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Purpose To investigate meibomian gland (MG) alteration in patients with systemic lupus erythematosus (SLE). Methods This study included 23 SLE patients evaluated with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and 21 healthy controls (HCs). All the subjects were evaluated with Ocular Surface Disease Index (OSDI) questionnaire, and the eyes were performed examinations of tear meniscus height (TMH), non-invasive keratographic tear film break-up time (NIKBUT), Schirmer I Test, MG eyelid score, meibography score, and in vivo confocal microscopy (IVCM) on the meibomian gland. Results There was no significant difference between the SLE patients and the HCs in the TMH, NIKBUT, and Schirmer I Test. However, the SLE patients had higher MG eyelid scores and meibography scores on both upper eyelid and lower eyelid than the HCs. Through meibography observation, 34.8% of the SLE patients presented MG deficiency in Grade 3, whereas that of all the HCs were less than Grade 3. The SLE patients were found to have significant MG atrophy and vascular enrichment around the meibomian glands (MGs). The SLE patients were also found to have excessive inflammatory cell infiltration around the MGs, especially the typical lymph node-like foci of inflammatory cell infiltration. Conclusions MG alteration can be found in the SLE patients. Examinations of the MGs can help diagnose or infer ocular diseases at an early stage of SLE.

In this account, pectin components were obtained from akebia trifoliate koiaz peels with the acid extraction technology. The chemical constituent of the akebia trifoliate koiaz peels extract (ATKPE) was analyzed and its anti-corrosion performance for mild steel in HCl medium was investigated by electrochemical methods, surface analysis and theoretical calculations. Experimental results show that ATKPE exhibits excellent corrosion inhibition characteristic, and its inhibition efficiency can be as high as 90% when the concentration of ATKPE is 800 mg/L. Electrochemical measurements show that ATKPE is a mixed-type corrosion inhibitor consisting with Langmuir adsorption model. In addition, SEM, AFM and contact angle observations suggests that the ATKPE may attach firmly to the metal surface by forming a barrier film. XPS and ATR-FTIR results further verify the bonding interaction between the functional groups and steel substrate. Meanwhile, quantum chemical calculations and molecular dynamics (MD) simulations were performed to reveal the inhibition mechanism at molecular/atomic level. In brief, our findings demonstrate a novel environmentally benign, efficient corrosion inhibitor for steel protection in acidic media.

Background Posterolateral tibial plateau fractures (PTPF) remain a challenge for orthopedics surgeons because the special anatomical structures of the posterolateral corner of knee joint including the fibular head, the lateral collateral ligament, and the peroneal nerve, which impedes the exposure of the fracture fragments and need irregular implants to get a stable fixation. The purpose of present study was to introduce a new articular fracture fragments restoration technique for three patterns of PTPF and investigate the relationship between associated soft injuries and fracture patterns. Methods From May 2016 to April 2018, 31 patients with PTPF who had undertaken arthroscopically assisted reduction and fixation (AARF) were enrolled in present study. Demographic data, pre-operation, and post-operation X plan films, three-dimensional computed tomography (CT) scans and magnetic resonance imaging (MRI) were reviewed. Present samples were divided into three patterns with lateral inclination (LI), posterior inclination (PI), and parallel compression (PC) according to the orientation of the articular fragment inclination. Rasmussen anatomical score was used to assess the radiological results. Rasmussen functional score, Hospital for Special Surgery knee-rating Score (HSS), and range of motion (ROM) of the knee joint at the final follow-up were measured to evaluate the clinical outcomes. Results In this series, the post-operation tibial plateau angle (TPA) was 9.7° ± 3.5°(range 4.0°–15.8°) and the Rasmussen anatomical score was 17.7 ± 0.7(range 16–18); clinical outcomes showed that the HSS score was 92.7 ± 21.8 (range 90–96) and the Rasmussen functional score was 27.9 ± 1.0 (range 26–30). Of all the patients, the anterior cruciate ligament (ACL) injuries including the ACL tibial attachment ruptures occurred in 16 patients (51.6%), meniscus lesions happened in 19 patients (61.3%), medial collateral ligament (MCL) injuries were founded in 13 patients (41.9%). The number of ACL injuries including the ACL tibial attachment ruptures in the PI fracture pattern (12 cases) is significantly higher than LI (2 cases) and PC (2 cases) fracture pattern (p < 0.05). Conclusion Profound understanding the different patterns of PTPF and using our reduction technique will facilitate to restore the main articular fracture fragments. The PI fracture patterns have a significant high incidence of the ACL ruptures. Level of evidence Therapeutic study, Level IV.

BackgroundBronchial rupture in children is a rare but dangerous complication after chest trauma that has been associated with increased mortality. Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) is reported as one of the treatments for this life-threatening complication.Case presentationA 4-year-old boy who suffered from bronchial rupture and traumatic wet lung complicated by cardiac arrest after chest trauma was admitted to an adult ECMO center. He had two cardiac arrests-one before and one during the operation. The total duration of cardiac arrest was 30 minutes. V-V ECMO was initiated because of severe hypoxia and carbon dioxide retention during the operation. ECMO was performed for 6 days, and mechanical ventilation lasted 11 days. On the 31st day after the operation, he recovered completely and discharged without neurological deficit.ConclusionV-V ECMO can be considered for support in children with severe acute respiratory failure after bronchial rupture. In an emergency, V-V ECMO can be carried out effectively in a qualified and experienced adult ECMO center. But the application of ECMO in children is different from that in adults and requires more refined management.

Background Bronchial rupture in children is a rare but dangerous complication after chest trauma and is associated with increased mortality. Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) is reported as one of the treatments for this life-threatening complication. Case presentation A 4-year-old boy with bronchial rupture and traumatic wet lung complicated by cardiac arrest after chest trauma was admitted to an adult ECMO centre. He experienced two cardiac arrests, one before and one during the operation. The total duration of cardiac arrest was 30 min. V-V ECMO was initiated because of severe hypoxia and hypercapnia during the operation. ECMO was performed for 6 days, and mechanical ventilation lasted 11 days. On the 31st day after surgery, he had recovered completely and was discharged without neurological deficit. Conclusion V-V ECMO can be considered for supportive care in children with severe acute respiratory failure after bronchial rupture. In an emergency, V-V ECMO can be carried out effectively in a qualified and experienced adult ECMO centre. However, the application of ECMO in children is different from that in adults and requires more refined management.

Methylene blue, the FDA-grandfathered drug was proved to be neuroprotective in ischemic stroke in rat. However, the mechanism of the protective effect was unknown. In this study, we used different animal models to investigate the effect of MB administration given within and beyond the therapeutic time window on behavioral deficits and infarct volume and related mechanism about the white matter protection. Middle cerebral artery occlusion and reperfusion (MCAO) and photothrombotic middle cerebral artery occlusion (PT-MCAO) models were used. Behavioral deficits and infarct volume were measured by foot fault test, Garcia neurological score, and TTC staining. Black gold staining and western blot were used to evaluate the brain white matter injury. We found that intraperitoneal administration of MB immediately or 24 h after the MCAO or PT-MCAO surgery reduced infarct volume, improved the neurological deficits, and reduced the white matter injury via myelin basic protein (BMP) protection. These findings suggested that MB relieved the white matter injury besides neuronal protection and has potential therapeutic effects on ischemic stroke.

Background Chronic kidney disease (CKD) is an independent risk factor for bone and mineral metabolism disorder. Bone and mineral metabolism disorder develop gradually with the progression of renal failure. Various abnormalities include elevated fibroblast growth factor-23, decreased levels of 1,25-Dihydroxy Vitamin D (1,25-(OH)2D), and secondary hyperparathyroidism. This study aimed to evaluate the biomarkers and inflammation indexes of CKD-mineral and bone disorder (MBD), and to examine the associations of serum alkaline phosphatase (ALP) levels with serum C-reactive protein (CRP) levels and leukocyte count, in patients with end-stage renal disease (ESRD). Methods ESRD patients who were yet to initiate dialysis were enrolled as the study subjects. All CKD patients who were discharged from our hospital between January 1, 2013, and December 31, 2017, were screened. Based on quartiles of serum ALP, all subjects were categorized into four subgroups. The clinical characteristics of patients in the four subgroups were investigated. The prevalence of hypocalcemia, hyperphosphatemia, elevated intact parathyroid hormone (iPTH), and elevated CRP level was calculated in the four subgroups. The association between serum ALP and inflammation indexes was examined using regression analysis. Results Based on the inclusion criteria and exclusion criteria, 256 cases with ESRD were included in our study. The overall prevalence of hypocalcemia and hyperphosphatemia was 57.81% and 89.84%, respectively. Of the patients with ESRD, 174 (68.75%) had an elevated iPTH level >2 times of the upper limit of normal value), and 40 (15.63%) had an elevated iPTH level >9 times of the upper limit of normal value Discrepancies between serum ALP and iPTH levels were found in 29 patients. In the adjusted model, log-transformed CRP, log-transformed iPTH, and leukocyte count were significantly associated with log-transformed ALP. Conclusions Hypocalcemia, hyperphosphatemia, and increased levels of iPTH and CRP were found to be extremely common in ESRD patients. Discrepancies between serum ALP and iPTH were also observed. Our results also indicate that serum ALP level is associated with the levels of iPTH and CRP, as well as leukocyte count.

BACKGROUND The time of enteral nutrition (EN) administration on patients with sepsis is controversial. The study was to explore the effect of early enteral nutrition (EEN) on the prognosis of patients with sepsis. METHODS We performed a secondary analysis of the acute gastrointestinal injury grade study. The patients were divided into two groups from the time of EN administration: EEN group (n=85): EN within 24 hours; Control group (N=78): EN after 24 hours. The key observation was the length of ICU stay, and length of hospital stay, and 28- and 60-day mortality. RESULTS Of 676 patients, 163 were included. There are no significant between-group differences in the characteristics at baseline. The overall mortality rate at 28 days in the EEN group was 28.2% vs. 43.6% in the control group (P=0.041). The mortality rate at 60 days in the EEN group was 36.5% vs. 52.6% in the control group (P=0.039). In a subgroup analysis of patients who whether used vasoactive drugs: the EEN group was found to be significantly associated with 60-day mortality (P=0.039). The ICU stay length in the EEN group was longer than in the control group {11 [8-22] vs. 10 [6-16]; P=0.022}. Also, the length of the hospital stay was longer than in the Control group {23 [14-53] vs. 18 [10-39]; P=0.023}. Univariate Cox regression analysis showed that EEN, using vasoactive drugs, Acute kidney injury (AKI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and the global acute gastrointestinal injury (AGI) grade were significantly (P

Objectives. The purpose of this study was to evaluate the evidence of art therapy on the psychological outcome, quality of life (QOL), and cancer-related symptoms in women with gynecological cancer. Methods. A systematic literature search was conducted. The randomized controlled trials, quasiexperimental studies, case reports, and qualitative studies were all included. Result. 1,587 articles were retrieved. A total of 9 articles met the inclusion criteria. The existing studies provided initial evidence to suggest that art therapy may benefit gynecological cancer patients with respect to improving psychological outcome and QOL, reducing fatigue related to cancer, and improving subjective overall health condition. However, the quality of the current evidence limits the efficacy of these findings. Conclusion. Research on art therapy of gynecologic cancer patients is insufficient. We cannot draw the conclusion that art therapy benefits gynecological cancer patients in the psychological outcome, QOL, and cancer-related symptoms. More rigorous research is needed.

OBJECTIVE To assess the incidence rates and risk factors for episiotomy during vaginal childbirth in a Western China context. METHODS A retrospective hospital-based cohort study was conducted using computerized data of 3721 singleton vaginal deliveries after 28 weeks of gestation. Women who underwent episiotomy were compared with those who did not. RESULTS The overall prevalence of episiotomy was 44.0% (1636/3721); 52.9% (1458/2756) among primiparas and 18.4% (178/965) among multiparas (P

Background The extensile lateral approach (ELA) has been widely used to treat displaced intra-articular calcaneal fractures (DIACFs) and remains the gold standard procedure. Orthopedic surgeons are extremely concerned of the high rate of wound complications. This study intended to report a new surgical technique of the lateral wall osteotomy combined with an embedded biodegradable implant for treating DIACFs and assess clinical and radiological results. Methods From May 2013 to December 2015, a total of 17 patients with 19 calcaneal fractures underwent surgical treatment using our new technique. Radiographic images, computed tomography (CT) scans, and magnetic resonance (MR) images of the operative limb were obtained to assess fracture healing and biodegradable implant degradation. American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score at the last follow-up was obtained to assess functional result for all cases. Böhler’s and Gissane’s angles, width, and height of the injured calcaneus were analyzed using preoperative and last follow-up radiographic images. Results All radiological parameters were significantly improved at the last follow-up, with an increase of 15.58°, 8.38°, and 7.65 mm in Böhler’s angle, Gissane’s angle, and calcaneal height, respectively, and a decrease of 2.51 mm in calcaneal width (p

Ischemic stroke is a leading cause of death and disability worldwide. Advances in early recognition of stroke symptoms and the transport of patients to specialized stroke centers has been a major step in improvement of mortality and morbidity. Speed is essential since current intravenous thrombolytic treatments can only be delivered in a very narrow therapeutic window. Intravenous therapy requires specialized skills, subjects the medication to first pass metabolism, and the issue of blood to brain transport is a major problem.

Background Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that commonly affects the kidneys. Research into markers that can predict the prognosis of tubulointerstitial lupus nephritis (LN) has been impeded by the lack of well-designed studies. Methods In this study, we selected and merged 3 sets of renal biopsy tubulointerstitial data from GSE32591, GSE69438, and GSE127797, including 95 LN and 15 living healthy donors. CIBERSORTx was utilized for differentially infiltrating immune cell (DIIC) analysis. Weighted Gene Co-Expression network analysis (WGCNA) was employed to explore differentially expressed gene (DEG) related modules. Combined WGCNA hub genes and protein-protein interaction (PPI) validation was used for immune marker identification. Lastly, unsupervised clustering was carried out to validate the correlation between these markers and clinical characteristics. Results Our findings unveiled TYROBP, C1QB, LAPTM5, CTSS, PTPRC as the 5 immune markers, which were negatively correlated with glomerular filtration rate (GFR). Specifically, the expression levels of TYROBP and C1QB were significantly different between proliferative LN (PLN) and membranous LN (MLN). Unsupervised clustering could aggregate LN by these immune marker expression spectrums. Conclusions This study is the first to identify infiltrating immune cells and associated molecular patterns in the tubulointerstitium of LN by utilizing bioinformatics methods. These findings contribute to a better understanding of the mechanisms behind LN, and promote more precise diagnosis.

We propose a scheme for generation of the high-order phonon sideband spectra (HPS) and frequency comb arising from the strain-induced coupling of a nitrogen-vacancy (NV) impurity to a resonant vibrational mode of a diamond nanoresonator. The underlying nonlinear process of the nanomechanical system, due to the coupling between the NV center and an additional pump laser in a phonon nanoresonator, results in the formation of efficient HPS and the frequency comb. Using a perturbation method, we give an explicit analytical expression for second-order phonon sideband generation. Our numerical simulations show that the HPS and frequency comb exhibit ultralow power consumption and good tunability of phonon sideband-line spacing, number, and intensity in a wide parameter range. The sideband-line spacing is determined entirely by the beating frequency between the two input lasers and is as low as a few megahertz. Of particular interest is that the symmetry of the phonon frequency comb can be controlled by adjusting some parameters. Our approach based on a solid system with good integration and expansibility may be useful for the construction of phonon networks.

In this paper, the dynamics of discrete optical phonon solitons is investigated in an array of coupled phonon cavities. The gain of each cavity is induced by pumping a nitrogen-vacancy defect. And we can control the saturable nonlinear effects by adjusting the intensity of external field. In the case of weak nonlinear loss, the bright and dark phonon solitons with analytical expression are obtained and the solitons are stable. By introducing a nontrivial phase for photons tunneling between adjacent cavities, a complex Ginzburg-Landau equation is derived in the continuum limit and we can also obtain Ginzburg-Landau solitons solution in suitable parameter range.

The starch-branching enzyme (SBE) catalyzes the formation of branch points by cleaving the α-1,4 linkage in polyglucans and reattaching the chain via an α-1,6 linkage. Three types of SBE isoforms (SBEI, SBEII, and SBEIII) exist in higher plants, with the number of SBE isoforms being species-specific. This study isolated the SBEIII cDNA sequence (3,780 bp), designated TaSBEIII (accession no. JQ346193), from common wheat (Triticum aestivum L.) using the RACE method, revealing that the SBEIII gene exists in common wheat. The open reading frame of TaSBEIII was 2,748 bp. The predicted protein of 916 amino acids contained the specific characteristics of the SBEIII protein: four highly conserved regions and a central (α/β)(8) barrel domain. The SBE activity of the protein expressed in Escherichia coli (BL21) was also measured and verified. During the wheat grain filling period, TaSBEIII was constitutively expressed. The role of the TaSBEIII gene in starch synthesis is discussed.

Increased plasma levels of bilirubin have been reported in rat models and patients with alcoholic liver disease (ALD). The constitutive androstane receptor (CAR) is a known xenobiotic receptor, which induces the detoxification and transport of bilirubin. In the present study, the bilirubin transport regulatory mechanisms, and the role of CAR activation in hepatic and extrahepatic bilirubin clearance were investigated in a murine model of ALD. The mice were fed a Lieber-DeCarli ethanol diet or an isocaloric control diet for 4 weeks, followed by the administration of CAR agonists, 1,4-bis-[2‑(3,5-dichlorpyridyloxy)]benzene (TCPOBOP) and phenobarbital (PB), and their vehicles to examine the effect of the pharmacological activation of CAR on serum levels of bilirubin and on the bilirubin clearance pathway in ALD by serological survey, western blotting and reverse transcription‑quantitative polymerase chain reaction. The results showed that chronic ethanol ingestion impaired the nuclear translocation of CAR, which was accompanied by elevated serum levels of bilirubin, suppression of the expression of hepatic and renal organic anion transporting polypeptide (OATP) 1A1 and hepatic multidrug resistance‑associated protein 2 (MRP2), and induction of the expression of UDP-glucuronosyltransferase (UGT) 1A1. The activation of CAR by TCPOBOP and PB resulted in downregulation of the serum levels of bilirubin followed by selective upregulation of the expression levels of OATP1A1, OATP1A4, UGT1A1 and MRP2 in ALD. These results revealed the bilirubin transport regulatory mechanisms and highlighted the importance of CAR in modulating the bilirubin clearance pathway in the ALD mouse model.

Green logistics which based on ecological environmental protection and sustainable development changed the unilaterally influencing relations between development and logistics, life of consumption and logistics, and it represented the future development direction and trend of logistics. Based on existing definitions of green logistics, this paper analyzed the connotation and related concepts of green logistics both in China and abroad and dissected the connotation of green logistics in aspects of objective, function, content, actors, etc. And the insufficiency of existing research results and future development direction were given on the basis of existing research results. In the current society, with the rapid development of economy, modern logistics activity has become increasingly frequent. At the same time, development of these two just affects each other. It is undeniable that development of modern logistics will promote economic development; meanwhile, rapid development of economy can also increase the logistics quantity. Therefore, they just supplement each other. With continuous development of economy, the demand for logistics increases continuously. Under the condition of high demand, many problems occur, such as urban traffic congestion, waste of resources and fuel consumption. Under such situations, the influence of logistics development on social environment is quite severe and it goes against sustainable development of economy in a new period. At present, people's environmental awareness increases gradually, and they begin to explore new logistics systems which can not only satisfy the demand of social development but also restrain the influence of logistics activity on environment. Thereby, "green logistics" emerges as the times require. "Green logistics" not only effectively improves the environment pollution problems of traditional logistics but also accords with the general trend of the current environmental protection. Therefore, it is the direction of future logistics development. As for study on "green logistics", a definition is proposed for green logistics in Logistics Terms (GB/T 18354-2001) published in 2001. However, the extensive logistics professionals lack a comprehensive understanding about green logistics and its characteristics. As a result, they cannot fully understand and even misunderstand green logistics, or some unnecessary faults might be caused. Therefore, it can provide reference for practical work of green logistics to strengthen cognition about green logistics and accurately comprehend the connotation of green logistics.