Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus

The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip.

PURPOSE

To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L_1-4) in elderly men with type 2 diabetes mellitus (T2DM).

METHODS

We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score <  - 1.0).

RESULTS

Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm², P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075-74.222], P = 0.043).  CONCLUSION: Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.

[Preliminary evaluation on the efficacy of emergency transcatheter aortic valve replacement: a multicenter study]

Objectives: To explore the efficacy and safety of emergency transcatheter aortic valve replacement (TAVR). Methods: Data of patients who underwent emergency TAVR in eight centers, namely Fuwai Hospital, Wuhan Asia Heart Hospital, Xijing Hospital, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Guangdong Provincial People's Hospital, Zhongshan Hospital Affiliated to Fudan University, the First Affiliated Hospital of Zhengzhou University, the Second Xiangya Hospital of Central South University, between May 2017 and December 2020 were retrospectively analyzed. The use of mechanical circulatory support system (MCS) and the results of laboratory tests (N-terminal B-type natriuretic peptide (NT-proBNP)) and echocardiography (mean aortic valve cross valve pressure difference and left ventricular ejection fraction) before and after operation were collected. The primary endpoint was all-cause death, and the secondary endpoints were stroke, major bleeding, major vascular complications, myocardial infarction, permanent pacemaker implantation, and acute renal injury. Device success was caculated, which refered to absence of procedural mortality and correct positioning of a single prosthetic heart valve into the proper anatomical location and intended performance of the prosthetic heart valve (mean aortic valve gradient<20 mmHg(1 mmHg=0.133 kPa) or peak velocity<3 m/s, with no moderate or severe prosthetic valve regurgitation). Kaplan-Meier survival curve was used to estimate the survival rate of patients during follow-up. Results: This study included 48 patients. The age was (72.5±8.1) years, and 34 patients were males (70.8%). Device success rate was 91.7% (44/48). The mean aortic valve transvalvular pressure was significantly decreased after operation ((12.3±6.4)mmHg vs. (60.2±23.8)mmHg, P<0.000 1). Left ventricular ejection fraction was significantly increased ((41.5±11.7)% vs. (31.0±11.3)%, P<0.000 1). NT-proBNP significantly decreased (3 492.0 (1 638.8, 7 165.5) ng/L vs. 12 418.5 (6 693.8, 35 000.0) ng/L, P<0.000 1). In-hospital all-cause mortality was 8.3% (4/48). During hospitalization, the rate of stroke was 2.1% (1/48), major bleeding was 6.3% (3/48), major vascular complications was 10.4% (5/48), myocardial infarction was 4.2% (2/48), permanent pacemaker implantation was 6.3% (3/48), and the rate of acute renal injury was 12.5% (6/48). MCS was used in 20 patients (41.7%). The median follow-up time was 196 days. During the follow-up, one patient died (due to systemic metastasis of pancreatic cancer), two cases suffered new myocardial infarction and one case received permanent pacemaker implantation. The survival rate of 30 days, 1 year and 2 years after the operation were 91.7% (44/48), 89.6% (43/48), 89.6% (43/48), respectively. Conclusion: Emergency TAVR may be a safe and effective treatment for patients with severe decompensated aortic valve stenosis.

First Measurement of High-Energy Reactor Antineutrinos at Daya Bay

This Letter reports the first measurement of high-energy reactor antineutrinos at Daya Bay, with nearly 9000 inverse beta decay candidates in the prompt energy region of 8-12 MeV observed over 1958 days of data collection. A multivariate analysis is used to separate 2500 signal events from background statistically. The hypothesis of no reactor antineutrinos with neutrino energy above 10 MeV is rejected with a significance of 6.2 standard deviations. A 29% antineutrino flux deficit in the prompt energy region of 8-11 MeV is observed compared to a recent model prediction. We provide the unfolded antineutrino spectrum above 7 MeV as a data-based reference for other experiments. This result provides the first direct observation of the production of antineutrinos from several high-Q_{β} isotopes in commercial reactors.

Observation of a State X(2600) in the π^{+}π^{-}η' System in the Process J/ψ→γπ^{+}π^{-}η'

Based on (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, the process J/ψ→γπ^{+}π^{-}η^{'} is studied using two largest decay channels of the η^{'} meson, η^{'}→γπ^{+}π^{-} and η^{'}→ηπ^{+}π^{-}, η→γγ. A new resonance, which we denote as the X(2600), is observed with a statistical significance larger than 20σ in the π^{+}π^{-}η^{'} invariant mass spectrum, and it has a connection to a structure around 1.5  GeV/c^{2} in the π^{+}π^{-} invariant mass spectrum. A simultaneous fit on the π^{+}π^{-}η^{'} and π^{+}π^{-} invariant mass spectra with the two η^{'} decay modes indicates that the mass and width of the X(2600) state are 2618.3±2.0_{-1.4}^{+16.3}  MeV/c^{2} and 195±5_{-17}^{+26}  MeV, where the first uncertainties are statistical, and the second systematic.

Effects of deoxynivalenol on the histomorphology of the liver and kidneys and the expression of MAPKs in weaned rabbits

Deoxynivalenol (DON) is widely present in grain-based feeds and food. It has attracted great attention due to its high contamination rate and strong toxicity. The objective of this study was to analyse the toxic effects of DON on the liver and kidneys of weaned rabbits. 45 weaned male rabbits were allocated into control, low DON dose (0.5 mg/kg body weight), and high DON dose (1.5 mg/kg body weight) groups. Saline or DON was administrated intragastrically in the empty stomach of rabbits every morning. After 24 days of treatment, liver and kidney samples were collected for histological, reverse transcription-quantitative polymerase chain reaction (qRT-PCR), and immunohistochemistry analyses. Haematoxylin eosin staining showed that 0.5 mg/kg BW DON caused mild damage to the liver and kidney morphology, while 1.5 mg/kg body weight DON resulted in hepatic vacuolation and necrosis, as well as tubular stenosis and lesions. Data from qRT-PCR, Western blot, and immunohistochemistry revealed that the mRNA and protein expression and the distribution range of extracellular signal-regulated kinase, p38, and c-Jun NH2-terminal kinase were increased in the liver and kidneys. In conclusion, DON at the tested concentrations damaged the liver and kidneys of rabbits by affecting the expression of key proteins from the mitogen-activated protein kinase signalling pathway. The damage extent was proportional to the amount of DON ingested.

Observation of J/ψ Electromagnetic Dalitz Decays to X(1835), X(2120), and X(2370)

Using a sample of about 10^{10}  J/ψ events collected at a center-of-mass energy sqrt[s]=3.097  GeV with the BESIII detector, the electromagnetic Dalitz decays J/ψ→e^{+}e^{-}π^{+}π^{-}η^{'}, with η^{'}→γπ^{+}π^{-} and η^{'}→π^{+}π^{-}η, have been studied. The decay J/ψ→e^{+}e^{-}X(1835) is observed with a significance of 15σ, and also an e^{+}e^{-} invariant-mass dependent transition form factor of J/ψ→e^{+}e^{-}X(1835) is presented for the first time. The intermediate states X(2120) and X(2370) are also observed in the π^{+}π^{-}η^{'} invariant-mass spectrum with significances of 5.3σ and 7.3σ. The corresponding product branching fractions for J/ψ→e^{+}e^{-}X, X→π^{+}π^{-}η^{'} [X=X(1835), X(2120), and X(2370)] are reported.

[Successful prediction and the process of the weaning of veno-arterial extracorporeal membrane oxygenation]

The weaning of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is one of the clinical challenges, and hospitals have developed experience-based strategies, so there is still a lack of unified standards and procedures for weaning. This paper discusses this issue from the definition of weaning success, evaluation of patients before weaning, predictive indicators, weaning process, etc. Summarizing research progress and problems so that providing guidance for the development of ECMO in the future, such as perfecting weaning process and putting forward scoring system to predict weaning success and clinical outcome.

Smartphone-based gamification intervention to increase physical activity participation among patients with coronary heart disease: intermediate results of a randomized controlled trial

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work is financially supported by a Construction Programme of Independent Innovation Ability of Community Health Nursing Engineering Laboratory in Jilin Province (Study code: 2020C038-8) awarded to FL.

Background

Despite the benefits, patients with coronary heart disease are less likely to engage in physical activity. Gamification is the use of game design elements (such as points, leaderboards, progress bars, and badges) in nongame contexts to increase motivation and engagement. Scientific evidence suggests that smartphone-based gamification interventions have the potential to increase physical activity participation. However, empirical evidence on the efficacy of such interventions among patients with coronary heart disease is still emerging.

Purpose

This study incorporates behavioral economics into a gamification intervention based on a smartphone app (WeChat applet) to explore whether a gamification intervention can improve participation in physical activity and other related physical and psychological outcomes in patients with coronary heart disease.

Methods

A group of 108 participants (mean age 53.0+10.5, 18.5% female) with coronary heart disease were randomly assigned to three groups (Control group: WeChat applet+step goal setting; Individual group: WeChat applet+step goal setting+gamification; Team group: WeChat applet+step goal setting+gamification+collaboration). The primary outcomes included the change in daily steps and the proportion of patient-days that step goals achieved. Patients also completed Psychological Needs Satisfaction in Exercise Scale (PNSE), Behavioural Regulation in Exercise Questionnaire (BREQ)-3, Physical Activity Enjoyment Scale (PACES), Generalised Anxiety Disorder (GAD)-7, Patient Health Questionnaire (PHQ)-9 at baseline, 12 weeks and 24 weeks.

Results

Compared with the control group (n=36), participants in the individual group (n=36) had a significantly greater increase in mean daily steps from baseline during the intervention group (difference 988; 95% CI, 259 - 1717; P&lt;0.01), and had a significantly greater proportion of patient-days that step goals achieved (difference 0.38; 95% CI, 0.04 - 0.13; P&lt;.001), competence (difference 0.6, 95% CI, 0.3 - 0.8; P&lt;.001), autonomous motivation (difference 3.3; 95% CI, 2.2 to 4.4; P&lt;.001), weight (difference -1.2, 95% CI, -1.8 to -0.6; P&lt;.001), BMI (difference -0.4; 95% CI -0.6 to -0.2; P&lt;.001) and waist circumference (difference -1.2; 95% CI -1.7 to -0.6; P&lt;.001). Participants in team group (n=36) had a significantly greater increase in competence (difference 0.3; 95% CI 0.1 to 0.6; P&lt;.001), relatedness (difference 0.9; 95% CI 0.7 to 1.2; P&lt;.001), autonomous motivation (difference 3.0; 95% CI 2.1 to 4.0; P&lt;.001),however, no significant difference of change in step counts was found between team group and control group.

Conclusions

A smartphone-based gamification intervention may be an effective way to promote physical activity in patients with coronary heart disease within 12 weeks if we incorporate appropriate game elements into the smartphone application.

[Research advances on mesenchymal stem cells and their derivatives in the treatment of acne scars]

Acne is a common chronic inflammatory disease of the skin that often occurs on the face, and acne scars are often secondary to the healing process of acne, which often leads to impaired appearance and psychological disorders of patients. The current treatment for acne scars is extremely difficult. With the development of regenerative medicine, stem cell transplantation has become a new treatment for acne scars. In recent years, it has been reported that stem cells and their derivatives can effectively antagonize the formation of acne scars. Therefore, this paper briefly reviews the basic and clinical researches on the treatment of acne scars with various mesenchymal stem cells and their derivatives, aiming to provide theoretical basis and reference for the stem cell therapy of acne scars.

948 THE DEVELOPMENT OF A DYSPHAGIA CUP TO IMPROVE WATER INTAKE AND REDUCE CAREGIVER BURDEN IN CHANGI GENERAL HOSPITAL (CGH)

 

At any one time, &gt;60% of the beds in the 1,000 bedded CGH is occupied by an elderly &gt;65. Ensuring adequate water intake among the elderly patients is a challenge. Hence, 90% of our elderly inpatients in the acute wards did not consume the recommended daily allowance of fluid. Causes for poor water consumption included dysphagia requiring thickened fluids, manpower reasons, patient and environmental factors. The Geriatrician led a team to explore, designed and developed a dysphagia cup to improve fluid intake for the elderly inpatients, with input from nursing, occupational and speech therapists. The plan-do-study-act methodology was employed in this study. Training was provided to nursing staff and caregivers prior to issuing the cups.

Results

The cup improves availability of water for the patients, encourages autonomy so the patients may drink independently without aspirating, reduces caregiver burden while thickening prior to serving fluids and improves patient care.

The improved water consumption reduces adverse outcomes associated with dehydration such as delirium, constipation and long length of stay. Results showed improvement in water consumption among 75% of the patients, with 62% increase in amount of fluid consumption. 83% of patients were able to drink independently with &gt;90% caregiver (nurses and family) satisfaction. The cups saved nursing time significantly, projected to save 14 full time nurses a year and 67% improvement in nursing productivity, for CGH.

Conclusion

Encouraging the elderly to drink is labour intensive and time consuming, especially for patients with dysphagia. Time saving was proven for thickening fluids and since patients drink independently, time was saved for assisting/supervising patients while drinking. Since the cup has measuring gauge, it was faster to thicken fluids. The cup holds enough fluids for several serving, the caregiver need not prepare to thicken fluids prior to every serving.

Probing CP symmetry and weak phases with entangled double-strange baryons

Though immensely successful, the standard model of particle physics does not offer any explanation as to why our Universe contains so much more matter than antimatter. A key to a dynamically generated matter-antimatter asymmetry is the existence of processes that violate the combined charge conjugation and parity (CP) symmetry1. As such, precision tests of CP symmetry may be used to search for physics beyond the standard model. However, hadrons decay through an interplay of strong and weak processes, quantified in terms of relative phases between the amplitudes. Although previous experiments constructed CP observables that depend on both strong and weak phases, we present an approach where sequential two-body decays of entangled multi-strange baryon-antibaryon pairs provide a separation between these phases. Our method, exploiting spin entanglement between the double-strange Ξ- baryon and its antiparticle2 [Formula: see text], has enabled a direct determination of the weak-phase difference, (ξP - ξS) = (1.2 ± 3.4 ± 0.8) × 10-2 rad. Furthermore, three independent CP observables can be constructed from our measured parameters. The precision in the estimated parameters for a given data sample size is several orders of magnitude greater than achieved with previous methods3. Finally, we provide an independent measurement of the recently debated Λ decay parameter αΛ (refs. 4,5). The [Formula: see text] asymmetry is in agreement with and compatible in precision to the most precise previous measurement4.

Altered dynamic functional topology in first-episode untreated patients with schizophrenia can aid in early diagnosis

Introduction

There is a growing consensus on brain networks that it is not immutable but rather a dynamic complex system for adapting environment. The neuroimaging research studying how brain regions work collaboratively with dynamic methods had demonstrated its effectiveness in revealing the neural mechanisms of schizophrenia.

Objectives

To investigate altered dynamic brain functional topology in first-episode untreated schizophrenia patients (SZs) and establish classification models to find objective brain imaging biomarkers.

Methods

Resting-state-functional magnetic resonance data for SZs and matched healthy controls were obtained(Table1).

Power-264-template was used to extract nodes and sliding-window approach was carried out to establish functional connectivity matrices. Functional topology was assessed by eigenvector centrality(EC) and node efficiency and its time-fluctuating was evaluated with coefficient of variation(CV). Group differences of dynamic topology and correlation analysis between Positive and Negative Syndrome Scale(PANSS) scores and topology indices showing group differences, which also were used in establishing classification models, was examed.

Results

The CV of node efficiency in angular and paracingulate gyrus was larger in SZs. There are 13 nodes assigned into several brain networks displaying altered CV of EC between groups(Figure1.A). Fluctuation of EC of the node in DMN, which was lower in SZs, showed negative correlation with PANSS total scores(Figure1.B). Dynamic functional topology of above nodes was used to train classification models and demonstrated 80% and 71% accuracy for support vector classification(SVC) and random forest(RF), respectively(Figure2).

Conclusions

Dynamic functional topology illustrated a capability in identifying SZs. Aberrated dynamics of DMN relevant to severity of patient’s symptoms could reveal the reason why it contributed to classification.

Disclosure

No significant relationships.

Brain controllability and clinical relevance in schizophrenia

Introduction

Apart from the psychiatric symptoms, cognitive deficits are also the core symptoms of schizophrenia. Brain network control theory provided information on the role of a specific brain region in the cognitive control process, helping understand the neural mechanism of cognitive impairment in schizophrenia.

Objectives

To characterize the control properties of functional brain network in first-episode untreated patients with schizophrenia and the relationships between controllability and psychiatric symptoms, as well as exploring the predictive value of controllability in differentiating patients from healthy controls (HCs).

Methods

Average and modal controllability of brain networks were calculated and compared between 133 first-episode untreated patients with schizophrenia and 135 HCs. The associations between controllability and clinical symptoms were evaluated using sparse canonical correlation analysis. Support vector machine (SVM) and SVM-recursive feature elimination combined with the controllability were performed to establish the individual prediction model.

Results

Compared to HCs, the patients with schizophrenia showed increased average controllability and decreased modal controllability in dorsal anterior cingulate cortex (dACC). Brain controllability predominantly in somatomotor, default mode, and visual networks was associated with the positive symptomatology of schizophrenia. The established model could identify patients with an accuracy of 0.68. Furthermore, the most discriminative features were located in dACC, medial prefrontal lobe, precuneus and superior temporal gyrus.

Conclusions

Altered controllability in dACC may play a critical role in the neuropathological mechanisms of cognitive deficit in schizophrenia, which could drive the brain function to different states to cope with varied cognitive tasks. As symptom-related biomarkers, controllability could be also beneficial to individual prediction in schizophrenia.

Disclosure

No significant relationships.

[Analysis of liver function injury associated with 2019-nCoV Omicron mutant strains]

Objective: To investigate the clinical features and influencing factors of liver function injury in patients with 2019-nCoV/SARS-CoV-2 Omicron mutant strains. Methods: 1 183 confirmed imported cases of SARS-CoV-2 who were admitted at Shanghai Public Health Clinical Center (affiliated to Fudan University) from July 1, 2021 to January 15, 2022 were collected. Clinical data, viral genotyping and laboratory test results were collected to retrospectively analyze the basic condition and clinical characteristics of liver function injury. Statistical analysis was performed using t-test or Wilcoxon rank-sum test, χ² test or Fisher's exact test, Pearson correlation test and logistic regression analysis. Results: 125 (10.6%) cases had raised baseline ALT level and 60 (5.1%) cases had abnormal baseline AST level. Among them, 33 cases (2.8%) had received hepatoprotective drugs. Liver function injury was generally mild in SARS-CoV-2 infection and minimal in Omicron mutant strains. Leukocyte count was increased in patients with raised alanine aminotransferase (ALT) [(6.96±1.78)×10⁹/L vs. (6.41±1.96)×10⁹/L, P=0.005 2], CT scan showed the proportion of liver hypodensity was significantly increased (2.4% vs. 0.3%, P=0.018 0). High-sensitivity C-reactive protein [(7.83±22.36) mg/L vs. (2.68±6.21) mg/L, P=0.007 8] and D-dimer [(0.34±0.39) μg/ml vs. (0.31±0.75) μg/ml, P=0.047 5] levels were higher in patients with raised AST than normal group. 26 cases had normal liver function at hospital admission; however, abnormal liver function was occurred during the course of the disease. Another 8 patients had abnormal liver function at hospital admission, and reduced liver function further during the course of treatment. Recovery time and length of hospital stay was significantly affected in patients with worsened liver function. Baseline body mass index value [odds ratio (OR)]=1.80, P=0.047), non-Omicron strains (OR=12.63, P=0.046), D-dimer (OR=2.36, P=0.047) and interleukin-6 levels (OR=1.03, P=0.009), and those who used glucocorticoids and/or ulinastatin after hospital admission (OR=6.89, P=0.034) had a higher risk of worsening liver function. Conclusions: Liver dysfunction could be observed among COVID-19 patients. Patients infected with omicron variant generally showed mild liver injury. Dynamic monitoring of liver function is necessary, especially among those with baseline elevated IL-6, D-Dimer level and use of antiinflammation medication during treatment.

Analgesic and Sedative Effects of Different Doses of Dexmedetomidine Combined with Butorphanol in Continuous Analgesia after a Cesarean Section

Objective

The present study is designed to study the analgesic and sedative effect of different doses of dexmedetomidine combined with butorphanol in continuous analgesia after a cesarean section.

Methods

A total of 60 puerperae undergoing a cesarean section recruited from a single center were divided into three groups according to the postoperative continuous analgesia protocol: control group (100 mL of normal saline containing 10 µg/kg fentanyl and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), DB1 group (100 mL of normal saline containing 1.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), and DB2 group (100 mL normal saline containing 2.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h). We compared the blood pressure, heart rate, oxygen saturation, VAS score, Ramsay score, and adverse reactions of puerperae among the three groups after surgery.

Results

The baseline data all have no significant difference in the three groups (p > 0.05). Compared with those in the control group, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB1 group and DB2 group were significantly decreased at 6, 24, and 48 h (P < 0.05), while the Ramsay scores of the puerperae in DB1 group and DB2 group were significantly increased at 6, 24, and 48 h (p < 0.05). At the same time, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB2 group were significantly lower than those in the DB1 group (P < 0.05), while the Ramsay scores of the puerperae in DB2 group were significantly higher than those in the DB1 group (P < 0.05). Also, there is no significant difference in oxygen saturation and adverse reactions of puerperae among the three groups after surgery (p > 0.05).

Conclusion

Dexmedetomidine combined with butorphanol can improve the analgesic and sedative effects in continuous analgesia after a cesarean section, and the analgesic and sedative effects of dexmedetomidine in the high-dose group are better than those in the low-dose group.

Anesthetic Effect of the Fascia Iliaca Compartment Block with Different Approaches on Total Hip Arthroplasty and Its Effect on Postoperative Cognitive Dysfunction and Inflammation

Objective

The objective of this article is to make a comparison of the anesthetic effects of the inside and outside fascia iliaca compartment block (FICB) in total hip arthroplasty (THA) and to study the effect of the different approaches of the FICB on postoperative cognitive dysfunction (POCD) and serum inflammatory cytokines in THA patients.

Methods

A total of 60 patients who received THA treatment from January 2021 to December 2021 were divided into two groups, namely, Inside group (inside approach of the FICB) and Outside group (outside approach of the FICB), according to the different approaches of the FICB. Forty-eight hours after surgery, we compared the use of ropacaine dosage, visual analogue scale (VAS) score, the use of patient-controlled analgesia (PCA), mini-mental state examination (MMSE) score, the incidence of POCD, and the serum levels of IL-1, IL-6. Secondary indicators include surgical indicators and the quality of anesthesia cannula.

Results

The ratio of re-fix the catheter, intubation time, and the use of ropacaine dosage at 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p &lt; 0.05), while the depth of cannulation in the Outside group was significantly lower than that in the Inside group (p &lt; 0.05). VAS scores were comparable between the Inside and the Outside groups, except at 24 h after surgery. The use of PCA from 24 to 48 h after surgery in the Outside group was significantly higher than that in the Inside group (p &lt; 0.05). The MMSE score and the incidence of POCD in the Outside group were higher than that in the Inside group. At the same time, the serum IL-1β levels at 1 and 6 h after surgery and the serum IL-6 levels at 1, 6, 24, and 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p &lt; 0.05).

Conclusion

Compared with the outside approach of the FICB, the inside approach of the FICB has better anesthetic effect, better postoperative analgesia, fewer postoperative analgesics, lower incidence of POCD, and lower serum cytokines during the treatment of THA patients.

[Laparoscopic transgastric necrosectomy in treatment of wall-off pancreatic necrosis]

Mini-invasive surgical or endoscopic step-up approach is the first choice of pancreatic necrosectomy for infected wall-off necrosis. Surgical debridement has the advantage of high efficiency,low cost and good accessibility,while the complication rate of pancreatic fistula and incision hernia after endoscopic necrosectomy is low.Laparoscopic transgastric necrosectomy(LTGN) can combine the advantages of surgical and endoscopic debridement,and may become one of the important methods for the surgical treatment of necrotizing pancreatitis in the future. This paper focuses on the technical advantages,surgical points,indications and application status of LTGN,so as to provide reference for the technical promotion.

Ultrabright Electron Bunch Injection in a Plasma Wakefield Driven by a Superluminal Flying Focus Electron Beam

We propose a new method for self-injection of high-quality electron bunches in the plasma wakefield structure in the blowout regime utilizing a "flying focus" produced by a drive beam with an energy chirp. In a flying focus the speed of the density centroid of the drive bunch can be superluminal or subluminal by utilizing the chromatic dependence of the focusing optics. We first derive the focal velocity and the characteristic length of the focal spot in terms of the focal length and an energy chirp. We then demonstrate using multidimensional particle-in-cell simulations that a wake driven by a superluminally propagating flying focus of an electron beam can generate GeV-level electron bunches with ultralow normalized slice emittance (∼30  nm rad), high current (∼17  kA), low slice energy spread (∼0.1%), and therefore high normalized brightness (>10^{19}  A/m^{2}/rad^{2}) in a plasma of density ∼10^{19}  cm^{-3}. The injection process is highly controllable and tunable by changing the focal velocity and shaping the drive beam current. Near-term experiments at FACET II where the capabilities to generate tens of kA, <10  fs drivers are planned, could potentially produce beams with brightness near 10^{20}  A/m^{2}/rad^{2}.

[Research advances on thymosin β4 in promoting wound healing]

With the aging of population and the development of social economy, the incidence of chronic wounds is increasing day by day, while the incidence of burns and trauma remains at a high level, making wound repair an increasingly concerned area in clinical practice. Thymosin β4 is a naturally occurring small molecule protein in vivo, which is widely distributed in a variety of body fluids and cells, especially in platelets. Thymosin β4 has biological activities of promoting angiogenesis, anti-inflammation, anti-apoptosis, and anti-fibrosis, and has many important functions in wound repair. Thymosin β4 has been observed to promote the healing of various wounds, such as burns, diabetic ulcers, pressure ulcers. This paper will review the molecular structure, mechanism of wound healing promotion, pharmacokinetics, and clinical application of thymosin β4, aiming to introduce its potential in wound treatment and the shortcomings of current researches.

Observation of the Singly Cabibbo Suppressed Decay Λ_{c}^{+}→nπ^{+}

The singly Cabibbo-suppressed decay Λ_{c}^{+}→nπ^{+} is observed for the first time with a statistical significance of 7.3σ by using 3.9  fb^{-1} of e^{+}e^{-} collision data collected at center-of-mass energies between 4.612 and 4.699 GeV with the BESIII detector at BEPCII. The branching fraction of Λ_{c}^{+}→nπ^{+} is measured to be (6.6±1.2_{stat}±0.4_{syst})×10^{-4}. By taking the upper limit of branching fractions of Λ_{c}^{+}→pπ^{0} from the Belle experiment, the ratio of branching fractions between Λ_{c}^{+}→nπ^{+} and Λ_{c}^{+}→pπ^{0} is calculated to be larger than 7.2 at the 90% confidence level, which disagrees with most predictions of the available phenomenological models. In addition, the branching fractions of the Cabibbo-favored decays Λ_{c}^{+}→Λπ^{+} and Λ_{c}^{+}→Σ^{0}π^{+} are measured to be (1.31±0.08_{stat}±0.05_{syst})×10^{-2} and (1.22±0.08_{stat}±0.07_{syst})×10^{-2}, respectively, which are consistent with previous results.

[Tracing investigation and analysis of a Clostridium botulinum food poisoning incident in Bayingolin Mongolian Autonomous Prefecture, Xinjiang]

To analyze a suspected case of Clostridium botulinum food poisoning in Bayingolin Mongolian Autonomous Prefecture, Xinjiang and to help validating the diagnosis and providing technical support for clinical treatment. The basic information and clinical manifestations of food poisoning cases were investigated by using the epidemiological method of food safety accidents. The botulinum toxin genes in the samples were detected by real-time PCR and inoculation of KM mouse. The enriched bacteria were further purified and validated. PFGE and cluster analysis were performed on five isolates. Clostridium botulinum type A was detected in two homemade fermented bean samples and stool lavage fluid samples of three patients from enriched samples by toxin test and real-time PCR, and were further validated after isolation of Clostridium botulinum. PFGE showed 100% homology among five isolates. Five isolates of bacteria isolated from the stool lavage fluid of three patients and two homemade fermented bean curd were identified as the same source through PFGE. The cause of this food poisoning cases is food pollution of Clostridium botulinum type A.