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Abstract Background Our study aims to examine stress–strain data of the four major knee ligaments—the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL)—under transient impacts in various knee joint regions and directions within the static standing position of the human body. Subsequently, we will analyze the varying biomechanical properties of knee ligaments under distinct loading conditions. Methods A 3D simulation model of the human knee joint including bone, meniscus, articular cartilage, ligaments, and other tissues, was reconstructed from MRI images. A vertical load of 300 N was applied to the femur model’s top surface to mimic the static standing position, and a 134 N load was applied to the impacted area of the knee joint. Nine scenarios were created to examine the effects of anterior, posterior, and lateral external forces on the upper, middle, and lower regions of the knee joint. Results The PCL exhibited the highest stress levels among the four ligaments when anterior loads were applied to the upper, middle, and lower parts of the knee, with maximum stresses at the PCL-fibula junction measuring 59.895 MPa, 27.481 MPa, and 28.607 MPa, respectively. Highest stresses on the PCL were observed under posterior loads on the upper, middle, and lower knee areas, with peak stresses of 57.421 MPa, 38.147 MPa, and 26.904 MPa, focusing notably on the PCL-tibia junction. When a lateral load was placed on the upper knee joint, the ACL showed the highest stress 32.102 MPa. Likewise, in a lateral impact on the middle knee joint, the ACL also had the highest stress of 29.544 MPa, with peak force at the ACL-tibia junction each time. In a lateral impact on the lower knee area, the LCL had the highest stress of 22.279 MPa, with the highest force at the LCL-fibula junction. Furthermore, the maximum stress data table indicates that stresses in the ligaments are typically higher when the upper portion of the knee is affected compared to when the middle and lower parts are impacted. Conclusions This study recommends people avoid impacting the upper knee and use the middle and lower parts of the knee effectively against external forces to minimize ligament damage and safeguard the knee.

Autologous fat grafting technology has become a new method for breast reconstruction after breast surgery due to its advantages of simple operation, low immunogenicity, fewer complications, high patient acceptance, and natural filling effect. However, the unpredictable fate of transplanted fat limits its widespread application. Currently, many studies have made certain progress in improving the survival rate of fat grafts. This article provides an overview of autologous fat grafting technology, including the mechanisms of fat graft survival, techniques for obtaining and transplanting adipose tissue, methods for enhancing graft survival, and complications associated with fat grafting.

Abstract Background Urosepsis is a life-threatening organ disease in which pathogenic microorganisms in the urine enter the blood through the vessels, causing an imbalance in the immune response to infection. The aim of this study was to elucidate the role of testicular orphan receptor 4 (TR4) in urosepsis. Methods The role of TR4 in the progression and prognosis of urosepsis was confirmed by analyzing data from online databases and clinical human samples. To mimic urosepsis, we injected E. coli bacteria into the renal pelvis of mice to create a urosepsis model. Hematoxylin and eosin staining was used to observe histopathological changes in urosepsis. The effects of the upregulation or downregulation of TR4 on macrophage pyroptosis were verified in vitro. Chromatin immunoprecipitation assay was used to verify the effect of TR4 on Gasdermin D (GSDMD) transcription. Results TR4 was more highly expressed in the nonsurviving group than in the surviving group. Furthermore, overexpressing TR4 promoted inflammatory cytokine expression, and knocking down TR4 attenuated inflammatory cytokine expression. Mechanistically, TR4 promoted pyroptosis by regulating the expression of GSDMD in urosepsis. Furthermore, we also found that TR4 knockdown protected mice from urosepsis induced by the E. coli. Conclusions TR4 functions as a key regulator of urosepsis by mediating pyroptosis, which regulates GSDMD expression. Targeting TR4 may be a potential strategy for urosepsis treatment.

Abstract Background The establishment of sister chromatid cohesion N-acetyltransferase 2 (ESCO2) is involved in the development of multiple malignancies. However, its role in hypopharyngeal carcinoma (HPC) progression remains uncharacterized. Methods This study employed bioinformatics to determine the ESCO2 expression in head and neck squamous cell carcinoma (HNSC) and normal tissues. In vitro cell proliferation, migration, apoptosis, and/or cell cycle distribution assays were used to determine the function of ESCO2 and its relationship with STAT1. Xenograft models were established in nude mice to determine ESCO2 in HPC growth in vivo. Co-immunoprecipitation/mass spectrometry (Co-IP/MS) was conducted to identify the potential ESCO2 binding partners. Results We found that ESCO2 expression was elevated in HNSC tissues, and ESCO2 depletion suppressed tumor cell migration in vitro and inhibited tumor growth in vitro and in vivo. Co-IP/MS and immunoblotting assays revealed the interaction between ESCO2 and STAT1 in HPC cells. STAT1-overexpression compromised ESCO2-mediated suppressive effects on HPC cell proliferation, viability, and migration. Conclusions These findings suggest that ESCO2 is crucial in promoting HPC malignant progression through the STAT1 pathway and provides novel therapeutic targets for HPC treatment.

Abstract Background Brucellosis, caused by Brucella spp., is a major zoonotic public health threat. Although several Brucella vaccines have been demonstrated for use in animals, Brucella spp. can cause human infection and to date, there are no human‐use vaccines licensed by any agency. Recently, methods in vaccine informatics have made major breakthroughs in peptide‐based epitopes, opening up a new avenue of vaccine development. Objectives The purpose of this article was to identify potential antigenic peptides in Brucella by proteome and peptidome analyses. Methods Mouse infection models were first established by injection with Brucella and spleen protein profiles were then analysed. Subsequently, the major histocompatibility complex class I or II (major histocompatibility complex [MHC]‐I/II)‐binding peptides in blood samples were collected by immunoprecipitation and peptides derived from Brucella proteins were identified through liquid chromatography–mass spectrometry (LC‐MS/MS). These peptides were then evaluated in a variety of ways, such as in terms of conservation in Brucella and synchronicity in predicted peptides (similarity and coverage), which allowed us to more effectively measure their antigenic potential. Results The expression of the inflammatory cytokines IL1B and IFN‐γ was significantly altered in the spleen of infected mice and some Brucella proteins, such as Muri, AcpP and GroES, were also detected. Meanwhile, in blood, 35 peptides were identified and most showed high conservation, highlighting their potential as antigen epitopes for vaccine development. In particular, we identified four proteins containing both MHC‐I‐ and MHC‐II‐binding peptides including AtpA, AtpD, DnaK and BAbS19_II02030. They were also compared with the predicted peptides to estimate their reliability. Conclusions The peptides we screened could bind to MHC molecules. After being stimulated with antigen T epitopes, Memory T cells can stimulate T cell activation and promote immune responses. Our results indicated that the peptides we identified may be good candidate targets for the design of subunit vaccines and these results pave the way for the study of safer vaccines against Brucella.

The rapid progress of interdisciplinary researches from materials science, biotechnologies, biomedical engineering, and medicine, have resulted in the emerging of bioinspired skins for various fantasticating applications. Bioinspired skin is highly promising in the application of rehabilitation medicine owing to their advantages, including personalization, excellent biocompatibility, multi-functionality, easy maintainability and wearability, and mass production. Therefore, this review presents the recent progress of bioinspired skin towards next-generation rehabilitation medicine. The classification is first briefly introduced. Then, various applications of bioinspired skins in the field of rehabilitation medicine at home and abroad are discussed in detail. Last, we provide the challenges we are facing now, and propose the next research directions.

It is important to improve the accuracy of models estimating aboveground biomass (AGB) in large areas with complex geography and high forest heterogeneity. In this study, k-nearest neighbors (k-NN), gradient boosting machine (GBM), random forest (RF), quantile random forest (QRF), regularized random forest (RRF), and Bayesian regularization neural network (BRNN) machine learning algorithms were constructed to estimate the AGB of four forest types based on environmental factors and the variables selected by the Boruta algorithm in Yunnan Province and using integrated Landsat 8 OLI and Sentinel 2A images. The results showed that (1) DEM was the most important variable for estimating the AGB of coniferous forests, evergreen broadleaved forests, deciduous broadleaved forests, and mixed forests; while the vegetation index was the most important variable for estimating deciduous broadleaved forests, the climatic factors had a higher variable importance for estimating coniferous and mixed forests, and texture features and vegetation index had a higher variable importance for estimating evergreen broadleaved forests. (2) In terms of specific model performance for the four forest types, RRF was the best model both in estimating the AGB of coniferous forests and mixed forests; the R2 and RMSE for coniferous forests were 0.63 and 43.23 Mg ha−1, respectively, and the R2 and RMSE for mixed forests were 0.56 and 47.79 Mg ha−1, respectively. BRNN performed the best in estimating the AGB of evergreen broadleaved forests; the R2 was 0.53 and the RMSE was 68.16 Mg ha−1. QRF was the best in estimating the AGB of deciduous broadleaved forests, with R2 of 0.43 and RMSE of 45.09 Mg ha−1. (3) RRF was the best model for the four forest types according to the mean values, with R2 and RMSE of 0.503 and 52.335 Mg ha−1, respectively. In conclusion, different variables and suitable models should be considered when estimating the AGB of different forest types. This study could provide a reference for the estimation of forest AGB based on remote sensing in complex terrain areas with a high degree of forest heterogeneity.

Abstract Terrestrial ecosystem water retention (TEWR) service is subject to climate change and elevated atmospheric carbon dioxide concentration (eCO2), however, the relevant processes by which future climate change and eCO2 affect TEWR are poorly understood. Here, we use the factorial simulation experiments from the Inter‐Sectoral Impact Model Intercomparison Project to address this research question. The experiments are based on three dynamic global vegetation models forced with the same climate change scenarios. Results suggest that compared to the preindustrial level, during 2070–2099, (a) TEWR change is highly uncertain, especially in the Southern Hemisphere. (b) Climate change will dominate the pattern of future TEWR change compared with eCO2. (c) Precipitation and runoff change will dominate the future TEWR change in various regions, and the direct role of evapotranspiration (ET) on TEWR will be relatively small. (d) eCO2 will mainly affect vegetation dynamics in energy‐limited regions to affect the runoff, and consequently affecting TEWR change. (e) eCO2 will decrease ET and increase the runoff, resulting in a slight TWER change. These findings improve the understanding of the responses of TEWR to future climate change and eCO2.

Abstract Background Familial benign chronic pemphigus, also known as Hailey-Hailey disease (HHD), is a clinically rare bullous Dermatosis. However the mechanism has not been clarified. The study aim to detect novel mutations in exons of ATP2C1 gene in HHD patients; to explore the possible mechnism of HHD pathogenesis by examining the expression profile of hSPCA1, miR-203, p63, Notch1 and HKII proteins in the skin lesions of HHD patients. Methods Genomic DNA was extracted from peripheral blood of HHD patients. All exons of ATP2C1 gene in HHD patients were amplified by PCR and the products were purified and sequenced. All related signaling proteins of interest were stained by using skin lesion tissues from HHD patients and miR-203 levels were also determined. Results One synonymous mutation c.G2598A (in exon 26), one nonsense mutation c.C635A and two missense mutations c.C1286A (p.A429D) and c. A1931G (p. D644G) were identified. The nonsense mutation changed codon UCG to stop codon UAG, causing a premature polypeptide chain of the functional region A. The two missense mutations were located in the region P (phosphorylation region) and the Mn binding site of hSPCA1. The level of hSPCA1 was significantly decreased in HHD patients compared to the normal human controls, accompanied by an increase of miR-203 level and a decrease of p63 and HKII levels. Conclusion In our study, we found four mutations in HHD. Meanwhile we found increase of miR-203 level and a decrease of p63 and HKII levels. In addition, Notch1, which was negatively regulated p63, is downregulated. These factors may be involved in the signaling pathways of HHD pathogenesis. Our data showed that both p63 and miR-203 may have significant regulatory effects on Notch1 in the skin.

Percutaneous nephrolithotomy (PCNL) is an effective and well accepted procedure for the treatment of large and complex renal calculi. We encountered a patient with a misplaced percutaneous nephrostomy drainage tube (PNDT) into the contralateral renal vein resulting thrombus formation after undergoing right side PCNL. We placed a temporary filter to prevent embolism and started anti-coagulation therapy immediately and finally the PNDT was removed without bleeding. Keywords: Complication, Inferior vena cava, Percutaneous nephrolithotomy, Embolization, Renal calculus

Objective To compare the efficacy of two different treatment approaches for auricular pseudocyst. Methods This retrospective study reviewed data from patients with auricular pseudocyst that were treated with either anterior wall resection plus radiofrequency ablation compression (surgical group) or simple aspiration and compression suturing (control group). The following outcomes were compared between the two groups: therapeutic response (cure, good or none), duration of postoperative medication (antibiotics) use, duration of postoperative pain, duration of recovery of appearance and rate of complications (infection, auricular thickening, incision swelling and recurrence). Results A total of 386 patients were enrolled in the study: 218 in the surgical group and 168 in the control group. Duration of postoperative medication use, duration of postoperative pain, duration of recovery of appearance and rate of postoperative complications were significantly lower in the surgical group compared with the control group. The overall therapeutic response (cure and good response) was significantly greater in the surgical group than in the control group. Conclusion Auricular pseudocyst can be effectively treated by both of these methods, but anterior wall resection plus radiofrequency ablation compression might be more effective.

Objective To determine the effect of personalized psychological interventions on the recovery of patients with sudden deafness. Methods Participants were 438 patients with sudden deafness who were randomly allocated to observation and control groups. Patients in the control group received routine nursing care and drug treatment. Patients in the observation group received personalized psychological interventions, routine nursing care and drug treatment. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to measure anxiety and depression. The Simple Coping Style Questionnaire (SCSQ) and the Satisfaction With Life Scale (SWLS) were used to evaluate coping styles, attitude toward life and quality of life. Results Patients in both groups had similar SAS and SDS scores at the time of admission. After treatment, there was a significant difference in SAS and SDS scores between the observation and control groups, indicating that the observation group had less anxiety and depression. Both groups had increased SCSQ and SWLS scores following treatment, indicating improvements in positive coping and satisfaction with life. Conclusion Effective psychological interventions may change negative thoughts, increase response rate and improve quality of life.

Objective Previous studies have shown that patients with obstructive sleep apnea syndrome (OSAS) may have various vestibular abnormalities, and these mainly present as subclinical lesions. In this study, we attempted to combine ocular vestibular-evoked myogenic potentials (VEMPs) and cervical (VEMPs) to investigate vestibular dysfunction in patients with OSAS. Methods Thirty-eight patients with severe OSAS and 42 healthy controls were enrolled and divided into two groups according to results of polysomnography. All parameters of VEMP graphs were analyzed. Results The response rate of ocular VEMPs was significantly lower in patients with severe OSAS (85.5%) than in controls (96.4%). The mean n1 latency of patients with severe OSAS (10.6 ± 1.0 months) was significantly longer than that of controls (10.2 ± 1.1 months). With regard to cervical VEMP, p1-n1 amplitudes were significantly different between the groups. Other VEMP parameters were not significantly different between the groups. Conclusions VEMPs can potentially be used to evaluate vestibular system lesions at the early stage of OSAS, including not only the vestibular nerve, but also the otolith organs involved.

Formic acid is an appealing hydrogen storage material. In order to rapidly produce hydrogen from formic acid under relatively mild conditions, high-efficiency and stable photocatalytic systems are of great significance to prompt hydrogen (H2) evolution from formic acid. In this paper, an efficient and stable photocatalytic system (CdS/P/MoS2) for H2 production from formic acid is successfully constructed by elemental P doping of CdS nanorods combining with in situ photodeposition of MoS2. In this system, P doping reduces the band gap of CdS for enhanced light absorption, as well as promoting the separation of photogenerated charge carriers. More importantly, MoS2 nanoparticles decorated on P-doped CdS nanorods can play as noble-metal-free cocatalysts, which increase the light adsorption, facilitate the charge transfer and effectively accelerate the hydrogen evolution reaction. Consequently, the apparent quantum efficiency (AQE) of the designed CdS/P/MoS2 is up to 6.39% at 420 nm, while the H2 evolution rate is boosted to 68.89 mmol·g−1·h−1, which is 10 times higher than that of pristine CdS. This study could provide an alternative strategy for the development of competitive CdS-based photocatalysts as well as noble-metal-free photocatalytic systems toward efficient hydrogen production.

Objectives: The present study compared the safety and efficacy of combined laparoscopic ureterolithotomy (LU) and flexible ureteroscopy with percutaneous nephrolithotomy (PCNL) for removing large impacted upper ureteral stones with concurrent renal stones. Methods: This study included 52 patients who underwent combined LU and retrograde flexible ureteroscopy for removing renal stones (group A) or PCNL (group B) for removing large upper impacted ureteral stones and concurrent renal stones at our department from January 2014 to December 2016. Patient demographics, stone characteristics, and procedure-related parameters including stone-free rate, operation time, hospital stay after surgery, mean decrease in hemoglobin levels, visual analog scale (VAS) score, auxiliary procedure rate, and complication rate were compared between groups A and B. Results: Results of this study showed that both procedures were effective for removing large impacted upper ureteral stones with concurrent renal stones. The stone-free rate after a single procedure was 95.7% in group A and 89.7% in group B (p = 0.62). The operation time was longer in group A than in group B (112.2 ± 23.3 min versus 96.2 ± 16.4 min, p = 0.006). However, no significant difference was observed between the two groups with respect to the length of hospital stay after the surgery (5 days versus 6 days, p = 0.06). The decrease in hemoglobin levels was significantly higher in group B than in group A (−0.64 ± 0.36 g/dL versus −1.44 ± 0.65 g/dL, p

Abstract Background It is generally acknowledged that the determination of harmful chemical compounds excreted into saliva is useful for assessing their exposure levels. The aim of the present study was to compare the total arsenic and its species in saliva and urine samples collected from the people residing in an arsenic-contaminated area of China and to further verify the feasibility of using salivary arsenic as a new biomarker of arsenic exposure. Methods Total arsenic and speciation analyses in urine and saliva samples among 70 residents exposed to arsenic from drinking water in Shanxi, China were carried out by high-performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP/MS). Results The result showed that, total arsenic concentration in saliva was relatively lower than in urine samples, but it existed a strong positive correlation with total urinary arsenic, drinking water arsenic and different skin lesions. For arsenic metabolism analyses, AsIII, AsV, MMA, and DMA were detected in all of the urine samples with the dominating species of DMA (73.2%). Different with urinary arsenic species, most arsenic species in saliva were not methylated. The major species in saliva was iAs (AsIII + AsV, 76.18%), followed by DMA (13.08%) and MMA (9.13%). And the primary methylation index (PMI), second methylation index (SMI) and proportion of the four different species (AsIII, AsV, MMA, and DMA) in saliva showed no significant positive relationship with that of in urine. Conclusions These findings indicated saliva may be used as a useful tool for biological monitoring of total arsenic exposure in the crowd rather than an efficient tool for assessing arsenic metabolism in human body after exposed to arsenic.

The high manganese steel is widely used in wear-resisting parts of the cone crusher, such as the grinding mill wall and crushing wall. In this work, the microstructure and wear resistance of an ultra-high manganese steel (Mn18Cr2Mo) were analyzed by electron diffraction and high-resolution transmission electron microscope (HRTEM) observation and impact abrasive wear test. The results show that there are spherical or block Mo _2 C and strip-like (Fe, Cr) _3 C phases in Mn18Cr2Mo manganese steel. The orientation of the Mo _2 C phase and the austenite matrix are [001] _austenite // $\left[10\overline{1}\right]$ _Mo _2 _C , (020) _austenite //(020) _Mo _2 _C , $\left(\overline{2}00\right)$ _austenite //(202) _Mo _2 _C and $\left(\overline{2}20\right)$ _austenite //(242) _Mo _2 _C . The that of the (Fe, Cr) _3 C phase and the austenite matrix are [011] _austenite // $\left[12\overline{1}\right]$ _(Fe, Cr) _3 _C and $\left(11\overline{1}\right)$ _austenite //(210) _(Fe, Cr) _3 _C . Besides, $\left(\overline{1}1\overline{1}\right)$ _austenite is approximately parallel to $\left(1\overline{1}3\right)$ _(Fe, Cr) _3 _C . The interface relation of (002) _austenite is approximately parallel to $\left(\overline{1}\overline{2}3\right)$ _(Fe, Cr) _3 _C . Owing to high density dislocations, deformation bands, microcrystal and non-crystalline, the wear resistance of the Mn18Cr2Mo manganese steel is 1.83 times that of the Mn13 manganese steel under the impact abrasive wear test.

The early phase of extremity rehabilitation training has high potential impact for stroke patients. However, most of the lower limb rehabilitation robots in hospitals are proposed just suitable for patients at the middle or later recovery stage. This article investigates a new sitting/lying multi-joint lower limb rehabilitation robot. It can be used at all recovery stages, including the initial stage. Based on man–machine engineering and the innovative design for mechanism, the leg length of the lower limb rehabilitation robot is automatically adjusted to fit patients with different heights. The lower limb rehabilitation robot is a typical human–machine system, and the limb safety of the patient is the most important principle to be considered in its design. The hip joint rotation ranges are different in people’s sitting and lying postures. Different training postures cannot make the training workspace unique. Besides the leg lengths and joint rotation angles varied with different patients, the idea of variable workspace of the lower limb rehabilitation robot is first proposed. Based on the variable workspace, three trajectory planning methods are developed. In order to verify the trajectory planning methods, an experimental study has been conducted. Theoretical and actual curves of the hip rotation, knee rotation, and leg mechanism end point motion trajectories are obtained for three unimpaired subjects. Most importantly, a clinical trial demonstrated the safety and feasibility of the proposed lower limb rehabilitation robot.

Cerebral blood flow autoregulation (CA) shifts to higher blood pressures in chronic hypertensive patients, which increases their risk for brain damage. Although cerebral vascular smooth muscle cells express the potent vasodilatatory peptides calcitonin gene-related peptide (CGRP) and adrenomedullin (AM) and their receptors (calcitonin receptor-like receptor (Calclr), receptor-modifying proteins (RAMP) 1 and 2), their contribution to CA during chronic hypertension is poorly understood. Here we report that chronic (10 weeks) hypertensive (one-kidney-one-clip-method) mice overexpressing the Calclr in smooth muscle cells (CLR-tg), which increases the natural sensitivity of the brain vasculature to CGRP and AM show significantly better blood pressure drop-induced cerebrovascular reactivity than wt controls. Compared to sham mice, this was paralleled by increased cerebral CGRP-binding sites (receptor autoradiography), significantly in CLR-tg but not wt mice. AM-binding sites remained unchanged. Whereas hypertension did not alter RAMP-1 expression (droplet digital (dd) PCR) in either mouse line, RAMP-2 expression dropped significantly in both mouse lines by about 65%. Moreover, in wt only Calclr expression was reduced by about 70% parallel to an increase of smooth muscle actin (Acta2) expression. Thus, chronic hypertension induces a stoichiometric shift between CGRP and AM receptors in favor of the CGRP receptor. However, the parallel reduction of Calclr expression observed in wt mice but not CLR-tg mice appears to be a key mechanism in chronic hypertension impairing cerebrovascular reactivity.

Probes for monitoring mRNA expression in vivo are of great interest for the study of biological and biomedical problems, but progress has been hampered by poor signal to noise and effective means for delivering the probes into live cells. Herein we report a PNA·DNA strand displacement-activated fluorescent probe that can image the expression of iNOS (inducible nitric oxide synthase) mRNA, a marker of inflammation. The probe consists of a fluorescein labeled antisense PNA annealed to a shorter DABCYLplus-labeled DNA which quenches the fluorescence, but when the quencher strand is displaced by the target mRNA the fluorescence is restored. DNA was used for the quencher strand to facilitate electrostatic binding of the otherwise netural PNA strand to a cationic shell crosslinked knedel-like (cSCK) nanoparticle which can deliver the PNA·DNA duplex probe into cells with less toxicity and greater efficiency than other transfection agents. RAW 264.7 mouse macrophage cells transfected with the iNOS PNA·DNA probe via the cSCK showed a 16 to 54-fold increase in average fluorescence per cell upon iNOS stimulation. The increase was 4 to 7-fold higher than that for a non-complementary probe, thereby validating the ability of a PNA·DNA strand displacement-activated probe to image mRNA expression in vivo.