[One case of severe exogenous lipoid pneumonia complicated with lung abscess caused by diesel inhalation]

Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances, which is prone to secondary bacterial infection, resulting in the formation of local abscesses, which can be life-threatening in severe cases. This paper reports a case of a 55-year-old patient with diesel aspiration, secondary to Klebsiella pneumoniae (ESBL positive) and Candida glabrata infection resulting in lung abscess formation. He was treated with a variety of antibacterial drugs for anti-infection, non-invasive ventilator ventilation, bronchoalveolar lavage, glucocorticoids, phlegm and other medical treatments. Finally, he underwent middle lobectomy for improvement and was discharged from the hospital, and he recovered well with regular follow-up.

Constraints on Heavy Decaying Dark Matter from 570 Days of LHAASO Observations

The kilometer square array (KM2A) of the large high altitude air shower observatory (LHAASO) aims at surveying the northern γ-ray sky at energies above 10 TeV with unprecedented sensitivity. γ-ray observations have long been one of the most powerful tools for dark matter searches, as, e.g., high-energy γ rays could be produced by the decays of heavy dark matter particles. In this Letter, we present the first dark matter analysis with LHAASO-KM2A, using the first 340 days of data from 1/2-KM2A and 230 days of data from 3/4-KM2A. Several regions of interest are used to search for a signal and account for the residual cosmic-ray background after γ/hadron separation. We find no excess of dark matter signals, and thus place some of the strongest γ-ray constraints on the lifetime of heavy dark matter particles with mass between 10^{5} and 10^{9}  GeV. Our results with LHAASO are robust, and have important implications for dark matter interpretations of the diffuse astrophysical high-energy neutrino emission.

Exploring Lorentz Invariance Violation from Ultrahigh-Energy γ Rays Observed by LHAASO

Recently, the LHAASO Collaboration published the detection of 12 ultrahigh-energy γ-ray sources above 100 TeV, with the highest energy photon reaching 1.4 PeV. The first detection of PeV γ rays from astrophysical sources may provide a very sensitive probe of the effect of the Lorentz invariance violation (LIV), which results in decay of high-energy γ rays in the superluminal scenario and hence a sharp cutoff of the energy spectrum. Two highest energy sources are studied in this work. No signature of the existence of the LIV is found in their energy spectra, and the lower limits on the LIV energy scale are derived. Our results show that the first-order LIV energy scale should be higher than about 10^{5} times the Planck scale M_{Pl} and that the second-order LIV scale is >10^{-3}M_{Pl}. Both limits improve by at least one order of magnitude the previous results.

[Study on the diagnostic value of transient elastography, APRI and FIB-4 for liver fibrosis in children with non-alcoholic fatty liver disease]

Objective: To evaluate the diagnostic value of transient elastography, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on 4 factors (FIB-4) for liver fibrosis in children with non-alcoholic fatty liver disease (NAFLD). Methods: A retrospective study was conducted on 100 cases of nonalcoholic fatty liver disease in Hunan Children's Hospital between August 2015 to October 2020 to collect liver tissue pathological and clinical data. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic value of liver stiffness measurement (LSM), APRI and FIB-4 in the diagnosis of different stages of liver fibrosis caused by NAFLD in children. Results: The area under the ROC curve (AUC) value of LSM, APRI and FIB-4 for diagnosing liver fibrosis (S≥1) were 0.701 [95% confidence interval (CI): 0.579 ~ 0.822, P = 0.011], 0.606 (95%CI: 0.436 ~ 0.775, P = 0.182), and 0.568 (95%CI: 0.397 ~ 0.740, P = 0.387), respectively. The best cut-off values were 6.65 kPa, 21.20, and 0.18, respectively. The AUCs value of LSM, APRI, and FIB-4 for diagnosing significant liver fibrosis (S≥ 2) were 0.660 (95% CI: 0.552 ~ 0.768, P = 0.006), 0.578 (95% CI: 0.464 ~ 0.691, P = 0.182) and 0.541 (95% CI: 0.427 ~ 0.655, P = 0.482), respectively. The best cut-off values were 7.35kpa, 24.78 and 0.22, respectively. The AUCs value of LSM, APRI and FIB-4 for the diagnosis of advanced liver fibrosis (S≥ 3) were 0.639 (95% CI: 0.446 ~ 0.832, P = 0.134), 0.613 (95% CI: 0.447 ~ 0.779, P = 0.223) and 0.587 (95% CI: 0.411 ~ 0.764, P = 0.346), respectively. The best cut-off values were 8.55kpa, 26.66 and 0.27, respectively. Conclusion: The transient elastography technique has a better diagnostic value than APRI and FIB-4 for liver fibrosis in children with NAFLD.

Peta-electron volt gamma-ray emission from the Crab Nebula

The Crab Nebula is a bright source of gamma rays powered by the Crab Pulsar's rotational energy through the formation and termination of a relativistic electron-positron wind. We report the detection of gamma rays from this source with energies from 5 × 10^-4 to 1.1 peta-electron volts with a spectrum showing gradual steepening over three energy decades. The ultrahigh-energy photons imply the presence of a peta-electron volt electron accelerator (a pevatron) in the nebula, with an acceleration rate exceeding 15% of the theoretical limit. We constrain the pevatron's size between 0.025 and 0.1 parsecs and the magnetic field to ≈110 microgauss. The production rate of peta-electron volt electrons, 2.5 × 10³⁶ ergs per second, constitutes 0.5% of the pulsar spin-down luminosity, although we cannot exclude a contribution of peta-electron volt protons to the production of the highest-energy gamma rays.

Extended Very-High-Energy Gamma-Ray Emission Surrounding PSR J0622+3749 Observed by LHAASO-KM2A

We report the discovery of an extended very-high-energy (VHE) gamma-ray source around the location of the middle-aged (207.8 kyr) pulsar PSR J0622+3749 with the Large High-Altitude Air Shower Observatory (LHAASO). The source is detected with a significance of 8.2σ for E>25  TeV assuming a Gaussian template. The best-fit location is (right ascension, declination) =(95.47°±0.11°,37.92°±0.09°), and the extension is 0.40°±0.07°. The energy spectrum can be described by a power-law spectrum with an index of -2.92±0.17_{stat}±0.02_{sys}. No clear extended multiwavelength counterpart of the LHAASO source has been found from the radio to sub-TeV bands. The LHAASO observations are consistent with the scenario that VHE electrons escaped from the pulsar, diffused in the interstellar medium, and scattered the interstellar radiation field. If interpreted as the pulsar halo scenario, the diffusion coefficient, inferred for electrons with median energies of ∼160  TeV, is consistent with those obtained from the extended halos around Geminga and Monogem and much smaller than that derived from cosmic ray secondaries. The LHAASO discovery of this source thus likely enriches the class of so-called pulsar halos and confirms that high-energy particles generally diffuse very slowly in the disturbed medium around pulsars.

Ultrahigh-energy photons up to 1.4 petaelectronvolts from 12 γ-ray Galactic sources

The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10¹⁵ electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays¹. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref. ²). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane^3-6, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.

Validation of the Pain Resilience Scale in Chinese-speaking patients with temporomandibular disorders pain

To validate the Pain Resilience Scale (PRS) for use in Chinese patients with temporomandibular disorders (TMD) pain. According to international guidelines, the original PRS was first translated and cross-culturally adapted to formulate the Chinese version of PRS (PRS-C). A total of 152 patients with TMD pain were recruited to complete series of questionnaires. Reliability of the PRS-C was investigated using internal consistency and test-retest reliability. Validity of the PRS-C was calculated using cross-cultural validity and convergent validity. Cross-cultural validity was evaluated by examining the confirmatory factor analysis (CFA). And convergent validity was examined through correlating the PRS-C scores with scores of 2 commonly used pain-related measures (the Connor-Davidson Resilience Scale [CD-RISC] and the Tampa Scale for Kinesiophobia for Temporomandibular Disorders [TSK-TMD]). The PRS-C had a high internal consistency (Cronbach's alpha = 0.92) and good test-retest reliability (intra-class correlation coefficient [ICC] = 0.81). The CFA supported a 2-factor model for the PRS-C with acceptable fit to the data. The fit indices were chi-square/DF = 2.21, GFI = 0.91, TLI = 0.97, CFI = 0.98 and RMSEA = 0.08. As regards convergent validity, the PRS-C evidenced moderate-to-good relationships with the CD-RISC and the TSK-TMD. The PRS-C shows good psychometric properties and could be considered as a reliable and valid measure to evaluate pain-related resilience in patients with TMD pain.

[Application of laparoscopic transection of median hepatic fissure in difficult laparoscopic liver resections]

Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava. Transection of the MHF was accurately achieved. Finally, dissection of the second and third porta hepatis were carefully performed and mobilization of the transected liver was achieved. This technique of laparoscopic transection of MHF was successfully performed in 13 patients in difficult laparoscopic liver resections. Results: Between April 2014 and August 2015, 13 patients received the technique of laparoscopic transection of MHF in difficult laparoscopic liver resections, including 10 cases of laparoscopic right hepatectomy, two cases of laparoscopic left hepatectomy and one case of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). The maximum size of the transected tumor was 15 centimeter. Duration of surgery was 240-430 min[Mean, 324.4±50.0]; the time for transection of the MHF was 40-118 min[mean, 66.4±22.7]. Blood loss was 200-2 000 ml[583.3±452.9]. The length of postoperative hospital stay was 6-25 days[mean, 13.2±5.2]. Seven patients received intraoperative transfusions. No postoperative intraabdominal bleeding, liver failure or other severe postoperative complications occurred. No perioperative death occurred. Conclusions: Application of laparoscopic transection of the MHF in difficult laparoscopic liver resections can help to clearly expose the second and third porta hepatis, especially in patients who have huge tumors and poor exposure for hepatic dissection. Moreover, precise location and transection of the MHF remains very important strategies of applying this technique.

Development of the Chinese version of the Oro-facial Esthetic Scale

The aim of this study was to investigate the psychometric properties of the Oro-facial Esthetic Scale among Chinese-speaking patients. The original Oro-facial Esthetic Scale was cross-culturally adapted in accordance with the international standards to develop a Chinese version (OES-C). Unlike the original Oro-facial Esthetic Scale, the version employed in this study used a 5-point Likert scale with items rated from unsatisfactory to most satisfactory. Psychometric evaluation included the reliability and validity of the OES-C. The reliability of the OES-C was determined through internal consistency and test-retest methods. The validity of OES-C was analysed by content validity, discriminative validity, construct validity and convergent validity. The corrected item-total correlation coefficients of the OES-C ranged from 0·859 to 0·910. The inter-item correlation coefficients between each two of the eight items of the OES-C ranged from 0·766 to 0·922. The values of ICC ranged from 0·79 (95% CI = 0·54-0·98) to 0·93 (95% CI = 0·87-0·99), indicating an excellent agreement. Construct validity was proved by the presence of one-factor structure that accounted for 83·507% of the variance and fitted well into the model. Convergent validity was confirmed by the association between OES-C scores and self-reported oral aesthetics and three questions from the Oral Health Impact Profile related to aesthetics (correlation coefficients ranged from -0·830 to -0·702, P < 0·001). OES-C scores discriminated aesthetically impaired patients from healthy controls. This study provides preliminary evidence concerning the reliability and validity of the OES-C. The results show that the OES-C may be a useful tool for assessment of oro-facial esthetics in China.

Genetic loci mapping associated with maize kernel number per ear based on a recombinant inbred line population grown under different nitrogen regimes

Kernel number per ear (KNE) is one of the most important yield-related agronomic traits in maize (Zea mays). To clarify its genetic basis, we made a quantitative trait locus (QTL) analysis of KNE in a recombinant inbred line population derived from lines Mo17 and Huangzao4, under two nitrogen (N) regimes. Seven QTLs, on chromosomes 4, 6 and 9, were mapped under the high N regime, which explained phenotypic variation ranging from 5.03 to 15.49%. Under the low N regime, three QTLs were located on chromosomes 6 and 9, which accounted for phenotypic variation ranging from 8.54 to 12.21%. These QTLs had different mapping intervals to their nearest markers, ranging from 0 to 16.5 cM. According to the chromosome positions and genetic effects of these QTLs, only seven QTLs for KNE were identified in our experiment, out of which three were found under both N regimes, on chromosomes 6 (one) and 9 (two); the other four were mapped only under the high N regime, on chromosomes 4 (three) and 6 (one). This information could be useful for developing marker-assisted selection in maize-breeding projects.

[Levels of plasma TF and TFPI activities in patients with acute leukemia]

OBJECTIVE

To investigate the changes of plasma tissue factor(TF) and tissue factor pathway inhibitor(TFPI) activities in the patients with acute leukemia.

METHODS

TF and TFPI activities were measured by using chromogenic assays.

RESULTS

Plasma TF activity in the patients with acute leukemia was higher and TFPI activity was lower than those in normal(P < 0.01). In 7 patients who underwent the first chemotherapy, the plasma TF activity was decreased after chemotherapy(P < 0.01), while TFPI activity increased(P < 0.05).

CONCLUSION

The unbalance between plasma TF and TFPI activities contributes to the coagulant disorders in acute leukemia.

Mechanical properties of a biodegradable bone regeneration scaffold

Poly (Propylene Fumarate) (PPF), a novel, bulk erosion, biodegradable polymer, has been shown to have osteoconductive effects in vivo when used as a bone regeneration scaffold (Peter, S. J., Suggs, L. J., Yaszemski, M. J., Engel, P. S., and Mikos, A. J., 1999, J. Biomater. Sci. Polym. Ed., 10, pp. 363-373). The material properties of the polymer allow it to be injected into irregularly shaped voids in vivo and provide mechanical stability as well as function as a bone regeneration scaffold. We fabricated a series of biomaterial composites, comprised of varying quantities of PPF, NaCl and beta-tricalcium phosphate (beta-TCP), into the shape of right circular cylinders and tested the mechanical properties in four-point bending and compression. The mean modulus of elasticity in compression (Ec) was 1204.2 MPa (SD 32.2) and the mean modulus of elasticity in bending (Eb) was 1274.7 MPa (SD 125.7). All of the moduli were on the order of magnitude of trabecular bone. Changing the level of NaCl from 20 to 40 percent, by mass, did not decrease Ec and Eb significantly, but did decrease bending and compressive strength significantly. Increasing the beta-TCP from 0.25 g/g PPF to 0.5 g/g PPF increased all of the measured mechanical properties of PPF/NVP composites. These results indicate that this biodegradable polymer composite is an attractive candidate for use as a replacement scaffold for trabecular bone.

["Bu-yang huanwu tang" inhibited the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits]

BACKGROUND AND OBJECTIVE

"Bu-yang huanwu tang", a decoction of Chinese herbs widely used in the treatment for cardio- and cerebro-vascular diseases, has been demonstrated to be able to inhibit platelet adhesion and aggregation, to lower blood lipids, to regulate vascular tone from animal experiments. The aim of this study is to determine whether this decoction inhibits the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits.

METHODS

Three groups of rabbits received the following different diets for 9 weeks: 1. standard diet; 2. atherogenic diet(standard diet plus 1% cholesterol and 3.3% fat); 3. atherogenic diet plus this decoction(5 g.kg-1.d-1). Plasma lipids, 6-keto-PGF1 alpha, endothelin levels were detected and the histological atherosclerotic changes were evaluated.

RESULTS

This decoction inhibited the progression of aortic and abdominal aortic intimal plaques and reduced aortic intimal thickening.

CONCLUSION

The anti-atherogenic mechanism might be related to the decrease of plasma cholesterol and triglycerides and the increase of PGI2. The facts suggest that "Bu-yang huanwu tang" has antiatherogenic and antithrombotic effects.

[The development of a multifunctional molecular electrophoretograms processing system]

This paper presents to you the principles, composition and features of the multifunctional molecular electrophoretograms processing system.

[Revision of the biological significance of the contact system]

Current concept of blood coagulation is divided into two stages: an "initiation" stage which is handled by tissue factor pathway, and an "augmentation" stage handled by intrinsic pathway beginning in factor XI. Recent studies have demonstrated that the contact system is a modulator for vascular biology with vascular tone regulation, anticoagulant, profibrinolytic, antiadhesive and proinflammatory functions. Changes of contact system are associated with sepsis, thrombosis, etc.

[Expression of tissue factor of astrocytes and its signal transductional pathways]

The aim of this study was to observe the expression of tissue factor (TF) of astrocytes in basic culture medium and under the condition stimulated by thrombin and to explore the relevant signal transduction pathways. The results showed that 4-bromo calcium ionophore (A23187) and phorbol 12-myristate 13-acetate (PMA) enhanced significantly the TF expression of astrocytes, but the expression was decreased markedly by trifluoperazine (TFP) and 1-(5-isoquinolinyl sulfonyl)-3-methyl-piperazine (H7) in the basic medium. Thrombin increased significantly the TF expression of astrocytes, which was obviously inhibited by TFP and H7. The results above indicate that astrocytes can express TF activity in the basic medium, which is promoted by thrombin, probably through some pathways involving Ca2+/CaM and protein kinase C (PKC).

[Roles of intercellar Ca2+ and protein kinase C played in tissue factor pathway inhibitor and tissue factor expression in human umbilic vein endothelial cells]

The purpose of the present study was to elucidate the roles that protein kinase C (PKC) and calcium played in the tissue factor (TF) synthesis and tissue factor pathway inhibitory (TFPI) release in human umbilic vein endothelial cells (HUVEC). A23187 was used to represent calcium ionophore and phorbol 12-myristate 13-acetate (PMA) as that of PKC activator. TF activity in the lysed HUVEC was measured using one stage clotting assay. TFPI activity in the conditioned medium of HUVEC was assessed by the two-step chromogenic method. The results showed that the TF activities in A23187, PMA and A23187 + PMA groups were remarkably higher (P < 0.01) than that in control. Among the three treated groups, the TF activities in both A23187 group and A23187 + PMA group were lower than that in the PMA group (P < 0.05), but the difference between the former two groups was statically insignificant (P > 0.05). In contrast to the control group, the TFPI activity in the A23187 group was not statistically different (P > 0.05). However, the TFPI activities in the PMA group and the A23187 + PMA group were markedly higher than those in the control group and the A23187 group (P < 0.01). These findings indicate that PKC and calcium ion promote TF synthesis in HUVEC but the effect of the former is stronger than that of the latter, and that the release of TFPI from HUVEC is facilitated by PKC and not significantly affected by calcium ion.

[Changes in oxygen free radical and prostacyclin in thromboangiitis obliterans and its relationship with syndrome differentiation]

Malondialdehyde (MDA) and 6-keto-PGF1 alpha levels in plasma and erythrocyte superoxide dismutase activities (Ery-SODA) were observed in 56 cases of thromboangiitis obliterans (TAO). The results showed that: (1) Ery-SODA and 6-keto-PGF1 alpha levels lowered and MDA raised significantly in TAO (P < 0.01), compared with that in control. (2) 6-keto-PGF1 alpha levels were markedly related with Ery-SODA and MDA in TAO (P < 0.01). (3) Ery-SODA and 6-keto-PGF1 alpha levels were lower and MDA higher in III phase of TAO than that in II phase. (4) Ery-SODA and 6-keto-PGF1 alpha levels markedly declined and MDA contents elevated significantly in Dampness-Heat (DH) and Heat-Toxin (HT) group, compared with that in Yin-Cold (YC) group and Blood-Stasis (BS) group, respectively (P < 0.05, P < 0.01); all above substances between YC and BS group or between DH and HT group had no significant differences (P > 0.05). (5) Ery-SODA and 6-keto-PGF1 alpha levels were lower and MDA higher in Heat Syndrome than that in Cold Syndrome (P < 0.01). It suggested that oxygen free radical and lipid peroxide response that might participate in vascular endothelial cell injury in TAO markedly increased and the detection of these substances might provide complementary evidences for syndrome differentiation of TAO.

[Effect of buyang huanwu decoction on the antithrombotic functions of the vessel wall]

The effects of Buyang Huanwu Decoction (BYHWD) on the antithrombotic functions of vessel wall were studied with human umbilical vein perfusion. It was observed that the both of Von Willebrand factor release stimulated by thrombin from the vessel walls and conversion of fibrinogen to fibrin catalyzed by thrombin were inhibited by BYHWD. There were no obvious effects of BYHWD on the thrombin adsorption to the vessel walls and the thrombin induced release of PGI2 as well as fibrinolysis inhibiting activity from the vessel walls.