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Vascular calcification (VC), as a prevalent feature of atherosclerosis (AS), is a life-threatening pathological change. Mitofusin 2 (MFN2) has been reported to be down-regulated and participate in the pathogenesis of AS. Here, we explored the feasible impacts of MFN2 on VC in AS.Atherosclerotic lesion was evaluated by Oil Red O staining. The VC was detected by Alizarin Red S staining, ALP staining, and calcium content in vascular smooth muscle cells (VSMCs) or atherosclerotic mice. The chondrocyte differentiation of VSMCs was measured by Alcian blue staining. Western blotting and qRT-PCR were used to determine the protein and mRNA expression of associated molecules. Intermolecular interaction was measured by ChIP and dual luciferase assays.The expression of MFN2 and E2F1 was reduced in the aorta tissues of AS patients and mice. Silencing of MFN2 drove calcification in VSMCs and aortas of atherosclerotic mice as confirmed by up-regulating RUNX2, OPG levels, and down-regulating SM22α, α-SMA levels. The chondrocyte differentiation of VSMCs was accelerated by MFN2 knockdown through inducing the expression of Aggrecan, Collagen II, and SOX9. In addition, E2F1 promoted the transcription and expression of MFN2 in VSMCs. Overexpression of MFN2 or E2F1 suppressed ox-LDL-induced VSMC calcification. Finally, MFN2 depletion enhanced VSMC calcification via activating RAS-RAF-ERK1/2 pathway.Our results suggest that silencing of MFN2 drives VC via activating RAS-RAF-ERK1/2 pathway in the progression of AS, thus MFN2 may be a therapeutic target for AS.

Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve (AN) during surgery. Nerve repair is an effective method to restore trapezius muscle function, and includes neurolysis, direct suture, and nerve grafting. The suprascapular nerve (SCN) and AN are next to each other in position. The function of the AN and SCN in shoulder elevation and abduction movement is synergistic. SCN might be considered by surgeons for AN reanimation.To obtain anatomical and clinical data for partial suprascapular nerve-to-AN transfer.Ten sides of cadavers perfused with formalin were obtained from the Department of Human Anatomy, Histology and Embryology, Peking University Health Science Center. The SCN (The whole length of the AN in the trapezius muscle was 16.89 cm. The average numbers of branches distributed in the descending, horizontal and ascending portions were 3.8, 2.6 and 2.2, respectively. The diameter of the AN was 1.94 mm at the anterior border of the trapezius. The length of the suprascapular nerve from the origin of the brachial plexus to the scapular notch was longer than the distance of the suprascapular nerve from the origin point to the point where the accessory nerve entered the upper edge of the trapezius muscle. The amplitude of trapezius muscle electromyography indicated that both the horizontal and ascending portions of the trapezius muscle on the right side had better function than the left side nine months after surgery. The results showed that the right-sided supraspinatus and infraspinatus muscles did not lose more function than the left side.Based on anatomical data and clinical application, partial suprascapular nerve-to-AN transfer could be achieved and may improve innervation of the affected trapezius muscle after radical neck dissection.

Accurate reconstruction of orbital and midfacial defects following extensive globe-sparing maxillectomy is challenging, due to the complex anatomy of facial skeleton. The aim of this study is to evaluate the outcomes of individually bent titanium mesh in navigation-assisted reconstruction of post-ablative orbits in comparison with that without intraoperative navigation. Forty-one patients undergone globe-sparing maxillectomy and orbital floor reconstruction using individually bent titanium mesh with or without intraoperative navigation were assessed. Pre- and postoperative orbital projection and volume measurements were performed on both orbits. The unaffected orbit was used as a control for comparison. True-to-original orbital reconstruction was achieved in this study. The average difference of globe projection and orbital volume between unaffected and reconstructed orbits was 0.8 ± 0.5 mm and 0.9 ± 1.2cm

Atherosclerosis is the most common arterial disease and is closely related to vascular calcification. CircHIPK3 has been implicated in atherosclerosis development, but the possible downstream regulatory mechanisms remain unclear. The levels of circHIPK3, miR-106a and MFN2 in tissues and blood samples of patients with atherosclerosis were detected by RT-qPCR. The levels of circHIPK3, miR-106a and MFN2 were detected by RT-qPCR and the expression levels of MFN2, osteogenic and cartilage differentiation marker proteins were detected by western blot in vitro. ALP staining, Alizarin Red staining, and calcium content detection evaluated the degree of osteogenic differentiation of cells. Alcian blue staining detected the level of cell cartilage differentiation. Luciferase detected the targeting relationship between circHIPK3 and miR-106a-5p, as well as miR-106a-5p and MFN2. CircHIPK3 and MFN2 were low expressed and miR-106a-5p was highly expressed in tissues and blood samples of patients with atherosclerosis, as well as vascular smooth muscle cell (VSMC) with osteogenic and cartilage differentiation. Overexpression of circHIPK3 reduced the cell mineralization and calcium content. Overexpression of circHIPK3 inhibited osteogenic differentiation by decreasing ALP activity, RUNX2, and OPG expression, and increasing SM22α and SMA level. What's more, overexpression of circHIPK3 decreased the chondrogenic differentiation by inhibiting the protein level of SOX9, aggrecan, and collagen II. CircHIPK3 targeted miR-106a-5p and miR-106a-5p targeted MFN2. MiR-106a-5p overexpression or MFN2 depletion repressed the effect of circHIPK3 overexpression on VSMC calcification. CircHIPK3 regulated osteogenic and cartilage differentiation of VSMC via miR-106a-5p/MFN2 axis, indicating a target for treating vascular calcification.

To the best of our knowledge, this is the largest clinical retrospective study in AN‐SAH patients, and is the first time to establish accurate predictive models paired with bleeding pattern. Background Angiogram‐negative subarachnoid hemorrhage (AN‐SAH) has a definite incidence of delayed cerebral ischemia (DCI) and poor clinical outcomes. The purpose is to screen independent factors and establish a nomogram to guide the clinical therapy and assess post‐discharge prognosis. Methods We identified 273 consecutive patients referred to our institute from 2013 to 2018 for AN‐SAH. A nomogram to predict poor outcomes was formulated based on the multivariable models of independent risk factors. The accuracy and discrimination of nomograms were determined in training and internal validation cohorts. Results The overall poor outcome rates of AN‐SAH were 14.3% and 8.7% at 3 months and 12 months, respectively. In addition, perimesencephalic AN‐SAH (PAN‐SAH) presented with a more unfavorable prognosis compared with non‐perimesencephalic AN‐SAH (NPAN‐SAH). The clinical prognosis was associated with the World Federation of Neurosurgical Societies scale (WFNS) (odds ratio, 3.82 [95% CI, 1.15‐12.67] for 3‐month outcome; and odds ratio, 31.69 [95% CI, 3.65‐275.43] for 12‐month outcome), Subarachnoid hemorrhage Early Brain Edema Score (SEBES) (odds ratio, 10.39 [95% CI, 1.98‐54.64] for 3‐month outcome; odds ratio, 10.01 [95% CI, 1.87‐53.73] for 12‐month outcome), and symptomatic vasospasm (odds ratio, 3.16 [95% CI, 1.03‐9.70] for 3‐month outcome; odds ratio, 5.15 [95% CI, 1.34‐19.85] for 12‐month outcome). The nomogram was constructed based on the above features, which represented great predictive value in clinical outcomes. Conclusions Symptomatic vasospasm, high WFNS, cerebral edema, and NPAN‐SAH after hemorrhage were associated with poor outcome of AN‐SAH. The nomogram with WFNS (3‐5), SEBES (3‐4), vasospasm, and NPAN‐SAH represented a practical approach to provide individualized risk assessment for AN‐SAH patients., To the best of our knowledge, this is the largest clinical retrospective study in AN‐SAH, and is the first time to establish accurate predictive models paired with bleeding pattern.

Reconstruction of complete bilateral maxillary defects (CBMDs) can be challenging due to the extensive loss of bone and soft tissues. This is a retrospective case series of 46 consecutive patients with CBMDs that were reconstructed with different microvascular free flaps. The authors aimed to evaluate the surgical outcomes and discuss the different reconstruction options in this case series. Thirty-six patients underwent reconstruction following ablation surgery for malignant tumors, 6 for benign tumors, 3 patients were treated for osteomyelitis, and 1 patient underwent free flap reconstruction for posttraumatic defects. Free fibula flap (n = 26) is the most commonly used reconstruction method in this case series, which was used in all defect types. This is followed by anterolateral thigh flap (n = 10), 5 rectus abdominis myocutaneous free flap, 3 radial forearm free flaps, and 2 composite free flaps. In this series, 44 free flaps survived, whereas only 2 flaps were lost. All patients could resume a soft diet postoperatively. Reconstruction of CBMDs with vascularized free flaps is a safe and reliable procedure.

Objective The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure. Material and methods The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Titanium mesh exposure was recorded and the risk factors were identified. Results Mean follow-up was for 24.8 months (range, 6-92 months). Ophthalmic function was successfully restored in 63/66 patients. Aesthetic restoration was not considered satisfactory by 10 patients. Titanium mesh exposure occurred in six patients (exposure rate, 9.1%). Preoperative radiotherapy was identified as an independent risk factor for mesh exposure (OR = 28.8, P = 0.006). Previous surgery, postoperative radiotherapy, pathological type of the primary lesion, the type of tissue flap applied, and the use of intraoperative navigation were not significant risk factors. Six patients with titanium mesh exposure underwent second surgery, but mesh exposure recurred in two patients due to insufficient soft tissue coverage. Conclusion Individualized titanium mesh with free flap can effectively restore maxilla-orbital defects. Preoperative radiotherapy is an independent predictor of postoperative titanium mesh exposure. Adequate soft tissue coverage of the mesh may reduce the risk of mesh exposure. Level of evidence Level 4 (case-control study) Laryngoscope, 2021.

Stroke-associated pneumonia (SAP) has been found as a common complication in acute ischemic stroke (AIS) patients. Large artery atherosclerosis (LAA) infarct is a major subtype of AIS. This study aimed to build a clinical prediction model for SAP of LAA type AIS patients.This study included 295 patients with LAA type AIS. Univariate analyses and logistic regression analyses were conducted to determine the independent predictors for the modeling purpose. Nomogram used receiver operating characteristics to assess the accuracy of the model, and the calibration plots were employed to assess the fitting degree between the model and the practical scenario. One hundred and five patients were employed for the external validation to test the stability of the model.From the univariate analysis, patients' ages, neutrophil-to-lymphocyte ratios, National Institute of Health Stroke scale (NIHSS) scores, red blood cell, sex, history of coronary artery disease, stroke location and volume-viscosity swallow test showed statistical difference in the development group for the occurrence of SAP. By incorporating the factors above into a multivariate logistic regression analysis, patients' ages, neutrophil-to-lymphocyte ratios, NIHSS, and volume-viscosity swallow test emerged as the independent risk factors of the development of SAP. The nomogram based on the mentioned 4 variables above achieved a receiver operating characteristic of 0.951 and a validation group of 0.946.The proposed nomogram is capable of predicting predict the occurrence of SAP in LAA type AIS patients, and it may identify high-risk patients in time and present information for in-depth treatment.

Background The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex OKC) and comprehensively improve the understanding of this disease. Material and Methods We retrospectively investigated five cases of PIOSCC ex OKC at Peking University School and Hospital of Stomatology. We also conducted a systematic review of studies on PIOSCC ex OKC by using online databases from their inception until February 2020. Results In our series of five cases, all lesions were located in the mandible. Three cases (60%) showed recurrent OKCs and two cases (40%) showed primary OKCs. During the follow-up period, one patient died of local relapse. No patients developed metastasis. On the basis of our literature survey, we selected 22 articles reporting 29 patients with PIOSCC ex OKC. Seven of these patients (24.1%) showed local recurrence, three patients (10.3%) developed cervical metastasis, three patients (10.3%) developed distant metastasis (in the pleura in one case and in the lung in two cases), and seven patients died from the disease during the follow-up period. The disease-specific 5-year survival rate in the study group was 53.2%. Through univariate and multivariate analysis, local recurrence was identified as the only significant independent prognostic factor for survival (P < 0.05). Conclusions The results suggest that PIOSCC ex OKC is a rare intermediate-grade malignancy. Although elective neck dissection is typically unnecessary, adequate therapy should be applied to achieve the lowest local recurrence rate possible to ensure a favorable survival rate. Key words:Primary intraosseous squamous cell carcinoma, odontogenic keratocyst, prognosis.

To determine whether diabetes mellitus (DM) contributes to the drug resistance of carbamazepine (CBZ), we investigated the correlation between the blood glucose status and the CBZ resistance condition in patients with trigeminal neuralgia (TN). A total of 155 TN patients treated with the CBZ monotherapy were selected at Shanghai General Hospital and Shanghai Xinhua Hospital from September 2018 to January 2020. Among them, 15 were diagnosed with DM. Patients’ CBZ resistance levels were evaluated according to progression-free survival. We utilized ordered multiple classification logistic regression to determine the dominant factors leading to CBZ resistance. We analyzed the correlation between hemoglobin A1c (HbA1c) and progression-free survival using the Pearson correlation analysis. The regression analysis showed that DM was the only factor affecting CBZ resistance (p = 0.035; OR = 0.327; 95% CI, 0.115–0.926). Progression-free survival was 28.5 ± 21.2 months in the DM group and 66.0 ± 33.2 months in the non-DM group. The concentration of HbA1c in the blood was negatively correlated with progression-free survival (r = − 0.197; p = 0.014). This study shows that blood glucose status is a significant factor contributing to the CBZ resistance in the treatment of TN. The progression-free survival of patients is affected by the status of DM and blood HbAlc levels.

This study aimed to establish an effective prognostic nomogram for microvascular decompression (MVD)–treated trigeminal neuralgia (TN). The nomogram was based on a retrospective cohort study of 1054 patients with TN. During the period 2005–2014, 845 patients at our department treated TN with MVD and served as a development cohort. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The model was externally validated by 209 TN patients during 2014–2016. Multivariate cox analysis suggested that the patient’s age, atypical pain, vascular type, number of offending vessels, and second MVD were significant factors influencing the prognosis of MVD-treated TN. The C index of nomogram in the development cohort was 0.767 (95% CI, 0.739–0.794), and 0.749 (95% CI, 0.688–0.810) in the validation cohort. We developed and validated a nomogram to predict 3-year overall remission rate after MVD treatment of TN. The nomogram can be used in clinical trials to determine the likelihood of pain recurrence in TN patients treated with MVD for 3 years to aid in the comprehensive treatment of TN.

The mechanism of sodium sulfide (Na2S) on the flotation of cyanide-depressed pyrite using potassium amyl xanthate (PAX) as collector was investigated by flotation test and electrochemical measurements. The flotation results show that both PAX and Na2S can promote the flotation recovery of cyanide-depressed pyrite and their combination can further improve the pyrite flotation recovery. Electrochemical measurements show that PAX and Na2S interacted with cyanide-depressed pyrite through different mechanisms. PAX competed with cyanide and was adsorbed on the pyrite surface in the form of dixanthogen, thus enhancing the hydrophobicity and flotation of cyanide-depressed pyrite. Unlike PAX, Na2S rendered the pyrite surface hydrophobic through the reduction of ferricyanide species and the formation of elemental sulfur S0 and polysulfide. The combined application of PAX and Na2S induced superior pyrite flotation recovery because of a synergistic effect between PAX and Na2S.

Increasing evidence suggests that inflammation is associated with the development of acute ischemic stroke (AIS). The neutrophil-to-lymphocyte ratio (N/L) is an important marker of inflammation and is highly correlated with mortality in stroke patients in recent studies. The N/L of patients who experience hemorrhagic transformation (HT) after AIS is know, but any relationship between N/L and large artery atherosclerosis (LAA) remains unclear, this is our present topic. We enrolled 185 patients with LAA-type HT in the development cohort from a prospective, consecutive, hospital-based stroke registry to this end. We matched these patients to 213 LAA patients who did not develop HT as controls. The incidence of HT after LAA was significantly greater (P

Summary: NMDA receptors (NMDARs) are critical for physiological synaptic plasticity, learning, and memory and for pathological plasticity and neuronal death. The GluN1 subunit is encoded by a single gene, GRIN1, with 8 splice variants, but whether the diversity generated by this splicing has physiological consequences remains enigmatic. Here, we generate mice lacking from the GluN1 exon 5-encoded N1 cassette (GluN1a mice) or compulsorily expressing this exon (GluN1b mice). Despite no differences in basal synaptic transmission, long-term potentiation in the hippocampus is significantly enhanced in GluN1a mice compared with that in GluN1b mice. Furthermore, GluN1a mice learn more quickly and have significantly better spatial memory performance than do GluN1b mice. In addition, in human iPSC-derived neurons in autism spectrum disorder NMDARs show characteristics of N1-lacking GluN1. Our findings indicate that alternative splicing of GluN1 is a mechanism for controlling physiological long-lasting synaptic potentiation, learning, and memory. : NMDA receptors (NMDARs) are critical for synaptic plasticity, learning, and memory and for pathological plasticity and neuronal death. Sengar et al. report that alternative splicing of exon 5 of the obligatory GluN1 subunit of the NMDAR controls the gain of long-lasting synaptic potentiation, learning, and memory in mice. Keywords: GluN1, NMDA Receptor, long-term potentiation, N1 cassette, autism, splicing

OBJECT Microvascular decompression (MVD) is the most popular surgical procedure for treating Trigeminal neuralgia (TN). In this article, the authors conducted a large case series in which patients underwent MVD for TN, and focus on surgical outcomes, intraoperative findings, complications and risk factors. METHODS From January 2017 to June 2017, a total of 84 patients with TN were treated with MVD in our department. The authors retrospectively analyzed the surgical outcomes and postoperative complications of these patients. Risk factors were analyzed by binary logistic regression analysis. RESULTS Of the 84 patients, 69 had complete postoperative symptom relief (BNI I-II). A total of 28 patients developed postoperative facial numbness (BNI III-IV) and 1 patient died intraoperatively. With binary logistic regression analysis, significant risk factors for postoperative Facial numbness (FN) were longer operation time (odds ratio [OR] 1.153, P

Objective Overlapping surgery, performed by the same primary attending surgeon asynchronously, has gained significant attention from the government and media as potentially harmful to patients. Therefore, the goal of this study was to evaluate the outcomes and safety of overlapping versus nonoverlapping microvascular decompression (MVD) operations. Methods Patients who underwent MVD operations were retrospectively reviewed: 1153 with hemifacial spasm (HFS), 694 (60.2%) of whom underwent overlapping procedures, and 935 with trigeminal neuralgia (TN), 612 (65.5%) of whom underwent overlapping procedures. Collected variables included patient age, sex, side, disease duration, clinical characteristic, comorbidity, affected vessel, intraoperative neuroelectrophysiology, operation time under microscope, total surgical procedure times, mean length of stay (LOS), efficacy (at discharge, 6 months, 1 year), short-term complications, and long-term complications. χ2 and t tests were performed to compare overlapping versus nonoverlapping cases, and then multivariate analysis were conducted to adjust for patient demographics, clinical characteristics, and comorbidity between the 2 groups. Results Patient variables (age, sex, side, disease duration, clinical characteristic, and comorbidity), affected vessel, and intraoperative neuroelectrophysiology were similar between the 2 groups. After adjustment for patient demographics, clinical characteristics, and comorbidity, overlapping surgeries had longer total surgical procedure times (HFS: standardized coefficient = 0.066, P Conclusions Overlapping MVD operations may be performed safely at our institution. Further prospective studies are needed to understand the association of overlapping surgery among MVD operations.

Purpose Zygomatic complex defects after extensive maxillectomy can cause severe esthetic and functional deformities. Patient-specific titanium mesh fabricated using a computer-assisted technique is a promising method for such midface reconstruction. The aim of this study was to evaluate the application and clinical outcomes of this technique. Patients and Methods This was a retrospective study that included 9 patients with zygomatic complex defects after extensive maxillectomy from 2015 through 2017 at the authors' institution. A 3-dimensional stereo model was obtained based on mirror images of the unaffected side to fabricate a patient-specific titanium mesh using computer-assisted design and manufacturing. Titanium mesh was used to restore the contour of the zygomatic complex with free flap reconstruction after tumor resection. Anterolateral thigh flaps were used in 8 cases and a myocutaneous fibula flap was used in 1 case. Symmetry of the zygomatic complex was evaluated by measuring the zygomatic eminence on the postoperative computed tomogram, and complications were recorded during follow-up visits. Facial symmetry was self-evaluated and scored. Results Mean duration for follow-up was 27.3 months (range, 15 to 39 months). Mean deviation of the zygomatic eminence between the reconstructed and unaffected sides was 1.4 ± 0.5 mm. No significant difference was noted in the zygomatic eminence between the reconstructed and unaffected sides (P = .591). Titanium mesh exposure occurred in only 1 patient after radiotherapy. There were no other remarkable complications. All patients were satisfied with their postoperative facial symmetry. Conclusion Patient-specific titanium mesh fabricated using a computer-assisted technique was an alternative option for extensive zygomatic complex reconstruction, resulting in acceptable clinical outcomes. A study with a larger sample and long-term follow-up is needed for the observation of long-term outcomes and risk of titanium mesh-related complications.

Ewing sarcoma (EwS) is an aggressive malignant neoplasm composed of small round cells. The heterogeneity and developmental trajectories of EwS are uncertain.Single-cell RNA sequencing was performed on 4 EwS tumor tissue samples, and 3 transcriptional atlases were generated. K-nearest neighbor algorithm was used to predict the origin of tumor cells at single-cell resolution. Monocle2 package was used to perform pseudotime trajectory analysis in tumor cells. Differentially expressed genes were compared against those in all other clusters via the FindMarkers function, and then they were subjected to GO analysis using clusterProfiler package.Combined with the results of k-nearest neighbor algorithm and pseudotime trajectory analysis in tumor cells, we thought meningeal EwS originated from neural crest cells during epithelial to mesenchymal transition and simulated the process of neural crest cell lineage differentiation. But for perirenal EwS and spinal EwS, we hypothesized that after the neural crest cell lineage mutated into them, the tumor cells did not maintain the differentiation trajectory of neural crest cell lineage, and the development trajectory of tumor cells became chaotic. GO analysis results showed that interferon signaling pathway-related biological processes play an essential role in the tumorigenesis and tumor progression process of EwS, and among these biological processes genes, JAK1 gene up-regulated most significantly and highly expressed in all tumor cells. Ruxolitinib was used to explore the function of JAK1. Targeting JAK1 can promote apoptosis of EwS tumor cells, inhibit the migration and invasion of EwS tumor cells, and inhibit cell proliferation by inducing cell cycle S phase arrest.EwS was derived from neural crest cell lineage with variable developmental timing of oncogenic conversion, and the JAK1 might be a candidate for therapeutic targets of EwS.

To investigate the osteogenic effect of nano-grade pearl powder(NPP)/chitosan-hyaluronic acid (C-HA)/recombinant human bone morphology protein-2 (rhBMP-2) artificial bone.A bone defect model with a diameter of 7 mm and a height of 10 mm was made at the distal end of the femur. NPP/C-HA stent containing rhBMP-2 was prepared according to the shape of the defect. No material was implanted in the defect as blank group. NPP/C-HA was used as the control group, NPP/C-HA/rhBMP-2 was implanted into the experimental group. At 4 weeks, 8 weeks, and 12 weeks, the bone effects of each component were detected by cone-beam CT(CBCT), H-E and Masson staining. Serum ALP activity and OCN in tissues to determine the osteogenic differentiation and osteogenesis maturity were detected. SPSS 18.0 software package was used for statistical analysis.At 12 weeks, the defect was completely repaired in the experimental group. No immunological side effects such as inflammation and rejection were observed. At 8 and 12 weeks, CBCT showed that the experimental group had a higher CT value (Hounsfield units, HU) compared with the control group and the blank group(P0.05). H-E and Masson staining showed that the experimental group had obvious new bone formation compared with the control group and the blank group at 8 weeks and 12 weeks, and ALP activity of the experimental group was significantly different from the control group and the blank group at 8 weeks. OCN immunohistochemical scoring of the experimental group was significantly different from the control group and the blank group(P0.05).NPP/C-HA/rhBMP-2 has good tissue fusion, osteoinductivity, osteoconductivity and osteogenicity, which is expected to provide more effective treatment for bone repair.

Background and Purpose. There are increasing evidences that show that the prognosis of patients with acute ischemic stroke (AIS) is closely related to the inflammatory response. In the inflammation caused by AIS, plasma C-reactive protein (CRP) will increase and is associated with prognosis in these patients; few studies have looked at the relationship between CRP and large artery atherosclerosis- (LAA-) type AIS. We aim to investigate the role of CRP in predicting the functional outcome of LAA-type AIS patients. Methods. We prospectively included 200 patients with LAA-type AIS and tested their CRP levels on admission. We followed these patients consecutively. The primary outcome was an adverse event, defined as a modified Rankin Scale score of 2-6 at months 3, 6, and 12 after discharge. A logistic regression model was used to analyze the relationship between CRP and the functional outcome of LAA stroke. Results. We divided 200 patients into 3 groups evenly based on CRP level. After adjustment for gender, age, smoking history, drinking history, history of hyperlipidemia, history of diabetes, lipid levels, and blood glucose levels, logistic regression showed that the incidence of LAA-type AIS poor outcome was positively associated with CRP level at admission, whether it was 3 months, 6 months, or 12 months after discharge, respectively (OR: 2.574, 95% CI: 1.213-5.463; OR: 2.806, 95% CI: 1.298-6.065; OR: 2.492, 95% CI: 1.167-5.321. In the highest tertile vs. the lowest tertile as a reference), and both were statistically different. Conclusions. High CRP level predicts poor functional outcome in LAA-type AIS patients, which provides a strong basis for clinicians to make treatment decisions for these patients.

Oil-paper insulation is the key insulation structure of the transformers, whose aging condition is closely related to the operations of the equipment. The degree of polymerization (DP) is the direct parameter characterizing the aging condition of oil-paper insulation. Recently, the near infrared spectroscopy (NIRS) measurement powered by quantitative analysis is used to evaluate DP of the insulating papers mainly. While the applications of NIRS for DP evaluation is constrained because the present spectral quantitative analysis method is not accurate and stable enough, especially for onsite tests. In this paper, we propose a Gaussian process regression (GPR) method to predict DP of the oil- paper insulation in laboratory as well as in field. Firstly, the basic principles of GPR algorithm are illustrated. A GPR model for DP prediction is established based on the spectra of differently aged insulating paper samples which are prepared in laboratory. The GPR model show a high prediction accuracy both for training set and testing set. The established GPR model is finally applied on the DP prediction of insulating papers originating from a de-tanked transformer. The accurate predicted DP and the reliable aging assessment results indicate that the established model can be implemented on site.

Targeting detection of micro-space-debris in Earth orbit, a double layered two-dimensional (2-D) polyvinylidene fluoride (PVDF) sensor is designed, with the use of the polarized PVDF piezoelectric film, to identify the projectile diameter and impact spot, velocity and angle of micro-debris. The double layered 2-D PVDF sensor developed by employing resistive charge division, i.e., a set of conducting strips on the front surface and an orthogonal set on the back surface of each layer. Each aluminum foil is connected to an external resistance respectively, and with the design of corresponding hardware circuit to constitute a double layered 2-D PVDF sensor. Hypervelocity impact (HVI) experiments are implemented with a two-stage light gas gun to verify the designed double layered 2-D PVDF sensor. The results show that the designed sensor can be used to characterize the parameter of space debris.

In low Earth orbit (LEO), the large-scale and long-term orbital spacecraft is likely to be impacted by micrometeoroids and orbital debris (MMOD), which will lead to gas leakage and then seriously threaten the safety of spacecraft and astronauts. However, it is still a challenge task to locate the leakage source, due to the randomness, multiband and dispersion of the leakage signal. Targeting sensing the gas leakage in time and accurate localization of the leakage source, an improved beamforming algorithm is proposed, and used to locate the leakage source of 1 mm, 2 mm and 3 mm diameter holes respectively. The improved algorithm uses a narrowband filter with automatic frequency window to select the best frequency band, as well as to delay overlay different signal speeds with various frequency bands via a dispersion curve. Experimental results show that the improved algorithm can accurately locate the artificial leak sources with different diameters.

Heterozygous loss-of-function mutations in SHANK2 are associated with autism spectrum disorder (ASD). We generated cortical neurons from induced pluripotent stem cells (iPSC) derived from neurotypic and ASD-affected donors. We developed Sparse coculture for Connectivity (SparCon) assays where SHANK2 and control neurons were differentially labeled and sparsely seeded together on a lawn of unlabeled control neurons. We observed increases in dendrite length, dendrite complexity, synapse number, and frequency of spontaneous excitatory postsynaptic currents. These findings were phenocopied in gene-edited homozygous SHANK2 knockout cells and rescued by gene correction of an ASD SHANK2 mutation. Dendrite length increases were exacerbated by IGF1, TG003, or BDNF, and suppressed by DHPG treatment. The transcriptome in isogenic SHANK2 neurons was perturbed in synapse, plasticity, and neuronal morphogenesis gene sets and ASD gene modules, and activity-dependent dendrite extension was impaired. Our findings provide evidence for hyperconnectivity and altered transcriptome in SHANK2 neurons derived from ASD subjects.

Objective To evaluate the efficacy of the second operation within 1 week after ineffective microvascular decompression (MVD) for patients with primary hemifacial spasm (HFS), and to find out the causes of failure. Methods The surgery records and postoperative follow-ups of 52 primary HFS patients who had poor relief of spasm after their first MVDs were investigated. Patients were divided into 2 groups. Group A included 46 patients (16 males and 30 females) that went through the second operation within 1 week after the failure of the first MVD. Group B included 6 patients (3 males and 3 females) which did not take the reoperation. The level of spasm of each patient was then re-evaluated 1 year after the first surgery. Results Among 52 patients who had poor relief after the first MVD between April 2016 and October 2019, 46 patients underwent a second MVD within 1 week while 6 patients refused to take the reoperation. Their mean duration of HFS was 102.4 ± 57.9 months. During reoperations for patients in group A, we discovered additional sites of neurovascular compression in 11 cases (23.91%). Forty-five patients (97.82%) in group A achieved complete relief 1 year after the second surgery while there was 1 recurrent case. Four patients (66.67%) in group B achieved delayed relief 1 year after the first surgery, while the other 2 patients were still suffering facial spasm in the 1-year follow-up. Group A demonstrated higher relief rate compared to group B in the 1 year follow up (P = 0.032). Although no severe complications occurred on patients in both group, 4 of them suffered grade II facial palsy, and another 3 patients had developed mild temporary hearing loss on the operation side. Conclusion The second operation within 1 week after an ineffective MVD is safe and effective. Full revealing of root exit zone and making sure no neurovascular compression missed with abnormal muscle response monitoring are the keys to a successful MVD.

Bearings are an important component in rotating machinery and their failure can lead to serious injuries and economic losses, therefore the diagnosis of bearing faults and the guarantee of their smooth operation are essential steps in maintaining the safe and stable operation of modern machinery and equipment. Traditional bearing fault diagnosis methods focus on manually designing complex noise reduction, filtering, and feature extraction processes, however, these processes are too cumbersome and lack intelligence, making it increasingly difficult to rely on manual diagnosis with large amounts of data. With the development of information technology, convolutional neural networks have been proposed for bearing fault detection and identification. However, these convolutional models have the disadvantage of having difficulty handling fault-time information, leading to a lack of classification accuracy. So this paper proposes a transformer-based fault diagnosis method, using the short-time Fourier transform to convert the one-dimensional fault signal into a two-dimensional image, and then input the two-dimensional image into the transformer model for classification. Experimental results show that the fault classification can reach an accuracy of 98.45%.

Background Although large artery atherosclerosis (LAA) is the most common type of cerebral infarction, non-LAA is not uncommon. The purpose of this paper is to investigate the prognosis of patients with non-LAA and to establish a corresponding nomogram. Patients and methods Between June 2016 and June 2017, we had 1101 admissions for acute ischemic stroke (AIS). Of these, 848 were LAA and 253 were non-LAA. Patients were followed up every 3 months with a minimum of 1 year of follow-up. After excluding patients who were lost follow-up and patients who did not meet the inclusion criteria, a total of 152 non-LAA patients were included in this cohort study. After single-factor analysis and multifactor logistic regression analysis, the risk factors associated with prognosis were derived and different nomograms were developed based on these risk factors. After comparison, the best model is derived. Results Logistics regression found that the patient’s National Institutes of Health Stroke Scale (NIHSS) score, ejection fraction (EF), creatine kinase-MB (CK-MB), age, neutrophil-to-lymphocyte ratio (NLR), aspartate aminotransferase (AST), and serum albumin were independently related to the patient’s prognosis. We thus developed three models: model 1: single NIHSS score, AUC = 0.8534; model 2, NIHSS + cardiac parameters (CK-MB, EF), AUC = 0.9325; model 3, NIHSS + CK−MB + EF + age + AST + NLR + albumin, AUC = 0.9598. We compare the three models: model 1 vs model 2, z = − 2.85, p = 0.004; model 2 vs model 3, z = − 1.58, p = 0.122. Therefore, model 2 is considered to be the accurate and convenient model. Conclusions Predicting the prognosis of patients with non-LAA is important, and our nomogram, built on the NIHSS and cardiac parameters, can predict the prognosis accurately and provide a powerful reference for clinical decision making.

Recently, the pretraining of models has been successfully applied to unsupervised and semi-supervised neural machine translation. A cross-lingual language model uses a pretrained masked language model to initialize the encoder and decoder of the translation model, which greatly improves the translation quality. However, because of a mismatch in the number of layers, the pretrained model can only initialize part of the decoder&rsquo, s parameters. In this paper, we use a layer-wise coordination transformer and a consistent pretraining translation transformer instead of a vanilla transformer as the translation model. The former has only an encoder, and the latter has an encoder and a decoder, but the encoder and decoder have exactly the same parameters. Both models can guarantee that all parameters in the translation model can be initialized by the pretrained model. Experiments on the Chinese&ndash, English and English&ndash, German datasets show that compared with the vanilla transformer baseline, our models achieve better performance with fewer parameters when the parallel corpus is small.