Genetic programming-based predictive model for the Cr removal effect of in-situ electrokinetic remediation in contaminated soil.

Soil electrokinetic remediation is an emerging and efficient in-situ remediation technology for reducing environmental risks. Promoting the dissolution and migration of Cr in soil under the electric field is crucial to decrease soil toxicity and ecological influences. However, it is difficult to establish strong relationships between soil treatment and impact factors and to quantify their contributions. Machine learning can help establish pollutant migration models, but it is challenging to derive predictive formulas to improve remediation efficiency, describe the predictive model construction process, and reflect the importance of the predictors for better regulation. Therefore, this paper established a predictive model for the electrokinetic remediation of Cr-contaminated soil using genetic programming (GP) after determining the characteristic parameters which influenced the remediation effect, described the model's adaptive optimization process through the algorithm's function, and identified the sensitivity factors affecting the Cr removal effect. Results showed that the Cr(VI) and total Cr concentrations predicted by GP were in satisfactory agreement with the experimental values, 92% of the training data and 90% of the validation data achieved errors within 1%, and could fully reflect the target ions' content variation in different soil layers. By substituting the above prediction formulas into Sobol sensitivity analysis, it was determined that conductivity, pH, current, and moisture content dramatically affected the Cr content variation in distinguished regions. For overall contaminated area, the system current and soil pH were the most sensitive factors for Cr(VI) and total Cr contents. Remediation efforts throughout the contaminated area should focus on the role of current versus soil pH. GP and sensitivity analysis can provide decision support and operational guidance for in-situ soil electrokinetic treatment by establishing a remediation effect prediction model, expediting the development and innovation of electrokinetic technology.

Automatic Segmentation of Magnetic Resonance Images of Severe Patients with Advanced Liver Cancer and the Molecular Mechanism of Emodin-Induced Apoptosis of HepG2 Cells under the Deep Learning.

To improve the accuracy of clinical diagnosis of severe patients with advanced liver cancer and enhance the effect of chemotherapy treatment, the U-Net model was optimized by introducing the batch normalization (BN) layer and the dropout layer, and the segmentation training and verification of the optimized model were realized by the magnetic resonance (MR) image data. Subsequently, HepG2 cells were taken as the research objects and treated with 0, 10, 20, 40, 60, 80, and 100 µmol/L emodin (EMO), respectively. The methyl thiazolyl tetrazolium (MTT) method was used to explore the changes in cell viability, the acridine orange (AO)/ethidium bromide (EB) and 4',6-diamidino-2-phenylindole (DAPI) were used for staining, the Annexin V fluorescein isothiocyanate (FITC)/propidium iodide (PI) (Annexin V-FITC/PI) was adopted to detect the apoptosis after EMO treatment, and the Western blot (WB) method was used with the purpose of exploring the changes in protein expression levels of PARP, Bcl-2, and p53 in the cells after treatment. It was found that compared with the original U-Net model, the introduction of the BN layer and the dropout layer can improve the robustness of the U-Net model, and the optimized U-Net model had the highest dice similarity coefficient (DSC) (98.45%) and mean average precision (MAP) (0.88) for the liver tumor segmentation.

Creating a three-dimensional surface with antireflective properties by using femtosecond-laser Bessel-beam-assisted thermal oxidation.

Metal surfaces with low reflectance have received considerable attention for their great optical, electrical, and thermal properties. However, the difficulty in achieving low reflectance on curved metal surfaces has hindered their practical applications. We propose a rapid and flexible method for processing a three-dimensional surface with antireflective properties. A Bessel beam created using an axicon is employed to generate ripple structures on the curved surface, thereby assisting subsequent thermal oxidation. Ripple structures coated with oxide semiconductor nanowires are then processed on a Cu substrate, thus further reducing reflectance. Antireflective properties with a minimum reflectance of less than 0.015 at a wavelength of 500-1200 nm could be achieved by using this method. This presented approach reduces dimensionality in laser processing, subsequently improving processing efficiency, and provides a foundation for the practical application of metal antireflective surfaces.

Evaluation of lower blepharoplasty treated with the SmartLipo 1064-nm system and its clinical implications: A retrospective review.

INTRODUCTION: This study used the SmartLipo 1064-nm system to remove herniated orbital fat tissue to improve lower eyelid appearance. A retrospective review of 128 patients was performed to evaluate the size of prominent fat pads and complications. MATERIALS AND METHODS: Altogether, 128 patients underwent a procedure using the SmartLipo 1064-nm system via postseptal access, which helped locate fat tissue more precisely. Digital photographs were taken preoperatively and at one week and six months postoperatively. Eyebag sizes were determined preoperatively and six months postoperatively using the Non-Contact 3D Digitizer. RESULTS: Altogether, 118 primary and 10 revision patients (average age 31 years) were placed in one of two groups: mildly protruding fat pads (group 1, 86 patients) and moderately protruding fat pads (group 2, 42 patients). After injection of about 1 ml of anesthetic and 1 ml of 0.9% iced saline on each side, the patients received an average 450 joules of energy delivered at 20 Hz and 3 W. Postoperatively, the eyebag's height, depth, and area were significantly reduced in both groups (р = 0.000). The main symptoms (swelling, chemosis, engorgement, and pain) subsided within 5-7 days. CONCLUSION: The SmartLipo 1064-nm system with postseptal access, a minimally invasive procedure, can be used to correct mildly and moderately prominent fat pads.

A Study of the Morbidity Involved in Whole Rib Harvesting and In Situ Splitting Rib Harvesting Surgery.

BACKGROUND: Although there have been several reports that detail the in situ rib splitting harvesting surgical procedure, there are limited published studies evaluating this procedure and the traditional whole rib harvesting approach. In this study, the authors conducted a retrospective controlled study on the complications related to the 2 rib harvesting approaches. METHODS: From March 2012 to May 2014, 24 patients were treated with rib grating, of whom 9 patients received conventional rib harvesting surgery and 15 patients received in situ splitting harvesting surgery. In all patients, a 3-dimensional computed tomography study of the chest was performed 7 days postoperatively. Postoperative complications were assessed and postoperative pain was assessed using a visual analog scale after the first 24, 48, and 72 hours after the surgery. RESULTS: The complication rate for in situ splitting rib harvesting was 6.67% versus 44.44% for patients treated with whole rib grafting surgery. After 48 and 72 hours, the visual analog scale scores in patients treated with in situ splitting rib grafts were significantly lower than the patients treated with traditional surgery. CONCLUSION: The in situ splitting approach for obtaining a rib results in a clinically significant reduction in complications compared with the traditional approach.

Classification of nasolabial folds in Asians and the corresponding surgical approaches: By Shanghai 9th People's Hospital.

INTRODUCTION: One of the earliest signs of aging appears in the nasolabial fold, which is a special anatomical region that requires many factors for comprehensive assessment. Hence, it is inadequate to rely on a single index to facilitate the classification of nasolabial folds. Through clinical observation, we have observed that traditional filling treatments provide little improvement for some patients, which prompted us to seek a more specific and scientific classification standard and assessment system. METHODS: A total of 900 patients who sought facial rejuvenation treatment in Shanghai 9th People's Hospital were invited in this study. We observed the different nasolabial fold traits for different age groups and in different states, and the results were compared with the Wrinkle Severity Rating Scale (WSRS). We summarized the data, presented a classification scheme, and proposed a selection of treatment options. RESULTS: Consideration of the anatomical and histological features of nasolabial folds allowed us to divide nasolabial folds into five types, namely the skin type, fat pad type, muscular type, bone retrusion type, and hybrid type. CONCLUSION: Because different types of nasolabial folds require different treatments, it is crucial to accurately assess and correctly classify the conditions.

Serial reconstruction of anophthalmic orbits with 'bag-shaped' flaps.

BACKGROUND: The author's goal was to present an approach for serial surgical reconstruction of anophthalmic orbits with 'bag-shaped' flaps and cartilage transplantation. METHODS: A review was performed of 53 patients who underwent serial physiological orbital reconstruction between 2006 and 2013. Orbital reconstruction was performed serially in stages, including "bag-shaped" flap transplantation, medial and lateral canthoplasty, tarsus reconstruction, and improvement of the strength of the levator palpebrae superior muscles. Curative effects were evaluated by the surgeons and patients jointly. RESULTS: Among the total of 53 cases, the curative effects were assessed as excellent in 28 patients, good in 17 patients, moderate in 6 patients, and poor in 2 patients. Two cases suffered necrosis of the bag-shaped flap, which was remedied with a frontal island flap and skin grafting; 4 cases experienced shallowness of the lower fornix, of which three were remedied by deepening of the lower fornix and the other by lower eyelid suspension. The appearance of the reconstructed eye socket was acceptable, natural and persistent. CONCLUSION: This procedure offers staged and serial reconstruction of anophthalmic orbits, according to the orbital shape and the volume loss of the orbital soft tissue. It is an ideal approach to reconstruct eye sockets, with a high survival rate of the flaps, acceptable appearance of the reconstructed eye socket, and stable depth of the upper and lower eyelid fornices.

In vivo early intervention and the therapeutic effects of 20(s)-ginsenoside rg3 on hypertrophic scar formation.

BACKGROUND: Intra-lesional injections of corticosteroids, interferon, and chemotherapeutic drugs are currently the most popular treatments of hypertrophic scar formation. However, these drugs can only be used after HS is formed, and not during the inflammatory phase of wound healing, which regulates the HS forming process. OBJECTIVE: To investigate a new, effective, combining therapeutic and safe drug for early intervention and treatment for hypertrophic scars. METHODS: Cell viability assay and flow cytometric analysis were studied in vitro. Animal studies were done to investigate the combining therapeutic effects of 20(S)-ginsenoside Rg3 (Rg3) on the inflammatory phase of wound healing and HS formation. RESULTS: In vitro studies showed that Rg3 can inhibit HS fibroblasts proliferation and induce HSF apoptosis in a concentration-dependent manner. In vivo studies demonstrated that Rg3 can limit the exaggerated inflammation, and do not delay the wound healing process, which indicates that Rg3 could be used as an early intervention to reduce HS formation. Topical injection of 4 mg/mL Rg3 can reduce HS formation by 34%. Histological and molecular studies revealed that Rg3 injection inhibits fibroblasts proliferation thus reduced the accumulation of collagen fibers, and down-regulates VEGF expression in the HS tissue. CONCLUSION: Rg3 can be employed as an early intervention and a combining therapeutic drug to reduce inflammation and HS formation as well.

Reversed Z-plasty and its variations to release wide-scar contraction.

BACKGROUND AND AIM: Z-plasty is one of the most widely used techniques in plastic and reconstructive surgery. It is useful especially to release linear-scar contractures, yet difficult to use for wide scars. The aim of this study was to report on a new technique for the effective release of contractures for wide scars using reversed Z-plasty and its variations. METHODS: This report describes a novel technique to release contractures effectively for wide scars using reversed Z-plasty and its variation. The design is a reverse style of conventional Z-plasty. In our case series, the reversed three-flap, four-flap Z-plasty or its variation was chosen depending on the width of the contracted scar. RESULTS: We performed this technique on 28 patients. All wounds healed well and the scar contracture was satisfactorily released. CONCLUSION: This procedure is useful and practical for wide-scar contractures.

Use of ginsenoside Rg3-loaded electrospun PLGA fibrous membranes as wound cover induces healing and inhibits hypertrophic scar formation of the skin.

Prevention of hypertrophic scar formation of the skin requires a complex treatment process, which mainly includes promoting skin regeneration in an early stage while inhibiting hypertrophic formation in a later stage. Electrospinning PLGA with the three-dimensional micro/nano-fibrous structure and as drugs carrier, could be used as an excellent skin repair scaffold. However, it is difficult to combine the advantage of nanofibrous membranes and drug carriers to achieve early and late treatment. In this study, Ginsenoside-Rg3 (Rg3) loaded hydrophilic poly(D,L-lactide-co-glycolide) (PLGA) electrospun fibrous membranes coated with chitosan (CS) were fabricated by combining electrospinning and pressure-driven permeation (PDP) technology. The PDP method was able to significantly improve the hydrophilicity of electrospun fibrous membranes through surface coating of the hydrophilic fibers with CS, while maintaining the Rg3 releasing rate of PLGA electrospun fibrous membranes. Experimental wounds of animal covered with PDP treated fibrous membranes completely re-epithelialized and healed 3-4 days earlier than the wounds in control groups. Scar elevation index (SEI) measurements and histologic characteristics revealed that Rg3 significantly inhibited scar formation 28 days post-surgery. Moreover, RT-PCR assays and western blot analysis revealed that at day 28 after wound induction the expression of VEGF, mRNA and Collagen Type I in the scars treated with Rg3 was decreased compared to control groups. Taken together PLGA-Rg3/CS electrospun fibrous membranes induced repair of tissue damage in the early stage and inhibited scar formation in the late stage of wound healing. These dual-functional membranes present a combined therapeutic approach for inhibiting hypertrophic scars of the skin.

bFGF-grafted electrospun fibrous scaffolds via poly(dopamine) for skin wound healing.

Electrospun fibrous membranes coated with basic fibroblast growth factor (bFGF) are effective medical devices to promote wound healing. However, the current strategies of adding bFGF generally cause degradation of electrospun materials or damage to the bioactivity of the biomolecules. Here, we have developed a simple strategy for surface bFGF-functionalization of electrospun fibers in an aqueous solution, which maintained original fiber properties and growth factor bioactivity. Polydopamine (PDA) forming the mussel foot protein was chosen as an adhesive polymeric bridge-layer between substrate poly(lactide-co-glycolide) (PLGA) fibers and bFGF. The bFGF-grafted PDA was analyzed using scanning electron microscopy, water contact angle measurements, and X-ray photoelectron spectroscopy. Improved hydrophilicity together with a stable fibrous structure and biodegradable fibrous matrix suggested that the PLGA/PDA-bFGF electrospun fibrous scaffolds have great potential for promoting wound healing. In vitro experiments showed that the bFGF-grafted PLGA electrospun fibrous scaffolds have highly enhanced adhesion, viability, and proliferation of human dermal fibroblasts. In vivo results showed that such scaffolds shortened wound healing time, accelerated epithelialization and promoted skin remodeling. Therefore, this PDA modification method can be a useful tool to graft biomolecules onto polymeric electrospun fibrous scaffolds which are potential scaffold candidates for repairing skin tissue.

In vivo inhibition of hypertrophic scars by implantable ginsenoside-Rg3-loaded electrospun fibrous membranes.

Clinically, hypertrophic scarring (HS) is a major concern for patients and has been a challenge for surgeons, as there is a lack of treatments that can intervene early in the formation of HS. This study reports on a Chinese drug, 20(R)-ginsenoside Rg3 (GS-Rg3), which can inhibit in vivo the early formation of HS and later HS hyperplasia by inducing the apoptosis of fibroblasts, inhibiting inflammation and down-regulating VEGF expression. Implantable biodegradable GS-Rg3-loaded poly(l-lactide) (PLA) fibrous membranes were successfully fabricated using co-electrospinning technology to control drug release and improve drug utilization. The in vivo releasing time of GS-Rg3 lasts for 3 months, and the drug concentration released in rabbits can be controlled by varying the drug content of the electrospun fibers. Histological observations of HE staining indicate that GS-Rg3/PLA significantly inhibits the HS formation, with obvious improvements in terms of dermis layer thickness, epidermis layer thickness and fibroblast proliferation. The results of immunohistochemistry staining and Masson's trichrome staining demonstrate that GS-Rg3/PLA electrospun fibrous membranes significantly inhibit HS formation, with decreased expression of collagen fibers and microvessels. VEGF protein levels are much lower in the group treated with GS-Rg3/PLA eletrospun membranes compared with other groups. These results demonstrate that GS-Rg3 is a novel drug, capable of inhibiting the early formation of HS and later HS hyperplasia. GS-Rg3/PLA electrospun membrane is a very promising new treatment for early and long-term treatment of HS.

New experiences in treating postburn talipes equinovarus associated with bone and joint pathologic changes.

This article aims to solve the problem of postburn talipes equinovarus associated with bone and joint pathologic changes by simplified and modified techniques. In addition to lengthening the shortened Achilles tendon and the contracted scar above it, we performed triple arthrodesis directly on the densely scarred, deformed foot without replacing the scar tissue with normal tissue tube or flap. Only the proximal scar-periosteum wound edge of the curved incision, 2 cm distal to the conventional one, was elevated to expose the bones to be excised. The two excised wedge-shaped bone blocks, one on the dorsum and the other on the lateral side of the deformed foot, were composed of a larger part of the talus and lesser parts of the navicular, cuboid and calcaneus bones. All the patients who could not stand or walk without crutches pre-operatively obtained a good operative result, which enabled them to do so without crutches postoperatively. We conclude that the scar tissue can be elevated without risk of necrosis if it is still attached firmly to the underlying periosteum, and arthrodesis can be done under it. Incision wound healing and bone union is not exclusively a problem.

Pedicled superficial temporal fascia sandwich flap for reconstruction of severe facial depression.

Facial soft tissue hypoplasia is a prominent feature of Parry-Romberg syndrome and hemifacial microsomia. Superficial temporal fascia has been used in the clinical application of the contour restoration, but it is too thin to reconstruct severe facial depression. To improve the thickness of the transplanted tissue flap, the pedicled superficial temporal fascia sandwich complex flap was designed for the reconstruction of severe facial depression and evaluation of its effect. There were 2 kinds of these complex flaps. The first kind was 2 free dermis-fat flaps fixed onto the superficial temporal fascia, which were applied in large and deep depression. The second was a piece of free dermis-fat flap sandwiched between the folded superficial temporal fascia, which were applied in small but deep upper-midface depression. Fifteen patients with facial depression deformities were involved in this study, in which 8 patients had Parry-Romberg syndrome, 4 patients had hemifacial microsomia, and 3 patients had traumatic facial depression. Postoperative follow-up for 2 to 24 months showed that the method had a good cosmetic result. Based on the results of our patients in this series, the surgical results were favorable, and it is a simple procedure and yields effective, safe, and satisfactory results.

[Immediately mammaplasty after resection of large breast fibroadenoma].

OBJECTIVE: To explore an ideal technique for remodeling the breast after resection of large breast fibroadenoma. METHODS: Based on the principle of breast reduction, an operation plan was designed. The new locations of the nipple, and the areola and the area of the breast skin to be resected were marked. The preoperative-marked skin, epidermis, and the whole breast tumor were resected routinely. Then breast remodeling followed according to augmentation mammoplasty. Seven patients underwent this operation. RESULTS: The operative results were satisfactory in terms of multiple parameters during the follow-up period. CONCLUSIONS: This operation can effectively resect the breast tumor and remodel the breast simultaneously.