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Background Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy. However, the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010. Aim To retrospectively analyze the factors related to failed trial of labor and the clinical indications for cesarean section conversion, explore how to promote the trial of labor success rate, and determine the feasibility of reducing the rate of conversion to cesarean section. Methods A retrospective analysis was performed on 9240 maternal women who met vaginal delivery conditions and required a trial of labor from January 2016 to December 2018 at our hospital. Among them, 8164 pregnant women who had a successful trial of labor were used as a control group, and 1076 pregnant women who had a failed trial of labor and converted to an emergency cesarean section were used as an observation group. The patients' clinical data during hospitalization were collected for comparative analysis, the related factors of the failed trial of labor were discussed, and reasonable prevention and resolution strategies were proposed to increase the success rate of trial of labor. Results The analysis revealed that advanced age (≥ 35 years old), macrosomia (≥ 4000 g), delayed pregnancy (≥ 41 wk), use of uterine contraction drugs, primipara, and fever during labor were associated with conversion to an emergency cesarean section in the failed trial of labor. Multivariate regression analysis showed that age, gestational age, primipara, use of uterine contraction drugs, fever during birth, and newborn weight led to a higher probability of conversion to an emergency cesarean section in the failed trial of labor. The analysis indicated that the following clinical indications were associated with the conversion to cesarean section in the failed trial of labor: Fetal distress (44.3%), social factors (12.8%), malpresentation (face presentation, persistent occipitoposterior position, and persistent occipitotransverse position) (9.4%), and cephalopelvic disproportion (8.9%). Conclusion The conversion to emergency cesarean section in failed trial of labor is affected by many factors. Medical staff should take appropriate preventive measures for the main factors, increase the trial of labor success rate, improve the quality of delivery, ensure the safety of mother and child during the perinatal period, and improve the relationship between doctors and patients.

Zeng-Bing Liu,1 Qiang Li,1 Wen-Xia Liu,1 Xin-Hai Li,1 Kai Ma,1 Yu-Bao Huo,1 Jin-Guang Wang,1 Qing-He Wang,1 Ya-Dong Yu2 1Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China; 2Department of Hand Surgeries, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Zeng-Bing Liu, Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, No. 485 of Xinhua West Road, Taocheng District, Hengshui, 053000, People’s Republic of China, Tel +86 318 2173010, Email drliuzbhfs@outlook.comObjective: The present study aims to explore the (1) clinical effects of the modified Masquelet technique, whose improved Masquelet technique innovates the in vitro plasticity of the bone cement module and prefabricated hollow design, and the Kirschner wire external fixation-assisted autologous bone transplantation technique in the treatment of segmental metacarpophalangeal bone defects and (2) the differences between the two techniques.Methods: The clinical data of 32 patients with segmental metacarpophalangeal bone defects (15 patients treated with the modified Masquelet technique and 17 patients treated with the self-made Kirschner wire external fixation technique) admitted to our department between January 2012 and January 2020 were retrospectively analyzed. The postoperative bone healing time, hand function, and complications were compared between the two groups.Results: The two groups were comparable; there were no significant differences in age, sex, length of bone defect, and time from injury to operation between the two groups (P > 0.05). All patients were followed up with for 6– 24 months (average = 13.7 months), and all patients with segmental metacarpophalangeal bone defects achieved fracture healing. The postoperative hospital stay, fracture healing time, functionary scores of the affected limb, and incidence of severe complications were better in the modified group than in the external fixation group (P < 0.05).Conclusion: Compared with the Kirschner wire external fixation stent assisted autologous bone transplantation, the improved Masquelet technique has the advantages of simple operation, fast healing, accurate effect, wide indications, and less complications, making it more worthy of clinical promotion.Keywords: segmental metacarpophalangeal bone defect, modified, Masquelet technique, curative effect

Patient: Male, 65-year-old Final Diagnosis: Esophageal scab Symptoms: Choking • esophageal foreign body Medication:— Clinical Procedure: — Specialty: Molecular Biology • Gastroenterology and Hepatology • Pathology Objective: Unknown ethiology Background: Parasitic helminths in the esophagus are rare. Here, we report a case of esophageal scab mimicking a parasite. Case Report: A 65-year-old man was admitted to our hospital because after choking on food. Gastroscopy showed 2 foreign bodies adherent to the esophagus wall 28 and 34 cm from the incisor, which appeared to be a fluke. Two fluke-like foreign bodies (1.5 and 1.8 cm in length) were removed from the esophageal ulcer with forceps. After fixation with alcohol, the suspected fluke-like foreign bodies were noted to be brown and woody. Under a light microscope, the structure of the foreign body was not apparent, and no typical flatworm tegument structure was demonstrated on pathologic sections, but it had a blood clot-like structure. Administration of albendazole did not expel any helminths. A stool examination showed no eggs of the putative flukes. The genomic DNA of the suspected flukes was extracted and a 700 bp fragment was amplified by universal barcoding primers. The sequencing showed that the homology with human cytochrome c oxidase subunit I gene was 98.8%. Conclusions: The scab formed by the esophageal ulcer was identified based on clinical manifestations, anti-helminth and stool examinations, parasite morphology, and molecular biology. Our experience with this case suggests that the universal barcoding technique can be used for identification of foreign bodies suspected to be parasites.

To evaluate the effect of L-carnitine (LC) on low sperm acrosin activity in infertile man.A total of 240 male infertility patients with low sperm acrosin activity were randomly assigned to an LC group (n = 180) and a control group (n = 60) to be treated with LC (1g, tid) and vitamin E (VE) capsules (100 mg, tid) respectively, both for 3 months. Based on the results of routine semen analysis, the patients in the experimental group were further divided into oligozoospermia, asthenozoospermia and normozoospermia subgroups. Semen parameters and sperm acrosin activity were examined before and after treatment.Totally, 220 of the patients completed the treatment and follow-up, 163 in the LC medication and 57 in the VE control group. Compared with the baseline, the percentage of progressively motile sperm (PMS) was significantly increased in the LC group after 3 months of treatment (［32.58 ± 1.13］% vs ［36.35 ± 1.26］%, P0.05), and so was sperm acrosin activity (［37.05±0.66］ vs ［58.61±1.93］ μIU/106 sperm, P0.01). Sperm concentration, PMS and sperm acrosin activity were also improved in the VE control group after treatment, but with no statistically significant difference (P0.05). In comparison with pretreatment, remarkable increases were observed after LC medication in sperm concentration in the oligozoospermia subgroup (［11.27 ± 0.73］ vs ［21.82 ± 4.21］ ×10⁶/ml, P0.01) and PMS in the asthenozoospermia patients (［20.61 ± 0.85］% vs ［29.81 ± 1.88］%, P0.01). And sperm acrosin activity was even higher after treatment in the asthenozoospermia than in the oligozoospermia and normozoospermia subgroups (［60.85 ± 3.04］ vs ［56.32 ± 2.86］ and ［57.09 ± 6.31］ μIU/106 sperm, P0.05).L-carnitine can effectively elevate sperm acrosin activity in male infertility patients, particularly in those with asthenozoospermia.

The precipitation behavior of V-N microalloyed steel during normalizing process was studied by physicochemical phase analysis and transmission electron microscopy (TEM). The effect of precipitation behavior on mechanical properties was investigated by theoretical calculations. The results showed that 32.9% of V(C,N) precipitates remained undissolved in the austenite during the soaking step of the normalizing process. These precipitates prevented the growth of the austenite grains. During the subsequent cooling process, the dissolved V(C,N) re-precipitated and played a role in precipitation strengthening. The undissolved V(C,N) induced intragranular ferrite nucleation and refined the ferrite grains. Consequently, compared with hot-rolled steel, the normalized steel exhibited increased grain-refining strengthening but diminished precipitation strengthening, leading to an improvement of the impact energy at the expense of about 40 MPa yield strength.

This research is intended to provide academic reference and design guidance for further studies to determine the most effective means to reduce a ship’s resistance through an air-cavity. On the basis of potential theory and on the assumption of an ideal and irrotational fluid, this paper drives a method for calculating air cavity formation using slender ship theory then points out the parameters directly related to the formation of air cavities and their interrelationships. Simulations showed that the formation of an air cavity is affected by cavitation number, velocity, groove geometry and groove size. When the ship’s velocity and groove structure are given, the cavitation number must be within range to form a steady air cavity. The interface between air and water forms a wave shape and could be adjusted by an air injection system.

In the ultraviolet missile approach warning signal processing, strong noise and burst interference will affect the test missile target, but the classic two-dimensional filtering algorithm cannot effectively filter out the interference, because the strong noise and burst interference and spatial location spatial frequency position is uncertain. This paper presents a three-dimensional image sequences filtering algorithm, the two-dimensional and one-dimensional spatial filter IIR filter composed of the time, the two filters are stable. This article also gives the stability detection algorithm. An advantage of three-dimensional recursive filter is a small amount of computation, and can achieve rapid real-time image sequences filtering. Ultraviolet missile approach warning signal processing simulation results show that three-dimensional filtering and related algorithms presented in this paper are correct, efficient and practical.

Human carboxylesterases 1 (hCE1), one of the most important human drug metabolizing enzymes, catalyzes the hydrolysis of a large number of structurally diverse of endogenous and exogenous substrates. However, a practical, reliable and sensitive method for the precise measurement of hCE1 activities in complex biological samples has been rarely reported. In this study, a liquid chromatography-fluorescence detection (LC-FD) based method was developed for highly selective and sensitive measurement of hCE1 activities in human tissue and cell preparations. This method was based on the fluorimetric detection of HMBT, the hydrolyzed product of BMBT which was a newly developed specific probe substrate for hCE1. The developed LC-FD method was fully validated in terms of specificity, sensitivity, linearity, precision, recovery and stability. With the help of LC separation, most polar endogenous compounds in biological samples could be eluted in the column dead time, which is very beneficial for accurate determination of hCE1 activities in complex biological samples. The lower limit of quantification for HMBT (product of hCE1) of this LC-FD based method was as low as 20nM, which was quite lower than other reported methods. The method also exhibited good precision, both intra- and inter- assay variances were both lower than 2.5%. Furthermore, the newly developed method was successfully applied to measure hCE1 activity in human liver preparations from individual donors (n=12), as well as in homogenates from eleven different human cell lines. All these findings combined with this practical method are very helpful for the deep understanding of the expression and function of hCE1 in human biological samples.

Combination therapy has prolonged the survival of patients with small cell lung cancer (SCLC), an aggressive neoplasm characterized by a high rate of metastasis. In the present study the effect of sequential treatment of ursolic acid chlorophenyl triazole (UACT) followed by 5-fluorouracil (5-FU) on human small cell lung cancer cells was investigated. The results revealed a synergistic effect of the sequential treatment with UACT and 5-FUcombination on cytotoxic activities, NF- k B protein activation, repression of TNF-induced NF- k B-dependent reporter gene expression, and TNF-induced COX-2, MMP-9 and Cyclin D1 activation in H209 cells. The synergism in apoptotic cell death was observed in H209, H69, 87-5,and Lu135 cells. The synergistic effect of UACT and 5-FU was observed at a concentration of 50 nM of UACT and 20 µM of 5-FU. These results indicate that UACT and 5-FU combination can be a promising chemotherapeutic regimen in the treatment of SCLC.

AIM: To evaluate the association of β-2 adrenergic receptor (β2-AR) gene polymorphism with response of variceal pressure to propranolol in cirrhosis. METHODS: Sixty-four non-related cirrhotic patients participated in this study and accepted variceal pressure measurement before and after propranolol administration. Polymorphism of the β2-AR gene was determined by directly sequencing of the polymerase chain reaction products from the DNA samples that were prepared from the patients. RESULTS: The prevalence of Gly16-Glu/Gln27 and Arg16-Gln27 homozygotes, and compound heterozygotes was 29.7%, 10.9%, and 59.4%, respectively. Patients with cirrhosis with Gly16-Glu/Gln27 homozygotes had a greater decrease of variceal pressure after propranolol administration than those with Arg16-Gln27 homozygotes or with compound heterozygotes (22.4% ± 2.1%, 13.1% ± 2.7% and 12.5% ± 3.1%, respectively, P < 0.01). CONCLUSION: The variceal pressure response to propranolol was associated with polymorphism of β2-AR gene. Patients with the Gly16-Glu/Gln27 homozygotes probably benefit from propranolol therapy.

AIM: To explore the effect of intravariceal-mucosal sclerotherapy using small dose of sclerosant on the recurrence of esophageal varices. METHODS: We randomly assigned 38 cirrhotic patients with previous variceal bleeding and high variceal pressure (> 15.2 mmHg) to receive endoscopic variceal ligation (EVL) and combined intravariceal and esophageal mucosal sclerotherapy (combined group) using small-volume sclerosant. The end-points of the study were rebleeding and recurrence of esophageal varices. RESULTS: During a median follow-up period of 16 mo, varices recurred in 1 patient in the combined group as compared with 7 patients in the EVL group (P = 0.045). Rebleeding occurred in 3 patients in the EVL group as compared with 1 patient in the combined group (P = 0.687). No patient died in the two groups. No significant differences were observed between the two groups with respect to serious adverse events. CONCLUSION: Intravariceal-mucosal sclerotherapy using small dose of sclerosant is more effective than EVL in decreasing the incidence of variceal recurrence for cirrhotic patients.

Prions are associated with neurodegenerative diseases induced by transmissible spongiform encephalopathies. The infectious scrapie form is referred to as PrP Sc , which has conformational change from normal prion with predominant α-helical conformation to the abnormal PrP Sc that is rich in β-sheet content. Neurodegenerative diseases have been found from both human and bovine sources, but there are no reports about infected by transmissible spongiform encephalopathies from rabbit, canine and horse sources. Here we used coarse-grained Gō model to compare the difference among human, bovine, rabbit, canine, and horse normal (cellular) prion proteins. The denatured state of normal prion has relation with the conversion from normal to abnormal prion protein, so we used all-atom Gō model to investigate the folding pathway and energy landscape for human prion protein. Through using coarse-grained Gō model, the cooperativity of the five prion proteins was characterized in terms of calorimetric criterion, sigmoidal transition, and free-energy profile. The rabbit and horse prion proteins have higher folding free-energy barrier and cooperativity, and canine prion protein has slightly higher folding free-energy barrier comparing with human and bovine prion proteins. The results from all-atom Gō model confirmed the validity of C α-Gō model. The correlations of our results with previous experimental and theoretical researches were discussed.