Causal relationships between obesity-related anthropometric indicators and sepsis risk: a Mendelian-randomization study.

Background: Previous studies have reported an association between obesity and risk of sepsis. However, the results have been inconsistent, and no causal inference can be drawn from them. Therefore, we conducted a Mendelian-randomization (MR) study to investigate causal relationships between available obesity-related anthropometric indicators and sepsis risk. Methods: We performed MR analyses using genome-wide association study (GWAS) summary statistics on 14 anthropometric indicators [namely body mass index (BMI), waist and hip circumferences (WC, HC), basal metabolic rate (BMR), whole-body fat mass (WBFM), trunk fat mass (TFM), leg fat mass (LFM), arm fat mass (AFM), body fat percentage (BFP), whole-body fat-free mass (WBFFM), trunk fat-free mass (TFFM), leg fat-free mass (LFFM), arm fat-free mass (AFFM), and whole-body water mass (WBWM)], sepsis, critical care sepsis, and 28-day death due to sepsis from the UK Biobank and FinnGen cohort. The primary method of MR analysis was inverse variance-weighted average method. Sensitivity analyses, including heterogeneity and horizontal-pleiotropy tests, were conducted to assess the stability of the MR results. Additionally, we applied multiple-variable MR (MVMR) to evaluate the effect of BMI on the relationship between each anthropometric indicator and sepsis risk. Results: Our MR analysis demonstrated causal relationships between 14 anthropometric indicators and sepsis of different severities. After we adjusted for BMI, MVMR analyses indicated that WC, BMR, LFM, WBFFM, TFFM, AFFM, and WBWM remained significantly associated with the presence of sepsis (all p < 0.05). A sensitivity analysis confirmed the reliability of our MR results, and no significant horizontal pleiotropy was detected. Conclusion: This MR study revealed that increases in obesity-related anthropometric indicators had causal associations with a higher risk of sepsis, which might provide important insights for the identification of individuals at risk for sepsis in community and hospital settings.

Exploring the efficacy of laser speckle contrast imaging in the stratified diagnosis of rosacea: a quantitative analysis of facial blood flow dynamics across varied regions.

Background: Rosacea has a high incidence, significantly impacts quality of life, and lacks sufficient diagnostic techniques. This study aimed to investigate the feasibility of laser speckle contrast imaging (LSCI) for measuring facial blood perfusion in patients with rosacea and to identify differences in blood flow among various facial regions associated with different rosacea subtypes. Methods: From June to December 2023, 45 patients were recruited, with 9 excluded, leaving 36 subjects: 12 with erythematotelangiectatic rosacea (ETR), 12 with papulopustular rosacea (PPR), and 12 healthy controls. The Think View multispectral imaging analyzer assessed inflammation via gray reading values across the full face and five facial areas: forehead, nose, cheeks, and chin. LSCI measured and analyzed blood perfusion in the same areas. Plasma biomarkers interleukin-6 (IL-6), IL-1ß, and tumor necrosis factor-α (TNF-α) were tested in different groups. Results: Both ETR and PPR groups showed increased average blood perfusion and facial inflammation intensity by gray values compared to controls, with statistically significant differences. Average blood perfusion of ETR and PPR groups showed increased values in the forehead, cheeks, and nose, compared to controls, and the values in the cheeks were statistically different between ETR and PPR. The facial inflammation intensity of the ETR group showed increased values in the forehead and cheeks, and the PPR group showed increased gray values in the forehead, cheeks, nose, and chin compared to controls, and the values for the cheeks, nose, and chin were statistically significantly different between ETR and PPR. Plasma biomarkers IL-6, IL-1ß, and TNF-α were significantly elevated in both ETR and PPR groups compared to controls. Conclusion: LSCI is a valuable, non-invasive tool for assessing blood flow dynamics in rosacea, providing a data foundation for clinical research. Different rosacea subtypes exhibit distinct lesion distribution and blood flow patterns, and both ETR and PPR could affect all facial areas, particularly the cheeks in ETR and the forehead, nose, and chin in PPR.

Efficacy and safety of low-dose esketamine for painless gastrointestinal endoscopy in adults: a systematic evaluation and meta-analysis.

Object: The benefits of low-dose esketamine for painless gastrointestinal endoscopy remain unclear. As such, the present study aimed to investigate the efficacy and safety of low-dose esketamine for this procedure. Methods: Seven common databases were searched for clinical studies investigating low-dose esketamine for painless gastrointestinal endoscopy. Subsequently, a meta-analysis was performed to synthesize and analyze the data extracted from studies fulfilling the inclusion criteria. Results: Meta-analysis revealed that, compared with propofol, low-dose esketamine in combination with propofol significantly reduced recovery time by 0.56 min (mean difference [MD] -0.56%, 95% confidence interval (CI) -1.08 to -0.05, p = 0.03), induction time by 9.84 s (MD -9.84, 95% CI -12.93 to -6.75, p < 0.00001), propofol dosage by 51.05 mg (MD -51.05, 95% CI -81.53 to -20.57, p = 0.01), and increased mean arterial pressure by 6.23 mmHg (MD 6.23, 95% CI 1.37 to 11.08, p = 0.01). Meanwhile, low-dose esketamine reduced injection pain by 63% (relative risk [RR] 0.37, 95% CI 0.28 to 0.49, p < 0.00001), involuntary movements by 40% (RR 0.60, 95% Cl 0.42 to 0.85, p < 0.005), choking by 42% (RR 0.58, 95% Cl 0.38 to 0.88, p = 0.01), bradycardia by 68% (RR 0.32, 95% Cl 0.18 to 0.58, p = 0.0002), hypotension by 71% (RR 0.29, 95% Cl 0.21 to 0.40, p < 0.00001), respiratory depression by 63% (RR 0.37, 95% 0.26 to 0.51, p < 0.00001), additional cases of propofol by 53% (RR 0.47, 95% Cl 0.29 to 0.77, p = 0.002), and increased hypertension by 1000% (RR 11.00, 95% Cl 1.45 to 83.28, p = 0.02). There were no significant differences in mean heart rate, mean oximetry saturation, delirium, dizziness, vomiting, tachycardia, and hypoxemia. Subgroup analyses revealed that, compared with other dose groups, 0.25 mg/kg esketamine afforded additional benefits in recovery and induction time, mean arterial pressure, involuntary movements, hypoxemia, and respiratory depression. Conclusion: Low-dose esketamine was found to be safe and effective for providing anesthesia during gastrointestinal endoscopy, with 0.25 mg/kg identified as the optimal dose within the dosage ranges examined. However, caution should be exercised when administering this drug to patients with inadequate preoperative blood pressure control.

ALDH2 is a novel biomarker and exerts an inhibitory effect on melanoma.

Melanoma is a malignant skin tumor. This study aimed to explore and assess the effect of novel biomarkers on the progression of melanoma. Differently expressed genes (DEGs) were screened from GSE3189 and GSE46517 datasets of Gene Expression Omnibus database using GEO2R. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted based on the identified DEGs. Hub genes were identified and assessed using protein-protein interaction networks, principal component analysis, and receiver operating characteristic curves. Quantitative real-time polymerase chain reaction was employed to measure the mRNA expression levels. TIMER revealed the association between aldehyde dehydrogenase 2 (ALDH2) and tumor immune microenvironment. The viability, proliferation, migration, and invasion were detected by cell counting kit-8, 5-ethynyl-2'-deoxyuridine, wound healing, and transwell assays. Total 241 common DEGs were screened out from GSE3189 and GSE46517 datasets. We determined 6 hub genes with high prediction values for melanoma, which could distinguish tumor samples from normal samples. ALDH2, ADH1B, ALDH3A2, DPT, EPHX2, and GATM were down-regulated in A375 and SK-MEL-2 cells, compared with the human normal melanin cell line (PIG1 cells). ALDH2 was selected as the candidate gene in this research, presenting a high diagnostic and predictive value for melanoma. ALDH2 had a positive correlation with the infiltrating levels of immune cells in melanoma microenvironment. Overexpression of ALDH2 inhibited cell viability, proliferation, migration, and invasion of A375/SK-MEL-2 cells. ALDH2 is a new gene biomarker of melanoma, which exerts an inhibitory effect on melanoma.

Exosomes Derived from Astragaloside IV-pretreated Endothelial Progenitor Cells (AS-IV-Exos) Alleviated Endothelial Oxidative Stress and Dysfunction Via the miR-210/ Nox2/ROS Pathway.

BACKGROUND: Chronic hyperglycemia in diabetes induces oxidative stress, leading to damage to the vascular system. In this study, we aimed to evaluate the effects and mechanisms of AS-IV-Exos in alleviating endothelial oxidative stress and dysfunction caused by high glucose (HG). METHODS: Histopathological changes were observed using HE staining, and CD31 expression was assessed through immunohistochemistry (IHC). Cell proliferation was evaluated through CCK8 and EDU assays. The levels of ROS, SOD, and GSH-Px in the skin tissues of each group were measured using ELISA. Cell adhesion, migration, and tube formation abilities were assessed using adhesion, Transwell, and tube formation experiments. ROS levels in HUVEC cells were measured using flow cytometry. The levels of miR-210 and Nox2 were determined through quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The expression of Nox2, SOD, GSH-Px, CD63, and CD81 was confirmed using WB. RESULTS: The level of miR-210 was reduced in diabetes-induced skin damage, while the levels of Nox2 and ROS increased. Treatment with AS-IV increased the level of miR-210 in EPC-Exos. Compared to Exos, AS-IV-Exos significantly reduced the proliferation rate, adhesion number, migration speed, and tube-forming ability of HGdamaged HUVEC cells. AS-IV-Exos also significantly decreased the levels of SOD and GSH-Px in HG-treated HUVEC cells and reduced the levels of Nox2 and GSH-Px. However, ROS levels and Nox2 could reverse this effect. CONCLUSION: AS-IV-Exos effectively alleviated endothelial oxidative stress and dysfunction induced by HG through the miR-210/Nox2/ROS pathway.

Astragaloside IV (ASIV) Mediates Endothelial Progenitor Cell (EPC) Exosomal LINC01963 to Inhibit Pyroptosis and Oxidative Stress in High Glucose-impaired Endothelial Cells.

BACKGROUND: Hyperglycemia is widespread in the world's population, increasing the risk of many diseases. This study aimed to explore the regulatory effect and mechanism of astragaloside IV (ASIV)-mediated endothelial progenitor cells (EPCs) exosomal LINC01963 in endothelial cells (HUVECs) impaired by high glucose. METHODS: Morphologies of exosomes were observed by light microscope and electron microscope. Immunofluorescence was used to identify EPCs and detect the expressions of caspase-1. LINC01963 was detected by quantitative reverse transcription PCR. NLRP3, ASC, and caspase-3 were detected by Western Blot. Nanoparticle tracking analysis was carried out to analyze the exosome diameter. High-throughput sequencing was applied to screen target lncRNAs. The proliferation of endothelial cells was measured by cell counting kit-8 assay. The apoptosis level of HUVECs was detected by flow cytometry and TdT-mediated dUTP Nick-End labeling. The levels of IL- 1ß, IL-18, ROS, SOD, MDA, and LDH were measured by enzyme-linked immunosorbent assay. RESULTS: ASIV could promote the secretion of the EPC exosome. LINC01963 was obtained by high-throughput sequencing. It was observed that high glucose could inhibit the proliferation, reduce the level of SOD, the expression of NLRP3, ASC, and caspase- 1, increase the levels of IL-1ß, IL-18, ROS, MDA, and LDH, and promote apoptosis of HUVECs. Whereas LINC01963 could inhibit the apoptosis of HUVECs, the increase the expression of NLRP3, ASC, and caspase-1, and decrease the levels of IL-1ß, IL-18, ROS, MDA, and LDH. CONCLUSION: EPCs exosomal LINC01963 play an inhibitory role in high glucoseinduced pyroptosis and oxidative stress of HUVECs. This study provides new ideas and directions for treating hyperglycemia and researching exosomal lncRNAs.

Deep Learning-Enhanced Internet of Things for Activity Recognition in Post-Stroke Rehabilitation.

Wearable sensors provide a more effective means of activity monitoring and management by recording patients' daily activity data for assessing their daily function and rehabilitation progress, as well as providing a convenient and practical solution for human activity recognition (HAR). However, during the motor rehabilitation of stroke patients, sensors provide vast amounts of high-dimensional data that are large and complex. To enhance the accuracy of activity monitoring and identification, as well as address the limitations of real-time processing, data visualization, and tracking in conventional monitoring approaches, it is essential to perform valid data processing and analysis. This paper combines deep learning models to explore the potential relationships and patterns between data to build an intelligent post-stroke rehabilitation system. This paper proposes a novel framework aimed at accurately recognizing activities performed by stroke patients. Our approach leverages a data fusion mechanism based on multiple sensors to construct a fusion tensor and employs a bidirectional long and short-term memory (BiLSTM) network enhanced with an attention mechanism. This network effectively captures temporal patterns and long-term dependencies within the data, resulting in improved performance for wearable sensor-based activity classification. Furthermore, we introduce an enhanced loss function to optimize the learning process. To assess the performance of the proposed model algorithm, two benchmark datasets were employed. These datasets served as the basis for evaluating and comparing the baseline method as well as other proposed methods. The experimental results clearly demonstrated that the proposed model outperformed the compared methods, indicating its superior performance in activity recognition.

Modified separators boost polysulfides adsorption-catalysis in lithium-sulfur batteries from Ni@Co hetero-nanocrystals into CNT-porous carbon dual frameworks.

In this manuscript, nickel/cobalt bimetallic nanocrystals confining into three-dimensional interpenetrating dual-carbon conductive structure (NiCo@C/CNTs) were successfully manufactured by annealing its core-shell structure (Ni-ZIF-67@ZIF-8) precursor under the high temperature. The results presented that the bimetallic nickel and cobalt nanocrystals with superior catalytic activity could quickly convert solid Li2S/Li2S2into soluble LiPSs and effectively decrease the energy barrier. While the hierarchical CNT-porous carbon dual frameworks can provide quick electron/ion transport because of their large specific surface area and the exposure of enough active sites. When used as the separator modifier for lithium sulfur batteries, the battery properties were significantly improved with high specific capacity, outstanding rate capability, and long-term cycle stability. Specifically, its initial specific capacity can achieve to 1038.51 mAh g-1 at 0.5C. At the high rate of 3C, it still delivers satisfactory discharge capacity of 555 mAhg-1 and the capacity decay rate is only 0.065% per cycle after 1000 cycles at 1C. Furthermore, even exposed to heavy sulfur loading (3.61 mg/cm2), they still maintain promising cycle stability. Therefore, such kinds of MOFs derivative with powerful chemical immobilization and catalytic conversion for polysulfides provides a novel guidance for the modification separator and the potential application in the field of high-performance Li-S batteries.

Evaluation for causal effects of socioeconomic traits on risk of female genital prolapse (FGP): a multivariable Mendelian randomization analysis.

BACKGROUND: Although observational studies have established some socioeconomic traits to be independent risk factors for pelvic organ prolapse (POP), they can not infer causality since they are easily biased by confounding factors and reverse causality. Moreover, it remains ambiguous which one or several of socioeconomic traits play predominant roles in the associations with POP risk. Mendelian randomization (MR) overcomes these biases and can even determine one or several socioeconomic traits predominantly accounting for the associations. OBJECTIVE: We conducted a multivariable Mendelian randomization (MVMR) analysis to disentangle whether one or more of five categories of socioeconomic traits, "age at which full-time education completed (abbreviated as "EA")", "job involving heavy manual or physical work ("heavy work")", "average total household income before tax (income)", "Townsend deprivation index at recruitment (TDI)", and "leisure/social activities" exerted independent and predominant effects on POP risk. METHODS: We first screened single-nucleotide polymorphisms (SNPs) as proxies for five individual socioeconomic traits and female genital prolapse (FGP, approximate surrogate for POP due to no GWASs for POP) to conduct Univariable Mendelian randomization (UVMR) analyses to estimate causal associations of five socioeconomic traits with FGP risk using IVW method as major analysis. Additionally, we conducted heterogeneity, pleiotropy, and sensitivity analysis to assess the robustness of our results. Then, we harvested a combination of SNPs as an integrated proxy for the five socioeconomic traits to perform a MVMR analysis based on IVW MVMR model. RESULTS: UVMR analyses based on IVW method identified causal effect of EA (OR 0.759, 95%CI 0.629-0.916, p = 0.004), but denied that of the other five traits on FGP risk (all p > 0.05). Heterogeneity analyses, pleiotropy analyses, "leave-one-out" sensitivity analyses and MR-PRESSO adjustments did not detect heterogeneity, pleiotropic effects, or result fluctuation by outlying SNPs in the effect estimates of six socioeconomic traits on FGP risk (all p > 0.05). Further, MVMR analyses determined a predominant role of EA playing in the associations of socioeconomic traits with FGP risk based on both MVMR Model 1 (OR 0.842, 95%CI 0.744-0.953, p = 0.006) and Model 2 (OR 0.857, 95%CI 0.759-0.967, p = 0.012). CONCLUSION: Our UVMR and MVMR analyses provided genetic evidence that one socioeconomic trait, lower educational attainment, is associated with risk of female genital prolapse, and even independently and predominantly accounts for the associations of socioeconomic traits with risk of female genital prolapse.

Investigating the influence of an adjustable zoned air mattress on sleep: a multinight polysomnography study.

Introduction: A comfortable mattress should improve sleep quality. In this study, we sought to investigate the specific sleep parameters that could be affected by a mattress and explore any potential differences between the effects felt by each sex. Methods: A total of 20 healthy young adults (10 females and 20 males; 22.10 ± 1.25 years) participated in the experiments. A smart adjustable zoned air mattress was designed to maintain comfortable support, and an ordinary mattress was used for comparison. The participants individually spent four nights on these two mattresses in four orders for polysomnography (PSG) scoring. Sleep architecture, electroencephalogram (EEG) spectrum, and heart rate variability (HRV), which reflect the central and autonomic nervous activities, were used to compare the difference between the two mattresses. Results: An individual difference exited in sleep performance. The modes of influence of the mattresses were different between the sexes. The adjustable air mattress and the increase in experimental nights improved female participants' sleep efficiency, while male participants exhibited a smaller response to different mattresses. With an increasing number of experiment nights, both sexes showed increased REM and decreased N2 proportions; the N3 sleep proportion decreased in the male participants, and the heart rate decreased in both sexes. The performance of the EEG spectrum supports the above results. In addition, the adjustable air mattress weakened automatic nerve activity during N3 sleep in most participants. The female participants appeared to be more sensitive to mattresses. Experiment night was associated with psychological factors. There were differences in the results for this influence between the sexes. Conclusion: This study may shed some light on the differences between the ideal sleep environment of each sex.

Associations of migraines with suicide ideation or attempts: A meta-analysis.

Objective: Whether migraine is associated with a higher risk of suicide ideation and/or attempts remains controversial. Therefore, we aimed to evaluate these potential associations in migraine patients by performing a meta-analysis of previously published data. Methods: We searched for studies published up to 31 June 2022 that compared the risk of suicide ideation/attempt in migraineurs and non-migraineurs in PubMed, EMBASE, and Web of Science databases. Sixteen studies fulfilled the eligibility criteria. We applied Random-effects models to calculate pooled adjusted odds ratios (AORs) and 95% confidence intervals (CIs) in patients with migraine. Results: Migraine patients were at a significantly increased risk of suicide ideation (AOR 1.33, 95% CI 1.15-1.54) and suicide attempts (AOR 1.70, 95% CI 1.42-2.03). The increase in risk may be greater in adults (>19 years) than in younger individuals. Conclusion: The available evidence indicates a significant association of migraines with suicide ideation and attempts. Future work should confirm and extend these findings, as well as explore whether they are affected by ethnicity or geography.

Yigong Powder regulates CXCL12/CXCR4 signaling to reduce glutamate release and prevent cognitive decline in mouse model of aging / 中国中药杂志

This study aims to explore the effect of preventive administration of Yigong Powder on the learning and memory abilities of the mouse model of aging induced by D-galactose and decipher the underlying mechanism, so as to provide a basis for the application of Yigong Powder in the prevention and treatment of cognitive decline. Forty KM mice were randomized into control, model, donepezil(1.5 mg·kg~(-1)), and high-dose(7.5 g·kg~(-1)) and low-dose(3.75 g·kg~(-1)) Yigong Powder groups. The mice in other groups except the control group were injected with D-galactose(200 g·kg~(-1)) at the back of the neck for the modeling of aging. At the same time, the mice were administrated with corresponding drugs by gavage for one month. Morris water maze was used to examine the learning and memory abilities of the mice. Hematoxylin-eosin staining was employed to observe the pathological and morphological changes of the hippocampus. The immunofluorescence assay was employed to detect the expression of ionized calcium-binding adapter molecule 1(IBA1), glial fibrillary acidic protein(GFAP), chemokine C-X-C-motif ligand 12(CXCL12), chemokine C-X-C-motif receptor 4(CXCR4) in the hippocampus and observe the positional relationship between IBA1, GFAP, and CXCR4. Western blot was employed to determine the protein levels of extracellular regulated kinase(ERK), p-ERK, and tumor necrosis factor receptor 1(TNFR1). Enzyme-linked immunosorbent assay was employed to measure the levels of glutamate and tumor necrosis factor(TNF-α) in the brain tissue and the level of TNF-α in the serum and spleen. Yigong Powder significantly shortened the escape latency, increased the times crossing platforms, and prolonged the cumulative time in quadrants of the aging mice. It alleviated the nerve cell disarrangement, increased intercellular space, and cell degeneration or death in the hippocampus and reduced the pathology score of the damaged nerve. Moreover, Yigong Powder reduced the positive area of IBA1 and GFAP, reduced the levels of TNF-α in the brain tissue, serum, and spleen, and decreased spleen index. Furthermore, Yigong Powder decreased the average fluorescence intensity of CXCL12 and CXCR4, reduced CXCR4-positive astrocytes and microglia, down-regulated the protein levels of p-ERK/ERK and TNFR1, and lowered the level of glutamate in the brain tissue. This study showed that the preventive administration of Yigong Powder can ameliorate the learning and memory decline of the D-galactose-induced aging mice by regulating the immune function of the spleen and the CXCL12/CXCR4 signaling in the brain to reduce glutamate release. However, the mechanism of Yigong San in preventing and treating dementia via regulating spleen and stomach function remains to be studied.

Breath-by-breath measurement of exhaled ammonia by acetone-modifier positive photoionization ion mobility spectrometry via online dilution and purging sampling / 药物分析学报

Exhaled ammonia(NH3)is an essential noninvasive biomarker for disease diagnosis.In this study,an acetone-modifier positive photoionization ion mobility spectrometry(AM-PIMS)method was developed for accurate qualitative and quantitative analysis of exhaled NH3 with high selectivity and sensitivity.Acetone was introduced into the drift tube along with the drift gas as a modifier,and the characteristic NH3 product ion peak of(C3H6O)4NH4+(K0=1.45 cm2/V·s)was obtained through the ion-molecule reaction with acetone reactant ions(C3H6O)2H+(K0=1.87 cm2/V·s),which significantly increased the peak-to-peak resolution and improved the accuracy of exhaled NH3 qualitative identification.Moreover,the interference of high humidity and the memory effect of NH3 molecules were significantly reduced via online dilution and purging sampling,thus realizing breath-by-breath measurement.As a result,a wide quantitative range of 5.87-140.92 μmol/L with a response time of 40 ms was achieved,and the exhaled NH3 profile could be synchronized with the concentration curve of exhaled CO2.Finally,the analytical capacity of AM-PIMS was demonstrated by measuring the exhaled NH3 of healthy subjects,demon-strating its great potential for clinical disease diagnosis.

Construction of multi-level medical training platform system in clinical skills simulation training center / 中华医学教育探索杂志

This study mainly introduces the exploration of the construction and management of multi-level medical training platform in clinical skills center of the Affiliated Hospital of Yangzhou University. Through the construction of a multi-level clinical skills training platform, a reasonable hierarchical training program is formulated by taking the clinical basic skills training platform and the clinical specialist skills training platform as the basic core teaching content. This program adopts various ways to improve the teaching quality, effectively promote students' ability of clinical practice step by step, meet the needs of different levels of medical personnel in different stages, scientifically and effectively cultivate the high-quality medical personals, and give full play to the role of hospital clinical skills center in medical education, which lays a good foundation for the continuous improvement of teaching quality in hospitals.

Long-term clinical value of composite biomaterial mesh in inguinal hernia repair: a multi-center prospective randomized controlled study / 中华消化外科杂志

Objective:To investigate the long-term clinical value of composite biomaterial mesh in inguinal hernia repair.Methods:The prospective randomized controlled non-inferiority study was conducted. The clinical data of 172 adult patients with inguinal hernia who were admitted to 3 medical centers, including Huadong Hospital Affiliated to Fudan University et al, from July 2014 to February 2015 were selected. Based on random number table, patients were divided into two groups. Patients underwent technique of abdominal wall reinforcement with biological mesh. Patients using the electrospun composite biomaterial mesh were allocated into experimental group, and patients using the small intestinal submucosa mesh were allocated into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) endpoint of the study. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Taking the recurrence rate of hernia at 6 years after surgery as the basis of efficacy evaluation, the Cochran-Mantel-Haenszel test was used for comparison between groups. The confidence interval method was used to conduct non-inferiority statistical analysis. If the lower limit of 95% confidence interval of the difference of recurrence rate of hernia between the experiment group and the control group was more than -10%, the experiment group was considered to be non-inferior to the control group. If the lower limit of 95% confidence interval is more than 0, the experiment group was considered to be superior to the control group. Results:(1) Grouping situations of the enrolled patients. A total of 172 adult patients with inguinal hernia were selected for eligibility. They were males, aged (61±2)years. All 172 patients were randomly divided into to the experimental group and the control group with 86 cases in each group. At 6 years after surgery, 20 patients in the experi-mental group and 19 patients in the control group was lost to follow-up. (2) Endpoint of the study. ① The primary endpoint of study. At 6 years after surgery, no patient had recurrence in the 66 patients of experimental group and 4 patients had recurrence in the 67 patients of control group. Results of non-inferiority statistical analysis showed that the 95% confidence interval of the difference of recurrence rate of hernia between the two groups was 0.27% to 14.41%, with the lower limit as 0.27%, which was more than -10% and simultaneously more than 0. ② The secondary endpoint of study. There was no significant difference in the simple verbal scale between the two groups after 6 months and 6 years at rest or cough status ( P>0.05). At a follow-up of 6 months after surgery, 2 cases of the experimental group and 5 patients of the control group had complications, showing no significant difference between the two groups( χ2=1.38, P>0.05). At a follow-up of 6 years after surgery, no complication occurred in either group. Conclusion:Composite biological mesh in inguinal repair is safe and feasible, which can have low long-term recurrence and achieve good long-term efficacy.

A Belief Two-Level Weighted Clustering Method for Incomplete Pattern Based on Multiview Fusion.

Incomplete pattern clustering is a challenging task because the unknown attributes of the missing data introduce uncertain information that affects the accuracy of the results. In addition, the clustering method based on the single view ignores the complementary information from multiple views. Therefore, a new belief two-level weighted clustering method based on multiview fusion (BTC-MV) is proposed to deal with incomplete patterns. Initially, the BTC-MV method estimates the missing data by an attribute-level weighted imputation method with k-nearest neighbor (KNN) strategy based on multiple views. The unknown attributes are replaced by the average of the KNN. Then, the clustering method based on multiple views is proposed for a complete data set with estimations; the view weights represent the reliability of the evidence from different source spaces. The membership values from multiple views, which indicate the probability of the pattern belonging to different categories, reduce the risk of misclustering. Finally, a view-level weighted fusion strategy based on the belief function theory is proposed to integrate the membership values from different source spaces, which improves the accuracy of the clustering task. To validate the performance of the BTC-MV method, extensive experiments are conducted to compare with classical methods, such as MI-KM, MI-KMVC, KNNI-FCM, and KNNI-MFCM. Results on six UCI data sets show that the error rate of the BTC-MV method is lower than that of the other methods. Therefore, it can be concluded that the BTC-MV method has superior performance in dealing with incomplete patterns.

Enhanced Tribocatalytic Degradation of Organic Pollutants by ZnO Nanoparticles of High Crystallinity.

More and more metal oxide nanomaterials are being synthesized and investigated for degradation of organic pollutants through harvesting friction energy, yet the strategy to optimize their performance for this application has not been carefully explored up to date. In this work, three commercially available ZnO powders are selected and compared for tribocatalytic degradation of organic dyes, among which ZnO-1 and ZnO-2 are agglomerates of spherical nanoparticles around 20 nm, and ZnO-3 are particles of high crystallinity with a regular prismatic shape and smooth surfaces, ranging from 50 to 150 nm. Compared with ZnO-1 and ZnO-2, ZnO-3 exhibits a much higher tribocatalytic degradation performance, and a high degradation rate constant of 6.566 × 10-2 min-1 is achieved for RhB, which is superior compared with previous tribocatalytic reports. The stability and universality of ZnO-3 were demonstrated through cycling tests and degradation of different types of dyes. Furthermore, the mechanism of tribocatalysis revealed that h+ was the main active species in the degradation process by ZnO. This work highlights the great significance of high crystallinity rather than a large specific surface area for the development of high-performance tribocatalysts and demonstrates the great potential of tribocatalysis for water remediation.

Piezoelectric polarization promoted spatial separation of photoexcited electrons and holes in two-dimensional g-C3N4 nanosheets for efficient elimination of chlorophenols.

Graphitic carbon nitride (g-C3N4) has been proved to be a potential photocatalyst for environment purification, but the high recombination rate of photogenerated carriers leads to the low photocatalytic efficiency. Herein, we report the enhanced degradation of chlorophenols by 2D ultrathin g-C3N4 nanosheets with intrinsic piezoelectricity through photopiezocatalysis strategy. Under the simultaneous visible-light irradiation and ultrasonic vibration, the 2D g-C3N4 presented improved removal efficiency for elimination of 2,4-dichlorophenol (2,4-DCP) with an apparent rate constant of 6.65 × 10-2 min-1, which was 6.7 and 2.2 times of the photocatalysis and piezocatalysis, respectively. The improved removal efficiency was attributed to the sufficient separation of free charges driven by the ultrasound-induced piezoelectric field in the 2D g-C3N4, which was demonstrated by the enhanced current response under photopiezocatalysis mode. Additionally, the photopiezocatalysis of 2D g-C3N4 was proved to possess well universality for removing different chlorophenols, as well as high durability and dechlorination efficiency. Finally, a possible photopiezocatalytic mechanism for removal of 2,4-DCP was proposed based on the electron paramagnetic resonance (EPR) technique and the determination of intermediates through liquid chromatography-mass spectrometry (LC-MS) analysis. This work provides a promising strategy for the design of energy-conversion materials towards capturing solar and mechanical energy in ambient environment.

Expression of neuropeptide Y, calcitonin gene related peptide and inducible nitric oxide synthase in myocardium of rats with heart failure / 解剖学报

Objective To explore the relationship between the content of neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), inducible nitric oxide synthase (iNOS) and the changes of the corresponding receptors in myocardial tissue and the development of heart failure. Methods Doxorubicin was used to prepare rat heart failure models(10 rats), control group (10 rats), Cardiac ultrasound testing evaluated its cardiac function, the distribution of nerve fibers was detected by nerve staining kit method, the tissue expression levels of NPY, CGRP, iNOS and neuropeptide Y receptor Y1 (NPY1R), receptor activity modifying protein 1 (RAMP1), guanylate cyclase beta 1(GCYB1) were observed by immunofluorescence and immunohistochemical staining method. Western blotting was used to detect the protein expression levels of NPY, CGRP, iNOS and NPY1R, RAMP1, GCYB1 receptors in myocardial tissue. Results Compared with the control group, the protein expression level and tissue expression distribution of CGRP in the myocardial tissue of the heart failure group were significantly decreased (P<0.05), while the density of nerve fibers, the protein expression level and tissue expression distribution of NPY and iNOS were significantly increased (P<0.05). The protein expression levels of GCYB1 and RAMP1 in myocardial tissue of the heart failure group were significantly increased, while the protein expression levels of NPY1R were significantly decreased (P<0.05). Conclusion Heart failure can lead to remodeling of the content and distribution of nerve fibers, CGRP, NPY, iNOS and their receptors in myocardial tissue, which may be one of the causes of cardiac innervation disorders.

A systematic review and meta-analysis on the efficacy and safety of traditional Chinese medicine bath in the treatment of psoriasis vulgaris.

BACKGROUND: To clarify the efficacy and safety of traditional Chinese medicine (TCM) bath in the treatment of psoriasis vulgaris, meta-analysis and systematic evaluation were adopted to comprehensively evaluate the published articles. METHODS: Combing the terms "traditional Chinese medicine bath" and "psoriasis vulgaris", the articles were searched for in the databases of China Knowledge Network (CNKI), Baidu scholar, Wanfang, Chinese Biomedical Literature Database (CBM), Weipu Database, Medline, Embase, Chinese Medical Citation Index (CMCI), and PubMed. The quality of articles was evaluated using the RevMan 5.3 software provided by the Cochrane system. RESULTS: A total of 13 articles were included. From the funnel chart drawn, it could be seen that the circles and the midline of most articles were not symmetrical, and the publication was biased, so the conclusions obtained were relatively credible. The heterogeneity analysis of TCM bath in treatment of psoriasis vulgaris showed that 13 articles reporting the total effective rate (TER) and the TERs of the two groups displayed obvious differences [P<0.05, 95% confidence interval (CI): 2.9 to 4.77]; there were 8 articles reporting the incidence of adverse reactions, and the incidence of adverse reactions between the two groups was greatly different (P<0.05, 95% CI: 0.22 to 0.77); and there were 9 articles reporting the psoriasis area and severity index, and the overall efficacy was greatly different between the two groups (P<0.05, 95% CI: -5.38 to -1.88). DISCUSSION: The TER of the meta-analysis of treatment in this study was higher in the experimental group; the incidence of adverse reactions was lower in the experimental group; and the area and severity of psoriasis were lower in the experimental group, so it was concluded that the TCM bath had a significant effect on the treatment of psoriasis vulgaris.