Hemoadsorption and Coagulation Systemic Rebalance in Patients Undergoing Nonelective Cardiac Surgery and Treated with Antithrombotics.

INTRODUCTION: Insufficient withdrawal duration of antithrombotics leads to excessive bleeding after major surgery. We hypothesize that intraoperative hemoadsorption (HA) can reduce postoperative allogeneic transfusion requirements and excessive bleeding events (EBE), without an increase in ischemic/thromboembolic events (ITE) in patients who have taken antithrombotics and undergone nonelective cardiac surgery. METHODS: A total of 460 patients admitted to our hospital from 2018 to 2022 were included in this study and divided into two groups: HA and non-HA. Because of the risk of bias due to differences in antithrombotic type, withdrawal duration, or basic coagulation function, propensity score matching was used for analyses. RESULTS: Out of 154 cases in the HA group, 144 pairs were successfully matched. No HA safety events such as hemolysis, hypotension, or device failure occurred. After matching, the two groups were found to be comparable in preoperative antithrombotic type, withdrawal duration, platelets and coagulation function, and demographic and perioperative characteristics. Although the HA group did not have a reduced incidence of EBE, this group exhibited significant decreases in the transfusion rate and volume, the incidence of ITE, acute kidney injury, and central nervous system injury. CONCLUSIONS: For patients who have undergone nonelective cardiac surgery and taken antithrombotics, HA can simply and safely rebalance the postoperative coagulation system and have associations with reduced transfusion and postoperative ITE.

Boosting Charge Utilization in Self-Powered Photodetector for Real-Time High-Throughput Ultraviolet Communication.

Ultraviolet (UV) communication is a cutting-edge technology in communication battlefields, and self-powered photodetectors as their optical receivers hold great potential. However, suboptimal charge utilization has largely limited the further performance enhancement of self-powered photodetectors for high-throughput communication application. Herein, a self-powered Ti3 C2 Tx -hybrid poly(3,4 ethylenedioxythiophene):poly-styrene sulfonate (PEDOT:PSS)/ZnO (TPZ) photodetector is designed, which aims to boost charge utilization for desirable applications. The device takes advantage of photothermal effect to intensify pyro-photoelectric effect as well as the increased conductivity of the PEDOT:PSS, which significantly facilitated charge separation, accelerated charge transport, and suppressed interface charge recombination. Consequently, the self-powered TPZ photodetector exhibits superior comprehensive performance with high responsivity of 12.3 mA W-1 and fast response time of 62.2 µs, together with outstanding reversible and stable cyclic operation. Furthermore, the TPZ photodetector has been successfully applied in an integrated UV communication system as the self-powered optical receiver capable of real-time high-throughput information transmission with ASCII code under 9600 baud rate. This work provides the design insight of highly performing self-powered photodetectors to achieve high-efficiency optical communication in the future.

[Influence and Driving of Environmental Heterogeneity on the Epilithic Diatom Community in Xiangxi River, a Tributary of the Three Gorges Reservoir Area].

Environmental heterogeneity can not only increase species diversity to some extent but also affect the stability of terrestrial communities. However, how environmental heterogeneity affects species diversity of epilithic diatom communities in aquatic ecosystems is rarely reported. In this study, therefore, epilithic diatoms and their roles in driving species diversity were explored by quantifying and comparing the environmental heterogeneity in Xiangxi River, a tributary of the Three Gorges Reservoir Area (TGR), on a time scale. The results showed that environmental heterogeneity, taxonomic ß-diversity, and functional ß-diversity in non-impoundment periods were significantly higher than those in impoundment periods. Moreover, the turnover components in the two hydrological periods showed the highest contribution to ß-diversity. However, the taxonomic α-diversity in impoundment periods was significantly higher than that in non-impoundment periods. In addition, functional richness in functional α-diversity was significantly higher in non-impoundment periods than that in impoundment periods, whereas there was no significant difference in other functional α-diversity, i.e., functional dispersion and functional evenness, found between the two periods. Multiple regression on (dis)similarity matrices (MRM) analysis indicated that ammonium nitrogen (NH4+-N) and silicate (SiO32--Si) were the key environmental heterogeneous factors affecting the epilithic diatom community in Xiangxi River during the non-impoundment periods, whereas the key heterogeneous factors were ammonium nitrogen (NH4+-N), silicate (SiO32--Si), and total phosphorus (TP) during the impoundment periods. These results suggested that the environmental heterogeneity during different hydrological periods in TGR can significantly affect the community structure of epilithic diatoms, resulting in the differentiation of species within the community and even affecting the stability of aquatic ecosystems.

[Impounding Impacts of the Three Gorges Reservoir on Phytoplankton Function Groups and Its Relationship with Resource Use Efficiency].

In order to investigate the relationship between phytoplankton community functional group compositions and resource use efficiency in important tributaries of the Three Gorges Reservoir, phytoplankton and environment parameters were sampled from five tributaries, the Xiangxi River, Daning River, Meixi River, Pengxi River, and Huangjin River, in August and November, 2020. There were 119 species (variants) belonging to 62 genera and 7 phyla identified in summer, whereas 118 species (variants) belonging to 7 divisions of 58 genera were found in winter. According to Padisak's theory, all phytoplankton were divided into 25 functional groups, of which there were six important functional groups in both summer and winter:L0, H1, D, Y, MP, and P in summer and L0, H1, A, M, MP, and Y in winter. The α-diversity of the phytoplankton functional group in summer was higher than that in winter. Moreover, a higher α-diversity was also found in downstream samples relative to that in upstream samples, indicating that the community structure was more complex, and the community stability was relatively better in downstream regions of the rivers. Redundancy analysis (RDA) showed that the environment factors, i.e., ν, pH, permanganate index, WT, and RUETN, significantly affected phytoplankton functional groups (P<0.05). Variance partitioning analysis (VPA) indicated that environmental factors had a higher explanatory degree for the change in functional group composition in summer (45.23%); on the contrary, resource use efficiency had a higher explanatory degree in winter (42.33%). The linear fitted model showed that functional groups L0, H1, D, and Y showed a significant positive correlation relationship with RUETN and RUETP in summer, whereas only four functional groups (M, MP, Y, and A) had a linear relationship with RUETP, and all function groups had a good linear relationship with RUETN in winter. These results indicated that the functional groups belonging to cyanobacteria, dinoflagellates, and cryptophyta were more efficient at using limited resources in summer, whereas the diatoms had a good linear relationship with resource use efficiency and formed a dominant group in the low temperature environment of winter. These results suggest that the impounding of the Three Gorges Reservoir area can significantly change the resource use efficiency of phytoplankton, resulting in changes in the phytoplankton functional group composition and community structure.

[Succession Pattern and Consequences of the Dominant Species During Cyanobacterial Bloom and Its Influencing Factors].

The succession of dominant species always occurs during cyanobacterial blooms because there are certain conditions for cyanobacterial blooms formed by different cyanobacteria; this results in more uncertain and complex effects in cyanobacterial blooms. However, the succession pattern and consequences of dominant species and its driving factors have not received enough attention during cyanobacteria blooms. In this study, the phytoplankton community characteristics and water environment factors of Nanpeng Reservoir, a drinking water source in Chongqing, were monitored and analyzed from April to September 2018. The results showed that:① a total of 108 species of phytoplankton belonging to 59 genera and 8 phyla were identified in Nanpeng Reservoir. Of this, 13 species of 4 phyla were identified as dominant species, among which the dominance index of Cylindrospermopsis raciborskii was the highest, followed by that of Pseudoanabaena sp. ② The most dominant cyanobacteria were Pseudoanabaena and Cylindrospermopsis in May and July, respectively, in which cyanobacteria density peaked, whereas the Shannon-Weiner diversity and Pielou evenness were significantly lower than those in the other months. ③ NMDS results showed that the correlation between Cylindrospermopsis or Pseudoanabaena and the ambient phytoplankton community was 0.58 and 0.48, respectively. Moreover, the VPA results showed that 47.51% of the community variation could be explained by environmental factors, and only 12.04% and 12.74% of variation in community composition could be explained by Cylindrospermopsis and Pseudoanabaena, respectively. ④ The abundance of Cylindrospermopsis was significantly positively affected by WT, pH, and RUEN and negatively affected by SD and RUEP. However, the abundance of Pseudoanabaena was significantly positively affected by permanganate index and negatively affected by EC and DO. These results suggested that both dominating cyanobacteria had significant effects on the surrounding phytoplankton community. Relative to that of Pseudoanabaena, however, Cylindrospermopsis had a more obvious impact on the aquatic ecosystem. Moreover, the synergistic effect of N limitation and warming of the water column may have caused the replacement of Pseudoanabaena with Cylindrospermopsis to form a dominant population.

Experimental and Numerical Investigation of Intact, Defective and Repaired Countersunk Composite Joints under Tensile Loading.

Bolted joints are commonly used for assembling carbon fiber/resin composite structures. Since drilling may generate defects at hole edges which affect mechanical properties, it is of great engineering significance to develop proper repair methods to restore the mechanical properties of the defective parts. However, there are few studies on hole edge defects and their repair methods. Therefore, a novelty short fiber filling repair method was proposed to repair defective holes in this study. The mechanical properties of intact, defective and repaired countersunk composite joints were compared and investigated. Experimental tensile tests showed that defective joints had lower initial stiffness and failure loads compared to intact joints, while the mechanical properties were effectively restored after repair. Three-dimensional finite element models were also established to analyze the damage process of the joints. Results of numerical modelling were consistent with the experimental results. The simulations showed that changes in contact behaviors and local deformations caused by hole edge defects led to the low initial stiffness and stiffness transition point of the joint, while this phenomenon was reduced after repair. Additionally, despite different joint types, laminate failure mainly occurred around the hole and countersink.

Tough and Degradable Self-Healing Elastomer from Synergistic Soft-Hard Segments Design for Biomechano-Robust Artificial Skin.

Increasing biomechanical applications of skin-inspired devices raise higher requirements for the skin-bionic robustness and environmental compatibility of elastomers. Here, a tough and degradable self-healing elastomer (TDSE) is developed by a synergistic soft-hard segments design. The polyester/polyether copolymer is introduced in soft segments to endow TDSE with flexibility and degradability. The two isomeric diamines are regulated in hard segments for elevating the toughness and fracture energy to 82.38 MJ/m3 and 43299 J/m2 and autonomous self-healing ability with 93% efficiency in 7 h for the TDSE. Employing TDSE and ionic liquid, a biomechano-robust artificial skin (BA-skin) is constructed with a stretch-insensitive mechanosensation capability during 50% cyclic stretching. The BA-skin has high biomechano-robustness to bear tear damage and good environmental compatibility with total decomposability in a lipase solution. This work provides a molecular design guideline for high-performance skin-bionic elastomers for applications in skin-inspired devices.

[Analysis of Phytoplankton Community Stability and Influencing Factors in a Tributary of the Three Gorges Reservoir].

Changes in the community stability of freshwater phytoplankton not only induce a series of ecological environment problems but also influence freshwater ecosystem service functions. To understand the changes in community stability and its driving factors, phytoplankton and environmental parameters were analyzed at 11 sample sites in Huaxi River, a tributary of the Three Gorges Reservoir, in spring, summer, autumn, and winter. Moreover, the resource use efficiency (RUEPP), phytoplankton richness (S), phytoplankton evenness (J), and community turnover (BC) were also determined. Results showed that a total of 8 phyla, including 103 genera and 380 species, were identified in Huaxi River throughout the year. Among them, 264 species were collected in spring, 181 in summer, 197 in autumn, and 183 in winter. The number of Chlorophyta was the largest, followed by Bacillariophyta, Euglenophyta, and Cyanophyta. The number of species and cell density in S0 site were the smallest, while those in S2 site were the largest. The RUEPP was fluctuated in four seasons, with the maximum in summer and the minimum in autumn. BC was significantly negatively correlated with RUEPP, phytoplankton richness, total phosphorus (TP), orthophosphate (PO43--P), total nitrogen (TN), nitrate (NO3--N), permanganate index, and conductivity (Spc); however, it was significantly positively correlated with phytoplankton evenness and dissolved oxygen (DO). These results suggest that water level regulation in the Three Gorges Reservoir has a significant impact on the structure of phytoplankton community in Huaxi River, which leads to the instability of phytoplankton community and easy replacement, and the degree of community turnover is affected by the combined effect of biological and abiotic factors.

Experimental Study on Compression Failure of Composite Laminates with Prefabricated Surface Cracks.

A new compression test fixture was designed in the present work to study the damage tolerance of composite laminates with surface cracks or notches. The compression failure behaviors of CCF300/5228A quasi-isotropic composite laminates with prefabricated surface cracks were studied experimentally. Through the size design of the test fixture and specimens and an application of a simple test method, the complex crack growth process was captured. The experimental results showed that the compression failure modes were mainly affected by crack angles and depths, and there were two typical failure modes, which were local intra- and inter-laminar damage propagating from the crack tips and delamination growth induced from the crack leading edge. This study verified the validity of the test fixture and test method, and revealed the compression failure mechanisms of composite laminates with surface cracks.

Application of the Mimic Valsalva Maneuver with the Help of a Saccule in Cerebrospinal Fluid Rhinorrhea Reconstruction Surgery.

OBJECTIVE: To explore the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist in order to locate the leakage channel and repair the fistula during intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea. METHODS: From 2012 to 2014, 8 patients were diagnosed with cerebrospinal fluid rhinorrhea by medical histories, physical and biochemical examination. All patients were treated with intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea. During the surgery, the mimic Valsalva maneuver with the help of a saccule was carried out once or twice by an anesthetist during the operation. Intranasal endoscopy was used to accurately locate the leakage site as shown by the exact fistula. Temporal fascia, fascia lata, middle turbinate mucosa and nasal septum mucosa were all used to repair the fistula. RESULTS: After the surrounding mucosa was removed, the exact leakage sites were accurately found. Fascia materials were used in all 8 patients. All patients were successfully treated after their first operation, and 1 patient was successfully treated by two operations with no complications and recurrences. All the patients were followed up for 1 month to 2 years. CONCLUSION: The convenient method of the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist has a good prospect in cerebrospinal fluid rhinorrhea reconstruction surgery.

Successful treatment of Kimura's disease with leflunomide and methylprednisolone: a case report.

Kimura's disease (KD) is an uncommon, chronic inflammatory disease characterized by tumor-like lesions in the soft tissue and lymph nodes and increased peripheral blood eosinophil counts and serum immunoglobulin E (IgE). Prednisone is widely used to treat the disease. Here, we reported a 59-year-old KD patient failed to response to prednisone. Leflunomide combined with methylprednisolone (Medrol) were carried out to treat KD and encouraging outcome was obtained during the medication and 1 year follow up period.

[Comparative study on pathology of non involuting congenital hemangioma and infantile hemangioma].

OBJECTIVE: To distinguish non involuting congenital hemangioma (NICH) and infantile hemangioma (IH) by comparing the pathological structure and marker antigen expression. METHODS: From Jan. 2005 to Aug. 2010, 39 paraffin-embedded samples, including 13 cases of NICH, 13 cases of proliferating IH and 13 cases of involuting IH, were collected from operation. Hematoxylin-eosin staining was used to observe the pathological structure. Immunohistochemical analysis was also performed to investigate the expression of Glut-1. RESULTS: The lobules of capillaries were well-defined in NICH. The lobules were surrounded by abundant fibrous tissue. The capillaries were often large and integrity in NICH. There were few mitosis and apoptosis in endothelial cells and stromal cells in NICH. While in IH, the pathologic findings were totally different. Immunochemistry revealed that the Glut-1 was expressed in endothelial cells of IH, but not in NICH. CONCLUSIONS: NICH has a steady histologic structure and low proliferation, while the endothelial cells in proliferative IH has a high proliferation. Glut-1 can be used as the reliable marker antigen for differential diagnosis of NICH and proliferative infantile hemangiomas.

Vigilance detection based on sparse representation of EEG.

Electroencephalogram (EEG) based vigilance detection of those people who engage in long time attention demanding tasks such as monotonous monitoring or driving is a key field in the research of brain-computer interface (BCI). However, robust detection of human vigilance from EEG is very difficult due to the low SNR nature of EEG signals. Recently, compressive sensing and sparse representation become successful tools in the fields of signal reconstruction and machine learning. In this paper, we propose to use the sparse representation of EEG to the vigilance detection problem. We first use continuous wavelet transform to extract the rhythm features of EEG data, and then employ the sparse representation method to the wavelet transform coefficients. We collect five subjects' EEG recordings in a simulation driving environment and apply the proposed method to detect the vigilance of the subjects. The experimental results show that the algorithm framework proposed in this paper can successfully estimate driver's vigilance with the average accuracy about 94.22 %. We also compare our algorithm framework with other vigilance estimation methods using different feature extraction and classifier selection approaches, the result shows that the proposed method has obvious advantages in the classification accuracy.

[Effects of hyperbilirubinemia on distortion product otoacoustic emission, auditory brainstem response and mismatch negativity in guinea pigs].

OBJECTIVE: To explore the characteristics of distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR) and mismatch negativity (MMN) in guinea pigs with hyperbilirubinemia and assess the impact of hyperbilirubinemia on their hearing functions. METHOD: Normal neonatal guinea pigs were randomly divided into normal control, low- and high-dose bilirubin groups. DPOAE, ABR and MMN were tested and compared between the 3 groups of guinea pigs. RESULTS: The DPOAE was comparable between the 3 groups (P>0.05). The guinea pigs with peritoneal injection of low-dose bilirubin exhibited significantly prolonged wave III and V latencies and I-III interwave intervals during the ABR test in comparison with the control group (P<0.05). All the ABR parameters were significantly different between the high-dose bilirubin group and the control group (P<0.05). The detection rates of MMN were significantly different between the 3 groups (Chi(2)=7.438, P=0.024), and the average MMN latency was significantly shorter in the control group than in the high-dose group (P<0.05), but the amplitudes of MMN remained similar between the 3 groups (P>0.05). CONCLUSIONS: Hyperbilirubinemia results impairment primarily of retrocochlear auditory pathway with relative mild damage of the cochlear. Apart from sensorineural auditory impairment, hyperbilirubinemia may also cause central auditory processing abnormalities.

[Comparative study of pure tone stimuli and Chinese speech stimuli on auditory event-related potentials].

OBJECTIVE: To compare the characteristics of auditory event-related potentials (AERP) evoked by pure tone stimuli and Chinese speech stimuli respectively, and to explore the feasibility of using Chinese speech stimuli to evoke AERP for Chinese. METHODS: AERP were tested by both Chinese speech and pure tone as stimuli in normal young participants (83 ears in 44 young postgraduate students), then each AERP wave form were scored. The latencies, amplitudes and scores of AERP evoked by speech stimuli were compared with by pure tone stimuli. RESULTS: Typical waves of AERP were recorded and identified more easily with speech stimuli than pure tone stimuli, moreover, the differences were statistically significance (X2 = 4.0, P = 0.039). The latency and amplitude of P3 evoked by both Chinese speech stimuli and pure tone stimuli in the 72 ears were no significant difference (P > 0.05). But the mean scores of AERP evoked by speech stimuli were significantly higher than those evoked by pure tone stimuli (t = 6.57, P = 0.000). N2 and P3 latency in left ear evoked by speech stimuli were significantly shorter than those evoked by pure tone stimuli (P = 0.002, P = 0.003). However there were no significant differences in right ear(P > 0.05). CONCLUSIONS: Chinese speech stimuli were more consistent with requests of AERP test and custom of Chinese spoken language, so the Chinese speech stimuli was more available for Chinese's AERP test than pure tone stimuli.

[The distribution and evolution of pericytes in infantile hemangioma].

OBJECTIVE: To investigate the distribution, phenotype and development of pericytes in infantile hemangioma. METHODS: Fifty-two infantile hemangioma samples were included in our study. alpha-SMA was used as the marker antigen to observe the distribution of pericytes. Transmission electron microscope and TUNEL method were used to analyze the apoptosis of pericytes. RESULTS: In the early and middle proliferating stage, there existed many pericytes in hemangioma; Pericytes together with endothelial cells generated vasculogenesis. In the late proliferating stage, many pericytes became apoptotic. In the early involuting stage, there were only a few of pericytes around the microvessels; After that, the microvessels became obstruction progressively and pericytes disappeared finally. CONCLUSIONS: The pericyte is one of the major constitutive cells of hemangioma. The vasculogenesis, development and disappearance of microvessels undertaken by pericytes and endothelial cells lead to the pathologic evolution of infantile hemangioma.

[The expression and role of glucose transporter-1 in infantile hemangioma].

OBJECTIVE: To investigate the expression and role of glucose transporter-1 (Glut1) in infantile hemangioma. METHODS: Fifty-two samples from infantile hemangioma, 25 in cavernous venous malformation, 9 in arteriovenous malformation, 2 in capillary malformation and 5 in normal skin samples were involved in this study. The EnVision immunohistochemical stain was used to investigate the expression of Glut1 protein in these samples. RESULTS: In the early proliferating stage, a number of endothelial cells expressed Glut1. In the middle proliferating stage, most of vascular endothelial cells and scattered endothelial cells expressed Glut1. In the late proliferating stage, the expression of Glut1 decreased quickly. In the involuting stage, all hemangioma samples didn't express Glut1. All of the samples from the cavernous venous malformations, arteriovenous malformations, capillary malformations and normal skin had no expression of Glut1. CONCLUSIONS: Glut1 may be one of the phenotypes of infantile hemangioma endothelial cells in their development, rather than the inherent character. The expression of Glut1 changes according to the metabolic need of infantile hemangioma cells.

[33 cases of craniofacial clefts: experience in diagnosis and treatment with tessier classification].

OBJECTIVE: To introduce our experience in diagnosis and treatment of 33 patients with Tessier craniofacial clefts. METHODS: 33 patients with craniofacial clefts were classified by Tessier classification. According to the type and severity of the clefts, various techniques, from simple local flap transfer to complicated osteotomy and bone grafting were used to correct the deformity in 29 patients. RESULTS: All patients who underwent corrective operation were satisfied with the result, and there were no complications. CONCLUSIONS: (1) Tessier classification is very important for plastic surgeon to find potential craniofacial deformities related to main signs. (2) No. 7 cleft is one of most common Tessier craniofacial clefts. (3) Each Tessier cleft is unique, therefore, the treatment plans cannot be standardized. Specific corrective operation must be performed on each patient according to the type and severity of the cleft, including simple local flap transfer to complicated osteotomy and bone grafting or distraction osteogenesis.

[The expression and role of Fas/FasL in infantile hemangioma].

OBJECTIVE: To investigate the expression of Fas/FasL in infantile hemangiomas and discuss the role of Fas/FasL in the pathologic evolution of infantile hemangioma. METHOD: The EnVision immunohistochemical stain and RT-PCR technique was used to examine the expression of Fas/FasL protein and mRNA in the infantile hemangiomas. RESULTS: (1) In the early and middle proliferating stage, a number of infantile hemangioma cells expressed Fas. In the late proliferating stage, the number of positive cells increased obviously and the expression of Fas mRNA was reaching the strongest level. In the early regressing stage the Fas still existed in some cells and after that the expression decreased quickly. (2) Up to the middle proliferating stage, there were a few of FasL(+) cells foound. In the late proliferating stage, the number of FasL(+) cells increased significantly. From the early regressing stage, the number of FasL(+) cells decreased rapidly and disappeared. CONCLUSION: There may exist significant correlation between the expression of Fas/FasL and the development of the infantile hemangioma cells. The apoptosis of the infantile hemangioma cells mediated by Fas/ FasL may be the major reason of the spontaneous involution of infantile hemangioma.

An innovation in the subcutaneous island pedicle flap for cutaneous reconstruction.

The aim of this study was to describe an innovation of the transposition pedicle island flap for reconstruction of the medium-sized skin defects in the face, neck and hand. Twenty-seven cases of skin tumours and scars were surgically excised and reconstructed with this island flap. ALL flap survived with primary healing postoperatively. With a follow-up from 1 to 22 months, functionally and cosmetically satisfactory outcomes were achieved. This modification of transposition island flap provides a competitive repair alternative for the treatment of medium-sized skin defects.