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For acute ischemic stroke treatment, the limitations of treatment methods and the high incidence of perioperative complications seriously affect the survival rate and postoperative recovery of patients. Human umbilical cord mesenchymal stem cells (hucMSCs) have multi-directional differentiation potential and immune regulation function, which is a potential cell therapy. The present investigation involved developing a model of cerebral ischemia-reperfusion injury by thrombectomy after middle cerebral artery occlusion (MCAO) for 90 min in rats and utilizing comprehensive multi-system evaluation methods, including the detection of brain tissue ischemia, postoperative survival rate, neurological score, anesthesia recovery monitoring, pain evaluation, stress response, and postoperative pulmonary complications, to elucidate the curative effect of tail vein injection of hucMSCs on MCAO's perioperative complications. Based on our research, it has been determined that hucMSCs treatment can reduce the volume of brain tissue ischemia, promote the recovery of neurological function, and improve the postoperative survival rate of MCAO in rats. At the same time, hucMSCs treatment can prolong the time of anesthesia recovery, relieve the occurrence of delirium during anesthesia recovery, and also have a good control effect on postoperative weight loss, facial pain expression, and lung injury. It can also reduce postoperative stress response by regulating blood glucose and serum levels of stress-related proteins including TNF-α, IL-6, CRP, NE, cortisol, ß-endorphin, and IL-10, and ultimately promote the recovery of MCAO's perioperative complications.
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OBJECTIVE: To investigate the clinical effect of orthopedic robot combined with Starr pelvic reduction frame in the treatment of Tile type C pelvic ring fracture. METHODS: From October 2019 to May 2021, 14 patients with type C pelvic ring fracture were treated with robotic combined with Starr pelvic reduction frame, including 9 males and 5 females. The age ranged from 33 to 69 years. All the 14 patients had fresh closed fractures without femur, tibia and fibula fracture. Surgery was completed from 4 to 7 d after hospital admission. During the operation, the X-ray carbon bed was used, the pelvic ring was reduced by Starr pelvis reduction frame, and pelvic ring fracture was treated by orthopedic robot. Operation time, bleeding volume, fluoroscopy times of single screw placement, fracture reduction quality, affected limb function and complications were observed. Radiological reduction was evaluated using Matta scoring standard, and clinical efficacy was evaluated by Majeed pelvic function scoring system at the final follow-up. RESULTS: All of 14 patients successfully completed the operation, the operation time was 84 to 141 min, the bleeding volume was 20 to 50 ml, and the fluoroscopy times of single screw insertion was 4 to 9 times. All of 14 patients were followed up for 12 to 24 months. The healing time was 3 to 7 months. No complications such as fracture of internal fixation, screw loosening, infection and nerve injury were found. According to the evaluation criteria of Matta imaging reduction, 9 cases were excellent, 4 cases were good, and 1 case was fair. At the final follow-up, Majeed pelvic function scoring system was used:10 cases were excellent, 4 cases were good. CONCLUSION: The treatment of type C pelvic ring fracture with robotic combined Starr pelvis reduction frame is simple, time-saving, less trauma, less complications and effective.
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Fracturas Óseas , Huesos Pélvicos , Procedimientos Quirúrgicos Robotizados , Humanos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Huesos Pélvicos/lesiones , Huesos Pélvicos/cirugía , Anciano , Fracturas Óseas/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Fijación Interna de Fracturas/métodosRESUMEN
BACKGROUND AND OBJECTIVE: Low-dose computed tomography (LDCT) scans significantly reduce radiation exposure, but introduce higher levels of noise and artifacts that compromise image quality and diagnostic accuracy. Supervised learning methods have proven effective in denoising LDCT images, but are hampered by the need for large, paired datasets, which pose significant challenges in data acquisition. This study aims to develop a robust unsupervised LDCT denoising method that overcomes the reliance on paired LDCT and normal-dose CT (NDCT) samples, paving the way for more accessible and practical denoising techniques. METHODS: We propose a novel unsupervised network model, Bidirectional Contrastive Unsupervised Denoising (BCUD), for LDCT denoising. This model innovatively combines a bidirectional network structure with contrastive learning theory to map the precise mutual correspondence between the noisy LDCT image domain and the clean NDCT image domain. Specifically, we employ dual encoders and discriminators for domain-specific data generation, and use unique projection heads for each domain to adaptively learn customized embedded representations. We then align corresponding features across domains within the learned embedding spaces to achieve effective noise reduction. This approach fundamentally improves the model's ability to match features in latent space, thereby improving noise reduction while preserving fine image detail. RESULTS: Through extensive experimental validation on the AAPM-Mayo public dataset and real-world clinical datasets, the proposed BCUD method demonstrated superior performance. It achieved a peak signal-to-noise ratio (PSNR) of 31.387 dB, a structural similarity index measure (SSIM) of 0.886, an information fidelity criterion (IFC) of 2.305, and a visual information fidelity (VIF) of 0.373. Notably, subjective evaluation by radiologists resulted in a mean score of 4.23, highlighting its advantages over existing methods in terms of clinical applicability. CONCLUSIONS: This paper presents an innovative unsupervised LDCT denoising method using a bidirectional contrastive network, which greatly improves clinical applicability by eliminating the need for perfectly matched image pairs. The method sets a new benchmark in unsupervised LDCT image denoising, excelling in noise reduction and preservation of fine structural details.
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Relación Señal-Ruido , Tomografía Computarizada por Rayos X , Tomografía Computarizada por Rayos X/métodos , Humanos , Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Dosis de Radiación , Aprendizaje Automático no Supervisado , Redes Neurales de la Computación , ArtefactosRESUMEN
BACKGROUND: Ankle fractures are prevalent injuries that necessitate precise diagnostic tools. Traditional diagnostic methods have limitations that can be addressed using machine learning techniques, with the potential to improve accuracy and expedite diagnoses. METHODS: We trained various deep learning architectures, notably the Adapted ResNet50 with SENet capabilities, to identify ankle fractures using a curated dataset of radiographic images. Model performance was evaluated using common metrics like accuracy, precision, and recall. Additionally, Grad-CAM visualizations were employed to interpret model decisions. RESULTS: The Adapted ResNet50 with SENet capabilities consistently outperformed other models, achieving an accuracy of 93%, AUC of 95%, and recall of 92%. Grad-CAM visualizations provided insights into areas of the radiographs that the model deemed significant in its decisions. CONCLUSIONS: The Adapted ResNet50 model enhanced with SENet capabilities demonstrated superior performance in detecting ankle fractures, offering a promising tool to complement traditional diagnostic methods. However, continuous refinement and expert validation are essential to ensure optimal application in clinical settings.
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Fracturas de Tobillo , Humanos , Fracturas de Tobillo/diagnóstico por imagen , Benchmarking , Aprendizaje AutomáticoRESUMEN
As one of the three major outdoor components of the railroad signal system, the track circuit plays an important role in ensuring the safety and efficiency of train operation. Therefore, when a fault occurs, the cause of the fault needs to be found quickly and accurately and dealt with in a timely manner to avoid affecting the efficiency of train operation and the occurrence of safety accidents. This article proposes a fault diagnosis method based on multi-scale attention network, which uses Gramian Angular Field (GAF) to transform one-dimensional time series into two-dimensional images, making full use of the advantages of convolutional networks in processing image data. A new feature fusion training structure is designed to effectively train the model, fully extract features at different scales, and fusing spatial feature information through spatial attention mechanisms. Finally, experiments are conducted using real track circuit fault datasets, and the accuracy of fault diagnosis reaches 99.36%, and our model demonstrates better performance compared to classical and state-of-the-art models. And the ablation experiments verified that each module in the designed model plays a key role.
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Objective. The textures and detailed structures in computed tomography (CT) images are highly desirable for clinical diagnosis. This study aims to expand the current body of work on textures and details preserving convolutional neural networks for low-dose CT (LDCT) image denoising task.Approach. This study proposed a novel multi-scale feature aggregation and fusion network (MFAF-net) for LDCT image denoising. Specifically, we proposed a multi-scale residual feature aggregation module to characterize multi-scale structural information in CT images, which captures regional-specific inter-scale variations using learned weights. We further proposed a cross-level feature fusion module to integrate cross-level features, which adaptively weights the contributions of features from encoder to decoder by using a spatial pyramid attention mechanism. Moreover, we proposed a self-supervised multi-level perceptual loss module to generate multi-level auxiliary perceptual supervision for recovery of salient textures and structures of tissues and lesions in CT images, which takes advantage of abundant semantic information at various levels. We introduced parameters for the perceptual loss to adaptively weight the contributions of auxiliary features of different levels and we also introduced an automatic parameter tuning strategy for these parameters.Main results. Extensive experimental studies were performed to validate the effectiveness of the proposed method. Experimental results demonstrate that the proposed method can achieve better performance on both fine textures preservation and noise suppression for CT image denoising task compared with other competitive convolutional neural network (CNN) based methods.Significance. The proposed MFAF-net takes advantage of multi-scale receptive fields, cross-level features integration and self-supervised multi-level perceptual loss, enabling more effective recovering of fine textures and detailed structures of tissues and lesions in CT images.
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Procesamiento de Imagen Asistido por Computador , Tomografía Computarizada por Rayos X , Tomografía Computarizada por Rayos X/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Humanos , Redes Neurales de la Computación , Dosis de Radiación , Relación Señal-RuidoRESUMEN
In this study, fava bean protein (FPI) was isolated from flours prepared from dehulled seeds and compared to FPI extracted from whole flours; in the latter case, flours were prepared either by dry- or wet-milling. Significant differences in composition and functionality were observed between the three FPIs produced. Dehulling maximized protein purity, oil-absorption capacity, solubility, foamablity and minimized both starchy and non-starchy carbohydrate contents. Protein isolated from wet-milled whole beans provided higher mass and extraction yields, better water-absorption capacity, and exhibited higher surface charge (zeta potential) compared to other samples. The protein extracted from dry-milled whole seed exhibited a higher least gelation concentration, emulsifying activity and zeta value compared to its dehulled counterpart. Dehulling was also found to be a useful process to increase the lightness/whiteness of protein powder. Overall, the present findings provide useful technological information relating to the production of FPI with and without a dehulling step.
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OBJECTIVE: Notch-1 is a signal regulatory protein with extensive effects in myeloid cells, but its role in aneurysms remains to be fully clarified. In this study, therefore, the aneurysm mouse model with myeloid-specific knockout of Notch-1 was established to observe the role of Notch-1 in aneurysm progression. METHODS AND RESULTS: The effect of Notch-1 was assessed by pathological staining and Western blotting. It was found that after myeloid-specific knockout of Notch-1 in the aneurysm mouse model, the area of aneurysms and the macrophage infiltration were significantly reduced, the damage to arterial elastic plates was significantly relieved, and the oxidative stress level significantly declined. The results of Western blotting showed that after myeloid-specific knockout of Notch-1, the levels of oxidative stress-related proteins p22 and p47 in aneurysm tissues significantly declined, accompanied by a significant increase in the protein level of Src homology 2 domain-containing tyrosine phosphatase-2 (SHP2). In addition, the levels of phosphorylated myeloid differential protein-88 (MyD88), TIR domain-containing adaptor-inducing interferon-ß (TRIF) and nuclear factor-κB (NF-κB), and inflammatory cytokines interferon-γ (IFN-γ), interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) also significantly decreased after myeloid-specific knockout of Notch-1. Following myeloid-specific knockout of Notch-1, the phagocytic capacity of macrophages was enhanced by promoting the SHP2 signaling pathway. CONCLUSION: Notch-1 in monocytes/macrophages can activate the Toll-like receptor (TLR)-mediated inflammatory and stress responses by activating oxidative stress and inhibiting the SHP2 protein expression, thus facilitating aneurysm progression.
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Aneurisma , Factor 88 de Diferenciación Mieloide , Receptor Notch1 , Animales , Ratones , Proteínas Adaptadoras del Transporte Vesicular/metabolismo , Factor 88 de Diferenciación Mieloide/genética , Factor 88 de Diferenciación Mieloide/metabolismo , FN-kappa B/metabolismo , Estrés Oxidativo , Transducción de Señal , Receptor Notch1/genéticaRESUMEN
BACKGROUND: Posterior malleolus fractures are known to be associated with ankle instability. The complexities involved in obtaining precise laboratory-based spatial pressure measurements of the ankle highlight the significance of exploring the biomechanical implications of these fractures. METHODS: Finite element analysis was utilized to examine the stress distribution across the contact surface of the ankle joint, both in its natural state and under varied sagittal fracture line angles. The study aimed to identify stress concentration zones and understand the influence of sagittal angles on stress distribution. RESULTS: Three distinct stress concentration zones were identified on the ankle's contact surface: the anterolateral tibia, the anteromedial tibia, and the fracture line. The most significant stress was observed at the fracture line when a fracture occurs. Stress at the fracture line notably spikes as the sagittal angle decreases, which can potentially compromise ankle stability. Larger sagittal angles exhibited only minor stress variations at the contact surface's three vertices. It was inferred that sagittal angles below 60° might pose risks to ankle stability. CONCLUSIONS: The research underscores the potential implications of fractures on the stress profile of the ankle joint, emphasizing the role of the contact surface in ensuring stability. The identification of three zones of stress concentration and the influence of sagittal angles on stress distribution offers a valuable reference for therapeutic decision-making. Further, the study reinforces the importance of evaluating sagittal fracture angles, suggesting that angles below 60° may compromise ankle stability.
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Fracturas de Tobillo , Inestabilidad de la Articulación , Humanos , Fracturas de Tobillo/diagnóstico por imagen , Fracturas de Tobillo/complicaciones , Tobillo , Análisis de Elementos Finitos , Articulación del Tobillo , Fijación Interna de FracturasRESUMEN
Background: Low-dose computed tomography (LDCT) scans can effectively reduce the radiation damage to patients, but this is highly detrimental to CT image quality. Deep convolutional neural networks (CNNs) have shown their potential in improving LDCT image quality. However, the conventional CNN-based approaches rely fundamentally on the convolution operations, which are ineffective for modeling the correlations among nonlocal similar structures and the regionally distinct statistical properties in CT images. This modeling deficiency hampers the denoising performance for CT images derived in this manner. Methods: In this paper, we propose an adaptive global context (AGC) modeling scheme to describe the nonlocal correlations and the regionally distinct statistics in CT images with negligible computation load. We further propose an AGC-based long-short residual encoder-decoder (AGC-LSRED) network for efficient LDCT image noise artifact-suppression tasks. Specifically, stacks of residual AGC attention blocks (RAGCBs) with long and short skip connections are constructed in the AGC-LSRED network, which allows valuable structural and positional information to be bypassed through these identity-based skip connections and thus eases the training of the deep denoising network. For training the AGC-LSRED network, we propose a compound loss that combines the L1 loss, adversarial loss, and self-supervised multi-scale perceptual loss. Results: Quantitative and qualitative experimental studies were performed to verify and validate the effectiveness of the proposed method. The simulation experiments demonstrated the proposed method exhibits the best result in terms of noise suppression [root-mean-square error (RMSE) =9.02; peak signal-to-noise ratio (PSNR) =33.17] and fine structure preservation [structural similarity index (SSIM) =0.925] compared with other competitive CNN-based methods. The experiments on real data illustrated that the proposed method has advantages over other methods in terms of radiologists' subjective assessment scores (averaged scores =4.34). Conclusions: With the use of the AGC modeling scheme to characterize the structural information in CT images and of residual AGC-attention blocks with long and short skip connections to ease the network training, the proposed AGC-LSRED method achieves satisfactory results in preserving fine anatomical structures and suppressing noise in LDCT images.
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Brown rice exhibits higher nutritional value and attracts more and more attentions; however, the change in phospholipid molecular species in brown rice during aging is poorly understood. In this study, shotgun lipidomics was employed to investigate the changes in phospholipid molecular species in four brown rice varieties (two japonica rice and two indica rice) during accelerated aging. A total of 64 phospholipid molecular species were identified, and most of them were rich in polyunsaturated fatty acids. For japonica rice, phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylglycerol (PG) gradually decreased during accelerated aging. However, the content of PC, PE, and PG in indica rice showed no difference during accelerated aging. Significantly different phospholipid molecular species from four brown rice were screened during accelerated aging. Based on these significantly different phospholipids, the metabolic pathways including glycerophospholipid metabolism and linoleic acid metabolism during accelerated aging were depicted. The findings from this study could be helpful in explaining the impact of accelerated aging on phospholipids of brown rice, and offer an understanding on relationships between phospholipids degradation and brown rice deterioration.
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Oryza , Fosfolípidos , Fosfolípidos/metabolismo , Oryza/metabolismo , Lipidómica , Ácidos Grasos Insaturados , FosfatidilcolinasRESUMEN
This study aimed to comprehensively elucidate the vital secondary metabolites of Wuchang Daohuaxiang (DHX) rice through widely targeted metabolomics analysis. Among the secondary metabolites detected, a total of 30 differential ones were screened out and categorized into 4 different classes, including 6 alkaloids (20%), 15 flavonoids (50%), 6 phenolic acids (20%), and 3 terpenoids (10%) between DHX and control groups. Of these, compounds as zarzissine, fagomine, arbutin, p-Hydroxypheny-ß-D-allopyranoside, pimaric acid, kaurenoic acid, and isopimaric acid were more abundant in DHX than control group, with the possibility in serve as key secondary metabolites of DHX rice. Furthermore, arbutin, trigonelline and 6'-O-Feruloyl-D-sucrose were optimized as potential biomarkers for DHX rice discrimination. This study would supply data support for DHX rice authenticity and quality improvement.
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Oryza , Oryza/metabolismo , Arbutina/metabolismo , Metabolómica , Terpenos/metabolismo , ChinaRESUMEN
This study aimed to elucidate the effect of the accelerating storage (40 °C, 10 weeks) of foxtail millet on the edible and cooking quality of its porridge. The structural alteration of the in-situ protein and starch in foxtail millet, as well as the physicochemical properties were investigated. Both the homogeneity and palatability of millet porridge were significantly improved after 8-week storage of millet, while its proximate compositions remained unchanged. Meanwhile, the accelerating storage increased the water absorption and swelling of millet by 20 % and 22 %, respectively. The morphological studies (using the SEM, CLSM and TEM) revealed that the starch granules in the stored millet became easier to swell and melt, leading to better gelatinization with a higher coverage extension in protein bodies. FTIR results showed that the protein hydrogen bonds in the stored millet became stronger and the starch ordered degree was reduced. Compared to the native foxtail millet, the peak, trough, final, and setback viscosity of the stored sample increased by 27 %, 76 %, 115 % and 143 %, respectively, while the onset, peak, and conclusion temperature increased by 0.80, 1.10 and 0.80 °C, respectively. Besides, the G' and Gâ³ of the stored foxtail millet were significantly higher than its native counterpart.
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Panicum , Setaria (Planta) , Almidón/química , Setaria (Planta)/química , Fenómenos Químicos , Viscosidad , Panicum/química , Culinaria , MijosRESUMEN
Brown rice exhibits higher nutritional value and attracts more and more attentions; however, lipid alteration in brown rice during aging is poorly understood. In this study, lipidomics and volatilomics were employed to investigate free fatty acids, triglycerides, and volatile oxidative degradation products of lipids in brown rice during accelerated aging for 70 days. The results showed that the total free fatty acids in brown rice increased significantly (2.90-4.14 times) while triglycerides decreased remarkably at the initial stage of aging. Monounsaturated and polyunsaturated aldehydes, ketones, and acids increased obviously in brown rice during accelerated aging for 70 days. The screening of significantly different compounds indicated that the enzymatic hydrolysis of triglycerides (EHT) and enzymatic oxidation of lipids (EOL) were the main biochemical behaviors at the initial stage of aging (0-28 day) while automatic oxidation of lipids (AOL) was the primary chemical reaction for 28-70 days aging.
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Oryza , Oryza/química , Lipidómica , Ácidos Grasos no Esterificados/metabolismo , Triglicéridos/metabolismo , Estrés OxidativoRESUMEN
OBJECTIVE: Valgus-impacted femoral neck fractures with or without posterior tilt of the femoral head are very common and full of pitfalls in clinical practice, which may lead to femoral neck shortening (FNS) and avascular necrosis (AVN). The study tries to introduce a novel technical trick aiming at anatomical reduction of valgus-impacted femoral neck fracture with minimally invasive procedure, and summarize the clinical prognosis in case series. METHODS: In this retrospective study, 24 patients (seven men and 17 women) with valgus-impacted femoral neck fractures between May 2017 and July 2020 were managed by "in-out-in" percutaneous reduction technique (percutaneous reduction group). Another 24 cases (10 men and 14 women) suffering the fractures underwent in situ fixation were enrolled as control group for function comparison (in situ fixation group). All patients were followed up for 24-42 months. The clinical outcomes included complications after operations (χ2 test) and Harris Hip Score (HHS) for hip function (unpaired t test) in the two groups. The radiographic outcomes were evaluated by collodiaphyseal angle, posterior tilt angle, and FNS before the operation and during the follow-up in the percutaneous reduction group (unpaired t test). RESULTS: Patients' preoperative data, including age, sex, affected side, fracture types, and medical history, were similar between the two groups, respectively (p > 0.05). After surgery, the mean HHS at 6, 12, and 24 months were all better in the percutaneous reduction group (76 ± 6.72, 85.34 ± 6.33 and 90.54 ± 5.81) than that in the in situ fixation group (70.86 ± 6.91, 80 ± 6.11 and 84.1 ± 7.82), respectively (p < 0.05). One patient suffered fixation failure with screws retreat and one patient suffered AVN in the percutaneous reduction group. In the in situ fixation group, AVN occurred in two patients at last follow-up. There was no significant difference in complication amounts between the two groups (p > 0.05). In the percutaneous reduction group, collodiaphyseal angle, posterior tilt angle, and amount of FNS were significantly different between preoperative cases and immediately postoperative cases (p < 0.05). However, there was no statistical difference of the measurements among postoperative cases at different time points (within 24 h, 6 months, and 2 years postoperatively) (p > 0.05). CONCLUSIONS: Our experience of the technique and the case series show that "in-out-in" percutaneous reduction technique for treatment of valgus-impacted femoral neck fracture with or without posterior tilt of the femoral head is safe and effective for achieving successful bone union and satisfactory function.
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Fracturas del Cuello Femoral , Osteonecrosis , Masculino , Humanos , Femenino , Estudios Retrospectivos , Resultado del Tratamiento , Fijación Interna de Fracturas/métodos , Fracturas del Cuello Femoral/cirugíaRESUMEN
Rice quality changes during storage. However, few studies have reported the difference in protein structure between the indica and japonica varieties of rice during storage. The current research characterized the structural properties of the rice protein, and further investigated the proteomic profiles of Jianzhen 2 (indica rice) and Nanjing 9108 (japonica rice) during storage using the TMT labeling method. A significant reduction in free sulfhydryl content and an increase in disulfide bonds content and surface hydrophobicity were observed in both varieties after storage. The results of FTIR indicated that the changes in the protein's secondary structure of Nanjing 9108 (japonica rice) were more significant than in Jianzhen 2 (indica rice). A total of 4039 proteins in Nanjing 9108 and 4301 proteins in Jianzhen 2 were identified by TMT-labeled proteomics analysis in this study. Significantly, changes were detected in 831 proteins in Nanjing 9108, while only in 60 proteins in Jianzhen 2. Protein processing in endoplasmic reticulum, starch, and sucrose metabolism were both accelerated in both varieties, while oxidative phosphorylation in mitochondria, glycolysis, fatty acid metabolism, and glutathione metabolism were enhanced in Nanjing 9108 (japonica rice). This study provides insight into the proteomic changes and protein structure in rice induced by storage.
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OBJECTIVE: To explore clinical efficacy of staged surgery in treating complex closed Pilon fracture. METHODS: From June 2019 to January 2021, 29 patients with complex closed Pilon fracture were treated by staging surgery, including 18 males and 11 females, aged ranged from 31 to 68 years old with an average of (43.50±6.62) years old;7 cases were typeâ ¡and 22 cases were type â ¢ according to Ruedi-Allgower classification. All patients had fresh closed fractures without talus and calcaneal fractures. The time from injury to closed reduction and external fixation, the interval between two stages of surgery, fracture healing time and complications were recorded. American Orthopedic Foot and Ankle Society(AOFAS) was used to assess clinical effects. Burwell-Charnley system was used to evaluate radiological reduction. RESULTS: All 29 patients were followed up from 13 to 30 months with an aver age of (15.43±5.31) months. All fractures healed well from 2 to 6 months with an average of (3.77±1.22) months. No internal fixation fracture, screw loosening, infection, internal fixation irritation, ankle stiffness occurred. The time from injury to closed reduction and cross-ankle fixation ranged from 1.22 to 7.34 h with an average of(2.31±3.52) h, the interval between two stages ranged from 5 to 9 days with an average of (5.98±2.11) days. AOFAS score was improved from 34.11±6.89 before operation to 90.10±10.11 after oepration at 12 months(P<0.05). According to AOFAS grading, 16 patients got excellent result, 9 good and 4 moderate. Fifteen patients got anatomic reduction, 12 patients were good reduction, and 2 cases were poor reduction according to Burwell-Charnley system. CONCLUSION: Staged surgery for complex closed Pilon fracture has advantages of less complications, statisfied reduction, stable fixation, which could obtain good recovery of ankle joint.
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Fracturas de Tobillo , Traumatismos del Tobillo , Fracturas de la Tibia , Adulto , Anciano , Fracturas de Tobillo/cirugía , Traumatismos del Tobillo/cirugía , Femenino , Fijación Interna de Fracturas , Curación de Fractura , Humanos , Lactante , Masculino , Persona de Mediana Edad , Fracturas de la Tibia/cirugíaRESUMEN
OBJECTIVE: Surgical treatment for Schatzker type II tibial plateau fractures remains challenging and requires high-quality research. The aim of the study is to compare the "windowing" and "open book" techniques for the treatment of Schatzker type II tibial plateau fractures. METHODS: In this prospective study, all patients with Schatzker type II tibial plateau fractures between January 2014 and December 2017 were managed by open reduction and internal fixation using an anterolateral incision approach. "Windowing" group included 78 patients (53 men and 25 women), with an average age of 57.7 ± 13.5 years, who underwent the "windowing" technique, in which the procedure was performed through a small cortical window against the depressed zone of the lateral plateau. The "open book" group included 80 patients (56 men and 24 women), with an average age of 54.8 ± 12.4 years, who underwent the technique. The clinical outcomes included the Rasmussen classification of knee function and grading of post-traumatic arthritis. The radiographic outcome (x-ray and computed tomography [CT]) was the reduction quality of the lateral plateau based on the modified Rasmussen radiological assessment. The patient-reported outcome was visual analogue scale (VAS) scores. RESULTS: The mean follow-up time for the158 patients was 32 months (range, 24-42 months). The time elapsed from injury to surgery in "windowing" group and "open book" group were 3.7 ± 1.2 (range, 1-10 days) and 3.5 ± 1.4 days (range, 1-11 days), respectively, with no significant difference between the groups (P > 0.05). The operation times did not differ significantly between the "windowing" group (61.0 ± 8.3 min, range, 45-120 min) and the "open book" group (61.2 ± 10.4 min, range, 40-123 min) (P > 0.05). After surgery, CT revealed five (6.4%) and 15 (18.8%) cases of articular depression in the "windowing" and "open book" groups, respectively. Significant differences were observed in the articular depression of tibial plateau fractures between the groups (P < 0.05). However, condylar widening or valgus/varus did not differ significantly between the groups. Furthermore, no significant differences in knee function were observed during follow-up (P > 0.05). VAS scores were similar between the groups at 24 months after surgery (P > 0.05). There were significant differences in the number of severe post-traumatic arthritis (grades 2 and 3) cases between the groups (P < 0.05). CONCLUSIONS: The "windowing" and "open book" techniques are both effective for the treatment of Schatzker type II tibial plateau fractures. However, the "windowing" technique provides better reduction quality, leading to a satisfactory prognosis.
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Artritis , Fracturas de la Tibia , Adulto , Anciano , Femenino , Fijación Interna de Fracturas/métodos , Humanos , Masculino , Persona de Mediana Edad , Reducción Abierta/métodos , Estudios Prospectivos , Estudios Retrospectivos , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Resultado del TratamientoRESUMEN
Wuchang Daohuaxiang (DHX) rice is a famous product in China, while identification and authentication method is limited. Due to the special taste and flavor of DHX, lipidomics was conducted to discriminate it from faked rice. First, lipid profiles of DHX and other nine rice varieties were required from the established UPLC-Q/TOF-MS/MS method. The compositions and contents of lipids significantly varied among different rice. Then, twenty-six potential biomarkers containing 6 DGs, 5 PAs, 4 PCs, 1 PE, 3 PGs, 2 PIs, 2 PSs, 2 SMs, and 1 Cer were characterized and verified for identifying DHX from all faked rice. The accuracy of developed methods for DHX discrimination was 97.14%. In addition, OPLS-DA models were established for DHX distinction between each of the nine rice cultivars. Our results would supply as supplementary tools for discrimination of DHX rice for supervision departments and industries.
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Oryza , Biomarcadores , Lipidómica , Lípidos , Espectrometría de Masas en TándemRESUMEN
To determine the changes in the quality of rice during storage, this study investigated the comprehensive metabolomic profiles of Nanjing 9108 (typical japonica rice) and Jianzhen 2 (typical indica rice) varieties in China, using metabolomics. A total of 13 categories of 593 metabolites including lipids (134 species), phenolic acids (78 species), flavonoids (70 species), alkaloids (67 species), organic acids (64 species), amino acids and derivatives (64 species), saccharides and alcohols (44 species), nucleotides and derivatives (37 species), vitamins (14 species), lignans and coumarins (9 species), tannins (2 species), terpenoids (2 species), and others (8 species) were identified in both varieties. The result showed significant changes in 204 metabolites in Nanjing 9108, while only 26 were altered in Jianzhen 2 during storage. These metabolites involved 46 metabolic pathways. The TCA cycle, linoleic, and α-linolenic acid metabolic pathways were unique in Nanjing 9108. Finally, the results of quantitative mass spectrometry of 11 metabolites provided insight into biomarkers associated with quality deterioration of rice. This study provides insights into the mechanism of deterioration in the quality of rice during storage.