Effects of percutaneous endovascular angioplasty for severe stenosis or occlusion of subclavian artery.

To investigate the effect and safety of percutaneous endovascular angioplasty (PEA) with optional stenting for the treatment of severe stenosis or occlusion of subclavian artery, patients with severe stenosis ≥ 70% or occlusion of subclavian artery treated with PEA were retrospectively enrolled. The clinical data were analyzed. A total of 222 patients were retrospectively enrolled, including 151 males (68.0%) and 71 females (32.0%) aged 48-86 (mean 63.9 ± 9.0) years. Forty-seven (21.2%) patients had comorbidities. Subclavian artery stenosis ≥ 70% was present in 201 (90.5%) patients and complete subclavian occlusion in 21 (9.5%) cases. Angioplasty was successfully performed in all (100%) patients. Balloon-expandable stents were used in 190 (85.6%) cases, and self-expandable stents in 20 (9.0%) cases. Only 12 (5.4%) cases were treated with balloon dilation only. Among 210 patients treated with stent angioplasty, 71 (33.8% or 71/210) cases underwent balloon pre-dilation, 139 (66.2% or 139/210) had direct deployment of balloon-expandable stents, and 2 (1.0% or 2/210) experienced balloon post-dilation. Distal embolization protection devices were used in 5 (2.3% or 5/222) cases. Periprocedural complications occurred in 3 (1.4%) patients, including aortic dissection in 2 (0.9%) cases and right middle cerebral artery embolism in 1 (0.5%). No hemorrhage occurred. Among 182 (82.0%) patients with 6-month follow-up, restenosis > 70% occurred in 1 (0.5%) patient, and among 68 (30.6%) patients with 12-month follow-up, restenosis > 70% took place in 11 (16.2%) patients. Percutaneous endovascular angioplasty can be safely and efficiently performed for the treatment of severe stenosis ≥ 70% or occlusion of subclavian artery.

Significance of atherosclerotic plaque location in recanalizing non-acute long-segment occlusion of the internal carotid artery.

To investigate the significance of atherosclerotic plaque location in hybrid surgery comprising both endovascular recanalization approaches and carotid endarterectomy for symptomatic atherosclerotic non-acute long-segment occlusion of the internal carotid artery (ICA), 162 patients were enrolled, including 120 (74.1%) patients in the proximal plaque group and 42 (25.9%) in the distal plaque group. Surgical recanalization was performed in all patients, with successful recanalization in 119 (99.2%) patients in the proximal and 39 (92.9%) in the distal plaque group. The total successful recanalization rate was 97.5% (158/162) with a failure rate of 2.5% (4/162). Periprocedural complications occurred in 5 (4.2% or 5/120) patients in the proximal plaque group, including neck infection in two (1.7%), recurrent nerve injury in 1 (0.8%), and laryngeal edema in 2 (1.7%), and 2 (4.8%) in the distal plaque group, including femoral puncture infection in 2 (4.8%). No severe complications occurred in either group. Univariate analysis showed plaque location was a significant (P = 0.018) risk factor for successful recanalization, and multivariate analysis indicated that the plaque location remained a significant independent risk factor for recanalization success (P = 0.017). In follow-up 6-48 months after the recanalization surgery, reocclusion occurred in two (2.8%) patients in the proximal plaque group and 4 (13.3%) in the distal plaque group. In conclusion, although hybrid surgery achieves similar outcomes in patients with ICA occlusion caused by either proximal or distal atherosclerotic plaques, plaque location may be a significant risk factor for successful recanalization of symptomatic non-acute long-segment ICA occlusion.

Expression of immune-related genes in rheumatoid arthritis and a two-sample Mendelian randomization study of immune cells / 中国组织工程研究

BACKGROUND:Rheumatoid arthritis is a chronic systemic autoimmune disease.It is important to study the immunological changes involved in it for diagnosis and treatment. OBJECTIVE:To identify immune-related biomarkers associated with rheumatoid arthritis utilizing bioinformatics techniques and examine alterations in immune cell infiltration as well as the relationship between immune cells and biomarkers. METHODS:Differential expression analysis was used to identify the immune-related genes that were up-regulated in rheumatoid arthritis based on the GEO and Immport databases.Kyoto encyclopedia of genes and genomes(KEGG)and gene ontology(GO)enrichment analyses were used to investigate the possible function of these elevated genes.The immunological characteristic genes associated with rheumatoid arthritis were screened using least absolute shrinkage and selection operator(Lasso)and support vector machine recursive feature elimination(SVM-RFE).Independent datasets were used for difference validation,and the diagnostic performance was evaluated by plotting receiver operating characteristic curves for feature genes.Immune cell infiltration was used to analyze the differential profile of immune cells in rheumatoid arthritis and the correlation between the characterized genes and immune cells.In order to ascertain the causal relationship between monocytes and rheumatoid arthritis in immune cells,Mendelian randomization analysis was ultimately employed. RESULTS AND CONCLUSION:There were 39 upregulated differentially expressed genes in rheumatoid arthritis.The genes were primarily enriched in chemotaxis,cytokine activity,and immune receptor activity,according to GO enrichment analysis,while kEGG enrichment analysis revealed that the genes were considerably enriched in the tumor necrosis factor signaling pathway and peripheral leukocyte migration.Lasso and SVM-RFE identified five feature genes:CXCL13,SDC1,IGLC1,PLXNC1,and SLC29A3.Independent dataset validation of the feature genes found them to be similarly highly expressed in rheumatoid arthritis samples,with area under the curve values greater than 0.8 for all five feature genes in both datasets.Immune cell infiltration indicated that most immune cells,including natural killer cells and monocytes,exhibited increased levels of infiltration in rheumatoid arthritis samples.The correlation analysis revealed a significant positive correlation between memory B cells and immature B cells and these five feature genes.Correlation analysis showed that the five feature genes were positively correlated with memory B cells and immature B cells.The inverse variance weighting method revealed that monocytes were associated with the risk of developing rheumatoid arthritis.

Establishment and analysis of osteoarthritis diagnosis model based on artificial neural networks / 中国组织工程研究

BACKGROUND:Rapid developments in the field of bioinformatics have provided new methods for the diagnosis of osteoarthritis.Artificial neural networks have powerful data computing and classification capabilities,which have shown better performance in disease diagnosis. OBJECTIVE:To establish a new diagnostic predictive model of osteoarthritis based on artificial neural network and to verify the diagnostic value of the model in osteoarthritis with an external dataset. METHODS:The eligible osteoarthritis-related data sets were downloaded through GEO database search and divided into Train group and Test group.The gene expression matrix of the Train group was analyzed to screen the differentially expressed genes.GO and KEGG enrichment analyses were performed on the differentially expressed genes.Through Lasso regression model,support vector machine model and random forest tree model,the key genes of osteoarthritis were further identified from the differentially expressed genes.The R software"Neuralnet"package was then used to construct the osteoarthritis diagnosis model based on artificial neural network,and the model performance was evaluated by the five-fold cross-validation.Two independent data sets in the Test group were used to verify their diagnostic results. RESULTS AND CONCLUSION:A total of 90 differentially expressed genes related to osteoarthritis were obtained by differential analysis,of which 33 were down-regulated and 57 were up-regulated.GO enrichment analysis showed that the differentially expressed genes were mainly involved in the following biological processes,including leukocyte-mediated immunity,leukocyte migration in bone marrow and chemokine production.KEGG enrichment analysis showed that these genes were mainly enriched in rheumatoid arthritis,interleukin-17 signaling pathway and osteoclast differentiation pathway.Five key genes for the diagnosis of osteoarthritis,HMGB2,GADD45A,SLC19A2,TPPP3 and FOLR2,were identified by three machine learning methods.The artificial neural network model of five key genes in the Train group showed that the accuracy was 96.36%and the area under the curve was 0.997.The five-fold cross validation of the neural network model showed that the average area under the curve was greater than 0.9 and the model was of robustness.Two independent data sets in the Test group showed its area under the curve was 0.814 and 0.788 respectively.Therefore,the establishment of an artificial neural network model for the diagnosis of osteoarthritis has a certain diagnostic value.

Transradial intra-aortic catheter looping in the angioplasty of severe intracranial symptomatic arteriosclerotic diseases.

Purpose: This study aims to investigate the effect and feasibility of intra-aortic catheter looping via transradial access in angioplasty for symptomatic intracranial severe (>70%) atherosclerotic stenosis or occlusion of large arteries (SISOLAs). Materials and methods: Patients with SISOLAs who underwent transradial endovascular angioplasty using the catheter looping technique in the ascending aorta were retrospectively enrolled. The clinical data and treatment outcomes were analyzed. Results: Fifteen patients aged 48-71 years were enrolled in this study. Left vertebrobasilar artery occlusion was present in 1 (6.7%) patient, severe left middle cerebral artery stenosis in 7 (46.7%) patients, severe left internal carotid artery (ICA) stenosis of the ophthalmic segment in 4 (26.7%) patients, severe left ICA stenosis of the cavernous segment in 2 (13.3%) patients, and severe right middle cerebral artery stenosis in 2 (13.3%) patients. The arterial stenosis ranged from 70 to 92% (mean 86%) before stenting. The looping of a guiding catheter in the ascending aorta via transradial access for angioplasty was successful in all patients (100%). The vertebral artery intracranial segment occlusion was successfully recanalized, while severe stenosis in the remaining 14 patients was successfully eliminated. After endovascular recanalization, the residual stenosis was reduced by 12-26% (median 18%). No puncture-related complications or surgical-related neurological complications occurred in these patients. In the follow-up angiography conducted on 10 (66.7%) patients after 6-25 months, no in-stent restenosis was detected. Conclusion: Intra-aortic guiding catheter looping via transradial access for endovascular angioplasty of SISOLAs is technically safe, feasible, and effective, especially when the transfemoral artery approach is difficult or impossible to undertake.

Transradial access with intra-aortic catheter looping for the treatment of intracranial aneurysms.

Purpose: The study aimed to investigate the feasibility and effect of transradial access with intra-aortic catheter looping for the treatment of intracranial aneurysms. Materials and methods: This retrospective one-center study was performed on patients with intracranial aneurysms which were embolized through transradial access with intra-aortic catheter looping because of the difficulty of transfemoral access or transradial access without intra-aortic catheter looping. The imaging and clinical data were analyzed. Results: A total of 11 patients were enrolled, including seven (63.6%) male patients. Most patients were associated with one or two risk factors of atherosclerosis. There were nine aneurysms in the left internal carotid artery system and two aneurysms in the right internal carotid artery system. All 11 patients had complications with different anatomic variations or vascular diseases, which made endovascular operation via the transfemoral artery difficult or a failure. The right transradial artery approach was adopted in all patients, and the success rate of intra-aortic catheter looping was 100%. Embolization of intracranial aneurysms was successfully completed in all patients. No instability of the guide catheter was encountered. No puncture site complications or surgical-related neurological complications occurred. Conclusion: Transradial access with intra-aortic catheter looping for embolization of intracranial aneurysms is technically feasible, safe, and efficient as an important supplementary approach to the routine transfemoral access or transradial access without intra-aortic catheter looping.

Nanothermometry with Enhanced Sensitivity and Enlarged Working Range Using Diamond Sensors.

Nanothermometry is increasingly demanded in frontier research in physics, chemistry, materials science and engineering, and biomedicine. An ideal thermometer should have features of reliable temperature interpretation, high sensitivity, fast response, minimum disturbance of the target's temperature, applicability in a variety of environments, and a large working temperature range. For applications in nanosystems, high spatial resolution is also desirable. Such requirements impose great challenges in nanothermometry since the shrinking of the sensor volume usually leads to a reduction in sensitivity.Diamond with nitrogen-vacancy (NV) centers provides opportunities for nanothermometry. NV center spins have sharp resonances due to their superb coherence. NV centers are multimodal sensors. They can directly sense magnetic fields, electric fields, temperature, pressure, and nuclear spins and, through proper transduction, measure other quantities such as the pH and deformation. In particular, their spin resonance frequencies vary with temperature, making them a promising thermometer. The high thermal conductivity, high hardness, chemical stability, and biocompatibility of diamond enable reliable and fast temperature sensing in complex environments ranging from erosive liquids to live systems. Chemical processing of diamond surfaces allows various functionalities such as targeting. The small size and the targeting capability of nanodiamonds then enable site-specific temperature sensing with nanoscale spatial resolution. However, the sensitivity of NV-based nanothermometry is yet to meet the requirement of practical systems with a large gap of a few orders of magnitude. On the other hand, although NV-based quantum sensing works well from 0.3 to 600 K, extending the sensing scheme to high temperature remains challenging due to uncertainty in identifying the exact physical limits and possible solution at elevated temperatures.This Account focuses on our efforts to enhance the temperature sensitivity and widen the working temperature range of diamond-based nanothermometry. We start with explaining the working principle and features of NV-based thermometry with examples of applications. Then a transducer-based concept is introduced with practical schemes to improve the sensitivity of the nanodiamond thermometer. Specifically, we show that the temperature signal can be transduced and amplified by adopting hybrid structures of nanodiamond and magnetic nanoparticles, which results in a record temperature sensitivity of 76 µK/√Hz. We also demonstrate quantum sensing with NV at high temperatures of up to 1000 K by adopting a pulsed heating-cooling scheme to carry out the spin polarization and readout at room temperature and the spin manipulation (sensing) at high temperatures. Finally, unsolved problems and future endeavors of diamond nanothermometry are discussed.

Braiding Lateral Morphotropic Grain Boundaries in Homogenetic Oxides.

Interfaces formed by correlated oxides offer a critical avenue for discovering emergent phenomena and quantum states. However, the fabrication of oxide interfaces with variable crystallographic orientations and strain states integrated along a film plane is extremely challenging by conventional layer-by-layer stacking or self-assembling. Here, the creation of morphotropic grain boundaries (GBs) in laterally interconnected cobaltite homostructures is reported. Single-crystalline substrates and suspended ultrathin freestanding membranes provide independent templates for coherent epitaxy and constraint on the growth orientation, resulting in seamless and atomically sharp GBs. Electronic states and magnetic behavior in hybrid structures are laterally modulated and isolated by GBs, enabling artificially engineered functionalities in the planar matrix. This work offers a simple and scalable method for fabricating unprecedented innovative interfaces through controlled synthesis routes as well as providing a platform for exploring potential applications in neuromorphics, solid-state batteries, and catalysis.

Treatment of tibial plateau fractures using modified double reverse traction technique / 中华创伤骨科杂志

Objective:To study the clinical efficacy of our modified double reverse traction technique in the treatment of tibial plateau fractures.Methods:A retrospective study was conducted of the 66 patients with tibial plateau fracture who had been treated by our modified double reverse traction technique at Articular Department, Zhongshan Hospital of Traditional Chinese Medicine from March 2019 to December 2021. There were 37 males and 29 females, with an age of (44±14) years. The double reverse traction technique was used in all patients for reduction of the tibial plateau fracture, and their collapsed articular surfaces were restored by our self-designed universal high affinity prying technique, or by fibular graft support, or by the hooping technique to restore the transverse diameter of the tibial plateau which had been widened. The outcomes of fracture reduction at 2 days postoperation were recorded and evaluated by Rasmussen imaging assessment. Complications were also recorded. The visual analog scale (VAS) pain scores and Hospital for Special Surgery (HSS) scores were compared between preoperation, 3 and 6 months postoperation and the rates of fracture healing between 3 and 6 months postoperation.Results:This group of 66 patients was followed up for 12.0(8.0, 16.5) months. The Rasmussen imaging assessment at 2 days postoperation: 60 excellent, 4 good, and 2 fair cases, yielding an excellent to good rate of 97.0% (64/66). At 3 and 6 months postoperation, the VAS scores [1 (0, 1) and 0 (0, 1)] and HSS scores [84 (78, 88) and 91 (85, 95)] were significantly improved compared with those before operation [4 (3, 5) and 36 (29, 39)], and the values at 6 months postoperation were significantly improved compared with those at 3 months postoperation ( P<0.05). The rate of clinical fracture healing at 6 months postoperation (100%, 66/66) was significantly higher than that at 3 months postoperation (77.3%, 51/66) ( P<0.05). Perioperatively, no adverse events were observed like incision infection, deep vein thrombosis of lower limbs, or failure or exposure of internal fixation, except for delayed incision healing in only one patient. Conclusion:In the minimally invasive surgery for tibial plateau fractures, our modified double reverse traction technique can result in excellent fracture reduction by imaging assessment, fine functional recovery of the knee joint and relief of pain.

Long Noncoding RNA Cytoskeleton Regulator RNA Suppresses Apoptosis in Hepatoma Cells by Modulating the miR-125a-5p/ HS1-Associated Protein X-1 Axis to Induce Caspase-9 Inactivation

Background/Aims@#The involvement of long noncoding RNAs in the carcinogenesis of hepatocellular carcinoma (HCC) has been well documented by substantial evidence. However, whether cytoskeleton regulator RNA (CYTOR) could affect the progression of HCC remains unclear. @*Methods@#The relative expression of CYTOR, miR-125a-5p and HS1-associated protein X-1 (HAX-1) mRNA in HCC cells were determined via quantitative real-time polymerase chain reaction. The viability of treated HCC cells was measured by Cell Counting Kit-8 assay. Cell apoptosis was estimated by flow cytometry analysis, assessment of caspase-9 activity and terminal deoxynucleotidyl transferase dUTP nick-end labeling staining, and Western blot of apoptosisrelated proteins. The interplay between CYTOR or HAX-1 and miR-125a-5p was validated by dual-luciferase reporter assay. @*Results@#CYTOR was upregulated and miR-125a-5p was downregulated in HCC cells. CYTOR silencing inhibited cell proliferation and promoted cell apoptosis in HepG2 and SMMC-7721 cells.miR-125a-5p was sponged and negatively regulated by CYTOR, and HAX-1 was directly targeted and negatively modulated by miR-125a-5p. Overexpression of miR-125a-5p enhanced the repressive effects of CYTOR knockdown on HCC cells, and knockdown of HAX-1 enhanced the inhibitory effects of miR-125a-5p mimics on HCC cells. @*Conclusions@#CYTOR silencing facilitates HCC cell apoptosis in vitro via the miR-125a-5p/HAX-1 axis.

A comparative study for the efficacies of transaxillary non-inflatable endoscopic surgery versus traditional surgery for papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the efficacies between open surgery and axillary non-inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods: A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non-inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer-Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results: A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x¯±s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ2=41.47, P<0.05). Conclusion: Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy.

Endovascular treatment of intracranial vertebral artery unruptured dissecting aneurysms: Comparison of flow diversion and stent-assisted coiling or stenting alone.

Purpose: To investigate the effect and safety of flow diverters in the treatment of unruptured dissecting intracranial aneurysms of the vertebral artery in comparison with stent-assisted coiling or stenting alone. Materials and methods: Patients with unruptured dissecting intracranial aneurysms of the vertebral artery treated with the flow diverter, stent-assisted coiling, or stenting alone were retrospectively enrolled. The clinical data were analyzed and compared. Results: Twenty-five patients were enrolled in the flow diversion group and 42 patients in the stenting group. Twenty-six flow diverters were deployed in the flow diversion group. Immediate angiography revealed contrast agent retention within the aneurysm cavity in all patients. In the stenting group, 48 stents were deployed, and immediate angiographic outcome showed O'Kelly-Marotta (OKM) grade D in 18 (42.9%) aneurysms, grade C in 16 (38.1%), and grade B in 8 (19.0%). Periprocedural ischemic complications of thrombosis occurred in two (4.8%) patients and were treated with thrombolysis. In the flow diversion group, 19 (76%) patients underwent angiographic follow-up 3-46 (median 24) months after the procedure, with the OKM grade D in 11 (57.9%) patients, C in two (10.5%), and B in six (31.6%). The aneurysm recurrence rate was zero, and all diverters remained patent. Asymptomatic instent stenosis occurred in two (10.5%) patients. In seven of the ten patients with mild or moderate parent artery stenosis before the procedure who experienced angiographic follow-up, the stenosis was improved in five (71.4%) patients. In the stenting group, angiographic follow-up was carried out in 33 (78.6%) patients 6-58 months (median 34) after the procedure, with OKM grade D in 22 (66.7%) patients, grade C in five (15.2%), grade B in three (9.1%), and aneurysm recurrence (grade B, with increased contrast agent into the aneurysm cavity) in three (9.1%). Five (16.7%) patients experienced asymptomatic instent stenosis, and six of the 12 patients (50%) with parent artery stenosis were improved. Conclusion: Flow diverters with or without selective adjunctive coiling for the treatment of unruptured dissecting intracranial aneurysms of the vertebral artery may be safe and effective with good occlusion effects not inferior to those of stent-assisted coiling and stenting alone even though the long-term effect still warrants confirmation.

Synthesis and Growth Mechanism of SiS2 Rods.

The SiS2 rods exhibit a significant anisotropy property applied in a special field such as in the one of all-solid-state lithium-ion batteries and so on. In this work, the orthorhombic SiS2 rods with high chemical/phase purity were prepared by an elemental method, either through a boiling or a steaming process, at 1023-1073 K for 3 h and under the saturated S-vapor pressure (2.57-3.83 MPa) in a closed sealed-tube system. The composition, crystal structure, morphology, and growth mechanism were investigated. Results showed that the growth orientation of SiS2 along the <0 0 1> is intrinsically governed by the crystal structure motif. It could exist in both processes and the latter tends to show in macroscopic morphology. Using the pressure-temperature diagram, structure refinement, pole figures, image analyses, and so forth, factors influencing the purity and growth of SiS2 rods were concluded from the thermodynamics and kinetics viewpoints.

Room-Temperature Ferromagnetism at an Oxide-Nitride Interface.

Heterointerfaces have led to the discovery of novel electronic and magnetic states because of their strongly entangled electronic degrees of freedom. Single-phase chromium compounds always exhibit antiferromagnetism following the prediction of the Goodenough-Kanamori rules. So far, exchange coupling between chromium ions via heteroanions has not been explored and the associated quantum states are unknown. Here, we report the successful epitaxial synthesis and characterization of chromium oxide (Cr_{2}O_{3})-chromium nitride (CrN) superlattices. Room-temperature ferromagnetic spin ordering is achieved at the interfaces between these two antiferromagnets, and the magnitude of the effect decays with increasing layer thickness. First-principles calculations indicate that robust ferromagnetic spin interaction between Cr^{3+} ions via anion-hybridization across the interface yields the lowest total energy. This work opens the door to fundamental understanding of the unexpected and exceptional properties of oxide-nitride interfaces and provides access to hidden phases at low-dimensional quantum heterostructures.

Evaluation of the effect of comprehensive prevention and management of diabetes mellitus of two cross-sectional surveys based on community population / 中华预防医学杂志

To investigate the prevalence of diabetes mellitus (DM) among residents in Chongchuan district, Nantong city in 2012 and 2018, and evaluate the effectiveness of community comprehensive management of DM. Based on the data of 17 780 and 13 382 residents in the cross-sectional surveys of the " National Demonstration Area for Comprehensive Prevention and Control of Chronic Diseases " project in Chongchuan District of Nantong City, Jiangsu Province in 2012 and 2018, 4 583 and 3 996 DM-related information were obtained. The population of Jiangsu Province in 2012 and 2018 was used as the reference for standardization. The rates of prevalence and management (including awareness, treatment, treatment of patients who knew their diabetic situation, control and control of patients under treatment) of DM in the two surveys were compared using chi-square test. The results showed that in 2012 and 2018, the prevalence rates of DM were 12.0% and 15.7% (χ²=24.25, P<0.05), and the standardized rates were 10.1% and 10.8% (χ²=1.05, P=0.306). The incidence rates were 5.7% and 2.3%, respectively (χ²=55.60, P<0.05). The standardized prevalence rates in the two surveys were 9.7% and 11.6% for males (χ²=3.66, P=0.056) and 10.5% and 9.9% for females (χ²=0.50, P=0.481), 7.2% and 6.5% (χ²=0.85, P=0.357) for people aged 18-59 years old and 20.6% and 21.9% (χ²=0.91, P=0.339) for people aged 60 years and over, respectively. The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, control, and control of patients under treatment in 2018 were 84.4%, 80.3%, 95.2%, 58.4%, and 70.2%, respectively, higher than 47.2%, 23.4%, 44.8%, 30.4% and 59.4% in 2012 (χ²=183.33, χ²=380.65, χ²=282.99, χ²=93.24, χ²=6.22, all P<0.05). Among men, the standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control in 2018 were 85.8%, 78.8%, 91.8% and 62.7%, higher than 50.5%, 37.5%, 72.3% and 32.6% in 2012 (χ²=78.40, χ²=96.17, χ²=27.55, χ²=48.96, all P<0.05). Similarly, the standardized management rates in 2018 were 83.0%, 81.7%, 98.5%, 54.1% and 65.1%, higher than 44.0%, 10.0%, 18.3%, 28.2% and 48.8% in 2012 among women (χ²=105.52, χ²=326.36, χ²=317.22, χ²=43.34, χ²=3.87, all P<0.05). The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control of people aged 18-59 and 60 years and over were 82.9%, 79.7%, 96.1%, 55.0% and 88.0%, 81.8%, 93.0% and 67.2%, higher than 42.6%, 19.8%, 42.2%, 27.5% and 63.9%, 36.8%, 53.9%, 40.8% in 2012 (χ²=44.51, χ²=102.17, χ²=57.78, χ²=21.65, all P<0.05; χ²=71.18, χ²=181.55, χ²=146.26, χ²=59.23, all P<0.05). The comprehensive prevention and control system of chronic diseases, which comprehensively covered the life of community residents, had good management effect on DM, and effectively promoted health education and health promotion.

Study on the driving mechanism of the formation of doctors′ turnover intention in public hospitals based on the grounded theory / 中华医院管理杂志

Objective:To explore the driving mechanism contributing to doctors′ turnover intention in public hospitals based on the grounded theory.Methods:" Willingness or intention for doctors to quit public hospitals" was used as the theme word, and the literature was retrieved from CNKI published from January 1, 2017 to January 1, 2022. Based on the grounded theory, NVivo 11.0 software was used for a qualitative analysis of the literature. The three-level coding method of open coding, axial coding and selective coding was used to identify the main categories affecting the willingness of doctors to quit public hospitals. On this basis, the driving mechanism model was integrated. In-depth interviews with hospital managers were used to test the theoretical saturation.Results:When 31 papers were coded, four level-1 influencing factors of the formation of doctors′ turnover intention in public hospitals were summarized: career selection deviation, practice reality, perceived experience and external opportunity. Among them, perceived experience was the direct driving factor; career selection deviation was the initial driving factor, and the practice reality was the key driving factor, both of them affected the perceived experience; external opportunity was the possible driving factor.Conclusions:In order to prevent doctors from willing to leave, the following measures are expected: the hospital management should improve both its recruitment evaluation indexes and recruitment effectiveness; pay attention to doctors′ psychological capital management and cultivate positive perception; promote the reform of performance pay, emphasize fairness and value; pay attention to employee relationship management and build a supportive hospital culture.

Estimations on Properties of Redox Reactions to Electrical Energy and Storage Device of Thermoelectric Pipe (TEP) Using Polymeric Nanofluids.

A thermoelectric pipe (TEP) is constructed by tubular graphite electrodes, Teflon material, and stainless-steel tube containing polymeric nanofluids as electrolytes in this study. Heat dissipation and power generation (generating capacity) are both fulfilled with temperature difference via the thermal-electrochemistry and redox reaction effects of polymeric nanofluids. The notion of TEP is to recover the dissipative heat from the heat capacity generated by the relevant machine systems. The thermal conductivity and power density empirical formulas of the novel TEP were derived through the intelligent dimensional analysis with thermoelectric experiments and evaluated at temperatures between 25 and 100 °C and vacuum pressures between 400 and 760 torr. The results revealed that the polymeric nanofluids composed of titanium dioxide (TiO2) nanoparticles with 0.2 wt.% sodium hydroxide (NaOH) of the novel TEP have the best thermoelectric performance among these electrolytes, including TiO2 nanofluid, TiO2 nanofluid with 0.2 wt.% NaOH, deionized water, and seawater. Furthermore, the thermal conductivity and power density of the novel TEP are 203.1 W/(m·K) and 21.16 W/m3, respectively.

Association of Nanodiamond Rotation Dynamics with Cell Activities by Translation-Rotation Tracking.

Correlated translation-orientation tracking of single particles can provide important information for understanding the dynamics of live systems and their interaction with the probes. However, full six-dimensional (6D) motion tracking has yet to be achieved. Here, we developed synchronized 3D translation and 3D rotation tracking of single diamond particles based on nitrogen-vacancy center sensing. We first performed 6D tracking of diamond particles attached to a giant plasma membrane vesicle to demonstrate the method. Quantitative analysis of diamond particles' motion allowed elimination of the geometric effect and revealed the net rotation on the vesicle. 6D tracking was then applied to measure live cell dynamics. Motion characteristics of nanodiamonds on cell membranes under various controlled physiological conditions suggest that the nanodiamonds' rotation is associated with cell metabolic activities. Our technique extends the toolbox of single particle tracking and provides a unique solution to problems where correlated analysis of translation and rotation is critical.

Evaluation of association between methylenetetrahydrofolate reductase and azoospermia: A meta-analysis.

BACKGROUND: Infertility affects childbearing age couples all over the world. One of the important reasons for infertility is genetic factors. Our study evaluated the association between methylenetetrahydrofolate reductase (MTHFR) and azoospermia. METHODS: Multiple databases like MEDLINE, EMBASE, Cochrane library, and China journal full-text database were used to search for relevant studies, and full-text articles involved in the evaluation of MTHFR and azoospermia. The results were evaluated using STATA 12.0. Heterogeneity analysis, sensitivity analysis, and bias analysis were also performed on the data. RESULTS: Thirteen related studies eventually met the inclusion criteria. Significant association between C677T polymorphism and azoospermia (relative risk [RR] = 0.94 [0.90, 0.99], I2 = 60.9%, P = .002), and between A1298C polymorphism and azoospermia (RR = 0.98 [0.94, 1.02], I2 = 56.3%, P = .011) was observed. Meanwhile, in subgroup analysis, Caucasians had higher risk than Mongolians in association between MTHFR and azoospermia. CONCLUSION: There was association between MTHFR polymorphism and azoospermia. Caucasian populations had higher risk than Mongolian populations in association between MTHFR and azoospermia.

Analysis of early complications of free gracilis muscle transfer in reconstruction of brachial plexus injury / 中华显微外科杂志

Objective:To explore the causes and preventive measures of early complications after free gracilis muscle transfer in reconstruction of brachial plexus injury, and to improve the postoperative function of the transferred gracilis muscle.Methods:Patients were recruited from August, 2005 to December, 2016. All 111 patients of brachial plexus injury underwent reconstructive surgery using 122 free gracilis flaps. Early postoperative complications, including recipient site, donor site and systemic complications, were closely observed and recorded. Outcome measurements included incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion and salvage rate. The postoperative strength of gracilis was evaluated according to the BMRC score. The data were statistically analyzed. The difference was statistically significant if P<0.05. Results:The survival rate of 122 free gracilis transfers was 98.4% (120/122). Early complications occurred in 32 cases (including 2 complications in 6 patients) : 27 cases with recipient site complications (84.4%), 4 with donor site complications and 7 with systemic complications. Among the 32 cases of complications, 17 flap compromises caused by vascular obstruction and 15 of them were salvaged completely after exploration. Flap crisis was the main issue that affected the postoperative function of gracilis muscle, and 58.8% (10/17) of patients with vascular crisis showed muscle strength above M 3 after surgery. The main causes of vascular crisis were venous tortuosity and venous thrombosis, which had nothing to do with operation time and intraoperative blood loss. Conclusion:Flap crisis is the main factor affecting the postoperative function of gracilis. The rate of flap salvage can be tremendously increased by early detection, re-exploration and effective management of the flap crisis.