[Attention should be paid to sleep disorders in critically ill patients and its recognition and intervention].

The sleep deficiency and sleep disturbance of critically ill patients may result in adverse outcomes, negative effects on early rehabilitation, and may persist well beyond the intensive care unit (ICU). It has been paid more and more attention in clinical practice. The sleep problems of critically ill patients are associated with suffered critical illness, ICU environments, and coexisting sleep disorders before critical illness. Poor sleep quality, insufficient sleep duration, severe sleep fragmentation and irregular circadian rhythms during critical care illness have been extensively described. In addition, ICU patients have been specifically shown to experience atypical sleep and pathologic wakefulness. So the sleep in critical ill patients should be evaluated. Sleep can be evaluated by both subjective assessment and objective measurements, including polysomnography and actigraphy. According to individual situation, comprehensive, interdisciplinary, and personalized interventions, which include treating critical illness, improving ICU environment to reduce interference to sleep, nonpharmacological treatment to relax and stabilize sleep, and treating coexisting sleep disorders, should be taken to improve the patient's sleep and then to promote the early rehabilitation of critically ill patients.

[Effects of surface treatment on the phase and fracture strength of yttria- and magnesia-stabilized zirconia implants].

OBJECTIVE: To evaluate the effects of surface treatment on the phase and fracture strength of yttria-and magnesia-stabilized and its mechanisms. METHODS: One-piece cylindrical screw-type implants were fabricated with yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and magnesia partially stabilized zirconia (Mg-PSZ) using computer aided design (CAD)/computer aided manufacture (CAM) technique.They were divided into three groups: (1) placed in water for 1 h after final sintering (control group), (2) sandblasting using 110 µm Al2O3 particles, (3) sandblasting plus etching with hydrofluoric acid for 1 h.The surface morphology and roughness of the implants were evaluated.Tetragonal to monoclinic transformation was measured on the surface by X-ray diffraction.Static tests of the zirconia implants were carried out at room temperature following the International Standards Organization (ISO)14801:2014 Standard. RESULTS: Both sandblasting alone and sandblasting plus acid etching significantly increased surface roughness (Ra) of Mg-PSZ and Y-TZP implants (P < 0.01), with sandblasting plus acid etching exhibited the highest surface roughness.No monoclinic band was detected in Mg-PSZ surface.Compared with the control group, the surface monoclinic content of Mg-PSZ had no obvious change after surface treatments.However, strong monoclinic bands appeared in surface modified Y-TZP.Monoclinic content of Y-TZP was higher than that of control group (1.55%) after both sandblasting alone (16.44%) and sandblasting plus acid etching (7.68%).For Mg-PSZ implants, fracture strengths of sandblasting group and sandblasting plus acid etching group were (294.1±3.3) N and (331.3±26.4) N respectively, which were lower than that of control group (458.4±48.7) N with significant differences (P < 0.01).For Y-TZP implants, fracture strength of control group was (827.3±101.6) N.Compared with control group, sandblasting group showed significantly higher fracture strength (P=0.03), which was (1 162.9±116.5) N.While sandblasting plus acid etching group had a fracture strength of (867.2±171.0) N, with no significant difference with control group (P>0.99). CONCLUSION: Sandblasting improved the fracture strength of Y-TZP implants.For the Mg-PSZ implants manufactured in this study, surface treatments with sandblasting and sandblasting plus acid etching resulted in a decrease of fracture strength.

[Correlation analysis of age and microbial characteristics in saliva and feces of high-risk population of upper gastrointestinal cancer].

Objective: To explore the correlation between age and diversity and microbial composition in saliva and feces microbiota in high-risk population of upper gastrointestinal cancer. Methods: Based on the national project on early diagnosis and early treatment of upper gastrointestinal cancer, 38 participants were enrolled in Linzhou in Henan province in August 2019. The participant information was collected by questionnaire. Saliva and feces specimens were collected from each participant for 16S rRNA sequencing and bioinformatics analysis. Spearman rank correlation was used to analyze the correlation between age and α diversity (Observed ASVs and Shannon index) and relative abundance of microbiota (phyla, genera, and species) in saliva and feces. Results: The median age (age range) of 38 participants was 54 (43-60) years old, and there were 16 males (42.1%). The Observed ASVs of saliva was negatively correlated with age (rs=-0.35, P<0.05), but the observed ASVs of feces was not correlated with age. In saliva, the relative abundance of Treponema (rs=‒0.44, P<0.05), Alloprevotella (rs=‒0.42, P<0.05), and Porphyromonas (rs=‒0.41,P<0.05) were significantly negatively correlated with age. At the species level, the relative abundance of Porphyromonas endodontalis, Alloprevotella tannerae, Haemophilus influenza, Moraxella bovoculi, Prevotella sp.oral clone ID019, and Prevotella sp.oral clone ASCG10 in saliva were significantly negatively correlated with age, and the rs values were -0.50, -0.40, -0.38, -0.35, -0.33 and -0.33 (P<0.05), respectively. In feces, the relative abundance of Enterobacteria (rs=-0.35, P<0.05), Escherichia (rs=-0.33, P<0.05), and Bifidobacteria (rs=0.33, P<0.05) were correlated with age. At the species level, the relative abundance of Romboutsia sedimentorum, Citrobacter murliniae, and bacteroides uniformis in feces were correlated with age, and the rs values were -0.42, -0.37 and 0.36 (P<0.05), respectively. Conclusion: Age of the high-risk population of upper gastrointestinal cancer is correlated with the relative abundance of microbiota in saliva and feces.

[Study on the related factors of esophageal cancer and precancerous lesions in rural residents aged 40-69 years in Shandong Province].

Objective: To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. Methods: In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. Results: The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI: 1.65-2.19), 60-69 years old (OR=5.28, 95%CI: 4.11-7.30), primary school education or below (OR=1.50, 95%CI: 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB (OR=1.41, 95%CI: 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. Conclusion: The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.

Why hasn't this woman been screened for breast and cervical cancer? - Evidence from a Chinese population-based study.

OBJECTIVE: Less than half of eligible Chinese rural women have been screened for breast and cervical cancer. The objective of this study was to describe individual-level reasons for attending or not attending 'two cancers' screening using Andersen's Behavioral Model of Health Services Use. STUDY DESIGN: Cross-sectional study. METHODS: The study sample was from the Health Services Survey in 2013 in Jiangsu, China. A total of 6520 rural women aged 36-65 years answered the questions on 'two cancers' screening participation and were included in the final analysis, which consisted of univariate and multivariate logistic regression. RESULTS: In the results of multivariate logistic regression, factors significantly associated with having 'two cancers' screening included educational level (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.65-0.92), per capita household income (OR = 0.65, 95% CI = 0.58-0.73), availability of female medical faculty in township facilities (OR = 0.35, 95% CI = 0.28-0.42), quality of life (OR = 0.72, 95% CI = 0.58-0.90), being nulliparous (OR = 3.21, 95% CI = 1.96-5.26), and multiparous (OR = 1.91, 95% CI = 1.68-2.16). CONCLUSION: To reduce inadequate screening service utilization of breast and cervical cancer in rural areas, efforts should be made not only to target the vulnerable rural women with lower income, lower educational level, and lower health conditions but also to further improve access to female primary-care providers. Strategies are also urgently needed to focus on nulliparous and multiparous women.

[Study on the serum 25-hydroxyvitamin D levels of benign paroxysmal positional vertigo patients].

Objective:To study whether serum 25-hydroxy vitamin D can be used as an independent indicator of prognosis in patients with benign paroxysmal positional vertigo. Method:Two hundred and two patients with BPPV were collected and divided into vitamin D deficiency group and control group according to their serum 25-OHD level. The severity of the symptoms and the recurrence rate were compared between the two groups. Result:Compared with the control group, patients with vitamin D deficiency group showed severer symptoms, either in longer duration of vertigo, lower success rate of repositioning maneuver treatment at the first time, or higher recurrence rate within six months. Conclusion:Serum 25-OHD level was negatively correlated with the severity and prognosis of BPPV, and could be used as an important index to evaluate the prognosis of BPPV.

Fast formation and growth of high-density Sn whiskers in Mg/Sn-based solder/Mg joints by ultrasonic-assisted soldering: Phenomena, mechanism and prevention.

A universally applicable method for promoting the fast formation and growth of high-density Sn whiskers on solders was developed by fabricating Mg/Sn-based solder/Mg joints using ultrasonic-assisted soldering at 250 °C for 6 s and then subjected to thermal aging at 25 °C for 7 d. The results showed that the use of the ultrasonic-assisted soldering could produce the supersaturated dissolution of Mg in the liquid Sn and lead to the existence of two forms of Mg in Sn after solidification. Moreover, the formation and growth of the high-density whiskers were facilitated by the specific contributions of both of the Mg forms in the solid Sn. Specifically, interstitial Mg can provide the persistent driving force for Sn whisker growth, whereas the Mg2Sn phase can increase the formation probability of Sn whiskers. In addition, we presented that the formation and growth of Sn whiskers in the Sn-based solders can be significantly restricted by a small amount of Zn addition (≥3 wt.%), and the prevention mechanisms are attributed to the segregation of Zn atoms at grain or phase boundaries and the formation of the lamellar-type Zn-rich structures in the solder.

Genetic variability and diversity of the main resources of lily assessed via phenotypic characters, pollen morphology, and ISSR markers.

Lily (Lilium spp), which belongs to Lilium, is one kind of monocotyledon. As a perennial ornamental plant with extremely high esthetic, edible, and medicinal value, lily has gained much favor due to its mostly showy flowers of various colors and elegant shape. In this research, we studied experimental materials in a sample of 49 individuals including 40 cultivars, nine species of wild lily, and their variants. The collection of 40 cultivars covered all six hybrids in the genus, i.e., Asiatic hybrids, Oriental hybrids, Longiflorum hybrids, LA hybrids, LO hybrids, and OT hybrids. Genetic diversity and inter-relationships were assessed through analysis of phenotypic characteristics, pollen morphology, and ISSR molecular markers. Quantitative characters were selected to analyze phenotypic variation, with results indicating greater variability in petiole length as compared to other characters. Pollen morphological observations suggested that the largest variation coefficient between all hybrids and wild species was the lumina. ISSR makers demonstrated that both cultivars and wild species possess a high level of genetic diversity. Specifically, the genetic diversity of wild lily was higher than cultivars.

[Effect of the Chinese Herbal Medicinal Ingredients in Huoxiang Zhengqi Liquid on Alcohol Metabolism in Rats].

OBJECTIVES: To study the changes of alcohol content and pharmacokinetic parameter in rats after taking Huoxiang Zhengqi liquid. METHODS: The rats were randomly divided into three groups and given with white alcohol at the dose of 3.0 mL/kg, low-dose and high-dose Chinese medicine liquor, respectively. The blood was collected before administration and 5 min, 10 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, 6 h and 8 h after administration by cutting rats' tails. The concentrations of alcohol in blood were detected by headspace-gas chromatography method. The main pharmacokinetic parameters were calculated by DAS 2.0, and then analyzed by SPSS 17.0. RESULTS: The difference of maximum blood concentrations between high-dose Chinese medicine alcohol group and white alcohol group was statistically significant （P<0.05）. There was no significant difference in other pharmacokinetic parameters among three groups （P>0.05）. CONCLUSIONS: The Chinese herbal medicinal ingredients in the Huoxiang Zhengqi liquid has no effect on the metabolism and elimination of ethanol in rats. The research provides useful reference for the qualitative assessment and processing of traffic accident cases involved in Huoxiang Zhengqi liquid and the studies related to drug-interaction.

Reverse Dorsoradial Flaps for Thumb Coverage Show Increased Sensory Recovery with Smaller Flap Sizes.

BACKGROUND: Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery. METHODS: From February 2010 to February 2011, 19 patients were treated consecutively with RHD flap without neurorrhaphy. At final follow-up, flap sensibility was assessed by Semmes-Weinstein (SW) monofilament, moving two-point discrimination (M-2PD), and static two-point discrimination (S-2PD) tests. Patient satisfaction, active range-of-motion of the joints, patient complications, and cold intolerance severity score questionnaire were sequentially evaluated. The patients were divided into two groups based on the S-2PD results and another two groups based on flap size. RESULTS: The mean SW monofilament sensitivity and M-2PD and S-2PD scores on the flap were 4.01 g and 9.26 mm, and 10.63 mm, respectively. Highly positive correlations existed between the flap size and the M-2PD and S-2PD scores. Moreover, in the respective groups based on S-2PD scores and flap size, no statistical difference was found among age, sex, and follow-up time, but the flap size and S-2PD scores were statistically different. CONCLUSIONS: RHD flap without neurorrhaphy is a recommendable technique for relatively small-sized thumb-defect reconstruction, which can achieve a satisfactory sensory recovery.

Rotenone impairs autophagic flux and lysosomal functions in Parkinson's disease.

BACKGROUND: Rotenone is an environmental neurotoxin that induces accumulation of α-synuclein and degeneration of dopaminergic neurons in substantia nigra pars compacta (SNpc), but the molecular mechanisms are not fully understood. We investigated whether rotenone induced impairment of autophagic flux and lysosomal functions. METHODS: Autophagy flux, accumulation of α-synuclein, lysosomal membrane integrity and neurodegeneration were assessed in the rotenone-treated rat model and PC12 cells, and the effects of the autophagy inducer trehalose on rotenone's cytotoxicity were also studied. RESULTS: Rotenone administration significantly reduced motor activity and caused a loss of tyrosine hydroxylase in SNpc of Lewis rats. The degeneration of nigral dopaminergic neurons was accompanied by the deposition of α-synuclein aggregates, autophagosomes and redistribution of cathepsin D from lysosomes to the cytosol. In cultured PC12 cells, rotenone also induced increases in protein levels of α-synuclein, microtubule-associated protein 1 light chain 3-II, Beclin 1, and p62. Rotenone increased lysosomal membrane permeability as evidenced by leakage of N-acetyl-beta-d-glucosaminidase and cathepsin D, the effects were blocked by reactive oxygen species scavenger tiron. Autophagy inducer trehalose enhanced the nuclear translocation of transcription factor EB, accelerated the clearance of autophagosomes and α-synuclein and attenuated rotenone-induced cell death of PC12 cells. Meanwhile, administration of trehalose to rats in drinking water (2%) decreased rotenone-induced dopaminergic neurons loss in SNpc. CONCLUSIONS: These studies indicate that the lysosomal dysfunction contributes to rotenone's neurotoxicity and restoration of lysosomal function could be a new therapeutic strategy for Parkinson's disease.

New roles of filopodia and podosomes in the differentiation and fusion process of osteoclasts.

The cytoskeleton mediates various cellular processes such as differentiation and fusion, including in the filopodia and podosomes. However, apart from cell migration and formation of the sealing zone, little is known regarding the changes and related regulatory mechanisms of the cytoskeleton and additional roles of the filopodia and podosomes during the differentiation and fusion of osteoclasts. The cytomorphology and cytoskeleton of osteoclasts in the differentiation process were evaluated using tartrate-resistant acid phosphatase staining and immunofluorescence staining. Moreover, the expression levels of Rho GTPases and enzymes related to osteoclast differentiation and bone resorption were detected by quantitative reverse transcription-polymerase chain reaction. We detected 3 types of filopodia in osteoclast precursors and only 1 type of filopodia in undifferentiated cells. Mature osteoclasts were completely devoid of filopodia. Interestingly, cell fusion was highly specific, and the fusion initially occurred to the filopodia. Confocal images revealed that F-actin and microtubules significantly differed among fused cells. These results suggest that filopodia and podosomes not only play important roles in cell migration and the formation of sealing zones but also in the pre-fusion selectivity of 2 cells and the movement direction of the cell nucleus and cytoplasm during the fusion process. In addition, cdc42v1, RhoU, and RhoF regulate the formation of 3 types of filopodia during various stages of differentiation, while Rac1, Rac2, and filament A may be associated with cell selectivity during the fusion process.

Influence of grape seed proanthocyanidin extract in broiler chickens: effect on chicken coccidiosis and antioxidant status.

Grape seed proanthocyanidin extract (GSPE) has been widely used as a human food supplement for health promotion and disease prevention. However, there was little information regarding its application in animal nutrition. The aim of the current study is to determine the effect of GSPE at different concentrations on chicken performance, and the status of antioxidant/oxidant system after the Eimeria tenella infection. In the first experiment, GSPE incorporated in the diet at 5, 10, 20, 40, and 80 mg/kg significantly decreased mortality and increased weight gain after the E. tenella infection, and the protective effect of GSPE was dose-dependent. The lowest mortality and the greatest growth gains were recorded in the group of birds fed with GSPE between 10 to 20 mg/kg. In the second experiment, 12 mg/kg of GSPE supplementation in the diet significantly reduced the mortality and lesion scores in birds after the infection with 5 x 10(4) and 1 x 10(5) oocysts of E. tenella. The weight gains also improved significantly. After the oral infection with 5 x 10(4) and 1 x 10(5) of E. tenella, analysis of the status of antioxidant/oxidant system revealed that plasma NO increased significantly from 7.11 to 21.31 micromol/L, plasma superoxide dismutase (SOD) decreased from 126.55 to 111.14 U/mL, and malondiadehyde increased, suggesting oxidative stress was increased in circulation. However, supplementation of 12 mg/kg GSPE reduced the level of plasma NO from 21.31 to 14.73 micromol/L and increased plasma SOD activities from 111.14 to 133.27 U/mL. The effects of incorporation of GSPE into the poultry diet on the concentration of plasma NO, malondiadehyde, and SOD indicated that the lower concentration of dietary GSPE was able to restore the balance of antioxidant/oxidant system that was exerted by the oxidative stress after the parasite infection. The current results suggested GSPE can act as an antioxidant in diet to improve the performance of broiler chickens and remedy the clinical symptoms caused by the oxidative stress of E. tenella infection.

Medial sural artery perforator flap for repair of the hand.

We report our experience of using the medial sural artery perforator flap in the reconstruction of soft tissue defects in the hand in seven cases with 1 to 2 year follow-up. The flap is harvested from the posteromedial aspect of the leg, just below the knee and superficial to the medial head of the gastrocnemius muscle. It is based on the perforator arteries and veins supplied by the medial sural artery. The flaps ranged in size from 14 x 10 cm to 8 x 6 cm. The donor area was closed directly or by a skin graft. All but one flap survived. The cosmetic results were satisfactory and without apparent bulkiness. Similarity of colour and thickness of the donor and recipient sites are advantages. We feel that this new flap is a satisfactory option for use in the hand, particularly for extended soft tissue defects on the dorsal hand.

Gestational diabetes mellitus in Chinese women.

OBJECTIVE: To determine whether foreign diagnostic criteria for the diagnosis of gestational diabetes mellitus (GDM) are suitable for Chinese pregnant women. METHODS: The study participants were 340 pregnant women receiving obstetric care at the Shanghai Jiaotong University-Affiliated Sixth People's Hospital in Shanghai, China. The normal-pregnancy group comprised 190 women with no risk factor for GDM and the high-risk pregnancy group comprised 150 women who had at least one high-risk factor for GDM. All women took the diagnostic 100-g, 3-h oral glucose tolerance test (100-g 3-h OGTT) between 24 and 28 weeks of pregnancy. The results of the 100-g 3-h OGTT were classified according to three different sets of diagnostic criteria: (1) new, "Chinese" diagnostic criteria based on the results from the 100-g 3-h OGTT performed in the 190 healthy participating women; (2) the Carpenter and Coustan criteria; and (3) the National Diabetes Data Group (NDDG) criteria. Venous plasma glucose (VPG) was measured by the glucose oxidase method. A consistency check was used for analysis. Obstetric and neonatal outcomes were recorded. RESULTS: With 97.5% as the statistical cutoff value for the 100-g 3-h OGTT, the new diagnostic criteria for this study, based on data obtained from the 100-g 3-h OGTT performed on the 190 participating healthy pregnant women, were 5.2, 10.3, 8.9, and 7.7 mmol/L at 0, 60, 120, and 180 min. The e value was 0.83 for the new criteria vs. the Carpenter and Coustan criteria (P<0.001) and 0.70 for the new criteria vs. the NDDG criteria (P<0.001). In women with GDM and gestational-impaired glucose tolerance (GIGT), the incidence rates of macrosomia by the new criteria and the Carpenter and Coustan criteria were similar, but higher than the rates calculated with the NDDG criteria (P<0.05). CONCLUSION: With venous plasma glucose level measured by the glucose oxidase method, the Carpenter and Coustan criteria are applicable to Chinese pregnant women for diagnosis of GDM.

[Mechanical efficacy of different internal fixation devices in the treatment of thoracolumbar fractures].

To know the efficacy of different internal fixation devices used in the treatment of thoracolumbar fractures, specimens of 15 adult cadaveric (T-8 to L-4) were prepared and were divided into 5 groups for comparative study. Except the control group, the vertebra of T-12 of every specimen in other 4 groups was artificially fractured, imitating flexion fracture dislocation, with standard technic. Then, they were fixed in each group, with Luque's rod, Dick's screw, pedicle screw plate or Dunn's device respectively. The stress distribution and yielding stress under load and dimensional motions in each group were recorded and compared among the groups and with the control. In the experimental groups, Dunn's device gave the strongest support, against load on the anterior and middle columns. Dick's screw and pedicle screw plate could theoretically fix the anterior, middle and posterior columns rigidly; however, because of the weakness persisted in the connection of their components, their fixation effectiveness was reduced. Luque's rod acted though effectively against bending on every direction, it could not stand much axial load. It is obvious that each of these 4 devices has its own advantages and could be used to prevent horizontal displacement of the fixed fracture, but fail to control torsional stress.