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Objective To observe the clinical efficacy of Redo-Bentall surgery in the reoperation of aortic root lesions. Methods A retrospective analysis was performed on 46 patients who underwent Redo-Bentall surgery for aortic root lesions in our department from June 2010 to April 2022. They were 35 males and 11 females, at a mean age of 43.37±12.79 years, in 4.96±6.76 years since the last operation. General clinical data in perioperative period and during follow-up were collected and analyzed. Kaplan-Meier survival analysis was used to compare the survival rates of each etiological group. Results There were 9 cases of central end otitis, 12 cases of Behset's disease, and 25 cases of other causes. After operation, 4 cases (8.70%) experienced cardiac arrest, 4 cases (8.70%) renal failure, 2 cases (4.35%) gastrointestinal bleeding, 2 cases (4.35%) new third-degree atrioventricular block and 2 cases (4.35%) permanent pacemaker placement. In perioperative period, 3 cases (6.52%) died in hospital. During a mean follow-up of 5.03±3.27 years after discharge, 5 cases (11.63%) were lost to follow-up, 1 case died (2.33%), 1 case had lacunar infarction (2.33%), and no severe bleeding or embolism complications was observed in the rest patients. The long-term survival rate was significantly lower in the endocarditis group (62.3%) and the Behcet's disease group (70%) than the other etiological groups (80%, P < 0.05). Conclusion The application of Redo-Bentall in the reoperation of aortic root lesions is safe and effective, but the survival rate is quite lower in the patients with infective endocarditis and Behcet's disease.

A top drive is an essential mechanical device in oil field drilling since it provides the necessary torque for the drilling operations. Manufacturers in the oil and gas industry typically perform in-housing testing and classify the Safe Working Load of top drives. Testing a top drive requires a unique test stand, thus making testing top drives from other manufacturers a difficult challenge. A fixture adapter can be designed using geometric constraints and intuition to make testing apparatus semi-universal, yet they are often bulky and heavy, posing more significant safety concerns. This study aims to first numerically assess the existing fixture adapter and then structurally optimize it for enhancing its structural integrity and efficiency under various severe working environments. Therefore, finite element analysis (FEA) was performed on the existing fixture adapter, and compliance minimization topology optimization was employed. Four load and boundary conditions were used from the three most frequent operation scenarios for the fixture adapters: (i) drilling standby, (ii) staging area, (iii) drilling make-up, and (iv) break-up. The FEA results indicated that no safety factor was compromised with a 50% and 60% mass retention constraint via topology optimization compared to the original fixture adapter. The optimized fixture adapter was also tested under compression using printed 3D prototypes to validate the finite analysis and topology optimization processes.

Alkylphenols are a kind of compounds produced by alkylation of phenolic compounds. Compared with other non-hydrocarbon compounds, alkylphenols are more soluble in water. In this paper, through three groups of oil-water distribution experiments at different temperatures (25 ℃, 45 ℃ and 65 ℃), different brine concentrations (4000 mg/L, 6000 mg/L and 8000 mg/L) and different crude oil types (X37, X45 and X61), the distribution characteristics of alkylphenols between oil and water were studied, and the variation law of alkylphenol distribution coefficient was determined. The results show that the oil-water partition coefficient increases with the increase of alkyl molecular weight of homologues; The oil-water partition coefficient of alkylphenols decreases with the increase of temperature, and alkyl homologues with higher molecular weights are more sensitive to temperature; The partition coefficient of alkylphenol in oil-water system increases with the increase of water salinity. According to the experimental results, temperature and salinity of water phase will cause the difference of oil-water partition coefficient of alkylphenol, and the influence of temperature is greater than that of salinity. The distribution behavior of alkylphenols between oil and water can provide more reference for the secondary migration of crude oil and the direction of water drive front in reservoir development.

Backgrounds: Gastric cancer (GC) remains a global health threat due to frequent treatment failures caused by primary or acquired resistance. Although cancer-associated fibroblasts (CAFs) have been implicated in this process, it is still unclear which specific subtype(s) of CAFs hinder T-cell infiltration and promote resistance to immunotherapy. Methods: We analyzed the GC fibroblast atlas in detail by combining 63,955 single cells from 14 scRNA-seq datasets. We also performed RNA-seq data in a local GC cohort and examined 13 bulk RNA-seq datasets to understand the biological and clinical roles of different CAF subsets. Additionally, we conducted in vitro experiments to study the role of specific proteins in GC development. Results: We identified a total of 17 fibroblast subsets in gastric cancer, nine of which did not fit into the existing CAFs classification. These subsets exhibited significant heterogeneity in distribution and biological characteristics (metabolism, cell-cell interactions, differentiation state), as well as clinical functions such as prognosis and response to immunotherapy. In particular, cluster 6 stood out for its high expression of MFAP5, CFD, and PI16; it was found to be negatively associated with both overall survival and response to immunotherapy in GC. This association was linked to an immunosuppressive microenvironment characterized by an increase in M2 macrophages but higher levels of T cell dysfunction and exclusion—a feature shared by tumors expressing MFAP5. Furthermore, the addition of human recombinant MFAP5 promoted proliferation and migration of HGC-27 cells by inducing the MFAP5/NOTCH1/HEY1 signaling pathway. Conclusion: We introduce a high-resolution GC fibroblast atlas. The 17 identified fibroblast clusters provide valuable opportunities for gaining deeper biological insights into the relationship between fibroblasts and GC development. Particularly, cluster 6 and its specific marker MFAP5 could serve as prognostic factors in GC and form a foundation for personalized therapeutic combinations to address primary resistance to ICIs. [ABSTRACT FROM AUTHOR]

Background: Advanced glycation end products (AGEs), a group of food processing byproducts, have been implicated in the development of various diseases. However, the relationship between circulating AGEs and sleep disorders remains uncertain. Methods: This cross-sectional study elucidated the association of plasma AGEs with sleep disorders among 1732 Chinese adults who participated in the initial visit (2019–2020) of the Tongji–Shenzhen Cohort (TJSZC). Sleep behavior was assessed using self-reported questionnaires and precise accelerometers. Plasma levels of AGEs, including Nε-(Carboxymethyl)lysine (CML), Nε-(Carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine (MG-H1), were quantified by ultra-high performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS). Results: In logistic regression, per IQR increment in individual AGEs was associated with an increased odds ratio of short sleep duration (CML: 1.11 [1.00, 1.23]; CEL: 1.16, [1.04, 1.30]), poor sleep quality (CML: 1.33 [1.10, 1.60]; CEL: 1.53, [1.17, 2.00]; MG-H1: 1.61 [1.25, 2.07]), excessive daytime sleepiness (CML: 1.33 [1.11, 1.60]; MG-H1: 1.39 [1.09, 1.77]), and insomnia (CML: 1.29 [1.05, 1.59]). Furthermore, in weighted quantile sum regression and Bayesian kernel machine regression analyses, elevated overall exposure levels of plasma AGEs were associated with an increased risk of sleep disorders, including short sleep duration, poor sleep quality, excessive daytime sleepiness, and insomnia, with CML being identified as the leading contributor. Insufficient vegetable intake and higher dietary fat intake was associated with an increase in plasma CEL. Conclusions: These findings support a significant association between plasma AGEs and sleep disorders, indicating that AGEs may adversely influence sleep health and reducing the intake of AGEs may facilitate preventing and ameliorating sleep disorders. [ABSTRACT FROM AUTHOR]

Abstract Background There are no reports on the incidence of chronic mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with chronic mercury poisoning. Methods Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3 %), kidney (16.4 %) and breathing (8.0 %). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.50 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months. Conclusions Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.

The mechanical properties of woven jute fiber-reinforced PLA polymer laminates additively manufactured through Laminated Object Manufacturing (LOM) technology are simulated using the finite element method in this work. Woven jute fiber reinforcements are used to strengthen bio-thermoplastic PLA polymers in creating highly biodegradable composite structures that can serve as one of the environmentally friendly alternatives for synthetic composites. A LOM 3D printer prototype was designed and built by the authors. All woven jute/PLA biocomposite laminated specimens made using the built prototype in this study had their tensile and flexural properties measured using ASTM test standards. These laminated structures were modeled using the ANSYS Mechanical Composite PrepPost (ACP) module, and then both testing processes were simulated using the experimentally measured input values. The FEA simulation results indicated a close match with experimental results, with a maximum difference of 9.18%. This study served as an exemplary case study using the FEA method to predict the mechanical behaviors of biocomposite laminate materials made through a novel manufacturing process. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical efficacy of off-pump coronary artery bypass grafting in the treatment for acute myocardial infarction. Methods A total of 43 patients with acute myocardial infarction who were given off-pump coronary artery bypass grafting (OPCAB) surgery by the same medical team in Department of Cardiovascular Surgery of our hospital from February 2014 to January 2020 were enrolled as the treatment group, and their clinical data were collected and retrospectively analyzed. Among them, there were 5 females and 38 males, at a mean age of 62.40±9.14 years, 20 cases (46.5%) of left main coronary artery disease and 23 cases (53.5%) of multi-vessel disease, and 8 cases (18.6%) of ST-segment elevation myocardial infarction (STEMI), and 35 cases (81.4%) of non-ST-segment elevation myocardial infarction (NSTEMI). Another 46 patients of non-acute myocardial infarction who also underwent OPCAB during the same period were randomly selected and assigned into the control group, including 8 females and 38 males (62.40±9.14 years old), and 25 cases (54.3%) of left main disease and 21 cases (45.7%) of multi-vessel disease. The clinical indicators during the operation, at the first day following operation, and during the hospitalization period were collected and compared between the 2 groups. Results In the treatment group, 2 patients were converted to operation under cardiopulmonary bypass because of intraoperative ventricular fibrillation, 1 patient died of arrhythmia, and 1 experienced postoperative cerebral infarction. In the control group, there was no death and 1 case developed cerebral infarction. However, as for the clinical indicators during the operation, at the first day following operation, and during hospitalization, there were no significant differences between the 2 groups. Conclusion Off-pump coronary artery bypass grafting is safe and effective for patients with acute myocardial infarction.

Objective To compare the efficiency between on- and off-pump coronary artery bypass grafting (CABG) in elderly patients by propensity score matching (PSM). Methods From June 2014 to June 2019, a total of 301 patients (older than 70 years) undergoing CABG in our department were recruited in this study. For 51 patients underwent off-pump CABG (OPCABG), they were 44 males and 7 females, at an age of 70 to 83 (73.31±2.73) years. Another 51 patients including 46 males and 5 females, aged 70-78 (72.82±1.86) years, were selected from the remaining 250 patients treated with on-pump CABG (ONCABG) by PSM. Postoperative recovery was analyzed and compared between the 2 groups. Results There were no statistical differences in the mortality and cases needing intra-aortic balloon pump between the OPCABG and the ONCABG groups. But the former group had shorter endotracheal intubation (10.64±5.07 vs 15.07±5.35 h, P=0.000), less drainage volume at the day after surgery (307.15±132.16 vs 480.78±130.42 mL, P=0.000), and lower percentage of the patients needing continuous renal replacement therapy when compared with the ONCABG group. Conclusion Both OPCABG and the ONCABG surgeries are effective treatment for the elderly patients with coronary heart disease. However, OPCABG is superior to ONCABG in accelerating postoperative recovery and reducing postoperative complications.