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A retro-odontoid pseudotumor (ROP) is commonly associated with atlantoaxial instability or rheumatoid arthritis. However, ROP in the absence of atlantoaxial instability or rheumatoid arthritis, which is termed idiopathic ROP (IROP), is a rare condition. The pathomechanisms and optimal treatment strategies for IROP remain controversial. The aim of the present study was to evaluate the radiographic and clinical characteristics of IROP patients and to assess the efficiency of atlantoaxial/occipitocervical fusion on IROP regression.Data from 5 patients diagnosed with IROP were retrospectively reviewed. Posterior atlantoaxial or occipitocervical fixation and fusion were performed in 4 patients and C1 posterior arch resection alone in 1 patient. The patients' features, surgical procedures, and complications were recorded. The retro-odontoid soft tissue thickness was measured on preoperative and postoperative magnetic resonance imaging to evaluate IROP regression.The mean follow-up time was 37 months. ROP regression was achieved in patients who received atlantoaxial/occipitocervical fusion, but not for the patient with C1 posterior resection alone. There were no observed neurovascular complications associated with surgery.IROP was related to a restricted range of motion of the subaxial spine. Upper cervical fixation is an optional treatment that produces IROP regression over time. By contrast, direct removal of the IROP is unnecessary.

Background: To investigate the clinical efficacy of the axillary approach in the surgical treatment of Ideberg type I and II scapular glenoid fractures. Methods: Retrospective analysis of 13 cases of scapular glenoid fracture treated in the affiliated Hospital of Jining Medical College, Jiaxiang County People hospital, Zoucheng City people Hospital, Yanzhou District People Hospital, and Juancheng County people Hospital from December 2020 to January 2022. Eight males (including one bilateral) and five females, with an average age of 57.5 years (range from 33 to 75 years). According to Ideberg classification, there were 10 cases of type Ⅰ a, 1 case of type Ⅰ a combined with type Ⅰ b, and 2 cases of type Ⅱ. All patients were treated with axillary approach surgery and seven patients with combined anterior shoulder dislocation were treated by first-stage manipulation and second-stage reoperation. Seven patients were fixed with a wire anchor, three patients with type Ⅰ a were fixed with a "T" plate, and five patients were complicated with rotator cuff tear and were repaired with a wire anchor. At the last follow-up, the Constant-Murley shoulder function score, visual analog score (VAS), DASH score, and Hawkins grade were used to evaluate shoulder function, pain, and stability after treatment. Results: All 13 patients in this group were followed up thoroughly, and the follow-up time was 12-25 months, with an average of 18.6 months. The operation time was 65-135min, with an average of 85.6 min. Intraoperative blood loss ranged from 20 to 120mL, averaging 55.6ml. The duration of hospitalization ranged from 7 to 22 days, with an average of 9.6 days. The surgical incisions of all patients were grade-A healing. Bone healing of glenoid fractures was observed three months after the operation. At the last follow-up, the shoulder range of motion was forward flexion 160.5°±9.3°, abduction 155.6°±12.5°, external rotation (neutral position) 40.7°±5.8°, internal rotation (neutral position) 65.4°±12.1°. The Constant-Murley score for the shoulder joint was (92.3±6.5) points (range 85-95), and the DASH score was (12.16±6.86) points (range 3.26 to 26.75). Conclusions: The axillary approach for Ideberg type I and II scapular glenoid fractures is a feasible surgical approach with complete access through the muscle gap, minimal surgical trauma, mild postoperative pain, and satisfactory clinical results.

Background: Osteoarthritis (OA) is a common type of degenerative joint diseases that is regulated by a combination of complex intercellular signals and modulators, including non-coding RNAs. Mounting evidence suggests that miR-31-5p is physiologically involved in the regulation of chondrocytes, but the mechanism remains unclear. Methods: Expression levels of miR-31-5p and SOX4 in OA cartilage tissues and in IL-1β-stimulated chondrocytes were examined by quantification polymerase chain reaction (q-PCR) or immunohistochemistry assays. Cell proliferation and apoptosis were detected by Cell Counting Kit-8 (CCK-8) and flow cytometry assays, respectively. Expression of LC3 was detected using immunofluorescence staining. Expressions of autophagy-related proteins and extracellular regulated protein kinase (ERK)/mechanical target of rapamycin kinase (mTORC1) signal-related proteins were measured by Western blot analysis. Molecular interaction was validated by dual luciferase reporter assay. Results: Downregulation of miR-31-5p and upregulation of SOX4 were observed in both OA patients and OA chondrocytes. Mechanistic experiments revealed that miR-31-5p negatively modulated SOX4 expression by directly targeting its 3′- untranslated region. Moreover, overexpression of miR-31-5p suppressed the activation of mTORC1 in an ERK-dependent manner by inhibiting SOX4. Further functional experiments demonstrated that overexpressing miR-31-5p in OA chondrocytes markedly promoted its proliferation and autophagy while inhibiting apoptosis. However, these effects were abolished by overexpression of SOX4 or treatment with 3BDO, an mTOR activator. Conclusion: These results demonstrated that miR-31-5p enhanced survival and autophagy of OA chondrocytes through inactivation of mTORC1 via directly targeting SOX4, suggesting that miR-31-5p may play a protective role in OA progression.

The modified-half-normal distribution often occurs as one of the posterior conditionals in many Bayesian statistical models. In order to developa uniformly efficient random variate generator for the entire parameter range of such distribution, we propose a relaxed transformed density rejection method such that it is available in case the optimal contact points in the original transformed density rejection method have no closed-form. Simulation results verify that the resultant generator is fast and robust for various distribution parameters. The proposed generator is particularly suitable for the varying parameter case such as in Gibbs sampler.

The variations of single event transient (SET) pulse width of high-LET heavy ion irradiation in 16-nm-thick bulk silicon fin field-effect transistor (FinFET) inverter chains with different driven strengths are measured at different temperatures. Three-dimensional (3D) technology computer-aided design simulations are carried out to study the SET pulse width and saturation current varying with temperature. Experimental and simulation results indicate that the increase in temperature will enhance the parasitic bipolar effect of bulk FinFET technology, resulting in the increase of SET pulse width. On the other hand, the increase of inverter driven strength will change the layout topology, which has a complex influence on the SET temperature effects of FinFET inverter chains. The experimental and simulation results show that the device with the strongest driven strength has the least dependence on temperature.

Downstream processing of mAb charge variants is difficult owing to their similar molecular structures and surface charge properties. This study aimed to apply a novel twin‐column continuous chromatography (called N‐rich mode) to separate and enrich acidic variants of an IgG1 mAb. Besides, a comparison study with traditional scaled‐up batch‐mode cation exchange (CEX) chromatography was conducted. For the N‐rich process, two 3.93 mL columns were used, and the buffer system, flow rate and elution gradient slope were optimized. The results showed that 1.33 mg acidic variants with nearly 100% purity could be attained after a 22‐cycle accumulation. The yield was 86.21% with the productivity of 7.82 mg/L/h. On the other hand, for the batch CEX process, 4.15 mL column was first used to optimize the separation conditions, and then a scaled‐up column of 88.20 mL was used to separate 1.19 mg acidic variants with the purity of nearly 100%. The yield was 59.18% with the productivity of 7.78 mg/L/h. By comparing between the N‐rich and scaled‐up CEX processes, the results indicated that the N‐rich method displays a remarkable advantage on the product yield, i.e. 1.46‐fold increment without the loss of productivity and purity. Generally, twin‐column N‐rich continuous chromatography displays a high potential to enrich minor compounds with a higher yield, more flexibility and lower resin cost.

C10H14O6, triclinic, P 1 ‾ $P\overline{1}$ (no. 2), a = 7.5531(2) Å, b = 9.3964(3) Å, c = 9.5089(3) Å, α = 61.8330(10)°, β = 68.6230(10)°, γ = 86.5750(10)°, V = 548.80(3) Å3, Z = 2, R gt (F) = 0.0485, wRref (F 2) = 0.1438, T = 170.0 K.

Background Acute lung injury (ALI) caused by intestinal ischemia–reperfusion is a life-threatening disease. Interferon gene stimulator (STING) is a cytoplasmic DNA sensor that participates in the initiation of the inflammatory response. This study aims to establish whether C-176 (STING inhibitor) improves ALI under intestinal ischemia–reperfusion conditions. Methods To induce ALI, 72 male C57BL/6 mice were subjected to intestinal ischemia for 60 min and reperfusion for 3 h. Through intraperitoneal injection, C-176, a selective STING inhibitor, was injected 30 min before surgical treatment; meanwhile, compound C, an antagonist of adenosine monophosphate-activated protein kinase (AMPK), was administered 30 min after surgery. Based on immunofluorescence and Western blot assays, post-ALI assessments included lung water content (TLW), bronchoalveolar lavage fluid (BALF) protein, H&E staining, Masson staining, pulmonary pyroptosis [Gasdermin-D (GSDMD), cleaved caspase-1], and apoptosis (TUNEL, cleaved caspase-3). Results C-176 administration significantly attenuated intestinal ischemia–reperfusion-mediated ALI; this effect was reflected by exacerbated TLW and BALF protein, aggravated lung injury score, elevated degree of pulmonary fibrosis, increased TUNEL- and GSDMD-positive cells, and upregulated phospho-AMPK, cleaved caspase-1, cleaved caspase-3 and IFNβ mRNA expression. Moreover, C-176 increased phospho-AMPK under ALI conditions. Nonetheless, compound C partially reversed these beneficial effects. Conclusion C-176, a selective STING inhibitor, improves intestinal ischemia–reperfusion-mediated ALI, and its underlying mechanism may be associated with AMPK signal activation.

Based on the Erdogan fundamental solutions for infinite cracked plates, a new hybrid boundary node method for linear fracture problems is proposed in this paper. The origin singular intensity factor for the Erdogan fundamental solutions is developed to overcome the singular when the field points are coincided with the source points, and no virtual source points are needed, a new scheme for calculating the origin singular intensity factor for the Erdogan fundamental solutions is developed. Based on the Erdogan fundamental solutions, the zero traction boundary condition on crack surfaces is naturally and strictly satisfied in this method, and no nodes are arranged on the crack surface in the entire calculation process. Based on the Erdogan fundamental solution of stress intensity factor for the mixed mode crack, the stress intensity factor of the present method can be easily interpolated by the Erdogan fundamental solutions. As a result, no complex scheme for calculating stress intensity factor is needed. Based on those theories and methods, the proposed method is further applied to analyze some linear crack problems, and the computational accuracy, convergence rate and the versatility of the present method are demonstrated in details.

Background: Acute lung injury (ALI) caused by intestinal ischemia-reperfusion is a life-threatening disease. Interferon gene stimulator (STING) is a cytoplasmic DNA sensor, participating in the initiation of inflammatory response. This study aims to establish whether C-176 (STING inhibitor) improves the ALI under intestinal ischemia-reperfusion conditions.Methods: To induce ALI, 72 C57BL/6 mice male were subjected to intestinal ischemia-reperfusion for 90 min. Through intraperitoneal injection, C-176, a selective STING inhibitor was injected 30 minutes before surgical treatment; meanwhile, compound C, an antagonist of adenosine monophosphate-activated protein kinase (AMPK) was administered 30 min after surgery. Based on immunofluorescence and Western blot assays, post-ALI assessments included lung water content (TLW), bronchoalveolar lavage fluid (BALF) protein, H&E staining, Masson staining, pulmonary apoptosis (TUNEL, cleaved caspase-3), and pyroptosis (Gasdermin-D [GSDMD], cleaved caspase-1).Results: C-176 administration significantly attenuated intestinal ischemia-reperfusion-mediated ALI; this was reflected by exasperated TLW and BALF protein, aggravated lung injury score, elevated degree of pulmonary fibrosis, increased TUNEL- and GSDMD-positive cells, as well as upregulated phosphor-AMPK, cleaved caspase-3, and cleaved caspase-1 expression. Moreover, C-176 increased phosphor-AMPK under ALI conditions. Nonetheless, compound C partially reversed these beneficial effects.Conclusion: C-176, a selective STING inhibitor improves intestinal ischemia-reperfusion-mediated ALI, and its underlying mechanism may be associated with AMPK signal activation.

BackgroundThe CD47-SIRPα pathway acts as an important myeloid cell immune checkpoint and targeting the CD47/SIRPα axis represents a promising strategy to promote antitumor immunity. Several CD47-targeting agents show encouraging early activity in clinical trials. However, due to ubiquitous expression of CD47, the antigen sink and hematologic toxicity, such as anemia and thrombocytopenia, are main problems for developing CD47-targeting therapies. Considering the limited expression of SIRPα, targeting SIRPα is an alternative approach to block the CD47-SIRPα pathway, which may result in differential efficacy and safety profiles.MethodsSIRPα-targeting antibody BR105 was generated by hybridoma fusion and following humanization. BR105 was characterized for binding to human SIRPα alleles and blockade of the interaction with CD47. The functional activity was determined in in vitro phagocytosis assays by using human macrophages. The effect of BR105 on human T cell activation was studied using an OKT3-induced T-cell proliferation assay and an allogeneic mixed lymphocyte reaction. Human SIRPα-humanized immunodeficient mice were used in cancer models for evaluating the in vivo antitumor efficacy of BR105. Safety was addressed in a repeat-dose toxicity study in cynomolgus monkeys, and toxicokinetic analysis was further evaluated.ResultsBR105 shows broad binding activity across various SIRPα variants, and potently blocks the interaction of SIRPα and CD47. In vitro functional assays demonstrated that BR105 synergizes with therapeutic antibodies to promote phagocytosis of tumor cells. Moreover, the combination of BR105 and therapeutic antibody significantly inhibits tumor growth in a xenograft tumor model. Although BR105 may slightly bind to SIRPγ, it does not inhibit T cell activation, unlike other non-selective SIRPα-targeting antibody and CD47-targeting agents. Toxicity studies in non-human primates show that BR105 is well tolerated with no treatment-related adverse effects noted.ConclusionsThe novel and differentiated SIRPα-targeting antibody, BR105, was discovered and displays promising antitumor efficacy in vitro and in vivo. BR105 has a favorable safety profile and shows no adverse effects on T cell functionality. These data support further clinical development of BR105, especially as a therapeutic agent to enhance efficacy when used in combination with tumor-targeting antibodies or antibodies that target other immune checkpoints.

PurposeThis clinical research aims to assess the safety and efficacy of a combination of fusiform capsulectomy of the posterior capsule and percutaneous flexion tendon release in the treatment of a fused knee with severe flexion contracture during total knee arthroplasty (TKA).MethodsA retrospective analysis was performed in three patients (six knees) who had preoperative severe bony fused flexion contracture (>80°) prior to TKA and received a combination of fusiform capsulectomy of posterior capsule and percutaneous flexion tendon release during TKA between January 2016 and December 2019. The range of motion (ROM), knee functional score, postoperative complications, and radiographic results were evaluated.ResultThree patients (six knees) were enrolled in this study. The mean duration of follow-up was 42.83 ± 15.77 months. The postoperative knee ROM was 100.0 (76.0, 102.75) (p p p ConclusionThe technique of a combination of fusiform capsulectomy of the posterior capsule and percutaneous flexion tendon release is an effective and safe method during primary TKA for a fused knee with severe flexion contracture.

Highly effective catalysts are of great importance for artificial nitrogen fixation. Inspired by the natural nitrogenase, we biomimetically designed an inorganic catalyst, Mo(IV)-doped FeS2, for el...

Objective The disease complexity of metastatic non-small-cell lung cancer (mNSCLC) makes it difficult for physicians to make clinical decisions efficiently and accurately. The Watson for Oncology (WFO) system of artificial intelligence might help physicians by providing fast and precise treatment regimens. This study measured the concordance of the medical treatment regimens of the WFO system and actual clinical regimens, with the aim of determining the suitability of WFO recommendations for Chinese patients with mNSCLC. Methods Retrospective data of mNSCLC patients were input to the WFO, which generated a treatment regimen (WFO regimen). The actual regimen was made by physicians in a medical team for patients (medical-team regimen). The factors influencing the consistency of the two treatment options were analyzed by univariate and multivariate analyses. Results The concordance rate was 85.16% between the WFO and medical-team regimens for mNSCLC patients. Logistic regression showed that the concordance differed significantly for various pathological types and gene mutations in two treatment regimens. Patients with adenocarcinoma had a lower rate of "recommended" regimen than those with squamous cell carcinoma. There was a statistically significant difference in EGFR-mutant patients for "not recommended" regimens with inconsistency rate of 18.75%. In conclusion, the WFO regimen has 85.16% consistency rate with medical-team regimen in our treatment center. The different pathological type and different gene mutation markedly influenced the agreement rate of the two treatment regimens. Conclusion WFO recommendations have high applicability to mNSCLC patients in our hospital. This study demonstrates that the valuable WFO system may assist the doctors better to determine the accurate and effective treatment regimens for mNSCLC patients in the Chinese medical setting.

Cost-effective, highly efficient and stable non-noble metal-based catalysts for the oxygen evolution reaction (OER) are very crucial for energy storage and conversion. Here, an amorphous cobalt nickel phosphate (CoNiPO4 ), containing a considerable amount of high-valence Ni3+ species as an efficient electrocatalyst for OER in alkaline solution, is reported. The catalyst was converted from Co-doped Ni2 P through pulsed laser ablation in liquid (PLAL) and exhibits a large specific surface area of 162.5 m2 g-1 and a low overpotential of 238 mV at 10 mA cm-2 with a Tafel slope of 46 mV dec-1 , which is much lower than those of commercial RuO2 and IrO2 . This work demonstrates that PLAL is a powerful technology for generating amorphous CoNiPO4 with high-valence Ni3+ , thus paving a new way towards highly effective OER catalysts.

Interferon-induced transmembrane protein 3 (IFITM3) as an antiviral factor can inhibit replication of several viruses including influenza virus. A single-nucleotide polymorphism rs12252-C of IFITM3 results in a truncated IFITM3 protein lacking its first 21 amino acids, which is much higher in the Han Chinese population and associated with severe illness in adults infected with pandemic influenza H1N1/09 virus. To investigate if IFITM3 or IFITM3 rs12252-C could affect the antibody response after influenza vaccination, we detected the haemagglutination inhibition (HI) of 171 healthy young adult volunteers (IFITM3 rs12252-C/C, C/T, T/T carriers) and in an IFITM3-deletion mouse model (Ifitm3-/-) after trivalent inactivated vaccine (TIV) immunization. Seroconversion rates for H1N1, H3N2 and B viruses in IFITM3 rs12252-C/C genotype carriers was lower compared with C/T and T/T donors. Significantly lower levels of specific antibodies to H1N1, H3N2 and B viruses and total IgG were observed in Ifitm3-/- mice. Correspondingly, the numbers of splenic germinal centre (GC) B cells, plasma cells, TIV-specific IgG+ antibody secreting cells and T follicular helper cells in Ifitm3-/- mice were lower compared with wild type mice. However, the number of memory B cells was higher in Ifitm3-/- mice at day 7 after booster. The HI level of Ifitm3-/- mice remained lower than WT mice after third vaccination. Moreover, the transcriptional network regulating GC B cell and plasma cell differentiation was abnormal in Ifitm3-/- mice. Our results indicate that IFITM3 deletion attenuated the antibody response. The mechanism of influenza-IFITM3 interactions affecting the antibody response requires further investigation.

Proper development of the human placenta is of vital importance for a successful pregnancy, and a series of pregnancy complications are considered originating from dysfunctional placentas. Like other organ system development, placentation requires large numbers of co-regulators, while the underlying molecular mechanisms orchestrating the placental formation and function are poorly understood. Although we have made many signs of progress in understanding the placental architectures and developments using mouse models, the species-specific differences impede our progress due to the lack of appropriate model systems. In the past few years, major progress has been made by the establishment of novel in-vitro self-renewing stem cell models, as well as identifying the full picture of the cellular organization of the maternal and fetal interface. Providing the tools for the investigation of placentation and reproductive-related regulation mechanism. In this review, we focus on the detailed progress of the human trophoblast stem cells culturing system, and the cellular and molecular terrain at the maternal-fetal interface, respectively, thus providing new insights into placental development. Key words: Human placenta; Maternal-fetal interface; Trophoblast stem cell

BackgroundThere have been reports of increasing azole resistance in Candida tropicalis, especially in the Asia-Pacific region. Here we report on the epidemiology and antifungal susceptibility of C. tropicalis causing invasive candidiasis in China, from a 9-year surveillance study.MethodsFrom August 2009 to July 2018, C. tropicalis isolates (n = 3702) were collected from 87 hospitals across China. Species identification was carried out by mass spectrometry or rDNA sequencing. Antifungal susceptibility was determined by Clinical and Laboratory Standards Institute disk diffusion (CHIF-NET10–14, n = 1510) or Sensititre YeastOne (CHIF-NET15–18, n = 2192) methods.ResultsOverall, 22.2% (823/3702) of the isolates were resistant to fluconazole, with 90.4% (744/823) being cross-resistant to voriconazole. In addition, 16.9 (370/2192) and 71.7% (1572/2192) of the isolates were of non-wild-type phenotype to itraconazole and posaconazole, respectively. Over the 9 years of surveillance, the fluconazole resistance rate continued to increase, rising from 5.7 (7/122) to 31.8% (236/741), while that for voriconazole was almost the same, rising from 5.7 (7/122) to 29.1% (216/741), with no significant statistical differences across the geographic regions. However, significant difference in fluconazole resistance rate was noted between isolates cultured from blood (27.2%, 489/1799) and those from non-blood (17.6%, 334/1903) specimens (P-value < 0.05), and amongst isolates collected from medical wards (28.1%, 312/1110) versus intensive care units (19.6%, 214/1092) and surgical wards (17.9%, 194/1086) (Bonferroni adjusted P-value < 0.05). Although echinocandin resistance remained low (0.8%, 18/2192) during the surveillance period, it was observed in most administrative regions, and one-third (6/18) of these isolates were simultaneously resistant to fluconazole.ConclusionThe continual decrease in the rate of azole susceptibility among C. tropicalis strains has become a nationwide challenge in China, and the emergence of multi-drug resistance could pose further threats. These phenomena call for effective efforts in future interventions.

To evaluate the clinical effects of 1-stage revascularization, vacuum sealing drainage covering the wound, temporary external fixation and 2-stage Ilizarov bone transport for the treatment limb destruction injury.Nine patients with limb destruction injury between September 2014 and June 2019 at our institute were evaluated retrospectively. The age of patient was 21 to 51 years with an average of 33 years. The injuries were caused by vehicle accidents in 4 patients, gunshot in 1 patient, and crushing injuries in 4 patients. All of them had vascular injury. The average length of bone defect was 9.5 (8.3-10) cm. Regular follow-up was performed on wound healing, bone transport time, bone healing time, external fixation index, and limb function.All patients underwent 1-stage revascularization and temporary external fixation during emergency surgery, and then gradual bone transport by Ilizarov fixator was performed until the broken fracture site was reunited.Nine patients were followed up for 12 to 48 months (average 30 months). Six patients were treated with autogenous cancellous bone graft for the second time, and 2 patients healed spontaneously. The mean wound healing time was 86 (73-90) days. The bone transport time was 97 (88.3-105.3) days, and the bone mineralization time was 164.5 (156.8-181.3) days, and the healing time of the docking sites was 6.8 (6.1-8.3) months. The external fixator time was 14.5 (12.5-17) months with the external fixation index was 1.5 (1.4-1.8) m/cm. At the last follow-up, according to the Association for the Study of the Method of Ilizarov functional scores, excellent functional outcomes were obtained in 5 patients, good in 1 patients, moderate in 2 patients. According to the Association for the Study of the Method of Ilizarov Radiological System, excellent functional outcomes were obtained in 6 cases and good in 2 cases.One-stage revascularization and temporary external fixation combined with 2-stage Ilizarov bone transport technique for the treatment of bone defects in limb destruction injury have satisfactory clinical effects and few complications, and can be applied under the condition of strict understanding of surgical indications.

A new phenylspirodrimane dimer derivative (1) was isolated from cultures of the tin mine tailings-associated fungus Stachybotrys chartarum. Its structure was elucidated on the basis of extensive spectroscopic analyses.

Bifunctional electrocatalysts for both hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) are very crucial for converting water into clean fuel through overall water splitting. H...

Considering the different carbonic source utilisation abilities of microbial species, we used six carbonic supplements to acclimate the microorganisms in two types of compost teas (named CT...

While some individuals infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present mild-to-severe disease, many SARS-CoV-2-infected individuals are asymptomatic. We sought to identify the distinction of immune response between asymptomatic and moderate patients. We performed single-cell transcriptome and T-cell/B-cell receptor (TCR/BCR) sequencing in 37 longitudinal collected peripheral blood mononuclear cell samples from asymptomatic, moderate, and severe patients with healthy controls. Asymptomatic patients displayed increased CD56briCD16− natural killer (NK) cells and upregulation of interferon-gamma in effector CD4+ and CD8+ T cells and NK cells. They showed more robust TCR clonal expansion, especially in effector CD4+ T cells, but lack strong BCR clonal expansion compared to moderate patients. Moreover, asymptomatic patients have lower interferon-stimulated genes (ISGs) expression in general but large interpatient variability, whereas moderate patients showed various magnitude and temporal dynamics of the ISGs expression across multiple cell populations but lower than a patient with severe disease. Our data provide evidence of different immune signatures to SARS-CoV-2 in asymptomatic infections.

Breast ptosis is a deformity commonly found in patients seeking breast augmentation. Current mastopexy techniques rely on incisions on the breast to correct ptosis; nonetheless, they leave extensive scars. Having to opt for a visibly scarred breast over a ptotic breast can be a difficult choice.We sought an innovative internal suture mastopexy for hypomastia of mild breast ptosis.A procedure that left a tiny scar on the nipple-areolar complex was introduced. This method was safe and efficient when combining mastopexy with augmentation.Overall, 53 patients underwent this operation in the Plastic and Cosmetic Department of Guangdong Second Provincial General Hospital from January 1, 2013, to June 30, 2017, with a mean follow-up of 38 ± 16 months. The pre-operation and post-operation SN-N lines (the distance from the sternal notch to the nipple) were 21.8 ± 1.2 cm and 20.7 ± 1.0 cm, respectively; the difference was statistically significant (P0.05). The patients and surgeon expressed satisfaction with the procedure.Based on the results of the present study, which included more than 50 patients, we believe that internal suture mastopexy can be used as an effective alternative hypomastia in patients with mild breast ptosis.IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. .

Background: Posterior pilon fracture is a type of ankle fracture associated with poorer treatment results compared to the conventional ankle fracture. This is partly related to the lack of consensus on the classification, approach selection, and internal fixation method for this type of fracture. This study aimed to investigate the clinical efficacy of posterolateral approach versus extended modified posteromedial approach for surgical treatment of posterior pilon fracture. Methods: Data of 67 patients with posterior pilon fracture who received fixation with a buttress plate between January 2015 and December 2018 were retrospectively reviewed. Patients received steel plate fixation through either the posterolateral approach (n = 35, group A) or the extended modified posteromedial approach (n = 32, group B). Operation time, intraoperative blood loss, excellent and good rate of reduction, fracture healing time, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale score, and Visual Analogue Scale score were compared between groups A and B. Results: All patients were followed up for an average period of 15.4 months. No nonunion, failure of internal fixation, or anklebone stiffness occurred in either group during the follow-up period. However, the operation time was significantly shorter, intraoperative blood loss was significantly lower, AOFAS Ankle-Hindfoot Scale score was significantly higher, and Visual Analogue Scale score was significantly lower in group B than in group A (P < 0.05). Conclusion: Compared to the posterolateral approach, the extended modified posteromedial approach can provide a better surgical field for the treatment of posterior pilon fracture, which allows reduction and fixation of this type of fractures under direct vision and evaluation of reduction effects, and reduces operation time and intraoperative blood loss. Combining this approach with supporting steel plate fixation enables early functional rehabilitation of the ankle with more satisfactory clinical results.

Aim To study the imaging characteristics of lacrimal punctum lesion with optical coherence tomography (OCT), and provide imaging basis for the diagnosis and treatment of lacrimal punctum diseases. Methods A total of 25 patients (28 eyes) with epiphora and lacrimal puncta lesions were enrolled. Lacrimal puncta lesions included: punctum membrane obstruction in 7 cases (9 eyes), punctum agenesis in 1 case (1 eye), a mass protruded from the punctum in 1 case (1 eye), slit puncta in 1 case (1 eye), peri-puncta mass in 2 cases (2 eyes), chronic dacryocystitis in 4 cases (4 eyes), and primary puncta stenosis in 9 cases (10 eyes; 3 eyes mild, 4 eyes moderate and 3 eyes severe). All patients were examined by slit lamp microscopy and OCT to observe the morphological characteristics of abnormal punctum. Results Two types of complete membrane obstruction and incomplete membrane obstruction of puncta were observed in OCT images of 7 patients. No lacrimal punctum and lacrimal canalicular cavity were found in 1 case with punctum agenesis. OCT images showed that a narrow lumen remained in the lacrimal puncta in 1 patient with a mass protruded from the punctum. OCT of punctum in a patient with slit punctum after stent placement showed stent and abnormal lacrimal structure. No abnormal intraluminal structure was found in 2 cases of peri-puncta mass after OCT scan, and the lacunar space was narrower than that of the contralateral eye. OCT of puncta in 4 patients with chronic dacryocystitis showed that pus floated in tear with lump-like medium-low reflex. In 9 patients with primary lacrimal puncta stenosis, OCT image could clearly show the changes of puncta lumen in different degrees and shapes. Conclusion OCT is feasible for the examination of pathological punctum, and can provide imaging basis for the diagnosis and treatment of punctum disease.

In this paper, a dilated convolutional neural network is proposed for hyperspectral image classification. Compared with other methods, 2-dimension dilated convolution is used for the first time to extract and classify the spatial-spectral features in hyperspectral image processing fields. Firstly, 1-dimension convolution is extended to 2-dimension convolution for spatial-spectral features extraction. Secondly, a dilated convolutional structure is utilized to fuse the multi-scale information, which is used to extract the multi-scale information without loss of resolution. The experiments of University of Pavia were repeated with the method proposed in this paper, and some better results are obtained, which proved the effectiveness of the proposed model.

Derivatives of oxazine dyes were synthesized on mulitigram scales via efficient synthetic strategies. One practical route was selected to prepare compounds 6, 9 and 10, especially water-soluble compound 6 was obtained in better yield than reported, and compound 10 was insoluble in aqueous media in absence of phenolic-OH. Compounds 3 and 9 were found to be clear pH-dependent between pH = 4.0 and 10.0, and could be used as acid-base indicators to measure intracellular pH. Compounds 6, 9, 10 all have carboxylic acid functionalities, which could be activated and used to conjugate the dyes to biomolecules. In addition, compounds 6 and 9 with good solubility in aqueous media were used to develop a simple, quick, safe, highly sensitive staining method to detect PHAs-producing bacteria on heat-fixed smears, which was confirmed by fluorescence images of PHAs granules of bacteria.

Background Filler injection is a popular cosmetic procedure, but it can entail vascular complications. Periorbital injections have the highest risk within the entire injection area. Objectives The authors sought to systematically screen for periorbital arterial variations prior to treatment. Methods The external carotid arteries of 10 cadaveric heads were infused with adequate lead oxide contrast. The facial and superficial temporal arteries of another 11 cadaveric heads were injected with the contrast in sequential order. Computed tomography (CT) scanning was performed after injection of contrast, and 3-dimensional (3D) CT scans were reconstructed using validated algorithms. Results Three types of periorbital blood vessels were found to derive from the ophthalmic artery, including 30% directly originating from the ophthalmic artery, 65% originating from its trochlear branch, and 5% originating from its supraorbital branch. In the forehead, the ophthalmic artery, originating from the internal carotid arteries, formed anastomoses between the frontal branch of the superficial temporal artery, originating from the external carotid artery, with the deep and superficial branches of the supratrochlear and supraorbital arteries, respectively. The lateral orbit and malar plexus can be classified into 4 types based on the trunk artery: the zygomatic orbital artery (27%), the transverse facial artery (23%), the premasseteric branch of the facial artery (19%), and all 3 contributing equally (31%). Conclusions Postmortem 3D CT can map periorbital arterial variations. The branching pattern of the ophthalmic artery, the ophthalmic angiosome in the forehead, and the distribution of the lateral orbit and malar plexus were identified at high resolution to guide clinical practice.

Purpose The purpose of this study is to investigate the diagnostic role of Hounsfield unit (HU) values on noncontrast computed tomography (CT) for differentiating benignity from malignancy in the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) 4-5 nodules with coarse calcifications. Patients and Methods CT images of 216 ACR TI-RADS 4-5 nodules with coarse calcifications from 207 patients who underwent surgery in our hospital between 2017 and 2019 were retrospectively reviewed. The average HU values (AHUVs) and maximum HU values (MHUVs) of the nodules were measured on noncontrast CT. The distribution of AHUVs and MHUVs in benign and malignant nodules with coarse calcifications was analyzed using the Mann–Whitney test. Receiver operating characteristic (ROC) curves were used to identify the best cut-off values. Diagnostic performances were assessed according to the area under the ROC curve (AUC), sensitivity and specificity. Results Of the 216 ACR TI-RADS 4-5 nodules with coarse calcifications, 170 were benign and 46 were malignant. The AHUVs of benign and malignant nodules were 791 HU [interquartile range (IQR), 543–1025 HU] and 486 HU (IQR, 406–670 HU), respectively (P < 0.001). The MHUVs of benign and malignant nodules were 1084 HU (IQR, 717–1477 HU) and 677 HU (IQR, 441–986 HU), respectively (P < 0.001). The AUCs for AHUVs and MHUVs for predicting benign nodules with coarse calcifications were 0.759 and 0.732, and the cut-off values were 627.5 HU and 806.0 HU, with sensitivities of 67.6% and 68.8% and specificities of 73.9% and 67.4%, respectively. The sensitivity and specificity of the combination were 68.8% and 76.1%. Conclusion AHUVs and MHUVs were helpful in differentiating benignity from malignancy in ACR TI-RADS 4-5 nodules with coarse calcifications. This may provide an important basis for reducing misdiagnosis and unnecessary aspiration or surgical trauma.

For hundreds of years, Ding 1541 is used in traditional Chinese medicine (TCM) for the treatment of numerous ailments, including qi and blood stasis-related disorders. It showed good efficacy in relieving irregular menstruation, dysmenorrhea, metrorrhagia, and metrostaxis. Now, Ding 1541 has been widely used in various conditions, including primary dysmenorrhea, menstrual disorder, endometriosis, infertility, premenopausal syndrome, polycystic ovary syndrome, and premature ovarian failure. Compared with western medicine treatment, Ding 1541 has showed some advantages. In this review, we tried to summarize the underlying mechanisms for Ding 1541's effects. We collected clinical data and briefly analyzed these diseases based on the theories of TCM and the pathology. These data suggested that the underlying mechanisms of Ding 1541 involved increasing uterine blood supply, decreasing menstrual blood prostaglandin F2α level, improving the immune, and enhancing the function of the hypothalamus-pituitary-ovary, etc.

Background The carrier of hydroxyethyl starch (HES) may play a critical role in kidney injury in fluid resuscitation. This study aimed mainly to compare effects of pyruvate-enriched saline with normal saline (NS) and acetate Ringer's (AR) solution as a carrier in HES130/0.4 on kidney function in rats subjected to severe burns. Methods Using a lethal burn model, 140 rats were randomly allocated in seven groups (n = 20): sham group (group S); no fluid after burn (group N); burn resuscitated with NS (group NS); burn resuscitated with pyruvate saline (group PS); burn resuscitated with AR plus pyruvate-HES (group SP); burn resuscitated with AR plus acetate-HES (group SA), and burn resuscitated with AR plus NS-HES (group SN). A low volume (18.75 mL·kg−1 during 12 h) of HES130/0.4 was infused with the ratio of 1:1 to crystalloids. Renal surface blood flow, blood creatinine and blood urea nitrogen, early sensitive indicators of kidney function: alpha-1 microglobulin, cystatin-C, and neutrophil gelatinase–associated lipocalin in blood and urine, and kidney tissue water contents were determined. Renal histopathological alterations with Paller scores were also measured at 8 h and 24 h after burn (n = 10), respectively. Results The results showed in a comparable manner that group SP was the best in three HES groups and group PS was superior to group NS in renal preservation; group SP appeared significantly beneficial compared with group PS in renal surface blood flow, cystatin-C, neutrophil gelatinase-associated lipocalin, water contents, and Paller scores at 8-h or both time points after burn, respectively (all P Conclusions The carrier of HES130/0.4 played a crucial role in kidney injury in fluid resuscitation of rats subjected to severe burns. Pyruvate-enriched HES130/0.4 was superior and HES130/0.4, per se, might be not renocytotoxic, but renoprotective. Further studies are warranted.

AIM To evaluate the impact of enhanced recovery after surgery (ERAS) programs on postoperative complications of pancreatic surgery. METHODS Computer searches were performed in databases (including PubMed, Cochrane Library and Embase) for randomized controlled trials or case-control studies describing ERAS programs in patients undergoing pancreatic surgery published between January 1995 and August 2017. Two researchers independently evaluated the quality of the studies’ extracted data that met the inclusion criteria and performed a meta-analysis using RevMan5.3.5 software. Forest plots, demonstrating the outcomes of the ERAS group vs the control group after pancreatic surgery, and funnel plots were used to evaluate potential publication bias. RESULTS Twenty case-control studies including 3694 patients, published between January 1995 and August 2017, were selected for the meta-analysis. This study included the ERAS group (n = 1886) and the control group (n = 1808), which adopted the traditional perioperative management. Compared to the control group, the ERAS group had lower delayed gastric emptying rates [odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.48-0.72, P < 0.00001], lower postoperative complication rates (OR = 0.57, 95%CI: 0.45-0.72, P < 0.00001), particularly for the mild postoperative complications (Clavien-Dindo I-II) (OR = 0.71, 95%CI: 0.58-0.88, P = 0.002), lower abdominal infection rates (OR = 0.70, 95%CI: 0.54-0.90, P = 0.006), and shorter postoperative length of hospital stay (PLOS) (WMD = -4.45, 95%CI: -5.99 to -2.91, P < 0.00001). However, there were no significant differences in complications, such as, postoperative pancreatic fistulas, moderate to severe complications (Clavien-Dindo III- V), mortality, readmission and unintended reoperation, in both groups. CONCLUSION The perioperative implementation of ERAS programs in pancreatic surgery is safe and effective, can decrease postoperative complication rates, and can promote recovery for patients.

Combining the multivariate probit models with the multivariate partially linear single-index models, we propose new semiparametric latent variable models for multivariate ordinal response data. Bas...

Mixed-mode chromatography (MMC) is a promising technology for protein separation with high adsorption capacity, good selectivity, salt-tolerance, and facile elution. Expanded bed adsorption (EBA) can capture target proteins directly from bioparticle containing crude feedstock without solid–liquid separation. In this study, MMC and EBA were combined to develop a mixed-mode EBA technique for human serum albumin (HSA) separation. Two mixed-mode EBA resins (using quartz-densified agarose beads and tungsten carbide/agarose composite beads, respectively) with tryptamine as the ligand were prepared (TA-S and TA-T). Static and dynamic adsorption behaviors of HSA were determined under varying conditions and typical adsorption properties of pH dependence and salt-tolerance were found. The performance of the resins in expanded bed was studied, and the dynamic binding capacities at 10% breakthrough (Q10%) of TA-S and TA-T at bed expansion of 1.8 were 27.54 and 18.04 mg/mL settled resin, respectively. Moreover, these ...

Rationale: Open total dislocation of ankle joint is rare and often caused by high-energy injury. The present study describes a patient with open total lateral dislocation of ankle joint without fractures and obtained a satisfactory clinical result following early debridement and irrigation, one-stage repairment of ligaments, and plaster external fixation. Patient concerns: The patient, a 45-year-old male, complained of right foot pain with bleeding and limited motion. Physical examination showed a 15-cm open wound at the medial ankle region, with soft tissues impaired and ankle bones exposed. The 3 dimensional reconstruction computed tomography (CT) examination showed an open total dislocation of ankle joint without concomitant fractures. Diagnoses: open total lateral dislocation of ankle joint without fractures Interventions: Early modern wound care including thorough debridement and irrigation on the wound was performed to remove contaminated soft tissues. Subsequently, the dislocated ankle joint was reduced by hand and the medial and lateral collateral ligaments were repaired using wire anchors. Outcomes: The medial wound healed at 2 weeks after surgery, and several common complications such as infection and skin necrosis did not occur. The last follow-up showed a good range of metatarsal flexion and extension of the injured foot, and obvious signs of traumatic arthritis were not observed. According to Kaikkonen ankle function score, the patient was assessed with 90 points. Lessons: For open total dislocation of ankle joint, early treatment should focus on debridement and irrigation, reduction and fixation of the dislocated ankle, protection of the weak soft tissues, and stable external fixation to promote wound healing and reduce the incidence of related complications.

We quantified the serum levels of 34 cytokines/chemokines in 30 patients with SARS-CoV-2 infection. Elevated levels of IP-10 and IL-7 were detected in the acute and convalescent stages of the infection and were highly associated with disease severity.

We propose a latent semi-parametric model for ordinal data in which the single-index model is used to evaluate the effects of the latent covariates on the latent response. We develop a Bayesian sampling-based method with free-knot splines to analyze the proposed model. As the index may vary from minus infinity to plus infinity, the traditional spline that is defined on a finite interval cannot be applied directly to approximate the unknown link function. We consider a modified version to address this problem by first transforming the index into the unit interval via a continuously cumulative distribution function and then constructing the spline bases on the unit interval. To obtain a rapidly convergent algorithm, we make use of the partial collapse and parameter expansion and reparameterization techniques, improve the movement step of Bayesian splines with free knots so that all the knots can be relocated each time instead of only one knot, and design a generalized Gibbs step. We check the performance of the proposed model and estimation method by a simulation study and apply them to analyze a real dataset.

As flow improvers for heavy crude oil, two oil-soluble copolymers (DM-S-VA, DA-S-VA) were successfully synthesized and characterized by 1H NMR and GPC. A rich alkyl chain and appropriate molecular weight of copolymer play fundamental role in viscosity reduction of heavy oil. Furthermore, synergistic effect of surfactants on polymers can promote the viscosity reduction, and the best formulation can increase the viscosity reduction rate to 78% to oil A. Comparing with the apparent viscosity of the different heavy oil mixing system in a wide shear rate range (0.1–200 s−1), the results show good stability and viscosity reducing effect.

We carried out a pool culture experiment to determine the optimal water treatment depth in loam and clay soils during the late growth stage of super rice. Three controlled water depth treatments of 0–5, 0–10 and 0–15 cm below the soil surface were established using alternate wetting and drying irrigation, and the soil water potential (0 to –25 kPa) was measured at 5, 10 and 15 cm. A 2-cm water layer was used as the control. We measured soil enzyme activities, root antioxidant enzyme activities, chlorophyll fluorescence parameters, and rice yield. The results showed that the 0–5-cm water depth treatment significantly increased root antioxidant enzyme activities in loam soil compared with the control, whereas soil enzyme activities, chlorophyll fluorescence parameters and yield did not differ from those of the control. The 0–10- and 0–15-cm water depth treatments also increased root antioxidant enzyme activities, whereas soil enzyme activities, chlorophyll fluorescence parameters and yield decreased. In clay soil, the soil enzyme activities, root antioxidant enzyme activities, chlorophyll fluorescence parameters, and yield did not change with the 0–5-cm water treatment, whereas the 0–10- and 0–15-cm water treatments improved these parameters. Therefore, the appropriate depths for soil water during the late growth period of rice with a 0 to –25 kPa water potential were 5 cm in loam and 15 cm in clay soil.

The four polymers with different contents of alkyl chain (C12–C18), styrene, and vinyl acetate were synthesized and employed as the viscosity reducers for super heavy oils A and B. Compared with the apparent viscosity of heavy oil in a wide share rate range (0–200 s−1) at 50°C, it can be seen that the optimal efficiency could be achieved to reduce viscosity when the polymers have suitable length of alkyl chain in the permeation of small molecules (vinyl acetate). Furthermore, the adaptation of the polymers to different oil samples and application temperature of polymers were also studied.

Background: Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population. Methods: A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes. Results: A total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1–1.4, P < 0.001), after adjusting for diabetes and sleep-related confounders in the multivariable models. Habitual snoring was also associated with isolated impaired fasting glucose (IFG; OR: 1.3, 95% CI: 1.0–1.6; P < 0.001) and isolated impaired glucose tolerance (IGT; OR: 1.3, 95% CI: 1.2–1.5; P < 0.001), but not IFG + IGT (OR: 1.1, 95% CI: 0.9–1.4; P = 0.281). When stratified by total cholesterol (TC) levels, this association between habitual snoring and prediabetes was observed only in individuals with TC