Natural products - Dawn of keloid treatment.

Keloids are prevalent pathological scars, often leading to cosmetic deformities and hindering joint mobility.They cause discomfort, including burning and itching, while gradually expanding and potentially posing a risk of cancer.Developing effective drugs and treatments for keloids has been a persistent challenge in the medical field. Natural products are an important source of innovative drugs and a breakthrough for many knotty disease.Herein, keywords of "natural, plant, compound, extract" were combined with "keloid" and searched in PubMed and Google Scholar, respectively. A total of 32 natural products as well as 9 extracts possessing the potential for treating keloids were ultimately identified.Current research in this field faces a significant challenge due to the lack of suitable animal models, resulting in a predominant reliance on in vitro studies.In vivo and clinical studies are notably scarce as a result.Moreover, there is a notable deficiency in research focusing on the role of nutrients in keloid formation and treatment.The appropriate dosage form (oral, topical, injectable) is crucial for the development of natural product drugs. Finally, the conclusion was hereby made that natural products, when used as adjuncts to other treatments, hold significant potential in the management of keloids.By summarizing the natural products and elucidating their mechanisms in keloid treatment, the present study aims to stimulate further discoveries and research in drug development for effectively addressing this challenging condition.

Janus kinase inhibitors in atopic dermatitis: an umbrella review of meta-analyses.

Background: Clinicians and healthcare policymakers have been drenched with a deluge of overlapping meta-analyses (MAs), and the necessity for comprehensive and clearly defined evidence of Janus kinase inhibitors (JKIs) in atopic dermatitis (AD) is urgent. Methods: Six databases were searched for MAs published until October 2023. Qualitative description of MAs was mainly used, and Investigator's Global Assessment response (IGA response), the 75% improvement in Eczema Area and Severity Index (the EASI75), peak pruritus Numerical rating score (PP-NRS), and adverse effects were cited to describe the efficacy and safety of JKIs. The methodological quality of the included MAs was assessed by A Measurement Tool to Assess Systematic Reviews II (AMSTAR II), and the quality of evidence was evaluated by the grading of recommendations, assessment, development, and evaluation (GRADE). Results: Sixteen MAs were pooled in this review, of which five studies appraised JKIs, five appraised systemic JKIs, five papers assessed abrocitinib only, and one assessed baricitinib. Two studies were of "high" methodological quality and 14 MAs were of "moderate" quality. Eleven MAs integrated the results of JKIs and reported that JKIs provide faster onset of IGA response (RR=2.83, 95% CI [2.25, 3.56], high-quality evidence). Similarly, 10 MAs showed that JAK inhibitors were more effective in improving the EASI75 (RR=2.84, 95% CI [2.2, 3.67], high-quality evidence). Results from 12 MAs showed JKIs were active in reducing the PP-NRS (SMD=-0.49, 95% CI [-0.67, -0.32]). All MAs affirmed JKIs added no adverse effects leading to discontinuation and serious adverse events (P<0.05). However, 200mg of abrocitinib had a higher risk of acne (RR=4.34, 95% CI [1.61, 11.71), herpes zoster (RR=1.64, 95% CI [0.42, 6.39]), headache (RR=1.76, 95% CI [1.03, 3]), and nausea (RR=7.81, 95% CI [3.84, 15.87]). Upadacitinib was known to increase acne (RR=6.23, 95% CI [4.08, 9.49]), nasopharyngitis (RR=1.36, 95% CI [1.03, 1.8]) and blood creatine phosphokinase (blood CPK) (RR=2.41, 95% CI [1.47, 3.95]). Baricitinib at 2mg was associated with increased blood CPK (RR=2.25, 95% CI [1.1, 2.97]). Conclusion: Compared to placebo or dupilumab, the administration of JKIs can ameliorate IGA response more effectively, improve the EASI75, and relieve pruritus without severe adverse effect, while accompanied by more acne, nasopharyngitis, headache, and digestive disturbances. The curative effect of 200 mg of abrocitinib is significant and more caution should be given in patients with gastrointestinal dysfunction, herpes zoster, and those who are acne-prone. Baricitinib and upadacitinib should be avoided in populations at high risk for cardiovascular events. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369369, PROSPERO (CRD42022369369).

Joint optimization of headway and number of stops for bilateral bus rapid transit.

The bilateral Bus Rapid Transit (BRT) system is a kind of BRT system in which the stops are located in the middle of the transit lane. By simultaneously serving transit lines in opposite directions, it is particularly designed to save space resources and enhance service quality. To improve the operational efficiency of the bilateral BRT, this paper optimizes the operational performance of bilateral BRT with elastic demand. The objective is to minimize the generalized time cost per passenger of the system by jointly optimizing the headway and number of stops of bilateral BRT. The cost includes the agency operating and user travel. The optimal design model is formulated as a mixed-integer program and solved using a fuzzy analytic hierarchy process (FAHP) and a genetic algorithm (GA). We conduct a case study and sensitivity analysis to show the effectiveness and reliability of the proposed approach. We conclude that the optimized minimum generalized cost per passenger is lower than the actual case for all demand levels, especially at off-peak hours, by about 22.5%. In addition, we find that the weights of agency and user costs have the most significant impact on headway, whereas the influence of walking, vehicle speed, and route length is minimal. In contrast, the optimal number of BRT stops is mostly influenced by the route length, and walking speed has essentially no effect on the optimal number of stops. Finally, we find that the generalized cost per passenger at peak hours is 10% to 15% smaller than at off-peak hours in various scenarios.

Microbiome: Role in Inflammatory Skin Diseases.

As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies.

Interlayer and Phase Engineering Modifications of K-MoS2@C Nanoflowers for High-Performance Degradable Zn-Ion Batteries.

2D transition metal dichalcogenides (TMDs) have garnered significant interest as cathode materials for aqueous zinc-ion batteries (AZIBs) due to their open transport channels and abundant Zn2+ intercalation sites. However, unmodified TMDs exhibit low electrochemical activity and poor kinetics owing to the high binding energy and large hydration radius of divalent Zn2+. To overcome these limitations, an interlayer engineering strategy is proposed where K+ is preintercalated into K-MoS2 nanosheets, which then undergo in situ growth on carbon nanospheres (denoted as K-MoS2@C nanoflowers). This strategy stimulates in-plane redox-active sites, expands the interlayer spacing (from 6.16 to 9.42 Å), and induces the formation of abundant MoS2 1T-phase. The K-MoS2@C cathode demonstrates excellent redox activity and fast kinetics, attributed to the potassium ions acting as a structural "stabilizer" and an electrostatic interaction "shield," accelerating charge transfer, promoting Zn2+ diffusion, and ensuring structural stability. Meanwhile, the carbon nanospheres serve as a 3D conductive network for Zn2+ and enhance the cathode's hydrophilicity. More significantly, the outstanding electrochemical performance of K-MoS2@C, along with its superior biocompatibility and degradability of its related components, can enable an implantable energy supply, providing novel opportunities for the application of transient electronics.

A soft implantable energy supply system that integrates wireless charging and biodegradable Zn-ion hybrid supercapacitors.

The advent of implantable bioelectronic devices offers prospective solutions toward health monitoring and disease diagnosis and treatments. However, advances in power modules have lagged far behind the tissue-integrated sensor nodes and circuit units. Here, we report a soft implantable power system that monolithically integrates wireless energy transmission and storage modules. The energy storage unit comprises biodegradable Zn-ion hybrid supercapacitors that use molybdenum sulfide (MoS2) nanosheets as cathode, ion-crosslinked alginate gel as electrolyte, and zinc foil as anode, achieving high capacitance (93.5 mF cm-2) and output voltage (1.3 V). Systematic investigations have been conducted to elucidate the charge storage mechanism of the supercapacitor and to assess the biodegradability and biocompatibility of the materials. Furthermore, the wirelessly transmitted energy can not only supply power directly to applications but also charge supercapacitors to ensure a constant, reliable power output. Its power supply capabilities have also been successfully demonstrated for controlled drug delivery.

Understanding the effect of sociodemographic and psychological latent characteristics on flex-route transit acceptance.

Flex-route transit (FRT) has significant advantages in low-demand areas. Existing studies have focused on practical experience, strategic planning, and operational planning. Few studies have addressed the effect of sociodemographic and psychological latent characteristics on the acceptance of FRT. This study aims at exploring the effect of sociodemographic and psychological latent characteristics on FRT acceptance. To finish the goal, a household survey is conducted from April to May 2020 in Nanjing, China. The survey includes sociodemographic characteristics and observed variables of individuals. Firstly, the study extracts six psychological latent characteristics to reflect individuals' attitudes based on previous and mature researches in the field of technology acceptance model (TAM) and theory of planned behavior (TPB). Then, a multiple indicators and multiple causes (MIMIC) is applied to calculate six psychological latent characteristics. Finally, an integrated model, consisting of the MIMIC and a binary logit model (BLM), is applied to match sociodemographic and psychological latent characteristics. The BLM with sociodemographic characteristics is developed as the reference model to compare the effects of psychological latent characteristics. Results show that psychological latent factors play a significant role in estimating the effect on FRT acceptance. Results of the integrated model show that the parameter of car is -0.325, displaying individuals with private cars are more reluctant to use FRT. Therefore, restricting private cars is an effective measure to facilitate FRT. Improving flexibility (0.241) is a significant measure to facilitate FRT. Findings are expected to facilitate decision-making of transport planners and engineers, and therefore enhance the service of the FRT system.

High-Performance Biodegradable Energy Storage Devices Enabled by Heterostructured MoO3 -MoS2 Composites.

Biodegradable implantable devices are of growing interest in biosensors and bioelectronics. One of the key unresolved challenges is the availability of power supply. To enable biodegradable energy-storage devices, herein, 2D heterostructured MoO3 -MoS2 nanosheet arrays are synthesized on water-soluble Mo foil, showing a high areal capacitance of 164.38 mF cm-2 (at 0.5 mA cm-2 ). Employing the MoO3 -MoS2 composite as electrodes of a symmetric supercapacitor, an asymmetric Zn-ion hybrid supercapacitor, and an Mg primary battery are demonstrated. Benefiting from the advantages of MoO3 -MoS2 heterostructure, the Zn-ion hybrid supercapacitors deliver a high areal capacitance (181.86 mF cm-2 at 0.5 mA cm-2 ) and energy density (30.56 µWh cm-2 ), and the Mg primary batteries provide a stable high output voltage (≈1.6 V) and a long working life in air/liquid environment. All of the used materials exhibit desirable biocompatibility, and these fabricated devices are also fully biodegradable. Demonstration experiments display their potential applications as biodegradable power sources for various electronic devices.

Characteristics of clinical details and endolymphatic hydrops in unilateral and bilateral Ménière's disease in a single Asian group.

Objectives: To elucidate the characteristics of the clinical details and endolymphatic hydrops (EH) in bilateral Ménière's disease (BMD). Methods: A total of 545 patients with definite MD were enrolled. Demographic variables; the age of onset; disease course; inner ear function; the coexistence of related disorders such as migraine, delayed MD, drop attacks, and autoimmune diseases; familial history; and characteristics of EH were analyzed. Results: In the study population, the prevalence of BMD was 15.4%. The disease duration of BMD (84.0 ± 89.6 months) was significantly longer than that of unilateral MD (UMD, 60.1 ± 94.0 months) (P = 0.001). As evaluated by hearing thresholds and cervical and ocular vestibular evoked myogenic potentials, inner ear functions were more deteriorated in BMD (P < 0.05) than in UMD. The proportions of delayed MD and a family history of vertigo were significantly larger in BMD (P < 0.05). EH was observed in 100% of cases on the clinically affected side and 6.1% of cases on the unaffected side. Conclusion: A low prevalence of BMD, longer disease duration, higher frequencies of delayed MD, and family history of vertigo in patients with BMD were significant findings observed in the present study. All affected ears presented with EH, and a low percentage of unaffected sides presented with EH.

Key Technologies of Physical and Virtual Test Rig for Railway Freight Car body.

On the one hand, considering that the traditional fatigue method of railway freight cars is based on damage as a parameter, the influence of stress waveform cannot be considered. On the other hand, physical experiments have the characteristics of lag, long period, and high cost. The full-scale physical test and virtual test of car body are carried out. First of all, the data processing method of small deletion and the inverse problem load acquisition method based on data to data are proposed. Secondly, the dynamic stress calculation method with the bench as the boundary is proposed. Finally, taking the obtained load as the input of the physical and virtual bench, a new fatigue test method for simulating the running attitude of the car body line is completed. The acceleration RMS error of the C70E gondola body is less than 6%, the stress RMS is less than 13%, and the equivalent mileage is 3.125 million highway test results show that the car meets the life requirements of the car body. The inverse problem analysis results of virtual and physical tests are basically consistent, and the study of this method provides a basis for improving the fatigue reliability of freight car bodies.

Fusion Bonding Possibility for Incompatible Polymers by the Novel Ultrasonic Welding Technology: Effect of Interfacial Compatibilization.

Fusion bonding for polymers has been successfully welded for the same and dissimilar materials. However, it is difficult to bond incompatible polymers due to poor interfacial adhesion. Usually, interfacial compatibilization can resolve this problem. According to the mechanism, an interlayer solder sheet (ISS) consisting of maleic anhydride-functionalized polypropylene (PP-g-MAH) and polyamide6 (PA6) was introduced into the ultrasonic welding (USW) device. In this way, it successfully realized the weldability between PP and PA6. The welding strength of PP-PA6 reached 22.3 MPa, about 84% welding strength for the PP body and 63% tensile strength for PP. Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM) showed the formation of PP-g-PA6 copolymer in blends. This copolymer played the role of an emulsifier, which enhanced the interfacial adhesion between PP and PA6 in two phases, leading to micron-scale homogeneity. In the USW process, the copolymer could act as a bridge between PP and PA6 molecular chains to realize the fusion bonding of incompatible polymers. Finally, we proposed the fusion bonding model for PP-PA6 interfaces.

3D Real IR MR Findings in Acoustic Neuromas: Altered Perilymph Metabolism.

OBJECTIVES: This study aimed to investigate the perilymph metabolism by analyzing the 3D real IR MR findings in acoustic neuroma (AN) after intravenous administration of gadolinium (Gd). METHODS: Eleven patients (6 men and 5 women) diagnosed with AN were included, and 3D real IR MRI was performed 4 hours after intravenous Gd injection. The signal intensity and details of inner ear, tumor, and internal auditory canal (IAC) by MRI were analyzed. RESULTS: Four patients had tumors confined to the IAC, and 5 had tumors that extended to the cerebellopontine angle cistern. The signal intensity of the cochlea, vestibule, and IAC fundus was conspicuously enhanced in 3D real IR images than the control side. One patient had a tumor in the cochlea, in which the signal intensity of the semicircular canal and vestibule was increased. One patient had an intravestibular tumor in which the signal intensity of the semicircular canal was increased and the cochlea had endolymphatic hydrops in the affected ear. CONCLUSIONS: The synchronously increased signal intensity in the inner ear and IAC may indicate that IAC may serve as a channel for removal of the perilymph in the inner ear; the blockage by the tumor may have changed the hydrodynamics of the perilymph to cause a longer retention of Gd in the inner ear.

Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province.

BACKGROUND: The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients. METHODS: Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared. RESULTS: Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P <  0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046). CONCLUSIONS: The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

Tissue Engineering and Regenerative Medicine: Achievements, Future, and Sustainability in Asia.

Exploring innovative solutions to improve the healthcare of the aging and diseased population continues to be a global challenge. Among a number of strategies toward this goal, tissue engineering and regenerative medicine (TERM) has gradually evolved into a promising approach to meet future needs of patients. TERM has recently received increasing attention in Asia, as evidenced by the markedly increased number of researchers, publications, clinical trials, and translational products. This review aims to give a brief overview of TERM development in Asia over the last decade by highlighting some of the important advances in this field and featuring major achievements of representative research groups. The development of novel biomaterials and enabling technologies, identification of new cell sources, and applications of TERM in various tissues are briefly introduced. Finally, the achievement of TERM in Asia, including important publications, representative discoveries, clinical trials, and examples of commercial products will be introduced. Discussion on current limitations and future directions in this hot topic will also be provided.

Treatment of adhesive otitis media by tympanoplasty combined with fascia grafting catheterization.

PURPOSE: The best surgical method for the management of adhesive otitis media is controversial. The aim of the study was to explore the feasibility and effectiveness of tympanoplasty combined with fascia grafting catheterization in the treatment of adhesive otitis media. METHODS: This was a retrospective study of patients with adhesive otitis media and who underwent tympanoplasty combined with fascia grafting and catheterization between April 2015 and December 2016 at the Eye-Ear-Nose-Throat Hospital Affiliated to Fudan University. All injured ears were examined by pure tone audiometry at 0.5, 1 and 2 kHz before and at 3 months after operation. RESULTS: Thirty-five patients (35 ears) were followed for 12-44 months. The air-conduction pure tone average was 31.7 ± 12.3 dBnHL. Hearing of 28 patients (80%) was improved to a practical level within 40 dBnHL, but 2 patients (6%) had no change in postoperative hearing. Numbers of patients with spontaneous prolapse, artificial removal of tympanic membrane ventilation tube, and unobstructed in place were 15, 12, and 8, respectively. Twenty-seven patients had perforations left after the prolapse and removal of tympanic membrane ventilation tubes, of which 22 (81%) had perforations healing by themselves. All patients had dry ears after operation, without recurrence. Thirty-three patients (94%) had dry ears within 3 months and only 2 patients (6%) for more than 6 months. CONCLUSION: Tympanoplasty combined with fascia grafting catheterization is effective in the treatment of adhesive otitis media.

Clinical Features and Endolymphatic Hydrops in Patients With MRI Evidence of Hydrops.

OBJECTIVES:: The purpose of this study was to investigate the correlation between grades of endolymphatic hydrops (ELH) and clinical characteristics and determine the detailed clinical characteristics of Ménière's disease (MD) patients with evidence of hydrops based on magnetic resonance imaging (MRI). METHODS:: One hundred ninety-eight MD patients (396 ears) with MRI evidence of hydrops were included. ELH grades were evaluated using the Nakashima grading standard. Correlations between the extent of ELH and clinical features were evaluated. Detailed clinical characteristics were analyzed to assess the clinical diagnostic criteria. RESULTS:: Of 198 patients, ELH was observed in 100% of cases on the clinically affected side and 8.6% of cases on the asymptomatic side. In addition, 98.5% of ELH was classified as moderate or significant grade. Low-frequency hearing loss was significantly correlated with the extent of both vestibular and cochlear hydrops, whereas the vertigo attack frequency showed no significant correlation with ELH grades. The disease duration of MD with bilateral ELH was longer than that with unilateral ELH. The clinical characteristics were variant and did not completely fit the proposed diagnostic criteria. CONCLUSIONS:: MRI findings have relevance to the clinical severity, to a certain extent, but not vestibular symptoms. The proposed diagnostic criteria based on clinical characteristics may be partially effective; analysis of the detailed clinical characteristics of MD was meaningful. Diagnosis of MD based on both MRI and clinical symptoms could facilitate an early diagnosis.

The Preparation and Properties Study of High CRI White LED Based on Remote Phosphor Technology.

Focusing on the defects in the lighting color of LED lamps and the chip heat exists in the traditional LED package which caused phosphor performance degradation, color temperature drift and the uneven light, the remote phosphor package which is emerging in recent years is used in this paper. With yellow-green YGG phosphor and nitrogen red phosphors mixing with silica gel, the remote phosphor is made and then encapsulated as the LED lamps. A lot of experiments were made to determine the best ratio of yellow green phosphor, red phosphor and silica gel, LED lamps with different color temperature was prepared. The lamps were also tested and analyzed with some parameters such as e color coordinates, luminous efficiency, color rendering index (CRI), R9, color quality scale (CQS), color temperature, and the gamut area index (GAI), which provide a more objective and comprehensive evaluation to the high quality LED lighting. Experimental results show that the optimum ratio of red and yellow-green phosphor is 1∶7.6, and total phosphor with silica gel is 1∶5，at this time the white LED lighting color temperature is 4 113 K, the color coordinate (x, y) is (0.375 4, 0.373 1), luminous efficiency is 52.33 lm·w-1, color gamut is 0.981, color rendering index is up to 96, R9 is 97, color quality scale Qa is up to 93, and the gamut area index is 79. Compared with the traditional packaging，the surface temperature ofthe remote phosphor encapsulated fluorescent plate is much lower than that of adhesive dispensing encapsulation, which can effectively avoid the harmful effect caused by high temperature on the LED.

The effect of lime-dried sewage sludge on the heat-resistance of eco-cement.

The treatment and disposal of sewage sludge is a growing problem for sewage treatment plants. One method of disposal is to use sewage sludge as partial replacement for raw material in cement manufacture. Although this process has been well researched, little attention has been given to the thermal properties of cement that has had sewage sludge incorporated in the manufacturing process. This study investigated the fire endurance of eco-cement to which lime-dried sludge (LDS) had been added. LDS was added in proportions of 0%, 3%, 6%, 9%, and 12% (by weight) to the raw material. The eco-cement was exposed to 200, 400, or 600 °C for 3 h. The residual strength and the microstructural properties of eco-cement were then studied. Results showed that the eco-cement samples suffered less damage than conventional cement at 600 °C. The microstructural studies showed that LDS incorporation could reduce Ca(OH)(2) content. It was concluded that LDS has the potential to improve the heat resistance of eco-cement products.

[Effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with Moderate-severe obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To explore the effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with moderate-severe OSAHS. METHOD: One hundred and sixteen young and middle-aged patients with moderate-severe OSAHS received simultaneous multi-level surgery. PSG,malondialdehyde (MDA), advanced oxidation protein products (AOPP) and 8-isoprostaneF2α (8-iso-PGF2α) were tested, together with the evaluation of the questionnaires of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE) and Epworth sleepiness scale (ESS) before and 6 months after surgery. RESULT: (1) The AHI, TS90% and LSaO2 were all improved significantly 6 months after operation. No severe complications were observed in any patient. (2) The preoperative MoCA and MMSE scores were (23.52 ± 2.64) and (26.54 ± 1.07) respectively. The cognitive impairment were detected in OSAHS patients. MoCA was negatively correlated with AHI, TS90%, MDA, AOPP and 8-iso-PGF2a, while positively correlated with LSaO2 (P < 0.05, r = -0.233, -0.190, -0.256, -0.247, -0.221 and 0.215, respectively). Cognitive impairment was mainly manifested as disorder in the visual space and execu- tive function, memory and delayed recall (mainly short-term memory). (3) MoCA and MMSE scores were both increased (P < 0.05) after the operation. MoCA showed negative correlations with MDA, AOPP, 8-iso-PGF2α, AHI and TS90%, and positive correlation with LSaO2 (P < 0.05, r = -0.495, -0.463, -0.397, -0.332, -0.292 and 0.336, respectively). CONCLUSION: Oxidative stress and cognitive dysfunction are closely related in young and middle-aged patients with Moderate-severe OSAHS. Oxidative stress may play an important role in cognitive function of young and middle-aged patients with Moderate-severe OSAHS. Multi-level surgery can improve oxidative stress so that to improve cognitive impairment.

[Clinical value of percutaneous ethanol ablation in complicated renal carcinoma].

OBJECTIVE: To probe clinical value of percutaneous ethanol ablation (PEA) in complicated renal carcinoma. METHODS: 10 cases complicated renal carcinoma patients with 16 lesions ranged from 1.7-8.4 cm totally, renal cancer in 7 cases, renal hamartoma in 3 cases,underwent CT guided percutaneous ethanol ablation (PEA) by local anesthesia Plain and contrast CT scan was adopted to evaluate clinical effect and make follow-up. RESULTS: Each patient accepted 2 times PEA in average with follow-up time ranged from 2 to 26 months averaged in 18 months. No recurrence was seen in 1 case isolated renal patient unfortunately with renal cancer through 1 year and 9 months follow-up after 2 times PEA. The other isolated renal cancer patient died of acute renal failure after 4 times PEA. Lesions were fully ablated in 2 cases renal cancer patients with low back pain and blood urine and symptoms disappeared after PEA accordingly. Other 3 cases renal cancer patients went through 1 year and 6 months, 2 years and 2 months, and 1 year follow-up respectively. 1 case died of distant metastasis and 2 cases kept stabilization evaluated by CT scan. Hemorrhage within lesions disappeared in 2 cases renal hamartoma after just one time PEA, which kept stabilization through 1 year, 1 year and 10 months follow-up respectively. 1 case hamartoma patient gave up treatment after 2 times PEA. No complications including urinary fistula, hemorrhage, intestinal perforation and needle track implantation were seen in all patients. CONCLUSION: CT guided PEA is a microinvasive, positive curative effect and facultative method in treating complicated renal carcinomas. But for isolated renal patient with renal cancer,PEA should be performed cautiously.