Wood-Structured Nanomaterials as Highly Efficient, Self-Standing Electrocatalysts for Water Splitting.

Electrocatalytic water splitting (EWS) driven by renewable energy is widely considered an environmentally friendly and sustainable approach for generating hydrogen (H2), an ideal energy carrier for the future. However, the efficiency and economic viability of large-scale water electrolysis depend on electrocatalysts that can efficiently accelerate the electrochemical reactions taking place at the two electrodes. Wood-derived nanomaterials are well-suited for serving as EWS catalysts because of their hierarchically porous structure with high surface area and low tortuosity, compositional tunability, cost-effectiveness, and self-standing integral electrode configuration. Here, recent advancements in the design and synthesis of wood-structured nanomaterials serving as advanced electrocatalysts for water splitting are summarized. First, the design principles and corresponding strategies toward highly effective wood-structured electrocatalysts (WSECs) are emphasized. Then, a comprehensive overview of current findings on WSECs, encompassing diverse structural designs and functionalities such as supported-metal nanoparticles (NPs), single-atom catalysts (SACs), metal compounds, and heterostructured electrocatalysts based on engineered wood hosts are presented. Subsequently, the application of these WSECs in various aspects of water splitting, including the hydrogen evolution reaction (HER), oxygen evolution reaction (OER), overall water splitting (OWS), and hybrid water electrolysis (HWE) are explored. Finally, the prospects, challenges, and opportunities associated with the broad application of WSECs are briefly discussed. This review aims to provide a comprehensive understanding of the ongoing developments in water-splitting catalysts, along with outlining design principles for the future development of WSECs.

High Isolation MIMO Antenna System for 5G N77/N78/N79 Bands.

This paper presents a symmetric dual-band multiple-input multiple-output (MIMO) antenna system tailored for fifth-generation (5G) mobile terminals. Operating within the 5G frequency bands N77/N78 (3.4-3.6 GHz) and N79 (4.8-5.0 GHz), the proposed MIMO system achieves high isolation between adjacent antenna elements through slotting and self-decoupling technologies. Antenna elements are strategically positioned on two frames perpendicular to the smartphone's main board. Each antenna element integrates a rectangular microstrip radiator on the inner frame surface, accompanied by a grounded rectangular ring on the outer frame surface. The feed line, situated atop the main board, connects to an external SMA connector located at the main board's bottom. Measurement results reveal isolations exceeding 20 dB for the lower band and 24 dB for the higher band. The fabricated and tested MIMO antenna system demonstrates excellent agreement between simulation and measurement outcomes.

Hydrazone-Linked Covalent Organic Frameworks.

Hydrazone-linked covalent organic frameworks (COFs) with structural flexibility, heteroatomic sites, post-modification ability and high hydrolytic stability have attracted great attention from scientific community. Hydrazone-linked COFs, as a subclass of Schiff-base COFs, was firstly reported in 2011 by Yaghi's group and later witnessed prosperous development in various aspects. Their adjustable structures, precise pore channels and plentiful heteroatomic sites of hydrazone-linked structures possess much potential in diverse applications, for example, adsorption/separation, chemical sensing, catalysis and energy storage, etc. Up to date, the systematic reviews about the reported hydrazone-linked COFs are still rare. Therefore, in this review, we will summarize their preparation methods, characteristics and related applications, and discuss the opportunity or challenge of hydrazone-linked COFs. We hope this review could provide new insights about hydrazone-linked COFs for exploring more appealing functions or applications.

Clinical features of patients with rheumatic and musculoskeletal diseases during the coronavirus disease 2019 pandemic and the association of its relapse with infection: Across-sectional study.

AIM: The aim of this study was to investigate the clinical features of patients with rheumatic and musculoskeletal diseases (RMDs) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the relationship between RMDs relapse and SARS-CoV-2 infection. METHODS: We carried out a cross-sectional observational study among 585 patients with RMDs and 619 individuals without RMDs. Data on demographics, the clinical features of coronavirus disease 2019 (COVID-19), antirheumatic therapy, and RMD relapse were collected. Differences between RMDs and control groups, infected and uninfected groups, relapse and non-relapse RMDs groups were examined. The influence of COVID-19 infection on medications and relapse of RMDs was also assessed. RESULTS: Among 1204 participants finally recruited for analysis, 1030 (85.5%) were infected with COVID-19. Seven hundred and ninety-five (77.2%) of infected individuals were female, and the median age was 40 years (IQR 33, 50). Patients in the RMD group had a relatively lower risk of COVID-19 symptoms whereas were significantly more likely to require hospitalization (6.7% vs. 2.2%). In the RMDs group, younger patients who were under the age of 65 were more likely to report more symptoms. More patients with RMD relapse (27, 34.6%) adjusted their medications during the period of COVID-19 infection than those without relapse (59, 13.2%). CONCLUSION: Patients with RMDs were at lower risk of symptoms of COVID-19. Rheumatic and musculoskeletal disease patients experience a higher risk of relapse especially when they adjust medications during COVID-19 infection. The long-term prognosis of infected RMDs patients need further investigation.

Zigzag Hopping Site Embedded Covalent Organic Frameworks Coating for Zn Anode.

Precise design and tuning of Zn hopping/transfer sites with deeper understanding of the dendrite-formation mechanism is vital in artificial anode protective coating for aqueous Zn-ion batteries (AZIBs). Here, we probe into the role of anode-coating interfaces by designing a series of anhydride-based covalent organic frameworks (i.e., PI-DP-COF and PI-DT-COF) with specifically designed zigzag hopping sites and zincophilic anhydride groups that can serve as desired platforms to investigate the related Zn2+ hopping/transfer behaviours as well as the interfacial interaction. Combining theoretical calculations with experiments, the ABC stacking models of these COFs endow the structures with specific zigzag sites along the 1D channel that can accelerate Zn2+ transfer kinetics, lower surface-energy, homogenize ion-distribution or electric-filed. Attributed to these superiorities, thus-obtained optimal PI-DT-COF cells offer excellent cycling lifespan in both symmetric-cell (2000 cycles at 60 mA cm-2) and full-cell (1600 cycles at 2 A g-1), outperforming almost all the reported porous crystalline materials.

Heterostructured Co/CeO2-Decorating N-Doped Porous Carbon Nanocubes as Efficient Sulfur Hosts with Enhanced Rate Capability and Cycling Durability toward Room-Temperature Na-S Batteries.

Room-temperature sodium-sulfur (RT Na-S) batteries have gained significant interest thanks to their satisfactory energy density and abundant earth resources. Nevertheless, practical implementations of RT Na-S batteries are still impeded by serious shuttle effects of sodium polysulfide (NaPS) intermediates, sluggish redox kinetics of cathodes, and poor electronic conductivity from S-species. To solve these problems, heterostructured Co/CeO2-decorating N-doped porous carbon nanocubes (Co/CeO2-NPC) are constructed as a S support, which integrates the strong adsorption and fast conversion of NaPSs, together with superior electronic conductivity. Consequently, the as-synthesized S@Co/CeO2-NPC cathode for RT Na-S batteries exhibits improved rate performance (1275, 561.1, and 485 mAh g-1 at 0.1, 5, and 10 C, respectively) and superior cyclic durability (capacity degeneration of 0.027% per cycle after 1000 cycles at 5 C). Such a S cathode combining a heterostructure interface, hierarchical porous carbon nanocubes, and polar compositions can considerably increase electronic conductivity and promote NaPS adsorption and conversion, achieving superior performance toward RT Na-S batteries.

Eight-Element Dual-Band Multiple-Input Multiple-Output Mobile Phone Antenna for 5G and Wireless Local Area Network Applications.

This paper proposes an eight-element dual-band multiple-input multiple-output (MIMO) antenna that operates in the fifth generation (5G), n78 (3400-3600 MHz), and WLAN (5275-5850 MHz) bands to accommodate the usage scenarios of 5G mobile phones. The eight antenna elements are printed on two long frames, which significantly reduce the usage of the internal space of the mobile phone. Each antenna element is printed on both surfaces of one frame, which consists of a radiator on the internal surface and a defected ground plane on the outer surface. The radiator is a rectangular ring fed by a 50 Ω microstrip line which is printed on the top surface of the system board. A parasitic unit is printed on the outer surface of each frame, which is composed of an inverted H-shaped and four L-shaped patches. Each parasitic unit is connected to the internal surface of the frames through a via, and then it is connected to a 1.5 mm wide microstrip line on the top surface of the system board, which is connected to the ground plane on the bottom surface of the system board by a via. Four L-shaped slots, four rectangular slots, and four U-shaped slots are etched onto the system board, which provides good isolation between the antenna elements. Two merged rectangular rings are printed on the center of each frame, which improves the isolation further. The return loss is better than 6 dB, and the isolation between the units is better than 15 dB in the required working frequency bands. In addition, the use of a defected ground structure not only makes the antenna element obtain better isolation but also improves the overall working efficiency. The measurement results show that the proposed MIMO antenna structure can be an ideal solution for 5G and WLAN applications.

A Miniature Eight-Port Antenna Array Based on Split-Ring Resonators for 5G Sub-6 GHz Handset Applications.

In this article, a miniature eight-port multiple-input multiple-output (MIMO) antenna array is proposed for fifth-generation (5G) sub-6 GHz handset applications. The individual antenna element comprises a radiator shaped like the Chinese character "" (phonetically represented as "Wang") and three split-ring resonators (SRR) on the metal frame. The size of the individual antenna element is only 6.8 × 7 × 1 mm3 (47.6 mm3). The proposed antenna element has a -10 dB impedance bandwidth of 1.7 GHz (from 3.3 GHz to 5 GHz) that can cover 5G New Radio (NR) sub-6 GHz bands N77 (3.3-4.2 GHz), N78 (3.3-3.8 GHz), and N79 (4.4-5 GHz). The evolution design, the current distribution, the effects of single-handed holding, and the analysis of the parameters are deduced to study the approach used to design the featured antenna. The measured total efficiencies are from 40% to 80%, the isolation is better than 12 dB, the calculated envelope correlation coefficient (ECC) is less than 0.12, and the calculated channel capacity (CC) ranges from 35 to 38 bps/Hz. The presented antenna array is a good alternative to 5G mobile handsets with wideband operation, a metal frame, and minimized spacing.

Polydatin protects against calcium oxalate crystal-induced renal injury through the cytoplasmic/mitochondrial reactive oxygen species-NLRP3 inflammasome pathway.

BACKGROUND: Oxidative stress and inflammatory responses are critical factors in calcium oxalate (CaOx) crystal-induced renal injury. Reactive oxygen species (ROS) are usually produced in the cytoplasm and mitochondria and trigger the priming and activation of the NLRP3 inflammasome, thereby regulating cytokines and inflammation. Polydatin is a plant rhizome extract with anti-inflammatory, antioxidant, and antitumor effects. However, it remains not clear whether and how these pathophysiological processes exists in CaOx crystal-induced renal inflammatory injury. METHODS: Here, we measured the expression of the NLRP3 inflammasome, IL-18, IL-1ß, intracellular and mitochondrial ROS (mtROS) levels and relevant morphological changes in treated renal tubular epithelial cells (TECs) and stone-forming rats. The study further explored the action of intracellular ROS and mtROS on these inflammatory damage, and the beneficial effects and pathway of polydatin. RESULTS: We verified that CaOx crystal-induced cytoplasmic ROS and mtROS upregulation promoted the priming and activation of the NLRP3 inflammasome, thereby stimulating IL-18/1ß maturation and activation. Polydatin can relieve oxidative stress and inflammatory damage by decreasing ROS. We further demonstrated that mtROS is the main target for polydatin to exert the NLRP3 inflammasome-regulating function. The inhibition of mtROS can effectively relieve the inflammatory damage to TECs and kidney caused by CaOx crystal. CONCLUSION: These findings provide new insight into the relationship between mitochondrial damage and inflammation in nephrolithiasis and show that polydatin-mediated anti-inflammatory and antioxidative protection is a therapeutic strategy for, but not limited to, crystalline nephropathy.

Identifying Cancer Driver Pathways Based on the Mouth Brooding Fish Algorithm.

Identifying the driver genes of cancer progression is of great significance in improving our understanding of the causes of cancer and promoting the development of personalized treatment. In this paper, we identify the driver genes at the pathway level via an existing intelligent optimization algorithm, named the Mouth Brooding Fish (MBF) algorithm. Many methods based on the maximum weight submatrix model to identify driver pathways attach equal importance to coverage and exclusivity and assign them equal weight, but those methods ignore the impact of mutational heterogeneity. Here, we use principal component analysis (PCA) to incorporate covariate data to reduce the complexity of the algorithm and construct a maximum weight submatrix model considering different weights of coverage and exclusivity. Using this strategy, the unfavorable effect of mutational heterogeneity is overcome to some extent. Data involving lung adenocarcinoma and glioblastoma multiforme were tested with this method and the results compared with the MDPFinder, Dendrix, and Mutex methods. When the driver pathway size was 10, the recognition accuracy of the MBF method reached 80% in both datasets, and the weight values of the submatrix were 1.7 and 1.89, respectively, which are better than those of the compared methods. At the same time, in the signal pathway enrichment analysis, the important role of the driver genes identified by our MBF method in the cancer signaling pathway is revealed, and the validity of these driver genes is demonstrated from the perspective of their biological effects.

Hollow Nitrogen-Doped porous carbon spheres decorated with atomically dispersed Ni-N3 sites for efficient electrocatalytic CO2 reduction.

Hollow nitrogen-doped porous carbon spheres (HNCS) with plentiful coordination N sites, high surface area, and superior electrical conductivity are ideal catalyst supports due to their easily access of reactants to active sites and excellent stability. To date, nevertheless, little has been reported on HNCS as supports to metal-single-atomic sites for CO2 reduction (CO2R). Here we report our findings in preparation of nickel-single-atom catalysts anchored on HNCS (Ni SAC@HNCS) for highly efficient CO2R. The obtained Ni SAC@HNCS catalyst exhibits excellent activity and selectivity for the electrocatalytic CO2-to-CO conversion, achieving a Faradaic efficiency (FE) of 95.2% and a partial current density of 20.2 mA cm-2. When applied to a flow cell, the Ni SAC@HNCS delivers above 95% FECO over a wide potential range and a peak FECO of 99%. Further, there is no obvious degradation in FECO and the current for CO production during continuous electrocatalysis of 9 h, suggesting good stability of Ni SAC@HNCS.

Management of Rheumatoid Arthritis With a Digital Health Application: A Multicenter, Pragmatic Randomized Clinical Trial.

IMPORTANCE: Digital health applications have been shown to be effective in the management of chronic diseases with simple treatment targets. The potential clinical value of digital health applications in rheumatoid arthritis (RA) has not been well studied. OBJECTIVE: To investigate whether assessing patient-reported outcomes using digital health applications could result in disease control for patients with RA. DESIGN, SETTING, AND PARTICIPANTS: This is a multicenter, open-label randomized clinical trial in 22 tertiary hospitals across China. Eligible participants were adult patients with RA. Participants were enrolled from November 1, 2018, to May 28, 2019, with a 12-month follow-up. The statisticians and rheumatologists who assessed disease activity were blinded. Investigators and participants were not blind to group assignment. Analysis was conducted from October 2020 to May 2022. INTERVENTIONS: Participants were randomly assigned at a 1:1 ratio (block size of 4) to a smart system of disease management group (SSDM) or a conventional care control group. Upon the completion of the 6-month parallel comparison, patients in the conventional care control group were instructed to use the SSDM application for an extension of 6 months. MAIN OUTCOMES AND MEASURES: The primary outcome was the rate of patients with disease activity score in 28 joints using the C-reactive protein (DAS28-CRP) of 3.2 or less at month 6. RESULTS: Of 3374 participants screened, 2204 were randomized, and 2197 patients with RA (mean [SD] age, 50.5 [12.4] years; 1812 [82.5%] female) were enrolled. The study included 1099 participants in the SSDM group and 1098 participants in the control group. At month 6, the rate of patients with DAS28-CRP of 3.2 or less was 71.0% (780 of 1099 patients) in the SSDM group vs 64.5% (708 of 1098 patients) in the control group (difference between groups, 6.6%; 95% CI, 2.7% to 10.4%; P = .001). At month 12, the rate of patients with DAS28-CRP of 3.2 or less in the control group increased to a level (77.7%) that was comparable with that (78,2%) in the SSDM group (difference between groups, -0.2%; 95% CI, -3.9% to 3.4%; P = .90). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of RA, the use of a digital health application with patient-reported outcomes was associated with an increase in disease control rate. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03715595.

Characteristics of recurrent acute urinary retention in BPH patients in the United States: Retrospective analysis of US-based insurance claims database.

PURPOSE: The objective of this study is to analyze characteristics of recurrent acute urinary retention (AUR) in patients with benign prostatic hyperplasia (BPH), utilizing a population based data set. Also, we sought to report on how AUR was treated, specifically regarding the need and length of catheterization and types of procedures utilized for mitigation. MATERIALS & METHODS: A retrospective observational cohort study was performed using Optum's deidentified Clinformatics® Data Mart Database. We compared two groups, BPH patients with AUR (n = 180,737) and BPH patients without AUR (n = 1,139,760) from January 1, 2003 to December 31, 2017. Also, we analyzed the factors affecting the development of multiple episodes of AUR through age-adjusted multivariate analysis. RESULTS: In contrast to the 47.7% of patients who had a single AUR episode, 33.5% of AUR patients developed 3 or more subsequent episodes of retention. For age matched patients, the risks of additional episodes of retention increase significantly with older age, Caucasian race, diabetes, neurologic conditions, or low income. Overall, the rate of BPH surgery in AUR patients over the study period decreased and the most common procedure was transurethral resection of the prostate. CONCLUSIONS: Risk factors for multiple episodes of AUR included age (60 and older), Caucasian race, lower income socioeconomic status, diabetes, and neurological disorders. Patients with a high probability of developing recurrent episodes of AUR are recommended to receive preemptive BPH medication before such AUR occurrences. Also, more expeditious surgical treatment should be considered rather than temporary catheterization when AUR occurs.

Chemically modified small interfering RNA targeting Hedgehog signaling pathway for rheumatoid arthritis therapy.

Rheumatoid arthritis (RA) is an inflammatory disease that leads to disability; however, existing therapies are still unsatisfactory. Activated fibroblast-like synoviocytes (FLSs) play an essential role in synovitis formation and joint destruction in RA. The Hedgehog signaling pathway is aberrantly activated and contributes to the aggressive phenotype of RA-FLSs. However, it remains uncertain whether inhibiting Smoothened (SMO), a critical component of the Hedgehog signaling pathway, is an effective treatment for RA. Here, we design a series of small interfering RNAs (siRNAs) that specifically target the SMO gene. With precise chemical modifications, siRNAs' efficacy and stability are significantly improved, and the off-target effects are minimized. The optimized chemically modified siRNA (si-S1A3-Chol) decreases RA-FLS proliferation and invasiveness without the transfection reagent. Furthermore, si-S1A3-Chol injected intra-articularly effectively alleviates joint destruction and improves motor function in collagen-induced arthritis mouse models. Consequently, our results demonstrate that chemically modified siRNA targeting the Hedgehog signaling pathway may be a potential therapy for RA.

Integrated Micro Space Electrostatic Field in Aqueous Zn-Ion Battery: Scalable Electrospray Fabrication of Porous Crystalline Anode Coating.

The inhomogeneous consumption of anions and direct contact between electrolyte and anode during the Zn-deposition process generate Zn-dendrites and side reactions that can aggravate the space-charge effect to hinder the practical implementation of zinc-metal batteries (ZMBs). Herein, electrospray has been applied for the scalable fabrication (>10 000 cm2 in a batch-experiment) of hetero-metallic cluster covalent-organic-frameworks (MCOF-Ti6 Cu3 ) nanosheet-coating (MNC) with integrated micro space electrostatic field for ZMBs anode protection. The MNC@Zn symmetric cell presents ultralow overpotential (≈72.8 mV) over 10 000 cycles at 1 mAh cm-2 with 20 mA cm-2 , which is superior to bare Zn and state-of-the-art porous crystalline materials. Theoretical calculations reveal that MNC with integrated micro space electrostatic field can facilitate the deposition-kinetic and homogenize the electric field of anode to significantly promote the lifespan of ZMBs.

Contemporary trends in the surgical management of urinary incontinence after radical prostatectomy in the United States.

PURPOSE: To identify trends, costs, and predictors in the use of different surgical procedures for post-radical prostatectomy incontinence (PPI). MATERIALS AND METHODS: We identified 21,589 men who were diagnosed with localized prostate cancer (PCa) and treated with radical prostatectomy (RP) from 2003 to 2017. The primary outcome was the incontinence procedure performances. Optum's de-identified Clinformatics® Data Mart Database was queried to define the cohort of interest. The average costs of the different incontinence procedures were obtained and compared. Also, demographic, and clinical predictors of incontinence surgery were evaluated by multivariable regression analysis. RESULTS: Of the 21,589 men with localized PCa treated with RP, 740 (3.43%) underwent at least one incontinence procedure during a median of 5 years of follow-up. In total, there were 844 unique incontinence procedures. Male slings were the most common procedure (47.5%), had an intermediate cost compared to the other treatment options, and was the first-choice treatment for the majority of patients (50%). The use of an artificial urinary sphincter (AUS) was the second most common (35.3%), but also was the most expensive treatment and was first-choice-treatment for 32.3% of patients. On multivariable analysis, metabolic syndrome related disorders, adjuvant/salvage radiation therapy as well as a history of neurological comorbidities were independently associated with an increased likelihood of incontinence surgery. CONCLUSIONS: The receipt of male slings increased and then subsequently decreased, while AUS utilization was stable, and the use of urethral bulking agents was uncommon. From a cost standpoint, AUS was the most expensive option. Finally, patient's comorbidity history and RP related factors were found to influence the choice for primary or subsequent PPI interventions.

Zeolitic Imidazolate Frameworks Derived Co9 S8 /Nitrogen-Doped Hollow Porous Carbon Spheres as Efficient Bifunctional Electrocatalysts for Rechargeable Zinc-Air Batteries.

The development of nonprecious metal-based electrocatalysts with remarkable catalytic activity and long-cycling lifespan toward oxygen reduction reaction (ORR) and evolution reaction (OER) is especially important for rechargeable zinc-air batteries (ZABs). Herein, monodispersed Co9 S8 nanoparticles embedded in nitrogen-doped hierarchically porous hollow carbon spheres (Co9 S8 NPs/NHCS) are synthesized through a template-assisted strategy followed by a co-assembly, thermal annealing, and sulfurization process. Benefiting from larger specific surface area, hierarchically porous hollow structure, and carbon nanotubes self-growth, the obtained Co9 S8 NPs/NHCS-0.5 electrocatalyst exhibits decent performance for ORR (E1/2 =0.85 V) and OER (E10 =1.55 V). A rechargeable ZAB assembled using the Co9 S8 NPs/NHCS-0.5 as air cathode delivers a maximum power density of 116 mW cm-2 , high open circuit voltage of 1.47 V, and good durability (no obvious voltage decay after 1200 cycles (200 hours)). Such a hierarchically porous hollow structure of Co9 S8 NPs/NHCS-0.5 provides a confined space shell and an interconnected hollow core to achieve outstanding bifunctional catalytic activity and cycling stability, which surpass the benchmark Pt/C-RuO2 .

[Double plate technique and tendon fixation of long head of biceps brachii in treating Neer 3 to 4 partial fractures of proximal humerus].

OBJECTIVE: To explore clinical effect of double plate technique in treating Neer 3 to 4 partial fractures of proximal humerus. METHODS: From May 2018 to December 2020, 38 patients with proximal humeral classified to Neer 3 to 4 partial fractures were treated with double plate technique and long head tendon fixation of biceps brachii, including 23 males and 15 females, aged from 41 to 89 years old with an average of (67.00 ± 9.76) years old;23 patients classified to Neer 3 fracture, 15 classified to Neer 4 fracture;the time from injury to operation ranged from 5 to 12 days with an average of (8.00±2.86) days. Degree of pain was evaluated by numerical rating scale(NRS) on the third day after operation; change of height of humeral head and angle of humeral neck stem were measured and compared between 2 days and 1 year after operation. Neer score was used to evaluate recovery of shoulder joint after operation at 1 year after operation. RESULTS: All 38 patients were followed up for 12 to 19 months with an average of (14.00±1.59) months. NRS score at 3 days after operation was (1.95±0.73) points. Fracture healing time ranged from 2.2 to 3.2 months with an average of(2.60±0.27) months. There were no significant difference in the height of humeral head and angle of humeral neck trunk between two days and 1 year after operation(P>0.05). Four Neer 4 fracture patients occurred absorption of greater tubercle of humerus and partial cystic change of humeral head, but the activity function of shoulder joint was good. Postoperative Neer score at 1 year was 89.50±5.19, and 20 patients got excellent results, 16 good, and 2 moderate. CONCLUSION: Double plate technique and long head tendon fixation of biceps brachii were used to treat Neer 3 to 4 fractures of proximal humerus has good clinical effect, and postoperative pain was mild, without special instruments.

Mycobacterium Vaccae Regulate γδT17 and γδTreg Cells in Mice Asthmatic Lung.

Background Dysregulation of the balance between different T cell populations is believed to be an important basis for asthma.Objective To observe the changes in γδT subtypes in transgenic asthmatic mice after aerosol inhalation of Mycobacterium vaccae, and to further investigate the mechanism of M. vaccae in asthmatic mice and its relationship with γδT cells.Methods TCR-ß-/- mice were exposed to atomized normal saline or M. vaccae for 5 days and the γδT cells from the lung tissues were isolated. Changes in γδT17 and γδTreg populations were detected. Asthma was induced in BALB/c mice using ovalbumin, which was then transplanted with control or M. vaccae-primed γδT cells. First we analyzed the content of γδT cells that secrete IL-17 (IL-17 γδT cells) and Foxp3+ γδT cells in lung tissues and then measured the content of IL-17 in the bronchoalveolar lavage fluid (BALF) by ELISA.Results Exposure to M. vaccae increased and decreased the relative proportions of Foxp3+ γδT cells and IL-17+ γδT cells, respectively, thereby decreasing airway reactivity and inflammation levels in asthmatic mice, and significantly decreasing IL-17 levels in BALF. Furthermore, mice treated with these primed T cells showed a decrease in IL-17+ γδT cells, and a concomitant increase in Foxp3+ γδT cells in their lung tissues. Furthermore, adoptive transfer of M. vaccae-primed γδT cells decreased GATA3 and NICD and increased T-bet in lung.Conclusions The M. vaccae-primed γδT cells alleviated the symptoms of asthma by reversing Th2 polarization in the lungs and inhibiting the Notch/GATA3 pathway.

Attitudes toward COVID-19 Vaccination: A Survey of Chinese Patients with Rheumatic Diseases.

The coronavirus disease 2019 (COVID-19) pandemic has imposed enormous morbidity and mortality burdens. Patients with rheumatic diseases (RDs) are vulnerable to the COVID-19 infection, given their immunocompromised status. Ensuring acceptance of the COVID-19 vaccine is important and has attracted attention by health professionals. In this study, we designed an online cross-sectional survey that used an online questionnaire from 8 May 2021 to 4 October 2021. Attitudes toward the COVID-19 vaccination, personal information, current disease activity status, adverse events (AEs), and knowledge sources of vaccines were collected. Descriptive statistics, nonparametric tests, and ordinal logistic regression were used to analyze the data. A total of 1022 questionnaires were received, among which 70.2% (720/1022) of patients with RDs agreed to vaccination, while only 31.6% of patients were actually vaccinated. Male, employed, high-income patients and those with inactive disease showed a more positive attitude. Concerns of AEs and disease flare were the main factors affecting vaccination willingness. Only 29.6% (304/1022) of patients thought they had received enough information about the COVID-19 vaccine from their doctors. In conclusion, most patients with RDs in China intended to get vaccinated, although the vaccination rate in this particular population was low. Rheumatologists should take more responsibility in COVID-19 vaccination education of patients with RDs.