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The present research aims to study the effects of swaddled and traditional tub bathing on premature infants to identify better ways to bathe.Eligible premature infants (n = 60) were randomly assigned to either swaddled bathing or traditional tub bathing group. Stress scores and physiological indicators were measured 10 min before, immediately after, and 10 min after bathing. Crying times were also recorded for both groups. Data were reported as mean and standard deviation (SD) or frequency (percentage). For analyzing the data, the Student t-test and Chi-square test were employed.Swaddled bathing has less effect on the respiratory rate, heart rate, and oxygen saturation (p 0.05). Both bathing methods led to a decrease in the temperature of infants. Still, the temperature of infants 10 min after bathing, in the swaddled bathing group was rose higher than the traditional tub bathing (t = 2.813, p 0.05). The stress score of the swaddled bathing group, immediately after and ten minutes after bathing was lower than the traditional tub bathing group. The crying time of the swaddled bathing group was 32 ± 24.740(s) lower than the traditional tub bathing group 94.43 ± 41.625(s).The advantages of swaddled bathing over traditional tub bathing were validated for feasibility in China's preterm infants. Swaddled bathing is recommended method for bathing technique in the neonatal intensive care unit.Swaddled bathing is beneficial for the development of premature infants, as it results in less noxious stimuli and stress on the developing premature neonates.

Advances in instrumentation and technique have facilitated minimally invasive surgeries for cardiac myxoma treatment. This study aims to compare the clinical outcomes between the thoracoscopic and robotic approaches for myxoma resection. Intraoperative data and postoperative data of 46 patients who underwent either thoracoscopic (n = 15) or robotic (n = 31) cardiac myxoma resection in our center between July 2013 and September 2022 were retrospectively compared. There was no in-hospital death in either group. Meanwhile, the operative time and cardiopulmonary bypass time were significantly shorter in the robotic group than in thoracoscopic group (P = 0.015 and P = 0.035, respectively). Furthermore, shorter ICU stays (P = 0.006), shorter postoperative mechanical ventilation time (P = 0.035) and less thoracic drainage (P = 0.040) were observed in the robotic group. However, the operating room costs and total hospital costs were both significantly lower in thoracoscopic group (P = 0.004 and P = 0.007, respectively). There was no significant difference between two groups regarding the incidence of postoperative complications (P > 0.05). Lastly, a faster return to exercise was noted in robotic group than in thoracoscopic group (Log-Rank χ2 = 4.094, P = 0.043). Both approaches can be safe and feasible for myxoma resection. However, regardless of higher expenses, the robotic myxoma resection approach provides shorter operation time, less postoperative thoracic drainage, and faster recovery than total thoracoscopic technique.

The release of paracrine factors from endothelial progenitor cell (EPC) sheet is a central mechanism of tissue repair. The purpose of this study was to constuct the rat bone marrow derived-endothelial progenitor cell (BM-EPCs) sheet and investigate invest the role of stromal cell-derived factor-1α (SDF-1α)/CXCR4 axis in the biological function of BM-EPCs sheet. BM-EPC cells were identified by the cell-surface markers-CD34/CD133/VE-cadherin/KDR using flow cytometry and dual affinity for acLDL and UEA-1. After 7 days of incubation, the BM-EPC single-cell suspensions were seeded on thermo-sensitive plate to harvest the BM-EPC cell sheets. The expression levels of SDF-1α/CXCR4 axis-associated genes and proteins were examined using RT-qPCR and western blot analysis, and enzyme-linked immunosorbent assay (ELISA) was applied to determine the concentration of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and SDF-1α in the cell culture medium. The BM-EPC cell sheets were successfully harvested. Moreover, BM-EPC cell sheets have superior migration and tube formation activity when compared with single cell suspension. When capillary-like tube were formed from EPCs sheets, the releasing of paracrine factors such as VEGF, EGF and SDF-1α were increased. To reveal the mechanism of tube formation of BM-EPCs sheets, our research showed that the activation of PI3K/AKT/eNOS pathway was involved in the process, because the phosphorylation of CXCR, PI3K, AKT and eNOS were increased. BM-EPC cell sheets have superior paracrine and tube formation activity than the BM-EPC single-cell. The strong ability to secrete paracrine factors was be potentially related to the SDF-1α/CXCR4 axis through PI3K/AKT/eNOS pathway.

Doxorubicin (DOX) is a highly efficient chemotherapeutic drug limited by its cardiotoxicity. Galectin-3 (Gal-3) overexpression is associated with several cardiovascular diseases. In this study, the in vivo models of DOX-treated rats and the in vitro model of DOX-treated H9C2 cells were used. DOX induced cardiac injury and dysfunction accompanied with the upregulation of Gal-3 at the end of the experiment, while inhibition of Gal-3 with modified citrus pectin (MCP) exhibited a dramatic improvement in cardiac function of the DOX-treated rats, as manifested by increased left ventricular systolic pressure and ±dp/dtmaxand decreased left ventricular end-diastolic pressure. The plasma levels of myocardial injury markers such as lactate dehydrogenase, creatine kinase, creatine kinase-MB, and cardiac troponin I were decreased after MCP treatment. In parallel, MCP attenuated myocardial tissue markers of oxidative stress such as hydrogen peroxide and malondialdehyde restored the activities of superoxide dismutase, catalase, and glutathione peroxidase and upregulated antioxidant peroxiredoxin-4 (Prx-4). To further verify the role of Prx-4, it was downregulated by siRNA-mediated knockdown in H9C2 cells. MCP could not reverse DOX-induced oxidative stress in Prx-4-knock-down cells. In conclusion, Gal-3 mediated DOX-induced cardiotoxicity and Gal-3 inhibition attenuated DOX-induced cardiac dysfunction by upregulating the expression of Prx-4 to reduce myocardial oxidative stress.

The inerter-based isolation system, which comprises an inerter, a dashpot, and a spring, has been shown to be effective for improving the dynamic performance of isolated structures. However, the underlying theoretical basis of its vibration control mechanism has not been studied for superstructures with inerter-based isolation system; in particular, the functionality of the inerter has not been explicitly demonstrated. In this study, the displacement mitigation mechanism is established by deriving a fundamental equation, designated as the displacement demand equation. The mechanism is explained by clarifying the functionality of the inerter-based isolation system to determine the theoretical relationship between the displacements of the superstructure and isolation layer. A nominal displacement demand ratio is defined to evaluate the overall displacement demand of the structure–inerter-based isolation system, by considering the contribution of the inerter-based isolation system. Following the displacement mitigation mechanism, design strategies are developed for inerter-based isolation system, where the isolation frequency ratio can be directly determined once the target displacement performance of the entire structure–inerter-based isolation system is prespecified. In addition, the inertance-mass ratio and damping ratio of the inerter-based isolation system can be obtained according to the target demand of the superstructure displacement. Finally, a series of examples are used to verify the derived displacement demand equation and proposed design strategy. In this study, the displacement mitigation mechanism yields an effective design method that is suitable for the inerter-based isolation system and has a clear physical basis. Through the proposed displacement mitigation–oriented optimal strategy, a target displacement demand for a structure can be satisfied directly, which also provides an optimized displacement performance for the isolation layer. The displacement mitigation mechanism and equation are practical for the simplification of the design procedure and help to reveal the advantageous features of the inerter-based isolation system.

The inerter-based systems have proven to be effective for vibration control of adjacent structures. The interaction through the soil medium between adjacent structures in urban areas is generally a...

Background: The benign cardiac tumor is a common disease. We often completely removed it by operation. However, the characteristic of the tumor is not studied deeply. Here, we used the technique of single-cell RNA sequencing to analyze cell composition and growth patterns in a giant cardiac tumor. Case presentation: A 65-year-old woman presented to our hospital with 5 day of chest tightness, dyspnea, lower abdominal distension. Echocardiography revealed a mass in the right atrium. An emergency operation was carried out to prevent tumor shedding. The single-cell RNA sequencing was applied to analysis the nature of the tumor.Conclusion: Single-cell RNA sequencing is a good manner to analyze the growth pattern and search for therapeutic targets. Based on the result of single-cell RNA sequencing, it is helpful to reduce the recurrence of the tumor and benefit the quality of life of patients.

We report a 39-year-old Chinese man with a giant ascending aortic aneurysm that compressed the left main bronchus and esophagus. Cabrol procedure was successfully performed. The symptoms of dry cough, dysphagia, chest tightness, and asthma disappeared. Without any complications, the patient was discharged home

Introducing a tuned mass damper (TMD) into the friction pendulum system (FPS) has been proven to be an effective approach for improving the seismic performances of base-isolated structures. However, its seismic response mitigation effect is related to the quality of the mass employed, which unavoidably requires a necessary large mass under the requirement of a high seismic performance level. To avoid introducing the extra mass of the tuned mass damper (TMD) in the friction pendulum system (FPS) of a base-isolated structure, we herein introduce a lightweight inerter subsystem that has a series-parallel layout; comprises an inerter, a spring, and a damping element; and adds almost no mass. A structure isolated by the proposed friction pendulum inerter system (FPIS) was studied by nonlinear stochastic response analysis within a probabilistic framework, and an optimal design method for a structure with the FPIS was developed to simultaneously reduce the base shear force and the base isolation floor displacement. Based on the stochastic analysis results, parametric studies and a robustness analysis were conducted, and the impact of the FPIS’s mechanical layout on the seismic response mitigation effect was investigated. The analysis results demonstrated that the FPIS significantly reduced structural responses under different types of seismic excitations. Using the proposed optimal design method, target base shear force can be achieved at a minimized cost to the base isolation floor displacement. Compared to the FPS system with a TMD, the proposed FPIS enhances the seismic response mitigation effect by avoiding the extra mass that increases the seismic energy input to the base isolation floor.

The splash-lubricated intermediate gearbox of a helicopter is employed to investigate the influence of an oil guide device on lubrication performance in spiral bevel geared transmissions. A CFD (Computational Fluid Dynamics) numerical model of the gearbox which is mainly composed of an oil guide device, spiral bevel gears and the casing wall is built to study the oil distribution inside the gearbox. The present CFD model is validated by comparing experimental results and corresponding simulation ones. Influences of the oil tank capacity, the hole diameter and the fillet radius of oil guide tubes on the oil flow rate in the oil guide tubes are analyzed. It is shown that the hole diameter and the fillet radius of oil guide tubes can exert important influence on oil flow rate in the oil guide tubes while oil tank capacity does the reverse; the oil guide device structure has little influence on the oil flow of contact zone of gear pair and churning power losses in the spiral bevel gearbox.

Background: Myocardial ischemia-reperfusion injury (I/R) has been improved with drugs and effective reperfusion, but it still cannot be prevented. We compared the effects of renal denervation (RDN) and angiotensin receptor neprilysin inhibitors (ARNIs) on cardiomyocyte apoptosis after I/R to explore whether RDN can reduce cardiomyocyte apoptosis by improving endoplasmic reticulum stress.Methods: Sixty male specific pathogen free (SPF) Wister rats were randomly divided into six groups.(n=6):(a) normal; (b) sham; (c) I/R; (d) RDN; (e) I/R+RDN and (f) I/R+ARNI. We established the I/R rat model by ligating the left anterior descending artery. Rats were exposed tThe renal artery was exposed and then smeared phenol on the vessel for chemical ablation. The I/R+ARNI group received ARNIs for 2 weeks until killed. We also collected the cardiac tissues and blood serum to determine I/R-related indicators and analyze the potential mechanisms involved.Results: The levels of Norepinephrine (NE), Ang II, and aldosterone (ALD)increased significantly in the I/R group but decreased significantly after RDN and ARNI intervention. The expression of Bax, caspase-3, CHOP, PERK, and ATF4 protein was significantly increased in the I/R group, which compared to other groups, and the level of CHOP, PERK, and ATF4 gene expression increased. After RDN intervention, these expression levels recovered to varying degrees. Conclusion: Our results provide new evidence that RDN ameliorates cardiomyocyte apoptosis in I/R. The effect of RDN may be associated with regulating the endoplasmic reticulum stress PERK/ATF4 signaling pathway.

Background: The release of a wide array of endothelial progenitor cell (EPC) sheet-secreted paracrine factors is central to the mechanism by which these cells contribute to tissue repair. The purpose of this study was to fabricate BM-EPC sheet and conduct preliminary investigation on the paracrine effect of SDF-1ɑ about the role of the stromal cell-derived factor-1α (SDF-1α)/CXCR4 axis in the form of tubular structures from BM-EPCs sheet.Methods: EPCs derived from rat bone marrow (BM-EPC) were identified and isolated by the cell-surface markers CD34/CD133/VE-cadherin/KDR using flow cytometry, as well as by dual affinity for acLDL and UEA-1. Single-cell suspensions were seeded on temperature-responsive cell culture dishes. After 7 days of incubation, the BM-EPC cells were easily harvested as cell sheets, and a series of biochemical experiments were performed in vitro. The expression levels of SDF-1α/CXCR4 axis-associated genes and proteins were examined using RT‑qPCR and western blot analysis, and enzyme-linked immunosorbent assay (ELISA) was applied to determine the concentrations of VEGF, EGF and SDF-1α in the cell culture medium.Results: The BM-EPC cell sheets were successfully harvested. Moreover, BM-EPC cell sheets have superior proliferation and tube formation activity when compare with single cell suspension. When capillary-like tube were formed from EPCs sheets, the releasing of paracrine factors such as VEGF, EGF, and SDF-1ɑ were increasing. To drive the tube formation of BM-EPCs sheets, our mechanism research showed that the activation of PI3K/AKT/eNOS pathway since the phosphorylation of protein CXCR, PI3K, AKT and eNOS were increasing. Conclusion: BM-EPC cell sheets have superior proliferation and tube formation activity that can be used for tissue repair. The strong ability to secrete paracrine factors was be related to the SDF-1α/CXCR4 axis through PI3K/AKT/eNOS pathway.

Objective To investigate the relationship between lipoprotein(a) gene ( LPA) polymorphisms and calcific aortic valve disease (CAVD) and coronary heart disease (CHD) in Han Chinese. Methods A total of 148 patients were recruited (n = 71 with CAVD and n = 77 with CHD) based on a diagnosis achieved using color Doppler echocardiography, coronary angiography, or computed tomography angiography. Seventy-one control individuals without CAVD or CHD were also recruited. Biomarkers including levels of lipoprotein(a) [Lp(a)], low-density lipoprotein and high-density lipoprotein cholesterol, apolipoprotein A1, and apolipoprotein B were tested. LPA polymorphisms rs10455872, rs6415084, rs3798221, and rs7770628 were analyzed using SNaPshot SNP. Results Lp(a) levels were significantly higher in CAVD and CHD groups compared with controls. There was no significant difference in the allelic frequency distribution of rs3798221, rs7770628, or rs6415084 between CHD, CAVD, and control groups. Linear regression showed that rs3798221, rs7770628, and rs6415084 were associated with increased Lp(a) concentrations. Two CAVD patients among the 219 participants carried AG minor alleles at rs10455872, while the remainder carried AA minor alleles. Conclusion rs3798221, rs6415084, and rs7770628 polymorphisms within LPA are associated with higher Lp(a) plasma levels, which correlate with increased CAVD and CHD risks.

The porcine circovirus (PCV) is one of the most economically important infection diseases of pigs. Granulocyte–macrophage colony-stimulating factor (GM-CSF) or Flic as an immune adjuvant has been shown to enhance the immunogenicity of vaccines in previous study. However, the composite biological adjuvants stimulate more effective immunological response. In this study, the porcine GM-CSF (pGM-CSF) and FliC protein were expressed by pSUMO in E.coli Rosetta (DE3) and purified by Ni-NTA Sepharose, respectively. The immunogenicity of PCV vaccine with pGM-CSF and FliC was firstly evaluated to identify the immunoenhancement in mice. The results indicated that mice immunized with vaccine + pGM-CSF + FliC enhanced immune responses ability significantly and quickly. Then, the immune response level of PCV vaccine with pGM-CSF and FliC was assessed in piglets. The results indicated that pigs immunized with vaccine + pGM-CSF + FliC showed significantly higher PCV antibody level than those immunized with vaccine and single adjuvant or vaccine alone. Furthermore, pigs in the vaccine + pGM-CSF + FliC group elicited stronger CD4+ and CD8 + T cells proliferative responses than those in all other groups and showed the effectively up-regulated transcriptional level of IL-1, IL-8 and IL-17 stimulating the immune system. We demonstrated that GM-CSF and FliC as composite biological adjuvants of the vaccine showed a stronger immune response and it is promising application for vaccines to against PCV.

To predict the churning power losses in a gearbox with spiral bevel geared transmission, based on the Computational Fluid Dynamics (CFD) method, a numerical simulation model for the splash lubrication of the intermediate gearbox of a helicopter including gear box housing, a spiral bevel gear pair and an oil guide device is established and validated by the churning power losses prediction of experiments showing a good agreement. With the model, churning power losses of a gearbox with spiral bevel geared transmission are obtained; influences of gear rotational speed, oil fill level, oil temperature, oil dynamic viscosity, oil density, and tilt angle of the helicopter, on the churning power losses are analyzed.

Various inerter systems utilizing velocity-dependent damping for vibration control have been developed. However, a velocity-dependent damping element may exhibit relatively poor performance compared to a displacement-dependent damping element (DDE) of equivalent damping ratio, when the structural deformation is small in the early stage of the seismic response. To address this issue, the advantage of DDE in generating a larger control force in the early stage of excitation is promoted here and enhanced by a supplemental inerter-spring-system, thus realizing a proposed novel displacement-dependent damping inerter system (DDIS). First, the influence of various DDIS-parameters is carried out by resorting to the stochastic linearization method to handle non-linear terms. Then, seismic responses of the DDIS-controlled system are evaluated in the time domain taking the non-linearity into account, thus validating the accuracy of the stochastic dynamic analysis. Several design cases are considered, all of which demonstrated damping enhancement and timely control achieved by the DDIS. The results show that the energy dissipation as well as reduction of structural displacement and acceleration accomplished by the proposed system are significant. DDIS suppresses structural responses in a timely manner, as soon as the peak excitation occurs. In addition, it is demonstrated that interactions among the inerter, spring, and DDE, which constitute the damping-enhancement mechanism, lead to a higher energy-dissipation efficiency compared to the DDE alone.

Inerter systems have been proven to be effective vibration control devices. The energy-input-dissipation flow offers an alternative perspective to reveal the working mechanism of inerter-based systems for vibration control. In this study, the energy-based method is used to analytically explain the discovered benefits of inerter systems including the reduction in input energy and the enhancement of energy dissipation, which further yields optimal design for the inerter systems. Closed-form energy equations are derived for structures equipped with a basic inerter system composed of a grounded or ungrounded inerter. These energy equations theoretically establish the quantified relationship between the powers of input and dissipation and the key parameters of the inerter system in an analytical form. Furthermore, the differences in working mechanisms between inerter systems composed of grounded or ungrounded inerters are characterized via comparative analysis in terms of the displacement control, enhanced energy dissipation efficiency, and input energy reduction. Based on the revealed energy working basis, a unified energy-dissipation-based optimization strategy is developed to simultaneously control the displacement and energy responses. Finally, numerical examples are presented to validate the derived energy equations and the proposed optimization strategy. The findings of this study show that the energy equation supplies an analytical measurement for evaluating the input power of inerter-based structures and quantifies the energy dissipation effect of the inerter system. In particular, the derived energy equation explicitly reveals the dual benefits of an inerter system with a grounded inerter, which reduces the input power of the entire inerter-based structure and simultaneously dissipates the vibrational energy. Following the energy-dissipation-based optimal design strategy, which directly applies the grounded inerter to reduce input power or potentially uses the ungrounded inerter to enhance the energy dissipation effect, the target displacement can be quantitively achieved by the optimized inerter systems.

Interleukin (IL)‐37 and neutrophils are considered to be involved in human cancer, but their prognostic significance in colorectal cancer (CRC) has not been elucidated. The aim of this study was to evaluate the prognostic value of IL‐37 expression and neutrophil levels in CRC. We retrospectively analyzed IL‐37 expression, CD66b+ neutrophil levels, and mismatch repair (MMR) status in 337 paraffin‐embedded CRC specimens from the training cohort by immunohistochemistry. Their prognostic values were assessed using Kaplan‐Meier curves and multivariate Cox regression models. Moreover, several risk factors were used to form nomograms to evaluate survival, and the performance of the nomograms was assessed with respect to calibration, discrimination, and clinical usefulness. Further validation was performed in an independent cohort of 245 cases. Low IL‐37 expression and high CD66b+ neutrophil levels were significantly associated with diminished disease‐free survival (DFS) and overall survival (OS), and patients with MMR‐deficient CRC had better clinical outcomes. Furthermore, multivariate Cox analysis identified IL‐37, CD66b+ neutrophils, and MMR status as independent prognostic factors for DFS and OS. Two nomograms integrating the three markers with four clinicopathological risk factors were developed and validated for predicting DFS and OS with good calibration and discrimination (C‐index: training cohort, 0.798 (95% confidence interval:0.764‐0.832) and 0.828 (0.796‐0.860), respectively; validation cohort, 0.739 (0.696‐0.783) and 0.761 (0.715‐0.808), respectively). Decision curve analysis demonstrated that the nomograms were clinically useful. Intratumoral IL‐37, CD66b+ neutrophils, and MMR status were independent prognostic factors for CRC patients. Nomograms incorporating these biomarkers and clinicopathological features could be conveniently used to facilitate the individualized prediction of DFS and OS.

This study proposes a novel tuned liquid inerter system (TLIS) that employs a tuned liquid element and an inerter-based subsystem, including damping, stiffness, and inerter elements, to completely utilize their synergy benefits. The stochastic analyses for both damped and undamped structure-TLIS systems are conducted, and the analytical solution to the displacement response is derived for an undamped structure. Using the stochastic response results, the vibration control effect of the proposed TLIS is characterized through an extensive analysis in comparison with classic tuned liquid dampers. A parametric analysis is then performed to investigate the response variation pattern of the structure-TLIS with respect to the changes in TLIS parameters. Inspired by the parametric analysis, an optimal design framework for the most economical condition is developed for the TLIS by simultaneously considering the structural performance and control force. In particular, for a TLIS in the presence of an existing tuned liquid element, the optimal damping and stiffness ratios of the inerter subsystem in the TLIS are derived in an analytical form as the functions of tuned liquid mass and inertance to ensure structural responses are minimized. Moreover, the corresponding design procedure and examples are provided to validate the effectiveness of the proposed TLIS and design methods. It is concluded that the employment of the inerter-based subsystem in the TLIS can substantially improve the structural performance and reduce the displacement response of the tuned liquid in comparison with the classic tuned liquid damper for a given liquid mass. The optimal design of the TLIS can satisfy the target structural performance demands despite optimizing control cost. Simultaneously, the function of the tuned liquid element is partly substituted by the added inerter element, which implicitly facilitates the minimization of the physical mass of the TLIS to achieve lightweight-based control.

Previous studies on structures isolated by inerter-based systems have been conducted assuming they are constructed on a fixed base and neglecting the soil condition and impact of soil–structure interaction (SSI) on the structural performance. To this end, this paper proposes an optimal design method for an inerter isolation system (IIS) considering the soil condition in a demand-oriented design framework. Initially, an analytical model of a structure with an IIS installed under fixed-base and flexible-soil conditions is developed in the frequency domain, wherein an SSI model is established using the frequency-dependent stiffness and damping elements. Within a probabilistic framework analysis, the stochastic responses of the structure isolated by the IIS are determined by both considering and ignoring the effects of SSI. A parametric analysis is conducted to study the variation in the structural performance with respect to the IIS parameters and to comprehensively investigate the effect of SSI on the vibration mitigation effect of the IIS; the superstructure deformation, base shear force, and base isolation displacement are the employed performance indices. A demand-oriented optimal design strategy is then proposed to determine the IIS parameters for a structure on a fixed base and further developed for a structure on flexible soil. The analysis results show that the SSI effect should be considered for structures equipped with an IIS and installed on flexible soil. Moreover, because of the SSI effect, the IIS is designed assuming that a fixed base will fail to behave as expected, particularly in terms of its vibration mitigation and damping enhancement effects. The proposed design method enables the structure to achieve the target base shear force response, regardless of the type of soil foundation, by incorporating the SSI effect into the IIS design for structures on flexible soils.