijun Hao Department of Anaesthesiology, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region, People’s Republic of ChinaCorrespondence: Zaijun Hao, Department of Anesthesiology, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region, 017000, People’s Republic of China, Tel/Fax +8615204778880, Email dengdairy@126.comPurpose: Evaluate the efficacy and safety of remimazolam besylate combined with esketamine for outpatient colonoscopy.Patients and methods: A total of 150 outpatients undergoing colonoscopy were randomized into two groups. A MOAA/S score ≤ 3 was maintained. The primary outcome was the rate of successful colonoscopy completion. Time indicators, hemodynamic parameters, the consumption of lidocaine, esketamine, propofol and remimazolam besylate, MOAA/S scores and bispectral index (BIS) values, the lowest SpO2, body movement, the use of rescue medication, endoscopist and patient satisfaction, recall of the procedure, mini-mental state examination (MMSE), fatigue level and adverse events were recorded.Results: Procedure completion was equivalent between groups (P > 0.05). Both induction and awakening times were significantly shorter in the P group (P < 0.05). There were no significant differences in colonoscopy time and discharge time (P > 0.05). The lowest SpO2 was significantly lower in the P group, while the level of fatigue was higher (P < 0.05). Patient satisfaction was significantly higher in the R group (P < 0.05). Endoscopist satisfaction was significantly higher in the P group (P < 0.05). There were no significant differences in both systolic and diastolic blood pressure between groups except at T5 and T6 (P > 0.05). Both HR and RR were significantly lower in the P group from T3 to T5 (P < 0.05). BIS values were significantly lower in the P group from T3 to T5, while MOAA/S was significantly lower in the P group at T3 and T4 (P < 0.05). Pain on injection was significantly higher in the P group (P < 0.05).Conclusion: Remimazolam besylate has a similar efficacy to propofol when combined with subanesthetic doses of esketamine during outpatient colonoscopy. Remimazolam besylate combined with esketamine resulted in less injection pain and more stable hemodynamics, although it prolonged induction and awakening time.Keywords: remimazolam besylate, propofol, esketamine, colonoscopy

Kaiping Zhang,1,2 Yin Zhang,2 Min Chao,2 Zongyao Hao1 1Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology, Anhui Medical University; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui Province, 230000, People’s Republic of China; 2Department of Urology, Anhui Provincial Children’s Hospital/Children’s Hospital of Fudan University (Affiliated Anhui Branch), Hefei, Anhui Province, 230000, People’s Republic of ChinaCorrespondence: Zongyao Hao, Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology, Anhui Medical University, Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Jixi Road, Hefei, Anhui Province, 230000, People’s Republic of China, Email haozongyao@163.comPurpose: The study was to detect the pathogenic bacterial profile and antibiogram among children with congenital anomalies of the kidney and urinary tract (CAKUT).Patients and Methods: A retrospective analysis was performed using medical records of urine culture results and antibiotic susceptibility results in patients with UTIs from March 2017 to March 2022. Antimicrobial susceptibility pattern was determined by a standard agar disc diffusion method.Results: A total of 568 children were included. The proportion of culture-positive UTI was 59.15% (336/568). More than nine types of bacteria were isolated with most pathogens being Gram-negative species. Among Gram-negative isolates, the predominant bacteria were Escherichia coli (30.95%, 104/336) followed by Klebsiella pneumoniae (9.23%). Escherichia coli isolates were highly sensitive to amikacin (95.19%), ertapenem (94.23%), nitrofurantoin (93.27%), imipenem (91.35%), and piperacillin-tazobactam (90.38%) and high rate of resistant were also detected to ampicillin (92.31%), cephazolin (73.08%), ceftriaxone (70.19%), trimethoprim-sulfamethoxazole (61.54%) and ampicillin-sulbactam (57.69%). Klebsiella pneumoniae isolates showed sensitive to ertapenem (96.77%), amikacin (96.77%), imipenem (93.55%), piperacillin-tazobactam (90.32%) and gentamicin (83.87%), while highly resistant were observed to ampicillin (96.77%), cephazolin (74.19%), ceftazidime (61.29%), ceftriaxone (61.29%), and aztreonam (61.29%). The isolated Gram-positive bacteria mainly contained Enterococcus faecalis and Enterococcus faecium (each 15.77%). Enterococcus faecalis were sensitive to vancomycin, penicillin-G, tigecycline, nitrofurantoin and linezolid (100%, 94.34%, 88.68%, 88.68%, 86.79, respectively) and resistant to tetracycline (86.79%), quinupristi (83.02%), erythromycin (73.58%). Enterococcus faecium also showed a similar result. Multiple drug resistance (MDR) was observed in 264 (80.00%) of the 360 bacterial isolates. Only age was significantly associated with a culture-positive UTI.Conclusion: A higher prevalence of culture-positive UTI was detected. Escherichia coli was the most prevalent uropathogen followed by Enterococcus faecalis and Enterococcus faecium. These uropathogens showed highly resistant to the commonly used antibiotics. Moreover, MDR was commonly observed. Thus, empiric therapy is unsatisfactory as drug sensitivity always varies over time.Keywords: urinary tract infection, congenital anomalies of the kidney and urinary tract, multi-drug resistance, prevalence, antimicrobial susceptibility

Chunhui Tian, Weipin Xie, Lifang Chen, Xuebao Liu, Zhongping Hao Department of Otorhinolaryngology Head and Neck Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, People’s Republic of ChinaCorrespondence: Chunhui Tian, Department of Otorhinolaryngology Head and Neck Surgery, Suzhou Hospital Affiliated to Anhui Medical University, 299 Bianhe Road, Suzhou, 234000, People’s Republic of China, Tel +86 18405576337, Email chunhuient@163.comObjective: To introduce a novel method of modified through and through suture with collagen sutures in conjunction with anterior chondrectomy of auricular pseudocyst and assess its therapeutic efficacy.Subjects and Methods: The study comprised 87 patients with unilateral auricular pseudocyst, treated in our department from December 2019 to November 2021. Following anterior chondrectomy of the cyst, modified through and through suture was performed using collagen sutures. Evaluation of successful resolution of the problem, assessment of complications, recurrence, and ultimate ear cosmesis was undertaken with a minimum of 6 months follow-up.Results: There were 83 males and 4 females, ages ranged from 26– 78 years old, with a median age of 41 years. The right and left ears were affected in, 52 and 35 patients, respectively. Local skin color deepening was found in 15 patients within 3 months, which returned to normal within 5 months. During the follow-up, such complications as anaphylaxis, hematocele in the surgical cavity, incision infection, and deformity were not observed in any patients. All patients were cured with a single operation without relapse.Conclusion: The modified through and through suture with collagen sutures in conjunction with anterior chondrectomy of an auricular pseudocyst is characterized by a straightforward, single-stage operation, with no relapses, few complications, restoration of normal ear cosmesis, and high patient acceptance.Keywords: auricle pseudocyst, anterior resection, modified suture, management

Wenwu Xiao,1 Huaichun Yang,1 Zhuangfu Wang,2 Haian Mao,1 Hongjiang Wang,1 Zengming Hao,1 Yao Zu,1 Chuhuai Wang1 1Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Faculty of Population Health Sciences, Institute of Child Health I, University College London, London, UKCorrespondence: Chuhuai Wang, Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Er Road, Guangzhou, 510080, People’s Republic of China, Tel +86 13316191023, Email wangchuh@mail.sysu.edu.cnAbstract: Low back pain is a major global public health problem, but the current intervention effect is not ideal. A large body of previous literature suggests that patients with chronic low back pain may have abnormal postural control, which is more evident in the dual task situation. In recent years, research on postural control in patients with low back pain under dual-task conditions has gradually become a hot topic. However, the results obtained from these studies were not entirely consistent. In this review, we summarized relevant studies on the performance of postural control in patients with low back pain under dual-task conditions, analyze it from the perspective of the theoretical model of dual-task interaction, the specific research paradigm of dual task, the performance of postural control, and the related factors affecting postural control performance, etc. It was reasonable to assume that patients with low back pain might have a certain degree of abnormal postural control, and this abnormality was affected by comprehensive factors such as age, cognitive resource capacity, attention needs, complex sensorimotor integration, external environment, etc. Furthermore, postural control performance in low back pain patients under dual-task conditions was further influenced by the nature and complexity of the different tasks. In general, the more attention resources were needed, the external environmental conditions were worse, and the age-related functions were degenerate, etc., the weaker posture control ability was. In short, a deeper understanding of postural control in patients with low back pain under dual-task conditions may shed light on more references for the rehabilitation and management of low back pain, as well as some new ideas for scientific research on cognition and postural control.Keywords: postural control, low back pain, dual-task, cognitive, motor

Zhenyu Hao &ast;, Yongqiong Deng &ast;, Yuanmin He, Xia Xiong Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yongqiong Deng, Department of Dermatology, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping Street, Luzhou, 646000, People’s Republic of China, Tel +8613679670608, Email dengyongqiong1@126.comAbstract: Signet-ring cell (SRC) is a histologic type in which cells show unique features under the microscope. We mainly found signet-ring cells (SRCs) in gastrointestinal and breast tumors. Cutaneous metastasis from internal carcinomas was an uncommon presentation. The cases of signet-ring cell carcinoma (SRCC) metastasis to the skin were rarely reported. Cutaneous metastasis indicated a poor prognosis for a patient. Here, we report a female who had huge grape-like nodules arising from gastrointestinal SRCC in her trunk and thigh.Keywords: signet-ring cutaneous metastasis, SRCC, signet-ring cell carcinoma, unknown primary tumors, gastrointestinal tumors

Zhigang Liu,1,2,&ast; Baisheng Fu,2,&ast; Weicheng Xu,2 Fanxiao Liu,2 Jinlei Dong,2 Lianxin Li,2 Dongsheng Zhou,2 Zhenhai Hao,2 Shun Lu2 1Department of Orthopaedics Surgery, Haining People’s Hospital, Jiaxing, People’s Republic of China; 2Department of Orthopaedics Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shun Lu, Department of Orthopaedics Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China, Tel +8618653189700, Email sdqdpdlushun@163.comPurpose: Traumatic sciatic nerve injury is one of the most serious consequences of acetabular fracture. However, reports on this type of injury are rare. In this study, we investigated the demographics of acetabular fracture with traumatic sciatic nerve injury, the clinical characteristics of patients with these injuries, and potential risk factors.Patients and Methods: We retrospectively reviewed patients diagnosed to have acetabular fracture at our trauma center between January 2014 and June 2021. Data on patient demographics, characteristics of the acetabular fracture, whether or not sciatic nerve injury occurred, types of sciatic nerve injury, and risk factors were analyzed.Results: A total of 195 patients met the diagnostic criteria for acetabular fractures. The average Injury Severity Score was 25.9 and the average Abbreviated Injury Scale score was 12.4. Road traffic accidents and falls from height were the main causes. Chest injuries and lower extremity fractures were the most common associated injuries. Posterior wall fractures were the most common fracture type. After exclusion of spinal cord and iatrogenic sciatic nerve injuries, 18 patients with acetabular fractures had traumatic sciatic nerve injury. Four of the 19 sides with traumatic sciatic nerve injury involved the common peroneal nerve division and 15 involved both the common peroneal and tibial nerve divisions. Logistic regression analysis identified a higher AIS score, posterior column fracture, and posterior hip dislocation to be predictors of traumatic sciatic nerve injury.Conclusion: Acetabular fractures were mostly high-energy injuries. Posterior wall fractures were the most common acetabular fracture types. Most patients sustained injury to the sciatic nerve as well as injury to the common peroneal and tibial nerve divisions. A higher AIS score, posterior column fracture, and posterior hip dislocation were predictors of acetabular fracture combined with traumatic sciatic nerve injury.Keywords: acetabular fractures, traumatic sciatic nerve injury, posterior hip dislocation

Questions: All else being equal, populations of dioecious species with a 50:50 sex ratio have only half the effective reproductive population size of bisexual species of equal abundance. Consequently, there is a need to explain how dioecious and bisexual species coexist. Increased mean individual seed mass, fecundity, and population density have all been proposed as attributes of unisexual individuals or populations that may contribute to the persistence or resilience of dioecious species. To date, no studies have compared sympatric dioecious and cosexual species with respect to all three components of fitness. In this study, we sought evidence for these compensatory advantages (higher seed mass, greater seed production per unit basal area, and higher population density) in dioecious species. Location: Five 20–25 ha forest dynamic plots spanning a latitudinal gradient in China, including two temperate, two subtropical, and one tropical forest. Methods: We used a phylogenetically corrected generalized linear modelling approach to assess the phylogenetic dependence and joint evolution of sexual system, seed mass and production, and ecological abundances among 48–333 species and 32,568–136,237 individuals per forest. Results: Across all five forests, we detected no consistent advantage for dioecious relative to sympatric cosexual species with respect to mean individual seed mass, seed production or the density of stems in any size class. Conclusions: Our study suggests that seed traits may provide compensatory mechanisms in some forests, but most often the coexistence of sexual systems cannot be explained by advantages of dioecy related to seed quality and demographic parameters. Future investigations of the factors that promote coexistence may increase our understanding by expanding the search to include attributes such as lifespan and tolerance or resistance to herbivores.

Charge order is now accepted as an integral constituent of cuprate high-temperature superconductors, one that is intimately related to other electronic instabilities including antiferromagnetism and superconductivity1–11. Unlike conventional Peierls density waves, the charge correlations in cuprates have been predicted to display a rich momentum space topology depending on the underlying fermiology12–18. However, charge order has only been observed along the high-symmetry Cu–O bond directions. Here, using resonant soft X-ray scattering, we investigate the evolution of the full momentum space topology of charge correlations in T′-(Nd,Pr)2CuO4 as a function of electron doping. We report that, when the parent Mott insulator is doped, charge correlations first emerge with full rotational symmetry in momentum space, indicating glassy charge density modulation in real space possibly seeded by local defects. At higher doping levels, the orientation of charge correlations is locked to the Cu–O bond directions, restoring a more conventional long-ranged bidirectional charge order. Through charge susceptibility calculations, we reproduce the evolution in topology of charge correlations across the antiferromagnetic phase boundary and propose a revised phase diagram of T′-Ln2CuO4 with a superconducting region extending toward the Mott limit.

Zhengyang Hao, Yanzhou Zhang Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of ChinaCorrespondence: Yanzhou Zhang, Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China, Email zhangyanzhou666@outlook.comObjective: Dapagliflozin 10 mg and empagliflozin 10 mg have been recommended to treat heart failure with reduced ejection fraction (HFrEF), and the purpose of this study was to compare the efficacy and safety of them in HFrEF.Methods: Two hundred and thirty-three patients with HFrEF admitted to a tertiary hospital of Zhengzhou and commenced to take dapagliflozin 10 mg/d or empagliflozin 10 mg/d were retrospectively included and separated into the dapagliflozin group (n=105) and the empagliflozin group (n=128). Their cardiac function indices before and after therapy were compared, together with the ratios of adverse events during therapy.Results: After 6 months of therapy, left ventricular ejection fraction was higher, and the ratio of New York Heart Association functional class III or IV, left ventricular end-diastolic diameter, and N-terminal pro-B-type natriuretic peptide were lower in the empagliflozin group than the dapagliflozin group (P< 0.05). During 6 months of therapy, there were no statistically significant differences for the ratios of hypotension, deteriorating kidney function, and genitourinary infections between the dapagliflozin and empagliflozin groups (P> 0.05).Conclusion: Despite its many limitations, this study suggested that different SGLT2 inhibitors might have differences regarding efficacy in HFrEF. We look forward to future studies to verify our conjectures.Keywords: dapagliflozin, empagliflozin, heart failure with reduced ejection fraction

Meng Zhang,1– 3,&ast; Yi Liu,1– 3,&ast; Jing Chen,1– 3,&ast; Lei Chen,1– 3 Li Zhang,1– 3 Xianguo Chen,1– 3 Zongyao Hao,1– 3 Chaozhao Liang1– 3 1Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China; 2Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China; 3Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zongyao Hao; Chaozhao Liang, Department of Urology, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Shushan District, Hefei City, 230022, Anhui, People’s Republic of China, Tel/Fax +86 55162923095, Email haozongyao@163.com; liang_chaozhao@ahmu.edu.cnBackground: Chronic nonbacterial prostatitis (CNP) has a high incidence, low cure rate, and unclear pathogenesis. Here, we aimed to systematically identify effective diagnostic and therapeutic targets for CNP.Methods: Prostate tissues were obtained from established mouse models and negative controls and were used for mRNA array sequencing and immunohistochemistry (IHC) staining. Predominant pathways were identified based on pathway enrichment analysis and pharmaceutical experiments. We also investigated the functional role of CXCL12 on CP, a critical factor belonging to the predominant chemotaxis pathway, and employed IHC staining to explore the influence of the CXCL12/CXCR4 axis on the activation of the NF-κB, AKT, and STAT3 signaling pathways. Serum samples derived from both CNP cases and healthy controls were used to determine the secretion level of CXCL12.Results: By employing mRNA array sequencing and immunohistochemistry, we found that CXCR4, CXCL12, CD44, and OFLM4 were highly expressed in the infiltrated inflammatory T cells of the prostate tissues generated from CNP mice, while they were rarely expressed on the epithelial cells. Based on the pathway enrichment results, we applied pathway inhibitors to suppress the activity of these classic pathways. We found that targeting the CXCL12/CXCR4 axis with its specific antagonist AMD3100 remarkably alleviated inflammatory infiltration of the prostate in CNP models. Similar results were obtained when we replaced AMD3100 with adenovirus-associated virus (AAV)-shCxcl12. To clarify the potential mechanisms of how the CXCL12/CXCR4 axis influences the pathogenesis of CNP, we tested the classical downstream pathways. The results suggested that p-Akt, p-STAT3, and p-NF-κB were more highly expressed on the inflammatory cells of the prostate derived from the CNP model and were partly suppressed after applying AMD3100 or delivering AAV-shCxcl12, indicating that the CXCL12/CXCR4 axis potentially functioned through AKT/NF-κB and STAT3 signaling to influence the pathogenesis of CNP.Conclusion: Our study provides potential diagnostic biomarkers and therapeutic targets for CNP.Keywords: chronic nonbacterial prostatitis, mRNA array sequencing, CXCL12/CXCR4, AMD3100

High energy consumption and poor processing quality are common problems in wood sawing. To address these issues, in this article, specific cutting energy and surface roughness were investigated with saw blade speed as control variables. Analysing the effect of parameters on specific cutting energy and surface roughness. The sawing parameters were optimised with the objectives of minimum specific cutting energy and minimum surface roughness. The findings indicate that specific cutting energy and surface roughness reduction with increasing rake angle; specific cutting energy and surface roughness decrease with increasing spindle speed; specific cutting energy decreases and surface roughness increases with increasing feed rate. ANOVA analysis reveals that sawing speed (n) has the most significant impact on specific cutting energy during oak cutting. The optimal solution derived from TOPSIS suggests a specific cutting energy of 2E7 J/m3 and a surface roughness of 1.758 μm. The innovation of this paper is the study of the specific cutting energy and the optimisation of parameters. These findings provide valuable theoretical and practical guidance for enhancing the efficiency and quality of oak processing while minimizing energy consumption. [ABSTRACT FROM AUTHOR]

Aims: Patterns of spatial community dissimilarity have inspired a large body of theory in ecology and biogeography. Yet key gaps remain in our understanding of the local-scale ecological processes underlying species replacement and species nestedness, the two fundamental components of spatial community dissimilarity. Here, we examined the relative influence of dispersal limitation, habitat filtering and interspecific species interactions on local-scale patterns of the replacement and nestedness components in eight stem-mapped temperate forest mega-plots at different ontogenetic stages (large versus small trees). Location: Eight large (20–35 ha), fully mapped temperate forest plots in northern China and northern U.S.A. Time period: 2004–2016. Major taxa studied: Woody plants. Methods: We combined decomposition of community dissimilarity (based on the Ružička index) and spatial point-pattern analysis to compare the spatial (i.e., distance-dependent) replacement and nestedness components of each plot with that expected under five spatially explicit null models representing different hypotheses on community-assembly mechanisms. Results: Our analyses revealed complex results. In all eight forests, spatial community dissimilarity was best explained by species replacement among local tree assemblages and by a null model based on dispersal limitation. In contrast, spatial nestedness for large and small trees was best explained by random placement and habitat filtering, respectively, in addition to dispersal limitation. However, interspecific interactions did not contribute to local replacement and nestedness. Main conclusions: Species replacement is the predominant process accounting for spatial community dissimilarity in these temperate forests and caused largely by local-scale species clustering associated with dispersal limitation. Nestedness, in contrast, is less prevalent and primarily associated with larger variation in local species richness as caused by spatial richness gradients or ‘hotspots’ of local species richness. The novel use of replacement and nestedness measures in point pattern analysis is a promising approach to assess local-scale biodiversity patterns and to explore their causes.

Chuanzi Liu,1 Zhichao Hao,1 Tao Yang,1 Fushi Wang,2 Feng Sun,3 Wei Teng1 1Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Institute of Stomatological Research, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei - MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, People’s Republic of China; 3Analysis and Testing Center, South China Normal University, Guangzhou, People’s Republic of ChinaCorrespondence: Wei Teng Email tengwei@mail.sysu.edu.cnBackground: To manage the sharp pain of dentine hypersensitivity, various materials are utilized to conduct dentine remineralization. However, many prior materials are limited with their single function and complicated operations. In this study, silica and calcium (strontium) carbonates mineralized nano cellulose fibrous (Si/Ca(Sr)-NCF) mat with the ability to release acid resistant and biomimetic mineralizational silica/calcium (strontium) carbonate co-precipitation nanoparticles (Si/Ca(Sr) NPs) were fabricated. The dentine occluding effects, antibacterial activity and cytocompatibility of the Si/Ca(Sr)-NCF mats were evaluated.Methods: The Si/Ca(Sr)-NCF mats were fabricated by dipping the electrospun nano cellulose fiber (NCF) into silica and calcium (strontium) carbonate liquid. Physicochemical characterizations and ion release were confirmed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), ion release assays and transmission electron microscopy (TEM). Sixty dentine discs were randomly divided into five groups: 1, blank NCF; 2, Si/Ca(Sr 0)-NCF; 3, Si/Ca(Sr 0.01)-NCF; 4, Si/Ca(Sr 0.05)-NCF; 5, Si/Ca(Sr 0.1)-NCF. Dentine discs were mineralized by the mats and observed with SEM immediately, after acid challenge and remineralized in artificial saliva. The releasing liquid was investigated by TEM and type I collagen model. Then, antibacterial property and cytocompatibility were evaluated.Results: SEM and TEM results confirmed that the experiment mats continuously released amorphous Si/Ca(Sr) NPs and consequently realized anti-acid dentine biomimetic remineralization. Homogeneous surface coverage and collagen intrafibrillar mineralization in strontium adding groups illustrated the mineralization effect was not only by in site precipitation, but also collagen heterogeneous nucleation. Additionally, acceptable antibacterial and cytocompatibility properties were illustrated in low and middle Sr2+ containing mats.Conclusion: In vitro studies on human dentine discs and type I collagen demonstrated that Si/Ca(Sr)–NCF system was a multifunction system inducing anti-acid, biomimetic, antibacterial and cytocompatible dentine remineralization. This multifunction mat would be a promising DH treatment candidate for complicated exposed dentine surfaces.Keywords: mineralization, silica, dentine hypersensitivity, strontium carbonates, electrospinning

Zhihao Hao,1,* Yinjuan Guo,2,* Lulin Rao,3 Jingyi Yu,3 Qing Zhan,4 Yanlei Xu,4 Bingjie Wang,2 Xiaocui Wu,2 Fangyou Yu2 1Department of Laboratory Medicine, Shandong Provincial Third Hospital, Cheeloo College of Mdicine, Shandong University, Ji Nan, 250000, People’s Republic of China; 2Department of Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200082, People’s Republic of China; 3Department of Laboratory Medicine, Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China; 4Department of Laboratory Medicine, Nanchang University, Nanchang, 330000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fangyou YuDepartment of Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Yangpu District, Shanghai, 200082, People’s Republic of ChinaEmail wzjxyfy@163.comIntroduction: Biofilm formation by Staphylococcus aureus is an important virulence determinant mediated by the polysaccharide intercellular adhesin (PIA) encoded by the ica operon or mediated by surface and extracellular proteins. SarX is a 250-residue two-domain SarA homolog that activates spa transcription. Previous studies demonstrated that Staphylococcus epidermidis SarX protein regulated the transcriptional activity of the agr and ica loci and controlled the biofilm phenotype, primarily by regulating icaADBC transcription and PIA production.Results: In this study, biofilm formation and detachment of the clinical isolate S. aureus SA75 were significantly decreased in the sarX mutant strain. The effect of sarX mutation on S. aureus biofilm formation was related to the production of PIA and not to that of eDNA. Deletion of sarX was associated with a 1.8-fold reduction in spa transcription as determined by RT-PCR analysis, and this reduction could be restored by chromosomal complementation of sarX. Expression of Spa protein was also decreased in the S. aureus sarX mutant.Conclusion: sarX promoted biofilm production of S. aureus that may primarily be mediated through increasing ica operon expression and PIA production. Furthermore, deletion of sarX reduced S. aureus biofilm formation by downregulating spa.Keywords: Staphylococcus aureus, ica, biofilm formation, sarX, spa

Peng Wang, 1 Longfei Hu, 1 Zhihui Hao 2 1Agricultural Bio-Pharmaceutical Laboratory, Qingdao Agricultural University, Qingdao 266109, People’s Republic of China; 2National Centre for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing 100089, People’s Republic of ChinaCorrespondence: Zhihui HaoNational Centre for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing 100089, People’s Republic of ChinaEmail abplab@126.comPurpose: The emergence of plasmid-mediated quinolone resistance (PMQR) is a global challenge in the treatment of clinical disease in both humans and animals and is exacerbated by the presence of different PMQR genes existing in the same bacterial strain. Here, we discovered that a natural isoquinoline alkaloid palmatine extracted from traditional Chinese medicinal plants effectively inhibited the activity of PMQR proteins QnrS and AAC(6′)-Ib-cr.Methods: In total 120 clinical ciprofloxacin-resistant Escherichia coli (E. coli) were screened for the presence of qnrS and aac(6ʹ)-Ib-cr by PCR. Recombinant E. coli that produced QnrS or AAC(6ʹ)-Ib-cr proteins were constructed and the correct expression was confirmed by MALDI/TOF MS analysis and SDS-PAGE. A minimal inhibitory concentration (MICs) assay, growth curve assay and time-kill assay were conducted to evaluate the in vitro antibacterial activity of palmatine and the combination of palmatine and ciprofloxacin. Cytotoxicity assays and mouse thigh infection model were used to evaluate the in vivo synergies. Molecular docking, gyrase supercoiling assay and acetylation assay were used to clarify the mechanism of action.Results: Palmatine effectively restored the activity of ciprofloxacin against qnrS and aac(6ʹ)-Ib-cr-positive E. coli strains in a synergistic manner in vitro. In addition, the combined therapy significantly reduced the bacterial burden in a mouse thigh infection model. Molecular docking revealed that palmatine bound at the functional large loop B of QnrS and Trp102Arg and Asp179Tyr in the binding pocket of AAC(6′)-Ib-cr. Furthermore, interaction analysis confirmed that palmatine reduced the gyrase protective effect of QnrS and the acetylation effect of AAC(6′)-Ib-cr.Conclusion: Our findings suggest that palmatine is a potential efficacious compound to restore PMQR-mediated ciprofloxacin resistance and warrants further preclinical evaluations.Keywords: plasmid-mediated quinolone resistance, PMQR, palmatine, QnrS, AAC(6′)-Ib-cr, inhibitor

Junling Yang,1 Zaijun Hao,1 Wei Li,1 Caiping Duan,1 Xiujuan Fan,1 Jing Xin,1 Chunguang Ren2 1Department of Anesthesiology, Ordos Central Hospital, Ordos, People’s Republic of China; 2Department of Anesthesiology, Liaocheng People’s Hospital, Liaocheng, Shandong, People’s Republic of ChinaCorrespondence: Chunguang Ren Email weiyichunguang@163.comBackground: Although video-assisted thoracoscopic surgery (VATS) is increasingly used, the optimal analgesia strategy is still unknown. We explore the efficacy and safety of preemptive ultrasound-guided paravertebral block (PVB) combined with parecoxib during VATS.Methods: Seventy-four patients were divided into two groups. PVBs were performed before anesthesia induction under real-time ultrasound guidance. Visual analog scale (VAS) score with coughing at 48 h after surgery, postoperative sufentanil consumption and level of sedation (LOS) at 1, 4, 8, 12, 24, and 48 h postoperatively, intraoperative hemodynamics, satisfaction scores of patients and surgeons, remedial measures, time to chest tube removed and mobilization, adverse effects and hospital stay length were recorded. We also recorded inflammatory markers, respiratory function and the prevalence of chronic pain after surgery.Results: VAS scores at rest and with coughing during the first 24 h after surgery were significantly lower in the P group (P< 0.05). Consumption of sevoflurane, remifentanil, and dexmedetomidine was all significantly reduced in the P group (P< 0.05). The consumption of sufentanil within 48 h after surgery, time to first dose and total dose of rescue ketorolac was significantly lower in the P group (P< 0.05). The FEV1/FVC ratio was significantly higher in the P group at 1 and 3 d after surgery (P< 0.05). Times to chest tube removal and mobilization were significantly shorter in the P group (P< 0.05). Compared with the C group, the level of both ACTH and cortisol was significantly reduced in the P group at 1 and 3 d after surgery (P< 0.05).Conclusion: PVB combined with parecoxib was associated with better pain relief, decreased sufentanil and ketorolac consumption, less hemodynamic instability, and a lower surgery-related stress response. However, the incidences of chronic pain 3 and 6 months after surgery and the risk of complication except urinary retention were not significantly different between groups.Keywords: paravertebral block, parecoxib, video-assisted thoracic surgery, preemptive analgesia