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The mission of psychology is to enable people to lead a more meaningful and happy life, which is of great relevance to exploring the meaningfulness of life. The influence of family, as the initial environment of life, and personality, as a unique and solid characteristic of individuals, on the sense of meaning in life is of great significance. Most of the current studies have explored the influence of each on the sense of meaning in life, but few studies have linked the three. This study explores the intrinsic link between the three and concludes that family is directly related to meaning in life and indirectly influences meaning in life mediated by positive personality; personality is related to a sense of meaning in life.

Zijia Liu,1 Guangyan Xu,1 Yuelun Zhang,2 Hanyu Duan,3 Yuanyuan Zhu,4 Li Xu1 1Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Anesthesiology, Tibet Autonomous Region People’s Hospital, Lhasa, People’s Republic of China; 4Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Li Xu, Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, People’s Republic of China, Tel +86 10 6915 2020, Fax +86 10 6915 5580, Email pumchxuli@163.comPurpose: Guidelines have not recommended routine transthoracic echocardiography (TTE) for elderly patients prior to noncardiac surgery. We aimed to evaluate the significance of preoperative TTE to predict perioperative cardiac complications (PCCs) for elderly patients with coronary artery disease (CAD) undergoing noncardiac surgery.Patients and methods: We retrospectively reviewed 2204 patients over 65 years of age with CAD who underwent TTE before intermediate- or high-risk noncardiac surgery in a teaching hospital in China between September 2013 and August 2019. The revised cardiac risk index (RCRI) was assessed. PCCs comprised acute coronary syndrome, heart failure, new-onset severe arrhythmia, nonfatal cardiac arrest, and cardiac death. Logistic regression was used to build the prediction model for PCCs. Discrimination was evaluated using receiver operating characteristic curves, and a nomogram of the predictive model was constructed.Results: PCCs occurred in 189 (8.6%) patients. Multivariable analysis showed that eight clinical risk factors (age, history of myocardial infarction, insulin therapy for diabetes, New York Heart Association classification, preoperative serum creatinine, preoperative electrocardiogram ST-T abnormality and pathological Q wave, and American Society of Anesthesiologists classification) and five TTE parameters (left atrial anteroposterior dimension, left ventricular ejection fraction, left ventricular diastolic dysfunction, pulmonary hypertension, and regional ventricular wall motion abnormality) were associated with PCCs. The receiver operating characteristic curve for the clinical plus TTE model provided better discrimination for PCCs compared with the RCRI model (area under the curve: 0.731 vs 0.564; P < 0.001) and the clinical model (area under the curve: 0.731 vs 0.697, P = 0.001), respectively. The clinical plus TTE model was presented as a prognostic nomogram.Conclusion: Preoperative TTE may help predict PCCs in elderly patients with CAD undergoing noncardiac surgery, and the prognostic nomogram from this study appeared to be useful for the assessment of perioperative cardiac risk.Keywords: transthoracic echocardiography, elderly, coronary artery disease, noncardiac surgery, perioperative cardiac complication

Background:: Although esophageal carcinoma (EC) is one of the most common cancers in the world, details of its pathogenesis remain unclear. Metabolic reprogramming is a main feature of EC. Mitochondrial dysfunction, especially the decrease in mitochondrial complex I (MTCI), plays an important role in the occurrence and development of EC. Objective:: The objective of the study was to analyze and validate the metabolic abnormalities and the role of MTCI in esophageal squamous cell carcinoma. Methods:: In this work, we collected transcriptomic data from 160 esophageal squamous carcinoma samples and 11 normal tissue samples from The Cancer Genome Atlas (TCGA). The OmicsBean and GEPIA2 were used to conduct an analysis of differential gene expression and survival in clinical samples. Rotenone was used to inhibit the MTCI activity. Subsequently, we detected lactate production, glucose uptake, and ATP production. method: In this work, we collected transcriptomic data from 160 esophageal squamous carcinoma samples and 11 normal tissue samples from The Cancer Genome Atlas (TCGA). The OmicsBean and GEPIA2 was used to conduct analysis of differential gene expression and survival in clinical samples. Rotenone was used to inhibit the MTCI activity. Subsequently, we detected lactate production, glucose uptake, and ATP production. Results:: A total of 1710 genes were identified as being significantly differentially expressed. The Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis suggested that these differentially expressed genes (DEGs) were significantly enriched in various pathways related to carcinoma tumorigenesis and progression. Moreover, we further identified abnormalities in metabolic pathways, in particular, the significantly low expression of multiple subunits of MTCI genes (ND1, ND2, ND3, ND4, ND4L, ND5, and ND6). Rotenone was used to inhibit the MTCI activity of EC109 cells, and it was found that the decrease in MTCI activity promoted HIF1A expression, glucose consumption, lactate production, ATP production, and cell migration. Conclusion:: Our results indicated the occurrence of abnormal metabolism involving decreased mitochondrial complex I activity and increased glycolysis in esophageal squamous cell carcinoma (ESCC), which might be related to its development and degree of malignancy. conclusion: Our results indicate the occurrence of abnormal metabolism involving decreased mitochondrial complex I activity and increased glycolysis in esophageal squamous cell carcinoma (ESCC), which may be related to its development and degree of malignancy.

Abstract: Acute ischemic stroke is one of the leading causes of disability and death worldwide. The brain tissue adjacent to the central necrotic core was first defined as ischemic penumbra characterized by reduced cerebral blood flow (CBF) with electrical failure but maintained ionic homeostasis and transmembrane electrical potentials. Since then, the evolving concepts of the ischemic penumbra have been proposed based on energy metabolism, CBF thresholds and protein synthesis, which provide insight for the diagnosis and treatment of acute ischemic stroke. This paper summarizes the recent advances in the understanding of ischemic penumbra, from its discovery to the diagnosis methods based on imaging techniques and biomarkers, finally some of the treatments developed. In addition, we discussed future perspectives on therapeutic targets beyond ischemic penumbra to develop a treatment for acute ischemic stroke.

The adsorption and self-assembly structures of melamine molecules on an Ag(111) surface are studied by low temperature scanning tunneling microscopy (STM) combined with tip-enhanced Raman spectroscopy (TERS). Two ordered self-assembly phases of melamine molecules on Ag(111) were studied by STM and TERS, combining with first-principles simulations. The α-phase consists of flat-lying melamine molecules, while the β-phase consists of mixed up-standing/tilted melamine molecules. Moreover, dehydrogenation of melamine can be controlled by annealing the sample as well as by a tip-enhanced photo-catalytic effect. Our work demonstrates TERS as a powerful tool not only for investigating the configuration and vibration properties of molecules on a metal surface with high spatial resolution but also for manipulating the chemical reactions with tip and photo-induced effects.

Polaron is a composite quasiparticle derived from an excess carrier trapped by local lattice distortion, and it has been studied extensively for decades both theoretically and experimentally. However, atomic-scale creation and manipulation of single-polarons in real space have still not been achieved so far, which precludes the atomistic understanding of the properties of polarons as well as their applications. Herein, using scanning tunneling microscopy, we succeeded to create single polarons in a monolayer two-dimensional semiconductor, CoCl2. Combined with first-principles calculations, two stable polaron configurations, centered at on-top and hollow sites, respectively, have been revealed. Remarkably, a series of manipulation progresses, from creation, erasure to transition, can be accurately implemented on individual polarons. Our results pave the way to understand the polaronic physics at atomic level, and the easy control of single polarons in 2D semiconductor may open the door to 2D polaronics including the data storage.

Purpose The differentiation of the ameloblastoma and odontogenic keratocyst directly affects the formulation of surgical plans, while the results of differential diagnosis by imaging alone are not satisfactory. This paper aimed to propose an algorithm based on convolutional neural networks (CNN) structure to significantly improve the classification accuracy of these two tumors. Methods A total of 420 digital panoramic radiographs provided by 401 patients were acquired from the Shanghai Ninth People’s Hospital. Each of them was cropped to a patch as a region of interest by radiologists. Furthermore, inverse logarithm transformation and histogram equalization were employed to increase the contrast of the region of interest (ROI). To alleviate overfitting, random rotation and flip transform as data augmentation algorithms were adopted to the training dataset. We provided a CNN structure based on a transfer learning algorithm, which consists of two branches in parallel. The output of the network is a two-dimensional vector representing the predicted scores of ameloblastoma and odontogenic keratocyst, respectively. Results The proposed network achieved an accuracy of 90.36% (AUC = 0.946), while sensitivity and specificity were 92.88% and 87.80%, respectively. Two other networks named VGG-19 and ResNet-50 and a network trained from scratch were also used in the experiment, which achieved accuracy of 80.72%, 78.31%, and 69.88%, respectively. Conclusions We proposed an algorithm that significantly improves the differential diagnosis accuracy of ameloblastoma and odontogenic keratocyst and has the utility to provide a reliable recommendation to the oral maxillofacial specialists before surgery.

Background and aim Subretinal fibrosis resulting from neovascular age-related macular degeneration (nAMD) is one of the major causes of serious and irreversible vision loss worldwide, and no definite and effective treatment exists currently. Retinal pigmented epithelium (RPE) cells are crucial in maintaining the visual function of normal eyes and its epithelial–mesenchymal transition (EMT) is associated with the pathogenesis of subretinal fibrosis. Stem cell-derived exosomes have been reported to play a crucial role in tissue fibrosis by transferring their molecular contents. This study aimed to explore the effects of human umbilical cord-derived mesenchymal stem cell exosomes (hucMSC-Exo) on subretinal fibrosis in vivo and in vitro and to investigate the anti-fibrotic mechanism of action of hucMSC-Exo. Methods In this study, human umbilical cord-derived mesenchymal stem cells (hucMSCs) were successfully cultured and identified, and exosomes were isolated from the supernatant by ultracentrifugation. A laser-induced choroidal neovascularization (CNV) and subretinal fibrosis model indicated that the intravitreal administration of hucMSC-Exo effectively alleviated subretinal fibrosis in vivo. Furthermore, hucMSC-Exo could efficaciously suppress the migration of retinal pigmented epithelial (RPE) cells and promote the mesenchymal–epithelial transition by delivering miR-27b-3p. The latent binding of miR-27b-3p to homeobox protein Hox-C6 (HOXC6) was analyzed by bioinformatics prediction and luciferase reporter assays. Results This study showed that the intravitreal injection of hucMSC-Exo effectively ameliorated laser-induced CNV and subretinal fibrosis via the suppression of epithelial–mesenchymal transition (EMT) process. In addition, hucMSC-Exo containing miR-27b repressed the EMT process in RPE cells induced by transforming growth factor-beta2 (TGF-β2) via inhibiting HOXC6 expression. Conclusions The present study showed that HucMSC-derived exosomal miR-27b could reverse the process of EMT induced by TGF-β2 via inhibiting HOXC6, indicating that the exosomal miR-27b/HOXC6 axis might play a vital role in ameliorating subretinal fibrosis. The present study proposed a promising therapeutic agent for treating ocular fibrotic diseases and provided insights into the mechanism of action of hucMSC-Exo on subretinal fibrosis.

Large-scale jaw reconstruction can hardly achieve satisfactory results only by relying on doctors' experience. In this study, we assessed a new approach using a machine learning algorithm based on jaw feature points to assist complex jaw reconstruction in patients with maxillary and mandibular defects.One hundred and two computed tomography (CT) data on the jaw were collected and 16 skeletal marker points on the jaw were selected. The machine learning algorithm learned the positional relationship between points and built a model, which was used to predict the coordinate position of an unknown point. Then the model was used for a surgical plan in clinical cases.The linear regression model based on machine learning can control the error within 3 mm. In linear models, Lasso has a slight advantage over the others. We used Lasso to predict the missing points for two patients with maxillary and mandibular defect, respectively. The operation was carried out as planned, and the defects were successfully repaired.The restoration of jaw feature points based on a machine learning algorithm is expected to solve large-scale jaw defects without contralateral reference.

Bolted joints are major components to connect the multiple stages of disks in the aero-engine, which directly influences the motion state of the rotor system. This paper studies the effect of some typical structure parameters on the time-varying bending stiffness of the bolted disk-disk joint through finite-element simulations. Based on the Lagrange’s equations, a two-node element used to represent the bolted joint is derived, which is called the joint element. Then, a mathematical model of the rotor system with a bolted disk-disk joint supported by ball bearings is established through the Timoshenko beam and the joint element. The dynamic model is numerically solved using the Newmark-β method. The largest Lyapunov exponent, three-dimension spectral plots, and frequency-response curves are employed to reveal the effect of the bending behavior on the rotor dynamics. Comparisons indicate that the structural parameter of the bolted joint has a slight influence on motion stability, critical speed, and amplitude corresponding to the critical speed. Finally, an experimental study is conducted through a bolted-disk joint rotor test rig with an electrical tightening wrench, showing that the increase of pre-tightening torque will lead to a decrease of the amplitude corresponding to critical speed due to the hardening effect. The modeling method proposed in the present work paves a way for modeling and analyzing of the rotor system with a bolted disk-disk joint.

Zijia Liu,1 Guangyan Xu,1 Li Xu,1 Yuelun Zhang,2 Yuguang Huang1 1Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of China; 2Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of ChinaCorrespondence: Li Xu Tel +86 10 6915 2020Fax +86 10 6915 5580Email pumchxuli@163.comPurpose: Ever-increasing noncardiac surgeries are performed in patients aged 80 years or over with coronary artery disease (CAD). The objective of the study was to explore the incidence and risk factors of perioperative cardiac complications (PCCs) for the oldest-old patients with CAD undergoing noncardiac surgery, which have not been evaluated previously.Patients and Methods: A total of 547 patients, aged over 80 years, with a history of CAD who underwent noncardiac surgery were enrolled in this retrospective study. Perioperative clinical variables were extracted from the electronic medical records database. The primary outcome was the occurrence of PCCs intraoperatively or within 30 days postoperatively, defined as any of the following complications: acute coronary syndrome, heart failure, new-onset severe arrhythmia, nonfatal cardiac arrest, and cardiac death. Multivariate logistic regression analysis and multivariate Cox regression model were both performed to estimate the risk factors of PCCs. The incidence of PCCs overtime was illustrated by the Kaplan–Meier curve with a stratified Log-rank test.Results: One hundred six (19.4%) patients developed at least one PCC, and 15 (2.7%) patients developed cardiac death. The independent risk factors contributing to PCCs were age ≧85 years; body mass index ≧30 kg/m2; the history of angina within 6 months; metabolic equivalents < 4; hypertension without regular treatment; preoperative ST-T segment abnormality; anesthesia time > 3 h and drainage ≧200 mL within 24 h postoperatively.Conclusion: The incidence of PCCs in elderly patients over 80 years with CAD who underwent noncardiac surgery was high. Comprehensive preoperative evaluation, skilled surgical technique, and regular postoperative monitoring may help to reduce the occurrence of PCCs in this high-risk population.Keywords: oldest-old, coronary artery disease, noncardiac surgery, perioperative, cardiac complications

A dynamic model of the rotor-bearing system with bolted joint structure is set up based on the Lagrange’s equations, which considers the bearing clearance, the gyroscopic effect and the initial deformation due to the non-uniform preload. The nonlinear dynamic responses of the system were obtained by using the Runge–Kutta–Fehlberg method, and then the influence of the radial bearing clearance on the nonlinear dynamic behaviors of the rotor system is studied by means of bifurcation diagram, frequency spectrum, shaft orbits and Poincare maps. The results indicate that the larger bearing clearance will make the system enter into chaotic motion at a lower rotating speed. In addition, with the increase in bearing clearance, the duration of the chaotic motion becomes longer. Furthermore, the influence of initial deformation on the stability of the bolted joint rotor system with bearing clearance is studied. The results show that when the bearing clearance is present, the instability speed of the rotor system will gradually rise with the increase in initial deformation. Meanwhile, as the bearing clearance continuously increases, the regions of the chaotic motion become less and smaller, and the motion state should be completely changed under certain initial deformation. The related results can provide guidance for the optimization and design of the bolted joint rotor-bearing system.

BACKGROUND Patients with lung cancer often experience reduced functional capacity and quality of life after surgery. The current study investigated the impact of a short-term, home-based, multimodal prehabilitation program on perioperative functional capacity in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for nonsmall cell lung cancer (NSCLC). METHODS A randomized controlled trial was conducted with 73 patients. Patients in the prehabilitation group (n = 37) received a 2-week multimodal intervention program before surgery, including aerobic and resistance exercises, respiratory training, nutrition counseling with whey protein supplementation, and psychological guidance. Patients in the control group (n = 36) received the usual clinical care. The assessors were blinded to the patient allocation. The primary outcome was perioperative functional capacity measured as the 6-minute walk distance (6MWD), which was assessed at 1 day before and 30 days after surgery. A linear mixed-effects model was built to analyze the perioperative 6MWD. Other outcomes included lung function, disability and psychometric evaluations, length of stay (LOS), short-term recovery quality, postoperative complications, and mortality. RESULTS The median duration of prehabilitation was 15 days. The average 6MWD was 60.9 m higher perioperatively in the prehabilitation group compared to the control group (95% confidence interval [CI], 32.4-89.5; P < .001). There were no differences in lung function, disability and psychological assessment, LOS, short-term recovery quality, postoperative complications, and mortality, except for forced vital capacity (FVC; 0.35 L higher in the prehabilitation group, 95% CI, 0.05-0.66; P = .021). CONCLUSIONS A 2-week, home-based, multimodal prehabilitation program could produce clinically relevant improvements in perioperative functional capacity in patients undergoing VATS lobectomy for lung cancer.

Dandelions (Taraxacum spp.) are wild plants with a long history of use as a functional food and as medicine. Chlorogenic acid (CGA) and caffeic acid (CA) are organic acid components of Taraxacum antungense Kitag. that exhibit antioxidant, anti-inflammatory, and other pharmacological effects. This study aimed to determine the regulatory mechanism of CGA biosynthesis and the role of the CGA biosynthetic gene (HQT), encoding hydroxycinnamoyl-CoA quinate hydroxycinnamoyl transferase, in T. antungense. Quantitative real-time polymerase chain reaction revealed significant changes in the tissue distribution of HQT expression in T. antungense transgenic lines overexpressing HQT. CGA but not CA concentrations differed significantly between the wild-type T. antungense and transgenic lines overexpressing HQT. Further, the CGA concentration was significantly higher in the leaves than in the roots. The upregulation of TaHQT elevated the CGA levels by up to 82.49% in the leaves, whereas RNA interference (RNAi) resulted in 51.48% reduction. Comparison of physiological parameters (malondialdehyde, proline, and total chlorophyll concentrations) under salt stress conditions revealed that the overexpression lines were more salt resistant than the wild-type and RNAi lines. These findings indicate that TaHQT positively regulates the CGA biosynthesis and enhances salt tolerance in the overexpression lines.

Oesophageal cancer is one of the deadliest cancers in the world. Oesophageal squamous cell carcinoma (ESCC) is the most prevalent histological type of oesophageal cancer. Oesophageal cancer has a poor prognosis because of its invasiveness. Thus, it is especially important to seek effective treatment methods. Research indicates that long non-coding RNAs (lncRNAs) play a significant role in the occurrence and development of oesophageal cancer. The aim of this study was to describe the role of LINC00958 in ESCC. Bioinformatics and real-time quantitative polymerase chain reaction (RT-qPCR) methods were utilized to predict and verify the expression of LINC00958 in ESCC. Related functional experiments, including cell proliferation, migration and invasion, were performed. In addition, a western blot and a dual luciferase reporter gene experiment were used to study the detailed carcinogenic mechanism of LINC00958. The results indicated there was a high expression of LINC00958 in ESCC, which promoted proliferation, migration, invasion and Epithelial–Mesenchymal Transition (EMT) of ESCC cells, and this effect may be via regulating miR-510-5p.

The residential natural ventilation rates have a significant impact on indoor thermal comfort and air quality and building energy consumption. The characteristics of the indoor-outdoor temperature difference and wind pressure change over time, as well as the occupants' window opening behavior and the use of HVAC systems, resulting in the residential air change rate being dynamic with time. Many previous studies of residential ventilation measured the steady-state air change rates, which does not reflect the actual dynamic characteristics. In this study, a field measurement was conducted in a bedroom of one natural ventilation residential building in Beijing with continuously monitoring the CO2 concentration, indoor air temperature, and outdoor meteorological parameters for one year. Using the CO2 released by occupants as a tracer gas, the extended Kalman filter based on the Transient Mass Balance Equation (TMBE) was adopted to calculate the dynamic air change rate. This method can effectively filter the CO2 concentration measurement noise. The trend of air change rate with each influencing factor was analyzed. This study is expected to lay the foundation for future studies of dynamic air change rates in residential buildings.