[The experience on the construction of the cluster prevention and control system for COVID-19 infection in designated hospitals during the period of "Category B infectious disease treated as Category A"].

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features.

STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated. METHODS: A retrospective study was carried out on a sample of 290 patients who underwent L4-5 TLIF at Zhongda Hospital, Southeast University, from January 2015 to January 2021. The study collected baseline data and preoperative radiographic features of L3-4 and L5-S1. The determination of the outcome variable was based on X-ray results spanning over 24 months and JOA scores. Multivariate logistic regression was used to identify the risk factors in constructing a nomogram. RESULTS: Independent risk factors for L3-4 degeneration after TLIF included osteoarthritis of L3-4 facet joints, L3-4 foraminal stenosis, L4 upper endplate osteochondritis, L3-4 local lordosis angle, and L3-4 spinal stenosis. Independent risk factors for L5-S1 degeneration after TLIF included osteoarthritis of L5-S1 facet joints, L5-S1 intervertebral disc degeneration, L5-S1 spinal stenosis, L5-S1 coronal imbalance, and S1 upper endplate osteochondritis. A predictive model was developed. The AUC for the prediction models at L3-4 and L5-S1 were .945 and .956. The calibration curve demonstrated good consistency between the predicted and actual probabilities. The DCA curve indicated the clinical benefit and practical value of this predictive model. CONCLUSION: This study established nomograms for postoperative degeneration at L3-4 and L5-S1 based on selected preoperative radiographic features. These models provide a valuable auxiliary decision-making system for clinicians and aid in early surgical decisions.

Phenamacril and carbendazim regulate trichothecene mycotoxin synthesis by affecting ROS levels in F. asiaticum.

Fusarium head blight caused by Fusarium asiaticum is an important cereal crop disease, and the trichothecene mycotoxins produced by F. asiaticum can contaminate wheat grain, which is very harmful to humans and animals. To effectively control FHB in large areas, the application of fungicides is the major strategy; however, the application of different types of fungicides has varying influences on the accumulation of trichothecene mycotoxins in F. asiaticum. In this study, phenamacril inhibited trichothecene mycotoxin accumulation in F. asiaticum; however, carbendazim (N-1H-benzimidazol-2-yl-carbamic acid, methyl ester) induced trichothecene mycotoxin accumulation. Additionally, phenamacril led to a lower level of reactive oxygen species (ROS) by inducing gene expression of the catalase and superoxide dismutase (SOD) pathways in F. asiaticum, whereas carbendazim stimulated ROS accumulation by inhibiting gene expression of the catalase and SOD pathways. Based on these results, we conclude that phenamacril and carbendazim regulate trichothecene mycotoxin synthesis by affecting ROS levels in F. asiaticum.

vwa1 Knockout in Zebrafish Causes Abnormal Craniofacial Chondrogenesis by Regulating FGF Pathway.

Hemifacial microsomia (HFM), a rare disorder of first- and second-pharyngeal arch development, has been linked to a point mutation in VWA1 (von Willebrand factor A domain containing 1), encoding the protein WARP in a five-generation pedigree. However, how the VWA1 mutation relates to the pathogenesis of HFM is largely unknown. Here, we sought to elucidate the effects of the VWA1 mutation at the molecular level by generating a vwa1-knockout zebrafish line using CRISPR/Cas9. Mutants and crispants showed cartilage dysmorphologies, including hypoplastic Meckel's cartilage and palatoquadrate cartilage, malformed ceratohyal with widened angle, and deformed or absent ceratobranchial cartilages. Chondrocytes exhibited a smaller size and aspect ratio and were aligned irregularly. In situ hybridization and RT-qPCR showed a decrease in barx1 and col2a1a expression, indicating abnormal cranial neural crest cell (CNCC) condensation and differentiation. CNCC proliferation and survival were also impaired in the mutants. Expression of FGF pathway components, including fgf8a, fgfr1, fgfr2, fgfr3, fgfr4, and runx2a, was decreased, implying a role for VWA1 in regulating FGF signaling. Our results demonstrate that VWA1 is essential for zebrafish chondrogenesis through effects on condensation, differentiation, proliferation, and apoptosis of CNCCs, and likely impacts chondrogenesis through regulation of the FGF pathway.

Revisiting the environmental kuznets curve hypothesis in 208 counties: The roles of trade openness, human capital, renewable energy and natural resource rent.

Achieving carbon neutral requires a comprehensive understanding of the effect of different key factors on carbon emissions. To this end, this study investigates the effect of trade openness, human capital, renewable energy and natural resource rent on carbon emissions within the framework of the environmental Kuznets curve (EKC) hypothesis. Second-generation econometric tests, Generalized Method of Moments and Fully Modified Ordinary Least Squares estimator were developed based on the aggregated dataset of 208 countries from 1990 to 2018. The results show that (i) the EKC hypothesis is validated when the effects of trade openness, human capital, renewable energy consumption, and natural resource rents are considered. The relationship between income level and carbon emissions shows an "inverted U-shaped" curve at the global level. Besides, the real GDP per capita corresponding to the EKC turning point is 19,203$. (ii) Renewable energy consumption and human capital have heterogeneous effects on carbon emissions in before- and after-EKC turning points. Specifically, renewable energy consumption has a better emission reduction effect for countries before the EKC turning point, with effects of -0.4334 and -0.1598, respectively; human capital has a better emission reduction effect for countries after the EKC turning point, with effects of -0.6311 and -0.3398, respectively.(iii) the mitigation effect of trade openness on carbon emissions is only effective in countries with weak decoupling after EKC turning points, with a mitigating effect of -0.0615. However, natural resource rents increase carbon emissions in most countries.

Melatonin Attenuates Ropivacaine-Induced Apoptosis by Inhibiting Excessive Mitophagy Through the Parkin/PINK1 Pathway in PC12 and HT22 Cells.

Melatonin, as an endogenous circadian indoleamine secreted by the pineal gland, executes extensive biological functions, including antioxidant, anti-inflammatory, anti-tumor, and neuroprotective effects. Although melatonin has been reported to serve as a potential therapeutic against many nerve injury diseases, its effect on ropivacaine-induced neurotoxicity remains obscure. Our research aimed to explore the impact and mechanism of melatonin on ropivacaine-induced neurotoxicity. Our results showed that melatonin pretreatment protected the cell viability, morphology, and apoptosis of PC12 and HT22 cells, and it also improved ropivacaine-induced mitochondrial dysfunction and the activation of mitophagy. In addition, we found that autophagy activation with rapamycin significantly weakened the protective effect of melatonin against ropivacaine-induced apoptosis, whereas autophagy inhibition with 3-MA enhanced the effect of melatonin. We also detected the activation of Parkin and PINK1, a canonical mechanism for mitophagy regulation, and results shown that melatonin downregulated the expression of Parkin and PINK1, and upregulated Tomm20 and COXIV proteins, so that those results indicated that melatonin protected ropivacaine-induced apoptosis through suppressing excessive mitophagy by inhibiting the Parkin/PINK1 pathway. Melatonin may be a useful potential therapeutic agent against ropivacaine-induced neurotoxicity.

Do environmental regulation and urbanization help decouple economic growth from water consumption at national and subnational scales in China?

Moving to economic growth without water consumption growth is essential to sustainability of both water and economy. This work is aimed to estimate the decoupling state between economic growth and water consumption and then to investigate the effects of urbanization and environmental regulation on water consumption at national and subnational scales using panel data of 30 provinces in China from 2004 to 2019. The decoupling results show that (i) there are only two types between China's water consumption and economic growth: weak decoupling (80%) and strong decoupling (20%); (ii) the weak decoupling has transitioned to strong decoupling after 2013; and that (iii) the decoupling degree of the water-poor region is weaker than that of the water-rich region. The results of causal relationships estimation show that an average 1% increase in urbanization level and environmental regulation leads to 0.3359% and 0.0104% drop in water consumption, respectively, which indicates that urbanization and environmental regulation have inhibited water consumption at the national scale. At the subnational sale, the effects of environmental regulation and urbanization on water consumption are heterogeneous. An average 1% increase in environmental regulation led to only a 0.0161% drop in water consumption in the water-poor region, whereas an average 1% increase in urbanization level led to only a 0.9838% drop in water consumption in the water-rich region. This means that the inhibition of environmental regulation on water use appears in the water-poor region, while the inhibition of urbanization is more prominent in the water-rich region.

Ropivacaine Induces Cell Cycle Arrest in the G0/G1 Phase and Apoptosis of PC12 Cells via Inhibiting Mitochondrial STAT3 Translocation.

STAT3 has neuroprotective effect via non-canonical activation and mitochondrial translocation, but its effect on ropivacaine-induced neurotoxicity remains unclear. Our previous study revealed that apoptosis was an important mechanism of ropivacaine-induced neurotoxicity; this study is to illustrate the relationship between STAT3 with ropivacaine-induced apoptosis. Those results showed that ropivacaine treatment decreased cell viability, induced cell cycle arrest in the G0/G1 phase, apoptosis, oxidative stress, and mitochondrial dysfunction in PC12 cells. Moreover, ropivacaine decreased the phosphorylated levels of STAT3 at Ser727 and downregulated the expression of STAT3 upstream gene IL-6. The mitochondrial translocation of STAT3 was also hindered by ropivacaine. To further illustrate the connection of STAT3 protein structure with ropivacaine, the autodock-vina was used to examine the interaction between STAT3 and ropivacaine, and the results showed that ropivacaine could bind to STAT3's proline site and other sites. In addition, the activator and inhibitor of mitoSTAT3 translocation were used to demonstrate it was involved in ropivacaine-induced apoptosis; the results showed that enhancing the mitochondrial STAT3 translocation could prevent ropivacaine-induced apoptosis. Finally, the expression of p-STAT3 and the levels of apoptosis in the spinal cord were also detected; the results were consistent with the cell experiment; ropivacaine decreased the expression of p-STAT3 protein and increased the levels of apoptosis in the spinal cord. We demonstrated that ropivacaine induced apoptosis by inhibiting the phosphorylation of STAT3 at Ser727 and the mitochondrial STAT3 translocation. This effect was reversed by the activation of the mitochondrial STAT3 translocation.

P53 inhibitor pifithrin-α inhibits ropivacaine-induced neuronal apoptosis via the mitochondrial apoptosis pathway.

The neurotoxicity of local anesthetics (LAs) has attracted more and more attention, However, they lack preventive and therapeutic measures. Many studies have shown that apoptosis plays an important role in the process of LA-induced neurotoxicity. As an important signaling molecule to activate apoptosis, p53 has been proved to be involved in the neurotoxicity induced by LAs, but the mechanism is unclear. In this study, we explored the effect of pifithrin-α (PFT-α), a p53 inhibitor, on apoptosis by ropivacaine (Rop) in vivo and in vitro. Cell viability and apoptosis detected by CCK-8 and a JC-1 apoptosis detection kit, the changes of spinal cord structure observed after hematoxylin and eosin staining, apoptosis of the spinal cord measured by terminal deoxynucleotidyl transferase dUTP nick end labeling staining, behavioral assessment of the nerve Injury evaluated by the detection of sciatic nerve conduction velocity (SNCV) andmechanical withdrawal threshold (MWT), the expression of p53 and many apoptosis-related genes included Bax, Bcl-2, and caspase-3 detected by quantitative real-time polymerase chain reaction, Western blot analysis, immunofluorescence, and immunohistochemistry. Results showed that PC12 cell viability decreased because of Rop, but the pretreatment of PFT-α could protect it. And PFT-α reduced the injuries in the spinal cord by Rop included vacuoles or edema. The results of immunofluorescence and immunohistochemistry testing showed that PFT-α inhibited the p53 protein upregulated by Rop. Apoptosis rate and many proapoptotic genes include p53, Bax, caspase-3 messenger RNA, and proteins were increased by Rop, but PFT-α could decrease it. In conclusion, PFT-α inhibited cell apoptosis and spinal cord injuries induced by Rop.

Does robotic-assisted thymectomy have advantages over video-assisted thymectomy in short-term outcomes? A systematic view and meta-analysis.

OBJECTIVES: A thymic epithelial tumour is the most common primary tumour in the anterior mediastinum of adults. A few retrospective studies compared the short-term outcomes between robotic-assisted thymectomy (RAT) and video-assisted thymectomy (VAT). So, it is necessary to conduct a meta-analysis to further compare these 2 surgical techniques. METHODS: EMBASE, Medline and Web of Science were used. Thesaurus terms and medical subject headings were used in Medline and EMBASE, respectively. The Newcastle-Ottawa scale was used for grading because the included studies were all case-control studies. RESULTS: Nine studies were included in the meta-analysis with a total of 723 patients, including 315 patients in the RAT group and 408 patients in the VAT group. The meta-analysis [odds ratio (OR) 0.24, 95% confidence interval (CI) 0.06-0.94; P = 0.041], indicating that RAT yielded a significantly lower rate of conversion compared with VAT. Duration of drainage with RAT was significantly less than that with VAT (weighted mean difference = -1.10; 95% CI -1.98 to -0.22; P = 0.014). The pooled analysis (weighted mean difference = -103.6; 95% CI -199.21 to -7.98; P = 0.034) suggested that patients in the RAT group had less drainage than those in the VAT group. The recurrence rates in both groups were comparable (OR 0.19, 95% CI 0.03-1.20; P = 0.078). CONCLUSIONS: RAT has advantages over VAT in terms of short-term outcomes such as shorter duration of drainage, less total drainage and a lower rate of conversion. The recurrence rate was comparable between the 2 techniques. Therefore, RAT could be considered as an alternative treatment for diseases of the thymus.

What does the China's economic recovery after COVID-19 pandemic mean for the economic growth and energy consumption of other countries?

China is the first major economy to show a recovery after a slowdown induced by the COVID-19 pandemic. This work aims to explore what the China's economic recovery after the COVID-19 pandemic means for the economic growth and energy consumption of the other countries using the global VAR quarterly data. In the long term, spillover effects of China's economic growth have the most obvious impact on upper-middle-income countries' economic growth (0.17%), followed by the economic growth of lower-middle-income countries (0.16%) and high-income countries (0.15%). However, the spillover effect of China's economic growth has the most significant impact on energy consumption in high-income countries (0.11%-0.45%), followed by energy consumption in upper-middle-income countries (0.08%-0.33%) and in lower-middle-income countries (-0.02%-0.05%). Our results indicate upper-middle-income countries will benefit the most from China's economic recovery post-COVID-19, followed by lower-middle-income countries and high-income countries. The spillover effect of China's economic recovery post-COVID-19 brings the most obvious impact on the increase in energy consumption in high-income countries, followed by middle-income countries. It also should be noted that the spillover effect of China's economic growth does not necessarily lead to an increase in energy consumption lower-middle-income countries. Generally, the spillover effect of China's economic recovery on other countries' economic growth is much more than other countries' energy consumption.

The effects of trade openness on decoupling carbon emissions from economic growth - Evidence from 182 countries.

The current rise of protectionism has become the main uncertainty associated with global energy, economy, and the environment. Furthermore, the decoupling carbon emissions from economic growth is crucial for implementing Intended Nationally Determined Contributions (INDCs). These INDCs would be discounted if decreasing carbon emissions would require sacrificing economic growth. This study explored the effect of protectionism (by measuring trade openness based on available data) on the decoupling carbon emissions from economic growth. For this, the heterogenous effects of trade openness on carbon emissions were investigated using in data of 182 countries from 1990 to 2015. The results show that trade openness decreased carbon emissions in high-income and upper-middle-income countries, while having no significant impact on carbon emissions of lower-middle-income countries; even worse, for low-income countries, trade openness increased carbon emissions. The heterogeneous effects of trade openness on carbon emissions indicate that trade openness positively impacts the decoupling economic growth from carbon emission in rich countries, but negatively impacts poor countries. In addition, increasing individual incomes and population distort the decoupling economic growth from carbon emissions. Renewable energy and high oil prices contributed to the decoupling economic growth from carbon emissions. These effects are similar in all countries. Targeted policy implications are presented that enable the decoupling economic growth from carbon emissions for countries with different income levels.

Microscopic removal of type III dens invaginatus and preparation of apical barrier with mineral trioxide aggregate in a maxillary lateral incisor: A case report and review of literature.

BACKGROUND: Invaginated teeth pose greater challenges in clinical management because of their complex configuration. With advancements in equipment and materials, such as the dental operation microscope, cone-beam computed tomography and mineral trioxide aggregate, the preservation rate of type III dens invaginatus could be greatly increased. CASE SUMMARY: This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth. With the aid of cone-beam computed tomography, type III dens invaginatus with apical periodontitis was diagnosed and confirmed. Three-visit endodontic treatment was performed. In the first visit, the invagination was carefully removed under the dental operation microscope, and chemomechanical preparation was done. In the second visit, mineral trioxide aggregate apical barrier surgery was performed in this tooth. In the third visit, the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology. A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations. CONCLUSION: In this case, removal of the entire abnormal structure provided great convenience for the follow-up treatment. When confronted with the same clinical case in the future, we can take a similar approach to address it.

Ropivacaine mesylate exerts neurotoxicity via up-regulation of Fas/FasL expression in rat pheochromocytoma PC12 cells.

It has been shown that local anesthetics have potential neurotoxicity, but the exact mechanism remains unclear. In this study, PC12 cells were treated with different concentrations of ropivacaine mesylate (0.1, 0.5, 1, 2 and 4 mmol/L) for 24 h, the cell viability was assessed by CCK-8 assay. Then, cells in 0.5 mmol/L ropivacaine group, 2 mmol/L ropivacaine group and control group were subjected to morphological observation under a light microscope, assessment of cell necrosis by Hoechst33342/PI staining and apoptosis by Annexin V-FITC/PI staining, and the detection of Fas and FasL expression by qPCR, immunofluorescence and Western blot. Results showed that the cell viability decreased significantly (P<0.05), necrosis and apoptosis rate increased markedly (P<0.05), and the expression of Fas, FasL, caspase-3 and caspase-8 increased dramatically (P<0.05) with the increase in the concentration of ropivacaine mesylate. Therefore, ropivacaine mesylate may induce the apoptosis of PC12 cells, which may be related to the up-regulation of Fas/FasL.

Assessment of the Second Mesiobuccal Root Canal in Maxillary First Molars: A Cone-beam Computed Tomographic Study.

INTRODUCTION: The purpose of this study was to investigate the incidence and location of the second mesiobuccal (MB2) root canal of the maxillary first molar and the relationship between the presence of an MB2 canal and the distribution of canal orifices on the pulpal floor with the aid of cone-beam computed tomographic (CBCT) technology. METHODS: A total of 1008 maxillary first molars (548 patients) were randomly selected and analyzed through CBCT imaging. The association between the incidence of MB2 canals and potential impacting factors including sex, side, age, and the distribution of the main root canal orifices on the pulpal floor was explored. The interorifice distances (ie, the length of a line between the center point of any 2 orifices) at the pulpal floor level were measured using Mimics 10.01 software (ImageWorks, Materialise, Belgium). RESULTS: The majority of 3-rooted maxillary first molars showed 2 root canals (85.4%) in the mesiobuccal root. The incidence of MB2 canals had no statistically significant difference between the left and right sides (P > .05) but had a significant association with the patients' sex and age (P < .05). Receiver operating characteristic curve analysis showed a high diagnostic accuracy (the area under the receiver operating characteristic curve = 0.92) of using the distance ratio of the interorifice distance between the main mesiobuccal and the palatal root canal orifices to the interorifice distance between the distobuccal and the palatal root canal orifices to predict the presence of an MB2 canal. A larger distance ratio (>1.26) indicated a highly probable existence of an MB2 canal. In this study, no molar presented an MB2 canal with a distance ratio of less than 1.16, whereas all molars with a ratio greater than 1.37 presented an MB2 canal without exception. A Bland-Altman scatterplot showed great agreement between the distances of the main mesiobuccal and the distobuccal canal orifices and the second mesiobuccal and the distobuccal canal orifices. CONCLUSIONS: Understanding the incidence of MB2 canals and the distribution pattern of canal orifices on the pulpal floor may help clinicians to quickly identify and locate MB2 canals.

N-arylated-lactam-type iminosugars as new immunosuppressive agents: discovery, optimization, and biological evaluation.

We have previously described the discovery of N-alkylated iminosugars that showed immunosuppressive activity both in vitro and in vivo. Herein, we report the synthesis and biological evaluation of N-arylated lactam-type iminosugar derivatives. The synthesis started from simple monosaccharides and featured a Buchwald-Hartwig coupling reaction to construct the key N-aryl connection, thereby providing a highly diverse compound library. Structure-activity relationship studies, guided by a mouse-spleen-proliferation assay, led to the identification of 'hit' compound 12 f. Subsequently, the systematic modification of compound 12 f afforded compounds 21 h, 21 k, 21 n, 21 t, and 21 x with improved activities (IC50 =12-30 µM) and low Jurkat cytotoxicities (IC50 >100 µM). These new compounds also inhibited the secretion of IFN-γ and IL-4, which are hallmark cytokines of Th1 and Th2 cells, respectively. This work demonstrated that the N-arylated iminosugar structure represents a new scaffold with immunosuppressive activity.