[Systemic lupus erythematosus associated macrophage activation syndrome with neuropsychiatric symptoms: A report of 2 cases].

Systemic lupus erythematosus (SLE) associated macrophage activation syndrome (MAS) is clinically severe, with a high mortality rate and rare neuropsychiatric symptoms. In the course of diagnosis and treatment, it is necessary to actively determine whether the neuropsychiatric symptoms in patients are caused by neuropsychiatric systemic lupus erythematosus (NPSLE) or macrophage activation syndrome. This paper retrospectively analyzed the clinical data of 2 cases of SLE associated MAS with neuropsychiatric lesions, Case 1: A 30-year-old female had obvious alopecia in 2019, accompanied by emaciation, fatigue and dry mouth. In March 2021, she felt weak legs and fell down, followed by fever and chills without obvious causes. After completing relevant examinations, she was diagnosed with SLE and given symptomatic treatments such as hormones and anti-infection, but the patient still had fever. The relevant examinations showed moderate anemia, elevated ferritin, elevated triglycerides, decreased NK cell activity, and a perforin positivity rate of 4.27%, which led to the diagnosis of "pre-hemophagocytic syndrome (HPS)". In May 2021, the patient showed mental trance and babble, and was diagnosed with "SLE-associated MAS"after completing relevant examinations. After treatment with methylprednisolone, anti-infection and psychotropic drugs, the patient's temperature was normal and mental symptoms improved. Case 2: A 30-year-old female patient developed butterfly erythema on both sides of the nose on her face and several erythema on her neck in June 2019, accompanied by alopecia, oral ulcers, and fever. She was diagnosed with "SLE" after completing relevant examinations, and her condition was relieved after treatment with methylprednisolone and human immunoglobulin. In October 2019, the patient showed apathy, no lethargy, and fever again, accompanied by dizziness and vomiting. The relevant examination indicated moderate anemia, decreased NK cell activity, elevated triglycerides, and elevated ferritin. The patient was considered to be diagnosed with "SLE, NPSLE, and SLE-associated MAS". After treatment with hormones, human immunoglobulin, anti-infection, rituximab (Mabthera), the patient's condition improved and was discharged from the hospital. After discharge, the patient regularly took methylprednisolone tablets (Medrol), and her psychiatric symptoms were still intermittent. In November 2019, she developed symptoms of fever, mania, and delirium, and later turned to an apathetic state, and was given methylprednisolone intravenous drip and olanzapine tablets (Zyprexa) orally. After the mental symptoms improved, she was treated with rituximab (Mabthera). Later, due to repeated infections, she was replaced with Belizumab (Benlysta), and she was recovered from her psychiatric anomalies in March 2021. Through the analysis of clinical symptoms, imaging examination, laboratory examination, treatment course and effect, it is speculated that the neuropsychiatric symptoms of case 1 are more likely to be caused by MAS, and that of case 2 is more likely to be caused by SLE. At present, there is no direct laboratory basis for the identification of the two neuropsychiatric symptoms. The etiology of neuropsychiatric symptoms can be determined by clinical manifestations, imaging manifestations, cerebrospinal fluid detection, and the patient's response to treatment. Early diagnosis is of great significance for guiding clinical treatment, monitoring the condition and judging the prognosis. The good prognosis of the two cases in this paper is closely related to the early diagnosis, treatment and intervention of the disease.

[Value of procalcitonin in the diagnosis of perioperative infection in patients undergoing primary hip replacement].

OBJECTIVE: To analyze the value of procalcitonin (PCT) in the diagnosis of perioperative infection associated with implants in patients with primary hip arthroplasty. METHODS: A retrospective study was conducted on 150 patients who underwent primary hip arthroplasty from June 2018 to June 2020, including 86 males and 64 females, aged from 47 to 77 years old with an average of (57.04±7.43) years. All patients with primary hip arthroplasty were divided into infection group and non infection group according to whether there was infection after operation. Blood samples were collected from the elbow vein before operation (D0) and on the 4, 6, 8 days after operation(D4, D6 and D8) respectively to detect the serum PCT level and white blood cell count (WBC) level. RESULTS: Among 150 patients with primary hip arthroplasty, 34 patients with postoperative infection were in the infection group, and 116 patients without postoperative infection were in the noninfection group. In the infection group, there were 19 cases of superficial surgical site infection(55.88%, 19/34), 9 cases of urinary tract infection (26.47%, 9/34), and 6 cases of pneumonia(17.65%, 6/34). After bacterial culture in the infection group, there were 9 cases of Staphylococcus aureus, 3 cases of Escherichia coli, 3 cases of Staphylococcus epidermidis, 3 cases of Streptococcus constellation, 3 cases of Candida albicans, 6 cases of Klebsiella pneumoniae, 2 cases of Escherichia coli and Streptococcus agalactis, 3 cases of coagulase invisible staphylococcus and Burkholderia cepacia, 2 cases of Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa. There was no significant difference in PCT levels between two groups in D0(P=0.081), D4(P=0.069) and D6(P=0.093), but there was significant difference in D8(P=0.007). There was no significant difference in WBC between two groups at any time point(P>0.05). The results of receiver operating characteristic curve(ROC) showed that the AUC of PCT diagnosis was 0.978[95%CI(0.933, 1.022)] and that of WBC was 0.562[95%CI(0.398, 0.726)], PCT was an important predictor of infection after primary hip arthroplasty(AUC>0.9). When the critical value was 0.526 ng/ml, the sensitivity and specificity of PCT diagnosis are 36% and 100%, respectively, WBC was not a significant predictor of infection after primary hip arthroplasty (0.5

Rapid cultivation of anammox sludge based on Ca-alginate cell beads.

Current gel entrapment technology has certain advantages for the enrichment of anammox sludge. In this study, the optimal preparation conditions and cultivation equipment of Ca-alginate cell beads for the culturing anammox sludge were proposed. The preparation parameters of the Ca-alginate cell beads were as follows: 3% sodium alginate, 4% CaCl2, VSA:Vcell = 1:1, a drop height of 9 cm, stirring speed of 300 rpm, and cross-linking time of 24 h. The prepared cell beads were regular spheres with a uniform size and hard texture. Throughout the 9 days of cultivation, the number of anammox bacteria in the Ca-alginate cell beads was 4.3 times that of the initial sludge, and the color of the cell beads changed from yellowish-brown to reddish-brown. Scanning electron microscopy (SEM) analysis showed that the SA gel beads had a good microporous structure. The fluorescence in situ hybridization (FISH) results illustrated that the bacteria were mostly dispersed inside the Ca-alginate cell beads. Additionally, the qPCR results implied that only a relatively small amount of anammox biomass (2.74×106 copies/gel-bead) was required to quickly start the anammox process. The anammox bacteria in the Ca-alginate cell beads grew with a fast growth rate in a short period and exhibited high activity due to diffusion limitations. In addition, the anammox bacteria cultivated in the Ca-alginate cell beads could adapt to the increase in substrate concentration in a short period. The optimal incubation time of this gel entrapment method for anammox sludge was no more than 17 days under the experimental conditions of this work. Therefore, this simple and practicable gel entrapment method may serve as a suitable pre-culture means for the rapid enrichment of anammox bacteria.

[Delimitation of urban development boundary based on ecological sensitivity evaluation and CA-Markov simulation in plain city:A case of Nanchang, Jiangxi, China]. / 基于生态敏感性评价和CA-Markov模拟的平原型城市开发边界划定­­ä»¥å—昌市为例.

The rational delimitation of urban development boundary plays an important role in guiding the orderly growth of urban space and ensure proper environment health of urban space. In this study, we evaluated the ecological sensitivity of Nanchang City from four aspects (soil erosion, habitat, geological disaster and water resource) and simulated urban expansion in 2020 based on CA-Markov and land use data in 2000, 2010 and 2015. Spatial decision-making analysis of the two aspects was carried out in combination to the future development of the study area. We proposed a new method of delimitating urban development boundary integrating environmental protection and urban development through the dynamic coordination of both aspects. The results showed that ecological sensitivity of Nanchang City was moderate. The scale of urban construction land based on CA Markov simulation was 1239.67 km2, which slightly exceeded the planned construction land target (1201.65 km2). When the dynamic adjustment was done by superimposing the ecological sensitivity evaluation results with the expansion simulation results, the adjusted construction land scale of Nanchang City was 1193.15 km2, which met the planned requirement. Consideration of the coordination of protection and development could not only protect the ecological space, but also help to guide the orderly growth of urban space and ensure the healthy development of urban space, and thus was an important way to achieve a win-win situation between rational urban development and ecological protection.

Spatiotemporal patterns of the trade-off and synergy relationship among ecosystem services in Poyang Lake Region, China.

Poyang Lake region is the largest freshwater lake impacted area in China. Quantitative analysis of trade-off and synergy in ecosystem service is of great significance for realizing regional sustainable development. Based on multi-source data of remote sensing, soil, meteorology and DEM, we quantitatively measured food supply service, soil conservation service and water yield service in Poyang Lake region from 2005 to 2015, and analyzed their spatiotemporal patterns and evolution characteristics. The spatial and temporal characteristics of trade-off and synergy between services on the scale of 1 km×1 km were analyzed by using correlation analysis, hot spot analysis and spatial mapping method. The differences of ecosystem services and their relationships in the perspective of land use were studied. The results showed that food supply service increased, soil conservation service decreased, and water yield service increased first and then decreased during the study period. In terms of spatial distribution, food supply service presented "low-high-low-high" in the northwest-southeast direction, soil conservation service was concentrated in high and low values, and water yield service was high in south and low in north. There were trade-off relationships between food supply and soil conservation, and between food supply and water yield. There was synergistic relationship between soil conservation and water yield. Moreover, the relationship between food supply and soil conservation showed a spatial pattern of synergy in northern but trade-off in southern region. There was a clear spatial trade-off between food supply and water yield, and from north to south the relationship between soil conservation and water yield existed synergy-tradeoff-synergy differentiation, like a "sandwich". Among different land use types, there was a significant synergy between cultivated land and food supply, garden land and soil conservation, water area and water yield, but trade-off relationships between construction land and three services. The relationship between food supply and soil conservation and water yield was mainly trade-off in different land use types. The relationship between soil conservation and water yield was synergy in cultivated land, garden land, grassland and construction land, but was trade-off in water and unused land. The hot spots of multiple ecosystem services in the Poyang Lake region were mainly in the eastern and sou-thern plain areas, with a decreasing trend.

Largely enhanced photocatalytic hydrogen production rate of CdS/(Au-ReS2) nanospheres by the dielectric-plasmon hybrid antenna effect.

In this study, we synthesized CdS/(Au-ReS2) nanospheres that have highly efficient photocatalytic hydrogen production activity induced by dielectric-plasmon hybrid antenna resonance. As the diameter (D) of ReS2 nanospheres consisting of 2D nanosheets increases from 114 ± 11 to 218 ± 25 nm, the resonance wavelength of the ReS2 dielectric antenna is tuned from 380 to 620 nm and the hydrogen production rate for the CdS/(Au-ReS2) nanospheres increases by more than 1.85 times and reaches a value as high as 3060 µmol g-1 h-1, with a 9% weight percentage of Au. Due to the enhancements of the local electromagnetic field and excitation energy transfer by the ReS2-Au dielectric-plasmon hybrid antenna, the hydrogen production rate for the CdS/(Au-ReS2) nanospheres (D = 218 ± 25 nm) is 797, 319, 105 and 12 times larger than that for pure ReS2, Au-ReS2, CdS, and CdS-ReS2, respectively. Additionally, the persistence and reusability measurements indicate a favorable stability of CdS/(Au-ReS2). These results provide a strategy to prepare a new class of dielectric-plasmon hybrid antennas consisting of 2D materials and metal nanoparticles, which have promise in applications ranging from photocatalysis to nonlinear optics.

[Case-control study on calcaneal locking plates and tension band with Kirschner's nail for the treatment of patellar fracture].

OBJECTIVE: To compare clinical effect between calcaneal locking plates and tension band with Kirschner's nail for the treatment of patellar fracture. METHODS: From December 2009 to December 2017, 58 patients with patellar fracture were divided into plate group(calcaneal locking plate) and tension band(tension band with Kirschner's nail) by surgical method. There were 29 patients in plate group, including 14 males and 15 females, aged from 18 to 72 years old with an average of (36.9±11.5) years old; while there were 29 patients in tension band group, including 17 males and 12 females, aged from 20 to 70 years old with an average of (37.7±14.4) years old. Operative time, blood loss, fracture healing time, follow-up time and postoperative complications were compared between two groups. Böstman score was applied to compared therapeutic effects at 12 months after operation. RESULTS: There was no significant differences in following-up time between plate group(18.4±2.6) months and tension band group(17.8±3.6) months. According to Böstman score at 12 months after operation, plate group was (28.5±4.6) and (25.7±4.3) in tension band group, and had statistical difference between two group(t=2.395, P=0.020). Twenty-six patients got excellent results, 3 moderate in plate group; while 14 patients got excellent results, 11 moderate and 4 poor in tension band group, and had obviously meaning between two groups(χ²=12.17 P=0.02). There were no significant differences in operative time(t=1.978, P=0.53), blood loss(t=1.740, P=0.87), fracture healing time(t=0.65, P=0.517) and postoperative complications(χ²=0.268, P=0.604) between two groups. CONCLUSIONS: Calcaneal locking plates for patellar fracture has advantages of more wide range of clinical application, more reliable fixation, and more satisfactory surgical curative method, its clinical effects is better than that of tension band with kirschner nail.

Largely enhanced photocatalytic activity of Au/XS2/Au (X = Re, Mo) antenna-reactor hybrids: charge and energy transfer.

An antenna-reactor hybrid coupling plasmonic antenna with catalytic nanoparticles is a new strategy to optimize photocatalytic activity. Herein, we have rationally proposed a Au/XS2/Au (X = Re, Mo) antenna reactor, which has a large Au core as the antenna and small satellite Au nanoparticles as the reactor separated by an ultrathin two-dimensional transition-metal dichalcogenide XS2 shell (∼2.6 nm). Due to efficient charge transfer across the XS2 shell as well as energy transfer via coupling of the Au antenna and Au reactor, the photocatalytic activity has been largely enhanced: Au/ReS2/Au exhibits a 3.59-fold enhancement, whereas Au/MoS2/Au exhibits a 2.66-fold enhancement as compared to that of the sum of the three individual components. The different enhancement in the Au/ReS2/Au and Au/MoS2/Au antenna-reactor hybrid is related to the competition and cooperation of charge and energy transfer. These results indicate the great potential of the Au/XS2/Au antenna-reactor hybrid for the development of highly efficient plasmonic photocatalysts.

Strong magnetic resonances and largely enhanced second-harmonic generation of colloidal MoS2 and ReS2@Au nanoantennas with assembled 2D nanosheets.

Colloidal disk-like and sphere-like MoS2 nanoantennas are synthesized. They consist of curly and interlaced 2D nanosheets. The resonance peak of the MoS2 nanoantennas can be tuned from 500 to 900 nm by adjusting the size and shape. The strong magnetic and electric resonances of the dielectric antennas are revealed by theoretical calculations with Mie theory. The second harmonic generation (SHG) of the exfoliated nanosheets and the synthesized nanodisks and nanospheres is investigated and compared by scanning the excitation laser wavelength. SHG enhancement of 52 fold is observed for the spherical nanoantennas at 400 nm, which is attributed to the nanoantenna-enhanced two-photon resonance excitation of the D exciton of MoS2 monolayers. Moreover, ReS2@Au plasmon-dielectric hybrid nanoantennas are also synthesized. The SHG of Au nanoparticles is enhanced 8.5 times by the coupling of the two types of nanoantennas. This new class of optical nanoantennas consisting of 2D materials and exhibiting unique linear and nonlinear optical responses will bring promising applications ranging from nonlinear photonics to photochemistry.

Plasmon-Enhanced Photoelectrochemical Current and Hydrogen Production of (MoS2-TiO2)/Au Hybrids.

Three component hybrid (MoS2-TiO2)/Au substrate is fabricated by loading plasmonic Au nanorods on the MoS2 nanosheets coated TiO2 nanorod arrays. It is used for photoelectrochemical (PEC) cell and photocatalyst for hydrogen generation. Owing to the charge transfer between the MoS2-TiO2 hetero-structure, the PEC current density and hydrogen generation of TiO2 nanoarrays are enhanced 2.8 and 2.6 times. The broadband photochemical properties are further enhanced after Au nanorods loading. The plasmon resonance of Au nanorods provides more effective light-harvesting, induces hot-electron injection, and accelerates photo-excited charges separation. The results have suggested a route to construct nanohybrid by combining one-dimensional arrays and two-dimensional nanosheets, meanwhile have successfully utilized plasmonic nanorods as a sensitizer to improve the photochemical properties of the semiconductor nanocomposite.

Reduced expression of PTEN and increased PTEN phosphorylation at residue Ser380 in gastric cancer tissues: a novel mechanism of PTEN inactivation.

AIM: PTEN is a tumor suppressor gene in different cancers. This study was to determine the protein expression of PTEN and phosphorylation of PTEN (p-PTEN) at residue Ser380 in different histology specimens of gastric tissues. METHODS: A total of 179tissue specimens of normal gastric mucosa, chronic gastritis, intestinal metaplasia, dysplasia, and gastric cancer were recruited for immunohistochemical analysis of PTEN and p-PTEN expression. Four gastric cancer AGS, MKN-45, MKN-28, and SGC-7901 cell lines and a non-cancerous gastric GES-1 cell line were used to detect expression of PTEN and p-PTEN protein using Western blot. RESULTS: Expression level of PTEN protein was significantly decreased in gastric cancer tissues compared to normal gastric mucosa, chronic gastritis, intestinal metaplasia and dysplasia (P<0.05). In contrast, p-PTEN protein level was significantly increased in intestinal metaplasia, dysplasia and gastric cancer compared to normal gastric mucosa and chronic gastritis (P<0.05). However, there was no any association of PTEN and p-PTEN expression with clinicopathological characteristics from gastric cancer patients. Moreover, the ratio of p-PTEN and PTEN was higher in gastric cancer cell lines than that of the non-malignant cells. CONCLUSIONS: This study demonstrated that aberrant expression of PTEN and p-PTEN at residue Ser380 was early event that could contribute to gastric carcinogenesis, and that PTEN phosphorylation at residue Ser380 could be a mechanism for PTEN inactivation.

[Minimally invasive percutaneous plate osteosynthesis for the treatment of intertrochanteric femoral fractures of Evans IlI and IV in elderly patients].

OBJECTIVE: To study therapeutic effects of minimally invasive percutaneous plate osteosynthesis for the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients. METHODS: From December 2007 to April 2010, 23 patients with intertrochanteric femoral fractures were reviewed. Among the patients, 11 patients were male and 12 patients were female,ranging in age from 62 to 90 years, with a mean of 72.8 years. According to Evans classification, 13 patients were type III and 10 patients were type IV. All the patients were treated with proximal femoral locking plate (minimally invasive percutaneous plate osteosynthesis, MIPPO) surgery. RESULTS: The operative time ranged from 45 to 60 min, with an average of 50 min. The blood loss ranged from 60 to 100 ml, averaged 80 ml. All the patients were followed up,and the duration ranged from 9 to 18 months, with an average of 11 months. The healing time based X-ray ranged from 3 to 6 months, with an average of 4 months. According to hip scoring criteria evaluation: 18 patients got an excellent results, 5 good. CONCLUSION: For the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients, MIPPO has advantages such as small trauma, reliable fixation, which has good clinical application.

[An experiment study and clinical observation of the influence of free-skin-grafted scrotal avulsion injuries on spermatogenesis].

OBJECTIVE: To explore the influence of Free-skin-grafted penoscrotal avulsion injuries on spermatogenesis. METHODS: Forty-two male New Zealand albino rabbits during child-bearing period were divided into the experimental group (n = 24) and the control group (n = 18) using random digits table, and 24 female rabbits with reproductive history were used for mating experiment. The experimental group animal's scrotum skin were excised, and the split skin from abdominal region was used to repair the skin defect of scrotum. The control group did not any processing. Six rabbits were randomly chosen respectively in control group and on the 3rd and 8th weekend after the model was successfully established in experimental group. The testicular surface temperature was measured in the eighteen rabbits using the method of burying thermometer, then the testicular biopsy were performed for hematoxylin-eosin (HE) staining. On the 8(th) weekend after the model was successfully established in experimental group, matched-pair feed was performed in the other 12 rabbits respectively in experimental group and in control group. Observation of corresponding mother rabbit fertility. Three patients of penoscrotal avulsion injuries were treated using split skin grafts, and the information of sex life and the quality of sperm were obtained by follow up. RESULTS: The testicular surface temperature was similar on the 3rd and 8th weekend after the model was successfully established in experimental group [(36.15 ± 0.24)°C, (36.77 ± 0.42)°C] with that of the control group. Testis tissue (HE) staining showed the tier of spermatogenic cells was rule arrangement and lot of mature sperms were found in the convoluted seminiferous tubules in control group. The tier of spermatogenic cells was diminished and disposed derangement, the spermatozoa were not seen on the 3(th) weekend of the experiment group. The tier of spermatogenic cells was increased and some spermatozoa were seen on the 8th weekend of the experiment group. Male and female matched-pair feed showed the experimental group conception rate 8/12, and 4.1 ± 3.2 rabbit babies were born averagely, while that of was 12/12 and 6.0 ± 1.3 in control group (P > 0.05). The skin grafts there were some contracture in early stage (1 - 2 months) when the skin grafts applied to repair the avulsing scrotum in three patients. But the skin grafts became loose with downward sagging and there were the good cosmetic result in one year, and without any contracture. The sperm quality was normal after the skin grafts applied to repair the avulsing scrotum in the late stage. CONCLUSIONS: The skin grafting is little arrest the testicle spermatogenesis in the three methods (skin flap reconstruction scrotum, testicle buried, split skin grafting) that have usually been used to repair scrotum skin lose. For a young male, the best treatment for penoscrotal avulsion injuries is free skin grafting, while skin flaps are not recommended for reconstructing the scrotum.

3D nanostructured Ni(OH)2 microspheres as an efficient immobilization matrix of Ru(bpy)3(2+) for high-performance electrochemiluminescence sensor.

The electrochemistry and electrochemiluminescence (ECL) of novel three-dimensional nanostructured Ru(bpy)(3)(2+)/Ni(OH)(2) microspheres were investigated for the first time. The negatively charged porous Ni(OH)(2) microspheres composed of Ni(OH)(2) nanowires were specifically designed to interact with Ru(bpy)(3)(2+). The large surface area and porous structure of Ni(OH)(2) microspheres enhance loading of Ru(bpy)(3)(2+) and mass transport of the model analyte, tripropylamine (TPA). Excellent ECL performance of the presented sensor was achieved including good stability and wide linear range from 7.7x10(-10) to 3.8x10(-3)M with the detection limit of 2.6x10(-10)M to TPA.

Long-term prognosis of free skin-grafted penoscrotal avulsion injuries in two patients.

OBJECTIVE: To observe the long-term results of free skin-grafted penoscrotal avulsion injury. METHODS: Two young males with penoscrotal avulsion injuries were followed up after repair by free skin grafting. RESULTS: Good cosmetic results were attained without any contracture of the free skin grafts, and the sperm quality was normal at the late stage. CONCLUSION: For young males, the best treatment for penoscrotal avulsion injuries is free skin grafting, while skin flaps are not recommended for reconstructing the scrotum.

[Repair of high-voltage electrical burn in the neck].

OBJECTIVE: To explore methods of repair of high-voltage electrical burn in the neck. METHODS: Thirty-seven patients with high-voltage electrical burn in neck hospitalized since 1985 were enrolled in this study. After debridement, the wounds were repaired with latissimus dorsi myocutaneous flap, trapezius myocutaneous flap, platysma myocutaneous flaps, pectoralis major myocutaneous flap, or latissimus dorsi myocutaneous flap combined with pectoralis major myocutaneous flap. RESULTS: Necrosis occurred at edge of flap (about 1 - 2 cm in breadth) in 3 patients, and the other flaps survived well with perfect appearance and local function. CONCLUSION: To repair with pedicled myocutaneous flaps and combined flaps after early debridement can be safe, effective and reliable in the management of patients with high-voltage electrical burn in the neck.