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The automatic localization of the lumbar region is essential for the diagnosis of lumbar diseases, the study of lumbar morphology, and the surgical planning. Although the existing researches have made great progress, it still faces several challenges. First, the various lumbar diseases and pathologies cause different abnormalities in the lumbar shape and appearance. Second, the numbers of lumbar vertebrae are irregular (some people have an additional vertebra L6). To tackle these challenges, we propose a novel lumbar region localization method based on bone anatomy feature graphs. Specifically, a feature graph (called LS) considering the anatomy of the sacrum and the lumbar vertebra is proposed to locate the inferior boundary of L5 or L6. A feature graph (called TL) considering the anatomy of the thoracic vertebra and the lumbar vertebra is proposed to locate the superior boundary of L1. Extensive experimental analysis is performed on a public available dataset xVertSeg and a private dataset which contains 197 CT scans. The localization results show that the proposed method is robust and can be applied to normal scans, scoliosis scans, deformity scans, hyperosteogeny scans, 6 lumbar vertebrae scans and lumbar implant scans. The Dice and Jaccard coefficients are 98.09 ± 0.84% and 96.27 ± 1.62% respectively.

Life-cycle cost (LCC) theory can be effectively applied to improve the efficiency and quality of power plant equipment and asset management. However, specific aspects of the LCC calculation and evaluation model require further research for practical application. This paper proposes an LCC assessment model for the management of electric power plant equipment during its service life. A membership function method based on fuzzy logic is used to improve the allocation of modernization and overhaul projects to multiple equipment assets. An LCC assessment model and evaluation system for power equipment are proposed and successfully applied to the equipment and project management of a Guangzhou power plant in the China Southern Power Grid, providing a decision-making mechanism that facilitates efficient operation and optimal utilization of power plant equipment and assets.

Aims/Introduction Emerging evidence has indicated that long non‐coding ribonucleic acids play important roles in the development and progression of diabetic retinopathy (DR). It is reported that urothelial carcinoma‐associated 1 (UCA1) is highly expressed in diabetic lymphoendothelial cells and influences glucose metabolism in rats with DR. The aim of the present study was to explore the role of UCA1 in the mechanism of DR. Materials and Methods Gene expression analyses in fibrovascular membranes excised from patients with DR using public microarray datasets (GSE60436). Reverse transcription polymerase chain reaction was carried out to detect UCA1, micro‐ribonucleic acid (miR)‐624‐3p and vascular endothelial growth factor C (VEGF‐C) expressions in the blood of patients and human retinal endothelial cells (HRECs). Furthermore, Cell Counting kit‐8, Transwell assay, and tube formation assay were used to identify biological effects of UCA1 on HRECs proliferation, migration ability and angiogenesis in vitro. Results UCA1 and VEGF‐C were elevated in DR patients and high glucose‐induced HRECs cell lines, whereas miR‐624‐3p was decreased. UCA1 inhibition inhibited proliferation, angiogenesis and migration of HRECs cells under high‐glucose condition. Luciferase reporter assay showed that UCA1 could sponge with miR‐624‐3p, which could directly target VEGF‐C. Finally, we proved a pathway that UCA1 promoted cell proliferation, migration and angiogenesis through sponging with miR‐624‐3p, thereby upregulating VEGF‐C in high‐glucose‐induced HRECs. Conclusions We identified UCA1 as an important factor associated with DR, which could regulate the expression of VEGF‐C by sponging miR‐624‐3p in human retinal endothelial cells. Our results pave the way for further studies on diagnostic and therapeutic studies related to UCA1 in DR patients., In this manuscript, we identified urothelial carcinoma‐associated 1 as a significantly upregulated gene in diabetic retinopathy patients. We proved a pathway that urothelial carcinoma‐associated 1 promoted cell proliferation, migration and angiogenesis through sponging with micro‐ribonucleic acid‐624‐3p, thereby upregulating vascular endothelial growth factor C in high‐glucose‐induced human retinal endothelial cells.

To observe the effects of herb-partitioned moxibustion and ginger-partitioned moxibustion on the growth of colon tumors in rats with colitis-associated colon cancer (CACC), and explore the mechanism of moxibustion intervening CACC through the purinergic receptor P2X ligand-gated ion channel 7 (P2X7R)/signal transducer and activator of transcription 3 (STAT3)/vascular endothelial growth factor (VEGF) pathway. A total of 26 male Sprague-Dawley rats were selected. According to the random number table method, 6 rats were selected as the normal group. The remaining 20 rats were injected intraperitoneally with azoxymethane (AOM) combined with oral dextran sodium sulfate (DSS) to prepare the CACC model. After the model was successfully established, 2 rats were randomly selected for model identification. The remaining 18 rats which were successfully modeled were randomly divided into a model group, a herb-partitioned moxibustion group and a ginger-partitioned moxibustion group, with 6 rats in each group. Moxibustion intervention was performed in the herb-partitioned moxibustion group and the ginger-partitioned moxibustion group at Qihai (CV 6) and bilateral Tianshu (ST 25). Moxibustion was performed twice at each point each time, once a day, at a 1-day interval after 6 consecutive interventions, for a total of 30 interventions. After intervention, the colon tumor load, pathological change and histopathological score were observed. Immunohistochemistry was used to detect the expressions of VEGF, P2X7R, phospho-STAT3 (p-STAT3), and nuclear factor-kappa B p65 (NF-κB p65) proteins in rat colon tissue. Western blot was used to detect the levels of p-STAT3 and NF-κB p65 proteins in rat colon tissue. Compared with the normal group, the colon tumor load and histopathological score in the model group were significantly increased (both P

The pharmacokinetics of levofloxacin mesylate in healthy adult giant panda is unknown. In this study, the pharmacokinetics of levofloxacin after intramuscular administration at a dose of 2 mg/kg and oral administration at a dose of 3 mg/kg in healthy adult giant pandas was determined. Levofloxacin concentrations in plasma were determined using liquid chromatography. In the levofloxacin intramuscular administration group, the absorption and elimination half-lives of the drug were determined to be 0.123 (range: 0.02) hr and 5.402 (range: 0.70) hr, respectively. In the levofloxacin oral administration group, the absorption and elimination half-lives were determined to be 0.325 (range: 0.02) hr and 7.143 (range: 0.63) hr, respectively. Furthermore, the blood-drug concentration of levofloxacin was found to be above 1 μg/ml after 8 hr of intramuscular administration and above 0.5 μg/ml after 12 hr of oral administration. In this study, HPLC conditions and pretreatment methods of plasma samples were optimized and a detection method was established. Our results indicated that in healthy adult giant pandas, levofloxacin was rapidly absorbed and slowly eliminated. This study will therefore provide to be a guide in veterinary research and will be helpful in the rational use of levofloxacin in giant panda.

Background Many studies have described the relationship between kidney stones and stroke, but the results are controversial, so we conducted this meta-analysis to estimate the relationship between kidney stones and the risk of developing stroke. Methods Studies were marked with a comprehensive search of PubMed, EMBASE, Google, and ISI Web of Science databases through 25 March 2020. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a random-effects model or fix-effects model was used to compute the pooled combined risk estimate. Heterogeneity was reported as I2. We performed subgroup and sensitivity analysis to assess potential sources of heterogeneity. Results Eight studies of seven articles involving 3,526,808 participants were included in the meta-analysis. Overall, kidney stones were associated with a moderate risk of stroke incidence (HR, 1.24; 95% CI, 1.11–1.40; I2=79.6%; p=0.000). We conducted a sensitivity analysis by removing the studies that had a high risk of bias. Heterogeneity subsequently decreased significantly, while an increased risk of stroke in patient with kidney stones was again demonstrated (HR, 1.16; 95% CI, 1.11–1.23; I2=28.7%; p=0.000). Stratifying analysis showed that the results were more pronounced for ischemic stroke (HR, 1.14; 95% CI, 1.08–1.22; I2=15.6%; p=0.00) and the follow-up duration ≥10 years (HR, 1.18; 95% CI, 1.10–1.27; I2=31.6%; p=0.003). Conclusions Our meta-analysis suggests that patients with kidney stones may have a modestly increased risk of developing stroke, especially in ischemic stroke. More large-scaled and clinical trials should be done to identify the relative impact of kidney stones on stroke outcomes in the future.

Background Persistent and chronic diarrhea is difficult to treat, and infection is still the main cause. In this study, we investigate the application value of xTAG gastrointestinal pathogen panel (xTAG GPP) multiplex PCR in the early diagnosis of persistent and chronic diarrhea in children and to understand the epidemiology of intestinal diarrhea pathogens. Methods One hundred ninety-nine specimens were collected from Nanjing Children’s Hospital Affiliated to Nanjing Medical University (Nanjing, China). We compared the xTAG GPP multiplex PCR assay with traditional methods (culture, rapid enzyme immunoassay chromatography, and microscopic examination) and performed a statistical analysis. Results The positive rate of the xTAG GPP multiplex PCR assay of diarrhea specimens from 199 patients was 72.86% (145/199). The virus detection rate was 48.7%, and rotavirus A was the most common organism detected (34.67%), concentrated in winter, and was common in children. The second most common organism detected was norovirus GI/GII (20.6%). The positive rate of this bacteria was 40.2%, and Campylobacter (22.11%, 44/199) was most frequently detected. C. difficile toxins A/B and Salmonella was detected in 44 and 17 samples, respectively. Infections with Shigella occurred 4 times, and E. coli O157 was only detected once. Three samples were parasitic (1.51%), two samples were positive for Entamoeba histolytica, and one was positive for Cryptosporidium. Adenovirus 40/41, STEC, ETEC, Giardia, Yersinia enterocolitica and Vibrio cholerae were not detected. In total, 86 (43.2%) infected specimens with a single pathogen were detected. There were 59 coinfections (29.65% of the samples) of viruses and/or bacteria and/or parasites. Coinfections involved 49 double infections (24.62%), 9 triple infections (4.52%) and 1 quadruple infections (0.5%). Norovirus GI/GII was found to have the highest involvement, with 32 coinfections (16.08%). Conclusion The xTAG GPP multiplex PCR assay is simple, sensitive, and specific and can be used as a quick way to diagnose persistent and chronic diarrhea in children.

BACKGROUND The aim of this study was to determine whether higher density screw constructs resulted in better surgical outcomes in patients with scoliosis secondary to Marfan syndrome (MF-S) with large thoracic curves (≥70°). MATERIAL AND METHODS There were 34 MF-S patients who met the inclusion criteria and were evaluated radiographically before surgery, 2 weeks after operation, and at the final follow-up. The mean screw density was taken as the boundary, and patients were categorized as either in the high density (HD) group or the low density (LD) group. Parameters measured included coronal Cobb angle, T5-T12 kyphosis (TK), and T12-S1 lordosis (LL). Additionally, the operation duration, estimated blood loss, screw accuracy, complication rate, and clinical outcomes were compared between the 2 groups. RESULTS The mean screw density of all patients was 1.40±0.15 (range 1.13 to 1.67). Correction rate of the thoracic curve was closely related to the screw density at the concave side (r=0.783, P=0.007). Intergroup comparison showed a significantly higher correction rate of the thoracic coronal curve in HD group (56.59±4.80% versus 44.54±9.61%, P=0.036). At last follow-up, coronal correction loss of >5° occurred in 8 cases (47.1%) in the LD group and 3 cases (17.6%) in the HD group. Both groups demonstrated improvement in each domain of the SRS-22 questionnaire after surgery and no significant intergroup difference was found. CONCLUSIONS The high-density pedicle screw construct contributed to the significantly improved correction rate of thoracic curves in MF-S patients with large thoracic curves (≥70°). Additionally, increasing of pedicle screw number could help to enhance the structural stability and reduce the correction loss during the follow-up period.

In this paper, based on FPGA, a wide-band, high-resolution, low-cost dual-channel fiber laser beat signal demodulation system is studied, which combines mixing technology and Fast Fourier Transform (FFT). It is used to demodulate the frequency difference information of dual-channel laser signal in real time. Based on the principle of optical heterodyne detection, two single-frequency fiber lasers with central wavelengths of 1550.001~1550.601nm output dual-channel laser signals with a wavelength interval of 5~30pm are used to conduct the experiment of beat signal demodulation system. The experiment proves that the circuit can realize realtime detection of beat signal in the frequency band of 0.41~3.45GHz. Frequency resolution up to 7.6kHz.

The harmonics generated by a large number of power electronic equipment in the power grid will seriously affect the measurement accuracy of electric energy measuring instruments. Therefore, in order to determine the anti-harmonic interference performance of electric energy meters, harmonic influence tests are required in the national standards of electric energy meters and the type evaluation outline. As the main standard device used in the harmonic impact test of the electric energy meter, the reference meter has passed the measurement verification, but its verification items do not include the detection of the harmonic measurement performance. In order to ensure the validity of the harmonic impact test of the electric energy meter, it is necessary to test the harmonic measurement performance of the reference meter. This paper designs a set of measurement and detection schemes that uses power comparison method to trace the source of harmonics of reference meters. It has important reference value for improving the accuracy of harmonic measurement and the reliability of electric energy meter type test.

Background Moistening of surgical instruments affects the quality of instrument cleaning, thereby affecting the degree of cross-contamination and in-hospital infection among patients. Surgical instruments should be kept moist immediately after use in order to avoid concentrations of contamination remaining on surgical instrument surfaces. Implementation and pass rates of surgical instrument moistening have been rarely studied. We aimed to investigate the factors affecting implementation and pass rates of surgical instrument moistening. Methods A cross-sectional study was conducted to investigate surgical instrument moistening procedures within 22 clinical departments of the West China Second University Hospital, Sichuan University over 122 days between September and December 2019. We collected data from departmental staff using an interviewer-administrated questionnaire. Data about implementation and pass rates of surgical instrument moistening was analyzed in SPSS20.0. Results Implementation and pass rates of surgical instrument moistening were 57.25% and 31.98%, respectively. Factor analysis showed that implementation rates of moistening were affected by instrument structure (X2 = 143.670; P = 0.001), the number of instruments inside the pack (X2 = 140.135; P = 0.001), and the person responsible for keeping surgical instruments moist (X2 = 8.052; P = 0.005). Correlation analysis showed that instrument structure and the number of instruments inside the pack were negatively correlated with implementation rates of moistening. The more complex the structure and the greater the number of the instruments inside the pack, the lower implementation rates of moistening. Conclusion Implementation and pass rates of surgical instrument moistening were low, and failed to meet the central sterile supply department applicable industrial standard, hence the potential risk of hospital-acquired infection was considerable. Staff that manipulate reusable surgical instruments should be trained to properly moisten the instruments and institutional protocols should be established to ensure standardization and respect of guidelines.

Background: Recent studies suggest that mesenchymal stem cells (MSCs) may have therapeutic potential for both acute myocardial infarction (AMI) and chronic ischemic cardiomyopathy (ICM). However, the rational route of delivery MSC therapy has not reached consensus. We performed a systematic review of clinical trials evaluating the rational route of delivery MSCs for AMI or ICM.Methods: Databases including Embase, PubMed, and Cochrane Central Register of Controlled Trials were searched from inception to February 2021. Studies that examined the use of MSCs in adults with AMI or ICM were eligible. Bias of included studies were assessed by the Cochrane risk of bias tool. The primary outcome was cardiac function assessed by left ventricular ejection fraction (LVEF) and the secondary outcome was cardiac remodeling which was assessed by left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV), we also explored the safety between different routes. Results: 18 studies fulfilled eligibility criteria, which consist of 11 studies evaluated AMI and 7 studies evaluated ICM. In AMI group, only when patients received intracoronary infusion(IC) can improve LVEF (SMD 0.88, 95% CI 0.64-1.12), and there was a decrease in LVEDV&LVESV when administered IC or intravenous infusion (IV). While in ICM group, no significant difference in LVEF was noted no matter administered which route, and transendocardial stem cell injection(TESI) seems to be effective in decreasing LVEDV&LVESV. Safety appeared no difference between different routes. Conclusions: Results from our systematic review suggest that intracoronary infusion seems more effective for MSC’s delivery in AMI group, while in ICM group, TESI better.

BACKGROUND CONTEXT The surgical strategy to decide distal fusion level for Scheuermann kyphosis (SK) is controversial. Some spinal surgeons advocate that instrumentation should end at the first lordotic vertebra (FLV), whereas others recommend extending spinal fusion to the sagittal stable vertebra (SSV). Scheuermann kyphosis has two curve patterns: Scheuermann thoracic kyphosis (STK), with the curve apex above or at T10; and Scheuermann thoracolumbar kyphosis (STLK), with the curve apex below T10. To our knowledge, curve patterns have not been taken into consideration when determining the distal fusion level. PURPOSE This study aims to analyze the clinical and radiographic outcomes, including the distal junctional problems, in pediatric patients with STK and STLK who underwent fusion with different distal fusion levels. STUDY DESIGN This is a retrospective, single-center, institutional review board-approved study. PATIENT SAMPLE A total of 45 consecutive pediatric patients with STK or STLK. OUTCOME MEASURES The following parameters were evaluated: global kyphosis (GK), deformity angular ratio (DAR), correction rate of GK and DAR, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sagittal vertical axis (SVA), T1 pelvic angle (TPA), the distance from the center of the lower instrumented vertebra (LIV) to the posterior sacral vertical line, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and distal junctional kyphosis (DJK). METHODS This work was supported by the National Natural Science Foundation of China (Grant No. 81171672), Nanjing Clinical Medical Center, and Jiangsu Provincial Key Medical Center. Patients with STK were fused to SSV at the distal level (Group STK), whereas patients with STLK were fused to FLV (Group STLK). Whole spine x-rays obtained before surgery, immediately after operation, and at the latest follow-up were evaluated. The radiographic and clinical data were compared between Groups STK and STLK. All patients had a minimum of 2 years of follow-up. RESULTS Before surgery, Groups STK and STLK were comparable in terms of age, gender, body mass index, fusion levels, follow-up time, some radiographic parameters and the 22-item Scoliosis Research Society questionnaire (SRS-22) evaluation. DAR and TLK were significantly smaller, whereas PI was significantly greater, in Group STK than those in Group STLK. Despite different distal fusion strategies, STK and STLK were corrected to an equivalent extent, with similar GK, correction rate, LL, SVA, TPA, PT, and SS immediately after operation and at the final follow-up. The DAR and TLK retained were smaller, whereas the PI retained was greater, in Group STK than STLK after surgery. Distal junctional kyphosis complications were found in five patients with STK curve type. In Group STK, patients with DJK were found to have significantly larger preoperative GK (87.5±7.0 vs. 77.5±9.0, p=.024), correction rate of GK (62.9±10.2% vs. 51.3±8.5%, p=.021), and correction rate of DAR (55.9±4.5% vs. 36.6±13.7%, p=.011) than those without DJK. Pre- and postoperative SRS-22 assessments did not show any significant difference between Groups STK and STLK or between patients with and without DJK. CONCLUSIONS Curve patterns should be taken into attention when determining the optimal distal fusion level in correction surgery for SK. For patients with STLK, relatively shorter fusion stopping at FLV is enough to correct SK with the preservation of more lumbar motility and less development of DJK. For patients with STK, we suggest extending fusion to the SSV, which could restrict more distal junctional problems than fusion to the FLV. Large GK and correction degree might be the associated factors of developing DJK in STK patients.

The rapid growth of fabric images needs fast retrieval for related applications, such as fashion design. The goal of fabric image retrieval is to retrieve and rank relevant fabrics from a large scale fabric database to visually assist users’ online shopping process in e-commerce. Most of existing solutions to this issue are not invariant with respect to 2D similarity or affine transformations, much less to 3D transformations of textured surface. In this paper, we propose a new search method with a shape based local affine invariant texture characteristics. By employing topographic map to represent fabric images, which is a complete, multi-scale and contrast invariant representation, the proposed method first obtains a tree of shapes from the topographic map. Then, a group of statistics is applied on these shapes to acquire a set of features that are invariant to 3D transformations. We finally represent these features combing relations between shapes, and based on the representation the similarity of pairs of fabric images can be estimated. To evaluate the performance of our algorithm, we conducted a series of experiments on a real-world fabric image dataset, and compared the proposed method with other previous ones. Experimental results demonstrate that the time of the proposed method spending in searching is less than 1 second, and meanwhile a higher PR score than others is obtained.

Geriatric patients undergoing mastectomy have a weakened organism and slow recovery of gastrointestinal function after surgery, which may lead to various complications, affect the absorption of intestinal nutrients, and prolong the healing rate of wounds. Therefore, it is necessary to find an effective nursing program to promote the recovery of gastrointestinal function and prevent postoperative complications in elderly patients undergoing mastectomy. With the continuous development and advancement of computer and communication technologies, telecare is gaining more and more attention and has become an important part of medical information technology construction. Falls endanger the elderly and other special populations, especially after a sudden but unassisted fall, which may be life-threatening. Timely fall detection and rescue can win valuable time for treatment and rescue, which is very important to protect users’ health and improve medical monitoring. In order to provide better medical care to the elderly population and reduce the harm caused by falls, this paper will focus on the fall problem of the elderly in telecare. In order to facilitate the detection of falls of the elderly, we design an Android sensor-based data acquisition scheme, using the built-in acceleration sensor in the Android system to collect the human acceleration information, and through the JMS middleware technology, the collected data are transmitted to MATLAB for analysis and processing in real time. This paper preprocesses and synthesizes the collected human body data and visualizes the acceleration changes of various typical daily activities of the human body and breast cancer, then extracts the relevant data features according to the synthesized SVM curve, constructs a pattern recognition algorithm using the extracted features, and verifies the effectiveness of the pattern recognition algorithm through experiments.

Miners face a series of potential safety hazards in underground work, among which the life-saving function of miners' clothing is particularly important. This article investigates the causes of current mine accidents and the impact of the mine environment, analyses the design and research status of miners' uniforms from the perspective of the market and academia, and emphasizes and puts forward the idea of optimizing the design of miners' uniforms through the characteristics of miners' underground operation and the requirements for their protective performance. Based on the 2F (fashion, function) design model, the basic principles of miners' clothing design are summarized. The design of miners' clothing is studied from three design factors: positioning element, structural design and protective fabric. The purpose is to improve miners' clothing for comfort, positioning, life-saving, hygienic, antimicrobial, etc., shorten search and rescue times, and improve rescue times in mining accidents, to increase the survival rate.

Bipolar disorder (BD) may be associated with an increased risk of stroke, but to date, the results of the studies are still controversial. This study aimed to assess the association of BD with stroke incidence and mortality by a meta-analysis. PubMed, EMBASE, the Cochrane library databases, and Web of Science databases were searched from inception to July 2020. We regarded stroke as a composite endpoint. The pooled hazard ratio (HRs) of 95% confidence interval (Cls) was calculated. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity of the pooled estimation. A total of 7 studies involving a total of 13,305,007 participants were included in this meta-analysis. Pooled analysis showed participants with BD experienced a significantly increased risk of both stroke incidence (combined HR, 1.43; 95% CI, 1.24–1.66; p = 0.000) and stroke mortality (combined HR, 1.54; 95% CI, 1.09–2.18; p = 0.013) compared to participants without BD. In addition, the pooled estimate of multivariate HRs of stroke incidence and mortality were 1.35 (95% CI: 1.26–1.45); 2.30 ( 95% CI: 1.37–3.85) among men and 1.43 (95% CI:1.27–1.60); 2.08 (95% CI:1.60–2.71) among women respectively. This meta-analysis suggests that BD may modestly increase the risk of both stroke incidence and mortality. Extensive clinical observational studies should be conducted in the future to explore whether BD is a potentially modifiable risk factor for stroke.

Among the users of public library, the elderly readers have become the vulnerable group in the information service of Public Library due to their physiological and psychological problems. Taking Tai'an public library as an example, this paper uses the method of questionnaire survey and actual interview to carry out the relevant research on information service, and holds that the information service of elderly users should be fully considered when purchasing digital resources. The library should consider the needs of the elderly readers, provide a comfortable environment for the elderly readers, change the concept of librarians, start with details to serve the elderly users, improve the cultivation of the information literacy of the elderly readers, and strengthen the investment in infrastructure for the elderly.

Background: Remdesivir, a nucleoside analogue antiviral drug developed for Ebola, is approved by the US Food and Drug Administration for the treatment of COVID-19. However, the findings of randomised controlled trials (RCTs) and observational studies vary regarding the effectiveness of remdesivir. We aimed to comprehensively review the available evidence identify the effectiveness and safety of remdesivir in patients with COVID-19.Methods: Seven databases (PubMed, Web of Science, Embase, Wanfang database, SinoMed, Chinese National Knowledge Infrastructure and Chinese Science Journal Database) were searched for literatures published until November 2020.Following the PRISMA flow diagram, we included RCTs and prospective observational studies that reported the effectiveness and safety of remdesivir in patients with COVID-19. With extracting study details, as well as patient characteristics and outcomes, data were meta-analyzed by using Review Manager software version 5.4.1. Meta-analyses were conducted with fixed-effect model or random-effect model to calculate risk ratio (RR).Results: Four studies involving 2,279 patients were included in this meta-analysis. Compared with placebo, 10-day remdesivir was associated with significant increased clinical improvement on days 14 and 28 with RR 1.19 (95%CI 1.09-1.30) and RR 1.09 (95%CI 1.03-1.16). The clinical improvement of 5-day remdesivir was better than 10-day remdesivir on days 7 with RR 1.20 (95%CI 1.02-1.41), but the efficacy advantage of 5-day remdesivir disappeared on days 14 (RR 1.08; 95%CI 0.90-1.29). Remdesivir was associated with lower serious adverse events rates and grade 3 or 4 adverse events rates as compared with placebo with RR 0.75(95%CI 0.63-0.89) and RR 0.89(95%CI 0.80-0.99). Compared with 10-day remdesivir, 5-day remdesivir for patients with COVID-19 decreased the risk of serious adverse events rates and grade 3 or 4 adverse events rates with RR 0.65(95%CI 0.47-0.88) and RR 0.74 (95%CI 0.58-0.95). Conclusions: Our meta-analysis suggested that remdesivir would increase clinical improvement conditions and decrease serious adverse events on patients with COVID-19. 5-day remdesivir had the similar clinical effectiveness and mortality with 10-day remdesivir, and had lower serious adverse events rate. Comprehensive considering the cost and benefit, 5-day remdesivir may be a better therapeutic option if available medical resources are limited.

In recent years, with the rapid development of my country's power infrastructure level, higher requirements have been correspondingly put forward for the support of informatization, the degree of interaction of data and information, and the real-time degree and accuracy of analysis. According to the hidden dangers and safety requirements of various aspects of the electric power construction site, this paper proposes an informationized solution for the safety of the electric power construction site. In terms of power project management, build power project management applications to support power engineering project management business, and realize the integrated management of the progress of power engineering projects and construction teams by the management unit; in terms of power engineering construction plan management, monitor the power engineering construction plan, Release construction plans in a timely manner and grasp the implementation of construction plans; in terms of safety supervision of power construction sites, use on-site control terminals, integrate mobile application technology, and standardize power engineering construction operations through standardized operation guidance, strengthen the safety awareness of construction personnel, and provide The personnel adds a line of defense; in terms of safety system and standard management, the current power engineering safety rules and regulations, standards, regulations and other documents are released to facilitate mutual inquiry and reference among various units.

Background: The relationship between MTHFR (5, 10-methylene tetrahydrofolate reductase) gene polymorphisms and Systemic Lupus Erythematosus (SLE) has been wildly studied, but the results are still conflicting. Therefore, the purpose of this meta and pooled analysis was to identify the role of the MTHFR SNP (single nucleotide polymorphism, rs1801133) in SLE in a large sample of subjects and to assess the risk of SLE. Methods: Data were collected from EMBASE, PubMed and China National Knowledge Infrastructure from inception to August, 2019. Summary odds ratio (OR) with 95% confidence interval (CI) was applied to assess the association. Subgroup and sensitivity analysis were performed to assess the potential sources of heterogeneity of the pooled estimation. Results: We identified seven eligible studies involving 882 cases and 991 controls. MTHFR rs1801133 T carrier was significantly associated with increased risk of SLE when comparing to C allele [ORs were 1.766 (1.014–3.075) for T carrier vs CC, P = .04]. Furthermore, the results of the subgroup analysis by genotyping methods suggested that T allele significantly contributed to the risk of SLE for both by polymerase chain reaction-TaqMan (PCR-TaqMan) [10.111 (2.634–38.813) for TT vs CC, 3.467 (1.324–9.078) for CT vs CC and 3.744 (1.143–12.264) for TT vs C carrier]. Also the results of the subgroup analysis by ethnicity suggested that T allele significantly contributed to the risk of SLE for Asians [9.679 (4.444–21.082) for TT vs CC, 5.866 (3.021–11.389) for T carrier vs CC and 8.052 (3.861–16.795) for TT vs C carrier]. Conclusion: This cumulative meta-analysis showed that the MTHFR SNP (rs1801133) contributed to susceptibility of SLE. However, more multicentre well-designed case-control studies and larger sample sizes are exceedingly required to validate our findings in the future.

An accurate calibration method of millivolt AC voltage source based on cascaded voltage divider and AC-DC transfer technology is proposed in this paper. The cascaded voltage divider and 792A AC-DC transfer standard are adopted to trace the measured millivolt AC voltage to the known national AC voltage standard. By using the substitution measurement method and choosing the combination of different voltage proportion and different range of 792A, the AC voltage in the range of 10 mV∼200 mV at the frequency of 55 Hz∼5 kHz is accurately calibrated. Results show that the relative error of any measured millivolt AC voltage is within $\pm 40\ \mu \mathrm{V}/\mathrm{V}$ , and the expanded uncertainty is better than $130\ \mu \mathrm{V}/\mathrm{V}$ , which shows that this method can meet the traceability requirements of millivolt AC voltage source.

Purpose Endometriosis is a common, chronic gynecological disease that affects women’s fertility potential. Dydrogesterone is an effective and safe drug that is under-utilized due to limited clinical research. The purpose of this evidence mapping is to identify, describe, and analyze the current available evidence regarding dydrogesterone for the treatment of endometriosis. Materials and methods We performed a search in electronic databases: Medline, The Cochrane Library, EMBASE, PubMed, CNKI, Wanfang, VIP, and CBM. We also hand-searched google for relevant studies. Our primary outcomes included changes in pain relief including pelvic pain, dysmenorrhea, and dyspareunia. Secondary outcomes included pregnancy rate, frequency of analgesic use, and other reported outcomes according to specific settings in the studies. Results Of 377 references screened, 19 studies were included in the data synthesis involving 1709 female participants. Nearly three-quarters were either randomized control trials or clinical control trials. Compared with gestrinone, dydrogesterone relieved dysmenorrhea, increased the pregnancy rate, and reduced the risk of certain adverse events. Compared with GnRH-a, dydrogesterone also lowered the risk of endometriosis recurrence and elevated transaminase levels. Whether there was any difference in efficacy between dydrogesterone and leuprolide acetate, letrozole or traditional Chinese medicine remains unclear due to insufficient data. Conclusions The amount and quality of evidence evaluating the effects of dydrogesterone for the treatment of endometriosis is generally very low. Limited evidence suggests that dydrogesterone may have some advantages over gestrinone, GnRH agonists, and other therapeutic interventions in treating endometriosis. However, this conclusion should be interpreted with caution.

Representation learning has been proven to play an important role in the unprecedented success of machine learning models in numerous tasks, such as machine translation, face recognition and recommendation. The majority of existing representation learning approaches often require a large number of consistent and noise-free labels. However, due to various reasons such as budget constraints and privacy concerns, labels are very limited in many real-world scenarios. Directly applying standard representation learning approaches on small labeled data sets will easily run into over-fitting problems and lead to sub-optimal solutions. Even worse, in some domains such as education, the limited labels are usually annotated by multiple workers with diverse expertise, which yields noises and inconsistency in such crowdsourcing settings. In this paper, we propose a novel framework which aims to learn effective representations from limited data with crowdsourced labels. Specifically, we design a grouping based deep neural network to learn embeddings from a limited number of training samples and present a Bayesian confidence estimator to capture the inconsistency among crowdsourced labels. Furthermore, to expedite the training process, we develop a hard example selection procedure to adaptively pick up training examples that are misclassified by the model. Extensive experiments conducted on three real-world data sets demonstrate the superiority of our framework on learning representations from limited data with crowdsourced labels, comparing with various state-of-the-art baselines. In addition, we provide a comprehensive analysis on each of the main components of our proposed framework and also introduce the promising results it achieved in our real production to fully understand the proposed framework., Comment: IEEE Transactions on Knowledge and Data Engineering (Accepted)

Qi, blood and the meridians are fundamental concepts in Chinese medicine (CM), which are components of the human body and maintain physiological function. Pathological changes of qi, blood and meridians may lead to discomfort and disease. Treatment with acupuncture or herbal medicine aims to regulate qi and blood so as to recover normal function of the meridians. This paper explores the nature of qi as well as compares and correlates them with the structures of the human body. We propose a conceptualization of qi as being similar to the interstitial fluid, and the meridians as being similar to interstitial space of low hydraulic resistance in the body. Hence, qi running in the meridians can be understood as interstitial fluid flowing via interstitial space of low hydraulic resistance.

Childhood community-acquired pneumonia (CAP) is a common illness; however, comprehensive studies of hospitalizations for CAP among children in China based on prospective and multicenter data collection are limited. The aim of this investigation was to determine the respiratory pathogens responsible for CAP in hospitalized children. From January to December 2015, oropharyngeal swabs and blood serum were collected from hospitalized children with CAP symptoms ranging in age from 6 months to 14 years at 10 hospitals across China. We used immunofluorescence to detect antibodies for eight respiratory viruses and passive agglutination to detect specific IgM against Mycoplasma pneumoniae (M. pneumoniae). Of 1500 children presenting with CAP, 691 (46.1%) tested positive for at least one pathogen (virus or M. pneumoniae). M. pneumoniae (32.4%) was detected most frequently, followed by respiratory syncytial virus (11.5%), adenovirus (5.0%), influenza A virus (4.1 %), influenza B virus (3.4%), parainfluenza virus types 2 and 3 type (3.1 %), parainfluenza virus type 1 (2.9%), and human metapneumovirus (0.3%). Co-infections were identified in 128 (18.5%) of the 691 cases. These data provide a better understanding of viral etiology and M. pneumoniae in CAP in children between 6 months and 14 years in China. More study of the etiologic investigations that would further aid the management of pneumonia is required. With effective immunization for RSV, ADV, and M. pneumoniae infections, more than one-half of the pneumonia cases in this study could have been prevented.

Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate analysis of general data and catheterizing data of tumor patients was then carried out, and data of single factors with statistical significance were incorporated into multi-factor Logistic regression model for analysis. Results: PICC catheter-related blood stream infection occurred to 16 patients, and occurrence rate was 2.73%. Multi-factor Logistic regression analysis results showed that number of puncturing times, positioning method and maintenance frequency were risk factors for tumor patients’ peripherally inserted central catheter catheter-related blood stream infection, and odds risk values were respectively 8.762, 9.253 and 10.324. Conclusion: for tumor patients implanted with peripherally inserted central catheters, using ECG positioning during strict sterile operation and catheterizing process to avoid repeated puncturing and increasing maintenance frequency could effectively reduce occurrence of PICC catheter-related blood stream infection.

Background/Aims: Regulatory T (Treg) cells have been associated with neuroprotection by inhibiting microglial activation in animal models of Parkinson's disease (PD), a progressive neurodegenerative disease characterized by dopaminergic neuronal loss in the nigrostriatal system. Herein, we show that Treg cells directly protect dopaminergic neurons against 1-methyl-4-phenylpyridinium (MPP+) neurotoxicity via an interaction between the two transmembrane proteins CD47 and signal regulatory protein α (SIRPA). Methods: Primary ventral mesencephalic (VM) cells or VM neurons were pretreated with Treg cells before MPP+ treatment. Transwell co-culture of Treg cells and VM neurons was used to assess the effects of the Treg cytokines transforming growth factor (TGF)-β1 and interleukin (IL)-10 on dopaminergic neurons. Live cell imaging system detected a dynamic contact of Treg cells with VM neurons that were stained with CD47 and SIRPA, respectively. Dopaminergic neuronal loss, which was assessed by the number of tyrosine hydroxylase (TH)-immunoreactive cells, was examined after silencing CD47 in Treg cells or silencing SIRPA in VM neurons. Results: Treg cells prevented MPP+-induced dopaminergic neuronal loss and glial inflammatory responses. TGF-β1 and IL-10 secreted from Treg cells did not significantly prevent MPP+-induced dopaminergic neuronal loss in transwell co-culture of Treg cells and VM neurons. CD47 and SIRPA were expressed by Treg cells and VM neurons, respectively. CD47-labeled Treg cells dynamically contacted with SIRPA-labeled VM neurons. Silencing CD47 gene in Treg cells impaired the ability of Treg cells to protect dopaminergic neurons against MPP+ toxicity. Similarly, SIRPA knockdown in VM neurons reduced the ability of Treg cell neuroprotection. Rac1/Akt signaling pathway in VM neurons was activated by CD47-SIRPA interaction between Treg cells and the neurons. Inhibiting Rac1/Akt signaling in VM neurons compromised Treg cell neuroprotection. Conclusion: Treg cells protect dopaminergic neurons against MPP+ neurotoxicity by a cell-to-cell contact mechanism underlying CD47-SIRPA interaction and Rac1/Akt activation.

The automatic detection of hand-held digital multimeter has always been a difficult problem in the field of electrical metrology due to the lack of corresponding programmable interface. In this paper, a multi-channel automatic detection device for digital multimeter is developed, which can simultaneously calibrate seven different types of digital multimeter. Taking DC voltage as an example, the results of calibration using the former calibration method are compared with those after using the device. The results show that the developed device can meet the daily calibration of hand-held digital multimeter and ensure the calibration. On the premise of accuracy, the efficiency is increased by 70%.

Fan Shaofei, Chairman of the Board and Chief Executive Officer of Ping An Wanjia Healthcare, a subsidiary of Ping An Group, joined the healthcare sector and has become expert in the investment and management of large organizations as well as operation in healthcare organizations. China has achieved tremendous progress in health promotion, but facing multiple challenges. The quality of care remains as an important topic for China’s healthcare system. The Wanjia Hierarchical Accreditation Standards is the tool for standard practices regarding safety and quality in primary level healthcare organizations in the hope of standardizing the healthcare services and establishing the management system through the process of aligning clinics to the requirements. The demands on healthcare and relevant services in China concentrate on the primary level. However, 80% of the resources are centralized in the cities, among which, 80% are in the large and medium size hospitals.

IoT is revolutionizing the world. One of its renowned applications is a smart door lock system to protect the valuables and secrets behind the door. In IoT based system the user is transmitting his confidential data over the network which may contain passwords and other information, which are as crucial as the secrets or valuables behind the door. To resolve the valuables security and information security issues, we uniquely propose a password based and cryptographically shielded highly secure door lock system. We designed and developed a complete system including an Android smartphone app, using cryptographic algorithms for secure communication and programmable hardware with sensors and actuators in order to control unauthorized access. This cryptoLock not only protects our valuables behind the door but also it protects our data which is being transmitted over the network. It gives easy remote access, controls unauthorized access and gives a complete sense of security.

An emergency response requires coordinating various activities, time considerations, available resources, proficient organization, collaboration of services, departments or workforce to give the earliest response during an emergency situation. The aim of this study was to explore the use of advanced visual simulation tool for emergency response planning with the help of Unity 3D models. The research methodology comprises the framework to evaluate a terrorism scenario using the simulation tools e.g. computers software to study or decide the best possible course of action, location-tracking algorithm using the shortest path algorithm to find the quickest way to the desired location. The proposed model data was analyzed to test the simulated emergency response using 3ds Max software. The visual simulation connected real-time monitoring and tracking of various objects or activities and present a simple approach to apply the advanced simulation techniques to solve real world problems e.g. emergency response design or management of pre-designed activities.

As a result of technical and social successes, Baidu has become one of the most valuable brands in China. A high-tech company, Baidu regards the development of breakthrough technology as one of its foundational tenets. Currently, it has global recognition as a leader in the fields of search, artificial intelligence (AI), cloud computing, and Big Data. Baidu believes that the growth of the internet is complementary to its third generation-AI, an important technical innovation of the company. The later part of this chapter presents an overview of Baidu’s AI technology for retinal image analysis. We will discuss the general algorithms architecture first. Then the architecture will be dissected to explain the construction of each of Baidu’s retinal algorithms. We present detection models include diabetic retinopathy (DR), glaucoma (GC), and age-related macular degeneration (AMD). Additionally, we propose a retinal image quality assessment module for ensuring the usability of eye-disease detection models under various situations in real-world tasks. Baidu’s AI algorithm integrates valuable clinical knowledge with end-to-end disease detection via interpretation modules. This yield benefits from both data-driven features and clinical experiences for retinal image analysis. We then provide experimental results and real-world efficacy proofing applications of the algorithms. The chapter concludes with an evaluation of Baidu’s AI retinal analysis system, which aims to utilize AI capacity to enhance user experience.

Two-dimensional atomic crystals (2DACs) are the layered materials that can be exfoliated into the thickness of one unit cell, and attract extensive attention in current condensed matter physics. The atoms contained in a 2DAC are completely exposed, thus rendering them extremely sensitive to the external environment. Therefore, the exfoliation, transfer, rotation, stacking, encapsulation and device fabrication processes are particularly important for the electronic device quality and electrical transport properties of 2DACs. We review the recent progress of the transfer methods for 2DACs, especially the milestones in the improving of the transport properties of these two-dimensional electron gases (2DEGs). For electronic devices based on 2DACs, the quality of the devices is evaluated in terms of the disorder of 2DEG, contact resistance, carrier mobility, and observed quantum Hall states, and their corresponding transfer technology, device structure and fabrication processes are also discussed in detail.

A retrospective study.To evaluate the effect of preoperative clavicle chest cage angle difference (CCAD) on postoperative radiographic shoulder imbalance, cosmetic shoulder balance, patient's satisfaction, and surgeon's fulfillment in Lenke I adolescent idiopathic scoliosis (AIS).CCAD is a novel predictor of postoperative radiographic shoulder imbalance in AIS. However, radiographic shoulder balance does not always correspond to cosmetic shoulder balance.Forty-four Lenke I AIS patients treated with posterior spinal fusion with a minimum 2-year follow-up were analyzed. Shoulder height difference (SHD) and CCAD were measured on anteroposterior standing radiographs. The inner shoulder height (SHi) and the outer shoulder height (SHo) were measured using the patients' photographs. The patients' satisfaction and the surgeons' fulfillment were evaluated using a questionnaire. A receiver operative characteristic curve analysis was performed to explore the threshold values of preoperative CCAD in the prediction of the final follow-up radiographic shoulder imbalance, patients' satisfaction, and surgeons' fulfillment.At the final follow-up, the preoperative CCAD was significantly greater in patients with unbalanced shoulders (SHD ≥1 cm). For cosmetic shoulder balance at the final follow-up, there was no significant difference in preoperative CCAD between Group 1i (SHi ≥1 cm, n = 14) and Group 2i (SHi 1 cm, n = 30), and the preoperative CCAD was also similar between Group 1o (SHo ≥1 cm, n = 17) and Group 2o (SHo 1 cm, n = 27). For patients' satisfaction and surgeons' fulfillment, the preoperative CCAD was significantly greater in patients with unsatisfied outcomes. The threshold value of preoperative CCAD to predict the final follow-up radiographic shoulder imbalance, patients' satisfaction, and surgeons' fulfillment was 5.5°.CCAD is a good radiographic predictor for postoperative radiographic shoulder imbalance in Lenke I AIS patients. Moreover, it is also associated with the patients' satisfaction and surgeons' fulfillment postoperatively. However, CCAD cannot predict postoperative cosmetic shoulder balance.4.

Rationale Pulmonary embolism (PE) is a life-threatening manifestation of venous thromboembolism. Rivaroxaban is an oral anticoagulant, which directly inhibits Factor Xa. The objective of the current study was, in comparison to the standard-therapy method, to investigate the potential of rivaroxaban to improve the treatment of patients with PE, and to reduce hemorrhage in the standard-therapy group through adjusting the dose of warfarin by CYP2C9 and VKORC1 genotypes. Methods Sixty-two PE patients with or without deep venous thrombosis (DVT) was randomized to rivaroxaban mono-therapy or standard-therapy with enoxaparin followed by vitamin K antagonist (VKA). Concentration of the anticoagulants was adjusted according to the results of CYP2C9 and VKORC1 genotypes in order to stabilize the international normalized rate (INR) at 2.0–3.0 range. Length of hospital stay at initial hospitalization was compared, therapeutic efficacy was examined by computed tomographic pulmonary angiography (CTPA) and ventilation/perfusion (V/Q) scan, and side-effect of anti-coagulants was monitored at 1-month, and 3- or 6-months follow-up check points. Results We found that, overall, patients who received rivaroxaban mono-therapy had a significantly shorter length of hospital stay compared with patients who received standard-therapy of enoxaparin followed by VKA (9.29 ± 3.70 versus 11.38 ± 3.12 days, P = 0.021). The therapeutic efficacy was of no marked difference between these two groups. However, after one month treatment, 50% (16/32) of the standard-therapy group had mild hemorrhage, which was significantly higher than that of rivaroxaban mono-therapy group (16.7%, 5/30, P = 0.006). Moreover, a significantly higher rate in the standard-therapy group (22.2% versus 3.4%, P = 0.032) was found after 3 or 6 months therapy. Major bleeding was slightly but not significantly higher in the standard-therapy group than that in the rivaroxaban therapy group. In addition, 2 (6.3%) patients died from Life-threatening bleeding in the standard-therapy group. Conclusion Findings of the current study suggested that rivaroxaban mono-therapy result in shorter hospital stay compared to the standard-therapy. Implication of CYP2C9 and VKORC1 genotypes in determining dose of warfarin, however, remains to be further examined in larger cohort studies.

We hypothesized that by using coronal MRI, Chiari I malformation could be more precisely diagnosed, would provide simple anatomic landmarks, would provide information regarding asymmetry of hindbrain herniation, and would be a better method for analyzing the tonsillar herniation postoperatively when the opisthion has been removed. Fifty consecutive pediatric patients diagnosed with Chiari I malformation had comparison between the measurements of their caudally descended cerebellar tonsils on midsagittal and coronal MRI images. On MRI coronal imaging, tonsillar asymmetry was found in 48 patients. Maximal left tonsillar descent was 20.9 mm, and maximal right tonsillar descent was 17.4 mm. On MRI sagittal imaging, tonsillar descent ranged from 5 to 27.4 mm. Fifty-eight % of patients had syringomyelia. Five patients (10 %) on coronal MRI were found to have both cerebellar tonsils that were less than 3 mm below the foramen magnum. However, all of these patients had greater than 3 mm of tonsillar ectopia on sagittal imaging. Nineteen patients (38 %) on coronal MRI were found to have one of the cerebellar tonsils that were less than 3 mm below the foramen magnum. Similarly, each of these had greater than 3 mm of tonsillar ecotpia as measured on midsagittal MRI. Also, based on these findings, Chiari I malformation is almost always an asymmetrical tonsillar ectopia. Sagittal MRI overestimates the degree of tonsillar ectopia in patients with Chiari I malformation. Misdiagnosis may occur if sagittal imaging alone is used. The cerebellar tonsils are paramedian structures, and this should be kept in mind when interpreting midline sagittal MRI.

STUDY DESIGN A retrospective study. OBJECTIVE Aim of the study was to investigate morphological differences in the vertebrae of scoliosis secondary to neurofibromatosis type 1 (NF1-S) with and without paraspinal neurofibromas and to identify the relationship between paraspinal neurofibromas and vertebral deformity. SUMMARY OF BACKGROUND DATA Scoliosis is the most common orthopedic manifestation of NF1. Erosion or infiltration of the bone by localized neurofibromas was suggested as one of the primary etiology for the vertebral deformity. METHODS One hundred fourteen patients with NF1-S were classified into spinal tumor (ST) group and nontumor (NT) group with respect to the presence of paraspinal neurofibromas. The curve pattern, curve magnitude, the shape and location of paraspinal neurofibromas, and various kinds of morphological changes of vertebrae were evaluated by complete radiographs were compared between the two groups to determine whether the presence of paraspinal neurofibromas could be associated with a more severe vertebral deformity. RESULTS The ST and NT groups included 54 patients (age, 16.8 ± 5.5 years) and 60 patients (age, 17.3 ± 4.2 years), respectively. The Cobb angles of the main curve were 72.3° ± 20.6° and 65.4° ± 19.4° for the ST and NT groups, respectively. No significant differences were observed between the two groups in age, sex ratio, and Cobb angle. There were significant differences between the ST and NT groups in apical vertebral rotation (36.8° ± 7.2° vs. 27.5° ± 6.8°; P

STUDY DESIGN A retrospective radiographic analysis. OBJECTIVE The aim of this study was to investigate the scoliosis curve patterns/features and magnetic resonance imaging (MRI) tonsillar ectopia characteristics in Chiari I malformation without syringomyelia (CMI-only). SUMMARY OF BACKGROUND DATA The development of scoliosis associated with a CMI typically has been ascribed to the presence of syringomyelia. However, a subset of CMI patients with scoliosis may not have a concomitant syrinx. Scoliosis in these patients has been very poorly documented in the literature. METHODS A retrospective study was conducted on patients with a scoliosis secondary to CMI-only. The curve direction, curve pattern/features, and side of the dominant tonsillar ectopia were recorded and assessed quantitatively. On the basis of the measurement results, associations between the scoliosis curve patterns/features and MRI tonsillar ectopia characteristics were analyzed. RESULTS A total of 26 patients, consisting of seven males and 19 females with an average age of 15.4 years, were included in the current study. In 19 patients with asymmetrically displaced tonsils, the concordance between the dominant side of the asymmetrically displaced tonsils and curve direction was 78.9%. A statistically significant association was found between the dominant side of the tonsillar ectopia and the convex side of scoliosis according to Fisher exact test (P = 0.045). In addition, it was noted that there was a high incidence (52.9%) of atypical curve patterns in CMI-only patients. A significantly high incidence of atypical features with a superior shift of either the apical or the end vertebrae was found in 85.7% of thoracic curves and 40% of lumbar curves. CONCLUSION Scoliosis associated with CMI-only was found to have atypical curve patterns in all cases, and the direction of scoliosis was highly consistent with the dominant side of asymmetrically tonsillar herniation. These findings should be considered as an argument in favor of a nonidiopathic etiology and lead to more evidence that simple tonsillar impaction can provide enough impetus to produce or exaggerate scoliotic curvature. LEVEL OF EVIDENCE 3.

Recycling of lead-acid batteries is an important sector of the lead-acid battery industry, and green technologies with low energy consumption and pollutant emission are in urgent demand. A new pre-desulfurization process of damped lead battery paste sodium carbonate based on “surface update” was developed, and the optimum reaction conditions were investigated. According to the experimental results, the process can maintain the sulfur content of lead paste under 0.5% at the optimum reaction conditions: pH = 8–10 and a molar ratio of Na 2 CO 3 to PbSO 4 of 1.00–1.10:1. The desulfurization efficiency increases with the reaction temperature and can be qualified within 40 min in each experiment. The effect of “surface update” contributes to the enhancing effect in the desulfurization process. The new process has a great advantage in desulfurization efficiency compared with the traditional processes.

The purpose of this study was to introduce a powerful technique for the treatment of kyphoscoliosis. There are currently multiple techniques for sacropelvic fixation, including trans-iliac bars and iliac and iliosacral screws. Several studies have documented the use of these instrumentation techniques; however, a ubiquitous problematic issue concerns the need for separate incisions for the use of offset connectors, which add to surgical time and morbidity. Any additional dissection of the skin, subcutaneous tissue or muscle in this area is believed to increase the incidence of complications of wound healing. However, as stated above, the above-mentioned techniques require separate incisions for the use of offset connectors, which add to surgical time and morbidity. The novel technique of S2 alar-iliac (S2AI) pelvic fixation has been developed to address some of these issues. However, a technique for achieving correction of kyphoscoliosis with pelvic obliquity in adult patients with spinal deformity has not previously been described. Our entry point is based on the S1 foramen and is typically up to 5 mm caudal and 2 to 3 mm lateral to that foramen. Once the S1 foramen has been identified, a blunt instrument can be used to probe the alar ridge. The screw trajectory is 40°-50° from horizontal and 20°-30° caudal, aimed toward the greater trochanter and rostral to the sciatic notch. A 36-year-old female patient presented with a 3-year history of low back pain, and progressive thoracolumbar kyphoscoliosis. In this typical case, we performed S2AI fixation with transforaminal lumbar interbody fusion and hemivertebra resection technique to treat her lumbosacral kyphoscoliosis. Satisfactory improvement in her preoperative lumbar kyphoscoliosis was found at 3-month follow-up.

To investigate whether the posterior cranial fossa (PCF) morphology in Chiari I malformation without syringomyelia (also called syrinx) (CMI-only) is different from that in Chiari I malformation with syrinx (CMI-S). Nineteen CMI patients without syrinx constituted the CMI-only group, whereas 48 CMI patients with syrinx were assigned to the CMI-S group. Another cohort of 40 age-matched asymptomatic adolescents was enrolled to serve as the control group. Six measurements were evaluated and compared between these three groups from T1-weighted magnetic resonance (MR) imaging, including the length of the clivus (AB), the anteroposterior diameter of the foramen magnum (BC), the length of the supraocciput (CD), the anteroposterior diameter of the posterior fossa (DA), the posterior fossa height (BE) and the clivus gradient ( $${\angle }\alpha$$ ). The posterior cranial fossa morphology in relation to syrinx severity was also investigated. Compared to the normal controls, the AB, CD, DA, BE and $${\angle }\alpha$$ were significantly larger in the CMI-S group. Similar changes in AB, CD, DA and BE were also demonstrated in the CMI-only group, while the clivus gradient ( $${\angle }\alpha$$ ) was found to be normal when compared with the control group. A significantly decreased clivus gradient was observed in the CMI-S group as compared to CMI-only group. In addition, the clivus was significantly flattened in patients with a distended-syrinx in comparison to those with a non-distended syrinx. Small size of the posterior fossa was detected both in CMI cases with and without syrinx. The clivus gradient served as the only morphologic difference in the PCF between CMI-S and CMI-only patients and was correlated with the severity of the syrinx, may support the theory that the restricted circulation of cerebrospinal fluid at the anterior paramedial subarachnoid space contributes to the formation of a syrinx.

Objective Numerous studies have reported that patients with cancer seem to be more likely to be diagnosed with COVID-19. However, it is still unknown the prevalence of different types of cancer in patients with COVID-19. Therefore, this study will explore which type of cancer patients are more susceptible to the SARS-COX-2. Methods Eligible studies were identified by searching several electronic databases for relevant studies published before April 28, 2020. The language was restricted to English or Chinese. The meta-analysis was performed using Stata 12.0. The GEPIA database evaluated the expression of SARS-COX-2 infection key genes in different types of normal and tumor samples. Results A total of 6 studies, including 205 patients, were identified to be eligible for this meta-analysis. Among the cancer patients infected by SARS-COX-2, the proportion of patients with the lung, colorectal, breast, esophagus, bladder, pancreatic and cervical cancer were 24.7 %, 20.5 %, 13.0 %, 7.6 %,7.3 %,6.1 %,and 6.0 %, respectively. These findings were also corroborated by the results of the GEPIA database. Conclusion Compared with other types of cancer, lung cancer and colorectal cancer are more susceptible to SARS-COX-2 infection.