Intelligent robot-assisted fracture reduction system for the treatment of unstable pelvic fractures.

BACKGROUND: Precise and minimally invasive closed reduction is the premise of minimally invasive internal fixation. This paper aims to explore the safety and efficacy of a robot-assisted fracture reduction system (RAFR) in the treatment of pelvic fractures and to analyze its clinical advantages and existing problems. METHODS: The RAFR system intelligently designed the optimal reduction path and target position based on a preoperative three-dimensional(3D) CT scan of the patient. The reduction robotic arm automatically reduced the affected hemipelvis according to the pre-planned reduction path. RESULTS: The average residual displacement was the 6.65 ± 3.59 mm. According to Matta's criteria, there were 7 excellent, 10 good, and 3 fair, and the excellent and good rate was 85%. No postoperative complications occurred. CONCLUSION: In our study, the RAFR system could complete accurate and minimally invasive closed reduction for most patients with unstable pelvic fractures, which could achieve good fracture reduction quality and short-term efficacy.

Ecological risk assessment and identification of the distinct microbial groups in heavy metal-polluted river sediments.

To assess the health of river ecosystems, it is essential to quantify the ecological risk of heavy metals in river sediments and the structure of microbial communities. As important tributaries of the Tuo River in the upper reaches of the Yangtze River, the Mianyuan River and the Shiting River, are closely related to the economic development and human daily life in the region. This study assessed the ecological risks of heavy-metal-polluted river sediments, the heavy-metal-driven bacterial communities were revealed, and the relationships between the ecological risks and the identical bacterial communities were discussed. The Cd content was significantly greater than the environmental background value, leading to a serious pollution and very high ecological risk at the confluence of the two rivers and the upper reaches of the Mianyuan River. Microbial community analysis showed that Rhodobacter, Nocardioides, Sphingomonas, and Pseudarthrobacter were the dominant bacterial genera in the sediments of the Shiting River. However, the dominant bacterial genera in the Mianyuan River were Kouleothrix, Dechloromonas, Gaiella, Pedomicrobium, and Hyphomicrobium. Mantel test results showed (r = 0.5977, P = 0.005) that the Cd, As, Zn, Pb, Cr, and Cu were important factors that influenced differences in the distribution of sediment bacterial communities Mianyuan and Shiting rivers. A correlation heatmap showed that heavy metals were negatively correlated for most bacterial communities, but some bacterial communities were tolerant and showed a positive correlation. Overall, the microbial structure of the river sediments showed a diverse spatial distribution due to the influence of heavy metals. The results will improve the understanding of rivers contaminated by heavy metals and provide theoretical support for conservation and in situ ecological restoration of river ecosystems.

Combination of the BISAP Score and miR-155 is Applied in Predicting the Severity of Acute Pancreatitis.

Purpose: To evaluate the predictive value of combination of Bedside Index for Severity in AP (BISAP) score and miR-155 for the severity of acute pancreatitis (AP). Patients and Methods: A total of 1046 AP patients were divided into control group and case group according to the severity of AP [mild and moderately severe AP vs severe AP (SAP)]. Demographic data, comorbidities, clinical characteristics and laboratory data were collected. Multivariate analysis was conducted for the variables with two-sided P<0.10 in univariate analysis to identify independent associated factors for progression to SAP in AP patients. The predictive values were evaluated using receiver operating characteristic (ROC) curve, and the area under curve (AUC) was compared using Z test. Results: A total of 117 (11.2%) patients were evaluated as SAP. Univariate analysis showed that there were significant differences in age, hypertension, ICU admission, hospital stay, Leukocytes, CRP, BUN, BISAP score and miR-155 between case group and control group (P<0.05), and the P value of Fibrinogen was <0.10. Multivariate analysis showed that the BISAP score, BUN, Leukocytes, age and CRP were independent risk factors for progression to SAP among AP patients after adjusting for hypertension, ICU admission, hospital stay and Fibrinogen, while miR-155 was a protective factor. The ROC curves demonstrated the AUCs of BISAP score, miR-155 and their combination were 0.842 (SE: 0.017, 95% CI: 0.809-0.874), 0.751 (SE: 0.022, 95% CI: 0.708-0.793) and 0.945 (SE: 0.007, 95% CI: 0.931-0.959), respectively. Z test showed that the AUC of combination prediction was significantly higher than that of individual predictions (0.945 vs 0.842, Z=5.602, P<0.001; 0.945 vs 0.751, Z=8.403, P<0.001). The sensitivity, specificity and negative predictive value (NPV) of combination prediction were 95.7%, 93.6% and 99.4%, respectively. Conclusion: The combination of the BISAP score and miR-155 should be utilized to elevate the predictive value for the severity of AP in clinic.

Prediction of prognosis in sepsis patients by the SOFA score combined with miR-150.

BACKGROUND: The sequential organ failure assessment (SOFA) score, designed to evaluate sepsis-associated organ dysfunction in intensive care unit (ICU) patients, is associated with the prognosis of sepsis patients. MicroRNA-150 (miR-150) is one of the first miRs to be detected in patients with sepsis and other critical illnesses, and to have an association with the prognosis of critical illness and sepsis. OBJECTIVES: To assess the predictive value of the combination of the SOFA score and miR-150 levels for the prognosis of sepsis patients. MATERIAL AND METHODS: We retrospectively included 437 adult patients with sepsis who were divided into a death group (n = 138, 31.6%) and a survival group (n = 299, 68.4%), according to their survival status at the 28-day follow-up. Binary logistic regression was performed to identify independent associations. Receiver operator characteristic (ROC) curve was employed to assess the predictive values. The Z-test was used to compare the area under curve (AUC). RESULTS: Multivariate analysis demonstrated that miR-150 (odds ratio (OR): 0.549, 95% confidence interval (95% CI) [0.372, 0.826], p < 0.001), the SOFA score (OR: 1.216, 95% CI [1.039, 1.807], p = 0.008), age, procalcitonin (PCT), and septic shock were independently associated with 28-day mortality of sepsis patients following the adjustment for chronic renal failure, hypertension, diabetes mellitus, activated partial thromboplastin time (APTT), serum creatinine (SCr), blood urea nitrogen (BUN), and total bilirubin (TBil). The AUC of miR-150, the SOFA score and their combination in predicting the 28-day mortality of sepsis patients was 0.762 (standard error (SE): 0.023, 95% CI [0.717, 0.808]), 0.735 (SE: 0.025, 95% CI [0.687, 0.784]) and 0.886 (SE: 0.015, 95% CI [0.857, 0.916]), respectively. The AUC of their combined prediction was significantly greater than the independent prediction (0.886 compared to 0.762, Z = 4.516, p < 0.001; 0.886 compared to 0.735, Z = 5.179, p < 0.001). The sensitivity and specificity of combination prediction were 86.2% and 80.6%, respectively. CONCLUSIONS: The combination of the SOFA score and miR-150 could improve the prediction of prognosis in sepsis patients.

Structure and Performance Analysis of Signal Acquisition and Doppler Tracking in LEO Augmented GNSS Receiver.

Due to the low signal power, the Global Navigation Satellite System (GNSS) signal is vulnerable to interference and even cannot be captured or tracked in harsh environments. As an alternative, the Low Earth Orbit (LEO) satellite has been widely used in the navigation field due to the advantages of low cost and strong signals. It is becoming a significant component of the new combined navigation system with GNSS. The combination of an LEO Doppler signal and GNSS observables can improve the positioning accuracy and high-precision positioning convergence time of the GNSS receiver. However, the GNSS signal receiving capability cannot be improved from this data fusion level. We propose a novel assisted structure where GNSS signal acquisition and Doppler tracking are assisted by LEO Doppler positioning. The receiver uses the LEO signal to achieve Doppler positioning firstly. Then, the coarse position with the GNSS navigation messages received from LEO, as well as the estimated clock information, is used to assist in the acquisition and tracking of GNSS. In this way, the GNSS receiver's sensitivity can get the benefit from this integrated system. The paper presents the structure of the assisted receiver and analyzes the assisted GNSS signal acquisition and carrier tracking performance in detail. Simulation experiments of this assisted structure are carried out to verify its superiority of acquisition and tracking sensitivity in comparison with standalone GNSS receivers. Theoretical analysis and experimental results show that the proposed acquisition method can achieve 90% detection probability at a carrier-to-noise ratio (C/N0) of 15 dB-Hz, which is about 8 dB higher than the conventional acquisition method without assistance; the proposed tracking method can track weak signals of 5 dB-Hz, which is about 4 dB higher than the conventional method. Therefore, this novel LEO-assisted receiver has significantly improved weak signal acquisition and tracking sensitivity.

Value of Combination of the A2DS2 Score and IL-6 in Predicting Stroke-Associated Pneumonia.

PURPOSE: To evaluate the value of the combination of the age, atrial fibrillation, dysphagia, male sex, and National Institutes of Health Stroke Scale (A2DS2) score and serum interleukin 6 (IL-6) concentration in predicting stroke-associated pneumonia (SAP). PATIENTS AND METHODS: A total of 398 patients with acute ischemic stroke (AIS) from the medical ward was included in this retrospective study. They were divided into the SAP group and non-SAP group according to the diagnostic criteria of SAP. Multivariate analysis was performed to analyze the association between the A2DS2 score, serum IL-6 concentration, and SAP using a backward stepwise logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the value of the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 in predicting SAP. RESULTS: SAP was diagnosed in 70 patients (17.6%). Multivariate analysis showed that the A2DS2 score (odds ratio [OR]: 2.25, 95% confidence interval [CI]: 1.17-4.99, P=0.017) and serum IL-6 concentration (OR: 1.76, 95% CI: 1.44-1.95, P<0.001) was independently associated with SAP after adjusting for age, smoking, hypertension, hyperlipidemia, and atrial fibrillation. When the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 were employed to predict SAP, the AUC was 0.824 (SE: 0.026, 95% CI: 0.773-0.875), 0.715 (SE: 0.034, 95% CI: 0.641-0.788) and 0.917 (SE: 0.015, 95% CI: 0.887-0.946), respectively. The AUC of combinative prediction was significantly higher than independent prediction (0.917 vs. 0.824, Z=3.098, P<0.001; 0.917 vs. 0.715, Z=5.436, P<0.001). CONCLUSION: The addition of serum IL-6 to the A2DS2 score could significantly enhance the AUC of predicting SAP in AIS patients from the medical ward.

[Expression of AP-1 and TGF-beta1 in kidney of iodine deficient rats and its significance].

AIM: To observe the variation in expression of AP-1 and TGF-beta1 in rat kidney of iodine deficiency, to explore the nosogenesis of renal damage in the region of iodine deficiency. METHODS: The models of deficient iodine rats were established by treatment with low iodine diet, wistar rats were divided into gentle low iodine group(GLIG), dense low iodine group(DLIG) and control group(CL). Serum levels of thyroid humone were determined by chemiluminescent immunoassay. To observe the gene expression of c-Jun by using RT-PCR, observe the expression of TGF-beta1 by using immunohistochemistry. RESULTS: Compared with CL, the FT3, FT4 of DLIG were significantly decreased(P<0.01), the FT3 of GLIG were significantly decreased(P<0.01), the FT4 of GLIG were not significantly decreased(P>0.05). Compared with GLIG, the FT3, FT4 of DLIG were significantly decreased(P<0.01). Compared with CL, GLIG group, the gene expression of c-Jun was significantly increased(P<0.01) in DLIG group. Compared with CL group, the level of c-Jun was slightly increased(P>0.05)in GLIG group. Compared with CL, the TGF-beta1 of DLIG was significantly increased, the TGF-beta1 of GLIG was significantly increased. Compared with GLIG, the TGF-beta1 of DLIG was significantly increased. CONCLUSION: Iodine deficiency can decrease the secretion of thyroid humone, can lead the activation of c-Jun and TGF-beta1 in kidney. This finding suggest that AP-1 signal transduction pathway participate in the nosogenesis of renal damage.