Search

The study aimed to construct prognostic models for OS and CSS in patients with T1N0M0 glottic SCC. In addition, we used PSM to re-assess the effect of surgery alone and radiation alone.The Surveillance, Epidemiology, and End Results database was searched for patients with confirmed T1N0M0 glottic SCC. Patients with complete data were randomly divided into the training and the validation cohort (7:3), Cox-regression analysis was performed to identified significant predictors of OS and CSS. PSM was used to mimic randomized controlled the trials. Kaplan-Meier survival method and log-rank tests were utilized for survival analysis.A total 1827 patients met the inclusion criteria. Survival analysis indicated that the patients who underwent the primary site surgery had a better OS (P = 0.002) and CSS (P = 0.008), compared with non-surgery patients. Cox-regression analysis proved that age, marital status, T1 stages, surgery, radiation, sequential treatments, and chemotherapy had significant effects on OS. While age, marital status, histologic grade, surgery, radiation, sequential treatments, and chemotherapy were substantially associated with CSS. Patients who received primary site surgery had a better OS and CSS, compared with non-surgical patients. Patients receiving radiation had a better CSS than non-radiation patients. However, patients who received sequential treatments or chemotherapy had a worse OS and CSS, compared with controlled groups. Predictive nomogram models were established to predict patients' prognosis with good consistency between the actual observation and the nomogram prediction. Before PSM, patients who underwent surgery alone had a better OS and CSS than those who received radiation alone. After PSM, patients receiving surgery still had a better OS than those receiving radiation. However, there were no statistically significant differences in CSS.Nomogram models were developed to predict OS and CSS in patients with T1N0M0 glottic SCC. Primary site surgery could definitely increase OS and CSS, while radiation could significantly increase CSS. Using PSM, surgery alone could significantly enhance OS, as compared to radiation alone. Chemotherapy should not be recommended for early glottic carcinoma.

Purpose To analyze the impact of AAD on the severity and mortality of COVID-19 patients and compare clinical outcomes between patients with and without AAD. Methods In the systematic review and meta-analysis, we searched PubMed, Embase, Web of Science for studies reporting allergic rhinitis, asthma prevalence in COVID-19 patients and compared clinical outcomes, and excluded duplicate publications, reviews, comments, single or few cases reports (

The optimal treatments for adult benign laryngotracheal stenosis presently remains controversial. The majority of the disadvantages of endoscopic interventions with high recurrence rate and open surgical therapy accompanied by sophisticated techniques, complication and mortality, highlights the dilemma of option for treatments.To compare endoscopic treatments with open surgical interventions in adult patients with benign laryngotracheal stenosis, analyze their clinical outcomes, recurrence, complication and mortality.In the meta-analysis, the databases including PubMed, Embase, Ovid and Web of Science were searched for studies reporting adult benign laryngotracheal stenosis, and clinical outcomes were compared. The duplicate publications, reviews, comments or letters, conference abstracts, case reports were excluded. The random effect model was used for calculating the pooled effect estimates.Eight studies (1627 cases) referring to six retrospective and two prospective researches were ultimately included in the meta-analysis. The decreased risk estimates of recurrence rate in patients receiving open surgical interventions were detected, comparing with endoscopic interventions (P 0.05). Subgroup analysis revealed that decreased risk estimates of restenosis rate were also observed in patients receiving open surgical interventions compared with endoscopic interventions (P 0.05), based on prospective studies, Europe and America, 2-year follow-up, laryngeal stenosis, stenotic length without inter-group difference or stenotic grade II alone. However, there were no statistically significant difference of recurrence rate between the two interventions (P 0.05) based on retrospective studies, South Asia and Africa, ≥ 2-year follow-up, involving tracheal lesion, stenotic length with inter-group difference, or stenotic grades of I-IV. No notable difference in the incidence of complication or mortality were identified.Open surgical interventions were more suitable for most laryngotracheal stenosis without contraindications. Endoscopic interventions are increasingly being used to treat simple laryngotracheal stenosis, as well as complex airway stenosis in carefully selected cases. Multi-center prospective randomized controlled trials should be conducted to search for the standard treatments for laryngotracheal stenosis.

This study aimed to evaluate the outcome of surgical debridement combined with postoperative hip spica immobilization in the treatment of hip joint tuberculosis in children.This retrospective study enrolled 87 children with stage I to III hip joint tuberculosis treated surgically at our hospital from January 2010 to January 2016. All patients considering hip tuberculosis routinely received a 4-week conservative treatment first, including rest, protected weight-bearing, and 4-drugs antitubercular chemotherapy. Surgical debridement was indicated when there was no relief after this conservative protocol. Patients were divided into 2 groups according to the duration of hip spica immobilization after operation: group A (hip spica for 4 wk, 39 patients) and group B (hip spica for 6 wk, 48 patients). All patients were recommended partial weight-bearing for 7 days and then followed the same hip joint exercises program when spica was removed. Postoperative radiographs, hip dislocation or subluxation, and modified Harris hip score (MHHS) were assessed. All patients were followed up at least 5 years.There were 87 patients enrolled in our study, including 34 females and 53 males, with a mean age of 7.2±2.8 years old (range: 2 to 14 y). No significant difference was observed between these 2 groups in baseline data. In group A, the mean MHHS improved from 52.1±14.7 before surgery to 87.8±8.3 at the final follow-up ( P0.000). In group B, there was also a significant difference between the preoperative MHHS (52.7±9.4) and the final MHHS (88.6±6.5) ( P0.000). Although there was no significant difference between these 2 groups in the final MHHS ( P =0.593), there were also no significant differences between these 2 groups in wound healing delay (3 in group A and 6 in group B, P =0.705) and pathologic subluxation (3 in group A and 1 in group B, P =0.467). The only difference between group A (79.2±8.5) and group B (75.5±7.5) was the early functional outcome assessed by using MHHS after 1 month of hip joint exercises ( P =0.032).Surgical debridement combined with antitubercular chemotherapy is an effective treatment for stage I to III hip tuberculosis in children when there is no improvement after conservative treatment. Prolonged hip spica immobilization may not reduce the risk of hip subluxation after open surgical debridement but could lead to a delay in early functional recovery. Time of spica immobilization should be individualized and based on the surgeon's evaluation and the patient's condition.

Radial neck fracture is a less common injury in childhood and many factors are associated with the final functional outcomes. This study aimed to describe the clinical and radiological results of the patients with radial neck fractures treated surgically and assess the potential risk factors for poor functional outcomes.This study enrolled 101 children with radial neck fracture and treated surgically at our department. Patients were followed up at least three years and assessed clinically and radiographically. The primary outcome of this study was the functional outcome assessed by using Metaizeau criteria and the secondary outcome was complications of radial head necrosis, postoperative radial nerve palsy, bone union, infection, and skin irritation. Related risk factors for unsatisfactory functional outcomes were recorded and analyzed by multivariable logistic regression.In total, 101 patients with 101 elbows (44 on the left side, 57 on the right side) were evaluated in our study, including 55 females (54.5%) and 46 males (45.5%), with a mean age of 7.5±2.7 years old (range, 3 to 14 years). There were 65.3% excellent (66 cases), 18.8% good (19 cases), 11.9% fair (12 cases), and 4.0% bad (4 cases) results in these patients. The rate of satisfactory outcome was 65.3% (66/101) and the rate of "unsatisfactory outcome" was 34.7% (35/101). Complications included postoperative radial nerve palsies in 15 cases (14.9%), radial head necrosis in 4 cases (4.0%), skin irritation due to the nail-end in 5 cases (5.0%), infection in 2 cases (2.0%), and bone nonunion in 1 patient (1.0%). Only Judet type (OR, 5.78; CI, 1.72-19.39, p=0.005) and surgical method (OR, 12.68; CI, 2.55-63.06, p=0.002) were independent risk factors for the unsatisfactory functional outcomes.Closed reduction with intramedullary fixation is a primary treatment for type III and IV radial neck fractures in children. Fracture severity classified as Judet type IV and open surgical method were independent predictors for unsatisfactory functional outcomes.

Background: Previous studies concerning the effect of plasma hemoglobin (HB) and other factors that may modify the risk of death in people living with HIV/AIDS (PLHIV) treated with antiretroviral therapy (ART) are limited. Results: Higher HB was independently linked to a lower death risk in PLHIV, with a decrease of 29% (13%, 43%) per standard deviation (SD) increment after adjusting for CD4, VL and other potential factors [hazard ratio (HR): 0.71, 95% confidence interval (CI): 0.57-0.87, P

Small-sized, low-cost, and high-sensitivity sensors are required for pressure-sensing applications because of their critical role in consumer electronics, automotive applications, and industrial environments. Thus, micro/nanoscale pressure sensors based on micro/nanofabrication and micro/nanoelectromechanical system technologies have emerged as a promising class of pressure sensors on account of their remarkable miniaturization and performance. These sensors have recently been developed to feature multifunctionality and applicability to novel scenarios, such as smart wearable devices and health monitoring systems. In this review, we summarize the major sensing principles used in micro/nanoscale pressure sensors and discuss recent progress in the development of four major categories of these sensors, namely, novel material-based, flexible, implantable, and self-powered pressure sensors. Keywords: M/NEMS, Pressure sensor, Flexible sensor, Piezoresistive sensor, Capacitive sensor, Piezoelectric sensor, Resonant sensor, 2D material

ObjectMarital status plays different roles as a risk factor on survival in various cancers . The study is aimed to analyze the impact of marital status on survival of oral and oropharyngeal squamous cell carcinoma(OPSCC) at population level based on SEER database using propensity-score matching method(PSM).Methods37,023 eligible patients were extracted from the Surveillance, Epidemiology, and End Results(SEER) database, and analyzed the impact of various marital status on cancer-specific survival(CSS) of OPSCC by Kaplan-Meier method and Cox regression model. Then we used propensity-score matching analysis to balance baseline characteristics between married, single, divorced and widowed patients. The impact of various marital status after pairwise matching using p-value adjusted and PSM on CSS was re-analyzed by Kaplan-Meier method.ResultsThe age, sex, race, tumor location, pathologic grades, SEER stages, treatments, composite socioeconomic status(C-SES), insurance, and marital status were identified as independent prognostic factors for CSS of OPSCC. Widowed patients presented the worst CSS, compared with married, single, and divorced patients(P

Background Optimal ω-6/ω-3 polyunsaturated fatty acids ratio (PUFAR) is reported to exert protective effects against chronic diseases. However, data on PUFAR and diabetic retinopathy (DR) remains scarce. We aimed to thoroughly quantify whether and how PUFAR was related to DR as well as its role in DR detection. Methods This two-centre case-control study was conducted from August 2017 to June 2018 in China, participants were matched using a propensity score matching algorithm. We adopted multivariable logistic regression models and restricted cubic spline analyses to estimate the independent association of PUFAR with DR, adjusting for confounders identified using a directed acyclic graph. The value of PUFAR as a biomarker for DR identification was further evaluated by receiver operating characteristic analyses and Hosmer-Lemeshow tests. Findings An apparent negative relationship between PUFAR and DR was observed. Adjusted odds of DR decreased by 79% (OR: 0·21, 95% CI: 0·10–0·40) with an interquartile range increase in PUFAR. Similar results were also obtained in tertile analysis. As compared to those in the 1st tertile of PUFAR, the adjusted odds of DR decreased by 76% (OR: 0·24, 95% CI: 0·08–0·66) and 93% (OR: 0·07, 95% CI: 0·03–0·22) for subjects in the 2nd and 3rd tertiles, respectively. Good calibration and discrimination of the PUFAR associated predictive model were detected and PUFAR = 35 would be an ideal cut-off value for DR identification. Interpretation Our results suggest that serum PUAFR is inversely associated with DR. Although PUFAR-alteration is not observed amongst different stages of DR, it can serve as an ideal biomarker in distinguishing patients with DR from those without DR. Funding This study was funded by Natural Science Foundation of Zhejiang Province, Zhejiang Basic Public Welfare Research Project, the Major Project of the Eye Hospital of Wenzhou Medical University, and the Academician's Science and Technology Innovation Program in Zhejiang province. Part of this work was also funded by the National Nature Science Foundation of China, and Research Project for College Students in Wenzhou Medical University.

IntroductionDespite advances in diabetic retinopathy (DR) medications, early identification is vitally important for DR administration and remains a major challenge. This study aims to develop a novel system of multidimensional network biomarkers (MDNBs) based on a widely targeted metabolomics approach to detect DR among patients with type 2 diabetes mellitus (T2DM) efficiently.Research design and methodsIn this propensity score matching-based case-control study, we used ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system for serum metabolites assessment of 69 pairs of patients with T2DM with DR (cases) and without DR (controls). Comprehensive analysis, including principal component analysis, orthogonal partial least squares discriminant analysis, generalized linear regression models and a 1000-times permutation test on metabolomics characteristics were conducted to detect candidate MDNBs depending on the discovery set. Receiver operating characteristic analysis was applied for the validation of capability and feasibility of MDNBs based on a separate validation set.ResultsWe detected 613 features (318 in positive and 295 in negative ESI modes) in which 63 metabolites were highly relevant to the presence of DR. A panel of MDNBs containing linoleic acid, nicotinuric acid, ornithine and phenylacetylglutamine was determined based on the discovery set. Depending on the separate validation set, the area under the curve (95% CI), sensitivity and specificity of this MDNBs system were 0.92 (0.84 to 1.0), 96% and 78%, respectively.ConclusionsThis study demonstrates that metabolomics-based MDNBs are associated with the presence of DR and capable of distinguishing DR from T2DM efficiently. Our data also provide new insights into the mechanisms of DR and the potential value for new treatment targets development. Additional studies are needed to confirm our findings.

Direct comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. We aimed to compare the intraocular asymmetry of VF loss among patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF defects were categorized into 3 stages (early, moderate, and advanced), and each hemifield was divided into 5 regions according to the Glaucoma hemifield test (GHT). The mean total deviation (TD) of each GHT region was calculated. In the early stage, the paracentral, peripheral arcuate 1 and peripheral arcuate 2 regions in the superior hemifield in the NTG group had significantly worse mean TDs than their corresponding regions in the inferior hemifield. In the advanced stage, the central region in the superior hemifield in the PACG group had a significantly worse mean TD than that in the inferior hemifield. There was no significant difference in the mean TD for any of the five regions between hemifields across all severity levels in the in the HTG group. The superior hemifield was affected more severely than the inferior hemifield in all three subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG than in PACG and HTG.

Background and objectives Accumulating evidences suggest that chronic systemic inflammation (CSI) is independently associated with large number of major non-communicable chronic diseases (NCDs) ranging from metabolic disorders to cancers, and neutrophil-to-lymphocyte ratio (NLR) has been accepted as a novel, convenient marker for CSI response. Testosterone deficiency in men is linked to high risk of NCDs. This cross-sectional study aimed to investigate the individual and joint association of bioavailable testosterone (BIOT) and aging with NLR. Methods A total of 132 male adults were enrolled during Jan. 2011 and Oct. 2017 in the first affiliated hospital of University of Science and Technology of China. Local weighted regression (LOESS) and multivariable generalized linear regression models were utilized to comprehensively examine the individual and joint association between BIOT and age with NLR. Results Obvious linear relationships between NLR and BIOT or age were observed with the LOESS models. NLR was negatively correlated to BIOT after adjusting for some potential confounding factors (P = 0.034). As compared to the lowest quartile of BIOT, the adjusted decrease of NLR for the 2nd, 3rd and 4th quartiles were 0.40, 0.64 and 0.72, respectively. Meanwhile, NLR was observed to be independently correlated to elevated age (P = 0.043). Furthermore, as compared to the counterparts, men over 70 years combined with plasma BIOT less than 4.7 nmol/L had the highest NLR level, which suggested that low BIOT and aging jointly correlated to the level of NLR (P = 0.005). Conclusion BIOT deficiency and aging were individually and jointly correlated to CSI. Men over 70 years combined with BIOT

Oxidative DNA damage pathogenically links to some major diseases. This study aimed to comprehensively assess the association between serum total cholesterol (TC) and oxidative DNA damage based on propensity score matching (PSM) method. A total of 407 participants chronically exposed to arsenic via drinking water from China were enrolled. Oxidative DNA damage was determined with urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG). Serum TC was classified into favourable TC (FTC, TC5.18 mmol/L) and unfavourable TC (NFTC, TC ≥5.18 mmol/L) categories. Multivariable generalised linear regression model was applied to examine the association. Of 407 participants, 125 pairs with FTC and NFTC subjects were matched using PSM. Urinary 8-OHdG/creatinine levels in NFTC were significantly higher than those in FTC category (

Programmed death‑ligand 1 (PD‑L1), an immune co‑stimulatory molecule, is expressed on various cancer cells and the surface of immune cells. Its overexpression on tumor cells suppresses the immune response to promote tumor cell immune escape. The present study demonstrated that PD‑L1 was critical in head and neck squamous cell carcinoma (HNSCC) carcinogenesis. Immunohistochemical analysis of HNSCC tissue microarrays revealed that PD‑L1 was overexpressed in tumor tissue, and its expression increased as tumor malignancy progressed (from grade I to IV). Subsequently, the expression of PD‑L1 was knocked down or overexpressed in the HNSCC cell lines Cal‑27 and Fadu. It was demonstrated that PD‑L1 significantly induced HNSCC cell proliferation and colony forming ability. Cell proliferation was also promoted in Cal‑27 cell xenograft BALB/c nude mice. In addition, it was determined by western blotting that the PD‑L1‑mediated increase in HNSCC cell proliferation may have been associated with the activation of mammalian target of rapamycin (mTOR) signaling pathway. Furthermore, mTOR inhibitor (rapamycin) prevented the increase in proliferation. Based on these results, it was concluded that PD‑L1 promoted cell proliferation of HNSCC cells through mTOR signaling, and blocking PD‑L1 may be conducive in HNSCC therapy.

The data directly comparing the spatial pattern of VF defects between primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) is not available. We aim to compare the asymmetric patterns of VF defects in patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF examinations were performed with standard automated perimetry (HFA, SITA-standard strategy, 24-2), and defects were categorized into 3 stages (early, moderate, and advanced) and each hemifield was divided into 5 regions according to Glaucoma Hemifield Test (GHT). The mean total deviation (TD) of each GHT region was calculated. The relationship between the values of pattern standard deviation (PSD) and mean TD was assessed. In the early stage, nasal region of PACG, central region of HTG and all five regions of NTG in the superior hemifield had significantly worse mean TD than their counterparts in the inferior hemifield. In the moderate stage, three regions of NTG in the superior hemifield had significantly worse mean TD than their inferior counterparts. In the advanced stage, central region of PACG, and central and paracentral regions of HTG in the superior hemifield had significantly worse mean TD than their inferior counterparts. When participants were matched by age, sex and mean deviation, in PACG and HTG eyes, all 5 GHT regions in the superior hemifield had worse mean TD than that that of their inferior-hemifield counterparts; however, the differences were not statistically significant. In NTG eyes, the paracentral, nasal, arcuate 1 and arcuate 2 regions in the superior hemifield had significantly worse mean TDs than their inferior counterparts. The superior hemifield is affected more severely than the inferior hemifield in all 3 subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG compared to PACG and HTG.

Objective Early identification of diabetic retinopathy (DR) is key to prioritizing therapy and preventing permanent blindness. This study aims to propose a machine learning model for DR early diagnosis using metabolomics and clinical indicators. Methods From 2017 to 2018, 950 participants were enrolled from two affiliated hospitals of Wenzhou Medical University and Anhui Medical University. A total of 69 matched blocks including healthy volunteers, type 2 diabetes, and DR patients were obtained from a propensity score matching-based metabolomics study. UPLC-ESI-MS/MS system was utilized for serum metabolic fingerprint data. CART decision trees (DT) were used to identify the potential biomarkers. Finally, the nomogram model was developed using the multivariable conditional logistic regression models. The calibration curve, Hosmer–Lemeshow test, receiver operating characteristic curve, and decision curve analysis were applied to evaluate the performance of this predictive model. Results The mean age of enrolled subjects was 56.7 years with a standard deviation of 9.2, and 61.4% were males. Based on the DT model, 2-pyrrolidone completely separated healthy controls from diabetic patients, and thiamine triphosphate (ThTP) might be a principal metabolite for DR detection. The developed nomogram model (including diabetes duration, systolic blood pressure and ThTP) shows an excellent quality of classification, with AUCs (95% CI) of 0.99 (0.97–1.00) and 0.99 (0.95–1.00) in training and testing sets, respectively. Furthermore, the predictive model also has a reasonable degree of calibration. Conclusions The nomogram presents an accurate and favorable prediction for DR detection. Further research with larger study populations is needed to confirm our findings.

Background: Optimal ω-6/ω-3 polyunsaturated fatty acids ratio (PUFAR) is reported to exert protective effects against chronic diseases. However, data on PUFAR and diabetic retinopathy (DR) are scarce. We aimed to thoroughly quantify how PUFAR was associated with DR as well as its role in DR detection. Methods: This is a two-center case-control study, patients were matched using a propensity score algorithm. Multivariable logistic regression models and restricted cubic spline analyses were used to examine the association of PUFAR with DR after adjusting for confounders, which were screened by directed acyclic graph. Performance of the predictive ability to identify DR with PUFAR was assessed by receiver operating characteristic (ROC) analysis and Hosmer-Lemeshow test. Findings: An apparent negative relationship between PUFAR and DR was observed. Adjusted likelihood of DR decreased by 79% (OR:0.21, 95% CI:0.10-0.40) with per interquartile range of PUFAR elevation. Similar results were also obtained in tertile analysis. As compared to those in the 1st tertile of PUFAR, the adjusted odds of DR decreased by 76% (OR:0.24, 95% CI:0.08-0.66) and 93% (OR:0.07, 95% CI:0.03-0.22) for subjects in the 2nd and 3rd tertiles, respectively. Good calibration and discrimination of the predictive model were detected and consistent in both training and testing sets, and PUFAR=35 would be an ideal cut-off value for DR identification. Interpretation: Our present study shows that serum PUAFR was inversely associated with DR and could serve as an ideal biomarker in distinguishing DR from type 2 diabetes. Funding: This study was funded by Natural Science Foundation of Zhejiang Province, Zhejiang Basic Public Welfare Research Project, the Major Project of the Eye Hospital of Wenzhou Medical University and the academician’s science, and technology innovation program in Zhejiang province. Part of this work was also funded by the National Nature Science Foundation of China and Science and Research Funding Project for College Students in Wenzhou Medical University. Declaration of Interest: We declare no conflicts of interests. Ethical Approval: The protocol had been carefully reviewed and approved by the Ethic committee of the Eye hospital of Wenzhou medical university before the study (Number: KYK [2017] 46).

Aflatoxin B1 (AFB1) is a highly toxic mycotoxin that enters the human body through the food chain and poses a serious threat to human health. In this paper, polydopamine (PDA)-coated Fe3O4 magnetic nanoparticles (Fe3O4@PDA MNPs) were prepared by the co-precipitation method to enrich aflatoxin from edible oil. Transmission electron microscopy (TEM), Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and vibrating sample magnetometer were used to characterize the Fe3O4@PDA MNPs. Using the obtained Fe3O4@PDA MNPs as an adsorbent, a simple method for enriching AFB1 from samples by magnetic solid phase extraction (MSPE) combined with fluorescence rapid detection was developed. The effects of the ratio of Fe3O4 MNPs to PDA, adsorption dosage, sample volume, adsorption time, and elution time on enrichment of AFB1 were investigated to determine the optimal experimental conditions. This method has good intraday and daytime precision.

Objective: To investigate the implementation of evidence-based nursing model (EBNM) in health education and its influences on the therapeutic effects, degrees of pain, adverse emotions, postoperative complications and degrees of cognition of health knowledge of elderly fracture patients. Methods: A total of 75 elderly patients with hip fractures receiving surgery in the First People’s Hospital of Chuzhou from January 2019 to June 2020 were selected as the study subjects, and were divided into control group (n = 37) and experimental group (n = 38) in accordance with random number table method. The control group received conventional health education, while the experimental group received health education intervention based on EBNM. The changes in therapeutic effects, degrees of pain, complications, adverse emotional reactions and degrees of cognition of health knowledge were compared between the two groups. Results: After intervention, the hospital stay and fracture healing time in the experimental group were shorter than those in the control group (P < 0.05). Compared with those before intervention, the scores of Berg balance scale (BBS) and Fugl-Meyer assessment (FMA) were elevated, while numerical rating scale (NRS) score was decreased remarkably after intervention. After intervention, the experimental group showed remarkably higher scores of BBS and FMA and degrees of cognition of health knowledge and significantly lower scores of NRS and the overall risk of postoperative complications than the control group (P < 0.05). The scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in the two groups decreased after intervention (P < 0.05). Conclusion: Health education intervention based on EBNM can effectively improve patients’ understanding of the fracture, quality of prognosis, fracture healing time, the occurrence of adverse emotions and the incidence rate of complications of elderly fracture patients.

Diabetic retinopathy (DR), the most common microvascular complication of diabetes and leading cause of visual impairment in adults worldwide, is suggested to be linked to abnormal lipid metabolism. The present study aims to comprehensively investigate the relationship between n-6 polyunsaturated fatty acids (PUFAs) and DR. This was a propensity score matching based case–control study, including 69 pairs of DR patients and type 2 diabetic patients without DR with mean age of 56.7 ± 9.2 years. Five n-6 PUFAs were determined by UPLC-ESI-MS/MS system. Principle component regression (PCR) and multiple conditional logistic regression models were used to investigate the association of DR risk with n-6 PUFAs depending on independent training and testing sets, respectively. According to locally weighted regression model, we observed obvious negative correlation between levels of five n-6 PUFAs (linoleic acid, γ-linolenic acid, eicosadienoic acid, dihomo-γ-linolenic acid and arachidonicacid) and DR. Based on multiple PCR model, we also observed significant negative association between the five n-6 PUFAs and DR with adjusted OR (95% CI) as 0.62 (0.43,0.87). When being evaluated depending on the testing set, the association was still existed, and PCR model had excellent classification performance, in which area under the curve (AUC) was 0.88 (95% CI: 0.78, 0.99). In addition, the model also had valid calibration with a non-significant Hosmer–Lemeshow Chi-square of 9.44 (P = 0.307) in the testing set. n-6 PUFAs were inversely associated with the presence of DR, and the principle component could be potential indicator in distinguishing DR from other T2D patients.

Background and Objectives. Diabetic kidney disease is a leading cause of chronic kidney disease and end-stage renal disease across the world. Early identification of DKD is vitally important for the effective prevention and control of it. However, the available indicators are doubtful in the early diagnosis of DKD. This study is aimed at determining novel sensitive and specific biomarkers to distinguish DKD from their counterparts effectively based on the widely targeted metabolomics approach. Materials and Method. This case-control study involved 44 T2DM patients. Among them, 24 participants with DKD were defined as the cases and another 20 without DKD were defined as the controls. The ultraperformance liquid chromatography-electrospray ionization-tandem mass spectrometry system was applied for the assessment of the serum metabolic profiles. Comprehensive analysis of metabolomics characteristics was conducted to detect the candidate metabolic biomarkers and assess their capability and feasibility. Result. A total of 11 differential metabolites, including Hexadecanoic Acid (C16:0), Linolelaidic Acid (C18:2N6T), Linoleic Acid (C18:2N6C), Trans-4-Hydroxy-L-Proline, 6-Aminocaproic Acid, L-Dihydroorotic Acid, 6-Methylmercaptopurine, Piperidine, Azoxystrobin Acid, Lysopc 20:4, and Cuminaldehyde, were determined as the potential biomarkers for the DKD early identification, based on the multivariable generalized linear regression model and receiver operating characteristic analysis. Conclusion. Serum metabolites might act as sensitive and specific biomarkers for DKD early detection. Further longitudinal studies are needed to confirm our findings.

Satellite attitude control flywheel is the important component of the attitude control system in military light agile satellite. At present, a main trend has arisen with using high performance composite material to satisfy the lightweight, large moment and long life of the attitude control flywheel. However, defects such as delamination, splitting, resin burn, and subsurface damage may be likely to occur during the cutting process owing to the anisotropic and non-homogeneous material structure of CFRP. In this paper, the single factor milling experiment was conducted. Invar-M30 composite co-curing materials were milled with different cutting speeds and feeds. The milling force and surface integrity, including the surface topography, defects and the bonding condition of the machined surface, were emphatically tested and analyzed to further study surface defects and its causes, and research the main factors affecting the quality of the processing surface. Finally, based on the cutting force and surface integrity detected on the experiment, the cutting parameters of the Invar-M30 composite co-cured material were optimized, which may supply experimental support for the manufacture of the attitude control flywheel.

Here we report a self-induced catalyst-free preparation of TiO2 nanowires by APCVD. High-density single-crystalline hydrophilic TiO2 nanowires have been successfully prepared on a Ti5Si3 layer by chemical vapour deposition at 720 °C using 10 SCCM O2 for 120 min, using SiH4, TiCl4, and O2 as precursors. The nanowires are approximately 2–5 μm long, the diameter is about 20–40 nm. The TiO2 nanowires grow along the [001] direction of the tetragonal rutile TiO2 crystal from the bottom, with the tip being pushed upwards. The growth process can be defined as a self-induced growth. The 432 and 463 nm band of TiO2 nanowires assigned to self-trapped excitons and OVs, which is beneficial for the hydrophilic property of the nanowires. The contact angle of TiO2 nanowires after ultraviolet irradiation is low (5.1°), exhibiting excellent hydrophilic property.

ObjectivesWe investigated the association of specific serum amino acids (AAs) with the odds of arsenic-induced skin lesions (AISL) and their ability to distinguish patients with AISL from people chronically exposed to arsenic.DesignCase–control study.SettingThree arsenic-exposed villages in Wuyuan County, Hetao Plain, Inner Mongolia, China were evaluated.ParticipantsAmong the 450 residents aged 18–79 years, who were chronically exposed to arsenic via drinking water, 56 were diagnosed as having AISL (defined as cases). Another 56 participants without AISL, matched by gender and age (±1 year) from the same population, were examined as controls.Main outcome measures and methodsAA levels were determined by ultra-high-performance liquid chromatography–quadrupole time-of-flight mass spectrometry-based metabolomics analysis. Potential confounding variables were identified via a standardised questionnaire and clinical examination. Multivariable conditional logistic regression model and receiver operating characteristic curve analyses were performed to investigate the relationship between specific AAs and AISL.ResultsTryptophan and phenylalanine levels were negatively associated with AISL (pConclusionsSpecific AAs may be linked to AISL and play important roles in early AISL identification.Trial Registration numberNCT02235948.

PURPOSE To investigate the prevalence and associations of myopic anisometropia in Chinese adults. METHODS A total of 3,791 Chinese refractive surgery candidates with myopia (25.15±7.09 years old, Mean±SD) were recruited. All eyes underwent a standardized ophthalmological examination. Associations between myopic anisometropia and age, gender, spherical ametropia, astigmatism, and axial length (AL) were analyzed by means of the chi-squared test, nonparametric Kruskal-Wallis or Mann-Whitney test, binomial logistic regression analyses, and multivariate logistic regression analysis. RESULTS The mean myopic anisometropic level was 0.96 D and prevalence of myopic anisometropia was 29.62% (defined as myopic anisometropia ≥1.00 D). The prevalence and severity of myopic anisometropia increased with age, larger interocular AL difference, and higher cylindrical power (all P

In this study, we have developed a new type of highly sensitive pressure sensor based on a microelectro mechanical system (MEMS) aluminum nitride (AlN) contour-mode resonator (CMR), which is experimentally verified by measuring pressure changes within the range of 0 kPa to 200 kPa. The CMR-based pressure sensor, offering enhanced linearity, achieves an improved sensitivity of 16.51 Hz/hPa, making it suitable for performing quantitative in-line monitoring of gaseous species production reactions, e.g. in real time detection of a hydrogen peroxide decomposition reaction.

Background: Accurate forecast of the death risk is crucial to the administration of people living with HIV/AIDS (PLHIV). We aimed to establish and validate an effective prognosis nomogram in PLHIV receiving antiretroviral therapy (ART). Methods: All the data were obtained from 2006 to 2018 in the Wenzhou area from China AIDS prevention and control information system. Factors included in the nomogram were determined by univariate and multiple Cox proportional hazard analysis based on the training set. The receiver operating characteristic (ROC) and calibration curves were used to assess its predictive accuracy and discriminative ability. Its clinical utility was also evaluated using decision curve analysis (DCA), X-tile analysis and Kaplan-Meier curve, respectively in an independent validation set. Findings: Independent prognostic factors including haemoglobin, viral load and CD4+ T-cell count were determined and contained in the nomogram. Good agreement between the prediction by nomogram and actual observation could be detected in the calibration curve for mortality, especially in the first year. In the training cohort, AUC (95% CI) and C-index (95% CI) were 0.93 (0.90, 0.96) and 0.90 (0.85, 0.96), respectively. In the validation set, the nomogram still revealed excellent discriminations [AUC (95% CI): 0.95 (0.91, 1.00)] and good calibration [C-index (95% CI): 0.92 (0.82–1.00)]. Moreover, DCA also demonstrated that the nomogram was clinical beneficial. Additionally, participants could be classified into three distinct (low, middle and high) risk groups by the nomogram. Interpretation: The nomogram presents accurate and favourable prognostic prediction for PLHIV who underwent ART. Funding: This work was supported by Zhejiang Basic Public Welfare Research Project (LGF19H260011), Wenzhou Basic Public Welfare Research Project (Y20180201), the Initial Scientific Research Fund (KYQD170301), the Major Project of the Eye Hospital Wenzhou the Major Project of the Eye Hospital Wenzhou Medical University (YNZD201602). Part of this work was also funded by National Natural Science Foundation of China (81670777) and Science and Technology Innovation Activity Plan and New Talents Plan for College Students in Zhejiang Province (2019R413073). The funders had no roles in study design, data collection, data analysis, interpretation and writing of the report. Keywords: PLHIV, Nomogram, Prognosis, HIV/AIDS-related mortality, DCA

Earthquakes are non-negligible hazards for the designing of offshore wind farms in the coastal regions of China, such as Bohai Bay. So, it is necessary to analyze the response of offshore wind turbines (OWTs) under earthquakes. Fluid mechanics are applied to the model, the interactions of sea water and the substructure are based on fluid theory analysis in this paper. Moreover, it takes into account of the influence of fluid-solid coupling effect, radiation effect of wave loads and pile-soil interactions on the OWT. By establishing the finite element model (FEM) and dynamic equation of a tripod OWT, the measured onshore and offshore seismic waves are applied in the finite element analysis of the Tripod OWT respectively, and the numerical analysis of a tripod OWT structure under different measured seismic waves is carried out. More detailed comparison of the differences between onshore and offshore seismic waves is carried out in the paper. The result shows that the offshore seismic waves stimulate more significant responses than the onshore one, which can be attributed to that abundant seismic frequencies are found around the fundamental frequencies of the OWT. the seismic response analysis is conservative by using the onshore seismic waves, however, using the offshore seismic waves is closer to the actual situation.