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Abstract Based on the characteristics of Kummell’s disease (KD) and related anatomical structures of the thoracolumbar spine, a novel bone cement screw system has been designed to effectively avoid the cement loosening and displacement. This experiment aimed to assess the biological effects of the novel bone cement screw system in KD on fresh cadaveric thoracolumbar spine specimens, thereby discussing its potential application value and providing a foundation for clinical implementation. This study employed a total of 50 fresh female adult cadaver specimens. Each specimen underwent extraction of the T12 to L2 segment followed by the creation of an artificial KD model at the L1 segment and subsequent establishment of five distinct types of bone cement repair models. Model A represents the percutaneous vertebroplasty (PVP) model, Model B combines PVP with unilateral percutaneous pediculoplasty (PPP), Model C combines PVP with bilateral PPP, Model D introduces the novel bone cement screw combined with unilateral PVP, and Model E combines the novel screw with bilateral PVP, each group consists of 10 specimens. Subsequently, the six-axis spine robot was employed to execute cement three-dimensional biomechanical strength tests in six directions, including anterior flexion and posterior extension, left and right lateral bending, as well as left and right rotation. The novel bone cement screw, whether used unilaterally or bilaterally in combination with the PVP model, exhibits significantly reduced bone cement mobility and superior biomechanical stability during anterior flexion, posterior extension, left lateral bending, and right lateral bending (P 0.05).When comparing the novel bone cement screw combined with PVP unilaterally and bilaterally, no statistically significant difference was observed in the stability of bone cement across all six directions of motion (P>0.05). To conclude, this novel bone cement bridging screw system exhibits superior biomechanical stability compared to commonly used treatments. Furthermore, both unilateral and bilateral implementations of the novel bone cement screw system yield without significant differences observed. These findings present a reliable and innovative approach for clinical management of KD.

Introduction: Subthalamic nucleus deep brain stimulation (STN-DBS) is a proven treatment modality for Parkinson’s disease (PD), reducing dyskinesia and time spent in the “OFF” state. This study evaluates the long-term outcomes of STN-DBS in PD patients up to 10 years post-surgery in Singapore. Method: We conducted a retrospective review of Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) scores, activities of daily living (ADLs), disease milestones, dopaminergic drug prescriptions, and adverse events in patients before and after STN-DBS surgery. Results: A total of 94 PD patients who underwent bilateral STN-DBS were included. STN-DBS reduced time in the “OFF” state by 36.9% at 1 year (P=0.034) and 40.9% at 5 years (P=0.006). Time with dyskinesia did not significantly change. Levodopa equivalent daily dose was reduced by 35.1% by 5 years (P less than 0.001). MDS-UPDRS-II and III scores increased from 5 years post-DBS by 40.5% and 35.4%, respectively. Independence in ADLs decreased, though not significantly. The prevalence of frequent falls increased at 5 years. Surgery- and device-related adverse events were uncommon and generally mild. Conclusion: STN-DBS provides sustained relief from motor complications and reduced medication requirements in PD patients in Singapore. This study highlights STN-DBS as an effective treatment option, significantly enhancing the quality of life for those with PD.

Four new species of Liphistius belonging to the birmanicus species group are described from Myanmar based on both sexes: L. kalaw Zhan & Xu, sp. nov. (♂♀), L. kanpetlet Zhan & Xu, sp. nov. (♂♀), L. nawngau Zhan & Xu, sp. nov. (♂♀) and L. rostratus Zhan & Xu, sp. nov. (♂♀). Currently, Myanmar stands as the westernmost country where Liphistius is distributed, with the new species L. kanpetlet sp. nov. being found in the westernmost region of Myanmar.

Summary: Systemic sclerosis (SSc) is an autoimmune disease affecting multiple tissues. The underlying causes and mechanisms of subcutaneous adipose tissue (SAT) loss in SSc remain unclear. Recent studies have highlighted the role of microRNAs in adipogenesis. Our study found that miR-4769-3p was upregulated in SSc patients and its silencing promoted SAT recovery in bleomycin-induced SSc mice, suggesting that miR-4769-3p might affect adipogenesis in SSc. Manipulating miR-4769-3p expression in 3T3-L1 cells revealed that its inhibition enhanced adipogenesis, while its overexpression weakened it. Further investigations showed that miR-4769-3p bound to 3′UTR of ubiquitin-specific protease-18 (USP18), inhibiting its expression, while USP18 interacted with voltage-dependent anion channel-2 (VDAC2), both of which were reduced in SSc. Silencing either USP18 or VDAC2 attenuated adipogenesis. Notably, USP18 inhibited VDAC2 ubiquitination and degradation, whereas miR-4769-3p reversed the VDAC2-induced elevation of adipogenesis, suggesting that miR-4769-3p inhibited adipogenesis by negatively regulating the USP18/VDAC2 pathway, providing a potential therapeutic target for SSc.

In this paper, we present an analog-mixed-signal 6T SRAM computing-in-memory (CIM) macro. The macro uses dual-wordline 6T bitcells to reduce power consumption and write-disturb issues. The macro also proposes an analog computation logic circuit for high precision, energy efficient charge-domain computation. The bitcell structure combined with the analog computation logic circuit allows direct input of signed activations and weights to the chip for full signed computation. The proposed macro consists of four CIM blocks, each with four $32\times 8$ compute blocks, a pulse generator, an analog computation logic circuit and a SAR-ADC. Fabricated in a 55 nm process, our CIM macro test chip achieves an energy efficiency of 7.3 TOPS/W. A comprehensive computing test that encompasses the entire range of inputs and weights has been conducted. The results show that the CIM macro test chip can achieve a precision of 79.51% in a 1-FE error range of 71.88%. The target application of the proposed CIM macro is lightweight neural networks, this is demonstrated by mapping a pre-trained network into the macro and achieving a recognition accuracy of 92.28% on the CIFAR-10 dataset. The design surpasses existing designs in comprehensive consideration of energy efficiency, technology and bit width.

With the development of artificial intelligence and the further deepening of medical-engineering integration, spine surgical robot-assisted (RA) technique has made significant progress and its applicability in clinical practice is constantly expanding in recent years. In this review, we have systematically summarized the majority of literature related to spine surgical robots in the past decade, and not only classified robots accordingly, but also summarized the latest research progress in RA technique for screw placement such as cervical, thoracic, and lumbar pedicle screws, cortical bone trajectory screws, cervical lateral mass screws, and S2 sacroiliac screws; guiding targeted puncture and placement of endoscope via the intervertebral foramen; complete resection of spinal tumor tissue; and decompressive laminectomy. In addition, this report also provides a detailed evaluation of RA technique’s advantages and disadvantages, and clarifies the accuracy, safety, and practicality of RA technique. We consider that this review can help clinical physicians further understand and familiarize the current clinical application status of spine surgical robots, thereby promoting the continuous improvement and popularization of RA technique, and ultimately benefiting numerous patients.

In order to enhance the stability of the power grid and increase the ability of the power grid to absorb photovoltaic energy, while enriching the prediction model of photovoltaic power generation, improve the precision reading of the prediction model. This paper proposes a short-term forecasting model of photovoltaic power generation based on K-means++clustering- Snake Optimizer algorithm (SO) - Gate Recurrent Unit(GRU). First, Pearson correlation coefficient analysis is used to screen out variables that are not related to the actual output of power generation.Then, select historical data with similar weather fluctuation degree as the training sample through K-means++clustering, use SO algorithm to optimize the parameters of GRU network, and use the optimized GRU network to predict photovoltaic power generation, Finally, through the simulation of a photovoltaic power station in Beijing, the results show that the prediction model proposed in this paper has improved the prediction accuracy compared with other traditional prediction models when the weather is almost no fluctuation, the weather has some fluctuations and the weather fluctuation is very severe. This research can provide reference for energy storage research of integrated energy system.

Abstract Objective The authors investigated the expression of IgG4 and IgG in cutaneous Rosai-Dorfman Disease (CRDD) to further improve the understanding of this disease. Methods The authors retrospectively reviewed the clinicopathological features of 23 CRDD patients. The authors diagnosed CRDD by the presence of emperipolesis and immunohistochemical (IHC) staining of histiocytes consisting of S-100(+)/CD68(+)/CD1a(-) cells. The expressions of IgG and IgG4 in cutaneous specimens were assessed by IHC (EnVision) and quantitatively calculated by a medical image analysis system. Results All 23 patients, including 14 males and 9 females, were confirmed to have CRDD. Their ages ranged from 17 to 68 years (mean 47.91 ± 14.16). The most frequently affected skin regions were the face, followed by the trunk, ears, neck, limbs, and genitals. In 16 of these cases, the disease presented as a single lesion. IHC staining of sections showed that IgG was positive (≥ 10 cells/High-Power Field [HPF]) in 22 cases, while IgG4 was positive (≥ 10 cells/HPF) in 18 cases. Moreover, the IgG4/IgG proportion ranged from 1.7% to 85.7% (mean 29.50 ± 24.67%, median 18.4%) in the 18 cases. Study limitations In the majority of studies, as well as in the current study, the design. RDD is a rare disease, so the sample size is small. In the next studies to come, the authors will expand the sample for multi-center verification and in-depth study. Conclusion The positive rates of IgG4 and IgG and the IgG4/IgG ratio assessed through IHC staining may be important in understanding the pathogenesis of CRDD.

Background: Only few studies have focused on the metabolite differences between asymptomatic neurocognitive impairment (ANI) and cognitively normal people living with HIV (PLWH). The current study aims to examine whether brain metabolisms in basal ganglia (BG) by magnetic resonance spectroscopy (MRS) were potential to discriminate ANI from cognitively normal PLWH. Methods: According to neuropsychological (NP) test, 80 PLWH (37.4 ± 10.2 years) were divided into ANI group (HIV-ANI, n = 31) and NP normal group (HIV-normal, n = 49). Brain metabolisms by MRS from right BG were compared between groups, including N-acetylaspartate and N-acetyl aspartylglutamate (tNAA), creatine and phosphocreatine (tCr), and choline-containing compounds (tCho). A total value of three metabolites were introduced. All brain metabolisms were evaluated as its percentage of total. Furthermore, correlations between MRS and NP and clinical measures were evaluated. A logistic regression model was applied, and the AUC values for the model and the continuous factors were compared using receiver operating curve (ROC) analysis. Results: Compared to HIV-normal group, tNAA/total was lower and tCr/total was higher in the HIV-ANI group (P

Biological tissue information of the lung, such as cells and proteins, can be obtained from bronchoalveolar lavage fluid (BALF), through which it can be used as a complement to lung biopsy pathology. BALF cells can be confused with each other due to the similarity of their characteristics and differences in the way sections are handled or viewed. This poses a great challenge for cell detection. In this paper, An Improved Yolov5s Based on Transformer Backbone Network for Detection and Classification of BALF Cells is proposed, focusing on the detection of four types of cells in BALF: macrophages, lymphocytes, neutrophils and eosinophils. The network is mainly based on the Yolov5s network and uses Swin Transformer V2 technology in the backbone network to improve cell detection accuracy by obtaining global information; the C3Ghost module (a variant of the Convolutional Neural Network architecture) is used in the neck network to reduce the number of parameters during feature channel fusion and to improve feature expression performance. In addition, embedding intersection over union Loss (EIoU_Loss) was used as a bounding box regression loss function to speed up the bounding box regression rate, resulting in higher accuracy of the algorithm. The experiments showed that our model could achieve mAP of 81.29% and Recall of 80.47%. Compared to the original Yolov5s, the mAP has improved by 3.3% and Recall by 3.67%. We also compared it with Yolov7 and the newly launched Yolov8s. mAP improved by 0.02% and 2.36% over Yolov7 and Yolov8s respectively, while the FPS of our model was higher than both of them, achieving a balance of efficiency and accuracy, further demonstrating the superiority of our model.

Background: Recent studies have shown that inflammatory indicators are closely related to the prognosis of patients with hepatocellular carcinoma, and they can serve as powerful indices for predicting recurrence and survival time after treatment. However, the predictive ability of inflammatory indicators has not been systematically studied in patients receiving transarterial chemoembolization (TACE). Therefore, the objective of this research was to determine the predictive value of preoperative inflammatory indicators for unresectable hepatocellular carcinoma treated with TACE. Methods: Our retrospective research involved 381 treatment-naïve patients in 3 institutions, including the First Affiliated Hospital of Soochow University , Nantong First People’s Hospital , and Nantong Tumor Hospital , from January 2007 to December 2020 that received TACE as initial treatment. Relevant data of patients were collected from the electronic medical record database, and the recurrence and survival time of patients after treatment were followed up. Least absolute shrinkage and selection operator (LASSO) algorithm was used to compress and screen the variables. We utilized Cox regression to determine the independent factors associated with patient outcomes and constructed a nomogram based on multivariate results. Finally, the nomogram was verified from discriminability, calibration ability, and practical applicability. Results: Multivariate analysis revealed that the levels of aspartate aminotransferase-to-platelet ratio index (APRI) and lymphocyte count were independent influential indicators for overall survival (OS), whereas the levels of platelet-to-lymphocyte ratio (PLR) was an independent influential index for progression. Nomograms exhibited an excellent concordance index (C-index), in the nomogram of OS, the C-index was 0.753 and 0.755 in training and validation cohort, respectively; and in the nomogram of progression, the C-index was 0.781 and 0.700, respectively. The time-dependent C-index, time-dependent receiver operating characteristic (ROC), and time-dependent area under the curve (AUC) of the nomogram all exhibited ideal discrimination ability. Calibration curves significantly coincided with the standard lines, which indicated that the nomogram had high stability and low degree of over-fitting. Decision curve analysis revealed a wider range of threshold probabilities and could augment net benefits. The Kaplan-Meier curves for risk stratification indicated that the prognosis of patients varied significantly between risk categories ( P

Background The continuous occurrence of Kummell's disease is extremely rare in clinical practice, and its treatment is difficult. The study aimed to present a rare case of consecutive Kummell's disease combined with Parkinson's disease (PD) and experienced internal fixation failure. Case presentation A 69‐year‐old female patient had a history of PD for 10 years, and was treated by posterior decompression, fixation, and fusion because of Kummell's disease of T12 with neurological damage. The patient's back pain and lower limb pain were significantly improved after surgery. Twenty‐two months later, the patient was rehospitalized for Kummell's disease of L4 with neuropathic pain of left lower extremity. She received almost identical surgical procedures as T12 lesion, and the difference was no L4 vertebroplasty preformed due to the fact that the L4 vertebrae collapse was not obvious, the intravertebral vacuum cleft (IVC) range was small, and the pedicle screw fixation strength was high. The pain symptoms were significantly relieved after operation. Unfortunately, there was a complication of internal fixation failure that occurred a month later, and a revision operation was carried out. Conclusion Osteoporosis combined with PD may lead patients to become prone to consecutive Kummell's disease, and patients are prone to experience failure of internal fixation. Bone cement filling of vertebral IVC and effective support of anterior vertebral column are very important procedures to ensure the clinical efficacy of treating Kummell's disease.

We diagnose and describe three new species of the primitively segmented spider genus Liphistius from Thailand, based on male palp and female genital morphology: L. hatyai Zhan & Xu, sp. nov. (♂♀), L. keeratikiati Zhan & Xu, sp. nov. (♂♀), and L. inthanon Zhan & Xu, sp. nov. (♂♀). The classification of the three new species of Liphistius is discussed: L. hatyai sp. nov. and L. keeratikiati sp. nov. are assigned to the trang-group, and L. inthanon sp. nov. is placed in the bristowei-group according to male palp and female genital morphology.

Kummell’s Disease (KD) was originally proposed by Dr. Hermann Kummell in 1891 as a type of delayed posttraumatic vertebral collapse, which is a clinical phenomenon. The purpose of this experiment is to compare the strength of bone cement and the novel bone cement bridging screw in the treatment of thoracolumbar Kummell disease (KD) with other treatment methods. Thirty sheep spine specimens were selected. T12 to L2 segments were selected, and a KD intravertebral vacuum cleft model was made at the L1 segment. According to the ways of cement filling, the specimens were divided into percutaneous vertebroplasty (PVP), PVP combined with unilateral percutaneous pediculoplasty (PPP), PVP combined with bilateral PPP, unilateral novel bone cement bridging screw system combined with PVP, and bilateral cement bridging screw system combined with PVP groups. There were two experiments: three-dimensional biomechanical strength test and axial compression test. In the three-dimensional biomechanical strength test, we measured the strength of bone cement in specimens under six motion states, including flexion, extension, left bending, right bending, and left and right axial rotations. In the axial compression test, we detected the maximum axial pressure that the bone cement could withstand when it was under pressure until the bone cement was displaced. The unilateral or bilateral novel bone cement bridging screw with PVP groups had the best strength under flexion, extension, left bending, right bending, and had better biomechanical strength, with a significant difference from the other three groups (p < 0.05). There was no significant difference between the unilateral or bilateral novel bone cement bridging screw with PVP groups (p > 0.05). Unilateral and bilateral novel bone cement bridging screw could achieve similar bone cement strength. Compared with the other three groups, the unilateral or bilateral novel bone cement bridging screw with PVP groups are higher 136.35%, 152.43%; 41.93%, 51.58%; 34.37%, 43.50% respectively. The bilateral novel bone cement bridging screw with PVP could bear the largest pressure under vertical force. To conclude, the novel bone cement bridging screw can increase the strength of bone cement and avoid the loosening and displacement of bone cement in the treatment of KD of the thoracolumbar spine.

Abstract In recent years, with the in-depth research on spinal tuberculosis, posterior surgery alone has been praised highly by more and more surgeons due to the better correction of kyphosis, better maintenance of spinal physiological curvature, smaller surgical trauma and fewer surgical complications. However, there is currently lack of relevant reports about the efficacy of posterior surgery alone in the treatment of tuberculosis in the T4–6 segments. This study aimed to evaluate the clinical study efficacy and feasibility of one-stage posterior-only surgical treatment for thoracic spinal tuberculosis in the T4–6 segments. 67 patients with tuberculosis in T4–6 segments who underwent one-stage posterior-only surgery were included in this study. The clinical efficacy was evaluated using statistical analysis based on the data about erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Oswestry Dability Index (ODI) score, Visual Analogue Scale (VAS) score and Cobb angle before surgery, after surgery and at the last follow-up. All patients completed fusion during the follow-up period of 6–9 months. ESR and CRP were returned to normal for all patients at 6 months follow-up. In the meanwhile, among the 27 patients combined with neurological impairment, neurological functions of 22 cases (81.48%) recovered completely at the last follow-up (P

As the memory footprint requirement and computational scale concerned, the light-weighted Binary Neural Networks (BNNs) have great advantages in limited-resources platforms, such as AIoT (Artificial Intelligence in Internet of Things) edge terminals, wearable and portable devices, etc. However, the binarization process naturally brings considerable information losses and further deteriorates the accuracy. In this article, three aspects are introduced to better the binarized ReActNet accuracy performance with a more low-complex computation. Firstly, an improved Binarized Ghost Module (BGM) for the ReActNet is proposed to increase the feature maps information. At the same time, the computational scale of this structure is still kept at a very low level. Secondly, we propose a new Label-aware Loss Function (LLF) in the penultimate layer as a supervisor which takes the label information into consideration. This auxiliary loss function makes each category’s feature vectors more separate, and improve the final fully-connected layer’s classification accuracy accordingly. Thirdly, the Normalization-based Attention Module (NAM) method is adopted to regulate the activation flow. The module helps to avoid the gradient saturation problem. With these three approaches, our improved binarized network outperforms the other state-of-the-art methods. It can achieve 71.4% Top-1 accuracy on the ImageNet and 86.45% accuracy on the CIFAR-10 respectively. Meanwhile, its computational scale OPs is the least $0.86\times {10}^{8}$ compared with the other mainstream BNN models. The experimental results prove the effectiveness of our proposals, and the study is very helpful and promising for the future low-power hardware implementations.

Lip verrucous carcinoma is a rare low-grade neoplasm, with an unsightly appearance and locally aggressive nature. Treatment of verrucous carcinoma is as yet challenging, no well-defined guidelines for effective and safe management of this disease are available. A case of a patient with a huge verrucous carcinoma of the lower lip successfully treated by surgical excision and double Abbe flap reconstruction technique is presented, and striking features of lip locations of this tumor as well as their management are discussed.

Abstract Background Lactose malabsorption occurs in around 68% of the world’s population, causing lactose intolerance (LI) symptoms, such as abdominal pain, bloating, and diarrhea. To alleviate LI, previous studies have mainly focused on strengthening intestinal β-galactosidase activity while neglecting the inconspicuous drop in the colon pH caused by the fermentation of non-hydrolyzed lactose by the gut microbes. A drop in colon pH will reduce the intestinal β-galactosidase activity and influence intestinal homeostasis. Results Here, we synthesized a tri-stable-switch circuit equipped with high β-galactosidase activity and pH rescue ability. This circuit can switch in functionality between the expression of β-galactosidase and expression of L-lactate dehydrogenase in response to an intestinal lactose signal and intestinal pH signal, respectively. We confirmed that the circuit functionality was efficient in bacterial cultures at a range of pH levels, and in preventing a drop in pH and β-galactosidase activity after lactose administration to mice. An impact of the circuit on gut microbiota composition was also indicated. Conclusions Due to its ability to flexibly adapt to environmental variation, in particular to stabilize colon pH and maintain β-galactosidase activity after lactose influx, the tri-stable-switch circuit can serve as a promising prototype for the relief of lactose intolerance.

Abstract Fusion with a titanium mesh cage (TMC) has become popular as a conventional method after cervical anterior corpectomy, but postoperative TMC subsidence has often been reported in the literature. We designed a novel anatomic cervical TMC to reduce the postoperative subsidence rate. According to the test process specified in the American Society of Testing Materials (ASTM) F2267 standard, three-dimensional finite element analysis was used to compare the anti-subsidence characteristics of a traditional TMC (TTMC) and novel TMC (NTMC). Through analysis, the relative propensity values of a device to subside (Kp) of the TTMC and NTMC were 665.5 N/mm and 1007.2 N/mm, respectively. A higher Kp measurement is generally expected to indicate that the device is more resistant to subsidence into a vertebral body. The results showed that the novel anatomic titanium mesh cage (NTMC) significantly improved the anti-subsidence performance after anterior cervical corpectomy and fusion (ACCF), which was approximately 51.3% higher than that of the traditional titanium mesh cage.

Osteoporosis is called a silent disease, because it is difficult to detect until comprehensive examinations for osteoporosis are performed or osteoporotic fractures occur. Zoledronic acid is currently the first-line anti-osteoporotic drug, with good efficacy and treatment compliance. A major advantage of zoledronic acid is that intravenous zoledronic acid often guarantees a therapeutic effect for up to 1 year after infusion. The reasons why zoledronic acid is effective in improving osteoporosis are that it can inhibit osteoclast differentiation and induce osteoclast apoptosis, thus suppressing bone resorption and increasing bone density. The story between zoledronic acid and osteoclasts has been written long time ago. Both the canonical receptor activator of the receptor activator of nuclear factor-κB ligand (RANKL) pathway and the non-canonical Wnt pathway are the main pathways by which zoledronic acid inhibits osteoclast differentiation. Farnesyl pyrophosphate synthase (FPPS), reactive oxygen species (ROS), and ferroptosis that was first proposed in 2012, are all considered to be closely associated with zoledronic acid-induced osteoclast apoptosis. Here, we provide a brief review of the recent progress on the study of zoledronic acid and osteoclasts, and hope to elaborate how zoledronic acid improves osteoporosis by acting on osteoclasts.

ObjectivePrevious studies on HIV-infected (HIV+) individuals have revealed brain structural alterations underlying HIV-associated neurocognitive disorders. Most studies have adopted the widely used voxel-based morphological analysis of T1-weighted images or tracked-based analysis of diffusion tensor images. In this study, we investigated the HIV-related morphological changes using the deformation-based morphometry (DBM) analysis of T1-weighted images, which is another useful tool with high regional sensitivity.Materials and MethodsA total of 157 HIV+ (34.7 ± 8.5 years old) and 110 age-matched HIV-uninfected (HIV-) (33.7 ± 10.1 years old) men were recruited. All participants underwent neurocognitive assessments and brain scans, including high-resolution structural imaging and resting-state functional imaging. Structural alterations in HIV+ individuals were analyzed using DBM. Functional brain networks connected to the deformed regions were further investigated in a seed-based connectivity analysis. The correlations between imaging and cognitive or clinical measures were examined.ResultsThe DBM analysis revealed decreased values (i.e., tissue atrophy) in the bilateral frontal regions in the HIV+ group, including bilateral superior frontal gyrus, left middle frontal gyrus, and their neighboring white matter tract, superior corona radiata. The functional connectivity between the right superior frontal gyrus and the right inferior temporal region was enhanced in the HIV+ group, the connectivity strength of which was significantly correlated with the global deficit scores (r = 0.214, P = 0.034), and deficits in learning (r = 0.246, P = 0.014) and recall (r = 0.218, P = 0.031). Increased DBM indexes (i.e., tissue enlargement) of the right cerebellum were also observed in the HIV+ group.ConclusionThe current study revealed both gray and white matter volume changes in frontal regions and cerebellum in HIV+ individuals using DBM, complementing previous voxel-based morphological studies. Structural alterations were not limited to the local regions but were accompanied by disrupted functional connectivity between them and other relevant regions. Disruptions in neural networks were associated with cognitive performance, which may be related to HIV-associated neurocognitive disorders.

Background: Although vaccines have been launched, COVID-19 has not been effectively curbed, and the number of infections is increasing. Compared with western medicine, Traditional Chinese Medicine has made some achievements in the treatment of COVID-19, which should be paid attention to and play a greater role. As a classical Chinese medicine prescription for treating pestilence, Lianhuaqingwen (LHQW) has gone to many countries with the Chinese medical team to participate in the local fight against the epidemic, which has been widely recognized. Methods: We searched MEDLINE, EMBASE, AMED, Chchrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), VIP Information Database (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang Database from inception up to November 24, 2021, which formed the basis for evidence used to formulate recommendations. Sixteen randomized controlled trials (RCTs) involving 1896 patients were enrolled. LHQW is a traditional Chinese medicine compound preparation, which contains 13 traditional Chinese medicine (TCM) components. Two dosage formulations of LHQW were included: granule and capsule. The most commonly used dosage formulation was granule (15/17, 88.24%), followed by capsule (2/17, 11.76%). Conclusion: This systematic review and Meta analysis suggested that, in the treatment of COVID-19, LHQW Capsule (Granule) could not only significantly improve the fever symptoms, shorten the fever time, but also reduce the cough and fatigue symptoms, improve the clinical efficiency, improve the lung CT, significantly reduce the number of patients with mild to severe diseases, and have certain anti-inflammatory effect. And there is no server adverse events which support the safety of LHQW Capsule (Granule) for the treatment of COVID-19. As a classic formula of TCM, LHQW Capsule (Granule) could be used as potential candidates for COVID-19 in this battle.

This study describes the anatomy of the saphenous artery (SA) perforators in minipigs and the development of a new animal model. First, the anatomic characteristics of the SA and perforators in minipigs were examined after latex-lead oxide perfusion. Subsequently, the right hind limbs of 10 minipigs were used to generate capillary perforator flaps (group A; utilizing the SA and 5.5 cm of deep fascia above the knee), while all perforators of the left hind limbs were reserved (group B). Four additional minipigs were used to evaluate SA perforator flaps with capillary perforators plus sarcolemma and a small amount of muscle (group C). Preoperative and postoperative CTA of both hind limbs confirmed that all perforators were ligated in groups A and C. The average length of the SA was 14.86 ± 0.76 mm. The diameters of the SA at initiation, the medial tibial condyle, and the medial malleolus were 1.73 ± 0.15 mm, 1.50 ± 0.12 mm, and 1.30 ± 0.13 mm, respectively. There were 7.09 ± 1.16 perforators per hind limb, with an average diameter of 0.40 ± 0.13 mm (range, 0.10–0.78 mm), and the majority (96.2%) had a diameter >0.2 mm. The survival rates of the flaps in groups A, B, and C were 32 ± 39%, 100%, and 60.2 ± 17%, respectively. The position of the SA in minipigs is constant, its diameter is relatively large, and it has many perforators, allowing it to be used as a reliable model of perforator flaps, including capillary perforator flaps.

Autoimmune diseases are a group of heterogeneous diseases with diverse clinical manifestations that can be divided into systemic and organ-specific. The common etiology of autoimmune diseases is the destruction of immune tolerance and the production of autoantibodies, which attack specific tissues and/or organs in the body. The pathogenesis of autoimmune diseases is complicated, and genetic, environmental, infectious, and even psychological factors work together to cause aberrant innate and adaptive immune responses. Although the exact mechanisms are unclear, recently, excessive exacerbation of pyroptosis, as a bond between innate and adaptive immunity, has been proven to play a crucial role in the development of autoimmune disease. Pyroptosis is characterized by pore formation on cell membranes, as well as cell rupture and the excretion of intracellular contents and pro-inflammatory cytokines, such as IL-1β and IL-18. This overactive inflammatory programmed cell death disrupts immune system homeostasis and promotes autoimmunity. This review examines the molecular structure of classical inflammasomes, including NLRP3, AIM2, and P2X7-NLRP3, as the switches of pyroptosis, and their molecular regulation mechanisms. The sophisticated pyroptosis pathways, including the canonical caspase-1-mediated pathway, the noncanonical caspase-4/5/11-mediated pathway, the emerging caspase-3-mediated pathway, and the caspase-independent pathway, are also described. We highlight the recent advances in pyroptosis in autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, Sjögren’s syndrome and dermatomyositis, and attempt to identify its potential advantages as a therapeutic target or prognostic marker in these diseases.

Laribacter hongkongensis is a new emerging foodborne pathogen that causes community-acquired gastroenteritis and traveler’s diarrhea. However, the genetic features of L. hongkongensis have not yet been properly understood. A total of 45 aquatic animal-associated L. hongkongensis strains isolated from intestinal specimens of frogs and grass carps were subjected to whole-genome sequencing (WGS), along with the genome data of 4 reported human clinical strains, the analysis of virulence genes, carbohydrate-active enzymes, and antimicrobial resistance (AMR) determinants were carried out for comprehensively understanding of this new foodborne pathogen. Human clinical strains were genetically more related to some strains from frogs inferred from phylogenetic trees. The distribution of virulence genes and carbohydrate-active enzymes exhibited different patterns among strains of different sources, reflecting their adaption to different host environments and indicating different potentials to infect humans. Thirty-two AMR genes were detected, susceptibility to 18 clinical used antibiotics including aminoglycoside, chloramphenicol, trimethoprim, and sulfa was checked to evaluate the availability of clinical medicines. Resistance to Rifampicin, Cefazolin, ceftazidime, Ampicillin, and ceftriaxone is prevalent in most strains, resistance to tetracycline, trimethoprim-sulfamethoxazole, ciprofloxacin, and levofloxacin are aggregated in nearly half of frog-derived strains, suggesting that drug resistance of frog-derived strains is more serious, and clinical treatment for L. hongkongensis infection should be more cautious.

Abstract Hidrotic ectodermal dysplasia (HED) is a rare inherited syndrome characterised by nail dystrophy, palmoplantar hyperkeratosis and alopecia. Four mutations (p.G11R, p.A88V, p.V37E and p.D50N) in gap junction beta 6 (GJB6) gene, which codes connexin30 protein, have been found to cause HED in different populations. Here, we reported a big Chinese family in which 24 patients over five generations were suffered with HED. Sequence analysis identified all 24 patients carry a recurrent missense mutation c.263C > T (p.A88V) in GJB6. Our results reveal gene testing of GJB6 is important for diagnosis, prenatal diagnosis and future gene treatment of HED.

Abstract Lithium–sulfur batteries (LSBs) are considered as the next generation of advanced rechargeable batteries because of their high energy density. In this study, sulfur and CoxS electrocatalyst are deposited on carbon nanotube buckypaper (S/CoxS/BP) by a facile electrodeposition method and are used as a binder-free high-performance cathode for LSBs. Elemental sulfur is deposited on buckypaper by electrooxidation of a polysulfide solution (~ S6 2−). This approach substantially increased the current and time efficiency of sulfur electrochemical deposition on conductive material for LSBs. S/CoxS/BP cathode could deliver an initial discharge capacity as high as 1650 mAh g−1 at 0.1 C, which is close to the theoretical capacity of sulfur. At current rate of 0.5 C, the S/CoxS/BP has a capacity of 1420 mAh g−1 at the first cycle and 715 mAh g−1 after 500 cycles with a fading rate of 0.099% per cycle. The high capacity of S/CoxS/BP is attributed to both the homogeneous dispersion of nanosized sulfur within BP and the presence of CoxS catalyst. The sodium dodecyl sulfate (SDS) pretreatment of BP renders it polarity to bind polysulfides and thus facilitates the good dispersibility of nanosized sulfur within BP. CoxS catalyst accelerates the kinetics of polysulfide conversion and reduces the presence of polysulfide in the cathode, which suppresses the polysulfide diffusion to anode, i.e., the shuttle effect. The mitigation of the active material loss improves not only the capacity but also the cyclability of S/CoxS/BP. Graphic Abstract

To avoid the irregularities during the level set evolution, a fractional distance regularized variational model is proposed for image segmentation. We first define a fractional distance regularization term which punishes the deviation of the level set function (LSF) and the signed distance function. Since the fractional derivative of the constant value function outside the starting point is nonzero, the fractional gradient modular of the LSF does not approach infinity where the integer order gradient modular is close to 0. This prevents the sharp reverse diffusion of LSF in flat areas and ensures the smooth evolution of LSF. Then, we use the Grünwald-Letnikov (G-L) fractional derivative to derive the discrete forms of the conjugate of fractional derivatives and fractional divergence. To facilitate the calculation of fractional derivatives and their conjugates, we designed their covering templates. Finally, a numerical solution to the minimization of the energy functional is obtained from these discrete forms and covering templates. Numerical experiments of medical images with different modalities show that the model in this paper can well segment weak images and intensity inhomogeneity images.

Liquid crystals (LCs) are appealing biomaterials for applications in bone regenerative medicine due to their tunable physical properties and anisotropic viscoelastic behavior. This study reports a novel composite poly (L-lactide) (PLLA) scaffold that is manufactured by a simple electrospinning and biomineralization technique that precisely controls the fibrous structure in liquid LC phase. The enriched-LC composites have superior mineralization ability than neat PLLA; furthermore BMSC cells were inoculated onto the HAP-PLLA/LC with hydroxyapatite (HAP) composite scaffold to test the capability for osteogenesis in vitro. The results show that the PLLA/LC with HAP produced by mineralization leads to better cell compatibility, which is beneficial to cell proliferation, osteogenic differentiation, and expression of the angiogenic CD31 gene. Moreover, in vivo studies showed that the HAP-PLLA/LC scaffold with a bone-like environment significantly accelerates new and mature lamellar bone formation by development of a microenvironment for vascularized bone regeneration. Thus, this bionic composite scaffold in an LC state combining osteogenesis with vascularized activities is a promising biomaterial for bone regeneration in defective areas.

AimTo investigate clinical and computed tomography (CT) radiomics nomogram for preoperative differentiation of lung adenocarcinoma (LAC) from lung tuberculoma (LTB) in patients with pulmonary solitary solid nodule (PSSN).Materials and MethodsA total of 313 patients were recruited in this retrospective study, including 96 pathologically confirmed LAC and 217 clinically confirmed LTB. Patients were assigned at random to training set (n = 220) and validation set (n = 93) according to 7:3 ratio. A total of 2,589 radiomics features were extracted from each three-dimensional (3D) lung nodule on thin-slice CT images and radiomics signatures were built using the least absolute shrinkage and selection operator (LASSO) logistic regression. The predictive nomogram was established based on radiomics and clinical features. Decision curve analysis was performed with training and validation sets to assess the clinical usefulness of the prediction model.ResultsA total of six clinical features were selected as independent predictors, including spiculated sign, vacuole, minimum diameter of nodule, mediastinal lymphadenectasis, sex, and age. The radiomics nomogram of lung nodules, consisting of 15 selected radiomics parameters and six clinical features showed good prediction in the training set [area under the curve (AUC), 1.00; 95% confidence interval (CI), 0.99–1.00] and validation set (AUC, 0.99; 95% CI, 0.98–1.00). The nomogram model that combined radiomics and clinical features was better than both single models (p < 0.05). Decision curve analysis showed that radiomics features were beneficial to clinical settings.ConclusionThe radiomics nomogram, derived from unenhanced thin-slice chest CT images, showed favorable prediction efficacy for differentiating LAC from LTB in patients with PSSN.

Abstract Background Transcatheter closure of perimembranous ventricular septal defects is one of the greatest challenges in interventional cardiology. Short- and midium-term follow-up data for large samples are limited. This report presents our experience with transcatheter closure of perimembranous ventricular septal defects using an occluder. Methods Two hundred fifty-three patients included in the database of the Second Affiliated Hospital and Yuying Children’s Hospital from January 2011– December 2015 with transcatheter closure of perimembranous ventricular septal defects and discharged from follow-up. All patients were invited for clinical and transthoracic echocardiography, electrocardiogram, and thoracic radiography check-up. Results Device implantation was successful in 252 of 253 patients (99.6%). The median age was 42 months (range 27–216 months). The median follow-up duration was 36 months (range 6–60 months). The mean defect diameter was 3.5 ± 1.4 mm and the mean size of the ventricular septal defect rim below the aortic valve was 3.7 ± 1.8 mm. The mean diameter of the devices used was 4 mm. Thirty-seven patients developed arrhythmia after the procedure and recovered within 24 months; four patients had hemolysis and four had moderate tricuspid valve regurgitation. No other serious adverse event occurred during the follow-up period. Conclusion Transcatheter closure of perimembranous ventricular septal defects using an occluder is safe and effective in most patients.

Nonlocal means (NLM), a patch-based nonlocal recovery paradigm, has attracted much attention in recent decades. The decay parameter will greatly affect restoration performance of the NLM method. However, the existing NLM methods with decay parameter adaptation cannot determine this parameter effectively. To address this problem, we have proposed the minimum mean square error (MSE) based decay parameter adaptation method for the NLM denoising. In the proposed method, the globally optimal decay parameter is determined to produce the pre-denoised image based on the derived relation between the global minimum MSE and the decay parameter. Then, the pixel-wise MSE is estimated based on the pre-denoised result and the corresponding method noise. Finally, the optimal pixel-wise decay parameter is obtained by minimizing the pixel-wise MSE to produce the estimated restored image and the boosting strategy is implemented on this image to generate the final denoised result. Extensive simulations on the standard test images and real images corrupted with Gaussian noise and speckle noise demonstrate that the proposed method significantly outperforms some compared NLM methods in noise reduction and detail preservation and can provide better restoration performance than other state-of-the-art denoising methods in most cases in terms of objective metrics and human vision.

PurposeTo develop and validate a nomogram for differentiating invasive adenocarcinoma (IAC) from adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) presenting as ground-glass nodules (GGNs) measuring 5-10mm in diameter.Materials and MethodsThis retrospective study included 446 patients with 478 GGNs histopathologically confirmed AIS, MIA or IAC. These patients were assigned to a primary cohort, an internal validation cohort and an external validation cohort. The segmentation of these GGNs on thin-slice computed tomography (CT) were performed semi-automatically with in-house software. Radiomics features were then extracted from unenhanced CT images with PyRadiomics. Radiological features of these GGNs were also collected. Radiomics features were investigated for usefulness in building radiomics signatures by spearman correlation analysis, minimum redundancy maximum relevance (mRMR) feature ranking method and least absolute shrinkage and selection operator (LASSO) classifier. Multivariable logistic regression analysis was used to develop a nomogram incorporating the radiomics signature and radiological features. The performance of the nomogram was assessed with discrimination, calibration, clinical usefulness and evaluated on the validation cohorts.ResultsFive radiomics features remained after features selection. The model incorporating radiomics signatures and four radiological features (bubble-like appearance, tumor-lung interface, mean CT value, average diameter) showed good calibration and good discrimination with AUC of 0.831(95%CI, 0.772~0.890). Application of the nomogram in the internal validation cohort with AUC of 0.792 (95%CI, 0.712~0.871) and in the external validation cohort with AUC of 0.833 (95%CI, 0.729-0.938) also indicated good calibration and good discrimination. The decision curve analysis demonstrated that the nomogram was clinically useful.ConclusionThis study presents a nomogram incorporating the radiomics signatures and radiological features, which can be used to predict the risk of IAC in patients with GGNs measuring 5-10mm in diameter individually.

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist–big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist–big-edge ASDO had no serious adverse events or complications.

Systemic lupus erythematosus (SLE) is a spectrum of autoimmune disorders characterized by continuous inflammation and the production of autoantibodies. Monocytes, as precursors of dendritic cells and macrophages, are involved in the pathogenesis of SLE, particularly in the inflammatory reactions. Previous studies have proved that Pam3CSK4, as a synthetic ligand of TLR2, could stimulate monocytes to differentiated into a M2-like phenotype which presented immunosuppressive functions. However, the underlying mechanisms remain to be further studied. Here, we reported an increased expression of PPAR-γ in the CD14+ monocytes from SLE patients, particularly in the treated group of SLE patients and the group with positive anti-dsDNA antibodies. Additionally, PPAR-γ expression decreased in the SLE patients with skin lesion. Furthermore, we demonstrated that Pam3CSK4 stimulation can decrease the expression of CCR7, CD80, IL-1β, IL-6, IL-12, and NF-κB which were related to the M1-like subset of monocytes and increased the expression of ARG1 which was related to the M2-like subset through upregulated PPAR-γ expression and consequently downregulated NF-κB expression in the CD14+ monocytes in a time-dependent manner. ChIP-qPCR results further demonstrated that Pam3CSK4 pretreatment could modulate PPAR-γ expression by regulating histone modification through the inhibition of Sirt1 binding to the PPAR-γ promoter. Taken together, our study indicated a protective role of TLR2/Sirt1/PPAR-γ pathway in the pathogenesis of SLE which provided potential therapeutic strategies.

PurposePrevious studies have revealed increased frontal brain activation during speech comprehension in background noise. Few, however, used tonal languages. The normal pattern of brain activation during a challenging speech-in-nose task using a tonal language remains unclear. The Mandarin Hearing-in-Noise Test (HINT) is a well-established test for assessing the ability to interpret speech in background noise. The current study used Mandarin HINT (MHINT) sentences and functional magnetic resonance imaging (fMRI) to assess brain activation with MHINT sentences.MethodsThirty native Mandarin-speaking subjects with normal peripheral hearing were recruited. Functional MRI was performed while subjects were presented with either HINT “clear” sentences with low-level background noise [signal-to-noise ratio (SNR) = +3 dB] or “noisy” sentences with high-level background noise (SNR = −5 dB). Subjects were instructed to answer with a button press whether a visually presented target word was included in the sentence. Brain activation between noisy and clear sentences was compared. Activation in each condition was also compared to a resting, no sentence presentation, condition.ResultsNoisy sentence comprehension showed increased activity in areas associated with tone processing and working memory, including the right superior and middle frontal gyri [Brodmann Areas (BAs) 46, 10]. Reduced activity with noisy sentences was seen in auditory, language, memory and somatosensory areas, including the bilateral superior and middle temporal gyri, left Heschl’s gyrus (BAs 21, 22), right temporal pole (BA 38), bilateral amygdala-hippocampus junction, and parahippocampal gyrus (BAs 28, 35), left inferior parietal lobule extending to left postcentral gyrus (BAs 2, 40), and left putamen.ConclusionIncreased frontal activation in the right hemisphere occurred when comprehending noisy spoken sentences in Mandarin. Compared to studies using non-tonal languages, this activation was strongly right-sided and involved subregions not previously reported. These findings may reflect additional effort in lexical tone perception in this tonal language. Additionally, this continuous fMRI protocol may offer a time-efficient way to assess group differences in brain activation with a challenging speech-in-noise task.

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Although the successful deployment of lithium-ion batteries (LIBs) in various fields such as consumer electronics, electric vehicles and electric grid, the efforts are still ongoing to pursue the next-generation battery systems with higher energy densities. Interest has been increasing in the batteries relying on the multivalent-ions such as Mg2+, Zn2+, and Al3+, because of the higher volumetric energy densities than those of monovalent-ion batteries including LIBs and Na-ion batteries. Among them, magnesium batteries have attracted much attention due to the promising characteristics of Mg anode: a low redox potential (−2.356 V vs. SHE), a high volumetric energy density (3,833 mAh cm−3), atmospheric stability and the earth-abundance. However, the development of Mg batteries has progressed little since the first Mg-ion rechargeable battery was reported in 2000. A severe technological bottleneck concerns the organic electrolytes, which have limited compatibility with Mg anode and form an Mg-ion insulating passivation layer on the anode surface. Consequently, beneficial to the good chemical and mechanical stability, Mg-ion solid electrolyte should be a promising alternative to the liquid electrolyte. Herein, a mini review is presented to focus on the recent development of Mg-ion solid conductor. The performances and the limitations were also discussed in the review. We hope that the mini review could provide a quick grasp of the challenges in the area and inspire researchers to develop applicable solid electrolyte candidates for Mg batteries.

Recently, the commercial market has seen an increase in the availability of smart wearable Internet of things (IoT) devices (wearables) including such items as: smart shoes, smart watches, wrist bands, and pendants. Many of these devices are part of the human-in-the-loop cyber-physical systems. In this research, the authors have designed and developed an embedded sensory IoT system with a low-power Bluetooth communication module to collect body single node voltage using a smartphone. Their approach for sensing the user's movement builds on work in the electric field sensing. Experimentation and verification have been conducted on a group of test subjects with different test scenarios including remaining at rest, walking, jumping, running, hand waving, eating, and bending over. They designed and developed their sensor to detect body motion data, and then used their algorithm to analyse the collected data. This study introduces the use of signal processing techniques for sensor data analytics to detect human body motion. The system can detect activity with a high degree of accuracy (∼ 87%).

Abscisic acid responsive element binding factors (ABFs) play crucial roles in plant responses to abiotic stress. However, little is known about the roles of ABFs in alpine subnival plants, which can survive under extreme environmental conditions. Here, we cloned and characterized an ABF1 homolog, CbABF1, from the alpine subnival plant Chorispora bungeana. Expression of CbABF1 was induced by cold, drought, and abscisic acid. Subcellular localization analysis revealed that CbABF1 was located in the nucleus. Further, CbABF1 had transactivation activity, which was dependent on the N-terminal region containing 89 residues. A Snf1-related protein kinase, CbSnRK2.6, interacted with CbABF1 in yeast two-hybrid analysis and bimolecular fluorescence complementation assays. Transient expression assay revealed that CbSnRK2.6 enhanced the transactivation of CbABF1 on ABRE cis-element. We further found that heterologous expression of CbABF1 in tobacco improved plant tolerance to freezing and drought stress, in which the survival rates of the transgenic plants increased around 40 and 60%, respectively, compared with wild-type plants. Moreover, the transgenic plants accumulated less reactive oxygen species, accompanied by high activities of antioxidant enzymes and elevated expression of stress-responsive genes. Our results thus suggest that CbABF1 is a transcription factor that plays an important role in cold and drought tolerance and is a candidate gene in molecular breeding of stress-tolerant crops.

CaMKv is a pseduokinase of unknown function. Here, the authors identify the protein as a substrate of the protein kinase Cdk5, and show that CaMKv is synthesized in response to neural activity and plays an important role in maintaining dendritic spines, synaptic plasticity, and hippocampal memory via RhoA inhibition.

Aims: To systemically investigate the in vitro and in vivo antibacterial properties of tebipenem pivoxil tablet. In addition, acute toxicity of this preparation was also studied. Methods: In vitro, minimum inhibitory concentration (MIC) or minimal inhibitory concentration (MBC) were determined by using the serial 2-fold broth or agar dilution methods. Further, cumulative MIC inhibition curves were then made to assess the antibacterial effects of the drug at various concentrations. In vivo, minimum lethal dose (MLD) in combination with maximum tolerance dose (MTD) was used to measure the acute toxicity of the tebipenem pivoxil tablet in mice. After that, sepsis mouse models challenged with Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae, respectively, were established to evaluate the anti-infective effect of this preparation. Results: The MIC90 values of tebipenem pivoxil against Gram-positive bacteria such as methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-sensitive Staphylococcus epidermidis (MSSE), methicillin-resistant Staphylococcus epidermidis (MRSE), Pyogenic streptococcus, and Enterococcus faecalis were ≤0.125, 16, 0.5, 8, ≤0.125, and 32 μg/mL, respectively. Correspondingly, the MIC90 values of tebipenem pivoxil against Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Haemophilus influenzae, Pseudomonas aeruginosa, and Acinetobacter baumannii were 1, 0.5, ≤0.125, 0.25, 64, 64 μg/mL, respectively. The MBC values of tebipenem pivoxil against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae were 0.016–2, 0.063–32, 0.031–32 μg/mL, respectively. The acute toxicity study showed that the MLD of the tebipenem pivoxil tablet was 4.00 g/kg and the MTD was 3.40 g/kg in mice. In all the sepsis mouse models, the simultaneous administration of the tebipenem pivoxil tablets significantly reduced mortality of the sepsis-model mice as compared with the control. Furthermore, the survival rate in the tebipenem pivoxil tablet group was remarkably higher than that in the meropenem group in all the sepsis mouse models tested. In the sepsis model challenged with Staphylococcus aureus ATCC29213, Escherichia coli ATCC25922, Pseudomonas aeruginosa ATCC27853, and Pseudomonas aeruginosa clinical strain, respectively, tebipenem pivoxil tablet (100 mg/kg) displayed a better protective effect than tebipenem pivoxil granules (100 mg/kg). Conclusions: In summary, tebipenem pivoxil displays an excellent antibacterial activity against a variety of pathogenic bacteria in vitro. Importantly, tebipenem pivoxil tablet significantly protects the sepsis mice challenged with various pathogenic bacteria, which may provide a potential approach to treating bacterial sepsis in clinic.