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MXenes have been long sought-after for their exceptional electrical conductivity, large family members, mechanical stability, tunable surface groups, and ease of processability. In particular, they have become the leading materials for electromagnetic (EM) wave absorption. Herein, MXenes’ crystal and electronic structures, as well as EM wave absorption related to those properties, are discussed. The structures and EM functions of MXene hybrids are systematically arranged. The crystal and electronic structure, EM characteristics, and EM response of MXene-based hybrids, as well as their relationship are revealed. Moreover, we propose the main challenges, and predict future directions in this rapidly broadening field.

In clinical, the center of pressure (CoP) is commonly used for accessing the stability of a person’s postural control, which is highly associated with various neurological diseases and movement disorders such as Alzheimer’s disease, Parkinson’s disease, chronic ankle instability. Such a disease usually has a long development or rehabilitation process which requires long-term CoP monitoring. The current CoP evaluation process does not meet the requirement, as it is often complicated and expensive through either the lab-based equipment or the clinical evaluation procedure. Different wearable sensor-based systems with less cost and restrictions have emerged, but their way of CoP calculation requires deliberate calibration of the positions of their sensors, which are not feasible in daily CoP monitoring. In this study, we developed a long-term CoP monitoring system in a smart-shoe form. First, a thin and flexible smart insole with optimal sensor locations was designed to be compact and energy sufficient for a whole-day usage. Then, a user-friendly app on the smartphone with a cloud-based data managing system was developed for applications in both clinical and home environments. Additionally, a simplified CoP estimation model was created without the need for calibration. Lastly, a machine learning-based human activity recognition method was incorporated to make the CoP detection process more automatic. Through a thorough validation test with the clinical level lab equipment, our system can generate the CoP measurements with high accuracy.

Backgrounds This study investigated the global incidence and mortality of cervical cancer, its predictors, the temporal trend by country and age. Methods Data from Global Cancer Observatory 2020 for 185 countries was used to estimate current cervical cancer incidence and mortality and their associations with predictors by linear regression analysis. Estimated age-standardized rates (ASR) and average annual percentage changes (AAPC) from cancer registries for up to 53 countries through 2018 were used for trend analysis by joinpoint regression. Results Wide variations in cervical cancer were observed globally with the highest rates of incidence and mortality in East Africa (ASR, 40.1 and 28.6). The incidence and mortality of cervical cancer were positively associated with human papillomavirus, human immunodeficiency virus infection and negatively associated with cervical cancer screening coverage. In the most recent 5 years, reduction of incidence and mortality was found from 22 (AAPC, −11.2 to −0.5) and 27 countries (−21.5 to −0.3). Increase of incidence and mortality was found from 13 (1.7 to 6.5) and 5 (0.3 to 1.8) countries. Comparing to women aged above 50 years, increasing incidence were additionally found among women under age 50 years from 9 countries (ranging from 0.2 in Denmark to 3.8 in Sweden). Conclusions While most countries with cancer registry have shown reduction in cervical cancer incidence and mortality, the increasing incidence among younger women from some developed countries warrants further implementation of effective cancer screening.

Background Emerging evidence showed that bone metabolism and cardiovascular disease (CVD) are closely related. We previously observed a potential immediate risk of cardiovascular mortality after hip fracture. However, whether there is an immediate risk of cardiovascular events after hip fracture is unclear. The aim of this study was to evaluate the risk for major adverse cardiovascular events (MACEs) between patients having experienced falls with and without hip fracture. Methods This retrospective population-based cohort study used data from a centralized electronic health record database managed by Hong Kong Hospital Authority. Patients having experienced falls with and without hip fracture were matched by propensity score (PS) at a 1:1 ratio. Adjusted associations between hip fracture and risk of MACEs were evaluated using competing risk regression after accounting for competing risk of death. Results Competing risk regression showed that hip fracture was associated with increased 1-year risk of MACEs (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.21–1.33; p < .001), with a 1-year cumulative incidence difference of 2.40% (1.94%–2.87%). The HR was the highest in the first 90-days after hip fracture (HR of 1.32), and such an estimate was continuously reduced in 180 days, 270 days, and 1 year after hip fracture. Conclusions Hip fracture was associated with increased immediate risk of MACEs. This study suggested that a prompt evaluation of MACE among older adults aged 65 years and older who are diagnosed with hip fracture irrespectively of cardiovascular risk factors may be important, as early management may reduce subsequent risk of MACE.

Background This study aimed to describe the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW) rural adults in Xinjiang and to explore their influencing factors. Methods We selected 13,525 Uyghur, Kazakh and Han participants in Kashi, Yili and Shihezi areas in Xinjiang from 2009 to 2010. Weight status was classified according to body mass index. Metabolic phenotype was further defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Results The prevalence of normal weight, overweight, and obesity were 51.6, 30.2, and 14.4%, respectively. The mean age of the population was 45.04 years. The prevalence of MHO was 5.5% overall and was 38.5% among obese participants. The prevalence of MUNW was 15.5% overall and was 30.1% among normal weight participants. A metabolically healthy phenotype among obese individuals was positively associated with females and vegetable consumption ≥4 plates per week. However, this was inversely associated with higher age, red meat consumption ≥2 kg per week, and larger waist circumference (WC). Conversely, a metabolically unhealthy phenotype among normal-weight individuals was positively associated with higher age, red meat consumption ≥2 kg per week, and larger WC; this was however inversely associated with vegetable consumption ≥4 plates per week. Conclusions The prevalence of MHO among obese adults in Xinjiang is higher than that of Han adults, while the prevalence of MUNW among normal weight adults is lower than that among Han adults. In obese and normal weight participants, higher age, more red meat consumption, and larger WC increase the risk of metabolic abnormality, and more vegetable consumption reduces the risk of metabolic abnormality.

Fifth-generation (5G) is as much a challenge as an opportunity. Getting insight into the nature of manipulating electromagnetic (EM) response is greatly imperative to guide the scientific research and technological exploitation at such a critical time. Herein, the dielectric “genes” of graphene-based heterostructure is further demonstrated experimentally and theoretically based on previous work, endowing unlimited possibility to manipulate EM response, even at elevated temperature. The dielectric “genes” categories are successfully discriminated, mainly including conduction network, intrinsic defects, impurity defects, and interfaces, and their temperature evolution is revealed in detail. By multiscale tailoring of “genes”, the maximal reflection loss (RL) is raised up to −58.1 dB at T = 423 K with a greatly reduced matching thickness of 1.16 mm, and the EM interference shielding performance emerges with an effective absorption efficiency (Aeff) higher than 70%. These findings of dielectric “genes” will open up an unexpected horizon for smart material design in the coming 5G age, providing a great boost for promoting the next-generation smart devices, as well as environmental government and protection.

This study aimed to investigate the prevalence of dyslipidemia and its related factors among urban adults aged 35 to 79 years in Southwestern China. From September 2013 to March 2014, a multi-stage sampling was conducted, and a total of 10,221 people aged 35–79 years living in Chengdu and Chongqing were included. More than 30 investigators were trained in data collection, including questionnaire, anthropometric measurements and blood biomarkers testing. The prevalence of high triglycerides (≥ 2.3 mmol/L), high total cholesterol (≥ 6.2 mmol/L), high low-density lipoprotein cholesterol (≥ 4.1 mmol/L), low high-density lipoprotein cholesterol (

Background This study aims to investigate the temporal trend as well as the burden of primary liver cancer among Mongol and non-Mongol in China. Materials and methods The registered data from up to 20 monitoring points in the periods of 2008 to 2015 in Inner Mongolia were used to calculate and model the trend of liver cancer among Mongol and non-Mongol using log-linear regression. Logistic regression was used to characterise the risk of liver cancer by using hospitalization records from 2008 to 2017. Results Over the study period, significant reduction of liver cancer mortality was found among non-Mongol population (4.8/100,000 from 23.7/100,000 to 18.9/100,000, p=0.04), while the increase of liver cancer mortality was observed among the Mongolian population (8.4/100,000 from 10.7/100,000 to 19.1/100,000, p=0.02), particularly the Mongol from East (25.5/100,000 from 11.2/100,000 to 36.7/100,000, p=0.005). Comparing to the non-Mongol patients with primary liver cancer, the Mongolian patients were more likely to be from East Inner Mongolia (aOR=3.65, 95% CI:2.75-4.87) and those residing in urban area (aOR=2.11, 95%CI: 1.55-2.91). In 2015, a total of 3056 primary liver cancer deaths could be converted if the four known risk factors (HBV, Hepatitis C Virus, alcohol consumption and smoking) could be prevented. HBV remained to be the leading risk factor of liver cancer (PAF=56%, contributing to 2616 deaths) with the highest among the Mongol from East (PAF=65.1%, contributing to 763 deaths). Conclusion The continuing increase of primary liver cancer among Mongol suggested further interventions were needed to combat its burden.

Inflammation plays an important role in the pathological process of ischemic stroke, and systemic inflammation affects patient prognosis. As resident immune cells in the brain, microglia are significantly involved in immune defense and tissue repair under various pathological conditions, including cerebral ischemia. Although the differentiation of M1 and M2 microglia is certainly oversimplified, changing the activation state of microglia appears to be an intriguing therapeutic strategy for cerebral ischemia. Recent evidence indicates that both mesenchymal stem cells (MSCs) and MSC-derived extracellular vesicles (EVs) regulate inflammation and modify tissue repair under preclinical stroke conditions. However, the precise mechanisms of these signaling pathways, especially in the context of the mutual interaction between MSCs or MSC-derived EVs and resident microglia, have not been sufficiently unveiled. Hence, this review summarizes the state-of-the-art knowledge on MSC- and MSC-EV-mediated regulation of microglial activity under ischemic stroke conditions with respect to various signaling pathways, including cytokines, neurotrophic factors, transcription factors, and microRNAs.

Exposure to PM2.5 pollution is a significant health concern and increases risks for cancers in China. However, the studies regarding the effect of PM2.5 and esophageal cancer incidence (ECI) among urban-rural areas are limited. In this study, we examined the sex- and area-specific association between exposure to PM2.5 and ECI, as well as explored the corresponding lag effects on ECI using a geographical weighted Poisson regression. We found significantly positive effect on ECI for males and females in different models, with the greatest increase of 1.44% (95% CI: 1.30%, 1.59%) and 2.42% (95% CI: 2.17%, 2.66%) in per 10 ug/m3 increase of PM2.5 for males and females at single year lag7 and lag4 after all covariates controlled, respectively. We also found that the long-term effect of PM2.5 on ECI was relatively stable at all moving average year lags. Moreover, rural areas had higher ECI risks for males (0.17%) and females (0.64%) with longer lag period than urban areas. In addition, higher risks for both sexes appeared in north, northwestern, and east China. The findings indicated that long-term exposure to PM2.5 was significantly associated with increased risks for ECI, which reinforce a comprehensive understanding for ECI related to PM2.5.

A series of polymer photodetectors with device configuration of ITO/PEDOT:PSS/P3HT:PC61BM/C60/Al were prepared by using P3HT as the donor material and PC61BM as the acceptor material. By regulating the content of 1,8-diiodooctane (DIO) (V/V: 1%, 3%, 5%) as a processing additive, the morphology of the active layer can be greatly improved. With C60 as the hole blocking layer, the dark current density of the device can be reduced by about an order of magnitude. When employing 3% DIO (V/V) in the active layer processing, the photodetetcors present the best performance, and the detectivity of the device is 1.52×1012 Jones at 540 nm under a bias of −0.1 V. Moreover, it also has a wider linear dynamic range of 60 dB as well as faster response speed (τr/τf=0.53/0.71 µs) than those of devices with other content of DIO additives.

Highlights The industrial application and foundational research of MXenes at gigahertz frequency are systematically reviewed.The design principles of “lightweight, wide, and strong” are specifically highlighted.Current challenges and future directions for MXenes in wireless communication and electromagnetic attenuation are outlined., There is an urgent global need for wireless communication utilizing materials that can provide simultaneous flexibility and high conductivity. Avoiding the harmful effects of electromagnetic (EM) radiation from wireless communication is a persistent research hot spot. Two-dimensional (2D) materials are the preferred choice as wireless communication and EM attenuation materials as they are lightweight with high aspect ratios and possess distinguished electronic properties. MXenes, as a novel family of 2D materials, have shown excellent properties in various fields, owing to their excellent electrical conductivity, mechanical stability, high flexibility, and ease of processability. To date, research on the utility of MXenes for wireless communication has been actively pursued. Moreover, MXenes have become the leading materials for EM attenuation. Herein, we systematically review the recent advances in MXene-based materials with different structural designs for wireless communication, electromagnetic interference (EMI) shielding, and EM wave absorption. The relationship governing the structural design and the effectiveness for wireless communication, EMI shielding, and EM wave absorption is clearly revealed. Furthermore, our review mainly focuses on future challenges and guidelines for designing MXene-based materials for industrial application and foundational research.

There are few epidemiological studies on the relationships between trace element exposure and depression in the elderly Chinese population. We studied the levels of strontium (Sr), manganese (Mn), vanadium (V), barium (Ba), aluminum (Al), titanium (Ti), arsenic (As) and selenium (Se) in whole blood, and the relationships between trace element exposure and depressive symptoms in elderly Chinese individuals in a community. Data was obtained from the baseline investigation of the Health of Elderly and Environment Risk Factor Cohort, established in Lu'an municipality, Anhui Province, China, from June to September 2016. The levels of eight trace elements were determined by inductively coupled plasma mass spectrometry (ICP-MS), reflecting individuals’ exposure levels. The geriatric depression scale (GDS-30) was applied to screen depression in the elderly cohort. Binary logistic regression was used to analyze the associations between trace elements and depressive symptoms. All analyses were stratified by sex. Results show that among of 954 elderly participants, 27.13%, had depressive symptoms according to the GDS-30. The detection rate of Al was 91.70%, the detection rate of Ti was 89.55%, and the detection rate of other six mineral elements was 94.12–94.31%. High concentrations of Sr and Ba were found to be risk factors for depressive symptoms. Sr and Ba tertiles were related to an increased risk of depressive symptoms, with odds ratios (ORs) of 1.84 and 2.15 for the highest tertiles, respectively. When stratified by sex, increased whole blood levels of Sr and Ba were associated with depressive symptoms in women, but not in men.

The development of high-efficiency microwave absorbing materials in different frequency bands is expected to satisfy the requirement of real-time communication and national defense especially active camouflage in the information era. Herein, a carbon modified nickel cobalt oxide, C–NiCo2O4, porous nanofiber is successfully constructed by electrospinning and in-situ hierarchical thermal treatment engineering. The thermal treatment temperature enables tailoring of the C content of C–NiCo2O4 so as to modulate the conduction loss. More importantly, the absorption frequency can be tuned from Ku to X and even to C band due to that the proper tailoring affords varying synergy effect of dielectric and magnetic properties on impedance matching degree of each C–NiCo2O4 composite. Since low reflection loss suggests efficient energy conversion and heat generation, the high electromagnetic absorption makes the material extremely potential for application in multifunctional nano-micro electromagnetic devices.

A multi-functional electromagnetic (EM) device is an important pillar for promoting the progress of an intelligent society. Herein, a ZIF-67 nanoneedle array assembled on a nickel substrate is used as a precursor to construct a C/Co3O4 nanoarray via a simple thermal treatment approach, integrating the two functions of EM and thermal shielding. Its unique three-dimensional porous structure and integrated components endow this material with an average shielding efficiency of 99.62% and a maximum temperature difference of about 25 K. In addition, this skeleton structure features light weight, low density and small cost, which can be utilized to construct wearable devices to protect human beings from EM and thermal radiation. This study furnishes a novel horizon for the design and construction of multi-functional and wearable EM devices, and promotes the development of the EM field and the progress of multi-disciplinary technologies.

TiO2 is not among the traditional electromagnetic (EM) absorbing material candidates owing to its poor response in the EM wave region. Although the EM wave absorption performance can be improved by hybrid and/or hydrogenated TiO2, the difficulty and risk of the experimental process are increased. Herein, rutile TiO2 nanorod was successfully prepared by two-step method. The analysis of dielectric properties exhibits that rutile TiO2 nanorod has excellent charge storage capacity. The results of EM wave absorbing performance show that impedance matching caused by anomalous resonance leads to frequency selective absorption. Such anomalous resonance is due to the resonant polarization of ionic clusters formed by oxygen ions and titanium ions. Moreover, metastructure design shows that the EM absorption frequency and the EM wave absorption bandwidth can be tuned through the design of metamaterial. Our founding will broaden the field of vision for the design of EM wave absorbing materials in the future.

BACKGROUND A hybrid operating room (Hybrid-OR) is a surgical theatre that combines a conventional operating room with advanced medical imaging devices. There are still plenty of limitations when endovascular treatment or microsurgical treatment is used individually to treat large or giant carotid-ophthalmic aneurysms. AIM To explore and summarize the technical features and effectiveness of the application of a Hybrid-OR in managing major intracranial carotid-ophthalmic aneurysms. METHODS The Department of Neurosurgery treated 12 cases of large or giant intracranial carotid-ophthalmic aneurysms between March 2013 and December 2019 in a Hybrid-OR. All cases were treated with clipping and parent vessel reconstruction. RESULTS With the assistance of the Hybrid-OR, the rate of incomplete intraoperative aneurysm clipping decreased from 25% (3/12) to 0%, while the rate of vessel stenosis decreased from 16.7% (2/12) to 8.35% (1/12). In terms of thromboembolic events, ischemic infarction complication occurred in only one patient, and none of the patients experienced embolic infarction complications. All 12 patients were followed for an average of 3 years, and no aneurysms recurred. The postoperative recovery was evaluated with the modified Rankin Scale (mRS): 11 patients showed no symptoms (mRS = 0), 1 patient showed slight disability (mRS 1-2), and none of the patients had severe disability (mRS = 5) or died (mRS = 6). CONCLUSION The Hybrid-OR provides new ideas for the surgical clipping of large or giant intracranial carotid-ophthalmic aneurysms and decreases the rate of intraoperative vessel stenosis and unsuccessful clipping.

BACKGROUND Facial cosmetic procedures become popular for people with a desire to have a younger appearance, and cosmetic technology has developed rapidly over the past several decades. However, increasing complications related to cosmetic injections have been reported, and infection is one of the most serious problems and can cause anxiety and facial injury. We here report a case of Majocchi's granuloma (MG) caused by Trichophyton rubrum after facial injection of hyaluronic acid. CASE SUMMARY A 37-year-old woman presented to our hospital with a history of red papules, nodules, and abscesses on her left zygomatic arch for 2 mo. She had received a cosmetic injection of hyaluronic acid on the left side of her face prior to the appearance of the lesions. MG caused by Trichophyton rubrum after facial injection of hyaluronic acid was diagnosed based on morphology and molecular biological identification. In vitro antifungal susceptibility testing was conducted according to the Clinical and Laboratory Standards Institute M38-A2 method. Minimal inhibitory concentrations were used to evaluate the antifungal susceptibility. The antifungal agents and their minimal inhibitory concentrations for the strain were terbinafine (< 0.5 μg/mL), itraconazole (0.06 μg/mL), amphotericin B (0.25 μg/mL), fluconazole (32 μg/mL), voriconazole (0.125 μg/mL), posaconazole (0.125 μg/mL), and isavuconazole (0.06 μg/mL). We initially administered 250 mg/d oral terbinafine for 2 mo, but the patient still had painful papules, nodules and abscesses on her face. Then, we adjusted the treatment to itraconazole 400 mg/d for 8 wk based on the in vitro antifungal susceptibility testing results. The skin lesions improved significantly, and there was no recurrence during follow-up. CONCLUSION This case revealed that facial injection of hyaluronic acid may cause serious MG. Antifungal susceptibility testing should be considered in the treatment of MG caused by Trichophyton rubrum.

The fragility fracture discriminative ability of radius quantitative ultrasound (QUS) was evaluated in a systematic review of 13 studies, including 16,681 individuals and 1296 fractures. The radial speed of sound (SOS) per standard deviation (SD) decrease contributed to an increased risk of total and hip fracture by 32% and 66% in women. Osteoporotic fracture, as a devastating consequence of osteoporosis, brings severe socio-economic burden. The availability of dual-energy X-ray absorptiometry (DXA), as the gold standard of diagnosis, was quite limited in remote areas. Radius QUS measured by SOS shows potential in fracture discriminative ability where DXA equipment is not available. This study aimed to provide a comprehensive evaluation of the association between radius QUS and fracture risk. A detailed article search was carried out on PubMed, EMBASE, Cochrane Libraries, CNKI, Wan-Fang database, VIP, and SinoMed for studies published between January 1980 and February 2020. We determined the estimated relative risk (RR) for fracture per each radial SOS SD decrease. A meta-analysis of studies was performed under the random-effects model. A total of 16,681 individuals were included in this review. Among the participants, 5892 were male and 10,789 were female. A total of 1296 cases of fragility fracture were included. With each SD decrease in radial SOS, the risk of overall fragility fracture and hip fracture was increased by 21% and 55%, respectively. Particularly, the risk was increased by 32% and 66% for women. The association was even stronger for postmenopausal women. Radius QUS showed great potential as an effective tool for fracture risk evaluation, especially for women.

Aim: To evaluate the clinical value of abnormal laboratory results of multiple organs in patients with coronavirus disease 2019 (COVID-2019) and to help clinicians perform correct treatment. Results: Elevated neutrophil-to-LYM ratio (NLR), D-dimer(D-D), interleukin (IL)-6, IL-10, IL-2, interferon-Y, and age were significantly associated with the severity of illness. However, significant and sustained decreases were observed in the LYM subset (p

Background Breast cancer metastasis is the main problem that affects the therapy and prognosis of breast cancer patients. Studies have indicated the role of microRNAs in breast cancer regulation, but the mechanisms are largely unknown. Methods In this study, we determined the expression of microRNA-30c-5p (miR-30c-5p) and coactosin-like protein 1 (COTL1) gene in breast cancer tissues, and revealed their effects on breast cancer metastasis regulation. Breast cancer and paracancerous tissues were collected. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to analyze the expression of miR-30c-5p and COTL1, and breast cancer cell line (MCF-7) was employed to verify the relationship between miR-30c-5p and COTL1. Western blot analysis and immunofluorescence were used for proteins analysis and microfilament observation, respectively. A dual-luciferase reporter gene was used for microRNA-gene interaction assay. Results The results showed that the expression of miR-30c-5p decreased, while the expression of COTL1 increased in breast cancer tissues. The results of luciferase reporting gene assay showed that, COTL1 was the target of miR-30c-5p. After miR-30c-5p was upregulated, the expression of COTL1 was reduced, microfilament arrangement was in disorder, and cell migration ability was inhibited. After miR-30c-5p was downregulated, the expression of COTL1 was increased, and the cell migration ability was enhanced. COTL1 protein expression levels were significantly higher in cancer tissues with lymph node metastasis. Conclusions These findings indicate that miR-30c-5p/COTL1 pathway regulates breast cancer metastasis and can be used as a potential therapy target.

Background Hepatocellular carcinoma (HCC) is one of the most frequent cancers in the world. In this study, differentially expressed genes (DEGs) between tumor tissues and normal tissues were identified using the comprehensive analysis method in bioinformatics. Materials and Methods We downloaded 3 mRNA expression profiles from the Gene Expression Omnibus database to identify DEGs between tumor tissues and adjacent normal tissues. The Gene Ontology, Kyoto Encyclopedia of Genes and Genomes pathway analysis, protein-protein interaction network was performed to understand the function of DEGs. OncoLnc, which was linked to The Cancer Genome Atlas survival data, was used to investigate the prognostic values of hub genes. The expression of selected hub genes was validated by the quantitative real-time polymerase chain reaction. Results A total of 235 DEGs, consisting of 36 upregulated and 199 downregulated genes, were identified between tumor tissue and normal tissue. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis results showed the upregulated DEGs to be significantly enriched in cell division, mid-body, ATP binding and oocyte meiosis pathways. The downregulated DEGs were mainly involved in epoxygenase P450 pathway, extracellular region, oxidoreductase activity and metabolic pathways. Ten hub genes, including Aurora kinase A, Cell division cycle 20, formiminotransferase cyclodeaminase, UBE2C, Cyclin B2, pituitary tumor-transforming gene 1, CDKN3, CKS1B, Topoisomerase-II alpha and KIF20A, were identified as the key genes in HCC. Survival analysis found the expression of hub genes to be significantly correlated with the survival of patients with HCC. Conclusions The present study identified hub genes and pathways in HCC that may be potential targets for diagnosis, treatment and prognostic prediction.

Background A hybrid operating room (hybrid-OR) is a surgical space that combines a conventional operating room with advanced medical imaging devices. Aim To explore and summarize the technical features and effectiveness of the application of a hybrid-OR in dealing with spinal dural arteriovenous fistulas (SDAVFs). Methods Eleven patients with SDAVFs were treated with the use of a hybrid-OR at the Department of Neurosurgery of our hospital between January 2015 and December 2018. The dual-marker localization technique was used in the hybrid-OR to locate the SDAVFs and skin incision, and the interoperative digital subtraction angiography (DSA) technique was used before and after microsurgical ligation of the fistulae in the hybrid-OR to verify the accuracy of obliteration. The patients were followed for an average of 2 years after the operation, and the preoperative American Spinal Cord Injury Association (ASIA) score and postoperative ASIA score at 6 mo after the operation were compared. Results The location and skin incision of the SDAVFs were accurately obtained by using the dual-marker localization technique in the hybrid-OR in all patients, and there were no cases that required expansion of the range of the bone window in order to expose the lesions. Intraoperative error obliteration occurred and was identified in two patients by using the intraoperative DSA technique; therefore, the findings provided by the intraoperative DSA system significantly changed the surgical procedure in these two patients. With the assistance of the hybrid-OR, the feeding artery was correctly ligated in all cases, and the intraoperative error obliteration rate decreased from 18.2% (2/11) to 0%. All 11 patients were followed for an average of 2 years. The ASIA score at 6 mo after the operation was significantly improved compared with the preoperative ASIA score, and there were no patients with late recurrence during the follow-up. Conclusion Compared with intra-arterial embolization for the treatment of SDAVFs, hybrid-ORs can solve the problem of a higher incidence of initial failure and late recurrence. Compared with direct occlusion of SDAVFs in microsurgery, hybrid-ORs can take advantage of the intraoperative DSA system for locating the shunt and verifying the obliteration of fistulae in order to reduce the error obliteration rate. At this point, our experience suggests that the safety and ease of use make hybrid-ORs combined with microsurgery and intraoperative DSA systems an attractive modality for dealing with SDAVFs.

In Singapore, the use of traditional Chinese medicine (TCM) alongside Western medicine (WM) is common. There are risks of adverse herb-drug interactions when taken concurrently. Current literature suggests that TCM use is not regularly reported to WM doctors in Singapore, but the underlying reasons are not understood.A cross-sectional study was conducted across Singapore by administering questionnaires to TCM-using patients and WM-practising general practitioners (GPs). The questionnaire examined the following themes: (1) demographics and TCM use pattern; (2) respondents' (patients and GPs) knowledge and beliefs about TCM and the factors influencing the discussion of TCM during the WM consultation; and (3) respondents' qualitative suggestions to increase disclosure rate.A total of 484 patients and 334 GPs were surveyed. Factors associated with patients' initiation of TCM discussion include length of consultation (odds ratio [OR]: 2.1; P 0.001), comfort level in discussing TCM (OR: 1.6; P 0.001) and belief in importance of discussion (OR: 1.4; P = 0.017). Doctor's initiation of discussion (74%) was the top patient-ranked factor influencing their discussion of TCM. For doctors, knowledge of TCM indications (OR: 2.2; P 0.001), belief in importance of discussion (OR: 2.1; P 0.001) and comfort level in discussing TCM (OR: 1.9; P = 0.001) were associated with their initiation of TCM use discussion. Possible WM-TCM interactions (58%) was the top doctor-ranked factor influencing their discussion of TCM.The discussion of TCM in a WM setting is multifactorial. Interventions include doctors' active screening for TCM use in patients and equipping doctors with TCM knowledge. Improving communication between patients and doctors is key to avoiding harmful herb-drug interactions.

Different from an arch bridge, the load-carrying capacity of a box structure mainly depends on the bending capacity of corrugated steel. This paper explores the mechanical properties of a corrugated steel box bridge. The mechanical properties of a 13 m span corrugated steel box bridge under static and dynamic loads were tested. Three static load conditions were tested, and four dynamic load conditions were tested, including 20 km/h, 40 km/h, 60 km/h, and 80 km/h. Through the analysis of section strain, vault displacement, dynamic strain, and internal force, the following conclusions can be drawn: (1) when the static load changes from the right arch foot and vault to the left arch foot, the strain value of each measuring point continues to increase, which may be caused by the accumulation of deformation due to the adjustment of the stress state of the soil and corrugated steel caused by loading; (2) the displacement change in the test is more sensitive than the strain change; (3) the vault strain reaches the maximum value at a specific speed of 60 km/h. This is related to the structural resonance caused by vehicle operation, and the natural frequency of the corrugated steel box bridge can be determined by a field vehicle dynamic load test; (4) the damping value of an embedded corrugated steel bridge is large, and the energy dissipation capacity is strong, which is very beneficial to structural earthquake resistance and to reducing the structural resonance under traffic load; (5) the dynamic increasing strain coefficient is less than 1, which means that the strain caused by a dynamic load is far less than that caused by a static load, and it reaches the maximum value at a certain speed (60km/h); (6) the maximum bending stress and maximum axial stress of the corrugated steel box bridge tested in this paper are basically the same, which indicates that the axial stress of the box structure cannot be ignored. However, the box structure design method proposed in the CHBDC code does not consider the axial stress, so it is necessary to further improve the box structure design method; (7) most of the axial force of a box corrugated steel bridge is tensile force. The pavement structure layer has an effect on the overall performance of the corrugated steel box bridge, which is similar to the decompression plate: it makes the overall stress (I ∼ V section) more uniform and the bending moment smaller.

Background & aims Hepatitis B vaccine has been included in the infant immunization schedule since 1991 in the US. We aimed to assess its effectiveness against hepatitis B virus (HBV) infection and its impact on mortality. Approach & results The study population was participants aged 6+ years with HBV vaccination history and an HBV serologic testing from National Health and Nutrition Examination Survey, 1999-2018. Participants aged 18+ years with linked mortality records from 1999-2014 were followed for mortality analysis. Multivariable logistic regression was used to compute vaccine effectiveness (VE) overall, by year of birth, and age. Cox regression was used to estimate hazards ratios (HRs) for all-cause, cancer-related, and cardiovascular-related mortality. A total of 64107 participants were included in the main analysis with 29600 (40.7%) completed HBV vaccine (>=3 dose, vaccinated). The highest vaccination uptake was found among those born after 1991 at 86.5%. Vaccinated participants had higher prevalence of vaccine-induced immunity than unvaccinated (47.2% vs 7.4%). Among those born after 1991, VE was found at 58% (95% CI, 18%-79%) overall and 85% for those aged >=20 years (mean age, 22), whereas no effect was found among those born prior to 1990. HBV vaccination was associated with reduced risk of all-cause mortality (HR=0.78, 95% CI, 0.68-0.90) and cancer-related mortality (HR=0.76, 95% CI, 0.58-1.00) but not for cardiovascular-related mortality. Conclusion In universal infant vaccination era, HBV vaccine showed substantial effectiveness against HBV infection and maintained strong protection for 20 years. It was also associated with reduced risk of all-cause and cancer-related mortality.

Purpose: To reviewed our measures and other experiences associated with the treatment of glaucoma patients during the 2019 novel coronavirus disease (COVID-19) outbreak . Methods: Measures consistent with the clinical situation and the type of glaucoma were implemented in each case. Results: Consultation for treatment was provided through a WeChat glaucoma patient group. In our survey, 58.5%patients indicated an increase in negative emotions during the outbreak, and psychological counseling was provided frequently. Difficulties in purchasing eye drops were reported by 79.2% of glaucoma patients, so an online medicine supply system was set up and eyedrops from the pharmacy or hospital pharmacy were mailed to the patients. Phacoemulsification with goniosynechialysis was performed in7acute primary angle-closure glaucomapatients (11eyes) who experienced sustained high IOP(onset time, 12-65d). The IOP decreased significantly after the operation(t=7.895，PConclusion: Effective measures can relieve thepsychological pressure and intraocular symptoms in glaucoma patientsin epidemic outbreak areas.

Wenqiang Wang,1,&ast; Jia He,1,&ast; Yunhua Hu,1 Yanpeng Song,2 Xianghui Zhang,1 Heng Guo,1 Xinping Wang,1 Mulatibieke Keerman,1 Jiaolong Ma,1 Yizhong Yan,1 Jingyu Zhang,1 Rulin Ma,1 Shuxia Guo1,3 1Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China; 2Department of Social Work, The First Affiliated Hospital of Shihezi University Medical College, Shihezi, Xinjiang, People’s Republic of China; 3Department of NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, The First Affiliated Hospital of Shihezi University Medical College, Shihezi, Xinjiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shuxia GuoDepartment of Public Health, The Key Laboratory of Preventive Medicine, Building No. 1, Shihezi University School of Medicine, Suite 721, Beier Road, Shihezi, 832000, Xinjiang, People’s Republic of ChinaTel +86-1800-9932-625Fax +86-993-2057-153Email gsxshzu@sina.comRulin MaDepartment of Public Health, The Key Laboratory of Preventive Medicine, Building No. 1, Shihezi University School of Medicine, Suite 816, Beier Road, Shihezi, 832000, Xinjiang, People’s Republic of ChinaTel +86-1330-9930-561Fax +86-993-2057-153Email marulin@shzu.edu.cnBackground: We aimed to identify the relationship between metabolically healthy obesity (MHO), a special subtype of obesity, and the incidence of cardiovascular disease (CVD) in rural Xinjiang.Methods: Body mass index (BMI) and the Joint Interim Statement criteria were utilized to define obesity and metabolic status, respectively. A baseline survey was conducted between 2010 and 2012. The cohort was followed-up until 2017, including 5059 participants (2953 Uyghurs and 2106 Kazakhs) in the analysis.Results: During 6.78 years of follow-up, 471 individuals developed CVD, 10.8% (n=545) of whom were obese, and the prevalence of MHO and MHNW was 5.2% and 54.5%, respectively. Compared with metabolically healthy normal weight subjects, the subjects with MHO had an increased risk of CVD (hazard ratio [HR]=1.76, 95% confidence interval [CI]: 1.23− 2.51), while the metabolically unhealthy obesity (MUO) group had an even higher risk (HR=3.80, 95% CI: 2.87− 5.03). Additionally, there were sex differences in the relationship between BMI-metabolic status and incident CVD (Pinteraction =0.027). Compared with the subjects with MHO, those with MUO had an increased risk of CVD (HR=1.84, 95% CI: 1.26− 2.71).Conclusion: MHO was associated with a high risk of CVD among adults in rural Xinjiang. In each BMI category, metabolically unhealthy subjects had a higher risk of developing CVD than did metabolically healthy subjects.Keywords: metabolically healthy obesity, cardiovascular disease, rural areas, epidemiology

Background: To estimate the transition probabilities of esophageal cancer（EC） and its precancerous lesions by Markov model, which could provide important information for EC screening about choosing reasonable screening and follow-up intervals.Methods: The transition probabilities among pathological stages were estimated by establishing Markov models for the natural history of EC and repeatedly adjusting and calibrating Markov models by comparing the modeled incidence and distributions of pathological stages (alone or combined) with observed data in real-world condition. Results: In one year, the probabilities were 0.024, 0.05, 0.12 for people from health state progressing to mild dysplasia (mD), mild dysplasia (mD) to moderate dysplasia (MD), and moderate dysplasia (MD) to severe dysplasia/carcinoma in situ (SD/CIS), respectively. The age-specific transition probabilities were 0.08~0.18 for severe dysplasia/carcinoma in situ (SD/CIS) progressing to intramucosal carcinoma(IC), 0.4~0.87 for intramucosal carcinoma (IC) to submucosal carcinoma (T1N0M0) (SC), and 0.2~0.85 for submucosal carcinoma (T1N0M0) (SC) to invasive carcinoma (INC). The progression probabilities increased with age and the severity of the disease. Based on the estimated transition probabilities, we predicted the incidence of EC and distributions of its pathological stages. Comparisons between modeled results with observed data confirmed the validation of our transition probabilities.Conclusions: An esophageal cancer transition model in high-risk areas of China has been established with validity. It could be a point of reference for further economic evaluation and policy formulation of esophageal cancer screening.

Objective The aim of this study was to identify and validate ferroptosis-related markers in ulcerative colitis (UC) to explore new directions for UC diagnosis and treatment. Methods We screened UC chips and ferroptosis-related genes from the Gene Expression Omnibus (GEO), FerrDb, and GeneCards databases. The differentially expressed genes (DEGs) and ferroptosis-related DEGs between the UC group and normal controls were analyzed using bioinformatics methods. Enrichment analysis, protein–protein interaction analysis, and hub genes were screened. Peripheral blood chip and animal experiments were used to validate the ferroptosis-related hub genes. Finally, hub gene–transcription factor, hub gene–microRNA (miRNA), and hub gene–drug interaction networks were constructed. Results Overall, 26 ferroptosis-related DEGs were identified that were significantly enriched in energy pathways and metabolism. We identified ten ferroptosis-related hub genes from the protein–protein interaction network: IL6, PTGS2, HIF1A, CD44, MUC1, CAV1, NOS2, CXCL2, SCD, and ACSL4. In the peripheral blood chip GSE94648, CD44 and MUC1 were upregulated, which was consistent with the expression trend in GSE75214. Animal experiments showed that CD44 expression was significantly increased in the colon. Conclusions Our findings indicate that CD44 and MUC1 may be ferroptosis-related markers in UC.

Thalidomide induces γ-globin expression in erythroid progenitor cells, but its efficacy on patients with transfusion-dependent β-thalassemia (TDT) remains unclear. In this phase 2, multi-center, randomized, double-blind clinical trial, we aimed to determine the safety and efficacy of thalidomide in TDT patients. A hundred patients of 14 years or older were randomly assigned to receive placebo or thalidomide for 12 weeks, followed by an extension phase of at least 36 weeks. The primary endpoint was the change of hemoglobin (Hb) level in the patients. The secondary endpoints included the red blood cell (RBC) units transfused and adverse effects. In the placebo-controlled period, Hb concentrations in patients treated with thalidomide achieved a median elevation of 14.0 (range, 2.5 to 37.5) g/L, whereas Hb in patients treated with placebo did not significantly change. Within the 12 weeks, the mean RBC transfusion volume for patients treated with thalidomide and placebo was 5.4 ± 5.0 U and 10.3 ± 6.4 U, respectively (P β0/β0 and HBS1L-MYB (rs9399137 C/T, C/C; rs4895441 A/G, G/G) genotypes. These results demonstrated that thalidomide is effective in patients with TDT.

PurposeDipeptidylpeptidase-4 (DPP-4) inhibitors, including linagliptin, alogliptin, saxagliptin, sitagliptin, and vildagliptin, are used for the treatment of type 2 diabetes mellitus (T2DM) patients in China. This study assessed the economic outcomes of different DPP-4 inhibitors in patients with T2DM inadequately controlled with metformin in the Chinese context.Materials and MethodsIn this study, the validated Chinese Outcomes Model for T2DM (COMT) was conducted to project economic outcomes from the perspective of Chinese healthcare service providers. Efficacy and safety, medical expenditure, and utility data were derived from the literature, which were assigned to model variables. The primary outputs of the model included the lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). One-way and probability sensitivity analysis was conducted to assess the potential uncertainties of parameters.ResultsOf the five competing strategies, alogliptin 25 mg strategy yielded the most significant health outcome, which associated with improvements in discounted QALY of 0.007, 0.014, 0.011, and 0.022 versus linagliptin 5 mg, saxagliptin 5 mg, sitagliptin 100 mg and vildagliptin50 mg, respectively. The sitagliptin 100 mg strategy was the cheapest option. The ICER of alogliptin 25 mg against sitagliptin 100 mg strategy was $6,952 per additional QALY gained, and the rest of the strategies were dominated or extended dominated. The most influential parameters were the cost of DPP-4 inhibitors and their treatment efficacy.ConclusionsThese results suggested that alogliptin was a preferred treatment option compared with other DPP-4 inhibitors for Chinese patients whose T2DM are inadequately controlled on metformin monotherapy.

Background: The use of oviposition attractants is a promising approach to control populations of mosquito vectors at the source; however, the knowledge on oviposition stimulation in Aedes albopictus is very limited. In recent years, tea bags have been proven to attract Aedes aegypti to lay eggs, but the sources of tea are wide and varied; moreover, the factors and mechanisms in tea bags that attract mosquitoes remain unclear.Methods: The effects of three kinds of Chinese tea, nonfermented, fully fermented and postfermented, were comparatively evaluated for their ability to attract mosquito oviposition at dose of 5g/L, 1.5g/L and 0.5g/L, respectively. The attractants in the Liu-pao tea infusion were isolated with gas chromatography–mass spectrometry (GC-MS).Results: Among the three types of fermented teas, the Guangxi Liu-pao tea infusion was a successful oviposition attractant for Ae. albopictus at all the dose tested, and the average OAIs of 5 g/L Liu-pao tea soaked for 7 d and 14 d were 0.73 and 0.67, respectively. Further, in one month of soaking 0.5g/L Liu-Pao tea, the average oviposition activity indexes (OAIs) for Ae.aegypti of soaking for 21 d and 28 d were 0.89 and 0.63, respectively. Functional analyses showed that the compound cedrol at 1 mg/L tested for Ae. albopictus, the average OAI was 0.38.Conclusion: Liu-pao tea can effectively attract Ae. albopictus to lay eggs, and cedrol is one of the ingredients attracting Aedes mosquitoes to lay eggs. These results shed light on the development of Aedes mosquito oviposition attractants and will help to develop innovative monitoring and prevention strategies for Aedes-borne diseases.

Background and Aims Esophageal squamous cell cancer (ESCC) is one of the leading malignant cancers with a high incidence and mortality. Exploring novel serum biomarkers will help improve the management and monitoring of ESCC. Methods In the present study, we first used a ProcartaPlex Array to screen for serum proteins that were increased in 40 ESCC patients compared with matched normal controls; we found that eight proteins (IL‐2, IL‐5, IP‐10, IL‐8, eotaxin, TNF‐α, HGF, and MIP‐1b) had higher serum levels in ESCC patients than in normal controls. We further verified the clinical relevance of the candidate biomarkers with a larger sample of sera. Results In the 174 tested ESCC patients and 189 normal controls, the serum levels of eotaxin and IP‐10 were significantly higher in patients than in normal controls (p = 0.0038, 0.0031). In particular, these two proteins were also elevated in the sera of patients with early‐stage (0‐IIA) ESCC (p = 0.0041, 0.0412). When combining CEA and CYFRA21‐1 (in use clinically) with eotaxin or IP‐10, the effectiveness of detecting ESCC was superior to that of CEA and/or CYFRA21‐1 alone. Moreover, the serum level of eotaxin dropped significantly after surgical resection of primary tumors compared with that in preoperative ESCC samples (p, Serum samples from 40 ESCC patients and 40 normal controls were used to screen protein candidates by using ProcartaPlex Array in the biomarker discovery stage. The diagnostic values of the candidate IL‐2, IL‐5, IP‐10, IL‐8, eotaxin, TNF‐α, HGF, MIP‐1b using ELISA were further evaluated in 363 serum samples in the biomarker assessment stage and were finally evaluation value of protein panels for the detection and therapy monitoring of ESCC.

Xiaopeng Cui,1,2,* Wen-Qiang Xin,1,* Bangyue Wang,1 Yan Zhao,1 Changkai Hou,1 Shifei Cai,1 Chao Peng,1 Zhen Wang,1 Jian Li,1 Linchun Huan,3 Lei Chen,2 Xinyu Yang1 1Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Department of Neurosurgery, Tianjin Fifth Central Hospital, Tianjin, People’s Republic of China; 3Department of Neurosurgery, Linyi People’s Hospital, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xinyu YangDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Medical University, 154 Anshan Road, Peace Zone, Tianjin, 300041, People’s Republic of ChinaEmail yangxinyu@tmu.edu.cnLei ChenDepartment of Neurosurgery, Tianjin Fifth Central Hospital, 41 Zhejiang Road, Binhai New Area, Tianjin, 300450, People’s Republic of ChinaEmail chenlei1130@163.comObjective: Several studies have reported that single-nucleotide polymorphisms (SNPs) of the CDKN2A/CDKN2B gene on chromosome 9p21.3 are associated with increased risk of intracranial aneurysm (IA). However, the association between IAs and SNPs of CDKN2A/CDKN2B in Chinese Han people is yet to be evaluated. This study examined the association of the SNPs rs10811661 and rs4977574 with IA in the Chinese Han population.Methods: A total of 595 IA patients and 600 sex- and age-matched controls were enrolled in the study. Peripheral blood was collected and stored at – 80°C until use. CDKN2A/CDKN2B was identified using polymerase chain reaction–ligase detection reaction. SNP genotyping was performed for rs10811661 and rs4977574 using a MassArray system. Associations between these two SNPs and IAs was tested with χ2 or Fisher’s exact tests and multivariate logistic regression.Results: rs10811661 and rs4977574 were significantly associated with IA. The frequency of rs10811661-T in IA was higher than in controls (OR 1.26, 95% CI 1.07– 1.49; P< 0.01). There was no significant difference in frequency of haplotype between control subjects and IA patients.Conclusion: rs10811661 and rs4977574 on 9p21.3 were strongly associated with genetic susceptibility to IA in the Chinese Han population, which emphasizes a need for further investigation.Keywords: intracranial aneurysm, CDKN2A/CDKN2B gene, Chinese Han population, SNP

Background The morbidity of knee arthritis is increasing among aged people and total knee arthroplasty has been its mainstream treatment to date. Postoperative rehabilitation is an important part of the procedure. However, the intense pain during the functional exercise involved has always been a challenge for both patients and health care professionals. The aim of this study is to test the analgesic effect of a mixture of nitrous oxide/oxygeb (1:1) inhalation for patients who are doing functional exercise 1 month after total knee arthroplasty. Methods/design This double-blind, randomized, placebo-controlled study will be implemented in the Rehabilitation Department in the General Hospital of Ningxia Medical University. Patients aged between 50 and 75 years who underwent a primary unilateral total knee arthroplasty are eligible for inclusion. The key exclusion criteria include: epilepsy, pulmonary embolism, intestinal obstruction, aerothorax. The treatment group (A) will receive a pre-prepared nitrous oxide/oxygen mixture plus conventional treatment (no analgesics), and the control group (B) will receive oxygen plus conventional treatment (no analgesics). Patients, physicians, therapists, and data collectors are all blind to the experiment. Assessments will be taken immediately after functional exercise begins (T0), 5 min (T1) after functional exercise begins, and 5 min after functional exercise has finished (T2). Patients will be randomly allocated between a treatment group (A) and a control group (B) in a ratio of 1:1. Primary outcome, including pain severity in the procedure, will be taken for each group. Secondary outcomes include blood pressure, heart rate, oxygen saturation, side effects, knee joint range of motion, Knee Society Score (KSS), rescue analgesia need, and satisfaction from both therapists and patients. Discussion This study will focus on exploring a fast and efficient analgesic for patients who are doing functional exercise after total knee arthroplasty. Our previous studies suggested that the prefixed nitrous oxide/oxygen mixture was an efficacious analgesic for the management of burn-dressing pain and breakthrough cancer pain. The results of this study should provide a more in-depth insight into the effects of this analgesic method. If this treatment proves successful, it could be implemented widely for patients doing functional exercise in the rehabilitation department. Trial registration ChiCTR-INR-17012891. Registered on 6 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3472-7) contains supplementary material, which is available to authorized users.

Aim: The purpose of this study was to conduct a meta-analysis to systematically compare the clinical outcomes between knee barbed sutures (KBS) and knee traditional sutures (KTS) for wound closure in total knee arthroplasty (TKA). Method: This study retrieved potential academic articles comparing the clinical outcomes between KBS and KTS in TKA from the MEDLINE database, the PubMed database, the EMBASE database and the Cochrane Library. The reference articles for the identified studies were carefully reviewed to ensure that all available documents were represented in the study. Results: A total of 14 articles (eight randomized controlled trials [RCTs], six non-RCTs) were involved in our study. The overall participants of barbed Sutures group were 1255, whereas it was 1247 in the traditional sutures. Our meta-analysis showed that KBS is preferable for wound closure of TKA as its shorter lower total cost (weighted mean difference [WMD] = -276.281, 95% CI = -480.281 to -72.280; p = 0.008) and wound closure time (WMD = -4.895,95% CI = -6.105 to -3.685; p < 0.001). However, there was no difference in any complications (p = 0.572), wound complications (p = 0.550), superficial infection (p = 0.918), deep infection (p = 0.654), wound dehiscence (p = 0.649), suture abscess (p = 0.939), arthrofibrosis (p = 0.970), needle sticks (p = 0.158), suture breakage (p = 0.371) and knee society scores (KSS; p = 0.073). Conclusion: The use of KBS in TKA is associated with significantly shortened wound closure times and total closure cost without increased risk of intraoperative needle sticks and suture breakage and postoperative incision complications. Given the relevant possible biases in our study, adequately powered and more RCTs with long-term follow-up are needed to compare the efficacy and safety between KBS and KTS.

The purpose of this study was to evaluate the efficacy of surgical revascularization versus conservative treatment and different surgical modalities, in order to provide evidence for the patient with moyamoya disease (MMD) to choose the appropriate treatment.We comprehensively searched PubMed, Embase, Web of Science, and the Cochrane Library for articles published regarding MMD treatment. If the ITwenty-seven articles were included in the meta-analysis. The surgery group is more advantageous in reducing the risk of future stroke events than conservative treatment in MMD patients (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.20-0.33, P0.001). In addition, the surgical group also had an advantage in terms of increased cerebral perfusion (OR 7.16, 95% CI 3.28-15.64, P0.001) and death due to rebleeding (OR 0.27, 95% CI 0.10-0.72, P0.01). Direct surgery showed a significant efficacy over indirect surgery (OR 2.03, 95% CI 1.32-3.13, P0.01). No obvious difference was found between the direct and indirect bypass subset (OR 0.76, 95% CI 0.51-1.14, P = 0.185). Angiographic results in patients undergoing direct bypass surgery are more pronounced (OR 0.20, 95% CI 0.06-0.67, P0.01).In patients with symptomatic moyamoya disease, bypass surgery is more effective than conservative treatment to prevent future strokes. In surgical patients, direct bypass seems to reduce the risk of stroke more than an indirect bypass.

Objectives The purpose of this study was to conduct a meta-analysis to systematically compare the safety and efficacy of carotid endarterectomy and carotid artery stenting in contralateral carotid occlusion patients who needed reperfusion. Methods This study retrieved potential academic articles comparing results between carotid endarterectomy and carotid artery stenting for patients with contralateral carotid occlusion from the MEDLINE database, the PubMed database the EMBASE database, and the Cochrane Library from January 1990 to May 2018. The reference articles for the identified studies were carefully reviewed to ensure that all available documents were represented in the study. Results Four retrospective cohort study involving 6252 patients with contralateral carotid occlusion were included in our meta-analysis. During 30-day follow-up, there is significant difference in post-procedure mortality (odds ratio (OR) = 0.476, 95% confidence interval (CI) (0.306–0.740), P = 0.001); no significant differences are not found in post-procedure stroke (risk difference (RD) = 0.002, 95%CI (–0.007 to 0.011); P = 0.631), myocardial infarction (RD = 0.003, 95%CI (–0.002 to 0.008); P = 0.301), and transient cerebral ischemia (RD = 1.059, 95%CI (–0.188 to 5.964); P = 0.948). Conclusions Carotid endarterectomy was associated with a lower incidence of mortality compared to carotid artery stenting for patients with contralateral carotid occlusion. Regarding stroke, myocardial infarction, and transient ischemic attack, there was no significant difference between the two groups. More randomized controlled trials and prospective cohorts are necessary to help further clarify the ideal approach for these patients.

Purpose Genetic factors play a vital role in intracranial aneurysm (IA) onset and development. Studying the relationship between IA and the Sox17 polymorphisms in diverse populations is essential for establishing credibility. Patients and methods We collected blood samples derived from a total of 596 sporadic IA patients and 600 individual controls in several medical institutes in China. We used the Sequenom MassArray system for single nucleotide polymorphisms (SNPs) genotyping after DNA extraction. The SNPs data was tested and analyzed in PLINK (version 1.9). Multiple-testing was performed in PLINK to make the statistics more rigorous and accurate. Results We found that the allelic G of rs1072737 (OR=1.303, genomic-control corrected P-value =0.001032) is a risk allele, while the allelic G of rs9298506 (OR=0.7253, genomic-control corrected P-value =0.01559) is a protective allele in Chinese Han people. Conclusion The allelic G of rs1072737 is a risk factor for IA, while the allelic G of rs9298506 serves as a protective factor for IA in Chinese Han people.

MXene, a shining star of two-dimensional (2D) materials, perfectly showcases layered structure, outstanding electrical conductivity, tunable active surface, and excellent mechanical strength, all of which make it extremely attractive in various applications, in particular for the ever growing market of microwave absorption (MA) and electromagnetic interference (EMI) shielding technology. Herein, we introduce the synthetic strategies, structure and properties of MXene-based materials. The current research progresses on the dielectric properties of MXene are comprehensively summarized and analyzed. We objectively overview and evaluate the state-of-the-art in electromagnetic wave absorbing and shielding of MXene-based matrials and dissect the major problems and bottlenecks. In addition, prospective research opportunities are highlighted toward the development of advanced MXene-based materials for MA and EMI shielding.

Background The prevalence of type 2 diabetes in youth is escalating rapidly. We aimed to evaluate the effects of liraglutide on beta-cell function, metabolic productions of oxidative stress, low grade inflammation compared with metformin in young patients with recent onset type 2 diabetes mellitus. Methods Sixty patients were randomly assigned to receive 8-week liraglutide or metformin treatment. Beta-cell function was assessed by modified beta cell function index (MBCI), early phase of insulin secretion index (ΔI30/ΔG30), proinsuin to insulin ratio (P/I) and the insulin area under the curve (AUCins). The expression of 8-OH-dG and 8-iso-PGF2α and hs-C-reactive protein (hs-CRP) were measured as indications of oxidative stress and low grade inflammation. Results After 8 weeks liraglutide treatment, MBCI, ΔI30/ΔG30, AUCins significantly increased, 8-OH-dG, 8-iso-PGF2α, P/I and hs-CRP remarkably reduced. The differences before and after 8-week liraglutide treatment in ΔMBCI (11.1 [2.81, 43.08] vs 0.00 [− 8.16, 10.47], P = 0.017), ΔLNΔI30/ΔG30 (0.44 [0.04, 0.85] vs − 0.09 [− 0.33, 0.36], P = 0.049), ΔAUCins (117 [− 8, 376] vs − 21 [− 314, 109] mIU/L, P = 0.013), ΔP/I (− 0.05 [− 0.09, − 0.03] vs − 0.02 [− 0.04, 0.01], P = 0.026)were remarkably enhanced compared to those of the metformin therapy. The expression of 8-OH-dG, 8-iso-PGF2α and hs-CRP also decreased after 8-week metformin treatment. Conclusions These data demonstrated that liraglutide administration was more effective on ameliorating beta-cell function than metformin treatment in young patients with new-onset type 2 diabetes mellitus. Both liraglutide and metformin could alleviate the level of oxidative stress and attenuate low grade inflammatory, we speculate this effect may not the main mechanism of beta-cell function improvement by liraglutide in diabetic patients. Trial registration Chinese Clinical Trials registry, chiCTR1800018008, Registered 27 August 2018—retrospectively registered.

Impending climate warming is expected to influence plant growth and distribution ranges. However, synchronous comparisons of growth dynamics associated with biotic factors across latitudinal, longitudinal and altitudinal gradients at a single species’ level have received little attention. In the present study, we investigated growth variations (radial and height growth) of Quercus variabilis along latitudinal, longitudinal and altitudinal gradients; meanwhile, the effects of environmental factors (climate, soil and stand conditions) on growth across the three geographical gradients were ranked and apportioned using linear mixed-effects models. Our results indicated that the radial growth of ringwood and latewood increased with latitude, and latewood and height growth decreased with longitude; furthermore, the growth sensitivity to climate were less in the southern and eastern populations than the northern and western. When pooling all sites’ data, we found that climate variables were not solely decisive factors to drive the geographic variations in the growth of Q. variabilis, stand conditions (stand density and total basal area) and soil properties (Ca, Mg, N and N/P) also played important roles in shaping large geographical patterns of the oak growth.

Objective The aim of this study was, first, to ascertain the efficacy of radioiodine therapy (RIT) for Graves’ disease (GD) based on a calculated-dose regime and, second, to determine the value of 99mTc-pertechnetate thyroid scintigraphy in predicting the clinical outcomes of RIT. Methods One hundred and thirty nine consecutive GD patients who underwent RIT using a calculated-dose method in our hospital from January 2015 to September 2015 were retrospectively evaluated. Radioiodine dose was calculated based on the Marinelli's formula. 99mTc-pertechnetate uptake, age, gender, thyroid mass, duration of the disease, previous antithyroid drugs treatment, serum levels of TSH, FT3 and FT4, a positive rate of TPOAb and Anti-TRAb, radioiodine dose and follow-up were evaluated as potential interference factors for RIT success. Results One hundred and eight (77.7%) GD patients including 71 (51.1%) euthyroid and 37 (26.6%) hypothyroid were successful, but 31 (22.3%) remained hyperthyroid (treatment failure). Significant differences were found between the treatment success group and the failure group in 99mTc-pertechnetate uptake (p Conclusion Our study has shown that a calculated radioiodine dose is effective in treating GD patients with a consequent low rate of hypothyroid. A 99mTc-pertechnetate uptake above 18.4% is a significant predictor of treatment failure and these patients should receive a higher radioiodine dose in this scenario.

The miniature high-frequency monolithic crystal filter is developed according to the requirement of model. The main electrical performance of the monolithic crystal filter is better than that of technical specifications, and the parameters of passband bandwidth, insert loss, passband ripple, shape factor, parasitic suppression, stopband attenuation meet the requirements of users.