Study on Varicella-Zoster Virus Antibody Levels among Children Aged 1-7 Years in Changzhou, China.

We aim to understand the varicella-zoster virus (VZV) antibody levels in children after vaccination and to construct VZV-IgG centile curves and reference values for children aged 1-7 years. From September to October 2023, a total of 806 children were recruited according to the time intervals of 1 month, 6 months, 1 year, 2 years, and 3 years after vaccination, as well as age groups. A generalized additive model for location, shape, and scale (GAMLSS) was applied to estimate P3, P10, P25, P50, P75, P90, and P97 centile reference values of VZV-IgG, and 95% reference intervals were calculated. A total of 785 children were included in the analysis, with an overall positivity rate of 70.3%, a median antibody concentration of 192.05 (82.89-571.14) mIU/mL, and a positivity rate of 57.7% for one dose of vaccine and 84.2% for two doses. Antibody positivity rates at 1 month, 6 months, 1 year, 2 years, and 3 years after vaccination were 65.1%, 74.4%, 80.4%, 67.7%, and 63.0%, respectively. The GAMLSS results showed that VZV-IgG had a tendency to increase and then decrease after vaccination, and the second dose of vaccination could significantly increase VZV-IgG. Two doses of varicella vaccine should be administered to children in a timely manner and included in the routine vaccination programs.

Effect of physical activity on anxiety, depression and obesity index in children and adolescents with obesity: A meta-analysis.

FOR FULL-LENGTH ARTICLES: This study systematically identified the effects of physical activity (PA) on depression, anxiety and weight-related outcomes among children and adolescents with overweight/obesity. EMBASE, The Cochrane Library, Web of Science, and PubMed were searched from January 1, 2000 to August 1, 2022 for peer-reviewed papers. Meta-analyses were conducted to ascertain the effect of physical activity on symptoms of anxiety, depression and weight-related outcomes in overweight/obese children and adolescents. Twenty-five studies representing 2188 participants, with median age 12.08 years old (8.3 to 18.44 years) were included. Depressive and anxiety symptoms, BMI, BMI z-scores, weight, waist circumference and height were evaluated. After incorporating the effects of PA interventions on children and adolescents with overweight/obesity, PA could improve depressive and anxiety symptoms, but not obesity indexes except waist circumference. While, PA combined with other interventions have a significant effect both on anxiety symptoms and BMI compared to pure PA intervention. In terms of intervention duration, we observed that durations falling within the range of 8 to 24 weeks exhibited the most positive effects on reducing depressive symptoms. FOR SHORT COMMUNICATIONS: We included 25 articles on the effects of physical activity on psychological states such as depression and anxiety, weight, BMI and other weight-related indicators in children and adolescents with overweight/obesity. We attempted to determine the most appropriate type of physical activity intervention for children and adolescents with overweight/obesity, as well as the most appropriate population characteristics and duration by combining the outcome data from each article. This has a great enlightening effect for health workers to carry out corresponding strategies in the future.

The impact of dietary and sleep rhythms on blood pressure in children and adolescents: a cross-sectional study.

Evidence about the relationship between meal and sleep time and CVD in children is scarce. The aims of this study were to describe the association between life rhythm patterns and blood pressure in children. This research was conducted among 5,608 children aged 6 to 15 years old in Chongqing and Sichuan provinces in 2021 and 2022. Dietary and sleep rhythms information was collected. The time of the first meal and last meal, and sleep time, were obtained. The mean age was 10.48 ± 2.24 years old, with 2958 (52.75%) male participants. The mean feeding window on weekdays was 11.69 h, 12.42 h, and 13.23 h for participants aged 6-7 years old, 8-12 years old and 13-15 years old, respectively. Weekday feeding window and last mealtime were positively correlated with blood pressure levels. And the changes in the feeding window between weekdays and weekends were significantly correlated with BP. Sleep duration and change in wake time were significantly correlated with SBP. Based on these results, this study identified the optimal combination of dietary and sleep rhythm interventions for children younger than 12 years of age and aged 12 and older, respectively. Disorder dietary and sleep rhythms disorders may correlate with elevated blood pressure levels, suggesting developing optimal dietary and sleep rhythm patterns could prevent the incidence of CVDs in children. The optimal dietary rhythm was defined by the indexes of breakfast time, dinner time and daily feeding window. As good meal patterns are defined as satisfied the following three items: for children younger than 12 years should have breakfast after 7:30 am; aged 12 years and over should have breakfast after 7 am; having dinner before 6 pm; daily feeding window less than 12.5 h. And less optimal dietary rhythm should satisfy any condition or eat dinner between 6 pm and 8 pm; and poor dietary rhythm should not satisfy any of the three criteria and eat dinner after 8 pm. Children with optimal dietary rhythm (in group A) had lower SBP (P < 0.001), DBP (P = 0.002) and MAP (P < 0.001) than those in group C.

The estimated effect of increasing fruit interventions on controlling body weight in children and adolescents: A meta-analysis.

BACKGROUND: The impact of increased fruit consumption on weight change remains a matter of debate. OBJECTIVE: This study aimed to evaluate the effects of interventions targeted at promoting fruit consumption and managing body weight in children and adolescents. METHODS: Four electronic databases, including PubMed, Web of science, Embase, and the Cochrane Library, were searched from January 1, 2000, to October 10th, 2023, to identify Randomized controlled trials (RCTs) that assessed changes in fruit consumption and obesity indicators. RESULTS: A total of 22 trials including 12,678 participants who met our inclusion criteria were selected for this review. The meta-analysis demonstrated that the interventions increased fruit intake (MD = 78.58 g/day (95% CI 53.09 to 104.07), P < 0.001) in children and adolescents. The mean reduction of body mass index was 0.27 kg/m2 (95% CI -0.59 to 0.05 kg/m2, P = 0.101). And no significant decreases were observed in body mass index-z scores, but there was a significant decrease in waist circumference (MD = -0.65 cm (95% CI -1.15 to -0.05 cm), P < 0.05). Increased fruit intake was shown to be associated with a lower prevalence of obesity when compared to the control group (odds ratio [OR]: 0.74, 95% CI 0.60 to 0.90), P < 0.05). CONCLUSIONS: This meta-analysis provided evidence that interventions aimed at increasing fruit consumption were effective at reducing obesity prevalence.

Engineering of the LAMP-CRISPR/Cas12b platform for Chlamydia psittaci detection.

Introduction. Chlamydia psittaci (C. psittaci) is a zoonotic infection, that causes psittacosis (parrot fever) in humans, leading to severe clinical manifestations, including severe pneumonia, adult respiratory distress syndrome, and, in rare cases, death.Gap Statement. Rapid, sensitive and specific detection of C. psittaci facilitates timely diagnosis and treatment of patients.Aim. This study aimed to engineer the LAMP-CRISPR/Cas12b platform for C. psittaci detection.Methodology. The loop-mediated isothermal amplification (LAMP) technique and clustered regularly interspaced short palindromic repeats-CRISPR associated protein 12b (CRISPR-Cas12b) assay were combined to establish two-step and one-tube LAMP-CRISPR/Cas12b reaction systems, respectively, for rapidly detecting C. psittaci.Results. The two-step and one-tube LAMP-CRISPR/Cas12b assay could complete detection within 1 h. No cross-reactivity was observed from non-C. psittaci templates with specific LAMP amplification primers and single-guide RNA (sgRNA) targeting the highly conserved short fragment CPSIT_0429 gene of C. psittaci. The detection limits of the two-step and one-tube LAMP-CRISPR/Cas12b reaction were 102 aM and 103 aM, respectively. The results were consistent with qPCR for nucleic acid detection in 160 clinical samples, including 80 suspected C. psittaci samples, kept in the laboratory.Conclusions. The LAMP-CRISPR/Cas12b assay developed in this study provides a sensitive and specific method for rapidly detecting C. psittaci and offers technical support for its rapid diagnosis.

Reliable and Scalable Piezoresistive Sensors with an MXene/MoS2 Hierarchical Nanostructure for Health Signals Monitoring.

The increased popularity of wearable electronic devices has led to a greater need for advanced sensors. However, fabricating pressure sensors that are flexible, highly sensitive, robust, and compatible with large-scale fabrication technology is challenging. This work investigates a piezoresistive sensor constructed from an MXene/MoS2 hierarchical nanostructure, which is obtained through an easy and inexpensive fabrication process. The sensor exhibits a high sensitivity of 0.42 kPa-1 (0-1.5 kPa), rapid response (∼36 ms), and remarkable mechanical durability (∼10,000 cycles at 13 kPa). The sensor has been demonstrated to be successful in detecting human motion, speech recognition, and physiological signals, particularly in analyzing human pulse. These data can be used to alert and identify irregularities in human health. Additionally, the sensing units are able to construct sensor arrays of various sizes and configurations, enabling pressure distribution imaging in a variety of application scenarios. This research proposes a cost-effective and scalable approach to fabricating piezoresistive sensors and sensor arrays, which can be utilized for monitoring human health and for use in human-machine interfaces.

Migration Behavior of Inclusions at the Solidification Front in Oxide Metallurgy.

Distribution of inclusions plays an essential role in inducing intracrystalline ferrite, and the migration behavior of inclusions during solidification has a significant influence on their distribution. The solidification process of DH36 (ASTMA36) steel and the migration behavior of inclusions at the solidification front were observed in situ using high-temperature laser confocal microscopy. The annexation, rejection, and drift behavior of inclusions in the solid-liquid two-phase region were analyzed, providing a theoretical basis for regulating the distribution of inclusions. Analysis of inclusion trajectories showed that the velocity of inclusions decreases significantly as they near the solidification front. Further study of the force on inclusions at the solidification frontier shows three situations: attraction, repulsion, and no influence. Additionally, a pulsed magnetic field was applied during the solidification process. The original dendritic growth mode changed to that of equiaxed crystals. The compelling attraction distance for inclusion particles with a diameter of 6 µm at the solidification interface front increased from 46 µm to 89 µm, i.e., the effective length for the solidification front engulfing inclusions can be increased by controlling the flow of molten steel.

Molecular Characteristics and Genetic Analysis of Extensively Drug-Resistant Isolates with different Tn3 Mobile Genetic Elements.

Extensively drug-resistant (XDR) bacteria are the main caues for causing clinical infectious diseases. Our aim was to distinguish the present molecular epidemiological situation of XDR Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli isolates recovered from local hospitals in Changzhou. Antibiotic susceptibility and phenotypic analysis, multilocus sequence typing and Pulsed Field Gel Electrophoresis were performed to trace these isolates. Resistant phenotype and gene analysis from 29 XDR strains demonstrated that they mainly included TEM, CTX-M-1/2, OXA-48, and KPC products. A. baumannii strains belonged to sequence type (ST) ST224, and carrying the blaCTX-M-2/TEM gene. The quinolone genes aac(6')-ib-cr and qnrB were carrying only in A. baumannii and E.coli. Three (2.3%) of these strains were found to contain the blaNDM-1 or blaNDM-5 gene. A new genotype of K. pneumoniae was found as ST2639. Epidemic characteristics of the XDR clones showed that antibiotic resistance genes distributed unevenly in different wards in Changzhou's local hospitals. With the sequencing of blaNDM carrying isolates, the plasmids often carrying a highly conservative Tn3-relavent mobile genetic element. The especially coupled insert sequence ISKox3 may be a distinctive resistance gene transfer loci. The genotypic diversity variation of XDRs suggested that tracking and isolating the sources of antibiotic resistance especially MBL-encoding genes such as blaNDM-will help manage the risk of infection by these XDRs.

A retrospective study of initial root canal treatment failure in maxillary premolars via using cone-beam computed tomography.

BACKGROUND: This case-series study examined canal morphology and common factors for endodontic failure in maxillary first and second premolars that were referred for retreatment owing to clinical symptoms or radiographic signs. METHODS: Records were retrospectively searched using Current Dental Terminology codes to identify maxillary first and second premolars with endodontic failure. Periapical and cone-beam computed tomographic images were examined to determine Vertucci classifications and suspected factors related to treatment failure. RESULTS: A total of 235 teeth from 213 patients were included for evaluation. The following Vertucci classification of canal configurations were observed for maxillary first and second premolars: type I (1-1) (4.6% and 32.0%, respectively), type II (2-1) (15.9% and 27.9%, respectively), type III (2-2) (76.1% and 36.1%, respectively), type IV (1-2) (0% and 2%, respectively), and type V (3) (3.4% and 2%, respectively). More treatment failures were noticed in maxillary second premolars than first premolars and in females than in males. The 4 most common factors related to failure were inadequate filling, restorative failure, vertical root fracture, and missed canals. Missed canals were more frequently identified in maxillary second premolars (21.8%) than first premolars (11.4%) (P = .044). CONCLUSIONS: Multiple factors are associated with primary root canal treatment failures in maxillary premolars. Variations in canal morphology appear to be underappreciated in maxillary second premolars. PRACTICAL IMPLICATIONS: Maxillary second premolars have more complicated canal configurations than first premolars. Besides adequate filling, clinicians should give extra attention to anatomic variability in second premolars owing to higher failure incidence.

Epidemiological and genetic characteristics of sapovirus clusters in Changzhou schools from 2019 to 2022 / 中国学校卫生

Objective@#To analyze the epidemiological characteristics and genetic characteristics of sapovirus (SaV) in a cluster of schools in Changzhou, so as to provide a reference for the treatment of clustered vomiting and diarrhea events in schools.@*Methods@#The epidemiological data and laboratory test data of sapovirus clusters in Changzhou from 2019 to 2022 were collected and analyzed. Partial VP1 genes of SaV positive samples were amplified and sequenced for phylogenetic analysis.@*Results@#A total of 8 cases of clusters of SaV epidemics were reported in Changzhou City from 2019 to 2022, with 118 reported cases. The total attack rate was 1.47%, and the median of the attack number was 15. There were 6 outbreaks in kindergartens and 2 outbreaks in primary schools, which were reported in the epidemic period from September to December. The main clinical manifestations were vomiting (113 cases, 95.76 %), abdominal pain (39 cases, 33.05%), and diarrhea (16 cases, 13.56%). Among the 8 outbreaks, 17 sample strains were successfully sequenced. 5 outbreaks were GII.3 , and the other 3 outbreaks were GI.1, GI .3 and GII.2. GI and GII were the main genotypes in this area, and GII .3 was the predominant strain.@*Conclusion@#SaV is an important pathogen in the clusters of vomiting and diarrhea in schools after the transmission of norovirus. Continuous surveillance of SaV should be carried out to further understand its epidemiological characteristics and genotype distribution, so as to provide scientific basis for the prevention and control of the epidemic in schools.

Relationship between dietary fruit intake and overweight and obesity in children / 中国学校卫生

Objective@#To explore the relationship between fruit intake and the risk of overweight with obesity in children, so as to provide references for the prevention of childhood obesity.@*Methods@#From September to November 2014, a stratified cluster sampling method was used to select 6 369 children aged 6-12 from two elementary schools of a country in rural Chongqing for physical examinations and questionnaire surveys, and 1 814 children in grades 1-2 at baseline were followed up from March to May 2019. The relationship between fruit intake and the prevalence of overweight and obesity was analyzed.@*Results@#According to the percentile of fruit intake, the 6 369 children at baseline were assigned to three groups: Q 1 (< P 33.3 , fruit intake <100 g/d), Q 2 ( P 33.3 - P 66.7 , fruit intake:100-214.3 g/d), and Q 3 (> P 66.7 , fruit intake >214.3 g/d). For the baseline survey results, children in the Q 2 group had a lower weight and Body Mass Index (BMI) ( P <0.05); the prevalence of overweight and obesity among children in the Q 1 group was the highest (32.03%), and the prevalence of overweight and obesity among boys in the Q 2 group was the lowest (31.94%) after gender stratification ( P <0.05). The follow up survey results showed no significant differences between the three groups in terms of changes in height, weight, and BMI ( P >0.05); but the prevalence of obesity among youth in the Q 2 group was the lowest (5.07%, P <0.05). Compared with youth in the Q 2 group, the risk of obesity was higher among those in the Q 1 group at baseline survey ( OR=1.41, 95%CI=1.10-1.81, P <0.05), and was higher among those in the Q 3 group at follow up survey ( RR= 1.83, 95%CI=1.21-2.75, P <0.05).@*Conclusion@#Deviating from moderate fruit intake may increase the likelihood of overweight and obesity in children, and it is recommended that children are encouraged to consume fruits as part of a well balanced diet to prevent the occurrence of obesity.

Highly stable, stretchable, and versatile electrodes by coupling of NiCoS nanosheets with metallic networks for flexible electronics.

The rapid development of portable electronics has contributed to an urgent demand for versatile and flexible electrodes of wearable energy storage devices and pressure sensors. We fabricate a stretchable electrode by coupling the nickel-cobalt sulfide (NiCoS) nanosheet layer with Ag@NiCo nanowire (NW) networks. NiCoS wrinkled nanostructure, highly conductive networks, and intense interactions between substrate/networks and active materials/networks endow the electrodes with excellent energy storage capacity, superior electrochemical/mechanical stability, and good conductivity. A high-performance asymmetric supercapacitor is developed using the composite electrode. It operates in a wide potential window of 1.4 V and achieves a maximum energy density of 40.0 W h kg-1 at a power density of 1.1 kW kg-1; it also exhibits excellent mechanical flexibility and good waterproof performance. Moreover, a sandwiched capacitive pressure sensor constructed using the same electrodes has a wide sensing range (up to 260 kPa), low detection limit (∼47 mN), fast response (∼66 ms), and excellent mechanical stability (10 000 cycles). This study demonstrates that the appropriate design of the functional electrode facilitates the construction of various high-performance devices, denoting the versatility of our electrodes in the development of wearable electronics.

Death in a farmer with underlying diseases carrying Vibrio cholerae non-O1/non-O139 producing zonula occludens toxin.

OBJECTIVES: The non-O1/non-O139 Vibrio cholerae caused outbreaks or sporadic cases of gastroenteritis that was rarely seen in good sanitary condition. It was described a case of systemic multiple organ lesions that worsened because of non-O1/non-O139 V. cholerae, suggesting that serogroups have a potential virulence in enhancing pathogenicity with patients with underlying diseases compared with a healthy population. DESIGN OR METHODS: Samples are identified by strain culture, polymerase chain reaction (PCR) virulence identification, and whole genome sequencing. RESULTS: A middle-aged man was diagnosed with cytotoxin-producing and nontoxin V. cholerae non-O1/non-O139 serogroups. Although lacking the CT toxin encoded by ctxAB gene, the pathogenesis of cholera relies on the synergistic action of many other genes, especially virulence genes. CONCLUSIONS: This case suggested that the laborers engaging in agricultural production are at potential risk of V. cholerae infection by exposure of open wounds to contaminated water . However, epidemiological investigation should focus on the objective cause of the change of working environment. Furthermore, common diseases can possibly enhance the virulence of non-O1/non-O139 serogroups by attacking the tight junction of small intestinal epithelial cells, further triggering bacteremia, a process that may lead to death within 48-72 hours, which requires great attention.

Genetic diversity of norovirus associated with outbreaks in school children with acute gastroenteritis in Changzhou, China, 2018-2019.

Norovirus is one of the major causes of outbreaks and sporadic cases of acute gastroenteritis in school children. Obtaining local genotype diversity information regarding norovirus is important for developing and evaluating prevention strategies of the transmission of this virus in school children. Clinical specimens, obtained from the routine acute gastroenteritis surveillance network from 2018 to 2019, were primarily tested using commercial real-time PCR Kit. Samples with Ct value less than 25 were selected and used for complete genome sequencing and those with Ct value between 25 and 30 were selected and used for he partial VP1 and RdRp regions sequencing. Phylogenetic trees of the viral genome were constructed by using the neighbor-joining method with bootstrap analysis of 1000 replicates in MEGA 6.0. Epidemiological surveillance of acute intestinal infections (n = 384) showed high-level detection (73.18%) of human norovirus in school endemic acute gastroenteritis events in Changzhou, with obvious epidemic characteristics in autumn and winter. Through genotyping, it was found that 93.12% of norovirus were GII, including GII.2, GII.3, GII.4, GII.6, GII.7, and GII.17. By October 2019, two norovirus genotypes, GII.4[P31] and GII.17[P17], became the preponderant epidemic strains. Phylogenetic analysis of the new GII.17[P17] complete genomes showed close relationship with Miyagi strain identified in Japan in 2015, and GII.4[P31] showed close relationship with Jinan strain indentified in China in 2017. The study highlights the emerging role of GII.4[P31] and GII.17[P17] in causing endemic acute gastroenteritis outbreaks at school children, in Changzhou, China in 2019.

Effects of Antimicrobial Peptide Microcin C7 on Growth Performance, Immune and Intestinal Barrier Functions, and Cecal Microbiota of Broilers.

Microcin C7 is an antimicrobial peptide produced by Escherichia coli, composed of a heptapeptide with a modified adenosine monophosphate. This study was performed to evaluate the effects of Microcin C7 as a potential substrate to traditional antibiotics on growth performance, immune functions, intestinal barrier, and cecal microbiota of broilers. In the current study, 300 healthy Arbor Acres broiler chicks were randomly assigned to one of five treatments including a corn-soybean basal diet and basal diet supplemented with antibiotic or 2, 4, and 6 mg/kg Microcin C7. Results showed that Microcin C7 significantly decreased the F/G ratio of broilers; significantly increased the levels of serum cytokine IL-10, immunoglobulins IgG and IgM, and ileal sIgA secretion; significantly decreased the level of serum cytokine TNF-α. Microcin C7 significantly increased villus height and V/C ratio and significantly decreased crypt depth in small intestine of broilers. Microcin C7 significantly increased gene expression of tight junction protein Occludin and ZO-1 and significantly decreased gene expression of pro-inflammatory and chemokine TNF-α, IL-8, IFN-γ, Toll-like receptors TLR2 and TLR4, and downstream molecular MyD88 in the jejunum of broilers. Microcin C7 significantly increased the number of Lactobacillus and decreased the number of total bacteria and Escherichia coli in the cecum of broilers. Microcin C7 also significantly increased short-chain fatty acid (SCFA) and lactic acid levels in the ileum and cecum of broilers. In conclusion, diet supplemented with Microcin C7 significantly improved growth performance, strengthened immune functions, enhanced intestinal barrier, and regulated cecal microbiota of broilers. Therefore, the antimicrobial peptide Microcin C7 may have the potential to be an ideal alternative to antibiotic.

[High expression of ICOS on CD4+ T cells and ICOSL on CD19+ B cells in peripheral blood and its positive correlation with TRAb in Graves' disease].

Objective To detect the expression of inducible co-stimulator and inducible co-stimulator ligand (ICOS/ICOSL) on peripheral lymphocytes in patients with Graves' disease (GD) and its clinical significance. Methods A total of 105 untreated GD patients and 67 healthy controls were enrolled in our study. 19 GD patients treated with anti-thyroid drugs were followed up in the outpatient department until TRAb were negative. The peripheral blood mononuclear cells (PBMCs) were separated and analyzed with PCR. ICOS expression on CD4+/CD8+ T cells and ICOSL expression on CD19+ B cells were detected by flow cytometry. The correlations between the expression of ICOS/ICOSL with thyroid parameters and TRAb were analyzed. Results The expression of both ICOS and ICOSL mRNA in PBMCs of the untreated GD patients were significantly higher than those in the healthy controls. Compared with healthy controls, ICOS expression on CD4+ T cells and ICOSL expression on CD19+ B cells were up-regulated significantly in the GD patients. Correlation analysis showed that ICOS expression on CD4+ T cells was positively correlated with the level of free triiodothyronine (FT3) in the GD patients. In the group of GD patients with high TRAb titers in serum, ICOSL expression on CD19+ B cells notably increased as compared with that in the patients with low TRAb. ICOS expression on CD4+ T cells and ICOSL expression on CD19+ B cells were recovered in the GD patients with negative TRAb. Conclusion The expression of ICOS on the surface of CD4+ T cells and ICOSL on CD19+ B cells in peripheral blood of patients with Graves's disease are significantly increased.With the decrease of TRAb level, the expression levels of ICOS on the surface of CD4+ T cells and ICOSL on CD19+ B cells are restored.

Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis.

BACKGROUND: There are various techniques to reduce blood loss in total knee arthroplasty (TKA), including the use of a tourniquet and tranexamic acid (TXA). In this study, we studied the combined effect of TXA with a tourniquet on blood loss in the setting of primary TKA. METHODS: Randomized controlled trials (RCTs) of nine treatment methods were included (placebo, intravenous [i.v.] TXA, topical TXA, i.v.-combined topical TXA, oral TXA, placebo + tourniquet, i.v. TXA +tourniquet, topical TXA + tourniquet, and i.v.-combined topical TXA + tourniquet). The patients were divided into eight groups according to the different treatment strategies, with 30 cases per group. The differences in the total blood volume, the number of patients transfused, the hemoglobin before and after the operation, and complications after the operation were compared. RESULTS: Totally 15 RCTs meeting our inclusion criteria were collected in this study. Compared with the placebo + tourniquet group, the i.v. TXA + tourniquet group displayed lower hemoglobin reduction value, pulmonary embolism (PE) incidence, total blood loss, and blood transfusion risk; the topical TXA + tourniquet group showed reduced PE incidence, total blood loss, and blood transfusion risk, and the i.v.-combined topical TXA and i.v.-combined topical TXA + tourniquet groups showed decreased total blood loss and lower blood transfusion risk. Retrospective clinical study results also demonstrated that the efficacy of i.v.-combined topical TXA was the best. CONCLUSIONS: Our meta-analysis indicates that i.v.-combined topical TXA provides a low total blood loss without increasing the blood transfusion risk in patients undergoing total knee replacement surgery.

Vital pulp therapy of a dens evaginatus‒affected tooth with an immature apex and inflamed pulpal and periapical tissue: a case report.

Dens evaginatus (DE) is a developmental anomaly presenting as an enamel-covered tubercle on the occlusal surface of a premolar, particularly found in people of Asian descent. This case report describes partial pulpotomy in a mandibular premolar with a fractured evaginatus tubercle and endodontic infection. A 10.5-year-old girl of Asian descent was referred for endodontic evaluation and treatment because of local swelling and pain. Clinical examination suggested the presence of DE in a noncarious mandibular right second premolar with a diagnosis of symptomatic irreversible pulpitis and symptomatic apical periodontitis. On access, the pulp was hemorrhagic. A single-appointment mineral trioxide aggregate (MTA) pulpotomy and an immediate composite resin restoration were performed. Recall examinations at 3, 6, and 18 months verified periapical healing and root development without clinical symptoms. This case report suggests that MTA pulpotomy could be a viable alternative option for DE-affected immature teeth with pulpal and periapical inflammation.

Binder-Free Nickel Oxide Lamellar Layer Anchored CoOx Nanoparticles on Nickel Foam for Supercapacitor Electrodes.

To enhance the connection of electroactive materials/current collector and accelerate the transport efficiency of the electrons, a binder-free electrode composed of nickel oxide anchored CoOx nanoparticles on modified commercial nickel foam (NF) was developed. The nickel oxide layer with lamellar structure which supplied skeleton to load CoOx electroactive materials directly grew on the NF surface, leading to a tight connection between the current collector and electroactive materials. The fabricated electrode exhibits a specific capacitance of 475 F/g at 1 mA/cm2. A high capacitance retention of 96% after 3000 cycles is achieved, attributed to the binding improvement at the current collector/electroactive materials interface. Moreover, an asymmetric supercapacitor with an operating voltage window of 1.4 V was assembled using oxidized NF anchored with cobalt oxide as the cathode and activated stainless steel wire mesh as the anode. The device achieves a maximum energy density of 2.43 Wh/kg and power density of 0.18 kW/kg, respectively. The modified NF substrate conducted by a facile and effective electrolysis process, which also could be applied to deposit other electroactive materials for the energy storage devices.

Safety and Effectiveness of De-escalated Radiation Dose in T1-3 Nasopharyngeal Carcinoma: A Propensity Matched Analysis.

Backgrounds: With the excellent local control in T1 to T3 nasopharyngeal carcinoma (NPC) treated with intensity modulated radiotherapy (IMRT), the importance of toxicities is increasingly being recognised. This retrospective propensity score analysis sought to assess whether moderate dose reduction compromised long-term outcome compared with standard dose in T1-3 NPCs. Materials and Methods: A total of 266 patients (67 female, 199 male) with a median age of 50 years between June 2011 and June 2015 were analysed. All were treated with IMRT, with or without systemic chemotherapy. The prescription radiation dose to gross tumor is 70Gy/2.12Gy/33F in our institution. Results: With a median follow-up time of 50 months, the 5-year loco-regional failure-free survival (LRFS) and overall survival (OS) were 93.5% and 81.8%, respectively. 32 patients received radiation dose less than prescription dose, with a median dose of 63.6Gy (53-67Gy). Another 234 patients received exactly the prescription dose of 70Gy. Propensity scores were computed (32 patients treated with de-escalated dose and 64 patients with standard dose), there was no significant difference in 5-year LRFS and 5-year OS between the two groups (92.5% and 91.7% with standard dose; 82.1% and 85.7% with de-escalation dose; p=0.863 for LRFS and 0.869 for OS). No independent prognostic factor was associated with loco-regional failure in univariate analysis. Conclusions: T1-3 nasopharyngeal carcinoma presenting with superior locoregional control, a moderately reduced dose (about 10%) delivered with IMRT resulted in comparable prognosis to those with prescription dose of 70Gy.