The effect of a split-dose intravenous dexamethasone and a single high-dose on postoperative blood glucose after total joint arthroplasty: a randomized double-blind placebo-controlled trial.

BACKGROUND: In patients undergoing total joint arthroplasty (TJA), the administration of dexamethasone may contribute to perioperative blood glucose (BG) disturbances, potentially resulting in complications, even in patients without diabetes. This study aimed to demonstrate the impact of different administration regimens of dexamethasone in postoperative BG levels. METHODS: In this randomized, controlled, double-blind trial, 136 patients without diabetes scheduled for TJA were randomly assigned to three groups: two perioperative saline injections (Group A, placebo); a single preoperative injection of 20 mg dexamethasone and a postoperative saline injection (Group B), and two perioperative injections of 10 mg dexamethasone (Group C). Primary outcomes were the postoperative fasting blood glucose (FBG) levels. Secondary outcome parameters were the postoperative postprandial blood glucose (PBG) levels. Postoperative complications within 90 days were also recorded. Risk factors for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl were investigated. RESULTS: Compared to Group A, there were transient increases in FBG and PBG on postoperative days (PODs) 0 and 1 in Groups B and C. Statistical differences in FBG and PBG among the three groups were nearly absent from POD 1 onward. Both dexamethasone regimens did not increase the risk for postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl. Elevated preoperative HbA1c levels may increase the risk of postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl, respectively. CONCLUSION: Perioperative intravenous high-dose dexamethasone to patients without diabetes has transient effects on increasing BG levels after TJA. However, no differences were found between the split-dose and single high-dose regimens. The elevated preoperative HbA1c, but not the dexamethasone regimens were the risk factor for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl. TRIAL REGISTRATION: Chinese Clinical Trail Registry, ChiCTR2300069473. Registered 17 March 2023, https://www.chictr.org.cn/showproj.html?proj=186760 .

Spectral Tensor Layers for Communication-Free Distributed Deep Learning.

In this article, we propose a novel spectral tensor layer for communication-free distributed deep learning. The overall framework is as follows: first, we represent the data in tensor form (instead of vector form) and replace the matrix product in conventional neural networks with the tensor product, which in effect imposes certain transformed-induced structure on the original weight matrices, e.g., a block-circulant structure; then, we apply a linear transform along a certain dimension to split the original dataset into multiple spectral subdatasets; as a result, the proposed spectral tensor network consists of parallel branches where each branch is a conventional neural network trained on a spectral subdataset with ZERO communication cost. The parallel branches are directly ensembled (i.e., the weighted sum of their outputs) to generate an overall network with substantially stronger generalization capability than that of each branch. Moreover, the proposed method enjoys a byproduct of decentralization gain in terms of memory and computation, compared with traditional networks. It is a natural yet elegant solution for heterogeneous data in federated learning (FL), where data at different nodes have different resolutions. Finally, we evaluate the proposed spectral tensor networks on the MNIST, CIFAR-10, ImageNet-1K, and ImageNet-21K datasets, respectively, to verify that they simultaneously achieve communication-free distributed learning, distributed storage reduction, parallel computation speedup, and learning with multiresolution data.

Effects of Dexamethasone on Postoperative Glycemic Control in Patients After Primary Total Joint Arthroplasty: A Randomized Double-Blind Controlled Trial.

BACKGROUND: In patients undergoing total joint arthroplasty, the use of dexamethasone (DEX) may cause perioperative blood glucose (BG) disorders, leading to complications even in patients who do not have diabetes. We aimed to evaluate the effects of different DEX doses on perioperative BG levels. METHODS: A total of 135 patients who do not have diabetes were randomized into three groups: preoperative intravenous (IV) injection of normal saline (Group A, the placebo group), preoperative IV injection of 10 mg DEX (Group B), and preoperative IV injection of 20 mg DEX (Group C). Postoperative fasting BG (FBG) levels were designated as the primary outcome, while postoperative postprandial BG (PBG) levels were assigned as the secondary outcome. The incidence of complications was recorded. We also investigated the risk factors for FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL. RESULTS: The FBG levels were higher in Groups B and C than in Group A on postoperative days (PODs) 0 and 1. The PBG levels were lower for Groups A and B compared to Group C on POD 1. No differences in FBG or PBG were detected beyond POD 1. Elevated preoperative glycosylated hemoglobin A1c levels increased the risk of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL, respectively. However, preoperative IV injection of DEX was not associated with FBG ≥ 140 mg/dL or PBG ≥ 180 mg/dL. No differences were found in postoperative complications among the three groups. CONCLUSIONS: The preoperative IV administration of 10 or 20 mg DEX in patients who do not have diabetes showed transient effects on postoperative BG after total joint arthroplasty. The preoperative glycosylated hemoglobin A1c level threshold (regardless of the administration or dosage of DEX) that increased the risk for the occurrence of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL was 5.75 and 5.85%, respectively.

Misdiagnosis of synovial sarcoma - cellular myofibroma with SRF-RELA gene fusion: A case report.

BACKGROUND: Cellular myofibroma is a rare subtype of myofibroma that was first described in 2017. Its diagnosis is often challenging because of its relative rarity, lack of known genetic abnormalities, and expression of muscle markers that can be confused with sarcomas that have myogenic differentiation. Currently, scholars have limited knowledge of this disease, and published cases are few. Further accumulation of diagnostic and treatment experiences is required. CASE SUMMARY: A 16-year-old girl experienced left upper limb swelling for 3 years. She sought medical attention at a local hospital 10 months ago, where magnetic resonance imaging revealed a 5-cm soft tissue mass. Needle biopsy performed at a local hospital resulted in the diagnosis of a spindle cell soft tissue sarcoma. The patient was referred to our hospital for limb salvage surgery with endoprosthetic replacement. She was initially diagnosed with a synovial sarcoma. Consequently, clinical management with chemotherapy was continued for the malignant sarcoma. Our pathology department also performed fluorescence in situ hybridization for result validation, which returned negative for SS18 gene breaks, indicating that it was not a synovial sarcoma. Next-generation sequencing was used to identify the SRF-RELA rearrangement. The final pathological diagnosis was a cellular/myofibroblastic neoplasm with an SRF-RELA gene fusion. The patient had initially received two courses of chemotherapy; however, chemotherapy was discontinued after the final diagnosis. CONCLUSION: This case was misdiagnosed because of its rare occurrence, benign biological behavior, and pathological similarity to soft tissue sarcoma.

Always positive covalent organic nanosheet enabling pH-independent adsorption and removal of Cr(â ¥).

Rapid and highly effective removal of hexavalent chromium (Cr(Ⅵ)) is extremely vital to water resources restoration and environmental protection. To overcome the pH limitation faced by most ionic absorbents, an always positive covalent organic nanosheet (CON) material was prepared and its Cr(VI) adsorption and removal capability was investigated in detail. As-prepared EB-TFB CON (TFB = 1,3,5-benzaldehyde, EB = ethidium bromide) shows strong electropositivity in the tested pH range of 1 ∼ 10, display a pH-independent Cr(VI) removal ability, and work well for Cr(VI) pollution treatment with good anti-interference capability and reusability in a wide pH range covering almost all Cr(VI)-contaminated real water samples, thus eliminating the requirement for pH adjustment. Moreover, the nanosheet structure, which is obtained by a facile ultrasonic-assisted self-exfoliation, endows EB-TFB CON with fully exposed active sites and shortened mass transfer channels, and the Cr(VI) adsorption equilibrium can be reached within 15 min with a high adsorption capacity of 280.57 mg·g-1. The proposed Cr(VI) removal mechanism, which is attributed to the synergetic contributions of electrostatic adsorption, ion exchange and chemical reduction, is demonstrated by experiments and theoretical calculations. This work not only provides a general Cr(VI) absorbent without pH limitation, but also presents a paradigm to prepare ionic CONs with relatively constant surface charges.

Collagen-based scaffolds with high wet-state cyclic compressibility for potential oral application.

Soft tissue substitutes have been developed to treat gingival recessions to avoid a second surgical site. However, products of pure collagen for clinical application lack their original mechanical strengths and tend to degrade fast in vivo. In this study, a collagen-based scaffold crosslinked with oxidized sodium alginate (OSA-Col) was developed to promote mechanical properties. Compared with commercial products collagen matrix (CM) and collagen sponge (CS), OSA-Col scaffolds presented higher wet-state cyclic compressibility, early anti-degradation ability, similar hemocompatibility and cytocompatibility. Furthermore, in the subcutaneous implantation experiment, OSA2-Col3 scaffolds showed better anti-degradation performance than CS scaffolds and superior neovascularization than CM scaffolds. These results demonstrated that OSA2-Col3 scaffolds had potential as a new soft tissue substitute for the treatment of gingival recessions.

Adsorption-desorption behaviors of ciprofloxacin onto aged polystyrene fragments in aquatic environments.

As two emerging pollutants of great concern, microplastics (MPs) and antibiotics inevitably cooccur in various aquatic environments and interact with each other, impacting the fate and ecological risks. Aging obviously complicates their interaction and deserves further study. Therefore, the adsorption-desorption behaviors of ciprofloxacin (CIP) onto polystyrene (PS) fragments with various aging extent were investigated, and the key physiochemical properties influencing the interaction and the interaction mechanisms were clarified by redundancy analysis, FTIR and XPS spectra. The physicochemical properties of PS MPs were significantly changed with aging time, and the morphological and chemical changes seemed to occur asynchronously. The adsorption of CIP onto the pristine PS MPs relied on physisorption, especially the ion-involving electrostatic and cation-π interaction. Due to the hydrogen bonding formed by the C-OH, CO, and O-CO groups of PS and CIP, the adsorption capacities of the aged PS MPs were greatly increased. The desorption efficiency of CIP from MPs in the gastric fluid was closely related to the solution ionic strengths, C-OH and CO groups of MPs, while that in the intestinal fluid was associated with O-CO groups of MPs. The different impact factors could be well described by the differences in the chemical components and pHs of the simulated gastric and intestinal fluids. This study gives a comprehensive understanding of the adsorption-desorption behaviors of antibiotics onto MPs at a molecular level and indicates that MPs could act as Trojan horses to transport antibiotics into aquatic organisms.

Primary ovarian angiosarcoma: Two case reports and review of literature.

BACKGROUND: Angiosarcoma (AS) is a rare and highly aggressive soft tissue disease that most commonly arises in deep soft tissues. There are only a few reported cases of AS involving the ovary and even fewer reports of the underlying molecular abnormalities. Here, we briefly review two cases of primary ovarian AS (oAS) with specific molecular events and immune checkpoints. The clinical features and prognosis of the disease, diagnosis, differential diagnosis, and new treatment approaches are discussed based on a literature review. CASE SUMMARY: Case 1: A 51-year-old female patient was admitted with right lower limb pain for 5 mo, and lower abdominal pain with hematuria for 1 mo. Partial removal of rectus abdominis muscle and fascia, partial hysterectomy, bilateral salpingo-oophorectomy, and inguinal and pelvic lymphadenectomy were performed. Pathology revealed primary oAS. Fluorescence in situ hybridization revealed c-MYC gene amplification. MESNA + ADM + IFO + DTIC (MAID) regimen was administered, but stable disease was achieved. The patient died 1 mo later. Case 2: A 41-year-old female patient presented with fatigue, nausea, decreased appetite, and diffuse abdominal pain. On physical examination, the abdomen was distended and a complex cystic mass was palpable in the right pelvic cavity. Pathology revealed primary oAS. MAID chemotherapy was administered and programmed death ligand 1 (PD-L1) staining was performed on the tumor samples. The patient benefited from anti-PD-1 immunotherapy and is alive without any evidence of disease 27 mo off therapy in follow-up. CONCLUSION: Long-term survival benefit for primary oAS can be achieved by alternative therapeutic strategies using pathological indicators to inform treatment.

Impacts of gait biomechanics of patients with thoracolumbar kyphosis secondary to Scheuermann's disease.

Introduction: Thoracolumbar kyphosis (TLK) is a common feature in patients with spinal deformities. However, due to limited studies, the impacts of TLK on gait have not been reported. The objective of the study was to quantify and evaluate the impacts of gait biomechanics of patients with TLK secondary to Scheuermann's disease. Methods: Twenty cases of Scheuermann's disease patients with TLK and twenty cases of asymptomatic participants were recruited into this study. And the gait motion analysis was conducted. Results: The stride length was shorter in the TLK group compared to control group (1.24 ± 0.11 m vs. 1.36 ± 0.21 m, p = 0.04). Compared to control group, the stride time and step time were more prolonged in the TLK group (1.18 ± 0.11s vs. 1.11 ± 0.08 s, p = 0.03; 0.59 ± 0.06 s vs. 0.56 ± 0.04 s, p = 0.04). The gait speed of the TLK group was significantly slower than it of control group (1.05 ± 0.12 m/s vs. 1.17 ± 0.14 m/s, p = 0.01); In the sagittal plane, the range of motion (ROM) of the hip in the TLK group was significantly smaller than that of the control group (37.71 ± 4.35° vs. 40.05 ± 3.71°, p = 0.00). In the transverse plane, the adduction/abduction ROMs of the knee and ankle, as well as the internal and external rotation of the knee, were smaller in TLK group than ROMs in the control group (4.66 ± 2.21° vs. 5.61 ± 1.82°, p = 0.00; 11.48 ± 3.97° vs. 13.16 ± 5.6°, p = 0.02; 9.00 ± 5.14° vs. 12.95 ± 5.78°, p = 0.00). Discussion: The main finding of this study was that measurements of gait patterns and joint movement of the TLK group were significantly lower than those of the control group. And these impacts have the potential to exacerbate degenerative progress of joints in the lower extremities. These abnormal features of gait can also serve as a guideline for physicians to focus on TLK in these patients.

Real-Time Decoding of Snapshot Compressive Imaging Using Tensor FISTA-Net.

Snapshot compressive imaging (SCI) cameras compress high-speed videos or hyperspectral images into measurement frames. However, decoding the data frames from measurement frames is compute-intensive. Existing state-of-the-art decoding algorithms suffer from low decoding quality or heavy running time or both, which are not practical for real-time applications. In this article, we exploit the powerful learning ability of deep neural networks (DNN) and propose a novel tensor fast iterative shrinkage-thresholding algorithm net (Tensor FISTA-Net) as a real-time decoder for SCI cameras. Since SCI cameras have an accurate physical model, we can trade training time for the decoding time by generating abundant synthetic data and training a decoder on the cloud. Tensor FISTA-Net not only learns a sparse representation of the frames through convolution layers but also reduces the decoding time and memory consumption significantly through tensor operations, which makes Tensor FISTA-Net an appropriate approach for a real-time decoder. Our proposed Tensor FISTA-Net obtains an average PSNR improvement of 0.79-2.84 dB (video images) and 2.61-4.43 dB (hyperspectral images) over the state-of-the-art algorithms, along with more clear and detailed visual results on real SCI datasets, Hammer and Wheel, respectively. Our Tensor FISTA-Net reaches 45 frames per second in video datasets and 70 frames per second in hyperspectral datasets, meeting the real-time requirement. Besides, the trained model occupies only a 12 -MB memory footprint, making it applicable to real-time Internet of Things (IoT) applications.

Case analysis of epilepsy, neurodevelopmental disorder, and motor disorders associated with mutations in the dehydrodolichyl diphosphate synthase gene.

The objective of this study is to analyze the role of dehydrodolichyl diphosphate synthase (DHDDS), a crucial enzyme in the mevalonate pathway, and its encoded mutations in the onset of developmental delay and seizures, with or without movement abnormalities. Its genotype-phenotype characteristics are still inconclusive. We analyzed the clinical characteristics of epilepsy, and neurodevelopmental and motor disorders related to DHDDS gene mutations and report the genotype-phenotype characteristics of a child with epilepsy caused by DHDDS gene mutation, providing a summary and a statistical analysis of epilepsy cases associated with DHDDS gene mutation up until February 2022. METHODS: Using "DHDDS; epilepsy; neurodevelopmental disorder" as the keywords, the literature relevant to DHDDS gene mutations up until February 2022 was reviewed. A total of 25 cases were retrieved, among which 21 cases with complete data were included in the chi-squared test. The clinical characteristics of DHDDS gene-related cases were summarized and analyzed. RESULTS: The onset of epilepsy caused by mutations of the DHDDS gene typically occurs during infancy. Predominantly, the mutation occurs in the locus of c.632G>A p.R211Q. Myoclonus is frequently the initial manifestation of epilepsy; it frequently coexists with neurodevelopmental disorder and intellectual disability, and patients have no specific type of motor disorder. Cranial magnetic resonance imaging (MRI) reveals no abnormalities, whereas electroencephalogram (EEG) frequently exhibits abnormalities. Valproic acid (VPA) yields good curative effects. CONCLUSION: Mutations in the DHDDS gene are associated with congenital glycosylation disorder, autosomal recessive retinitis pigmentosa, and epilepsy. According to statistical analysis using the chi-squared test, for pediatric patients with mutations in this gene locus, most of the epilepsy types are myoclonic epilepsies with intellectual disability and neurodevelopmental disorders. They have normal brain MRIs and abnormal EEGs. VPA produces beneficial therapeutic results and the differences are all statistically significant. The current diagnosis still relies on next-generation sequencing or whole-exome sequencing.

High-intensity ultrasound improved the physicochemical and gelling properties of Litopenaeus vannamei myofibrillar protein.

The effects of high-intensity ultrasound on the physicochemical and gelling properties of Litopenaeus vannamei (L. vannamei) myofibrillar protein (MP) were investigated. MP solutions were subjected to ultrasound treatment (power 100 W, 300 W, and 500 W). It was found that the carbonyl and free amino contents of MP increased significantly with increasing ultrasound power, accompanied by enhanced emulsification properties. The increase of free radical and carbonyl content indicated that ultrasound induced the oxidation of MP. With the increase of ultrasound power, it was found that the total sulfhydryl content of the shrimp MP decreased, but the surface hydrophobicity increased significantly, which might be closely related to the conformational changes of MP. Meanwhile, a significant increase of ß-sheet but a decrease of α-helix in the secondary structure of MP was observed with increasing ultrasound power, indicating that ultrasound treatment induced the stretching and flexibility of MP molecules. SDS-PAGE showed that L. vannamei MP consisted of myosin heavy chain, actin, myosin light chain, paramyosin and tropomyosin. Ultrasound treatment could lead to some degree of oxidative aggregation of MP. The results of rheological properties indicated that ultrasound treatment enhanced the viscoelasticity of MP and further improved the gel strength of MP gel. This study can provide a theoretical basis for the functional modification of shrimp MP and the processing of its surimi products.

[Temporal and Spatial Variation Characteristics of Heavy Metal in Atmospheric Deposition in China from 2000 to 2018].

Owing to the significant impact of heavy metals in atmospheric deposition on soil, clear knowledge on the present situation and temporal and spatial variation in fluxes of heavy metals in atmospheric deposition all around China is urgently needed. In this study, we collected 99 published papers on deposition fluxes of heavy metals from 2001 to 2021 based on the CNKI and Web of Science database and extracted 718 to 1672 monitoring points from these papers. The Meta-analysis method was used to calculate the weighted average of deposition fluxes of heavy metals, and the spatial-temporal characteristics in different periods from 2000 to 2018 were studied by subgroup analysis, which compared the differences between different types of areas, such as agricultural and rural areas and urban and industrial areas. The results showed that the annual fluxes of heavy metals in atmospheric deposition[mg·(m2·a)-1] in China were as follows:Zn (96.75)>Pb (23.37)>Cu (12.77)>Cr (11.04)>Ni (6.61)>As (2.97)>Cd (0.48)>Hg (0.05). Overall, the estimated value of deposition fluxes in China from 2000 to 2018 was higher than that of rural areas in England from 1995 to 1998. The deposition fluxes in industrial areas and urban areas were much higher than those in the agricultural and rural areas, especially the industrial areas where the heavy metal pollution was more serious. The deposition fluxes of As and Cd in the Changsha-Zhuzhou-Xiangtan area were relatively high, whereas the atmospheric deposition of heavy metals in Northeast China, the Pearl River Delta, and North China Plain was more serious than that in the other areas. In the past 20 years, the annual deposition fluxes of Cd fluctuated around the overall average, without an obviously declining trend, whereas the deposition fluxes of Cd in the urban, agricultural, and rural areas showed a trend of growth. These results suggested that precise and risk control measures of atmospheric emissions should be established based on the characteristics of regional industrial structure, which should cover all levels, all types, and all regions. In addition, more restrictive measures should be taken to solve the current problem caused by the higher deposition flux of Cd in atmospheric deposition.

An Experimental Investigation of the Mechanical Behavior and Particle Crushing Characteristic of Volcanic Soil.

Volcanic soil is a special soil that is well-known for its distinctive texture, vesicular nature, and particle fragility. The fragility characteristic of volcanic soil is the main factor affecting the foundation stability in road engineering. This study focuses on the mechanical properties and particle crushing characteristics of volcanic soil retrieved from Northeast China. A series of triaxial consolidation and drainage shear tests are performed on volcanic coarse-grained soil (5 mm > d > 0.075 mm) under different initial relative densities and effective confining pressures. Results show the peak friction angle of volcanic soil significantly decreases with the increase of confining pressure. The particle crushing degree of volcanic soil increases with the increase of confining pressure, particle size, and relative density. The relative breakage rate of the same particle size group has a good linear relationship with a fractal dimension. Moreover, for the same particle size, the relationship between plastic work and relative breakage rate can be fitted by a power function, which is not significantly affected by relative density or effective confining pressure. From an engineering view, in addition to increasing the compaction degree of volcanic soil, volcanic soil with fine particles used as a roadbed filler can significantly reduce the deformation of the roadbed and improve the bearing capacity of the foundation.

Effect of phytic acid combined with lactic acid on color and texture deterioration of ready-to-eat shrimps during storage.

To retard the deterioration of texture and color of ready-to-eat (RTE) shrimps during storage, phytic acid (PA) and lactic acid (LA) were used to soak the shrimp prior to cooking. The factors affecting texture (water holding capacity, protein oxidation and degradation, and microstructure) and color (Maillard reaction and lipid oxidation) were determined separately. The free radical and copper ion content were also determined in order to investigate the regulation mechanism of phytic acid and lactic acid on the texture and color of RTE shrimps. It was found that the inhibitor-treated RTE shrimps showed better texture and color properties than the control group, and the compound inhibitor (PA + LA) showed a better inhibition effect than single inhibitor. In addition, PA and LA prevented the oxidation of RTE shrimps by scavenging free radicals and chelating copper ions, which in turn enabled the regulation of color and texture deterioration.

Effects of antioxidants of bamboo leaves on protein digestion and transport of cooked abalone muscles.

The effects of oxidation on protein digestion and transport in cooked abalone muscles were investigated using a combination of simulated digestion and everted-rat-gut-sac models for the first time. Boiling heat treatments caused protein oxidation in the abalone muscles, reflected by increases in the carbonyl group and disulfide bond contents, protein hydrophobicity and aggregation degree, as well as decreases in the free sulfhydryl group and amino acid contents. Protein oxidation significantly inhibited the degree of hydrolysis, digestion rate, and digestibility of the abalone muscles in the simulated digestion model. The results from the everted-rat-gut-sac model showed that amino acid and peptide transport levels from the digestion products of the cooked abalone muscles were lower than those of the uncooked samples. In contrast, the addition of antioxidants of bamboo leaves mitigated heat-treatment-induced protein oxidation, aggregation and increased hydrophobicity, and consequently improved abalone muscle protein digestibility and transport levels.

Nondestructive 3D imaging and quantification of hydrated biofilm matrix by confocal Raman microscopy coupled with non-negative matrix factorization.

Biofilms are ubiquitous in natural and engineered environments and of great importance in drinking water distribution and biological wastewater treatment systems. Simultaneously acquiring the chemical and structural information of the hydrated biofilm matrix is essential for the cognition and regulation of biofilms in the environmental field. However, the complexity of samples and the limited approaches prevent a holistic understanding of the biofilm matrix. In this work, an approach based on the confocal Raman mapping technique integrated with non-negative matrix factorization (NMF) analysis was developed to probe the hydrated biofilm matrix in situ. The flexibility of the NMF analysis was utilized to subtract the undesired water background signal and resolve the meaningful biological components from Raman spectra of the hydrated biofilms. Diverse chemical components such as proteins, bacterial cells, glycolipids and polyhydroxyalkanoates (PHA) were unraveled within the distinct Pseudomonas spp. biofilm matrices, and the corresponding 3-dimensional spatial organization was visualized and quantified. Of these components, glycolipids and PHA were unique to the P. aeruginosa and P. putida biofilm matrix, respectively. Furthermore, their high abundances in the lower region of the biofilm matrix were found to be related to the specific physiological functions and surrounding microenvironments. Overall, the results demonstrate that our NMF Raman mapping method could serve as a powerful tool complementary to the conventional approaches for identifying and visualizing the chemical components in the biofilm matrix. This work may facilitate the online characterization of the biofilm matrix widely present in the environment and advance the fundamental understanding of biofilm.

Radiographic and clinical outcomes of surgical treatment of Kümmell's disease with thoracolumbar kyphosis: a minimal two-year follow-up.

BACKGROUND: Up to now in the surgical treatment of Kümmell's disease combined with thoracolumbar kyphosis, little research has focused on the evaluation of the imaging and clinical outcomes of restoring the normal alignment and sagittal balance of the spine. This study aimed to evaluate the short to mid-term radiographic and clinical outcomes in the treatment of Kümmell's disease with thoracolumbar kyphosis. METHODS: From February 2016 to May 2018, 30 cases of Kümmell's disease with thoracolumbar kyphosis were divided into group A and B according to whether the kyphosis was combined with neurological deficits. All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance. The radiographic outcomes and clinical outcomes of the cases were retrospectively evaluated. The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS) before operation,immediately after operation,and the last follow-up of each case were measured and evaluated. The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups. Statistical software SPSS21.0 was used to analyze the data. RESULTS: In group A: Mean SVA before operation was 75 mm and 26.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 39°, and 7.1° at the final postoperative evaluation (P = 0.000); Mean NRS before operation was 4.7, compared with 0.9 at the final postoperative evaluation (P = 0.000). In group B: Mean preoperative SVA was 62.5 mm and decreases to 30.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 33°, and 9.7° 2 years post-operation (P = 0.000); Mean NRS prior to surgery was 4.0, and 0.8 at the last follow-up evaluation (P = 0.000). The improvement of the NRS scores of groups A and B was related to the improvement of the cobb angle (P = 0.020); (P = 0.009) respectively. CONCLUSION: In the treatment of Kümmell's disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.

A case of 15q11-q13 duplication syndrome and literature review.

BACKGROUND: The chromosomal 15q11-q13 regions are structurally complex, and their abnormalities are associated with various neuropsychiatric disorders, including autism spectrum disorder (ASD), epilepsy, Angelman syndrome, and Prader-Willi syndrome. CASE DESCRIPTION: A 6-year-old child was admitted to the hospital as a result of an "epileptic status" showing ASD, intractable epilepsy, and total developmental retardation. Chromosome gene detection showed repetitive variation in the 15q11-q13 regions, and the video electroencephalogram was abnormal. Although children are currently given antiepileptic treatment and rehabilitation training, intermittent seizures can still occur. CONCLUSION: The clinical phenotypes of 15q11-q13 repetitive syndrome are complex, and vary in severity. Children with intractable epilepsy, ASD, and language and motor retardation should be considered to have this syndrome, which requires confirmation by multiplex ligation-dependent probe amplification and gene detection. These approaches can enable early rehabilitation treatment and improve the patients' quality of life.

YAP1 is a Prognostic Biomarker and Correlated with Immune Cell Infiltration in Pancreatic Cancer.

Yes-associated protein-1 (YAP1) is an important effector of the Hippo pathway and has crosstalk with other cancer signaling pathways. It induces an immunosuppressive tumor microenvironment by activating pathways in several cellular components. However, the mechanisms by which it drives immune infiltration in pancreatic cancer remain poorly understood. We analyzed the expression of YAP1 as well as its prognostic value and correlations with immune infiltrates in various cancers, with a focus on pancreatic cancer. In particular, using the Oncomine database and Gene Expression Profiling Interactive Analysis (GEPIA) database, we found that YAP1 is differentially expressed between tumor tissues and control tissues in a number of cancers and in particular, is elevated in pancreatic cancer. Using the Kaplan-Meier plotter, GEPIA, and Long-term Outcome and Gene Expression Profiling database of pan-cancers (LOGpc), we further established the prognostic value of YAP1. We found that YAP1 expression was significantly related to outcomes in multiple types of cancer based on data from The Cancer Genome Atlas, particularly in pancreatic cancer. Correlations between YAP1 and immune cell infiltration and immune cell marker expression were examined using Tumor Immune Estimation Resource and GEPIA. High expression levels of YAP1 were significantly associated with a variety of immune markers and immune cell subsets in pancreatic cancer. These results suggest that YAP1 is correlated with patient outcomes and tumor immune cell infiltration in multiple cancer types and is a valuable prognostic biomarker in pancreatic cancer.