Comparison of simulation and predictive efficacy for hemorrhagic fever with renal syndrome incidence in mainland China based on five time series models.

Background: Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic infectious disease commonly found in Asia and Europe, characterized by fever, hemorrhage, shock, and renal failure. China is the most severely affected region, necessitating an analysis of the temporal incidence patterns in the country. Methods: We employed Autoregressive Integrated Moving Average (ARIMA), Long Short-Term Memory (LSTM), Convolutional Neural Network (CNN), Nonlinear AutoRegressive with eXogenous inputs (NARX), and a hybrid CNN-LSTM model to model and forecast time series data spanning from January 2009 to November 2023 in the mainland China. By comparing the simulated performance of these models on training and testing sets, we determined the most suitable model. Results: Overall, the CNN-LSTM model demonstrated optimal fitting performance (with Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and Mean Absolute Error (MAE) of 93.77/270.66, 7.59%/38.96%, and 64.37/189.73 for the training and testing sets, respectively, lower than those of individual CNN or LSTM models). Conclusion: The hybrid CNN-LSTM model seamlessly integrates CNN's data feature extraction and LSTM's recurrent prediction capabilities, rendering it theoretically applicable for simulating diverse distributed time series data. We recommend that the CNN-LSTM model be considered as a valuable time series analysis tool for disease prediction by policy-makers.

The safety and effectiveness of laparoscopic off-clamp tumor evacuation versus traditional nephron-sparing surgery for large (>4 cm) sporadic renal angiomyolipomas.

BACKGROUND: Off-clamp nephron-sparing surgery (NSS) have been selectively performed in renal tumors in which the majority are T1a (<4 cm) renal caners. Less is known, however, whether off-clamp is a safe and effective option for treatment of Sporadic Renal Angiomyolipomas (RAML), especially in those >4 cm. The objective of our study was to compare the perioperative and renal function outcomes of a novel off-clamp tumor evacuation technique versus conventional laparoscopic NSS for the treatment of large sporadic RAMLs (>4 cm). METHODS: From January 2021 to June 2022, 42 patients diagnosed with RAML were prospectively randomized to receive laparoscopic standard NSS (Group 1) and off-clamp tumor evacuation (Group 2). The surgical and postoperative outcomes of both groups were compared. RESULTS: Baseline characteristics demonstrated no discernible variation between Group 1 and Group 2. Compared to Group 1, Group 2 was associated shorter operative time (92.5 vs 82.3 min, p < 0.001), elimination of warm ischemic time (22.9 vs 0 min, p < 0.001), more blood loss (92.6 vs 161.9 ml, p = 0.02), and lower short-term renal function reduction of the operated kidney (17.2% vs 9%; p < 0.001). Neither major complication nor recurrence occurred. CONCLUSION: It seems that transperitoneal laparoscopic off-clamp tumor evacuation is a feasible and safe option for the treatment of RAML, with the added benefit of preserving renal function to a greater extent than the traditional methods.

Efficacy of ultrasound-guided radiofrequency ablation of papillary thyroid microcarcinoma after one year.

OBJECTIVE: This study aims to evaluate the feasibility and safety of percutaneous radiofrequency ablation guided by ultrasound for treating papillary thyroid microcarcinoma. METHOD: At our institution, fifty people who had been treated for micropapillary thyroid cancer with ultrasound-guided radiofrequency ablation were chosen. Thyroid function was evaluated after one month, and the volume of the ablation region was assessed immediately, 3, 6, and 12 months after treatment. At the same time, the complications or adverse reactions after treatment were evaluated. RESULTS: As time passed, the volume of the ablation area decreased gradually, showing a regression trend. There was a significant difference in the volume of the ablation area between adjacent groups (P < 0.05), and the tumor volume reduction ratio (VRR) of the ablation area was a statistically significant difference between adjacent groups (P < 0.05). There was no significant difference between the indexes related to thyroid function before and after treatment(P > 0.05). No local recurrence or distant metastasis was found during follow-up; The most common complication after the operation was a slight pain in the neck. A few patients had toothache and neck swelling symptoms, and the above symptoms subsided within 24 h after the operation. CONCLUSION: Ultrasound-guided radiofrequency ablation is safe and effective for treating single-focus micropapillary thyroid carcinoma while retaining thyroid function, with few and minor complications, which can be used as an ideal surgical option.

Anion-Mediated In Situ Reconstruction of the Bi2MoO6 Precatalyst for Enhanced Electrochemical CO2 Reduction over a Wide Potential Window.

Electrochemical CO2 reduction reaction (eCO2RR) is a viable approach to achieve carbon neutrality. Bismuth-based electrocatalysts demonstrate exceptional selectivity in CO2-to-formate conversion, but their reconstruction mechanisms during the eCO2RR remain elusive. Herein, the reconstruction processes of bismuth molybdate (Bi2MoO6) nanoplates are elucidated during the eCO2RR. Operando and ex situ measurements reveal the in situ partial reduction of Bi2MoO6 to Bi metal, forming Bi@Bi2MoO6 at negative potentials. Meanwhile, CO32- ions in the electrolyte spontaneously exchange with MoO42- in Bi2MoO6. The obtained Bi@Bi2MoO6/Bi2O2CO3 delivers a formate Faradaic efficiency (FE) of 95.2% at -1.0 V. Notably, high formate FEs (>90%) are maintained within a wide 500 mV window. Although computational calculations indicate a higher energy barrier for *OCHO formation on Bi2O2CO3, the prevention of excessive reduction to metal Bi significantly enhances long-term stability. Furthermore, the CO32- ion exchange process occurs in various 2D Bi-containing precatalysts, which should be emphasized in further studies.

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports.

BACKGROUND AND AIMS: Though increasing studies reported the management of spontaneous isolated celiac artery dissection (ICAD), the characteristics and etiology of ICAD in different age-stage patients have not been well-studied. Our study was designed to describe and further to compare the clinical features of spontaneous ICAD between young and old patients. METHODS: We searched PubMed, Embase, and Web of Science up to March 1, 2023 for spontaneous ICAD case reports. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently. Statistical analysis was performed using SPSS software (version 19.0; IBM Corp, Armonk, NY) and Stata 12.0 (Stata Corp., College Station, TX). Descriptive results were presented as the mean ±â€…standard deviation or percent. The comparison results between young and old patients were displayed as risk ratio (RR) or standardized mean difference (SMD) with its 95% confidence intervals (CI). RESULTS: We totally identified 60 reports in the present analysis. The mean age of patients was 52.4 years, with the majority of patients being male (84.4%). The majority of patients were symptomatic and commonest presentation was abdominal pain (76.7%). Most patients (63.2%) had comorbidities or history and hypertension and smoking were the top 2 conditions with proportion of 63.3% and 40.5% respectively. When comparing young to old patients with ICAD, no significant difference was found in demographic and clinical features including sex, comorbidities/history, and symptoms. However, we found that young patients with ICAD experienced significantly longer dissection length (SMD 1.01, 95% CI 0.16-1.86; P = .015) and distance from ostium (SMD 0.96, 95% CI 0.07-1.85; P = .013), but no significant difference was observed in true lumen compression (SMD -0.39, 95% CI -1.22-0.44; P = .364). In addition, our results showed that ICAD in young patients extending more to distal arteries, including common hepatic artery/hepatic artery (RR 2.04, 95% CI 1.13-3.68; P = .01), splenic artery (RR 2.36, 95% CI 1.24-4.49; P = .017) and left gastric artery (RR 25.42; 95% CI 1.55-417.74; P = .04). CONCLUSIONS: Though spontaneous ICAD had multitudinous clinic-pathologic features, it was apt to middle-aged males and symptomatic and abdominal pain was always the commonest presentation. Hypertension and smoking were the top 2 conditions of ICAD patients. There was significant difference between young and old patients in radiographic characteristics of ICAD which may lead to different treatment and outcomes.

Changes in the airway microbiome in patients with bronchiectasis.

This study used metagenomic next-generation sequencing (mNGS) technology to explore the changes of the microbial characteristics in the lower respiratory tract in patients with acute exacerbations of bronchiectasis (noncystic fibrosis) to guide clinical treatment and improve patients' quality of life and prognosis. This prospective study included 54 patients with acute exacerbation and 46 clinically stable patients admitted to the Respiratory and Critical Care Medicine Center of the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to July 2022. Sputum was subjected to routine microbiological tests, and bronchoalveolar lavage fluid (BALF) samples were subjected to microbiological tests and mNGS of BALF before empirical antibiotic therapy. Serum inflammatory markers (white blood cell count, interleukin-6, procalcitonin, and C-reactive protein) were measured. In addition, we evaluated the pathogen of mNGS and compared the airway microbiome composition of patients with acute exacerbation and control patients. The mean age of our cohort was 56 ±â€…15.2 years. Eighty-nine patients had positive results by mNGS. There was a significant difference in the detection of viruses between the groups (χ2 = 6.954, P < .01). The fungal species Candida albicans, Pneumocystis jirovecii, and Aspergillus fumigatus were significantly more common in patients with acute exacerbations (χ2 = 5.98, P = .014). The bacterial species Acinetobacter baumannii, Mycobacterium tuberculosis, Haemophilus influenzae, Haemophilus parahaemolyticus, Abiotrophia defectiva, and Micromonas micros were significantly more prevalent in patients with acute exacerbations (χ2 = 4.065, P = .044). The most common bacterial species isolated from the sputum and BALF samples of patients with acute exacerbation was A. baumannii. Chlamydia psittaci was found in 4 patients. In addition, of 77 patients with negative sputum culture, 66 had positive results by mNGS, demonstrating the increased sensitivity and accuracy of mNGS. Patients with acute exacerbation of bronchiectasis tend to have mixed infections in the lower respiratory tract. The frequency of viruses, fungi, and Mycoplasma was higher in these patients. Our findings suggest that mNGS could be used to identify pathogenic microorganisms in these patients, increasing the effectiveness of antibiotic therapy.

Clinical Evaluation of Metagenomic Next-Generation Sequencing and Identification of Risk Factors in Patients with Severe Community-Acquired Pneumonia.

Purpose: Severe community-acquired pneumonia (SCAP) is the leading cause of death among patients with infectious diseases worldwide. This study aimed to evaluate the effectiveness of metagenomic next-generation sequencing (mNGS) through detecting pathogens in bronchoalveolar lavage fluid (BALF) and identifying risk factors for recovery in SCAP patients. Patients and Methods: This prospective study recruited 158 SCAP patients admitted to respiratory intensive care unit that were randomly divided into control and study groups, with receiving conventional tests and the same conventional tests plus mNGS, respectively. The diagnostic efficiency of mNGS was evaluated by comparing with conventional tests. Furthermore, univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for recovery in SCAP patients, and a nomogram prediction model was established based on these factors. Results: Within the study group, the pathogen detection rate was significantly higher with mNGS than that with conventional tests (84.81% vs 45.57%, P < 0.001), with a positive coincidence rate of 94.44%. Acinetobacter baumannii (21.52%, 17/79), Candida albicans (17.72%, 14/79), and Klebsiella pneumonia (15.19%, 12/79) were the top three common pathogens detected by mNGS. Of note, the improvement rate of patients in the study group was significantly higher than that in the control group. The further analysis revealed that the increased levels of interleukin-6, blood urea nitrogen, procalcitonin, the longer length of hospital stay, and bacterial infection were independent risk factors for recovery of SCAP patients, while mNGS detection status was a protective factor. The predictive model showed a good performance for the modeling and validation sets. Conclusion: Early mNGS exhibited a superior diagnostic efficiency to conventional tests in SCAP patients, which can reduce the risk of death in SCAP patients. Moreover, the clinical factors could also be used for the management and prognosis prediction of SCAP patients.

Electrospinning Evolution Derived from TRIZ Theory for Directly Writing Patterned Nanofibers.

Nanofibers (NFs) have the advantages of tremendous flexibility, small size and a high surface-to-weight ratio and are widely used in sensors, drug carriers and filters. Patterned NFs have expanded their application fields in tissue engineering and electronics. Electrospinning (ES) is widely used to prepare nonwoven NFs by stretching polymer solution jets with electric forces. However, patterned NFs cannot be easily fabricated using ordinary ES methods: the process gradually deteriorates them as repulsion effects between the deposited NFs and the incoming ones increase while residual charges in the fibers accumulate. Repulsion effects are unavoidable because charges in the polymer solution jets are the fundamental forces that are meant to stretch the jets into NFs. TRIZ theory is an effective innovation method for resolving conflicts and eliminating contradictions. Based on the material-field model and the contradiction matrix of TRIZ theory, we propose a strategy to improve ES devices, neutralizing the charges retained in NFs by alternating the current power of the correct frequency, thus successfully fabricating patterned NFs with clear boundaries and good continuity. This study demonstrates a strategy for resolving conflicts in innovation processes based on TRIZ theory and fabricating patterned NFs for potential applications in flexible electronics and wearable sensors.

Functional biochar fabricated from red mud and walnut shell for phosphorus wastewater treatment: Role of minerals.

A novel functional biochar (BC) was prepared from industrial waste red mud (RM) and low-cost walnut shell by one facile-step pyrolysis method to adsorb phosphorus (P) in wastewater. The preparation conditions for RM-BC were optimized using Response Surface Methodology. The adsorption characteristics of P were investigated in batch mode experiments, while a variety of techniques were used to characterize RM-BC composites. The impact of key minerals (hematite, quartz, and calcite) in RM on the P removal efficiency of the RM-BC composite was studied. The results showed that RM-BC composite produced at 320 °C for 58 min, with a 1:1 mass ratio of walnut shell and RM, had a maximum P sorption capacity of 15.48 mg g-1, which was more than double that of the raw BC. The removal of P from water was found to be facilitated significantly by hematite, which forms Fe-O-P bonds, undergoes surface precipitation, and exchanges ligands. This research provides evidence for the effectiveness of RM-BC in treating P in water, laying the foundation for future scaling-up trials.

A Rate-Dependent Cell Microinjection Model Based on Membrane Theory.

As an effective method to deliver external materials into biological cells, microinjection has been widely applied in the biomedical field. However, the knowledge of cell mechanical property is still inadequate, which greatly limits the efficiency and success rate of injection. Thus, a new rate-dependent mechanical model based on membrane theory is proposed for the first time. In this model, an analytical equilibrium equation between the injection force and cell deformation is established by considering the speed effect of microinjection. Different from the traditional membrane-theory-based model, the elastic coefficient of the constitutive material in the proposed model is modified as a function of the injection velocity and acceleration, effectively simulating the influence of speeds on the mechanical responses and providing a more generalized and practical model. Using this model, other mechanical responses at different speeds can be also accurately predicted, including the distribution of membrane tension and stress and the deformed shape. To verify the validity of the model, numerical simulations and experiments were carried out. The results show that the proposed model can match the real mechanical responses well at different injection speeds up to 2 mm/s. The model presented in this paper will be promising in the application of automatic batch cell microinjection with high efficiency.

Optimized protocol for double vaccine immunization against classical swine fever and porcine reproductive and respiratory syndrome.

BACKGROUND: Classical swine fever and porcine reproductive and respiratory syndrome have seriously affected the development of the swine breeding industry in China. Vaccine immunization remains the main way to prevent these infections. The aim of this study was to establish an optimized protocol for vaccine immunization against classical swine fever virus (CSFV) and porcine reproductive and respiratory syndrome virus (PRRSV). METHODS: Blood samples were collected from the anterior vena cava of pigs after immunization, and blood indices, secreted levels of specific antibodies and neutralizing antibodies associated with humoral immunity, the proliferation capacity of T lymphocytes as a measure of cellular immunity, and secreted levels of IFN-γ and TNF-α were determined. RESULTS: The results showed that simultaneous immunization against CSFV and PRRSV infections induced strong and specific humoral and T-cellular immune responses, high levels of cytokine IFN-γ secretion and delayed secretion of cytokine TNF-α. Moreover, significantly higher lymphocyte percentages and red blood cell and leukocyte counts were found in the group simultaneously immunized against CSFV and PRRSV. However, no statistically significant differences were observed in hemoglobin values, neutrophil counts, and median cell percentages among the S + PRRS, PRRS-S, and S-PRRS groups. CONCLUSION: This study demonstrated that simultaneous immunization against CSFV and PRRSV had the advantages of inducing a rapid, enhanced, and long-lasting immune response. These findings provide a theoretical basis for the establishment of a reasonable and optimized vaccine immunization protocol against CSFV and PRRSV in combination with a variety of other vaccine inoculations.

Three-Dimensional Printing Model Enhances Correct Identification and Understanding of Pelvic Fracture in Medical Students.

OBJECTIVE: Understanding the anatomy behind a pelvic fracture can be a significant challenge to medical students. Recent advances in three-dimensional printing technology offers a novel approach to facilitate the learning of complex fracture. We have described here how the 3-dimension printing (3Dp) models can help medical students improve their understanding in and identification of pelvic fractures. DESIGN: One hundred students were randomized into 2 teaching module groups (with or without 3Dp models). Prior to randomization assignment, a 50-minute didactic lecture covering elementary knowledge of anatomy, Young-Burgess classification, and traumatic mechanism of pelvic fracture was delivered to all students. The 3Dp group received X-rays, CT images, and 3Dp models of the eight pelvic fractures during presentation, while the students in the control group only obtained X-rays and CT scans of the same 8 pelvic fractures. Young-Burgess classification system and injury mechanism of pelvic fracture, time for evaluation, and subjective questions were conducted to assess the learning outcomes. SETTING: A medical student program based in a LevelⅠtrauma center PARTICIPANTS: One hundred students in their 4th year of a 5-year clinical medicine program (for a medical bachelor degree) RESULTS: Students receiving 3Dp model had a higher rate of identifying the correct pelvic fracture via Young-Burgess identification compared to these without 3Dp model. Moreover, the accuracy of identifying the injury mechanism was significantly higher in the 3Dp group than that in group without 3Dp model. Participant in 3Dp group had faster assessment time compared to the control group. Subjective survey results suggested that 3Dp model would increase the learning interest and enhance the understanding of pelvic fracture. In addition, majority of students (83%) reported that they would like to use 3Dp model in other surgical course education. CONCLUSIONS: 3Dp model increased the perceived accuracy of pelvic fracture identification and understanding of injury mechanism. Moreover, 3Dp model promoted the subjective interest and motivation of students in pelvic fracture learning. Therefore, 3Dp model can be considered as a valuable educational tool for learning pelvic fracture in medical students.

Modeling and control of cable-driven continuum robot used for minimally invasive surgery.

Continuum robot has great advantages in minimally invasive surgery (MIS) due to the slenderness and dexterity. But the friction and backlash result in the low trajectory tracking accuracy. This paper aims to study the transmission process of the driving force and the error compensation method. The statics is performed considering the frictional transmission process, and the variation of friction force with driving force is revealed by the model. The hysteresis effect of the tip trajectory is revealed. Then the relationship between the load history and the robot shape is studied, next, the deflection of the robot subject to the different loading forces can be predicted. The correctness of the mechanical model is verified by numerical simulation and experiments. Furthermore, the control methods according to the cable length and the driving force are compared respectively, and a method of error compensation according to the cable length is worked out considering the mechanical model. The rationality of the compensation method is validated by experiment. The results show that the compensation method based on cable length greatly improves the control accuracy, and the maximum deviation is 1.08 mm. The established model and compensation method create conditions for clinical application of the proposed continuum robot.

A lightweight hierarchical convolution network for brain tumor segmentation.

BACKGROUND: Brain tumor segmentation plays a significant role in clinical treatment and surgical planning. Recently, several deep convolutional networks have been proposed for brain tumor segmentation and have achieved impressive performance. However, most state-of-the-art models use 3D convolution networks, which require high computational costs. This makes it difficult to apply these models to medical equipment in the future. Additionally, due to the large diversity of the brain tumor and uncertain boundaries between sub-regions, some models cannot well-segment multiple tumors in the brain at the same time. RESULTS: In this paper, we proposed a lightweight hierarchical convolution network, called LHC-Net. Our network uses a multi-scale strategy which the common 3D convolution is replaced by the hierarchical convolution with residual-like connections. It improves the ability of multi-scale feature extraction and greatly reduces parameters and computation resources. On the BraTS2020 dataset, LHC-Net achieves the Dice scores of 76.38%, 90.01% and 83.32% for ET, WT and TC, respectively, which is better than that of 3D U-Net with 73.50%, 89.42% and 81.92%. Especially on the multi-tumor set, our model shows significant performance improvement. In addition, LHC-Net has 1.65M parameters and 35.58G FLOPs, which is two times fewer parameters and three times less computation compared with 3D U-Net. CONCLUSION: Our proposed method achieves automatic segmentation of tumor sub-regions from four-modal brain MRI images. LHC-Net achieves competitive segmentation performance with fewer parameters and less computation than the state-of-the-art models. It means that our model can be applied under limited medical computing resources. By using the multi-scale strategy on channels, LHC-Net can well-segment multiple tumors in the patient's brain. It has great potential for application to other multi-scale segmentation tasks.

Methane emission, methanogenic and methanotrophic communities during rice-growing seasons differ in diversified rice rotation systems.

Appropriate crop rotation in rice field is an important measure to maintain soil fertility and rice productivity. However, the effects of different rice rotation systems on methane (CH4) emission and the underlying mechanisms, as well as rice grain yields have not been well assessed. Here, a 2-year field study involving three rice rotation systems (Wh-PR: wheat-flooded rice rotation, Ra-PR: rapeseed-flooded rice rotation, Ra-UR: rapeseed-aerobic rice rotation) was conducted. CH4 emissions, methanogenic and methanotrophic communities and rice grain yields were measured during rice growing seasons to determine which rice rotation pattern can reduce CH4 emissions and improve rice grain yields. The average cumulative CH4 emission was 136.19 kg C ha-1 in Ra-PR system, which was significantly higher than that in Wh-PR and Ra-UR systems by 60.6 % and 14.6-fold, respectively. These results were mainly attributed to the low soil dissolved organic carbon in Wh-PR system and the well aerated soil condition in Ra-UR system, as compared with Ra-PR system. Rice grain yields exhibited no significant differences among the three rotation systems in 2019 and 2020. The abundances of methanogens in Ra-PR system were obviously higher than those in Wh-PR and Ra-UR systems. While the abundances of methanotrophs were comparable between Ra-PR and Wh-PR systems, which exhibited significantly lower abundances than that in Ra-UR system. CH4 fluxes showed markedly positive relations to the abundances of methanogens, while exhibited no relationship with the abundances of methanotrophs. Both methanogenic and methanotrophic community compositions differed considerably in Wh-PR and Ra-UR systems in comparison with Ra-PR system. Specifically, the relative low abundances of Methanothrix and Type I methanotrophs occurred in Wh-PR and Ra-UR systems, whereas Methanosarcina, Methanocella, Methanomassiliicoccus and type II methanotrophs (Methylocystis and Methylosinus) were found in higher relative abundances in Wh-PR and Ra-UR systems. Overall, changing the preceding upland crop types or introducing aerobic rice to substitute flooded rice in rice-based rotation systems could diminish CH4 emissions, mainly by regulating soil properties and eventually changing soil methanogenic and methanotrophic communities.

Clinical outcomes and functional analysis of third space robotic and endoscopic cooperative surgery versus laparoscopic wedge resection for gastric submucosal tumours: a propensity score-matched study.

Third space robotic and endoscopic cooperative surgery (TS-RECS) is a novel minimally invasive surgery for resecting gastric submucosal tumours (GSMTs), which could accomplish the completely oncological curability and maximal functional preservation. This study investigated the clinical outcomes and gastrointestinal function after TS-RECS versus laparoscopic wedge resection (LWR) for GSMTs. This was a single-centre retrospective study that included 130 patients with GSMTs who underwent LWR or TS-RECS from 2013 to 2019. To overcome selection biases, we performed propensity score matching (1:1) using seven covariates that could impact the group assignment and outcomes. Then, the clinical outcomes and gastrointestinal function in the LWR and TS-RECS groups were compared in a matched cohort. Among the 130 enrolled patients, 96 patients underwent LWR, and 34 underwent TS-RECS and were matched into 30 patients for each group. There was no significant difference in the operation time between the two groups (P = 0.543). However, the TS-RECS group had significantly less blood loss (20,5-100 vs 95,10-310 ml, P < 0.0001) and better postoperative recovery in terms of time to oral intake (2,2-4 vs 3,2-6 days, P < 0.0001) and postoperative hospital stay (5,4-10 vs 8.5,5-16 days, P < 0.0001) than the LWR group. The severity and frequency scores of postoperative gastrointestinal symptoms in the TS-RECS group were significantly lower than those in the LWR group. The median follow-up period was 24 months (10-60 months) in the LWR group and 18 months (10-27 months) in the TS-RECS group, and there was in total a single recurrence in the LWR group. TS-RECS appears to be a technically safe and effective surgery with preservation of gastrointestinal function for resection of GSMT resection.

Composite proportional-integral sliding mode control with feedforward control for cell puncture mechanism with piezoelectric actuation.

This paper presents a novel control strategy to compensate hysteretic nonlinearity and achieve precise positioning control of a cell puncture mechanism driven by a piezoelectric actuator (PEA). A dynamic model of the cell puncture mechanism is developed based on the Bouc-Wen model. Parameters of the nonlinear model are identified by particle swarm optimization. The strategy of feedforward (FF) control and sliding mode feedback (FB) control based on the Bouc-Wen inverse model is further developed to position the cell puncture mechanism. Zebrafish embryo is used as the validation object, wherein a cell micropuncture experiment is successfully performed. Proportional-integral sliding mode FB control plus FF control has a simple structure and exhibits excellent performance. Thus, this method can be easily extended to other micro-or nanopositioning mechanisms based on PEAs and adopted in practical applications.

Pentahydroxy flavonoid isolated from Madhuca indica ameliorated adjuvant-induced arthritis via modulation of inflammatory pathways.

Rheumatoid arthritis (RA) is an autoimmune disease associated with advanced joint dysfunction. Madhuca indica J. F. Gmel, from the family Sapotaceae, is an Indian medicinal plant reported to have an array of pharmacological properties. The aim of present investigation was to determine the anti-arthritic potential of an isolated phytoconstituent from methanolic leaf extract of Madhuca indica (MI-ALC) against FCA-induced experimental arthritis. Polyarthritis was induced in female rats (strain: Wistar) via an intradermal injection of FCA (0.1 mL) into the tail. Polyarthritis developed after 32 days of FCA administration. Then rats were treated orally with an isolated phytoconstituent from MI-ALC at doses of 5, 10, and 20 mg/kg. Findings suggested that High-Performance Thin-Layer Chromatography, Fourier-Transform Infrared Spectroscopy, and Liquid Chromatography-Mass Spectrometry spectral analyses of the phytoconstituent isolated from MI-ALC confirmed the structure as 3,5,7,3',4'-Pentahydroxy flavone (i.e., QTN). Treatment with QTN (10 and 20 mg/kg) showed significant (p < 0.05) inhibition of increased joint diameter, paw volume, paw withdrawal threshold, and latency. The elevated synovial oxidative stress (Superoxide dismutase, reduced glutathione, and malondialdehyde) and protein levels of Tumor necrosis factor-α (TNF-α) and Interleukin (ILs) were markedly (p < 0.05) reduced by QTN. It also effectively (p < 0.05) ameliorated cyclooxygenase-2 (COX-2), Nuclear factor of kappa light polypeptide gene enhancer in B cells (NF-kß) and its inhibitor-α (Ikßα), and ATP-activated P2 purinergic receptors (P2X7) protein expressions as determined by western blot analysis. In conclusion, QTN ameliorates FCA-induced hyperalgesia through modulation of elevated inflammatory release (NF-kß, Ikßα, P2X7, and COX-2), oxido-nitrosative stress, and pro-inflammatory cytokines (ILs and TNF-α) in experimental rats.