Exploration of the common pathogenic link between COVID-19 and diabetic foot ulcers: An in silico approach.

Background and Aims: The Coronavirus Disease-19 (COVID-19) is posing an ongoing threat to human health. Patients of diabetic foot ulcer (DFU) are susceptible to COVID-19-induced adverse outcomes. Nevertheless, investigations into their mutual molecular mechanisms have been limited to date. In the present work, we tried to uncover the shared pathogenesis and regulatory gene targets of COVID-19 and DFU. Methods: In this study, we chose GSE161281 as the COVID-19 data set, which contained severe acute respiratory syndrome coronavirus 2 infected human induced embryonic stem cell-derived peripheral neurons (n = 2) with uninfected controls (n = 2). The GSE134431 designated as the DFU data set, comprising full-thickness DFU (n = 13) and diabetic foot skin (n = 8) samples from diabetic patients. The differential expressed genes (DEGs) were identified from GSE161281 and GSE134431, and the common DEGs between COVID-19 and DFU were extracted. Multifactor regulatory network and co-expression network of the common DEGs were analyzed, along with candidate drug prediction. Results: Altogether, six common DEGs (dickkopf-related protein 1 [DKK1], serine proteinase inhibitor A3 [SERPINA3], ras homolog family member D [RHOD], myelin protein zero like 3 [MPZL3], Claudin-11 [CLDN11], and epidermal growth factor receptor pathway substrate 8-like 1 [EPS8L1]) were found between COVID-19 and DFU. Functional analyses indicated that pathways of apoptotic and Wnt signaling may contribute to progression of COVID-19. Gene co-expression network implied the shared pathways of immune regulation and cytokine response participated collectively in the development of DFU and COVID-19. A multifactor regulatory network was constructed integrating the corresponding microRNAs (miRNAs) and transcription factors. Additionally, we proposed potential drug objects for the combined therapy. Conclusion: Our study revealed the shared molecular mechanisms underlying COVID-19 and DFU. The identified pivotal targets and common pathways can provide new perspectives for further research and assist the development of management strategies in patients of DFU complicated with COVID-19.

Preparation and Validation of a Longitudinally and Transversely Stiffened Panel Based on Hybrid RTM Composite Materials.

In the face of the difficulty in achieving high-quality integrated molding of longitudinally and transversely stiffened panels for helicopters by resin-matrix composite materials, we combine the prepreg process and the resin transfer molding (RTM) process to propose a hybrid resin transfer molding (HRTM) for composite stiffened panel structures. The HRTM process uses a mixture of prepreg and dry fabric to lay up a hybrid fiber preform, and involves injecting liquid resin technology. Using this process, a longitudinally and transversely stiffened panel structure is prepared, and the failure modes under compressive load are explored. The results show that at the injection temperature of the RTM resin, the prepreg resin dissolves slightly and has little effect on the viscosity of the RTM resin. Both resins have good miscibility at the curing temperature, which allows for the overall curing of the resin. A removable box core mold for the HRTM molding is designed, which makes it convenient for the mold to be removed after molding and is suitable for the overall molding of the composite stiffened panel. Ultrasonic C-scan results show that the internal quality of the composite laminates prepared using the HRTM process is good. A compression test proves that the composite stiffened panel undergoes sequential buckling deformation in different areas under compressive load, followed by localized debonding and delamination of the skin, and finally failure due to the fracture of the longitudinal reinforcement ribs on both sides. The compressive performance of the test specimen is in good agreement with the finite element simulation results. The verification results show that the HRTM process can achieve high-quality integrated molding of the composite longitudinally and transversely stiffened panel structure.

Mining the potential therapeutic targets for COVID-19 infection in patients with severe burn injuries via bioinformatics analysis.

The Coronavirus Disease-19 (COVID-19) pandemic is posing a serious challenge to human health. Burn victims are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to delayed recovery and even profound debilitation. Nevertheless, the molecular mechanisms underlying COVID-19 and severe burn are yet to be elucidated. In our work, the differentially expressed genes (DEGs) were identified from GSE157852 and GSE19743, and the common DEGs between COVID-19 and severe burn were extracted. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), protein-protein interactions (PPI), gene coexpression network, and multifactor regulatory network analysis of hub genes were carried out. A total of 44 common DEGs were found between COVID-19 and severe burn. Functional analyses indicated that the pathways of immune regulation and cytokine response participated collectively in the development of severe burn and progression of COVID-19. Ten significant hub genes were identified, including MERTK, SIRPA, TLR3, ITGB1, DPP4, PTPRC, LY75, IFIT1, IL4R, and CD2. In addition, the gene coexpression network and regulatory network were constructed containing 42 microRNAs (miRNAs) and 2 transcription factors (TFs). Our study showed the shared pathogenic link between COVID-19 and severe burn. The identified common genes and pivotal pathways pave a new road for future mechanistic researches in severe burn injuries complicated with COVID-19.

Neutron powder-diffraction study of phase transitions in strontium-doped bismuth ferrite: 1. Variation with chemical composition.

We report results from a study of the crystal and magnetic structures of strontium-doped BiFeO3using neutron powder diffraction and the Rietveld method. Measurements were obtained over a wide range of temperatures from 300-800 K for compositions between 10%-16% replacement of bismuth by strontium. The results show a clear variation of the two main structural deformations-symmetry-breaking rotations of the FeO6octahedra and polar ionic displacements that give ferroelectricity-with chemical composition, but relatively little variation with temperature. On the other hand, the antiferromagnetic order shows a variation with temperature and a second-order phase transition consistent with the classical Heisenberg model. There is, however, very little variation in the behaviour of the antiferromagnetism with chemical composition, and hence with the degree of the structural symmetry-breaking distortions. We therefore conclude that there is no significant coupling between antiferromagnetism and ferroelectricity in Sr-doped BiFeO3and, by extension, in pure BiFeO3.

Construction of pelvic floor muscle rehabilitation training program for patients undergoing laparoscopic radical prostatectomy.

Background: Laparoscopic radical prostatectomy (LRP) is the standard treatment for early localized PCa, of which urinary incontinence is the most common postoperative complication. Pelvic floor muscle rehabilitation training is recognized as the first line of intervention measures, but the existing rehabilitation training programs are not clear in the formulation process, the content is not unified, and the clinical operability is not strong. In order to better guide clinical pelvic floor muscle rehabilitation training after LRP and prevent and control urinary incontinence, this study constructed a pelvic floor muscle rehabilitation training program for LRP patients. Methods: Literature analysis, qualitative interview, and an expert group meeting method were used to form the draft of pelvic floor muscle rehabilitation training program for LRP patients. On this basis, after 2 rounds of Delphi expert consultation, the research team modified and improved the program. Results: The consultation experts involved in the 2 rounds were the same, 15 questionnaires were sent out, and 15 were recovered with an effective recovery of 100%. The expert authority coefficient was 0.87. In the second round of consultation, Kendall's harmony coefficient was 0.14 (P<0.001), the mean coefficient of variation of expert opinion was 0.07 (P<0.001), and the mean value of importance assigned to each item was 4.53-5.00 points. Finally, the pelvic floor muscle rehabilitation training program for LRR patients was formed. Including rehabilitation training evaluation, rehabilitation training advanced time and content, rehabilitation training form of three first-level indicators, 12 second-level indicators, 53 third-level indicators. Conclusions: The pelvic floor muscle rehabilitation training program for LRP patients developed in this study is scientific, reliable, safe and feasible, which can provide reference for clinical pelvic floor muscle rehabilitation training after LRP and prevention and control of urinary incontinence.

Construction of a nursing solution to prevent and control urinary tract infection in the early stages of kidney transplantation.

BACKGROUND: To construct a nursing solution for the prevention and control of urinary tract infection (UTI) in the early stage after kidney transplantation, and to provide systematic and standardized nursing intervention measures for patients in the early stage after kidney transplantation. METHODS: The preliminary draft of intervention plan was formulated based on risk factor analysis research results of early UTI after kidney transplantation, combined with theoretical research, literature review, and research group meeting. The Delphi method was used to consult 15 experts for two rounds, and the entries were modified according to the opinions of the experts. RESULTS: After two rounds of consultation, the expert opinions tended to be consistent, and expert authority coefficient was 0.87. The Kendall harmony coefficient of importance and feasibility indexes of the two rounds of consultation were 0.407, 0.651 and 0.545, 0.686, respectively, with statistically significant differences (P<0.001). The nursing solution consisted of eight first-level indexes and 35 second-level indexes. The eight first-level indexes included admission symptom evaluation, UTI monitoring, health education, sports intervention, nutrition intervention, ward management, risk factor prevention and nursing, and psychosocial intervention. CONCLUSIONS: This study constructed a scientific and reliable nursing solution for the prevention and control of early UTI after kidney transplantation, which is hugely important for guiding clinical nursing work.

Analysis of risk factors for early urinary tract infection after kidney transplantation.

BACKGROUND: Urinary tract infection (UTI) is the most common kind of infection in the early stage after kidney transplantation. Although many studies have investigated the risk factors for UTI following kidney transplantation, few studies have focused on the risk factors for UTI in the early stage after transplantation. METHODS: The early-stage data of patients who underwent kidney transplantation between January 2018 and December 2019 in a first-class tertiary hospital in Suzhou, China, were retrospectively analyzed. The general and UTI information of the recipients was subjected to univariate analysis. Variables with statistical significance in the univariate analysis were included in a multivariate logistic regression model. RESULTS: A total of 129 recipients were recruited, among whom 62 patients had a UTI in the early stage after kidney transplantation (48.1%), and the median (interquartile range) of onset time was 5 (4, 10) days after the surgery. A total of 324 strains of UTI pathogens were detected in the 62 recipients after kidney transplantation, 279 of which were gram-negative bacilli (86.1%). Multivariate logistic regression analysis showed that female sex and delayed graft function (DGF) were independent risk factors for early-stage UTI, with odds ratios of 0.095 and 3.753, respectively. CONCLUSIONS: The incidence of early UTI after kidney transplantation is high. Females and DGF patients are more prone to UTIs. Comprehensive prevention and treatment measures should be taken as early as possible against the risk factors to reduce the incidence of UTI.

The use of a homemade rate adjustment card in patients with continuous bladder irrigation after transurethral resection of the prostate.

BACKGROUND: In China, the incidence of benign prostatic hyperplasia (BPH) is rising with the average lifespan of men. Transurethral resection of the prostate (TURP) is recognized as the gold standard for surgical treatment of BPH. Continuous bladder irrigation (CBI) is often required after operation. The irrigation rate is often manually adjusted based on the color of the drainage fluid, but it is difficult to know how much to adjust it based on color. To better adjust the irrigation rate and reduce related complications, we developed and evaluated a post-TURP CBI rate adjustment card. METHODS: A total of 103 BPH patients who underwent post-TURP CBI at our hospital between April and July 2020 were enrolled in this study and were assigned to the control group (n=49) or the experimental group (n=54) according to the different hospital areas. In the control group, the CBI rate was adjusted based on the clinical evaluation of the color of the drainage fluid; in the experimental group, the CBI rate was adjusted based on the color of drainage fluid evaluated with our homemade post-TURP CBI rate adjustment card. RESULTS: The incidence of bladder spasm, the incidence of clot-related catheter blockage, the volume of irrigation solution used, and the irrigation time were significantly lower or shorter in the experimental group than in the control group. The patient satisfaction score was significantly higher in the experimental group (P<0.05). CONCLUSIONS: For BPH patients receiving post-TURP CBI, the homemade post-TURP CBI rate adjustment card can provide objective data for clinical care, reduce postoperative complications, and improve patient satisfaction. Therefore, it should be more widely used in clinical practice.

Influence of transitional care on the self-care ability of kidney transplant recipients after discharge.

BACKGROUND: Renal transplantation is the optimal treatment for end-stage renal diseases. However, low self-care ability after discharge seriously reduces the postoperative quality of life and decreases the survival of both patients and grafts. Transitional care entails a broad range of services designed to ensure health care continuity from hospital to home. Continuous nursing service for patients with kidney transplantation can meet the nursing needs of patients, heighten patients' disease knowledge and self-care ability, guarantee patients' quality of life, and improve the survival rate of the kidney and patient in general. METHODS: A total of 100 kidney transplant recipients were enrolled by using a simple random sampling method. A transitional care team was established to offer transitional care to the discharged patients via telephone calls, outpatient visits, family visits, and kidney transplant patients' clubs. The self-designed disease knowledge questionnaire and the exercise of self-care agency (ESCA) scale were used to evaluate and compare the patients' conditions before and after the implementation of transitional care. RESULTS: The patient's knowledge about self-monitoring, correct medication, reasonable diet, and proper exercise, along with their self-care abilities, were significantly improved after the implementation of transitional care (all P<0.05). CONCLUSIONS: Transitional care can improve the patient's disease knowledge and self-care ability and thus increase the patient's quality of life.

Highly Monodisperse Cu-Sn Alloy Nanoplates for Efficient Nitrophenol Reduction Reaction via Promotion Effect of Tin.

The hexagonal copper-tin alloy (Cu-Sn) nanoplates were synthesized using a high temperature solvent method, the length of six equilateral edges of hexagonal Cu-Sn nanoplates was 23 nm, and the thickness was 13 nm. The obtained hexagonal Cu-Sn nanoplates were highly monodisperse and allowed the formation of nanoarrays arranged with long-range order. The hexagonal Cu-Sn nanoplates exhibited high catalytic activity on catalytic hydrogenation of 4-nitrophenol to 4-aminophenol. Due to the promotion effect of Sn, the apparent rate constant (ka) of hexagonal Cu-Sn nanoplates was three times that of Cu nanoparticles. The density functional theory (DFT) calculations and experimental results demonstrated that Sn could promote the coordination process of -NO2 of 4-nitrophenol with Cu-Sn nanoplates and contribute to activation of 4-nitrophenol. In addition, the hexagonal Cu-Sn nanoplates showed high stability and reusability for the reduction reaction, good adaptability in different pH and the ionic strength, and wide applicability for the degradation of methylene blue, methyl orange, and rhodamine B, even in the industrial wastewater, suggesting that the Cu-Sn nanoplates are promising catalysts in organic industry wastewater treatment.

Copper Nanoflower Assembled by Sub-2 nm Rough Nanowires for Efficient Oxygen Reduction Reaction: High Stability and Poison Resistance and Density Functional Calculations.

The copper nanoflowers, assembled by sub-2 nm rough nanowires with high catalytic active (200) facets, are prepared by a prompt and simple method with cetyltrimethylammonium bromide (CTAB) as a capping agent. The CTAB plays a vital role in the synthesis process, whereas the copper nanorod arrays assembled by copper nanoparticles are obtained without CTAB. The copper nanoflowers are used as catalysts in oxygen reduction reactions and exhibit excellent electrocatalytic activity, which shows nearly the same activity compared with the commercial Pt/C catalyst, attributing to the nanoflower-exposed higher catalytic active (200) facets. Furthermore, the nanoflowers can avoid methanol-poison effect and show better long-term operation stability. The density functional theory was used to calculate the atom energy of Cu(100) facets and Cu(111) facets. Both of O2 dissociation and H2O activation on the facets are very easy. However, the difference between Cu(100) facets and Cu(111) facets is the adsorption and dissociation energy of O2, and the adsorption and activation of oxygen molecule is much easier on Cu(100) facets than on Cu(111) facets because of the more open nature of (100) facets.

[Repair of deep wound on the head due to high-voltage electrical burn].

OBJECTIVE: To explore the methods for repairing deep wound on the head due to high-voltage electrical burn (HEB). METHODS: Twenty-six patients with deep wounds on the head due to HEB were hospitalized from June 2002 to May 2012. They were all injured by high-voltage (voltage ranged from 380 V to 300 kV) electric current, involving head and several other parts over the body. The total burn area ranged from 1% to 75% TBSA, and the depth ranged from deep partial-thickness to full-thickness (including muscle or even bone). Scalp defect area ranged from 3 cm×2 cm to 20 cm×18 cm, and the maximum size of skull exposure was 12 cm×9 cm and the maximum size of skull defect was 7 cm×6 cm. The wounds of 26 patients were repaired with 7 local advance flaps, 4 bilateral rotation flaps, 18 local rotation flaps combined with thin split-thickness skin grafts in donor site, and 3 free anterolateral thigh flaps with vascular anastomosis. In four of the 26 patients, expander was used in the early stage after burn and 5 after wound healing (with thin split-thickness grafts). RESULTS: All flaps and skin grafts survived, except for one flap which was complicated by wound infection, and it was healed after dressing and secondary suturing. The implanted expander expanded smoothly. Patients were followed up for 15 days to three years after surgery. Satisfactory results were obtained, and wounds of 15 patients were repaired completely. CONCLUSIONS: Deep wound on the head due to HEB should be repaired with suitable flap combined with skin graft in donor site, and implantation of expander according to the injury area and condition of patient.

[Experience in the treatment of severe pressure sore].

OBJECTIVE: To summarize the experience in the treatment of severe pressure sore. METHODS: From Aug. 2007 to Jun. 2011, 21 cases of severe pressure sore with 43 III-IV degree lesions were treated with combination treatment, including vacuum sealing drainage technique, local fascia flaps, upper or lower gluteus maximus island myocutaneous flaps, lower gluteus maximus myocutaneous flap, neurocutaneous femoris posterior flaps, tensor fascia lata island myocutaneous flaps, free latissimus dorsi myocutaneous flaps, and skin graft, combined with stryker frame and nursing tracking guidance. 13 of 21 cases had multiple pressure sore. Among them, 5 III degree pressure sores were covered by skin grafting and 3 non-caudal III degree pressure sores (< 2 cm in width) were directly closed after debridement. 8 of 21 cases had single IV degree pressure sore. RESULTS: All the 43 wounds healed completely. 5 wounds in 3 cases had effusion under flap which healed after re-drainage. The wounds were not healed in 3 cases with flap transposition which were also healed after re-debridement. All the flaps survived completely. 16 cases were followed up for 2-26 months. Recurrence happened in 4 cases after discharge because of not following the required nursing care. CONCLUSIONS: Comprehensive application of vacuum sealing drainage technique, multiple myocutaneous flaps and skin grafting, combined with stryker frame and nursing tracking guidance after discharge can be used for the treatment of severe pressure sore with satisfactory results.

[Reverse small saphenous vein-sural neurovascular island flap for t he reconstruction ofsoft tissue defect on foot and ankle in children].

OBJECTIVE: To investigate the clinical application of reversed small saphenous vein-sural neurovascular island flap for reconstruction of soft tissue defect on foot and ankle in children. METHODS: From July 2006 to June 2008, 8 children with soft tissue defects on foot, heel or ankle were treated with reversed small saphenous vein-sural neurovascular island flaps. The size of flaps ranged from 6 cm x 5 cm to 9 cm x 7 cm. The upper margin of the flaps reached the upper third of cruris, with 1 case reaching the transverse line of popliteal fossa. RESULTS: All the flaps survived. The patients were followed up for 1 - 17 months with good aesthetic and functional results. The growth of the two legs had no difference. The sensation of the flaps improved with no heel ulcer and no dysfunction at the donor site. The upper boundary of flaps can reach the upper third of the cruris even the reansverse line of popliteal fossa. The rotation point of the flaps located at 4 - 6 cm above the lateral ankle in children. CONCLUSIONS: The reversed small saphenous vein-sural neurovascular island flap in children has a reliable survival area. The operation is easily performed without any obvious influence on the growth of the operated cruris. It is a good reconstructive method for soft tissue defect in foot and ankle.