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Yuanyuan Tang,1 Baihui Fu,2 Qun Tong3 1Department of Orthopaedics, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China; 2Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China; 3Bachelor of Neurosurgery, Spine Research Center, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Baihui Fu, Email f18846812513@163.comObjective: To analyze the distribution and drug resistance of pathogens in patients with postoperative infection following knee arthroplasty (TKA) for knee osteoarthritis (KOA) and to explore the effectiveness of high-quality nursing interventions postoperatively.Methods: A retrospective analysis was conducted on clinical data from 87 KOA patients who underwent TKA and developed postoperative wound infections (infection group) at the first Affiliated Hospital of Harbin Medical University from July 2022 to September 2024. Another 87 patients without postoperative infection during the same period were selected as the control group. Deep wound exudate samples were collected from the infection group for pathogen culture, isolation, and identification. Drug susceptibility testing was performed using the K-B disk diffusion method. Additionally, venous blood samples were collected from both the infection and control groups one week after surgery, and serum levels of inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), procalcitonin (PCT)] were measured using enzyme-linked immunosorbent assay (ELISA). According to the type of nursing interventions received, the infection group was divided into the conventional care group (n=43, receiving standard orthopedic perioperative care) and the high-quality care group (n=44, receiving comprehensive high-quality care based on routine care). The pain levels [Visual Analog Scale (VAS) scores], knee joint function [Hospital for Special Surgery (HSS) knee scores], activities of daily living (modified Barthel index), and patient satisfaction [Newcastle Satisfaction with Nursing Service (NSNS) scale] were compared between the two groups.Results: Among the 87 KOA patients with postoperative infection after TKA, 83 patients had a single pathogen infection, and 4 patients had mixed infections with two pathogens, resulting in the cultivation and isolation of 91 pathogens. Of these, 63 (69.23%) were Gram-positive bacteria, primarily Staphylococcus aureus (29.67%) and Staphylococcus epidermidis (17.58%). There were 25 (27.47%) Gram-negative bacteria, primarily Escherichia coli (9.89%) and Pseudomonas aeruginosa (6.59%). Three (3.30%) fungal strains were isolated, all identified as Candida albicans. Gram-positive bacteria showed high resistance to penicillin, benzylpenicillin, ampicillin, erythromycin, clindamycin, ciprofloxacin, and gentamicin, but low resistance to gatifloxacin, and no resistance to vancomycin or teicoplanin. Gram-negative bacteria showed high resistance to ciprofloxacin, levofloxacin, gentamicin, and tobramycin, but low resistance to cefepime, imipenem, meropenem, gatifloxacin, and amikacin. The infection group had significantly higher serum levels of IL-6, TNF-α, and PCT compared to the control group (P< 0.05). The VAS scores at 24 hours, 3 days, and 7 days postoperatively were significantly lower in the high-quality care group compared to the conventional care group (P< 0.05). The HSS scores and modified Barthel index scores at 3 months postoperatively were higher than preoperative values in both groups, with a greater improvement observed in the high-quality care group (P< 0.05). The satisfaction rate in the high-quality care group (93.18%) was significantly higher than in the conventional care group (74.42%) (P< 0.05).Conclusion: The primary pathogens causing postoperative wound infections in KOA patients after TKA are Gram-positive bacteria, with Staphylococcus aureus and Staphylococcus epidermidis being predominant. Serum levels of inflammatory markers are significantly higher in infection patients compared to non-infection patients. High-quality nursing interventions can effectively alleviate postoperative pain, promote recovery of knee joint function, enhance activities of daily living, and improve patient satisfaction.Keywords: knee osteoarthritis, knee arthroplasty, postoperative wound infection, pathogen distribution and drug resistance, high-quality nursing care

Xiaoqi Chu,1,2,&ast; Yusong Ge,3,&ast; Chao Geng,1,2 Peipei Cao,1,2 Penghu Wei,2 Bin Fu,2 Zihao Deng,4 Yuhao Li,5,6 Guoguang Zhao2,7 1Optometry Institute, School of Medicine Nankai University, Tianjin, People’s Republic of China; 2Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing Municipal Geriatric Medical Research Center, Beijing, People’s Republic of China; 3Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China; 4Cancer Center, Capital Medical University, Beijing, People’s Republic of China; 5Central Laboratory, Xuanwu Hospital Capital Medical University, Beijing Municipal Geriatric Medical Research Center, Beijing, People’s Republic of China; 6Department of Pathology, School of Medicine Nankai University, Tianjin, People’s Republic of China; 7National Medical Center for Neurological Diseases, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guoguang Zhao, Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing Municipal Geriatric Medical Research Center, Beijing, People’s Republic of China, Email ggzhao@vip.sina.com Yuhao Li, Central Laboratory, Xuanwu Hospital Capital Medical University, Beijing Municipal Geriatric Medical Research Center, Beijing, People’s Republic of China, Email liyuhao@xwhosp.orgPurpose: Lactate, previously considered a metabolic waste product, has been shown to have neuroprotective potential. This study aims to investigate the impact of lactate intervention and its underlying mechanisms on epilepsy.Methods: HT22 cells were stimulated with glutamate to construct an excitotoxicity cell model. An acute epilepsy model was established in mice by kainic acid induction. The neuronal damage, microglial activation, inflammatory responses, and functional changes were determined by TUNEL assays, immunohistochemistry, quantitative real-time polymerase chain reaction and behavioral tests. The differentially gene expression and functional enrichment were analyzed with RNA sequencing.Results: The in vitro lactate intervention reduced the number of apoptotic cells, the release of inflammatory factors, and the expression of vesicular glutamate transporter 1. In mice with acute epilepsy, lactate treatment mitigated neuronal damage, microglial activation, and inflammatory responses in the hippocampus and ameliorated anxiety-like behavior and cognitive impairment.Conclusion: Lactate exerts therapeutic effects on epilepsy through the chemokine signaling pathway. The neuroinflammation is an important contributor to cognitive impairment. Targeting inflammatory pathways is a promising strategy for improving the prognosis of epilepsy. Keywords: lactate, neuroinflammation, cognitive impairment, neuronal damage, chemokine, epilepsy

Lu Qian,1,&ast; BinHai Fu,2,&ast; Hong He,2 Shan Liu,1 RenCai Lu2 1Department of Pathology, the First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, People’s Republic of China; 2Department of Nuclear Medicine, The First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: RenCai Lu, Department of Nuclear Medicine, The First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, No. 157 Jinbi Road, Kunming, Yunnan, 650032, People’s Republic of China, Tel +86 087163614503, Email lrc_09@126.comObjective: This study aimed to explore the value of a radiomic nomogram based on contrast-enhanced computed tomography (CECT) for differentiating benign and malignant solid-containing renal masses.Materials and Methods: A total of 122 patients with pathologically confirmed benign (n=47) or malignant (n=75) solid-containing renal masses were enrolled in this study. Radiomic features were extracted from the arterial, venous and delayed phases and further analysed by dimensionality reduction and selection. Four mainstream machine learning algorithm training models, namely, support vector machine (SVM), k-nearest neighbour (kNN), light gradient boosting (LightGBM) and logistic regression (LR), were constructed to determine the best classifier model. Univariate and multivariate analyses were used to determine the best clinical characteristics for constructing a clinical model. The radiomic and clinical signatures were integrated to construct a combined radiomic nomogram model. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the performance of the radiomic nomogram, radiomic signature, and clinical model.Results: Thirteen radiomic features were selected for the development of the radiomic signature. Among the various radiomic models, the LR model demonstrated superior predictive efficiency and robustness, yielding an AUC of 0.952 in the training cohort and 0.887 in the test cohort. The AUC for the clinical model was 0.854 in the training cohort and 0.747 in the test cohort. Furthermore, the radiomic nomogram, which incorporated sex, age, alcohol consumption history, and the radiomic signature, exhibited excellent discriminative performance, yielding an AUC of 0.973 in the training cohort and 0.900 in the test cohort.Conclusion: The radiomic nomogram based on CECT offers a promising and noninvasive approach for distinguishing malignant from benign solid renal masses. This tool can be used to guide treatment strategies effectively and can provide valuable insights for clinicians.Keywords: computed tomography, renal neoplasm, radiomics, machine learning

Chao Zhang,1,2,&ast; Man Yu,3,&ast; Longyao Zhang,1,2 Xin Zhou,1,2 Jinchang Han,1,2 Bifeng Fu,1,2 Hongfei Xue,1,2 Chao Zhang1,2 1Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300380, People’s Republic of China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300380, People’s Republic of China; 3Department of Nephrology and Rheumatology, Second Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin, 300250, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongfei Xue; Chao Zhang, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300380, People’s Republic of China, Email 2538287036@qq.com; zhangchao2004.love@163.comBackground: Acupuncture is an effective treatment for knee osteoarthritis (KOA), reducing pain and improving function. While melatonin (MLT) has notable pain relief benefits, the analgesic mechanism of acupuncture in KOA and its relationship with melatonin are still unknown. This study aims to explore this mechanism.Methods: In this work, the KOA rabbit model was constructed using the traditional Hulth method, and the therapeutic effect was assessed by the Lequesne MG score and Pain assessment by hot plate test. The pathological alterations of cartilage tissue were observed using hematoxylin and eosin (H&E) staining, Safranin O-fast green and MASSON staining to observe the pathological changes in cartilage tissue, and the efficacy was evaluated according to the principles of Mankin score and Osteoarthritis Research Society International (OARSI) score. Meanwhile, MLT in serum, cyclic adenosine monophosphate (cAMP) in cartilage, and matrix metalloproteinase-3 (MMP-3) in joint fluid were detected by enzyme-linked immunosorbent assay. In addition, the expression of aromatic L-amino acid N-acetyltransferase (AANAT), melatonin receptor 1 (MT1) and 2 (MT2) mRNAs in cartilage was determined by real-time quantitative reverse transcription-polymerase chain reaction, and the levels of proteins related to PKA/CREB signaling pathway were detected by Western blotting.Results: Based on the results of Lequesne MG score and Pain assessment by hot plate test experimental data, the treatment group presented significant improvements in knee pain and overall function relative to OA (Osteoarthritis) group. Besides, according to results of histologic staining, Mankin and OARSI scores, articular cartilage degeneration of treatment group remarkably improved. In addition, acupuncture significantly reduced the expression of the inflammatory factor MMP-3 in knee joint fluid and significantly increased the levels of MLT, AANAT, MT1, MT2, cAMP, PKA and CREB.Conclusion: By regulating sympathetic excitability, acupuncture may activate the MLT/cAMP/PKA/CREB signaling pathway, decrease inflammatory factor expression and slow down degradation of articular cartilage, resulting in the relief of knee pain.Keywords: acupuncture, knee osteoarthritis, MLT/cAMP/PKA/CREB pathway, melatonin

In this synthesis, we assess present research and anticipate future development needs in modeling water quality in watersheds. We first discuss areas of potential improvement in the representation of freshwater systems pertaining to water quality, including representation of environmental interfaces, in-stream water quality and process interactions, soil health and land management, and (peri-)urban areas. In addition, we provide insights into the contemporary challenges in the practices of watershed water quality modeling, including quality control of monitoring data, model parameterization and calibration, uncertainty management, scale mismatches, and provisioning of modeling tools. Finally, we make three recommendations to provide a path forward for improving watershed water quality modeling science, infrastructure, and practices. These include building stronger collaborations between experimentalists and modelers, bridging gaps between modelers and stakeholders, and cultivating and applying procedural knowledge to better govern and support water quality modeling processes within organizations.

Xiangpeng Zhan, Luyao Chen, Ming Jiang, Bin Fu Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of ChinaCorrespondence: Bin Fu; Luyao Chen, Email urofbin@163.com; chenluyao301@163.comObjective: To construct a prognostic model that estimates the probability of overall survival for T1 high-grade bladder cancer patients after radical cystectomy.Patients and Methods: We enrolled 801 patients diagnosed with T1 high grade and received radical cystectomy from the Surveillance, Epidemiology, and End Results (SEER) database (2004– 2015). All patients were randomly divided into the development group (n = 561) and validation group (n = 240) with the ratio of 7:3. Cox proportional hazards regression analyses were used to filter variables and the Kaplan–Meier method to evaluate survival outcomes. The results of sensitivity analysis determined the variables in the final model. The performance of the model was internally validated by calibration curves, the receiver operating characteristic (ROC) curves, and the concordance index (C-index).Results: The mean survival months were 56.086 in the development group and 58.21 in the validation group. Six variables including age, marital status, tumour size, tumour sites, region nodes examined, and N stage were incorporated in the final nomogram. The accuracy of the nomogram for prediction of overall survival was estimated by C-index (0.732; 0.712– 0.752) and AUC (0.771 for 3-year; 0.766 for 5-year) in the development group. In the validation group, the C-index of the nomogram was 0.752 (0.723– 0.781), and AUC was 0.761 for 3-year as well as 0.793 for 5-year. These results all showed better performance than the AJCC stage. Calibration plots for 3- and 5-year overall survival presented good concordance in both the development and validation group.Conclusion: We have established a prognostic nomogram that provides a more accurate and relevant individualized probability of overall survival for patients with T1HG bladder transitional cell carcinoma after radical cystectomy. It can contribute to improving patient counselling and treatment selection.Keywords: T1 high-grade, SEER, nomogram, prognosis, radical cystectomy, bladder cancer

Ru Chen,1,2,&ast; Zhicheng Zhang,1,&ast; Bing Hu,1,&ast; Ming Jiang,1,&ast; Ping Zheng,3 Wen Deng,1 Bin Fu,1,4 Ting Sun1,4 1Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang City, 330000, Jiangxi Province, People’s Republic of China; 2Department of Urology, The First Hospital of Putian City, Putian, 350001, Fujian, People’s Republic of China; 3Department of Urology, Shangrao municipal Hospital, Shangrao, 334000, Jiangxi Province, People’s Republic of China; 4Jiangxi Institute of Urology, Nanchang City, 330000, Jiangxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bin Fu; Ting Sun, Email urofbin@163.com; 361439919033@email.ncu.edu.cnBackground: Multiple studies have identified that E2F transcriptions act as important regulators for the tumorigenesis and progression of several human cancers. However, little is known about the function of E2Fs in clear cell renal cell carcinoma (ccRCC).Methods: We firstly investigated the expression levels, genetic alteration, and biological function of E2Fs in patients with ccRCC and the connections between the immune cell infiltration and the overall survivals of ccRCC patients with the E2Fs expression levels based on UALCAN, The Cancer Genome Atlas database, Gene Expression Profiling Interactive Analysis, TIMER, STRING, GSCALite and cBioPortal databases.Results: Results revealed that the expression levels of E2F1/2/3/4/6/7/8 were markedly upregulated in patients with ccRCC, while the expression of E2F5 displayed an opposite trend. We also experimentally validated the overexpression of E2F3/4/7 in human ccRCC tissues and ccRCC cell lines. Furthermore, the high E2F1/2/3/4/7/8 expression levels were clearly associated with worse pathological characteristics of ccRCC, including high pathological stage, poor molecular subtypes and high tumor grade. Meanwhile, high expression levels of E2F1/2/4/7/8 were evidently associated with worse overall survivals (OSs) and progression-free survivals (PFSs) of patients harboring ccRCC. Univariate and multivariate analyses illustrated that the expressions of E2F4/5/7 were independent factors associated with the OSs and PFSs of patients with ccRCC. Meanwhile, the mutations in E2Fs were also significantly related to poor OSs and PFSs of patients with ccRCC. Mechanically, the E2Fs genes synergistically promoted the progression of ccRCC by accelerating the cell cycle and inhibiting DNA damage response and apoptosis after performing the protein structure, functional enrichment, and PPI network analyses. In addition, E2Fs genes were also significantly associated with tumor immune cells infiltration and the drug sensitivity in ccRCC.Conclusion: As a result, E2F4/7 were highly expressed in ccRCC and significantly associated with worse pathological characteristics of ccRCC, including high pathological stage, poor molecular subtypes and high tumor grade, tumor immune cell infiltration, and drug sensitivity, consequently translating into poor OSs and PFSs of patients with ccRCC. Our results indicated that E2F4/7 could be potential biomarkers and therapeutic targets of ccRCC patients.Keywords: clear cell renal cell carcinoma, E2Fs, prognosis, UALCAN, GEPIA

Xiaochuan Zhang,1,2,&ast; Fajin Lv,1,&ast; Binjie Fu,1 Wangjia Li,1 Ruiyu Lin,1 Zhigang Chu1 1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Department of Radiology, Chonggang General Hospital, Chongqing, 400080, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhigang Chu, Tel +86 18723032809, Fax +86 23 68811487, Email chuzg0815@163.comPurpose: To investigate the clinical and computed tomography (CT) characteristics of peripheral small-cell lung cancer (pSCLC) to improve its early diagnosis.Patients and Methods: In total, 70, 132, 69, and 95 patients with pathological confirmed nodular (≤ 3 cm) pSCLC, peripheral non-small cell lung cancer (pNSCLC), benign lung tumor (pBLT), and inflammatory lesion (pIL) were enrolled in this study retrospectively. The clinical and CT data of studied patients with different lesions were analyzed and compared by univariate analysis. Multivariate analysis was used to reveal the key features to distinguish pSCLC from pNSCLC, pBLT, and pIL, respectively.Results: Univariate and multivariate analysis of the clinical and CT characteristics of studied patients indicated that 1) compared with pNSCLC and pIL, vessel convergence, spiculation, and peripheral ground-glass opacity were less common in pSCLC; 2) density homogeneity (OR = 38.84– 120.21, P < 0.05), bronchial cutoff sign (OR = 10.00– 60.13, P = 0.001), hilar lymph node enlargement (OR = 22.81– 95.08, P < 0.0001) (pSCLC vs pNSCLC, pBLT, and pIL), male sex (OR = 5.53– 10.92, P < 0.05) (pSCLC vs pNSCLC and pBLT), and emphysema (OR = 36.57– 56.63, P < 0.05) (pSCLC vs pBLT and pIL) were significantly and independently associated with pSCLC. Type I and II bronchial cutoff sign, especially type I, were closely related to pSCLC.Conclusion: Peripheral solid nodules with homogeneous density, bronchial cutoff sign, hilar lymph node enlargement, but without spiculation or vessel convergence in male patients with emphysema should be highly suspected of pSCLC.Keywords: small-cell lung carcinoma, non-small cell lung carcinoma, tomography, X-ray computed

Wen Deng,1,&ast; Gongxian Wang,1,&ast; Huanhuan Deng,2,&ast; Yan Yan,3,&ast; Ke Zhu,1,&ast; Ru Chen,1,4 Xiaoqiang Liu,1 Luyao Chen,1 Tao Zeng,2 Bin Fu1 1Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People’s Republic of China; 2Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People’s Republic of China; 3Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People’s Republic of China; 4Department of Urology, The First Hospital of Putian City, Putian City, Fujian Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bin Fu; Tao Zeng Tel + 86 13879103861; +86 18779101830Fax +86 0791-88698102; +86 0791-86120120Email urofbin@163.com; taozeng40709@sina.comPurpose: This study aimed to evaluate the functions of critical N6-methyladenosine (m6A)-related long non-coding RNAs (lncRNAs) and their correlations with immunotherapeutic targets in clear cell renal cell carcinoma (ccRCC).Methods: m6A-related lncRNAs were analyzed using the dataset from The Cancer Genome Atlas database via Pearson correlation analysis. Then, their prognostic functions in patients with ccRCC were determined via univariate Cox analysis. A prognostic m6A-related lncRNA signature (MRLS) in ccRCC was established using the least absolute shrinkage and selection operator (LASSO) Cox regression model. In addition, the correlations between these prognostic m6A-related lncRNAs with immune checkpoints were further evaluated in clinical samples.Results: MRLS was established by the LASSO Cox regression model on the basis of seven prognostic m6A-related lncRNAs. The risk score for each patient was calculated using the MRLS model, and the patients were further stratified into high- and low-risk subgroups. The MRLS model was validated with a robust prognostic ability by the stratification analysis. On the basis of age, grade, stage, and risk score, a nomogram was developed with a strong reliability in forecasting the overall survival percentages of the patients with ccRCC. Moreover, seven prognostic m6A-related lncRNAs enrolled in the MRLS model were found to be correlated with various immunotherapeutic targets, namely, PD-1, PD-L1, CTLA4, and LAG3, and the expression levels of which in the high-risk subgroup were significantly higher than those in the low-risk subgroup. The significant correlations between LINC00342 and the aforementioned immunotherapeutic targets were also confirmed in clinical samples.Conclusion: In this study, seven m6A-related lncRNAs were identified as potential biomarkers for forecasting the prognosis of patients with ccRCC and evaluating the efficacy of immunotherapy for these patients. Furthermore, a prognostic and predictive MRLS model with a high reliability was constructed to predict the overall survival probability of patients with ccRCC.Keywords: immunotherapy, N6-methyladenosine modification, long non-coding RNA, renal cell carcinoma, prognosis

Lei Zhang, Xuan Liu, Tong Li, Bing Xu, Binfang Fu Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of ChinaCorrespondence: Xuan LiuDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of ChinaTel +86 710 3524339Fax +86 710 3524330Email liuxuansk17@hotmail.comPurpose: Selective serotonin reuptake inhibitors (SSRIs) enhance angiogenesis and neurogenesis. Brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) play an important role in neurogenesis and angiogenesis. However, the effect of SSRIs on cognition and serum BDNF and VEGF in patients with vascular cognitive impairment no dementia (VCIND) is largely unknown.Patients and Methods: It was an open label study. Fifty VCIND patients were randomly allocated to receive fluoxetine (20 mg/d; n = 25) or no fluoxetine (control group; n = 25) for 12 weeks. VCIND patients received fluoxetine 20 mg/d and secondary prevention of stroke for 12 weeks in the fluoxetine group, whereas the control group received only secondary prevention of stroke for 12 weeks. The primary outcome and secondary outcome were of assessment of Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog) score, Ten Point Clock drawing test score (TPC), Verbal Fluency Test (VFT), Trail Making Test form a (TMTa), Trail Making Test form b (TMTb) and Digit Span Test score at baseline and week 12 in the both groups. And serum concentration of BDNF and VEGF was also tested at baseline and week 12 in both groups.Results: After 12 weeks, TPC scores increased more significantly in the fluoxetine group than in the control group, while TMTa score and TMTb score were decreased more significantly in the fluoxetine group than in the control group. We also found that the serum concentration of BDNF and VEGF in the fluoxetine group increased more significantly than in the control group. However, we found no significant differences in mean change from baseline between fluoxetine and control group in ADAS-Cog score, Digit Span Test score and VFT score.Conclusion: Fluoxetine may enhance cognition in certain cognitive domains and serum concentration of BDNF and VEGF in patients with VCIND.Keywords: cognition, enhancement, neuroprotection, selective serotonin reuptake inhibitors

Zhixin Zhang,&ast; Ying Shi,&ast; Haiyan Zheng, Zihuai Zhou, Zhifang Wu, Dongni Shen, Yiru Wang, Yizhou Zhang, Zhe Wang, Baiping Fu Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhe Wang; Baiping Fu Tel +86-571-87217427Fax +86-571-87217427Email 7319012@zju.edu.cn; fbp@zju.edu.cnObjective: This study investigated the effects of mineralizing film consisting of hydroxypropyl methylcellulose (HPMC) and amorphous fluorinated calcium phosphate (AFCP) nanoparticles on enamel white spot lesions (WSLs).Material and Methods: The AFCP nanoparticles and mineralizing film were prepared via nanoprecipitation and solvent evaporation, respectively. They were characterized with Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD), transmission electron microscopy (TEM), selected area electron diffraction (SAED), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), inductively coupled plasma atomic emission spectrometry (ICP-AES), and fluoride ion selective electrode. Thirty-two human enamel slices (4 mm × 4 mm × 1.5 mm) were highly polished and randomly assigned to four groups: negative control (no treatment); pure HPMC film; mineralizing film; GC Tooth Mousse Plus® (contains 10% CPP-ACP and 0.2% NaF). Subsequently, samples were challenged by a modified pH-cycling and characterized by color measurement, Micro-CT, SEM/EDX, and nanoindentation.Results: The mineralizing film could sustain release of Ca, P and F ions over 24 h and maintain AFCP nanoparticles in metastable state over 8∼ 12 h. During 4 weeks of pH cycling, the mineralizing film group exhibited least color change (∆E), mineral loss and lesion depth (120 ± 10 μm) among four groups (p < 0.05). SEM findings revealed that the porosities among enamel crystals increased in negative control and pure HPMC film groups after pH cycling, whereas in mineralizing film group, the original microstructure of enamel was well conserved and mineral deposits were detected between enamel prisms. Mineralizing film group demonstrated a least reduction of nanomechanical properties such as elastic modulus of 77.02 ± 6.84 GPa and hardness of 3.62 ± 0.57 GPa (p < 0.05).Conclusion: The mineralizing film might be a promising strategy for prevention and management of WSLs via inhibiting enamel demineralization and promoting enamel remineralization.Keywords: mineralizing film, white spot lesions, color, micro-CT, SEM/EDX, nanoindentation

The equilibrium shape of a thin inextensible membrane subject to solar radiation pressure under given boundary constraints is studied. The membrane is assumed to be insusceptible to elastic deformation and to have negligible bending resistance, and its steady-state shape is therefore described by a developable surface (i.e., a surface of zero Gaussian curvature), resulting from an equilibrium between radiation pressure and membrane tension forces. A quantitative understanding of the mechanics of such membranes is essential in characterizing the dynamics of solar sail spacecraft that use sail wing tip displacement as an attitude control mode. The analysis in this paper develops a theoretical foundation for the billowed wing shape. Under reasonable simplifying assumptions, the key result is that solar radiation pressure and a given wing tip displacement yield a billowed solar sail wing with the shape of a generalized cylinder (i.e., a developable ruled surface, whose rulings are all parallel, rather than a general developable with variable ruling directions). The base curve geometry for the solar sail is also determined as the solution to a boundary value problem. The results presented herein allow the shape of the billowed membrane to be computed to any desired precision, for any given tip displacement.

The transitional nuclei Xe132 and Xe133 are investigated after multinucleon-transfer (MNT) and fusion-evaporation reactions. Both nuclei are populated (i) in Xe136+Pb208 MNT reactions employing the high-resolution Advanced GAmma Tracking Array (AGATA) coupled to the magnetic spectrometer PRISMA, (ii) in the Xe136+Pt198 MNT reaction employing the GAMMASPHERE spectrometer in combination with the gas-detector array CHICO, and (iii) as an evaporation residue after a Te130(α,xn)Xe134-xn fusion-evaporation reaction employing the HORUS γ-ray array at the University of Cologne. The high-spin level schemes are considerably extended above the Jπ=(7-) and (10+) isomers in Xe132 and above the 11/2- isomer in Xe133. The results are compared to the high-spin systematics of the Z=54 as well as the N=78 and N=79 chains. Furthermore, evidence is found for a long-lived (T1/2â‰1μs) isomer in Xe133 which closes a gap along the N=79 isotones. Shell-model calculations employing the SN100PN and PQM130 effective interactions reproduce the experimental findings and provide guidance to the interpretation of the observed high-spin features.

The transitional nuclei Xe132 and Xe133 are investigated after multinucleon-transfer (MNT) and fusion-evaporation reactions. Both nuclei are populated (i) in Xe136+Pb208 MNT reactions employing the high-resolution Advanced GAmma Tracking Array (AGATA) coupled to the magnetic spectrometer PRISMA, (ii) in the Xe136+Pt198 MNT reaction employing the GAMMASPHERE spectrometer in combination with the gas-detector array CHICO, and (iii) as an evaporation residue after a Te130(α,xn)Xe134-xn fusion-evaporation reaction employing the HORUS γ-ray array at the University of Cologne. The high-spin level schemes are considerably extended above the Jπ=(7-) and (10+) isomers in Xe132 and above the 11/2- isomer in Xe133. The results are compared to the high-spin systematics of the Z=54 as well as the N=78 and N=79 chains. Furthermore, evidence is found for a long-lived (T1/2â‰1μs) isomer in Xe133 which closes a gap along the N=79 isotones. Shell-model calculations employing the SN100PN and PQM130 effective interactions reproduce the experimental findings and provide guidance to the interpretation of the observed high-spin features.

In order to improve the paper properties and enhance the utilization efficiency of functional chemical additives, surface sizing agents were prepared by combining water-soluble maleic anhydride acylated chitosan (MAAC), carboxymethylated chitosan (O-CMCS) and polyvinyl alcohol (PVA), and the effects of sizing process on the surface morphology, physical strength and antimicrobial properties of the dialysis paper were investigated. The results showed that when the coating weight was about 6.5 g/m2 and the dosage of the modified chitosan was about 1.5% of the paper weight, the dry tensile strength, wet tensile strength and burst strength of paper sized with MAAC/PVA sizing agent increased by 46.5%, 82.2% and 107%, respectively, compared to that of unsized paper, while the dry tensile strength, wet tensile strength and burst strength of paper sized with O-CMCS/PVA sizing agent increased by 41.4%, 53.6% and 107%, respectively. In addition, the paper sized with MAAC/PVA and O-CMCS/PVA sizing agent displayed excellent antibacterial effect, which had the antibacterial rate against E. coli of 94.8% and 92.9%, respectively. In a word, the physical strength and antimicrobial properties of paper could be greatly improved by adding a small amount of modified chitosan (CS) to the surface sizing agent, and the strength improvement and antibacterial effect of MAAC/PVA sizing agent were better than that of O-CMCS/PVA. [ABSTRACT FROM AUTHOR]

The high-spin structures and isomers of the N=81 isotones Xe135 and Ba137 are investigated after multinucleon-transfer (MNT) and fusion-evaporation reactions. Both nuclei are populated (i) in Xe136+U238 and (ii) Xe136+Pb208 MNT reactions employing the high-resolution Advanced Gamma Tracking Array (AGATA) coupled to the magnetic spectrometer PRISMA, (iii) in the Xe136+Pt198 MNT reaction employing the γ-ray array GAMMASPHERE in combination with the gas-detector array CHICO, and (iv) via a B11+Te130 fusion-evaporation reaction with the HORUS γ-ray array at the University of Cologne. The high-spin level schemesof Xe135 and Ba137 are considerably extended to higher energies. The 2058-keV (19/2-) state in Xe135 is identified as an isomer, closing a gap in the systematics along the N=81 isotones. Its half-life is measured to be 9.0(9) ns, corresponding to a reduced transition probability of B(E2,19/2-→15/2-)=0.52(6) W.u. The experimentally deduced reduced transition probabilities of the isomeric states are compared to shell-model predictions. Latest shell-model calculations reproduce the experimental findings generally well and provide guidance to the interpretation of the new levels.

The high-spin structures and isomers of the N=81 isotones Xe135 and Ba137 are investigated after multinucleon-transfer (MNT) and fusion-evaporation reactions. Both nuclei are populated (i) in Xe136+U238 and (ii) Xe136+Pb208 MNT reactions employing the high-resolution Advanced Gamma Tracking Array (AGATA) coupled to the magnetic spectrometer PRISMA, (iii) in the Xe136+Pt198 MNT reaction employing the γ-ray array GAMMASPHERE in combination with the gas-detector array CHICO, and (iv) via a B11+Te130 fusion-evaporation reaction with the HORUS γ-ray array at the University of Cologne. The high-spin level schemesof Xe135 and Ba137 are considerably extended to higher energies. The 2058-keV (19/2-) state in Xe135 is identified as an isomer, closing a gap in the systematics along the N=81 isotones. Its half-life is measured to be 9.0(9) ns, corresponding to a reduced transition probability of B(E2,19/2-→15/2-)=0.52(6) W.u. The experimentally deduced reduced transition probabilities of the isomeric states are compared to shell-model predictions. Latest shell-model calculations reproduce the experimental findings generally well and provide guidance to the interpretation of the new levels.