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Yi-Ting Lin,1 Wei-Chung Tsai,1 Hsueh-Yu Lu,1 Shih-Yuan Fang,1 Hsiang-Wen Chan,1 Chung-Hsiung Huang1,2 1Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan; 2Center for Marine Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, 20224, TaiwanCorrespondence: Chung-Hsiung Huang, Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan, Tel +886-2-2462-2192 ext. 5116, Email huangch@mail.ntou.edu.twBackground: Due to its prevalence, recurrence, and the emergence of drug-resistance, Candida vaginitis significantly impacts the well-being of women. Although cinnamon essential oil (CEO) possesses antifungal activity, its hydrophobic properties limit its clinical application.Purpose: To overcome this challenge, a nanoemulsification technology was employed to prepare cinnamon essential oil-nanoemulsion (CEO@NE), and its therapeutic efficacy and action mechanism for Candida vaginitis was investigated in vivo and in vitro.Materials and Methods: CEO@NE, composed of 4% CEO, 78% distilled water, and 18% Tween 80, was prepared by ultrasonic nanoemulsification. The physical properties, anti-Candida activity, cytotoxicity, immunomodulatory potential and storage stability of CEO@NE were explored. Subsequently, the effect of intravaginal CEO@NE treatment on Candida vaginitis was investigated in mice. To comprehend the possible mechanism of CEO@NE, an analysis was conducted to ascertain the production of intracellular reactive oxygen species (ROS) in C. albicans.Results: CEO@NE, with the droplet size less than 100 nm and robust storage stability for up to 8 weeks, exhibited comparable anti-Candida activity with CEO. CEO@NE at the concentration lower than 400 μg/mL had no cytotoxic and immunomodulatory effects on murine splenocytes. Intravaginal treatment of CEO@NE (400 μg/mL, 20 μL/day/mouse for 5 consecutive days) curbed Candida colonization, ameliorated histopathological changes, and suppressed inflammatory cytokine production in mice intravaginally challenged with C. albicans. Notably, this treatment preserved the density of vaginal lactic acid bacteria (LAB) crucial for vaginal health. Co-culturing C. albicans with CEO@NE revealed concentration-dependent augmentation of intracellular ROS generation and ensuing cell death. In addition, co-culturing LPS-stimulated murine splenocytes with CEO@NE yielded a decrease in the generation of cytokines.Conclusion: This discovery provides insight into the conceivable antifungal and anti-inflammatory mechanisms of CEO@NE to tackle Candida vaginitis. CEO@NE offers a promising avenue to address the limitations of current treatments, providing novel strategy for treating Candida vaginitis.Keywords: anti-inflammation, Candida vaginitis, cinnamon essential oil, nanoemulsion, reactive oxygen species

Chih-Hsuan Huang,1– 3 Hsin-Hung Wu,4,5 Yii-Ching Lee,6 Xiumei Li1 1Business School, Hubei University of Economics, Wuhan City, People’s Republic of China; 2Hubei Enterprise Culture Research Center, Hubei University of Economics, Wuhan, People’s Republic of China; 3Research Center of Hubei Logistics Development, Hubei University of Economics, Wuhan, People’s Republic of China; 4Department of Business Administration, National Changhua University of Education, Changhua City, Taiwan; 5Faculty of Education, State University of Malang, Malang, East Java, Indonesia; 6Department of Health Business Administration, Hung Kuang University, Taichung City, TaiwanCorrespondence: Yii-Ching Lee, Department of Health Business Administration, Hung Kuang University, No. 34 Zhongqi Road, Shalu District, Taichung City, Taiwan, Tel +886-4-26318652, Email yiiching.lee@sunrise.hk.edu.twPurpose: This research aims to investigate the role of management leadership in promoting a culture of patient safety within healthcare organizations. Through a comprehensive mediation analysis of the Chinese version of the safety attitudes questionnaire (CSAQ) and patient safety culture, the study examines the interplay between these critical factors and their combined influence on healthcare outcomes.Patients and Methods: In a medical center located in Taiwan, a cross-sectional survey was carried out utilizing the CSAQ. Among the 1500 distributed surveys, 1037 were returned and deemed valid, resulting in a return rate of 69.13%. To investigate the main measures, Structural Equation Modeling with mediation analysis was employed to scrutinize the direct and indirect effects of factors including teamwork climate, job satisfaction, stress recognition, perceptions of management, working conditions, and emotional exhaustion on safety climate.Results: The findings reveal that effective management leadership plays a pivotal role in shaping safety attitudes and fostering a robust patient safety culture. The study identifies three critical facets of patient safety that are entirely mediated by management perceptions: teamwork climate, working conditions, and stress recognition. The results highlight the importance of enhancing these dimensions to advance the patient safety culture within healthcare organizations. Moreover, stress recognition is identified as a critical factor influencing the organizational culture of patient safety.Conclusion: This research offers valuable insights for healthcare organizations seeking to prioritize patient safety and improve overall quality of care. By enhancing our understanding of the critical factors that shape safety attitudes and patient safety culture, this study provides a roadmap for effective management leadership and a culture of patient safety within healthcare organizations. The study underscores the significance of management leadership in promoting patient safety culture and highlights the importance of enhancing teamwork climate, working conditions, and stress recognition to advance patient safety culture.Keywords: management leadership, safety attitudes questionnaire, patient safety culture, mediation effect

Wei-Chung Tsai,1 Fang-Ling Liu,1 Ming-Hsi Huang,2 Chung-Hsiung Huang1,3 1Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan; 2National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan; 3Center for Marine Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, TaiwanCorrespondence: Chung-Hsiung Huang, Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan, Tel +886-2-2462-2192 ext 5116, Email huangch@mail.ntou.edu.twBackground: Intravaginal vaccination is an encouraging approach to prevent infectious vaginitis, with nanoemulsions showing effectiveness as mucosal adjuvants.Purpose: This study aimed to formulate a nanoemulsion incorporating Porphyra oligosaccharide (PO@NE) and assess its effectiveness as a mucosal adjuvant in intravaginal vaccines against candidal vaginitis.Materials and Methods: PO@NE was prepared, and the stability, immunomodulatory activity and cytotoxicity were screened in vitro. Further, the preventive effect of PO@NE as adjuvants for heat-killed Candida albicans (HK-CA) vaccines was explored in a murine model of candidal vaginitis, in comparison with those supplemented with polysaccharide (PP@NE). The mice were intravaginally vaccinated with 106 HK-CA cells, suspended in 1% NE without or with either PO or PP at a final concentration of 6.5 μg/mL, in a total volume of 20 μL. This vaccination was intravaginally administered once a week for 3 weeks. One week following the final vaccination, the mice underwent an intravaginal challenge with 107 C. albicans cells. One week after the challenge, the mice were euthanized to isolate serum, spleen, vaginal washes, and vaginal tissues for analysis.Results: PP@NE and PO@NE, with diameters approximately around 100 nm, exhibited exceptional stability at 4°C and low cytotoxicity when used at a concentration of 1% (v/v). Intravaginal vaccination with HK-CA adjuvanted with PO@NE effectively protected against candidal vaginitis evidenced by less Candida hyphae colonization, milder mucosal damage and cell infiltration. Moreover, enhanced mucosal antibody production, induction of T helper (Th)1 and Th17-related immune responses, enlarged the population of CD8+ cells, and elevated vaginal microflora diversity were observed in vaccinated mice. Interestingly, the potency was rather attenuated when PO@NE was replaced with PP@NE.Conclusion: These findings indicate PO@NE as a HK-CA vaccine adjuvant for candidal vaginitis prevention via enhancement of both cellular and humoral immunity and modulation of vaginal microflora, emphasizing further intravaginal vaccination development.Keywords: Candida albicans, mucosal vaccine adjuvant, nanoemulsion, Porphyra oligosaccharide, vaginitis

Hsuan Huang,1 Hsiao-Ling Su,2 Chih-Hsung Huang,2 Yi-Hsin Lin2 1Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, TaiwanCorrespondence: Yi-Hsin Lin, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan, Tel +886-2-2771-8151, Email slimesin0709@gmail.comBackground: During the COVID-19 pandemic, the national lockdown had a significant impact on healthcare systems and diabetes management. The results of relevant studies were inconsistent. The aim of the study was to investigate the impact of lockdown on glycemic control among patients with type 2 diabetes mellitus(T2D) in Taiwan.Methods: This was a retrospective study conducted in a single regional hospital in Northern Taiwan. The clinic characteristics of the patients were summarized. Anthropometric and biochemical data before and after the lockdown were collected and analyzed. Stepwise multiple regression analysis was performed to identify the independent determinants of variables, including baseline characteristics and laboratory parameters, for the changes in glycated hemoglobin(HbA1c).Results: A total of 943 (females 48.5%) patients with T2D were enrolled. The mean age of the patients was 60.6± 12.3years, with a mean HbA1c of 7.0± 1.0%, a mean diabetes duration of 7.3± 4.6years, and a mean body mass index(BMI) of 26.5± 4.5kg/m2. The overall means of HbA1c and fasting blood glucose were significantly improved after the lockdown compared to before (7.0± 1.0 vs 6.8± 0.9, p< 0.001 and 132.2± 33.3 vs 124.4± 30.0, p< 0.001, respectively). The proportion of patients achieving HbA1c target (≤ 7%) was higher after the lockdown compared to before (61.5% vs 68.9%, p< 0.001). Stepwise multiple regression analysis revealed that baseline HbA1c before the lockdown was a positive contributor to the change in HbA1c after the lockdown, whereas BMI and co-morbidity with dyslipidemia were negative contributors (standardized coefficient +0.16, p< 0.001; − 0.07, p=0.025; − 0.12, p=0.001, respectively).Conclusion: Our study highlights the benefits of lockdown measures on diabetic control in Northern Taiwan as a single-center experience with the improvement of HbA1c and fasting blood glucose. Understanding these consequences of national lockdown can help healthcare providers to improve diabetes care during the pandemic.Keywords: COVID-19 lockdown, type 2 diabetes mellitus, glycemic control

Wei-Chun Lin,1– 3 Chien-Hsiung Huang,2– 4 Liang-Tien Chien,4,5 Hsiao-Jung Tseng,6,7 Chip-Jin Ng,2,3,8 Kuang-Hung Hsu,2,3,9– 12 Chi-Chun Lin,2,3,13 Cheng-Yu Chien2– 4,13,14 1Department of Emergency Medicine, New Taipei Municipal TuCheng Hospital and Chang Gung University, New Taipei City, Taiwan; 2Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 4Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan; 5Fire Department, Taoyuan City Government, Taoyuan, Taiwan; 6Department of Statistics and Information Science, Fu Jen Catholic University, New Taipei City, Taiwan; 7Biostatistics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 8Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan; 9Laboratory for Epidemiology, Chang Gung University, Taoyuan, Taiwan; 10Laboratory for Epidemiology, Department of Health Care Management, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; 11Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; 12Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan; 13Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, Taiwan; 14Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, TaiwanCorrespondence: Cheng-Yu Chien, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Dist, Taoyuan City, Taiwan, Tel +886-3-3281200 &num; 2505, Fax +886-3-3287715, Email rainccy217@gmail.comObjective: The authors performed several tree-based algorithms and an association rules mining as data mining tools to find useful determinants for neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients as well as to assess the effect of the first-aid and basic characteristics in the EMS system.Patients and Methods: This was a retrospective cohort study. The outcome was Cerebral Performance Categories grading on OHCA patients at hospital discharge. Decision tree-based models inclusive of C4.5 algorithm, classification and regression tree and random forest were built to determine an OHCA patient’s prognosis. Association rules mining was another data mining method which we used to find the combination of prognostic factors linked to the outcome.Results: The total of 3520 patients were included in the final analysis. The mean age was 67.53 (± 18.4) year-old and 63.4% were men. To overcome the imbalance outcome issue in machine learning, the random forest has a better predictive ability for OHCA patients in overall accuracy (91.19%), weighted precision (88.76%), weighted recall (91.20%) and F1 score (0.9) by oversampling adjustment. Under association rules mining, patients who had any witness on the spot when encountering OHCA or who had ever ROSC during first-aid would be highly correlated with good CPC prognosis.Conclusion: The random forest has a better predictive ability for OHCA patients. This paper provides a role model applying several machine learning algorithms to the first-aid clinical assessment that will be promising combining with Artificial Intelligence for applying to emergency medical services.Keywords: cardiac arrest, tree-based algorithms, data mining

A statistical approach was carried out to identify the prevalent virulence factors responsible for post-weaning diarrhoea (PWD). Healthy piglets' faecal samples and diarrhoeic piglets' rectal swab specimens were secured. Twenty-six (26) and 100 independent enterotoxigenic Escherichia coli (ETEC) strains were subsequently isolated. These strains were assessed utilising polymerase chain reaction to identify the encoding genes of six virulence factors: heat-labile enterotoxin (LT; encoded by eltAB), heat-stable enterotoxin A (STa; encoded by estA), heat-stable enterotoxin B (STb; encoded by estB), enteroaggregative E. coli heat-stable enterotoxin 1 (EAST1; encoded by astA), Shiga toxin 2e (Stx2e; encoded by stx2e), and F18 fimbriae (encoded by fedA). The LT and ST secretions were investigated using enzyme-linked immunosorbent assays. From direct observation, no stx2e was evident in the 126 strains. Among the 26 strains retrieved from the healthy piglets, none harboured fedA or secreted LT; 23% (6/26) secreted ST, and 50% (13/26) carried astA. A statistical regression was applied on the 100 E. coli strains retrieved from the diarrhoeic piglets, where fedA was set as the dependent variable and the enterotoxin secretions were set as the independent variables. The results exhibit that the LT secretion was the only significant factor (P < 0.000 1) correlated to fedA in the diarrhoeic piglets; thus, it is concluded that the prevalent virulence factors for PWD were the ECET strain with F18 fimbriae adhesion and LT secretion, but not astA or stx2e.

Cheng-Hao Huang,1,2 Mei-Chen Lin,3,4 I-Ching Chou,5,6 Ching-Liang Hsieh2,7,8 1Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung City, 40402, Taiwan; 2Department of Chinese Medicine, China Medical University Hospital, Taichung City, 40447, Taiwan; 3Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan; 4College of Medicine, China Medical University, Taichung, 40402, Taiwan; 5School of Chinese Medicine, China Medical University, Taichung City, 40402, Taiwan; 6Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung City, 40447, Taiwan; 7Chinese Medicine Research Center, China Medical University, Taichung City, 40402, Taiwan; 8Graduate Institute of Acupuncture Science, China Medical University, Taichung City, 40402, TaiwanCorrespondence: Ching-Liang Hsieh, Graduate Institute of Acupuncture Science, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan, Tel +886-4-22053366 ext. 3128, Fax +886-4-22037690, Email clhsieh@mail.cmuh.org.twBackground: Migraine is a recurrent headache disease that has been identified as a risk factor for subsequent dementia. The present study collected data from Taiwan’s National Health Insurance Research Database (NHIRD) to investigate the incidence of dementia in patients with migraine who did or did not concurrently receive acupuncture treatment.Methods: A 1:1 propensity score method was used to match an equal number of patients (N = 4813) in the acupuncture and nonacupuncture cohorts based on sex, age, migraine diagnosis year, index year, insurance amount, urbanization level, baseline comorbidities, and medication usage. We employed Cox proportional hazards models to evaluate the risk of dementia.Results: Patients with migraine who received acupuncture treatment were found to have a lower risk of dementia (adjusted hazard ratio [aHR] = 0.51, 95% CI = 0.40– 0.65) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the nonacupuncture cohort (Log rank test, p < 0.001). This propensity score–matched cohort study demonstrated an association between acupuncture treatment and dementia development in patients with migraine in Taiwan.Conclusion: The results suggest that acupuncture treatment significantly reduced the development of dementia in patients with migraine.Keywords: acupuncture, migraine, dementia, National Health Insurance Research Database, NHIRD, propensity score, cohort

Chun-hui Huang,1,2,&ast; Peng-yi Hu,2,3,&ast; Qiu-yan Wu,2,3 Ming-yan Xia,2,3 Wen-liu Zhang,3 Zhi-qiang Lei,3 Dong-xun Li,3 Guo-song Zhang,2,3 Jian-fang Feng1,2 1School of Pharmacy, Guangxi University of Chinese Medicine, Nanning, Guangxi, 530200, People’s Republic of China; 2National Engineering Research Center of Chinese Medicine Solid Preparation Manufacturing Technology, Nanchang, 330006, People’s Republic of China; 3Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guo-song Zhang, National Engineering Research Center of Chinese Medicine Solid Preparation Manufacturing Technology, Nanchang, 330006, People’s Republic of China, Email zhgs81411@aliyun.com Jian-fang Feng, School of Pharmacy, Guangxi University of Chinese Medicine, Nanning, 530200, People’s Republic of China, Email fengjianfang@vip.163.comBackground: Ibuprofen (IBU), a nonsteroidal anti-inflammatory drug, shows poor gastrointestinal absorption due to its low solubility, which limits its clinical application.Objective: In the present study, we aimed to develop thermosensitive gel-mediated ibuprofen-solid lipid nanoparticles (IBU-SLN-ISG) to improve the dissolution and bioavailability of IBU after rectal delivery.Methods: IBU-loaded SLNs (IBU-SLNs) were developed and optimized applying Box-Behnken design. The optimized IBU-SLNs were characterized by physicochemical parameters and morphology. Then, the optimized IBU-SLNs was incorporated into the gel and characterized for gel properties and rheology and investigated its release in vitro, pharmacokinetics in vivo, rectal irritation and rectal retention time.Results: The optimized SLNs had an EE of 90.74 ± 1.40%, DL of 11.36 ± 1.20%, MPS of 166.77 ± 2.26 nm, PDI of 0.27 ± 0.08, and ZP of − 21.00 ± 0.59 mV. The FTIR spectra confirmed successful encapsulation of the drug inside the nanoparticle as only peaks responsible for the lipid could be identified. This corroborated well with XRD spectra, which showed a completely amorphous state of the IBU-SLNs as compared to the crystalline nature of the pure drug. The gelation temperature of the prepared IBU-SLN-ISG was 33.30 ± 0.78°C, the gelation time was 14.67 ± 2.52 s, the gel strength was 54.00 ± 1.41 s, and the mucoadhesion was (11.54± 0.37) × 102dyne/cm2. The in vitro results of IBU-SLNs and IBU-SLN-ISG showed a biphasic release pattern with initial burst release followed by sustained release. More importantly, IBU-SLN-ISG produced much better absorption of IBU and improved bioavailability in rats. In addition, IBU-SLN-ISG caused no irritation or damage to rectal tissues, and could be retained in the rectum for a long time.Conclusion: Thermosensitive in situ gel loaded with IBU-solid lipid nanoparticles might be further developed as a more convenient and effective rectal dosage form.Keywords: thermosensitive gel, ibuprofen, solid lipid nanoparticle, rectal delivery, bioavailability

Po-En Chiu,1,2,&ast; Zhonghua Fu,3,&ast; Guan-Wei Jian,4,5 Ching-Hsuan Huang,2,6 Te-Mao Li,2 Li-Wei Chou7– 9 1Department of Chinese Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; 2School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Institute of Fu’s Subcutaneous Needling, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 4Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan; 5Department of Chinese Medicine, Sinying Hospital, Ministry of Health and Welfare, Tainan, Taiwan; 6Department of Chinese Traumatology Medicine, China Medical University Hospital, Taichung, Taiwan; 7Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 8Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan; 9Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan&ast;These authors contributed equally to this workCorrespondence: Li-Wei ChouDepartment of Physical Medicine and Rehabilitation, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 40447, TaiwanTel +886-4-22052121-2381Fax +886-4-22026041Email chouliwe@gmail.comBackground: Knee osteoarthritis (OA) is a common clinical disease. Knee pain is the major symptom of knee OA and the primary reason why patients seek treatment. Fu’s subcutaneous needling (FSN) has been used to treat knee OA for more than 20 years. However, the establishment of treatment methods and rigorous evaluation of FSN’s efficacy are still lacking. A randomized single-blind clinical trial will be conducted to evaluate whether FSN treatment can immediately alleviate pain due to knee OA surrounding the patella and the curative effective of 1-week and 2-week treatments. In addition, the feasibility and initial effect of FSN treatment for patients with knee OA will be discussed.Materials and Methods: Patients with confirmed knee OA, as diagnosed by doctors using X-ray films or from clinical symptoms, who are over 50 years old will be participants recruited. They will be randomly assigned either FSN treatment or transcutaneous electrical nerve stimulation treatment. In addition, their pressure pain threshold, muscle tone of lower leg muscle, and physical ability will be measured. Participants will be asked to complete the questionnaires of Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne’ index as the measurements for quality of life.Results: The findings of this study will reveal whether FSN or transcutaneous electrical nerve stimulation is clinically efficacious for treating pain due to knee OA, with respect to muscle stiffness, gait, dynamic balance, the pressure pain threshold, and quality of life before and after treatment.Study Registration: This study is approved by the Research Ethics Committee of China Medical University & Hospital, Taichung, Taiwan (CMUH107-REC3-027) and registered at the ClinicalTrials.gov Protocol Registration and Results System (registration number NCT04356651).Keywords: dry needling, Fu’s subcutaneous needling, knee osteoarthritis, myofascial trigger point, tightened muscle

Chien Hsiu Huang, I-Hung Chen Department of Internal Medicine, Division of Chest Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, TaiwanCorrespondence: Chien Hsiu HuangDepartment of Internal Medicine, Division of Chest Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Min-Sheng Road, Dalin Town, Chiayi, TaiwanEmail dm550671@tzuchi.com.twBackground: We applied the tracheostomy decision-making program for respiratory care center prolonged mechanical ventilation patients. Our objectives are to correct the misconception of patients about tracheostomy. We expect to understand whether the program is effective in educating patients and whether the patients are satisfied with the results of their decision-making. We compared the prognostic differences between patients receiving tracheostomy and those who continue to have an endotracheal tube, which serves as our basis to provide suggestions for patients in the shared decision-making program.Patients and Methods: A retrospective study was conducted in Dalin Tzu Chi Hospital from January 2017 to December 2019. We set up a tracheostomy decision-making program. The medical team identified eligible patients. We tracked the survival of each patient and followed up on each patient to ask whether they thought they had made an optimal decision based on the results of their participation in the tracheostomy decision-making program in January 2020. Data of respiratory care center prolonged mechanical ventilation patients who participated in the tracheostomy decision-making program were collected and analyzed.Results: Fifty-seven respiratory care center patients attended the tracheostomy decision-making program. At the end of the study, 37 patients underwent tracheostomy (64.9%), and 20 patients maintained endotracheal tube intubation (35.1%). The survival rate of patients undergoing tracheostomy was 86.5% and 32 participants (86.5%) believed that they made an optimal decision after participating in the tracheostomy decision-making program. The survival rate of patients who maintained endotracheal tube intubation was 40%, and twenty (100%) participants believed that they made an optimal decision after participating in the tracheostomy decision-making program.Conclusion: The clinical application of the tracheostomy decision-making program ensures that patients have a clearer understanding of the methods of tracheostomy and endotracheal tube intubation. Overall, 91.2% of the participants believed that they made an optimal decision despite the end result.Keywords: shared decision making, respiratory care center, tracheostomy, endotracheal tube intubation

Shu-Jyuan Yang,1 Chung-Huan Huang,1 Chung-Hao Wang,2 Ming-Jium Shieh,1,3 Ke-Cheng Chen1,4 1Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan; 2Gene’e Tech Co. Ltd., New Taipei City, Taiwan; 3Department of Oncology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; 4Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanCorrespondence: Ke-Cheng Chen Tel +886-2-23123456 ext 65077Email 010288@ntuh.gov.twBackground: Lung cancer is the leading cause of cancer patient death in the world. There are many treatment options for lung cancer, including surgery, radiation therapy, chemotherapy, targeted therapy, and combined therapy. Despite significant progress has been made in the diagnosis and treatment of lung cancer during the past few decades, the prognosis is still unsatisfactory.Purpose: To resolve the problem of chemotherapy failure, we developed a magnetite-based nanomedicine for chemotherapy acting synergistically with loco-regional hyperthermia.Methods: The targeting carrier consisted of a complex of superparamagnetic iron oxide (SPIO) and poly(sodium styrene sulfonate) (PSS) at the core and a layer-by-layer shell with cisplatin (CDDP), together with methotrexate – human serum albumin conjugate (MTX−HSA conjugate) for lung cancer-specific targeting, referred to hereafter as SPIO@PSS/CDDP/HSA−MTX nanoparticles (NPs).Results: SPIO@PSS/CDDP/HSA−MTX NPs had good biocompatibility and stability in physiological solutions. Furthermore, SPIO@PSS/CDDP/HSA−MTX NPs exhibited a higher temperature increase rate than SPIO nanoparticles under irradiation by a radiofrequency (RF) generator. Therefore, SPIO@PSS/CDDP/HSA−MTX NPs could be used as a hyperthermia inducer under RF exposure after nanoparticles preferentially targeted and then accumulated at tumor sites. In addition, SPIO@PSS/CDDP/HSA−MTX NPs were developed to be used during combined chemotherapy and hyperthermia therapy, exhibiting a synergistic anticancer effect better than the effect of monotherapy.Conclusion: Both in vitro and in vivo results suggest that the designed SPIO@PSS/CDDP/HSA−MTX NPs are a powerful candidate nanoplatform for future antitumor treatment strategies.Keywords: lung cancer, hyperthermia, chemotherapy, superparamagnetic iron oxide nanoparticles, cisplatin, methotrexate

Chiung-Hsin Chang, 1 Horng-Chyuan Lin, 1, 2 Chia-Hung Yang, 3 Shu-Ting Gan, 4 Chi-Hsien Huang, 1 Fu-Tsai Chung, 1, 2, 5 Han-Chung Hu, 1, 2 Shu-Min Lin, 1, 2 Chih-Hao Chang 1, 2, 5 1Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 2Chang Gung University, College of Medicine, Taoyuan, Taiwan; 3Division of Cardiology, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan; 4Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, TaiwanCorrespondence: Chih-Hao Chang Department of Thoracic MedicineChang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanEmail ma7384@cgmh.org.twPurpose: The 6-min walk test (6MWT) is a useful tool to assess the physiologic function in patients with chronic obstructive pulmonary disease (COPD). The recent study showed that patients with COPD with oxygen desaturation during the 6MWT had an increased risk of exacerbation and death compared with those without oxygen desaturation. This study aimed to explore the potential risk factors for exercise-induced desaturation (EID) in patients with COPD.Patients and Methods: Adult patients with COPD were enrolled from the Chang Gung Research Database between January 2013 and January 2017. Age, sex, body mass index, underlying diseases, medications, and results of the pulmonary function tests and 6MWT were retrospectively collected and analyzed.Results: Among 1768 patients with COPD, 932 (52.7%) had oxygen desaturation, and the other 836 (47.3%) had no desaturation during the 6MWT. The patients with EID had a shorter 6-min walk distance than those without desaturation (352.08± 120.29 vs 426.56± 112.56, p< 0.0001). In the multivariate logistic regression analysis, older age, female sex, lower forced expiratory volume in 1 s, and comorbidity with atrial fibrillation (AF) were associated with oxygen desaturation during the 6MWT. Patients with EID had higher exacerbation frequency than those without desaturation in the 1-year follow-up period (0.59± 1.50 vs 0.34± 1.26, p< 0.0001). Patients with COPD with AF also had a higher rate of exacerbation requiring emergency department visit or hospitalization in the 1-year follow-up.Conclusion: This study demonstrates that older age, low FEV1, and female sex are risk factors for EID. Desaturation during 6MWT is related to frequent acute exacerbation of COPD in the 1-year follow-up.Keywords: 6-minute walk test, A-fib, exacerbation, hypoxia

Ting-Kuo Chang,1–3,* Yung-Chang Lu,1–3,* Shu-Ting Yeh,2,3 Tzu-Chiao Lin,2,3 Chun-Hsiung Huang,2–4 Chang-Hung Huang1–3,5 1Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; 2Department of Orthopaedic Surgery, MacKay Memorial Hospital, Taipei, Taiwan; 3Department of Medical Research, MacKay Memorial Hospital, Taipei County, Taiwan; 4Department of Orthopaedic Surgery, Changhua Christian Hospital, Changhua, Taiwan; 5Department of Dentistry, National Yang-Ming University, Taipei, Taiwan*These authors contributed equally to this workCorrespondence: Chang-Hung HuangDepartment of Medical Research, MacKay Memorial Hospital, No. 45, Minsheng Road, Tamshui District, New Taipei City, TaiwanEmail changhung0812@gmail.comBackground: Graphene and its derivatives have recently gained popularity in the biomedical field. Previous studies have confirmed that both the mechanical strength and wear resistance of graphene-containing polyethylene have been greatly improved. Therefore, it is being considered as an alternative for artificial joint replacement liners. Based on the literature, the wear debris generated from the traditional polymers used for orthopedic liners could lead to particle-induced osteolysis and, consequently, failure of joint replacement. However, the biological response of this novel graphene-based polymer is still unclear. Therefore, the current study aimed to investigate the in vitro and in vivo biological effects of graphene and graphene oxide (GO) particles on bone.Materials and Methods: The biological responses of graphene and GO particles were tested via in vitro and murine calvarial in vivo models. In the in vitro model, murine macrophage cells were mixed with particles and hydrogel and printed into two differently designed scaffolds; the induced proinflammatory cytokines were then tested. In the murine in vivo model, the particle size distribution was measured via SEM, and these particles were then administrated in the calvarial area, referring to our established model. A micro-CT and histological analysis were performed to examine the biological effects of the particles on bone health. The data were analyzed via the one-way analysis of variance to determine the differences between the groups.Results: Both graphene and GO induced significantly higher TNF-α and IL-6 secretion compared with the control in the three-dimensional in vitro model. In the murine calvarial in vivo test, the graphene and GO particles increased the bone mass compared with the sham groups in the micro-CT analysis. Bone formation was also observed in the histological analysis.Conclusion: In these in vivo and in vitro studies, the graphene and GO wear debris did not seem to induce harmful biological response effect to bone. Bone formation around the skull was observed in the calvarial model instead. Graphene-containing biomaterials could be a suitable new material for application in orthopedic prostheses due to their benefit of eliminating the risk of particle-induce osteolysis.Keywords: biological response, graphene, graphene oxide, osteolysis, osteogenesis

Yai-Ping Hsiao,1 Hui-Ting Chen,1 Yu-Chih Liang,2 Tse-En Wang,1 Kai-Hung Huang,3 Cheng-Chih Hsu,3 Hong-Jen Liang,4 Chung-Hsiung Huang,5 Tong-Rong Jan1 1Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan; 2School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 10617, Taiwan; 3Department of Chemistry, National Taiwan University, Taipei 10617, Taiwan; 4Department of Food Science, Yuanpei University, Hsinchu 30015, Taiwan; 5Department of Food Science, National Taiwan Ocean University, Keelung 20224, TaiwanCorrespondence: Tong-Rong JanDepartment and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, No.1, Sec. 4, Roosevelt Road, Taipei 10617, Taiwan, ROCTel +886-2-33661287Fax +886-2-23661475Email tonyjan@ntu.edu.twChung-Hsiung HuangDepartment of Food Science, National Taiwan Ocean University, No.2, Beining Road, Keelung 20224, TaiwanTel +886-2-24622192#5115Email huangch@mail.ntou.edu.twBackground: Honokiol has been reported to possess anti-inflammatory and neuroprotective activities. However, the poor aqueous solubility of honokiol limits its clinical application for systemic administration.Purpose: This study aims to develop a novel formulation of nanosome-encapsulated honokiol (NHNK) for intravenous therapy against mouse experimental autoimmune encephalomyelitis (EAE) that mimics human multiple sclerosis.Methods: Nanosomes and NHNK were prepared by using an ultra-high pressure homogenization (UHPH) method. Mice were treated with NHNK or empty nanosomes during the peak phase of EAE symptoms. Symptoms of EAE were monitored and samples of the spinal cord were obtained for histopathological examinations.Results: The stock of NHNK containing honokiol in the nanosome formulation, which showed the structure of single phospholipid bilayer membranes, was well formulated with the particle size of 48.0 ± 0.1 nm and the encapsulation efficiency 58.1 ± 4.2%. Intravenous administration of NHNK ameliorated the severity of EAE accompanied by a significant reduction of demyelination and inflammation in the spinal cord. Furthermore, NHNK decreased the number of IL-6+, Iba-1+TNF +, Iba-1+IL-12 p40+, and CD3+IFN-γ+ cells infiltrating the spinal cord.Conclusion: The UHPH method simplified the preparation of NHNK with uniformly distributed nanosize and high encapsulation efficiency. Intravenous administration of NHNK ameliorated the severity of EAE by suppressing the infiltration of activated microglia and Th1 cells into the spinal cord. Collectively, these results suggest that the formulation of NHNK is a prospective therapeutic approach for inflammatory CNS diseases, such as multiple sclerosis.Keywords: experimental autoimmune encephalomyelitis, honokiol, nanosome, neuroinflammation, ultra-high pressure homogenization

Yai-Ping Hsiao,1 Chung-Hsiung Huang,2 Yu-Chin Lin,3 Tong-Rong Jan1 1Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan; 2Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan; 3Department of Medicinal Botanicals and Health Applications, College of Biotechnology & Bioresources, Da-Yeh University, Changhua, Taiwan Background: Medicinal preparations of iron oxide nanoparticles (IONPs) have been used as MRI contrast agents for the diagnosis of hepatic tumors and the assessment of neuroinflammation and blood–brain barrier integrity. However, it remains mostly unclear whether exposure to IONPs affects neuroinflammation under disease conditions. The present study aims to investigate the impact of IONPs on autoimmune-mediated neuroinflammation using a murine model of experimental autoimmune encephalomyelitis (EAE) that mimics human multiple sclerosis.Methods: Mice were either left untreated or immunized with myelin oligodendrocyte glycoprotein on day 0 followed by two injections of pertussis toxin for EAE induction. The EAE mice were intravenously administered with a single dose of the carboxydextran-coated IONPs, ferucarbotran (20 mg Fe/kg) and/or saline (as vehicle) on day 18. Symptoms of EAE were daily monitored until the mice were killed on day 30. Tissue sections of the brain and spinal cord were prepared for histopathological examinations. Iron deposition, neuron demyelination and inflammatory cell infiltration were examined using histochemical staining. The infiltration of microglial and T cells, and cytokine expression were examined by immunohistochemical staining and/or reverse transcription polymerase chain reaction (RT-PCR).Results: Iron deposition was detected in both the brain and spinal cord of EAE mice 3 days post-ferucarbotran treatment. The clinical and pathological scores of EAE, percentage of myelin loss and infiltration of inflammatory cells into the spinal cord were significantly deteriorated in EAE mice treated with ferucarbotran. Furthermore, ferucarbotran treatment increased the number of CD3+, Iba-1+, IL-6+, Iba-1+TNF-α+ and CD3+IFN-γ+ cells in the spinal cord of EAE mice.Conclusion: A single exposure to ferucarbotran exacerbated neuroinflammation and disease severity of EAE, which might be attributed to the enhanced activation of microglia and T cells. These results demonstrated that the pro-inflammatory effect of ferucarbotran on the central nervous system is closely associated with the deterioration of autoimmunity. Keywords: experimental autoimmune encephalomyelitis, ferucarbotran, iron oxide nanoparticles, microglia, neuroinflammation, T cell, multiple sclerosis

Ching-Hui Huang,1–3,* Ya-Yun Lai,4,* Yu-Jui Kuo,4,5 Su-Ching Yang,6 Yu-Jun Chang,7 Kuo-Kuan Chang,8 Wen-Kang Chen4 1Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; 2Department of Beauty Science, Graduate Institute of Beauty Science Technology, Chienkuo Technology University, Changhua, Taiwan; 3School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Applied Cosmetology, National Tainan Junior College of Nursing, Tainan, Taiwan; 5Department of Traditional Chinese Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan; 6Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan; 7Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan; 8Department of Hepatogastroenterology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan *These authors contributed equally to this work Background: Liver cirrhosis is an uncommon but not rare side effect of amiodarone-induced hepatotoxicity. Patients with hepatitis B virus and hepatitis C virus infections are at a high risk for developing liver cirrhosis. However, the relationship between this treatment and risk of liver cirrhosis in high-risk chronic hepatitis B and chronic hepatitis C patients is unknown.Patients and methods: The present study identified amiodarone users (N=8,081) from the Taiwan National Health Insurance Research Database from 1997 through 2013. A total of 32,324 subjects with age, comorbidities, gender, and index date-matched non-amiodarone users were selected as controls (non-amiodarone cohort). The incidences of cumulative liver cirrhosis were compared between cohorts. Stratified Cox’s regression hazard models were used to assess possible comorbidity-attributable risks for liver cirrhosis.Results: The amiodarone cohort had a nonsignificant risk of liver cirrhosis compared with the non-amiodarone cohort, with a HR of 1.17 (95% CI: 0.93–1.47; P=0.1723). Patients with specific comorbid diseases, including type 2 diabetes mellitus, chronic hepatitis B, chronic hepatitis C, and heart failure, were probably at a high risk of developing liver cirrhosis. The use of statins was associated with a significant 42% reduction in the risk of liver cirrhosis.Conclusion: Patients in the amiodarone cohort had no excess risk of liver cirrhosis compared with patients in the non-amiodarone cohort. Long-term surveillance for liver toxicity in high-risk patients with amiodarone treatment is suggested. Keywords: amiodarone, liver cirrhosis, Taiwan, hepatitis

Chao-Chien Chang,1,2 Mei-Ling Chang,2 Chi-Hung Huang,2 Po-Ching Chou,2 Eng-Thiam Ong,2 Chih-Hui Chin2 1Department of Pharmacology, School of Medicine, Taipei Medical University, 2Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan Background: Carotid intima-media thickness (CIMT) and plaque formation have been used as surrogate end-points for evaluating the regression and/or progression of atherosclerotic cardiovascular disease, but their predictive value for stable coronary artery disease (CAD) is inconclusive. Methods: Carotid ultrasonography was performed in patients who underwent noninvasive multislice computed tomography (MSCT) angiography for CAD suspected, due to chest pain. CIMT and plaque formation on the left and right common carotid arteries (CCAs), carotid bulb (CB), and proximal internal carotid arteries (ICAs) were evaluated, and the relationship between angiographic CAD, CIMT, and plaque formation was determined. Results: 120 patients (95 male; 25 female), with a mean age ± standard deviation of 61 ± 11 years (range: 35–89 years) were recruited. Because age had a significant impact on CAD (r = 0.191; P = 0.036), CCA plaques (r = 0.368; P = 0.001), ICA plaques (r = 0.334; P = 0.004), and mean CIMT (r = 0.436; P = 0.001), patients were divided into two groups aged

Chia-Chu Chang,1,2 Hung-Hsiang Liou,1 Chia-Lin Wu,1 Chirn-Bin Chang,1,2 Yu-Jun Chang,3 Ping-Fang Chiu,1,2 Ching-Hui Huang41Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; 2School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 3Epidemiology and Biostatistics Center, 4Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, TaiwanBackground: The purpose of this study was to examine whether long-term use of anticoagulants in elderly patients with atrial fibrillation (AF) and chronic kidney disease (CKD) influences renal function.Methods: In this retrospective observational study, we reviewed the records of 2023 patients who attended our institution for treatment of CKD between January 2001 and September 2012. Inclusion criteria were having been under review for three months or more, age older than 60 years, permanent AF, a CHADS2 score > 2, and National Kidney Foundation Kidney Disease Outcomes Quality Initiative CKD stage 3–5. Sixty-one patients fulfilled these criteria, and were divided into those receiving antiplatelet anticoagulation (group A) and those receiving warfarin (group B). The results of laboratory investigations and estimated glomerular filtration rate (GFR) were recorded at months 3, 6, 12, and 18 from treatment initiation. We also recorded the occurrence of serious cardiovascular and neurological events, significant bleeding, and survival beyond 12 years.Results: Of the 61 patients enrolled, 35 were in group A and 26 were in group B. The mean international normalized ratio (INR) was 1.95 ± 1.01 (goal < 3.0). After adjustment for potential confounding variables, we found that patients in group B had a higher estimated GFR (6.06 ± 2.36 mL per minute, P = 0.01). Over a 12-year observation period, group B patients had significantly (P = 0.013) better survival than group A, with an adjusted hazard ratio for mortality of 0.318 (P = 0.022).Conclusion: Warfarin therapy may delay deterioration in renal function and improve survival of elderly patients with CKD and AF.Keywords: aged, atrial fibrillation, chronic kidney disease, vitamin K antagonists, warfarin

© Gallego Romero et al. Comparative genomics studies in primates are restricted due to our limited access to samples. In order to gain better insight into the genetic processes that underlie variation in complex phenotypes in primates, we must have access to faithful model systems for a wide range of cell types. To facilitate this, we generated a panel of 7 fully characterized chimpanzee induced pluripotent stem cell (iPSC) lines derived from healthy donors. To demonstrate the utility of comparative iPSC panels, we collected RNA-sequencing and DNA methylation data from the chimpanzee iPSCs and the corresponding fibroblast lines, as well as from 7 human iPSCs and their source lines, which encompass multiple populations and cell types. We observe much less withinspecies variation in iPSCs than in somatic cells, indicating the reprogramming process erases many inter-individual differences. The low within-species regulatory variation in iPSCs allowed us to identify many novel inter-species regulatory differences of small magnitude.

Objective To discuss the perioperative blood transfusion strategy of patients with hereditary coagulation factor deficiency through the perioperative blood coagulation management of a patient with coagulation factor Ⅺ deficiency and hemangioma of knee joint. Methods Coagulation factor activity test and gene test were used to confirm the patients with coagulation factor Ⅺ antecedent deficiency. Perioperative bleeding risk assessment, thromboela-stogram(TEG) and coagulation factors detection were performed to detect the coagulation status of the patients. 400 mL fresh frozen plasma was transfused before surgery and first day after surgery, 200 mL daily for 3 days thereafter. Results The level of APTT was controlled from 97.1 s before operation to 36.9 s after operation. There was no obvious bleeding during operation, and the wound healed well after operation. Conclusion In the situation of lack of commercial coagulation factors, transfusion of blood products such as fresh frozen plasma can significantly improve the coagulation function and reduce the risk of intraoperative bleeding in patients with hereditary coagulation factor deficiency during perioperative period.

ObjectivesNanofluid technology is an important means to improve the thermal conductivity of energy storage materials in solar thermal power plants. However, the nanoparticles in actual molten salt based nanofluid usually aggregate and settle down, which significantly affects the thermal performance of the composites. To gain a deeper insight into the variation of thermophysical properties of molten salt based nanofluids, the silica nanoparticles with different aggregation morphologies were constructed in solar salt.MethodsThe effects of system temperature, mass fraction of nanoparticles, and micromorphology of aggregates were investigated based on the molecular dynamics simulation and lattice Boltzmann method.ResultsIt is found that the inclusion of nanoparticles can effectively enhance the thermal conductivity of the base fluid. Compared with the uniformly dispersed nanofluid, the heat conduction performance of the aggregated nanofluid is better, and it decreases with the increase of fractal dimension of agglomerates. Moreover, the thermal conductivity of nanofluid is negatively correlated with temperature and aggregate size, and positively correlated with mass fraction of nanoparticles, backbone length of each aggregate and degree of agglomeration.ConclusionsThe research results reveal the mechanism of nanoparticle aggregation on the heat transport within phase change materials and provide critical reference on the design of thermophysical properties of molten salt based nanofluids.

Objective The research is specially carried out aiming to meet the operational requirements for interoperability between city railway CBTC (communication-based train control) and railway CTCS-2 (China train control system level 2) signaling systems. Method Based on the existing architectures of CBTC and CTCS-2 signaling systems, a fusion plan for these two is proposed. Two fusion plans are compared in terms of cost investment, impact scope, renovation difficulty, and applicable range. Ultimately, the fusion plan with on-board equipment that accommodates ground equipment of both signaling systems is chosen. The ground equipment design follows the principle of ′minimizing changes to CTCS equipment while adding or modifying CBTC equipment′, and the on-board equipment design follows the principle of ′keeping ATP (automatic train protection) core equipment independent while maximizing the reuse of peripheral components′. Under the premises of ensuring system operational efficiency and compliance with CTCS-2 standards, two conversion plans are proposed, ′train conversion from CTCS-2 line to CBTC line′ and ′train conversion from CBTC line to CTCS-2 line′, aiming to achieve bidirectional interoperability between city railway CBTC and CTCS-2 systems. Result & Conclusion The research results indicate that the implementation of the chosen plan can enhance city railway transportation efficiency, optimize transportation organization and management, improve the network functionality of rail transit, and promote coordinated development between central cities and surrounding areas.

Catfish bone collagen peptide-calcium (F3-Ca) chelatate, which had been prepared in our laboratory, was evaluated for its effect on calcium transport and absorption using a Caco-2 cell model. Its effect on the alkaline phosphatase (ALP) activity of osteoblast hFoB1.19 and the expression of the key genes and proteins involved in osteoblast differentiation was also investigated. The results indicated that the chelate increased calcium transport in Caco-2 cells to 0.31 mg/mL, and promoted the mineralization of osteoblasts. The chelate at a concentration of 100 μg/mL increased the ALP activity of osteoblasts by 53.68% compared with the control group. Reverse transcription-polymerase chain reaction (RT-PCR) and protein immunoblot analysis showed that F3-Ca chelate increased the gene and protein expression levels of osteoprotegerin (OPG), osteocalcin (OCN) and runt-related transcription factor 2 (Runx2) in osteoblasts, reduced those of receptor activator for nuclear factor-κB ligand (RANKL), and increase the ratio of OPG/RANKL, thus activating the OPG/RANKL/receptor activator for nuclear factor-κb (RANK) signaling pathway, promoting the proliferation, differentiation and mineralization of osteoblasts, and ultimately resulting in enhanced calcium absorption and anti-osteoporosis activity. This study provides a scientific basis for the high-value utilization of catfish bone and the development of new calcium supplements.

In recent years, studying dolomite diagenesis and controlling factors of reservoir development from microscopic perspective has become a hot subject in deep carbonate gas exploration. In this study, we have carried out a fine classification of different types of dolomite reservoirs in the Fei-3 Member of the Lower Triassic Feixianguan Formation in the Puguang area, and the distribution law and main controlling factors of dolomite reservoirs have been clarified. The results show that the dolomite reservoirs of the Fei-3 Member in the Puguang area include three rock types: residual structure dolomite, microbial dolomite, and crystalline dolomite, and the main reservoir space types are intergranular pores, solution pores/caves, and inter-crystalline pores, respectively, and the solution fractures are mainly developed in the residual structure and microbial dolomites. Most of the dolomite reservoirs are distributed in the Fei 31 sub-member, and the residual structure dolomite is mainly distributed in the relative paleomorphic highs of the Fei 31 sub-member; microbial dolomite is mainly developed in the platform environment with shallow water and intermittent exposure, and is controlled by the growth conditions of microorganisms; the crystalline dolomite is mostly distributed in the relatively shallow water and relatively limited dolomite flat environment. On the plane, the dolomite reservoirs are distributed in the form of clumps. The distribution of residual structure dolomite reservoir is controlled by paleotopography and early exposure corrosion. Microbial dolomite is formed in the microbial mat microfacies, and the distribution range of microbial mat controls the development of microbial dolomites. The diagenetic types of the dolomites in the target layer include dolomitization, dissolution, rupture, and material filling. Various kinds of pores formed by syngenetic dissolution provide channels for later buried dissolution, and organic acids formed by organic matter maturation under deep burial conditions play a crucial role in dissolution of dolomite and promote the formation of dissolution pores. In the burial stage, hydrocarbons enter the dolomite, which can effectively prevent the growth of late authigenic minerals, thus promoting the preservation of pores. The structural fracture system formed by late tectonic movement can communicate with different pore groups and improve the reservoir quality.

High-temperature superconducting (HTS) cables, with their prominent advantages of large capacity, low loss, current selflimit,and environment friendliness, are a new promising solution for addressing the challenges regarding urban power grid upgrades,large-capacity power applications, and efficient power transmission. Exploring the development of related industries has both basic research and engineering application values. This study analyzes the technical characteristics and application elements of HTS cables and summarizes the application scenarios of HTS cables, including super switch stations, high-current-dedicated lines, data center power supply, electrolytic aluminum and electrolytic water hydrogen production using new energy, centralized charging stations, urban rail transit, and large-capacity direct-current power grids. Moreover, this study summarizes the development and application progress of HTS cables from both international and domestic perspectives, comprehensively reviewing the key product development, key technology research, and engineering project implementation in China. Further exploration was conducted on future development challenges, including strengthening operation and maintenance technologies, overcoming large-scale refrigeration technologies, reducing overall project costs, coupling with traditional power grid facilities, and forming a profit sharing mechanism. Targeted development suggestions are also proposed. This study is expected to provide references for the high-quality development of HTS cables.

The low-carbon transformation of decommissioned offshore oil and gas platforms is an optimal model for intensive resource utilization and for fully exploiting the economic and ecological benefits of decommissioned platforms. It is also an important measure to maintain and enhance the carbon reduction capacity of the marine sector. However, the green and low-carbon development process in China’s marine sector is just beginning, and the low-carbon transformation of decommissioned offshore oil and gas platforms mostly remains at the conceptual stage, urgently requiring practical and feasible comprehensive transformation plans based on low-carbon technologies. This study completes a survey and analysis of the current status of the disposal of decommissioned oil and gas platforms in China and the level of low-carbon technologies. It proposes a main form of transformation for constructing an offshore carbon recycling hub and three low-carbon transformation routes, clarifying key engineering implementation strategies for platform transformation, including platform safety assessment, selection strategies for transformation plans, and full lifecycle environmental protection. In response to practical issues such as the lack of regulations and policies for platform transformation, shortcomings in the application of low-carbon technologies in the marine sector, and unclear cross-industry cooperation mechanisms, it is recommended to improve platform transformation regulations and guiding policies. It is also necessary to focus on the offshore application performance of core technical equipment, optimize theoretical support for technology, and accelerate the transformation of domestic equipment. Priority should be given to carrying out demonstration projects for the transformation of decommissioned platforms to promote the low-carbon transformation process of decommissioned offshore platforms in China.

Objective To analyze the clinical effect of modified interventions of integrated Traditional Chinese and western medicine in nursing of stroke patients. Methods A total of 78 stroke patients were randomly divided into the control group and observation group, with 39 cases in each group. All patients received routine nursing interventions in the rehabilitation training, and those in the observation group were given modified interventions of integrated Traditional Chinese and western medicine. The Activity of Daily Living (ADL) and Fugl-Meyer Assessment (FMA) scores were compared between two groups, and patients’ satisfaction with nursing service was evaluated by using self-made questionnaire. Results Scores of ADL and FMA were increased in both two groups after interventions, and Scores of ADL and FMA in the observation group were higher than those in the control group (P＜0. 05). The nursing satisfaction rate of the observation group was higher than that of the control group, with a significant difference (P＜0. 05). Conclusion Modified interventions of integrated Traditional Chinese and western medicine are effective to improve the rehabilitation of limb motor function after stroke, and improve the prognosis and quality of life of stroke patients. (目的 分析对中风患者实施中西医结合优化护理干预的效果。方法 选取医院神经内科2018年4月—2019年4月收治的中风患者78例为研究对象, 随机分为对照组和观察组, 各39例。对照组患者康复训练中运用常规护理模式, 观察组在对照组基础上增加中西医结合优化护理干预。对比两组患者的生活质量评分和肢体运动功能评分, 采用自制量表评价患者护理满意度。结果 干预后, 观察组患者生活活动能力量表(ADL)评分和Fugl-Meyer评定量评分高于对照组, 差异有统计学意义(P＜0. 05)。观察组护理满意度高于对照组, 差异有统计学意义(P＜0. 05)。结论 对中风患者实施中西医结合优化护理干预措施, 能够促进患者运动功能康复, 对改善预后和生活质量具有积极意义。)

Given the increasing number of aging population in china, the rehabilitation nursing for stroke patients has been becoming the focus of attention in china. The Traditional Chinese Medicine acupuncture is proved to be an effective treatment of stroke and its sequelae. This paper reviewed studies on acupuncture rehabilitation nursing interventions for stroke patients in perspectives of cephalic acupuncture, body acupuncture and its combination with modern rehabilitation technologies, and provided reference for post-stroke rehabilitation practice. (随着人口老龄化趋势加重, 脑卒中患者的康复护理成为社会关注的重点。针刺治疗脑卒中及后遗症效果明确。本研究就头针、体针以及头体针联合现代康复在脑卒中康复干预中的应用现状进行综述, 旨在为促进脑卒中患者的功能康复提供参考。)

Objective·To investigate the effects of the cancer-testis antigen 14 (CT14) on embryonic and larval development in nematodes by using the model organism Caenorhabditis elegans (C. elegans), aiming to uncover its potential functions and mechanisms during development.Methods·Transgenic C. elegans strains were constructed by using microinjection for the inducible expression of human CT14 (HsCT14), a truncated mutant of CT14 (HsCT14∆CIR) lacking CT14-specific intermediate region (CIR), and a green fluorescent protein (GFP) control. The impacts of full-length and truncated mutant CT14 on nematode embryonic and larval development were analyzed and compared. Additionally, transgenic C. elegans strains with inducible expression of CT14 from various primates, including the crab-eating macaque (Macaca fascicularis) and mouse lemur (Microcebus murinus), were also constructed to assess the effects on egg hatching and larval-to-adult transformation rates. The differential gene expression in nematode embryos induced by CT14 was analyzed by Smart-seq transcriptome sequencing, with further insights gained through KEGG (Kyoto Encyclopedia of Genes and Genomes) and GSEA (Gene Set Enrichment Analysis), to explore the involved biological processes and pathways.Results·The induced expression of HsCT14 and its truncated mutant HsCT14∆CIR significantly reduced the hatching rate of nematode eggs, with a more pronounced effect observed in HsCT14-expressing strains. Differential interference contrast (DIC) microscopy imaging revealed significant morphological abnormalities in embryos expressing HsCT14 during the comma stage. Nematodes expressing HsCT14 or HsCT14∆CIR exhibited developmental arrest in larvae and substantially lower larval-to-adult transformation rates compared to the GFP control. The impact was more pronounced in nematodes expressing HsCT14 than those with HsCT14∆CIR. The expression of Macaca fascicularis CT14 (MfCT14) exhibited significant effects on the hatching rate and adult transformation rate, similar to that of HsCT14, while the expression of Microcebus murinus CT14 (MmCT14) displayed significantly reduced impact compared to HsCT14 and MfCT14. Smart-seq results indicated that CT14 expression affected various biological processes in nematode embryos, related to ATP-dependent chromatin remodeling and DNA replication.Conclusion·Ectopic expression of the cancer-testis antigen CT14 significantly disrupts both embryonic and larval developments in C. elegans, with the CIR sequence substantially enhancing this effect. It suggests that CT14 may play an important regulatory role in biological development by affecting gene expression in multiple pathways, including chromatin remodeling.

The current methods for identifying network traffic are generally designed and tested for specific network environments or datasets, making it difficult to generalize and apply to complex and ever-changing actual network environments. A robust traffic recognition algorithm based on graph neural networks was proposed for achieving accurate traffic recognition in practical network scenarios. Firstly, in response to the current algorithm’s neglect of network environment fluctuations and the decrease in accuracy caused by pattern changes, network flows were clustered and filtered by selecting high-level protocol features to reduce the impact of network bandwidth fluctuations on website access traffic behavior. Secondly, due to the fact that most current algorithms only perform single stream recognition and ignore the interrelationships between flows, the various types of feature information and their correlations of network flows were considered, and spatiotemporal correlation features between network flows were extracted through graph neural networks to fully learn network traffic characteristics. By complementing multiple flows and features, the robustness of the algorithm was improved. Finally, a Transformer model that could capture global data information was used as a classifier to analyze the multi type features of network data flow, achieving robust network traffic recognition. Approximately 1 500 and 1 400 visits to 21 target websites in different network environments were collected as datasets for training and testing, achieving an accuracy of 90.7%. Compared with the latest ProGraph algorithm, the accuracy is improved by 7.3%, and the experimental results verify the effectiveness of the proposed method.

The security challenges confronting the space-ground integrated network in 6G era were mainly disscussed, and an innovative scheme based on quantum security was proposed. Firstly, the developmental backdrop and evolving trends of the integrated network’s architecture were outlined, highlighting the distinct features and application contexts of both the transparent forwarding and on-board regeneration frameworks. Secondly, the security challenges faced by the space-ground integrated network were analyzed, especially the risks of data transmission security and access authentication. In response to these challenges, the innovative solutions were proposed to ensure the security of the space-ground integrated network based on quantum technology. By leveraging the unconditional security of quantum communication and the advantages of post-quantum cryptographic algorithms, end-to-end secure communication protection for the space-ground integrated network was provided. Finally, the feasibility of using quantum technology was verified to ensure the security of the space-ground integrated network.

ObjectiveTo understand the mortality trends among residents of Fuling District， Chongqing， before and after the COVID-19 outbreak， and to provide references for the government to formulate disease prevention and control policies and measures.MethodsData on mortality and population in Fuling District from 2017 to 2022 were collected to analyze population mortality and standardized mortality rates， and to compare the changes in the causes of death by year and before and after the pandemic.ResultsFrom 2017 to 2022， the crude mortality rate in Fuling District showed an upward trend （APC=3.04%， P

Objective: The use of the transcatheter aortic valve in low-risk patients might lead to a second intervention due to the deterioration of the first 1. Understanding the implantation height is key to an effective redo transcatheter aortic valve replacement treatment. Methods: The effects of implantation height on the performance of a balloon-expandable valve within a self-expandable valve were assessed using hemodynamic testing and particle image velocimetry. The hemodynamic performances, leaflet kinematics, and turbulent shear stresses were measured and compared. Results: When a second balloon-expandable valve was positioned at varying heights relative to the first self-expandable valve, the leaflet motion of the first valve transitioned from free opening and closing to overhanging, and eventually to being entirely pinned to the stent, forming a neo-skirt. When the leaflets of the self-expandable valve could move freely, a decrease in regurgitation fraction was observed, but with an increased pressure gradient across the valve. Flow visualization indicated that the overhanging leaflets disrupted the flow, generating a higher level of turbulence. Conclusions: This study suggests that the overhanging leaflets should be avoided, whereas the other 2 scenarios should be carefully evaluated based on an individual patient's anatomy and the cause of failure of the first valve.

This commentary abridges three closely related aspects of scholarly publishing, copyright transfer to publishers in the subscription-based model, posting of author-accepted versions to preprint servers, and publishing embargoes, to appreciate how each might impact the dissemination of information. We found no direct evidence showing that either copyright transfer or the posting of early (i.e., author-submitted or journal-accepted) versions of works to preprint servers stifle academics’ ability to share their papers openly. However, some key structural issues and incompatibilities in policies may dampen the wider adoption of preprints despite their widely promoted advantages for scientists. We found a 6- to 36-month embargo period in place by 10 of the world’s top largest publishers, depending on the version of the record. These embargoes may constrain the dissemination of knowledge.

Investigar el papel del IMC, las moléculas del perfil lipídico en suero y los cocientes lipoproteicos en los pólipos colorrectales.

With the rapid development and wide application of visible (VIS) and infrared (IR) detections, it is necessary to explore visible-infrared (VIS-IR) compatible camouflage. Here, we report a VIS-IR compatible and independent camouflage device which is composed of the upper IR-transparent VIS-color-patterned layer and the lower electrochromic IR layer. The upper layer has amorphous photonic structure of polystyrene nanospheres (PSNSs). By customizing the PSNS size, various colors can be realized for VIS camouflage. The lower electrochromic IR layer takes advantage of multiwall carbon nanotubes (MWCNTs) as the electrode as well as the IR active material. Experimental results reveal that different colors (including blue, green, and purple) have been obtained, and the IR emissivity can be electrically regulated from 0.43 to 0.9. Moreover, the prototype also exhibits good electrical stability as well as hydrophobic characteristic (the water contact angle of the outmost surface exceeds 120°). These output performances demonstrate the success of our design strategy for promoting the finding applied in camouflage fields as well as energy conservation fields.

Here we have shown the novel biosynthesis of silver nanoparticles (Ag NPs) encapsulated by chitosan polymers in the presence of Achillea millefolium aqueous extract (Ag NPs@CHI). The Ag ions were first embedded over the chitosan surface enriched with polar organofunctions like amines (NH2) and hydroxyls, and subsequently the ions were reduced green-metrically by the electron rich phytochemicals of the plant extract. After the synthesis numerous techniques, including the UV-vis spectrum, transmission electron microscopy, FE-SEM, EDS-elemental mapping, and ICP-AES, were used to study the physicochemical characteristics of the nanocomposite biomaterial. Next, we explored the material biologically in the anti-cutaneous squamous cell carcinoma effects against the corresponding cell lines like PM1, MET1, MET 4, SCC T9, SCC IC1MET, SCC IC19, SCC T8, and SCC T11. The related IC50 values of the nanocomposite against them were 182, 158, 177, 178, 177, 99, 62, and 183 µg/mL, respectively. The cytotoxicity in terms of percentage cell viability of cancer cells were decreased with the increase in the nanocomposite doses.

BackgroundDue to the high heterogeneity of schizophrenia, the factors influencing social cognitive impairment are controversial. The purpose of this study was to investigate the social cognitive dysfunction of deficit schizophrenia (DS), and to explore its clinical impact on the clinical characteristics and neurocognitive function assessment results.MethodsThis study involved 100 DS patients, 100 non-deficit schizophrenia (NDS) patients, and 100 healthy controls (HC). Social cognitive functions were assessed using the Eye Complex Emotion Discrimination Task (ECEDT), Game of Dice Task (GDT), and Iowa Gambling Task (IGT), while neurocognitive functions were examined using the Clock Drawing Task (CDT), the Verbal Fluency Task (VFT), Digit Span Test (DST), Stroop Color-word Test (SCWT), and Trail Making Test (TMT). We analyzed the differences in cognitive function among the three groups of patients and the correlation between cognitive function assessment results and Positive and Negative Syndrome Scale (PANSS) scores.ResultsComparison of neurocognitive functions among the three groups through CDT, VFT, DST, SCWT, and TMT revealed that in the values of these tests in the DS group differed significantly from those of the NDS and HC groups. However, the DSB of the NDS group was lower and the TMT results were significantly higher than those of the HC group. In the DS group, ECEDT emotion recognition was positively correlated with stroop colors and stroop interference; the score of gender recognition was positively correlated with VFT, DSF, and SCWT, and TMT-B; the total time spent was positively correlated with TMT; The GDT risky option was negatively correlated with VFT, DST, stroop word, and stroop interference; the negative feedback utilization was negatively correlated with PANSS-Negative; TMT was positively correlated with VFT; IGT was positively correlated with CDT, VFT, DST, and SCWT, but it was negatively correlated with PANSS-Negative and TMT, with statistically significant.ConclusionThere are significant social cognitive impairments in the perception of social information, judgment and resolution of social problems in deficit schizophrenia, which are closely related to negative symptoms and multidimensional neurocognitive dysfunction such as attention, learning, memory, brain information processing speed, cognitive flexibility, and functional executive power.

Objective To investigate the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and risk stratification indicators as well as thrombus burden in patients with moderate-to-high risk acute pulmonary embolism (APE), and to assess the changes in these parameters following interventional therapy. Methods This study retrospectively included patients with moderate-to-high risk APE who were admitted to the Department of Interventional Vascular Surgery at Putian First Hospital from May 2020 to May 2024. All patients received anticoagulation therapy, pulmonary artery catheter-directed thrombolysis, and/or mechanical thrombectomy. Patients were further divided into subgroup A if they did not present with any of the following conditions at admission: a) acute inflammatory diseases (including lung infections); b) malignant tumors; c) history of trauma or surgery within the past 2 months. Patients with any of the aforementioned conditions were classified as subgroup B. Additionally, 50 healthy individuals were randomly selected as the healthy control group. Results The NLR and PLR in subgroup A were significantly lower than those in subgroup B ( P .05), or between the N-terminal pro-B-type natriuretic peptide (NT-proBNP)-negative and NT-proBNP-positive groups ( P > .05). There were no significant correlations between NLR and PLR with risk stratification indicators and pulmonary artery embolism index ( P > .05). Compared with before treatment, NLR, troponin I, NT-proBNP, right ventricular diameter/left ventricular diameter ratio, and pulmonary artery embolism index were significantly reduced after treatment ( P .05). Conclusion Elevated NLR in patients with APE, which decreases after effective treatment, may be used for assessing disease status and treatment efficacy. However, there is no correlation between NLR and risk stratification indicators or thrombus burden. PLR does not demonstrate significant value in assessing APE.

In the steel industry, improving the hot charging and heat delivery ratio in the continuous casting of slabs and thick slabs can effectively reduce carbon emissions, lower energy consumption, and improve production efficiency. However, this puts very strict requirements on the surface quality of continuous-casting slab. Flame scarfing (or cleaning) technology is currently an important process in the metallurgy field, which can effectively remove impurities and crack defects on the surface and corners of continuous casting slab to ensure the quality and performance of the final product. Under the action of cleaning flame and iron oxide reaction heat, a cleaning molten pool is formed in the corner of the casting slab, and the shape and depth of the molten pool have an important influence on the cleaning effect. A three-dimensional mathematical model is developed to study the effect of slab cleaning speed and oxygen flow rate on the shape of the molten pool in the corners for the corner flame cleaning process. Simultaneously, a two-phase flow volume of fluid (VOF) model for gas-slag interactions is employed to examine the motion behavior of the molten slag. The results showed that when the operating conditions changed, the cleaning speed increased by 1 m/min, the length of the wide and narrow sides decreased by approximately 9.2 mm, and the depth of the corner pool decreased by approximately 5.3 mm. Moreover, a slag-blocking device was designed to mitigate the issue of slag splashing effectively based on the numerical simulation results compared with and without the slag-blocking device. These study works provide beneficial theoretical support and practical guidance for refining and optimizing flame-cleaning techniques.

IntroductionEsophagectomy patients who experience unplanned ICU admission (UIA) may experience a heavier economic burden and worse clinical outcomes than those who experience routine intensive care unit (ICU) admission. The aim of this study was to identify the risk factors for postoperative UIA in patients who underwent esophagectomy.MethodsWe retrospectively included patients with esophageal cancer who underwent esophagectomy. The characteristics of postoperative UIA were described, and univariable and multivariable analyses were performed based on the logistic regression model. Furthermore, a recursive partitioning analysis was adopted to stratify the patients according to the risk of UIA.ResultsA total of 628 patients were included in our final analysis, among whom 57 (9.1%) had an UIA. The patients in the UIA cohort had a higher rate of in-hospital mortality (P

ABSTRACT Banana stalk production for fiber is an important crop activity in southern China. The fiber extraction technology used has a great impact on the effectiveness and quality of the fiber from banana stalks. A mechanical model of the process for banana stalk fiber extraction was developed through theoretical analysis. The existing problems of machines for banana stalk fiber extraction include high rates of fiber impurity and damaged fibers. A 3-factor 3-horizon orthogonal rotation combination test was established. The rates of fiber impurity and damaged fibers were the evaluation indices. The significant order of the factors determining the rate of fiber impurity, from largest to smallest, was the gap between the scraper and the holding plate, the number of scrapers, and the rotational speed of the scraping knives roller. The significant order of factors for the rate of damaged fiber was the gap between the scraper, the rotational speed of the scraping knives roller, and the number of scrapers. The optimized banana straw fiber extraction machine was tested in the field. The results show that the development of this model can provide valuable experience and references for understanding and improving other similar agricultural machinery and equipment.

As rate-limiting enzymes of peroxisomal β-oxidation, acyl-coenzyme A oxidase (ACOXs) play vital roles in maintaining energy homeostasis and regulating reactive oxygen species (ROS) metabolism. However, there are no studies on the functions of ACOXs in crustaceans. In the present study, four full-length cDNA sequences of acoxs, namely the acox-1a (2403 bp), acox-1b (2733 bp), acox-3a (2878 bp) and acox-3b (3445 bp), were successfully isolated from mud crab Scylla paramamosain, which encoded 666, 673, 701 and 658 amino acids, respectively. Sequence analysis showed that the ACOX-1a, ACOX-1b and ACOX-3a possessed conserved structural domains like FAD-binding motif, fatty acyl CoA oxidase domain and peroxisomal targeting signal, while the ACOX-3b lacked peroxisomal targeting signal. Results of phylogenetic tree indicated that the four ACOXs of mud crab grouped gathered with their corresponding orthologues from crustaceans. The acox-1a, acox-3a and acox-3b were highly expressed in hepatopancreas, and the acox-1b was mainly distributed in muscle and hepatopancreas. Compared with feeding groups, the expression levels of acox-1a, acox-3a and acox-3b in hepatopancreas and acox-3a in muscle were markedly up-regulated in fasting groups, suggesting that the acoxs had significant effects in modulating energy balance during fasting. In addition, fasting significantly increased the transcriptional levels of nuclear factor erythroid 2-related factor (nrf2) and its downstream antioxidant genes (catalase (cat), glutathione peroxidase (gpx) and glutathione S-transferase (gst)) to improve antioxidant capacity for removing excessive ROS produced by ACOX-mediated peroxisomal β-oxidation. These results would be conducive to providing new insights into evolutionary characteristics and functions of acoxs in crustaceans.

【Objective】 Xinjiang in northwestern China is scarce in freshwater and commonly uses drip irrigation in its agricultural production. In this paper we study the effect of irrigation amount on growth, yield and water use efficiency (WUE) of spring wheat in the north of Xinjiang. 【Method】 The experiment was conducted in a field with the No. 6 variety used as the model plant. During its growth period, the crop was irrigated six times with irrigation amount in each time being 30, 37.5, 45, 52.5, 60, 67.5 mm, respectively. In each irrigation treatment, we measured the growth, yield and WUE of the spring wheat. 【Result】 Plant height increased with irrigation amount until the irrigation amount was 45 mm, after which a further increase in irrigation amount did not have a significant effect on plant height (P>0.05). The leaf area index (LAI) and the above-ground dry matter accumulation both increased with irrigation amount, but started to decline when irrigation amount exceeded 52.5 mm. The water consumption of the crop increased with irrigation amount, peaking when irrigation amount was 67.5 mm. The effective spike numbers, grain numbers per spike, 1000-grain weight, yield and WUE of the crop increased first and then declined as the irrigation amount increased. Among all treatments we compared, irrigating 52.5 mm of water in each of the six irrigations gave the highest yield and WUE, reaching 7 233.2 kg/hm2 and 15.23 kg/(hm2·mm), respectively (P