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The COVID-19 pandemic has caused great disruption in education systems around the world. Schools have in some cases ended or limited on-site teaching, and have shifted toward home online teaching. This situation is likely to cause increased uncertainty and anxiety for parents who on one hand may question the quality of home online learning yet, on the other, may not feel sufficiently confident or competent to guide their children's home online learning. Resulting anxiety is expected to be most evident in competitive educational contexts, such as those found throughout much of East Asia. Therefore, using China as the setting, and social comparison theory as the framework, this study examined how variation in parent social comparison relates to parent tutoring anxiety and, in turn, to the types of guided strategies parents use to promote their children's home online learning. The results indicated a positive relationship between parental upward social comparison and parental tutoring anxiety, but a negative relationship between parent downward social comparison and parental anxiety. Parental tutoring anxiety is positively related to the confirmation and structure types, but negatively related to the discovery type of guided approaches. The implication of this study is that parents who resist tendencies of competitive upward social comparison are likely to adopt more effective approaches to guiding their children's home online learning.

Background and Purpose— Hypoxic-ischemic brain damage is a well-recognized physiopathologic mechanism after aneurysmal subarachnoid hemorrhage (aSAH). The Ngb (neuroglobin) is a hemoprotein predominantly expressed in the brain with a high affinity for oxygen. Relationship between serum Ngb level and brain metabolism in aSAH patients has not been investigated previously. Methods— Thirty-six consecutive severe aSAH patients (Glasgow Coma Scale score ≤8 on admission) with multimodal neuromonitoring and 36 matched healthy subjects were included. Serum Ngb level was analyzed in combination with other time-matched cerebral microdialysis parameters, brain tissue oxygen tension, and 12-month neurological outcomes. Results— Serum Ngb level was correlated positively with cerebral microdialysis parameters and brain tissue oxygen tension ( P 3) 12 months after aSAH was associated with higher Ngb level but independent of age, sex, and disease severity ( P P Conclusions— Ngb may be a potential biomarker for reflecting brain tissue oxygen tension, brain metabolism, and functional outcome in severe aSAH patients and merits further study in the context of aSAH.

Introduction Lung large cell neuroendocrine carcinoma (L‐LCNEC) is a rare, aggressive tumor, for which the optimal treatment strategies for LCNEC have not yet been established. In order to explore how to improve the outcome of prognosis for patients with LCNEC, this study investigated the effect of different treatments based on the data obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Methods A total of 2594 LCNEC cases with conditional information were extracted from SEER database. Propensity Score Matching (PSM) method was conducted to reduce possible bias between groups. One‐way ANOVA was used to test the differences of characteristics between groups. Univariate and multivariate Cox proportional hazard models were applied to identify prognostic factors. Results Clinicopathologic characteristics including gender, age, TNM stage, T stage, N stage, and M stage were all identified as independent prognostic factors. Surgery benefited stage I, II, and III LCNEC patients’ prognoses. The combination treatment that surgery combining with chemotherapy was the optimal treatment for stage I, II, and III LCENC patients. Compared with palliative treatment, stage IV patients obtained better prognoses with the treatment of radiation, chemotherapy, or chemoradiation. When comparing the effect of the three treatments (radiation, chemotherapy, and chemoradiation) in achieving better prognosis for stage IV patients, chemotherapy alone was better than the other treatments. Conclusion Surgery combining with chemotherapy was the optimal treatment for stage I, II, and III LCNEC patients; chemotherapy alone achieves more benefit than the other treatments for stage IV patients.

There are several models of inquiry-based learning, some of which may be practiced in experimental classroom teaching, and some of which may be used in online teaching. This study proposes the “prediction-observation-quiz-explanation” (POQE) model to design a green energy generation learning program (i.e., how solar, wind, and water can produce energy) and to test how participants' cognitive-affective factors affect their interest in using this model. A total of 396 technical high school students participated in this experimental study, and 375 valid data were collected and subjected to confirmatory factor analysis with structural equation modelling. The results indicated that incremental belief of intelligence was negatively related to cognitive load, but positively related to green energy learning self-efficacy (GELSE) in practicing POQE. Cognitive load was negatively related to flow experience, while GELSE was positively related to flow experience. Finally, flow experience was positively related to the intention to continue online learning with the POQE model. The implications of this study are that e-learning designers can use this POQE model to develop more educational content for students to learn various concepts.

Technological literacy (TL) as the goal of technology education guides the construction of the technology education curriculum in China. Previous studies investigating technological literacy were limited to K-12 students and had some ambiguities in the definition of technology, theoretical framework, and assessed criterion, and a measurement instrument for use among the Chinese public is lacking. To address this need, the Technological Literacy Scale for the Chinese Public (TLSCP) was developed in this study. Based on DeVore’s infrastructure of technology and seven taxonomies of technologies proposed by the International Technology Education Association, the complexity, contents, and components of technology in the TLSCP were ensured. Combined with previous dimensions proposed by the National Academy of Engineering and the National Research Council and the goal of classification in the Chinese High School General Technological Curriculum Standards, a new classification of technological literacy incorporating technological attitude (TA), technological knowledge (TK), and technological capacity (TC) was developed. Through a 4-point Likert-type scale, Bloom’s Taxonomy of Cognitive Objectives, and Quellmalz Taxonomy, the content of the items in the TLSCP can be evaluated objectively. Data obtained from 1117 people in 31 provinces and municipalities were included in a pilot test investigating the reliability, validity, difficulty and discrimination ability of the TLSCP. The three dimensions of the TLSCP were reliable [TA (α = 0.889), TK (α = 0.693), and TC (α = 0.726)], the content validity was verified by seven experts in the fields of technology education, machinery and materials, and psychological assessment, and the construct validity (λ > 0.5) was good. Moreover, the difficulty of the items (p between 0.35 and 0.67) was appropriate, and item discrimination (rpb between 0.30 and 0.67) was acceptable. The TLSCP was useful for addressing the deficiencies in TL measurement instruments in China and improving the theoretical basis of international TL evaluations. It may be a good template for others who want to develop such an instrument in a different culture.

Introduction The purpose of this study was to describe the results using the Nd:YAG laser to reopen blocked glaucoma tube shunts in three ocular chemical burn patients with Boston keratoprostesis type I (KPro) implantation. Methods The medical records of the three patients at Zhongshan Ophthalmic Centre were reviewed. Results Patient 1, who had glaucoma secondary to KPro implantation, had undergone Ahmed glaucoma valve (AGV) implantation to control an elevated intraocular pressure (IOP). One day after surgery, the tube was observed to be embedded in the residual lens capsule. The capsule was opened by one 1.5 mJ laser pulse, with a subsequent drop in the IOP. In patient 2, the AGV and KPro had been implanted simultaneously. One month after surgery, the IOP increased to 35 mmHg, estimated by palpation, and a vitreous gel was seen blocking the tube. A Nd:YAG laser pulse was used to open the occluded tube. In patient 3, the tube was blocked by iris tissue; Nd:YAG laser treatment opened the tube. Conclusions The cases described here indicate that Nd:YAG laser treatment seems to be a valuable option for opening an occluded AGV tube in patients with KPro implantation. The correct location of the tube tip, visualized through the KPro optic, is essential for laser treatment. Electronic supplementary material The online version of this article (10.1007/s40123-019-0186-6) contains supplementary material, which is available to authorized users.

Using visualized bibliographic data and a range of quantitative research methods, the analysis of the International Journal of Technology and Design Education (IJTDE), which is included in the core collection of Social Science Citation Index, reached a number of conclusions. Firstly, IJTDE is an important platform for the exchange of research results in the field of technology education, and has a significant influence. Secondly, De Vries, Williams, Ankiewicz and a number of others are influential and prolific authors in the IJTDE. Authors from the USA, England, New Zealand, Taiwan and Australia make most contributions to the IJTDE, Delft University of Technology, University of Auckland and the University of Waikato are the more prolific institutions in the IJTDE. Thirdly, technology education, education, design, science, creativity, technology, design education, knowledge, student, technological literacy and problem solving are the most frequency keywords in the IJTDE. Creativity, design education, problem solving, curriculum development, design and critical thinking, practice, engineering education, and STEM education are research trends in the IJTDE between 2000 and 2018. Fourthly, the discipline knowledge base mainly focuses on teaching and design methods in the technological environment, and the definitions of technology-related concepts. The results enable a deeper understanding and consideration of the content and influence of IJTDE, and the research hotspots in the field of technology education.

Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach (TRA) for cerebral angiography versus the transfemoral approach (TFA) in patients. Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate, oppression time on puncture points, local vascular complication incidence (including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs (DVT), and bradycardia/hypotension were observed and compared between the two groups. Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in 1070 patients; compared with 1219 patients with transfemoral access, there was no significant difference (P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients. Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach. Keywords: Cerebral angiography, Transradial approach, Transfemoral approach, Intervention

Alkali burn (AB) is one of the most serious ocular traumas in the world, characterized by extreme ocular surface disorders, critical secondary dry eye and irreversible vision loss. The exact mechanisms involved are unknown. Innate immunity, including the involvement of Toll-like receptors (TLRs) and NOD-like receptors (NLRs), is believed to participate in the pathogenesis of the epithelia, but the exact mechanisms by which TLRs transduce signals to NLRs and downstream molecules to initiate innate immunity remain poorly defined. In this present study, we used murine models of AB and AB concomitant desiccating stress (DS) to investigate the potential functions and mechanisms of TLR4 in regulating NLRP3 and NLRP6 during AB injury and secondary dry eye. We demonstrated that AB injury induced activation of the TLR4-MyD88 pathway, leading to imbalanced NLRP3 and NLRP6 via the activation of caspase-8 signaling. DS worsened ocular surface disorders post-AB injury by magnifying this phenomenon. Caspase-8 signaling promoted NLRP3 upregulation via the nuclear factor (NF)-κB pathway, while NLRP6 suppressed NF-κB activation. Our findings also revealed that TLR4-MyD88 knockout can alleviate AB-induced or DS-worsened ocular surface disorders, shedding light on the potential therapeutic strategies in the future for AB injury. Taken together, our findings demonstrate that AB promotes the TLR4-MyD88-caspase-8 axis to cause imbalanced NLRP3/NLRP6, and DS exacerbates ocular surface damage via magnifying this imbalance.

The purpose of the present study was to investigate the relationship between the intrasellar pressure (ISP) and the microvascular structure of pituitary adenomas.We retrospectively analyzed the ISP in 66 patients with pituitary adenomas. The corresponding microvascular structure was obtained using immunohistochemistry and analyzed for its correlation with the ISP.The average ISP was 25.89 ± 8.27 mm Hg, and the ISP was not related to the size of the adenoma (Pearson correlation coefficient, 0.103; P = 0.415). The ISPs of adenomas with different Knosp grades were significantly different (P0.05). From grade 0 to grade 4, at first, the ISP increased with the Knosp grade and reached the first peak at grade 2. It then decreased at grade 3 and increased again at grade 4, showing a "double-peak" pattern. The minimal diameter and perimeter of the microvessels and the vessel-covered area percentage were positively related to the ISP. When these parameters were compared among the adenomas of different Knosp grades, they also exhibited a "double-peak" pattern.In the present study, we found that with the increase in pituitary adenoma size and invasion of the surrounding tissues, the ISP of pituitary adenomas showed a "double-peak" pattern. The ISP and certain parameters of the microvascular structure are related, because the microvasculature adaptively changes its structure in response to the changing ISP to ensure a sufficient blood supply to the adenoma. The specific mechanism of this phenomenon requires further study.

Additional file 2: Table S2. The oligo sequences for transfection in this study.

Background: Although independent association of socioeconomic status (SES) or physical activity (PA) with obesity has been well-documented in urban settings, their independent and joint associations on obesity measures are limited in rural regions.Methods: Almost 38,000 (n = 37,922) individuals were included from the Henan Rural Cohort Study. The International Physical Activity Questionnaire (IPAQ) was used to evaluate PA. Obesity was reflected by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). The independent and interactive effects of SES and PA on obesity were analyzed by logistic regression models and generalized linear regression models, respectively.Results: Compared with high education level, the OR (95%CI) of obesity defined by BMI with low education level was 1.466 (1.337, 1.608), 1.064 (0.924, 1.225), and 1.853 (1.625, 2.114) in total population, men and women, respectively. Besides, the OR (95%CI) of obesity defined by BMI associated with per capita monthly income were 1.089 (1.015, 1.170), 1.192 (1.055, 1.347), 1.038 (0.951, 1.133) in total population, men and women, respectively. Similar results had been observed in other obesity measures. Negative interactive association of low education level and PA on obesity measures were observed only in women (all P < 0.05).Conclusions: This study suggests that women are more susceptible to obesity concerning low SES and that adequate PA may be a potential target for mitigating the negative effect of low SES on obesity in women.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

Background: Glioma is highly heterogeneous. Real-time tumor markers in vivo can most truly reflect the clonal evolution of glioma, and can accurately monitor postoperative minimal residual disease (MRD) and early tumor DNA relapse. The histological and molecular markers of resected tumor could not represent the characteristics of recurrent tumor, and the reference basis of postoperative clinical treatment plan should be adjusted. Methods: This retrospective cohort analyzed 32 patients with glioma from January 1, 2018 to January 31, 2020. Samples of tumor tissue, tumor fluid in situ and cerebrospinal fluid were collected, and next-generation tumor DNA sequencing was performed. Findings: Adequate tumor DNA was detected in TISF. The consensus rate of shared mutations at tumor progression was 45.8%, the variant allele fractions (VAFs) for TISF mutations were between 0.1% and 84.3%. VAF and cfDNA concentrations increased as the tumor progressed. At tumor progression, 100% (15/15) of tumor DNA was positive in TISF, CSF-ctDNA was detected in only 4 patients (26.7%, 4/15). The concentration of cfDNA in TISF samples ranged from 0.9-346.5ng/ mL, while that in CSF was only 0.55-16.23ng/mL. The level of shared mutation VAF was higher than that of CSF in TISF. High concentration of cfDNA in early postoperative TISF indicates high residual disease in early postoperative TISF, which is an early recurrence risk ( 600 days Patients (p = 0.006). Interpretation: Tumor DNA derived from TISF can find the molecular information of MRD before tumor recurrence, which cannot be detected by imaging and CSF-ctDNA. It can provide accurate glioma genomic information in real-time in vivo, and can monitor tumor MRD, clonal evolution, early tumor DNA relapse, and provide clinical treatment strategies. Funding Statement: Science and Technology Tackle Program of Henan Province and Joint Project of Medical Science and Technology Tackling Plan of Henan Province (Grants no. 192102310126 and 201601016) Declaration of Interests: Authors declare that they have no competing interest. Ethics Approval Statement: Approval was obtained from the Ethics Committee and Institutional Review Committee of the People’s Hospital of Henan Province.

Additional file 1: Table S1. The primer sequences for qRT-PCR in this study.

Background Temozolomide (TMZ) resistance limits its application in glioma. Exosome can carry circular RNAs (circRNAs) to regulate drug resistance via sponging microRNAs (miRNAs). miRNAs can control mRNA expression by regulate the interaction with 3’UTR and methylation. Nanog homeobox (NANOG) is an important biomarker for TMZ resistance. Hitherto, it is unknown about the role of exosomal hsa_circ_0072083 (circ_0072083) in TMZ resistance in glioma, and whether it is associated with NANOG via regulating miRNA sponge and methylation. Methods TMZ-resistant (n = 36) and sensitive (n = 33) patients were recruited. The sensitive cells and constructed resistant cells were cultured and exposed to TMZ. circ_0072083, miR-1252-5p, AlkB homolog H5 (ALKBH5) and NANOG levels were examined via quantitative reverse transcription polymerase chain reaction and western blot. The half maximal inhibitory concentration (IC50) of TMZ, cell proliferation, apoptosis, migration and invasion were analyzed via Cell Counting Kit-8, colony formation, flow cytometry, wound healing and transwell assays. The in vivo function was assessed using xenograft model. The N6-methyladenosine (m6A) level was analyzed via methylated RNA immunoprecipitation (MeRIP). Target relationship was investigated via dual-luciferase reporter assay and RNA immunoprecipitation. Warburg effect was investigated via lactate production, glucose uptake and key enzymes expression. Exosome was isolated and confirmed via transmission electron microscopy and specific protein expression. Results circ_0072083 expression was increased in TMZ-resistant glioma tissues and cells. circ_0072083 knockdown restrained the resistance of resistant cells via decreasing IC50 of TMZ, proliferation, migration, invasion and xenograft tumor growth and increasing apoptosis. circ_0072083 silence reduced NANOG expression via blocking ALKBH5-mediated demethylation. circ_0072083 could regulate NANOG and ALKBH5 via targeting miR-1252-5p to control TMZ resistance. Warburg effect promoted the release of exosomal circ_0072083 in resistant cells. Exosomal circ_0072083 from resistant cells increased the resistance of sensitive cells to TMZ in vitro and xenograft model. Exosomal circ_0072083 level was enhanced in resistant patients, and it had a diagnostic value and indicated a lower overall survival in glioma. Conclusion Exosomal circ_0072083 promoted TMZ resistance via increasing NANOG via regulating miR-1252-5p-mediated degradation and demethylation in glioma.

Although solid-fuel use or smoking is associated with obesity measured by body mass index (BMI), research on their interactive effects on general and central obesity is limited. Data of 20,140 individuals in the Henan Rural Cohort Study was examined the independent and combined associations of solid-fuel use and smoking with prevalent obesity, which was measured by BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). Multiple adjusted logistic regression models showed that the OR (95% CI) of prevalent obesity measured by BMI associated with exposure to solid fuels alone or with smoking was 0.78 (0.70, 0.86) or 0.46 (0.32, 0.66), compared with neither smoking nor solid-fuel exposure. Similar results had been found in other obese anthropometric indices and in the results of linear regression analysis. The results indicated that solid-fuel use and smoking have a synergistic effect on reduction in obesity indices. The effects of household air pollution from solid-fuel use and smoking on obesity should be considered when exploring the influencing factors of obesity.

Background: Genome-wide association studies of lung cancer have shown a common variation at 15q24-25.1 as a determinant of risk, but the role of specific genes has not been proven. This study aims to explore the expression of mutations and the prognostic significance of 15q25 (CHRNA5 and PSMA4) mRNA in lung adenocarcinoma (LAC) based on immunohistochemistry, TCGA and bioinformatics. Methods: The expression of mutations on chromosome 15q25 of 576 primary LAC patients was selected and survival and gene expression data were extracted from TCGA. The relationship between expression of genes on 15q25 and clinical and prognostic Significance of LAC. An experiment with Beas-2b, A549 and H1299 cell lines was performed to further prove the difference in CHRNA5 and PSMA4 expression between lung cancer and normal cells. Immunohistochemistry data of CHRNA5 and PSMA4 were detected in LAC and normal tissues from 122 patients. Finally, Gene enrichment analysis (GSEA) was conducted to predict the regulatory genes of CHRNA5 and PSMA4. Results: CHRNA5 and PSMA4 are frequently mutated in TCGA (CHRNA5, 1.7%; PSMA4, 1.3%). Besides, the expression of CHRNA5 and PSMA4 was obviously higher in A549 and H1299 cells. And the immunohistochemical staining revealed that the levels of CHRNA5 and PSMA4 were considerably higher in the LAC group than in the normal group. Meanwhile, there was a significant association between high CHRNA5 expression and smoking history (P=0.011), smoking history pack year value (P=0.010). Furthermore, there was a significant correlation between CHRNA5 and PSMA4 expression levels and prognosis (P=0.003; P=0.008), and between higher expression and worse prognosis. GSEA results suggested that between samples with high CHRNA5 and PSMA4 expression were respectively enriched to cell cycle, base excision repair, oxidative phosphorylation, protein export, and aminoacyl tRNA biosynthesis, among others. Conclusions: CHRNA5 and PSMA4 mRNA expression has a significant impact on the clinical and survival of LAC, and they may be a potential target for treating patients with lung adenocarcinoma.

Meningioma (MEN) is a common central nervous system disease. Accumulating evidence indicated that long non-coding RNA maternally expressed gene 3 (MEG3) participated in the progression of MEN. However, the potential mechanisms of MEG3 in altering the aggressive phenotypes of MEN need further exploration. Levels of MEG3, microRNA (miR)-29c, and A-kinase anchor protein 12 (AKAP12) were determined using quantitative real-time Polymerase Chain Reaction (qRT-PCR) assay. Dual-luciferase reporter and RNA immunoprecipitation (RIP) assays were performed to verify the relationship between miR-29c and MEG3 or AKAP12. The protein level of AKAP12 was detected by western blot. Moreover, cell-cycle arrest, migration, invasion, and proliferation were assessed by flow cytometry, wound healing, transwell assays, and CCK-8 assay, respectively. Levels of MEG3 and AKAP12 were downregulated, while miR-29c was effectively increased in MEN tissues and cell line. Mechanically, MEG3 was a sponge of miR-29c to regulate the expression of AKAP12. Functionally, increase of MEG3 diminished cell-cycle, migration, invasion, and proliferation in MEN cells, and reintroduction of miR-29c could eliminate these effects. In addition, AKAP12 depletion overturned the inhibitory effects of miR-29c absence on cell-cycle, migration, invasion, and proliferation in vitro. Also, AKAP12 was co-regulated by MEG3/miR-29c axis. MEG3 mediated the aggressive behaviors of MEN cells via miR-29c/AKAP12 axis, supporting that MEG3 served as a promising biomarker for the diagnosis and treatment of human MEN.

This study aimed to describe the clinical features, surgical management of the eyelid and ocular surface, and outcomes of 16 patients implanted with a Boston type I keratoprosthesis (KPro). A retrospective, single-center, consecutive case series of 16 patients with Stevens–Johnson syndrome (1), ocular chemical burns (12), and ocular thermal burns (3) implanted with KPro was studied. All subjects were men aged 27–51 years. Surgical treatment and outcomes for eyelid malposition, symblepharon, and glaucoma were assessed. From September 2010 to February 2019, 29 patients were admitted to Zhongshan Ophthalmic Center for KPro implantation, of whom 16 (55%) required eyelid or ocular surface surgeries to maintain hydration and protect the corneal tissue, which is vulnerable to epithelial defects. Forty-one adnexal surgical procedures were performed. The most common indication for surgery was symblepharon, and the most frequent procedures were symblepharon lysis with ocular mucous membrane grafts and amniotic membranes (7) and full-thickness skin grafts to the eyelids (7). Preoperative conjunctival injection and corneal staining were documented in 9 (56%) and 8 (50%) eyes, respectively, and at up to 4 months postoperative follow-up (the last adnexal surgery before KPro) were recorded in 3 (19%, p = 0.03) and 2 (12%, p = 0.02) eyes, respectively. Glaucoma drainage devices were inserted in six patients. One patient with Stevens–Johnson syndrome underwent FP7 Ahmed glaucoma valve (AGV) implantation inferotemporally and developed plate exposure 2 months postoperatively. Five patients underwent FP8 AGV implantation with tube insertion into the vitreous cavity due to the scarred conjunctiva and limited subconjunctival space. In the study period, intraocular pressure (IOP) was in the normal range, and no tube or plate exposure was observed. The ocular environment is critical for successful KPro surgery. A multidisciplinary approach for any lid and ocular surface abnormality in ocular burns or Stevens–Johnson syndrome is important to improve the quality of the ocular surface and accommodate KPro and AGV, which is vital for maintaining vision after KPro surgery. FP8 AGV may be feasible for IOP control in adult KPro cases with restricted subconjunctival space.

Background The neuroglobin (Ngb) is well recognized as a potential biomarker for the hypoxic‐ischemic brain injury. However, connection between Ngb and delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) is still unclear. Objective To investigate the relationship between early stage Ngb level of aSAH patient and the occurrence of DCI. Methods We evaluated 126 aSAH patients who were enrolled into a prospective observational cohort study. Serum Ngb level on days 1, 2, 3, 5, and 7 after aSAH were determined using a commercial enzyme‐linked immunosorbent assay kit. The relationship between Ngb level and DCI was analyzed. Results Forty‐six (36.5%) aSAH patients experienced DCI. Patients with DCI had significantly higher Ngb levels than those without (p 8.4 ng/ml has a significantly worse DCI survival rate than those having day 3 Ngb level, Although qualitative or semiquantitative clinical grades (such as WFNS grade and modified Fisher grade) are well known to be associated with DCI following aSAH, identification of an easily measurable and more objective biomarker for predicting DCI might be helpful for early prediction and risk mitigation. In the current study, we found that the early stage neuroglobin level was a significant predictor of DCI in aSAH patients. Furthermore, combined use of WFNS grade and Ngb level might be able to better identify aSAH patients with high risk of DCI.

In this study, the sellar floor morphology of patients with pituitary adenoma is analyzed and a simple yet reliable method is identified to determine the location of bone window opening.Clinical information of 144 consecutively admitted patients was retrospectively analyzed. Enhanced magnetic resonance imaging of the midsagittal plane was selected as the reference for classifying the sellar floor. Intraoperative tumor location, extent of tumor resection, and follow-up results were analyzed for different types of sellar floor. The tuberculum sellae, lowest point of the sphenoid sinus, and the lowest point of the sellar floor and 3 lines related to them were used to classify the sellar floor. This is referred to as the "three points and three lines" method.Based on its location in the sphenoid sinus, the sellar floor can be classified into 4 types: 12 patients (8.3%) with high sellar, 70 (48.6%) with medium sellar, 30 (20.8%) with low sellar, and 32 (22.8%) with steep sellar. The maximum tumor diameter, maximum sellar floor diameter, and the intercarotid distance were all significantly different among patients with different types of sellar floor (P0.001). For all patients, quick intraoperative location of the sellar floor opening was achieved. A total of 104 patients (72.2%) had total tumor resection, 28 (19.40%) had subtotal tumor resection, and 4 (2.8%) had partial tumor resection. Twenty patients (13.9%) experienced cerebrospinal fluid leak, and there was no significant difference in cerebrospinal fluid leak rate among groups.Presurgical classification and location of the sellar floor are critical for understanding and assessing the transsphenoidal approach. Different types of sellar floor appeared in the surgery with different morphologic features. The three points and three lines method helps the surgeon to predetermine the location of the sellar floor opening and to shorten surgical time.

Output regulation is considered in this paper for ordinary differential equations cascaded by a wave equation, in which both the body equations and the uncontrolled end are subject to disturbances. The disturbances are generated by an exosystem. A backstepping state-feedback regulator is first designed to force the output to track the reference signal. The design is based on solving cascaded regulator equations, and the solvability condition of the equations is characterized in terms of a transfer function and the eigenvalues of the exosystem. An observer-based output-feedback regulator is then designed to solve the output regulation problem. Finally, the regulator tracking performance is illustrated through numerical simulations.

Endoscopic third ventriculostomy (ETV) provides a physiological restoration of cerebrospinal fluid and a shunt-free option for hydrocephalus children. Continuous developments in techniques and instruments have improved ETV as the first-line treatment. This paper focuses on the recent advances in surgical techniques, instruments, predictive models, imaging tools, and new cohort studies. The efficacy, safety, indications, and remaining challenges of ETV are discussed. More patients undergo ETV with a better outcome, identifying a new era of hydrocephalus treatment. Deeper understanding of ETV will improve a better shunt-free survival for pediatric hydrocephalus patients.

Aiming at the shortcomings of high cost and time-consumption in traditional liquid chromatography, an effective surface enhanced Raman scattering (SERS)-based trace detection method has been proposed to quantitatively identify the active component of traditional Chinese medicine. In this paper, a high-performance and versatile SERS platform based on Ag nanoparticles (NPs) self-assembly Ag-anodized aluminium (Ag NPs-Ag-AAO) nanoarray was fabricated by controllable physico-chemical preparation technology. The results indicated that the electromagnetic field enhancement effect was sharply strengthened as Ag NPs assembled, and the experimental enhancement factor (EEF) value was calculated to be 1.0083 × 106. This novel Ag NPs-Ag-AAO nanoarray with substantial “hot spots” exhibited high SERS signal reproducibility, with the relative standard deviation (RSD) value at less than 2.23%. More importantly, this SERS platform was applied to detect active component Baicalein in Scutellaria baicalensis, and the limit of detection (LOD) was located at 10 fg/mL. Therefore, this Ag NPs-Ag-AAO nanoarray with high sensitivity, strong Raman signal reproducibility and reliable practicability has broad application prospects in the rapid detection of trace substances in the active components of traditional Chinese medicine and is expected to be popularized.

Objective Previous studies have suggested that postoperative hypopituitarism in patients with nonsellar intracranial tumors is caused by traumatic surgery. However, with development of minimally invasive and precise neurosurgical techniques, the degree of injury to brain tissue has been reduced significantly, especially for parenchymal tumors. Therefore, understanding preexisting hypopituitarism and related risk factors can improve perioperative management for patients with nonsellar intracranial tumors. Methods Chart data were collected retrospectively from 83 patients with nonsellar intracranial tumors admitted to our hospital from May 2014 to April 2015. Pituitary function of each subject was determined based on results of preoperative serum pituitary hormone analysis. Univariate and multivariate logistic regression methods were used to analyze relationships between preoperative hypopituitarism and factors including age, sex, history of hypertension and secondary epilepsy, course of disease, tumor mass effect, site of tumor, intracranial pressure (ICP), cerebrospinal fluid content, and pituitary morphology. Results A total of 30 patients (36.14%) presented with preoperative hypopituitarism in either 1 axis or multiple axes; 23 (27.71%) were affected in 1 axis, and 7 (8.43%) were affected in multiple axes. Univariate analysis showed that risk factors for preoperative hypopituitarism in patients with a nonsellar intracranial tumor include an acute or subacute course (≤3 months), intracranial hypertension (ICP >200 mm H 2 O), and mass effect ( P P Conclusions Prevalence of hypopituitarism is high in patients with nonsellar intracranial tumors. The occurrence of hypopituitarism is correlated with factors including an acute or subacute course (≤3 months), intracranial hypertension (ICP >200 mm H 2 O), and mass effect ( P

Poly(2-hydroxyethyl methacrylate) (PHEMA) films with gradient crosslinking density are the only hydrogel films capable of generating regular wrinkling patterns upon swelling, however, they were synthesized via a complicated two-stage photopolymerization. In an effort to develop a simple synthesis method, we found that one-step UV-curing of HEMA liquid always results in films with corrugated surface, which is a common issue when curing liquid prepolymers. We further found that the introduction of a physical network in the prepolymer solution could prevent the surface from corrugating during UV curing. For this purpose, linear PHEMA was added into the prepolymer solutions, and PHEMA films with a smooth surface were successfully synthesized by a simple one-step UV curing. The resulting films generate various swelling-induced wrinkling patterns, including random worms, peanuts and long-range ordered hexagons, depending on the contents of crosslinker and linear PHEMA in the prepolymer solution. Particularly, large area, highly ordered, honeycomb-like wrinkling patterns were obtained from films with proper content of crosslinker and linear PHEMA. These regular patterns are expected to find applications such as the fabrication of uniform multicellular spheroids.

Herein, a double strategy to modify the cycling performance of pure silicon nanoparticles (SiPs) was applied. Hollow graphite fibers (HGFs) with a good graphite structure could improve the electrical conductivity of the electrode. The SiP/HGF composite maintained a discharge capacity of 556.2 mA h g−1 and a charge capacity of 548.6 mA h g−1 after 50 cycles at the current density of 50 mA g−1, which obviously promoted the lifetime as compared to that of the anode of pure SiPs. Carbon coating could minimize the direct contact between the SiPs and electrolyte and buffer the volume changes during cycling. The silicon nanoparticle/hollow graphite fiber/carbon-coated (SiP/HGF/C) composite delivered the initial discharge and charge capacities of 1327.2 and 936.6 mA h g−1, respectively, at a current density of 50 mA g−1. After the first cycle, the charge capacity began to steadily increase to 1122.7 mA h g−1 until the thirty-first cycle. The double strategy effectively buffered the volume changes, enhanced the intensity of the electrode, and improved the overall electrical conductivity during discharge–charge cycles. The low-cost SiP/HGF/C composite showed an optimized electrochemical performance as compared to the pure SiP anode.

Purpose AMP-activated protein kinase α1 (AMPK α1) associates closely with cancers. However, the relationship between AMPK α1 and non-small cell lung cancer (NSCLC) is not fully understood. In this study, we aim to explore the role and mechanism of AMPK α1 in NSCLC initiation and progression. Materials and Methods A total of 165 clinical NSCLC specimens were included in the formalin-fixed and paraffin-embedded (FFPE) lung cancer tissue arrays. The expression levels of AMPK α1 and thioredoxin (Trx) in NSCLC cancer tissues and adjacent non-tumor lung tissues were measured through using immunohistochemistry. MTT assay was used to detect cell proliferation. Intracellular ROS levels were measured by using H2DCFDA reagent. Lentiviruses including LV-PRKAA1-RNAi, LV-PRKAA1 and a negative LV-control were used to infect A549 cells to modulate AMPK α1 expression in vitro. Immunoblotting was used to determine the modulation relationship between AMPK α1 and Trx. Log rank test and Kaplan–Meier survival analysis were performed to evaluate the significances of AMPK α1 and Trx expression levels on NSCLC patients’ prognoses. Results AMPK α1 was highly expressed in NSCLC cancer tissues and correlated with poor prognosis in patients with NSCLC. In A549 cells, overexpression of AMPK α1 promoted proliferation, suppressed ROS levels and inhibited apoptosis. Moreover, inhibition of AMPK α1 expression achieved the opposite effects. Trx was significantly overexpressed in NSCLC cancer tissues; furthermore, Trx expressed much more in cytoplasm when compared with cell nucleus. Trx expression levels were positively correlated with AMPK α1 expression levels in NSCLC tissues. AMPK α1 could regulate Trx in A549 cells. No significant correlations were observed between Trx expression variances and prognoses in NSCLC patients. Combination of AMPK α1 and Trx had no advantage in predicting prognoses of NSCLC patients. Conclusion These results suggest that AMPK α1 serves a carcinogenic role at least in part through the regulation of Trx expression, and thus represents a potential treatment target in patients with NSCLC.

BACKGROUND The aneurysmal subarachnoid hemorrhage (aSAH) is an acute severe hemorrhagic stroke with high morbidity and mortality with poor prognosis. OBJECTIVE This study aims to analyze the changes of cerebral venous circulation in patients with aneurysmal subarachnoid hemorrhage by digital subtraction angiography (DSA). MATERIALS AND METHODS Totally, 57 patients with aSAH, 48 patients with unruptured aneurysms, and 45 patients without aneurysms (control group) were enrolled. The microvascular cerebral circulation time (mCCT), venous cerebral circulation time (vCCT), cerebral arterioles and cortical veins were analyzed by DSA. RESULTS There were changes of cerebral microvessels and cortical veins in patients with aSAH. The mCCT (6.15±1.37 s) and vCCT (2.79±0.34 s) of aSAH patients significantly increased compared with control patients (3.74±0.50 s; 2.64±0.32 s) (P

Purpose Dry eye disease (DED) is a common and multifactor-induced autoimmune ocular surface disease. Environmental factors, such as desiccating stress (DS) and hyperosmolarity, affect the corneal epithelium to induce ocular surface inflammation in DED. We aimed to explore the potential mechanisms by which innate immunity and pyroptosis are initiated in the mucosal epithelium in response to environmental stress. Methods Experimental dry eye was established in C57BL/6 J mice and genetic mice on the background of C57BL/6 J mice by subcutaneous injection of scopolamine and exposure to a desiccating environment. SDHCEC cell line was subjected to hyperosmolarity stress (450 mOsM). The phenol red thread tear test and corneal epithelial defects evaluation were used as assessments of severity of DED. RNA-sequencing, quantitative real-time PCR, western blotting and immunofluorescence staining were performed in this study. Results Loss-of-function studies indicated that genetic deletion of GSDMD alleviates DS-induced corneal epithelium defects, and GSDMD is needed for IL-33 processing. We further found that NLRP12 collaborates with NLRC4 inflammasome to initiate GSDMD-dependent pyroptosis, which requires TLR4-induced caspase-8 (CASP8) activation in the mucosal corneal epithelium in response to DS. Conclusions These findings provide compelling evidence that GSDMD-dependent pyroptosis plays a pivotal role in DED. A novel mechanism involving NLRP12 and NLRC4 inflammasomes-induced GSDMD-dependent pyroptosis, accompanied by IL-33 processing is responsible for ocular surface epithelial defects in response to environmental stress. GSDMD is required for IL-33 processing and the subsequent amplification of inflammatory cascades. These findings reveal novel therapeutic targets for treating DED.

Background To explore the mutations expression and prognostic significance of 15q25 (CHRNA5 and PSMA4) mRNA in lung adenocarcinoma (LAC) based on immunohistochemistry, TCGA and bioinformatics.Methods Mutations expression on chromosome 15q25 of 576 primary LAC patients was selected. And their survival and gene expression data were extracted from TCGA. The cell experiment about Beas-2b, A549 and H1299 cell lines were done to further prove the CHRNA5 and PSMA4 expression difference between lung cancer and normal cells. Immunohistochemistry data of CHRNA5 and PSMA4 were detected in LAC and normal tissues from 122 patients.Finally, Gene enrichment analysis (GSEA) was used to predict the regulatory genes of CHRNA5 and PSMA4.Results CHRNA5 and PSMA4 are frequently mutated in the TCGA (CHRNA5, 1.7%; PSMA4, 1.3%).The expression of CHRNA5 and PSMA4 were obviously higher in A549 and H1299 cells. Immunohistochemical staining revealed that the level of CHRNA5 and PSMA4 was considerably higher in LAC group than in normal group. There was a significant association between high expression of CHRNA5 and Smoking History (P = 0.011), Smoking History Pack Year Value(P = 0.010). Besides, there was a significant correlation between CHRNA5 and PSMA4 expression level and prognosis (P = 0.003; P = 0.008),and the higher expression, the worse prognosis. GSEA results suggested that CHRNA5 and PSMA4 high expression samples were respectively enriched to cell cycle, base excision repair, oxidative phosphorylation, protein export, aminoacyl tRNA biosynthesis etc.Conclusions The expression of CHRNA5 and PSMA4 mRNA has a significant impact on survival of LAC, they may be a potential target for treating patients with lung adenocarcinoma.