[Pathogenic characterization of Klebsiella pneumoniae resistant to carbapenems and polymyxin].

Objective: Analysis and investigation of pathogenic characteristics of polymyxin-and carbapenem-resistant Klebsiella pneumoniae (PR-CRKP). Methods: A total of 23 PR-CRKP strains isolated from clinical specimens from the General Hospital of Southern Theater Command from March 2019 to July 2021 were retrospectively collected, Whole-genome sequencing was performed on 23 PR-CRKP strains, resistance genes were identified by comparison of the CARD and the ResFinder database, high-resolution typing of PR-CRKP strains was analyzed by core genomic multilocus sequencing (cgMLST) and single nucleotide polymorphism (SNP); polymyxin resistance genes were determined by PCR and sequencing. Results: All PR-CRKP strains were KPC-2 producing ST11 types. cgMLST results showed that the evolutionary distance between the PR-CRKP strains and Klebsiella pneumoniae in mainland China was 66.44 on average, which is more closely related than foreign strains; the 23 PR-CRKP strains were divided into 3 main subclusters based on SNP phylogenetic trees, with some aggregation among Clade 2-1 in the isolation department and date. The two-component negative regulatory gene mgrB has seven mutation types including point mutations, different insertion fragments and different insertion positions. Conclusion: The close affinity of PR-CRKP strains indicate the possibility of nosocomial clonal transmission and the need to strengthen surveillance of PR-CRKP strains to prevent epidemic transmission of PR-CRKP.

[A case of severe ethylene glycol poisoning treated successfully by V-V ECMO combined with blood purification].

Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.

Which is the best treatment of osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty, or non-surgical treatment? A Bayesian network meta-analysis.

The aim of the current study was to use a Bayesian network meta-analysis to evaluate the relative benefits and risks of balloon kyphoplasty (BK), percutaneous vertebroplasty (PVP), and non-surgical treatment (NST) for patients with osteoporotic vertebral compression fractures (OVCFs). The results demonstrate that for pain and functional status, PVP was significantly better than NST, while the three treatments did not significantly differ in other outcomes. INTRODUCTION: BK, PVP, and NST are widely used to treat OVCFs, but preferable treatment is unknown. The aim of the current study was to use a Bayesian network meta-analysis to evaluate the relative benefits and risks of BK, PVP, and NST for patients with OVCFs. METHODS: PubMed, EMBASE, and the Cochrane Library were screened. Based on the preplanned eligibility criteria, we screened and included randomized controlled trials that compared BK, PVP, and NST in treating patients with OVCFs. The risk of bias for individual studies was appraised. The data were pooled using a Bayesian network meta-analysis and a traditional direct comparison meta-analysis. RESULTS: Of the 1057 relevant studies, 15 were eligible and included. Compared with NST, PVP significantly reduced pain, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ). The comparative efficacy of BK and PVP was similar for pain (mean difference (MD) 0.51, 95% credible interval (CrI) - 0.35 to 1.4), ODI (MD 0.11, 95% CrI - 13 to 13), and RMDQ (MD 1.2, 95% CrI - 2.7 to 5.4). The European Quality of Life-5 Dimensions (EQ-5D) and Physical Component Summary subscales of the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36 PCS) did not differ significantly. There were also no substantial differences in the risks of subsequent vertebral fractures, adjacent vertebral fractures, and re-fractures at the treated level across all comparators. The results of pairwise meta-analyses were almost consistent with those of network meta-analyses. The treatment ranking indicated that PVP had the highest probability of being the most effective for pain, ODI, RMDQ, and EQ-5D. BK had the highest probability of improving SF-36 PCS and of reducing the risk of subsequent vertebral fractures and re-fractures at the treated level. NST was ranked first in preventing adjacent vertebral fractures. CONCLUSION: PVP was the most effective method for improving pain, functional status, and quality of life (based on EQ-5D). BK emerged as the best intervention for decreasing the risk of subsequent vertebral fractures and re-fractures at the treated level. NST could be ranked first in reducing adjacent vertebral fractures. The future directions of OVCFs treatment will depend on the outcomes of additional and larger randomized trials in comparing BK with PVP.

[The 471st case: duodenal ulcer, mucor infection, and elevated IgG(4)].

Mucor infection is rarely reported in non-immunocompromised population, especially in isolated gastrointestinal tracts. IgG(4)-related diseases (IgG(4)-RD) have been recognized in recent years, but secondary causes of IgG(4) elevation should be differentiated. We reported a young man with duodenal mass and ulcer and high serum IgG(4) level. Histological biopsy of the mass revealed positive mucor mycelium and infiltration of IgG(4) positive plasma cells. Serum IgG(4) decreased to normal range after surgical resection and systemic antifungal treatment. This case suggests that isolated mucor mycosis infection can develop in the digestive tract and mimics as IgG(4)-related disease.

[Short-term and long-term survival in sleeve lobectomy by video-assisted thoracic surgery versus thoracotomy basing on the propensity score matching].

Objective: To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS). Methods: A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014. Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery. Twenty-one pairs (42 cases) patients were included for analysis. The t-test, χ(2) test or Fisher's exact probabilities was adopted, if appropriate, to compare demographics and outcomes between the 2 groups. The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons. Results: After propensity score-matched analysis, the VATS group had a longer operative time ((296.9±73.6) minutes vs. (218.1±59.2) minutes, t=3.82, P=0.00), but shorter postoperative drainage time ((3.3±1.5) days vs. (2.0±3.0) days, t=-0.93, P=0.01) and hospitalization time((6.7±2.8) days vs. (12.1±8.7)days, t=-1.72, P=0.01) than that of the thoracotomy group. Perioperative complications, 1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups. Conclusion: For suitable patients, sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.

[Analysis of risk factors related to the prognosis in patients with late-onset severe pneumonia after allogeneic hematopoietic stem cell transplantation].

Objective: To investigate the prognostic factors of late-onset severe pneumonia (LOSP) in patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: From January 2009 to December 2015, 68 patients with LOSP after allo-HSCT at Peking University Institute of Hematology were enrolled. In this retrospective study, univariate and multivariate analysis were used to evaluate the prognostic factors for LOSP after allo-HSCT. Results: The median time from allo-HSCT to the development of LOSP was 213 (90-2 330) days. The overall survival rate was 42.6% (29/68). The median survival time from LOSP to death was 21 days. Early mortality was defined as death within 21 days after LOSP, as late death more than or equal to 21 days. The median oxygenation index was 199.15 (92.21-290.48) mmHg. LOSPs in thirty-two patients (36.8%) were caused by virus, bacteria, fungi or mixed pathogens. The median C-reactive protein (CRP) was 75.65 (0.94-451.00) mg/L. The median procalcitonin (PCT) was 0.66 (0.00-249.00) µg/L. The higher PCT value indicated an early higher mortality rate by the ROC curve (PCT: cut-off ≥0.94 µg/L). Furthermore, multivariate analysis suggested that PCT more than or equal to 0.94 µg/L was a risk factor for early death of LOSP (OR=5.77, 95%CI 1.66-20.11, P=0.006). LOSP occurred later or equal to 213 days after allo-HSCT was also a risk factor of early death in LOSP (OR=4.74, 95%CI 1.33-16.89, P=0.017). No previous history of chronic graft versus host disease (GVHD) (OR=4.50, 95%CI 1.58-12.83, P=0.005) and LOSP later or equal to 213 days (OR=4.40, 95%CI 1.61-11.99, P=0.004) were the risk factors of late death in LOSP. Conclusions: PCT more than or equal to 0.94 µg/L and LOSP later or equal to 213 days are the risk factors of early death in LOSP. No previous chronic GVHD and LOSP later or equal to 213 days are the risk factors of late death in LOSP.

An overview of the development and application of the sonographic scoring system: differentiation of malignant from benign ovarian tumors.

PURPOSE: Ultrasonography is routinely used for the examination of ovarian tumors regarding preoperative diagnosis and postoperative therapeutic evaluation. However, its sensitivity and specificity in determining benign from malignant tumors should be further improved. In this study, we review the methods of sonographic scoring system for differentiating benign from malignant ovarian tumors, and its development and application. METHODS: We searched the Medline, EBSCO and China National Knowledge Infrastructure from inception to April 2015, we also used the Google Scholar search engine to obtain studies. RESULTS: The ultrasonic scoring system has important clinical value in the preoperative diagnosis of ovarian neoplasm, the sensitivity, specificity and accuracy are significantly higher than using conventional ultrasonography by various of ultrasonic techniques, including two-dimensional sonographic imaging, color Doppler imaging, power Doppler ultrasound, real-time three-dimensional ultrasound and contrast-enhanced ultrasonography. CONCLUSIONS: The sonographic scoring system can significantly improve the sensitivity, specificity and accuracy of ultrasonic diagnosis in ovarian tumors, and provides a semi-quantitative method for determining the nature of ovarian masses, guidance of the surgical treatment and evaluation of prognosis.

[Analysis of the control level and the affecting factors in 4-11 years old children with asthma].

OBJECTIVE: To assess the control level of 4-11 years old children with asthma and to explore the correlative factors affecting the control level of asthma. METHODS: One cross-sectional study was conducted of the 4-11 years old children with asthma from Pediatrics Outpatient Department of Peking University Third Hospital from October 2013 to February 2014. According to asthma control test (ACT), the control levels of asthma children could be divided into three levels: fully controlled, partly controlled and non-controlled. The partly controlled group and the non-controlled group were merged into the non-full controlled group. Life quality was compared between the full controlled group and the non-full controlled group. The correlative factors affecting the controlled level of asthma were analyzed by Logistic regression. The correlative case information was collected and the data were entered with EpiData software and analyzed with SPSS 17.0 software. RESULTS: Ninety asthma children were enrolled.The children from the full controlled group and the non-full controlled group accounted for 61.1% (55/90) and 38.9% (35/90), respectively. Life quality of the full controlled group was higher than that of the non-fully controlled group. There was no significant difference between the two groups on body mass index (BMI), education level of parents, parents or relative smoking, times of respiratory tract infection within 3 months, using asthma control drugs within 4 weeks before seeing a doctor and regularly taking medicine according to the doctor's advice (P>0.05). The binary Logistic regression analysis obtained three correlative factors affecting the control level of asthma: non-regular follow-up (OR=8.364, 95%CI: 1.816-38.532, P<0.05), being diagnosed with or suffering from allergic rhinitis (OR=6.728, 95% CI: 1.699-26.644, P<0.05) and accompanying with other allergic diseases (OR=3.926, 95%CI: 1.210-12.744, P<0.05). CONCLUSION: The results from the single center have shown that the asthma full-controlled rate of 4-11 years old children with asthma is not high. The higher control level, the better the life quality. Non-regular follow-up and being diagnosed with or suffering from allergic rhinitis are the correlative factors affecting the control level of 4-11 years old children with asthma. Meanwhile, accompanying with other allergic diseases, such as atopic dermatitis and food allergy is the protective factor for asthma control. The data from the multi-center and further study will be needed to demonstrate the results of this study.

Exploring the role of histone deacetylase inhibitors in cancer development and therapeutic potential.

The process of acetylation and deacetylation of histones within the nucleus operates within a dynamic equilibrium. Histone acetyltransferases (HATs) and histone deacetylases (HDACs) collaboratively and precisely regulate normal gene transcription and expression. Any disorder in the activity of HATs/HDACs can lead to uncontrolled gene expression, consequently resulting in tumorigenesis. Histone deacetylase inhibitors (HDACIs) have the capacity to block the cell cycle, thereby restraining tumor cell proliferation and tumor growth. Also, HDACIs exhibit a significant capability to diminish the expression of apoptosis protein inhibitors such as Bcl-2 and B-cell lymphoma-extra-large (Bcl-xL), while concurrently up-regulating pro-apoptotic proteins such as Bax, Bad, and Bim. Also, HDACIs demonstrate the ability to inhibit tumor cell angiogenesis. Representing a new category of targeted anti-cancer therapeutics, HDACIs possess the capability to restore the expression of tumor suppressor genes, induce apoptosis, and stimulate cell differentiation. Additionally, they exert anti-cancer effects through diverse pathways both in vivo and in vitro, thereby presenting promising prospects in tumor therapy. This review delves into the involvement of HDACs in cancer pathology and the therapeutic potential of HDACIs as emerging drugs in cancer treatment.

Low serum adiponectin levels are associated with an increased risk of diabetes in obese dogs.

OBJECTIVES: Adiponectin plays an important role in carbohydrate and lipid metabolism. However, the evidence regarding the association between adiponectin and diabetes mellitus in obese dogs is sparse. The aim of this study is to investigate the associations of adiponectin with the risk of diabetes mellitus in obese dogs on the basis of a prospective cohort study. MATERIALS AND METHODS: Serum adiponectin levels in obese dogs recruited from three small animal hospitals between 2015 and 2018 were measured by ELISA. Electronic health records were used to record the incidence of diabetes mellitus during follow-up for 3 years. RESULTS: A total of 862 dogs were included. Amongst the 862 dogs, 51 developed diabetes. Adiponectin levels were associated with diabetes mellitus after adjusting for sex, age, breed, exercise, body condition score, fasting plasma glucose, serum triglyceride and total cholesterol. When adjusting for sex, age, breed, exercise, body condition score, fasting plasma glucose, serum triglyceride and total cholesterol, the adjusted hazard ratios were 7.83 (95% confidence interval: 2.67 to 30.13) in the lowest adiponectin group and 1.96 (95% CI: 1.10 to 8.55) in the medium adiponectin group relative to that in the highest adiponectin group. The area under a curve of adiponectin's Receiver operating characteristic curve was 0.81 (95% CI: 0.76 to 0.86). CLINICAL SIGNIFICANCE: Low adiponectin is associated with diabetes mellitus and has a high risk of incident diabetes mellitus, implying the potential of adiponectin as a predictive biomarker of diabetes mellitus in obese dogs.

[Survey of Oncomelania hupensis in national schistosomiasis surveillance sites of Guangxi Zhuang Autonomous Region from 2015 to 2019].

OBJECTIVE: To investigate the distribution characteristics of Oncomelania hupensis in Guangxi Zhuang Autonomous Region, so as to provide insights into the assessment of the risk of schistosomiasis transmission and the scientific formulation of the schistosomiasis surveillance strategy. METHODS: From 2015 to 2019, a total of 19 national schistosomiasis surveillance sites were assigned in Guangxi Zhuang Autonomous Region, including 4 fixed sites and 15 mobile sites. Snail survey was performed by means of systematic sampling in combination with environmental sampling, and the infection of Schistosoma japonicum was detected by the crushing method combined with loop-mediated isothermal amplification (LAMP) assay. RESULTS: From 2015 to 2019, snail habitats were detected at areas of 17 040 to 39 527 m2, including 6 214 m2 emerging snail habitats and 16 563 m2 re-emerging snail habitats. The overall mean density of living snails was 0.019 2 snails/0.1 m2 and the occurrence of frames with snails was 1.11% in the national schistosomiasis surveillance sites; however, no S. japonicum infection was identified in snails. The area of snail habitats increased by 121.46% in the national surveillance sites in 2019 as compared to that in 2015; however, 50.34% (Z = -0.422, P > 0.05) and 42.85% (χ2 = 130.41, P < 0.01) reductions were seen in the overall means density of living snails and the occurrence of frames with snails. All snail habitats were distributed in the 4 fixed surveillance sites, and were mainly found in ditches, paddy fields and dry lands, with weeds as the primary vegetation type. CONCLUSIONS: There are still risk factors leading to re-emergent transmission of schistosomiasis in Guangxi Zhuang Autonomous Region, such as local snail spread, and the monitoring of schistosomiasis remains to be reinforced to further consolidate the achievements of schistosomiasis elimination in the region.

[Expert consensus on the strategy and measures to interrupt the transmission of schistosomiasis in China].

Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.

An efficient compact 300 mW narrow-linewidth single frequency fiber laser at 1.5 microm.

An efficient single frequency fiber laser by using a newly-developed Er(3+)/Yb(3+) co-doped single mode phosphate glass fiber with the net gain coefficient of 5.2 dB/cm and propagation loss coefficient of 0.04 dB/cm has been demonstrated. Over 300 mW stable continuous -wave single transverse and longitudinal mode seed lasering at 1.5 microm has been achieved from a 2.0 cm-long active fiber. The measured slope efficiency and the calculated quantum efficiency of laser emission are found to be 30.9% and 0.938 +/- 0.081, respectively. It is found that the linewidth of the fiber laser is less than 2 kHz, and the measured relative intensity noise (RIN) is around -120 dB/Hz in the frequency range of 50 to 500 kHz.

In vitro dopaminergic neuroprotective and in vivo antiparkinsonian-like effects of Delta 3,2-hydroxybakuchiol isolated from Psoralea corylifolia (L.).

Cocktail recipes containing Psoralea corylifolia seeds (PCS) are used to empirically treat Parkinson disease. A PCS isolate Delta(3),2-hydroxybakuchiol (BU) can inhibit dopamine uptake in dopamine transporter (DAT) transfected Chinese hamster ovary (CHO) cells, and dopamine reuptake blockade may provide an alternative approach for ameliorating parkinsonism. Here, we assessed the potential dopaminergic neuroprotective, and antiparkinsonian-like activity of BU. BU sample size was increased by using a scale-up extraction paradigm. Pharmacologically, BU significantly protected SK-N-SH cells from 1-methyl-4-phenylpyridinium (MPP(+)) insult, produced striking inhibitory actions on dopamine/norepinephrine uptake and WIN35,428 binding in synaptosomes on in vivo administration, and significantly preventing poor performance on rotarod and dopaminergic loss in substantia nigra in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mice. BU acts by protecting dopaminergic neurons from MPP(+) injury and preventing against MPTP-induced behavioral and histological lesions in the Parkinson's disease (PD) model, possibly by inhibiting monoamine transporters. These findings suggest that BU could be meaningful in PD treatment.

[Advances in the endotypes of chronic rhinosinusitis].

The pathogenesis of chronic rhinosinusitis（CRS） is complex. There are differences in the clinical manifestations and therapeutic effects of CRS dominated by different causes. At present, there is a lack of uniform classification standards in clinical practice. In this paper, the research progress in the endotype of CRS in recent years was discussed.

Porcine skeletal muscle differentially expressed gene CMYA1: isolation, characterization, mapping, expression and association analysis with carcass traits.

To investigate the differences in gene expression between some obese and lean pig breeds, differential display of mRNA was employed in our previous research. One differentially expressed EST (BI596262) was further identified as the porcine cardiomyopathy associated 1 (CMYA1) gene because of its homology to the human CMYA1 gene. The full-length DNA of the porcine CMYA1 gene encompasses 9379 bp, including a complete open reading frame encoding 1839 amino acid residues, a 158-bp 5'-untranslated region and a 630-bp 3'-untranslated region. The porcine CMYA1 gene was assigned to chromosome 13 by the radiation hybrid panel (IMpRH). The porcine CMYA1 gene was expressed only in the striated muscle. Single nucleotide polymorphism (SNP) scanning in the coding region identified one synonymous mutation (c.1053C>T) and three missense mutations, c.1394A>G (p.His465Arg), c.1751A>G (p.Asp582Gly) and c.3290C>A (p.Thr1097Asp). The allele frequencies were tested among about 200 unrelated pigs from several pig breeds. Linkage mapping was further conducted with the SNP c.1751A>G (p.Asp582Gly) in a Berkshire x Yorkshire resource family and this confirmed that porcine CMYA1 is closely linked with Sw344 (distance = 2 cM, LOD score is 129.47), an interesting region harbouring a QTL for back fat thickness. Association analysis in our experimental pig population showed that different genotypes of CMYA1 gene were associated with different back fat thicknesses (P < 0.05). Our results suggest that the porcine CMYA1 gene has effects on porcine back fat deposition and further investigation will be necessary to illustrate the underlying mechanisms.

Thermal stability and spectroscopic properties of Er3+-doped antimony-borosilicate glasses.

This paper reports on the optical spectroscopic properties and thermal stability of Er3+-doped antimony-borosilicate glasses for developing 1.5 microm optical amplifiers. Upon excitation at 980 nm laser diode, an intense 1.5 microm infrared fluorescence has been observed with the maximum full width at half maximum (FWHM) of 90 nm for Er3+-doped antimony-borosilicate glasses. The emission cross-section and the lifetime of the 4I13/2 level of Er3+ ions are 6.3 x 10(-21) cm2 and 0.30 ms, respectively. It is noted that the product of the emission cross-section and FWHM of the glass studied is as great as 567 x 10(-21) cm2 nm, which is comparable or higher than that of bismuthate and tellurite glasses.

Laser-diode-excited intense luminescence and green-upconversion in erbium-doped bismuth-germanate-lead glasses.

We investigate the spectroscopic properties of the 1.5-microm emission from the (4)I(13/2)-->(4)I(15/2) transition of Er(3+) ions in bismuth-germanate-lead glasses for applications in broadband fiber amplifiers. The emission peak locates at 1532nm with a full width at half-maximum (FWHM) of approximately 65nm. The measured lifetime and the calculated emission cross-section of this transition are 3.3ms and 8.66x10(-21)cm(2), respectively. IR-to-green-upconversion occurs simultaneously upon excitation of the 1.5-microm emission with a commercially available 980nm laser diode. Effects of PbF(2) content on the thermal stability, structure and spectroscopic properties of Er(3+)-doped bismuth-germanate-lead glasses have been examined. We find that the substitution with PbF(2) provides a couple of potentials: shortening the UV cutoff band and decreasing the phonon energy of host glasses. Codoping of Yb(3+) significantly enhances both the green-upconversion and 1.5-microm emission intensity by means of a nonradiative Yb(3+)-->Er(3+) energy transfer. Energy transfer processes and nonradiative phonon-assisted decays could account for the population of the (2)H(11/2) level, which is an emitting level of the green-upconversion of Er(3+). The results indicate the possibility towards the development of bismuth-germanate-lead based glasses as photonics devices.

Therapeutic effects of long-term continuous positive airway pressure treatment on improving leptomeningeal collateral circulation in obstructive sleep apnea syndrome patients.

OBJECTIVE: This study aims to use methods of scoring collaterals on CT angiography to analyze changes in collateral circulation in untreated patients with moderate and severe OSAS before and after nasal continuous positive airway pressure (CPAP) treatment. PATIENTS AND METHODS: Ninety-eight moderate and severe OSAS patients treated with nasal CPAP and seventy-four controls that weren't treated with CPAP, were involved in this study. Two independent neuroradiologists evaluated intracranial collaterals by using Miteff scale, modified Tan scale. Intracranial collaterals differences were compared between OSAS group (before and after treated) and control group. Correlations between intracranial collaterals and clinical parameters were analyzed. RESULTS: Compared with pre-therapy of moderate and severe groups, apnea-hypopnea index (AHI), oxygen desaturation index (ODI), epworth sleepness scale (ESS) were lower after treatment. The lowest oxygen saturation, average blood oxygen saturation, Miterff scale, modified Tan scale in moderate and severe groups were significantly increased after treatment. We documented significant decrease of Miterff scale after two years in moderate and severe OSAS group without CPAP therapy (n = 32, p < 0.01). Conversely, mild OSAS group without CPAP therapy did not change Miterff scale after two years (n = 32, p > 0.05). Multivariate Logistic regression analysis showed that AHI had significant impact on Miterff scale and modified Tan scale. Severe OSAS were independently related with Miterff scale (odds ratio 0.343, 95% confidence interval 0.301-0.391, p < 0.01) and modified Tan scale (odds ratio 0.267, 95% confidence interval 0.095-0.754, p = 0.013). CONCLUSIONS: Long-term CPAP treatment is a viable therapeutic choice for improving leptomeningeal collateral circulation in OSAS patients.

Design of a shattered pellet injection system on J-TEXT tokamak.

Disruptions have the possibility of causing severe wall damage to large tokamaks like ITER. The mitigation of disruption damage is essential to the safe operation of a large-scale tokamak. The shattered pellet injection (SPI) technique, which is regarded as the primary injection method for ITER, presents several advantages relative to massive gas injection, including more rapid particle delivery, higher total particle assimilation, and more centrally peaked particle deposition. A dedicated argon SPI system that focuses on disruption mitigation and runaway current dissipation has been designed for the Joint Texas Experimental Tokamak (J-TEXT). A refrigerator is used to form a single argon pellet at around 64 K. The pellet will be shaped with a 5 mm diameter and a 1.5-10 mm length. Helium gas at room temperature will be used as a propellant gas for pellet acceleration. The pellet can be injected with a speed of 150-300 m/s. The time interval between injection cycles is about 8 min. The pellet will be shattered at the edge of the plasma and then injected into the core of plasma. The first experiments of SPI fast shutdown and runaway current dissipation have been performed.