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To gain a deeper understanding of the pollution status and influencing factors of fine particles （PM 2.5 ） and their water-soluble ions （WSI） in Dalian and to implement precise control of pollution events such as haze and acid rain, PM 2.5 samples were collected in Dalian from June 2021 to May 2022. Then, the mass concentrations of PM 2.5 and WSI were determined using the weight method and ion chromatography, respectively, and the pollution characteristics and sources were analyzed. Furthermore, the causes of the high acidity of PM 2.5 in spring were discussed. The results showed that the annual average mass concentrations of PM 2.5 and WSI in Dalian during the sampling period were （33.24 ±28.87） μg·m -3 and （18.66 ±20.52） μg·m -3 , respectively, and the secondary ions （SNA, including SO 4 2- , NO 3 - , and NH 4 + ） accounted for the highest proportion of WSI [（86.2 ±9.3）%]. The order of ion concentration levels from highest to lowest was： NO 3 - >SO 4 2- >NH 4 + >Cl - >K + >Ca 2+ >Na + >Mg 2+ >F - . Due to the influence of meteorological conditions and coal combustion emissions during the concentrated heating period from late autumn to early spring, the seasonal variation in PM 2.5 and WSI was winter>spring>autumn>summer, whereas SNA was the highest in spring and the lowest in summer. The results of correlation and principal component analysis showed that WSI in PM 2.5 was mainly from the secondary transformation of atmospheric SO 2 and NO 2 （contributing to the majority of SNA）, mixed sources of combustion and dust （characterized by K + , Mg 2+ , Cl - , and F - ）, and sources of sand and sea salt （characterized by Na + , Ca 2+ , and Mg 2+ ）. In summer, the main combustion source was biomass burning, whereas in autumn, winter, and spring, coal combustion emissions were predominant. The change in wind direction from autumn to winter brought by a shift from the source of sea salt to soil dust； additionally, the external pollution transported by northwest winds contributed to the complexity of the sources of WSI in PM 2.5 during spring in Dalian. ISORROPIA-II model simulations suggested NH 4 NO 3 as the most present solid aerosol form in PM 2.5 in Dalian, followed by CaSO 4 and （NH 4 ） 2 SO 4 ； compared to that in solid aerosols, more SNA existed in liquid aerosols. The annual average pH of PM 2.5 in Dalian was 5.65 ±3.00, with pH values close to neutral in summer, autumn, and winter but significantly acidic in spring （2.03 ±3.18）. The high acidity observed in spring was attributed to the combination of low temperature, high humidity, and high SNA concentrations. These conditions resulted in higher aerosol water content and increased gas-to-particle conversion rates, ultimately leading to an ammonia-deficient environment. The backward trajectory and PSCF results indicated that the external transport of high acidity PM 2.5 in spring mainly came from the northwest （45.0%） and southwest （40.8%） directions. Mobile source emissions made the most significant contribution to the transportation of pollutants in the former, forming high-pollution source areas in the Beijing-Tianjin-Hebei Region, which may have been mainly related to urban motor vehicle and port vessel emissions； the latter was influenced by relatively strong stationary sources and showed higher SO 2 emissions in the southern part of Henan Province and the central part of Jiangsu Province.

The transcatheter edge-to-edge mitral valve repair (TEER) has been recommended as a reliable treatment option for selected patients with severe degenerative and functional mitral regurgitation (MR). Although MR patients with rheumatic etiology were excluded from two significant trials (EVEREST II and COAPT) that established a role for the TEER in degenerative and functional MR. However, it has been reported that the TEER procedure could be safely and effectively performed in carefully selected rheumatic MR patients. Therefore, we share a case report of successfully treating severe rheumatic MR using a novel-designed TEER system (JensClip TM )., (© 2024 Wiley Periodicals LLC.)

Competing Interests: Conflict of interest: None declared.

Developing scalable electrical stimulating platforms for cell and tissue engineering applications is limited by external power source dependency, wetting resistance, microscale size requirements, and suitable flexibility. Here, a versatile and scalable platform is developed to enable tunable electrical stimulation for biological applications by harnessing the giant magnetoelastic effect in soft systems, converting gentle air pressure (100-400 kPa) to yield a current of up to 10.5 mA and a voltage of 9.5 mV. The platform can be easily manufactured and scaled up for integration in multiwell magnetoelastic plates via 3D printing. The authors demonstrate that the electrical stimulation generated by this platform enhances the conversion of fibroblasts into neurons up to 2-fold (104%) and subsequent neuronal maturation up to 3-fold (251%). This easily configurable electrical stimulation device has broad applications in high throughput organ-on-a-chip systems, and paves the way for future development of neural engineering, including cellular therapy via implantable self-powered electrical stimulation devices., (© 2022 Wiley-VCH GmbH.)

(1) Background: Afatinib has been approved for patients with non-small cell lung cancer (NSCLC) carrying major uncommon epidermal growth factor receptor gene ( EGFR ) mutations. Dacomitinib, another second-generation tyrosine kinase inhibitor, has also shown promising potential for uncommon EGFR mutations. However, no comparative study has been conducted. (2) Methods: Two cohorts were employed: the AFANDA cohort, an ambispective cohort including 121 patients with uncommon EGFR mutations admitted to two tertiary hospitals in China, and an external validation afatinib cohort (ex-AC), extracted from the Afatinib Uncommon EGFR Mutations Database (N = 1140). The AFANDA cohort was divided into an afatinib cohort (AC) and a dacomitinib cohort (DC) for internal exploration. Objective response rate (ORR), progression-free survival (PFS), and adverse events (AEs) were assessed for comparison. Progression patterns and resistance mechanisms were explored. (3) Results: In total, 286 patients with advanced NSCLC carrying uncommon EGFR mutations treated with afatinib or dacomitinib were enrolled, including 79 in the AFANDA cohort (44 in the DC, 35 in the AC) and 207 in the ex-AC. In internal exploration, the ORR of the DC was significantly higher than that of the AC (60.5 vs. 26.7%, p = 0.008), but there was no significant difference in median PFS between the DC and the AC (12.0 months vs. 10.0 months, p = 0.305). Multivariate analysis confirmed an independent favorable effect of dacomitinib on PFS (hazard ratio (HR), 1.909; p = 0.047). In external validation, multivariate analysis confirmed the independent prognostic role of dacomitinib in PFS (HR, 1.953; p = 0.029). Propensity score matching analysis confirmed the superiority of dacomitinib over afatinib in terms of PFS in both univariate and multivariate analyses. Toxicity profiling analysis suggested more G1 ( p = 0.006), but fewer G3 ( p = 0.036) AEs in the DC than in the AC. Progression patterns revealed that the incidence of intracranial progression in the AC was significantly higher than that in the DC (50 vs. 21.1%, p = 0.002). Drug resistance analysis indicated no significant difference in the occurrence of T790M between the AC and the DC (11.8 vs. 15.4%, p = 0.772). (4) Conclusions: Compared with afatinib, dacomitinib demonstrated a more favorable activity with manageable toxicity and different progression patterns in patients with NSCLC carrying uncommon EGFR mutations.

To understand the temporal and spatial variations of reference crop evapotranspiration (ET 0 ) in Nenjiang River Basin, and clarify the effects of climatic factors on ET 0 , we calculated the daily ET 0 of each station in Nenjiang River Basin from 1970 to 2019 by Penman-Monteith formula, analyzed the temporal variation trend and spatial distribution pattern of ET 0 . We further quantitatively examined the sensitivity of ET 0 to meteorological factors by sensitivity analysis, and explored the contribution of meteorological factors to ET 0 changes. The results showed that ET 0 generally showed an insignificant decreasing trend during the study period in the Nenjiang River Basin. ET 0 decreased in spring, summer, and autumn, but increased in winter, and decreased from southeast to northwest. ET 0 had the highest sensitivity to relative humidity at both temporal and spatial scales. The sensitivity coefficients of mean temperature, relative humidity and wind speed increased gradually, while that of sunshine hours decreased gradually. ET 0 was sensitive to mean temperature in northern Greater Khingan Mountains and Lesser Khingan Mountains, while to wind speed in southern Greater Khingan Mountains and Songnen Plain. Wind speed was the main factor affecting the change of ET 0 in the whole year, spring, autumn, and winter. Sunshine hours was the main affecting factor in summer. The mean temperature and relative humidity had the greatest contribution to ET 0 in the north of Greater Khingan Mountains and Lesser Khingan Mountains, and it was the wind speed in Songnen Plain.

Background: Balloon-expandable valves (BEV) and self-expanding valves (SEV) for transcatheter aortic valve replacement (TAVR) have shown promising results in Western populations. Herein, we comparatively evaluated their hemodynamics and early clinical outcomes in a Chinese population., Methods: One hundred seventy-eight patients with symptomatic aortic stenosis who had undergone transfemoral TAVR using SEV (n=153; Venus-A, 97; VitaFlow, 56) or BEV (n=25; Sapien3) from September 2020 to April 2021 were retrospectively enrolled, and 25 pairs were propensity-score matched for 10 baseline variables. The primary study outcomes were aortic valve hemodynamics and postoperative complications at discharge and 3-month follow-up., Results: TAVR was successful in all patients. Compared with SEV group, the BEV group had similarly distributed baseline characteristics, procedural time, hospital stay, new pacemaker implantation, and paravalvular regurgitation grade. We also observed that the BEV group had lower rates of balloon pre-dilation (60% vs. 92%, P=0.018), post-dilation (0 vs. 20%, P=0.050) and second valve implantation (0 vs. 24%, P=0.022); higher mean transaortic gradient (14.3±6.1 vs. 10.8±4.9, P=0.030) and proportion of patients with elevated gradients (20% vs. 0, P=0.050) at discharge; and similar rehospitalization, mean transaortic gradient, new pacemaker implantation, and paravalvular regurgitation grade than the SEV group at the 3-month follow-up. There were no deaths in either group. However, the proportion of patients with elevated gradients in SEV group was higher at 3 months than before discharge (24% vs. 0, P=0.022)., Conclusions: BEV and SEV for transfemoral TAVR appear comparably safe and effective, with high device success and favorable 3-month clinical outcomes. However, the transaortic gradient and new pacemaker implantation in the SEV group increased during follow-up, warranting larger studies with longer-term follow-up., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-21-6637/coif). The authors have no conflicts of interest to declare., (2022 Annals of Translational Medicine. All rights reserved.)

The root of Paris polyphylla var. yunnanensis , a famous and endangered traditional Chinese herb, has a significant medicinal value. The aim of this study was to analyze the composition and functional characteristics of bacterial endophytes in roots, stems, and leaves of P. polyphylla var. yunnanensis . The 16S rRNA gene sequencing and functional prediction of bacterial endophytes in roots, stems, and leaves of P. polyphylla var. yunnanensis were conducted. The Chao and Shannon indices of the bacteria in roots were significantly higher than those in stems and leaves. The dominant endophyte phyla were Cyanobacteria, Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria. The main genera detected in roots were unclassified Cyanobacteria, Rhizobium, Flavobacterium , and Sphingobium ; the main genera in stems were norank&#95;c&#95;&#95;Cyanobacteria, Bacillus , and Pseudomonas ; the main genera in leaves were norank&#95;c&#95;&#95;Cyanobacteria and Rhizobium . The microbiota in roots was particularly enriched in functional categories "extracellular structures" and "cytoskeleton" compared with stems and leaves ( p < 0.05). Our study reveals the structural and functional characteristics of the endophytic bacteria in roots, stems, and leaves of P. polyphylla var. yunnanensis , which aids in the scientific understanding of this plant., The root of Paris polyphylla var. yunnanensis , a famous and endangered traditional Chinese herb, has a significant medicinal value. The aim of this study was to analyze the composition and functional characteristics of bacterial endophytes in roots, stems, and leaves of P. polyphylla var. yunnanensis . The 16S rRNA gene sequencing and functional prediction of bacterial endophytes in roots, stems, and leaves of P. polyphylla var. yunnanensis were conducted. The Chao and Shannon indices of the bacteria in roots were significantly higher than those in stems and leaves. The dominant endophyte phyla were Cyanobacteria, Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria. The main genera detected in roots were unclassified Cyanobacteria, Rhizobium, Flavobacterium , and Sphingobium ; the main genera in stems were norank&#95;c&#95;&#95;Cyanobacteria, Bacillus , and Pseudomonas ; the main genera in leaves were norank&#95;c&#95;&#95;Cyanobacteria and Rhizobium . The microbiota in roots was particularly enriched in functional categories “extracellular structures” and “cytoskeleton” compared with stems and leaves ( p < 0.05). Our study reveals the structural and functional characteristics of the endophytic bacteria in roots, stems, and leaves of P. polyphylla var. yunnanensis , which aids in the scientific understanding of this plant.

Background: Percutaneous balloon pulmonary valvuloplasty (PBPV) is the procedure of choice for uncomplicated severe or symptomatic pulmonary stenosis. Echocardiography (echo)-guided PBPV can completely avoid the use of radiation and contrast agents compared to fluoroscopy-guided PBPV. Although we have confirmed that echo-guided PBPV is feasible in humans, the poor visibility of the traditional catheter under echo greatly limits the promotion of this new technology., Methods: We produced a novel double-balloon catheter to make the catheter easy to be detected by echo through adding a guiding balloon at the distal end of the catheter. Echo-guided PBPV was performed on thirty healthy swine using either a novel catheter or a traditional catheter to evaluate the feasibility and safety of the novel double-balloon catheter. The feasibility was evaluated by the success rate of balloon inflation at the pulmonary valve annulus and the operating time. The safety was evaluated by the frequency of balloon slippage and the incidence of complications., Results: There were no significant between-group differences in terms of weight and the ratio of balloon diameter to pulmonary annulus diameter. The success rate was 93.3% and 60% in the novel and traditional groups, respectively. The novel group had significantly (p<0.05) lower mean procedure time (6.33±6.86min vs 24.8±9.79min) and lower frequency of balloon slippage (0.07±0.26 vs 0.53±0.52), arrhythmia (0.07±0.26 vs 0.47±0.52), and tricuspid regurgitation (6.7% vs 40%) than the traditional group. No myocardial hematoma or pericardial tamponade occurred in the novel catheter group., Conclusion: Although further studies and improvements are required, the study results indicate that the novel double-balloon catheter for echo-guided PBPV is feasible and safe., (Copyright © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Background: A percutaneous approach for pulmonary valve replacement (PVR) is a feasible alternative to surgical PVR in selected patients with severe pulmonary regurgitation after repair of tetralogy of Fallot. However, large right ventricular outflow tract (diameter ≥ 25 mm) remains challenging., Methods: This retrospective multicenter study enrolled consecutive patients with large right ventricular outflow tract who underwent percutaneous PVR (Venus P-valve, Venus MedTech Inc, Hangzhou, China) (n = 35) or surgical PVR (homograft valve; n = 30) between May 2014 and April 2017. Patients were followed up at 1, 3, 6, and 12 months, and yearly thereafter. Main study outcomes were pulmonary valve function and right ventricular function at discharge and midterm follow-up., Results: PVR was successful in all patients. Percutaneous compared with surgical PVR group had: similarly distributed baseline characteristics; shorter hospitalization, intensive care unit stay, and endotracheal intubation duration; lower cost; lower pulmonary valve gradient before discharge; lower pulmonary valve regurgitant grade (mean difference, -0.63; 95% CI -1.11 to -0.20, P = .022), pulmonary valve gradient (mean difference, -5.7 mm Hg; 95% CI -9.4 to -2.2 mm Hg, P = .005), and right ventricular end-diastolic volume index (mean difference, -9.5 mL/m 2 ; 95% CI -16.9 to -3.1 mL/m 2 , P = .022); and greater right ventricular ejection fraction (mean difference, 5.4%; 95% CI 2.4%-8.3%, P = .002) at median 36 months follow-up, without deaths in either group., Conclusions: Percutaneous PVR using Venus P-valve appeared to be a safe, efficacious and minimally invasive alternative to surgical PVR in selected patients with large right ventricular outflow tract yielding better right ventricular and pulmonary valve function at midterm follow-up., (Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Chemotherapy has improved the survival of non-small cell lung cancer (NSCLC) patients over the past few decades. However, there have not been any epidemiological studies on chemotherapy for Chinese NSCLC patients., Patients and Methods: The patients diagnosed as primary lung cancer between January 1, 2005, and December 31, 2014, in eight hospitals from eight provinces in China were retrospectively reviewed. Demographic and clinical data were extracted from medical history systems. Chi-square test and logistic regression were used to analyze the changes of chemotherapy usage and influential factors., Results: A total of 7184 lung cancer cases were eligible, among which 6481 NSCLC cases were included in this analysis. Among stage I/II patients, the percentages of receiving adjuvant chemotherapy did not change significantly between the earlier (28.5%) and the latter five years (25.7%) ( p = 0.1288). Among stage IIIA patients, the percentages of chemotherapy usage did not change significantly between the earlier and the latter five years in neo-adjuvant (7.5% vs 5.6%, p = 0.1478) and adjuvant (23.1% vs 26.8%, p = 0.1129) treatment. The proportions of first-line platinum-based doublets for stage IIIB/IV patients changed significantly over the 10 years ( p < 0.0001). Patients from provinces with inferior gross domestic product, with lower medical reimbursement rates and without smoking history were more likely to use the docetaxel/paclitaxel doublets, comparing with the gemcitabine doublets., Conclusion: From 2005 to 2014, there was no significant change in the chemotherapy pattern of early NSCLC. Economic factors mainly contributed to the significant changes in the first-line chemotherapy regimen selection for advanced patients., Competing Interests: The authors declare that they have no conflict of interest with respect to this research study and paper., (© 2020 Xing et al.)

Endophytic microorganisms absorb nutrients and prevent pathogen damage, supporting healthy plant growth. However, the relationship between endophytic bacteria and berberine synthesis in the medicinal plant Coptis teeta Wall. remains unclear. Herein, we explored the community composition of endophytic bacteria related to berberine in roots, stems, and leaves of wild-type and cultivated C. teeta . Endophytic bacterial communities were analyzed by 16S rRNA sequencing, and berberine content in roots was analyzed by high-performance liquid chromatography. Proteobacteria, Actinobacteria, and Bacteroidetes were the major phyla, and Mycobacterium , Salmonella , Nocardioides , Burkholderia-Paraburkholderia , and Rhizobium were the dominant genera in root, stem, and leaf tissues. Root berberine content was positively correlated with total N, total P, total K, and available K in rhizosphere soil. In addition, root berberine content was positively correlated with Microbacterium and norank&#95;f&#95;7B-8 , whereas soil total K was positively correlated with Microbacterium and Burkholderia-Paraburkholderia in roots. Our results demonstrated a clear correlation between dominant endophytic bacteria and berberine synthesis in C. teeta . The findings are useful for the promotion of berberine production in C. teeta via manipulation of endophytic bacteria., Competing Interests: Conflict of interestAll authors declared that there are no conflicts of interest., (© King Abdulaziz City for Science and Technology 2020.)

We compared the ecological characteristics of tussock individuals and populations undergoing natural and artificial restoration in Carex tussock wetlands in the Sun Island in Harbin and identified the relationships between the growth of Carex tussock and environmental factors. Results showed that there were obvious seasonal dynamics in morphological characteristics of C. appendiculata. Tussocks grew rapidly from May to June, peaked in June, and then decreased steadily from July to August. There were significant differences in ecological characteristics of Carex tussocks between natural and artificial restorations. The morphological characteristics of individual tussock, including leaf area, leaf width, fresh weight per ramet, dry weight per ramet, and the hummock shape indicators (hummock height, diameter, volume and surface area) in natural restored area were significantly higher than those in artificial transplanting area. For the Carex tussock community, tussock density, coverage and biomass in natural restoration area were significantly lower than those in artificial transplanting area. Soil water content, water depth and hummock spacing in natural restoration area were significantly higher than those in artificial restoration area, which facilitated the formation and development of individual tussock. Higher transplanting density was the main factor leading to higher density, coverage, and biomass in artificial restoration area. Our results suggested that the distribution characteristics of tussocks in natural restoration area should be taken into account in future restoration and protection works. Appropriate adjustment of the distance between hummock (54.22-117.89 cm) and population density (1.9-3.1 ind·m -2 ), as well as proper water recharge measures in spring in arid areas to regulate soil water content and water depth, would be conducive to promoting the growth and rapid recovery of Carex tussock, which would maintain the long-term health and stability of tussock wetland.

Pulmonary fibrosis (PF) is a crippling disease characterized by progressive dyspnea and associated with a high mortality rate, but its origin is unknown and there is no effective treatment. Yifei Sanjie formula (YFSJF) is a Chinese medicine that is widely used for treatment of respiratory systems disease. However, the molecular basis for the function of YFSJF has not been determined. Here we investigate the contribution of YFSJF in BLM-induced PF mice. Administration with YFSJF significantly alleviated the degree of BLM-induced collagen I and III deposition and the inflammatory injuring in the lungs and suppressed hydroxyproline release in PF animals. The active components of YFSJF are comprised with flavonoid, amino acids, saponins, oligosaccharide, organic acid, vitamin, esters, purine nucleosides. Additionally, there was a significant increase in autophagosomes, after treatment with YFSJF in PF animals. Interestingly, autophagy dysfunction by the blocker chloroquine (CQ) resulted in collagen deposition and inducing the expression of fibrosis-related genes. In addition, YFSJF-induced autophagy is mediated by the PI3K-AKT-mTOR pathway, and knockdown of PI3K by siRNA up-regulated the expression of autophagy-related genes and down-regulated the expression of collagen in human lung fibroblasts (HLF). Our findings provide a detailed understanding that YFSJF-antifibrotic effects are mainly mediated by triggering autophagy, and suppressing phosphorylation of the PI3K-AKT-mTOR pathway is required for YFSJF-curative effect., (Copyright © 2019 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

The thermally expandable microspheres (TEMs) were prepared through suspension polymerization with acrylonitrile (AN), methyl methacrylate (MMA) and methyl acrylate (MA) as the main monomers. Simultaneously, iso-pentane, n-hexane, iso-octane and other low-boiling hydrocarbons were prepared as blowing agents under two conditions, including high-pressure nitrogen and atmospheric conditions. The above physical foaming microspheres have a core-shell structure and excellent foaming effects. A layer of polyaniline (PANI) was deposited on the surface of the prepared TEMs by emulsion polymerization to obtain conductive and heat-expandable microspheres. Afterwards, the foaming ink was prepared by mixing the conductive TEMs and water-based ink. Finally, a conductive three-dimensional picture was obtained by screen-printing technology. This paper specifically focuses on the effects of particle size, morphology and the thermal expansion properties of the microspheres. The present research methods expect to obtain microspheres with a high foaming ratio, uniform particle size and antistatic properties, which may be applied to physical foaming ink.

Background: Surgical or percutaneous interventional treatment of severe congenital aortic valve stenosis (CAS) in early infancy remains challenging. This single-center, retrospective study analyzed midterm outcomes of a hybrid balloon valvuloplasty procedure through the ascending aorta by way of median sternotomy, including cases with improved technique., Methods: Included were 45 consecutive infants (aged <90 days) with CAS and selected for biventricular repair who underwent hybrid balloon valvuloplasty in a hybrid or ordinary operating room from October 2010 to March 2016. Patients were assessed at 1, 3, 6, and 12 months and yearly thereafter., Results: Hybrid balloon valvuloplasty was successful in all patients, with the last 8 treated in an ordinary operating room under only echocardiography guidance with a new sheath. Thirty-two patients were successfully rescued from low heart rate or left ventricular systolic dysfunction, or both, by cardiac massage under direct visualization; none required cardiopulmonary bypass. The degree of new aortic insufficiency was mild in 7 patients and changed from mild to moderate in 1 patient. Aortic valve pressure gradient decreased from 70.6 ± 17.5 mm Hg preoperatively to 15.2 ± 4.2 mm Hg immediately postoperatively (p < 0.001). Fluoroscopy time was 4.8 ± 2.3 minutes. At a median of 32.1 months (range, 1 to 68 months) follow-up, all patients were alive and healthy. Aortic valve pressure gradient remained low (19.1 ± 5.2 mm Hg). Left ventricular ejection fraction increased from 0.515 ± 0.134 (range, 0.21 to 0.70) preoperatively to 0.633 ± 0.035 (range, 0.58 to 0.75; p < 0.001). No aortic insufficiency developed, and no patient required reintervention., Conclusions: For infants with severe CAS, hybrid balloon valvuloplasty through the ascending aorta by way of a median sternotomy appears efficacious and safe up to midterm follow-up., (Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess safety and effectiveness of symmetric and asymmetric occluders in perventricular device closure without cardiopulmonary bypass of perimembranous ventricular septal defects (pmVSDs)., Methods: The present retrospective study enrolled 581 patients who underwent perventricular device closure of pmVSDs under transoesophageal echocardiography guidance from May 2011 to April 2016, and outpatient electrocardiography and transthoracic echocardiography assessments at 1, 3, 6 and 12 months, and yearly thereafter., Results: The overall success rate of device implantation was 92.6% (43 surgical conversions immediately). Between patients receiving symmetric ( n  = 353) and asymmetric ( n  = 185) occluders, there were no significant differences in age, weight and defect diameter distributions; however, both before discharge and at mean 28.6 ± 21.2 (range, 1-60)-month follow-up, the symmetric group had lower rates of trivial residual shunt (5.7% vs 11.4%, P  = 0.018; and 0.8% vs 5.9%, P  = 0.001) and bundle branch block (0.8% vs 5.4%, P  = 0.002; and 0.6% vs 3.8%, P  = 0.009); and at follow-up, the asymmetric group had lower residual shunt (47.6% vs 85.0%, P  = 0.020) and similar branch block (30.0% vs 33.3%, P  = 1.000) disappearance rates. There were no severe complications, i.e. aortic regurgitation, malignant arrhythmias, haemolysis or device dislocation., Conclusions: Perventricular device closure of pmVSDs appears safe and effective with symmetric and asymmetric occluders. However, the lower residual shunt disappearance and higher branch block incidence rates for asymmetric occluders would favour more proactive conversion to surgical repair immediately when residual shunt is present intraoperatively., (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Objective: The objective of this study was to assess the feasibility of percutaneous balloon pulmonary valvuloplasty (PBPV) under echocardiographic guidance only., Setting: PBPV has become the preferred choice for pulmonary valve stenosis (PS). We report the first-in-human successful PBPV under only echocardiography guidance for isolated PS., Methods: From March 2013 to December 2014, 34 patients with congenital PS underwent PBPV with echocardiography as the only imaging modality in the ordinary operation room or catheter lab. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography (TTE) was conducted at 1, 3, 6, and 12 months., Results: All 34 patients successfully underwent PBPV under echocardiography guidance without radiation and contrast agent. The pulmonic transvalvular pressure gradient dropped from 62.8 ± 10.1 mm Hg to 14.7 ± 4.2 mm Hg measured on catheterization (P < .05). The balloon diameter/pulmonary annulus diameter ratio was 1.34 ± 0.07. Slight regurgitation of the pulmonary valve occurred in five patients and mild pulmonary regurgitation occurred in one patients. The pulmonic transvalvular pressure gradient measured on TTE 12 months after the procedure was 14.1 ± 4.6 mm Hg. No pericardial effusion and peripheral vascular complications occurred., Conclusion: This study demonstrated that PBPV can be successfully performed under only echocardiography guidance and appears safe and effective while avoiding radiation and contrast agent use., (© 2016 Wiley Periodicals, Inc.)

Introduction: Percutaneous patent ductus arteriosus (PDA) occlusion has become the preferred therapeutic option, which uses fluoroscopy as the guidance. To reduce the x-ray exposure, PDA occlusion using the Amplatzer Duct Occluder II (ADO II) under guidance of transthoracic echocardiography only was conducted. This single center study aims to access the safety and efficiency of this new strategy., Methods and Results: From June 2013 to May 2015, 63 consecutive PDA patients underwent transthoracic echocardiography-guided PDA occlusion through the femoral artery. Outpatient follow-up was conducted at 1, 3, and 6 months, and yearly. Sixty-two patients successfully underwent echocardiography-guided percutaneous PDA occlusion. One patient was converted to minimally invasive transthoracic occlusion due to failure of delivery sheath passage through tortuous PDA. Mean procedure duration was 24.3 ± 7.0 minutes; ADO II diameter averaged 4.6 ± 0.9 mm; 8 cases showed traces of residual shunt immediately after operation which resolved after 24 hours; and mean hospital stay was 3.4 ± 0.5 days. There was no occluder migration, hemolysis, pericardial effusion, pulmonary branch or aortic stenosis at mean 13.5 ± 4.8 months follow-up., Conclusions: This study demonstrated that percutaneous PDA occlusion can be successfully performed under guidance of transthoracic echocardiography only and appears safe and effective while avoiding radiation and contrast agent use., (© 2016, Wiley Periodicals, Inc.)

Objective: To assess the clinical effectiveness of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius., Methods: According to Cochrane Systematic Review, Medline, Embase, Cochrane Li- brary, CNKI and CBM, randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software., Results: Totally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group (187 cases) and radial column plate group (204 cases). Meta-analysis result showed: compared with radial column plate group, volar plate group had significant difference in recovery of wrist function [SMD = 0.74, 95% CI (0.47, 1.01), P < 0.00001], Gartland-Werley scores [SMD = -1.39, 95% CI (-2.24, -0.53), P = 0.001], postoperative neural in- jury [OR = 3.67, 95% CI (1.37, 9.84), P = 0.01 1 and postoperative wrist pain [OR = 0.32, 95% CI (0.13, 0.74), P = 0.008]. But no significant difference was identified in DASH scores [SMD = -0.36, 95% CI (-0.97, 0.26), P = 0.25], radiographic result assess- ment [SMD = -0.18, 95% CI (-0.53, 0.16), P = 0.3], postoperative grip strength [SMD = 0.71, 95% CI (-0.12, 1.54),P = 0.09], postoperative tendinous damage [OR = 0.31, 95% CI (0.10, 0.98), P = 0.05] and carpal tunnel syndrome [OR = 0.96, 95% CI (0.63, 1.48), P = 0.87]., Conclusion: Compared with radial column plate internal fixation, volar approach plate fixation for treat- ment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However, the volar approach plate fix- ation was associated with a higher risk of long-term complications than the radial column approach plate fixation.

Background: Transesophageal echocardiogram-guided minimally invasive periventricular device closure of perimembranous ventricular septal defects (pmVSDs) without cardiopulmonary bypass is a treatment option for pmVSDs. We introduce our improvements to this technique and mid-term follow-up results., Methods: From May 2011 to May 2014, 187 patients with pmVSDs aged 6 months to 31 years (8.2 ± 10.2 years) were enrolled in this study. The procedure was performed through a new transthoracic approach of 1 to 2 cm without sternotomy. Device selection and the operative procedure were monitored by transesophageal echocardiogram. The patients underwent follow-up examinations of echocardiography and electrocardiogram at 1 month, 3 months, 6 months, and 1 year after the operation and annually thereafter., Results: The defects were closed successfully in 179 patients (95.7%), and in 8 patients the operation was converted to conventional surgical repair. Six patients (3.4%) had an incomplete right bundle branch block. One patient experienced an intermittent complete atrioventricular block on the fourth day after the operation, and sinus rhythm was restored by corticosteroid therapy after 5 days. A trivial residual shunt was observed in 8 patients (4.5%) during the procedure. The average hospital stay was 3.1 ± 0.9 days. Follow-up in all patients ranged from 1 month to 36 months (median, 12.6 months), and aortic regurgitation, malignant arrhythmia, and device dislocation were not observed in any patients. However, 3 patients (1.7%) still had a trivial residual shunt at their last follow-up., Conclusions: Periventricular device closure through a modified transthoracic approach without sternotomy is a potentially safe and effective treatment option for pmVSDs. Controlled studies with long-term follow-up are necessary., (Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: Demonstrate the benefits of percutaneous atrial septal defect (ASD) closure under guidance of transthoracic echocardiography (TTE) without fluoroscopy., Methods: From February 2013 to April 2014, 127 consecutive patients with an isolated type II ASD were recruited to undergo percutaneous closure under either TTE (n = 60, TTE group) or TEE (n = 67, TEE group) guidance. The TTE group received local anesthesia or sedation with propofol, and the TEE group received general anesthesia with endotracheal intubation. Follow-up examinations were performed for both groups at 1 month, 3 months, 6 months, and 1 year after discharge and annually thereafter., Results: The TTE group had a significantly shorter procedure time and respirator ventilation duration than the TEE group. The dose of propofol required, the cost, and the pharyngeal complication rate were significantly lower in the TTE group than in the TEE group. The median follow-up of 11.6 months was uneventful in all patients., Conclusions: Percutaneous ASD closure with TTE guidance as the only imaging tool avoids fluoroscopy, endotracheal intubation, and probe insertion and is associated with a satisfactory procedural success rate and lower costs. This procedure is a safe and reliable treatment for ASD., (© 2015, Wiley Periodicals, Inc.)

Background: Previous studies reported the association between single nucleotide polymorphism (SNP) of IL15 receptor alpha (IL15RA) gene with susceptibility to ossification of the posterior longitudinal ligament of the spine (OPLL). However, the results were still in controversy. Therefore, the purpose of the present study was to investigate the association between SNPs of IL15RA gene with susceptibility to OPLL in a Chinese Han population., Methods: A total of 235 OPLL patients and 250 age-matched healthy controls were recruited. All the subjects were genotyped using the PCR (polymerase chain reaction)-based invader assay. A case-control study was performed to define the contribution of rs2228059 and rs2296139 to predisposition of OPLL. We also performed subgroup analysis according to the different gender., Results: A significant association of rs2228059 with OPLL was observed in the Chinese Han population (p <0.001, OR = 1.63, 95% CI = 1.26-2.11). The subgroup analysis showed that there was a significant association between the allele frequency of rs2228059 and the susceptibility of OPLL in males (p = 0.002, OR = 1.72, 95% CI = 1.23-2.42). However, there was no significant association between SNP of rs2296139 and susceptibility to OPLL., Conclusions: The present study demonstrates that the SNP of rs2228059 in IL15RA gene is associated with susceptibility to OPLL in a Chinese Han population, especially in males.

Background: Ongoing studies using genomic microarrays and next-generation sequencing have demonstrated that the genetic contributions to cardiovascular diseases have been significantly ignored in the past. The aim of this study was to identify rare copy number variants in individuals with congenital pulmonary atresia (PA)., Methods and Results: Based on the hypothesis that rare structural variants encompassing key genes play an important role in heart development in PA patients, we performed high-resolution genome-wide microarrays for copy number variations (CNVs) in 82 PA patient-parent trios and 189 controls with an Illumina SNP array platform. CNVs were identified in 17/82 patients (20.7%), and eight of these CNVs (9.8%) are considered potentially pathogenic. Five de novo CNVs occurred at two known congenital heart disease (CHD) loci (16p13.1 and 22q11.2). Two de novo CNVs that may affect folate and vitamin B12 metabolism were identified for the first time. A de novo 1-Mb deletion at 17p13.2 may represent a rare genomic disorder that involves mild intellectual disability and associated facial features., Conclusions: Rare CNVs contribute to the pathogenesis of PA (9.8%), suggesting that the causes of PA are heterogeneous and pleiotropic. Together with previous data from animal models, our results might help identify a link between CHD and folate-mediated one-carbon metabolism (FOCM). With the accumulation of high-resolution SNP array data, these previously undescribed rare CNVs may help reveal critical gene(s) in CHD and may provide novel insights about CHD pathogenesis.

A new p-terphenyl 1 and a novel p-terphenyl derivative 3 bearing a benzothiazole moiety were isolated from halophilic actinomycete Nocardiopsis gilva YIM 90087, along with known p-terphenyl 2, antibiotic novobiocin 4, cyclodipeptides 5-13, and aromatic acids 14 and 15. Their structures were elucidated on the basis of the interpretation of spectral data and by comparison of the corresponding data with those reported previously. The p-terphenyl 1 showed antifungal activity against the three pathogenic fungi, including Fusarium avenaceum, Fusarium graminearum, and Fusarium culmorum, that caused Fusarium head blight with minimal inhibitory concentrations (MICs) of 8, 16, and 128 μg/mL, respectively. Compound 1 showed antifungal activity against Candida albicans with a MIC of 32 μg/mL and antibacterial activity against Bacillus subtilis with a MIC of 64 μg/mL. Novobiocin 4 showed antifungal activity against Pyricularia oryzae with a MIC of 16 μg/mL and antibacterial activity against B. subtilis with a MIC of 16 μg/mL and Staphylococcus aureus with a MIC of 64 μg/mL. The 1,1-diphenyl-2-picryl-hydrazyl assay suggested that 1, 3, and 4 exhibited 54.9% (2 mg/mL), 14.3% (4 mg/mL), and 47.7% (2 mg/mL) free radical scavenging activity, respectively. The positively charged 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid radical (ABTS(+•)) scavenging assay indicated that 1, 3, 4, and 8 exhibited 68.6% (1 mg/mL), 28.4% (2 mg/mL), 78.2% (0.5 mg/mL), and 54.6% (2 mg/mL) ABTS(+•) scavenging capacity, respectively. The superoxide anion radical scavenging assay suggested that 4 exhibited 77.9% superoxide anion radical scavenging capacity at 2 mg/mL. N. gilva YIM 90087 is a new resource for novobiocin 4.

Interstitial duplications of 8q12 encompassing CHD7 have recently been described as a new microduplication syndrome. Three 8q12 duplications have been reported with shared recognizable phenotype: Duane anomaly, developmental delay and dysmorphic facial features. We identified a 2.7 Mb duplication on chromosome 8q12 with SNP-array in a patient with growth delay, congenital heart defects, ear anomalies and torticollis. To our knowledge, this is the smallest duplication reported to date. Our findings support the notion that increased copy number of CHD7 may underlie the phenotype of the 8q12 duplication. Our study together with previous studies suggest that the 8q12 duplication could be defined as a novel syndrome., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objective: Six-sulfatoxymelatonin (aMT6s) is a primary urinary metabolite of melatonin. We examined the association between aMT6s levels and shift work estimated by a job exposure matrix (JEM) among healthy participants of the Shanghai Women's Health Study., Methods: Creatinine-adjusted aMT6s levels were measured in the urine samples of 300 women and related to JEM shift work categories., Results: Adjusted geometric means of aMT6s levels from urine samples collected before 08:00 hours were lower among persons holding nighttime shift work jobs. The adjusted aMT6s levels (ng/mg creatinine) were 8.36 [95% confidence intervals (95% CI) 4.47-15.6], 6.37 (95% CI 3.53-11.5), 6.20 (95% CI 3.33-11.5), 3.81 (95% CI 2.02-7.19), and 3.70 (95% CI 1.92-7.11) from the lowest (never held a shift work job) to the highest (current job likely involved all-night shift work) shift work JEM scores (P=0.05)., Conclusion: Our results indicate that nightshift work JEM scores were significantly and inversely associated with aMT6s levels in early morning spot urine samples collected between 07:00-08:00 hours.

A Gram-positive, non-motile actinobacterium, designated YIM 65754T, was isolated from the stem of Artemisia annua L., collected from Yunnan province, south-west China. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain YIM 65754T comprised an evolutionary lineage within the genus Rhodococcus. The isolate clustered with Rhodococcus pyridinivorans PDB9T, Rhodococcus gordoniae W 4937T and Rhodococcus rhodochrous DSM 43241T, with which it shared 98.4, 97.9 and 97.8 % 16S rRNA gene sequence similarities, respectively. However, DNA-DNA relatedness demonstrated that strain YIM 65754T was distinct from its closest phylogenetic neighbours. The cell-wall peptidoglycan contained meso-diaminopimelic acid, arabinose, galactose, mannose and glucose (cell-wall chemotype IV). The major menaquinone was MK-8(H2) and the predominant fatty acids were C16:0 (27.83 %), iso-C15:0 2-OH and/or C16:1ω7c (20.21 %) and 10-methyl C18:0 (17.50 %). The DNA G+C content was 66.2 mol%. On the basis of phenotypic, chemotaxonomic and phylogenetic evidence, the isolate represents a novel species of the genus Rhodococcus, for which the name Rhodococcus artemisiae sp. nov. is proposed; the type strain is YIM 65754T (=CCTCC AA 209042T=DSM 45380T).

During the course of our research on new actinobacterial sources, a novel actinomycete strain YIM 63101(T) was isolated from the surface-sterilized roots of Artemisia annua L. collected from Xishuangbanna, Yunnan province, south-west China and characterized by using a polyphasic approach. The strain formed well-differentiated aerial and substrate mycelia. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain YIM 63101(T) belongs to the genus Pseudonocardia, with highest similarity to "Pseudonocardia artemisiae YIM 63587(T)" (99.4%). Sequence similarities between strain YIM 63101(T) and the other Pseudonocardia species ranged from 97.0 (Pseudonocardia saturnea IMSNU 20052(T)) to 94.0% (Pseudonocardia compacta IMSNU 20111(T)). The chemotaxonomic characteristics, such as cell wall diaminopimelic acid, whole-cell sugars, fatty acid components and the major menaquinones suggested that the organism belonged to the genus Pseudonocardia. The G + C content of the genomic DNA was 69.4 mol%. Based on comparative analysis of physiological, biochemical and chemotaxonomic data, including low DNA-DNA hybridization results, it is proposed that strain YIM 63101(T) represents a novel species of the genus Pseudonocardia, named Pseudonocardia bannaensis sp. nov. The type strain is YIM 63101(T) (= CCTCC AA 208077 (T) = DSM 45300(T)).

5,7,12,14-Tetrachloro-6,13-diaza-6,13-dihydropentacene (TCDAHP) and 5,7,12,14-tetrachloro-6,13-diazapentacene (TCDAP) were synthesized and assessed as the active channel materials for thin-film transistor applications. Analyses of the crystal structures of these molecules revealed that both exhibited slipped pi-pi stacking of the long and fused aromatic moiety. Although the packing features of the two compounds are basically identical, their highest occupied molecular orbitals, which are relevant to hole transport, are very different. Better mobility was predicted for TCDAHP over TCDAP based on the dimeric structure in the X-ray coordinates. The morphologies of thin films of TCDAHP and TCDAP prepared by thermal evaporation depend critically on the substrate on which the molecules were deposited: from the amorphous state on a SiO(2)/Si surface to the crystalline state on a pentacene buffer layer surface. The performance of thin-film transistors prepared on various substrate surfaces was studied. While no field-effect mobility was observed for these films deposited on SiO(2)/Si, a high mobility of 1.4 cm(2)/(V s) for the TCDAHP film was achieved when deposited on a pentacene buffer layer prepared on a rubbed monolayer of n-nonyltrichlorosilane on a SiO(2)/Si surface. A similar device prepared from TCDAP gave a mobility of 0.13 cm(2)/(V s).

A two-year field located monitoring was carried out to study the impacts of hydro-periods on the lakeshore meadow wetland soil total nitrogen (TN) and hydrolysable nitrogen (HN) in Napahai plateau wetland in northwestern Yunnan province. The results show that meadow soil alternate drying-wetting is the significant characteristic influenced by hydro-periods. Hydro-periods of meadow wetland control the physical environment of meadow soil, and the occurrence of TN in the upper layer (0-20 cm) was influenced more significantly than in the deeper layer (20-40 cm) by wetland hydro-periods. The dynamics of TN (0.96-1.30 g/kg) show a shape of anomalous "W" in the upper layer. And in the rainy season, the dynamics of TN was the same as the trend of water level fluctuation, while the HN was in the reverse trend. The enzyme activities were influenced by hydro-periods and then controlled the mineralization process of organic nitrogen. In August when wetland water fell, the highest amount of HN was 222.19 mg/kg (0-20 cm layer) and 47.41 mg/kg (20-40 cm layer) respectively. But when the wetland water level rose, the HN was moved to wetland water by the rising water level, and the decrease amplitude was 42% and 48% respectively. Therefore the deterioration of the environment of water was aggravated.

We have achieved a growth of highly oriented crystalline pentacene thin films, with preferred a-b in-plane orientation with respect to the rubbing direction of a rubbed polymethylene surface. The polymethylene thin film, generated on a gold surface by gold-catalyzed decomposition of diazomethane, was annealed and gently rubbed in a fixed direction by a flannelette cloth to serve as an alignment layer during the deposition of pentacene molecules. Various surface analysis techniques, including reflection absorption IR spectroscopy (RAIRS), near-edge X-ray absorption fine structure (NEXAFS) spectroscopy, grazing incidence X-ray diffraction (GIXD), and atomic force microscopy were used to elucidate the structural details of the polymethylene and the pentacene thin films deposited on it. Two crystalline morphologies of pentacene thin film were observed: the minor one of rod-like molecular crystals having their long axes of the crystals perpendicular to the rubbing direction, and the dominant one of platelet-like and layered crystals having the molecular axes stand near vertical to the surface. Moreover, GIXD revealed that the rubbing on polymethylene indeed induced a preferential azimuthal alignment of pentacene crystallites. The deposition of pentacene at 25 degrees C led to a twin growth of crystallites with the [110] direction predominately aligned perpendicular to the rubbing direction. In contrast, the pentacene deposition at 50 degrees C produced twinned crystallites of lower twin angle and the [120] direction aligned parallel to the rubbing direction.

Objective: To investigate the high risk factors related to acute respiratory distress syndrome(ARDS) following serious thoracoabdominal injuries., Methods: The clinical data of 282 patients with serious thoracoabdominal injuries were retrospectively studied. Univariate and Cox multivariate regression analysis were used to determine the risk factors related to ARDS following serious thoracoabdominal injuries., Results: The incidence of ARDS was 31.9% (90/282) in patients with serious thoracoabdominal injuries. The mortality caused by ARDS was 37.8% (34/90). The univariate analysis and multivariate analysis demonstrated that the clinical conditions such as elder age, shock, dyspnea, abnormal arterial blood gas, hemopneumothorax, pulmonary contusion, flail chest, coexisting pulmonary diseases, multiple abdominal injury and high ISS score were the independent high risk factors related to ARDS., Conclusion: There are many high risk factors related to ARDS following severe thoracoabdominal injuries, which should be detected early and treated timely to decrease the incidence and mortality of A RDS.