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Additional file 1: Table S1. Evaluation results of brpA, relA, gtfB, gtfC, gtfD 3D structures. Table S2. Molecular Docking results with interacting residues of protein brpA, gbpB, spaP and compounds. Table S3. Molecular Docking results with interacting residues of protein gtfB, gtfC, gtfD, and compounds. Table S4 Molecular Docking results with interacting residues of protein relA, vicR and compounds. Figure S1. All 5 pockets detected in the 8 virulent proteins of S.mutans. Based on the sequence, the pockets in the functional domains of each protein were determined and presented with the name. Figure S2. Docking interaction of 8 components with brpA protein. A: the selected pocket in the functional domain of brpA protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S3. Docking interaction of 8 components with gbpB protein. A: the selected pocket in the functional domain of gbpB protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S4. Docking interaction of 8 components with vicR protein. A: the selected pocket in the functional domain of vicR protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S5. Docking interaction of 8 components with gtfB protein. A: the selected pocket in the functional domain of gtfB protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S6. Docking interaction of 8 components with gtfC protein. A: the selected pocket in the functional domain of gtfC protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S7. Docking interaction of 8 components with gtfD protein. A: the selected pocket in the functional domain of gtfD protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S8. Docking interaction of 8 components with relA protein. A: the selected pocket in the functional domain of relA protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds. Figure S9. Docking interaction of 8 components with spaP protein. A: the selected pocket in the functional domain of spaP protein; B: schematic presentation of docked complex interaction in 2D and 3D format. Blue to green range of surrounding depicts solubility of protein and different colors in 2D format represents different type of bonds.

Fusidane-type antibiotics, represented by helvolic acid, fusidic acid and cephalosporin P1, are fungi-derived antimicrobials with little cross-resistance to commonly used antibiotics. Generation of new fusidane-type derivatives is therefore of great value, but this is hindered by available approaches. Here, we developed a stochastic combinational strategy by random assembly of all the post-tailoring genes derived from helvolic acid, fusidic acid, and cephalosporin P1 biosynthetic pathways in a strain that produces their common intermediate. Among a total of 27 gene combinations, 24 combinations produce expected products and afford 58 fusidane-type analogues, of which 54 are new compounds. Moreover, random gene combination can induce unexpected activity of some post-tailoring enzymes, leading to a further increase in chemical diversity. These newly generated derivatives provide new insights into the structure‒activity relationship of fusidane-type antibiotics. The stochastic combinational strategy established in this study proves to be a powerful approach for expanding structural diversity of natural products., Graphical abstract Chemical diversification of fusidane-type antibiotics was accomplished using a stochastic combinational strategy through random assembly of all the post-tailoring genes derived from helvolic acid, fusidic acid and cephalosporin P1 pathways.Image 1

To observe the acupoint compatibility effect of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia, and its mechanism in regulating hypothalamic-pituitary-adrenal (HPA) axis and suprachiasmatic nucleus-pineal gland-melatonin (SCN-PG-MT) system.Ninety patients with insomnia were randomly divided into HT7, SP6 and HT7-SP6 (HT7 plus SP6) groups, with 30 cases in each group. Electroacupuncture (EA,5 Hz/25 Hz) was applied to HT7, SP6 or HT7-SP6 in each group for 30 min. The EA treatment was conducted once daily, 5 days a week for 2 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were observed, separately. The contents of serum adrenocorticotrophic hormone (ACTH), cortisol (CS) and melatonin (MT) were detected by ELISA.Compared with before treatment, the sleep quality, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI in the three groups after treatment were decreased (The compatibility of HT7 and SP6 has a synergism effect on the improvement of night sleep quality and daytime fatigue and sleepiness of insomnia patients, the mechanism may be related with its function in down-regulating the serum ACTH and CS levels and increasing the serum MT content. SP6 has a better effect than HT7, and plays a major role in acupoint compatibility.

Objectives Glochidion ellipticum Wight is a medicinal plant, rich in polyphenols, frequently used by the indigenous communities of Bangladesh and possess with multiple health benefits. It exerts anti-inflammatory and antidiarrheal properties, but the detailed chemical constituents are yet to be elucidated. Methods Glochidion ellipticum extracts were analyzed using ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry and then tested by both lipopolysaccharide (LPS) induced inflammation of Raw 264.7 macrophage cells and dextran sulfate sodium (DSS) induced acute colitis model. Blood serum was taken for fluorescein isothiocyanate–dextran (FITC-dextran) measurement and tissue samples were used to perform histology, RT-PCR and Western blotting. Key findings The extracts could lower the levels of nitric oxide (NO), reactive oxygen species (ROS) and pro-inflammatory cytokines significantly in LPS induced macrophage cells. The extracts could also reduce disease activity index (DAI) score, restore antioxidants and pro-oxidants and improve macroscopic and microscopic features of colonic tissues in DSS induced mice. Expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in protein level was markedly diminished (up to 51.21% and 71.11%, respectively) in the treatment groups compared to the model group of colitic mice. Conclusions Our findings suggested that G. ellipticum extracts ameliorate DSS colitis via blocking nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway, which make them to be potential candidates for further research against inflammation and colitis.

Objective To explore the cause and the treatment strategies of iliac limb occlusion after endovascular abdominal aortic aneurysm repair(EVAR). Methods The patients receiving EVAR in PUMC Hospital from January 2015 to December 2020 were retrospectively analyzed.Sixteen(2.7%)cases of iliac limb occlusion were identified,among which 6,9,and 1 cases underwent surgical bypass,endovascular or hybrid procedure,and conservative treatment,respectively. Results Fifteen cases were successfully treated.During the 10.6-month follow-up,2 cases receiving hybrid treatment underwent femoral-femoral bypass due to re-occlusion of the iliac limb. Conclusions Iliac limb occlusion mostly occurs in the acute phase after EVAR,and endovascular or hybrid treatment can be the first choice for iliac limb occlusion.It is suggested to focus on the risk factors for prevention.

Objective To investigate the risk factors for patients using intraoperative vasopressor infusions during carotid body tumor(CBT)excision.Patients' mean arterial pressure(MAP)and heart rate(HR)fluctuations as well as their requirements for vasoactive agents during surgery were assessed. Methods The patients receiving CBT excision in Peking Union Medical College Hospital from May 1,2013 to July 31,2017 were included for a retrospective cohort study.The potential factors of intraoperative requirement for vasopressor infusions were investigated using univariate analysis and Logistic multivariate analysis.Furthermore,the relationships of Shamblin types of CBT with intraoperative MAP/HR fluctuations and requirements for vasoactive agents were analyzed. Results A total of 108 patients with 116 CBTs were included.Univariate analysis revealed that maximum tumor diameter4 cm,intraoperative internal carotid artery injury,internal carotid artery reconstruction,malignant pathology,advanced Shamblin types(type Ⅱ and Ⅲ),estimated blood loss ≥400 ml,and operation duration4 hours were associated with intraoperative requirements for vasopressor infusions.Logistic analysis showed that Shamblin type Ⅲ(OR=2.286,95% CI=1.324-14.926,P=0.016)and operation duration4 hours(OR=3.874,95% CI=1.020-14.623,P=0.046)were risk factors for intraoperative requirements for vasopressor infusions during CBT surgery.In addition,Shamblin type Ⅲ was associated with intraoperative abnormal HR elevation and requirements for vasopressors.Conclusions Shamblin type Ⅲ and operation duration4 hours are risk factors for intraoperative requirements of patients for using vasopressor infusions during CBT surgery.Shamblin type Ⅲ is associated with intraoperative abnormal HR elevation and requirements for vasopressors.

In this study,magnetic diatomite was used as a carrier to load calcium peroxide(CaO

The objective of the present study was to investigate the mechanism whereby long-chain non-coding RNA (LncRNA) antisense non-coding RNA (ANRIL) in the INK4 locus promotes angiogenesis and thrombosis by the miR-99a and miR-449a interventional autophagy pathway. The expression of LncRNA ANRIL, autophagy-related gene beclin1, and miR-99a and miR-449a in human umbilical vein endothelial cells (HUVECs) was determined by qRT-PCR. Thrombomodulin expression was examined by Western blotting assays. The levels of autophagy-related factors were determined by ELISA. CCK-8 assays were used to assess cell viabilities. Apoptosis was detected by flow cytometry via annexin V-FITC/propidium iodide double labeling and TUNEL assays. The interaction between ANRIL, miR-99a and miR-449a was studied using luciferase reporter assays. The role of ANRIL in autophagy was assessed in rats. Our data revealed that ANRIL and beclin-1 were highly expressed, while miR-99a and miR-449a were down-regulated in HUVECs serum of the autophagy model. Luciferase reporter assays, in vitro rescue assays, and Matrigel assays demonstrated that ANRIL increased beclin-1 expression via miR-99a and miR-449a sponges to upregulate thrombomodulin and promote angiogenesis. In addition, in vivo experiments confirmed that knockdown of ANRIL reduced thrombosis in rats. In conclusion, ANRIL promotes angiogenesis and thrombosis by upregulating the expression of miR-99a and miR-449a during autophagy.

A pair of new tirucallane triterpenoid epimers, picraquassins M and N (1> and 2), were isolated from the stems of Picrasma quassioides (D. Don) Benn. Their structures were determined based on comprehensive spectroscopic and X-ray crystallographic analyses. In addition, their AChE inhibitory activity, cytotoxicity against five human tumour cell lines (SW480, MCF-7, HepG2, Hela, and PANC-1), and antimicrobial activity against two bacteria (Staphylococcus. aureus 209P and Escherichia coli ATCC0111) and two fungi (Candida albicans FIM709 and Aspergillus niger R330) were evaluated.

Picrasamide A (1), a new cinnamamide derivative, together with two new β-carboline alkaloids (2 and 3) and five known β-carboline alkaloids (4–8) were isolated from the stems of Picrasma quassioides (D. Don) Benn. Their structures were elucidated by detailed analyses of UV, IR, HRESIMS, and NMR data. Compound 1 was the first case of cinnamamide derivative from genus Picrasma. The AChE inhibitory activity and the antimicrobial activity of 1–8 were assessed. In addition, preliminary structure-activity relationships of these β-carboline alkaloids on the AChE inhibitory activity and antimicrobial activity were proposed.

Cladosporine A (

Gastrointestinal tract is the second largest organ in the body that mainly functions in nutrients and minerals intake through the intestinal barrier. Intestinal permeability maintains the circulation of minerals and nutrients from digested foods. Life and all the metabolic processes depend either directly or indirectly on proper functioning of GI tract. Compromised intestinal permeability and related disorders are common among all the patients with inflammatory bowel disease (IBD), which is a collective term of inflammatory diseases including Crohn's disease and ulcerative colitis. Many synthetic drugs are currently in use to treat IBD such as 5-aminosalicylic acid corticosteroids. However, they all have some drawbacks as long-term use result in many complications. These problems encourage us to look out for alternative medicine. Numerous in vitro and in vivo experiments showed that the plant-derived secondary metabolites including phenolic compounds, glucosinolates, alkaloids, terpenoids, oligosaccharides, and quinones could reduce permeability, ameliorate-related dysfunctions with promising results. In addition, many of them could modulate enzymatic activity, suppress the inflammatory transcriptional factors, ease oxidative stress, and reduce pro-inflammatory cytokines secretion. In this review, we summarized the phytochemicals, which were proven potent in treating increased intestinal permeability and related complication along with their mechanism of action.

Cladosporine A (1), a new indole diterpenoid alkaloid, was isolated from the extract of a fungal strain Cladosporium sp. JNU17DTH12-9-01. Its structure was elucidated by extensive spectroscopic analysis, and the absolute configurations were determined by electronic circular dichroism (ECD) experiments. This is the first report of the presence of indole diterpenoid alkaloid in the genus Cladosporium. The antimicrobial activities against Staphylococcus aureus 209P, Escherichia coli ATCC0111, Aspergillus niger R330, and Candida albicans FIM709 were evaluated. Compound 1 showed MICs of 4 μg/mL and 16 μg/mL against S. aureus 209P and C. albicans FIM709, respectively.

For this paper, thre-dimensional (3D) numerical simulations have been carried out by means of one 3D model established using FLUENT software according to the indirect dry air cooling towers of one ...

The natural draft cooling tower with water-cooled collectors has advantages including pump lift saving, being a type of energy-saving tower, and being suitable for application in huge capacity nuclear power plants. The height of the rain zone is reduced due to the existence of water-cooled collectors under the fill, which leads to a change of the tower's performance. In this paper, a three-dimensional mathematical model of the thermal and aerodynamic field of the tower is established. The thermal and resistance characteristics of the tower have been studied by a numerical simulation method. The study results include: (1) Owing to the existence of water-cooled collectors, the resistance of the rain zone is decreased and the total resistance of the tower is also decreased; (2) as the height of the rain zone for the natural draft cooling tower with water-cooled collectors is lower, the air velocity distribution in the fill section is more uniform than that of the natural draft cooling tower; and (3) ...

The inhibition of sedimentary phosphorus(P) was investigated under the CaO

Purpose. The microbiota composition of faeces and colonic contents were analysed to investigate the mechaninsm by which fermented soybean meal improves intestinal microbial communities, growth and immunity in weaning piglets. Methodology. Microbiota were investigated using16S rRNA gene sequencing and systematical bio-information Operational Taxonomic Units; α-diversity analyses indicated that fermented soybean meal increased bacterial species diversity. Results. The levels of Actinobacteria and Proteobacteia in faeces, and Firmicutes and Tenericutes in the colon, increased significantly in piglets fed fermented soybean meal (P

Objective To determine whether interval-spaced sessions of partial splenic artery embolization(PSE) is a safe and effective alternative treatment for hypersplenism in juvenile patients. Methods Eight patients(3 males and 5 females) were included in this retrospective study.All patients were diagnosed as hypersplenism and underwent PSE in 2-3 sessions separated by 1-2 month intervals.Immediate,short,and long term follow-up were done.The effectiveness of the treatment was evaluated.Results No major postoperative complication was noted.No patient developed septic shock,splenic abscess,or spleen rupture.Postoperative pain and fever were common and manageable;only two patients developed loculated pleural effusions,which were well alleviated after conservative treatment.All patients showed significant increase in thrombocytes and white blood cells count after the first session of embolization.The cell counts became remarkable after the last session and remained at normal levels during the follow-up period.Conclusions PSE using 2-3 interval-spaced sessions can effectively decrease spleen size and reverse hypersplenism in juvenile patients.Also,it may reduce the postoperative complications commonly seen in traditional PSE.

In this paper, a dual-functional tunable coding metasurface is presented at X band based on water substrate, which can realize two different functions of specific scattering pattern and absorption at two different frequency ranges. Besides, by changing the salinity of the saline water substrate, the absorption performance in high frequency can be tuned, while the scattering pattern in low frequency remains unchanged. A coding element is designed with small water cavity in it. Three coding sequences with different radiation patterns are designed to verify these functions, and one of them is fabricated and measured. Experimental results have good accordance with our simulations, which demonstrates our schemes. We believe this work can not only broaden our design manner of metasurfaces, but also have plenty potential applications in biological and medical detection domain.

The Gnaphalium pensylvanicum willd. is used in China as a folk medicine to treat anti-inflammatory, cough and rheumatism arthritis. The aim of this study was to evaluate the potential of the extract of G. pensylvanicum to treat hyperuricemia and acute gouty arthritis in animal model. G. pensylvanicum extract was evaluated in an experimental model with potassium oxonate (PO) induced hyperuricemia in mice which was used to evaluate anti-hyperuricemia activity and xanthine oxidase (XO) inhibition. Therapies for acute gouty arthritis was also investigated on monosodium urate (MSU) crystal induced paw edema model. G. pensylvanicum extract showed activity in reducing serum uric acid (Sur) through effect renal glucose transporter 9 (GLUT9), organic anion transporter 1 (OAT1) and urate transporter 1 (URAT1) mainly and inhibited XO activity in vivo of mice with PO induced hyperuricemia. The extract of G. pensylvanicum also showed significant anti-inflammatory activity and reduced the paw swelling on MSU crystal-induced paw edema model. Meanwhile, 13 caffeoylquinic acid derivatives and 1 flavone were identified by UPLC-ESI-MS/MS as the main active component of G. pensylvanicum. The extract of G. pensylvanicum showed significant effect on evaluated models and therefore may be active agents for the treatment of hyperuricemia and acute gouty arthritis.

Objective To report experience and result of endovascular repair for acute type B aortic dissection (ATBD). Methods Totally 125 ATBD patients receiving endovascular repair with stent-graft were enrolled in this study. Demographic data,operation details,perioperative findings,and follow-up results were retrospectively analyzed. Results All the 125 patients were successfully implanted with 135 stent-grafts. Thirteen cases were covered left subclavian artery,16 cases underwent left subclavian artery revascularization,and 10 cases underwent visceral artery revascularization. No perioperative mortality occurred. Meanwhile,the perioerative major adverse events included renal infarction (n=1),renal artery bleeding (n=2),stroke (n=2),myocardial infarction (n=1),and renal dysfunction (n=2;one of them suffered from permanent dialysis),and incision complication (n=5). The mean cost during hospital stay was (112 657±58 921) Yuan;more specifically,the cost for complicated dissection cases was significantly higher than uncomplicated cases [(171 623±93 635)Yuan vs. (92 531±48 721) Yuan,P0.001]. All the patients received regular follow-up for 3-120 months [mean (23.5±11.2) months],except that 14 cases (11.2%) lost to follow-up. During the follow-up,three deaths were reported,among whom one died due to rupture of distal dissection one year after primary operation. No re-intervention case was noted. Conclusions Endovascular repair for ATBD is safe and feasible. Emergency repair for complicated ATBD cases can get satisfactory results,although the medical cost is higher than uncomplicated cases.

Distributed energy and grid technology rapid development, its impact on the distribution grid protection is widespread concern. This paper describes the DG, Analysis of the access of distributed power for protection. Proposed protection architecture Based on MAS. Designed to compare the amount of current distributed power protection solutions. The program is simple and self-adaptability. This research is of great reference value.

Animal Toll-like receptors (TLRs) are involved in innate immunity. Toll proteins are generally transmembrane proteins. In this study, an atypical Toll-like receptor (HcToll-2) was identified from the triangle-shell pearl mussel Hyriopsis cumingii, which belongs to phylum Mollusca. Unlike the typical Toll like receptors with extracellular leucine-rich repeats (LRRs), transmembrane, and intracellular Toll/interleukin-1 receptor (TIR) domains, HcToll-2 has two homologous TIR domains located at the C-terminal (designated as HcTIR1 and HcTIR2) and lacks a transmembrane domain. Phylogenetic analysis showed that HcTIR1 was clustered with TIR of sea anemone Toll, and HcTIR2 was clustered with TIR of Drosophila Toll. HcToll-2 mRNA could be detected in the hepatopancreas and was upregulated after challenge with Escherichia coli and Staphylococcus aureus. Recombinant HcLRR protein with GST tag could bind to bacteria and also to LPS and PGN. Over-expression of both HcTIR1 and HcTIR2 induced drosomycin genes in Drosophila S2 cells. RNAi analysis showed that HcToll-2 was required for the expression of theromacin, which is a cysteine-rich antimicrobial peptide (AMP) gene. This research is the first report of an atypical Toll-like receptor HcToll-2 involved in antibacterial immunity through induction of AMP expression.

Semi-solid 7075 Al slurry was prepared by inverted cone-shaped pouring channel process (ICSPC) and temperature homogenization (TH) treatment was combined to make the slurry uniform and have a controllable solid fraction suitable for the follow-up rheocasting. The influence of cooling rate on the microstructure evolution of primary α (Al) during TH treatment was investigated. The results show that as the cooling rate of the slurry after being prepared reduces, the growth of primary α (Al) in the slurry tends to be nearly spherical and the uniformity of the organization is also enhanced. This may be due to the fact that lower cooling rate plays an important role in achieving the uniformity of temperature and composition in the remaining liquid, which is crucial to the formation of the spherical and homogeneous microstructure. However, a too low cooling rate will lead to a significant increase in grain growth time, which makes too coarse grains and more particles coalesce, so a certain abnormal growth of grain appears and the shape factor decreases slightly.

In this paper, we study the boundness and compactness of differences of weighted composition operators from the Bloch space B to the space H ∞ of bounded analytic functions on the open unit ball of C n . Moreover, we estimate the norm and the essential norm of differences of composition operators from B to H ∞ .

The semi-solid slurry of 7075 aluminum alloy was prepared by using an innovative non-stirring technology that can be called inverted cone-shaped pouring channel process (ICSPC). The effect of pouring temperature and structural parameters of the channel on the microstructure of semi-solid 7075 aluminum alloy slurry was investigated. The experimental results reveal that when keeping the pouring temperature within some range, the slurry with spherical primary α(Al) grains can be prepared by ICSPC process, and with the decline of the pouring temperature, the microstructure of semi-solid 7075 aluminum alloy is more desirable under the same channel. The appropriate combination of channel length and interior surface slope can also give rise to a transition of the growth morphology of primary α(Al) from coarse dendritic to coarse particle-like and further to fine-globular at the same pouring temperature. In ICSPC process, numerous effective heterogeneous nucleation takes place in the melt as it flowed along the interior surface of the channel and the morphology of primary α(Al) grains is virtually determined by the degree of contact condition between the superheat melt and the interior surface of the channel. A better contact condition stands for a stronger heat extraction from the melt, and will finally appear as a remarkable increase of primary α(Al) grains survived in the melt, which will conspicuously promote the spherical growth of the primary α(Al) grains.

Reconstruction of the internal carotid artery (ICA) is an operative challenge for lesions involving the lateral skull base because of excessive blood loss, intraoperative cranial nerve injury, and difficulties in cerebral protection.Between January 2010 and October 2014, 9 patients with vascular lesions at the lateral skull base were treated with a "pre-reconstruction" technique, which means reconstruction of the ICA in advance of excising the lesions.All operations were technically successful with no mortality or strokes. The mean blood loss was 921 ± 210 mL. The mean total clamping time was 18 ± 5 minutes. Among the 5 patients without invasion of specific cranial nerves, no long-term sequelae occurred during the follow-up period ranging from 11 to 54 months.With less blood loss, slighter cranial nerve injuries, and shorter clamping time, the "pre-reconstruction" technique was safe and effective for the treatment of vascular lesions at the lateral skull base. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1562-E1567, 2016.

The hydrothermal/solvothermal reactions of metal(II) nitrate hydrates with organic ligands (p-benzenediacrylic acid = H2pbda, 1,10-phenanthroline = phen) generate three three-dimensional (3-D) coordination polymers with (3,4)-connected (4.8.10)(42.6.8 × 102) topology (1, {[Cd2(pbda)2(phen)2](H2O)}n), 2-fold interpenetrating CdSO4-type open framework (2, [Zn3(pbda)3(phen)2]n), and 3-fold interpenetrated sra net (3, [Pb(pbda)]n). The porous zinc open framework 2 has the typical type-I sorption curve with a H2 uptake of 31 cm3·g−1(STP) at 77 K, BET surface area of 65.84 m2·g−1, and meso-[Zn2(pbda)2] helical motifs. With strong luminescent emission at 504 nm, complex 2 may be suitable as an excellent candidate for solid-state photosensitive materials at room temperature.

To analyze the effectiveness and costs of the eversion carotid endarterectomy (eCEA) and the carotid endarterectomy with patch angioplasty (pCEA) in treating carotid artery stenosis.Patients with carotid artery stenosis who underwent the carotid endarterectomy in the vascular surgery department of Peking Union Medical College Hospital from October 2009 to October 2012 were enrolled in this study. According to the two different surgical procedures, the patients were divided into eCEA group and pCEA group.The two groups were not significantly different in terms of gender ,age ,risk factors, stenosis degree of carotid artery, and the ratio of bilateral lesions (all P0.05).The ratio of shunt and antibiotics application, operative time, hospitalization cost, and length of hospital stay in the eCEA group were significantly lower than those in pCEA group (P0.05).The therapeutic effectiveness, complications, surgery-related death, restenosis, and ipsilateral stroke were not significantly different between these two groups (P0.05).Both surgical procedures are safe and effective in treating the carotid artery stenosis;however, eCEA has lower cost when compared with pCEA and therefore can be used as the first choice.

To compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.From September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.All patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.Both of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

To construct an experimental abdominal aortic aneurysm (AAA) swine model with Dacron patch for evaluating endovascular aneurysm repair (EVAR) technique.The experimental pigs were generally anesthetized for the open procedure of an aneurysm model creation with Dacron and subsequent arteriography and EVAR with stent graft. Repeat arteriography was performed after 3-month follow-up.AAA models were successfully constructed in all 10 experimental pigs. The average aneurysm diameter was (26.3±3.1)mm, increasing by (15.7±3.1)mm comparing to the primary aorta diameter (10.5±0.4)mm. The aorta diameter before and after the experiment showed significant difference (P0.001). All the animals were survived after the procedure. One swine died 24 hours after the subsequent EVAR because the covering of both renal arteries by the stent graft. The rest 9 animals survived well after the whole operation and 3-month follow-up. The surviving rates at 1 month and 3 months after the operation were both 90%. One type 2 endoleak (10%) was observed after the EVAR, which disappeared at 3-month follow-up.Open construction of experimental AAA swine models with Dacron patch is safe and feasible. The model can be used in the developing new EVAR techniques and implant training.

To analyze the efficacy and safety of eversion carotid endarterectomy (eCEA) and carotid endarterectomy with patch angioplasty (pCEA) in the treatment of carotid artery stenosis.The clinical data were collected and analyzed for the patients with carotid artery stenosis undergoing carotid endarterectomy at Department of Vascular Surgery, Peking Union Medical College Hospital from October 2009 to October 2012. According to two different surgical procedures, they were divided into 2 groups of eCEA and pCEA.A total of 248 patients received a follow-up. Among 274 cases of endarterectomy, 101 cases of eCEA and 173 cases of pCEA were performed. No significant difference (P0.05) existed between two groups in gender, age, risk factors, stenotic degree of carotid artery or ratio of bilateral lesions. The ratio of shunt (15.8%) and antibiotics (26.7%) application, the duration of operation (88 ± 20) min, intraoperative blood loss (45 ± 16) ml and the length of stay (16 ± 4) days in the group eCEA were significantly lower than those of group pCEA (P0.05). There was no significant difference (P0.05) between two groups in the ratio of complications, surgery-related mortality, restenosis and ipsilateral stroke.Both surgical procedures are both safe and effective in the treatment of carotid artery stenosis. However eCEA offers potential advantages. The choice of a particular surgical procedure depends on the surgeon experience and specific circumstances of carotid artery lesions.

To investigate the risk factors and surgical management of limb prosthetic vascular graft exposure.The clinical data of 17 patients suffering from limb prosthetic vascular graft exposure in Peking Union Medical College Hospital from August 2006 to December 2011 were retrospectively analyzed. Among 17 cases, 5 suffered from prosthetic vascular graft exposure after vascular bypass for the lower limb ischemia, whereas 12 were affected after the artificial graft arteriovenous fistula construction in the upper limbs for hemodialysis. The surgical procedures mainly included the local debridement as well as the local flap and transferred muscle-cutaneous flap reconstruction to preserve the prosthetic vascular graft.All 17 patients underwent local flap or muscle-cutaneous flap coverage procedure. After the surgery, the prosthetic vascular graft was successfully salvaged in 14 cases. The total successful rate was 82.4%. The surgery failed in three patients, in whom the prosthetic vascular grafts were finally removed.Local flap and transferred muscle-cutaneous flap reconstruction is an effective surgical management to salvage the exposed grafts.

Midkine (MK) is a growth factor that promotes neurite outgrowth and survival of neurons, and enhances the plasminogen activator in endothelial cells. A highly sensitive enzyme-linked immunoassay for MK was developed, involving affinity-purified anti-MK antibodies, their biotinylated form, and avidin-beta-galactosidase. The amount of bound avidin-beta-galactosidase was determined using a fluorogenic substrate, 4-methylumbelliferyl-beta-D-galactoside. This method allowed the detection of human and mouse MK in the range of 50 pg-10 ng. Pleiotrophin, which is related to MK in its amino acid sequence, did not show any cross reactivity. Employing this method, the MK levels in the developing mouse brain were determined. The MK level was 2 micrograms/g of wet tissue on the 12th day of gestation, and then steadily decreased during embryogenesis and postnatal development to 30 ng/g two months after birth. The assay method can also be applied to serum samples. Although the MK levels in the sera of normal human subjects were low or undetectable, 0.6-8 ng/ml of MK was detected in samples in the majority of cases of hepatocellular carcinomas.

To evaluate the results of a variety of alternative endovascular techniques applied to patients with complicated abdominal aortic aneurysm complex abdominal aortic aneurysm (cAAA) and unsuitable for open surgery.From January 2001 to December 2010, charts of all patients having an abdominal aortic aneurysm (AAA) were reviewed. Endovascular aneurysm repair (EVAR) was done in 138 patients, in which 9 patients were defined as cAAA such as juxta-renal AAA, short or angulated AAA neck, AAA with bilateral iliac artery aneurysms. There were 8 male and 1 female patients, aged from 26 to 87 years with a mean of 67 years. All these patients at high risk for open surgery were offered a modified EVAR technique including fenestrated technique, scallop technique, chimney technique, balloon assisted U-turn stenting and reverse-U stent-graft in 2, 5, 1 and 1 patients respectively.All techniques were successful and without severe postoperative complications. An intraoperative endoleak was found in 4 patients and was corrected immediately. One patient with type I and III endoleaks underwent dilatation with a compliant balloon. Two patients with type I endoleak underwent coil embolization (1 patient) and bare stent (1 patient). During follow-up, one patient with a type II endoleak who demonstrated no increase in sac diameter during follow-up was observed. Mean follow-up was 25.9 months (ranging from 4 to 79 months). No rupture occurred and 8 aneurysms shrink significantly. In 7 patients, critical vessels (renal and mesenteric arteries) were protected during the initial procedure and remained patent except in one patient who was performed reverse "U" stent graft with thrombosis in hypogastric artery.High-risk patients with cAAA inappropriate for traditional EVAR can be successfully treated by using simple ancillary endovascular techniques with acceptable short or mid-term results.

To evaluate the application of carotid endarterectomy (CEA) in the treatment of patients with bilateral moderate to severe carotid stenosis.We retrospectively analyzed the clinical data of 82 patients with bilateral moderate to severe carotid stenosis who were admitted to our hospital from January 2006 to December 2009. Of these patients, 64 underwent ipsilateral CEA and 18 underwent bilateral CEA.A total of 100 endarterectomies including 92 patching and 94 carotid shunt were performed. Seventy-six patients smoothly recovered from the surgery. Two patients suffered from cardiac ischemia and infarction and one died of massive cerebral infarction. Three patients presented with hyperperfusion syndrome,and one of them developed cerebral hemorrhage. Of 79 patients who were followed up regularly, 76 (96.2%) had no cerebral ischemia relevant to the operated carotid artery,one developed mild re-stenosis, and 2 suffered from neurological dysfunction.CEA should be performed in patients with bilateral moderate to severe carotid stenosis once the indication is confirmed.

To summarize the incidence, diagnosis and treatment of acute coronary syndrome (ACS) after carotid endarterectomy (CEA).From 2003 to 2009, 159 CEA were performed in 143 cases with severe atherosclerotic carotid artery stenosis. The clinical datas of ACS after CEA were collected.The average age was 66.2 +/- 9.0 years old, varying from 40 to 86. There were 5 cases (3.1%) suffered from 30-day perioperative stroke/death totally, of which 4 cases (3.6%) in the symptomatic carotid stenosis group and 1 case (2.1%) in the asymptomatic group. 13 cases (8.2%) were diagnosed as ACS after CEA, 12 of them recovered after medicine, but one case aggravated even after the conservative treatment. Percutaneous coronary angioplasty and stenting was performed then. All cases were cured without death. Diabetes mellitus (RR = 7.727, P = 0.001), smoking (RR = 8.138, P = 0.020) and cardiac infarction history (RR = 8.138, P = 0.020) are significant risk factors for ACS after CEA.ACS is an important non-neurological complication after CEA. Diabetes mellitus, smoking and cardiac infarction history are significant risk factors for ACS after CEA. Early diagnosis and appropriate medical intervention for ACS can improve the safety of CEA.

To summarize advancement of diagnosis and surgical intervention of popliteal artery entrapment syndrome (PAES).From March 2006 to August 2009, 11 patients (14 limbs) underwent surgical procedures, including 9 males (81.8%), with a median age of 22 years old (arranged from 15 to 56 years old). Three cases (27.2%) had both limbs involved. The chief complaint contained intermittent claudication in 8 cases and rest pain in 3 cases. The time from onset to admission arranged from 3 weeks to 10 years. 14 limbs were diagnosed as PAES through multidetector spiral computed tomography. Eleven cases were diagnosed as Delaney's type II or III, 1 case as type V and 2 cases as type I. Two limbs underwent popliteal artery release only, 8 limbs underwent popliteal artery release, thromboendarterectomy and angioplasty with a venous or prosthetic patch, 2 patients complaining acute limb ischemia underwent catheter-based thrombolysis and popliteal artery release subsequently, 2 patients with a occlusive segment longer than 5 cm in popliteal artery underwent below-knee femoral-popliteal artery bypass with in-situ greater saphenous vein graft. All the patients undertook anticoagulation treatment with coumadin after the operation.All the patients had their clinical symptoms released after the operation. One patient (1 limb) was recurrent 20 months after the operation and underwent embolectomy successfully. At a median follow up of 13 months (range 1 to 36 months), the primary patency rate was 92.9% (13/14), the total patency rate was 100% (14/14) and limb salvage rate was 100%. The ankle brachial index at neutral position improved significantly after the surgery in the 12 occluded limbs (1.11 +/- 0.10 vs. 0.62 +/- 0.14, P0.01).Multidetector spiral computed tomography is much helpful in diagnose and typing of PAES. Surgery should be performed as soon as the PAES is diagnosed. Appropriate surgical intervention can achieve satisfying effect according to different character of popliteal artery occlusions.