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Abstract With the widespread application of nuclear technology across various fields, ionizing radiation-induced injuries are becoming increasingly common. The bone marrow (BM) hematopoietic tissue is a primary target organ of radiation injury. Recent researches have confirmed that ionizing radiation-induced hematopoietic dysfunction mainly results from BM hematopoietic stem cells (HSCs) injury. Additionally, disrupting and reshaping BM microenvironment is a critical factor impacting both the injury and regeneration of HSCs post radiation. However, the regulatory mechanisms of ionizing radiation injury to BM HSCs and their microenvironment remain poorly understood, and prevention and treatment of radiation injury remain the focus and difficulty in radiation medicine research. In this review, we aim to summarize the effects and mechanisms of ionizing radiation-induced injury to BM HSCs and microenvironment, thereby enhancing our understanding of ionizing radiation-induced hematopoietic injury and providing insights for its prevention and treatment in the future.

Abstract Background Hematopoietic stem cell (HSC) regeneration underlies hematopoietic recovery from myelosuppression, which is a life-threatening side effect of cytotoxicity. HSC niche is profoundly disrupted after myelosuppressive injury, while if and how the niche is reshaped and regulates HSC regeneration are poorly understood. Methods A mouse model of radiation injury-induced myelosuppression was built by exposing mice to a sublethal dose of ionizing radiation. The dynamic changes in the number, distribution and functionality of HSCs and megakaryocytes were determined by flow cytometry, immunofluorescence, colony assay and bone marrow transplantation, in combination with transcriptomic analysis. The communication between HSCs and megakaryocytes was determined using a coculture system and adoptive transfer. The signaling mechanism was investigated both in vivo and in vitro, and was consolidated using megakaryocyte-specific knockout mice and transgenic mice. Results Megakaryocytes become a predominant component of HSC niche and localize closer to HSCs after radiation injury. Meanwhile, transient insulin-like growth factor 1 (IGF1) hypersecretion is predominantly provoked in megakaryocytes after radiation injury, whereas HSCs regenerate paralleling megakaryocytic IGF1 hypersecretion. Mechanistically, HSCs are particularly susceptible to megakaryocytic IGF1 hypersecretion, and mTOR downstream of IGF1 signaling not only promotes activation including proliferation and mitochondrial oxidative metabolism of HSCs, but also inhibits ferritinophagy to restrict HSC ferroptosis. Consequently, the delicate coordination between proliferation, mitochondrial oxidative metabolism and ferroptosis ensures functional HSC expansion after radiation injury. Importantly, punctual IGF1 administration simultaneously promotes HSC regeneration and hematopoietic recovery after radiation injury, representing a superior therapeutic approach for myelosuppression. Conclusions Our study identifies megakaryocytes as a last line of defense against myelosuppressive injury and megakaryocytic IGF1 as a novel niche signal safeguarding HSC regeneration.

The aiming jamming emitted by self-defense jammers renders various passive anti-jamming measures based on signal processing ineffective, posing severe threats to modern radars. Frequency agility, as an active countermeasure, enables the resistance of aiming jamming. In response to issues such as the unstable anti-jamming performance of traditional random frequency hopping, limited freedom in frequency selection, and the long time required for strategic learning, the paper proposes a fast-adaptive frequency-hopping strategy for a frequency agile radar. First, a frequency agile waveform with repeatable frequency selection is designed, providing more choices for an optimal solution. Accordingly, using the data collected through continuous confrontation between a radar and a jammer, and the exploration and feedback mechanism of deep reinforcement learning, a frequency-selection strategy is continuously optimized. Specifically, considering radar frequency from the previous time and jamming frequency perceived at the current time as reinforcement learning inputs, the neural network intelligently selects each subpulse frequency at the current time and optimizes the strategy until it is optimal based on the anti-jamming effectiveness evaluated by the target detection result and Signal-to-Jamming-plus-Noise Ratio (SJNR). To improve the convergence speed of the optimal strategy, the designed input state is independent of the historical time step, the introduced greedy strategy balances the search-utilization mechanism, and the SJNR differentiates rewards more. Multiple sets of simulations show that the proposed method can converge to the optimal strategy and has high convergence efficiency.

CO2-enhanced oil recovery (CO2-EOR) is a crucial method for CO2 utilization and sequestration, representing an important zero-carbon or even negative-carbon emission reduction technology. However, the low viscosity of CO2 and reservoir heterogeneity often result in early gas breakthrough, significantly reducing CO2 utilization and sequestration efficiency. A water-alternating-gas (WAG) injection is a technique for mitigating gas breakthrough and viscous fingering in CO2-EOR. However, it encounters challenges related to insufficient mobility control in highly heterogeneous and fractured reservoirs, resulting in gas channeling and low sweep efficiency. Despite the extensive application and research of a WAG injection in oil and gas reservoirs, the most recent comprehensive review dates back to 2018, which focuses on the mechanisms of EOR using conventional WAG. Herein, we give an updated and comprehensive review to incorporate the latest advancements in CO2-WAG flooding techniques for enhanced sweep efficiency, which includes the theory, applications, fluid displacement mechanisms, and control strategies of a CO2-WAG injection. It addresses common challenges, operational issues, and remedial measures in WAG projects by covering studies from experiments, simulations, and pore-scale modeling. This review aims to provide guidance and serve as a reference for the application and research advancement of CO2-EOR techniques in heterogeneous and fractured reservoirs.

The confinement effect in micro- and nanopores gives rise to distinct flow characteristics in fluids. Clarifying the fluid migration pattern in confined space is crucial for understanding and explaining the abnormal flow phenomena in unconventional reservoirs. In this study, flow characteristics of water and oil in alumina nanochannels were investigated with diameters ranging from 21 nm to 120 nm, and a heterogeneous viscosity flow model considering boundary fluid was proposed. Compared with the prediction of the HP equation, both types of fluids exhibit significant flow suppression in nanochannels. As the channel size decreases, the deviation degree increases. The fluid viscosity of the boundary region displays an upward trend as the channel size decreases and the influence of the interaction between the liquid and solid walls intensifies. The thickness of the boundary region gradually decreases with increasing pressure and eventually reaches a stable value, which is primarily determined by the strength of the interaction between the liquid and solid surfaces. Both the pore size and wettability are essential factors that affect the fluid flow. When the space scale is extremely small, the impact of wettability becomes more pronounced. Finally, the application of the heterogeneous flow model for permeability evaluation has yielded favorable fitting results. The model is of great significance for studying the fluid flow behavior in unconventional reservoirs.

Abstract Immune engineering, a burgeoning field within regenerative medicine, involves a spectrum of strategies to optimize the intricate interplay between tissue regenerative biomaterials and the host tissue. These strategies are applied across different types of biomaterials and various disease models, which encompasses finely modulating the immune response at the levels of immune cells and factors, aiming to mitigate adverse effects like fibrosis and persistent inflammation that may arise at the injury site and consequently promote tissue regeneration. With the continuous progress in electrospinning technology, the immunoregulatory capabilities of electrospun fibers have gained substantial attention over the years. Electrospun fibers, with their extracellular matrix‐like characteristics, high surface‐area‐to‐volume ratio, and reliable pharmaceutical compound capacity, have emerged as key players among tissue engineering materials. This review specifically focuses on the role of electrospun fiber‐based immune engineering, emphasizing their unique design strategies. Notably, electrospinning actively engages in immune engineering by modulating immune responses through four essential strategies: (i) surface modification, (ii) drug loading, (iii) physicochemical parameters, and (iv) biological grafting. This review presents a comprehensive overview of the intricate mechanisms of the immune system in injured tissues while unveiling the key strategies adopted by electrospun fibers to orchestrate immune regulation. Furthermore, the review explores the current developmental trends and limitations concerning the immunoregulatory function of electrospun fibers, aiming to drive the advancements in electrospun fiber‐based immune engineering to its full potential.

In order to identify and evaluate reservoir wettability, so as to select suitable mining methods to improve oil recovery, wettability evaluation through one-dimensional (1D) and two-dimensional (2D) nuclear magnetic resonance (NMR) technology combined with physical simulation experiments was carried out in this study, and the feasibility of the experimental method was verified by contact Angle method. According to the principle of hydrophilic inorganic content and hydrophobic organic content of shale, the wettability can be evaluated through vacuum self-imbibition oil and self-imbibition water physical simulation experiments combined with 1D NMR technology, that is, total water absorption can be considered as inorganic content, organic content can be obtained by subtracting total water absorption from total oil absorption, and adsorbed oil content can be obtained by subtracting pore volume from total oil absorption. In addition to the wettability measurement by contact Angle method to verify the experimental method, the occurrence ratio of adsorbed oil can also be verified twice by 2D NMR spectrum. The results show that the error between the proportion of adsorbed oil measured by 2D NMR spectrum and that measured by self-imbibition method is within 4%. In the saturated oil-bound water state, the bound water is within the relaxation interval of 110 ms and T2>10 ms. And the relaxation time of aqueous phase moved to the right compared with that in the saturated water state, the interaction force between water and the pore wall was weakened, showing the characteristics of free fluid, and the rock sample became oil-wet, which was consistent with the wettability results measured by contact Angle. Therefore, the wettability of rock samples can be evaluated by 1D NMR technique combined with vacuum imbibition method, or by analyzing the changes of NMR spectra of aqueous phase in completely saturated water and saturated oil-bound water.

Abstract Background Although epidural analgesia is considered the gold standard for pain relief during labor and is safe for maternity and fetus, the association between the epidural analgesia and pelvic floor disorders remains unclear. Thus we estimate the association between epidural analgesia and early postpartum urinary incontinence (UI). Methods A propensity score-matched retrospective cohort study was conducted at a university-affiliated hospital in Shanghai, China. Primiparous women with term, singleton, and vaginal delivery between December 2020 and February 2022 were included. UI was self-reported by maternity at 42 to 60 days postpartum and was classified by International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Using logistic regression models, the associations between epidural analgesia and early postpartum UI were assessed. Results Among 5190 participants, 3709 (71.5%) choose epidural anesthesia during labor. Analysis of the propensity-matched cohort (including 1447 maternal pairs) showed epidural anesthesia during labor was independently associated with UI in early postpartum period (aOR 1.50, 95% CI 1.24–1.81). This association was mainly contributed to stress UI (aOR 1.38, 95% CI 1.12–1.71) rather than urge UI (aOR 1.45, 95% CI 0.99–2.15) and mixed UI (aOR 1.52, 95% CI 0.95–2.45). Furthermore, we observed that the association between epidural anesthesia and UI was more pronounced among older women (≥ 35 y) and women with macrosomia (infant weight ≥ 4000 g), compared with their counterparts (both P for interaction

In order to understand the mechanism of air flooding shale oil, an online physical simulation method for enhanced shale oil recovery by air injection was established by integrating CT scanning and nuclear magnetic resonance (NMR). The development effect of shale oil by air flooding under different depletion pressures, the micro-production characteristics of pore throats with different sizes and the mechanism of shale oil recovery by air flooding were analyzed. The effects of air oxygen content, permeability, gas injection pressure, and fractures on the air flooding effect in shale and crude oil production in pores with different sizes were analyzed. The recovery of shale oil can be greatly improved by injecting air into the depleted shale reservoir, but the oil displacement efficiency and the production degree of different levels of pore throats vary with the injection timing. The higher the air oxygen content and the stronger the low-temperature oxidation, the higher the production degree of pores with different sizes and the higher the shale oil recovery. The higher the permeability and the better the pore throat connectivity, the stronger the fluid flow capacity and the higher the shale oil recovery. As the injection pressure increases, the lower limit of the production degree of pore throats decreases, but gas channeling may occur to cause a premature breakthrough; as a result, the recovery increases and then decreases. Fractures can effectively increase the contact area between gas and crude oil, and increase the air sweep coefficient and matrix oil drainage area by supplying oil to fractures through the matrix, which means that a proper fracturing before air injection can help to improve the oil displacement effect under a reasonable production pressure difference.

The combination of chemotherapy and photodynamic therapy (PDT) based on nanoparticles (NPs) has been extensively developed to improve the therapeutic effect and decrease the systemic toxicity of current treatments. However, overexpressed glutathione (GSH) in tumor cells efficiently scavenges singlet oxygens (1O2) generated from photosensitizers and results in the unsatisfactory efficacy of PDT. To address this obstacle, here we design H2O2-responsive polymer prodrug NPs with GSH-scavenger (Ce6@P(EG-a-CPBE) NPs) for chemo-photodynamic synergistic cancer therapy. They are constructed by the co-self-assembly of photosensitizer chlorin e6 (Ce6) and amphiphilic polymer prodrug P(EG-a-CPBE), which is synthesized from a hydrophilic alternating copolymer P(EG-a-PD) by conjugating hydrophobic anticancer drug chlorambucil (CB) via an H2O2-cleavable linker 4-(hydroxymethyl)phenylboronic acid (PBA). Ce6@P(EG-a-CPBE) NPs can efficiently prevent premature drug leakage in blood circulation because of the high stability of the PBA linker under the physiological environment and facilitate the delivery of Ce6 and CB to the tumor site after intravenous injection. Upon internalization of Ce6@P(EG-a-CPBE) NPs by tumor cells, PBA is cleaved rapidly triggered by endogenous H2O2 to release CB and Ce6. Ce6 can effectively generate abundant 1O2 under 660 nm light irradiation to synergistically kill cancer cells with CB. Concurrently, PBA can be transformed into a GSH-scavenger (quinine methide, QM) under intracellular H2O2 and prevent the depletion of 1O2, which induces the cooperatively strong oxidative stress and enhanced cancer cell apoptosis. Collectively, such H2O2-responsive polymer prodrug NPs loaded with photosensitizer provide a feasible approach to enhance chemo-photodynamic synergistic cancer treatment.

Despite breakthroughs in modern medical care, the incidence of cardiovascular disease (CVD) is even more prevalent globally. Increasing epidemiologic evidence indicates that emerging cardiovascular risk factors arising from the modern lifestyle, including psychosocial stress, sleep problems, unhealthy diet patterns, physical inactivity/sedentary behavior, alcohol consumption, and tobacco smoking, contribute significantly to this worldwide epidemic, while its underpinning mechanisms are enigmatic. Hematological and immune systems were recently demonstrated to play integrative roles in linking lifestyle to cardiovascular health. In particular, alterations in hematopoietic stem cell (HSC) homeostasis, which is usually characterized by proliferation, expansion, mobilization, megakaryocyte/myeloid-biased differentiation, and/or the pro-inflammatory priming of HSCs, have been shown to be involved in the persistent overproduction of pro-inflammatory myeloid leukocytes and platelets, the cellular protagonists of cardiovascular inflammation and thrombosis, respectively. Furthermore, certain lifestyle factors, such as a healthy diet pattern and physical exercise, have been documented to exert cardiovascular protective effects through promoting quiescence, bone marrow retention, balanced differentiation, and/or the anti-inflammatory priming of HSCs. Here, we review the current understanding of and progression in research on the mechanistic interrelationships among lifestyle, HSC homeostasis, and cardiovascular health. Given that adhering to a healthy lifestyle has become a mainstream primary preventative approach to lowering the cardiovascular burden, unmasking the causal links between lifestyle and cardiovascular health from the perspective of hematopoiesis would open new opportunities to prevent and treat CVD in the present age.

In view of the weak research on the availability of typical shale oil reservoirs from the perspective of development, this study introduced a two-dimensional nuclear magnetic resonance (NMR) evaluation method on the basis of the previous one-dimensional NMR combined with centrifugal physical simulation experiments. Not only the production characteristics of typical shale oil reservoirs were studied but also the microscopic production laws of different occurrence states were studied. The results show that the pore distribution of Jilin shale is more concentrated than that of Qinghai shale. The oil of the two blocks mainly occurs in 0.01–10 ms pores, and the occurrence ratio of Jilin shale in the pores is higher, which is more than 90%. The oil production of the two blocks is mainly dominated by 0.01–10 ms pores, and the utilization efficiency contribution of these pores in Jilin shale is higher, accounting for about 80%. The utilization efficiency (UE) increases logarithmically with centrifugal force, and the growth rate of Jilin shale is greater than that of Qinghai shale. The proportion of free oil in Jilin block is less than that in Qinghai block. The shale oil in the two blocks is both at 15% final UE, and the UE of free oil in Jilin shale is about 9% and that of Qinghai shale is about 12%. The recoverability of Jilin shale is lower than that of Qinghai shale.

The interrupted-sampling repeater jammer can sample, store, process and transmit part of the radar transmitter signal multiple times and the fake targets will form on the radar receiver. To improve the radar performance in the aforementioned jamming scenario, in this study, a new signal differential feature extraction method is proposed, and a judgment criterion is formulated based on the difference between the target echo and the Interrupted-Sampling Repeater Jamming (ISRJ) in the differential feature space to effectively identify and suppress the ISRJ while achieving target detection. Simulation results show that the proposed method has a remarkable ISRJ suppression performance. The equivalent signal-to-noise ratio is improved by at least 4.2 dB compared with three typical time-frequency domain filtering algorithms.

Abstract Background Stress urinary incontinence (SUI) is a common public health issue that negatively impacts the quality of life for women worldwide, of which early detection and rehabilitation are consequently pivotal. The aim of this study is to establish a simple nomogram for identifying women at risk of postpartum SUI. Methods A retrospective study was conducted in a tertiary specialized hospital in Shanghai, China. The study included only women with singleton, full-term, and vaginal deliveries. 2,441 women who delivered from July 2019 to November 2019 were included in the training cohort, and 610 women who delivered from January 2022 to February 2022 were included in the validation cohort. SUI was determined by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Univariate and multifactorial logistical regression were used to identify independent risk factors for postpartum SUI and further construct the nomogram accordingly. Based on concordance statistics (C-statistics), calibration curves, and decision curve analyses, we evaluated the performance of the nomogram in the training cohort and the validation cohort. In addition, the model was validated internally in the training cohort through cross-validation. Results There were no significant statistically differences in important baseline data such as age, pre-pregnancy BMI, and parity between the training and validation cohorts. SUI was observed in 431 (17.6%) and 125 (20.5%) women in the training and validation cohorts, respectively. According to the regression analysis, age, parity, second stage of labor, infant weight, and forceps delivery were included in the nomogram. The nomogram had a C-statistic of 0.80 (95% confidence interval [CI] 0.74–0.85) for predicting SUI. C-statistics were stable in both internally cross-validated training cohort (mean 0.81) and validation cohort (0.83 [95% CI 0.79–0.87]). The nomogram’s calibration curve was near the ideal diagonal line. Additionally, the model exhibited a positive net benefit from the decision curve analysis. Conclusion We have created a nomogram that can be utilized to quantify the risk of postpartum SUI for women with vaginal delivery. The model might contribute to predicting early postpartum SUI, thereby facilitating the management of SUI.

Hernia reconstruction is one of the most frequently practiced surgical procedures worldwide. Plastic surgery plays a pivotal role in reestablishing desired abdominal wall structure and function without the drawbacks traditionally associated with general surgery as excessive tension, postoperative pain, poor repair outcomes, and frequent recurrence. Surgical meshes have been the preferential choice for abdominal wall hernia repair to achieve the physical integrity and equivalent components of musculofascial layers. Despite the relevant progress in recent years, there are still unsolved challenges in surgical mesh design and complication settlement. This review provides a systemic summary of the hernia surgical mesh development deeply related to abdominal wall hernia pathology and classification. Commercial meshes, the first-generation prosthetic materials, and the most commonly used repair materials in the clinic are described in detail, addressing constrain side effects and rational strategies to establish characteristics of ideal hernia repair meshes. The engineered prosthetics are defined as a transit to the biomimetic smart hernia repair scaffolds with specific advantages and disadvantages, including hydrogel scaffolds, electrospinning membranes, and three-dimensional patches. Lastly, this review critically outlines the future research direction for successful hernia repair solutions by combing state-of-the-art techniques and materials.

Abstract As a kind of promising drug carriers, smart polymers have attracted much attention due to the effective and controlled drug release in target cells. Herein, a reactive oxygen species (ROS)‐responsive thioether‐containing amphiphilic hyperbranched polymer prepared from MTPA and TMPTGE (HBPMT) is synthesized from 3‐(methylthio)propylamine (MTPA) and trimethylolpropane triglycidyl ether (TMPTGE) by the amine‐epoxy click reaction via A2 + B3 one‐pot approach. Benefiting from its inherent amphiphilic nature, HBPMT can self‐assemble into stable micelles in water. Triggered by H2O2, these micelles can be dissociated rapidly because hydrophobic thioether segments in their cores are oxidized into hydrophilic sulfoxide or sulfone groups. Additionally, the ROS produced by photosensitizer under light irradiation can also play the same role of H2O2. Such HBPMT micelles can be utilized to encapsulate anticancer drug paclitaxel (PTX) and photosensitizer chlorin e6 (Ce6) simultaneously for drug delivery and control release. The methyl thiazolyl tetrazolium assay toward MCF‐7 tumor cells (a human breast adenocarcinoma cell line) indicates that these micelles encapsulated with PTX and Ce6 exhibit a significant combinational efficacy of cell proliferation inhibition, which means the promising potential for synergistic chemo‐photodynamic cancer therapy. Such a novel nanocarrier based on amphiphilic to hydrophilic transition would provide a candidate for controlled drug release and cancer combination therapy.

BackgroundSacrospinous ligament fixation (SSLF) is a minimally invasive and effective procedure for the treatment of apical prolapse. Because intraoperative exposure of the sacrospinous ligament is difficult, SSLF is difficult. The aim of our article is to determine the safety and feasibility of single-port extraperitoneal laparoscopic SSLF for apical prolapse.MethodsThis single-center, single-surgeon case series study included 9 patients with pelvic organ prolapse quantification (POP-Q) III or IV apical prolapse who underwent single-port laparoscopic SSLF. Additionally, transobturator tension-free vaginal tap (TVT-O) was performed in 2 patients, and anterior pelvic mesh reconstruction was performed in 1 patient.ResultsThe operative time ranged from 75 to 105 (mean, 88.9 ± 10.2) min, and blood loss ranged from 25 to 100 (mean, 43.3 ± 22.6) ml. No serious operative complications, blood transfusions, visceral injuries, or postoperative gluteal pain were reported for these patients. After 2–4 months of follow-up, no recurrence of POP, gluteal pain, urinary retention/incontinence, or other complications was observed.ConclusionTransvaginal single-port SSLF is a safe, effective, and easy-to-master operation for apical prolapse.

Soft tissue remodeling is a sophisticated process that sequentially provides dynamic biological signals to guide cell behavior. However, capturing these signals within hydrogel and directing over time has still been unrealized owing to the poor comprehension of physiological processes. Here, a bio-mimicking hydrogel is designed via thiol-ene click reaction to capture the early physical signal triggered by inflammation, and the chemical signals provided with chemokine and natural adhesion sites, which guaranteed the precise soft tissue remodeling. This bio-mimicking hydrogel efficiently facilitated cell anchoring, migration, and invasion in the 3D matrix due to the permissive space and the interaction with integrin receptors. Besides, the covalently grafted chemokine-like peptide is optimal for colonization and functional differentiation of endothelial cells through a HIF-1α dependent signal pathway. Furthermore, the early polarization of macrophages, collagen deposition and angiogenesis in rat acute wound model, and the increased blood perfusion in mouse skin flap model have confirmed that the bio-mimicking hydrogel realized precise soft tissue remodeling and opens new avenues for the phased repair of different tissues such as nerve, myocardium, and even bone.

Abstract Pelvic floor dysfunction is a common gynecological disease that adversely affects women's quality of life and mental health. Delivery is considered a significant independent risk factor for pelvic floor dysfunction. Surface electromyography (sEMG) values for the pelvic floor muscles (PFM) have been shown to differ according to different delivery modes. This study aimed to compare sEMG results between intrapartum and antepartum cesarean delivery (CD), 42–60 days after delivery. Data of women who underwent CD at the International Peace Maternity and Child Health Hospital were collected from September 2021 to December 2021. Myotrac Infiniti System was used to measure the electromyographic activity of PFM after 42–60 days of parturition. Propensity score matching (1:1) was applied to achieve a balance in baseline data between the two groups (intrapartum and antepartum CD). A total of 200 paired cases were selected for statistical analysis. In the propensity score‐matched analysis, there were no statistically significant differences in PFM sEMG between women with antepartum or intrapartum CD (p > 0.05 for all). We observed similar results with postpartum urinary incontinence (24 [12.0] vs. 21 [10.5]; adjusted odds ratio (aOR), 1.12 [95% confidence interval (CI) 0.60–2.12]; p = 0.717) and stress urinary incontinence (12 [6.0] vs. 14 [7.0]; aOR, 0.80 [95% CI 0.35–1.80]; p = 0.596) as outcomes. After excluding participants with intrapartum CD when the cervix was dilated

ObjectiveTo determine whether the indication of intrauterine balloon tamponade (IUBT) was associated with postpartum hemorrhage (PPH) outcomes.MethodsPatients with PPH who underwent IUBT between January 2013 and November 2021 were included in a cohort study. PPH outcomes in patients who had IUBT for indications of uterine atony were compared to those who had IUBT for indications of placental site bleeding. PPH outcomes included uterine artery embolization (UAE) or hysterectomy after IUBT, estimated blood loss (EBL) after balloon placement, and blood transfusion. Statistical analysis was performed using multivariate logistic regression.ResultsIUBT was performed on 603 cases, with 121 (20.1%) undergoing it for placental site bleeding and 482 (79.9%) for uterine atony. In general, IUBT was a reliable treatment for PPH, but the specific efficacy varied depending on the indication for placement. After controlling for confounding variables, compared to the indication of uterine atony, the indication of placental site bleeding increased the risk of transfusion of ≥4 units of PRBCs (aOR 2.47, 95%CI 1.32–3.98), EBL ≥ 300 ml after IUBT (aOR 3.78, 95%CI 2.22–5.33), and UAE or hysterectomy (aOR 2.52, 95%CI 1.20–6.01), respectively. Other factors associated with adverse PPH outcomes were lower antenatal hemoglobin, higher IUBT volume, longer duration of IUBT and larger shock index values.ConclusionsIUBT was less effective in treating PPH patients with indications of placental site bleeding than with indications of uterine atony. Follow-up monitoring of PPH patients with placental site bleeding should be intensified.

Background: Forceps-assisted vaginal delivery is closely associated with postpartum pelvic floor muscle (PFM) injury and postpartum pelvic floor dysfunction. The present study utilized Glazer PFM surface electromyography (sEMG) and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) for the objective assessment of postpartum PFM function to determine the effects of different forceps delivery indications on early postpartum pelvic floor function in primiparas. Methods: Four hundred primiparas whose pregnancies had been terminated by forceps delivery were divided into three groups based on the indication for forceps delivery: fetal distress (FD) (n = 260), prolonged second stage of labor (PSSL) (n = 30), and intrapartum fever combined with fetal distress (IFFD) (n = 110). Pelvic floor muscle surface electromyography (EMG) performed according to the Glazer protocol at 42–60 days postpartum was the primary outcome measure. Results: The overall Glazer assessment scores of the PSSL (54.4 ± 18.6) and IFFD (54.6 ± 15.8) groups were significantly lower than that of the FD group (59.3 ± 17.0) (p = 0.019). The peak EMG value during the fast-twitch stage for the FD, PSSL, and IFFD groups was 32.4 ± 17.7, 31.7 ± 26.1, and 26.5 ± 12.2 μV, respectively; the IFFD and FD groups were significantly different (p < 0.05). The incidence of postpartum stress urinary incontinence (SUI) was significantly higher in the IFFD and PSSL groups; the IFFD and FD groups were significantly different (p < 0.05). Conclusions: Intrapartum fever probably affects the early postpartum pelvic floor function of primiparas who underwent forceps delivery, which mainly manifests in the short term as reduced fast-twitch muscle strength and SUI.

Tight reservoirs are sensitive to stress changes during fracturing and oil and gas production. Facing different production modes, the variation characteristics of rock permeability and pore structure need to be further clarified. In this study, using a self-built high temperature and pressure physical simulation device and NMR equipment, the influence of the stress loading method, cyclic loading, and loading rate on rock permeability and pore characteristics were analyzed, and the relationship between them was clarified. The permeability sensitivity under variable confining pressure (63.3%) was greater than that of variable flow pressure (46.4%). The damage rate decreased with repeated loading (63.3%-35.8%) and increased loading rate (53.1%-42.3%). As for the pore features, when the net stress increased, the volume variation range of micropores was greater than that of mesopores. The damage rate of permeability (63.3%) was obviously larger than that of pore volume (10.4%). The slope of the fitted curve of permeability and pore volume decreased evidently with loading times. The structure deformation of rock skeleton and the migration of cement had a great influence on permeability in the first loading. Later, it was mainly the bulk deformation of rock particles, the particles’ contact surface increasing and the seepage space shrinking slowly. Eventually, the permeability remained stable due to the limited pore compression. This study can provide a reference for designing reasonable production parameters and reducing formation damage.

Main-lobe interrupted-sampling repeater jamming is a coherent type of interference. As this interference is injected through the main lobe of the antenna into a radar system, the interference heavily degrades the performance of the radar system. In this paper, we propose an anti-jamming method based on minimum variance distortionless response (MVDR) that estimates a covariance matrix by obtaining small-sample pure jamming signals through jamming recognition. Time-frequency analysis is performed in the one-dimensional range profile of the pulse-compressed radar echo, and the snapshot sampling of pure jamming is achieved by searching the range gates for the target and the jamming in a two-dimensional range-frequency graph considering the time-frequency differences between the target and jamming signals. Assuming that the available data of snapshot sampling are insufficient, a covariance matrix for pure jamming is reconstructed through an iterative adaptive approach (IAA) and used as the training sample for the MVDR beamformer to suppress main-lobe interrupted-sampling repeater jamming. Finally, the method is validated by comparing the simulation results with the measured results.

It is very important to effectively describe the sweep characteristics of CO2 miscible flooding based on physical models for actual reservoir development. In this study, based on the geological characteristics of the Jilin ultra-low permeability reservoir, which has significant vertical heterogeneity, a two-dimensional double-layer heterogeneous visualization model with a permeability contrast of 10 and thickness contrast of 2 was designed to perform experimental research on the sweep law of CO2 miscible flooding with an injection-production mode of “united injection and single production”. With the goal of determining the obvious differences in the gas absorption capacity and displacement power of the two layers, the CO2 dynamic miscible flooding characteristics were comprehensively analyzed, and the sweep law of CO2 miscible flooding, including the oil and gas flow trend, migration direction of the oil–gas interface, and distribution characteristics of the miscible zone, was further studied in combination with the oil displacement effect. In this experiment, the gas absorption capacity was the key factor affecting the sweep efficiency of the CO2 miscible flooding. Under the combined influence of the internal and external control factors of the reservoir thickness, permeability, and injection-production mode, the gas absorption capacity of the high-permeability layer was much greater than that of the low-permeability layer, resulting in the retention of a large amount of remaining oil in the low-permeability layer, which effectively displaced and swept the oil in the high-permeability layer. The gas absorption capacity of the reservoir, gravitational differentiation, and miscible mass transfer were key factors affecting the migration of the oil–gas interface and distribution of the miscible zone. The entire displacement process could be divided into three stages: ① The gas-free rapid oil production stage, which was dominated by the displacement; ② the low gas–oil ratio stable oil production stage, which was jointly affected by the displacement and miscible mass transfer; and ③ the high gas–oil ratio slow oil production stage, which was dominated by the effect of CO2 carrying.

The point target model is widely used in the synthetic aperture radar (SAR) imaging simulation. Based on this model, the radar echo of a continuously distributed target can be expressed as the linear summation of the echo of many point targets which are known as scatters. However, the discretisation strategy is problematic. The discretisation grid must be very fine to assure convergence, thus the computation burden is heavy. Moreover, the result depends on how the target is discretised. It is shown that the SAR image generated from this model of the same target is inconsistent when using different sampling strategy. To overcome these drawbacks, a parameterised model is proposed in this study, which not only greatly reduce the amount of calculation, but also guarantee consistency of the results. Finally, the correctness of the proposed model is verified by SAR imaging results from the generated echo data.

There are a large number of continuous line targets in the synthetic aperture radar (SAR) images of land scenes. The traditional SAR processing, which makes the continuous line targets becomes two point targets in traditional SAR images, cannot reveal the complete features of continuous line targets and cause enormous difficulties for SAR image interpretation. This study analyses the reason why traditional SAR processing cannot embody the edge characteristics of continuous line targets based on the sidelobe features of the SAR echo. The authors propose a new identification method based on the difference of the echo amplitude between continuous line target and point targets, which will help to interpret the continuous line targets in SAR images. Numerical simulation experiment based on the classical strip SAR validates the effectiveness of the proposed method.

Horseshoe kidney is a rare congenital renal dysplasia. It is often associated with various anatomical abnormalities, including renal vessel and ureter variability, which increase unpredictable surgical risks. This current report describes the case of a 42-year-old woman diagnosed as having cervical squamous cell carcinoma complicated by horseshoe kidney. She underwent laparoscopic radical hysterectomy, bilateral oophorectomy and lymph node dissection, including dissection of the pelvic, presacral and para-aortic lymph nodes. The surgery was challenging, but no serious complications occurred. Postoperative multi-slice computed tomography angiography confirmed the anatomical variation of the renal location, ureter and renal vessels. To our knowledge, this is the first reported case of cervical carcinoma complicated with horseshoe kidney.

The linear structures in synthetic aperture radar (SAR) images can provide important geometric information regarding the illuminated objects. However, the linear structures of various objects sometimes disappear in traditional SAR images, which severely affects the application in automated scene analysis and information extraction techniques. This paper proposes a parametric SAR image recovery method for linear structures of extended targets. By extracting the spatial phase distribution feature in image domain, the proposed method is used to identify the endpoints among all of the scattered points in SAR images and reconstruct the disappeared linear structures based on the scattering model. The method can be generally divided into three procedures: endpoints and point targets classification, linear structures recognition, and linear structures reconstruction. In the first step, the endpoints of linear structures and point targets are classified by setting a threshold related to the spatial phase distribution feature. Afterwards, the linear structures recognition method is used to determine which two endpoints can be formed into a linear structure. Finally, the parametric scattering models are used to reconstruct the disappeared linear structures. Experiments are conducted on both computer simulations and the data that were acquired by microwave anechoic chamber experiment, tower crane radar experiment, and unmanned vehicle radar experiment in order to validate the effectiveness and robustness of the proposed method.

This study evaluated the protective effect of proanthocyanidins (PCs) on reducing apoptosis in the mouse intestinal epithelial cell model MODE-K exposed to zearalenone (ZEA) through inhibition of the endoplasmic reticulum stress (ERS)-induced apoptosis pathway. Our results showed that PCs could reduce the rate of apoptosis in MODE-K cells exposed to ZEA (p < 0.01). PCs significantly increased the ZEA-induced antioxidant protective effects on the enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and on the content of GSH. PCs also significantly decreased the ZEA-induced increase in the content of malondialdehyde (MDA). The analysis indicated that ZEA increased both mRNA and protein expression levels of C/EBP homologous protein (CHOP), GRP78, c-Jun N-terminal kinase (JNK), and cysteinyl aspartate specific proteinase 12 (caspase-12) (p < 0.05), which are related to the ERS-induced apoptosis pathway. ZEA decreased levels of the pro-apoptotic related protein Bcl-2 (p < 0.05) and increased the anti-apoptotic related protein Bax (p < 0.05). Co-treatment with PCs was also shown to significantly reverse the expression levels of these proteins in MODE-K cells. The results demonstrated that PCs could protect MODE-K cells from oxidative stress and apoptosis induced by ZEA. The underlying mechanism may be that PCs can alleviate apoptosis in mouse intestinal epithelial cells by inhibition of the ERS-induced apoptosis pathway.

This study aims to explore the protective effect of selenium (Se) on chronic zearalenone (ZEN)-induced reproductive system damage in male mice and the possible protective molecular mechanism against this. The chronic ZEN-induced injury mouse model was established with the continuous intragastric administration of 40 mg/kg body mass (B.M.) ZEN for 28 days. Then, interventions with different doses (0.1, 0.2, and 0.4 mg/kg B.M.) of Se were conducted on mice to analyse the changes in organ indexes of epididymis and testis, antioxidant capability of testis, serum level of testosterone, sperm concentration and motility parameters, and the expression levels of apoptosis-associated genes and blood testis barrier- (BTB) related genes. Our results showed that Se could greatly improve the ZEN-induced decrease of epididymis indexes and testis indexes. Results also showed that the decrease in sperm concentration, sperm normality rate, and sperm motility parameters, including percentage of motile sperm (motile), tropism percentage (progressive) and sperm average path velocity (VAP), caused by ZEN were elevated upon administration of the higher dose (0.4 mg/kg) and intermediate dose (0.2 mg/kg) of Se. Selenium also significantly reduced the content of malondialdehyde (MDA) but enhanced the activities of antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) in the testis tissue. Further research demonstrated that ZEN increased the level of mRNA expression of BCL2-associated X protein (Bax) and caspase 3 (Casp3), decreased the level of mRNA expression of B cell leukemia/lymphoma 2 (Bcl2), vimentin (Vim) and cadherin 2 (Cdh2), whereas the co-administration of Se reversed these gene expression levels. Our results indicated that high levels of Se could protect against reproductive system damage in male mice caused by ZEN and the mechanism might such be that Se improved mice antioxidant ability, inhibited reproductive cell apoptosis, and increased the decrease of BTB integrity-related genes caused by ZEN.

Distributed array radar can improve radar detection capability and measurement accuracy. However, it will suffer cyclic ambiguity in its angle estimates according to the spatial Nyquist sampling theorem since the large sparse array is undersampling. Consequently, the state estimation accuracy and track validity probability degrades when the ambiguous angles are directly used for target tracking. This paper proposes a second probability data association filter (SePDAF)-based tracking method for distributed array radar. Firstly, the target motion model and radar measurement model is built. Secondly, the fusion result of each radar’s estimation is employed to the extended Kalman filter (EKF) to finish the first filtering. Thirdly, taking this result as prior knowledge, and associating with the array-processed ambiguous angles, the SePDAF is applied to accomplish the second filtering, and then achieving a high accuracy and stable trajectory with relatively low computational complexity. Moreover, the azimuth filtering accuracy will be promoted dramatically and the position filtering accuracy will also improve. Finally, simulations illustrate the effectiveness of the proposed method.

Although grape-seed proanthocyanidin extract (GSPE) demonstrates strong anti-oxidant activity, little research has been done to clearly reveal the protective effects on the hepatotoxicity caused by zearalenone (ZEN). This study is to explore the protective effect of GSPE on ZEN-induced oxidative damage of liver in Kunming mice and the possible protective molecular mechanism of GSPE. The results indicated that GSPE could greatly reduce the ZEN-induced increase of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities. GSPE also significantly decreased the content of MDA but enhanced the activities of antioxidant enzymes SOD and GSH-Px. The analysis indicated that ZEN decreased both mRNA expression levels and protein expression levels of nuclear erythroid2-related factor2 (Nrf2). Nrf2 is considered to be an essential antioxidative transcription factor, as downstream GSH-Px, γ-glutamyl cysteine synthetase (γ-GCS), hemeoxygenase-1 (HO-1), and quinone oxidoreductase 1 (NQO1) decreased simultaneously, whereas the pre-administration of GSPE groups was shown to elevate these expressions. The results indicated that GSPE exerted a protective effect on ZEN-induced hepatic injury and the mechanism might be related to the activation of the Nrf2/ARE signaling pathway.