The gut microbiota regulates the depressive-type behaviors and inflammatory processes after severe burn injuries in mice.

An emerging number of studies have recently revealed the correlation between burn injuries and psychological disorders. Gut microbiota and inflammatory factors may play a vital role in this process. Nevertheless, there are few studies conducted to disclose the potential mechanism of the gut microbiota between depression and burn injuries. In this study, we constructed a burn model of C57BL/6 mice, which showed that the symptom of depression became more and more severe with the burn of mice lasted longer. Meanwhile, there are significant differences of composition of gut microbiota among mice before and after burn. Then, we tested the inflammatory factors in the brain and peripheral blood, which showed an increased expression of Iba1, VWF, TNF-α and IL-6, and a decreased expression of IL-10 in burn mice. In addition, the expression of zonula occludens-1 (ZO-1) in cecum showed a down-regulation in burn mice, which indicated impaired intestinal barrier function. Lastly, the crossing fecal microbiota transplantation (FMT) and cohousing experiment were conducted to determine the functions of cross-transplantation of fecal microbiota on the depressive-type behaviours in burned mice. According to the score of Tail suspension test (TST), the burn mice were divided into two groups: Resilient mice (no-depressed mice) and Abnormal mice (depressed mice). After abnormal mice were transplanted with fecal microbiota of resilient mice, the symptom of depression was improved, and the expression of TNF-α, IL-6 and IL-10 return to normal levels (P < 0.05). On the contrary, after resilient mice were transplanted with fecal microbiota of abnormal mice both the TST scores and inflammatory factor developed depressive-type changes. In conclusion, our study demonstrated the changes of gut microbiota and inflammatory factors in depressed burn mice and non-depressed burn mice. The gut microbiota dysbiosis could impaired intestinal barrier function and lead to neuroinflammation, and this phenomenon could be significantly mitigated by FMT.

Clinical profile, management and risk factors for seizure-related burn injuries among patients with epilepsy in southwest China.

Objective: The epidemiological information associated with seizure-related burn injuries is lacking in China. Therefore, this study aims to analyze the clinical profile, management, outcome, and risk factors of burns that are directly caused by seizures among epileptic patients, and identify the epidemiological characteristics to develop effective preventive strategies. Methods: This study was conducted between January 2002 and December 2022 in a large Chinese burn center. Data including clinical profile, wound treatment, and outcome were analyzed. A multiple linear regression was used to screen the risk factors for the length of hospital stay (LOS), and a multiple logistic regression was used to screen the contributory factors for the amputation. Results: A total of 184 burn patients (55.98 % females) were enrolled, with a 0.78 % incidence rate during the study period. The mean age of the patients was 36.16 years (SD: 17.93). Patients aged 20-29 were the most affected age groups (23.37 %). Most burns were caused by flame, accounting for 60.33 % (111/184) of all cases. In total, 76.09 % of the 184 patients underwent at least one operation, and 35 patients (19.02 %) still required amputation during the study period. Burn sites (hands) had the greatest impact on amputation (OR = 3.799), followed by flame burns (OR = 3.723). The mean LOS/TBSA was 6.90 ± 8.53 d, and a larger TBSA, full-thickness burns, and a higher number of operations were identified as the risk factors for a longer LOS. There was one death among the 184 patients, with a mortality rate of 0.54 %. Conclusion: This study demonstrates that burn injuries are extremely harmful to individuals with epilepsy in China because they are at high risk of amputation and disability. Effective healthcare education and preventive programs that focus on lifestyle modifications and seizure control should be implemented to reduce the burn incidence in these populations.

Peripherally inserted central catheter related pericardial effusion/cardiac tamponade in neonates: Analysis of two cases and literature review.

RATIONALE: Peripherally inserted central catheter (PICC)-related pericardial effusion/cardiac tamponade is a rare but fatal complication which cause a high mortality if not timely diagnosed and treated. However, the atypical manifestations and the rapid deterioration present challenges for neonatologists, and there has been limited investigation reported globally to date. Furthermore, a systematic review and comprehensive summary of clinical management are lacking. The significance of this article lies in emphasizing the importance of maintaining vigilance in high-risk neonates and implementing effective management strategies for PICC-related pericardial effusion/cardiac tamponade, thereby contributing to saving more lives. PATIENT CONCERNS: In the current report, we discuss 2 cases of neonatal pericardial effusion/cardiac tamponade following PICC catheterization. DIAGNOSIS: The first case was diagnosed based on forensic autopsy and the second case was diagnosed by bedside echocardiography. INTERVENTIONS AND OUTCOMES: The first case was treated conservatively and the second case underwent pericardiocentesis, unfortunately both were died. LESSONS: Once sudden hemodynamic or respiratory abnormalities are detected in neonates with PICC placement, particularly in the preterm infants, prompt diagnosis by cardiac ultrasound is required to verify pericardial effusion/cardiac tamponade and immediate pericardiocentesis or pericardiotomy is necessary to improve survival.

Experimental Investigation on Microstructure Alteration and Surface Morphology While Grinding 20Cr2Ni4A Gears with Different Grinding Allowance Allocation.

Transmission gear is a key component of vehicles and its surface integrity affects the safety of the transmission system as well as the entire mechanical system. The design and optimization of allowances in form grinding are important for improving dimensional accuracy and machining efficiency during the manufacturing of heavy-duty gears. This work aims to investigate the effects of grinding allowance allocation on surface morphology, grinding temperature, microstructure, surface roughness, and microhardness fluctuation during the form grinding of 20Cr2Ni4A gears. Results indicated that grinding temperature was primarily influenced by rough grinding involving significant grinding depths exceeding 0.02 mm. The ground surface exhibited slight work hardening, while thermal softening led to a reduction in microhardness of around 40 HV. Ground surface roughness Ra varied from 0.930 µm to 1.636 µm, with an allowance allocation of the last two passes exerting the most significant influence. Analysis of surface and subsurface microstructures indicated that a removal thickness of 0.02 mm during fine grinding was insufficient to eliminate the roughness obtained from rough grinding. Evident ridges, gullies, and surface defects such as material extraction, adhesion, and plastic deformation were also observed. The proposed grinding strategy was validated in practical manufacturing with good surface quality and geometrical accuracy.

Serum iron fluctuations link ferroptosis process with mortality and prognosis of acute pancreatitis.

Recently, the existence of ferroptosis has been confirmed in chronic pancreatitis. However, its role in acute pancreatitis (AP) process, especially in critical status, has not yet been mentioned. To verify this hypothesis, we included 873 AP patients (training set) and 1,188 NAFLD patients (internal validation set) selected from MIMIC-III (Medical Information Mark for Intensive Care) database and 218 AP patients (external validation set) in Linshui County People's Hospital ICU data. We analyzed the correlation between mortality and ferroptosis associating factors (such as serum iron, ALP, lactate, etc.) in them through regression analysis. In addition, to test the significance of these factors, the nomogram, AUC, and DCA analysis were applied. The results showed that serum iron, IBC, ALP, and lactate (p < 0.05) were independent factors for the mortality and prognosis of these patients. These correlations suggest ferroptosis and follow-up cell programmed death may own an important clinical interference significance among this population.

Automated Student Classroom Behaviors' Perception and Identification Using Motion Sensors.

With the rapid development of artificial intelligence technology, the exploration and application in the field of intelligent education has become a research hotspot of increasing concern. In the actual classroom scenarios, students' classroom behavior is an important factor that directly affects their learning performance. Specifically, students with poor self-management abilities, particularly specific developmental disorders, may face educational and academic difficulties owing to physical or psychological factors. Therefore, the intelligent perception and identification of school-aged children's classroom behaviors are extremely valuable and significant. The traditional method for identifying students' classroom behavior relies on statistical surveys conducted by teachers, which incurs problems such as being time-consuming, labor-intensive, privacy-violating, and an inaccurate manual intervention. To address the above-mentioned issues, we constructed a motion sensor-based intelligent system to realize the perception and identification of classroom behavior in the current study. For the acquired sensor signal, we proposed a Voting-Based Dynamic Time Warping algorithm (VB-DTW) in which a voting mechanism is used to compare the similarities between adjacent clips and extract valid action segments. Subsequent experiments have verified that effective signal segments can help improve the accuracy of behavior identification. Furthermore, upon combining with the classroom motion data acquisition system, through the powerful feature extraction ability of the deep learning algorithms, the effectiveness and feasibility are verified from the perspectives of the dimensional signal characteristics and time series separately so as to realize the accurate, non-invasive and intelligent children's behavior detection. To verify the feasibility of the proposed method, a self-constructed dataset (SCB-13) was collected. Thirteen participants were invited to perform 14 common class behaviors, wearing motion sensors whose data were recorded by a program. In SCB-13, the proposed method achieved 100% identification accuracy. Based on the proposed algorithms, it is possible to provide immediate feedback on students' classroom performance and help them improve their learning performance while providing an essential reference basis and data support for constructing an intelligent digital education platform.

Grinding Force and Surface Formation Mechanisms of 17CrNi2MoVNb Alloy When Grinding with CBN and Alumina Wheels.

The 17CrNi2MoVNb alloy is widely used for manufacturing heavy-duty gears in vehicles' transmission systems, where grinding is a significant process affecting gears' working performance and service life. This work comprehensively analyzed the grinding force, surface morphology, and surface roughness when grinding 17CrNi2MoVNb alloy using alumina and CBN grinding wheels. Results showed that the maximum normal grinding force from the CBN wheel was only ~67% of the one from the alumina wheel. Due to the small size and limited cutting depth of CBN grains, the grinding force increased by about 20% when the grinding depth increased from 0.02 to 0.03 mm for CBN grinding wheels. Surface defects, including cavities and material tearing, were mainly found on the ground surface when using an alumina grinding wheel. The surface roughness Ra recorded from the CBN grinding wheel mainly ranged from 0.263 to 0.410 µm, accounting for less than 40% of the one from the alumina grinding wheel. The information from this work could provide benchmark data and references for optimizing grinding tools and parameters when manufacturing gears in the vehicle industry.

Surface Morphology and Subsurface Microstructure Evolution When Form Grinding 20Cr2Ni4A Alloys.

20Cr2Ni4A alloy is widely used in the manufacturing of heavy-duty gears, although limited information about its machinability during the form-grinding process has been reported. In this work, form-grinding trials on transmission gears of 20Cr2Ni4A alloy under various parameters were conducted. Surface morphology of the gear tooth, surface roughness distribution and microstructure evolution of the machined surface layer were comprehensively studied, and the influence of grinding parameters on grinding performance was investigated. The formation mechanisms of surface/subsurface defects during the form-grinding process, including plastic flow, deep grooves, successive crushing zone, adhesive chips and cavities, were analyzed. Results showed that the change in contact conditions between the grinding wheel and tooth surface led to the decrease in the surface roughness from tooth tip to root. Mechanical force and grinding heat promoted the deformation and refinement of the microstructure within the machined surface layer. With the increase in cutting depth and feed speed, the deformation ratio of the microstructure increased, which was also consistent with the variation trend in the form-grinding temperature.

Grinding Temperature and Surface Integrity of Quenched Automotive Transmission Gear during the Form Grinding Process.

Grinding burn is an undesired defect in gear machining, and a white layer is an indication of severe burn that is detrimental to gear surface performance. In this work, the influence of grinding parameters on the thickness of the white layer during form grinding of quenched transmission gear was investigated, and the microstructure evolution and mechanism of severe burn formation were analyzed. The grinding temperature increased with the grinding depth and grinding speed, with the highest level of ~290 °C. The thickness of the white layer exceeded 100 µm when the grinding depth was 0.03 mm, and the top layer was a plastic deformation layer followed by a fine-grained martensite layer. Coarse-grained acicular martensite was found at the interface between the white layer and softened dark layer. The mechanical effect and thermal softening mainly contributed to the formation of white layer stratification. The ground surface topography showed several scratches and typical grooves; when grinding depth increased to 0.03 mm, the grinding surface roughness Sa was relatively high and reached up to ~0.60 µm, mainly owing to severe plastic deformation under grinding wheel extrusion and the thermal effect.

Older age and depressive state are risk factors for re-positivity with SARS-CoV-2 Omicron variant.

Background: The reinfection rate of SARS-CoV-2 Omicron variant is high; thus, exploring the risk factors for reinfection is important for the effective control of the epidemic. This study aimed to explore the effects of psychological and sleep factors on re-positivity with Omicron. Methods: Through a prospective cohort study, 933 adult patients diagnosed with Omicron BA.2.2 infection and testing negative after treatment were included for screening and follow-up. We collected data on patients' demographic characteristics, SARS-CoV-2 Omicron vaccination status, anxiety, depression, and sleep status. Patients underwent nucleic acid testing for SARS-CoV-2 Omicron for 30 days. Regression and Kaplan-Meier analyses were used to determine the risk factors for re-positivity of Omicron. Results: Ultimately, 683 patients were included in the analysis. Logistic regression analysis showed that older age (P = 0.006) and depressive status (P = 0.006) were two independent risk factors for Omicron re-positivity. The odds ratios of re-positivity in patients aged ≥60 years and with a Patient Health Questionnaire-9 (PHQ-9) score ≥5 was 1.82 (95% confidence interval:1.18-2.78) and 2.22 (1.27-3.85), respectively. In addition, the time from infection to recovery was significantly longer in patients aged ≥60 years (17.2 ± 4.5 vs. 16.0 ± 4.4, P = 0.003) and in patients with PHQ-9≥5 (17.5 ± 4.2vs. 16.2 ± 4.5, P = 0.026). Kaplan-Meier analysis showed that there was a significantly higher primary re-positivity rate in patients aged ≥60 years (P = 0.004) and PHQ-9 ≥ 5 (P = 0.007). Conclusion: This study demonstrated that age of ≥60 years and depressive status were two independent risk factors for re-positivity with Omicron and that these factors could prolong the time from infection to recovery. Thus, it is necessary to pay particular attention to older adults and patients in a depressive state.

How to survive a periviable birth baby with birth weight of 450g: A case report.

RATIONALE: An increasing number of periviable birth newborns (PVBs) have emerged with concurrent growing high-risk pregnancy. To date, postnatal management of PVBs remains one of the most challenging issues and limited studies have been reported. PATIENT CONCERNS: A female baby born at 230/7 weeks of gestation with birth weight of 450g. DIAGNOSIS: PVB baby, respiratory distress syndrome (RDS), ventilator associated pneumonia (VAP), intraventricular hemorrhage (IVH), metabolic bone disease of prematurity (MBDP), transient hypothyroxinemia of prematurity (THOP), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). INTERVENTIONS: Individualized treatment and intensive care, including neonatal resuscitation, effective respiratory and circulatory support, venous access and nutrition, prevention and treatment of infection, management of endocrine and metabolic problems, individualized nursing such as developmental supportive care, integrated oral motor interventions, skin care, family-integrated-care, etc were performed according to existing literature. OUTCOMES: The baby was discharged home after 138 days of hospitalization with body weight of 2700 g, a full oral feed achieved, and without any requirement of respiratory support or oxygen supply. Now she is 38-month-old, with no significant long-term adverse sequelae. LESSONS: Our case expands the experience and knowledges of individualized and intensive management of PVB babies in their early life days, which increase PVBs' survival and improves their prognosis.

An interpretation of "congenital hypothyroidism: a 2020-2021 consensus guidelines update-an ENDO-European Reference Network initiative endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology". / 《2020~2021å¹´æ¬§æ´²å† åˆ†æ³Œå‚è€ƒç½‘å ±è¯†æŒ‡å—ï¼šå ˆå¤©æ€§ç”²çŠ¶è ºåŠŸèƒ½å‡ä½Žç—‡ã€‹è§£è¯».

Congenital hypothyroidism is one of the common diseases causing delayed intelligence development and growth retardation in children. In 2021, the ENDO-European Reference Network updated the practice guidelines for the diagnosis and management of congenital hypothyroidism. The guidelines give a comprehensive and detailed description of the screening, diagnosis, and management of congenital hypothyroidism in neonates. This article gives an interpretation of the guidelines in order to provide a reference for clinicians in China.

Rock Particle Motion Information Detection Based on Video Instance Segmentation.

The detection of rock particle motion information is the basis for revealing particle motion laws and quantitative analysis. Such a task is crucial in guiding engineering construction, preventing geological disasters, and verifying numerical models of particles. We propose a machine vision method based on video instance segmentation (VIS) to address the motion information detection problem in rock particles under a vibration load. First, we designed a classification loss function based on Arcface loss to improve the Mask R-CNN. This loss function introduces an angular distance based on SoftMax loss that distinguishes the objects and backgrounds with higher similarity. Second, this method combines the abovementioned Mask R-CNN and Deep Simple Online and Real-time Tracking (Deep SORT) to perform rock particle detection, segmentation, and tracking. Third, we utilized the equivalent ellipse characterization method for segmented particles, integrating with the proportional calibration algorithm to test the translation and detecting the rotation by calculating the change in the angle of the ellipse's major axis. The experimental results show that the improved Mask R-CNN obtains an accuracy of 93.36% on a self-created dataset and also has some advantages on public datasets. Combining the improved Mask R-CNN and Deep SORT could fulfill the VIS with a low ID switching rate while successfully detecting movement information. The average detection errors of translation and rotation are 5.10% and 14.49%, respectively. This study provides an intelligent scheme for detecting movement information of rock particles.

miR-19a-3p downregulates tissue factor and functions as a potential therapeutic target for sepsis-induced disseminated intravascular coagulation.

Sepsis-induced disseminated intravascular coagulation (DIC) is a common life-threatening terminal-stage disease with high mortality. This study aimed to identify effective miRNAs as therapeutic targets for DIC. Bioinformatics and luciferase reporter gene analyses were performed to predict miR-19a-3p and validate that it targets tissue factor (TF). Quantitative real-time PCR was used to detect the expression of miR-19a-3p and TF, and TF procoagulant activity was determined using the chromogenic substrate method. Western blotting was used to detect the protein levels of TF, AKT serine/threonine kinase (AKT), extracellular regulated protein kinases (ERK), nuclear factor kappa B (NF-κB) P65, NFKB inhibitor alpha (IκB-a) and their phosphorylated counterparts in cell experiments. Furthermore, a rat model was established to explore the potential of miR-19a-3p in DIC treatment. As a result, a human clinical study revealed that miR-19a-3p was downregulated and that TF was upregulated in neonates with sepsis-induced DIC compared with those in the control group. The luciferase reporter assay showed that TF was a direct target of miR-19a-3p. Cell experiments verified that the mRNA and protein levels of TF, and the p-AKT/AKT, p-Erk/Erk, p-P65/P65, p-IκB-a/IκB-a ratios, and TF procoagulant activity were significantly decreased in lipopolysaccharide (LPS) -induced human peripheral blood mononuclear cells (PBMCs) and human umbilical vein endothelial cells (HUVECs) inhibited by overexpression of miR-19a-3p, and that miR-19a-3p regulating TF was dependent on the NF-kB and AKT pathways. In vivo, miR-19a-3p injection into DIC rats suppressed the mRNA expression of TF; more importantly, significant improvements in coagulation function indicators and in histopathologies of lung and kidney were observed. In conclusion, miR-19a-3p may suppress DIC by targeting TF and might be a potential therapeutic target in treating sepsis-induced DIC.

Bovine surfactant in the treatment of pneumonia-induced-neonatal acute respiratory distress syndrome (NARDS) in neonates beyond 34 weeks of gestation: a multicentre, randomized, assessor-blinded, placebo-controlled trial.

Neonatal acute respiratory distress syndrome (NARDS) reflects pulmonary surfactant dysfunction, and the usage of bovine surfactant (Calsurf) supplement may therefore be beneficial. To determine whether bovine surfactant given in NARDS can improve oxygenation and survival rate, we conducted a multicenter, randomized trial between January 2018 and June 2019, and we compared Calsurf treatment to controls in neonates with pneumonia accompanied by NARDS. Neonates who met the Montreux criteria definition of NARDS were included, and those with congenital heart and lung malformations were excluded. Primary outcomes were oxygenation index (OI) after Calsurf administration, and secondary outcomes were mortality, and duration of ventilator and oxygen between the two groups, and also other morbidities. Cumulatively, 328 neonates were recruited and analyzed, 162 in the control group, and 166 in the Calsurf group. The results shows that OI in the Calsurf group were significantly lower than that in the control group at 4 h (7.2 ± 2.7 and 11.4 ± 9.1, P = 0.001); similarly, OI in the Calsurf group were significantly lower than in the control group at 12 h ( 7.5 ± 3.1 and 11.2 ± 9.2, P = 0.001). Mortality and duration of ventilator support or oxygen use between the two groups were not significantly different.Conclusion: Calsurf acutely improved OI immediately after administration in pneumonia-induced NARDS; although, we observed no significant decrease in mortality, duration of ventilator or oxygen, or major morbidity. What is known: • The definition proposed as the Monteux criteria for neonatal acute respiratory distress syndrome (NARDS). • Surfactant acutely improved oxygenation and significantly decreased mortality in children and adolescents with acute lung injury. What is new: • This is the first large randomized controlled trail to study on surfactant treatment of neonates with acute respiratory distress syndromes. • Surfactant acutely improved oxygenation immediately after administration in pneumonia-induced NARDS at a gestational age beyond 34 weeks.

[Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia].

OBJECTIVE: To investigate the effect of electroacupuncture (EA) analgesia at the latent stage of labor on epidural analgesia, labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia. METHODS: According to the random number table, 104 primipara of vaginal delivery were divided into three groups, named an EA group (37 cases), a sham-EA group (36 cases) and an epidural block group (31 cases). In the EA group, when the cervix opened up by 1 cm, Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu (LI4) and bilateral Sanyinjiao (SP6) to achieve EA analgesia till the active stage (the cervix up 3 cm). In the sham-EA group, the procedure was same as the EA group, but with the sham-stimulation. In the epidural block, EA was not used in intervention. When the cervix opened up 3 cm, the epidural block and the patient-controlled epidural analgesia were all adopted in each group. The score of visual analogue scale (VAS) and the dosage of Sufentanil and Ropivacaine in patient-controlled analgesia pump at the different time points were compared among the groups. Respectively, in 1 h of EA stimulation (T1), 2 h of EA stimulation (T2), at the moment of epidural block (T3) and the complete open of the cervix (T6), the venous blood sample was collected to determine the concentration of beta-endorphin (beta-EP), and the use time of oxytocin, the bleeding amount and the state of newborn were recorded. RESULTS: There was no statistical difference in immediate of EA stimulation (T0) among the groups in VAS score (P>0.05). But, in T1 to T6, VAS score in the EA group was reduced obviously as compared with the sham-EA group and the epidural block group separately (P<0.05). There was no statistical difference in the use time of oxytocin among the three groups (P>0.05). In the sham-EA group and the epidural block group, bleeding amount during labor and in 24 h after labor was all higher than that of the EA group (P<0.05). In each group, the concentration of beta-EP in T3 and T6 was increased obviously as compared with that in T1 and T2 respectively (P<0.05). In the EA group, the concentration of beta-EP in T1 to T3 and in T6 was higher than that in sham-EA group and the epidural block group respectively (P<0.05). The dosage of Ropivacaine and Sufentanil in the EA group was less than that in either the sham-EA group or the epidural block group (P<0.05). There was no significant difference in amniotic fluid turbidity rate and Apgar score among the three groups (P>0.05). CONCLUSION: Electroacupuncture analgesia at the latent stage of labor effectively relieves labor pain of primipara, increases the concentration of beta-EP, enhances the effect of epidural block analgesia, reduces labor bleeding and has no side effect on newborn. The combination of electroacupuncture analgesia and the epidural anesthesia in the latent stage is applicable in the whole process of labor.

COVID-19: Considerations for Children and Families During the Pandemic.

Coronavirus disease 2019 (COVID-19), a fatal virus caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a pandemic across the world. Despite early concerns, children appear to be less susceptible to acquiring SARS-CoV-2 and manifest minor clinical symptoms compared with adults. However, there still exists a risk of physical and psychological health problems in children and their families. In this review, we summarize the existing information about the mechanism of SARS-CoV-2 infection, the epidemiology of COVID-19, and the clinical manifestations, treatments, and further considerations regarding COVID-19 in children.

[Effect of preemptive electroacupuncture on pain reactions in primiparous parturients during vaginal delivery].

OBJECTIVE: To investigate the effect of preemptive electroacupuncture (EA) plus epidural block (EB) on pain reactions and stress hormone levels in primiparous parturients during labor. METHODS: A total of 104 primiparous parturients undergoing vaginal delivery were randomly divided into PA group (n=31), sham EA group (n=36) and EA group (n=37). EA (2 Hz/100 Hz, a tolerable strength) was applied to bilateral Hegu (LI4) and Sanyinjiao (SP6) beginning from the latency of the 1st birth process when the orifice of uterus was opened to about 1 cm wider till the active stage when the orifice of the uterus opened about 3 cm wider. Patients in the sham EA group received shallow acupuncture needle stimulation (without cutaneous penetration of the needle tip, and without stimulation electric current output). All the patients of the 3 groups were given EB (1% Lidocaine, 0.05% Sufentanil and 0.1% Ropivacaine) and patient-controlled epidural analgesia (PCEA) when the orifice of the uterus opened about 3 cm wider. The pain severity was assessed by using Visual Analogue Scale (VAS) at time-points of immediately after EA, 1 h after EA, 2 h after EA, immediately after EB, 1 h after EB, 2 h after EB and full open of the uterus orifice. The contents of serum adrenocorticotrophic hormone (ACTH) and cortisol (COR) were assayed by using ELISA. RESULTS: There was no significant difference in the VAS score at the immediate time of post-EA among the three groups (P>0.05). Compared with the EB group, the VAS scores at all time-points except the immediate time of post-EA were significantly decreased in the EA group (P<0.05). One and 2 h after EB, and after full open of the uterus orifice, the VAS scores in the 3 groups were all evidently decreased (P<0.05), and those of the EA group were significantly lower than those of the sham EA and EB groups (P<0.05). The three groups had a significant increase in the levels of serum ACTH and COR at time-points of 1 and 2 h after EA, immediately after EB, and when the orifice of the uterus was fully opened (P<0.05), presenting a gradual increase of their level during the course of labor. Compared with the EB group, the levels of serum ACTH and COR contents were considerably decreased in the EA group (rather than in the sham EA group) (P<0.05). The dosages of Ropivacaine and Sufentanil, the total pressing times and the effective pressing times of PCEA pump were significantly lower in the EA group than those in the EB and sham EA groups (P<0.05). CONCLUSION: EA plus epidural analgesia, given during the latency period of labor, can effectively alleviate pain, inhibit stress response and reduce the dosage of anesthetics in primiparous parturients throughout the labor process.

Improving tribological and anti-bacterial properties of titanium external fixation pins through surface ceramic conversion.

In this study, an advanced ceramic conversion surface engineering technology has been applied for the first time to self-drilling Ti6Al4V external fixation pins to improve their performance in terms of biomechanical, bio-tribological and antibacterial properties. Systematic characterisation of the ceramic conversion treated Ti pins was carried out using Scanning electron microscope, X-ray diffraction, Glow-discharge optical emission spectroscopy, nano- and micro-indentation and scratching; the biomechanical and bio-tribological properties of the surface engineered Ti pins were evaluated by insertion into high density bone simulation material; and the antibacterial behaviour was assessed with Staphylococcus aureus NCTC 6571. The experimental results have demonstrated that the surfaces of Ti6Al4V external fixation pins were successfully converted into a TiO2 rutile layer (~2 µm in thickness) supported by an oxygen hardened case (~15 µm in thickness) with very good bonding due to the in-situ conversion nature. The maximum insertion force and temperature were reduced from 192N and 31.2 °C when using the untreated pins to 182N and 26.1 °C when the ceramic conversion treated pins were tested. This is mainly due to the significantly increased hardness (more than three times) and the effectively enhanced wear resistance of the cutting edge of the self-drilling Ti pins following the ceramic conversion treatment. The antibacterial tests also revealed that there was a significantly reduced number of bacteria isolated from the ceramic conversion treated pins compared to the untreated pins of around 50 % after 20 h incubation, P < 0.01 (0.0024). The results reported are encouraging and could pave the way towards high-performance anti-bacterial titanium external fixation pins with reduced pin-track infection and pin loosing.

An in vivo study of hypoxia-inducible factor-1α signaling in ginsenoside Rg1-mediated brain repair after hypoxia/ischemia brain injury.

BACKGROUND: Hypoxia/ischemia (HI) brain injury is a common central nervous system insult in newborns. Studies have demonstrated bioactivity of ginsenoside Rg1 in increasing neural viability and promoting angiogenesis. However, there are few reports on roles of Rg1 in brain repair of neonatal HI, and the mechanisms involved are unclear. METHODS: a neonatal HI model was established by a modified Rice-Vannucci model (RVM) and pups received ginsenoside Rg1 or monosialotetrahexosyl ganglioside (GM1) treatment. Neurological function and pathologic damage of rats were evaluated. Cellular apoptosis was detected with Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Immunohistochemistry for von willebrand factor (vwf) was used to label micro vessels. Expression levels of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and cleaved caspase 3 (CC3) were detected by western blot. RESULTS: Both Rg1 and GM1 reduced neurological impairment and pathologic damage after HI by enhancing neural survival. Rg1, but not GM1, could also facilitate angiogenesis after HI. These pharmacological effects of Rg1 may be attributed to regulation of expression level of VEGF and CC3 and HIF-1α signaling pathway was involved. CONCLUSION: Rg1 plays a neuroprotective role in brain repair following neonatal HI, and HIF-1α is a potential target for therapeutic intervention in neonates with HI brain injury.