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The association between time to positivity (TTP) of blood culture and the clinical prognosis of patients with Klebsiella pneumoniae bloodstream infection (BSI) remains unclear. A retrospective study of 148 inpatients with BSI caused by K. pneumoniae was performed at Shanghai Tongji Hospital, China, from October 2016–2020. The total in-hospital fatality rate was 32%. The median TTP was 11.0 (7.7–16.1) h and the optimal cutoff for prediction of in-hospital mortality was 9.4 h according to the ROC curve. Early TTP (P = 0.01), but not by multivariate analysis (OR = 2.7, 95% CI 1.0–7.4, P = 0.06). Old age, serum creatinine, white blood cells, and C-reactive protein values were risk factors for in-hospital mortality by multivariate analysis. Early TTP was not a risk factor for septic shock (OR = 1.8, 95% CI 0.6–5.1, P = 0.27) or ICU admission (OR = 1.0, 95% CI 1.0–1.0, P = 0.32). In conclusion, the in-hospital fatality rate of patients with K. pneumoniae BSI was relatively high and associated with an early TTP of blood cultures. However, no increased risk of mortality, septic shock or ICU admission was evident in early TTP patients.

Rare small cell neuroendocrine carcinoma (SCNEC) cases showed alpha fetoprotein (AFP) expression in the endometrium. In this study, we reported a case of uterine SCNEC expressing AFP. In addition, a literature review was performed to investigate the potential mechanism and the clinicopathological features of SCNEC to provide clinical guidance. A 65-year-old female was referred to our hospital due to vaginal bleeding for 1 month in November 2020. The clinical features were summarized. After total hysterectomy and removal of bilateral appendages, the histological examination and immunohistochemistry examination were performed. Histological findings showed that the cancer cells were arranged in a nest-like pattern distributed in a lamellar manner. The smooth muscles of the uterus were invaded by cancer cells. Cancer cells were relatively consistent in size. Small glandular duct-like and rosettes-like structures were distinguished, together with necrotic tissues. The deep staining showed that the amount of cytoplasm was lower in the nucleus. Partial cancer cells had small nucleolus with an irregular profile. There were some mitotic figures. Immunohistochemistry examination indicated that there was a diffuse expression of CK, Syn, CgA, CD56, CK8/18, P16, AFP, HepPar-1, Glypican-3, and Ki67 (90%). In this case, we reported a SCNEC patient expressing AFP, Glypican-3, and HepPar-1.

The expression of sex-determining region Y (SRY)-like high-mobility group (HMG) box 2 (SOX2) in gastric cancer and the prognosis of patients are controversial. This study analyzed the relationship between SOX2 expression and baseline data, clinicopathological parameters, prognosis, and Helicobacter pylori infection in patients with gastric cancer, and provided new supplements for the diagnosis and treatment of gastric cancer.The articles which reported SOX2 expression in gastric cancer from medical database was collected. The literature search was conducted in PubMed, Google Scholar, Cochrane library, SpringerLink, China National Knowledge Infrastructure, Web of Science, and Wanfang databases, which were written in English and Chinese.A total of 32 articles, including 4641 gastric cancer patients. The results showed that SOX2 expression in gastric cancer group was lower than that in the para-cancerous control group (P.001). Statistical difference was found between the SOX2 expression and differentiation (Well/Moderate vs Poor), TNM stage (I/II vs III/IV), lymphatic invasion (N0 vs N+), edge infiltration (R0 vs R1), and H pylori infection in the pathological parameters. The prognosis analysis showed that the level of SOX2 expression was unrelated to the overall survival of patients (P = .329). No statistical difference was observed between the SOX2 expression and the baseline data of the patients (all P.05).Although downregulation expression of SOX2 are related to clinicopathological parameters in gastric cancer, which is not correlated with prognosis. This controversy over the expression of SOX2 will provide a new idea for the study of gastric cancer.

To explore the application effect of transitional nursing in patients with TIPS. A total of 368 patients were allocated to control group (conventional care) and intervention group (conventional care combined with transitional care). The Child–Pugh scores, blood ammonia levels, compliance behavior, medication compliance, and adverse event incidence rates were compared at 1, 3, 6, 9, and 12 months post-TIPS. There were significant differences in compliance behavior scores, Child–Pugh scores for group effects, time effects, and group × time interaction between the two groups at 1, 3, 6, 9, and 12 months post-TIPS, significant differences in blood ammonia levels at 9 months, and incidence of postoperative adverse events at 12 months after TIPS. Post-TIPS transitional care interventions increased patients’ access to scientifically informed nursing, significantly improved patients’ compliance behavior and health and decreased the incidence of postoperative adverse events.

Graphene, as an emerging 2D material, has been playing an important role in flexible electronics since its discovery in 2004. The representative fabrication methods of graphene include mechanical exfoliation, liquid-phase exfoliation, chemical vapor deposition, redox reaction, etc. Based on its excellent mechanical, electrical, thermo-acoustical, optical, and other properties, graphene has made a great progress in the development of mechanical sensors, microphone, sound source, electrophysiological detection, solar cells, synaptic transistors, light-emitting devices, and so on. In different application fields, large-scale, low-cost, high-quality, and excellent performance are important factors that limit the industrialization development of graphene. Therefore, laser scribing technology, roll-to-roll technology is used to reduce the cost. High-quality graphene can be obtained through chemical vapor deposition processes. The performance can be improved through the design of structure of the devices, and the homogeneity and stability of devices can be achieved by mechanized machining means. In total, graphene devices show promising prospect for the practical fields of sports monitoring, health detection, voice recognition, energy, etc. There is a hot issue for industry to create and maintain the market competitiveness of graphene products through increasing its versatility and killer application fields.

A method to grow few-layer graphene in the form of an “inverted pagoda” is proposed by controlling the pressure and the flow rate in a circulating chemical vapor deposition system. Such single-crystal few-layer graphene consists of one- to eight-layer graphene areas exhibiting layer growth characteristics. Moreover, each layer within this kind of few-layer graphene is in Bernal stacking. In this work, with increasing growth pressure, the self-limiting effect of graphene was successfully overcome, and the growth of graphene in the vertical direction was achieved. By controlling the ratio of H2/CH4, the morphology and the number of layers of the multilayer graphene under the single-layer graphene were modulated.

To investigate the relationship between the nutrition status of infants with bronchopulmonary dysplasia (BPD) at the first 4 weeks of life and the likelihood of developing neonatal malnutrition.A total of 1064 infants were divided into a BPD group and a non-BPD group. After propensity score matching, there were 282 infants in each group. Infants were further divided into a neonatal malnutrition （NM） group and a well-nourished （WN） group. Clinical factors, nutrition intake, and growth parameters were collected and analyzed. Multivariate logistic regression model was used to determine the factors associated with neonatal malnutrition.1. Compared with infants in the non-BPD group, the infants in BPD group had more fluid intake and lower calorie and protein intake after the second week, longer invasive ventilation time, and longer time to total oral feeding and parenteral nutrition (PN), and the difference was more significant in NM infants than in WN infants (P0.05). 2. The weight/length, body mass index, triponderal mass index, and weight gain velocity in the BPD group were significantly lower than in the non-BPD group (P0.05) and lower in NM infants than in WN ones (P0.05). 3. Multivariable system regression analysis showed that invasive ventilation time, lipid intake in week 4, time to reach full feeding, and duration of PN were independent risk factors for NM.Enhancing calorie and macronutrient intake, reducing invasive ventilation, and achieving full gastrointestinal feeding early may be effective measures to avoid malnutrition in infants with BPD.

Asthma is a heterogeneous inflammatory disorder of the airways, and multiple studies have addressed the vital role of the nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3)/caspase-1/interleukin-1

Wound healing in diabetic patients is a difficult problem to be solved at present. In addition, patients with diabetes have an increased risk of postoperative wound complications. “She-Xiang-Yu-Hong” (SXYH) ointment is a type of traditional Chinese medicine (TCM) compound used to treat wounds. Over the past few years, SXYH has been applied in the Affiliated Hospital of Chengdu University of TCM (Chengdu, China) for the treatment of diabetic foot infections and bedsores, whereas there has been rare research on the effect of SXYH ointment on wound healing. In this study, SXYH ointment was first applied to streptozotocin (STZ)-triggered diabetic ICR mice (4–6 weeks, 20 ± 2 g) to observe the accelerated wound healing and the shortened wound healing period. As indicated by the histology and biochemistry analyses of skin biopsies, the wounds treated using SXYH ointment showed an increase in the granulation tissue. Moreover, SXYH also modulated the inflammation response by regulating affinity proinflammatory cytokines release (e.g., IL-6 and TNF-α). Furthermore, SXYH ointment obviously improved collagen fiber deposition and tissue on the wound surface. On the whole, this study indicated that SXYH ointment could accelerate wound healing, promote blood vessel formation, and suppress inflammations. Thus, the clinical potential of SXYH ointment was demonstrated in the treatment of diabetes and refractory wounds.

Highly ordered arrays of WS2 crystals are grown on the SiO2/Si substrate using Pt/Ti metal as seed materials by a low pressure chemical vapor deposition method. High magnification SEM images and Raman spectrum reveal that the WS2 flakes are induced and grown around the Pt/Ti metal, and the diameter of a single unit is up to 100 μm, which have contribute to the direct construction of functional devices on the substrate. HRTEM measurements further confirm that the obtained flakes are the WS2 crystal with good crystallinity. The results show that highly ordered arrays of WS2 crystals will have potential applications in electronic and optoelectronic devices.

Growing evidence indicates that both obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) may be closely associated with the prevalence of pulmonary embolism (PE). However, the relationship of overlap syndrome (OS) (coexistence of OSA and COPD) with PE is unclear. The purpose of this study was to investigate whether OS were associated with increased PE prevalence.We performed a retrospective chart review of patients who underwent sleep study at Beijing An Zhen Hospital from 2011 to 2014. The association of OS with PE prevalence was estimated by using logistic regression models.In contrast to control patients (neither OSA nor COPD), those subjects with OS had higher odds of PE (OR9.61; 95%CI 4.02-21.31, p 0.001) with significance persisting after adjusting for covariates (OR 5.66; 95%CI 1.80-16.18, p = 0.004). Meanwhile, patients with OS compared with those with isolated OSA also had significantly higher odds of PE in univariate (OR 4.79; 95%CI 2.04-10.33, p = 0.0007) and adjusted models (OR 3.89; 95%CI 1.27-10.68, p = 0.019). In subgroup analysis, patients with OS had higher odds of PE than control group among male subjects (OR 8.12, 95%CI1.86-31.87, p = 0.007) and patients ≥ 58years (OR 5.50, 95%CI 1.51-18.14, p = 0.012) in multivariable models. Percentage of total sleep time with saturation lower than 90% (T90) ≥ 2.6% was significantly associated with prevalence of PE (OR 4.72, 95%CI1.34-19.83, p = 0.015) in subgroup of patients older than 58.OS is independently associated with PE prevalence. Longitudinal studies are needed to better understand the relationship with incident PE.

ReS2 flakes were grown through a vacuum vapor transport method without additional carrier gas during the reaction of S and NH4ReO4 precursors. With the pre-oxidation treatment on SiO2/Si substrate, we successfully suppressed the out-of-plane growth of ReS2 crystal in a large extent to obtain a larger area ReS2 flake. Raman and transmission electron microscopy (TEM) measurements indicate the excellent crystalline quality. This work demonstrates the innovations of vacuum vapor transport growth and significant influence of substrate oxidation treatment in promoting the in-plane growth of ReS2 crystal.

High-throughput growth of large size transition metal dichalcogenide (TMD) single crystals is an important challenge for their applications in the next generation electronic and optoelectronic integration devices. Here we report the high-throughput growth of submillimeter monolayer TMD single crystals by two-stage space confined chemical vapor deposition, where the nucleation density of TMD crystals is significantly decreased for the growth of large size monolayer crystals by the space confinement effect. Moreover, high-throughput growth of submillimeter TMD crystals is also achieved by stacking the substrates along the perpendicular direction to the flow of the reaction gases. The mobilities of the TMD materials produced in this way are up to 1.2, 17.0 and 25.0 cm2 (V s)-1 for monolayer WS2, WSe2 and MoS2 single crystals, respectively. The results demonstrate that two-stage space confined growth is a highly promising method for high-throughput fabrication of high-quality submillimeter monolayer TMD single crystals, which will pave a new pathway to large-scale production of TMD-based electronic and optoelectronic devices.

Background In 2016, the first global viral hepatitis elimination targets were endorsed. An estimated one-third of the world’s population of individuals with chronic hepatitis B virus (HBV) infection live in China and liver cancer is the sixth leading cause of mortality, but coverage of first-line antiviral treatment was low. In 2015, China was one of the first countries to initiate a consultative process for a renewed approach to viral hepatitis. We present the investment case for the scale-up of a comprehensive package of HBV interventions. Methods A dynamic simulation model of HBV was developed and used to simulate the Chinese HBV epidemic. We evaluated the impact, costs, and return on investment of a comprehensive package of prevention and treatment interventions from a societal perspective, incorporating costs of management of end-stage liver disease and lost productivity costs. Results Despite the successes of historical vaccination scale-up since 1992, there will be a projected 60 million people still living with HBV in 2030 and 10 million HBV-related deaths, including 5.7 million HBV-related cancer deaths between 2015 and 2030. This could be reduced by 2.1 million by highly active case-finding and optimal antiviral treatment regimens. The package of interventions is likely to have a positive return on investment to society of US$1.57 per US dollar invested. Conclusions Increases in HBV-related deaths for the next few decades pose a major public health threat in China. Active case-finding and access to optimal antiviral treatment are required to mitigate this risk. This investment case approach provides a real-world example of how applied modeling can support national dialog and inform policy planning., Approximately one-third of the world’s population with chronic Hepatitis B Virus (HBV) live in China. A comprehensive package of interventions against HBV, including case-finding and antiviral treatment, could reduce HBV-related deaths by 2.1 million and is likely to have a positive return on investment to society over 15 years.

BACKGROUND To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1, 3, 6 and 12 month post-TIPS. RESULTS Repeated measures analysis of variance showed significant group effects from 1, 3, 6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group 12 months after TIPS. The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects, time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients’ compliance behavior and health, decrease the incidence of HE and shunt dysfunction. TRIAL REGISTRATION www.clinicaltrials.gov; identifier: NCT02877953(08/23/2016) KEY WORDS Transjugular intrahepatic portosystemic shunt (TIPS); Transitional care; Compliance behaviors; Hepatic function.

AIM To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1,3,6 and 12 month post-TIPS. RESULTS Repeated measures analysis of variance showed significant group effects from 1,3,6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group12 months after TIPS.The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects ,time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients’ compliance behavior and health, decrease the incidence of HE and shunt dysfunction. KEW WORDS Transjugular intrahepatic portosystemic shunt (TIPS); Transitional care; Compliance behaviors; Hepatic function.

Objective Mesenchymal stem cells (MSCs) are well known to have the capability to form bone and cartilage, and chondrogenesis derived from MSCs is reported to be affected by mechanical stimuli. This research aimed to study the effects of low magnitude high frequency (LMHF) vibration on the chondrogenic differentiation of bone marrow-derived MSCs (BMSCs) which were cultured with chondrogenic medium, and to investigate the role of β-catenin cascade in this process. Methods Rat bone marrow-derived MSCs (BMSCs) were isolated and randomized into vibration and static cultures. The effect of vibration on BMSCs proliferation, differentiation and chondrogenic potential was assessed at the protein level. Results LMHFV did not affect the proliferation of BMSCs. However, this was accompanied by increased markers of chondrogenesis. The protein expression of chondrocyte-specific markers of Aggrecan, Sox9, and BMP7 were upregulated and Collagen X was decreased by LMHF vibration introduced at the chondrogenic differentiation in vitro. Specifically, thicker blue-stained particles were observed in Alcian Blue staining and the level of glycosaminoglycan were significantly increased respectively in the vibration culture group by 56.5 % and 93.6 % on the 7th and 14th day. The expression and nuclear translocation of β-catenin were activated in a significant manner. And inhibition of GSK-3β activity with Licl rearranged and intensified the cytoskeleton affected by vibration stimulation. Conclusions Our data demonstrated that LMHF mechanical vibration promotes BMSCs chondrogenic differentiation and implies β-catenin signal acts as an essential mediator in the mechano-biochemical transduction and subsequent transcriptional regulation in the process of chondrogenesis.

Background: Colorectal cancer (CRC) remains one of the leading causes of cancer-related death. The current study aimed to elucidate the mechanism by which exosomes carrying KRAS mutant contribute to neutrophil recruitment as well as the formation of the neutrophil extracellular traps (NETs) in CRC. Methods: APC-WT and APC-KRASG12D mouse models were initially established. The peripheral blood, spleen, bone marrow (BM) and mesenteric lymph nodes (mLN) were isolated to detect neutrophil content. Next, exosomes isolated from APC-WT and APC-KRASG12D mice were injected into APC-WT and APC-KRASG12D mice. The neutrophil ratio, NETs formation and IL-8 protein content in colon tissue were subsequently quantified. DKs-8 (wild type) and DKO-1 (KRAS mutant) cells were employed for in vitro experimentation. Then, DKs-8 cells were cultured with exosome-treated PMA stimulated neutrophil-forming NETs culture medium, with cell viability, invasion, migration, and adhesion evaluated. Results: Compared with APC-WT mice, the number of polyps and neutrophils in the peripheral blood, spleen and mLNs increased in APC-KRASG12D mice, with increased NETs formation, IL-8 expression, and exosomes. IL-8 upregulation, neutrophil recruitment and NETs formation were observed in mice injected with exosomes derived from APC-KRASG12D. The in vitro investigation results revealed that more NETs were formed by DKO-1-Exosomes, which were inhibited by DNAse. In addition, DKs-8 and DKO-1 cells-derived exosomes can adhere to NETs under static conditions in vitro. Exosomal KRAS mutants were noted to exert a stimulatory effect on the production of IL-8 while promoting NETs formation as well as CRC promotion. Conclusion: The results obtained provide evidence suggesting that exosomes may transfer mutant KRAS to recipient cells and trigger an increase in IL-8 production, promote neutrophil recruitment and form NETs, ultimately leading to the promotion of CRC. Funding Statement: This work was supported by the National Natural Science Foundation of China (81873975, 81802084, 81974314, 81902984), the Excellent Academic Leader Training Program of Shanghai Health System (2018BR31), the Medical Guidace Science and Technology Support Project of Shanghai (19411964800), the Natural Science Foundation of Shanghai (19ZR1448800), the Clinical Research and Cultivation Project of Shanghai Tongji Hospital [ITJ(ZD)1803, ITJ(ZD)1905, ITJ(QN)1905]. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The study protocol was approved by the Ethics Committee of Tongji Hospital of Tongji University. All subjects have written informed consent. All animal use and experiments were performed in strict accordance with the procedures approved by the National Cancer Institute Animal Care and Use Committee (ACUC).

Previous studies have demonstrated that low-magnitude, high-frequency (LMHF) mechanical vibrations (LM

Supplemental Digital Content is available in the text, Introduction: The Chinese herb da huang (DH) (Rhubarb) is commonly used for GIF intensive care unit (ICU)/pediatric intensive care unit (PICU) gastrointestinal failure (GIF) patients in China. However, the potential preventive and therapeutic effect of DH in these patients has not yet been studied systematically. Objectives: The aim of this study was to evaluate the preventive and therapeutic effects of DH in treating ICU/PICU GIF patients with the most recent evidence. Methods: We systematically searched 7 databases from inception to March 30, 2018. RevMan 5.3 software was used to perform a meta-analysis. GRADE methodology was applied to evaluate the quality of evidence for each outcome. The review protocol was registered on PROSPERO (CRD42018092710) in advance. Results: Seven studies comprising 788 pediatric or adult participants were included in this analysis. Three indicators, including GIF occurrence rates (gastrointestinal mucosal hemorrhage, enteroplegia), multiple organ dysfunction syndrome (MODS)-related items (occurrence rates of MODS, mortality rates of MODS) and duration in the ICU was analyzed. The GIF occurrence rate meta-analysis result was (RR 0.47, CI 95% 0.37-0.60; P = .95); MODS related items indicator result was (RR 0.44, CI 95% 0.33–0.59; P = .41); ICU duration ICU result was (RR -2.87, CI 95% -3.53--2.21; P = .40). The safety of Chinese herb DH (Rhubarb) remains unclear. Conclusion: Current evidence suggests that the Chinese herb rhubarb (DH) powder combined with Western medicine was inferior to Western medicine alone in terms of preventive and therapeutic effects in ICU/PICU patients in terms of decreasing GIF occurrence rates (gastrointestinal mucosal hemorrhage and enteroplegia), occurrence rates of MODS, mortality from MODS, and shortened duration time in the ICU/PICU. However, larger sample sizes and rigorously-designed studies are necessary to conclusively determine the association between DH powder and outcomes in ICU/PICU GIF patients.

Osteopontin (OPN), a secreted phosphoprotein, is a member of the small integrin-binding ligand N-linked glycoprotein (SIBLING) family of cell matrix proteins and participates in many biological activities. Studies have shown that OPN plays a role in bone metabolism and homeostasis. OPN not only is an important factor in neuron-mediated and endocrine-regulated bone mass, but also is involved in biological activities such as proliferation, migration, and adhesion of several bone-related cells, including bone marrow mesenchymal stem cells, hematopoietic stem cells, osteoclasts, and osteoblasts. OPN has been demonstrated to be closely related to the occurrence and development of many bone-related diseases, such as osteoporosis, rheumatoid arthritis, and osteosarcoma. As expected, the functions of OPN in the bone have become a research hotspot. In this article, we try to decipher the mechanism of OPN-regulated bone metabolism and bone diseases.

Background Culture-based diagnostic methods cannot achieve rapid and precise diagnoses for the identification of multiple diarrhoeal pathogens (DPs). A high-throughput multiplex genetic detection system (HMGS) was adapted and evaluated for the simultaneous identification and differentiation of infectious DPs and a broad analysis of DP infection aetiology. Results DP-HMGS was highly sensitive and specific for DP detection compared with culture-based techniques and was similar to singleplex real-time PCR. The uniform level of sensitivity of DP-HMGS for all DPs allowed us to remap the aetiology of acute diarrhoeal infections in Shanghai, correcting incidences of massively underdiagnosed DP species with accuracy approaching that of sequencing-based methods. The most frequent DPs were enteropathogenic Escherichia coli, rotavirus and Campylobacter jejuni. DP-HMGS detected two additional causes of infectious diarrhoea that were previously missed by routine culture-based methods: enterohemorrhagic E. coli and Yersinia enterocolitica. We demonstrated the age dependence of specific DP distributions, especially the distributions of rotavirus, intestinal adenovirus and Clostridium difficile in paediatric patients as well as those of dominant bacterial infections in adults, with a distinct “top 3” pattern for each age group. Finally, the multiplexing capability and high sensitivity of DP-HMGS allowed the detection of infections co-induced by multiple pathogens (approximately 1/3 of the cases), with some DPs preferentially co-occurring as infectious agents. Conclusions DP-HMGS has been shown to be a rapid, specific, sensitive and appropriate method for the simultaneous screening/detection of polymicrobial DP infections in faecal specimens. Widespread use of DP-HMGS is likely to advance routine diagnostic and clinical studies on the aetiology of acute diarrhoea. Electronic supplementary material The online version of this article (10.1186/s13099-018-0264-7) contains supplementary material, which is available to authorized users.

AIM: To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS: 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1,3,6 and 12 month post-TIPS. RESULTS: Repeated measures analysis of variance showed significant group effects from 1,3,6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group12 months after TIPS.The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects ,time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION: Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients' compliance behavior and health, decrease the incidence of HE and shunt dysfunction. Clinical Trial Number: The study was registered in an independent clinical trial database (www.clinicaltrials.gov; identifier: NCT02877953)( 08/23/2016). Funding Statement: The Xinjiang Shihezi Science and Technology Administration Department provided funding for the study. This work was supported by the Foundation of the Shanghai Public Health Bureau, No. 201740143; and the Project of Medical Key Specialty of Shanghai Municipality, No. ZK2015A22. Declaration of Interests: There are no conflicts of interest. Ethics Approval Statement: The study protocol was approved by the ethical committees for human investigations at the Third Affiliated Hospital of the Medical College, Shi he zi University and by the Local Department of Health and Family Planning Commission. The study protocol also fulfilled the guidelines of Good Clinical Practice in clinical trials.

In present study, we aimed at investigating the expression level of microRNA and the related gene which might be involved in retinopathy of prematurity. Neonatal SD rats were randomly divided into 2 groups, the first one having rats with NH4CI induced acidosis, as experimental group. We observed retinal vascular morphology and hyperplasia using microscope, for both experimental and control groups, in days 3, 5, 8, 10, 13 and 20 after birth. Total RNA from the retinal samples was obtained at each time point. MiR-126 and VEGF mRNA were measured by quantitative RT-PCR, while immunohistochemistry was applied to analyze the protein expression level of VEGF. Results showed significant differential expression of miR-126 in the acidosis-induced neonatal rats at day 8 when compared with control rats. The VEGF mRNA and protein quantitative results also demonstrated corresponding differential expression among the experimental and control groups. Results from this study revealed that VEGF mRNA and protein expression levels increased in day 10, while the expression of miR-126 was remarkably down-regulated. It is thus suggested that the miR-126 plays an important role in the development of acidosis-induced retinopathy.

The twist-angle dependence of exciton absorption in a molybdenum disulfide (MoS2)/graphene heterostructure (MGH) is reported. Using photoluminescence (PL) spectroscopy, we found that, as the twist angle increased, the MGH demonstrated an enhancement of PL intensity and a peak position blueshift, indicating that the exciton radiative recombination was positively correlated with the twist angle. In addition, optical reflectance measurements were performed in order to investigate the exciton absorption in the MGH. It was found that the reflectance of MGH samples was twist-angle dependent at wavelengths of 620 and 670 nm, which corresponds to the PL peak positions of MoS2. This was attributed to the change in interlayer charge transfer for different twist angles. Our findings confirm the tunability of the electronic structure in MGHs via the interlayer twist, which enriches our understanding of interlayer coupling and is important for the future development of electronic and optoelectronic devices based on 2D material heterostructures.

Collision detection is critical for collaborative assembly simulation to assist design processing. However, collisions between polygonal models may not reflect collisions between real objects in reality because of polygonal approximation and designed tolerance. This problem reduces the reliability of simulation in collaborative assembly and sometimes even results in wrong conclusions. To solve the problem, we propose a novel collision evaluation algorithm based on generalized penetration depth, approximation information, and tolerance information. Given two interfered polygonal models, generalized penetration depth is calculated using relative motion information. Then two thresholds, which are based on approximation information and tolerance information, are integrated to evaluate collisions between polygonal models. In order to distinguish the status of collisions for further analysis, the collisions between polygonal models are categorized into three types by evaluation algorithm, namely real collision, potential collision, and fake collision. Computational efficiency and accuracy of the evaluation algorithm are verified in a virtual collaborative assembly environment.

In named entity recognition, we often don't have a large in-domain training corpus or a knowledge base with adequate coverage to train a model directly. In this paper, we propose a method where, given training data in a related domain with similar (but not identical) named entity (NE) types and a small amount of in-domain training data, we use transfer learning to learn a domain-specific NE model. That is, the novelty in the task setup is that we assume not just domain mismatch, but also label mismatch.

Contact problems are one of the most challenging fields in virtual assembly. Information of contact states could be utilized to realize compliant motion of work pieces, to analyze the contact stress, to assist positioning parts and so on. Some methods have already been proposed to estimate contact states between objects and in most of these methods contact states between objects are simplified in order to realize real-time visual reality animation. While in virtual assembly contact states between parts are required to analyze contact stress, deformation and quality. Besides the contact state estimation method for virtual assembly should be able to handle a number of complex parts in real time. There are rarely known methods which could meet this requirement till now. In this study a contact state estimation algorithm based on surface-matching for virtual assembly is proposed. Contacts between parts are categorized into six basic types according to contact region of surfaces. Based on continuous collision detection of polyhedral models a novel contact state identification algorithm which is based on surface matching is proposed. Then contact evolution algorithm, which utilizes the extern force and contact information, is implemented to handle evolution of contact state. Finally a prototype system is developed to verify the above technologies. Experiment results reveal that contact state between parts could be estimated correctly in real time virtual assembly. The proposed contact state estimation algorithm provides a complete solution to obtain the contact state between parts in virtual assembly. Information of contact state between parts could be utilized to realize contact dynamic, contact stress analysis, assembly quality analysis, and so on.

Although in vivo studies have shown that low-magnitude, high-frequency (LMHF) vibration (LM: < 1 ×g; HF: 20-90 Hz) exhibits anabolic effects on skeletal homeostasis, the underlying cellular/molecular regulation involved in bone adaptation to LMHF vibration is little known. In this report, we tested the effects of microvibration (magnitude: 0.3 ×g, frequency: 40 Hz, amplitude: ± 50 μm, 30 min/12 h) on proliferation and osteodifferentiation of bone marrow-derived mesenchymal stromal cells (BMSCs) seeded on human bone-derived scaffolds. The scaffolds were prepared by partial demineralisation and deproteinisation. BMSCs were allowed to attach to the scaffolds for 3 days. Morphological study showed that spindle-shaped BMSCs almost completely covered the surface of bone-derived scaffold and these cells expressed higher ALP activity than those cultured on plates. After microvibration treatment, BMSC proliferation was decreased on day 7 and 10; however, numbers of genes and proteins expressed during osteogenesis, including Cbfa1, ALP, collagen I and osteocalcin were greatly increased. ERK1/2 activation was involved in microvibration-induced BMSC osteogenesis. Taken together, this study suggests that bone-derived scaffolds have good biocompatibility and show osteoinductive properties. By increasing the osteogenic lineage commitment of BMSCs and enhancing osteogenic gene expressions, microvibration promotes BMSC differentiation and increase bone formation of BMSCs seeded on bone-derived scaffolds. Moreover, ERK1/2 pathway plays an important role in microvibration-induced osteogenesis in BMSC cellular scaffolds.

BACKGROUND AND PURPOSE Caffeine is consumed extensively in Europe and North America. As a risk factor for osteoporosis, epidemiological studies have observed that caffeine can decrease bone mineral density, adversely affect calcium absorption and increase the risk of bone fracture. However, the exact mechanisms have not been fully investigated. Here, we examined the effects of caffeine on the viability and osteogenesis of rat bone marrow-derived mesenchymal stromal cells (rBMSCs).