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ABSTRACT We retrospectively reviewed the clinical data of 217 consecutive Chinese patients with isolated atherosclerotic popliteal artery lesions treated with atherectomy technique, DCB, and plain old balloon angioplasty from August 2017 to August 2022. There was no difference in the 48‐month patency rate between the atherectomy, DCB, and POBA groups (65%, 56%, and 51%, respectively; p = 0.3), as well as in adjusted Cox regression. Similarly, no difference was observed in the 48‐month clinically driven target lesion revascularization‐free (CDTLR‐free) rate among the groups (77%, 74%, and 65%; p = 0.34), confirmed by adjusted Cox regression. In the 48 months, a significant difference was observed in amputation‐free rates between the atherectomy, DCB, and POBA groups (97%, 91%, and 83%, respectively; p 0.9) and 65% versus 49% versus 49% (p = 0.3), showing no differences among the three groups. In the short lesion subgroup (

Background and aims: Liver cirrhosis is a complex disease that may result in increased morbidity and mortality following bariatric surgery (BS). This study aimed to explore the outcome of BS in patients with unexpected cirrhosis, focusing on postoperative complications and the progression of liver disease. Methods: A retrospective study of bariatric patients with cirrhosis from four centers in China between 2016 and 2023 was conducted, with follow-up for one year after BS. The primary outcome was the safety of BS in patients with unexpected cirrhosis, while the secondary outcome was the metabolic efficacy of BS in this group postoperatively. Results: A total of 47 patients met the study criteria, including 46 cases of Child-Pugh class A cirrhosis and 1 case of Child-Pugh B. Pathological examination confirmed nodular cirrhosis in 21 patients (44.68%), pseudolobule formation in 1 patient (2.13%), lipedema degeneration with inflammatory cell infiltration in 3 patients (6.38%), and chronic hepatitis in 1 patient (2.13%). The average percentage of total weight loss was 29.73 ± 6.53% at one year postoperatively. During the 30-day postoperative period, the complication rate was 6.38%, which included portal vein thrombosis, gastrointestinal bleeding, and intra-abdominal infection. Moreover, no cases of liver decompensation or mortality were reported during the follow-up period. The remission rates of comorbidities among 41 patients one year after surgery were as follows: dyslipidemia 100%, type 2 diabetes 82.61%, hypertension 84.62%, and obstructive sleep apnea syndrome 85.71%. Conclusions: BS can be safely performed in patients with unexpected cirrhosis in the compensated stage of liver disease, with low postoperative morbidity and no mortality observed during one-year follow-up.

The present study aimed to investigate the ameliorative effects of lysolecithin on fish stearin oil, meanwhile comparing the application of two different forms (lysolecithin powder and lysolecithin oil) and three inclusion levels (0.25, 0.75, 1.25 g kg−1) in largemouth bass. The entire study consisted of a 28-day digestibility trial and a consequent 68-day feeding experiment. Eight iso-nitrogenous (∼ 500 g kg−1) and iso-energetic (∼ 22 MJ kg−1) diets with high lipid level (∼ 170 g kg−1) were formulated to contain the same level of two different types of lysolecithin, and namely WFO (130 g kg−1 winterized fish oil), FSO (130 g kg−1 fish stearin oil), LLP (FSO + 1 g kg−1 lysolecithin powder, purity 250 g kg−1), MLP (FSO + 3 g kg−1 lysolecithin powder), HLP (FSO + 5 g kg−1 lysolecithin powder), LLO (FSO + 0.625 g kg−1 lysolecithin oil, purity 400 g kg−1), MLO (FSO + 1.875 g kg−1 lysolecithin oil) and HLO (FSO + 3.125 g kg−1 lysolecithin oil), respectively. Largemouth bass fed FSO showed lower apparent digestibility coefficients (ADCs) of nutrients (total fat, crude protein, gross energy, total amino acid, total essential amino acid) than the WFO. Without considering the lysolecithin type, medium and high doses (0.75, 1.25 g kg−1) significantly increased ADCs of nutrients compared with the 0.25 g kg−1 supplementation level. Lysolecithin oil significantly increased ADCs of nutrients than the lysolecithin powder. Thus, lysolecithin oil was chosen for 68-day feeding trial, and results showed the highest FBW, FI, WGR and SGR were recorded in diet HLO, and significantly higher than the FSO, LLO and MLO. Diet MLO significantly decreased lipid and energy in whole-body and lipid retention compared with the FSO, LLO and HLO. In addition, activity and mRNA expression of adipose triglyceride lipase significantly increased, while glycerol-3-phosphate acyltransferase 4 decreased in diet HLO.

Abstract Background Changes in microRNAs (miRNAs) are relevant to bariatric surgery and its comorbidities. The characteristics of changes in miRNAs of the early postoperative period following both bariatric procedures, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), as well as the factors that related to the effectiveness of early weight loss remain unclear. Methods We recruited 18 patients who performed SG and 15 patients who performed RYGB. Their preoperative and 1-month postoperative clinical data and fasting serum samples were collected, and the latter were analyzed by RNA-sequencing. Differential expression analysis of miRNAs was performed by the R-tool. Functional classification annotation and pathway enrichment analysis of targeted genes were analyzed by KOBAS software. The change profiles of miRNAs for both surgeries and their correlation with clinical characteristics and weight loss effectiveness were further analyzed. Results A total of 85 differentially expressed miRNAs were identified before and after SG, while a total of 76 were found before and after RYGB. The target genes of these miRNAs were similar in the Gene Ontology enrichment analysis in SG and RYGB, and the enrichment analysis in the Kyoto Encyclopedia of Genes and Genomes was mainly related to metabolic pathways. Hsa-miR-493-5p, hsa-miR-184, and hsa-miR-3199 exhibited similar changes in SG and RYGB, and the former two were correlated with clinical characteristics. Hsa-miR-6729-5p, hsa-miR-4659b-5p, and hsa-miR-2277-5p were correlated with the weight loss effectiveness of SG, while hsa-miR-4662a-5p was correlated with the weight loss effectiveness of RYGB. Conclusions Short-term metabolic improvement and weight loss occurring after SG and RYGB surgery might be related to changes in miRNAs, which act on multiple biological pathways by regulating genes. In addition, some clinical characteristics and miRNAs were related to the effectiveness of early weight loss after SG and RYGB surgery. Clinical Trial Registration ChiCTR2200058333.

Ovarian cancer (OC) is one of the leading causes of death from malignancy in women and lacks safe and efficient treatment. The novel biomaterial, recombinant humanized collagen type III (rhCOLIII), has been reported to have various biological functions, but its role in OC is unclear. This study aimed to reveal the function and mechanism of action of rhCOLIII in OC. We developed an injectable recombinant human collagen (rhCOL)-derived material with a molecular weight of 45 kDa, with a stable triple helix structure, high biocompatibility, water solubility and biosafety. The anti-tumor activity of rhCOLIII was comprehensively evaluated through in vitro and in vivo experiments. In vitro, our results showed that rhCOLIII inhibited the proliferation, migration, and invasion of ovarian cancer cells (OCCs), and induced apoptosis. In addition, rhCOLIII not only inhibited autophagy of OCCs but also increased the expression of MHC-1 molecule within OCCs. To further elucidate the mechanism of rhCOLIII in OC, we conducted joint analysis of RNA-Seq and proteomics, and found that rhCOLIII exerted anti-tumor function and autophagy inhibition by downregulating Glutathione S-transferase P1 (GSTP1). Furthermore, various rescue experiments were designed to demonstrate that rhCOLIII suppressed autophagy and proliferation of OCCs by mediating GSTP1. In vivo, we found that rhCOLIII could inhibit tumor growth and promote CD8+ T cell infiltration. Our results indicate that rhCOLIII has great anti-tumor potential activity in OC, and induces protective anti-tumor immunity by regulating autophagy through GSTP1. These findings illustrate the potential therapeutic prospects of rhCOLIII for OC treatment.

BackgroundThe relationship between thiamine intake and risk for peripheral artery disease (PAD) is unknown. We aimed to clarify the role of thiamine intake on risk for PAD and the implications of this relationship. The secondary objective of this study is to explore the potential non-linear dose–response relationship between exposure to thiamine intake and outcome risk for PAD.MethodsWe conducted a cross-sectional study involving 6,112 participants with US adults from the National Health and Nutrition Examination Survey (1999–2004). Logistic regression and restricted cubic spline were utilized to substantiate the research objectives.ResultsThe overall prevalence of risk for PAD was 7.9, 51% in males and 49% in females. After multivariable adjustment, lower thiamine intake was significantly and nonlinearly associated with higher risks of PAD among participants. Furthermore, we discovered L-shaped associations (p = 0.082) between thiamine intake and the risk of PAD, with an inflection point at 0.66 mg/day. Accordingly, in the threshold effect analysis, there was an inverse association between dietary thiamine intake and the risk in participants with dietary thiamine intake 0.05).ConclusionA non-linear association was revealed, showing that low and high levels of thiamine intake were associated with an increased the risk of peripheral artery disease in American adults. The inflection point at 0.66 mg/day and lower risk of PAD at 0.65–1.13mg/day of dietary thiamine intake may represent intervention targets for lowering the risk of PAD. The findings of this study require further validation and confirmation.

BackgroundPeripheral Artery Disease (PAD) is a common vascular disorder typically caused by atherosclerosis, leading to impaired blood supply to the lower extremities, resulting in pain, necrosis, and even amputation. Despite extensive research into the pathogenesis of PAD, many mysteries remain, particularly regarding its association with human blood metabolites.MethodsTo explore the causal relationship between 1,400 serum metabolites and PAD, a two-sample Mendelian randomization (MR) analysis was conducted. The Inverse Variance-Weighted (IVW) method was the primary technique used to estimate the causal impact of the metabolites on PAD. To enhance the analysis, several additional methods were employed: MR-Egger regression, weighted median, simple mode, and weighted mode. These methods provided a comprehensive evaluation beyond the primary IVW estimation. To ensure the validity of the MR findings, sensitivity analysis was performed. Furthermore, a bidirectional MR approach was applied to explore the possibility of a reverse causal effect between PAD and potential candidate metabolites.ResultsAfter rigorous selection, significant associations were found between 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) and X-17653 levels with PAD. 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) was positively associated with increased PAD risk (IVW OR = 1.13, 95% CI, 1.06–1.21; P

Lymphoma is a malignant tumour of the lymphatic system with an incidence rate of about 6.6 per 100,000 people. Among the many lymphoma types, the most common is non-Hodgkin’s lymphoma. Lymphomas are common in the gastrointestinal tract, breast, neck, etc., while those in female genital tracts are rare. In this article, we report four cases of primary female genital system lymphoid malignancies diagnosed and treated at our hospital from 2018 to 2023, with a systematic review.

Multifractal features of the pore structures of coal reservoirs control the transport and sustainable production of coalbed methane (CBM), which directly determines the efficiency of CBM extraction and is of great importance for CBM extraction. In order to investigate the multifractal characteristics of the pore structures of medium-high rank coals and their evolutionary trends during coalification, the medium-high rank coal samples from production mines in the Qinshui coal field were collected to investigate the evolution of the multiple fractal characteristics of medium-high rank coals macropores (> 50 nm), mesopores (2−50 nm) and micropores (< 2 nm) during coalification and their influencing factors by using multifractal theories and integrating the mercury intrusion porosimetry, low temperature nitrogen gas adsorption and low temperature carbon dioxide adsorption experiments, respectively. The results show that the generalized dimensional spectrum (Dq−q) and the multifractal singular spectrum (f(α)−α) of macro-, meso- and micropores of medium-high rank coals both satisfy the multifractal characteristics, which implies that the macro-, meso- and micropores of medium-high rank coals all exhibit multifractal behavior. Compared with macropores and mesopores, micropores have stronger non-homogeneity and lower pore connectivity exhibiting larger α0 and ∆D values and smaller H values. Coalification promotes the aggregation of macromolecules in coal, which changes the coal reservoir type from macropores dominant reservoir and macropores-micropores coexisting reservoir to micropores dominant reservoir, and the pore size distribution of different scales in coal tends to be homogenized, leading to the improvement of pore structure homogeneity and pore connectivity in medium-high rank coal reservoirs. Macropore and micropore volume fractions have positive and negative effects on pore structure heterogeneity in their respective pore size ranges, while mesopore volume fraction is not an effective constraint on mesopore pore size distribution heterogeneity. The vitrinite and inertinite groups show opposite effects on the heterogeneity of pore size distribution, with a positive correlation between V/I and H values and a negative correlation with α0. Vitrinite-rich coals develop more micropores and thus showing stronger pore structure homogeneity and better pore connectivity.

Abstract Background Amniotic fluid contamination (AFC) is a risk factor for neonatal hypoxic ischemic encephalopathy (HIE); however, the correlation between AFC level and the incidence and clinical grading of HIE, in addition to relevant biomarkers of brain damage, have not been assessed. Methods This single-center observational study included 75 neonates with moderate-to-severe HIE. The neonates with HIE were divided into four subgroups according to the AFC level: normal amniotic fluid with HIE group (NAF-HIE), I°AFC with HIE group (I°AFC-HIE), II°AFC with HIE group (II°AFC-HIE), and III°AFC with HIE group (III°AFC-HIE). The control groups consisted of 35 healthy neonates. The clinical grading of neonatal HIE was performed according to the criteria of Sarnat and Sarnat. Serum tau protein and S100B were detected by enzyme-linked immunosorbent assay kits. Correlations of serum tau protein and S100B were evaluated using the Pearson correlation analysis. Results (1) The incidence of neonatal HIE in the NAF-HIE group was 20 cases (26. 7%), I°AFC-HIE was 13 cases (17.3%), II°AFC-HIE was 10 cases (13.3%), and III°AFC-HIE was 32 cases (42. 7%). The incidence of moderate-to-severe HIE in the I°–III°AFC-HIE groups was 73.3% (55/75). (2) In 44 cases with severe HIE, 26 cases (59.1%) occurred in the III°AFC-HIE group, which had a significantly higher incidence of severe HIE than moderate HIE (p

BackgroundPersons with multiple chronic conditions face complex medical regimens and clinicians may not focus on what matters most to these patients who vary widely in their health priorities. Patient Priorities Care is a facilitator-led process designed to identify patients’ priorities and align decision-making and care, but the need for a facilitator has limited its widespread adoption. ObjectiveThe aims of this study are to design and test mechanisms for patients to complete a self-directed process for identifying priorities and providing their priorities to clinicians. MethodsThe study involved patients of at least 65 years of age at 2 family medicine practices with 5 physicians each. We first tested 2 versions of an interactive website and asked patients to bring their results to their visit. We then tested an Epic previsit questionnaire derived from the website’s questions and included standard previsit materials. We completed postintervention phone interviews and an online survey with participating patients and collected informal feedback and conducted a focus group with participating physicians. ResultsIn the test of the first website version, 17.3% (35/202) of invited patients went to the website, 11.4% (23/202) completed all of the questions, 2.5% (5/202) brought results to their visits, and the median session time was 43.0 (IQR 28.0) minutes. Patients expressed confusion about bringing results to the visit. After clarifying that issue in the second version, 15.1% (32/212) of patients went to the website, 14.6% (31/212) completed the questions, 1.9% (4/212) brought results to the visit, and the median session time was 35.0 (IQR 35.0) minutes. In the test of the Epic questionnaire, 26.4% (198/750) of patients completed the questionnaire before at least 1 visit, and the median completion time was 14.0 (IQR 23.0) minutes. The 8 main questions were answered 62.9% (129/205) to 95.6% (196/205) of the time. Patients who completed questionnaires were younger than those who did not (72.3 vs 76.1 years) and were more likely to complete at least 1 of their other assigned questionnaires (99.5%, 197/198) than those who did not (10.3%, 57/552). A total of 140 of 198 (70.7%) patients responded to a survey, and 86 remembered completing the questionnaire; 78 (90.7%) did not remember having difficulty answering the questions and 57 (68.7%) agreed or somewhat agreed that it helped them and their clinicians to understand their priorities. Doctors noted that the sickest patients did not complete the questionnaire and that the discussion provided a good segue into end-of-life care. ConclusionsEmbedding questionnaires assaying patient priorities into patient portals holds promise for expanding access to priorities-concordant care.

Abstract Background Many studies have covered the prevalence of obesity in different populations. However, studies on the prevalence and predictors of obesity among medical staff are lacking. The aim of our study is to investigate the prevalence of obesity among medical staff and to identify the related predictors. Methods Using a snowballing recruitment strategy in the form of an electronic questionnaire, a cross-sectional survey was conducted among 1201 medical staff from cooperative hospitals between January and March 2022. We designed a questionnaire to investigate the participants’ demographic, lifestyle, diet, physical activity, and work status. Results The overall prevalence of obesity was 8.5%, with males (13.7%) having a greater incidence than females (5.7%) (p 3/week (OR, 2.50; 95% CI 1.02–6.15, p = 0.046), and working a night shift > 1/week (OR, 2.17; 95% CI 1.02–4.61, p = 0.043) were independent predictive factors for obesity in men. For women, having midnight snack having midnight snack (OR, 2.93;95% CI 1.24–6.96, p = 0.015), good sleep quality (OR, 4.47; 95% CI 1.10–21.70, p = 0.038), and working a night shift > 1/week (OR, 3.62; 95% CI 1.73–7.57, p = 0.001) were independently associated with obesity. Conclusions Obesity presented a low prevalence among medical staff. Alcohol drinking, drinking sugar-sweetened beverages > 3/week, and night shift > 1/week predicted a higher risk of obesity in males. In females, having midnight snack, good sleep quality, and night shift > 1/week were independently associated with obesity. Level of evidence: V, descriptive study.

Complementary Metal-Oxide-Semiconductor (CMOS) image sensors (CISs), known for their high integration, low cost, and superior performance, have found widespread applications in satellite and space exploration. However, the readout circuits of pixel arrays are vulnerable to functional failures in complex or intense radiation environments, particularly due to transient γ radiation. Using Technology Computer-Aided Design (TCAD) device simulations and Simulation Program with Integrated Circuit Emphasis (SPICE) circuit simulations, combined with a double-exponential current source fault injection method, this study investigates the transient dose rate effect (TDRE) on a typical readout circuit of CISs. It presents the variations in the photoelectric signal under different dose rates and at different occurrence moments of the TDRE. The results show that, under low dose rates, the CIS readout circuit can still perform data acquisition and digital processing, with the photoelectric signal exhibiting some sensitivity to the occurrence moment. At high dose rates, however, the photoelectric signal not only remains sensitive to the occurrence moment but also shows significant discreteness. Further analysis of the CIS readout circuit sequence suggests that the occurrence moment is a critical factor affecting the circuit’s performance and should not be overlooked. These findings provide valuable insights and references for further research on the TDRE in circuits.

Abstract Transumbilical single-port laparoscopy is widely used in gynecological surgery. However, it is rarely used in the treatment of deep infiltrating endometriosis due to its own shortcomings and the complex condition of deep infiltrating endometriosis. The study aims to introduce a transumbilical single-port laparoscopic surgery based on retroperitoneal pelvic spaces anatomy, which can complete the operation of deep infiltrating endometriosis more easily. A retrospective analysis of 63 patients with deep infiltrating endometriosis treated by transumbilical single-port laparoscopy using this method was conducted. The operation duration was 120.00 (85.00 ± 170.00) (35–405) min, the estimated blood loss was 68.41 ± 39.35 ml, the postoperative hospital stay was 5.00 (4.00–6.00) days, and the incidence of postoperative complications was 4.76% (3/63). 1 patient was found to have intestinal injury during operation, 1 patient had ureteral injury after operation, and 1 patient had postoperative pelvic infection, with a recurrence rate of 9.52%. The postoperative scar score was 3.00 (3.00–4.00) and the postoperative satisfaction score was 9.00 (8.00–10.00). In summary, this study demonstrates the feasibility of transumbilical single-port laparoscopic surgery for deep infiltrating endometriosis based on retroperitoneal pelvic spaces anatomy. Hysterectomy, adenomyosis resection, etc. are also feasible with this method, boasting more obvious advantages. This method can make transumbilical single-port laparoscopy more widely used in deep infiltrating endometriosis.

Background MicroRNAs (miRNAs) exert an essential contribution to obesity and type 2 diabetes mellitus (T2DM). This study aimed to investigate the differences of miRNAs in the presence and absence of T2DM in patients with obesity, as well as before and after bariatric surgery in T2DM patients with obesity. Characterization of the common changes in both was further analyzed. Methods We enrolled 15 patients with obesity but without T2DM and 15 patients with both obesity and T2DM. Their preoperative clinical data and serum samples were collected, as well as 1 month after bariatric surgery. The serum samples were analyzed by miRNA sequencing, and the miRNAs profiles and target genes characteristics were compared. Results Patients with T2DM had 16 up-regulated and 32 down-regulated miRNAs compared to patients without T2DM. Improvement in metabolic metrics after bariatric surgery of T2DM patients with obesity was correlated with changes in miRNAs, as evidenced by the upregulation of 20 miRNAs and the downregulation of 30 miRNAs. Analysis of the two miRNAs profiles identified seven intersecting miRNAs that showed opposite changes. The target genes of these seven miRNAs were substantially enriched in terms or pathways associated with T2DM. Conclusion We determined the expression profiles of miRNAs in the obese population, with and without diabetes, before and after bariatric surgery. The miRNAs that intersected in the two comparisons were discovered. Both the miRNAs discovered and their target genes were closely associated with T2DM, demonstrating that they might be potential targets for the regulation of T2DM.

In recent years, as China experiences economic expansion and its corporations become more global, it has notably become a central hub for cross-border mergers and acquisitions (M&A) on the world stage. The Chinese government, in tandem, leverages these international M&A operations to drive industrial transformation and progress in technology. This research investigates the role of China's industrial policies in shaping cross-border M&A activities by examining recent instances. Findings indicate that relaxing financial barriers and applying specific industrial tactics bolster companies' abilities to secure funding, consequently energizing cross-border M&A initiatives. Several firms in these international mergers and acquisitions are intricately connected to political strategies, markedly affecting the formulation of industrial policies. This assertion is corroborated through the analysis of relevant statistical evidence. The study methodically collects and scrutinizes data to quantitatively depict the current landscape and influencing elements of cross-border M&A, thus providing concrete evidence for policy and business strategy formulation.

Purpose: Several therapeutic combinations are available for the treatment of advanced gastric cancer (AGC). It is unclear which combinations are most beneficial to the patients. The purpose of this study was to compare the efficacy and safety of Tegafur/ gimeracil/ oteracil (S-1) plus oxaliplatin (S-1OX) with capecitabine plus oxaliplatin (CAPOX) in patients with AGC. Materials and Methods: Relevant randomized controlled trials were searched in MEDLINE, EMBASE, The Cochrane Library (CENTRAL), two major Chinese biomedical databases (CBM, CNKI), and registry centers until July 22, 2019, with no language restrictions. Data were extracted for overall response rate (ORR), time to progression (TTP), overall survival time (OST), and toxicity. The systematic review was performed according to the recommendations of the Cochrane collaboration. RevMan 5.3.1 was used for statistical analysis. Results: A total of 6 randomized controlled trials involving 911 patients were included. The quality of the trials was less than 3 points. All the trials demonstrated a significantly improved toxicity (hand-foot syndrome and neuropathy) in the S-1OX trials (p < 0.05). There was no statistically significant difference (p > 0.05) between S-1OX versus CAPOX in terms of ORR, OST, TTP. Any of the subgroup analyses did not exhibit heterogeneity, so the fixed-effects model be used to execute the subgroup meta-analysis. Conclusions: Both S-1OX and CAPOX showed similar efficacy for treatment of AGC. However, S1-OX appeared to present less toxicity in terms of hand-foot syndrome and neuropathy as compared to CAPOX.

Objective To describe the experiences and opinions of general practitioners (GPs) in England regarding patients having access to their full online GP health records.Design Convenience sample, online survey.Participants 400 registered GPs in England.Main outcome measures Investigators measured GPs’ experiences and opinions about online record access (ORA), including patient care and their practice.Results A total of 400 GPs from all regions of England responded. A minority (130, 33%) believed ORA was a good idea. Most GPs believed a majority of patients would worry more (364, 91%) or find their GP records more confusing than helpful (338, 85%). Most GPs believed a majority of patients would find significant errors in their records (240, 60%), would better remember their care plan (280, 70%) and feel more in control of their care (243, 60%). The majority believed they will/already spend more time addressing patients’ questions outside of consultations (357, 89%), that consultations will/already take significantly longer (322, 81%) and that they will be/already are less candid in their documentation (289, 72%) after ORA. Nearly two-thirds of GPs believed ORA would increase their litigation (246, 62%).Conclusions Similar to clinicians in other countries, GPs in our sample were sceptical of ORA, believing patients would worry more and find their records more confusing than helpful. Most GPs also believed the practice would exacerbate work burdens. However, the majority of GPs in this survey also agreed there were multiple benefits to patients having online access to their primary care health records. The findings of this survey also contribute to a growing body of contrastive research from countries where ORA is advanced, demonstrating clinicians are sceptical while studies indicate patients appear to derive multiple benefits.

Transient γ-radiation and laser-simulated experiments were carried out to investigate the transient dose rate effect (TDRE) in SiGe heterojunction bipolar transistors (HBTs) for the first time. The results indicate that IBM43RF0100 SiGe HBTs experience a significant sensitivity of TDRE. For the laser-simulated experiment, the duration of transient current and charge collection are matched well with that of transient γ-radiation. The amplitude of transient photocurrent induced by the lower energy order of μJ approaches the transient photocurrent induced by transient γ-radiation. It is demonstrated that laser-simulated experiments are a candidate and a convenient method to evaluate the TDRE response of SiGe HBTs, which avoids serious electromagnetic interference in the transient γ-radiation environment.

Chronic alcohol consumption causes liver steatosis, cell death, and inflammation. Melatonin (MLT) is reported to alleviate alcoholic liver disease (ALD)-induced injury. However, its direct regulating targets in hepatocytes are not fully understood. In the current study, a cell-based screening model and a chronic ethanol-fed mice ALD model were used to test the protective mechanisms of MLT. MLT ameliorated ethanol-induced hepatocyte injury in both cell and animal models (optimal doses of 10 μmol/L and 5 mg/kg, respectively), including lowered liver steatosis, cell death, and inflammation. RNA-seq analysis and loss-of-function studies in AML-12 cells revealed that telomerase reverse transcriptase (TERT) was a key downstream effector of MLT. Biophysical assay found that epidermal growth factor receptor (EGFR) on the hepatocyte surface was a direct binding and regulating target of MLT. Liver specific knock-down of Tert or Egfr in the ALD mice model impaired MLT-mediated liver protection, partly through the regulation of nuclear brahma-related gene-1 (BRG1). Long-term administration (90 days) of MLT in healthy mice did not cause evident adverse effect. In conclusion, MLT is an efficacious and safe agent for ALD alleviation. Its direct regulating target in hepatocytes is EGFR and downstream BRG1–TERT axis. MLT might be used as a complimentary agent for alcoholics.

A new compact multifunctional pattern reconfigurable $2\times 2$ antenna array at 3.65 GHz with high gain and 16 (Multiple Input Multiple Output) MIMO modes is proposed. The single-element antenna includes 4 U-slots etched on the ground plane, with orthogonal slot orientations for polarization un-correlation, and fed using a reconfigurable feeding network with 4 PIN diodes. Hence, the single-element antenna is a pattern reconfigurable U-slot antenna with four pattern configurations. The average efficiency of 80%, the peak gain of 9.4 dB, and an overlapped −10 dB impedance-bandwidth of 200 MHz at a resonant frequency of 3.65 GHz in the n78 5G band are achieved. The single-element size is $55.5\times 54$ mm2, $0.66 \lambda _{0} \times 0.65 \lambda _{0}$ . The horizontal and vertical distances between the U-slots in a single-element are 30 mm $(0.36\lambda _{0})$ , and 27 mm $(0.32\lambda _{0})$ , respectively. The $2\times 2$ antenna array of such an element with a 58.5 mm $(0.7\lambda _{0})$ between the elements occupies a volume of $140\times 140\times 21$ mm3. The $2\times 2$ elements provide 16 reconfigurable U-slots with two modes of operation, Array Mode and Multiple-Input-Multiple-Output (MIMO) Mode. For the MIMO Mode, the antenna has a maximum Envelope Correlation Coefficient (ECC) of 0.1194 between the radiation patterns and a minimum isolation of 20 dB between the four ports. For the array Mode, a $4\times 4$ antenna array has a peak gain of 17 dBi, and a beam-steering range of $-50^{\circ} \leq \theta \leq 50^{\circ} $ in the two principle planes. The antenna is suitable for small cell base-station applications.

AimsTo evaluate the breadth, depth and effectiveness of the evidence quality of all existing studies on bariatric surgery and mental health outcomes.DesignUmbrella review of existing Systematic review and meta-analyses.Data sourcesPubMed, Embase, Web of Science, and the Cochrane Liberally databases of Systematic review and meta-analyses, and hand searching the reference lists of eligible publications.ResultsThe search identified nine studies and 20 mental health outcomes from 1251 studies. Evidence shows that bariatric surgery is associated with significant improvement in areas such as anxiety, depression and eating disorders (including binge-eating disorder), and there is a significant harmful association with suicide, self-harm and alcohol use disorder (AUD). Among them, the most studied outcome is depression (4 articles). High-quality evidence proves that the score of depressive symptoms can be significantly improved after bariatric surgery within a two-year follow-up period and is not affected by the follow-up time. Low-quality evidence shows that bariatric surgery can significantly reduce depressive symptoms regardless of age and BMI, with an odds ratio (OR) of 0.49. Regardless of the postoperative BMI, the anxiety symptoms of women over 40 still decreased significantly, with an OR of 0.58. Regardless of the type of surgery, surgery can significantly reduce the incidence of eating disorders and symptoms. However, there is no obvious change in the follow-up time of AUD in the first two years after bariatric surgery, and the risk increases obviously in the third year, with an OR of 1.825. The evidence of moderate research shows that the risk of suicide and self-harm increases after bariatric surgery. The odds ratios in the same population and the control group were 1.9 and 3.8 times, respectively.ConclusionBariatric surgery is beneficial for improving most mental health-related outcomes. However, we should be cautious about the increased risk of adverse mental health after surgery, such as suicide, self-harm, and AUD.

The aim of this study was to evaluate the effects of replacing fish meal (FM) or soy protein concentrate (SPC) with wheat gluten on growth performance, feed utilization, and nutrient digestibility and retention in Japanese seabass (Lateolabrax japonicus). Seven isonitrogenous (441–456 g kg−1 crude protein) and isocaloric (21.5–22.0 MJ kg−1 gross energy) diets were produced to replace 0%, 33.3%, 66.7% and 100% of FM or SPC with a mixture of wheat gluten, wheat, and taurine (GWT, 77.5% wheat gluten, 20.5% wheat and 2.0% taurine). The gradual replacement of protein in FM with GWT had no significant effects on feed intake, whole-body composition, and the hepatosomatic and viscerosomatic indices, but resulted in a linear decrease in the weight gain rate, feed efficiency, and retention of nitrogen, energy, and essential amino acids (Arg, His, Ile, Leu, Lys, Met, Phe, Thr, and Val). The apparent digestibility of most essential amino acids (Cys, His, Leu, Lys, and Phe) and total amino acids increased linearly. Replacement protein in SPC with GWT had no significant effects on feed intake, growth, the feed conversion ratio, whole-body composition, and the hepatosomatic index, but resulted in a linear decrease in nitrogen, energy, and Met retention; the digestibility of Cys and Met increased linearly. Overall, wheat gluten is a more effective alternative for replacing protein in SPC than FM.

Coenzyme Q10 (CoQ10) is a powerful antioxidant that is gradually being used in aquafeeds. Here, we examined the influence of oxidized fish oil and CoQ10 supplementation on intestinal microbiota of Micropterus salmoides at different growth stages. Three isonitrogenous and isoenergetic diets were formulated to contain 100% fresh fish oil (FFO), 100% oxidized fish oil (OFO) and OFO + 0.1% CoQ10 (QFO) and were fed to Micropterus salmoides (95 ± 0.60 g) for 70 days. Furthermore, three different growth stages (28-day, 49-day, 70-day) were selected to observe the dynamic changes of intestinal microbiota. The growth performance of fish fed QFO were significantly higher than that of fish fed OFO after a 70-day’s feeding. Intestinal microbial community of Micropterus salmoides was significantly affected by different growth stages more than diets. The abundance of phylum Proteobacteria showed an increasing trend, while the abundance of Firmicutes decreased with increased feeding time. Compared with OFO, diet supplemented with CoQ10 significantly increased the abundance of Firmicutes, and decreased Proteobacteria on the 28- and 70-day of feeding. When fish fed OFO and QFO, Simpson and Shannon indices significantly increased with increased feeding time from 28 to 70 days. Fish fed QFO significantly decreased the value of Bray-Curtis distance than those fed FFO on the 70-day of feeding. Moreover, Bray-Curtis distance showed an increased trend with increased feeding time. Notably, intestinal microbial functional prediction indicated that OFO suppressed amino acid metabolism, while long-term oral administration of CoQ10 could improve amino acid metabolism and detoxification of Micropterus salmoides. This study demonstrated that prolonged application of CoQ10 is needed to produce some beneficial effects to Micropterus salmoides.

Abstract Background Systemic sclerosis (SSc) is a rare detrimental disease warranting global research efforts. Evaluating how socio-economic factors impact country research output on SSc could help to identify solutions advancing research. Methods Publication production on SSc during 1969–2018 and data for structural and policy factors for WHO member countries were collected from public sources. Associations between SSc research output and country-level factors were investigated through panel regression. Difference-in-differences analysis further assessed the causal effects of rare disease legislation. Results SSc publications demonstrated exponential growth (r = 0.9410, as against an r = 0.8845 after linear adjustment), but were concentrated in high-income countries (HICs). Ten countries, nine of which were HICs, published 12,261 (77.5%) SSc publications but another 87 countries produced none. Gross domestic products (GDP), population and expenditure on research and development were positively associated with SSc publications (p

Abstract Background Gestational diabetes mellitus (GDM) has significant short and long-term health consequences for both the mother and child. There is limited but suggestive evidence that inulin could improve glucose tolerance during pregnancy. This study assessed the effect of inulin on glucose homeostasis and elucidated the molecular mechanisms underlying the inulin-induced antidiabetic effects during pregnancy. Method Female C57BL/6 mice were randomized to receive either no treatment, high-dose inulin and low-dose inulin for 7 weeks with measurement of biochemical profiles. A real-time2 (RT2) profiler polymerase chain reaction (PCR) array involved in glycolipid metabolism was measured. Results Inulin treatment facilitated glucose homeostasis in a dose-dependent manner by decreasing fasting blood glucose, advanced glycation end products and total cholesterol, and improving glucose tolerance. Suppressing resistin (RETN) expression was observed in the inulin treatment group and the expression was significantly correlated with fasting blood glucose levels. The ratios of p-IRS to IRS and p-Akt to Akt in liver tissue and the ratio of p-Akt to Akt in adipose tissue as well as the expression level of GLUT4 increased significantly after inulin treatment. Conclusions Our findings indicated improvement of glucose and lipid metabolism by inulin was to activate glucose transport through the translocation of GLUT4 which was mediated by insulin signaling pathway repairment due to decreased expression of RETN and enhanced phosphorylation of IRS and Akt in GDM mice.

BackgroundPostoperative nausea and vomiting (PONV) are common after laparoscopic sleeve gastrectomy (LSG), affecting patient satisfaction and postoperative recovery. The purpose of this study was to investigate the incidence and severity of PONV after LSG and the relationship between Helicobacter pylori (HP) and PONV.MethodsPatients undergoing LSG in our center from June 1, 2018, to May 31, 2022, were divided into HP-positive and HP-negative groups for retrospective analysis. The independent risk factors of PONV were determined by univariate and binary logistic regression analysis using a 1:1 propensity score matching (PSM) method.ResultsA total of 656 patients was enrolled, and 193 pairs of HP-positive and negative groups were matched after PSM. Both groups of patients had similar clinical features and surgical procedures. PONV occurred in 232 patients (60.1%) after LSG, and the incidence of PONV in HP-positive patients was 61.10%. The incidence and severity of PONV were statistically similar in both groups (P=0.815). Multivariate analysis showed that the female sex (OR=1.644, P=0.042), postoperative pain (OR=2.203, P=0.001) and use of postoperative opioid (OR=2.229, P=0.000) were independent risk factors for PONV after LSG, whereas T2DM (OR=0.510, P=0.009) and OSAS (OR=0.545, P=0.008) independently reduced the incidence rate of PONV. There was no difference either in smoking (P=0.255) or alcohol drinking (P=0.801). HP infection did not affect PONV (P=0.678).ConclusionsThe incidence of PONV following LSG was relatively high. Female sex, postoperative pain and use of postoperative opioid predicted a higher incidence of PONV. Patients with T2DM and OSAS were less likely to have PONV. There was no clear association between HP infection and PONV after LSG.

BackgroundIn 2022, NHS England announced plans to ensure that all adult primary care patients in England would have full online access to new data added to their general practitioner (GP) record. However, this plan has not yet been fully implemented. Since April 2020, the GP contract in England has already committed to offering patients full online record access on a prospective basis and on request. However, there has been limited research into UK GPs’ experiences and opinions about this practice innovation. ObjectiveThis study aimed to explore the experiences and opinions of GPs in England about patients’ access to their full web-based health record, including clinicians’ free-text summaries of the consultation (so-called “open notes”). MethodsIn March 2022, using a convenience sample, we administered a web-based mixed methods survey of 400 GPs in the United Kingdom to explore their experiences and opinions about the impact on patients and GPs’ practices to offer patients full online access to their health records. Participants were recruited using the clinician marketing service Doctors.net.uk from registered GPs currently working in England. We conducted a qualitative descriptive analysis of written responses (“comments”) to 4 open-ended questions embedded in a web-based questionnaire. ResultsOf 400 GPs, 224 (56%) left comments that were classified into 4 major themes: increased strain on GP practices, the potential to harm patients, changes to documentation, and legal concerns. GPs believed that patient access would lead to extra work for them, reduced efficiency, and increased burnout. The participants also believed that access would increase patient anxiety and incur risks to patient safety. Experienced and perceived documentation changes included reduced candor and changes to record functionality. Anticipated legal concerns encompassed fears about increased litigation risks and lack of legal guidance to GPs about how to manage documentation that would be read by patients and potential third parties. ConclusionsThis study provides timely information on the views of GPs in England regarding patient access to their web-based health records. Overwhelmingly, GPs were skeptical about the benefits of access both for patients and to their practices. These views are similar to those expressed by clinicians in other countries, including Nordic countries and the United States before patient access. The survey was limited by the convenience sample, and it is not possible to infer that our sample was representative of the opinions of GPs in England. More extensive, qualitative research is required to understand the perspectives of patients in England after experiencing access to their web-based records. Finally, further research is needed to explore objective measures of the impact of patient access to their records on health outcomes, clinician workload, and changes to documentation.

IntroductionBariatric surgeries induce well-documented weight loss and resolve obesity comorbidities. Sexual function is one of the aspects of life quality and may benefit from surgery. Few studies have revealed the impact of bariatric surgeries on sexual function in Chinese men with obesity.MethodsThis is a retrospective cohort study of patients undergoing bariatric surgery [laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB)]. Data were collected between September 2017 and February 2022. The International Index of Erectile Function (IIEF) questionnaire was used to evaluate erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. Sex hormones and other blood tests were evaluated before and at least 1 year after the surgery.ResultsFifty-nine Chinese male patients completed the IIEF questionnaire. The multivariate logistic regression analysis revealed that body mass index (BMI) was the single independent risk factor of the severity of erectile dysfunction (ED). Preoperative testosterone levels had negative correlations with BMI and waist circumference. Thirty-seven patients completed the postoperative questionnaire with a mean follow-up of 23.2 months.ConclusionBMI and waist circumference were negatively correlated with testosterone levels. BMI was an independent risk factor for the severity of ED. LSG and LRYGB led to positive and sustained improvement in sexual function of men with obesity. The two procedures had a comparable effect, more subjects being needed. Sex hormone levels also could be reversible. However, more weight loss did not predict a positive change in sexual function. A greater BMI loss might predict a greater increase in testosterone.

BackgroundFibrosis stages affect clinical prognoses related to nonalcoholic fatty liver disease (NAFLD). However, data on the prevalence and clinical features of significant fibrosis are scarce in Chinese bariatric surgery patients. We aimed to investigate the prevalence of significant fibrosis in bariatric surgery patients and to identify its predictors.MethodsWe prospectively enrolled the patients performing intra-operative liver biopsies during bariatric surgery from a bariatric surgery center in a university hospital between May 2020 and January 2022. Anthropometric characteristics, co-morbidities, laboratory data and pathology reports were collected and analyzed. The performance of non‐invasive models was evaluated.ResultsOf 373 patients, 68.9%% had non-alcoholic steatohepatitis (NASH) and 60.9% exhibited fibrosis. Significant fibrosis was present in 9.1% of patients, advanced fibrosis in 4.0%, and cirrhosis in 1.6%. Multivariate logistic regression showed that increasing age (odds ratio [OR], 1.06; p=0.003), presence of diabetes (OR, 2.62; p=0.019), elevated c- peptide (OR, 1.26; p=0.025) and elevated aspartate aminotransferase (AST) (OR, 1.02; p=0.004) were independent predictors of significant fibrosis. The non-invasive models, AST to Platelet ratio (APRI), Fibrosis‐4 (FIB-4), and Hepamet fibrosis scores (HFS) provided greater accuracy for predicting significant fibrosis, compared to the NAFLD Fibrosis Score (NFS) and BARD score.ConclusionMore than two-thirds of bariatric surgery patients had NASH and the prevalence of significant fibrosis was high. Elevated levels of AST and c- peptide, advanced age and diabetes indicated a higher risk of significant fibrosis. Non-invasive models, APRI, FIB-4 and HFS can be used to identify significant liver fibrosis in bariatric surgery patients.

Achieving an all-fiber ultra-fast system with above kW average power and mJ pulse energy is extremely challenging. This paper demonstrated a picosecond monolithic master oscillator power amplifier system at a 25 MHz repetition frequency with an average power of approximately 1.2 kW, a pulse energy of approximately 48 μJ and a peak power of approximately 0.45 MW. The nonlinear effects were suppressed by adopting a dispersion stretched seed pulse (with a narrow linewidth of 0.052 nm) and a multi-mode master amplifier with an extra-large mode area; then an ultimate narrow bandwidth of 1.32 nm and a moderately broadened pulse of approximately 107 ps were achieved. Meanwhile, the great spatio-temporal stability was verified experimentally, and no sign of transverse mode instability appeared even at the maximum output power. The system has shown great power and energy capability with a sacrificed beam propagation product of 5.28 mm $\cdot$ mrad. In addition, further scaling of the peak power and pulse energy can be achieved by employing a lower repetition and a conventional compressor.

β-glucan is widely used in aquaculture due to its immunostimulatory effects, but the specific effect and potential regulatory mechanism on largemouth bass (Micropterus salmoides) are still unclear. Here, we evaluated the effects of β-glucan on growth, resistance to Aeromonas schubertii, intestinal health, and transcriptome of largemouth bass to reveal the potential regulators, metabolic pathways, and altered differential microbiota. Four experimental diets were designed with β-glucan supplementation levels of 0 (control), 100 (LA-100), 200 (MA-200), and 300 (HA-300) mg kg-1, and each diet was fed to largemouth bass (79.30 ± 0.50 g) in triplicate for 70 days, followed by a 3-day challenge experiment. Results showed that different β-glucan supplementations had no significant effects on growth performance and whole-body composition. Fish fed a diet with 300 mg kg-1 β-glucan significantly increased the activity of lysozyme than those fed diets with 0 and 100 mg kg-1 β-glucan. In addition, the survival rate of largemouth bass in β-glucan supplementation groups was significantly higher than the control group at 12- and 24-h challenge by Aeromonas schubertii. Transcriptome analysis showed that a total of 1,245 genes were differentially expressed [|log2(fold change)| ≥1, q-value ≤0.05], including 109 immune-related differentially expressed genes (DEGs). Further analysis revealed that significantly upregulated and downregulated DEGs associated with immunity were mapped into 12 and 24 pathways, respectively. Results of intestinal microflora indicated that fish fed a diet with 300 mg kg-1 β-glucan had higher bacterial richness and diversity as evaluated by Sobs, Chao, Ace, and Simpson indices, but no significant differences were found in the comparison groups. Furthermore, 300 mg kg-1 β-glucan significantly increased the relative abundance of Mycoplasma and decreased Proteobacteria (mainly Escherichia-Shigella and Escherichia coli) and Bacillus anthracis in largemouth bass intestinal microflora. The findings of this study provided new insights that will be valuable in future studies to elucidate the mechanism of immunity enhancement by β-glucan.

The inherent drawbacks of the conventional B-mode ultrasound for metabolic dysfunction-associated steatotic liver disease (MASLD) are poorly understood. We aimed to investigate the impact factors and optimize the screening performance of ultrasound in MASLD. In a prospective pilot cohort recruited from July 2020 to January 2022, subjects who had undergone magnetic resonance imaging-based proton density fat fraction (MRI-PDFF), ultrasound, and laboratory test-based assessments were included in the deprivation cohort. A validation cohort including 426 patients with liver histologic assessments from five medical centers in South China was also recruited. A total of 1489 Chinese subjects were enrolled in the deprivation cohort, and ultrasound misdiagnosed 62.2% of the non-MASLD patients and failed to detect 6.1% of the MASLD patients. The number of metabolic dysfunction components and the alanine aminotransferase (ALT) level were associated with a missed diagnosis by ultrasound (OR = 0.67, 95% CI 0.55–0.82 p < 0.001; OR = 0.50, 95% CI 0.31–0.79, p = 0.003, respectively). Compared with ultrasound alone, the new strategy based on ultrasound, in combination with measurements of the number of metabolic dysfunction components and ALT and uric acid levels, significantly improved the AUROC both in the research cohort and the validation cohort (0.66 vs. 0.84, 0.83 vs. 0.92, respectively). The number of metabolic dysfunction components and ALT and uric acid levels improved the screening efficacy of ultrasound for MASLD.

Objective: The purpose of this review is to summarize drug selection for peri-menopausal symptoms caused by gonadotropin releasing-hormone agonist (GnRH-a) in the treatment of endometriosis. Mechanism: GnRH-a treatment often leads to low estrogen levels, resulting in peri-menopausal symptoms and osteoporosis. Add-back therapy relieves clinical symptoms by supplementing low-dose estrogen. The idea of “combined regulation” is to improve symptoms by adding plant preparations or proprietary Chinese medicines. Studies have shown that they may play a role by regulating serotonin activity. Findings in Brief: For patients treated with GnRH-a for less than 3 months, the combined-regulation regimen can be considered, whereas for patients who have had more than 3 courses of GnRH-a, add-back therapy with sex hormones must be used because the patients will have begun to have obvious bone-mass loss and even bone pain; this bone-mass loss is often irreversible. Conclusions: In the early treatment of endometriosis with GnRH-a, non-hormone combined-regulation therapy is a relatively safe and feasible choice, but hormone add-back therapy should be selected for patients who have had more than 3 courses of GnRH-a.

The digital transformation of equipment manufacturing enterprises is a gradual process in which enterprises, governments, and consumers form stakeholders. The equipment manufacturing enterprise is the executive body of digital transformation, the government is the maker of subsidy policies, and consumers are the users of digital products. The impact of the tripartite relationship on the efficacy of digital transformation requires further investigation. This article applies evolutionary game theory to scrutinize the propelling mechanism behind digital transformation in manufacturing firms specializing in equipment production. The research results show that (1) the intensity of government subsidies significantly affects the transformation progress of equipment manufacturing enterprises; (2) the increase in consumer preference accelerates the evolution speed of enterprises’ choice of implementing digital transformation strategies; and (3) the equipment manufacturing industry needs to improve the flexibility and adaptability of enterprises through flexible production so it relies more on digital technology to enable production and management services. However, as a result of constraints in data gathering, there is inadequate data to back up the sensitivity analysis in the case analysis section, potentially resulting in inadequate argumentation. Based on game theory and the simulation results, combined with the case analysis, three policy recommendations were proposed to strengthen the construction of the digital infrastructure, establish a dynamic adjustment mechanism for subsidies, and build a collaborative digital ecosystem for development.

Our previous work showed that [18F]P10A-1910 was a potential radioligand for use in imaging phosphodiesterase 10A (PDE10A). Specifically, it had high brain penetration and specific binding that was demonstrated in both rodents and non-human primates. Here, we present the first automatic cGMP-level production of [18F]P10A-1910 and translational PET/MRI study in living human brains. Successful one-step radiolabeling of [18F]P10A-1910 on a GE TRACERlab FX2N synthesis module was realized via two different methods. First, formulated [18F]P10A-1910 was derived from heating spirocyclic iodonium ylide in a tetra-n-butyl ammonium methanesulfonate solution. At the end of synthesis, it was obtained in non-decay corrected radiochemical yields (n.d.c. RCYs) of 12.4 ± 1.3%, with molar activities (MAs) of 90.3 ± 12.6 μmol (n = 7) (Method I). The boronic pinacol ester combined with copper and oxygen also delivered the radioligand with 16.8 ± 1.0% n. d.c. RCYs and 77.3 ± 20.7 GBq/μmol (n = 7) MAs after formulation (Method II). The radiochemical purity, radionuclidic purity, solvent residue, sterility, endotoxin content and other parameters were all validated for human use. Consistent with the distribution of PDE10A in the brain, escalating uptake of [18F]P10A-1910 was observed in the order of cerebellum (reference region), substantial nigra, caudate and putamen. The non-displaceable binding potential (BPND) was estimated by simplified reference-tissue model (SRTM); linear regressions demonstrated that BPND was well correlated with the most widely used semiquantitative parameter SUV. The strongest correlation was observed with SUV(50–60 min) (R2 = 0.966, p < 0.01). Collectively, these results indicated that a static scan protocol could be easily performed for PET imaging of PDE10A. Most importantly, that [18F]P10A-1910 is a promising radioligand to clinically quantify PDE10A.

Abstract Background Liver cancer is one of the most common cancers and causes of cancer death worldwide. The objective was to elucidate novel hub genes which were benefit for diagnosis, prognosis, and targeted therapy in liver cancer via integrated analysis. Methods GSE84402, GSE101685, and GSE112791 were filtered from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified by using the GEO2R. The GO and KEGG pathway of DEGs were analyzed in the DAVID. PPI and TF network of the DEGs were constructed by using the STRING, TRANSFAC, and Harmonizome. The relationship between hub genes and prognoses in liver cancer was analyzed in UALCAN based on The Cancer Genome Atlas (TCGA). The diagnostic value of hub genes was evaluated by ROC. The relationship between hub genes and tumor-infiltrate lymphocytes was analyzed in TIMER. The protein levels of hub genes were verified in HPA. The interaction between the hub genes and the drug were identified in DGIdb. Results In total, 108 upregulated and 60 downregulated DEGs were enriched in 148 GO terms and 20 KEGG pathways. The mRNA levels and protein levels of CDK1, HMMR, PTTG1, and TTK were higher in liver cancer tissues compared to normal tissues, which showed excellent diagnostic and prognostic value. CDK1, HMMR, PTTG1, and TTK were positively correlated with tumor-infiltrate lymphocytes, which might involve tumor immune response. The CDK1, HMMR, and TTK had close interaction with anticancer agents. Conclusions The CDK1, HMMR, PTTG1, and TTK were hub genes in liver cancer; hence, they might be potential biomarkers for diagnosis, prognosis, and targeted therapy of liver cancer.

Introduction: Bariatric surgery has grown in popularity over the past two decades, especially in the Asia-Pacific. Correspondingly, researchers’ interest in this field has also increased. This study aims to perform a bibliometric analysis of publications from Asia-Pacific represented by the International Federation for the Surgery of Obesity and Metabolic Disorders Asia-Pacific Chapter (IFSO-APC) and investigate the relevant factors that might affect the publications. Methods: The search terms for bariatric surgery were searched in Web of Science focusing on the period 2000-2021. Bibliometric analysis was performed after screening the search results. Univariate and multivariate regression analyses were performed on the number of publications and corresponding indicators obtained from official agencies. Results: A total of 9547 publications in IFSO-APC were retrieved, of which China had the largest number with 2782 publications. Authors and journals with major contributions were listed. The authors’ or affiliations’ cooperation networks mainly were limited to domestic. “Bariatric surgery” was the most frequent keyword with 2063 times and also the largest cluster. “Morbid obesity” was the strongest citation bursts. Multivariate analysis found that the number of publications in each country/region was associated with body mass index≥25 kg/m2, gross domestic product, and total population. Conclusion: Generally, Asia-Pacific represented by IFSO-APC scientific publications on bariatric surgery has grown significantly in the last two decades, but cooperation between countries/regions should be strengthened. “Morbid obesity” is the focus and frontier of research in this field.

The aim of this study was to evaluate the effects of wheat gluten as a substitute for fish meal (FM) and soy protein concentrate (SPC) in the low-fishmeal-based extruded diet in red spotted grouper Epinephelus akaara. Eight isonitrogenous (441–456 g kg−1) and isocaloric (21.5–22.0 MJ kg−1) diets were produced, including the control diet (R0), three diets with 33.3, 66.7, and 100% FM being replaced by a mixture of wheat gluten, wheat, and taurine (GWT) (RF1, RF2, RF3), three diets with 33.3, 66.7, and 100% SPC replaced by GWT (RS2, RS2, RS3) and one diet with 50% FM and 50% SPC replaced by GWT (RFS). Results showed that feed intake (FI), weight gain (WG), protein retention efficiency, and liver superoxide dismutase activity increased linearly, while feed conversion ratio (FCR) decreased linearly with the decrease of dietary FM. Additionally, FI, WG, and FCR significantly increased with decreasing dietary SPC. Overall, 100% FM or 61.2% SPC can be safely replaced by wheat gluten in the red-spotted grouper diet containing 20.0% FM and 21.4% SPC.

ObjectiveUndoubtedly, the relationship between serum uric acid (SUA) and obesity is less data for Chinese patients with obesity. This study aimed to examine the prevalence of hyperuricemia (HUA) and the association between SUA and patients with obesity.MethodsAll participants were categorized as overweight, obesity I, obesity II, and obesity III. In addition, based on SUA concentration, the participants were stratified into four quartiles. The authors used descriptive analysis, independent t-test, ANOVA, correlation analysis, and multiple linear regression models to verify the SUA level and obesity among Chinese adults.ResultsOverall, the estimated prevalence of HUA was 69.8%. In the BMI categories, the prevalence of HUA was 5.1% in overweight, 15.2% in obesity I, 16.9% in obesity II, and 32.5% in obesity III. Correlation analysis shows that SUA is strongly correlated with BMI, waist circumference (WC), and hip circumference (HC). Multiple linear regression analysis shows that high density–lipoprotein cholesterol (HDL-C) is a protective predictor of serum uric acid levels in patients with obesity. Compared with the overweight, obesity I, obesity II, and obesity III were more likely to have higher levels in the SUA levels.ConclusionWe mainly showed that the serum uric acid levels in Chinese patients with severe obesity declined slightly as age increased.

Background and ObjectiveAdenomyosis focus resection has always been the main surgical method for patients with uterine preservation, but its curative effect and surgical method are still controversial. We improved this method on the basis of the “double-flap method” and combined it with the levonorgestrel intrauterine delivery system (LNG-IUS) and gonadotropin-releasing hormone agonist (GnRH-a) sequential treatment to determine the clinical effect and feasibility of this scheme in the treatment of severe adenomyosis.MethodsThis is a retrospective review. A total of 64 patients with severe adenomyosis were treated in the Department of Gynecology of Changzhou Second People's Hospital, which is affiliated to Nanjing Medical University, from December 2017 to September 2021. The transabdominal approach and laparoscopic approach were adopted for the purposes of treatment in this study. Hence, the patients were subdivided into the transabdominal approach subgroup and the laparoscopic approach subgroup. The hemoglobin, visual analog score (VAS) score, menstruation score, and other indices of each patient before and after treatment were observed, recorded, and analyzed.ResultsAll 64 patients underwent the operation successfully. After the completion of sequential treatment, the CA125 decreased significantly 1 month after the operation, the average uterine volume significantly reduced, the hemoglobin value increased to a certain extent 3 months after the operation, and the menstrual score and dysmenorrhea during the first menstruation were significantly lower than they were before the operation. After the treatment, the therapeutic results of the transabdominal approach subgroup and endoscopic approach subgroup were compared on the basis of the observed indices, and no significant difference was observed (P > 0.05). Only one patient had a downward movement of the LNG-IUS, and the vaginal ultrasound showed that the upper end of the LNG-IUS was approximately 1.5 cm from the bottom of the uterine cavity. The average follow-up period was 24.02 ± 11.77 months, and no lesion progression was found in any patients.ConclusionFor patients suffering from severe adenomyosis who have no pregnancy plans and require uterine preservation, transabdominal or laparoscopic subtotal resection of the focus of adenomyosis, combined with the LNG-IUS + GnRH-a sequential treatment, may be a safe and effective alternative when conservative treatments such as drugs fail.

Somatic and expressional effects of replacing dietary fishmeal (FM) with a 1:1:2 combination of soy protein concentrate, corn gluten meal, and hydrolysate of forage-fish (HWF) or Pacific krill (HPK) were investigated in juvenile largemouth bass for 66 days. The control diet (FMC) contained 320 g kg−1of FM. Six extruded diets were produced with 3 rates of replacement at 25 %, 50 % and 75 % protein for each of the two hydrolysate combinations. Feed intake (FI) and weight gain (WGR) did not differ between fish fed HWF diets and FMC. Fish fed HPK50 and HPK75 had lower FI and WGR. FI linearly decreased with increasing HPK, while feed conversion ratio (FCR) increased. No significance was found in the FCR among groups fed FMC, HWF25, HWF50, and HPK25, whereas HWF75, HPK50, and HPK75 groups had significantly higher FCR. The apparent digestibility (AD) of crude protein (CP) increased with increasing HWF while HPK didn’t cause significant change. AD of lipid and energy were not affected by diet, and AD of most amino acids increased proportionally with HWF. No proximate composition or retention of crude or digestible protein or energy other than whole-body ash revealed HWF-related differences. Whole-body CP, lipid, ash contents and CP retentions showed significant dose response in HPK fed fish. The condition factor decreased linearly with increasing HPK. Fish fed HPK50 diet upregulated peptide transporter 1 (pept1) expression in the foregut. Expressions of both taurine transporter (taut) and pept1 were upregulated by increasing replacement from 0 % to 25 % HWF. Further increase in HWF replacement caused linear down regulation in expression of both transporters. In conclusion, HWF and HPK facilitated reduced use of fishmeal in practical diet for largemouth bass. Expressions of pept1 and taut were dose-dependent in fish fed HWF. HPK just caused single diet upregulation.

ObjectiveTo study the efficacy and safety of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse.DesignPatients were selected into this study on a voluntary basis to evaluate the short-term efficacy of this surgery by comparing the OP-Q scores before the operation, three months after the operation, and six months after the operation.Setting and PatientsEvaluate the clinical efficacy and safety by a retrospective analysis of the clinical data of the 18 patients with POP-Q grade III–IV pelvic organ prolapse treated by the Department of Gynecology of Nanjing Medical University Affiliated Changzhou No.2 People's Hospital from April 2020 to November 2020, and their post-operation follow-ups.InterventionsPatients with postoperative follow-ups found no obvious relapse without intervention measures.Measurements and Main ResultsThe transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation was performed successfully, and the anterior and posterior walls of vagina and/or trans-vaginal hysterectomy were repaired as appropriate. Except the total vaginal length (TVL), the P values of numerical analysis for all points before, three months after, and six months after the operation were all

PurposeThis paper aims to explore the safety and feasibility of a single-hole laparoscopic myomectomy through an abdominal scar approach.MethodThe clinical data of seven patients who underwent the single-hole laparoscopic myomectomy via the abdominal scar approach from January to November 2021 in the Department of Gynecology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, were studied retrospectively. The duration of operation, the intraoperative blood loss, the decrease of postoperative hemoglobin, and the postoperative visual analogue score (0 points: no pain, 10 points: maximum pain) were recorded.ResultsAll seven patients received the operation successfully, without changing to the conventional laparoscopic operation or open appendectomy. The average blood loss was 101.42 ± 7.89 ml, the average length of hospital stay was 5 ± 0.53 days, the average operation duration was 130 ± 26.86 min, and the 24-h pain score was 1.57 ± 0.53. The seven patients had no intraoperative or postoperative complications and no damage to the ureter or bladder. All patients could urinate spontaneously without urinary retention or urinary tract infection after catheter removal. No analgesic drugs were used after the operation.ConclusionThe single-hole laparoscopic myomectomy via the abdominal scar approach is a more aesthetic and feasible option for eligible patients, but more cases and studies are needed for further confirmation.

BackgroundEndometriosis (EMS) is a relapsing and estrogen-dependent disease. For endometriosis such as deep endometriosis and ovarian endometrioid cysts, surgery is the most effective treatment. Long-term follow-up showed that the recurrence rate of endometriosis after surgical treatment was high, so postoperative drugs were needed to reduce recurrence, and Gonadotropin-releasing hormone agonists (GnRH-a) were the most commonly used drug for postoperative management.GnRH-a may reduce the post-treatment endometriosis relapses by lowering the hormone levels in the body. However, the use of GnRH-a can give rise to perimenopausal symptoms, especially osteoporosis, bone loss, and bone pain, for which reason GnRH-a use is often limited. The add-back therapy is often used to alleviate the untoward effects caused by GnRH-a. However, long-term use of hormone drugs may lead to EMS recurrence, thrombosis, and breast cancer. Therefore, a safer and more effective drug is urgently needed to alleviate the untoward effects caused by GnRH-a. In recent years, scholars at home and abroad have found that isopropanolic Cimicifuga racemosa extract (ICR), as a plant extract, can better relieve the symptoms of perimenopausal women. At the same time, some studies have initially confirmed that black cohosh preparations can relieve the perimenopausal symptoms caused by GnRH-a treatment in EMS patients.ObjectiveTo investigate the effect of black cohosh preparations on the bone metabolism of rat models with GnRH-a-induced perimenopausal symptoms.MethodsThe rat models of perimenopausal symptoms were established by GnRH-a injection. and normal saline (NS injection) was used as the control. According to the modeling method and drug intervention, the rats were randomly divided into four groups: GnRH-a injection + saline intervention group (GnRH-a + NS), saline injection control + saline intervention group (NS + NS), GnRH-a injection + estradiol intervention group (GnRH-a + E2), and GnRH-a injection + black cohosh preparation intervention group (GnRH-a + ICR). The rat models were identified with the vaginal smear method, and then the corresponding drug intervention was administrated for 28 days. After the intervention, the rats were sacrificed. The rats’ bone mineral density (BMD) of the distal femur was detected by a dual-energy X-ray bone density scanner. Rat tibia bone tissues were decalcified and made into slices. The pathological and morphological changes of rat tibial bones in each group were observed through HE staining. Histomorphometry parameters of rat tibial bones in each group, such as trabecular bone volume (TBV), trabecular thickness (TbTh), trabecular number (TbN), and trabecular spacing (TbSp), were detected and analyzed by using an automatic image analysis system.Results(1) The BMD level of the distal femur in the GnRH-a + NS group was significantly lower than the NS + NS, GnRH-a + E2, and GnRH-a + ICR groups (P0.05). (2) The pathological changes of the tibia bones under the microscope in different groups were as follows: The tibia bone trabecular structure was normal in the NS + NS group, without trabecular thinning or fracture, and the arch structure was normal. In the GnRH-a + NS group, some trabecular structures tapered, the arch structure disappeared, but no obvious bone fracture was observed in the trabecula. In the GnRH-a + E2 and GnRH-a + ICR groups, the trabecular structures were normal, without trabecular bone thinning or fracture, and the arch structures were normal. (3) The TBV level of the GnRH-a + INS group was significantly lower than that of the NS + NS, GnRH-a + E2 and GnRH-a + ICR groups (P0.05). (4) The TbTh levels in the four groups had no significant difference (P>0.05). Compared with the NS + NS group, the TbTh levels in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups showed a descending tendency, while the TbTh levels in the GnRH-a + E2 and GnRH-a + ICR groups were slightly higher than that of the GnRH-a + NS group. However, such differences were not significant statistically (P>0.05). (5) Compared with the NS + NS group, the TbN levels in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups decreased remarkably (P0.05). (6) The TbSp level of the GnRH-a + NS group was significantly higher than that of the NS + NS, GnRH-a + E2, and GnRH-a + ICR groups (P0.05).ConclusionThe GnRH-a injection could achieve the desired effect. GnRH-a injection may lead to the loss of bone mass in rats. Black cohosh preparations, like estrogen, may have a protective effect on bone mass loss caused by GnRH-a injection.

Objectives Adipocytes and adipocyte lipid metabolism are closely related with obesity and type 2 diabetes, but the molecular mechanism still needs further investigation. The aim of this study is to discover the adipocyte genes and pathways involved in obesity and type 2 diabetes using bioinformatics analysis. Methods The GSE27951 gene expression profile was obtained. Software and online tools (STRING, Cytoscape, BioGPS, CTD, and FunRich) were used to identify core genes.21 human subcutaneous adipose samples, with 10 from type 2 diabetic patients and 11 from normal controls, were included in these analyses. Results 184 differentially expressed genes (DEGs) including 42 up-regulated genes and 142 down-regulated genes were found to be enriched in metabolism, receptor activity, collagen type IV and glutamine biosynthesis I pathway by using the enrichment analysis. Seven hub genes were identified from the PPI network using various software (Cytoscape, STRING, BioGPS, and CTD). Four core genes (COL4A2, ACACB, GLUL, and CD36) were found to be highly expressed in subcutaneous adipose tissue of obese patients accompanying type 2 diabetes. Conclusion COL4A2, ACACB, GLUL and CD36 might be the core molecular biomarkers of obesity in patients with or without type 2 diabetes.

Study ObjectiveThe aim was to investigate the outcome of vaginal delivery of full-term pregnancies in patients after transvaginal-natural orifice transluminal endoscopic surgery (vNOTES) treatment for gynecological disorders.DesignA case series report.SettingA medical university hospital.Patients12 cases of successful delivery after transvaginal-natural orifice transluminal endoscopic surgery.InterventionsLong-term follow-up of patients with fertility needs after transvaginal-natural orifice transluminal endoscopic surgery.Measurements and Main ResultsFrom 2018 to 2021, 163 cases of gynecological diseases were treated by vNOTES. One hundred forty-seven patients were followed up, with a follow-up rate of 90.1%. The average follow-up time was 28 (15–47) months, including 66 cases with fertility requirements. Among these 66 patients, 12 patients successfully got pregnant and completed delivery, including 10 cases of vaginal delivery and 2 cases of cesarean section, with no adverse pregnancy outcomes associated with vNOTES arising.ConclusionVaginal delivery of a full-term pregnancy after transvaginal-natural orifice transluminal endoscopic surgery appears to be safe and feasible and would not be one of the bases for elective cesarean delivery.

Vulvovaginal candidiasis (VVC) is considered the second most common cause of vaginitis after bacterial vaginosis and the most common lower genital tract infection during pregnancy. Candida albicans (C. albicans), an opportunistic pathogen, is the major species causing VVC. Recently, increasing researches have shown that lower reproductive tract infection during pregnancy can lead to various adverse pregnancy outcomes. However, the underlying mechanisms are not fully understood. Hence, we successfully established a mouse model of vaginal C. albicans infection and characterized the adverse pregnancy outcomes. C. albicans infection strikingly increased abortion rate and decreased litter size. Further analysis of placental development demonstrated that placental structure was abnormal, including that the area of spongiotrophoblast (Spo) and labyrinth (Lab) was reduced, and the formation of placental vessel was decreased in Lab zone. Accordingly, the expression of marker genes during placental development was downregulated. Collectively, the above findings revealed that vaginal C. albicans infection during pregnancy can inhibit placental development and ultimately lead to adverse pregnancy outcomes. This study enhances our comprehension of the effect of VVC on pregnancy, and placental dysplasia as a feasible orientation to explore VVC during pregnancy.

Sol-Gel-based reaction mixture sols have been long used to fabricate dense and uniform bioactive coatings with superior mechanical stability over metallic implants. On account of precise control over synthesis, fabrication, formed and low temperature of processing, this technology is one of the most feasible routes to produce bio-ceramic coatings. The study aims to develop a physical barrier over metal implants in form of bioinert Zirconia coatings, phase-stabilized using Dysprosium. The metallic substrates were cut into 10 mm × 10 mm samples and diamond polished after being polished with a 1000 grade emery sheet. Novel spin-coated zirconia films were fabricated over 316L Stainless steel substrates and were sintered at 600°C to obtain firm and uniform crack-free coatings. The thickness of the coatings was determined by ELCA-D meter thermal analysis was performed using TGA-DTA. Phase determination was performed using X-Ray diffraction followed by morphological investigations using Scanning electron microscopy. The corrosion resistance was evaluated with Polarization studies and electrokinetic data was derived using Tafel extrapolation. Biocompatibility evaluation was performed against MG-63 cell lines and RBCs along with bone-forming ability in vitro in SBF. Stable crack-free 3 Layer coatings fabricated at 2000 rpm for 3 s with a thickness of around 1 μm were found to be optimal for corrosion resistance behavior of steel implants at a low I Corr value of 0.501 µA/cm 2 and adhesion strength of 40.93 MPa when untreated falling down to 39.92 MPa when immersed in SBF. The study concludes that medium rpm coatings sustain enough sol to produce crack-free coatings that form a strong physical barrier between body fluid and implant surface thereby reducing the attack of corrosive ions and protecting the implant surface without participating in any form of bioactivity but supporting native bone regeneration capabilities.