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Abstract Background Dermatomyositis (DM) is an infrequent disease subgroup of idiopathic inflammatory myopathies characterized by distinct skin lesions. However, high heterogeneity makes clinical diagnosis and treatment of DM very challenging. Objectives Unsupervised classification in DM patients and analysis of key factors related to clinical outcomes. Methods This retrospective study was conducted between 2017 and 2022 at the Department of Rheumatology, Xiangya Hospital, Central South University. 162 DM patients were enrolled for unsupervised hierarchical cluster analysis. In addition, we divided the clinical outcomes of DM patients into four subgroups: withdrawal, stabilization, aggravation, and death, and compared the clinical profiles amongst the subgroups. Results Out of 162 DM patients, three clusters were defined. Cluster 1 (n = 40) was mainly grouped by patients with prominent muscular involvement and mild Interstitial Lung Disease (ILD). Cluster 2 (n = 72) grouped patients with skin rash, anti-Melanoma Differentiation Associated protein 5 positive (anti-MDA5+), and Rapid Progressive Interstitial Lung Disease (RP-ILD). Cluster 3 (n = 50) grouped patients with the mildest symptoms. The proportion of death increased across the three clusters (cluster 3 < cluster 1 < cluster 2). Study limitations The number of cases was limited for the subsequent construction and validation of predictive models. We did not review all skin symptoms or pathological changes in detail. Conclusions We reclassified DM into three clusters with different risks for poor outcome based on diverse clinical profiles. Clinical serological testing and cluster analysis are necessary to help clinicians evaluate patients during follow-up and conduct phenotype-based personalized care in DM.

ABSTRACT The objective of this study was to assess the effect of Suanzaoren decoction on stress response of horses in transportation. A total of six male Ili horses were equally divided into Suanzaoren decoction treatment group (n = 3; basal diet supplemented with Suanzaoren decoction, three times/day) and control group (n = 3; basal diet, three times/day). After feeding for five days, all horses were transported for 8 h to simulate stress. Blood and serum samples were obtained before transport (BT), during transport (T), and after transport (AT). Results showed that there was significant interaction between road transport and dietary Suanzaoren decoction supplementation for the white blood cells (WBC), intermediate cell ratio (MID%), granulocyte ratio (GRAN%), alanine aminotransferase (ALT), glucose (GLU), aspartate transaminase (AST), creatine (CK), cortisol (COR), human growth hormone (HGH), adrenocorticotropic hormone (ACTH) and arginine vasopressin content, insulin (INS), and thyronine 4 (T4) in blood and serum. The highest WBC was found in T group. The highest GRAN%, ALT, GLU, AST, CK, T4, ACTH, and INS contents were observed in serum from AT groups, which was decreased by treatment. In conclusion, dietary Suanzaoren decoction supplementation did relieve horse transportation stress. This study provides a useful clinical therapy for relieving transportation stress of horses.

Abstract ASEAN has arguably been one of the most successful regionalisms, which since its inception has undergone several profound challenges, including the 1997 Asian financial crisis. In response to the fierce competition among major powers and the economic and social challenges, ASEAN has concentrated on sustainable development to promote unity and centrality. Sustainable development cooperation aligns with the interests of ASEAN states and helps to promote the construction of the ASEAN community and strike a balance of power on the world stage. Nevertheless, there may be a need for more efforts to resolve the challenges facing sustainable development.

The ternary amorphous CuSeP2 was designed and prepared as the anode material of potassium ion battery for the first time, and its electrochemical performance was also investigated. After ball-milling with commercial graphene powder, it is used as the anode material for potassium ion battery with reversible specific capacity up to 300 mAh g-1, and the corresponding initial coulombic efficiency is close to 60%. What’s more, the specific capacity remains above 150 mAh g-1 after 100 cycles at 200 mA g-1. When increasing the current density to 1000 mA g-1, the CuSeP2/graphene composites still has a potassium storage specific capacity of 100 mAh g-1. Our results show that the potassium storage mechanism of the ternary CuSeP2 anode material is a typical conversion reaction and the introduction of Cu can not only buffer the volume expansion during the subsequent electrochemical reaction, but also effectively enhance the electrochemical reversibility of potassium ion.

ABSTRACT This paper discusses the design of a safflower picking robot control system and focuses on a navigation control subsystem based on multisensor fusion. A navigation subsystem, an identification and positioning subsystem, a picking subsystem, and a levelling subsystem are designed. The hardware and software of the navigation subsystem are designed in detail, and a multisensor fusion positioning method based on extended Kalman fusion technology is proposed. The accuracy and stability levels of different combined navigation methods are compared. To test the effectiveness and accuracy of the proposed method, an outdoor test is carried out. The test results show that the outdoor fusion positioning accuracy of the robot is less than 8 cm, and when the satellite signal is lost, the navigation control subsystem can still provide high positioning accuracy. The final positioning result obtained using the integrated positioning method of the wheel odometer + IMU + DGNSS is approximately 52% higher than that of the odometer, approximately 29% higher than that of the wheel odometer + IMU, and approximately 11% higher than that of the IMU + DGNSS.

ABSTRACT Objectives: Investigate the effect of closed reduction and per- cutaneous pedicle screw fixation in treating thoracolumbar fractures. Methods: This retrospective study analyzed 12 cases of single-segment thoracolumbar spine fractures without spinal cord and nerve injury at our department from March 2016 to September 2017. Patients were treated with closed reduction, percutaneous reduction, and internal fixation with solid pedicle screws. The operation time, intraoperative blood loss, anterior vertebral body height ratio (AVHR), Cobb angle (CA) of sagittal kyphosis, and VAS of back pain were determined and statistically compared. Results: The average operation time was 147.2 ± 45.6 min, and the average intraoperative bleeding was 67.8 ± 34.2 mL. All fractured vertebrae were completely reduced, their height was restored, and kyphosis was corrected. The average follow-up period was 10.6 ± 2.7 months, with significant improvements seen in the AVHR, CA of sagittal kyphosis, and VAS score (P < 0.01). One case had a broken rod after three months, and another had a postoperative infection. All the patients achieved bony healing. Conclusion: The treatment of thoracolumbar fractures by closed reduction and internal fixation with a percutaneous solid pedicle screw is simple, effective, and economical. Level of Evidence VI; Therapeutic Study, Case Series.

ABSTRACT Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted “Excellent” satisfaction and three “Good”, each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.

Resumo Fundamento Apesar das evidências crescentes de que o peptídeo natriurético N-terminal pró-cérebro (NT-proBNP) tem um valor prognóstico importante em adultos mais velhos, há dados limitados sobre seu valor preditivo prognóstico. Objetivos O objetivo deste estudo é avaliar o significado clínico do NT-proBNP em pacientes hospitalizados com mais de 80 anos de idade em Pequim, China. Métodos Este estudo prospectivo e observacional foi conduzido em 724 pacientes muito idosos em uma enfermaria geriátrica (idade ≥80 anos, variação, 80-100 anos, média, 86,6±3,0 anos). A análise de regressão linear multivariada foi utilizada para rastrear os fatores independentemente associados ao NT-proBNP, e o modelo de regressão de risco proporcional de Cox foi utilizado para rastrear as associações entre os níveis de NT-proBNP e os principais endpoints . Os principais endpoints avaliados foram mortes por todas as causas e ECAM. Valores de p

Durante los últimos veinte años, el auge económico de China ha estado acompañado por mayores ambiciones y por una política exterior cada vez más asertiva. Estos factores han introducido numerosos elementos de innovación y cambio en los mercados, las instituciones y la gobernanza global. Las implicaciones de estas innovaciones para la región latinoamericana aún no se han apreciado por completo. Este dossier de la revista Razón Crítica, cuya edición es fruto de la cooperación académica entre la Universidad de Bogotá Jorge Tadeo Lozano (Colombia) y el Centro de Estudio de los los Países Hispánicos del Instituto de la Franja y la Ruta de la Universidad del Suroeste (Chongqing, China), está enfocado en destacar las características de este cambio más relevantes para América Latina. Al observar varias áreas como la política exterior, la política comercial, las relaciones entre el Estado y el mercado, las cadenas de valor globales, la reducción de pobreza, entre otros, los autores de los artículos presentados han demostrado que Beijing, a punto de convertirse en la economía más grande del mundo, ha desencadenado cambios que se desarrollan rápidamente en una variedad de esferas cruciales.

China ha alcanzado grandes logros en la reducción de pobreza y ha sido ampliamente reconocida por el mundo. Por el contrario, América Latina y Caribe (ALC) está atrapada en la pobreza; así, la cooperación entre ambas partes va a ser muy importante para alcanzar los objetivos de la Agenda del Desarrollo Sostenible de la onu para 2030. Con el fin de evaluar las colaboraciones enfocadas en la reducción de pobreza hechas por ambas partes, y mejorar el proceso con estrategias viables, este artículo se realiza de manera cualitativa a través de una amplia lectura. Asimismo, se divide en tres objetivos principales: describir la pobreza desde una dimensión múltiple de alc, definir las ventajas y desafíos de las cooperaciones desde el nivel macro, meso y micro, y diseñar estrategias de mejora para la colaboración, enfocadas en la reducción de la pobreza de ambas partes en el futuro. Se descubre que, durante los últimos 20[1] años, China y ALC han realizado una gran cantidad de colaboraciones en términos políticos, económicos, infraestructurales, culturales y otros más; además, la promoción del desarrollo económico ha ayudado a reducir la tasa de pobreza. Sin embargo, también dificultan el proceso los desafíos, la falta de mecanismos políticos específicos, la construcción de infraestructura que produce influencias negativas; en ese sentido, el comercio internacional debe ampliar tanto el volumen como el rango de productos, el intercambio cultural debe ampliar su cobertura, etc. Por último, bajo los cinco indicadores de la iniciativa de La Franja y la Ruta, el artículo plantea una serie de estrategias para el futuro. [1] El presente artículo se estructura como resultado parcial del proyecto aprobado, con el código 2021WYZX05, por Chongqing Federation of Social Science; el proyecto 2021JY077 por Southwest University of China y el proyecto SWU2109230 por Fundamental Research Funds for the Central Universities of China.

Background: Atrial fibrillation (AF) is related to a higher risk of thromboembolic events and mortality. Some studies have demonstrated that the inflammatory biomarker interleukin-6 (IL-6) is associated with a higher risk of higher thrombosis in AF patients, but the real effect of IL-6 remains a controversy. Methods: We conducted a systematic review and meta-analysis to investigate the association between IL-6 and thromboembolic events, as well as bleeding events, acute coronary syndrome (ACS) events and all-cause mortality in AF. Results: A total of five studies involving 22 928 patients met our inclusion criteria for the systematic review. The higher level of IL-6 in AF patients is related to long-term thromboembolic events including stroke (RR 1.44, CI 95% 1.09-1.90, p=0.01). IL-6 meant a higher risk of long-term bleeding risk (RR 1.36, CI 95% 1.06-1.74, p=0.02), ACS risk (RR 1.81, CI 95% 1.43-2.30, p

ABSTRACT To mitigate the large demand for safflower picking labour and the low efficiency of manual picking, a safflower picking robot that is based on a parallel manipulator is designed. The whole robot mainly consists of a walking device, parallel manipulator device, vision device, picking device, filament collection device, control system, and motor drive system. The forward and inverse kinematics analysis of the parallel manipulator is analysed via a geometric method, the kinematics model is established, and the computational analysis of the parallel manipulator working speed is based on the Jacobi matrix. For driving angle errors of 0.001∼0.005°, the moving platform's motion accuracy is 0.2174–0.9387 mm, which meets the position accuracy requirements of the test stage. Based on MATLAB software, the Monte Carlo method is employed to solve the working space of the parallel manipulator, which is approximately an equilateral triangle with a side length of 0.35 m, which satisfies the safflower growth space picking conditions. The prototype is constructed, and safflower picking experiments are carried out under laboratory conditions. The average picking period of each flower bulb was 16 s, and the average net picking rate of the filaments was 87.91%. The experimental results verified the applicability of the safflower picking robot.

Traditional martial art is a pivotal part of Chinese folk culture. However, due to the impact of modern culture, the inheritance of various martial arts is threatened. Therefore, many efforts have been made by the Chinese government to protect this unique culture in the late 20th century. To provide practical indications for the safeguard of intangible cultural heritage, we conducted a literature review for the Chinese strategies concerning the safeguard of traditional martial arts (TMA) in the past 30 years, also tried to identify the advantages and shortcomings of current safeguard of TMA. Existing evidence indicates that the legislative safeguarding of Chinese TMA has gradually evolved into a system for preservation. Modern devices are important to maintain the current form of the intangible cultural heritage. Inviting inheritors of the TMA to teach relevant skills and knowledge in university campuses may play an important role in the dynamic safeguard of inheritance. On the other hand, shortcomings are also noticed. For instance, younger generations are not fully aware of the importance of TMA, thus specific education is needed. The means of transmission of TMA is still insufficient in the current information era.

This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.

ABSTRACT Objective: The Michigan State University (MSU) classification of lumbar disc herniation (LDH) is periodically used by various authors to classify disc herniation. We assessed the reliability of this classification system among orthopedic residents at our institute. Methods: Fifty T2 axial-cut magnetic resonance images (MRI) corresponding to the level of maximal disc herniation from patients diagnosed with a single LDH were selected and distributed to six orthopedic residents. All six residents gave a specific rating for each image based on the MSU classification; in addition, three residents gave ratings on two different occasions. The degree of agreement among residents was analyzed by calculating inter-observer and intra-observer reliability using the Kappa statistic. Results: The inter-observer reliability among the six residents calculated as the Fleiss’ Kappa was 0.422, which indicates moderate reliability. The intra-observer reliability of three selected residents calculated by Cohen's Kappa was 0.750, 0.772, and 0.859, which indicates substantial to almost perfect reliability. Variations in ratings were frequent in images portraying a broad-based disc herniation with spinal canal stenosis. Conclusion: Our findings demonstrate moderate homogeneity of ratings given by residents; however, test-retest results proved the ratings to be consistent. Level of Evidence II, Diagnostic studies - investigating a diagnostic examination.

Objective: Melatonin has a protective role in adults with cardiovascular disease, but the effects of melatonin in children with cardiac dysfunction are not well understood. This study was designed to explore the variations in melatonin, myeloperoxidase, and caspase‐3 levels in children suffering from heart failure. Methods: Seventy‐two pediatric patients with heart failure and twelve healthy children were enrolled in this study. A modified Ross scoring system was used to evaluate clinical cardiac function. Patients with a score of >2 points were included in the study and were divided into three groups according to severity of heart failure: mild (score: 3–6), moderate (score: 7–9), and severe (score: 10–12). Echocardiographic parameters, laboratory data, and serum levels of melatonin, myeloperoxidase, and caspase‐3 were measured and analyzed in all patients. Results: Compared with patients with mild and moderate heart failure, patients in the severe heart failure group had significantly decreased left ventricular ejection fraction (p 2 pontos foram incluídas no estudo e foram divididos em três grupos de acordo com a gravidade da insuficiência cardíaca: leve (escore: 3‐6), moderada (escore: 7‐9) e grave (escore: 10‐12). Os parâmetros ecocardiográficos, dados laboratoriais e níveis séricos de melatonina, mieloperoxidase e caspase 3 foram medidos e analisados em todos os pacientes. Resultados: Em comparação com os pacientes com insuficiência cardíaca de gravidade leve e moderada, os pacientes no grupo de insuficiência cardíaca grave apresentaram redução significativa da fração de ejeção do ventrículo esquerdo (p

Abstract Background: Pioglitazone has been widely used as an insulin-sensitizing agent for improving glycemic control in patients with type 2 diabetes mellitus. However, cardiovascular risk and protective effects of pioglitazone remain controversial. Objectives: In this study, we investigated whether pioglitazone affects cardiomyocyte apoptosis and hypertrophy by regulating the VEGFR-2 signaling pathway. Methods: Cardiomyocytes were enzymatically isolated from 1- to 3-day-old Sprague-Dawley rat ventricles. Effects of pioglitazone and the VEGFR-2-selective inhibitor apatinib on cardiomyocyte apoptotic rate was determined using flow cytometry, and hypertrophy was evaluated using [3H]-leucine incorporation. The protein expressions of unphosphorylated and phosphorylated VEGFR-2, Akt, P53, and mTOR were determined by Western-Blotting. Analysis of variance (ANOVA) was used to assess the differences between groups. Results: Pioglitazone and VEGFR-2-selective inhibitor apatinib reduced rat cardiomyocyte viability and cardiomyocyte hypertrophy induced by angiotensin II in vitro. Furthermore, in the same in vitro model, pioglitazone and apatinib significantly increased the expression of Bax and phosphorylated P53 and decreased the expression of phosphorylated VEGFR-2, Akt, and mTOR, which promote cardiomyocyte hypertrophy. Conclusions: These findings indicate that pioglitazone induces cardiomyocyte apoptosis and inhibits cardiomyocyte hypertrophy by modulating the VEGFR-2 signaling pathway.

Objective: To examine the psychometric properties of the Chinese version of the Yale-Brown Obsessive Compulsive Scale – Second Edition (Y-BOCS-II). Method: A total of 86 adults with a primary diagnosis of obsessive-compulsive disorder (OCD), ranging in age from 15 to 78 years, participated in the study. Participants were administered the Y-BOCS-II by a trained clinician who also rated overall illness severity on two additional measures. Patients completed the Obsessive Compulsive Inventory-Revised and Depression Anxiety Stress Scale-21. Results: Results indicated high internal consistency and fair 1-week test retest reliability. The Y-BOCS-II scales correlated strongly with clinician-rated obsessive-compulsive severity and modestly with self-reported obsessive-compulsive symptom frequency and distress. The relationship between Y-BOCS-II total score and depressive and anxiety symptoms was strong, which may reflect high rates of comorbid conditions in this sample or the linkage between obsessive-compulsive symptom severity and distress. Factor analysis demonstrated a two-factor structure consisting of obsession and compulsion factors, with interference due to obsessions cross-loading. Conclusions: Overall, these results support the use of the Y-BOCS-II among individuals from China. Future study by an independent group is necessary to replicate these findings, as well as investigate interrater reliability and treatment sensitivity.

Copredication, especially when combined with quantification, provides interesting examples to support the idea that common nouns have their own identity criteria, as once argued for by Geach and subsequently studied by others. In this paper, revisiting the use of dot-types in modern type theories to model copredication, we show that, when both copredication and quantification are involved, CNs are not just types but should better be interpreted as types associated with their own identity criteria. In other words, formally, CNs are setoids – pairs whose first component is a type that interprets the domain of a CN and whose second component gives the identity criterion for that CN. For copredication with quantification, identity criteria play an essential role in giving a proper treatment of individuation and counting and hence constructing appropriate semantics to facilitate reasoning correctly. With CNs being setoids, the dot-type approach provides an adequate theory for copredication in general and for copredication with quantification in particular. It is further explained that the CNs-as-types approach is still the appropriate characterisation of our approach to interpreting CNs since, in phenomena that do not involve the interaction of copredication with quantification, the identity criteria of related CNs are essentially the same and can be safely ignored.

ABSTRACT: Arbuscular mycorrhizal fungi (AMF) have been attracted more scientific attentions due to its critical role in enhancement of drought tolerance of plants for growth and vegetation restoration in karst fragile ecosystem. However, scientists know little about the AMF composition and diversity occurring in root systems of mulberry (Morus sp.), and in karst habitats which return land use from mulberry forestry, as well as the effects of soil environment change on the diversity of the AMF communities. To understand: (1) the AMF community composition and diversity at different stage of returning cropland to forest; and (2) the effects of soil environment change on the diversity of the AMF communities, soil and mulberry root samples were collected from Bijie and Libo sites, China, which experienced one and ten years, respectively, after returning croplands to forest. With the high throughput 454-sequencing technology, 8 known genera including 83 virtual species were distinguished and the genera Glomus, Paraglomus, Archaeospora and Diversispora were found to be dominant in soil and root sample. Compared to the samples in Libo, the genera Glomus, Paraglomus, Acaulospora and Claroideoglomus in root samples at Bijie site had a relatively abundance of species indicating that the returning cropland to forest is benefit to the AMF diversity and abundance, which was attribute to the variation of soil physiochemical properties. This conclusion is of great significance for guiding the return of farmland to forests.

Abstract Chemical leukoderma occurs due to the toxic effect of a variety of chemical agents. Mechanisms include either destruction or inhibition of melanocytes. We report two male patients (36 and 51 years old) who presented with multiple hypopigmented macules and patches on the neck, wrist, and legs after exposure to dimethyl sulfate in a chemical industry. Physical examination revealed irregular depigmentation macules with sharp edges and clear hyperpigmentation around the lesions. History of repeated exposure to a chemical agent can help the clinical diagnosis of chemical leukoderma. This diagnosis is very important for prognosis and therapeutic management of the disease.

Abstract Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. We report a 19-year-old man with hepatitis B who had local leukocytoclastic vasculitis induced by interferon-gama injection at the injection site. After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous lesion healed and no other cutaneous lesion occurred. We also made a mini review of such cases.

Abstract Background: Congenital heart defects (CHD), as the most common congenital anomaly, have been reported to be associated with chromosomal abnormalities. Currently, patients with CHD are routinely offered karyotyping and chromosomal microarray (CMA) testing, but the genotype-phenotype relationship has not yet been fully established. Objective: To determine the type and frequency of chromosomal abnormalities in fetuses with CHD and to analyze pregnancy outcomes of fetuses with heart abnormalities caused by different genetic factors. Methods: A total of 362 cases of CHD were enrolled from 2009 to 2016. Detailed ultrasound and laboratory examinations, including karyotyping and CMA, were performed. Outcome was obtained from discharge summaries. Results: Of the 362 fetuses, 220 were found with an isolated CHD, and 142 had CHD with extracardiac anomaly. Among these 362 fetuses, 140 were identified with a genetic cause, including 111 cases with aneuploidy, 10 cases with abnormality of chromosomal structure by karyotyping and 19 cases with pathogenic or likely pathogenic copy-number variations (CNVs) by CMA. The detection rate is close to 38.7%. Only one (identified as trisomy 18 syndrome) in 140 positive cases resulted in perinatal death, with the others being induced. The remaining 222 cases had negative results for both genetic testing and of these cases, 56 resulted in induced labor, and 77 had natural childbirth or caesarean births. The pregnancy outcome of the remaining 89 cases was uncertain. Conclusions: Karyotyping and CMA are effective and accurate prenatal genetic techniques for identifying fetal chromosomal abnormalities associated with cardiac defects, and this can assist clinical doctors to perform appropriate genetic counselling with regard to the etiology and outcome of CHD.

Abstract Background: Right ventricular function is a crucial factor of the prognosis of systemic lupus erythematosus (SLE). Objectives: To evaluate the right ventricular function in SLE patients with different degrees of pulmonary hypertension (PH) by strain and strain rate imaging. Methods: A total of 102 SLE patients and 30 healthy volunteers were studied between October 2015 and May 2016. Patients were divided into three groups according to pulmonary artery systolic pressure (PASP) estimated by echocardiography: group control (A); PASP ≤ 30 mmHg (group B, n = 37); PASP 30-50 mmHg (mild PH; group C, n = 34); and PASP ≥ 50 mmHg (moderate-to-severe PH; group D, n = 31). Longitudinal peak systolic strain (ε) and strain rate (SR), including systolic strain rate (SRs), early diastolic strain rate (SRe) and late diastolic strain rate (SRa) were measured in the basal, middle and apical segments of the right ventricular free wall in participants by two-dimensional speckle tracking echocardiography (2D-STE) from the apical four-chamber view. A p < 0.05 was set for statistical significance. Results: The parameters of ε, SRs, SRe, and SRa were significantly decreased in groups C and D compared with groups A and B. The ε of each segments was significantly lower in group D than in group C, while there were no differences in SRs, SRe and SRa between groups C and D. Conclusions: Strain and strain rate imaging could early detect the right ventricular dysfunction in SLE patients with PH, and provide important value for clinical therapy and prognosis of these patients. (Arq Bras Cardiol. 2018; [online].ahead print, PP.0-0)

O estudo apresenta um panorama do Teatro de Sombras tradicional chinês em seus mais de mil anos de existência. Mostra que essa arte é amplamente praticada em 28 Províncias do país e destaca os seus sete grandes estilos de criação e apresentação; analisa as principais características destes estilos-escolas, com destaque para a forma e desenho das personagens, os materiais com os quais são confeccionadas as silhuetas e as sonoridades empregadas nos espetáculos; menciona ações realizadas para preservar esta arte, bem como mudanças que ela sofre nos últimos tempos. Palavras-chave: China; teatro de sombras; teatro tradicional.

皮影，又称“灯影戏”或者“影戏”。有确切文字记载的影戏表演是在 宋代,距今也已经超过千年。它广泛流传于中国民间，是一种古老独特的民间戏曲 艺术。中国皮影广阔的分布于大江南北，大小差异各不相同，极富地域特色。据 《中国影戏》书中所作皮影分布图来看，全国除新疆、西藏、贵州、广西、海南 和澳门以外的二十八个省都有皮影分布，范围如此广泛让世人惊叹。（附图一） 一．中国皮影七大影系 全国皮影，按照大的文化背景划分，可以分为南北两派。而根据其造型 特征差异，按照地区的不同，两派影戏又可分七大影系：“1.秦（陕西省的简 称）晋（山西省的简称）影系。包括陕西皮影，甘肃皮影、山西皮影、四川北部 皮影、青海皮影。2.滦洲影系（又称唐山影系）。包括河北东部皮影、北京东城 皮影、东北皮影、内蒙皮影。3.山东影系。4.杭州影系。包括浙江皮影、上海皮 影。5.川（四川省的简称）鄂（安徽省的简称）滇（云南省的简称）大影。包括 湖北皮影、四川灯影（成都灯影）、河南南部皮影和云南皮影。6.湘（湖南省的 简称）赣（江西省的简称）影系。包括湖南影戏和江西影戏。7.潮州影系。包括 广东影戏、福建影戏和台湾影戏

Abstract Background: Although a proportion of CSX patients have impaired brachial artery flow-mediated dilatation (FMD) in response to hyperemia, suggesting that endothelial dysfunction in these patients may be systemic and not just confined to the coronary circulation; the underlying mechanisms triggering endothelial dysfunction in these patients are still incompletely understood. Objectives: To assess the association of the index of Microcirculatory Resistance (IMR) with endothelial dysfunction and inflammation in patients with CSX. Methods: We studied 20 CSX patients and 20 age and gender-matched control subjects. Thermodilution-derived coronary flow reserve (CFR) and IMR were measured using a pressure-temperature sensor-tipped guidewire. Brachial artery FMD was measured using high-resolution, two-dimensional ultrasound images obtained with a Doppler ultrasound device (HDI-ATL 5000, USA) with a 5 MHz to 12 MHz linear-array transducer. Results: Compared with in control subjects, CFR was significantly lower (2.42 ± 0.78 vs. 3.59 ± 0.79, p < 0.001); IMR was higher (32.2 ± 8.0 vs. 19.5 ± 5.5, p < 0.001); the concentration of hs-CRP and FMD was higher (4.75 ± 1.62 vs. 2.75 ± 1.50; 5.24 ± 2.41 vs. 8.57 ± 2.46, p < 0.001) in CSX patients. The Duke treadmill score (DTS) was correlated positively to CFR and FMD (0.489 and 0.661, p < 0.001), it was negative to IMR and hsCRP (-0.761 and -0.087, p < 0.001) in CSX patients. Conclusions: The main finding in this study is that the DTS measured in patients with CSX was associated to hsCRP and FMD. Moreover, the independent effects of exercise tolerance can significantly impair FMD and hsCRP in CSX patients; especially it is particularly important to whom where FMD was associated negatively with IMR.

Tests of the strain sweep, frequency sweep and stress relaxation for raw natural rubber coagulated by microorganisms (NR-m) and raw natural rubber coagulated by acid (NR-a) were carried out with the use of a rubber process analyzer (RPA). The results showed that the storage torque, complex viscosity of NR-m were higher than those of NR-a while the loss factor was lower. The effect of temperature on viscosity of raw NR was studied following the Arrhenious-Frenkel-Eyring model. The viscous flow behavior of NR-m was poorer than those of NR-a. Furthermore, stress relaxation measurements of raw NR showed a longer period of relaxation for NR-m.

Objective: To determine whether three variants (388 G>A, 521 T>C, and 463 C>A) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) are associated with neonatal hyperbilirubinemia. Data source: The China National Knowledge Infrastructure and MEDLINE databases were searched. The systematic review with meta-analysis included genetic studies which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. Data selection and extraction were performed independently by two reviewers. Summary of the findings: Ten articles were included in the study. The results revealed that SLCO1B1 388 G>A is associated with an increased risk of neonatal hyperbilirubinemia (OR, 1.39; 95% CI, 1.07–1.82) in Chinese neonates, but not in white, Thai, Latin American, or Malaysian neonates. The SLCO1B1 521 T>C mutation showed a low risk of neonatal hyperbilirubinemia in Chinese neonates, while no significant associations were found in Brazilian, white, Asian, Thai, and Malaysian neonates. There were no significant differences in SLCO1B1 463 C>A between the hyperbilirubinemia and the control group. Conclusion: This study demonstrated that the 388 G>A mutation of the SLCO1B1 gene is a risk factor for developing neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations; the SLCO1B1 521 T>C mutation provides protection for neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations.

AbstractPhacomatosis pigmentovascularis is a rare, congenital condition characterized by a combination of cutaneous melanocytic lesions and vascular malformation. We discuss an entirely unique case of Phacomatosis pigmentovascularis with nevus of Ota, extensive Mongolian spot, nevus flammeus, nevus anemicus and cutis marmorata telangiectatica congenita, which may represent a heretofore undescribed variant of phacomatosis pigmentovascularis.

A doença de Haff é uma síndrome que consiste de rabdomiólise não explicada. Pacientes que apresentam a doença de Haff relatam ter ingerido pescado nas últimas 24 horas antes do início da doença. A maioria dos pacientes sobrevive apresentando breve recuperação. O presente artigo é o primeiro relato de doença de Haff complicada por falência de múltiplos órgãos após ingestão de lagostim. Um homem chinês de 66 anos de idade ingeriu lagostim cozido na noite de 23 de junho de 2013. Chegou ao hospital 2 dias mais tarde, sendo admitido à unidade de terapia intensiva. Após a admissão, o paciente recebeu o diagnóstico de doença de Haff complicada por falência de múltiplos órgãos. Apesar dos tratamentos de suporte e sintomático, a condição do paciente deteriorou, vindo o mesmo a falecer em consequência da doença. A doença de Haff é uma rara síndrome clínica que é, às vezes, mal diagnosticada. O diagnóstico precoce e o tratamento adequado são essenciais para prevenir a progressão para falência de múltiplos órgãos.

We present a synthesis of findings from constructivist teaching experiments regarding six schemes children construct for reasoning multiplicatively and tasks to promote them. We provide a task-generating platform game, depictions of each scheme, and supporting tasks. Tasks must be distinguished from children’s thinking, and learning situations must be organized to (a) build on children’s available schemes, (b) promote the next scheme in the sequence, and (c) link to intended mathematical concepts. Presentamos una síntesis de hallazgos de experimentos de enseñanzaconstructivistas en relación con seis esquemas que los niños construyen para razonar multiplicativamente y tareas para promoverlos. Proveemos una plataforma de juego generadora de tareas, descripciones de cada esquema y tareas para apoyarlos. Las tareas deben distinguirse del pensamiento de los niños, y las situaciones de aprendizaje deben organizarse para que (a) se basen en los esquemas que los niños tienen disponibles, (b) promuevan el siguiente esquema en la secuencia y (c) se relacionen con los conceptos matemáticos pretendidos.