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Abstract Background Femoral head varus triggers poor clinical prognosis in intertrochanteric fracture patients with proximal femoral nail antirotation (PFNA) fixation. Studies present that changes in nail position and screw insertion angles will affect fixation stability, but the biomechanical significance of these factors on the risk of femoral head varus has yet to be identified in PFNA fixed patients. Methods Clinical data in PFNA fixed intertrochanteric fracture patients have been reviewed, the relative position of intermedullary nail has been judged in the instant postoperative lateral radiography. Regression analyses have been performed to identify the effect of this factor on femoral head varus. Corresponding biomechanical mechanism has been identified by numerical mechanical simulations. Results A clinical review revealed that ventral side nail insertion can trigger higher risk of femoral head varus, corresponding numerical mechanical simulations also recorded poor fixation stability in models with ventral side nail insertion, and changes in the trajectory of anti-rotation blade will not obviously affect this tendency. Conclusions Ventral side insertion of intramedullary nail can trigger higher risk of femoral head varus in PFNA fixed patients by deteriorating the instant postoperative biomechanical environment, and changes in blade trajectory cannot change this tendency biomechanically. Therefore, this nail position should be adjusted to optimize patients’ prognosis.

Abstract Background Rectovaginal fistula (RVF) is an abnormal channel formed by epithelial tissue between the anterior wall of the rectum and the posterior wall of the vagina, which manifests as vaginal gassing and defecation. It is one of the common complications of female pelvic surgeries. With the increased number of proctectomies for rectal cancer, the number of postoperative rectovaginal fistulas also increases. Once RVF occurs, the failure rate is still high with various treatments available. RVF causes great suffering to women and is still a major problem in treatment. Therefore, it is significant for female rectal cancer patients to prevent RVF after rectal cancer surgery. In this study, we introduce a new method to prevent RVF during rectal cancer radical operation. Methods In this randomized controlled trial (RCT), all operations are performed according to the principle of total mesorectal excision (TME) radical resection in rectal cancer surgery. All eligible participants will be divided into two groups: the experimental group and the control group. Experimental group: the anterior rectal wall of about 1 cm distal to the anastomosis was dislocated. Before the anastomosis of the rectal end, a fat flap (usually left side) containing the ovarian vascular pedicle was dislocated, measured by 10–15 cm in length and 2 cm in width. The fat flap containing the ovarian vascular pedicle was packed and fixed anterior to the anastomotic stoma with fibrin glue. Control group: surgery will be carried out in accordance with the TME principle. Participants will be compared on several variables, including the incidence of RVF after operation (primary outcomes), the occurrence time of postoperative RVF, the occurrence time of RVF after stoma closure, and other postoperative complications, such as anastomotic leakage, chylous leakage, and intestinal obstruction (secondary outcomes). The follow-up data collection will be conducted according to the follow-up time point, and the baseline data will also be collected for follow-up analysis. By comparing the incidence of rectovaginal leakage between the experimental group and the control group, we aim to explore the feasibility of this method for the prevention of postoperative RVF. Discussion This RCT will explore the feasibility of packing with a laparoscopic dislocated fat flap containing an ovarian vascular pedicle anterior to the anastomotic stoma after rectal cancer surgery to prevent RVF. Trial registration Chinese Clinical Trial Registry (ChiCTR) registration ChiCTR2000031449. Registered on June 26, 2019. All items of the WHO Trial registration data set can be found within the protocol.

Abstract Background There is few evidence of right ventricular (RV) function in fetuses with gestational diabetes mellitus (GDM). Therefore, the aim of this study was to assess the RV function of fetuses using routine and two-dimensional speckle-tracking echocardiography (2D STE) to determine the effects of well-controlled GDM in the third trimester. Methods We used a Philips Epiq7C ultrasound instrument to obtain RV data sets from 63 subjects from July 2019 to February 2022. We compared the free wall thickness (FWT), fractional area change (FAC), Tei index (TEI), tricuspid annular plane systolic excursion (TAPSE) and free wall longitudinal strain(FWLS)of the RV in mothers with well-controlled GDM and normal gestational age-matched fetuses. Results 63 third trimester fetuses (32 GDM; 31 healthy controls) met the enrolment criteria. Significant differences in fetal RV were detected between the GDM and control groups for the FAC (36.35 ± 6.19 vs. 41.59 ± 9.11; P = 0.008) and the FWLS (-18.28 ± 4.23 vs. -20.98 ± 5.49; P = 0.021). There was a significant difference among the segmental strains of the base, middle and apex of the RV free wall in the healthy controls (P = 0.003), but in the GDM group, there was no statistical difference (p = 0.076). RV FWLS had a strong correlation with FAC (r = 0.467; P = 0.0002). Conclusions In well-controlled GDM, there was measurable fetal RV hypertrophy and significant systolic function decline, indicating the presence of ventricular remodeling and dysfunction. 2D-STE can evaluate the RV free wall contraction in a more comprehensive way.

Abstract Objectives To develop a quantitative analysis method for right diaphragm deformation. This method is based on optical flow and applied to diaphragm ultrasound imaging. Methods This study enrolls six healthy subjects and eight patients under mechanical ventilation. Dynamic images with 3–5 breathing cycles were acquired from three directions of right diaphragm by a portable ultrasound system. Filtering and density clustering algorithms are used for denoising Digital Imaging and Communications in Medicine (DICOM) data. An optical flow based method is applied to track movements of the right diaphragm. An improved drift correction algorithm is used to optimize the results. The method can automatically analyze the respiratory cycle, inter-frame/cumulative vertical and horizontal displacements, and strain of the input right diaphragm ultrasound image. Results The optical-flow-based diaphragm ultrasound image motion tracking algorithm can accurately track the right diaphragm during respiratory motion. There are significant differences in horizontal and vertical displacements in each section (p-values 0.05 for all). Conclusions The developed method can quantitatively evaluate the inter-frame/cumulative displacement of the diaphragm in both horizontal and vertical directions, as well as the global strain in three different imaging planes. The above indicators can be used to evaluate diaphragmatic dynamics.

With the intensification of social employment pressure, the employment conflict of vocational college students has gradually shifted from quantitative to qualitative. The theoretical mechanism and path of the impact of digital literacy on the employment quality of vocational college students are explored through the combination of human capital and labor market theories in this study. In this paper, the digital literacy is used as an independent variable based on the employment quality as the dependent variable. The relevant control variable is set up, and the multivariate regression model is constructed. Finally, a questionnaire survey was conducted on college graduates in Jiangxi, and the influence and mechanism of digital literacy on the employment quality of college graduates were explored through a multiple regression analysis model. The results show that the regression coefficients of digital literacy of vocational college students are always positive, after all the control variables are included in the regression, the regression test coefficient of digital literacy level in the model (6) are, R2=5.15, P

The past decade has brought tremendous progress in diagnostic and therapeutic options for cerebrovascular diseases as exemplified by the advent of thrombectomy in ischemic stroke, benefitting a steeply increasing number of stroke patients and potentially paving the way for a renaissance of neuroprotectants. Progress in basic science has been equally impressive. Based on a deeper understanding of pathomechanisms underlying cerebrovascular diseases, new therapeutic targets have been identified and novel treatment strategies such as pre- and post-conditioning methods were developed. Moreover, translationally relevant aspects are increasingly recognized in basic science studies, which is believed to increase their predictive value and the relevance of obtained findings for clinical application.This review reports key results from some of the most remarkable and encouraging achievements in neurovascular research that have been reported at the 10th International Symposium on Neuroprotection and Neurorepair. Basic science topics discussed herein focus on aspects such as neuroinflammation, extracellular vesicles, and the role of sex and age on stroke recovery. Translational reports highlighted endovascular techniques and targeted delivery methods, neurorehabilitation, advanced functional testing approaches for experimental studies, pre-and post-conditioning approaches as well as novel imaging and treatment strategies. Beyond ischemic stroke, particular emphasis was given on activities in the fields of traumatic brain injury and cerebral hemorrhage in which promising preclinical and clinical results have been reported. Although the number of neutral outcomes in clinical trials is still remarkably high when targeting cerebrovascular diseases, we begin to evidence stepwise but continuous progress towards novel treatment options. Advances in preclinical and translational research as reported herein are believed to have formed a solid foundation for this progress.

HuR overexpression is related to poor survival in patients with colon cancer. HuR overexpression leads to stabilization of tumor-promoting mRNAs by binding to 3′UTR-resident AREs. Exosomes, nanosized lipid bilayer vesicles, mediate many steps in cancer progression. The potential role of exosomal HuR in colon cancer lung metastasis is unclear. HuR expression was assessed immunohistochemically in tumor tissue samples from 20 patients with metastatic or nonmetastatic colon cancer and colon cancer lung metastasis and benign lung disease samples from ten patients. Exosomes were isolated from HCT116 WT and HuR KO colon cancer cells, and uptake of PKH67- and PKH26-labeled exosomes by BEAS-2B cells was evaluated using fluorescence and confocal microscopy. C-Myc and p21protein and mRNA levels were measured by western blotting and RT-qPCR, respectively. In clinical patients, HuR overexpression was significantly enhanced in colon tissues of patients with lung metastasis. HuR expression was higher in lung tissue with metastasis of colonic origin than with benign lung disease. The effect of HuR-containing CRC exosomes compared to HuR-deficient exosomes on wound closure was observed as enhanced proliferation. BEAS-2B cell migration and invasion were enhanced after HuR-containing exosomes treatment. BEAS-2B cells showed similar uptake of PKH67 (HCT116 WT)- and PKH26 (HCT116 HuR KO)-labeled exosomes. Exosomal HuR stabilized c-Myc mRNA and downregulated p21 expression, leading to G1/S transition, in human bronchial epithelial cells. HuR overexpression is associated with lung metastasis in colon cancer patients. Exosomal HuR derived from colon cancer cells alter the biological effect on normal lung epithelial cells.

BackgroundLower extremity deep vein thrombosis (DVT) is one of the major postoperative complications in patients with ruptured intracranial aneurysms (RIA) who underwent endovascular treatment (EVT). However, patient-specific predictive models are still lacking. This study aimed to construct and validate a nomogram model for estimating the risk of lower extremity DVT for RIA patients who underwent EVT.MethodsThis cohort study enrolled 471 RIA patients who received EVT in our institution between 1 January 2020 to 4 February 2022. Perioperative information on participants is collected to develop and validate a nomogram for predicting lower extremity DVT in RIA patients after EVT. Predictive accuracy, discriminatory capability, and clinical effectiveness were evaluated by concordance index (C-index), calibration curves, and decision curve analysis.ResultMultivariate logistic regression analysis showed that age, albumin, D-dimer, GCS score, middle cerebral artery aneurysm, and delayed cerebral ischemia were independent predictors for lower extremity DVT. The nomogram for assessing individual risk of lower extremity DVT indicated good predictive accuracy in the primary cohort (c-index, 0.92) and the validation cohort (c-index, 0.85), with a wide threshold probability range (4–82%) and superior net benefit.ConclusionThe present study provided a reliable and convenient nomogram model developed with six optimal predictors to assess postoperative lower extremity DVT in RIA patients, which may benefit to strengthen the awareness of lower extremity DVT control and supply appropriate resources to forecast patients at high risk of RIA-related lower extremity DVT.

The enhancement of intercultural communicative competence is emphasized as one of the objectives of Second Language Acquisition. Recognizing the cultural knowledge and spiritual values carried by the target language texts is an effective way to improve learners’ daily communicative competence and cultivate a sense of cultural identity. As a part of traditional Chinese culture, Baijiu culture and its textual carriers also have unique teaching functions. This study applies the integration of Baijiu culture stories and storytelling pedagogy in the Teaching Chinese as a Second Language (TCSL) practice, for the purpose of exploring the effectiveness of Baijiu cultural story in Second-language acquisition(L2). Through theoretical analysis and teaching practice, it is found that the integrated application of Chinese Baijiu cultural story and storytelling method can comprehensively improve learners’ language skills and enable them to better engage in intercultural dialogue in an inclusive manner.

Abstract Background Lymph node (LN) metastasis is crucial in determining the prognosis and treatment options for colon cancer patients. Our work was to study whether the lymph nodes beyond D3 station in transverse colon cancer, especially 206 LN, should be dissected. Methods A total of 225 patients within our department were reviewed. The primary and secondary endpoints were overall survival (OS) and disease‐free survival (DFS). We employed Propensity score weighting (PSW) for weighing participants to balance observed confounders between the 206D+ group and the 206D− group. Results The rate of metastasis in station 206 was 9.3%. Only T stage (OR, 3.009; 95% CI, 1.018–8.892), N stage (OR, 9.818; 95% CI, 1.158–83.227), and M stage (OR, 26.126; 95% CI, 1.274–535.945) were an independent risk factor for 206 station metastasis in multivariate logistic analysis. The 206D+ group had a similarly survival than the 206D− group (3‐year DFS, 89.6% v 85.9%; p = 0.389; 3‐year OS, 94.6% v 85.3% p = 0.989). PSW further verified it. Metastasis of 206 station LN is not an independent prognostic factor, but a predictive factor of DFS. Conclusion Station 206 LN positive is a predictive factor for DFS. Only the patient with T1‐3, N+ who is at a high risk of 206 station LN metastases should consider dissecting 206 station LN.

Influenza pneumonia has challenged public health and social development. One of the hallmarks of severe influenza pneumonia is overproduction of pro-inflammatory cytokines and chemokines, which result from the continuous activation of intracellular signaling pathways, such as the NF-κB pathway, mediated by the interplay between viruses and host pattern recognition receptors (PRRs). It has been reported that traditional Chinese medicines (TCMs) can not only inhibit viral replication and inflammatory responses but also affect the expression of key components of PRRs and NF-κB signaling pathways. However, whether the antiviral and anti-inflammatory roles of TCM are related with its effects on NF-κB signaling pathway activated by PRRs remains unclear. Here, we reviewed the mechanism of PRRs-mediated activation of NF-κB signaling pathway following influenza virus infection and summarized the influence of anti-influenza TCMs on inflammatory responses and the PRRs/NF-κB signaling pathway, so as to provide better understanding of the mode of action of TCMs in the treatment of influenza pneumonia.

We report on the preparation of a pure ultracold sample of bosonic DyK Feshbach molecules, composed of the fermionic isotopes ^{161}Dy and ^{40}K. By sweeping a magnetic field across a resonance located near 7.3 G, we generate up to 5000 molecules at a temperature of approximately 50 nK. To purify the sample from remaining atoms, we employ a Stern-Gerlach technique that relies on magnetic levitation of the molecules in a very weak optical dipole trap. With the trapped molecules we finally reach a high phase-space density of about 0.1. We investigate the magnetic field dependence of the molecular binding energy and the magnetic moment, refining our knowledge of the resonance parameters. We also demonstrate a peculiar anisotropic expansion effect observed when the molecules are released from the trap and expand freely in the magnetic levitation field. Furthermore, we identify an important lifetime limitation that is imposed by the 1064-nm infrared trap light itself and not by inelastic collisions. The light-induced decay rate is found to be proportional to the trap light intensity and the closed-channel fraction of the Feshbach molecule. These observations suggest a one-photon coupling to electronically excited states to limit the lifetime and point to the prospect of loss suppression by optimizing the wavelength of the trapping light. Our results offer crucial insights and experimental progress towards achieving quantum-degenerate samples of DyK molecules and novel superfluids based on mass-imbalanced fermion mixtures.