Are the facet joint parameters risk factors for cage subsidence after TLIF in patients with lumbar degenerative spondylolisthesis?

PURPOSE: To assess whether preoperative facet joint parameters in patients with degenerative lumbar spondylolisthesis (DS) are risk factors for cage subsidence (CS) following transforaminal lumbar interbody fusion (TLIF). METHODS: We enrolled 112 patients with L4-5 DS who underwent TLIF and were followed up for > 1 year. Preoperative demographic characteristics, functional areas of paraspinal muscles and psoas major muscles (PS), total functional area relative to vertebral body area, functional cross-sectional area (FCSA) of PS and lumbar spine extensor muscles, normalized FCSA of PS to the vertebral body area (FCSA/VBA), lumbar indentation value, facet joint orientation, facet joint tropism (FT), cross-sectional area of the superior articular process (SAPA), intervertebral height index, vertebral Hounsfield unit (HU) value, lordosis distribution index, t-scores, sagittal plane parameters, visual analog scale (VAS) for low back pain, VAS for leg pain, Oswestry disability index, global alignment and proportion score and European quality of life-5 dimensions (EQ-5D) were assessed. RESULTS: Postoperative CS showed significant correlations with preoperative FO(L3-4), FT (L3 and L5), SAPA(L3-5), L5-HU, FCSA/VBA(L3-4), Pre- T-score, post-6-month VAS for back pain and EQ-5D scores among other factors. According to ROC curve analysis, the optimal decision points for FO(L3-4), L3-SAPA, FCSA/VBA(L3-4), L5-HU, and Pre- T-score were 35.88°, 43.76°,114.93, 1.73, 1.55, 136, and - 2.49. CONCLUSIONS: This study identified preoperative FO, SAPA, preoperative CT, Pre- T-score and the FCSA/VBA as independent risk factors for CS after TLIF for DS. These risk factors should enable spinal surgeons to closely monitor and prevent the occurrence of CS.

BACH1 impairs hepatocyte regeneration after hepatectomy with repeated ischemia/reperfusion by reprogramming energy metabolism and exacerbating oxidative stress.

BTB and CNC homology 1 (BACH1) regulates biological processes, including energy metabolism and oxidative stress. Insufficient liver regeneration after hepatectomy remains an issue for surgeons. The Pringle maneuver is widely used during hepatectomy and induces ischemia/reperfusion (I/R) injury in hepatocytes. A rat model of two-thirds partial hepatectomy with repeated I/R treatment was used to simulate clinical hepatectomy with Pringle maneuver. Delayed recovery of liver function after hepatectomy with the repeated Pringle maneuver in clinic and impaired liver regeneration in rat model were observed. Highly elevated lactate levels, along with reduced mitochondrial complex III and IV activities in liver tissues, indicated that the glycolytic phenotype was promoted after hepatectomy with repeated I/R. mRNA expression profile analysis of glycolysis-related genes in clinical samples and further verification experiments in rat models showed that high BACH1 expression levels correlated with the glycolytic phenotype after hepatectomy with repeated I/R. BACH1 overexpression restricted the proliferative potential of hepatocytes stimulated with HGF. High PDK1 expression and high lactate levels, together with low mitochondrial complex III and IV activities and reduced ATP concentrations, were detected in BACH1-overexpressing hepatocytes with HGF stimulation. Moreover, HO-1 expression was downregulated, and oxidative stress was exacerbated in the BACH1-overexpressing hepatocytes with HGF stimulation. Cell experiments involving repeated hypoxia/reoxygenation revealed that reactive oxygen species accumulation triggered the TGF-ß1/BACH1 axis in hepatocytes. Finally, inhibiting BACH1 with the inhibitor hemin effectively restored the liver regenerative ability after hepatectomy with repeated I/R. These results provide a potential therapeutic strategy for impaired liver regeneration after repeated I/R injury.

Effects of steaming on physicochemical and emulsification properties of gum arabic.

Gum arabic finds extensive application and typically undergoes sterilization prior to utilization in the food industry. This study explored the impact of steam sterilization temperature and duration on the physicochemical and emulsification characteristics of gum arabic, accompanied by proposed mechanisms elucidating observed effects. The results showed that when gum arabic was treated with high temperature sterilization (110 °C âˆ¼ 140 °C), the emulsion prepared turned unstable. The interfacial tension decreased from 8.26 mN/m to 6.77 mN/m after sterilization, while the elastic modulus decreased from 23.65 mN/m to 16.16 mN/m. Moreover, the circular dichroic chromatographic results indicated that the arabinogalactan protein (AGP) structure of gum arabic was more relaxed after high temperature treatment with ß-sheets content decreased from 36.2 % to 29.8 % and random coil content increased from 41.3 % to 51.8 %. Quartz crystal microbalance with dissipation (QCM-D) results demonstrated that emulsion surface film thickness and toughness decreased after sterilization treatment of gum arabic. The study indicates that high temperature sterilization may change protein structure in gum arabic and reduce the stability of prepared emulsions.

Carrageenan maintains the contractile phenotype of vascular smooth muscle cells by increasing macromolecular crowding in vitro.

BACKGROUND: The contractile phenotype of vascular smooth muscle cells (VSMCs) results in good diastolic and contractile capacities, and its altered function is the main pathophysiological basis for diseases such as hypertension. VSMCs exist as a synthetic phenotype in vitro, making it challenging to maintain a contractile phenotype for research. It is widely recognized that the common medium in vitro is significantly less crowded than in the in vivo environment. Additionally, VSMCs have a heightened sense for detecting changes in medium crowding. However, it is unclear whether macromolecular crowding (MMC) helps maintain the VSMCs contractile phenotype. PURPOSE: This study aimed to explore the phenotypic, behavioral and gene expression changes of VSMCs after increasing the crowding degree by adding carrageenan (CR). METHODS: The degree of medium crowding was examined by a dynamic light scattering assay; VSMCs survival and activity were examined by calcein/PI cell activity and toxicity and CCK-8 assays; VSMCs phenotypes and migration were examined by WB and wound healing assays; and gene expression was examined by transcriptomic analysis and RT-qPCR. RESULTS: Notably, 225 µg/mL CR significantly increased the crowding degree of the medium and did not affect cell survival. Simultaneously, CR significantly promoted the contraction phenotypic marker expression in VSMCs, shortened cell length, decreased cell proliferation, and inhibited cell migration. CR significantly altered gene expression in VSMCs. Specifically, 856 genes were upregulated and 1207 genes were downregulated. These alterations primarily affect the cellular ion channel transport, microtubule movement, respiratory metabolism, amino acid transport, and extracellular matrix synthesis. The upregulated genes were primarily involved in the cytoskeleton and contraction processes of VSMCs, whereas the downregulated genes were mainly involved in extracellular matrix synthesis. CONCLUSIONS: The in vitro study showed that VSMCs can maintain the contractile phenotype by sensing changes in the crowding of the culture environment, which can be maintained by adding CR.

Improving feed intake and rumen fermentation in lambs using mixed-dimensional attapulgite clay to adsorb naturally occurring mycotoxins.

This experiment was conducted to evaluate the effects of including a mixed-dimensional attapulgite clay (MDA) into a naturally moldly diet for Hu lambs. Fifty male Hu lambs with similar initial body weight (28.24 ±â€…1.80 kg) were randomly allocated into five dietary treatments: a basal diet containing naturally occurring mycotoxins with 0, 0.5, 1.0, and 2.0 kg/t MDA, and basal diet with a commercial mycotoxin adsorbent Solis with montmorillonite as the major component at 1 kg/t. Both MDA and Solis increased average daily gain (ADG) and dry matter intake (DMI; P ≤ 0.004), and there was no difference in growth performance between MDA and Solis (P ≥ 0.26). The final body weight, DMI, and ADG were linearly increased with increasing MDA supplementation (P < 0.01). Lambs treated with both MDA and Solis demonstrated greater apparent digestibility of dry matter (DM), organic matter (OM), and energy compared with the control group (P ≤ 0.03), and there were no differences in nutrient digestibilities between MDA and Solis (P ≥ 0.38). Digestibility of CP was linearly increased with the increasing MDA supplementation (P = 0.01). Neither MDA nor Solis affected rumen total volatile fatty acid (TVFA) concentration (P ≥ 0.39), but decreased the acetate-to-propionate ratio and molar proportion of n-butyrate (P ≤ 0.01), and MDA also increased the concentration of ammonia (P = 0.003). Besides, increasing MDA supplementation linearly reduced the acetate-to-propionate ratio and molar proportion of n-butyrate (P = 0.01), but linearly and quadratically increased the concentration of ammonia (P ≥ 0.003). These results showed that the incorporation of MDA into a naturally moldy diet of Hu lambs yielded comparable results to the Solis product, with higher growth performance and nutrient digestibility but lower acetate-to-propionate ratio observed. In conclusion, including ≥ 1 kg/t of MDA in high mycotoxin risk diets for growing lambs improves feed intake and rumen fermentation.

The issue of mycotoxin-contaminated animal feed has consistently presented a significant challenge in relation to animal health and production. The mixed-dimensional attapulgite clay (MDA) has been proven effective in binding polar mycotoxins such as aflatoxin, while also effectively adsorbing hydrophobic or weakly polar mycotoxins such as zearalenone (ZEN) and ochratoxin. Therefore, this study was undertaken to assess the impact of MDA inclusion in mycotoxin-contaminated diets on performance and rumen fermentation variables in lambs. The results indicated that MDA not only significantly improved the growth performance and nutrient digestibility of Hu lambs but also enhanced the molar proportion of propionate and ammonia concentration, and reduced the acetate to propionate ratio and the molar proportion of n-butyrate.

Change in screen time and overuse, and their association with psychological well-being among US-wide school-age children during the COVID-19 pandemic: analysis of the National Survey of Children's Health (NSCH) years 2018-21.

BACKGROUND: Previous studies on screen use and children's mental health during the Coronavirus Disease 2019 (COVID-19) pandemic focused only on the timeframe during the pandemic, on children between narrow age ranges, only among a subset of children who have previously reported COVID-related severe family economic hardship or worries, or did not distinguish between instructive versus recreational device usage. Thus, in this study, we analyzed trends, specifically related to recreational screen use, and associations with psychological well-being (PWB) in the years before versus during the COVID-19 pandemic, among a wide range of school-aged children, widely across the nation. METHODS: Using the National Survey of Children's Health (NSCH) years 2018-21, we analyzed a large random sample of school-aged children (6-17 years old) across the US (n = 88,823). We developed PWB issue scores (PWBIS) using self-reported measures relevant to this age group, and constructed regression models to assess the magnitude of the contribution of the pandemic on recreational screen use and PWB. RESULTS: The prevalence of recreational screen overuse and PWBIS increased significantly during the pandemic, compared to prior years. We also detected a notable effect of the pandemic on increased PWBIS, as well as its interaction term finding that it strengthened the association between screen time and PWBIS (p < 0.01 across all regression models). CONCLUSIONS: Accordingly, our results demonstrate the importance of the pandemic itself as an independent adverse factor and effect measure modifier for screen overuse and PWB more generally among all school-age children widely across the US. Our study used the most current data available, and future studies to evaluate whether these effects are persistent in the years after the pandemic are important.

PANEL 3: Otitis media animal models, cell culture, tissue regeneration & pathophysiology.

OBJECTIVE: To review and summarize recently published key articles on the topics of animal models, cell culture studies, tissue biomedical engineering and regeneration, and new models in relation to otitis media (OM). DATA SOURCE: Electronic databases: PubMed, National Library of Medicine, Ovid Medline. REVIEW METHODS: Key topics were assigned to the panel participants for identification and detailed evaluation. The PubMed reviews were focused on the period from June 2019 to June 2023, in any of the objective subject(s) or keywords listed above, noting the relevant references relating to these advances with a global overview and noting areas of recommendation(s). The final manuscript was prepared with input from all panel members. CONCLUSIONS: In conclusion, ex vivo and in vivo OM research models have seen great advancements in the past 4 years. From the usage of novel genetic and molecular tools to the refinement of in vivo inducible and spontaneous mouse models, to the introduction of a wide array of reliable middle ear epithelium (MEE) cell culture systems, the next five years are likely to experience exponential growth in OM pathophysiology discoveries. Moreover, advances in these systems will predictably facilitate rapid means for novel molecular therapeutic studies.

Modified FGF Hydrogel for Effective Axon Formation by Enhanced Regeneration of Myelin Sheath of Schwann Cells Using Rat Model.

Introduction: An acute spinal cord injury (SCI) is a debilitating event for which there is no targeted or effective treatment. Previous studies have shown that fibroblast growth factor (bFGF) and Schwann cells (SC) exert a protective effect on the injured tissues. Because of their easy injectability and strength, hydrogels are considered to be ideal candidates for creating loadable tissues. However, the application and mechanism of bFGF-hydrogels have not been explored. Methods: We synthesized a new class of bFGF-hydrosol and evaluated its safety and biocompatibility in vitro and in vivo. Next, an SCI rat model was established to evaluate the effect of the hydrosol on an SCI by detecting various pro-inflammatory markers and evaluating the injury. The ability of hydrosol to promote axon formation was evaluated by detecting corresponding indexes, and its ability to promote remyelination was evaluated by detecting the corresponding indexes in Schwann cells. Results: A novel in situ injectable hydrogel containing bFGF (HA-bFGF) was synthesized and found to have better biocompatibility than other gels. HA-bFGF helped to repair tissue damage after an SCI in vivo. Our mechanistic investigation also showed that HA-bFGF improved axon formation after an SCI by facilitating the regeneration of myelin sheath of Schwann cells. Conclusion: In this study, we found that HA-bFGF could promote neural restoration and tissue recovery after an SCI. Our results indicate that hydrogels loaded with bFGF can alleviate a spinal cord injury by promoting the remyelination of Schwann cells, reducing inflammation at the injured site, and ultimately promoting axon generation.

Clinical outcomes of modified versus traditional expansive open-door laminoplasty for cervical spondylotic myelopathy: A single-institution experience.

PURPOSE: To compare the surgical outcomes of modified expansive open-door laminoplasty (EOL) (C4-C6) and traditional EOL (C3-C7) in patients with cervical spondylotic myelopathy (CSM). METHODS: One hundred and two CSM patients were retrospectively recruited from Fujian Medical University Union Hospital between March 2012 and December 2019. Seventy-one patients with CSM underwent modified EOL, and 31 patients underwent traditional EOL. The primary endpoint was axial symptoms. RESULTS: Patients who underwent modified EOL had a significantly lower incidence of axial symptoms (odds ratio: 0.273; 95% confidence interval: 0.184-0.691; p = .002). The length of hospital stay (p = .263), and intraoperative blood loss (p = .402) were not significantly different between the groups. Significantly more postoperative drainage was observed in patients who underwent modified EOL (p < .001), while the cost of hospitalization in patients treated with traditional EOL was higher (p = .011). There were significant differences between modified and traditional EOL for the changes in range of motion (p < .001), modified Japanese Orthopaedic Association score (p = .001), and the Nurick grade (p = .014), while the changes of visual analogue scale (p = .250), and the neck disability index (p = .134) were not significantly different between the groups. CONCLUSION: This study found modified EOL may decrease the incidence of axial symptoms in patients with CSM compared to traditional EOL.

Identification and Analysis of a Four-Gene Set for Diagnosing SFTS Virus Infection Based on Machine Learning Methods and Its Association with Immune Cell Infiltration.

Severe Fever with thrombocytopenia syndrome (SFTS) is a highly fatal viral infectious disease that poses a significant threat to public health. Currently, the phase and pathogenesis of SFTS are not well understood, and there are no specific vaccines or effective treatment available. Therefore, it is crucial to identify biomarkers for diagnosing acute SFTS, which has a high mortality rate. In this study, we conducted differentially expressed genes (DEGs) analysis and WGCNA module analysis on the GSE144358 dataset, comparing the acute phase of SFTSV-infected patients with healthy individuals. Through the LASSO-Cox and random forest algorithms, a total of 2128 genes were analyzed, leading to the identification of four genes: ADIPOR1, CENPO, E2F2, and H2AC17. The GSEA analysis of these four genes demonstrated a significant correlation with immune cell function and cell cycle, aligning with the functional enrichment findings of DEGs. Furthermore, we also utilized CIBERSORT to analyze the immune cell infiltration and its correlation with characteristic genes. The results indicate that the combination of ADIPOR1, CENPO, E2F2, and H2AC17 genes has the potential as characteristic genes for diagnosing and studying the acute phase of SFTS virus (SFTSV) infection.

Wnt/ß­catenin signaling is a novel therapeutic target for tumor suppressor CYLD­silenced glioblastoma cells.

Tumor suppressor cylindromatosis (CYLD) dysfunction by its downregulation is significantly associated with poor prognosis in patients with glioblastoma (GBM), the most aggressive and malignant type of glioma. However, no effective treatment is currently available for patients with CYLD­downregulated GBM. The aim of the present study was to identify the crucial cell signaling pathways and novel therapeutic targets for CYLD downregulation in GBM cells. CYLD knockdown in GBM cells induced GBM malignant characteristics, such as proliferation, metastasis, and GBM stem­like cell (GSC) formation. Comprehensive proteomic analysis and RNA sequencing data from the tissues of patients with GBM revealed that Wnt/ß­catenin signaling was significantly activated by CYLD knockdown in patients with GBM. Furthermore, a Wnt/ß­catenin signaling inhibitor suppressed all CYLD knockdown­induced malignant characteristics of GBM. Taken together, the results of the present study revealed that Wnt/ß­catenin signaling is responsible for CYLD silencing­induced GBM malignancy; therefore, targeting Wnt/ß­catenin may be effective for the treatment of CYLD­negative patients with GBM with poor prognosis.

Co-circulation and co-infection of hantaviruses and Wenzhou mammarenavirus in small mammals and humans in Jiangxi, China.

Both Orthohantaviruses (HV) and Whenzhou Mammarenaviruses (WENV) are rodents borne viruses, allowing them to spread simultaneously in the same area and infect humans. To explore the potential threat of HV and WENV to public health safety, an environmental and laboratory investigation was conducted in 2020-2021, in Jiangxi province, China. A total of 461 small mammals of 7 species and paired sera from 43 suspected HFRS cases were collected from Jiangxi Province, China. Viral genomic RNA and specific antibodies against HV and WENV were detected to evaluate the epidemic situation of the two viruses. Hantaan virus (HTNV), seoul virus (SEOV) and WENV RNA were detected in the lungs of the captured mammals, which resulted 4.1% and 7.4% of HV and WENV RNA positive respectively. Co-infections of WENV and SEOV were detected from Rattus norvegicus, Mus musculus and Rattus flavipectus with an overall co-infection rate of 0.65%. The detection rates of antibodies in the blood against HV and WENV were 11.9% (55/461), and 13.2% (61/461) respectively. The prevalence of viral infection and viral genetic characters varied among the selected areas. In the paired sera of 43 suspected HFRS cases, 38 were with HV infection, 11 were with WENV IgG, and 7 with a 4-fold or more of WENV IgG titer elevation. These results revealed the fact of the co-circulating and coinfection of HV and WENV in the same area at the same time, which might impact on public health safety.

Analysis of the association between glomerular filtration rate, proteinuria and metabolic syndrome in chronic kidney patients based on longitudinal data.

Chronic kidney disease (CKD) is a group of chronic diseases caused by kidney damage from multiple causes. Metabolic syndrome (MS) manifests as dysfunction of endothelial cells and chronic functional inflammatory states, and may be involved in pathological changes related to renal impairment. Based on longitudinal data analysis of the association between estimated glomerular filtration rate (eGFR), proteinuria and MS in patients with CKD, this study aims to provide new ideas for the pathophysiological mechanism of CKD and a theoretical basis for the early prevention and effective intervention of MS-related kidney damage. A total of 126 patients with CKD were divided into non-MS group and MS group. According to the eGFR level, 126 patients with CKD were divided into G1 group, G2 group, G3a group, G3b group, G4 group and G5 group. Serum markers such as eGFR, urine protein, and triglycerides (TG) were collected. The correlation between eGFR, urine protein and MS-related indexes was analysed, and the risk factors affecting CKD complicated by MS were analysed. In patients with CKD, the levels of urine protein, abdominal circumference, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FPG) were increased with the course of the disease, but the levels of eGFR and high density lipoprotein (HDL-C) were decreased (p < 0.05). Abdominal circumference, TG, SBP, DBP, FP were significantly negatively correlated with eGFR, but HDL-C was positively correlated with eGFR (p < 0.05). Diabetes, hyperlipidemia, UA, and SBP were independent risk factors affecting CKD complicated MS, and eGFR were independent protective factors (p < 0.05). The combination of diabetes, hyperlipidemia, UA, SBP, and eGFR exhibited higher prediction value for the CKD patients complicated by MS. There was a certain correlation between between MS components with eGFR and urinary protein in patients with CKD. The early intervention treatment of MS was helpful in delaying the development of CKD and reducing proteinuria.

Red Blood Cell Membrane-Related Gene Variants and Clinical Risk Factors in Chinese Neonates with Hyperbilirubinemia.

INTRODUCTION: Neonatal hyperbilirubinemia is common and remains a clinical concern in China. Since neonatal hyperbilirubinemia is linked to genetic factors, we aimed to identify the gene variants of the red blood cell membrane (RBCM) and evaluate the clinical risk factors in Chinese neonates with hyperbilirubinemia. METHODS: 117 hyperbilirubinemia neonates (33 cases of moderate hyperbilirubinemia and 84 cases of severe hyperbilirubinemia) and 49 controls with normal bilirubin levels were selected as our study subjects. A customized 22-gene panel with next-generation sequencing (NGS) was designed to characterize genetic variations among the neonates. Sanger sequencing was used to verify the accuracy of the NGS. The clinical risk factors and potential effects of genetic variations in neonates with hyperbilirubinemia were subsequently assessed. RESULTS: After data filtering, suspected pathogenic variants of UGT1A1, SLCCO1B1, and RBCM-associated gene were identified in neonates, the combined numbers of RBCM-associated gene variants were found to have differences between the hyperbilirubinemia group and the controls (p = 0.008), they were also different between severe hyperbilirubinemia and moderate hyperbilirubinemia (p = 0.008), and were correlated with an increased risk of hyperbilirubinemia (odds ratio = 9.644, p = 0.006). The UGT1A1-rs4148323 variant in neonates with hyperbilirubinemia was significantly increased as compared with the controls (p < 0.001). However, there was no statistical difference for the SLCO1B1-rs2306283 variant between the hyperbilirubinemia group and the controls. In addition, breastfeeding contributed to an increased risk of hyperbilirubinemia. CONCLUSION: Our study highlights that the RBCM-related gene variants are an underestimated risk factor, which may play an important role in developing hyperbilirubinemia in Chinese newborns.

Suppression of innate and acquired immunity in severe hand foot and mouth disease caused by EV71 infections in children.

Hand, foot, and mouth disease (HFMD) is a common children infectious disease caused by human enteroviruses. Most of the cases have minimal symptoms, however, some patients may develop serious neurological, cardiac complications, or even death. The pathological mechanism leading to severe HFMD is not clearly understood, and the immunological status of the individual patient may play an important role. Transcriptomes of peripheral blood mononuclear cells from EV71-infected patients (n = 45) and healthy controls (n = 36) were examined. Immune pathways were up-regulated in patients with mild disease symptoms (n = 11, M) compared to the healthy controls (n = 36, H), demonstrating an effective anti-viral response upon EV71 infection. However, in patients with severe symptoms (n = 23, S) as well as severe patients following treatment (n = 11, A), their innate and acquired immune pathways were down-regulated, indicating a global immunity suppression. Such immune suppression characteristics could thus provide an opportunity for early EV-71 infection prognosis prediction. Based on our cohort, an SVM model using RNA-seq expression levels of five genes (MCL1, ZBTB37, PLEKHM1P, IFNAR2 and YEATS2) was developed and achieved a high ROC-AUC (91·3%) in predicting severe HFMD. Meanwhile, qPCR fold-changes method was performed based three genes (MCL1, IFNAR2 and YEATS2) on additional cohort. This qPCR method achieved a ROC-AUC of 78.6% in predicting severe HFMD, which the patients could be distinguished in 2-3 h. Therefore, our models demonstrate the possibility of HFMD severity prediction based on the selected biomarkers that predict severe HFMD effectively.

Secondary PM2.5 dominates aerosol pollution in the Yangtze River Delta region: Environmental and health effects of the Clean air Plan.

The Clean Air Plan has been active in China since 2013 to mitigate severe PM2.5 pollution. In this study, we applied the air quality model WRF-Chem to simulate PM2.5 in the Yangtze River Delta (YRD) region of China in 2017, with the aim of assessing the air quality improvement and its associated health burden in the final year of the Clean Air Plan. To better describe the fate of various PM2.5 compositions, we updated the chemical mechanisms in the model beforehand, including heterogeneous sulfate reactions, aqueous secondary organic aerosol (SOA) uptake, and volatility basis set (VBS) based SOA production. Both the observation and simulation results agreed that the stringent clear air action effectively reduced the PM2.5 pollution levels by âˆ¼ 30 %. The primary PM2.5 (-6 âˆ¼  - 16 % yr-1) showed a more significant decreasing trend than the secondary PM2.5 (-2 âˆ¼  - 8 % yr-1), which was mainly caused by the directivity of the clear air actions and the worsening ozone pollution in the recent years. The inconsistent decreasing trends of PM2.5 components subsequently led to an increasing proportion of secondary PM2.5. Nitrate particles, higher in the central and western YRD region, have replaced sulfate and have become the largest component of secondary inorganic aerosols year-round, except in summer, when strong ammonium nitrate evaporation occurs. In addition, SOA remains an important component (21 âˆ¼ 22 %) especially in summer, most of which is produced from the oxidation and ageing of semi/intermediate volatile organic compounds (S/IVOC). Furthermore, we quantified the associated health impacts and found that the Clean Air Plan has largely reduced premature mortality due to PM2.5 exposure in the YRD region from 399.1 thousand to 295.7 thousand. Our study highlights the benefits of the Clean Air Plan and suggests that subsequent PM2.5 improvement should be geared more towards controlling secondary pollutants.

Changes of adjacent segment biomechanics after anterior cervical interbody fusion with different profile design plate: single- versus double-level.

Low-profile angle-stable spacer Zero-P is claimed to reduce the morbidity associated with traditional plate and cage construct (PCC). Both Zero-P and PCC could achieve comparable mid- and long-term clinical and radiological outcomes in anterior cervical discectomy and fusion (ACDF). It is not clear whether Zero-P can reduce the incidence of adjacent segment degeneration (ASD), especially in multi-segmental fusion. This study aimed to test the effect of fusion level with Zero-P versus with PCC on adjacent-segment biomechanics in ACDF. A three-dimensional finite element (FE) model of an intact C2-T1 segment was built and validated. Six single- or double-level instrumented conditions were modeled from this intact FE model using Zero-P or the standard PCC. The biomechanical responses of adjacent segments at the cephalad and caudal levels of the operation level were assessed in terms of range of motion (ROM), stresses in the endplate and disc, loads in the facets. When comparing the increase of adjacent-segment motion in single-level PCC fusion versus Zero-P fusion, a significantly larger increase was found in double-level fusion condition. The fold changes of PCC versus Zero-P of intradiscal and endplate stress, and facet load at adjacent levels in the double-level fusion spine were significantly larger than that in the single-level fusion spine during the sagittal, the transverse, and the frontal plane motion. The increased value of biomechanical features was greater at above segment than that at below. The fold changes of PCC versus Zero-P at adjacent segment were most notable in flexion and extension movement. Low-profile device could decrease adjacent segment biomechanical burden compared to traditional PCC in ACDF, especially in double-level surgery. Zero-P could be a good alternative for traditional PCC in ACDF. Further clinical/in vivo studies will be necessary to explore the approaches selected for this study is warranted.

Changes in Intestinal Flora From Chronic Renal Failure Complicated With Coronary Heart Disease and its Correlation With Arterial Stiffness Index.

Context: One common and serious cardiovascular complication of chronic renal failure (CRF) is coronary heart disease (CHD). CRF can lead to an imbalance of patients' gut microbiota, and changes in intestinal flora might heavily affect CRF's development. Objective: The study intended to investigate the changes in intestinal flora of patients with CRF complicated with CHD and their relationship with ASI to understand the association of those changes and ASI with CRF comorbid with CHD, with the goal of offering a reliable clinical basis for active prevention and treatment of CRF and CHD in the future. Design: The research team designed a prospective controlled study. Setting: The study took place at the Affiliated Hospital of Hebei University in Baoding, Hebei, China. Participants: Participants were 86 patients with both CRF and CHD and 72 patients with CHD only who had been admitted to the hospital between October 2019 and January 2021. Intervention: The intervention group included participants who had received a diagnosis of CRF complicated with CHD and the control group included participants who had received a diagnosis of CHD only. Outcome Measures: The research team counted participants' intestinal flora and measured their ambulatory blood pressure and arterial stiffness index (ASI) to analyze the correlation of the ASI with the intestinal flora and the related factors impacting CHD in patients with CRF. Results: The monitoring of participants' ambulatory blood pressures showed that the intervention group's day systolic blood pressure (dSBP) and 24h SBP were significantly higher, while the group's day diastolic blood pressure (dDBP) and 24h DBP were significantly lower than those of the control group. The intervention group's levels of lactobacillus, bacteroidaceae, and bifidobacterium were significantly lower than those of the control group, and those intestinal flora were negatively correlated with ASI. The intervention group's levels of Escherichia coli and yeasts were significantly higher than those of the control group, and those intestinal flora were positively correlated with ASI. A significant relationship existed between lactobacillus and yeast and the occurrence of CHD in the CRF participants. Conclusions: Patients with both CRF and CHD have an obvious intestinal-flora imbalance, and the imbalance is strongly bound up with their ASI, which is of great reference significance for novel therapy of such patients and for the clinical application of ASI.