Comparative Genome-Wide Identification of the Fatty Acid Desaturase Gene Family in Tea and Oil Tea.

Camellia oil is valuable as an edible oil and serves as a base material for a range of high-value products. Camellia plants of significant economic importance, such as Camellia sinensis and Camellia oleifera, have been classified into sect. Thea and sect. Oleifera, respectively. Fatty acid desaturases play a crucial role in catalyzing the formation of double bonds at specific positions of fatty acid chains, leading to the production of unsaturated fatty acids and contributing to lipid synthesis. Comparative genomics results have revealed that expanded gene families in oil tea are enriched in functions related to lipid, fatty acid, and seed processes. To explore the function of the FAD gene family, a total of 82 FAD genes were identified in tea and oil tea. Transcriptome data showed the differential expression of the FAD gene family in mature seeds of tea tree and oil tea tree. Furthermore, the structural analysis and clustering of FAD proteins provided insights for the further exploration of the function of the FAD gene family and its role in lipid synthesis. Overall, these findings shed light on the role of the FAD gene family in Camellia plants and their involvement in lipid metabolism, as well as provide a reference for understanding their function in oil synthesis.

Innovative Hydrogel-Patch Combination for Large Annulus Fibrosus Defects: A Prospective Approach to Address Herniation Recurrence.

BACKGROUND CONTEXT: Large annulus fibrosus (AF) defects often lead to a high rate of reherniation, particularly in the medial AF region, which has limited self-healing capabilities. The increasing prevalence of herniated discs underscores the need for effective repair strategies. PURPOSE: The objectives of this study were to design an AF repair technique to reduce solve the current problems of insufficient mechanical properties and poor sealing capacity. STUDY DESIGN: In vitro biomechanical experiments and finite element analysis. METHODS: The materials used in this study were patches and hydrogels with good biocompatibility and sufficient mechanical properties to withstand loading in the lumbar spine. Five repair techniques were assessed in this study: hydrogel filler (HF), AF patch medial barrier (MB), AF patch medial barrier and hydrogel filler (MB&HF), AF patch medial-lateral barrier (MLB), and AF patch medial-lateral barrier and hydrogel filler (MLB&HF). The repair techniques were subjected to in vitro testing (400 N axial compression and 0-500 N fatigue loading at 5Hz) and finite element analysis (400 N axial compression) to evaluate the effectiveness at repairing large AF defects. The evaluation included repair tightness, spinal stability, and fatigue resistance. RESULTS: From the in vitro testing, the failure load of the repair techniques was in the following order HF < MB < MB&HF < MLB < MLB&HF. Both HF and MB groups failed to effectively increase intervertebral disc (IVD) stiffness, resulting in a reduction in spatial stability. The MLB, MB&HF, and MLB&HF groups partially restored IVD stiffness, with MLB&HF showing the most effective recovery (-24.13% ± 3.59%). From the finite element models, incorporating a hydrogel filler was best able to maintain the IVD height. Patch repair alone could not adequately reduce the high AF stress due to AF injury, but with hydrogel support, stress was substantially low and more uniformly distributed. All repair techniques demonstrated reduced stress around the damaged area on the AF, in comparison to the unrepaired model. The NP pressure in the HF group was closest to the intact group, and the patch repair reduced the NP pressure. The maximum patch deformation and suture stress were ranked as MB > MLB > MB&HF > MLB&HF. CONCLUSIONS: The combined use of patches and hydrogels exhibited promising mechanical properties post-discectomy, providing a promising solution for addressing large AF defects and improving disc stability. CLINICAL SIGNIFICANCE: This study introduces a promising method for repairing large annular fissure (AF) defects after disc herniation, combining patch repair with a hydrogel filler. These techniques hold potential for developing clinical AF repair products to address this challenging issue.

Tetraborated Intrinsically Axial Chiral Multi-resonance Thermally Activated Delayed Fluorescence Materials.

Chiral multi-resonance thermally activated delayed fluorescence (CP-MR-TADF) materials hold promise for circularly polarized organic light-emitting diodes (CP-OLEDs) and 3D displays. Herein, we present two pairs of tetraborated intrinsically axial CP-MR-TADF materials, R/S-BDBF-BOH and R/S-BDBT-BOH, with conjugation-extended bidibenzo[b,d]furan and bidibenzo[b,d]thiophene as chiral sources, which effectively participate in the distribution of the frontier molecular orbitals. Due to the heavy-atom effect, sulfur atoms are introduced to accelerate the reverse intersystem crossing process and increase the efficiency of molecules. R/S-BDBF-BOH and R/S-BDBT-BOH manifest ultra-pure blue emission with a maximum at 458/459 nm with a full width at half maximum of 27 nm, photoluminescence quantum yields of 90 %/91 %, and dissymmetry factors (|gPL|) of 6.8×10-4/8.5×10-4, respectively. Correspondingly, the CP-OLEDs exhibit good performances with an external quantum efficiency of 30.1 % and |gEL| factors of 1.2×10-3.

Supernatural Beliefs-Based Intervention to Improve Type-2 Diabetes Self-Management: A Pilot Randomized Controlled Trial from China.

China has over 100 million people living with type 2 diabetes mellitus (T2DM). Interventions framed around pre-existing personal beliefs in the supernatural may improve T2DM self-management, but such interventions are lacking in China. This pilot randomized controlled trial (RCT) assessed the feasibility of a full-scale RCT to evaluate the efficacy of a supernatural beliefs-based intervention on T2DM management self-efficacy in China. In 2019, 62 T2DM patients were enrolled at two hospitals in Suzhou, China. Participants were randomly assigned to view a 30-s control or intervention video at baseline. The control video showed general diabetes self-management information. The intervention video showed identical information, but also indicated that some diabetics with supernatural beliefs (chao ziran xinnian) have lower glycemic levels, because their beliefs enhance their confidence in diabetes self-management. Development of the intervention was guided by the theory of planned behavior and literature on spiritual framing health interventions. Baseline and follow-up measures after two weeks were assessed by interviewer administered surveys in-person and by telephone, respectively. Diabetes management self-efficacy was assessed with the diabetes management self-efficacy scale. Randomization of intervention allocation appeared to be successful. However, follow-up retention was low, especially for the intervention group (3% vs. 31%). A full-size efficacy RCT using the current study design is unlikely to succeed. T2DM patients shown the supernatural beliefs-based intervention had significantly higher loss to follow-up that was insurmountable. T2DM patients in Suzhou, China may not be receptive to brief, non-tailored supernatural beliefs-based interventions delivered to a general population in clinical settings.

Comparison of life cycle assessment between hydrogen production from silicon waste and alkaline water electrolysis.

With global warming becoming increasingly severe, environmental issues are receiving international attention. Crystalline silicon is an indispensable and important raw material for photovoltaic and semiconductor fields, but the cutting of crystalline silicon materials generates a large amount of silicon wastes. This article evaluates the environmental impact of a hydrogen production process using diamond-wire sawing silicon waste (DSSW) using the life cycle assessment (LCA) methodology. For comparison, it was also analyzed the environmental impact of the alkaline water electrolysis (AEL) hydrogen production route. In the DSSW alkaline catalyzed hydrolysis (DACH) hydrogen production route, the hydrogen production stage accounts for the main contribution of nine environmental impact indexes, including GWP, PED, ADP, AP, EP, ODP, ET, HT-cancer, and HT-non cancer, exceeding 56 %. Whereas for the AEL route, the environmental impacts of the electrolytic cell manufacturing stage can be neglected, and the operating stage contributes almost all the environmental impacts, contributing more than 92 % to the twelve environmental impact indexes. Compared to the AEL route, the DACH route has higher environmental impacts, with GWP index reaching 87.78 kg CO2 -eq/kg H2, PED index reaching 1772.90 MJ/kg H2, and IWU index reaching 622.37 kg/kg H2 which are 2.85, 4.07 and 7.56 times higher than the former, respectively. Although the environmental impact of the DACH route is significant, most of its indirect impacts were caused by the use of raw materials, and the energy consumption and direct environmental impact are both low. The environmental impact of the AEL route is mainly indirect effects generated due to the use of electricity. If clean renewable energy sources (e.g., solar PV, hydropower, geothermal or biofuels), were used for the AEL route, all twelve environmental impact indexes would be significantly reduced.

Role of the nucleotide-binding oligomerization domain-containing protein 1 pathway in the development of periodontitis.

OBJECTIVES: During innate immune defense, host pattern recognition receptors, including toll-like receptors and nucleotide-binding oligomerization domain-like receptors (NLRs), can activate downstream pathways by recognizing pathogen-associated molecular patterns produced by microorganisms, triggering immune responses. NOD1, an important cell membrane protein in the NLR-like receptor protein family, exerts anti-infective effects through γ-D-glutamyl-meso-diaminopimelic acid (iE-DAP) recognition. Oral epithelial cells resist bacterial invasion through iE-DAP-induced interleukin (IL)-8 production, recruiting neutrophils to sites of inflammation in response to bacterial threats to periodontal tissues. To date, the regulatory mechanisms of iE-DAP in gingival epithelial cells (GECs) are poorly understood. This study was conducted to investigate the role of the NOD1 pathway in the development of periodontitis by examining the effect of iE-DAP on IL-8 production in Ca9-22 cells. METHODS: IL-8 production by iE-DAP-stimulated-Ca9-22 cells was assessed using an enzyme-linked immunosorbent assay. Phosphorylation levels of intracellular signaling molecules were evaluated using western blot analyses. RESULTS: iE-DAP induced NOD1 receptor expression in Ca9-22 cells. Additionally, iE-DAP induced expression of pro-IL-1ß protein without extracellular secretion. Our results suggest that iE-DAP regulates IL-8 production by activating p38 mitogen-activated protein kinase (MAPK) and ERK1/2 signaling pathways. iE-DAP also promoted nuclear factor kappa-B p65 phosphorylation, facilitating its nuclear translocation. Notably, p38 MAPK and ERK1/2 inhibitors suppressed iE-DAP-stimulated IL-8 production, suggesting that JNK is not involved in this mechanism. CONCLUSIONS: Our results indicate that p38 MAPK and ERK1/2, but not JNK, are involved in innate immune responses in GECs.

Application and evaluation of hydrodissection in microwave ablation of liver tumours in difficult locations.

Objective: To investigate the safety and mid-term outcomes of hydrodissection-assisted microwave ablation (MWA) of hepatocellular carcinoma (HCC) in various difficult locations. Methods: A total of 131 HCC patients who underwent ultrasound-guided MWA from March 2017 to March 2019 were included. Following ultrasound examination, patients with tumors at difficult locations were treated with hydrodissection-assisted MWA (hydrodissection group), while those with tumors at conventional locations received MWA (control group). Both groups were compared concerning baseline characteristics, ablation parameters, complete ablation rates, and complication rates. Kaplan-Meier curves analyzed local tumor progression and overall survival, with stratified analysis for different difficult locations (adjacent to gastrointestinal tract, diaphragm, and subcapsular tumors). Additionally, Cox regression analyses were conducted to assess the impact of different difficult locations on these outcomes. Results: Complete ablation rates were similar between the hydrodissection and control groups (91.4% vs. 95.2%, P>0.05). Postoperative complications occurred in three patients, including liver abscess and biliary injury. No significant differences in major or minor complication rates were found between the groups (P>0.05). Local tumor progression was detected in 11 patients (8.4%) at the end of the follow-up period. Neither cumulative local tumor progression rate (P=0.757) nor overall survival rate (P=0.468) differed significantly between the groups. Stratified analysis showed no effect of tumor location difficulty on cumulative local tumor progression or overall survival. Tumor number and size served as independent predictors for overall survival, while minimal ablation margin ≤ 5mm independently predicted local tumor progression. In contrast, the tumor location was not statistically significant. Sensitivity analyses corroborated the robustness of the models. Conclusion: Hydrodissection-assisted MWA for HCC in various difficult locations demonstrated safe and effective, with complete ablation and mid-term outcomes comparable to those for tumors in conventional locations.

Fractionalization in Fractional Correlated Insulating States at n±1/3 Filled Twisted Bilayer Graphene.

Fractionalization without time-reversal symmetry breaking is a long-sought-after goal in the study of correlated phenomena. The earlier proposal of correlated insulating states at n±1/3 filling in twisted bilayer graphene and recent experimental observations of insulating states at those fillings strongly suggest that moiré graphene systems provide a new platform to realize time-reversal symmetric fractionalized states. However, the nature of fractional excitations and the effect of quantum fluctuation on the fractional correlated insulating states are unknown. We show that excitations of the fractional correlated insulator phases in the strong coupling limit carry fractional charges and exhibit fractonic restricted mobility. Upon introduction of quantum fluctuations, the resonance of "lemniscate" structured operators drives the system into quantum lemniscate liquid (QLL) or quantum lemniscate solid (QLS). We find an emergent U(1)×U(1) 1-form symmetry unifies distinct motions of the fractionally charged excitations in the strong coupling limit and in the QLL phase, while providing a new mechanism for fractional excitations in two dimensions. We predict emergent Luttinger liquid behavior upon dilute doping in the strong coupling limit due to restricted mobility and discuss implications at a general n±1/3 filling.

P38α contributes to TNF-α-induced IL-8 production in human gingival cells.

Tumor necrosis factor-alpha (TNF-α) is a major inflammatory cytokine that induces interleukin (IL)-8 production. Although some studies have reported the involvement of the p38 MAPK signaling pathway in TNF-α-induced IL-8 production, its specific regulatory mechanisms in gingival epithelial cells (GECs) are still poorly understood. In the present study, Ca9-22 cells were used as representative GECs to investigate the effect of p38 signaling on TNF-α-induced IL-8 production. We found that TNF-α enhanced IL-8 production in Ca9-22 cells by activating the p38 signaling pathway, and one of its isoforms, p38α, played a key role. P38α deletion markedly inhibited TNF-α-induced IL-8 expression in Ca9-22 cells, while p38α gene rescue could reverse this effect. Further studies revealed that TNF-α-induced IL-8 production was markedly reduced when the threonine 180 and tyrosine 182 p38α phosphorylation sites were targeted for mutagenesis to alanine and phenylalanine, respectively, suggesting their critical role in the process. In conclusion, p38α plays an important role in TNF-α-induced IL-8 production, providing a potential therapeutic target to prevent and treat periodontal disease.

Diamagnetic response and phase stiffness for interacting isolated narrow bands.

Superconductivity is a macroscopic manifestation of a quantum phenomenon where pairs of electrons delocalize and develop phase coherence over a long distance. A long-standing quest has been to address the underlying microscopic mechanisms that fundamentally limit the superconducting transition temperature, Tc. A platform which serves as an ideal playground for realizing "high"-temperature superconductors are materials where the electrons' kinetic energy is quenched and interactions provide the only energy scale in the problem. However, when the noninteracting bandwidth for a set of isolated bands is small compared to the interactions, the problem is inherently nonperturbative. In two spatial dimensions, Tc is controlled by superconducting phase stiffness. Here, we present a theoretical framework for computing the electromagnetic response for generic model Hamiltonians, which controls the maximum possible superconducting phase stiffness and thereby Tc, without resorting to any mean-field approximation. Our explicit computations demonstrate that the contribution to the phase stiffness arises from i) "integrating out" the remote bands that couple to the microscopic current operator and ii) the density-density interactions projected on to the isolated narrow bands. Our framework can be used to obtain an upper bound on the phase stiffness and relatedly Tc for a range of physically inspired models involving both topological and nontopological narrow bands with density-density interactions. We discuss a number of salient aspects of this formalism by applying it to a specific model of interacting flat bands and compare the upper bound against the known Tc from independent numerically exact computations.

The gut microbiota correlate with the disease characteristics and immune status of patients with untreated diffuse large B-cell lymphoma.

Background: Gut microbiota characteristics in patients with diffuse large B-cell lymphoma (DLBCL) are reportedly different when compared with the healthy population and it remains unclear if the gut microbiota affects host immunity and clinical disease features. This research investigated the gut microbiota in patients with untreated DLBCL and analyzed its correlation with patient clinical characteristics, humoral, and cell immune status. Methods: Thirty-five patients with untreated DLBCL and 20 healthy controls (HCs) were recruited to this study and microbiota differences in stool samples were analyzed by 16S rDNA sequencing. Absolute ratios of immune cell subset counts in peripheral blood were detected by flow cytometry and peripheral blood cytokine levels were detected by enzyme-linked immunosorbent assay. Relationships between changes in patient microbiomes and clinical characteristics, such as clinical stage, international prognostic index (IPI) risk stratification, cell origin, organ involved and treatment responses were investigated and correlations between differential microbiota and host immune indices were analyzed. Results: The alpha-diversity index of intestinal microecology in DLBCL patients was not significantly different when compared with HCs (P>0.05), nonetheless beta-diversity was significantly decreased (P=0.001). p_Proteobacteria were dominant in DLBCL, while p_Bacteroidetes abundance was significantly decreased when compared with HCs (P<0.05). Gut microbiota characteristics were identified that were associated with clinical features, such as tumor load, risk stratification and cell origin, and correlation analyses were performed between differential flora abundance associated with these clinical features and host immune status. The p_Firmicutes was positively correlated with absolute lymphocyte values, g_Prevotella_2 and s_un_g_Prevotella_2 were negatively correlated with absolute lymphocyte values, T cell counts and CD4 cell counts, while g_Pyramidobacter, s_un_g_Pyramidobacter, and f_Peptostreptococcaceae were negatively correlated with IgA. Conclusions: Dominant gut microbiota, abundance, diversity, and structure in DLBCL were influenced by the disease, correlated with patient immune status and this suggested that the microecology-immune axis may be involved in regulating lymphoma development. In the future, it may be possible to improve immune function in patients with DLBCL by regulating the gut microbiota, improve treatment response rates and increase patient survival rates.

Biomechanical evaluation of a novel intervertebral disc repair technique for large box-shaped ruptures.

Objective: The purpose of this study was to analyze the feasibility of repairing a ruptured intervertebral disc using a patch secured to the inner surface of the annulus fibrosus (AF). Different material properties and geometries for the patch were evaluated. Methods: Using finite element analysis, this study created a large box-shaped rupture in the posterior-lateral region of the AF and then repaired it with a circular and square inner patch. The elastic modulus of the patches ranged from 1 to 50 MPa to determine the effect on the nucleus pulposus (NP) pressure, vertical displacement, disc bulge, AF stress, segmental range of motion (ROM), patch stress, and suture stress. The results were compared against the intact spine to determine the most suitable shape and properties for the repair patch. Results: The intervertebral height and ROM of the repaired lumbar spine was similar to the intact spine and was independent of the patch material properties and geometry. The patches with a modulus of 2-3 MPa resulted in an NP pressure and AF stresses closest to the healthy disc, and produced minimal contact pressure on the cleft surfaces and minimal stress on the suture and patch of all models. Circular patches caused lower NP pressure, AF stress and patch stress than the square patch, but also caused greater stress on the suture. Conclusion: A circular patch with an elastic modulus of 2-3 MPa secured to the inner region of the ruptured annulus fibrosus was able to immediately close the rupture and maintain an NP pressure and AF stress similar to the intact intervertebral disc. This patch had the lowest risk of complications and produced the greatest restorative effect of all patches simulated in this study.

Combined Radiomics-Clinical Model to Predict Radiotherapy Response in Inoperable Stage III and IV Non-Small-Cell Lung Cancer.

Purpose: Radiotherapy is a promising treatment option for lung cancer, but patients' responses vary. The purpose of the study was to investigate the potential of radiomics and clinical signature for predicting the radiotherapy sensitivity and overall survival of inoperable stage III and IV non-small-cell lung cancer (NSCLC) patients. Materials: This retrospective study collected 104 inoperable stage III and IV NSCLC patients at the Yunnan Cancer Hospital from October 2016 to September 2020. They were divided into radiation-sensitive and non-sensitive groups. We used analysis of variance (ANOVA) to select features and support vector machine (SVM) to build the radiomic model. Furthermore, the logistic regression method was used to screen out clinically relevant predictive factors and construct the combined model of radiomics-clinical features. Finally, survival was estimated using the Kaplan-Meier method. Results: There were 40 patients in the radiation-sensitive group and 64 in the non-sensitive group. These patients were divided into training set (73 cases) and testing set (31 cases) according to the ratio of 7:3. Nine radiomics features and one clinical feature were significantly associated with radiotherapy sensitivity. Both the radiomics model and combined model have good predictive performance (the areas under the curve (AUC) values of the testing set were 0.864 (95% confidence interval [CI]: 0.683-0.996) and 0.868 (95% CI: 0.689-1.000), respectively). Only platelet level status was associated with overall survival. Conclusion: The combined model constructed based on radiomics and clinical features can effectively identify the radiation-sensitive population and provide valuable clinical information. Patients with higher platelet levels may have a poor prognosis.

Ultrafast charge transfer in a nonfullerene all-small-molecule organic solar cell: a nonadiabatic dynamics simulation with optimally tuned range-separated functional.

Herein, we have employed linear-response time dependent density functional theory (LR-TDDFT)-based nonadiabatic dynamics simulations to investigate the ultrafast charge transfer in a nonfullerene all-small-molecule donor-acceptor (D-A) system formed by a porphyrin small-molecule donor ZnP and a recently developed nonfullerene small-molecule acceptor 6TIC, during which the optimally tuned range-separated hybrid (OT-RSH) functional was adopted. In combination with static electronic structure calculations, several important conclusions were drawn. Firstly, the ZnP and 6TIC are more likely combined together non-covalently in parallel rather than in perpendicular to form ZnP-6TIC due to the much larger adsorption energies, i.e. -44.6 kcal mol-1vs. -25.2 kcal mol-1. Secondly, the excited state properties obtained by OT-RSH functionals seem more consistent with the experimental results compared to their untuned versions. Specifically, the energy of the lowest charge transfer (CT) state was predicted to be smaller than the lowest lying local excitation (LE) states using the OT-RSH functional-based LR-TDDFT calculations, which is beneficial for the charge transfer process that might be crucial for the high power conversion efficiency (PCE) achieved experimentally. In contrast, the untuned RS functionals all predict higher CT state energies, which is contradictory to the high PCE obtained in the experiment. Moreover, strong hybridization upon excitation between these states was revealed, which might be one of the reasons responsible for the high PCE observed in the experiment. Finally, ultrafast excited state relaxation can be completed within 500 fs due to the small energy gaps and the strong nonadiabatic couplings between these states, which is accompanied by ultrafast photoinduced electron transfer from ZnP to 6TIC and photoinduced hole transfer the other way around. The efficient charge transfer processes and the involvement of two charge generation channels might be another cause resulting in the excellent photovoltaic performance of ZnP-6TIC based OSCs. Our present work not only provides solid evidence for elucidating the underlying mechanism observed in previous experiments, but also suggests that the combination of OT-RSH functionals and LR-TDDFT-based nonadiabatic dynamics simulations might be a powerful tool for investigating the excited state dynamics of organic D-A systems, which is crucial for the theoretical design of novel OSCs with better performances in the future.

Utility of serum nuclear factor erythroid 2-related factor 2 as a potential prognostic biomarker of severe traumatic brain injury in adults: A prospective cohort study.

Objective: Nuclear factor erythroid 2-related factor 2 (Nrf2) may harbor endogenous neuroprotective role. We strived to ascertain the prognostic significance of serum Nrf2 in severe traumatic brain injury (sTBI). Methods: This prospective cohort study included 105 controls and 105 sTBI patients, whose serum Nrf2 levels were quantified. Its relations to traumatic severity and 180-day overall survival, mortality, and poor prognosis (extended Glasgow Outcome Scale score 1-4) were discerned using multivariate analysis. Results: There was a substantial enhancement of serum Nrf1 levels of patients (median, 10.9 vs. 3.3 ng/ml; P < 0.001), as compared to controls. Serum Nrf2 levels were independently correlative to Rotterdam computed tomography (CT) scores (ρ = 0.549, P < 0.001; t = 2.671, P = 0.009) and Glasgow Coma Scale (GCS) scores (ρ = -0.625, P < 0.001; t = -3.821, P < 0.001). Serum Nrf2 levels were significantly higher in non-survivors than in survivors (median, 12.9 vs. 10.3 ng/ml; P < 0.001) and in poor prognosis patients than in good prognosis patients (median, 12.5 vs. 9.4 ng/ml; P < 0.001). Patients with serum Nrf2 levels > median value (10.9 ng/ml) had markedly shorter 180-day overall survival time than the other remainders (mean, 129.3 vs. 161.3 days; P = 0.002). Serum Nrf2 levels were independently predictive of 180-day mortality (odds ratio, 1.361; P = 0.024), overall survival (hazard ratio, 1.214; P = 0.013), and poor prognosis (odds ratio, 1.329; P = 0.023). Serum Nrf2 levels distinguished the risks of 180-day mortality and poor prognosis with areas under receiver operating characteristic curve (AUCs) at 0.768 and 0.793, respectively. Serum Nrf2 levels > 10.3 ng/ml and 10.8 ng/ml discriminated patients at risk of 180-day mortality and poor prognosis with the maximum Youden indices of 0.404 and 0.455, respectively. Serum Nrf2 levels combined with GCS scores and Rotterdam CT scores for death prediction (AUC, 0.897; 95% CI, 0.837-0.957) had significantly higher AUC than GCS scores (P = 0.028), Rotterdam CT scores (P = 0.007), or serum Nrf2 levels (P = 0.006) alone, and the combination for poor outcome prediction (AUC, 0.889; 95% CI, 0.831-0.948) displayed significantly higher AUC than GCS scores (P = 0.035), Rotterdam CT scores (P = 0.006), or serum Nrf2 levels (P = 0.008) alone. Conclusion: Increased serum Nrf2 levels are tightly associated with traumatic severity and prognosis, supporting the considerable prognostic role of serum Nrf2 in sTBI.

Meta-Analysis of Different Acupuncture Points in the Treatment of Ankylosing Spondylitis with Supervised Moxibustion.

Objective: To investigate the clinical efficacy of different acupuncture points in the treatment of ankylosing spondylitis with supervised moxibustion. Methods: Retrospective analysis of 61 AS patients (diagnosed as ankylosing spondylitis of kidney-yang deficiency type by Chinese medicine) admitted to our hospital from January 2020 to February 2021, randomly divided into 30 cases in the experimental group (Du moxibustion + basic western medicine treatment) and 31 cases in the control group (basic western medicine treatment alone). The changes in quantitative scores of the main symptoms and major signs (thoracic mobility, occipital-wall distance, finger-ground distance, and laboratory index (ESR)) were analyzed before and after treatment. Results: Of the 30 cases in the experimental group, 2 were clinically cured, 3 were apparently effective, 21 were effective, and 4 were ineffective, with an overall effective rate of 86.7%; of the 31 cases in the control group, 1 was clinically cured, 1 was apparently effective, 1 was effective. 24 were effective, and 5 were ineffective, with an overall effective rate of 83.9%. Comparing the efficacy by t-test, P < 0.05, indicating that the effect of Du moxibustion + Western medicine treatment was better. Conclusion: The treatment of ankylosing spondylitis with kidney-yang deficiency by moxibustion + western medicine can improve the efficacy, alleviate the inflammatory response and improve the patient's symptoms and signs, and immune indexes.

[Biblio-metrology analysis on clinical application of Chengshan (BL57) in ancient Chinese medical literature].

OBJECTIVE: To analyze and sum up clinical application regularities of Chengshan (BL57) acupoint in ancient Chinese literature. METHODS: The book Zhonghua Yidian (Collection of Chinese Medical Classic Works, 5th edition) containing 1 156 ancient medical books was used as the retrieved literature source. The key retrieval words used were BL57 acupoint related indications, prescriptions, treatment methods and taboos, followed by sorting out relevant articles and establishing a database. RESULTS: A total of 196 articles meeting our inclusion standards of the present study, involving 61 ancient books which contain 174 related terms covering 56 diseases or syndromes of internal medicine, surgery, pediatrics, ophthalmology and otorhinola-ryngology, etc.. Among them, the most frequently attending disease treated by single BL57 or acupoints combination was limb meridian disorders, and the most frequently used auxiliary acupoint was Kunlun (BL60). The most frequently used auxiliary meridian was the Bladder Meridian of Foot Taiyang. In addition, a total of 71 terms involved the acupuncture and moxibustion techniques of BL57, covering 7 treatment methods. In terms of the treatment methods, the dose of moxibustion was five cones in each session, and the depth of acupuncture needle insertion was about seven fen. CONCLUSION: BL57 is widely used in various clinical departments, especially for limb meridian diseases.

ECMO in neonates: The association between cerebral hemodynamics with neurological function.

Extracorporeal membrane oxygenation (ECMO) is a superior life support technology, commonly employed in critical patients with severe respiratory or hemodynamic failure to provide effective respiratory and circulatory support, which is especially recommended for the treatment of critical neonates. However, the vascular management of neonates with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still under controversy. Reconstruction or ligation for the right common carotid artery (RCCA) after ECMO is inconclusive. This review summarized the existed studies on hemodynamics and neurological function after vascular ligation or reconstruction hoping to provide better strategies for vessel management in newborns after ECMO. After reconstruction, the right cerebral blood flow can increase immediately, and the normal blood supply can be restored rapidly. But the reconstructed vessel may be occluded and stenotic in long-term follow-ups. Ligation may cause lateralization damage, but there could be no significant effect owing to the establishment of collateral circulation. The completion of the circle of Willis, the congenital anomalies of cerebral or cervical vasculature, the duration of ECMO, and the vascular condition at the site of arterial catheterization should be assessed carefully before making the decision. It is also necessary to follow up on the reconstructed vessel sustainability, and the association between cerebral hemodynamics and neurological function requires further large-scale multi-center studies.

Biomechanical evaluation of a short-rod technique for lumbar fixation surgery.

Objective: The purpose of this study was to analyze the stability and instrument-related complications associated with fixation of the lumbar spine using the Short-Rod (SR) technique. Methods: Using finite element analysis, this study assessed the stability of a bilateral lumbar fixation system when inserting the pedicle screws at angles of 10°, 15°, and 20° to the endplate in the sagittal plane. Using the most stable construct with a screw angle, the model was then assessed with different rod lengths of 25, 30, 35, and 45 mm. The optimal screw inclination angle and rod length were incorporated into the SR model and compared against traditional parallel screw insertion (pedicle screws in parallel to the endplate, PPS) in terms of the stability and risk of instrument-related complications. The following parameters were evaluated using the validated L4-L5 lumbar finite element model: axial stiffness, range of motion (ROM), stress on the endplate and facet joint, von-Mises stress on the contact surface between the screw and rod (CSSR), and screw displacement. Results: The results showed that the SR model with a 15° screw inclination angle and 35 mm rod length was superior in terms of construct stability and risk of complications. Compared to the PPS model, the SR model had lower stiffness, lower ROM, less screw displacement, and lower stress on the facet cartilage, the CSSR, and screws. However, the SR model also suffered more stress on the endplate in flexion and lateral bending. Conclusion: The SR technique with a 15° screw inclination and 35 mm rod length offers good lumbar stability with a low risk of instrument-related complications.