Search

Zhiqiang Shi,1 Yu Liu,1,2 Xiaodan Chang,3 Yuan Gao,4 Min Hao,1 Shuo Feng,1 Haoyu Dong1 1Department of Traditional Chinese Medicine Surgery, College of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, People’s Republic of China; 2Department of Integrated Traditional Chinese and Western Medicine Surgery, College of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 3Department of Dermatology, Hohhot Second Hospital, Hohhot, People’s Republic of China; 4Department of Anorectal Diseases, Inner Mongolia Hospital of Traditional Chinese Medicine, Hohhot, People’s Republic of ChinaCorrespondence: Yu Liu, Inner Mongolia Medical University, Jinshan Development Zone, Hohhot, Inner Mongolia, People’s Republic of China, Tel +86-153-3471-2606, Email 15074930848@163.comPurpose: This paper aims to investigate the effect of Tounong San (TNS), a well-known traditional Chinese medicine prescription for suppurative infections, on the immune function.Methods: A suppurative infection model was established by injecting Staphylococcus aureus into subcutaneous tissue on the backs of rats. The expressions of CD68, CD163, CD31 and MPO in abscess tissues, phagocytosis rate and reactive oxygen species (ROS) of neutrophils in blood, phagocytosis function of peritoneal macrophages, and proliferation of blood lymphocytes, expression of IL-1, IL-6, CH50, TNF-α, IFN-γ, IgG, IgM in serum were detected at different time points.Results: On the 3rd day of medication, fibrinogen wrapped around the abscesses was visible in TNS groups, with an increase in new blood vessels and the expression of a large number of macrophages and neutrophils. On the 6th day, the pus of TNS groups diminished, and the number of new blood vessels reached its peak. On the 9th day, the abscesses disappeared in TNS groups, fewer new blood vessels, macrophages, and neutrophils were expressed, and more fibrocytes appeared and filled the original pus cavities. On the 3rd and 9th day of medication, the phagocytic rates of neutrophils and macrophages were significantly improved in TNS group, and the ROS content of neutrophils was increased on the 9th day. TNS has no effect on lymphocyte proliferation in vitro, but it can regulate the secretion of IgG and IgM by lymphocytes. TNS increases the level of IL-1, decreases the levels of IL-6 and TNF-α, and regulates the expressions of IFN-γ and CH50 in two ways.Conclusion: TNS can form fibrinogen-wrapped pus to prevent bacterial infection from going deeper, and to improve the phagocytic function of phagocytes, the secretion of lymphocytes, and the defense function of the complement system. Therefore, it is a competitive drug for the treatment of suppurative diseases.Keywords: Tounong San, suppurative infection, immune function, pharmacological mechanism

Jing Yang,1,&ast; Zhan Shi,1,&ast; Shafeng Jia,1,&ast; Jia Liu,2,&ast; Ling Jiang,2 Yueqin Zhu2 1Department of Obstetrics, Suzhou Municipal Hospital, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People’s Republic of China; 2Department of Nursing Department, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shafeng Jia, Department of Obstetrics, Suzhou Municipal Hospital, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215002, People’s Republic of China, Tel +86-0512-62362039, Email Jiashafeng_1215@163.com Jia Liu, Department of Nursing department, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215002, People’s Republic of China, No. 26, Daoqian Street, Email Liujia123@email.cnObjective: To analyse the clinical data of and provide a reference for the care and perinatal health care of twin pregnancy patients with complete hydatidiform mole and a coexistent foetus (CHM & CF).Methods: We searched the China National Knowledge Infrastructure (CNKI) and Wanfang and VIP databases to comprehensively collect clinical studies on the “clinical characteristics of complete hydatidiform mole and coexisting foetal twin pregnancy”. Patients’ data were extracted from the literature, and 60 patients were divided into Group A (live newborns not delivered, 47) and Group B (live newborns delivered, 13). The clinical characteristics of the two groups were compared to explore the pregnancy outcomes and influencing factors of persistent gestational trophoblastic disease (pGTD) in patients with CHM & CF.Results: The gestational week of diagnosis (Odd Ratio (OR)=0.203, 95% Confidence Interval (CI)=0.055– 0.753) and number of complications (OR=0.328, 95% CI=0.135– 0.793) were found to be independent influencing factors of pregnancy outcomes in patients with CHM & CF (p < 0.05). Ovulation induction therapy (OR=2.333, 95% CI=0.561– 9.708), preeclampsia (OR=75.000, 95% CI=11.041– 509.486) and the number of complications (OR=4.768, 95% CI=1.914– 11.875) were the independent influencing factors of developing pGTD (p < 0.05).Conclusion: Pregnancy should not be terminated immediately after the early detection of CHM & CF, and multiple factors should be considered. Preeclampsia may indicate a poor prognosis, and ovulation induction may increase the incidence of pGTD. Targeted nursing and psychological nursing should be carried out according to the clinical symptoms of the patients.Keywords: twin pregnancy, complete hydatidiform mole and coexistent foetus, persistent gestational trophoblastic disease, clinical characteristics, nursing

Chengzhen Liu,1,2 Shen Tu,3 Shikang Gong,1 Jinliang Guan,1 Zifu Shi,1 Yi Chen2 1Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, 410081, People’s Republic of China; 2School of Humanities and Management Science, Southwest Medical University, Luzhou, 626000, People’s Republic of China; 3Department of Psychology, School of Public Administration, Guizhou University of Finance and Economics, Guiyang, 550025, People’s Republic of ChinaCorrespondence: Zifu Shi; Yi Chen, Email shizf@hunnu.edu.cn; chenyi@swmu.edu.cnObjective: This study innovatively investigated the potential selection bias involved in processing multiple subliminal stimuli during creative problem-solving (CPS). It addresses the existing gap in specialized research on how the handling of multiple unconscious stimuli influences higher-order cognitive processes, particularly creativity.Methods: The study utilized a masked priming paradigm and a remote association task (RAT). Two experiments were conducted. Experiment 1 presented two stimuli simultaneously, with one being the correct answer, to examine whether there was a bias in the location of subliminal stimuli. In Experiment 2, two stimuli were presented sequentially, with one serving as the answer, to investigate whether there was a temporal bias in unconscious processing.Results: Our findings revealed that when solving easy RATs, subliminal stimuli presented on the left side had a negative priming effect compared to the right side. The results revealed that unconscious processing of subliminal stimuli enhanced performance on difficult CPS. Additionally, a temporal bias was observed, with more recent subliminal stimuli having a stronger effect than earlier stimuli.Conclusion: Unconscious processing can improve CPS, especially for difficult tasks, and there is a bias towards processing stimuli on the left and more recently presented stimuli. These findings contribute to our understanding of unconscious processing, particularly the processing of multiple subliminal stimuli in CPS, and provide insights into the biases that exist in unconscious processing.Keywords: unconscious priming, creative problem solving, remote association test, unconscious processing bias, multiple unconscious influences

Abstract Introduction With COVID-19 vaccination rolled out globally, increasing numbers of studies have shown that booster vaccines can enhance an individual’s protection against the infection, hospitalization, and death caused by SARS-CoV-2. This study evaluated the effectiveness of COVID-19 vaccine BBIBP-CorV booster against being infected (susceptibility), infecting others (infectiousness), and spreading the disease from one to another (transmission). Methods This retrospective cohort study investigated the close contacts of all officially ascertained COVID-19 confirmed cases in Urumqi, China between August 1 and September 7, 2022. Eligible records were divided into four subcohorts based on the vaccination status of both the close contact and their source case: group 2-2, 2-dose contacts seeded by 2-dose source case (as the reference level); group 2-3, 3-dose contacts seeded by 2-dose source case; group 3-2, 2-dose contacts seeded by 3-dose source case; and group 3-3, 3-dose contacts seeded by 3-dose source case. In the four subcohorts, multivariate logistic regression models were used to examine the vaccine effectiveness (VE) for the BBIBP-CorV booster dose. We adjusted for potential confounding variables, including the sex and age of source cases and close contacts, the calendar week of contact history and contact settings. We evaluated the statistical uncertainty using a 95% confidence interval (CI). In addition, we conducted subgroup analyses to evaluate VE by sex. Results The sample sizes of groups 2-2, 2-3, 3-2, and 3-3 were 1184, 3773, 4723, and 27,136 individuals, respectively. Overall VE against susceptibility (group 2-3 vs 2-2) was 42.1% (95% CI 10.6, 62.5), VE against infectiousness (group 3-2 vs 2-2) was 62.0% (95% CI 37.2, 77.0), and VE against transmission (group 3-3 vs 2-2) was 83.7% (95% CI 75.1, 89.4). In the sex-stratified subgroups, male close contacts showed similar VE compared to the overall. However, among female close contacts, while the booster dose improved VE against infectiousness and VE against susceptibility, the VEs were not significantly different from zero. Conclusion BBIBP-CorV vaccine booster was associated with mild to moderate levels of protection against Omicron susceptibility, infectiousness, and transmission. Real-world assessment of protective performance of COVID-19 vaccines against the risk of Omicron strains is continuously needed, and may provide information that helps vaccination strategy.

Abstract Background Atezolizumab plus bevacizumab was approved in 2020 as a first-line treatment for advanced hepatocellular carcinoma (HCC). The purpose of this study was to assess the curative effect and tolerability of the combination treatment in advanced HCC. Methods Web of Science, PubMed and Embase were retrieved for qualified literatures on the treatment of advanced HCC with atezolizumab plus bevacizumab until September 1, 2022. The outcomes included pooled overall response (OR), complete response (CR), partial response (PR), median overall survival (mOS), median progression-free survival (mPFS), and adverse events (AEs). Results Twenty-three studies, comprising 3168 patients, were enrolled. The pooled OR, CR, and PR rates of the long-term (more than six weeks) therapy response based on Response Evaluation Criteria in Solid Tumors (RECIST) were 26%, 2%, and 23%, respectively. The pooled OR, CR, and PR rates of the short-term (six weeks) therapeutic response evaluated with RECIST were 13%, 0%, and 15%, respectively. The pooled mOS and mPFS were 14.7 months and 6.66 months, respectively. During the treatment, 83% and 30% of patients experienced any grade AEs and grade 3 and above AEs, respectively. Conclusions Atezolizumab in combination with bevacizumab showed good efficacy and tolerability in the treatment of advanced HCC. Compared with short-term, non-first-line, and low-dose therapy, atezolizumab plus bevacizumab in long-term, first-line, and standard-dose treatment for advanced HCC showed a better tumor response rate.

Fei Wu,1,2,&ast; Haitao Sun,1,2,&ast; Zhang Shi,1,2 Changwu Zhou,1– 3 Peng Huang,1,2 Yuyao Xiao,1,2 Chun Yang,1,2 Mengsu Zeng1– 3 1Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mengsu Zeng, Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 13501922963, Email zeng.mengsu@zs-hospital.sh.cn Chun Yang, Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 18702135336, Email dryangchun@hotmail.comObjective: To determine the preoperative clinicoradiological factors to predict microvascular invasion (MVI) in patients with resectable multinodular hepatocellular carcinoma (mHCC), and further to establish and validate a stratified risk scoring system.Methods: Two hundred and seventy-three patients with pathologically confirmed mHCC (≥ 2 lesions) without major vascular invasion and biliary tract tumor thrombosis, who underwent preoperative contrast-enhanced MRI and hepatectomy, were consecutively enrolled (training/validation cohort=193/80). Preoperative clinicoradiological variables were collected and analyzed. The multivariable logistic regression was performed to determine the independent predictors of MVI and create a risk score system. The C-index, calibration curve and decision curve were used to evaluate the performance of the risk score. A risk score-based prognostic stratification system was performed in mHCC patients. The risk score system was further verified in the validation cohort.Results: AFP > 400 ng/mL, presence of satellite nodule, mosaic architecture and increased total tumor diameter were independent predictors of MVI while fat in mass was an independent protective factor of MVI. The risk score yielded satisfactory C-index values (training/validation cohort: 0.777/0.758) and fitted well in calibration curves. Decision curve analysis further confirmed its clinical utility. Based on the risk score, mHCC patients were stratified into high-/low-MVI-risk subgroups with significantly different recurrence-free survival (both P < 0.001).Conclusion: The presented risk score incorporating clinicoradiological parameters could stratify mHCC patients into high-risk and low-risk subgroups and predict prognosis in patients with resectable mHCC.Keywords: hepatocellular carcinoma, prognosis, magnetic resonance imaging, statistical model

The study of the transient electromagnetic detection device with small sized coil and easy installation underground will offer new insights into the real-time dynamic exploration and forecast water-bearing structure in excavation roadway.By drawing on the full-space transient electromagnetic theory, this paper adopted the three-dimensional time-domain finite element method for numerical simulation to explore the characteristics of the secondary field response obtained by small coil excitation and the transient electromagnetic response received by the magnetic core coil.This study constructed a geological-geophysical model of the water-bearing fault in front of the roadway excavation working face, studied the transient electromagnetic response characteristics of the small coil device for the water-bearing fault, and compared the effects of small coil and conventional coil in advance detection.The study shows that : ①the decay law of the induced electric potential generated by the small coil source excitation is the same as that of the induced electric potential generated by the conventional transmitting coil with time, ②the magnetic core coil can effectively improve the induced signal strength, ③the application of both the small coil device and the conventional coil device can effectively explain the distribution range of the low resistance area, ④the detection results match the verification results of the roadway excavation.Combined with the underground field test, this paper verified the applicability and effectiveness of the small coil device applied to mine transient electromagnetic method advance detection.

Lei Huang,1,2 Chengcheng Liu,1,2 Zhanjie Li,3 Xu Huang,1,4 Ruiying Zheng,1,2 Zhixin Shi,1,2 Xin Hong,1,2 Yufeng Qin,5 Genyan Liu1,2 1Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Branch of National Clinical Research Center for Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 3Department of Infection Control, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of Laboratory Medicine, the Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 5School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Genyan Liu, Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People’s Republic of China, Tel +86 25 68308025, Fax +86 25 83724440, Email liugenyan@njmu.edu.cnObjective: To investigate the transmission pathway of a MRSA prevalence in a pancreatic surgery ward in a Chinese teaching hospital.Methods: Molecular epidemiology investigations were carried out combined PFGE, MLST, SCCmec typing and whole-genome sequencing for 20 successive MRSA isolates (2 isolates from the ward environment). Resistance and virulence genes were detected using specific PCR. Bacterial identification and AST were performed using the Vitek 2 Compact System. Clinical data of enrolled cases were retrieved from electronic case records.Results: From January 2020 to May 2020, successive isolated 20 MRSA strains were clarified to 2 PFGE patterns (A = 19, B = 1) in the ward. Both isolates from environment and patients belonged to sequence type ST5-SCCmec II-spa type t311. MRSA-related resistance genes mecA, blaZ, ermA, ant(4’)-Ia and norA were found in each clone. All 20 isolates carried tst, hlg, hla, eta, eap, fnbA and seo virulence genes, other virulence genes such as sea, sec, seb, seg, sei, sem, sen, ebpS and fnbB were also found in partial stains. All patients had fever symptom, 27.8% were accompanied by diarrhea, 88.9% had undergone surgery or invasive procedures within 30 days. Finally, 94.4% of these patients recovered.Conclusion: This study confirmed a prevalence of ST5-MRSA-II-t311 clone in a surgery ward, indicated MRSA is a risk factor for post-surgery nosocomial infection and hand hygiene and environmental surveillance should not be ignored.Keywords: methicillin-resistantStaphylococcus aureus, ST5, SCCmec II, spa type t311, diarrhea, virulence genes

Zhen Shi,1 Pengfei Li,1 Wentao Wu,1 Yunduo Jiang,1 Yansong Wang1– 3 1Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, People’s Republic of China; 2NHC Key Laboratory of Cell Transplantation, Harbin Medical University, Harbin, Heilongjiang Province, People’s Republic of China; 3Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, Harbin Medical University, Harbin, Heilongjiang Province, People’s Republic of ChinaCorrespondence: Yansong Wang, Email wyshmu1975@163.comBackground: Percutaneous endoscopic interlaminar discectomy (PEID), one of the main techniques of spinal endoscopy, has achieved excellent results in treating lumbar disc herniation (LDH). However, its efficacy has not been systematically described in patients with LDH accompanied by Modic changes (MC).Purpose: The purpose of this study was to observe the clinical efficacy of PEID treatment of LDH accompanied by MC.Patients and Methods: A total of 207 patients who underwent PEID surgery for LDH were selected. According to the existence and type of MC on preoperative lumbar magnetic resonance images (MRI), they were divided into normal group (no MC, n=117), M1 group (MC I, n=23), and M2 group (MC II, n=67). According to the severity of MC, they were divided into MA group (grade A, n=45) and MBC group (grade B and C, n=45). The visual analog scale (VAS) score, Oswestry disability index (ODI) score, Disc height index (DHI), Lumbar lordosis angle (LL) and modified Macnab criteria were used to assess clinical outcomes.Results: Postoperative back pain and leg pain VAS scores and ODI scores were significantly improved in all groups compared with preoperative scores. Patients with MC showed a deterioration in postoperative back pain VAS scores and ODI scores as time went by, and postoperative DHI decreased significantly compared with preoperative. Postoperative LL did not change significantly in each group. There was no significant difference in complications, recurrence rate and excellent rate between the groups.Conclusion: Whether accompanied by MC or not, the efficacy of PEID for LDH was significant. However, postoperative back pain and functional status of patients with MC tend to deteriorate as time went by, especially those with type I or severe MC.Keywords: Modic changes, MC type, MC grade, percutaneous endoscopic interlaminar discectomy, lumbar disc herniation, low back pain

Abstract Background Various nonpharmaceutical interventions (NPIs) against COVID-19 continue to have an impact on socioeconomic and population behaviour patterns. However, the effect of NPIs on notifiable infectious diseases remains inconclusive due to the variability of the disease spectrum, high-incidence endemic diseases and environmental factors across different geographical regions. Thus, it is of public health interest to explore the influence of NPIs on notifiable infectious diseases in Yinchuan, Northwest China. Methods Based on data on notifiable infectious diseases (NIDs), air pollutants, meteorological data, and the number of health institutional personnel in Yinchuan, we first fitted dynamic regression time series models to the incidence of NIDs from 2013 to 2019 and then estimated the incidence for 2020. Then, we compared the projected time series data with the observed incidence of NIDs in 2020. We calculated the relative reduction in NIDs at different emergency response levels in 2020 to identify the impacts of NIPs on NIDs in Yinchuan. Results A total of 15,711 cases of NIDs were reported in Yinchuan in 2020, which was 42.59% lower than the average annual number of cases from 2013 to 2019. Natural focal diseases and vector-borne infectious diseases showed an increasing trend, as the observed incidence in 2020 was 46.86% higher than the estimated cases. The observed number of cases changed in respiratory infectious diseases, intestinal infectious diseases and sexually transmitted or bloodborne diseases were 65.27%, 58.45% and 35.01% higher than the expected number, respectively. The NIDs with the highest reductions in each subgroup were hand, foot, and mouth disease (5854 cases), infectious diarrhoea (2157 cases) and scarlet fever (832 cases), respectively. In addition, it was also found that the expected relative reduction in NIDs in 2020 showed a decline across different emergency response levels, as the relative reduction dropped from 65.65% (95% CI: -65.86%, 80.84%) during the level 1 response to 52.72% (95% CI: 20.84%, 66.30%) during the level 3 response. Conclusions The widespread implementation of NPIs in 2020 may have had significant inhibitory effects on the incidence of respiratory infectious diseases, intestinal infectious diseases and sexually transmitted or bloodborne diseases. The relative reduction in NIDs during different emergency response levels in 2020 showed a declining trend as the response level changed from level 1 to level 3. These results can serve as essential guidance for policy-makers and stakeholders to take specific actions to control infectious diseases and protect vulnerable populations in the future.

Abstract Objective The purpose of this study was to describe the changes in the gut microbiome of patients with cirrhosis and hepatic encephalopathy (HE), as well as quantify the variations in short-chain fatty acid (SCFA) and tryptophan metabolite levels in serum and faeces. Methods Fresh faeces and serum were collected from 20 healthy volunteers (NC group), 30 cirrhosis patients (Cir group), and 30 HE patients (HE group). Then, 16S rRNA sequencing and metabolite measurements were performed using the faeces. Gas chromatography‒mass spectrometry and ultrahigh-performance liquid chromatography-tandem mass spectrometry were used to measure SCFA and tryptophan levels, respectively. The results were analysed by SIMCA16.0.2 software. Differences in species were identified using MetaStat and t tests. The correlations among the levels of gut microbes and metabolites and clinical parameters were determined using Spearman correlation analysis. Results Patients with cirrhosis and HE had lower microbial species richness and diversity in faeces than healthy volunteers; these patients also had altered β-diversity. Serum valeric acid levels were significantly higher in the HE group than in the Cir group. Serum SCFA levels did not differ between the Cir and NC groups. Serum melatonin and 5-HTOL levels were significantly higher in the HE group than in the Cir group. The Cir and NC groups had significant differences in the levels of eight serum tryptophan metabolites. Furthermore, the levels of faecal SCFAs did not differ between the HE and Cir groups. Faecal IAA-Ala levels were significantly lower in the HE group than in the Cir group. There were significant differences in the levels of 6 faecal SCFAs and 7 faecal tryptophan metabolites between the Cir and NC groups. Certain gut microbes were associated with serum and faecal metabolites, and some metabolites were associated with certain clinical parameters. Conclusion Reduced microbial species richness and diversity were observed in patients with HE and cirrhosis. In both serum and faeces, the levels of different SCFAs and tryptophan metabolites showed varying patterns of change. In HE patients, the levels of some serum tryptophan metabolites, and not SCFAs, were correlated with liver function and systemic inflammation. Systemic inflammation in patients with cirrhosis was correlated with faecal acetic acid levels. In summary, this study identified metabolites important for HE and cirrhosis.

Pengfei Li,1 Zhen Shi,1 Yunduo Jiang,1 Zhibin Peng,1 Yansong Wang1– 3 1Department of Orthopedic Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, People’s Republic of China; 2NHC Key Laboratory of Cell Transplantation, Harbin Medical University, Harbin, People’s Republic of China; 3Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Yansong Wang, Department of Orthopedics, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, 150001, People’s Republic of China, Email wyshmu1975@163.comPurpose: The number of patients with lumbar spinal stenosis (LSS) with degenerative lumbar scoliosis (DLS) is gradually increasing as the population ages. The purpose of this study was to evaluate the clinical outcomes of 10-mm endoscopic minimally invasive interlaminar decompression for LSS with DLS and simple LSS.Material and Methods: The clinical data of 175 consecutive elderly patients with LSS were retrospectively analyzed. They were divided into LSS group and LSS with DLS group based on whether they were accompanied by DLS. Patient demographics, perioperative indicators, and clinical outcomes were recorded. Lumbar spine stability was assessed by imaging data. Meanwhile, visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified Macnab criteria were used to assess clinical outcomes.Results: There were 129 patients in the LSS group and 46 patients in the LSS with DLS group. Both groups had similar VAS and ODI scores preoperatively, and both were significantly lower postoperatively (P < 0.05). However, patients combined with DLS showed higher VAS scores for low back pain at 3 months and 1 year postoperatively (P < 0.05). In addition, postoperative LL and PI-LL were significantly improved in both groups (P < 0.05). However, patients in LSS with DLS group showed higher PT, PI and PI-LL before and after surgery. According to the modified Macnab criteria, the excellent and good rates were 92.25% and 89.13% in the LSS group and LSS with DLS group at the last follow-up, respectively.Conclusion: 10-mm endoscopic minimally invasive interlaminar decompression for LSS with or without DLS has shown satisfactory clinical outcomes. However, patients with DLS may have higher residual low back pain after surgery.Keywords: spinal stenosis, scoliosis, endoscope, minimally invasive, decompression, geriatric patients

Haojie Li,1 Zhan Shi,2 Xuejiao Chen,1 Junjie Wang,1 Jiacheng Ding,1 Shuoji Geng,1 Xinyuan Sheng,1 Songhe Shi1 1Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Pharmacy, Zhengzhou People’s Hospital, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Songhe Shi, Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, People’s Republic of China, Email ssh@zzu.edu.cnBackground: Non-alcoholic fatty liver disease (NAFLD) represents a large and growing public health problem. Insulin resistance (IR) plays a crucial role in the pathogenesis of NAFLD. The aim of this study was to determine the association of triglyceride-glucose (TyG) index, TyG index with body mass index (TyG-BMI), lipid accumulation product (LAP), visceral adiposity index (VAI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c) and metabolic score for IR (METS-IR) with NAFLD in older adults and to compare the discriminatory abilities of these six IR surrogates for NAFLD.Methods: This cross-sectional study included 72,225 subjects aged ≥ 60 years living in Xinzheng, Henan Province, from January 2021 to December 2021. The data were collected from the annual health examination dataset. Logistic regression models were used to examine the relationships between the six indicators and NAFLD risk. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different IR surrogates for NAFLD under the influence of potential risk factors.Results: After adjusting for multiple covariates, compared with the first quintile, the odds ratios (ORs) and 95% confidence intervals (CIs) of the highest quintiles of TyG-BMI were the most obvious (OR:43.02, 95% CI:38.89– 47.72), followed by the METS-IR (OR:34.49, 95% CI:31.41– 37.95). Restricted cubic spline analysis reported that there were non-linear positive association and dose-response relationship between 6 IR surrogates and NAFLD risk. Compared with other IR-related indicators (LAP, TyG, TG/HDL-c and VAI), TyG-BMI showed the highest AUC (AUC:0.8059;95% CI:0.8025– 0.8094). Additionally, METS-IR also had a high predictive performance for NAFLD, and the AUC was greater than 0.75 (AUC:0.7959;95% CI:0.7923– 0.7994).Conclusion: TyG-BMI and METS-IR had pronounced discrimination ability to NAFLD, which are recommended as complementary markers for the assessment of NAFLD risk both in clinic and in future epidemiological studies.Keywords: non-alcoholic fatty liver disease, insulin resistance surrogates, triglyceride-glucose index with body mass index, metabolic score for insulin resistance

Abstract Background The involvement of the central nervous system is a frequent yet underestimated complication of diabetes mellitus. Visual evoked potentials (VEP) are a simple, sensitive, and noninvasive method for detecting early alterations in central optic pathways. The objective of this paralleled randomized controlled trial was to evaluate the impact of ozone therapy on visual pathways in diabetic patients. Methods Sixty patients with type 2 diabetes visiting clinics of Baqiyatallah university in Tehran (Iran) hospital were randomly assigned to two experimental groups: Group 1 (N = 30) undergoing a cycle of 20 sessions of systemic oxygen-ozone therapy in addition to standard therapy for metabolic control; Group 2 (N = 30)—serving as control—receiving only standard therapy against diabetes. The primary study endpoints were two VEP parameters; P100 wave latency and P100 amplitude at 3 months. Moreover, HbA1c levels were measured before the start of treatment and three months later as secondary study endpoint. Results All 60 patients completed the clinical trial. P100 latency significantly reduced at 3 months since baseline. No correlation was found between repeated measures of P100 wave latency and HbA1c (Pearson’s r = 0.169, p = 0.291). There was no significant difference between baseline values and repeated measures of P100 wave amplitude over time in either group. No adverse effects were recorded. Conclusions Ozone therapy improved the conduction of impulses in optic pathways of diabetic patients. The improved glycemic control following ozone therpay may not fully explain the reduction of P100 wave latency though; other mechanistic effects of ozone may be involved.

Objective To investigate the cognition of colorectal cancer-related knowledge and influencing factors of patients with middle- and advanced-stage colorectal cancer in ethnic minority areas of Inner Mongolia. Methods According to the national population and the prevalence of colorectal cancer, 277 patients with colorectal cancer were selected by stratified and random sampling in Inner Mongolia. The patients were surveyed in Baotou, Chifeng, Bayannaoer, and other hospitals. The questionnaire included patients' basic information, cognition of colorectal cancer risk factors and screening knowledge, screening information, etc. Results Before suffering from the disease, the patients' knowledge of colorectal cancer (risk factors, early screening knowledge, treatment methods) was low. About 54.9% of patients were unaware of high risk factors for colorectal cancer, 75.8% of patients did not understand the knowledge of early screening of colorectal cancer, and 37.5% of patients did not underst and the treatment of colorectal cancer. The main influencing factors of colorectal cancer cognition were education level and occupation. Patients who work in institutions and enterprises and with higher education level had better cognition. Conclusion Patients with middle- and advanced-stage colorectal cancer in Inner Mongolia have poor knowledge and awareness of risk factors and screening of colorectal cancer before diagnosis. Education level and occupation are factors influencing colorectal cancer cognition, therefore, people with low knowledge rate of colorectal cancer and low education level as well as unemployed laid-off people should be given priority intervention.

Purpose Schizophrenia (SCH) is a severe psychiatric disorder associated with brain connectivity abnormalities, and early diagnosis can significantly reduce the burden on the families of the patients. Though several classification methods have been created to identify SCH, a reliable method is yet to be found. In this study, we explore the performance of multidimensional spatial feature fusion in the recognition of SCH. Materials and methods Using an MRI connectomes dataset, we extract the spatial pattern network (SPN) and diffusion map embedding (DME) features from functional connectivity (FC) and structural connectivity (SC) networks of both schizophrenic patients and healthy subjects, and we use both single mode features and fused features to classify the two groups. Results Compared to the single mode features, the fused features showed superior performance in classification. By fusing the SPN and DME features of the structural network, we obtained the highest accuracy of 87.50%. Conclusions Multidimensional spatial feature fusion is promising as a reliable method for the recognition of SCH.

Objectives: As the genetic variants of SARS-CoV-2 continuously pose threats to global health, evaluating superspreading potentials of emerging genetic variants is of importance for region-wide control of COVID-19 outbreaks. Methods: By using detailed epidemiological contact tracing data of test-positive COVID-19 cases collected between July and August 2021 in Nanjing and Yangzhou, China, we assessed the superspreading potential of outbreaks seeded by SARS-CoV-2 Delta variants. The transmission chains and case-clusters were constructed according to the individual-based surveillance data. We modelled the disease transmission as a classic branching process with transmission heterogeneity governed by negative binomial models. Subgroup analysis was conducted by different contact settings and age groups. Results: We reported a considerable heterogeneity in the contact patterns and transmissibility of Delta variants in eastern China. We estimated an expected 14% (95% CI: 11–16%) of the most infectious cases generated 80% of the total transmission. Conclusions: Delta variants demonstrated a significant potential of superspreading under strict control measures and active COVID-19 detecting efforts. Enhancing the surveillance on disease transmissibility especially in high-risk settings, along with rapid contact tracing and case isolations would be one of the key factors to mitigate the epidemic caused by the emerging genetic variants of SARS-CoV-2.

In order to develop lithium-ion batteries with high energy density, prelithium technology has attracted extensive attention. Li5FeO4was successfully prepared by molten salt method with LiNO3-LiOH mixed lithium salt as reaction medium and lithium source, and nano Fe2O3 as iron source in this work. Li5FeO4 as cathode prelithiation additive is applied to lithium-ion batteries. The synthesis conditions of Li5FeO4 were optimized by orthogonal experiment, and the effect of synthesis conditions on the electrochemical properties of the material was discussed. Li5FeO4 was added to the surface of LiFePO4 positive electrode and assembled with graphite negative electrode to form a full cell. Its effect on the electrochemical performance of the full cells and the mechanism of reducing the initial capacity loss of lithium-ion batteries were studied. The results show that Li5FeO4 cathode prelithiation additives with high purity, small particle size and outstanding electrochemical performance can be prepared by molten salt method. When Li5FeO4 with a mass fraction of 2.8%(based on the percentage of active materials mass) was added, the discharge specific capacity of first cycle for the LiFePO4/graphite full cell was 150 mAh·g-1 at 0.05 C, which was 8.5% higher than that without adding, after 100 cycles at 0.2 C. the capacity still increased by 7.1%, and the irreversible capacity of the svstem was restored.

Abstract Background Carotid atherosclerosis (CAS), an important factor in the development of stroke, is a major public health concern. The aim of this study was to establish and validate machine learning (ML) models for early screening of CAS using routine health check-up indicators in northeast China. Methods A total of 69,601 health check-up records from the health examination center of the First Hospital of China Medical University (Shenyang, China) were collected between 2018 and 2019. For the 2019 records, 80% were assigned to the training set and 20% to the testing set. The 2018 records were used as the external validation dataset. Ten ML algorithms, including decision tree (DT), K-nearest neighbors (KNN), logistic regression (LR), naive Bayes (NB), random forest (RF), multiplayer perceptron (MLP), extreme gradient boosting machine (XGB), gradient boosting decision tree (GBDT), linear support vector machine (SVM-linear), and non-linear support vector machine (SVM-nonlinear), were used to construct CAS screening models. The area under the receiver operating characteristic curve (auROC) and precision-recall curve (auPR) were used as measures of model performance. The SHapley Additive exPlanations (SHAP) method was used to demonstrate the interpretability of the optimal model. Results A total of 6315 records of patients undergoing carotid ultrasonography were collected; of these, 1632, 407, and 1141 patients were diagnosed with CAS in the training, internal validation, and external validation datasets, respectively. The GBDT model achieved the highest performance metrics with auROC of 0.860 (95% CI 0.839–0.880) in the internal validation dataset and 0.851 (95% CI 0.837–0.863) in the external validation dataset. Individuals with diabetes or those over 65 years of age showed low negative predictive value. In the interpretability analysis, age was the most important factor influencing the performance of the GBDT model, followed by sex and non-high-density lipoprotein cholesterol. Conclusions The ML models developed could provide good performance for CAS identification using routine health check-up indicators and could hopefully be applied in scenarios without ethnic and geographic heterogeneity for CAS prevention.

Background: Although the COVID-19 pandemic has persisted for more than two years with the evident excess mortality from diabetes, few studies have investigated its temporal patterns. This study aims to estimate the excess deaths from diabetes in the United States (US) during the COVID-19 pandemic and evaluate the excess deaths by spatiotemporal pattern, age groups, sex, and race/ethnicity. Methods: Diabetes as one of multiple causes of death or an underlying cause of death were both considered into analyses. The Poisson log-linear regression model was used to estimate weekly expected counts of deaths during the pandemic with adjustments for long-term trend and seasonality. Excess deaths were measured by the difference between observed and expected death counts, including weekly average excess deaths, excess death rate, and excess risk. We calculated the excess estimates by pandemic wave, US state, and demographic characteristic. Results: From March 2020 to March 2022, deaths that diabetes as one of multiple causes of death and an underlying cause of death were about 47.6 % and 18.4 % higher than the expected. The excess deaths of diabetes had evident temporal patterns with two large percentage increases observed during March 2020, to June 2020, and June 2021 to November 2021. The regional heterogeneity and underlying age and racial/ethnic disparities of the excess deaths were also clearly observed. Conclusions: This study highlighted the increased risks of diabetes mortality, heterogeneous spatiotemporal patterns, and associated demographic disparities during the pandemic. Practical actions are warranted to monitor disease progression, and lessen health disparities in patients with diabetes during the COVID-19 pandemic.

Cold rolling and heat treatment experiments of GH4169 alloy with different deformation were carried out. Effect of different cold rolling deformation and heat treatment state on microstructure and hardness of plate was analyzed. Cold rolling experimental results show that dislocation density is increased, dislocations are cross slipped, deformation texture are enhanced, twins boundaries are decreased and hardness is improved with the increasing of deformation. Different heat treatment experimental results show that when the cold rolling deformation within 0%-20%, after 980 ℃×10 min solution treatment, the recrystallization is incepted, grains are refined, deformed grains and dislocation are remained in the plate. When the deformation within 0%-20%, deformed grains are remained and recrystallized grain size is refined with the increasing of deformation, thus the hardness of solution treated plate is increased with the increasing of deformation. The recrystallization finished and work hardening is eliminated,thus the hardness of solution treated plate decline to undeformed level and remains unchanged when the deformation larger than 25%. The γ' and γ'' phases are precipitated in the plate after aging heat treatment, and the hardness of the plate is significantly higher than that of the cold rolled and solid solution treatment states, and the hardness is basically not affected by the deformation amount of cold rolling. The threshold value of cold rolling deformation for recrystallization inception of GH4169 alloy is within 5%-10% during 980 ℃ solution treatment. And the cold rolling deformation threshold value of complete recrystallization is about 25%. According to actual production condition, the optimal cold rolling deformation is larger than 25%, and the matched solution treatment is 980 ℃×10 min.

Abstract Background Lifestyle changes are important for the prevention and management of metabolic syndrome (MetS), but studies that focus on gender differences in the lifestyle risk factors of MetS are limited in China. This research aimed to generate a healthy lifestyle index (HLI) to assess the behavioral risk factors of MetS and its components, and to explore the gender differences in HLI score and other influencing factors of MetS. Methods A convenience sample of 532 outpatients were recruited from a general hospital in Changsha, China. The general information and HLI scores [including physical activity (PA), diet, smoking, alcohol use, and body mass index (BMI)] of the subjects were collected through questionnaires, and each patient’s height, weight, waist circumference, and other physical signs were measured. Logistic regression analysis was used to analyze the risk factors of MetS and its components. Results The prevalence of MetS was 33.3% for the whole sample (46.3% in males and 23.3% in females). The risk of MetS increased with age, smoking, unhealthy diet, and BMI in males and with age and BMI in females. Our logistic regression analysis showed that lower HLI (male: OR = 0.838,95%CI = 0.757–0.929; female: OR = 0.752, 95%CI = 0.645–0.876) and older age (male: OR = 2.899, 95%CI = 1.446–5.812; female: OR = 4.430, 95%CI = 1.640–11.969) were independent risk factors of MetS, for both sexes. Conclusion Low levels of HLI and older ages were independent risk factors of MetS in both males and females. The association between aging and MetS risk was stronger in females, while the association between unhealthy lifestyles and MetS risk was stronger in males. Our findings reinforced the expected gender differences in MetS prevalence and its risk factors, which has implications for the future development of gender-specific MetS prevention and intervention programs.

Abstract TM4SF1, a member of the transmembrane 4 superfamily, is crucial for both healthy and malignant human tissues. The significant function of TM4SF1 in the incidence and progression of cancer has been widely recognized in recent years. Although some achievements have been made in the study of TM4SF1, the effect of TM4SF1 on cancer stemness in hepatocellular carcinoma (HCC) and its molecular basis are yet to be reported. We found through abundant in vitro and in vivo experiments which the expression of TM4SF1 was positively correlated with the progression and cancer stemness of HCC. We identified the downstream protein MYH9 of TM4SF1 and its final regulatory target NOTCH pathway using bioinformatics analysis and protein mass spectrometry. We cultivated a Lenvatinib-resistant strain from HCC cells to examine the relationship between cancer stemness and tumor drug resistance. The study confirmed that TM4SF1 could regulate the NOTCH pathway by upregulating MYH9, thus promoting cancer stemness and Lenvatinib resistance in HCC. This study not only provided a new idea for the pathogenesis of HCC but also confirmed that TM4SF1 might become a new intervention point to improve the clinical efficacy of Lenvatinib in treating HCC.

Abstract Background Giant hepatic hemangiomas are rare and can cause serious complications that contribute to a high risk of perinatal mortality. The purpose of this article is to review the prenatal imaging features, treatment, pathology, and prognosis of an atypical fetal giant hepatic hemangioma and to discuss the differential diagnosis of fetal hepatic masses. Case presentation A gravida 9, para 0 woman at 32 gestational weeks came to our institution for prenatal ultrasound diagnosis. A complex, heterogeneous hepatic mass measuring 5.2 × 4.1 × 3.7 cm was discovered in the fetus using conventional two-dimensional ultrasound. The mass was solid and had both a high peak systolic velocity (PSV) of the feeding artery and intratumoral venous flow. Fetal magnetic resonance imaging (MRI) revealed a clear, hypointense T1-W and hyperintense T2-W solid hepatic mass. Prenatal diagnosis was very difficult due to the overlap of benign and malignant imaging features on prenatal ultrasound and MRI. Even postnatally, neither contrast-enhanced MRI nor contrast-enhanced computed tomography (CT) was useful in accurately diagnosing this hepatic mass. Due to persistently elevated Alpha-fetoprotein (AFP), a laparotomy was performed. Histopathological examination of the mass showed atypical features such as hepatic sinus dilation, hyperemia, and hepatic chordal hyperplasia. The patient was ultimately diagnosed with a giant hemangioma, and the prognosis was satisfactory. Conclusions When a hepatic vascular mass is found in a third trimester fetus a hemangioma should be considered as a possible diagnosis. However, prenatal diagnosis of fetal hepatic hemangiomas can be challenging due to atypical histopathological findings. Imaging and histopathological assays can provide useful information for the diagnosis and treatment of fetal hepatic masses.

Han Zhang,1– 3 Yefan Zhang,1– 3 Sen Sheng,1,2 Yang Xing,4 Zhongchen Mou,5 Yanqiu Zhang,1– 3 Zhixue Shi,1– 3 Zhenjie Yu,1,2 Qianqian Gao,1– 3 Weiqin Cai,1– 3 Qi Jing1– 3 1School of Management, Weifang Medical University, Weifang, Shandong, People’s Republic of China; 2“Health Shandong” Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, People’s Republic of China; 3China Academy of Rehabilitation and Health, Weifang Medical University, Weifang, People’s Republic of China; 4Weifang People’s Hospital, Weifang, People’s Republic of China; 5School of Psychology, Weifang Medical University, Weifang, People’s Republic of ChinaCorrespondence: Weiqin Cai; Qi Jing, School of Management, Weifang Medical University, No. 7166 Baotongxi Street, Weifang, 261053, People’s Republic of China, Tel +8618106369128, Email caiwq@wfmc.edu.cn; jingq@wfmc.edu.cnObjective: Although physical exercise has been shown to boost physical, psychological, and psychiatric conditions in older adults, there is a relative lack of research on the mechanisms involved in this process for older adults with type 2 diabetes mellitus (T2DM). We thus evaluated whether sleep quality and depression mediated the relationship between physical exercise and cognitive impairment in older adults with T2DM by focusing on the exercise–physiology–psychology and psychiatry connection.Methods: Self-reported data were collected from 2646 older adults with T2DM in Weifang, Shandong, China. Regression and bootstrap analyses were conducted to explore the chain mediator model including physical exercise, cognitive impairment, sleep quality, and depression.Results: Engaging in physical exercise (coefficient = − 0.6858, p < 0.001), high levels of sleep quality (coefficient = − 0.3397, p = 0.015), and low levels of depression (coefficient = 0.3866, p < 0.001) were significantly associated with a low level of cognitive impairment. Sleep quality and depression mediated the chain effect between physical exercise and cognitive impairment (total effect = − 1.0732, 95% CI [− 1.3652, − 0.7862]; direct effect = − 0.6858, 95% CI [− 0.9702, − 0.3974]; indirect effect = − 0.3875, 95% CI [− 0.5369, − 0.2521]).Conclusion: Physical exercise may improve sleep quality in older adults with T2DM, alleviating depression and delaying the development of cognitive impairment. Physical exercise can enhance patients’ ability to resist depression and cognitive impairment, and creating comfortable sleep environments can also reinforce the effects of this process. These findings have important implications for promoting healthy aging in older adults with T2DM.Keywords: physical exercise, cognitive impairment, older adults, depression, sleep quality, type 2 diabetes

Abstract Background The high immune evasion ability of SARS-COV-2 Omicron variant surprised the world and appears to be far stronger than any previous variant. Previous to Omicron it has been difficult to assess and compare immune evasion ability of different variants, including the Beta and Delta variants, because of the relatively small numbers of reinfections and because of the problems in correctly identifying reinfections in the population. This has led to different claims appearing in the literature. Thus we find claims of both high and low immune evasion for the Beta variant. Some findings have suggested that the Beta variant has a higher immune evasion ability than the Delta variant in South Africa, and others that it has a lower ability. Method In this brief report, we re-analyse a unique dataset of variant-specific reinfection data and a simple model to correct for the infection attack rates of different variants. Result We find that a model with the Delta variant having an equal or higher immune evasion ability than Beta variant is compatible with the data. Conclusion We conclude that the immune evasion ability of Beta variant is not stronger than Delta variant, and indeed, the immune evasion abilities of both variants are weak in South Africa.

Abstract To evaluate clinical value of metagenomic next-generation sequencing (mNGS) in people living with HIV/AIDS (PLWHA) who had CNS disorders. Cerebrospinal fluid (CSF) samples from 48 PLWHA presenting with CNS disorders were sequenced using mNGS and compared with clinical conventional diagnostic methods. In total, 36/48 ss(75%) patients were diagnosed with pathogen(s) infection by mNGS, and the positive detection proportion by mNGS was higher than that by clinical conventional diagnostic methods (75% vs 52.1%, X 2 = 5.441, P = 0.020). Thirteen out of 48 patients (27.1%) were detected with 3–7 pathogens by mNGS. Moreover, 77 pathogen strains were detected, of which 94.8% (73/77) by mNGS and 37.0% (30/77) by clinical conventional methods (X 2 = 54.206, P

Abstract Aim The transjugular intrahepatic portosystemic shunt (TIPS) procedure has been performed in China for 30 years, but our understanding of the status and difficulties associated with the use of TIPS for portal hypertension is incomplete. This study aims to investigate the current situation of the use of TIPS for portal hypertension, which should aid the development of TIPS in China. Methods This study involved a questionnaire survey, initiated by the China Portal Hypertension Alliance (CHESS) to investigate the use of TIPS for portal hypertension in China. Questionnaires were released on the Internet between August 16, 2022 and September 16, 2022. Detailed information was collected from 545 hospitals contracted by the CHESS in China, which performed TIPS surgery in 2021. Results The 545 hospitals covers the majority of hospitals in China that conduct TIPS intervention. In the survey, a total of 13,527 TIPS interventions were carried out with 94.1% (498/545) of them had a system of routine follow‐up after TIPS. The majority (42.6% [232/545]) believed that the main indication of TIPS was the control of acute bleeding. Overall, 48.1% (262/545) carried out early or pre‐emptive TIPS, 53.0% (289/545) carried out TIPS for cavernous transformation of the portal vein, and 81.0% (441/545) chose routine embolization of collateral circulation during operation. Most used coils (97.0% [475/490]) and biological glue (72.0% [353/490]) as embolic materials, and 78.5% (428/545) routinely performed intraoperative portal pressure gradient measurements. When selecting TIPS stents, 57.1% (311/545) chose viator‐specific stents, and 57.2% (312/545) chose conventional anticoagulation after TIPS. Conventional anticoagulation after TIPS is over a time interval of 3–6 months (55.4% [173/312]). The limitation of TIPS surgery is mainly its cost (72.3% [394/545]) and insufficient understanding of the procedure by doctors in other related departments (77.4% [422/545]). Most of the hospital teams accept the use of domestic instruments in TIPS surgery (92.7% [505/545]). Conclusions This survey shows that TIPS is an essential part of the treatment of portal hypertension in China. TIPS is widely used in Chinese patients with portal hypertension, and this survey presents a more comprehensive picture of the options and difficulties encountered in the implementation of TIPS. In the future, it is necessary to promote TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Abstract Background The ability to walk is crucial for maintaining independence and a high quality of life among older adults. Although gait characteristics have been extensively studied in older adults, most studies have investigated muscle activity in the joints of the trunk or the lower limbs without assessing their interactions. Thus, the causes of altered trunk and lower limb movement patterns in older adults remain to explore. Therefore, this study compared the joint kinematic parameters of both trunk and lower limbs between young and older adults to identify kinematic factors associated with changes in gait among older adults. Methods In total, 64 older (32 males, aged 68.34 ± 7.38 years; 32 females, aged 67.16 ± 6.66 years) and 64 young (32 males, aged 19.44 ± 0.84 years; 32 females, aged 19.69 ± 0.86 years) healthy adults participated in this study. The range of motion (ROM) of the thorax, pelvis, and trunk in the horizontal plane and of the hip, knee, and ankle joints of the lower limbs in the sagittal plane were measured using a motion capture system with wearable sensors. Two-way analysis of variance assessed differences in ROM by group, sex, and spatio-temporal gait parameters; Pearson correlation analysis assessed the correlation of the trunk and lower limbs. Results Step length, gait speed, and stride length were greater in young adults (p

C21H22N2O7S2Mn, monoclinic, P21/c (no. 14), a = 14.544(6) Å, b = 9.636(4) Å, c = 17.087(7) Å, β = 96.664(6)° $96.664(6){}^{\circ}$ , V = 2378.5(17) Å3, Z = 4, Rgt ${R}_{\mathit{g}\mathit{t}}$ (F) = 0.0349, wRref $w{R}_{\mathit{r}\mathit{e}\mathit{f}}$ (F 2) = 0.1036, T = 273.15 K.

C18H19BrN2NiO8, monoclinic, P21/n (no. 14), a = 16.7861(4) Å, b = 7.0732(2) Å, c = 17.1041(4) Å, β = 102.674(2)° $102.674(2){}^{\circ}$ , V = 1981.31(9) Å3, Z = 4, R gt(F) = 0.0340, wR ref(F 2) = 0.0670, T = 293(2) K.

Peng Huang,1,2,&ast; Xiaoyan Ni,1,2,&ast; Changwu Zhou,1– 3 Zhang Shi,1,2 Fei Wu,1,2 Yuyao Xiao,1,2 Chun Yang,1,2 Mengsu Zeng1– 3 1Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Institute of Medical Imaging, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mengsu Zeng, Shanghai Institute of Medical Imaging, Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 13501922963, Email zeng.mengsu@zs-hospital.sh.cn Chun Yang, Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 18702135336, Email dryangchun@hotmail.comObjective: To compare the pathologic diagnosis and survival of patients with subcentimeter and 1– 2 cm nodules that present with diagnostic hallmarks of hepatocellular carcinoma (HCC).Methods: Diagnostic hallmarks of HCC were defined as hyperintensity on T2 weighted imaging, restricted diffusion, arterial phase hyperenhancement, washout on portal venous phase, and hypointensity on hepatobiliary phase. We retrospectively included 139 patients undergoing curative resection with single nodules ≤ 2 cm that present imaging features described above on gadoxetic acid-enhanced MRI. The final diagnosis was confirmed by histopathological assessment. Recurrence-free survival (RFS) was compared using Kaplan–Meier analysis with the Log-rank test. Factors associated with overall and early recurrence were identified using Cox regression analysis.Results: Among 139 nodules (49 nodules < 1 cm), there was no significant difference in the percentage of HCC between subcentimeter and 1– 2 cm nodules (94.0% vs 94.4%, P > 0.999). Microvascular invasion (MVI) was less common in subcentimeter HCC (4.3% vs 17.6%, P = 0.032). There were 27 recurrences during a median follow-up time of 46.7 months. Patients with subcentimeter HCC achieved less recurrence, with a 5-year RFS rate of 87.3%. The MVI-positive patients had more early and overall recurrence. A tumor size < 1 cm was associated with lower overall recurrence (HR, 0.336; P = 0.047). No factors were independently associated with early recurrence.Conclusion: Subcentimeter nodules with diagnostic hallmarks of HCC are highly associated with HCC diagnosis and achieve less tumor recurrence after resection. Early diagnosis and treatment of subcentimeter HCC may be more appropriate.Keywords: carcinoma, hepatocellular, magnetic resonance imaging, gadolinium ethoxybenzyl DTPA

This trial aimed to compare the outcomes of drug-eluting beads transarterial chemoembolization (DEB-TACE) with CalliSpheres® microspheres (CSM) and conventional transarterial chemoembolization cTACE in the treatment of patients with unresectable hepatocellular carcinoma (HCC).

AlMaha Al Shammaa, Amna Al-Thani, Maryam Al-Kaabi, Kaltham Al-Saeed, Maria Alanazi, Zumin Shi Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, QatarCorrespondence: Zumin Shi, Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar, Tel +974 4403 6034, Fax +974 4403 4801, Email zumin@qu.edu.qaPurpose: Magnesium is vital to maintain normal physiological functions. We aimed to identify the association between serum magnesium and different measures of body adiposity among Qatari adults. We hypothesized that the association was mediated by depression and sleep duration.Patients and Methods: The study included 1000 adults aged 20 years and above who attended the Qatar Biobank Study (QBB) between 2012 and 2019. Body adiposity was assessed using dual-energy X-ray absorptiometry (DEXA). Serum magnesium concentration was measured. Sub-optimal magnesium was defined as magnesium concentration less than 0.85 mmol/L. The association was examined using linear regression.Results: The mean age of the participants (n=1000) was 35.8 (SD 10.3) years. More than half of the participants had sub-optimal magnesium concentrations (60.2% in men and 52.3% in women). Serum magnesium was inversely associated with different types of fat mass. In the fully adjusted model, per 1 SD increment of serum magnesium had standardized regression coefficients of − 0.09 (p 0.005) for total fat mass, − 0.08 (p 0.008) for trunk fat, − 0.09 (p 0.003) for gynoid fat and − 0.08 (p 0.008) for android fat. There was no gender difference in the association. The inverse association between serum magnesium and fat mass was significant in those with sleep duration ≥ 7 hours but not in those < 7 hours. Depressive symptom and sleep did not mediate the association between serum magnesium and fat mass. Serum magnesium was inversely associated with metabolic syndrome (per 1 SD increment had an odds ratio (OR) of 0.70 (95% CI 0.57– 0.85)).Conclusion: There was an inverse association between serum magnesium and fat mass, especially among those with an adequate sleep duration and without chronic conditions including diabetes, hypertension and depression.Keywords: serum magnesium, DEXA, body adiposity, total fat mass, Qatar Biobank, cross-sectional study

Jiacheng Ding,1 Xuejiao Chen,1 Zhan Shi,2 Kaizhi Bai,1 Songhe Shi1 1Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Pharmacy, Zhengzhou People’s Hospital, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Songhe Shi, Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou City, Henan Province, People’s Republic of China, Tel + 86 371 18037108985, Email ssh@zzu.edu.cnPurpose: Previous studies have shown that metabolically healthy obesity (MHO) and changes in its status are connected to an increased incidence of cardiovascular disease (CVD). Yet, fewer studies have been conducted in China, especially for the middle-aged and elderly population, a high-risk group. The purpose of the study was to investigate the association between metabolic health status and CVD events.Patients and Methods: A total of 46,055 participants were categorized into 6 subgroups with different metabolic states according to the existence of metabolic syndrome and body mass index (BMI). The changes in obesity and metabolic health status were defined from baseline to follow-up outcomes with a combination of overweight and obesity. Cox proportional hazards models estimated the association of CVD events and each BMI–metabolic groups.Results: MHO and metabolic abnormality normal weight (MANW) subjects had a higher HR of CVD, 1.62 (95% CI, 1.36– 1.92) and 1.24 (95% CI, 1.07– 1.44), respectively, than their metabolically healthy normal weight (MHNW) counterparts. Then, more than 50% and 30% of the metabolically healthy overweight or obesity (MHOO) populations maintained their status and converted to a metabolically unhealthy state, respectively. Stable MANW, MHOO and metabolically abnormal obesity (MAO) were associated with a higher risk for CVD, 1.68 (95% CI, 1.37– 2.05),1.26 (95% CI, 1.08– 1.47) and 1.65 (95% CI, 1.45– 1.88), respectively, than stable MHNW.Conclusion: Despite being of normal weight, MANW status is in fact a risk factor for CVD, as well as MHO, especially for the Chinese middle-aged and elderly population. Furthermore, metabolic health is a transient state for partial middle-aged and elderly Chinese individuals, and MAO has the highest risk of CVD, including coronary heart disease (CHD) and stroke.Keywords: metabolic health, obesity, heterogeneity, metabolically healthy obesity, cardiovascular disease, retrospective study

Flexible energy storage devices are at the forefront of next-generation power supplies, one of the most important components of which is the gel electrolyte. The dual network gel electrolyte for PAM/P123 zinc ion batteries was prepared by free radical polymerization. It was found that the addition of a small amount of triblock copolymer P123 can macroscopically improve the tensile strength, toughness and compressive strength of the gel electrolyte. Microscopically, the gel skeleton forms 0.6 μm mesopores and increases the surface pore distribution density, thereby improving the wettability of the electrolyte. The PAM/P123 series electrolytes not only have a high average swelling rate, but also have a higher conductivity than pure PAM electrolyte in the range of -30℃ to 65℃. Among which, PAM/P123-2 is a series of electrolytes with the best performance, with an average swelling rate of 1920.79%, and the conductivity at 0℃ is 36.2 mS·cm-1.The Zn/MnO2 battery prepared by using PAM/P123-2 gel electrolyte is stable during cycling at 0℃, with the capacity retention rate reaching 82.39% after 1000 cycles.

With the large-scale integration of distributed new energy sources into power grids and the wide application of power electronics， the power grid’s risk of oscillation has reached epidemic proportions and is resolving into broadband domain oscillation. Given the lack of effective means to monitor the broadband domain characteristics of the power grid on the dispatching side， a grid-oriented broadband monitoring system is developed. First， the hardware and software architectures of the system are introduced， and a broadband monitoring model is designed based on two mainstream extended versions of harmonic communication specifications. Then， a unified broadband data acquisition architecture and a unified broadband data service technology are proposed. Functional modules such as harmonic/interharmonic overrun alarm， historic broadband data query， and broadband oscillation alarm forwarding are developed to realize distributed acquisition， centralized monitoring， and analysis of high-capacity and high-rate broadband signals. Finally， it is shown through engineering practice that the broadband monitoring system provides powerful data support for dynamic monitoring， risk identification， prevention， and control in the more broadband domains in power grids.

BACKGROUND With the analytical technique development, the precision of Si isotopes analysis increases rapidly.Silicon isotopes are widely used in geochemistry, cosmochemistry, environmental chemistry and so on, and can be used to trace the circulation of crust-mantle material, the source of subducting fluid, and constrain the origin and evolution of the moon and extraterrestrial materials.To compare the precision and accuracy of Si isotope analysis results in different laboratories, it is necessary to analyze Si isotopes of reference materials with published Si isotope data.As generally used USGS reference materials are currently unavailable, it is important to report Si isotopes of new reference materials. OBJECTIVES In order to continuously conduct research in various fields with high-precision silicon isotope data, by providing a supply of new reference materials.Silicon isotopes of 30 GBW reference materials with different compositions, including 11 igneous rocks, 2 sedimentary rocks, 2 metamorphic rocks, 6 river/marine sediments and 9 soils, were analyzed.The SiO2 content of these reference materials ranged from 32.69% to 90.36%, covering the variation range of most natural samples. METHODS Alkali fusion method was used for sample digestion.Approximately 3-5mg of sample powder and 200mg of powdery NaOH were weighed in a 10mL silver crucible and heated.The Si purification was obtained using cation exchange resin AG50W-X12.6mol/L HNO3 and ultrapure water were used to clean the resin before sample loading.Silicon isotopes were measured by multi-collector inductively coupled plasma-mass spectrometry (MC-ICP-MS, Neptune Plus) at the laboratory in the University of Science and Technology of China (USTC), and the instrument mass bias was corrected by standard-sample-standard method, with a bracketing standard of NBS-28.The long-term reproducibility (over two years) of Si isotope analysis of one in-house standard (USTC-Si) and one international rock reference material (BHVO-2) were represented, with the δ30Si values of USTC-Si and BHVO-2 of-0.07‰±0.06‰(n=117, 2SD) and-0.29‰±0.06‰(n=320, 2SD), respectively.During Si isotope analysis, two rock reference materials BHVO-2 and AGV-2 were also analyzed to ensure the precision and accuracy of the data.The Si isotopic compositions of BHVO-2 and AGV-2 were consistent with the reported data in the previous literature (Figure 3), demonstrating the reliability of this measurement. RESULTS Except one sediment and two soil samples, the δ30Si values of most reference materials analyzed in this study range from-0.42‰ to-0.07‰, within the range of upper continental crust.The drainage sediment GBW07310 has the highest δ30Si value (0.85‰±0.01‰), while the yellow-red soil GBW07405 and the latosol GBW07407 have the lowest δ30Si values of-0.68‰±0.03‰ and-1.82‰±0.03‰, respectively. CONCLUSIONS The high-precision Si isotope data of 30 GBW reference materials helps replenish the database for Si isotope analysis.The Si isotope data of these standard materials show that the river sediment GBW07310 has a very high δ30Si value of-1.82‰±0.03‰, indicating that it may be formed by dissolved silicon precipitation, which are enriched in heavy Si isotopes; while highly weathered yellow-red soil GBW07405 and the latosol GBW07407 have the lowest δ30Si values of-0.68‰±0.03‰ and-1.82‰±0.03‰, respectively, indicating that the weathering and desiliconization process may lead to the loss of heavy Si isotopes.The δ30Si values of most remaining reference materials analyzed in this study vary from-0.42‰ to-0.07‰, within the variation range of the upper continental crust.There is no obvious correlation between δ30Si values and SiO2 contents of the 11 igneous rock reference materials, revealing that their Si isotopes were not controlled by partial melting or mineral crystallization processes, and there may be other processes which would affect the Si isotopic composition of these standards.In the case that generally used USGS reference materials have been sold out, these high-precision Si isotope data of GBW reference materials will supplement basic data for Si isotope testing in different laboratories and lay solid isotope research in various fields.

In this paper, cyclone separator is proposed for the first time to separate particles according to density, and it is applied to the recovery of lithium iron phosphate (LFP) from spent lithium battery materials for the first time. The effect of the flow field on the motion of injected particles in a cyclone separator is studied by means of computational fluid dynamics (CFD). It is found that there is a classification phenomenon caused by the difference in the particle densities and the separation process is simulated accordingly. The results show that 60% LiFePO4 in the original feed can be separated after 7 separations, and the mass purity is 91%, with 7% Al and 2% Fe under instantaneous surface injection conditions. Compared with the original feed, LFP is effectively recycled. After 15 separations, the efficiency increases to 76%. Under simulated continuous injection conditions, the separation efficiency of LFP is 61.22% after 20 simulated separations, and the mass purities of the separated products are 92.53% LFP, 6.92% Al, 0.44% Fe and 0.11% Cu. Compared with the traditional method, the new method has advantages of low energy consumption, low cost, theoretically no pollution, and great development potential.

Abstract Background Superspreading events (SSEs) played a critical role in fueling the COVID-19 outbreaks. Although it is well-known that COVID-19 epidemics exhibited substantial superspreading potential, little is known about the risk of observing SSEs in different contact settings. In this study, we aimed to assess the potential of superspreading in different contact settings in Japan. Method Transmission cluster data from Japan was collected between January and July 2020. Infector-infectee transmission pairs were constructed based on the contact tracing history. We fitted the data to negative binomial models to estimate the effective reproduction number (R) and dispersion parameter (k). Other epidemiological issues relating to the superspreading potential were also calculated. Results The overall estimated R and k are 0.561 (95% CrI: 0.496, 0.640) and 0.221 (95% CrI: 0.186, 0.262), respectively. The transmission in community, healthcare facilities and school manifest relatively higher superspreading potentials, compared to other contact settings. We inferred that 13.14% (95% CrI: 11.55%, 14.87%) of the most infectious cases generated 80% of the total transmission events. The probabilities of observing superspreading events for entire population and community, household, health care facilities, school, workplace contact settings are 1.75% (95% CrI: 1.57%, 1.99%), 0.49% (95% CrI: 0.22%, 1.18%), 0.07% (95% CrI: 0.06%, 0.08%), 0.67% (95% CrI: 0.31%, 1.21%), 0.33% (95% CrI: 0.13%, 0.94%), 0.32% (95% CrI: 0.21%, 0.60%), respectively. Conclusion The different potentials of superspreading in contact settings highlighted the need to continuously monitoring the transmissibility accompanied with the dispersion parameter, to timely identify high risk settings favoring the occurrence of SSEs.

Pathological features of Alzheimer's Disease (AD) include alterations in the structure and function of neurons as well as of myelin sheaths. Accumulated evidence shows that aerobic type of exercise can enhance neuroplasticity in mouse models of AD. However, whether and how aerobic exercise can affect myelin sheath repair and neuroprotection in the AD models remains unclear. In this study we tested the hypotheses that 1) myelin structural alterations in 3xTg-AD mice would be related to abnormalities in oligodendrocyte lineage cells, resulting in impaired learning and memory, and 2) a 6-month aerobic exercise intervention would have beneficial effects on such alterations. Two-month-old male 3xTg-AD mice were randomly assigned to a control (AC) or an exercise (AE) group, and age-matched male C57BL/6;129 mice were also randomly assigned to a normal control (NC) or an exercise (NE) group, with n = 12 in each group. Mice in the exercise groups were trained on a motor-drive treadmill, 60 min per day, 5 days per week for 6 months. Cognitive function was assessed at the end of the intervention period. Then, brain specimens were obtained for assessments of morphological and oligodendrocyte lineage cell changes. The results of electron microscopy showed that myelin ultrastructure demonstrated a higher percentage of loose and granulated myelin sheath around axons in the temporal lobe in the AC, as compared with the NC group, along with greater cognitive dysfunction at 8-months of age. These differences were accompanied by significantly greater myelin basic protein (MBP) expression and less neuron-glial antigen-2 (NG2) protein and mRNA levels in the AC, compared to the NC. However, there were no significant between-group differences in the G-ratio (the ratio of axon diameter to axon plus myelin sheath diameter) and 2′,3′-cyclic-nucleotide 3′-phosphodiesterase (CNPase) protein and mRNA levels. The aerobic exercise ameliorated cognitive deterioration and appeared to keep components of myelin sheath and oligodendrocyte precursor cells stabilized, resulting in a decrease in the percentage of loose and granulated myelin sheath and MBP protein, and an increase in NG2 protein and mRNA levels in the AE group. Therefore, the 6-month exercise intervention demonstrated beneficial effects on myelin lesions, abnormal differentiation of oligodendrocytes and general brain function in the 3xTg-AD mice, providing further insights into the role of aerobic exercise in management of neurodegeneration in AD by maintaining intact myelination.

Birth weight is an indicator linking intrauterine environmental exposures to later-life diseases, and intrauterine metal exposure may affect birth weight in a sex-specific manner. We investigated sex-specific associations between prenatal exposure to metal mixtures and birth weight in a Chinese birth cohort. The birth weight of 1296 boys and 1098 girls were recorded, and 10 metals in maternal urine samples collected during pregnancy were measured using inductively coupled plasma mass spectrometry. Bayesian Kernel Machine Regression was used to estimate the association of individual metals or metal mixtures and birth weight for gestational age (BW for GA). The model showed a sex-specific relationship between prenatal exposure to metal mixtures and BW for GA with a significant negative association in girls and a non-significant positive association in boys. Cadmium (Cd) and nickel (Ni) were positively and negatively associated with BW for GA in girls, respectively. Moreover, increasing thallium (Tl) concentration lowered the positive association between Cd and BW for GA and enhanced the negative association between Ni and BW for GA in girls. When exposure to other metals increased, the positive association with Cd diminished, whereas the negative association with Ni or Tl increased. Our findings provide evidence supporting the complex effects of intrauterine exposure to metal mixtures on the birth weight of girls and further highlight the sex heterogeneity in fetal development influenced by intrauterine environmental factors.

Abstract Background Increased frequency of circulating double negative T (DNT, CD4−CD8−CD3+) cells with protective immune function has been observed in human immunodeficiency virus (HIV) infection and tuberculosis (TB). Here the role of circulating TCRαβ+ DNT cells was further investigated in HIV/TB co-infection. Methods A cross-sectional study was conducted to investigate the frequency and functional profiles of peripheral TCRαβ+ DNT cells including apoptosis, chemokine and cytokine expression among healthy individuals and patients with TB, HIV infection and HIV/TB co-infection by cell surface staining and intracellular cytokine staining combined with flow cytometry. Results Significantly increased frequency of TCRαβ+ DNT cells was observed in HIV/TB co-infection than that in TB (p

Objective To evaluate the clinical effect of music therapy combined with sensory integration training on the improvement of motor function in children with cerebral palsy. Methods Fifty children with cerebral palsy were enrolled and randomly divided into the control (n = 25) and observation groups (n = 25). Conventional rehabilitation training was performed in the control group, and music therapy combined with sensory integration training were conducted on the basis of conventional rehabilitation training in the observation group. The course of treatment was 12 weeks in two groups. The 88-item version of the Gross Motor Function Measure (GMFM-88) scale and the Functional Independence Measure for Children (WeeFIM) scale were used to evaluate the gross motor function level and independence of daily life before and after the treatment in two groups. The differences were statistically compared between two groups. Results After 12 weeks of treatment, the D and E domain scores of GMFM-88 scale and WeeFIM scale of children in both groups were significantly higher than those before treatment (all P < 0.05), and the effect in the observation group was better than that in the control group (P < 0.05). Conclusion Compared with conventional rehabilitation training, music therapy combined with sensory integration training can improve the initiatives of children with cerebral palsy and improve their motor function and independent ability in daily life.

In view of widespread slagging on heating surfaces of boilers in power plants， the paper introduces a piezoelectric acceleration sensor for slag impact signal measurement to determine the size and position of the impact of slag on the water wall of the cold ash hopper. In order to verify the accuracy of the method， the slag on boiler water wall was simulated in a laboratory. By the symmetric arrangement of the acceleration sensors in four positions of the cold ash hopper， the four vibration starting times and the maximum amplitudes were measured to judge the fallen slag's approximate area. Moreover， the impact coefficient between the slag block and the cold ash hopper was obtained by calculation fitting. Finally， a sensor was installed in a boiler for on-site test in a power plant. The results show that the method can well locate and measure the slag mass.

In recent years, zinc alloys have shown great potential as orthopedic plant materials because of their excellent biocompatibility, osteoinductive and biodegradation activities in vivo. The physiological function, degradation rate and mechanical properties of pure zinc were introduced in this review. Taking the gap between the above indicators and the clinical needs of orthopedics as the clue and the alloy elements as the classification basis, the existing achievements of researchers to improve the properties of zinc-based materials by changing the microstructure of materials and triggering the corresponding strengthening mechanism, and using the physiological synergistic function of added elements were expounded in this paper. The standard formulation, alloy design improvement and the introduction of new technologies such as additive manufacturing in the field of medical zinc based materials were discussed in order to meet the diversified needs of clinical diagnosis and treatment.

To model estimated deaths averted by COVID-19 vaccines, we used state-of-the-art mathematical modeling, likelihood-based inference, and reported COVID-19 death and vaccination data. We estimated that >1.5 million deaths were averted in 12 countries. Our model can help assess effectiveness of the vaccination program, which is crucial for curbing the COVID-19 pandemic.

The fault diagnosis method of planetary gearbox based on machine learning relies on the artificial selection of the eigenvectors. The quality of eigenvectors selection largely determines the accuracy of the diagnosis method. The convolutional neural network (CNN) can extract characteristics automatically. But it is difficult to accurately diagnose the fault from a single vibration signal when it is used for the planetary gearbox fault diagnosis. To solve the above problems, a fault diagnosis method of planetary gearbox based on multi-information fusion and CNN is proposed. The method performs data layer fusion on three-dimensional (horizontal radial direction, vertical radial direction and axial direction) vibration signals and sound signals of the planetary gearbox. The one-dimensional vibration signals and sound signals are integrated into two-dimensional signals in a parallel connection mode. The two-dimensional signals are used as the input of CNN. The multiple convolutional layers and maximum pooling layers are used for depth characteristic extraction and information filtering. Finally, the Softmax classifier is used to achieve fault classification. The fault diagnosis experiment platform of the planetary gearbox is built. The vibration signals and sound signals of normal and fault states of the planetary gearbox under different speed and load conditions are collected and input into CNN for training and verification. Four single-source information of horizontal radial vibration signal, vertical radial vibration signal, axial vibration signal and sound signal are selected under the same conditions and combined with CNN respectively for comparison. The experiment is used to verify the superiority of the fault diagnosis method for planetary gearbox based on multi-information fusion and CNN. The experimental results show that the fault identification accuracy of the two methods of axial vibration signal+CNN and sound signal+CNN is 74.07% and 75.13% respectively. The fault identification accuracy of the two methods of horizontal radial vibration signal+CNN and vertical radial vibration signal+CNN is 89.70% and 87.09% respectively. The method based on multi-information fusion and CNN has the fastest convergence speed and the highest fault identification accuracy, which is 93.33%.