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隆突性皮肤纤维肉瘤（dermatofibrosarcoma protuberans，DFSP）是一种发生于浅表部位的局部侵袭性的低级别肉瘤，复发率高，儿童罕见。本文报道1例少见的发生于手背部的儿童DFSP。患儿男，6岁。因发现右手背侧包块1年，进行性增大3个月入院，超声示右手背皮下可见一大小约2.7 cm×2.1 cm×0.7 cm的低回声区。术后镜下观察，真皮内见短梭形瘤细胞弥漫浸润性生长，核分裂象较多见，表达CD34和bcl-2。分子检测结果：荧光原位杂交检测示COL1A1-PDGFB融合基因伴基因拷贝数增多，逆转录-聚合酶链反应及基因测序结果示COL1A1第38号外显子和PDGFB第2号外显子融合。.

Statistical graphics has a long history and is an important mean to present study design, analysis results and conclusions of medical research. A survey of statistical graphs of recent publications in Chinese and English academic journals shows that scientific and technical specifications of statistical graphics are still lacking. Based on the requirements of statistical graphics in prestigious medical journals (统计图形历史悠久，是呈现医学研究设计、结果、结论的重要方式。纵观近年来中英文学术期刊中的统计图形可知，当前医学研究人员对统计图形的科学性和规范性的把握尚有不足。本文以

Using the short-cadence data (1-min interval) of the Kepler space telescope, we conducted a statistical analysis for the characteristic time of stellar flares on Sun-like stars (SLS). Akin to solar flares, stellar flares show rise and decay light-curve profiles, which reflect the two distinct phases (rise phase and decay phase) of the flare process. We derived characteristic times of the two phases for the stellar flares of SLS, resulting in a median rise time of about 5.9 min and a median decay time of 22.6 min. It is found that both the rise time and the decay time of the stellar flares follow a lognormal distribution. The peak positions of the lognormal distributions for flare rise time and decay time are 3.5 min and 14.8 min, respectively. These time values for stellar flares are similar to the time-scale of solar flares, which supports the idea that stellar flares and solar flares have the same physical mechanism. The statistical results obtained in this work for SLS can be a benchmark of flare characteristic times when comparing with other types of stars., Published in Monthly Notices of the Royal Astronomical Society: Letters, 5 pages, 2 figures, 2 tables, 3 ancillary files

Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.银屑病关节炎是一种以累及脊柱和/或外周关节为主的银屑病相关的慢性进展性炎性关节炎。其临床表现复杂，具有显著的异质性，近50%的患者可在诊断2年内出现关节的侵蚀破坏，是一种致残性疾病。目前，我国对该病的认识不足，规范化诊治的普及依然欠缺。中华医学会风湿病学分会在借鉴国内外治疗指南和诊治经验的基础上，结合我国现状制定了本规范，旨在规范银屑病关节炎的诊断与治疗，减少误诊和漏诊，改善患者的预后。.

In precision optical applications, plastics thick-walled optical lenses are increasing. Dimensional stability and optical performance are the critical issues that should be addressed for plastic thick-walled lenses. A novel multi-layer counter-pressure injection molding process is proposed in this study. The experimental prism mold with moveable pistons was developed to investigate the effects of layering methods, counter-pressure and their combination on thick-walled optical lenses. The experimental results reveal that counter-pressure injection molding is effective in improving shrinkage, transmittance and refractive index of the thick-walled optical prism. Counter-pressure of the piston provided lower melt velocity and shorter flow path of melt to improve polymer molecules orientation, and also offered continuous holding pressure during the filling stage to eliminate defects such as shrinkage or short shots. The combination of counter-pressure and multi-layer injection molding technology further improved the dimension stability and optical performance of the thick-walled optical lens. Much thinner layers than the final wall thickness of prism ensures shrinkage reduction during the cooling stages. A thick-walled optical prism was fabricated successfully upon applying a multi-layer counter-pressure injection molding process.

Manure is a primary source of methane (CH4) emissions into the atmosphere. A large proportion of CH4from manure is emitted during storage, but this varies with storage methods. In this research, we tested whether covering a manure heap with plastic reduces CH4emission during a short-term composting process. A static chamber method was used to detect the CH4emission rate and the change of the physicochemical properties of cattle manure which was stored either uncovered (treatment UNCOVERED) or covered with plastic (treatment COVERED) for 30-day periods during the four seasons? The dry matter content of the COVERED treatment was significantly less than the UNCOVERED treatment (P< 0.01), and the C/N ratio of the COVERED treatment significantly greater than the UNCOVERED treatment (P> 0.05) under high temperature. In the UNCOVERED treatment, average daily methane (CH4) emissions were in the order summer > spring > autumn > winter. CH4emissions were positively correlated with the temperature (R2= 0.52,P< 0.01). Compared to the UNCOVERED treatment, the daily average CH4emission rates from COVERED treatment manure were less in the first 19 days of spring, 13 days of summer, 10 days of autumn and 30 days of winter. In summary, covering the manure pile with plastic reduces the evaporation of water during storage; and in winter, long-term covering with plastic film reduces the CH4emissions during the storage of manure.

分析人工肝（ALSS）治疗中出现肝素介导性血小板减少症后使用阿加曲班抗凝的疗效及安全性。本文收集1例ALSS治疗的肝衰竭患者，肝素抗凝治疗后出现肝素诱导的血小板减少症，换用阿加曲班抗凝治疗，收集患者的肝功能、凝血功能、血细胞分析等检测指标，对小剂量阿加曲班在ALSS治疗过程中抗凝的有效性及安全性进行分析。.

The ^{13}C(α,n)^{16}O reaction is the main neutron source for the slow-neutron-capture process in asymptotic giant branch stars and for the intermediate process. Direct measurements at astrophysical energies in above-ground laboratories are hindered by the extremely small cross sections and vast cosmic-ray-induced background. We performed the first consistent direct measurement in the range of E_{c.m.}=0.24 to 1.9 MeV using the accelerators at the China Jinping Underground Laboratory and Sichuan University. Our measurement covers almost the entire intermediate process Gamow window in which the large uncertainty of the previous experiments has been reduced from 60% down to 15%, eliminates the large systematic uncertainty in the extrapolation arising from the inconsistency of existing datasets, and provides a more reliable reaction rate for the studies of the slow-neutron-capture and intermediate processes along with the first direct determination of the alpha strength for the near-threshold state.

谷固醇血症是一种罕见的常染色体隐性遗传脂质代谢异常疾病，其特征为血浆和组织中谷固醇的含量增高、蓄积。现报道1例以血小板减少和肝功能异常就诊，通过相关检查发现ABCG5基因突变确诊为谷固醇血症患儿，同时分析患儿的临床特征。.

1. Tile-grey plumage is a unique and rare feather type of local chicken breeds in China, but its genetic mechanism and corresponding genes remain unknown. 2. In order to identify the genetic basis and molecular characteristics of tile-grey plumage, this experiment investigated variations of melanocortin 1 receptor (MC1R) gene in Yunnan Piao chickens with typical tile-grey plumage characteristics in contrast with three Yunnan local breeds as well as two standard breeds with different plumage colour, and analysed the association between genic variation and tile-grey plumage. 3. Through sequencing and comparison of the entire coding region of the MC1R gene, a total of 10 SNP loci were detected, of which eight were non-synonymous mutations that cause amino acid changes. The gene frequency and genotype frequency of the MC1R mutation sites in different breeds and different plumage colour groups revealed that C69T, T212C and A274G were significantly associated with tile-grey plumage. Eighteen haplotypes of the MC1R gene were constructed based on 10 nucleotide variations and eight amino acid variations. Haplotype distribution and the median joining network in breeds and plumage colour groups revealed a main haplotype (hap2) for tile-grey plumage. Hap2 is unique to the tile-grey feather of Piao chicken, and the individuals carrying this haplotype account for 62.96% of the whole tile-grey chicken. 4. The results of this study are of significance for further analysis of the molecular basis of tile-grey plumage and the selective breeding of tile-grey plumage.

Knowledge of genetic diversity and genes conferring disease resistance is essential for the effective use of wheat germplasm resistant to powdery mildew in breeding programs in southwest China. In this study, a collection of 140 common wheat varieties was evaluated for their resistance to powdery mildew in four different environments. Thirty-six varieties (25.71%) showed resistance in all four environments, and most of these varieties originated from the Guizhou Province. This collection was also scanned for molecular markers closely linked to the powdery mildew resistance genes. Most of the wheat varieties (79.86%) carried the resistance Pm30 gene locus. Genotyping by sequencing (GBS) was used to screen our collection against the whole genome. Finally, 6864 informative SNP markers were used to construct a consensus tree with 1000 bootstraps, which showed two groups based on their origins and the presence of the Pm21 gene locus. Our results provide useful information for breeding wheat resistant to powdery mildew in China, and they will likely contribute to the identification of new resistance genes in the future.

BackgroundAngiogenesis is an indispensable step in the growth and invasiveness of breast cancers involving a series of exquisite molecular steps. Pro-angiogenic factors, including vascular endothelial growth factor (VEGF), have been recognized as pivotal therapeutic targets in the treatment of breast cancer. More recently, a highly conserved transcription factor Twist has been reported to be involved in tumor angiogenesis and metastasis.MethodsThe expression of VEGF-C and Twist was immunohistochemically determined in tissue samples of primary tumors from 408 patients undergoing curative surgical resection for breast cancer. The correlations of VEGF-C and Twist expressions with clinicopathologic parameters as well as survival outcomes were evaluated.ResultsOf the 408 patients evaluated, approximately 70% had high expression of VEGF-C which was significantly associated with advanced tumor stages (P=0.019). Similarly, VEGF-C expression was associated with the proliferation index Ki67, N3 lymph node metastasis, and D2-40-positive lymphatic vessel invasion (LVI) in a univariate analysis. Furthermore, patients with high expressions of VEGF-C and Twist (V+T+) had significantly increased lymph node metastasis, higher clinical stage, and worse disease-free survival, DFS (P=0.001) and overall survival, OS (P=0.011).ConclusionsOur results suggested that co-expression of VEGF-C and Twist was associated with larger tumor size, higher numbers of lymph node involvement, D2-40-positive LVI, higher risk of distant metastasis, and worse DFS or OS in breast cancer patients.

Total knee and hip arthroplasty are one of the most commonly consistently successful surgeries in orthopedics worldwide. Literature has reported that depending upon the age and co-existing treatments, patients undergoing total knee and hip arthroplasty are often prone to increased risks of developing venous thromboembolic complications. In such cases, chemoprophylaxis with either direct oral anticoagulant therapy with factor-Xa inhibitors (i.e., rivaroxaban, apixaban, dabigatran) and aspirin are widely recommended. Recent surveys suggest that direct oral anticoagulants and aspirin have comparable efficacy. However, there is no consensus in the literature as to which drug is the safest. Therefore, in this review, we shall attempt to evaluate the comparative efficacy between direct oral anticoagulant drugs and aspirin in patients undergoing total joint arthroplasty. To compare risk of venous thromboembolism complications between use of direct oral anticoagulant drugs and aspirin in patients undergoing total knee and hip arthroplasty.A sensitive and specific analysis of the literature was performed according to the Cochrane and written according to PRISMA guidelines (Supplementary Table I). Five electronic databases (Web of Science, Embase, CENTRAL, Scopus, and Medline) were evaluated. To compare the efficacy between the drugs we conducted a random-effect meta-analysis according to the outcome (bleeding complications, venous thromboembolism or pulmonary embolism) and overall mortality in patients undergoing total knee and hip arthroplasty.Overall, 993 studies were found of which 117 had their full texts evaluated. A total of 161,463 patients undergoing total joint arthroplasty with mean age equal 66.2 ± 5.0 years were identified in 14 studies. Higher risks of venous thromboembolism (OR: 1.56 95% CI 1.21-2.01), pulmonary embolism (OR: 1.63, 95% CI: 1.31 -2.04) and overall mortality (OR: 1.35, 95% CI 1.04-1.74) for patients receiving aspirin were verified as compared to direct oral anticoagulant drugs. Subsequently, we further observed that the risks of bleeding complications (OR: 0.89 95% CI 0.67-1.18) were insignificant.The study reports higher risks of venous thromboembolism, pulmonary embolism, and overall mortality for the patients receiving aspirin before undergoing.

${\mathrm{Sr}}_{2}\mathrm{Ir}{\mathrm{O}}_{4}$ hosts a novel ${J}_{\mathrm{eff}\phantom{\rule{4pt}{0ex}}}=1/2$ Mott state and quasi-two-dimensional antiferromagnetic order, providing a unique avenue of exploring emergent states of matter and functions that are extraordinarily sensitive to any structural variations. Although the correlation between the physical property and the lattice structure in ${\mathrm{Sr}}_{2}\mathrm{Ir}{\mathrm{O}}_{4}$ has been a focused issue in the past decade, a common perception assumes that the magnetic ordering is essentially determined by the Ir-O-Ir bond angle. Therefore, a delicate modulation of this angle and, consequently, a major modulation of the magnetic ordering by chemical doping, such as Ga at the Ir site, has been extensively investigated and well believed. In this paper, however, we present a whole package of structure and magnetism data on a series of single-crystal and polycrystalline ${\mathrm{Sr}}_{2}{\mathrm{Ir}}_{1\ensuremath{-}x}{\mathrm{Ga}}_{x}{\mathrm{O}}_{4}$ samples, revealing the substantial difference in the N\'eel temperature ${T}_{N}$ between the two types of samples, and the ${T}_{N}$ value for the polycrystalline sample $x=0.09$ is even 64 K higher than that of the single-crystal sample $x=0.09$ ($\mathrm{\ensuremath{\Delta}}{T}_{\mathrm{N}}\ensuremath{\sim}64\phantom{\rule{0.16em}{0ex}}\mathrm{K}$ at $x=0.09$). Our systematic investigations demonstrate the crucial role of the c/a ratio in tuning the interlayer coupling and thereby the N\'eel point ${T}_{N}$, i.e., a higher ${T}_{N}$ can be achieved as c/a is reduced. The notable differences in structural parameters between the two groups of samples are probably caused by additional strain due to the massive grain boundaries in polycrystalline samples. The present paper suggests an additional ingredient of physics that is essential in modulating the emergent properties in ${\mathrm{Sr}}_{2}\mathrm{Ir}{\mathrm{O}}_{4}$ and probably other iridates.

Cajal间质细胞（interstitial cells of Cajal，ICC）在食管内与食管壁内神经及食管平滑肌构成“神经-ICC-肌肉”的功能单位，调节食管运动。贲门失弛缓症是食管动力障碍性疾病，表现为食管下括约肌失弛缓以及食管体部失蠕动，其病理生理机制并未阐明。本文综述ICC对食管运动功能的影响，以及对贲门失弛缓症发病的作用及机制。.

Ventriculo-peritoneal shunt (VPS) is a commonly used procedure for treating hydrocephalus of various causes. Delayed intracerebral hemorrhage (DICH) is regarded as a very rare complication after VPS procedure, with mechanisms still indeterminate. We report two cases of this condition whereby we discuss the characteristics and potential explanations for it in a short review of literature.Two female patients, aged 49, 76 respectively, were admitted to our hospital for hydrocephalus in the year 2021 as ordinary participants among many other patients with the same diagnosis. Unforeseeably, what made them special was DICH situations occurred after regular VPS procedures. Luckily both of them responded well to subsequent conservative treatment with no deterioration and were discharged promisingly in the end. Surprisingly, both of the valve mechanisms in these two functioned properly so far even after the ominous DICH events. Quality of life also improved a lot for them, thus we could consider the VPS surgery successful as well as the later management of the unwanted hematomas, in other words, a full recovery from DICH.Only few cases or series of DICH were reported in the past decades and the mechanisms of it still lack a verdict. We intend to attribute physical vascular injury due to a closer contact between cerebral blood vessels and the VPS catheter for DICH in the younger patient, while degenerative changes of brain tissue might be the protagonist in the elder one. More discreetness should be expected in perioperative management of VPS patients, with still a long way to go to fully understand the mechanisms of DICH and prevent the complication in highest measure.

We explored the effects of Fusobacterium nucleatum (F. nucleatum) in Neonatal necrotizing enterocolitis (NEC) and its possible mechanism.Patients with Neonatal NEC and normal healthy volunteers were collected for this study. Neonatal mice were administered with LPS and then exposed to hypoxia as a mice model of NEC. THP-1 cells were stimulated with LPS as an in vitro model of NEC.We have demonstrated F. nucleatum abundance correlated with patients with Neonatal NEC or mice with Neonatal NEC. Furthermore, F. nucleatum stimulated colitis and increased inflammation in mice and in vitro models. LncRNA ENO1-IT1 was an important target for F. nucleatum in NEC-inflammation. MiR-22-3p was a target gene of F. nucleatum in NEC via LncRNA ENO1-IT1. Next, IRF5 was a target gene of miR-22-3p in the function of F. nucleatum in NEC via LncRNA ENO1-IT1. Silencing IRF5 or over-expressing miR-22-3p relieved the role of lncRNA ENO1-IT1 on inflammation in NEC via CD206 and CD86 expression.Taken together, these results demonstrate that F. nucleatum is mechanically, biologically and clinically connected to NEC. LncRNA ENO1-IT1 may be important targets for F. nucleatum in NEC-inflammation, and a meaningful in treating patients with Neonatal NEC with elevated F. nucleatum.

To analyze the prognostic factors of extramedullary relapse (EMR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute lymphoblastic leukemia (ALL).The clinical data of 33 relapsed patients in 95 ALL patients receiving allo-HSCT were analyzed retrospectively. The median time of relapse was 5.7 (0.7-52.3) months. Extramedullary relapse was recorded in 10 cases (10.5%), bone marrow relapse in 15 cases (15.8%), and both extramedullary and marrow relapse were seen in 8 cases (8.4%). The median time of EMR was 7.4(0.7-52.3) months. The most commonly involved organ was central nervous system, followed by testis and bone. The 3-year OS rate in EMR patients was (33.3±11.1) %. Univariate analysis showed that disease state before transplantation (分析急性淋巴细胞白血病（ALL）异基因造血干细胞移植（allo-HSCT）后髓外复发（EMR）的影响因素和预后。回顾性分析2010年1月至2019年12月在郑州大学附属肿瘤医院95例接受allo-HSCT治疗的ALL患者中33例复发患者临床资料。结果显示，中位复发时间为5.7（0.7~52.3）个月，其中单纯EMR10例（10.5%），骨髓复发15例（15.8%），髓内和髓外同时复发8例（8.4%），EMR中位时间为7.4（0.7~52.3）个月，部位以中枢神经系统最多，其次为睾丸和骨骼。EMR患者3年总生存（OS）率为（33.3±11.1）%。单因素分析表明，移植前疾病状态、移植前伴髓外浸润、预处理方案、急性移植物抗宿主病（aGVHD）与EMR发生显著相关（

Despite generally favorable outcomes following knee arthroscopy, a certain subset of patients inevitably develops progression of knee disease, necessitating subsequent total knee arthroplasty (TKA). Therefore, the evaluation of TKA outcomes following arthroscopy has emerged as a major area of research. The aim of the current review is to measure the impact of prior arthroscopy on functional and adverse outcomes following TKA.Literature search was conducted in the databases including Medline, EMBASE, PubMed Central, ScienceDirect, Google Scholar and Cochrane library from inception until April 2021. Meta-analysis with random-effects model was conducted to calculate pooled odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval (CI) depending on the type of outcome.In total, 9 studies with 185,013 participants were included in the review. The majority of the studies were conducted in the USA and China. Almost all the studies had low quality as per Newcastle Ottawa (NO) scale. The pooled SMD for functional outcome was -0.19 [95%CI: -0.30 to -0.09], while the pooled OR for revision rate was 1.53 (95% CI: 1.21 to 1.92). In terms of postoperative complications, the pooled OR for stiffness was 1.55 (95% CI: 0.92-2.61), infection was 1.39 (95%CI: 1.17-1.67), aseptic loosening was 1.93 (95% CI: 1.19-3.11), VTE was 1.06 (95% CI: 0.83-1.35), and MUA was 1.33 (95% CI: 1.13-1.57) respectively.Prior arthroscopy has significant impact on the functional and adverse clinical outcomes following TKA. Surgeons need to develop a comprehensive intervention plan to manage these high-risk patients and reduce the rate of postoperative complications.

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.