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Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent three-dimensional spinal disorder, with a multifactorial pathogenesis, including genetics and environmental aspects. Treatment options include non-surgical and surgical treatment. Surgical interventions demonstrate positive outcomes in terms of deformity correction, pain relief, and improvements of the cardiac and pulmonary function. Surgical complications, including excessive blood loss and neurologic deficits, are reported in 2.27–12% of cases. Navigation-assisted techniques, such as the O-arm system, have been a recent focus with enhanced precision. This study aims to evaluate the results and complications of one-stage posterior instrumentation fusion in AIS patients assisted by O-arm navigation. Materials and Methods: This retrospective study assesses 55 patients with AIS (12–28 years) who underwent one-stage posterior instrumentation correction supported by O-arm navigation from June 2016 to August 2023. We examined radiological surgical outcomes (initial correction rate, loss of correction rate, last follow-up correction rate) and complications as major outcomes. The characteristics of the patients, intraoperative blood loss, operation time, number of fusion levels, and screw density were documented. Results: Of 73 patients, 55 met the inclusion criteria. The average age was 16.67 years, with a predominance of females (78.2%). The surgical outcomes demonstrated substantial initial correction (58.88%) and sustained positive radiological impact at the last follow-up (56.56%). Perioperative complications, including major and minor, occurred in 18.18% of the cases. Two patients experienced a major complication. Blood loss (509.46 mL) and operation time (402.13 min) were comparable to the literature ranges. Trend analysis indicated improvements in operation time and blood loss over the study period. Conclusions: O-arm navigation-assisted one-stage posterior instrumentation proves reliable for AIS corrective surgery, achieving significant and sustained positive radiological outcomes, lower correction loss, reduced intraoperative blood loss, and absence of implant-related complications. Despite the challenges, our study demonstrates the efficacy and maturation of this surgical approach.

Over the past few decades, on-chip photonic integrated circuits based on silicon photonics (SiPh) platforms have gained widespread attention due to the fact that they offer many advantages, such as high bandwidth, low loss, compact size, low power consumption, and high integration with different photonic devices. The demand for high-speed and high-performance SiPh devices is driven by the significant increase in demand for Internet traffic. In photonic integrated circuits, controlling optical signals to make them circulate in a specific direction is a highly researched area of study. However, achieving a purely passive on-chip optical circulating network on a SiPh platform is very challenging. Therefore, we propose and demonstrate, through simulations, an on-chip optical circulator network on a silicon-on-insulator (SOI) platform. The proposed device can also support mode conversion. The proposed on-chip optical circulating network consists of two kinds of tailor-made multi-mode interferometer (MMI) structures and waveguide crossings. Through the optical power division and mode combination capabilities of the MMI, an optical circulating network supporting high optical isolation and mode conversion is achieved. The proposed optical circulating network has a loss of 1.5 dB at each output port, while maintaining a high isolation of 35 dB in the transmission window from 1530 nm to 1570 nm.

Abstract Flank wear is the most common wear that happens in the end milling process. However, the process of detecting the flank wear is cumbersome. To achieve comprehensively automatic detecting the flank wear area of the spiral end milling cutter, this study proposed a novel flank wear detection method of combining the template matching and deep learning techniques to expand the curved surface images into panorama images, which is more available to detect the flank wear areas without choosing a specific position of cutting tool image. You Only Look Once v4 model was employed to automatically detect the range of cutting tips. Then, popular segmentation models, namely, U-Net, Segnet and Autoencoder were used to extract the areas of the tool flank wear. To evaluate the segmenting performance among these models, U-Net model obtained the best maximum dice coefficient score with 0.93. Moreover, the predicting wear areas of the U-Net model is presented in the trend figure, which can determine the times of the tool change depend on the curve of the tool wear. Overall, the experiments have shown that the proposed methods can effectively extract the tool wear regions of the spiral cutting tool. With the developed system, users can obtain detailed information about the cutting tool before being worn severely to change the cutting tools in advance.

Ischemic acute kidney injury (AKI) has always been a hot and difficult research topic in the field of renal diseases. This study aims to illustrate the safe warm ischemia time of kidney and the molecular network characteristics and pathological features of mild to severe ischemia reperfusion kidney injury. We established varying degrees of renal injury due to different ischemia time (0 min, 16 min, 18 min, 20 min, 22 min, 24 min, 26 min, 28 min, and 30 min) on unilateral (left kidney) ischemia-reperfusion injury and contralateral (right kidney) resection (uIRIx) mouse model. Mice were sacrificed 24 h after uIRIx, blood samples were harvested to detect serum creatinine (Scr), and kidney tissue samples were harvested to perform Periodic Acid-Schiff (PAS) staining and RNA-Seq. Differentially expressed genes (DEGs) were identificated, time-dependent gene expression patterns and functional enrichment analysis were further performed. Finally, qPCR was performed to validated RNA-Seq results. Our results indicated that there was no absolute safe renal warm ischemia time, and every minute of ischemia increases kidney damage. Warm ischemia 26min or above in mice makes severe kidney injury, renal pathology and SCr were both significantly changed. Warm ischemia between 18 and 26 min makes mild kidney injury, with changes in pathology and renal molecular expression, while SCr did not change. No obvious pathological changes but significant differences in molecular expression were found less than 16min warm ischemia. There are two key time intervals in the process of renal ischemia injury, 0 min–16 min (short-term) and 26 min–28 min (long-term). Gene expression of immune-related pathways were most significantly down-regulated in short-term ischemia, while metabolism-related pathways were the mainly enriched pathway in long-term ischemia. Taken together, this study provides novel insights into safe renal artery occlusion time in partial nephrectomy, and is of great value for elucidating molecular network characteristics and pathological features of mild to severe ischemia reperfusion kidney injury, and key genes related to metabolism and immune found in this study also provide potential diagnostic and therapeutic biomarkers for AKI.

We put forward and demonstrate a silicon photonics (SiPh)-based mode division multiplexed (MDM) optical power splitter that supports transverse-electric (TE) single-mode, dual-mode, and triple-mode (i.e., TE0, TE1, and TE2). An optical power splitter is needed for optical signal distribution and routing in optical interconnects. However, a traditional optical splitter only divides the power of the input optical signal. This means the same data information is received at all the output ports of the optical splitter. The powers at different output ports may change depending on the splitting ratio of the optical splitter. The main contributions of our proposed optical splitter are: (i) Different data information is received at different output ports of the optical splitter via the utilization of NOMA. By adjusting the power ratios of different channels in the digital domain (i.e., via software control) at the Tx, different channel data information can be received at different output ports of the splitter. It can increase the flexibility of optical signal distribution and routing. (ii) Besides, the proposed optical splitter can support the fundamental TE0 mode and the higher modes TE1, TE2, etc. Supporting mode-division multiplexing and multi-mode operation are important for future optical interconnects since the number of port counts is limited by the chip size. This can significantly increase the capacity besides wavelength division multiplexing (WDM) and spatial division multiplexing (SDM). The integrated SiPh MDM optical power splitter consists of a mode up-conversion section implemented by asymmetric directional couplers (ADCs) and a Y-branch structure for MDM power distribution. Here, we also propose and discuss the use of the Genetic algorithm (GA) for the MDM optical power splitter parameter optimization. Finally, to provide adjustable data rates at different output ports after the MDM optical power splitter, non-orthogonal multiple access—orthogonal frequency division multiplexing (NOMA-OFDM) is also employed. Experimental results validate that, in three modes (TE0, TE1, and TE2), user-1 and user-2 achieve data rates of (user-1: greater than 22 Gbit/s; user-2: greater than 12 Gbit/s) and (user-1: greater than 12 Gbit/s; user-2: 24 Gbit/s), respectively, at power-ratio (PR) = 2.0 or 3.0. Each channel meets the hard-decision forward-error-correction (HD-FEC, i.e., BER = 3.8 × 10−3) threshold. The proposed method allows flexible data rate allocation for multiple users for optical interconnects and system-on-chip networks.

To accurately identify the natural gas hydrates (NGH) in the sea area of the Makran Accretionary Prism, Pakistan, this paper presents the testing and analysis of major and trace elements in sediment samples taken from two stations (S2 and S3) in the area by the China Geological Survey. As shown by testing results, all major elements are slightly different in content between the two stations except SiO2 and CaO. This also applies to the trace elements that include Sr and Ba primarily and Cr, Ni and Zn secondarily. It can be concluded in this study that the tectonic setting of the Makran Accretionary Prism is dominated by oceanic island arc and that provenance of the Makran Accretionary Prism is dominated by felsic igneous provenance, which is at the initial weathering stage and mainly consists of granodiorite. Besides terrigenous detritus, there are sediments possibly originating from Makran-Bela Ophiolite from the northwestern part and Murray Ridge igneous rocks from the southeastern part. The V/Cr, Ni/Co, and V/(V+Ni) ratios indicate that sediments of the two stations are in an oxidation-suboxidation environment. However, the authors infer that the sedimentary environment of the sediments 3.0 m below the seafloor tends to be gradually transformed into a reduction environment by comparison with the Qiongdongnan Basin in the South China Sea where NGH has been discovered. The sediments in the Makran Accretionary Prism are rich in organic matter, with total organic carbon (TOC) content greater than 1%. According to comprehensive research, the organic matter in the sediments mainly originates from marine algae and has high TOC content, which is favorable for the formation of NGH.

As cyclical orbital movements of Earth, Milankovitch cycles can be recorded in sedimentary strata. The time they reflect can be used to accurately divide and compare strata. Milankovitch cycles recorded in strata enrich the stratigraphic theory, especially the theories of cycle stratigraphy, and thus they are widely used in geological survey engineering nowadays. This study explored the characteristics of the Milankovitch cycles recorded in the eastern depression of the North Yellow Sea Basin, highlighting their control over high-frequency stratigraphic sequences. The Eocene Milankovitch cycles in the depression were calculated based on the method proposed by J. Laskar, and their parameters primarily include eccentricity cycles of 125 ka and 99 ka, obliquity cycles of 51 ka and 39 ka, and precession cycles of 23 ka and 19 ka. Spectral analysis of gamma-ray (GR) and spontaneous potential (SP) log curves of the Eocene strata was carried out to divide and compare stratigraphic sequences, revealing that the spectral peaks correspond well to astronomical cycles. This indicates that the strata in the depression fully record Milankovitch cycles. Furthermore, there are long-, medium-, and short-term stratigraphic cycles in the eastern depression, with a thickness of 13.03–15.89 m, 3.70–5.21 m, and 2.17–2.94 m, respectively. The sedimentation rates of the Eocene strata were calculated to be 121.2–127.12 m/Ma accordingly. From the uplift to the center of the lacustrine basin along the slope in the eastern depression, both the sedimentation duration and the sediment thickness increase, while the sedimentation rate remains relatively stable. The Eocene strata can be divided into six stages of high-frequency sequences by continuous wavelet transformation, namely E6–E1 from bottom to top. The sedimentation duration and sedimentation rates of the sequences were calculated using spectral analysis with each of the sequences as a separate window. Moreover, the impacts of climate change on the sedimentary environment in the eastern depression were analyzed. It can be concluded that E6 was a lowstand system tract, E5 and E4 were lacustrine expansion system tracts, E3 was a highstand system tract, and E2 and E1 were lacustrine contraction system tracts. All these verify that Milankovitch cycles serve as an effective approach for the analysis of sedimentary cycles.

ABSTRACT: Oil and gas resources are short in Pakistan and no commercially viable oil and gas sources have been yet discovered in its offshore areas up to now. In this study, the onshore-offshore stratigraphic correlation and seismic data interpretation were conducted to determine the oil and gas resource potential in the Offshore Indus Basin, Pakistan. Based on the comprehensive analysis of the results and previous data, it is considered that the Cretaceous may widely exist and three sets of source rocks may be developed in the Offshore Indus Basin. The presence of Miocene mudstones has been proven by drilling to be high-quality source rocks, while the Cretaceous and Paleocene–Eocene mudstones are potential source rocks. Tectonic-lithologic traps are developed in the northwestern part of the basin affected by the strike-slip faults along Murray Ridge. Furthermore, the Cretaceous and Paleocene–Eocene source rocks are thick and are slightly affected by volcanic activities. Therefore, it can be inferred that the northwestern part of Offshore Indus Basin enjoys good prospects of oil and gas resources.

Earlier electroencephalographic studies have compared attractive and unattractive faces and between faces with other objects, such as flowers, without revealing if a recognition memory bias toward faces and flowers exists or whether humans exhibit enhanced specific components toward all attractive objects or only toward attractive faces. For objects with similar degrees of attractiveness, we sought to determine if the N170, P1, and N250 reflect upon the attractiveness of faces and flowers and demonstrated by comparing event-related potentials of humans' different perceptual mechanisms recognizing high attractive faces and high attractive flowers. The repeated high attractive faces tended to elicit a larger N170. Simultaneously, the P1 was preferentially associated with the repeated high attractive flowers, but both indicated that the repetitive enhancement effect only occurred on repeated attractive faces. Thus, differences existed in the perceptual mechanisms for processing repeated high attractive faces and repeated high attractive flowers. However, there was no significant difference in N250 between repeated faces and repeated flowers or between high attractive faces and high attractive flowers. Consequently, high attractive faces and high attractive flowers capture the beholder's memory bias in different processing stages. The N170 and P1 components are affected by attractiveness, thereby demonstrating the differences between human perceptual mechanisms in recognizing high attractive faces and objects.

ABSTRACT: Based on well logging and seismic data, combined with a comparative analysis of drilling data in the Lower Yangtze region, the sequence stratigraphic framework of the Qinglong Formation was established and divided into four third-order sequences. Each sequence is mainly composed of the transgress system tract (TST) and the high-stand system tract (HST). According to the lithology, logging curve and seismic reflection structure, the sedimentary filling characteristics and evolution law for the sequence are analyzed. The results show that each sequence is dominated by a half-cycle decline of sea level, and the rise-fall of sea level controls the distribution and evolution of sedimentary systems within the sequence. During the relative sea-level rise, sedimentation rates slow down and muddy sediments are developed. The characteristics of condensing intervals on the flooding surface are very obvious, and continental shelf and open platform deposition are mainly developed. During the relative decline of sea level, the thickness of sediments increased. The main developments were restricted platform and platform shoal environment, and locally developed evaporation platform environment.

Abstract Backgrounds The role of sphere-forming culture in enriching subpopulations with stem-cell properties in hepatocellular carcinoma (HCC) is unclear. The present study investigates its value in enriching cancer stem cells (CSCs) subpopulations and the mechanism by which HCC CSCs are maintained. Methods HCC cell lines and fresh primary tumor cells were cultured in serum-free and ultra-low attachment conditions to allow formation of HCC spheres. In vitro and in vivo experiments were performed to evaluate CSC characteristics. Expression levels of CSC-related genes were assessed by qRT-PCR and the correlation between sphere formation and clinical characteristics was investigated. Finally, gene expression profiling was performed to explore the molecular mechanism underlying HCC CSC maintenance. Results We found that both cell lines and primary tumor cells formed spheres. HCC spheres possessed the capacity for self-renewal, proliferation, drug resistance, and contained different subpopulations of CSCs. Of interest, 500 sphere-forming Huh7 cells or 200 primary tumor cells could generate tumors in immunodeficient animals. Sphere formation correlated with size, multiple tumors, satellite lesions, and advanced stage. Further investigation identified that the PPARα-SCD1 axis plays an important role in maintenance of the CSC properties of HCC sphere cells by promoting nuclear accumulation of β-Catenin. Inhibition of SCD1 interfered with sphere formation, down-regulated expression of CSC-related markers, and reduced β-Catenin nuclear accumulation. Conclusions Sphere-forming culture can effectively enrich subpopulations with stem-cell properties, which are maintained through activation of the PPARα-SCD1 axis. Therefore, we suggest that targeting the SCD1-related CSC machinery might provide a novel insight into HCC treatment.

ABSTRACT: The South Yellow Sea Basin is a large sedimentary basin superimposed by the Mesozoic-Paleozoic marine sedimentary basin and the Mesozoic-Cenozoic terrestrial sedimentary basin, where no oil and gas fields have been discovered after exploration for 58 years. After the failure of oil and gas exploration in terrestrial basins, the exploration target of the South Yellow Sea Basin turned to the marine Mesozoic-Paleozoic strata. After more than ten years’ investigation and research, a lot of achievements have been obtained. The latest exploration obtained effective seismic reflection data of deep marine facies by the application of seismic exploration technology characterized by high coverage, abundant low-frequency components and strong energy source for the deep South Yellow Sea Basin. In addition, some wells drilled the Middle-Upper Paleozoic strata, with obvious oil and gas shows discovered in some horizons. The recent petroleum geological research on the South Yellow Sea Basin shows that the structure zoning of the marine residual basin has been redetermined, the basin structure has been defined, and 3 seismic reflection marker layers are traceable and correlatable in the residual thick Middle-Paleozoic strata below the continental Meso-Cenozoic strata in the South Yellow Sea Basin. Based on these, the seismic sequence of the marine sedimentary strata was established. According to the avaliable oil and gas exploration and research, the marine Mesozoic-Paleozoic oil and gas prospects of the South Yellow Sea were predicted as follows. (1) The South Yellow Sea Basin has the same sedimentary formation and evolution history during the sedimentary period of the Middle-Paleozoic marine basin with the Sichuan Basin. (2) There are 3 regional high-quality source rocks. (3) The carbonate and clastic reservoirs are developed in the Mesozoic-Paleozoic strata. (4) The three source-reservoir-cap assemblages are relatively intact. (5) The Laoshan Uplift is a prospect area for the Lower Paleozoic oil and gas, and the Wunansha Uplift is one for the marine Upper Paleozoic oil and gas. (6) The Gaoshi stable zone in the Laoshan Uplift is a favorable zone. (7) The marine Mesozoic-Paleozoic strata in the South Yellow Sea Basin has the geological conditions required to form large oil and gas fields, with remarkable oil and gas resources prospect. An urgent problem to be addressed now within the South Yellow Sea Basin is to drill parametric wells for the Lower Paleozoic strata as the target, to establish the complete stratigraphic sequence since the Paleozoic period, to obtain resource evaluation parameters, and to realize the strategic discovery and achieve breakthrough in oil and gas exploration understanding.©2019 China Geology Editorial Office.

ABSTRACT: In order to make a breakthrough in Mesozoic-Paleozoic shale gas exploration in the South Yellow Sea Basin, a comparison of the preservation conditions was made within the Barnett shale gas reservoirs in the Fortworth Basin, the Jiaoshiba shale gas reservoirs in Sichuan Basin and potential shale gas reservoirs in Guizhou Province. The results show that the “Sandwich” structure is of great importance for shale gas accumulation. Therein to, the “Sandwich” structure is a kind of special reservoir-cap rock assemblage which consist of limestone or dolomite on the top, mudstone or shale layer in the middle and limestone or dolomite at the bottom. In consideration of the Mesozoic-Paleozoic in the Lower Yangtze, and Laoshan Uplift with weak Paleozoic deformation and thrust fault sealing on both flanks of the Laoshan Uplift, a conclusion can be drawn that the preservation conditions of shale gas probably developed “Sandwich” structures in the Lower Cambrian and Permian, which are key layers for the breakthrough of shale gas in the South Yellow Sea. Moreover, the preferred targets for shale gas drilling probably locate at both flanks of the Laoshan Uplift.

ABSTRACT: Based on the seismic data gathered in past years and the correlation between the sea and land areas of the Lower Yangtze Platform, the structural characteristics of the South Yellow Sea Basin since the Indosinian tectonic movement is studied in this paper. Three stages of structural deformation can be distinguished in the South Yellow Sea Basin since the Indosinian. The first stage, Late Indosinian to Early Yanshanian, was dominated by foreland deformation including both the uplifting and subsidence stages under an intensively compressional environment. The second stage, which is called the Huangqiao Event in the middle Yanshanian, was a change for stress fields from compression to extension. While in the third stage (the Sanduo Event) in the Late Himalayan, the basin developed a depression in the Neogene-Quaternary after rifting in the Late Cretaceous-Paleogene. The long-time evolution controlled 3 basin formation stages from a foreland basin, then a fault basin to a final depression basin. In conclusion, since the Indosinian, the South Yellow Sea Basin has experienced compressional fold and thrust, collisional orogen, compressional and tensional pulsation, strike-slip, extensional fault block and inversion structures, compression and convergence. The NE, NEE, nearly EW and NW trending structures developed in the basin. From west to east, the structural trend changed from NEE to near EW to NW. While from north to south, they changed from NEE to near EW with a strong-weak-strong zoning sequence. Vertically, the marine and terrestrial facies basins show a “seesaw” pattern with fold and thrust in the early stages, which is strong in the north and weak in the south and an extensional fault in later stages, which is strong in the north and weak in the south. In the marine facies basin, thrust deformation is more prevailing in the upper structural layer than that in the lower layer. The tectonic mechanism in the South Yellow Sea Basin is mainly affected by the collision between the Yangtze and North China Block, while the stress environment of large-scale strike-slip faults was owing to subduction of the Paleo-Pacific plate. The southern part of the Laoshan uplift is a weak deformation zone as well as a stress release zone, and the Meso-Paleozoic had been weakly reformed in later stages. The southern part of the Laoshan uplift is believed, therefore, to be a promising area for oil and gas exploration.

ABSTRACT Objective: The Michigan State University (MSU) classification of lumbar disc herniation (LDH) is periodically used by various authors to classify disc herniation. We assessed the reliability of this classification system among orthopedic residents at our institute. Methods: Fifty T2 axial-cut magnetic resonance images (MRI) corresponding to the level of maximal disc herniation from patients diagnosed with a single LDH were selected and distributed to six orthopedic residents. All six residents gave a specific rating for each image based on the MSU classification; in addition, three residents gave ratings on two different occasions. The degree of agreement among residents was analyzed by calculating inter-observer and intra-observer reliability using the Kappa statistic. Results: The inter-observer reliability among the six residents calculated as the Fleiss’ Kappa was 0.422, which indicates moderate reliability. The intra-observer reliability of three selected residents calculated by Cohen's Kappa was 0.750, 0.772, and 0.859, which indicates substantial to almost perfect reliability. Variations in ratings were frequent in images portraying a broad-based disc herniation with spinal canal stenosis. Conclusion: Our findings demonstrate moderate homogeneity of ratings given by residents; however, test-retest results proved the ratings to be consistent. Level of Evidence II, Diagnostic studies - investigating a diagnostic examination.

The deep learning technique has turned into a mature technique. In addition, many researchers have applied deep learning methods to classify products into defective categories. However, due to the limitations of the devices, the images from factories cannot be trained and inferenced in real-time. As a result, the AI technology could not be widely implemented in actual factory inspections. In this study, the proposed smart sorting screw system combines the internet of things technique and an anomaly network for detecting the defective region of the screw product. The proposed system has three prominent characteristics. First, the spiral screw images are stitched into a panoramic image to comprehensively detect the defective region that appears on the screw surface. Second, the anomaly network comprising of convolutional autoencoder (CAE) and adversarial autoencoder (AAE) networks is utilized to automatically recognize the defective areas in the absence of a defective-free image for model training. Third, the IoT technique is employed to upload the screw image to the cloud platform for model training and inference, in order to determine if the defective screw product is a pass or fail on the production line. The experimental results show that the image stitching method can precisely merge the spiral screw image to the panoramic image. Among these two anomaly models, the AAE network obtained the best maximum IOU of 0.41 and a maximum dice coefficient score of 0.59. The proposed system has the ability to automatically detect a defective screw image, which is helpful in reducing the flow of the defective products in order to enhance product quality.

Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a cutting loop. Although TURP is a minimally invasive procedure, bleeding is still the most common complication. Therefore, the evaluation, monitoring, and prevention of interop bleeding during TURP are very important issues. The main idea of this study is to rank bleeding levels during TURP surgery from videos. Generally, to judge bleeding level by human eyes from surgery videos is a difficult task, which requires sufficient experienced urologists. In this study, machine learning-based ranking algorithms are proposed to efficiently evaluate the ranking of blood levels. Based on the visual clarity of the surgical field, the four ranking of blood levels, including score 0: excellent; score 1: acceptable; score 2: slightly bad; and 3: bad, were identified by urologists who have sufficient experience in TURP surgery. The results of extensive experiments show that the revised accuracy can achieve 90, 89, 90, and 91%, respectively. Particularly, the results reveal that the proposed methods were capable of classifying the ranking of bleeding level accurately and efficiently reducing the burden of urologists.

Osteitis deformans, also known as Paget's disease, is characterized by accelerated osteoclastic activity followed by ineffective osteoblastic activity resulting in a deformed and fragile bone. It is more prevalent in Western Europe and relatively rare in Eastern Asia. It predominantly involves the lumbar spine, pelvis, and femur, frequently as polyostotic and rarely as monostotic disease. Here, we report a 64-year-old female, who presented with severe progressive back pain with no neurological symptoms. Radiographs revealed a picture frame L1 vertebra which was deformed and enlarged with loss of normal alignment. Magnetic resonance imaging revealed bone marrow changes involving all columns of L1 vertebra. Whole-body technetium-99 bone scan showed a solitary increased uptake of radioisotope by L1 vertebra. Considering the possibility of metastatic tumors, blood investigations were drawn for tumor markers which were within normal limits. A computed tomography-guided biopsy was done to facilitate diagnosis. Histopathology sections showed a mosaic pattern of bony trabeculae with multinucleated osteoclasts causing erosions and tunneling. A diagnosis of monostotic Paget's disease was made which satisfactorily responded to single-dose zoledronic acid treatment. A comprehensive literature review is provided.

Vertebroplasty (VP), balloon kyphoplasty (BKP), and vertebral stent (VS) are usually used for treating osteoporotic compression fractures. However, these procedures may pose risks of secondary adjacent level fractures. This study simulates finite element models of osteoporotic compression fractures treated with VP, BKP, and VS Vertebral resection method was used to simulate vertebra fracture with Young’s modulus set at 70 MPa to replicate osteoporosis. A follower load of (1175 N for flexion, and 500 N for all others) was applied in between vertebral bodies to simulate the muscle force. Moment loadings of 7.5 N-m in flexion, extension, lateral bending, axial rotation were applied respectively. The VS model had the highest von Mises stresses on the bone cement under all different loading conditions (flexion/5.91 MPa; extension/3.74 MPa; lateral bending/3.12 MPa; axial rotation/3.54 MPa). The stress distribution and maximum von Mises stresses of the adjacent segments, T11 inferior endplate and L1 superior endplate, showed no significant difference among three surgical models. The postoperative T12 stiffness for VP, BKP, and VS are 2898.48 N/mm, 4123.18 N/mm, and 4690.34 N/mm, respectively. The VS model led to superior surgical vertebra stiffness without significantly increasing the risks of adjacent fracture.

Transurethral resection of the prostate (TURP) is a surgical removal of obstructing prostate tissue. The total bleeding area is used to determine the performance of the TURP surgery. Although the traditional method for the detection of bleeding areas provides accurate results, it cannot detect them in time for surgery diagnosis. Moreover, it is easily disturbed to judge bleeding areas for experienced physicians because a red light pattern arising from the surgical cutting loop often appears on the images. Recently, the automatic computer-aided technique and artificial intelligence deep learning are broadly used in medical image recognition, which can effectively extract the desired features to reduce the burden of physicians and increase the accuracy of diagnosis. In this study, we integrated two state-of-the-art deep learning techniques for recognizing and extracting the red light areas arising from the cutting loop in the TURP surgery. First, the ResNet-50 model was used to recognize the red light pattern appearing in the chipped frames of the surgery videos. Then, the proposed Res-Unet model was used to segment the areas with the red light pattern and remove these areas. Finally, the hue, saturation, and value color space were used to classify the four levels of the blood loss under the circumstances of non-red light pattern images. The experiments have shown that the proposed Res-Unet model achieves higher accuracy than other segmentation algorithms in classifying the images with the red and non-red lights, and is able to extract the red light patterns and effectively remove them in the TURP surgery images. The proposed approaches presented here are capable of obtaining the level classifications of blood loss, which are helpful for physicians in diagnosis.

Background: Spinocerebellar ataxias (SCAs) are a group of neurodegenerative disorders that primarily cause the degeneration in the cerebellum, spinal cord, and brainstem. We study the clinical characteristics, radiological features and gene mutation in Chinese families with SCAs. Methods: In this study, we investigated 10 SCAs Chinese families with SCA1, SCA3/Machado-Joseph disease (MJD), SCA7, SCA8. There were 27 people who were genetically diagnosed as SCA, of which 21 people showed clinical symptoms, and 6 people had no clinical phenotype that we called them presymptomatic patients. In addition, 3 people with cerebellar ataxia and cataracts were diagnosed according to the Harding diagnostic criteria but failed to be recognized as SCAs on genetic testing. Clinical characteristic analyses of each type of SCAs and radiological examinations were performed. Results: We found that SCA3/MJD was the most common subtype in Han population in China, and the ratio of the pontine tegmentum and the posterior fossa area was negatively correlated with the number of cytosine-adenine-guanine (CAG) repeats; the disease duration was positively correlated with the International Cooperative Ataxia Rating Scale score; and the CAG repeats number of abnormal alleles was negatively correlated with the age of onset. Conclusions: Collectively our study is a systematic research on SCAs in China, which may help for the clinical diagnosis and prenatal screening of this disease, and it may also aid toward better understanding of this disease.

We previously reported that a novel marine compound, xyloketal B, has strong antioxidative actions in different models of cardiovascular diseases. Induction of heme oxygenase-1 (HO-1), an important endogenous antioxidant enzyme, has been considered as a potential therapeutic strategy for cardiovascular diseases. We here investigated whether xyloketal B exhibits its antioxidant activity through induction of HO-1. In human umbilical vein endothelial cells (HUVECs), xyloketal B significantly induced HO-1 gene expression and translocation of the nuclear factor-erythroid 2-related factor 2 (Nrf-2) in a concentration- and time-dependent manner. The protection of xyloketal B against angiotensin II-induced apoptosis and reactive oxygen species (ROS) production could be abrogated by the HO-1 specific inhibitor, tin protoporphyrin-IX (SnPP). Consistently, the suppressive effects of xyloketal B on NADPH oxidase activity could be reversed by SnPP in zebrafish embryos. In addition, xyloketal B induced Akt and Erk1/2 phosphorylation in a concentration- and time-dependent manner. Furthermore, PI3K inhibitor LY294002 and Erk1/2 inhibitor U0126 suppressed the induction of HO-1 and translocation of Nrf-2 by xyloketal B, whereas P38 inhibitor SB203580 did not. In conclusion, xyloketal B can induce HO-1 expression via PI3K/Akt/Nrf-2 pathways, and the induction of HO-1 is mainly responsible for the antioxidant and antiapoptotic actions of xyloketal B.

Dendrobium is a traditional Chinese herb with anti-diabetic effects and has diverse bibenzyls as well as phenanthrenes. Little is known about Dendrobium polyphenols anti-diabetic activities, so, a rich-polyphenols extract of D. loddigesii (DJP) was used for treatment of diabetic db/db mice; the serum biochemical index and tissue appearance were evaluated. In order to gain an insight into the anti-diabetic mechanism, the oxidative stress index, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and gut microbiota modulation were determined by ELISA, immunohistochemistry or high throughput sequencing 16S rRNA gene. The results revealed that DJP had the effects to decrease the blood glucose, body weight, low density lipoprotein cholesterol (LDL-C) levels and increase insulin (INS) level in the mice. DJP improved the mice fatty liver and diabetic nephropathy. DJP showed the anti-oxidative abilities to reduce the malondialdehyde (MDA) level and increase the contents of superoxide dismutase (SOD), catalase (CAT) as well as glutathione (GSH). DJP exerted the anti-inflammatory effects of decreasing expression of IL-6 and TNF-α. After treatment of DJP, the intestinal flora balance of the mice was ameliorated, increasing Bacteroidetes to Firmicutes ratios as well as the relative abundance of Prevotella/Akkermansia and reducing the relative abundance of S24-7/Rikenella/Escherichia coli. The function’s prediction of gut microbiota indicated that the microbial compositions involved carbohydrate metabolism or lipid metabolism were changed. This study revealed for the first time that DJP improves the mice symptoms of diabetes and complications, which might be due to the effects that DJP induced the decrease of inflammation as well as oxidative stress and improvement of intestinal flora balance.