Advances in air pollution control for vessels in China.

Vessel emissions have contributed a great deal to air quality deterioration in China. Hence, the Chinese government has promulgated a series of stringent emission regulations. It is in this context that vessel emission control technology research is in full swing. In particular, during the 13th Five-Year Plan, the air pollution control technology of vessels has greatly improved. Vessel emission control has followed two main governance routes: source emission reduction and aftertreatment technology. Source control focuses on alternative fuels, with two main directions, the development of new fuels and the modification of existing fuels. Moreover, after-treatment technologies have also been developed, including wet desulfurization technology using seawater or alkaline liquids as wet washing liquids and selective catalytic reduction (SCR) for the control of NOx emission. Due to China's increasingly stringent emissions standards and regulations, work on the development of clean alternative fuels and further upgrading the collaborative application of after-treatment technologies to meet the near-zero-emissions requirements of vessels is still necessary.

Technology development and cost analysis of multiple pollutant abatement for ultra-low emission coal-fired power plants in China.

The implementation of ultra-low emission (ULE) limits (SO2: 35 mg/m3, NOx: 50 mg/m3, PM: 10 mg/m3) promoted the development of flue gas treatment technologies in China. Pollutant control technology development for Chinese coal-fired power plants was summarized and an analysis of the applicability and cost of pollutant control technologies was conducted. Detailed data were collected from 30 ultra-low emission coal-fired units across China. Based on a cost analysis model, the average unit power generation incremental costs were 0.0144 and 0.0095 CNY/(kW·hr) for SO2 and NOx control technologies, respectively. The unit power generation incremental cost of twin spray tower technology was 7.2% higher than that of dual-loop spray tower technology. The effect of key parameters on operating cost was analyzed. The unit power generation incremental cost increased because of increments in the electricity price for SO2 control technology and the price of the reductant in NOx control technology. With high sulfur content or NOx concentration, the unit power generation incremental cost caused by pollutant control increased, whereas the unit pollutant abatement cost decreased. However, the annual operating hours or load increased, thereby leading to a decline in unit power generation incremental cost and unit pollutant abatement cost.

Self-powered p-CuI/n-GaN heterojunction UV photodetector based on thermal evaporated high quality CuI thin film.

With vacuum thermal evaporation, the CuI film was deposited on quartz and n-GaN substrates, and the morphology, crystalline structure and optical properties of the CuI films were investigated. According to the XRD results, the CuI film preferentially grew along [111] crystal orientation on the GaN epilayer. With Au and Ni/Au ohmic contact electrodes fabricated on CuI and n-GaN, a prototype p-CuI/n-GaN heterojunction UV photodetector strong UV spectral selectivity was created. At 0 V and 360 nm front illumination (0.32 mW/cm2), the heterojunction photodetector displayed outstanding self-powered detection performance with the responsivity (R), specific detectivity (D*), and on/off ratio up to 75.5 mA/W, 1.27×1012 Jones, and ∼2320, respectively. Meanwhile, the p-CuI/n-GaN heterojunction photodetector had excellent atmosphere stability.

Deep-ultraviolet photodetector based on pulsed-laser-deposited Cs3Cu2I5 films/n-Si heterojunction.

All-inorganic lead-free perovskite Cs3Cu2I5 thin films were prepared using pulsed laser deposition. Effects of the substrate temperature, laser energy, and laser frequency on the film structure and optoelectronic properties were studied. A heterojunction photodetector based on Cs3Cu2I5/n-Si was constructed, and the deep-ultraviolet photoresponse was obtained. A high Ilight/Idark ratio of 130 was achieved at -1.3V, and the peak response of the heterojunction photodetector was 70.8 mA/W (280 nm), with the corresponding specific detectivity of 9.44×1011cm⋅Hz1/2⋅W-1. Moreover, the device showed good stability after being exposed to air for 30 days.

MicroRNA-214 contributes to regulation of necroptosis via targeting ATF4 in diabetes-associated periodontitis.

Diabetes and periodontal diseases have a mutual promoting relationship that induces severe tissue damage and cell death. The potential roles of microRNAs (miRNAs) and the type of cell death involved in diabetes-associated periodontitis are obscure. The gingival tissues of patients were obtained and MC3T3-E1 cells were costimulated with high glucose and lipopolysaccharide (LPS). Osseous morphometric analysis was evaluated with micro-CT, and histological characteristics were measured by hematoxylin/eosin and immunohistochemical staining. Cytokine secretion was confirmed by enzyme-linked immunosorbent assay, and reactive oxygen species (ROS) was measured using a DCFH-DA probe kit. Gene expression was measured by real-time quantitative reverse transcription PCR (qRT-PCR), and protein expression was assessed by Western blot and immunofluorescence analysis. The miR-214 level, receptor-interacting serine-threonine protein (RIP) 1, RIP3, and phospho-mixed lineage kinase domain-like (p-MLKL) protein expression were elevated in the inflamed gingival tissues of diabetes-associated periodontitis patients, with activating transcription factor 4 (ATF4) expression showing the opposite effect. The high glucose (22 mM) could not induce significant increase of RIP1, RIP3, and p-MLKL; however, the high glucose and LPS (500-1000 ng/mL) cotreatment resulted in increase in the number of RIP1, RIP3, and p-MLKL in MC3T3-E1 cells. NAC (ROS inhibitor) inhibited RIP1, RIP3, and increased ATF4; however, necrostatin-1 (Nec-1) (RIP1 inhibitor) specifically inhibited the protein expression of RIP1 and RIP3 and had no influence on ATF4. The use of antagomir-214 suppressed the expression of miR-214, RIP1, RIP3, and p-MLKL, but increased ATF4 protein level in glucose and LPS-induced cells. ATF4 knockdown by ATF4 small interfering RNA offset the effect of antagomir-214. RIP1- and RIP3-dependent necroptosis was confirmed in the inflamed gingival tissues of diabetes-associated periodontitis patients and high glucose- and LPS- cotreated cells. It was suggested that miR-214-targeted ATF4 participated in the regulation of necroptosis in vivo and in vitro.

Design and synthesis of a vanadate-based ratiometric fluorescent probe for sequential recognition of Cu2+ ions and biothiols.

A novel YVO4:Eu3+@CDs core-shell nanomaterial with two main emission peaks at 405 and 617 nm was synthesized through a simple mixing method, in which the carbon quantum dots (CDs) self-assembled with the YVO4:Eu3+ nanoparticle, due to the high affinity of oxygen-containing groups such as -COOH or -OH of CDs to the metal ions on the surface of YVO4:Eu3+. The red fluorescence of YVO4:Eu3+@CDs located at 617 nm can be quenched by Cu2+ ions efficiently, while the blue emission remains invariable; based on this, we construct a ratio fluorescent probe YVO4:Eu3+@CDs for Cu2+ ion detection, in which the blue emission of CDs is selected as the reference signal, and the red emission of YVO4:Eu3+ acts as an output signal. Furthermore, the addition of biothiol recovers the quenched red fluorescence quickly, which can be completed in 18 minutes. Thus, YVO4:Eu3+@CDs can also be used as a 'turn on' ratio fluorescent probe for biothiol rapid detection. Taking l-cysteine (l-Cys) as the model, the fluorescence intensity of the 617 nm peak increases with increasing Cys, and the ratio of F617/F405 is linear to the concentration of Cys in the range of 0.1 µM to 10 µM with a detection limit of 41 nM. Compared with these single wavelength emission biothiol fluorescent probes, an obvious change in the fluorescence color from blue to pink can be conveniently observed by the naked eye under a UV lamp. Meanwhile, this ratiometric probe has also been demonstrated to be used for the visual identification of biothiols in real blood serum samples.

Exploring status and determinants of prenatal and postnatal visits in western China: in the background of the new health system reform.

BACKGROUND: Prenatal and postnatal visits are two effective interventions for protection and promotion of maternal health by reducing maternal mortality and improving the quality of birth. There is limited nationally representative data regarding the changes of prenatal and postnatal visits since the latest health system reform initiated in 2009 in Shaanxi, China. The aim of this study was to explore the current status and determinants of prenatal and postnatal visits in the background of new health system reform. METHODS: Data were drawn from two waves of National Health Service Surveys in Shaanxi Province which were conducted prior and post the health system reform in 2008 and 2013, respectively. A concentration index was employed to measure the degree of income-related inequality of maternal health services utilization. Multilevel mix-effects logistic regressions were applied to study the factors associated with prenatal and postnatal visits. RESULTS: The study sample consists of 2398 women aged 15-49 years old. The data of the 5th National Health Services Survey in 2013 showed in the criterion of the World Health Organization (WHO), the percentage of women receiving ≥4 prenatal visits was 84.79% for urban women and 82.20% for rural women, with women receiving ≥3 postnatal visits were 26.48 and 25.29% for urban and rural women respectively. In the criterion of China's ≥ 5 prenatal visits the percentages were 72.25% for urban women and 70.33% for rural women; 61.69% of urban women and 71.50% of rural women received ≥1 postnatal visits. As for urban women, the concentration index of postnatal visit utilization was -0.075 (95% CI:-0.148, -0.020) after the health system reform. The determinants related to prenatal and postnatal visits were the change of reform, women's education, parity and the delivery institution. CONCLUSIONS: This study showed the utilization of prenatal and postnatal visits met the requirement of the WHO, higher than other areas in China and other developing countries after the new health system reform. The new health system reform increased the utilization of postnatal visits in poor urban women and improved the frequency of prenatal and postnatal visits in rural women.

Health-related quality of life and its influencing factors for patients with hypertension: evidence from the urban and rural areas of Shaanxi Province, China.

BACKGROUND: Hypertension is an important public health issue in China, but there are few studies on health-related quality of life (HRQoL) for patients with hypertension in China. This study aims to examine the HRQoL as measured by EQ-5D and investigate the factors that influence HRQoL for patients with hypertension in Shaanxi Province, China. METHODS: Data were collected from the Shaanxi's fifth National Health Service Survey conducted in 2013. EQ-5D was employed to measure the HRQoL for patients with hypertension. The Chinese population-based preference trade-off time (TTO) model was used to convert the EQ-5D values. All descriptive analyses, including demographic characteristics, socio-economic status and clinical characteristics, were stratified by urban and rural residence. Tobit regression model was used to investigate the influencing factors of HRQoL. RESULTS: A statistically significant difference was observed between the EQ-5D utility scores of urban (0.891) and rural hypertension patients (0.870). The urban hypertension patients showed significantly higher utility scores than the rural patients in three of the five dimensions, namely usual activities, pain / discomfort and anxiety / depression. The influencing factors of HRQoL for hypertension patients in China included age, marital status, education level, employment status, physical activity and medical examination. For patients aged 55 years and above, EQ-5D utility score decreased significantly with increasing age. The EQ-5D score increased with higher education level. Married patients showed a higher EQ-5D score than divorced and widowed patients, and employed patients showed a higher score than unemployed and retired patients. Regular physical activity and medical examination had a positive effect on the HRQoL of hypertension patients. CONCLUSIONS: Our study indicated that urban hypertension patients might have higher HRQoL than rural patients in Shaanxi, China. To enhance HRQoL, it is necessary to strengthen the health education for hypertension patients to improve hypertension prevention and to adopt healthy habits such as regular physical activity. It is also important to strengthen the management and monitoring of hypertension in the elderly, and further implement the free medical examination program for the elderly under the public health programs.

[Treatment of Persistent Somatoform Pain Disorder by Floating Needle Therapy and Duloxetine].

OBJECTIVE: To evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD). METHODS: Totally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study. RESULTS: (1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05). CONCLUSIONS: Floating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

The effects of China's urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province.

INTRODUCTION: In order to alleviate the problem of "Kan Bing Nan, Kan Bing Gui" (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. METHODS: Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. RESULTS: For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. CONCLUSIONS: The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation.

Human Periodontal Ligament Stem Cells (hPDLSCs) Spontaneously Differentiate into Myofibroblasts to Repair Diabetic Wounds.

Advanced glycation end product (AGE) accumulation due to diabetes causes vascular and neurological lesions, delaying healing. The use of stem cells could overcome these problems. Although many studies have shown the potential beneficial effects of stem cell therapies in the treatment of chronic and refractory skin ulcers, their delivery methods are still under investigation. Human periodontal ligament stem cells (hPDLSCs) can spontaneously differentiate into myofibroblasts in specific cultures; therefore, they have the potential to effectively treat diabetic wounds and may also have applications in the field of medical cosmetics. The myofibroblastic differentiation ability of hPDLSCs in the presence of AGEs was evaluated by the expression of α-SMA and COL1A1 using RT-qPCR and WB technology. Wound healing in diabetic mice, induced by streptozotocin (STZ) and assessed using H&E staining, Masson staining, and immunohistochemical (IHC) and immunofluorescence (IF) staining, was used to validate the effects of hPDLSCs. In the wound tissues, the expression of α-SMA, COL1A1, CD31, CD206, iNOS, and vimentin was detected. The findings indicated that in H-DMEM, the expression of COL1A1 exhibited a significant decrease, while α-SMA demonstrated an increase in P7 cells, ignoring the damage from AGEs (p < 0.05). In an STZ-induced diabetic C57BL/6J mice whole-skin defect model, the healing rate of the hPDLSCs treatment group was significantly higher than that in the models (on the 7th day, the rate was 65.247% vs. 48.938%, p < 0.05). hPDLSCs have been shown to spontaneously differentiate into myofibroblasts in H-DMEM and resist damage from AGEs in both in vivo and in vitro models, suggesting their potential in the field of cosmetic dermatology.

[Piriform sinus hamartoma in children: a case report and literature review].

Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.

Research Advances on Stem Cell-Derived Extracellular Vesicles Promoting the Reconstruction of Alveolar Bone through RANKL/RANK/OPG Pathway.

Periodontal bone tissue defects and bone shortages are the most familiar and troublesome clinical problems in the oral cavity. Stem cell-derived extracellular vesicles (SC-EVs) have biological properties similar to their sources, and they could be a promising acellular therapy to assist with periodontal osteogenesis. In the course of alveolar bone remodeling, the RANKL/RANK/OPG signaling pathway is an important pathway involved in bone metabolism. This article summarizes the experimental studies of SC-EVs applied for the therapy of periodontal osteogenesis recently and explores the role of the RANKL/RANK/OPG pathway in their mechanism of action. Their unique patterns will open a new field of vision for people, and they will help to advance a possible future clinical treatment.

Co-transport of polystyrene microplastics and kaolinite colloids in goethite-coated quartz sand: Joint effects of heteropolymerization and surface charge modification.

This study investigated the transport behavior of polystyrene microplastics (MPs) in saturated quartz sand and goethite-coated sand in the presence of coexisting kaolinite colloids. Column experiments were conducted under a wide range of solution chemistry conditions, including pH levels of 6.0, 7.0, and 9.0, as well as background Na+ concentrations of 5 mM and 25 mM. We found that: (1) The individual transport of MPs in porous media diminished both with increasing background ion strength and decreasing pH, and its transport ability was significantly dominated by the interactions between MPs and porous media rather than the interplay between MPs, which has been further corroborated by the aggregation stability experiments of MPs particles. (2) MPs had a much lower ability to move through goethite-coated sand columns than quartz sand columns. This is because goethite coating reduces the repulsion energy barriers between porous media and MPs. The increased specific surface area and surface complexity of sand columns after goethite coating should also account for this difference. (3) MPs transport would be subjected to the differentiated impact of co-transported kaolinite colloids in the two types of porous media. The promotion effect of kaolinite colloid on MPs' transport capacity is not significantly affected by background ionic strength changes when quartz sand is served as the porous medium; however, the promotion effect is highly correlated with the background ionic strength when goethite-coated sand is served as the porous medium. In comparison with low background ionic strength conditions, kaolinite colloids under high background ionic strength conditions significantly facilitated MPs transport. This is mainly because under high background ionic conditions, kaolinite colloids are more likely to be deposited on the surface of goethite-covered sand, competing with MPs for the limited deposition sites. The extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory is applicable to describe the transport behavior of MPs.

Is simultaneous cranioplasty with cerebrospinal fluid shunts implantation as safe as staged procedures?

Objective: The combination of cranioplasty and ventriculoperitoneal shunt is a therapeutic strategy for patients with hydrocephalus after decompressive craniectomy (DC). However, the efficacies of simultaneous vs. staged surgery in reducing postoperative complications have not been conclusively determined. This was a meta-analysis of relevant studies to assess whether simultaneous surgery significantly reduces postoperative complication risks, compared to staged surgery. Methods: We systematically searched PubMed, Embase, Cochrane, Web of science databases for studies (published by 11 May 2022) comparing patients undergoing concurrent and staged cranioplasty and ventriculoperitoneal shunt. Our main endpoints were; overall postoperative complications, postoperative bleeding, postoperative infection and reoperation. We assessed the pooled data using a random effects model to compare complication rates using odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of the 494 identified studies, 12 were included in our analysis (N = 651 participants). Compared to staged surgery, concurrent surgery increased the relative risk for overall complications (pooled OR: 2.00; 95% CI: 1.10-3.67), however, it did not increase the relative risks for postoperative bleeding, postoperative infection or reoperation. Subgroup analysis revealed that in the Asian population, concurrent surgery increased the relative risks for overall complications (staged vs. concurrent group: OR: 2.41, 95% CI: 1.51-3.83, I 2 = 0.0%) and postoperative infections (staged vs. concurrent group: OR: 2.35, 95% CI: 1.06-5.21, I 2 = 31.8%). Conclusion: Compared to staged surgery, concurrent surgery increases the overall complication rates. However, differences between the two therapeutic approaches in terms of postoperative bleeding, postoperative infection, or reoperation are insignificant. Simultaneous surgery was associated with increased overall post-operative complications and post-operative infection rates in the Asian population.

Comparison of the Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound-Guided Puncture Biopsy in Different Sizes of Peripheral Pulmonary Lesions.

Objective: To compare the clinical value of contrast-enhanced ultrasound and conventional ultrasound-guided puncture biopsy in peripulmonary lesions of different sizes. Materials and Methods: 110 patients with peripulmonary lesions were randomly divided into two groups: the conventional ultrasound-guided group and the contrast-enhanced ultrasound-guided group. The lesions in the two groups were further divided into two groups according to the size of the lesions, and the tissues taken after puncture biopsy were sent for pathological examination. The pathological results were compared with the postoperative pathological results and other examination results, and the complications were recorded at the same time. Results: In the conventional ultrasound group, the success rate of single puncture was 72.7% and the success rate of puncture was 80.0%; in the contrast group, the success rate of single puncture was 90.9% and the success rate of puncture was 94.6%. The difference between the two groups was statistically significant. There was no significant difference in needle bleeding and pneumothorax between the two groups. In the <30 mm group, there was no significant difference in the success rate of single puncture and the success rate of puncture between the two groups according to the size of the lesions. In the ≥30 mm group, the success rate of single puncture (97.1%) and puncture success rate (97.1%) in the contrast guidance group were higher than those in the conventional ultrasound guidance group (70.3%, 78.4%) and the difference was statistically significant (p < 0.05). Conclusion: Compared with conventional ultrasound, for peripheral pulmonary lesions guided by contrast-enhanced ultrasonography, especially when the maximum diameter of the lesion is ≥ 30 mm, needle biopsy has better guiding significance; for peripheral lung lesions with a maximum diameter of <30 mm, contrast-enhanced ultrasonography is compared with conventional ultrasound guidance. The puncture success rate was not significantly different.

Neck and mediastinal hematoma caused by a foreign body in the esophagus with diagnostic difficulties: A case report.

BACKGROUND: Esophageal foreign body (FB) is a common clinical emergency. Clinically, computed tomography (CT) scans are important in the diagnosis of FBs in the esophagus. Here, we report a case of esophageal perforation and cervical hematoma, caused by a FB, whose uniqueness made rapid diagnosis difficult. CASE SUMMARY: A 42-year-old man was transferred to our hospital with esophageal perforation, which was accompanied by cervical and mediastinal hematoma. CT scans only revealed a black shadow, approximately 2.5 cm in diameter, in the upper esophagus. After multidisciplinary discussion, he was quickly subjected to mediastinal hematoma resection, peripheral nerve compression release, esophageal FB removal and esophagectomy. Eventually, we removed a small crab with a pointed tip from his esophagus. CONCLUSION: This was an unusual case of occurrence of sharp polygonal esophageal FBs caused by a small crab. Rapid diagnosis of this FB was difficult, mainly due to its translucent nature. Occurrence of sharp FBs, with cavities that sometimes only appear as black shadows on CT scans, can easily be mistaken for esophageal lumens. More attention should be paid to such sharp polygonal FBs.

Osteogenic peptides in periodontal ligament stem cell-containing three-dimensional bioscaffolds promote bone healing.

Bone tissue engineering shows great potential in bone regeneration; however, the lack of bone growth factors with high biocompatibility and efficiency is a major concern. Oligopeptides have drawn great attention due to their high biological efficacy, low toxicity, and low molecular weight. The oligopeptide SDSSD promotes the osteogenesis of human periodontal ligament stem cells (hPDLSCs) in vitro. The SDSSD-modified three-dimensional (3D) bioscaffolds promote osteogenesis and bone formation in the subcutaneous pockets of BALB/c nude mice and facilitate bone healing in vivo. Mechanistically, SDSSD promoted bone formation by binding to G protein-coupled receptors and regulating the AKT signaling pathway. 3D-printing bioscaffolds with SDSSD may be potential bone tissue engineering materials for treating bone defects.

Clinical characteristics for conservative therapy of pediatric parapharyngeal abscesses.

INTRODUCTION: The role of surgical drainage versus conservative therapy in treating patients with parapharyngeal abscesses is still a theme of debate. OBJECTIVES: This study aimed to investigate the characteristics associated with good outcomes in pediatric patients with parapharyngeal abscesses treated with conservative therapy. METHODS: This retrospective chart review was performed on children aged 0.3-14 years with the diagnosis of parapharyngeal abscesses confirmed by computed tomography from January 2013 to March 2018. Patients with a severe upper airway obstruction required early intervention, while those in a stable condition initially received conservative therapy with antibiotics. If the patients appeared unlikely to recover, additional surgical drainage was provided. Multivariate logistic regression models were constructed to investigate the clinical characteristics associated with a good response to conservative therapy. A receiver operating characteristic curve was used to identify the age and abscess size cutoff for predicting a successful response. RESULTS: A total of 48 children were included in the study. Patient age, antecedent illness, and abscess size were significantly associated with a response to therapy (Odds Ratio=1.326, 2.314 and 1.235, respectively). The age cutoff associated with the conservative therapy was 4.2 years (76.9% sensitivity, 68.2% specificity), and the abscess size cutoff associated with the conservative therapy was 23mm (84.6% sensitivity, 77.3% specificity). CONCLUSION: The findings suggested that younger age, smaller abscess size, and less frequent antecedent illnesses, such as upper respiratory tract infection and lymphadenitis, could predict a successful response to conservative therapy in pediatric patients with parapharyngeal abscesses.

Diagnosis and treatment of deep neck abscess due to congenital piriform sinus fistula in children.

INTRODUCTION: Congenital piriform sinus fistula is a relatively rare type of disease in clinical practice, most occurring during childhood, but doctors have insufficient knowledge regarding this disease, easily misdiagnosing it. OBJECTIVES: This study aimed to identify the characteristics of deep neck abscess due to congenital piriform sinus fistula in children. METHODS: We performed a retrospective study of 21 cases from January 2016 to August 2018 in our hospital. The onset age, clinical characteristics, auxiliary examination and clinical treatment of the patients was summarized to analyze the diagnosis, treatment characteristics and prognosis. RESULTS: Children from 11 days to 12 years-old were enrolled, with an average age of 3.5 years. Twenty patients had left congenital piriform sinus fistula and 1 had right congenital piriform sinus fistula. Cervical enhanced computed tomography imaging showed gas-liquid equilibrium or air-shadow in the abscesses in 18 cases, and neck ultrasound demonstrated gas echo in the thyroid region in 10 cases. All patients underwent low temperature plasma to seal the internal fistula and returned to the hospital for electronic laryngoscope and neck ultrasound examination at 3 months, 6 months and 1year after the surgery. No recurrence occurred in any patient. CONCLUSION: Congenital piriform sinus fistula is an important cause of deep neck abscess in children. The presence of purulent gas-liquid equilibrium or air shadow in cervical-enhanced computed tomography or ultrasound suggests a high possibility of the presence of an internal fistula, and endoscopic low temperature ablation can be done at the same time as the diagnostic endoscopy.