Risk factors for the outcome and prognosis of multiple myeloma patients with pathological fractures undergoing percutaneous vertebroplasty.

This study focuses on the clinical features affecting the outcome and prognosis of multiple myeloma (MM) associated with spinal fractures. We retrospectively analyzed the clinical data of 194 MM patients with pathologic thoracic or lumbar spine fractures admitted to Dongying People's Hospital from April 2005 to February 2021. Patients were categorized into effective and ineffective groups based on post-treatment pain scores and mobility to analyze the influencing factors on the efficacy. Univariate analysis showed that age ≥60 years, number of vertebral fractures ≥2, and conservative treatment were associated with the outcomes. The number of vertebral fractures ≥2 (OR=2.198, P=0.034) and conservative treatment (OR=1.685, P=0.012) were identified as independent risk factors. In addition, survival curves were depicted using the Kaplan-Meier method, and independent risk factors affecting 2-year survival included efficacy (HR=17.924, P<0.001), age (HR=3.544, P=0.003) and International Staging System staging (HR=10.770, P=0.001). Finally, we constructed a high-accuracy prognostic model for predicting 2-year survival of MM patients with pathologic fractures (AUC=0.756). In conclusion, this study identified independent risk factors affecting the outcome and survival of MM patients with morbid fractures by systematically analyzing clinical characteristics and constructing a survival prediction model, thus providing effective guideline for clinical treatment.

Curettage of lesion combined with reconstruction of intramedullary nail and bone cement for the treatment of subtrochanteric metastatic tumors of the femur.

This study investigated subtrochanteric femoral metastases using a retrospective approach by analyzing data from 109 patients with bone metastases (2015-2019). Surgical methods were compared: curettage with intramedullary nail and bone cement versus prosthetic reconstruction. Post-surgical assessments included joint function, bone metastasis-related serum markers, and complications. Univariate and multivariate logistic regression analysis was used to screen independent risk factors affecting patients' prognosis. R language was used to construct a nomogram model for predicting patients' 1- and 2-year survival, which was validated through ROC curves and the calibration chart. Patients treated with curettage showed superior postoperative outcomes, exhibiting significantly higher Karnofsky Performance Status (KPS) scores (80.00 vs. 70.00, P < 0.001) and Musculoskeletal Tumor Society Scores (MSTS) (23.86 ± 2.57 vs. 21.67 ± 3.24, P < 0.001). Both methods demonstrated comparable efficacy in pain control (VAS: 3.00 vs. 3.00, P > 0.05) and bone metabolism impact (ALP: 85.93 ± 14.44 vs. 83.19 ± 21.19; CTX-I: 3.03 ± 1.56 vs. 3.15 ± 1.75; PINP: 10.30 ± 4.41 vs. 11.57 ± 3.90; all P > 0.05). Cox regression identified treatment regimen, age, diabetes, and pre-treatment KPS score as significant survival factors (all P < 0.05). The nomogram model demonstrated high accuracy in predicting one-year and two-year survival (AUC: 0.821 and 0.790, respectively). In conclusion, curettage with intramedullary nail and bone cement enhances postoperative functional recovery and quality of life for subtrochanteric femoral metastases patients, representing a promising treatment method.

Synthesis of Triblock Polycarboxylate Superplasticizers with Well-Defined Structure and Its Dispersing Performance in ß-Hemihydrate Gypsum.

In this work, a novel AaBAb-type triblock polycarboxylate superplasticizers (PCEs) with well defined molecular structures were designed and synthesized, firstly, by reversible addition-fragmentation chain transfer (RAFT) polymerization, to explore the structure-property relationship PCEs in the ß-hemihydrate gypsum (ß-HH) system. Three PCEs with the same molecular weight and different structure were obtained by changing the feed ratio of the RAFT agent, initiator, and monomer. The effect of the chemical structure of PCEs on their dispersing property and water reduction capacity were assessed in gypsum by measuring the flowability of pastes and the adsorption ability of PCEs on gypsum. Results showed that among three PCEs, when the monomer ratio is 5:1 and a:b = 1:1, PCE-1 exhibited a higher working efficiency, verifying the contribution of regulating structural parameters to the improvement in performances of gypsum paste, because PCE-1 showed the strongest binding capacity with calcium ions due to the relatively equal amount of carboxyl groups at both ends. The AaBAb-type PCEs provide a special advantage over the conventional comb polymer to understand the relation between the structure and property of PCEs, and a direction for further development of PCEs of high performance.

Dispersion characteristics of the plug flow hazardous waste by multiple gas jets.

In cement kilns co-processing hazardous solid wastes, the material is transported to the calciner for incineration via pipelines. When the viscous material enters the calciner in the form of plug flow, the CO and NOx emitted by the cement kiln fluctuate greatly as a result of insufficient combustion. In order to improve the dispersion of materials, avoid accumulation and make the combustion more sufficient, an experimental system was established to study the influence of nozzle system i, distance d, and pushing speed v on the dispersion characteristics.The slump test showed that the material with a sludge mass fraction of 35 40% had good fluidity. Moreover, the shape of the dispersion area was V-shape when the dispersion length was less than 4 6 m and became a rectangle when the dispersion length was more than 6 m. Finally, the results showed that i = 3 yielded the best effect, followed by i = 5, and i = 2 had the worst effect. In addition, d = 160 mm yielded the best effect, followed by d = 240 mm, and d = 80 mm had the worst effect. As the pushing speed v increased, the dispersion effect gradually worsened. The material that was 2 m away from the spray gun accounted for about 50% of the total.Implications: In this paper, a method based on multiple gas jets atomization of hazardous waste is proposed and verified. This method can atomize the plug hazardous waste into granules, which not only improves the combustion efficiency of hazardous waste, but also reduces the fluctuation of CO. We believe that this method can be widely used in industry to increase the output of cement kiln collaborative disposal of hazardous waste.

Study the biomechanical performance of the membranous semicircular canal based on bionic models.

A BA (bionic ampulla) was designed and fabricated using an SMPF (Symmetric electrodes Metal core PVDF Fiber) sensor, which could imitate the sensory hair cells to sense the deformation of the cupula of the BA. Based on the BA, a bionic semicircular canal with membrane semicircular canal (MBSC) and a bionic semicircular canal without membrane semicircular canal (NBSC) were designed and fabricated. The biomechanical models of the MBSC and NBSC were established. The biomechanical models were verified through the perception experiments of the MBSC and the NBSC. The results showed that the SMPF could sense the deformation of the cupula. The MBSC and NBSC could sense the angular velocity and accelerations. What's more, it was speculated that in a human body, the endolymph probably had a function of liquid mass while the membranous semicircular canal and the cupula had a function similar to a spring in the human semicircular canal.

Influence of jet components on the aero-optical effects of a 3D supersonic mixing layer.

Aero-optical effects in the mixing layer have caused significant concern due to the negative influence of high-speed vehicles with infrared imaging guidance systems. Here, we study the influence of different cooling mediums on the aero-optical effects. Four different cooling components are considered: helium (He), nitrogen (N2), air, and argon (Ar). The large eddy simulation method and ray-tracing method are used, respectively, to simulate the 3D mixing layer and to calculate the optical path difference (OPD). The numerical results show that, as the molecular weight of the cooling mediums increases, the mixing layer transition advances and the 3D effect of the flow field is enhanced. The local minimum OPD values of the wavefront distortion are significantly correlated with the large-scale vortex structure of the mixing layer. The compression effect plays a dominant role in aero-optics before the large-scale structure forms. Once the large-scale vortex structure generates, the aero-optical effect is conducted by the density and compression effect. The cooling medium helium delays the development of the mixing layer and subsequently reduces the aero-optical effects. However, once the large-scale vortex structure forms, the aero-optical effect becomes serious due to the largest density difference between air and He.

Design and fabrication of an E-whisker using a PVDF ring.

Mammalian whiskers can perceive obstacles and airflows. In this study, an electronic whisker (E-whisker) sensor was designed and fabricated by setting a PVDF ring with symmetrical electrodes on the root of a fiber beam. Vibration displacements with different waveforms were applied at the free end of the E-whisker beam to study the relationship between the vibration displacements and the output signals. The E-whisker protrusion sensing ability was investigated by driving it to sweep through the surface of a base platform. A static E-whisker beam and a swinging E-whisker were then separately placed in a wind tunnel to detect the airflow perception of the sensor. The experimental results suggested that the E-whisker could sense the frequencies and amplitudes of displacements at its free end, the height and width of a platform or the heights of other irregular protrusions; the static E-whisker could sense the magnitude or direction of an impact airflow, while the swinging E-whisker could sense the magnitude of a constant airflow. Thus, this kind of E-whisker could perceive the environment and airflow through touch sensation and could be used as a physical model to study the principles and abilities of animal whiskers to perceive obstacles and airflows.

Numerical investigation on image degradation caused by aero-optical effects of the supersonic mixing layer.

The supersonic mixing layer over the optic window of a high-speed imaging guided vehicle is the primary turbulent flow causing aero-optical effects such as the target image blurring, jittering, and offsetting. Employing the large eddy simulation and ray tracing methods, this paper presents a numerical investigation on target image degradation of a beam passing through the supersonic mixing layer under different conditions. The distorted wavefront, degraded target image, and peak signal-to-noise ratio of the degraded image are proposed to quantitatively evaluate the target image degradation. On the whole, the degraded target image is mainly shown as image blurring, and the larger the convective Mach number of the flow field, the more severe the image degradation. It is found that the beam incident position should be away from transition area of the supersonic mixing layer for a clearer image, the larger inlet fluid density difference results in a more severe target image degradation due to the stronger density fluctuation of turbulent flow structures, and the optimal beam incident angle is about 30° for the current calculation conditions.

Charge transfer co-crystals based on donor-acceptor interactions for near-infrared photothermal conversion.

A co-crystal was obtained based on donor-acceptor interactions. The obvious charge transfer from the linear donor to the triangular acceptor units results in a quasi-two-dimensional CT complex with excellent near-infrared photothermal conversion efficiency. The co-crystals further acted as an excellent photothermal material in seawater desalination.

Cervical lordosis in asymptomatic individuals: a meta-analysis.

BACKGROUND: Cervical lordosis has important clinical and surgical implications. Cervical spine curvature is reported with considerable variability in individual studies. The aim of this study was to examine the existence and extent of cervical lordosis in asymptomatic individuals and to evaluate its relationship with age and gender. METHODS: A comprehensive literature search was conducted in several electronic databases. Study selection was based on pre-determined eligibility criteria. Random effects meta-analyses were performed to estimate the proportion of asymptomatic individuals with lordosis and the effect size of cervical lordotic curvature in these individuals which followed metaregression analysis to examine the factors affecting cervical lordosis. Data from 21 studies (15,364 asymptomatic individuals, age 42.30 years [95% confidence interval 36.42, 48.18], 54.2% males) were used in the present study. RESULTS: In this population, 63.99% [95% confidence interval 44.94, 83.03] individuals possessed lordotic curvature. Degree of lordotic curvature differed by method of measurement; 12.71° [6.59, 18.84] with Cobb C2-C7 method and 18.55° [14.48, 22.63] with posterior tangent method. Lordotic curvature was not significantly different between symptomatic and asymptomatic individuals but was significantly higher in males in comparison with females. Age was not significantly associated with lordotic cervical curvature. CONCLUSION: Majority of the asymptomatic individuals possesses lordotic cervical curvature which is higher in males than in females but have no relationship with age or symptoms.

Correcting aero-optical wavefront aberration of the supersonic mixing layer based on periodic pulse forcing.

A correction strategy for correcting the aero-optical wavefront aberration of the supersonic mixing layer is presented based on flow control that is implemented by periodic pulse forcing. The flow field of the controlled supersonic mixing layer is simulated by large eddy simulation, and the optical transmission trajectory of the incident beam is computed by the ray-tracing method. The key component of the correction strategy is a compensation signal employed to correct the aberrated wavefront, which is produced according to flow and control parameters. Three numerical examples, including cases of an incident beam at different streamwise locations, flow control with different pulse periods, and vortex evolution in a pulse period, are performed to test performance of the correction strategy. The numerical results indicate that the correction strategy has a great effect in perfecting the aberrated wavefront again, and hence the far-field beam quality is also improved remarkably. In the end, the possibility of experimental implementation of the presented correction strategy is discussed.

Aero-optical effects of an optical seeker with a supersonic jet for hypersonic vehicles in near space.

The aero-optical effects of an optical seeker with a supersonic jet for hypersonic vehicles in near space were investigated by three suites of cases, in which the altitude, angle of attack, and Mach number were varied in a large range. The direct simulation Monte Carlo based on the Boltzmann equation was used for flow computations and the ray-tracing method was used to simulate beam transmission through the nonuniform flow field over the optical window. Both imaging displacement and phase deviation were proposed as evaluation parameters, and along with Strehl ratio they were used to quantitatively evaluate aero-optical effects. The results show that aero-optical effects are quite weak when the altitude is greater than 30 km, the imaging displacement is related to the incident angle of a beam, and it is minimal when the incident angle is approximately 15°. For reducing the aero-optical effects, the optimal location of an aperture should be in the middle of the optical window.

Development of a temporal evolution model for aero-optical effects caused by vortices in the supersonic mixing layer.

The vortices inside mixing layers impose remarkable aero-optical distortions on a beam even at moderate subsonic speeds. Knowledge about aero-optical effects caused by vortices in the flow field, especially their spatial and temporal evolution, is limited for supersonic mixing layers because the flows have very high speeds. In this paper, the temporal evolution of aero-optical effects caused by vortices in the supersonic mixing layer was investigated. A large eddy simulation was used to simulate the supersonic flow. A novel approach, coordinate extraction of vortex core, which is based on the relationship between vortices and the profile of the optical path length over the flow field, was proposed to quantitatively calculate the radii and convective speeds of vortices. A model used to quantitatively describe the temporal evolution of aero-optical effects caused by vortices in the supersonic mixing layer was developed and validated with data of numerical calculation. The results indicated that the model is available. Finally, several conclusions drawn from this work were presented.

Male germ cell apoptosis and epigenetic histone modification induced by Tripterygium wilfordii Hook F.

Multiglycosides of Tripterygium wilfordii Hook f (GTW), a Chinese herb-derived medicine used as a remedy for rheumatoid arthritis, are considered to be a reversible anti-fertility drug affecting the mammalian spermatids. However, the mechanism behind this effect is still unknown. To study the possible mechanism behind the impact of GTW on spermatogenesis, we administered 4 groups of 4-week-old male mice with different doses of GTW. We found a dose-dependent decrease in the number of germ cells after 40 days of GTW treatment, and an increase in apoptotic cells from the low-dose to the high-dose group. During this same period the dimethylated level of histone H3 lysine 9 (H3K9me2) in GTW-treated testes germ cells declined. Additionally, spermatogonial stem cells (SSCs) from 6-day-old mice were isolated to evaluate the possible effect of GTW or triptolide on development of SSCs. We found a significantly higher incidence of apoptosis and lower dimethylation level of H3K9me2 in the SSCs of GTW or triptolide treatment than in controls. Thus, these data suggest that the GTW-induced apoptosis might be responsible for the fertility impairment in mice. This damage could be traced back to the early stages of spermatogenesis. GTW also affected the epigenetic modification of H3K9 in spermatogenesis. Molecular dynamics simulation suggested that triptolide and dimethylated or trimethylated H3K9 might have similar interaction mechanisms with EED (embryonic ectoderm development). These candidate activation mechanisms provide the first glimpse into the pathway of GTW-induced gonad toxicity, which is crucial for further research and clinical application.

Molecular analysis in combination with iodine staining may contribute to the risk prediction of esophageal squamous cell carcinoma.

PURPOSE: Mucosal iodine staining has improved the detection of precancerous lesions of the esophagus. However, this method is unable to exactly evaluate the risk status of the lesions. In the present study, we conducted a molecular analysis combining the iodine staining in esophageal squamous cell carcinomas (ESCC) and different premalignant lesions of the esophagus in order to improve the early diagnosis of ESCC. METHODS: Tumorous and precancerous lesions were procured as iodine-unstained areas in the resected specimens of ESCC patients by means of Lugol's iodine staining. Loss of heterozygosity (LOH) was detected with 35 microsatellite markers frequently reported to be deleted in ESCC. The markers with high frequency of LOH in tumorous and precancerous lesions of the same patient were subjected to further detection in iodine-unstained biopsy samples from the population screening in ESCC high-incidence region. RESULTS: Common alterations were observed at D3S3644, D3S1768, D3S3040, D3S4542, RPL14, D9S169, D13S171 and D13S263 in both cancer tissues and precancerous lesions around tumors. Interestingly, D3S3644, D3S1768, D3S3040, D3S4542, RPL14 and D13S263 were also found with high frequency of LOH in iodine-staining abnormal lesions from the population screening. Most importantly, LOH frequency increased with histological severity. CONCLUSION: Our data suggest that detection of these six markers in combination with iodine staining might contribute to the prediction for the risk of ESCC development and for the diagnosis of patients in preclinical and preneoplastic phase of the disease.

A novel region of deletion on 13q33-q34 in esophageal squamous cell carcinoma.

Chromosome 13 presents frequent allelic loss in esophageal squamous cell carcinomas (ESCC). However, no ESCC suppressor gene has been identified from this chromosome. To define common deletion regions that possibly contain the ESCC suppressor gene(s), we performed a mapping of allelic loss in 50 esophageal squamous cell carcinomas using a panel of 25 microsatellite markers on chromosome 13q21-qter, which has rarely been studied for allelic loss. Loss of heterozygosity (LOH) with high frequencies (> or = 50%) was observed at markers D13S1494, D13S1323, D13S248, D13S1315, D13S285, and D13S1295, in which the peak LOH (69.2%) was at locus D13S248. Seven cases presented LOH at three consecutive markers D13S248, D13S1315 and D13S285, 4 of which also displayed LOH at another adjacent marker D13S1295. This overlapping region of deletion covers an interval of 6.36 Mb at 13q33.1-q34, whose deletion has not previously been reported in ESCC. Tumors of grade II showed significantly more frequent LOH at D13S248 than those of grade I. A significantly higher frequency of allelic loss at D13S152 was also found in tumors with lymph node metastasis compared to those without lymph node metastasis. The present study defined a novel region of allelic loss in 13q33-q34. LOH at D13S248 and D13S152 are associated with higher tumor grade and metastasis, respectively.

Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis.

Patients who present with a ruptured acute appendicitis are often treated with antibiotic therapy and drainage followed by a delayed or interval appendectomy. We noticed interval appendectomy specimens with granulomatous inflammation and postulated that interval appendectomy may lead to granulomatous appendicitis. To test this hypothesis, we reviewed the histopathology of all interval appendectomy specimens within a 4-year period and compared them with a control group of patients who had acute appendicitis and underwent routine acute appendectomy. All slides were randomized and reviewed blindly to assess the inflammatory patterns, with special attention given to the presence of granulomas and other Crohn-like features. Twenty-two cases of interval appendectomy were found. The interval between symptom onset and appendectomy ranged from 30 to 95 days with a mean of 58 days, whereas all 44 control patients had surgery within 72 hours of symptoms onset. Thirteen (59.1%) of the 22 interval appendectomy cases contained granulomas compared with only 3 of 44 controls (P < 0.0001). Eight (36.4%) of the interval appendectomy cases had xanthogranulomatous inflammation compared with none in the acute appendicitis group (P < 0.0001). A Crohn-like appearance was seen in 11 (50.0%) of the interval appendectomy cases and 1 of the controls (P < 0.0001). Follow-up data were available in 8 of 11 cases with Crohn-like features; none developed Crohn disease during an average follow-up period of 23 months. Delayed or interval appendectomy specimens often have a characteristic inflammatory pattern that includes granulomas, xanthogranulomatous inflammation, mural fibrosis/thickening, and transmural chronic inflammation. Without the appropriate clinical history, these changes may be misinterpreted as Crohn disease.

Lipomatous variant of nasopharyngeal angiofibroma: a case report.

Nasopharyngeal angiofibroma is an uncommon benign vascular tumor that occurs in adolescent boys and young men. We describe an unusual histological variant of this entity characterized by a prominent adipose tissue component. The patient was a 35-year-old man with a 20-year history of nasal obstruction. Results of physical examination and angiography demonstrated a nasal mass consistent with a nasopharyngeal angiofibroma. We discuss the differential diagnoses pathologically for this lesion.