Do Community Home-Based Elderly Care Services Improve Life Satisfaction of Chinese Older Adults? An Empirical Analysis Based on the 2018 CLHLS Dataset.

Population aging has become a major challenge for the Chinese government. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018, this study adopts the propensity score matching (PSM) method to assess the effect of community home-based elderly care services (CHECS) on the life satisfaction of the elderly in China. The results demonstrate that CHECS can improve their life satisfaction. Compared with life care services (LCS) and medical care services (MCS), the positive effect of spiritual and cultural services (SCS) and reconciliation and legal services (RLS) is more obvious. Moreover, the heterogeneity test demonstrates that the effect is more significant for the elderly who live with their families, whose activities of daily living are unrestricted, and whose depression levels are lower. The results obtained indicate that CHECS need precise policies for different elderly groups, attention to the positive impact of SCS and RLS on the life satisfaction of the elderly, and the substantive effectiveness of LCS and MCS.

Dietary ellagic acid supplementation attenuates intestinal damage and oxidative stress by regulating gut microbiota in weanling piglets.

Intestinal oxidative stress triggers gut microbiota dysbiosis, which is involved in the etiology of post-weaning diarrhea and enteric infections. Ellagic acid (EA) can potentially serve as an antioxidant supplement to facilitate weaning transition by improving intestinal oxidative stress and gut microbiota dysbiosis. Therefore, we aimed to investigate the effects of dietary EA supplementation on the attenuation of intestinal damage, oxidative stress, and dysbiosis of gut microbiota in weanling piglets. A total of 126 piglets were randomly assigned into 3 groups and treated with a basal diet and 2 mL saline orally (Ctrl group), or the basal diet supplemented with 0.1% EA and 2 mL saline orally (EA group), or the basal diet and 2 mL fecal microbiota suspension from the EA group orally (FEA group), respectively, for 14 d. Compared with the Ctrl group, EA group improved growth performance by increasing average daily feed intake and average daily weight gain (P < 0.05) and decreasing fecal scores (P < 0.05). EA group also alleviated intestinal damage by increasing the tight junction protein occludin (P < 0.05), villus height, and villus height-to-crypt depth ratio (P < 0.05), while decreasing intestinal epithelial apoptosis (P < 0.05). Additionally, EA group enhanced the jejunum antioxidant capacity by increasing the total antioxidant capacity (P < 0.01), catalase (P < 0.05), and glutathione/oxidized glutathione (P < 0.05), but decreased the oxidative metabolite malondialdehyde (P < 0.05) compared to the Ctrl group. Compared with the Ctrl group, EA and FEA groups increased alpha diversity (P < 0.05), enriched beneficial bacteria (Ruminococcaceae and Clostridium ramosum), and increased metabolites short-chain fatty acids (P < 0.05). Correspondingly, FEA group gained effects comparable to those of EA group on growth performance, intestinal damage, and intestinal antioxidant capacity. In addition, the relative abundance of bacteria shifted in EA and FEA groups was significantly related to the examined indices (P < 0.05). Overall, dietary EA supplementation could improve growth performance and attenuate intestinal damage and oxidative stress by regulating the gut microbiota in weanling piglets.

A 3D visualization layered anatomy for acromial arterial rete and flap design.

BACKGROUND: The acromial arterial rete (AAR) is the junction between the skin blood supply of the cervical side and that of the upper arm, and it is the only site crossed by the trans-regional blood supply of the cervico-humeral flap (CHF). The aim of this study was to explore the structures of AAR to optimizing flap design. METHODS: A body arteriography and spiral CT scan were performed on 33 whole adult corpses. The 3D reconstruction was used to perform continuous digital layered anatomy of the shoulder and upper chest; the acromion and acromioclavicular joint were used as the center to observe the source, route and distribution characteristics of a perforating branch and their anastomosis. RESULTS: The perforating branches were separated from an acromial branch of the transverse cervical artery (97%), posterior humeral circumflex artery (95%), a deltoid branch of the thoracoacromial artery (95%), and the acromial branch of the thoracoacromial artery (93%). The diameter of the acromial branch of the transverse cervical artery at its initial location was 1.18 ± 0.37 mm; the trunk length was 12.53 ± 3.83 cm, and it was anastomosed with other blood vessels in three forms. CONCLUSION: Deep fascia should be included in the flap design. Three kinds of pedicled transfer flaps can be designed with the acromial branch of transverse carotid artery as the vascular pedicle. Free flaps can be designed with the acromial branch of thoracoacromial artery as the vascular pedicle.

A Dopant Replacement-Driven Molten Salt Method toward the Synthesis of Sub-5-nm-Sized Ultrathin Nanowires.

The high-temperature molten-salt method is an important inorganic synthetic route to a wide variety of morphological phenotypes. However, its utility is limited by the fact that it is typically incapable of producing ultrathin (<5 nm diameter) nanowires, which have a crucial role in novel nanotechnology applications. Herein, a rapid molten salt-based synthesis of sub-5-nm-sized nanowires of hexagonal tungsten oxide (h-WO3 ) that is critically dependent on a substantial proportion of molybdenum (Mo) dopant is described. This dopant-driven morphological transition in tungsten oxide (WO3 ) may be attributable to the collapse of layered structure, followed by nanocluster aggregation, coalescence, and recrystallization to form ultrathin nanowires. Interestingly, due to the structural properties of h-WO3 , the thus-formed ultrathin nanowires are demonstrated to be excellent photocatalysts for the production of ammonia (NH3 ) from nitrogen (N2 ) and water. The ultrathin nanowires exhibit a high photocatalytic NH3 -production activity with a rate of 370 µmol g-1 h-1 and an apparent quantum efficiency of 0.84% at 420 nm, which is more than twice that obtained from the best-performing Mo-doped W18 O49 nanowire catalysts. It is envisaged that the dopant replacement-driven synthetic protocol will allow for rapid access to a series of ultrathin nanostructures with intriguing properties and increase potential applications.

Three-Dimensional Visualization for Extended Deep Inferior Epigastric Perforator Flaps.

PURPOSE: The aim of the study was to provide an applied and digital anatomical basis of acquiring extended deep inferior epigastric perforator (DIEP) flaps for clinical use. METHODS: Five formalin-soaked specimens were received red latex injection and dissected by layers. The arteriography using the modified mixture of lead oxide-gelatin was performed on 10 adult cadavers that were serially scanned by a spiral computed tomography. The DIEPs were 3 dimensionally reconstructed by Mimics. RESULTS: The medial row perforators of DIEP arteries are located in the medial 1/third of rectus abdominis muscle, and lateral row perforators in the lateral 1/third of the muscle. The perforators distribute mainly from the upper tendinous intersection of umbilicus to below umbilicus within 8.0 cm, especially 4.0 cm. There are constant diameter 0.8-mm perforators or greater accompanied with nerveswithin this region. The main perforators are shown by fast direct volume rendering (VR) reconstruction method, and 3-dimensional images of DIEPs are acquired by dynamic reconstruction (DR) method. Consecutively, the adjacent perforators can be combined freely and the position and anastomosis of extended branches can be easily observed. The extended DIEP flaps were designed by VR and DR methods. CONCLUSIONS: The DIEPs can obtain large extended perforator flaps accompanied with nerves. The perforator close to the umbilicus should be selected while designing the DIEP flap. The 3-dimensional model of extended DIEP flaps can be established conveniently and intuitively by VR and DR methods of Mimics.

Comparative Study of Choke Vessel Reconstruction With Single and Multiple Perforator-Based Flaps on the Murine Back Using Delayed Surgery.

OBJECTIVE: Choke vessels, vascular anastomosis between adjacent angiosome, play an important role in flap expansion and survival. Here we established a flap model with single and multiple perforators to detect and compare the changes in choke vessels, discuss the effect of hemodynamics on the vascular morphology, and explore the underlying mechanism. METHODS: One hundred mice (7-8 weeks) were subjected to a "choke zone" surrounded by 4 perforators on their backs. Delayed surgery was performed by the ligation of 1, 2, or 3 perforators to establish flap models. The blood flow of the choke zone was measured by laser Doppler flowmetry preoperatively and 6 hours and 1, 3, 5, and 7 days. The morphological changes of choke vessels in the choke zone were observed by gross and histological analyses. Levels of angiogenesis-related markers such as endothelial nitric oxide synthase (eNOS), metalloproteinase 2, hypoxia-inducible factor 1α (HIF-1α), and intercellular adhesion molecule 2 (ICAM-2) were detected by Western blotting and enzyme-linked immunosorbent assay. RESULTS: Blood flow and microvascular count were obviously increased postoperatively and peaked and were maintained for 1 week (P < 0.01). Meanwhile, the diameters of the choke vessels expanded. The eNOS level was increased at 7 days (P < 0.05); however, the enzyme-linked immunosorbent assay results showed that the HIF-1α and ICAM-2 levels were decreased at 7 days. CONCLUSIONS: (1) The delayed surgery that kept a single perforator had the greatest impact on the choke zone. (2) Changes in choke vessels were closely related to the shear stress caused by enhanced blood perfusion after surgery. (3) Choke vessel growth was regulated by eNOS, metalloproteinase 2, HIF-1α, and ICAM-2.

Analytical fuzzy approach to biological data analysis.

The assessment of the physiological state of an individual requires an objective evaluation of biological data while taking into account both measurement noise and uncertainties arising from individual factors. We suggest to represent multi-dimensional medical data by means of an optimal fuzzy membership function. A carefully designed data model is introduced in a completely deterministic framework where uncertain variables are characterized by fuzzy membership functions. The study derives the analytical expressions of fuzzy membership functions on variables of the multivariate data model by maximizing the over-uncertainties-averaged-log-membership values of data samples around an initial guess. The analytical solution lends itself to a practical modeling algorithm facilitating the data classification. The experiments performed on the heartbeat interval data of 20 subjects verified that the proposed method is competing alternative to typically used pattern recognition and machine learning algorithms.

Comparative study of 3D reconstruction of rat sciatic nerve microvessels using Evans blue and lead oxide.

BACKGROUND: The blood supply of peripheral nerve grafts is one of the important factors that affect nerve regeneration. Many investigators have studied how intraneural microvessels are distributed and ways to promote the angiogenesis of grafts. However, there still does not exist an ideal intraneural microvascular model. The purpose of this study was to compare the three-dimensional (3D) reconstruction of microvessels of the sciatic nerve in Sprague-Dawley (SD) rats after systemic perfusion with Evans blue (EB) or lead oxide. METHODS: Ten adult SD rats were randomized to a fluorography group (EB) or radiography group (lead oxide). After administration of the perfusion agents, imaging information was obtained by fluorescence microscopy and micro-computed tomography (µCT). Three-dimensional reconstruction was performed, and the diameter of microvessels at a constant distance (a cross-section was taken every 1 mm), the vascular index, and volume were measured. Two-dimensional (2D) images were obtained by serial sectioning and µCT scanning using the two methods described. RESULTS: In the EB group, the diameter, vascular area, and vascular index of microvessels were 11.79 ± 7.23 µm, 0.14 ± 0.05 mm2, and 24.19 ± 5.03%, respectively, and in the lead oxide group 26.45 ± 11.81 µm, 0.06 ± 0.02 mm2, and 10.73 ± 2.06%, respectively. Microvessels with diameters <20 µm were visualized better in the EB group than in the lead oxide group (P < 0.01). However, there was no significant difference between the groups in the visualization of microvessels with diameters 20-49 µm (P > 0.05). CONCLUSIONS: Both EB and lead oxide can be used for 2D study of intraneural microvessels and 3D observation after reconstruction. Lead oxide is easy to use, and though its resolution is lower than that of EB for smaller microvessels with diameters <20 µm, it is more suitable for studying a large sample volume.

[A trail of three-dimensional visualization technique to observe intraneural microvessels of sciatic nerves in Sprague Dawley rats].

OBJECTIVE: To investigate the feasibility of establishing the visualization models of intraneural microvessels of sciatic nerves in Sprague Dawley (SD) rats by systemic infusion of Evan's blue (EB) or lead oxide and to compare the advantages and disadvantages. METHODS: Fifteen healthy adult SD rats of either gender, weighing 200-250 g, were randomly divided into traditional group (group A, n=5), fluorescence group (group B, n=5), and radiography group (group C, n=5). Ink, EB, and lead oxide, all mixed with gelatin solution, were injected in groups A, B, and C, respectively. After 2 hours of cryopreservation under 4 degrees C, all sciatic nerves were harvested and observed through stereomicroscope to make sure the filling condition. The two-dimentional (2D) images were then collected via reflexion fluorescent microscope in group B and via micro-CT scan in group C. All images were imported into computer to establish three-dimentional (3D) reconstruction models by Mimics 15.0. RESULTS: All groups could show the outline of intraneural microvessels of sciatic nerves under stereomicroscope. Diameters of them were measured under fluorescent microscope, ranging from 10 microm to 30 microm. Both groups B and C could establish 3D reconstruction models from 2D images. These models could clearly reproduce the structure of microvessels. CONCLUSION: Both EB and lead oxide can be used to establish 3D reconstruction models to observe structure of the intraneural vessels. However, EB has some disadvantages, such as predisposition to infiltration, grainy 2D images and time-consuming procedure; it is not suitable for researches of large specimen. Though 2D pictures from lead oxide have lower resolution than EB, it is easier to be manipulated and appropriate for experiments of large specimen.

Three-dimensional analysis of perforators of the posterior leg.

BACKGROUND: Three-dimensional evaluations of cutaneous perforator vessels provide useful clinical information to aid in the design of perforator flaps. By combining three-dimensional digital imaging and angiography, the authors developed a new three-dimensional visualization technique for vascular perforators. Their purpose was to produce a digitized model of the posterior leg to determine the anatomical relationships of perforators in each zone of the posterior leg. METHODS: Eight cadavers were injected with a modified lead oxide-gelatin mixture. Two cadavers were selected for three-dimensional reconstruction using a spiral computed tomography scanner and specialized volume-rendering software. Dissection, angiography, and photography of each layer were performed to outline the course of every perforator in the posterior leg. The area of the vascular territory supplied by each source vessel was calculated. Surface areas were measured using Scion Image software. RESULTS: The arterial supply to the integument of the posterior leg was divided into proximal, middle, and distal zones. There were 13 +/- 2.3 perforators with diameters of greater than or equal to 0.5 mm; the average external diameter was 0.8 +/- 0.2 mm. Each perforator supplied an average area of 38 +/- 9.0 cm. Perforators from the popliteal artery were large and consistent and supplied an average area of 55 +/- 20 cm; there were multiple anastomoses between perforators from the popliteal, posterior tibial, and peroneal arteries. The distal zone received its arterial supply from two to three smaller septocutaneous perforators, which are arranged longitudinally in one to two parallel chains. CONCLUSIONS: The posterior leg is an excellent donor site for local and distant flaps. Perforator flaps could be based in a variety of ways from each zone.