CT semi-quantitative score used as risk factor for hyponatremia in patients with COVID-19: a cross-sectional study.

Purpose: Chest computed tomography (CT) is used to determine the severity of COVID-19 pneumonia, and pneumonia is associated with hyponatremia. This study aims to explore the predictive value of the semi-quantitative CT visual score for hyponatremia in patients with COVID-19 to provide a reference for clinical practice. Methods: In this cross-sectional study, 343 patients with RT-PCR confirmed COVID-19, all patients underwent CT, and the severity of lung lesions was scored by radiologists using the semi-quantitative CT visual score. The risk factors of hyponatremia in COVID-19 patients were analyzed and combined with laboratory tests. The thyroid function changes caused by SARS-CoV-2 infection and their interaction with hyponatremia were also analyzed. Results: In patients with SARS-CoV-2 infection, the total severity score (TSS) of hyponatremia was higher [M(range), 3.5(2.5-5.5) vs 3.0(2.0-4.5) scores, P=0.001], implying that patients with hyponatremia had more severe lung lesions. The risk factors of hyponatremia in the multivariate regression model included age, vomiting, neutrophils, platelet, and total severity score. SARS-CoV-2 infection impacted thyroid function, and patients with hyponatremia showed a lower free triiodothyronine (3.1 ± 0.9 vs 3.7 ± 0.9, P=0.001) and thyroid stimulating hormone level [1.4(0.8-2.4) vs 2.2(1.2-3.4), P=0.038]. Conclusion: Semi-quantitative CT score can be used as a risk factor for hyponatremia in patients with COVID-19. There is a weak positive correlation between serum sodium and free triiodothyronine in patients with SARS-CoV-2 infection.

ABCB1 genetic polymorphisms affect opioid requirement by altering function of the intestinal P-glycoprotein.

The association between polymorphisms of the human ATP binding cassette subfamily B member 1 (ABCB1) gene and opioid response has attracted intense attention recently. As the ABCB1 gene encodes for the transporter P-glycoprotein in the brain and intestine involved in the pharmacokinetics of opioids, we investigated the effects of ABCB1 genetic polymorphisms on doses of opioids for pain relief and determined which pharmacokinetic process was affected in cancer pain patients. Sixty-eight cancer pain patients admitted for intrathecal therapy (ITT) were included. The association between ABCB1 genetic polymorphisms (C3435T, C1236T, G2677T/A and A61G) and systemic doses of opioids before ITT were investigated. Concentrations of oxycodone in plasma and cerebrospinal fluid (CSF) were determined by HPLC-MS/MS in 17 patients treated with oral oxycodone before ITT, and the influences of ABCB1 genetic polymorphisms on plasma-concentration to oral-dose ratios and CSF-concentration to plasma-concentration ratios of oral oxycodone were further analyzed. ABCB1 C3435T and G2677T/A polymorphisms were significantly associated with systemic doses of opioids before ITT, which coincided with the influences of ABCB1 C3435T and G2677T/A polymorphisms on the ratios of plasma-concentration to oral-dose. However, no significant difference was found in ratios of CSF-concentration to plasma-concentration among ABCB1 SNP genotypes. The present study provided the first evidence that ABCB1 C3435T and G2677T/A polymorphisms affect opioid requirement in cancer pain patients via altering transportation function of P-glycoprotein in the intestine, which will further expand our knowledge about pharmacokinetics of opioids and could contribute to the individualization of opioids use.

Structure Engineering of Acridine Donor to Optimize Color Purity of Blue Thermally Activated Delayed Fluorescence Emitters.

9,9-Dimethyl-9,10-dihydroacridine (DMAC) is one of the most widely used electron donor for constructing high-performance thermally activated delayed fluorescence (TADF) emitters. However, DMAC-based emitters often suffer from the imperfect color purity, particularly in blue emitters, due to its strong electron-donating capability. To modulate donor strength, 2,7-F-Ph-DMAC and 2,7-CF3-Ph-DMAC were designed by introducing the electron-withdrawing 2-fluorophenyl and 2-(trifluoromethyl)phenyl at the 2,7-positions of DMAC. These donors were used, in combination with 2,4,6-triphenyl-1,3,5-triazine (TRZ) acceptor, to develop novel TADF emitters 2,7-F-Ph-DMAC-TRZ and 2,7-CF3-Ph-DMAC-TRZ. Compared to the F- or CF3-free reference emitter, both two emitters showed hypsochromic effect in fluorescence and comparable photoluminescence quantum yields without sacrificing the reverse intersystem crossing rate constants. In particular, 2,7-CF3-Ph-DMAC-TRZ based OLED exhibited a blue shift by up to 39 nm and significantly improved Commission International de l'Éclairage (CIE) coordinates from (0.36, 0.55) to (0.22, 0.41), while the external quantum efficiency kept stable at about 22.5 %. This donor engineering strategy should be valid for improving the color purity of large amount of acridine based TADF emitters. It can be predicted that pure blue TADF emitters should be feasible if these F- or CF3-modifed acridine donors are combined with other weaker electron acceptors.

A Novel Lightweight Model for Underwater Image Enhancement.

Underwater images suffer from low contrast and color distortion. In order to improve the quality of underwater images and reduce storage and computational resources, this paper proposes a lightweight model Rep-UWnet to enhance underwater images. The model consists of a fully connected convolutional network and three densely connected RepConv blocks in series, with the input images connected to the output of each block with a Skip connection. First, the original underwater image is subjected to feature extraction by the SimSPPF module and is processed through feature summation with the original one to be produced as the input image. Then, the first convolutional layer with a kernel size of 3 × 3, generates 64 feature maps, and the multi-scale hybrid convolutional attention module enhances the useful features by reweighting the features of different channels. Second, three RepConv blocks are connected to reduce the number of parameters in extracting features and increase the test speed. Finally, a convolutional layer with 3 kernels generates enhanced underwater images. Our method reduces the number of parameters from 2.7 M to 0.45 M (around 83% reduction) but outperforms state-of-the-art algorithms by extensive experiments. Furthermore, we demonstrate our Rep-UWnet effectively improves high-level vision tasks like edge detection and single image depth estimation. This method not only surpasses the contrast method in objective quality, but also significantly improves the contrast, colorimetry, and clarity of underwater images in subjective quality.

Ultrasound-Guided Radiofrequency Ablation for Chronic Osteoarthritis Knee Pain in the Elderly: A Randomized Controlled Trial.

BACKGROUND: Osteoarthritis of the knee (KOA) is the main cause of disability in elderly people. Patients with KOA may often not achieve adequate pain control even after receiving all treatment modalities. OBJECTIVES: The objective of this study was to examine the efficacy of ultrasound-guided radiofrequency ablation (RFA) as a treatment for moderate and severe KOA. STUDY DESIGN: A prospective randomized controlled study. SETTING: The study was performed in the National Pain Management and Research Center of China-Japan Friendship Hospital. METHODS: Eligible participants were over 50 years old and had suffered from chronic knee joint pain for more than 6 months, scoring at least 4 on a numeric rating scale (NRS) and grade III-IV according to the Kellgren-Lawrence classification system. The target nerve selection principle was as follows: the superomedial genicular nerve (SMGN) branch and inferior medial genicular nerve (IMGN) branch of the saphenous nerve for medial knee pain, the superolateral genicular nerve (SLGN) branch of the femoral nerve for lateral pain, and the SMGN, IMGN, and SLGN branches for total knee pain. The main outcomes were the NRS pain score (including the most severe pain), the average pain, and the proportion of patients who had reached pain reduction of more than 2 points. The secondary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC) score. RFA at 70ºC was performed for 120 seconds per patient in the RFA group, and knee nerve blocks were performed in the control group. RESULTS: A total of 120 patients who met the inclusion criteria were selected in this study. The treatment groups showed significant differences in their mean NRS scores and worst pain during the first, third, and sixth months after treatment. There were significant differences in the mean WOMAC pain, physical function, and total scores between the treatment groups and over time. Between the treatment groups and over time, the mean WOMAC stiffness scores were not different. At each time point after treatment, the proportion of patients who needed analgesic drugs was significantly lower in the RFA group than in the control group. Univariate analysis showed that gender, age, pain course, and body mass index were not significantly correlated with the positive rate (NRS >= 2 score reduction). After we adjusted for multiple factors, the perceived beneficial effect of therapy was less when gonarthritis was more severe (P < 0.01). LIMITATION: This study's limitation is that it was performed in only one unit of the National Pain Management and Research Center. CONCLUSIONS: Ultrasound-guided RFA applied to knee nerves can significantly reduce KOA pain, improve knee joint function, improve patient satisfaction, and provide a feasible, safe, and effective minimally invasive procedure for moderate to severe KOA in elderly patients.

Re-tear after arthroscopic rotator cuff repair can be predicted using deep learning algorithm.

The application of artificial intelligence technology in the medical field has become increasingly prevalent, yet there remains significant room for exploration in its deep implementation. Within the field of orthopedics, which integrates closely with AI due to its extensive data requirements, rotator cuff injuries are a commonly encountered condition in joint motion. One of the most severe complications following rotator cuff repair surgery is the recurrence of tears, which has a significant impact on both patients and healthcare professionals. To address this issue, we utilized the innovative EV-GCN algorithm to train a predictive model. We collected medical records of 1,631 patients who underwent rotator cuff repair surgery at a single center over a span of 5 years. In the end, our model successfully predicted postoperative re-tear before the surgery using 62 preoperative variables with an accuracy of 96.93%, and achieved an accuracy of 79.55% on an independent external dataset of 518 cases from other centers. This model outperforms human doctors in predicting outcomes with high accuracy. Through this methodology and research, our aim is to utilize preoperative prediction models to assist in making informed medical decisions during and after surgery, leading to improved treatment effectiveness. This research method and strategy can be applied to other medical fields, and the research findings can assist in making healthcare decisions.

Anti-competitive adsorption of gaseous benzene on hydrophilic microporous carbon in humid conditions.

The adsorption capture of ambient volatile organic compounds (VOCs) is of practical importance for air quality management. Herein, unique anti-competitive adsorption behavior of benzene on a hydrophilic activated carbon (Procarb-900 (P900)) is evidenced in the presence of competing components (e.g., formaldehyde (FA) and/or moisture). Contrary to general expectations, the adsorption capacity of 10 Pa benzene (QB) onto P900 (30 mg) at the 99 % breakthrough level improves from 144.8 to 187 mg g-1 as the relative humidity (RH) increases from 0 to 25 %. Such pattern is maintained at 183.9 mg g-1 even at the relatively high RH of 50 %. Furthermore, QB exhibits a remarkable increase of 56.1 % (to 226.0 mg g-1) in the binary phase (100 ppm benzene plus 50 ppm FA) relative to its single phase (144.8 mg g-1). The kinetic studies confirm the occurrence of anti-competitive adsorption of benzene under humid conditions with the unusual decrease in rate constants at the elevated RHs (i.e., 25 and 50 %). The thermodynamic studies suggest the exothermic nature of benzene adsorption onto P900. The hydrophilicity of P900's outer surface promotes the preferential adsorption of polar FA and water vapor over non-polar benzene, which deforms the activated carbon texture and lowers the pore size distribution (PSD). The narrow PSD enhances benzene uptake in the complex systems due to the confinement effect. Overall, this study offers insights into the unique anti-competitive adsorption of non-polar VOCs (e.g., benzene) on hydrophilic microporous adsorbents in the presence of potential interferences such as polar water vapor and FA. These findings offer a guideline for the practical implementation of adsorption techniques for gaseous VOCs in humid conditions.

Deep Learning-Based Technique for Remote Sensing Image Enhancement Using Multiscale Feature Fusion.

The present study proposes a novel deep-learning model for remote sensing image enhancement. It maintains image details while enhancing brightness in the feature extraction module. An improved hierarchical model named Global Spatial Attention Network (GSA-Net), based on U-Net for image enhancement, is proposed to improve the model's performance. To circumvent the issue of insufficient sample data, gamma correction is applied to create low-light images, which are then used as training examples. A loss function is constructed using the Structural Similarity (SSIM) and Peak Signal-to-Noise Ratio (PSNR) indices. The GSA-Net network and loss function are utilized to restore images obtained via low-light remote sensing. This proposed method was tested on the Northwestern Polytechnical University Very-High-Resolution 10 (NWPU VHR-10) dataset, and its overall superiority was demonstrated in comparison with other state-of-the-art algorithms using various objective assessment indicators, such as PSNR, SSIM, and Learned Perceptual Image Patch Similarity (LPIPS). Furthermore, in high-level visual tasks such as object detection, this novel method provides better remote sensing images with distinct details and higher contrast than the competing methods.

Effect and safety profile of topical lidocaine on post-surgical neuropathic pain and quality of life: A systematic review and meta-analysis.

STUDY OBJECTIVE: Post-surgical chronic pain with a neuropathic component is usually more severe and leads to worse quality of life. We conducted this systematic review to examine the evidence of topical lidocaine for post-surgical neuropathic pain. DESIGN: Systematic review with meta-analysis. SETTING: Published randomized controlled trials (RCTs) comparing topical lidocaine with placebo or no topical lidocaine for post-surgical neuropathic pain. PATIENTS: Seven RCTs including 585 patients. INTERVENTIONS: We systematically searched databases for randomized controlled trials (RCTs) investigating the effect and safety outcomes of topical lidocaine compared with placebo or no intervention. MEASUREMENTS: We conducted meta-analyses to evaluate the effect of topical lidocaine on pain intensity, adverse events, and quality of life. Standardized mean difference (SMD) and relative risk (RR) with 95% CIs were effect measures for continuous and dichotomous outcomes, respectively. We assessed the risk of bias of included trials and the certainty of evidence for each outcome. MAIN RESULTS: Our review included 7 studies with 585 participants. There is moderate certainty evidence that topical lidocaine may increase the likelihood of global pain relief, with a relative risk (RR) of 1.98 (95% confidence interval (CI): 1.04, 3.76; I2 = 70%, P = 0.04). Low certainty evidence suggested topical lidocaine may lead to more reduction in pain intensity (SMD: -0.70; 95% confidence interval: -1.46, 0.06; I2 = 93%, P = 0.07). High certainty evidence showed that topical lidocaine did not increase the adverse event risk (RR: 1.04; 95% CI: 0.93, 1.16; I2 = 0%, P = 0.51). CONCLUSIONS: Topical lidocaine may lead to pain relief and is safe to use for patient with post-surgical pain, though its impact on quality of life is unclear. This review supports the use of topical lidocaine for patients with post-surgical pain, and reveals the evidence gap in topical lidocaine use. (Registration: PROSPERO CRD42021294100).

Effects of the Laser Micromelting Process Parameters on the Preparation of Micron-Sized FeCrAl Coatings on Zr Alloy Surfaces.

Laser micromelting (LMM) technology allows for the remelting of pre-positioned coatings on the surface of a specimen to form a metallurgical bond with the substrate material, significantly improving the coating's film-base bond. However, the high energy input from the laser modification process can cause severe element diffusion, rendering the coating susceptible to deformation and cracking. This can be mitigated by controlling the laser power, scanning speed, and offset of the LMM process. The temperature and stress fields of the samples in the LMM process were analyzed via finite element simulation. The effects of the LMM process parameters on the coating morphology were analyzed in conjunction with experiments. The results indicated that the laser power significantly affected the morphology of the coating after remelting, and a higher scanning speed was more likely to cause the coating to accumulate stress. Additionally, a smaller offset inhibited crack generation. At a laser power of 30 W, a scanning speed of 1200 mm/min, and a scanning spacing of 0.035 mm, the surface of the coating had no obvious defects and was relatively flat, and the adhesion and corrosion resistance were significantly improved. This study provides valuable guidance for improving the preparation of micron-sized protective coatings on Zr alloy surfaces.

Investigation of the Dislocation Density of NiCr Coatings Prepared Using PVD-LMM Technology.

Micron-sized coatings prepared using physical vapor deposition (PVD) technology can peel off in extreme environments because of their low adhesion. Laser micro-melting (LMM) technology can improve the properties of the fabricated integrated material due to its metallurgical combinations. However, the microstructural changes induced by the high-energy laser beam during the LMM process have not been investigated. In this study, we used the PVD-LMM technique to prepare NiCr coatings with a controlled thickness. The microstructural changes in the NiCr alloy coatings during melting and cooling crystallization were analyzed using molecular dynamics simulations. The simulation results demonstrated that the transition range of the atoms in the LMM process fluctuated synchronously with the temperature, and the hexagonal close-packed (HCP) structure increased. After the cooling crystallization, the perfect dislocations of the face-centered cubic (FCC) structure decreased significantly. The dislocation lines were mainly 1/6 <112> imperfect dislocations, and the dislocation density increased by 107.7%. The dislocations in the twinning region were affected by the twin boundaries and slip surfaces. They were plugged in their vicinity, resulting in a considerably higher dislocation density than in the other regions, and the material hardness increased significantly. This new technique may be important for the technological improvement of protective coatings on Zr alloy surfaces.

Mathematical assessment of monkeypox disease with the impact of vaccination using a fractional epidemiological modeling approach.

This present paper aims to examine various epidemiological aspects of the monkeypox viral infection using a fractional-order mathematical model. Initially, the model is formulated using integer-order nonlinear differential equations. The imperfect vaccination is considered for human population in the model formulation. The proposed model is then reformulated using a fractional order derivative with power law to gain a deeper understanding of disease dynamics. The values of the model parameters are determined from the cumulative reported monkeypox cases in the United States during the period from May 10th to October 10th, 2022. Besides this, some of the demographic parameters are evaluated from the population of the literature. We establish sufficient conditions to ensure the existence and uniqueness of the model's solution in the fractional case. Furthermore, the stability of the endemic equilibrium of the fractional monkeypox model is presented. The Lyapunov function approach is used to demonstrate the global stability of the model equilibria. Moreover, the fractional order model is numerically solved using an efficient numerical technique known as the fractional Adams-Bashforth-Moulton method. The numerical simulations are conducted using estimated parameters, considering various values of the fractional order of the Caputo derivative. The finding of this study reveals the impact of various model parameters and fractional order values on the dynamics and control of monkeypox.

Bioremediation of Catechol and Concurrent Accumulation of Biocompounds by the Microalga Crypthecodinium cohnii.

Burgeoning commercial applications of catechol have led to its excessive accumulation in the environment, thereby posing a severe ecological threat. Bioremediation has emerged as a promising solution. The potential of the microalga Crypthecodinium cohnii to degrade catechol and use the byproduct as a carbon source was investigated in this study. Catechol significantly increased C. cohnii growth and was rapidly catabolized within 60 h of cultivation. Transcriptomic analysis highlighted the key genes involved in catechol degradation. Real-time polymerase chain reaction (RT-PCR) analysis showed that transcription of key genes CatA, CatB, and SaID involved in the ortho-cleavage pathway was remarkably increased by 2.9-, 4.2-, and 2.4- fold, respectively. Key primary metabolite content was also markedly altered, with a specific increment in polyunsaturated fatty acids. Electron microscopy and antioxidant analysis showed that C. cohnii could tolerate catechol treatment without morphological aberrations or oxidative stress. The findings provide a strategy for C. cohnii in the bioremediation of catechol and concurrent polyunsaturated fatty acids (PUFA) accumulation.

Polymer bilayer-Micro arc oxidation surface coating on pure magnesium for bone implantation.

Background: Pure magnesium-based ortho-implants have a number of advantages. However, vital parameters like degradation rate and biocompatibility still call for significant improvement. Methods: In this study, poly (1,3-trimethylene carbonate) (PTMC) and polydopamine (PDA) bilayer and micro arc oxidation composite coatings were prepared successively on magnesium surface by immersion method and microarc oxidation. Its corrosion resistance and biocompatibility were evaluated by in vitro corrosion tests, cellular compatibility experiments, and in vivo animal experiments. Results: In vitro experiments demonstrated that the composite coating provides excellent corrosion protection and biocompatibility. Animal studies demonstrated that the composite coating slowed the degradation of the implant and was not toxic to animal viscera. Conclusion: In conclusion, the inorganic-organic composite coating proposed in this study provided good corrosion resistance and enhanced biocompatibility for pure magnesium implants. The translational potential of this article: The translational potential of this article is to develop an anti-corrosion composite coating on a pure magnesium surface and to verify the viability of its use in animal models. It is hoped to open up a new approach to the design of new degradable orthopedic magnesium-based implants.

Long-term effects of a tailored mindfulness-based program for Chinese intensive care unit nurses: A randomized parallel-group trial.

AIM: This study investigated the direct and long-term improvements that mindfulness-based interventions exert on intensive care unit nurses. We assessed an abbreviated four-week, twice-weekly mindfulness-based intervention program's effect on work-related mental health variables and examined whether the intervention impact was maintained at two- and six-month follow-up assessments. We also examined the training program's effects on work and life. BACKGROUND: Previous research has shown that mindfulness interventions exert positive effects immediately after treatment. However, few studies have examined whether treatment effects are maintained over time or under different circumstances. Moreover, treatment effects among Chinese intensive care unit nurses have rarely been examined. DESIGN: We conducted a randomized, non-blinded, parallel-group trial. METHODS: Participants included 90 intensive care unit nurses, divided into two cohorts, who participated in the program in October 2016 and April 2017. They completed validated measures of mindfulness, burnout syndromes, anxiety and depressive symptoms and well-being at baseline (T1), immediately after intervention (T2), two months after (T3) and six months after (T4) the intervention. RESULTS: We observed a significant group effect (1) immediately post-intervention and two months after intervention for mindfulness; (2) at two months after intervention for anxiety, depression and subjective well-being and (3) at post-intervention, two months after and six months after for emotional exhaustion. CONCLUSIONS: These findings suggest that the tailored four-week mindfulness-based intervention program improved intensive care unit nurses' mental health, although further research is needed to verify its feasibility in a clinical working environment.

Stability Control of Quadruped Robot Based on Active State Adjustment.

The quadruped robot has a strong motion performance and broad application prospects in practical applications. However, during the movement of the quadruped robot, it is easy to be affected by external disturbance and environmental changes, which makes it unable to achieve the ideal effect movement. Therefore, it is very important for the quadruped robot to adjust actively according to its own state detection. This paper proposes an active state adjustment control method based on its own state, which can realize disturbance recovery and active environment adaptation. Firstly, the controller is designed according to the physical model of the quadruped robot, and the foot forces are optimized using the quadratic program (QP) method. Then, the disturbance compensation method based on dynamic analysis is studied and combined with the controller itself. At the same time, according to the law of biological movement, the movement process of the quadruped robot is actively adjusted according to the different movement environment, so that it can adapt to various complex environments. Finally, it is verified in a simulation environment and quadruped robot prototype. The results show that the quadruped robot has a strong active disturbance recovery ability and active environment adaptability.

Tunable composite lattice structure for low-frequency and ultra-broadband underwater sound absorption.

The underwater sound absorption technique in low-frequency and broadband has far-reaching prospects since it is essential for noise reduction of deep-sea operation requirements and evading advanced underwater target detection. Here, we propose an underwater sound-absorbing composite lattice with low-frequency and ultra-broadband characteristics. The composite lattice is constructed by regular spatially stacking cells with different sizes of metallic core spheres. All the core spheres are coated with silicon rubbers, and cells are embedded in the rubber matrix. In the composite lattice stereostructure, the lattice cells convert incident longitudinal waves into transverse waves through multiple local resonance coupling and multiple scattering. The energy is localized and dissipated in the composite lattice. We analyze the relationship among the corresponding absorption spectrums, the displacement clouds, and the resonance modes of lattice cells. Then, we construct a composite lattice and realize low-frequency broadband absorption from 693 to 1106 Hz with absorptance above 0.8. Further, our investigation demonstrates that the absorption bandwidth can be extended to ultra-broadband from 1077 to 10 000 Hz, where the thickness of the composite lattice is λ/17.05. The proposed composite lattice provides a practical approach to designing ultrathin low-frequency and ultra-broadband acoustic absorption coating for underwater noise suppression.

Enhanced efficiency of calcium-derived oleoyl serine on osteoporosis via Wnt/ß-catenin pathway.

Osteoporosis is a common disease of the elderly that affects millions of patients worldwide. It is mainly characterized by low bone mineral density and increased risk of fracture due to the deterioration of the bone structure, leading to difficulties in functional recovery, reduced quality of life, increased disability risk and mortality in the population. It has already been a major public health problem. Osteoporosis is a chronic disease that is difficult to treat in the elderly population, so it is crucial to develop new drugs for the treatment of osteoporosis. Oleoyl serine, an endogenous fatty acyl amide found in bone, has been shown to have excellent anti-osteoporosis effects, but it is easily hydrolyzed by amidases in vivo. The aim of this study is to determine the anti-osteoporotic effect of calcium-derived oleoyl serine, a novel oleoyl serine derivative and the molecular mechanism underneath. In vitro experiments demonstrated that calcium-derived oleoyl serine suppressed the expression of Fabp4, and Cebpα while Alp, and Runx2 was significantly upregulated compared with the oleoyl serine group and control. With the activation of ß-catenin, calcium-derived oleoyl serine restored the abnormal osteogenesis and lipogenesis, indicating calcium-derived oleoyl serine compared with oleoyl serine has better effects on promoting osteogenesis and suppressing lipogenesis. In vivo experiment agreed with these findings that calcium-derived oleoyl serine promotes osteogenesis and suppresses its lipogenesis to ameliorate osteoporosis via a ß-catenin dependent method. It is a new candidate for treating osteoporosis.

Comparison of external system and implanted system in intrathecal therapy for refractory cancer pain in China: A retrospective study.

INTRODUCTION: Intrathecal therapy (ITT) via an implanted system was demonstrated for the treatment of refractory cancer pain for decades. Recently, the dissemination of ITT is enhanced in an external system way in Asia for a lower implantation cost. This study compares the efficacy, safety, and cost of the two ITT systems in refractory cancer pain patients in China. METHODS: One hundred and thirty-nine cancer pain patients who underwent implantation of the ITT system were included. One hundred and three patients received ITT via the external system (external group), while 36 patients received ITT via the implanted system (implanted group). A 1:2 propensity score matching procedure was used to yield a total of 89 patients for the final analysis. Medical records of included patients were retrospectively reviewed and pain scores, incidences of complications, and costs were compared. RESULTS: ITT via the external system provided pain relief as potent as ITT via the implanted system but was less time-consuming in the implantation phase (13 vs. 19 days, p < .01). Nausea/vomiting and urinary retention were the most frequent adverse events in both external and implanted groups (32.14%, 16.07% vs. 36.36%, 21.21%). No significant difference was found in the incidences of all kinds of complications. Compared to the implanted group, the external group cost less for the initial implantation (7268 vs. 26,275 US dollar [USD], p < .001) but had a significant higher maintenance cost (606.62 vs. 20.23 USD calculated monthly, p < .001). CONCLUSIONS: ITT via the external system is as effective and safe as that via the implanted system and has the advantage of being cheap in the upfront implantation but costs more during the maintenance process in China.

The prevalence and management of chronic pain in the Chinese population: findings from the China Pain Health Index (2020).

BACKGROUND: Chronic pain is a common disease; about 20% of people worldwide suffer from it. While compared with the research on the prevalence and management of chronic pain in developed countries, there is a relative lack of research in this field in China. This research aims to construct the China Pain Health Index (CPHI) to evaluate the current status of the prevalence and management of chronic pain in the Chinese population. METHODS: The dimensions and indicators of CPHI were determined through literature review, Delphi method, and analytical hierarchy process model, and the original values ​​of relevant indicators were obtained by collecting multi-source data. National and sub-provincial scores of CPHI (2020) were calculated by co-directional transformation, standardization, percentage transformation of the aggregate, and weighted summation. RESULTS: The highest CPHI score in 2020 is Beijing, and the lowest is Tibet. The top five provinces are Beijing (67.64 points), Shanghai (67.04 points), Zhejiang (65.74 points), Shandong (61.16 points), and Tianjin (59.99 points). The last five provinces are Tibet (33.10 points), Ningxia (37.24 points), Guizhou (39.85 points), Xinjiang (39.92 points), and Hainan (40.38 points). The prevalence of chronic pain is severe in Heilongjiang, Chongqing, Guizhou, Sichuan, and Fujian. Guizhou, Hainan, Xinjiang, Beijing, and Guangdong display a high burden of chronic pain. The five provinces of Guangdong, Shanghai, Beijing, Jiangsu, and Zhejiang have better treatment for chronic pain, while Tibet, Qinghai, Jilin, Ningxia, and Xinjiang have a lower quality of treatment. Beijing, Shanghai, Qinghai, Guangxi, and Hunan have relatively good development of chronic pain disciplines, while Tibet, Sichuan, Inner Mongolia, Hebei, and Guizhou are relatively poor. CONCLUSION: The economically developed provinces in China have higher CPHI scores, while economically underdeveloped areas have lower scores. The current pain diagnosis and treatment situation in economically developed regions is relatively good, while that in financially underdeveloped areas is rather poor. According to the variations in the prevalence and management of chronic pain among populations in different provinces in China, it is necessary to implement chronic pain intervention measures adapted to local conditions.