Treatment of lacrimal gland adenoid cystic carcinoma: a systematic review and Meta-analysis.

AIM: To evaluate lacrimal gland adenoid cystic carcinoma (LGACC) of prognosis in patients who underwent different treatment regimens. METHODS: We searched PubMed, EMBASE, and the Cochrane Library for studies done on the treatment of LGACC, between January 1987 and April 2022. A Meta-analysis was conducted to pool the 5-year overall survival rate (OR), and the 5-year recurrence rate (RR) and 5-year metastasis rate (MR) were assessed. RESULTS: The 30 studies involved 585 patients were included in the Meta-analysis. The pooled 5-year OR with surgery alone was 50%, the 5-year RR was 63%, and the 5-year MR was 34%. The pooled 5-year OR with surgery and adjuvant radiotherapy combined was 67% (95%CI 61%,73%), the 5-year RR was 41%, and the 5-year MR was 35%. The pooled 5-year OR with surgery and adjuvant chemoradiotherapy combined was 72% (95%CI 59%, 84%), the 5-year RR was 48%, and the 5-year MR was 36%. The pooled 5-year OR with surgery, intra-arterial cytoreductive chemotherapy, and adjuvant chemoradiotherapy combined was 78% (95%CI 68%, 89%), the 5-year RR was 15%, and the 5-year MR was 27%. CONCLUSION: Comprehensive treatment is more effective than surgery alone. Surgery combined with intra-arterial chemotherapy and adjuvant chemoradiotherapy seems to add value to the therapeutic effect of comprehensive treatment of LGACC but further high-quality research is required to validate this.

The poor prognosis of lacrimal gland adenocarcinoma: a clinical study and literature review.

PURPOSE: The incidence of lacrimal gland adenocarcinoma is low. This study was designed to analyze the clinical and prognostic characteristics of lacrimal gland adenocarcinoma. METHODS: This was a clinical study and literature review; 25 patients diagnosed with lacrimal gland adenocarcinoma by histopathology were enrolled and their medical history data were collected. RESULTS: The incidence of bone destruction and surrounding tissue invasion was 52% and 44%, respectively. The incidence of distant metastasis of lacrimal gland adenocarcinoma was about 50%. The 5-year overall survival rate of death or metastasis was 33.5%. Age, sex, laterality, tumor size, pathology type, bone destruction, nerve or perineural invasion, invasion of peripheral tissue, T stage, AR, Her-2 and treatment had no significant correlation with lacrimal adenocarcinoma's prognosis (P > 0.05), while the higher expression of Ki-67 may have higher risk of death or metastasis (P = 0.020). CONCLUSION: The incidence of bone destruction and distant metastasis of lacrimal adenocarcinoma is high and the imaging examination is necessary to assess the risk of distant metastasis. The 5-year survival rate of death or metastasis is 33.5% and the high expression of Ki-67 predicts poor prognosis of lacrimal adenocarcinoma.

Effects of different factors on the friction and wear mechanical properties of titanium alloy materials with cortical bones at near service conditions.

The artificial joint is one of the most effective methods to treat joint injuries. The service performance of artificial joints is gradually weakened because of the wear of artificial joints in actual service. In order to obtain the potential failure mechanism of the artificial joint in actual service, the study was carried out with the multiple factors that affect the service performance of the artificial joint. The experimental study was carried out on the change rule of mechanical behavior of the contact interface between the artificial joint of titanium alloy and cortical bone. The multi-factor is compression load, contact load, friction velocity, and lubrication environment, respectively. The results indicate that the friction coefficient, wear mass, and wear coefficient of Ti-6A1-4V titanium alloy decreased with the increasing of the compression load. The friction rate and the friction coefficient of Ti-6A1-4V titanium alloy decreased with the increasing of the contact load. The wear mass and friction coefficient of Ti-6A1-4V titanium alloy increased with the increasing of contact load. The lubrication effect is better with the increasing of lubricant concentration. Based on the observation of the SEM, the wear type influenced by compression load and friction rate is mainly abrasive wear and oxidation wear. The wear type influenced by contact load is mainly abrasive wear and adhesive wear. The wear type influenced by lubricants is mainly oxidation wear. When wear mass and wear coefficient are used as the criteria for evaluating friction and wear, the order of influential factors to friction and wear of Ti-6Al-4V titanium alloy plate is friction rate, compression load, contact load, and lubricant concentration. This research can provide a theoretical reference for the optimal manufacture of the artificial joint of titanium alloy and optimal rules of safe service conditions.

Automatic retinoblastoma screening and surveillance using deep learning.

BACKGROUND: Retinoblastoma is the most common intraocular malignancy in childhood. With the advanced management strategy, the globe salvage and overall survival have significantly improved, which proposes subsequent challenges regarding long-term surveillance and offspring screening. This study aimed to apply a deep learning algorithm to reduce the burden of follow-up and offspring screening. METHODS: This cohort study includes retinoblastoma patients who visited Beijing Tongren Hospital from March 2018 to January 2022 for deep learning algorism development. Clinical-suspected and treated retinoblastoma patients from February 2022 to June 2022 were prospectively collected for prospective validation. Images from the posterior pole and peripheral retina were collected, and reference standards were made according to the consensus of the multidisciplinary management team. A deep learning algorithm was trained to identify "normal fundus", "stable retinoblastoma" in which specific treatment is not required, and "active retinoblastoma" in which specific treatment is required. The performance of each classifier included sensitivity, specificity, accuracy, and cost-utility. RESULTS: A total of 36,623 images were included for developing the Deep Learning Assistant for Retinoblastoma Monitoring (DLA-RB) algorithm. In internal fivefold cross-validation, DLA-RB achieved an area under curve (AUC) of 0.998 (95% confidence interval [CI] 0.986-1.000) in distinguishing normal fundus and active retinoblastoma, and 0.940 (95% CI 0.851-0.996) in distinguishing stable and active retinoblastoma. From February 2022 to June 2022, 139 eyes of 103 patients were prospectively collected. In identifying active retinoblastoma tumours from all clinical-suspected patients and active retinoblastoma from all treated retinoblastoma patients, the AUC of DLA-RB reached 0.991 (95% CI 0.970-1.000), and 0.962 (95% CI 0.915-1.000), respectively. The combination between ophthalmologists and DLA-RB significantly improved the accuracy of competent ophthalmologists and residents regarding both binary tasks. Cost-utility analysis revealed DLA-RB-based diagnosis mode is cost-effective in both retinoblastoma diagnosis and active retinoblastoma identification. CONCLUSIONS: DLA-RB achieved high accuracy and sensitivity in identifying active retinoblastoma from the normal and stable retinoblastoma fundus. It can be used to surveil the activity of retinoblastoma during follow-up and screen high-risk offspring. Compared with referral procedures to ophthalmologic centres, DLA-RB-based screening and surveillance is cost-effective and can be incorporated within telemedicine programs. CLINICAL TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov (NCT05308043).

Effect of seat tilting on biomechanics of L4 in tractor drivers.

The tilting of the tractors' seat during deep tillage operations affects the drivers' sitting position, which can lead to lumbar spine injuries. To investigate the effect of seat tilting on the driver's L4 biomechanics, we built a tractor-driver musculoskeletal model in AnyBody™. The maximum activity of the driver's erector spinae at different tilted angles were measured by sEMG and compared with the simulation results to validate the model. The spatial position of the driver's spine at different tilted angles were obtained by 3 D motion capture. The model simulated the driver's spine posture during the actual tilt and investigated the effects of different tilted angles and vibration on the biomechanics of the driver's L4 . The results showed that as the tilt angle of the tractor increased, the load on the driver's L4 also increased, especially the shear force increased at a faster rate than the axial and normal forces, with the shear force on the driver's L4 increasing from 0 N to 138.7 N when the tractor was tilted from 0° to 15°. When vibration was applied to the musculoskeletal model, the maximum value of the shear force on the driver became progressively greater as the angle of tilt of the tractor increased. Overall, tilting the tractor can have a large impact on the biomechanics of the driver's L4, and tilting the tractor may be an important cause of lumbar spine injuries for tractor drivers.

Study of tractor side tilt operation on intervertebral disc injury between L4 and L5 in drivers.

The tilting of the cab seat when the tractor is in deep ploughing operation changes the sitting position of the driver, which may accelerate lumbar spine injury. This paper adopts the musculoskeletal model and the finite element model of the lumbar L4-L5 segment to predict the maximum Von-Mises stress and maximum strain of the driver's lumbar L4-L5 segment intervertebral disc. In this study, we used 3D motion capture to obtain the driver's spine position spatial data when the tractor tilted at different angles. A tractor-driver musculoskeletal model and a finite element model of the lumbar spine L4-L5 segments were created in AnyBody™ and Abaqus, respectively. The tractor-driver musculoskeletal model was used to calculate the load of the driver's lumbar spine L4-L5 segment at different angles of tractor tilt, which was used as the load condition of the finite element model of the lumbar spine L4-L5 segment, and then the influence of tractor tilt angle and vibration on the driver's lumbar spine L4-L5 disc was studied. The results show that the maximum Von-Mises stress and maximum strain of the driver's lumbar L4-L5 intervertebral disc will increase due to the tilt. The maximum Von-Mises stress occurs in the annulus II, and the maximum strain occurs in the upper end plate of the intervertebral disc. With the occurrence of tilt, the position of the maximum Von-Mises stress changes, which can lead to disc injury to the driver, and vibration may exacerbate this injury.

Long-term efficacy of enucleation combined with primary orbital implantation in children with retinoblastoma histopathological invasion of optic nerve.

Objective: This study aimed to observe the long-term effect of enucleation combined with primary orbital implantation in children with histopathologic optic nerve invasive retinoblastoma (RB). Methods: We retrospectively analyzed the clinical data and outcomes of children with RB optic nerve invasion confirmed by histopathology who underwent enucleation combined with primary orbital implantation between March 2010 and April 2014 in Beijing Tongren Hospital. The follow-up time ranged from 81 to 129 months, with a mean follow-up of 96 ± 14 months. Results: A total of 59 children were included in this study. There were 32 males and 27 females; 52 children were affected in one eye and seven children in both eyes. The time from onset of symptoms to visit was between 3 days and 16 months, with a mean of 2.2 ± 2.8 months. The age at the of surgery was between 2 and 65 months, with an average of 24 ± 13 months. Patients were classified based on the degree of optic nerve invasion into four grades: grade 1 (invasion of prelaminar) in 28 cases, grade 2 (invasion of laminar) in 14 cases, grade 3 (invasion of retrolaminar but not reaching the optic nerve transection) in 16 cases, and grade 4 (invasion of the optic nerve transection) in 1 case. Post-operatively, all children were treated with 0-9 cycles of intravenous chemotherapy based on histopathology results from the removed eye. Of the 59 children, 13 had postoperative complications, and one died from recurrence. The survival rate was 98% (58/59). There was one case of orbital implant exposure, one of orbital cellulitis, six of enophthalmos and superior sulcus deformity, two of blepharoptosis, one of granuloma complicated with blepharoptosis, and one with a subconjunctival cyst. Conclusion: For children with RB histopathologic invasion of the optic nerve, enucleation combined with primary orbital implantation reveals future potential treatment options when combined with a full course of intravenous chemotherapy.

Mechanical response and in-situ deformation mechanism of cortical bone materials under combined compression and torsion loads.

Bone fracture is an extremely dangerous health risk to human. Actually, cortical bone is often subjected to the complicated loading patterns. The mechanical properties and deformation mechanism under the complicated loading pattern could provide a more precise understanding for the bone fracture. For this purpose, the mechanical response and multi-scale deformation mechanism of cortical bone material were investigated by in-situ experimental research using the compression-torsion coupling loads as an example. It was found that the torsion strength and shear modulus all decreased under the compression-torsion coupling loads than single torsion load. This indicated bone would suffer greater risk of fracture under the compression-torsion coupling loads. Based on in-situ observation, it was found that the rapid reduction of the anisotropy of bone material under the compression load was the potential influencing factor. Because of the redistribution of the principal strain and the variations of cracks propagation, the comprehensive fracture pattern containing both transverse and longitudinal fracture was shown under the coupling loads, and finally resulted in the reduction of the torsion properties. This research could provide new references for researches on mechanical properties of cortical bone material under complicated loading patterns.

Family Socioeconomic Status and Chinese Adolescents' Academic Achievement in the Arts: The Mediating Role of Family Arts Resources and the Moderating Role of Family Arts Atmosphere.

In the present study, we examined the association between family socioeconomic status (SES) and adolescents' academic achievement in the arts and the mediating and moderating roles of family process factors, verified family investment model. Chinese adolescents (N = 8,723) in Grade 8 reported characteristics of family SES, family arts resources, and family arts atmosphere, and then completed a standardized test assessing academic achievement in music and visual art. The results showed that family SES significantly predicted adolescents' level of academic achievement in the arts after controlling for adolescents' gender and school location. The effect of family SES on adolescents' academic achievement in the arts was partly mediated by family arts resources, constituting 20.51% of the total predicted effect. In addition, family arts atmosphere moderated the association between family SES and adolescents' achievement in the arts. Specifically, family SES had a stronger relationship with academic achievement in the arts for adolescent with higher family arts atmosphere than for adolescent with poor family arts atmosphere. Findings in this study expands the field of influence of the family environments and enhance an understanding of the influence mechanisms of family environments on arts learning.

Material and relational asymmetry: The role of receivers' wealth and power status in children's resource allocation.

Asymmetries in social status, specifically social status related to wealth and relational power, appear to influence the ways in which children allocate resources. However, the impact of wealth and relational power status on children's resource allocation decisions has yet to be examined among children developing within a Chinese cultural context. In addition, how children weight the relative importance of these factors when they exist concurrently is not well understood. In Study 1, we examined the impact of recipients' wealth and relational power status on Chinese children's (3- to 8-year-olds; N = 199) allocation decisions. We found that across both categories of social status, 3- and 4-year-olds gave more to high-status individuals, whereas 7- and 8-year-olds gave more to low-status individuals, despite younger children also showing a strong egalitarian preference when the resources could be allocated equally. In Study 2, we investigated how children (3- to 8-year-olds; N = 219) weigh the relative importance of these two types of social status in situations where the level of recipients' wealth and relational power were either consistent or in conflict. When they needed to allocate the resources unequally, the youngest children were found to place greater emphasis on wealth over relational power and favored the high-status individual, whereas older children tended to favor the low-status individual and placed greater importance on relational power over wealth. Overall, we found a consistent age-related shift from favoring high-status individuals toward compensating low-status individuals, suggesting a developing concern for social equity.

Positive influence of peers' interpersonal character on children's interpersonal character: The moderating role of children's and peers' social status.

INTRODUCTION: Peers are an important source of influence on children's social development. This study investigated the positive association between peers' and children's interpersonal character (i.e., humanity and justice) and the moderating role of children's and peers' social status including wealth (family SES), power (class leadership), and prestige (social preference and social visibility). METHODS: The participants were 1555 fourth-to ninth-graders (Mage = 12.76; 46.9% boys) and their reciprocal playmates in China. Questionnaires and peer nomination methods were used to measure interpersonal character and social status. Children's reciprocal playmates were used as the source of peer influence. RESULTS: The playmates' humanity and justice were positively associated with the children's humanity and justice regardless of the child's grade, gender, or sibling status. Children's level of social visibility moderated the associations between the playmates' and the children's humanity and justice, with children of low social visibility being more strongly influenced by their playmates. The moderating role of playmates' social status was displayed in two modes and appeared in the secondary school and singleton samples. First, playmates with a higher social preference were more closely related to secondary school children's justice; second, playmates with lower social visibility were more closely related to secondary school children's and singletons' justice. CONCLUSIONS: The findings confirm the positive relationships between peers' and children's interpersonal character and reveal an important moderating role of prestige status, especially social visibility, among the relationships. This study extends the research on positive peer influence and contributes to knowledge of peer influence mechanisms.

Group bias in children's merit-based resource allocation.

From early in life, children show sensitivity to both merit and group membership. However, little research has examined how children react to the conflicting demands of allocating meritoriously and favoring in-groups during resource allocation over the course of their development. We compared how children aged 3-5 years and children aged 6-8 years allocated and reasoned about allocations to in-group and out-group members in a merit-based context. In Study 1, in four distribution tasks, children needed to allocate resources to high- and low-merit persons who were either in-group or out-group members and then indicate the reasons for their decisions. In Study 2, we chose the condition where the conflict between merit and group bias was strongest and further tested the effect of merit and group bias. We found that children prioritized merit across conditions, whereas in a context where the conflict was sufficiently intense they also took group membership into consideration. In addition, with age, children incorporated the conflicting demands of merit and group bias during resource allocation. The findings suggest that, with age, children weighed the moral concerns of merit and the social concerns of group bias when determining the allocation of resources.

Intergenerational transmission of interpersonal strengths: The role of parent gender, family processes, and child characteristics.

Interpersonal strengths are important positive traits of human beings. This study investigated the phenomenon and mechanisms of the intergenerational transmission of interpersonal strengths. A total of 992 fourth-to ninth-grade children (48.1% boys, Mage = 12.63) and both mothers and fathers in China were involved in the present study. The results showed that fathers' (but not mothers') interpersonal strengths were directly associated with children's interpersonal strengths. Different transmission mechanisms of mothers and fathers were found: mother-child relationships and fathers' parenting styles explained the association between parents' and children's interpersonal strengths and between marital relationships and children's interpersonal strengths. Consistent transmission effects and mechanisms were found across child grade, gender, and sibling status. The findings of the current study provide evidence of intergenerational correlations for both parents regarding interpersonal strengths. Parents (especially fathers) with interpersonal strengths can raise children with corresponding strengths through particular family processes regardless of child characteristics.

[Repair of bedsore over greater trochanter in paraplegic patients with rectus femoris island myocutaneous flap].

OBJECTIVE: To observe the effect of rectus femoris island myocutaneous flap for repairing bedsores in III and IV phases at the femoral greater trochanter area as a result of paraplegia. METHODS: Thirteen paraplegic patients who suffered bedsores in III and IV phases at the greater trochanter of femur area were hospitalized from July 2009 to June 2013. The bedsores ranged from 4.5 cm×4.0 cm to 10.0 cm× 9.0 cm in area. After debridement, the size of soft tissue defect ranged from 5.0 cm×4.5 cm to 10.5 cm×10.0 cm. Rectus femoris island myocutaneous flaps were used to repair these defects, with flap area ranging from 5.0 cm×5.0 cm to 11.0 cm×10.0 cm and muscular pedicle length ranging from 8 to 12 cm. The donor sites of muscular pedicle were closed by direct suture, while those resulted from forming myocutaneous flap were closed by the transplantation of autologous skin obtained from thigh. RESULTS: Necrosis appeared at the edge of myocutaneous flap in one patient, and it was healed after dressing change. The other 12 myocutaneous flaps survived well. Patients were followed up for 2 to 30 months, and bedsore did not recur. CONCLUSIONS: Rectus femoris island myocutaneous flap, with characteristics of reasonable design, large donor area, big rotation angle, and with wear-, tear-, and pressure-resistance, is suitable for repairing bedsores at III and IV phases at the greater trochanter of femur area in paraplegic patients.

[Technology of advanced glycation endproducts fluorescence measurement and precorrection].

The necessity to measure advanced glycation endproducts (AGE) was analyzed in the present paper, and the apparatus for measuring skin autofluorescence was also designed making use of the special excitation spectrum and emission spectrum. A portion of tissue at the volar side of the arm of individuals (11 diabetes and 19 control subjects) was illuminated with excitation light, i.e., monochromatic light around 370 nm, and the emission spectrum was detected on the skin of control subjects and diabetic patients respectively. All measurements were performed at room temperature in a semi-dark environment. It can be seen that different sites of an individual could lead to different results, and the color can also affect the results. The technology of fluorescence precorrection was applied in order to get rid of the influence of noise, different site of skin, the color of skin etc. The result indicates that the technology of precorrection is of avail and the repetitiveness is well.

[Design of advanced glycation endproducts fluorescence spectrum detecting system].

The method of making use of the technique of fluorescence spectrum to detect advanced glycation endproducts is discussed in the present pape. The emphasis is on the principle and structure of the fluorescence spectrum detecting system. In the end, the authors made use of the system to detect the excitation spectrum at the wavelengths of 365nm, 370nm, 375nm, 380nm and 385nm, respectively, and the authors found that 375nm is the best excitation wavelength. At the same time, the emission spectrum was also detected on the skin of nondiabetic people and patients with diabetes respectively. The result of the experiment indicates that there is a difference distinctly at about 450nm between them, and has proved the feasibility of the system. The detecting system does not need collecting blood sample, is a noninvasive detection technology, and avoids pain and infection to the patients. The process of detection is very rapid and convenient, and the repetitiveness is well. The patient can benefit from it to forecast and diagnose the state of illness such as diabetes, decrepitude and oxidative stress etc conveniently.