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Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF.To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF.This was a retrospective multicenter study.A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study.Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF.Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement.Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p.05).Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio80.7%), and restoration to less than its original size (postoperative APD ratio100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF.

The older adults with chronic disease usually show poor mental health and experience low quality of life (QOL). This study aimed to examine the mediating role of social support in the relationship between depression and QOL in community-dwelling older adults with chronic disease. A total of 387 Chinese older adults aged 60 or above with chronic disease were included in this cross-sectional study. Social support was negatively associated with depression and positively associated with physical component scale (PCS) and mental component scale (MCS). Depression and social support were all predictors of PCS and MCS. Mediation analysis suggested that social support partially mediated the impact of depression on PCS and MCS. Understanding the mediating role of social support might be beneficial in reducing the adverse impact of depression on QOL in community-dwelling older adults with chronic disease.

Objective: The systemic inflammatory and immune response directly influence the prognosis of patient with sepsis. By detecting the pro-/anti-inflammatory and immune biomarkers, we aim to understand the early systemic inflammatory response and immune status, and explore the potential biomarkers for diagnosis and treatment for pediatric patients with sepsis. Methods: 62 pediatric patients with sepsis and 48 pediatric patients without sepsis, between 9 months and 13 years old were included. The HLA-DR expression on CD14+ monocytes, the proportion of CD4+CD25+Foxp3+ Treg cells and IL-27+ CD4+ cells were analyzed by flow cytometry. The Foxp3, CTLA-4, GITR, IL-10, L-17A, IL-17F and IL-27 mRNA levels in CD4+cells were evaluated by Real-time PCR. And Cytokines IL-4, IFN-γ and TGF-β were measured by enzyme-linked immunosorbent assay. Results: Serum IFN-γ，transcription levels of IL-17A and IL-17F were higher than that in patients without sepsis (ppp+CD25+Treg cells in pediatric patients with sepsis (pp+ IL-27+ cells were significantly raised in pediatric patients with sepsis than that in pediatric patients without sepsis (pConclusion: At early stage of sepsis, the pro-inflammatory factors co-exist with anti-inflammatory factors, but the pro-inflammatory response dominates. The IL-27 may exert bi-directional regulation in the mixed immune responses, and can be detected as a potential biomarker for determination of immune status for pediatric patients with sepsis. Also, although the immune function influenced at early stage in pediatric patients with sepsis, the expression rate of HLA-DR was greater than 30%, so treatments of immune regulation could not be necessary at early stage for pediatric patients with sepsis.

Sepsis is an acute inflammatory reaction and a cause of acute respiratory distress syndrome (ARDS). In the present study, we explored the roles and underlying mechanism of the lncRNA Nuclear enriched abundant transcript 1 (NEAT1) in ARDS. The expression levels of genes, proteins and pro-inflammatory cytokines in patients with ARDS, LPS-stimulated cells and septic mouse models were quantified using qPCR, western blotting and ELISA assays, respectively. The molecular targeting relationship was validated by conducting a dual-luciferase reporter assay. Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8) assay. The cell cycle phase was determined by flow cytometry assay. The expression levels of NEAT1 and pro-inflammatory cytokines were higher in patients with ARDS and septic models than in controls. Knockdown of NEAT1 significantly increased cell proliferation and cycle progression and prolonged mouse survival in vitro and in vivo. Mechanistically, miR-27a was identified as a downstream target of NEAT1 and directly inhibited PTEN expression. Further rescue experiments revealed that inhibition of miR-27a impeded the promoting effects of NEAT1 silence on cell proliferation and cycle progression, whereas inhibition of PTEN markedly weakened the inhibitory effects of NEAT1 overexpression on cell proliferation and cycle progression. Altogether, our study revealed that NEAT1 plays a promoting role in the progression of ARDS via the NEAT1/miR-27a/PTEN regulatory network, providing new insight into the pathologic mechanism behind ARDS. Sepsis-induced acute lung injury has been clinically defined as acute respiratory distress syndrome (ARDS). In the present study, the authors reveal that NEAT1 plays a role in the inflammation and cell cycle progression of ARDS via the NEAT1/miR-27a/PTEN regulatory network, providing new insight into the pathologic mechanism behind ARDS.

Aims To assess the effect of peer support intervention on diabetes distress in people with type 2 diabetes. Background Diabetes distress may be decreased by peer support intervention, but findings about the effect of peer support on diabetes distress have been mixed. Design A systematic review and meta-analysis of randomized controlled studies. Data sources PubMed, Embase, CENTRAL, PsycINFO, Web of Science, and CINAHL databases were searched for randomized controlled trials from inception to 30 June 2018. Review methods Investigators assessed eligibility, extracted data, and assessed methodological quality. Standardized mean difference and 95% confidence intervals were calculated for pooled effect size. Results A total of 13 studies included in systematic review and 10 in meta-analysis. In the random-effects model, the pooled effect size showed current peer support intervention did not significantly reduce diabetes distress in type 2 diabetes population compared with usual care. Conclusion High quality and well-designed studies targeting at reducing diabetes distress are needed to further test the effect of peer support intervention on diabetes distress.

Background High-sensitivity cardiac troponin T (hs-cTnT) is detectable in elderly patients without clinical diagnosed cardiovascular disease. Elevated hs-cTnT levels predict increased cardiovascular risks and poor prognosis. The aim of this study was to determine the distribution and associated factors of hs-cTnT in geriatric inpatients without acute coronary syndrome (ACS). Methods Hs-cTnT was measured with a highly sensitive assay in 679 geriatric inpatients without ACS. Patients were further divided into 3 groups according to the tertile of hs-cTnT levels and single and multiple variable analyses were performed to assess the association of hs-cTnT to cardiovascular risk factors, biochemical measurements and echocardiographic abnormalities. Results Hs-cTnT was detectable (≥3 ng/L) in 98.4% of the subjects and 52.0% of the subjects had hs-cTnT levels ≥14 ng/L, which is at the 99th percentile Upper Reference Limit (URL). The levels of hs-cTnT were independently associated with N-terminal pro-brain natriuretic peptide (NT-proBNP), male gender, older age, estimated glomerular filtration rate (eGFR), left ventricular mass index (LVMI), diabetes mellitus (DM) and left ventricular ejection fraction (LVEF). There were no significant differences in hs-cTnT levels between geriatrics patients with stable coronary artery disease (SCAD) and those without SCAD. Conclusion Hs-cTnT elevation caused by non-ischemic acute conditions was very common in geriatric hospitalized patients. Due to increases in baseline hs-cTnT in the elderly, detection of a rise and/or fall in hs-cTnT levels is essential for determining a diagnosis of ACS or AMI in geriatric patients. Further studies are needed to establish age-specific 99th percentile values of hs-cTnT for elderly individuals.

Two novel fluorescent polymers PPOPAF and PPOCzF, with N+P–O− resonance structures inserted into the fluorene-alt-carbazole based backbone, were developed as blue emitters and hosts for an orange-red phosphor to realize fluorescent–phosphorescent (F–P) hybrid white polymer light-emitting diodes (WPLEDs). The polymers exhibit proper HOMO/LUMO energy levels, good thermal stability and high triplet energy (ET) levels. Devices using PPOPAF and PPOCzF as single emissive layers show deep-blue emission with CIE coordinates of (0.16, 0.10) and (0.17, 0.10), respectively. Moreover, in hybrid white devices, doping with various concentrations of iridium(III) bis(4-phenylthieno[3,2-c]pyridinato-N,C2) acetylacetonate (PO-01) (0.1%, 0.2%, 0.5 wt%), the PPOCzF-based devices give a significant improvement than that of PPOPAF. While the doping concentration is 0.1 wt%, a nearly standard white emission (CIE: 0.35, 0.33) was achieved. The maximum CE, PE, EQE of PPOCzF-based devices is 4.4 cd A−1, 1.1 lm W−1, and 1.7%, respectively.

According to the characteristic formula of planetary gear transmission, by studying the movement and torque transmission of planetary gear mechanism of Automatic Transmission, this paper presents a new method of transmission analysis by use of the matrix. The method established the mathematical model about the coupling form and shift constraint and torque transmission between the planetary lines based on matrix theory. It is generally applicable to the movement and torque calculation of complex planetary gear mechanism.

Lumbar transverse process fractures (LTPFs) are often with concomitant non-spinal-associated injuries (NSAIs). The purpose of this study was to analyze the correlation between the NSAIs and the LTPFs of different segments, amount, and concomitant thoracolumbar/lumbar vertebral fractures.A total of 1,181 patients with LTPFs or thoracolumbar/lumbar vertebral fractures were chosen between September 2006 and June 2010. The patients were divided into three groups: thoracolumbar/lumbar vertebral fractures without LTPFs, with associated LTPFs, and isolated LTPFs (iLTPFs). The correlation of the NSAIs of different sites and the LTPFs of different segments, amount, and concomitant thoracolumbar/lumbar vertebral fractures were analyzed between and within groups by χ test and logistic regression analysis.The incidence of NSAIs with iLTPFs and aLTFP groups were significantly higher than that of vertebral fractures without LTPF group (55.73% and 64.49% vs. 21.32%, respectively, p = 0.000). However, the incidence was not significantly different between the iLTPFs and the aLTFP groups (p = 0.106). The results with NSAIs of different sites were almost the same. L5TPFs were a stronger risk factor to NSAIs (relative risk [RR] = 15.72; 95% confidence interval [CI], 4.47-55.37; p = 0.000) in the iLTPF group (RR = 21.92; 95% CI, 6.68-71.92; p = 0.000) and in the vertebral fractures with associated LTPF group (RR = 9.42; 95% CI, 1.19-74.72; p = 0.034). L5TPFs were also a very important risk factor for pelvic injuries (RR = 46.10; 95% CI, 22.40-94.88; p = 0.000); 65.1% in L5iTPFs were accompanied with Tile-C pelvic injuries, slightly higher than in L5aTPFs (46.7%). L4TPFs were a risk factor to abdominal injuries within iLTPFs (RR = 2.27; 95% CI, 1.23-4.20; p = 0.009).The incidence of NSAIs is very high in cases with LTPFs, particularly with L5TPFs. A detailed investigation should be performed to search for NSAIs once LTPFs are identified so that appropriate treatment can be initiated.Level III.

The public department and the private investor is the commonly contractual subjects of the chartered operating project. Risk sharing idea is an important manifestation to contract justification. The public department determines the compensate degree to private investor through controlling the project’s beneficial period or the chartered operating price. Aim at part of the risk loss that the public department should undertake after risk events had happened; two flexible process models were studied. The adjustment to project beneficial period or product purchasing price was put forward in allusion to this kind of risks. Case study manifested that the adjustment method is feasible.

This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective of this review is to assess the effectiveness of anterior versus posterior surgical approaches in patients with multilevel cervical spondylotic myelopathy (MCSM), with a focus on pain intensity, quality of life, neurological outcomes, and harms/complications.

Non-traumatic rhabdomyolysis is a rare complication of acute pancreatitis. One of the major risk factors of both acute pancreatitis and rhabdomyolysis is alcohol abuse. However, only a few studies have reported the prognosis and association of severe acute pancreatitis (SAP) and rhabdomyolysis in alcohol abuse patients. In the present study, we report two cases presenting with SAP complicated by rhabdomyolysis following high-dose alcohol intake. The disease onset, clinical manifestations, laboratory data, diagnosis and treatment procedure of each patient were recorded, and the association with rhabdomyolysis was analyzed. Alcohol consumption was the most predominant cause of SAP and rhabdomyolysis in these patients. SAP-related rhabdomyolysis was primarily induced by the toxicity associated with pancreatic necrosis. The laboratory tests revealed that the concentration of serum creatine kinase (CK) and myoglobin increased and acute renal failure symptoms were present, which provided an exact diagnosis for SAP-induced rhabdomyolysis. Rhabdomyolysis and subsequent hypermyoglobinuria severely impaired kidney function and aggravated hypocalcemia. The therapy of early stage SAP complicated by rhabdomyolysis involved liquid resuscitation support. When first stage treatment fails, blood purification should be performed immediately. Both patients developed multiple organ failure (MOF) and succumbed to the disease. Considering the two cases presented, we conclude that alcohol-related SAP complicated by rhabdomyolysis may have a poor clinical prognosis.

This study investigates the clinical and radiographic characteristics of complex axis fractures with adjacent segment instability and describes the outcome of surgical treatment. Twenty-one patients (14 male, seven female; mean age = 34 years) with complex axis fractures and adjacent segment instability who were treated between August 2003 and June 2009 were retrospectively reviewed. Treatment selection was based on fracture type and stability of the upper cervical segments. All patients were immobilized with a hard collar for three months after surgery. The mean follow-up period was 12 months (range = 6–36 months). No intraoperative surgery-related complications were observed and fusion was achieved in all patients. The outcome was excellent for 17 patients, good for two patients, fair for one patient, and poor for one patient. The upper cervical segments that can become unstable due to complex axis fractures include the atlantoaxial and C2–3 joints. Recommended surgical treatments produce good results.

Objective. To discuss the practical value of the cough test during the tension-free vaginal tape (TVT) procedure.Methods. In the first group, 41 patients of female stress incontinence received TVT operations which were performed according to the Ulmsten’s method strictly, only that the stress of tape was adjusted in light of the cough test. In the second group, 44 patients of female stress incontinence received TVT operations in which the tape was put under the urethral tract without stress, not adjusted by cough test.Results. The cure rate was 38/41 (92.6%) in the cough test group and 41/44 (93.1%) in the noncough test group; detrusor pressure-uroflow study indicated that there were 11 cases in the obstruction zone in the cough test group while only 3 cases were in the obstruction zone in the noncough test group; 4 cases of urinary retention and 5 cases of voiding dysfunction were found in the cough test group, while difficulties of urination were not found in the non-cough test group.Conclusion. Adjusting the tape stress in accordance with the cough test during the TVT can increase the opportunity of urinary retention or difficulty of urination after operation. So there is no benefit of the cough test during tension-free vaginal tape procedure in preventing post-operative urinary retention.

Background: The purpose of this study was to summarize outcomes of patients with refractory multisegmental cervical spondylotic myelopathy (CSM) who were treated by combined single-level subtotal corpectomy and decompression of the intervertebral space using the anterior approach. Methods: Forty-five consecutive patients with multisegmental CSM were included; their ages ranged from 37 to 72 years. Seventeen (37.8%) patients had noncontiguous or ‘jumping’ multisegmental CSM and 28 (62.2%) had contiguous multisegmental CSM. The mean preoperative Japanese Orthopedic Association (JOA) score was 8.1 points. All patients underwent combined single-level decompression of the involved intervertebral space and subtotal corpectomy together with subsequent fusion and internal fixation. An anterior approach was used for all patients. A cage filled with bone graft was inserted and internal fixation was performed after single-level intervertebral space decompression. Mesh filled with bone graft was inserted and plate internal fixation was performed after subtotal corpectomy. Results: Follow-up data (average follow-up, 14 months) were available for all 45 patients; the mean postoperative JOA score was 13.2 points, which was significantly different from the preoperative JOA score. Bony fusion was achieved in all patients based on postoperative radiography, and no pseudoarthrosis was observed during follow-up. Conclusions: An excellent outcome can be achieved with the combination of single-level subtotal corpectomy and decompression of the intervertebral space using the anterior approach to treat multisegmental CSM.

Purpose: To investigate the effects of Yifukang oral liquid (YFKOL) on chemotherapy- and radiotherapy-induced myelosuppression, leucopenia and gastrointestinal tract disturbances. Methods: The effects of YFKOL on myelosuppression, leucopenia and gastrointestinal tract disturbances were assessed by cyclophosphamide- and Co60-induced leucopenia in mice, copper sulfate-induced emesis in pigeons, ethanol-induced gastric mucosal lesions in rats, gastric emptying and intestinal propulsion in mice. Results: In cyclophosphamide- and Co60-induced leucopenia assays, the mean white blood cell count (82.6 and 90.1 × 10 9 /L; 7.3 and 8.2 × 10 9 /L, respectively) and thighbone marrow granulocytes (66.1 % and 67.4 %; 60.8 and 66.5 %, respectively) were significantly (p < 0.05) increased after treatment with YFKOL (15 and 30 mL/kg), compared with the respective control (68.2 and 4.7 × 10 9 /L; 58.2 and 53.1 %). In emesis, gastric mucosal lesions, gastric emptying and intestinal propulsion assays, the mean frequency of emesis (30.8 and 22.3 times, respectively) and ulcer index (39.6 and 26.5, respectively) significantly (p < 0.05) decreased, and the mean gastric emptying (25.0 and 24.0 %) and intestinal propulsion (81.9 and 82.8 %) were significantly (p < 0.05) promoted after treatment with YFKOL (10 and 20 mL/kg), compared with the respective control (54.7 times, 62.8, 42.0 and 68.9 %). Conclusion: YFKOL may suppress chemotherapy- and radiotherapy-induced myelosuppression, leucopenia and gastrointestinal tract disturbances. Keywords: Yifukang oral liquid, Gastrointestinal tract disturbances, Leucopenia, Myelosuppression, Tumor, Chemotherapy, Radiotherapy

(–)Doxazosin, one of (±)doxazosin enantiomers, was speculated to have a pharmacological enantioselectivity between the cardiovascular system and the urinary system by comparison with (+)doxazosin. Therefore, to evaluate the potential benefits of (–)doxazosin in the treatment of benign prostate hyperplasia, we compared the effects of the 3 agents, using rat mesenteric artery preparations and obstructed bladder strips. Concentration–response curves for carbachol (contractile response) and isoprenaline (relaxant response) in detrusor muscle strips of the bladder outlet obstruction (BOO) rats were shifted to the left, with significant increases in the Emax values, and significant decreases in the EC50 values by comparison with the sham-operated rats (P < 0.05, n = 10). The enhanced responses in detrusor muscle strips of the BOO rats treated with (±)doxazosin and its enantiomers at 3 mg·(kg body mass)–1·day–1 for 2 weeks returned to normal levels, and the 3 agents inhibited the enhanced responses to carbachol and isoprenaline to the same extent. On the other hand, the 3 agents uncompetitively inhibited the vasoconstrictive response curves for NA in the rat isolated mesenteric artery, and the pKB value of (–)doxazosin at vascular α1-adrenoceptors was significantly smaller (P < 0.05, n = 6) than that of (+)doxazosin or (±)doxazosin. In conclusion, although (–)doxazosin inhibits vascular functional α1-adrenoceptors more weakly than (+)doxazosin, both agents equally ameliorate the enhanced responses in detrusor muscle of BOO rats, suggesting that the chiral carbon atom in the molecular structure of doxazosin does not affect its beneficial effects in the bladder smooth muscle of BOO rats.

Posterior short-segmental fixation is reliable for the management of thoracolumbar fractures; however, it is associated with recurrence of kyphosis and failure of fixation. This study compared the short-term results of short-segmental fixation combined with intermediate screws with those of conventional intersegmental fixation in the treatment of monosegmental thoracolumbar fractures. The records of 62 consecutive patients with thoracolumbar monosegmental fractures who underwent conventional 4-screw intersegmental fixation (35 patients) or short-segmental fixation combined with intermediate screws (27 patients) were reviewed. The study population included 43 men and 19 women (mean age, 44.1±13.6 years). The majority of fractures were L1 (28 [45.1%]) and T12 (21 [33.9%]) fractures. There were no significant differences between the 2 groups with respect to the preoperative relative height of the fractured vertebra or the segmental kyphotic angle. There was a significant difference in the restoration rate between the conventional and short-segmental fixation groups (62.6±38.7% vs 100.4±25.4%, respectively; P P P

Sustainable operation of sensor nodes powered by limited lifetime batteries is a key challenge. Environmental energy harvesting is an attractive technique to forestall this energy crisis of wireless sensor networks. To realize a self- sustaining wireless sensor node,the objective of this research is to develop a new power management circuit which is supplied with four photovoltaic batteries which harvests energy from environment. One of the photovoltaic batteries was over the encapsulated wireless sensor node and the others were installed the three lateral of the encapsulated wireless sensor node. The design date and experimental results demonstrate that the energy management system can extend the lifetime of sensor network and prove the feasibility of the energy management system . Keywords—photovoltaic battery; wireless sensor node; power management

Find a car in large park is a challenge for intelligent parking lot management system. In this paper, an intelligent car-searching approach for large parking lot is presented. In the new approach, some cameras are set up in each road. Vision information of the car, including car color and license plate are recognized and saved in database. Considering that no license plate recognition system can 100% recognize all plates, an intelligent car searching algorithm based on the similarity of license plate recognition and color classification probabilities is proposed to sort the retrieval results. The new approach is tested in a large outdoor park. Preliminary experimental results show the efficiency of proposed car-searching system.

In this case the diagnosis was unclear from the clinical presentation. Myocardial perfusion imaging with gating, though initially performed to look for myocardial ischemia, revealed a strikingly enlarged and dysfunctional right ventricle with the interventricular septum abnormally deviated toward the left ventricle, consistent with right ventricular pressure overload and pulmonary hypertension. These findings led to the performance of ventilation/perfusion lung scanning that showed evidence of pulmonary emboli.