Theoretical study of the effects of alloying elements on TiO2/Ti2AlNb interface adhesion properties

Ti2AlNb-based alloys are expected to be applied in the manufacture of parts of aeroengines to achieve the goal of increasing the thrust-to-weight ratio. However, the poor high temperature oxidation resistance of these alloys may hinder their applications. Alloying has been proven to be effective in improving oxidation resistance properties. However, the selection of alloying elements and their influence mechanisms are rarely studied. The TiO2/Ti2AlNb interface bonding interactions and the effects of alloying elements of Si, Sc, Y, Zr, Mo and Hf were investigated via first principles calculations. The separation energy and electronic structure were studied to explore the bonding interactions between the oxide scale and Ti2AlNb matrix. When Zr and Hf are used to replace Al, the bonding properties of the TiO2/Ti2AlNb interface are improved. The tensile and shear deformations of the interfacial zones are applied to study the influence of alloying elements on the TiO2 oxide spalling on Ti2AlNb. The tensile strength is increased by more than 2 GPa when Nb is substituted by the Sc, Zr and Hf elements. Therefore, Sc, Zr, and Hf are beneficial for inhibiting oxide spalling and will have great potential to improve the oxidation resistance properties.

[Clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated interstitial lung disease]

Objective: To analyze the clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis associated interstitial lung disease (DM-ILD). Methods: The patients with MDA5+DM-ILD who were admitted to Department of Respiratory Medicine, Nanjing Drum Tower Hospital from January 2017 to March 2021 were enrolled. The clinical data and survival information were analyzed retrospectively. Patients were divided into survival group or death group, and rapid progressive ILD (RP-ILD) group or non-rapid progressive ILD group, according to their survival status and clinical progression. Results: A total of 105 patients with anti-MDA5+DM-ILD (median age of onset 54 years) were enrolled, 58% being female (61 cases). The main sub-type of dermatomyositis was amyopathic dermatomyositis (n=74, 70%), followed by dermatomyositis (n=31, 30%). The main extrapulmonary manifestations were skin lesions (n=60, 57.1%), muscle manifestations(n=20, 19%) and arthralgia/arthritis (n=20, 19%). 15.4% of the patients had positive ANA (antibody titer≥1∶320), and 61.9% of the patients had anti-RO-52 kDa antibody. A total of 66 patients (62.8%) developed RP-ILD, and 58 patients (56.3%) died. Lower oxygenation index (OR=0.974, 95%CI:0.954-0.994, P=0.012) and no joint pain (OR=0.032, 95%CI: 0.002-0.663 P=0.026) were independent risk factors for RP-ILD. Cox regression analysis showed that RP-ILD (HR=3.194, 95%CI:1.025-9.954, P=0.045), older than 53 years (HR=3.450, 95%CI: 1.388-8.577, P=0.008), ferritin level more than 1 330.5 ng/ml (HR=3.032, 95%CI 1.208-7.610, P=0.018) and C-reactive protein (CRP) above 16.95 mg/L (HR=2.794, 95%CI:1.102-7.084, P=0.030) were independent predictors of mortality. Conclusions: The clinical manifestations of patients with anti-MDA5+DM-ILD presenting to the respiratory department were heterogeneous, with most being amyopathic dermatomyositis, and both the incidence of RP-ILD and the risk of death were high. Even in the absence of associated rash, joint, or muscle manifestations, anti-MDA5 antibody screening should be considered in patients with rapidly progressive ILD who were negative on baseline autoantibody screening but positive for anti-RO52kDa antibody.

Soluble ST2 in serum predicts the prognosis of idiopathic pulmonary fibrosis: a retrospective study

Background

Methods

Results

Conclusions

[Idiopathic pleuroparenehymal fibroelastosis: five case reports and review of literature]

Objective: To raise the awareness of idiopathic pleuroparenehymal fibroelastosis (iPPFE) through investigating the clinical, radiographic and pathological features. Methods: Five cases of iPPFE proved by pathology. The clinical data were studied respectively, and the relevant literature was reviewed. Results: All the cases of iPPFE were manifested by cough and dyspnea. The patients including 3 males and 2 females, aged from 30 to 70 years Chest CT scan showed pleural thickening, subpleural consolidation in both upper lungs complicated with tractive bronchiectasis.Computed tomography-guided percutaneous lung biopsy or surgical lung were performed and the same pathological showed pleura and subpleural dense elastic and collagen fibers. The elastic fibers stain was also positive,which was consistent with PPFE. One patient received low-dose corticosteroid, two received pirfenidone therapy, the others received no treatment. Three patients were stable during the follow-up. Conclusions: iPPFE has characteristic pathological features. However, the number of clinically reported cases is low due to missed diagnosis or misdiagnosed. Improving the understanding of features of iPPFE is helpful for the dianosis, therapy, and prognosis of this disease.

[Fibrinogen gamma-chain mutation, p.Ile171His, leads to hereditary hypofibrinogenemia]

Objective: To explore the clinical phenotype and genotype of a family with hereditary hypofibrinogenemia. Methods: Activated partial thrombin time (APTT), prothrombin time (PT),thrombin time (TT) and thrombelastogram (TEG) were tested in all family members. Fibrinogen activity and antigen were detected by Clauss method and immunoturbidimetric method respectively. All exons and flanking sequences of fibrinogen FGA,FGB,FGG genes were analyzed by PCR, and the products were subjected to Sanger sequencing. Results: The proband represented prolonged PT and TT, low Fg activity and antigen, elevated K value and decreased Angle value in TEG. Other family members reported similar changes including proband's father,daughter and son, and his elder brother and his niece. Exon 5 c.510_512 of FGG gene in the proband revealed a minor deletion mutation. Conclusion: The novel heterozygous missense mutation of exon 5 c.510_512del (Gln170_Ile171 del ins His) of FGG gene is the molecular mechanism that leads to hereditary hypofibrinogenemia in this family.

[CFTR gene variations and phenotypes in seven children]

Objective: To analyze the cystic fibrosis transmembrane conductance regulator (CFTR) gene variations and phenotypes in 7 Chinese children. Methods: In this retrospective study, the data of 7 children with CFTR gene variations admitted to Children's Hospital of Chongqing Medical University from December 2013 to October 2020 were extracted. The general information, clinical manifestations, gene variations, diagnosis and treatment were summarized. Results: Among the 7 children, 2 were males and 5 were females, aged 5.2(0.5-11.3) years. Main clinical manifestations included malnutrition (5 cases), recurrent respiratory infection (4 cases), bronchiectasis (3 cases), steatorrhea (3 cases), vomiting in infancy (2 cases), liver cirrhosis (2 cases), meconium ileus (1 case), metabolic alkalosis and hypochloremia (1 case). A total of 15 variations were found by whole exon sequencing and Sanger sequencing, among which 3 were newly discovered, and 7 were missense mutations. Four children were diagnosed as CF, and the other 3 were diagnosed as CFTR related disease (CFTR-RD). Compared with CF patients, the pancreatic insufficiency and typical CF lung disease were relatively mild in CFTR-RD patients. After treatment, 6 children were clinically improved, while the rest one withdrew treatment due to critical pulmonary infection and disturbance of water-electrolyte metabolism. Conclusions: The loci and phenotypes of CFTR gene variants vary hugely and the pathogenicity of some variations are not clear. Whole exon sequencing can facilitate the identification of CF-and CFTR-RD-causing variaions. For the cases not compatible with CF, CFTR-RD should be considered and evaluated by timely gene detection, so as to carry out appropriate long term management.

[Formation of study population for causal inference]

Epidemiological analysis describes and compares the characteristics of a certain number of people to make causal inferences. The formation of the study population is always the first step. In this paper, we first define the concepts of cross-sections at both individual level and population level and introduce the three assumptions needed in the measurements in observational studies, i. e. the true values of the attributes are stable with time, the attribute variables are independent and the individuals are independent during the measuring process. We also determine that the causal inference research should be unified based on the time of the occurrence or beginning of a postulated cause, or exposure, should be in. Then, based on the dual roles of the population cross-section with causal thinking, we propose that research designs can be classified into two types with different characteristics: history reconstruction research and future exploration research. Finally, we briefly analyze the research design framework and the relationship between estimated effects and different designs. The discussion of the formation of a study population from the perspective of causal thinking can make a foundation for the classification of causal inference research design with appropriate effect parameters, which needs to be further studied.

[A cohort study on the new infections and natural clearance of anal human papillomavirus types 16 and 18 in men who have sex with men]

Objective: To understand the infection status and elimination of anal human papillomavirus (HPV) among men who have sex with men (MSM) in Urumqi, Xinjiang. Methods: The sample size formula in cohort study, a dynamic cohort study method, was used, with the sample size estimated to be 712 according to the new infection rate of HPV16. With the help from non-government organzitions in Urumqi, we recruited 810 MSMs by the snowballing method, and a follow-up program was carried every six months. Anal exfoliated cells were collected to analyze HPV type 16 and 18 infection rates. For statistical analyses, Poisson regression was used to estimate the density of new infections and persistent infections. Cox proportional hazard model was used to explore the influencing factors on both new and persistent infections and the diseases' natural clearing. Results: A total of 810 MSM were recruited, and 482 MSMs with the number of follow-ups more than 2 times were included in the analysis, with the total follow-up numbers as 994.7 person-years. The median number of follow-up and follow-up times was 4 (P₂₅,P₇₅:3,5) times , and 2.2 (P₂₅,P₇₅:1.8, 2.6) years. The baseline infection rates of HPV16 and HPV18 were 8.5% (41/482) and 3.3% (16/482), respectively. And the baseline mixed infection rate of the two types was 0.6% (3/482). The first new infection densities of HPV16 and HPV18 were 10.06 (95%CI:8.12-12.45)/100 person-years and 5.24 (95%CI:3.95-6.96)/100 person-years. The rate of natural infection clearance of HPV16 and HPV18 were 71.2% (89/125) and 71.8% (46/64), respectively. The natural clearance rate of HPV18 after 1.5 years follow-up was higher than HPV16 (97.7% vs. 94.1%). The persistent infection rate of HPV16 and HPV18 were 4.5% (20/441) and 1.7% (8/466), respectively. The risk of persistent HPV16 infection among unmarried subjects was lower than that of married subjects (aHR=0.29,95%CI:0.12-0.71). The natural clearance rate of HPV18 without condom use in anal intercourse in the last six months was 2.63 times higher than that of condom use (95%CI:1.08-6.42). Conclusions: HPV16 and 18 new infections are more common among MSM in Urumqi, and the natural clearance rate is higher. Compared with HPV18, HPV16 has a higher density of new and persistent infections, a low natural clearance rate, and a greater risk of the diseases.

[Matching in observational research: from the directed acyclic graph perspective]

Matching is a standard method for selecting research objects regarding the observational research, which controls confounding factors and improves statistical efficiency. However, its role in controlling confounding is not consistent in different observational studies. Matching can eliminate the confounding bias of matching variables in cohort studies, but checking on itself cannot eliminate confounding bias in case-control studies. In matched case-control studies, researchers may not accurately judge whether the variable is a confounder. Sometimes the variables that are not confounders are mistakenly matched. In that case, it will result in overmatching, which will lead to the decline of statistical efficiency or the introduction of unavoidable bias or increase of workload. If the real confounding factors are omitted, it will cause confounding bias. Therefore, researchers should consider what kind of matching variable selection criteria should be formulated. A directed acyclic graph is a visual graphic language that can show the complicated causality among different epidemiological research designs. This article analyzes the role of Matching in different observational research designs from the perspective of the directed acyclic graph, formulates the selection criteria for matching variables in matched case-control studies, and provides some reference suggestions for future epidemiological research design.

Functionalized M2TiC2Tx MXenes (M = Cr and Mo; T = F, O, and OH) as high performance electrode materials for sodium ion batteries

First-principles calculations were performed to study the electrochemical performance of M2TiC2 (M = Cr or Mo) and M2TiC2Tx (T = O, F or OH) used as anode materials for sodium ion batteries (SIBs). The O functionalized MXenes (Cr2TiC2O2 and Mo2TiC2O2) are found to be more stable than F and OH terminated systems. The diffusion performance of sodium in MXene materials is mainly affected by the functional groups. The lowest diffusion barrier of functionalized MXenes is about one order larger in magnitude than that of bare MXenes. Although the introduction of O-groups hinders the diffusion of sodium, it can greatly improve the theoretical storage capacities. Meanwhile, the diffusion paths and diffusion energy barriers of Na are affected by Na concentration effects, while the interactions between terminations have little effect. Furthermore, multiple layers of sodium atoms are found to be adsorbed between the layers of M2TiC2O2, thus significantly increasing the theoretical capacities. The theoretical sodium storage capacities of M2TiC2O2 monolayers reach 515.70 mA h g-1 (M = Cr) and 362.46 mA h g-1 (M = Mo) and the OCVs can approach 0.034 V (M = Cr) and 0.042 V (M = Mo). Therefore, Cr2TiC2O2 and Mo2TiC2O2 are expected to be promising anode materials for SIBs due to their excellent properties, such as good electronic conductivity, low sodium diffusion barrier, and high theoretical sodium storage capacity.

[May cross-sectional studies provide causal inferences?]

Due to the flaws inherited in synchronicity, statistical association and survivor bias on variables under measurement, a common 'consensus' has been reached on "cross-sectiional studies (CSS) can lead to failure on causal inference". In this paper, under both causal thinking and diagram, the real and measured cross-sections are clearly defined that these two concepts only exist theoretically. In real CSS research, the temporal orders of measured variables are all non-synchronic, equivalent to the assumption that measurement variables are independent to each other, or there is no differentiated classification bias. Similar to cumulative case-control or historical cohort studies, both exposure and outcome that exist or occur before their measurements in cross-sectional studies, are actions of historical reconstruction or doing 'Archaeology'. One of the common preconditions for causal inference in such studies is that: there must be a causal relation between the measured variables and their historical counterparts. The measured variables are all agents of their corresponding real counterparts, and the temporal orders are not that important in causal inference. It is necessary to better understand the analytic role of the CSS.

[Co-prevalence relationship analysis on different metabolic syndrome scores and behavioral risk factors in adults from Urumqi based]

Objective: To investigate the influence of the prevalence and co-prevalence of risk factors for metabolic syndrome on the scores of different levels of metabolic syndrome in people receiving physical examination in Urumqi. Methods: Using the 2017 Xinjiang Health Examination Database, a total of 175 927 people from 7 districts and 1 county in Urumqi were selected as subjects. Face-to-face survey and body measurements were used to collect cardiovascular risk factors and metabolic syndrome scores. Metabolic syndrome scores were used. For the 0-5 points at 6 levels, χ(2), χ(2) trend test, correlation analysis of ordered variable Kendall's tau-b, and logistic regression analysis of ordered results were used to analyze the influence of prevalence and co-prevalence of behavioral risk factors on the MS scores. Results: The percentages of 6 metabolic syndrome scores in the sample population were 23.82%, 27.87%, 22.41%, 16.03%, 8.02%, and 1.85%, respectively. The scores of metabolic syndrome were different in different age groups, ethnic groups, groups with different drinking rates, and groups with different dietary types, with the differences all significant (P<0.05).The MS score in men increased with the increase of oil/salt rate and excessive drinking rate (P<0.01). The score in women increased with the increase of the current smoking rate, oil/salt rate, and increased with the decrease of physical activity (P≤0.01). There was no significant difference in the distribution of regular drinking rates between different score groups (P>0.05). The scores of metabolic syndrome increased with the increase of risk factors (P<0.05). Ordered results logistic analysis found that in the men with ≥3 risk factors and the metabolic syndrome score was 1.15 (1.06-1.26) times higher than that in the men without risk factor, as well as in women with 2 risk factors and≥3 risk factors. The metabolic syndrome scores were 1.38 (1.22-1.55), 2.02 (1.53-2.66) times higher than those in the women without risk factors. Conclusions: The physical examination group in Urumqi, the more the metabolic syndrome disease behavior risk factors clustered, the higher the metabolic syndrome score was. Therefore, comprehensive intervention measures should be taken to control the different forms of metabolic syndrome to prevent the occurrence and progress of the disease.

Changed hemodynamics in acute vasoreactivity testing: prognostic predictors in chronic thromboembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is similar to pulmonary arterial hypertension (PAH) in its pathogenesis. Changed hemodynamic parameters in acute vasoreactivity testing (AVT) have proved to be prognostic predictors of PAH. We wanted to determine whether these changed indices also impacted the prognosis of CTEPH. Data was retrieved for 86 CTEPH patients who underwent right heart catheterization (RHC) with AVT at Shanghai Pulmonary Hospital from 2009 to 2018 and following up for 20 ± 15 months for event. Cox proportional hazards models were performed to determine the predictors of independent event-free survival. Receiver operating characteristic curve was plotted to determine the cut-off value of independent parameters in CTEPH. Kaplan-Meier method and log-rank test were used to perform the Survival analyses. Forty seven patients had an event. Many hemodynamic indices improved after AVT. The event-free group had better mean right atrial pressure, mean pulmonary arterial pressure, pulmonary vascular resistance (PVR) and oxygen saturation of mixed venous blood (SvO2) both at baseline and after AVT. The event-free group also showed higher cardiac output (CO) and cardiac index (CI) after AVT. Among the changed hemodynamic parameters during the AVT, ΔCO, ΔCO/baseline CO, ΔCI, ΔCI/baseline CI and ΔPVR/baseline PVR were significantly higher in the event-free group. Foremost, ΔPVR/baseline PVR, PVR after AVT and baseline SvO2 were independent predictors for event-free survival. Patients with SvO2 ≥ 61.65% at baseline or PVR < 8.09 WU after AVT or ΔPVR/baseline PVR ≥ 0.054 had significantly better survival. Hemodynamic indices both at baseline and after AVT as well as the changes in these indices reflected the severity of CTEPH. Baseline SvO2, PVR after AVT, and ΔPVR/baseline PVR could be used as independent predictors to estimate the outcomes of CTEPH patients.

[Rush poppers use and risks of human papillomavirus infection among men who have sex with men in Urumqi: mediation effect through high-risk sexual behaviors]

Objective: To study the prevalence of rush poppers use among men who have sex with men (MSM) in Urumqi and to analyze the mediating effect of high-risk sexual behavior between the use of rush poppers and human papillomavirus (HPV) infection. Methods: From January to June 2018, 651 MSM were recruited through network and publicity. Data was collected by using online questionnaire and anal swab were collected from them for HPV genotyping. According to Baron and Kenny's criterion, multivariate logistic regression models was used to analyze the mediation effect of high-risks sexual behaviors (multiple sexual partners, anal intercourse condom use) between rush poppers use and HPV infection. Results: A total of 651 subjects were (32.0±8.0) years old, and 174 subjects (26.7%) had ever used rush poppers in the past 6 months, while 350 subjects (46.9%) had more than 2 sexual partners and 188 subjects (28.9%) did not use anal condom. After adjusting age and marital status, rush poppers use was associated with HPV infection (OR (95%CI) was 2.34 (1.63-3.36), P<0.05), and sexual partners in the past 6 months (OR (95%CI) was 2.72 (1.89-3.93), P<0.05).After adjustment for age, marital status, sexual partners in the past 6 months, and anal condom use, rush poppers use was still associated with HPV infection (OR (95%CI) was 2.21 (1.53-3.19), P<0.05).After adjustment and adjustment of age, marital status, rush poppers use and anal sex condom use, the number of sexual partners at nearly 6 months was still associated with HPV infection (OR (95%CI) was 1.46 (1.05-2.04), P<0.05). Conclusion: Sexual partners in the past 6 months have a mediation effect between rush poppers use and HPV infection in Urumqi. For the prevention of sexually transmitted diseases, we should focus on rush poppers use.

[Intraocular lens power calculation for high myopic eyes with cataract: comparison of three formulas]

Objective: To compare the accuracy of three different formulas for intraocular lens power calculation in high myopic eyes with cataract and analyze their influencial factors. Methods: One hundred and three high myopic patients of cataract (103 eyes), with average age of 60.2±8.8 years old (39.0-77.0), including 45 male and 54 female and with axial length ≥ 26 mm were enrolled in this retrospective case-series study. All of them underwent routine ocular examination and IOLMastermeasurement preoperatively and then underwent phacoemulsification through temporal clear-corneal incision with implantation of HumanOptic posterior chamber Intraocular lens (IOL). All analyses were conducted using SPSS version 19.0. Repeated-measures analysis of variance was applied to compare the refractive results one month postoperatively with the predicted IOL powers calculated by SRK/T, Holladay 1, or Haigis formula before surgery. The differences were further compared based on different grouping of axial length (AXL), corneal curvature (K) and corneal astigmatism (CA). The accuracies of the three formulas were analyzed using Bland-Altman analyses and the possible error sources of each formula were analyzed using multiple regression model. Results: The majority of patients enrolled had hyperopic shift after cataract surgery. The mean errors (ME) of the three formulas were SRK/T: 0.70±0.89D, Holladay 1: (1.20±0.88) D and Haigis: (0.60±0.88) D; the mean absolute errors (MAE) of the three formulas were (0.81±0.79) D, (1.23±0.84) D and (0.76±0.74) D, respectively. Both ME and MAE of Holladay formula were significantly greater than the other two formulas (F=86.31, P<0.01). Besides, the proportion of patients having a prediction error within 0.50 D was lower in those using Holladay formula (20.4%, 21/103) than the other two (SRK/T: 38.8%, 40/103, χ(2)=8.41, P<0.01, Haigis: 45.6%, 47/103, χ(2)=14.84, P<0.01). Bland-Altman analyses showed that the accuracies of all the three formulas were acceptable in patients of cataract with high myopia in clinical practice. ME and MAE tended to be larger with longer axial length, larger corneal curvature and astigmatism of the patients in all three formulas. However, in eyes with axial length> 30 mm or corneal curvature ≤43.00 D, the MAE of Haigis formula was lower than that of SRK/T formula (F=63.26,63.94, both P<0.01). The prediction error of SRK/T formula was positively correlated with axial length and corneal astigmatism (F=33.97, r=0.66, β=0.48, P<0.01 and β=0.42, P<0.01), while for Holladay and Haigis formulas, in addition to the previous two factors, the errors were also positively correlated with mean corneal curvature (Holladay 1: F=31.26, r=0.72, AXL: β=0.52, P<0.01, K: β=0.20, P<0.05 and CA: β=0.37, P<0.01; Haigis: F=30.96, r=0.72, AXL: β=0.33, P<0.01, K: β=0.40, P<0.01 and CA: β=0.37, P<0.01). Conclusions: In the selection of IOL formula for high myopic patients with cataract, Haigis or SRK/T would reduce the prediction error and serve as the more accurate formulas than Holladay 1. Haigis formula may be more accurate than SRK/T formula in case of AXL>30 mm or K≤43.00 D. (Chin J Ophthalmol, 2017, 53: 260-265).

[HIV infection and associated factors in men who have sex with men and also with women in Urumqi from 2010 to 2014]

Objective: To understand the demographic characteristics, sexual behaviors and the factors associated with HIV infection in men who have sex with men and also with women (MSMW) in Urumqi. Methods: According to the "National AIDS Sentinel Surveillance Protocol" , the data of MSM's demographic characteristics, sex behavior histories and serological detection results were collected through Urumqi AIDS sentinel surveillance system during 2010-2014. In MSM, those also had heterosexual behaviors were considered as MSMW. Results: Of 2 073 MSM surveyed, 216 (10.4%) were MSMW, and 115 MSMW (53.2%) were aged 30>years. Compared with MSM, MSMW were more prone to have commercial homosexual behaviors (OR=2.09, 95%CI: 1.35-3.21), and the condom use rate at the latest homosex was low among them (OR=0.58, 95%CI: 0.40-0.85). The HIV infection rates in MSMW and MSM were 7.4% and 9.0%, respectively, the difference had no significance (χ²=0.604, P>0.05). Multivariate logistic analysis showed that among the MSMW the condom use at the latest homosex (OR=0.24,95% CI: 0.09-0.71), and the number of anal sex in the past week (OR=6.63, 95% CI: 1.47-29.90) were the factors associated with HIV infection, and in MSM, the factors associated with HIV infection were non-Han nationality (OR=6.40, 95% CI:1.62-25.36), local residence time (OR=7.47, 95% CI: 1.98-28.20), using no condoms or using condoms occasionally at commercial sex (OR=6.14,95% CI:1.93-19.52). Conclusion: The HIV infection status and associated factors varied between MSMW and MSM in Urumqi. Therefore, it is necessary to take targeted AIDS prevention measures among them.

[Clinical effect of minimally-Invasive surgical-transforaminal lumbar interbody fusion technique associated with percutaneous pedicle screws in micro endoscopy discectomy]

Objective: To evaluate the clinical efficacy between the minimally-Invasive surgical (MIS)-transforaminal lumbar interbody fusion (TLIF) technique associated with percutaneous pedicle screws in micro endoscopy discectomyand MIS-TLIF technique associated with both sides of the lower lumbar spine Wiltse approach in Quadrant channel with treatment of single segment herniation associated with lumbar instability syndrome. Methods: From January 2012 to January 2015, 75 cases that meet the inclusion and exclusion criteria were treated by retrospective study method, which were divided into two groups in Department of Orthopedics, the Affiliated Hospital of Putian University.Experimental group(30 patients) were treated with MIS-TLIF technique associated with percutaneous pedicle screws in microendoscopy discectomy, control group were treated with MIS-TLIF technique associated with both sides of the lower lumbar spine Wiltse approach in Quadrant Chanel.Compare operation time, blood loss, postoperativehospital stay, clinical efficacy, nailing accuracy, fusion rate, postoperative pain scoring of two groups. Results: The blood loss[(102.1±5.5) min vs(103.7±7.7) min, t=-0.586, P>0.05], postoperative blood loss, hospital stay[(44.6±5.2) ml and(57.2±5.3) ml, (7.3±1.6) d and(9.3±1.9) d; t=-5.813, -2.774, P<0.05], JOA score before and after surgery in same group were statistically significant(P<0.05), respectively.Patients of two groups compared with operation time, clinical efficacy, nailing accuracy[group A: 97.5%, group B: 95.7%; χ(2)=3.00, P>0.05.Postoperative 3 month , group A: 96.7%(29/30), group B: 94.3%(33/35; χ(2)=0.79, P>0.05], fusion rate[group A: 96.7%(29/30), group B: 94.3%(33/35), χ(2)=0.79, P>0.05], preoperative JOA score[(20.4±2.4)score and(7.9±1.0), (19.1±2.7)score and(7.8±1.2)score], postoperative JOA score were no statistically significant respectively, P>0.05. JOA score of both groups were statistically significant respectively Before and after operate.Excellent rate: group A; 84.4%(25/30), group B: 80.0%(28/35), χ(2)=0.43, P>0.05. Conclusion: MIS-TLIF technique associated with percutaneous pedicle screws in micro endoscopy discectomy relative to conventional minimally invasive spine surgery had many advantages: minimal damage, operation conveniently, precisely clinical effect, that is a kind of feasible and reliable minimally invasive surgery which is worth promoting.

[Comparison of human papilloma virus infection status between men who have sex with men recruited from gay bathhouses and HIV voluntary counseling and testing clinics respectively in Urumqi]

Objective: To understand the human papilloma virus (HPV) infection status in men who have sex with men (MSM) recruited from gay bathhouses and HIV voluntary counseling and testing (VCT) clinics in Urumqi, Xinjiang Uygur autonomous region, and identify the associated risk factors. Methods: A total of 200 MSM aged ≥18 years were recruited by using the " snowballing" sampling method from gay bathhouses and VCT clinics in Urumqi during March-May, 2016. The MSM recruited completed questionnaires after filling in the informed consent form. The information about their demographic characteristics and sexual behaviors were collected, and anal swabs were collected from them for HPV genotyping. Results: The overall HPV infection rate was 54.0%. The HPV infection rate was 66.7%(74/111) in MSM from gay bathhouses and 38.2%(34/89) in MSM from VCT clinics and the high risk type HPV infection rate was 39.6% (44/111) in MSM from gay bathhouses and 14.6% (13/89) in MSM from VCT clinics, the differences were significant (χ(2)=16.112, P<0.05; χ(2)=15.190, P<0.05). Multiple logistic regression analysis indicated that the major risk factors for HPV infection included activity in gay bathhouse (OR=3.732, 95% CI: 1.950-7.141) and anal sexual behavior (OR=2.555, 95%CI: 1.329-4.912). Conclusion: The prevalence of HPV in MSM from gay bathhouses was higher than that in MSM from VCT clinics, indicating that close attention should be paid to the behavior intervention in MSM.

Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia: A Retrospective Study

Background:

Acute fibrinous and organizing pneumonia (AFOP) is a unique pathological entity with intra-alveolar fibrin in the form of “fibrin balls” and organizing pneumonia. It was divided into rare idiopathic interstitial pneumonia according to the classification notified by American Thoracic Society/European Respiratory Society in 2013. As a rare pathological entity, it is still not well known and recognized by clinicians. We reviewed the clinical features of 20 patients with AFOP diagnosed in a teaching hospital.

Methods:

The medical records of 20 patients with biopsy-proven diagnosis of AFOP were retrospectively reviewed. The patients’ symptoms, duration of the disease, comorbidities, clinical laboratory data, pulmonary function testing, radiographic studies, and the response to treatment were extracted and analyzed.

Results:

Fever was the most common symptom and was manifested in 90% of AFOP patients. For clinical laboratory findings, systematic inflammatory indicators, including C-reactive protein and erythrocyte sedimentation rate, were significantly higher than normal in AFOP patients. In accordance with this increased indicators, injured liver functions were common in AFOP patients. Inversely, AFOP patients had worse clinical conditions including anemia and hypoalbuminemia. For pulmonary function testing, AFOP patients showed the pattern of restrictive mixed with obstructive ventilation dysfunction. For high-resolution computerized tomography (HRCT) findings, the most common pattern for AFOP patients was lobar consolidation which was very similar to pneumonia. However, unlike pneumonia, AFOP patients responded well to glucocorticoids.

Conclusion:

Patients with AFOP manifest as acute inflammatory-like clinical laboratory parameters and lobar consolidation on HRCT, but respond well to steroid.

[Study on HIV prevention related knowledge-motivation-psychological model in men who have sex with men, based on a structural equation model]

OBJECTIVE

Knowledge-motivation-psychological model was set up and tested through structural equation model to provide evidence on HIV prevention related strategy in Men who have Sex with Men (MSM).

METHODS

Snowball sampling method was used to recruit a total of 550 MSM volunteers from two MSM Non-Governmental Organizations in Urumqi, Xinjiang province. HIV prevention related information on MSM was collected through a questionnaire survey. A total of 477 volunteers showed with complete information. HIV prevention related Knowledge-motivation-psychological model was built under related experience and literature. Relations between knowledge, motivation and psychological was studied, using a ' structural equation model' with data from the fitting questionnaires and modification of the model.

RESULTS

Structural equation model presented good fitting results. After revising the fitting index: RMSEA was 0.035, NFI was 0.965 and RFI was 0.920. Thereafter the exogenous latent variables would include knowledge, motivation and psychological effects. The endogenous latent variable appeared as prevention related behaviors. The standardized total effects of motivation, knowledge, psychological on prevention behavior were 0.44, 0.41 and 0.17 respectively. Correlation coefficient of motivation and psychological effects was 0.16. Correlation coefficient on knowledge and psychological effects was -0.17 (P<0.05). Correlation coefficient of knowledge and motivation did not show statistical significance.

CONCLUSION

Knowledge of HIV and motivation of HIV prevention did not show any accordance in MSM population. It was necessary to increase the awareness and to improve the motivation of HIV prevention in MSM population.

Serum Krebs von den Lungen-6 level as a diagnostic biomarker for interstitial lung disease in Chinese patients

OBJECTIVES

The purpose of this study was to determine the diagnostic and prognostic values of serum KL-6 levels in Chinese patients with interstitial lung disease (ILDs).

METHODS

A total of 1084 subjects including 373 cases of ILDs, 584 cases of non-ILD pulmonary diseases, and 127 healthy individuals were recruited from three clinical centers in China between January 2011 and December 2013. A total of 106 patients undergoing treatments for ILDs in Shanghai Pulmonary Hospital between January 2011 and December 2013 were enrolled. Baseline and posttreatment serum KL-6 levels were determined.

RESULTS

Serum KL-6 levels in patients with ILDs were significantly higher than those in patients with non-ILD pulmonary diseases or in healthy individuals (1492.09 ± 2230.08 U/mL vs 258.67 ± 268.73 U/mL or 178.73 ± 71.17 U/mL, all P < 0.05). At the cut-off value of 500 U/mL, the sensitivity and specificity of serum KL-6 as a diagnostic marker for ILDs was 77.75% and 94.51%, respectively. The Kappa value was 0.743 (P < 0.001). The area below the receiver operating characteristic curve was 0.922 with a 95% Confidence interval of 0.904-0.941 (P < 0.001). The posttreatment serum KL-6 levels significantly reduced in patients with improved ILDs, whereas markedly increased in patients with exacerbated ILDs (All P < 0.05).

CONCLUSIONS

Serum KL-6 levels might be a promising diagnostic biomarker for ILDs in Chinese patients. The prognostic value of serum KL-6 levels for ILDs remains to be verified by large-scaled studies.

First principles study on stability and hydrogen adsorption properties of Mg/Ti interface

The hydrogenation and stability properties of the Mg/Ti interface are studied by first-principles calculations. The strain of lattice and movement of ions were imposed to search for a stable Mg/Ti interface. The anti-symmetrical configuration was found to be the most stable. The easiest transition pathway from anti-symmetrical to symmetrical configuration may be through the diagonal direction with no energy barrier. The hydrogen adsorption at distinguished positions in the Mg/Ti interface is investigated. The negative hydrogen adsorption energy reaches -0.991 eV at the top site in the interface, which will highly favor the thermodynamic stability of the Mg/Ti interface. The electronic structure is studied and it was found that the Ti acts as a hydrogen atom 'capturer' and strong interactions between H and its surrounding Ti and Mg atoms are expected. Thus, inserting Ti layers could create an interfacial zone where the adsorptions of hydrogen atoms may get stabilized and therefore improve the hydrogen storage properties of Mg.

Effects of Omega-3 fatty acid on major cardiovascular events and mortality in patients with coronary heart disease: a meta-analysis of randomized controlled trials

AIM

There is considerable discrepancy regarding the protective effects of Omega-3 polyunsaturated fatty acids (Omega-3 PUFAs) in patients with coronary heart disease (CHD) from the early-phase clinical randomized controlled trials (RCTs). We conducted a meta-analysis of RCTs to address this issue.

DATA SYNTHESIS

Pubmed, the Cochrane Central Register of Controlled Trials, and EMBASE databases (∼ May 2013) were systematically searched. Odds ratios (OR) and associated 95% CI were retrieved by using random-effect model according to heterogeneity. A total of 14 RCTs involving 16,338 individuals in the Omega-3 PUFAs group and 16,318 in the control group were identified. Patients assigned to Omega-3 PUFAs did not demonstrate satisfactory improvements on major cardiovascular events (OR, 0.93; 95% CI, 0.86 to 1.01; P = 0.08; I(2) = 46%). By contrast, the reduced risks of death from cardiac causes, sudden cardiac death and death from all causes (OR, 0.88; 95% CI, 0.80 to 0.96; P = 0.003; I(2) = 0%; OR, 0.86; 95% CI, 0.76 to 0.98; P = 0.03; I(2) = 29%; and OR, 0.92; 95% CI, 0.85 to 0.99; P = 0.02; I(2) = 6%; respectively) were shown.

CONCLUSIONS

Supplement of Omega-3 PUFAs in patients with CHD is not associated with a protective effect on major cardiovascular events, while it does exert beneficial effects in reducing death from cardiac causes, sudden cardiac death and death from all causes. However, with currently available cardio-protective therapies, whether dietary supplementation with Omega-3 PUFAs should be still considered in patients with CHD is currently debated.

Effect of inhaled MgSO4 on FEV1 and PEF in children with asthma induced by acetylcholine: a randomized controlled clinical trail of 330 cases

OBJECTIVES

To determine the response of nebulized magnesium sulfate on the lung function of acetylcholine-induced asthma children.

METHODS

Three hundred and thirty children of asthma with positive bronchial provocation test were randomly divided into three groups: magnesium sulfate, albuterol, and a combination of magnesium sulfate and albuterol. Lung function was compared between the three groups.

RESULTS

Forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) as percentage over predicted at 10 min and 20 min in albuterol and combination group were significantly improved when compared to magnesium group. The changes in FEV1 and PEF expressed as absolute and percentage over predicted was not statistically significant from baseline to 20 min in magnesium, albuterol, and combination of magnesium sulfate and albuterol. There was no significant adverse effect observed during the present study.

CONCLUSION

Nebulized magnesium sulfate alone has a bronchodilatory effect in Ach-induced asthmatic children. The combination of MgSO4 and albuterol did not has a synergistic effect.

Dynamic approach to finite-temperature magnetic phase transitions in the extended J1-J2 model with vacancy order

The recently discovered iron-based superconductors A(y)Fe(2-x)Se(2) (A=K, Rb, Cs, Tl) show a long-range antiferromagnetic order with an unexpectedly high transition temperature T(N)~550 K and a unique √5×√5 vacancy order. Taking the extended J(1)-J(2) model as a minimal model, we investigate the finite-temperature magnetic phase transitions in a square lattice with a √5×√5 vacancy superstructure by using large-scale Monte Carlo simulations. By the parallel tempering technique, the block spin checkerboard and stripe antiferromagnetic states are detected to be the ground states for three representative sets of model parameters. The short-time dynamic approach is applied to accurately determine the critical temperature as well as the static and dynamic exponents. Our results indicate that the dramatic enhancement of the critical temperature as observed in experiments should be mainly due to a combination of the vacancy order and the block lattice contraction.

Single nucleotide polymorphisms in the ORM1-like 3 gene associated with childhood asthma in a Chinese population

Single nucleotide polymorphism (SNP)-based genome-wide association studies have revealed that polymorphisms of the ORM1-like 3 (ORMDL3) gene are associated with childhood asthma. We investigated genetic associations of SNPs in and around the ORMDL3 gene with childhood asthma in a Chinese population. Genomic DNA was extracted from peripheral venous blood drawn from 152 subjects with childhood asthma and from 190 control subjects. SNP genotyping was performed with the MassARRAY system (Sequenom) by means of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Among the six SNPs, only the genotype frequencies of rs7216389 were significantly different between asthmatic children and controls. Asthmatic children had a significantly higher frequency of T alleles [odds ratio (OR) = 1.653, 95% confidence interval (95%CI) = 1.170-2.333] in rs7216389, than controls. The TT genotype of rs7216389 was found to be a significant risk factor for childhood asthma by logistic regression analysis (OR = 1.704, 95%CI = 1.105-2.628). There was no significant association between the TT genotype of rs7216389 and clinical features of childhood asthma. We conclude that the ORMDL3 gene influences childhood asthma and that the TT genotype of the rs7216389 polymorphism is associated with childhood asthma in the Chinese population.

[Report of 2 cases of novel influenza A (H1N1) virus infection complicated with pneumonia and hypoxemia]

OBJECTIVE

to improve understanding of the novel influenza A (H1N1) virus infection complicated with pneumonia.

METHOD

clinical presentations, radiological data, laboratory data and treatments of 2 patients with pneumonia caused by the novel influenza A (H1N1) virus were retrospectively analyzed.

RESULTS

one patient was a middle-aged woman, and the other was a young man with a history of asthma. Both patients had fever (temperatures more than 39 degrees C), cough, and dyspnea. At the time of admission, both patients had hypoxemia. Chest computed tomography (CT) scan showed patchy distribution of consolidation and ground-glass opacity mainly in peripheral subpleural regions, as well as peribrochovascular lesions with air-bronchogram. The decreased and lymphocytes, elevated lactate dehydrogenase and creatine kinase were found in both patients. After admission, the patients received oseltamivir with a dose of 75 mg twice a day for a minimum of 5 days. Other treatments included antibiotics and methylprednisolone. One patient needed intermittent non-invasive ventilation for respiratory distress. Both patients recovered and the opacities on their chest CT were almost absorbed. WBC counts increased to normal and the levels of LDH and CK decreased.

CONCLUSIONS

patients with the novel influenza A (H1N1) virus infection may develop pneumonia. The manifestations are non-specific. Chest CT scan reveals patchy distribution of consolidation and ground-glass opacity. In addition to antiviral therapy, glucocorticoids may have some effects on the pulmonary lesions and be useful for improving the clinical conditions.

Rapid detection of oxacillin-resistant Staphylococcus aureus in blood cultures by an impedance method

The feasibility of using an impedance method for direct detection of oxacillin-resistant Staphylococcus aureus (ORSA) in blood cultures was evaluated. An aliquot (0.1 ml) of the positive blood culture, which showed growth of gram-positive cocci and demonstrated thermonuclease activity, was inoculated into the module well of a Bactometer incubator (bioMerieux Vitek, Hazelwood, Mo.) containing 0.6 ml of Mueller-Hinton agar supplemented with oxacillin (2 microg/ml). The modules were incubated at 37 degrees C, and the change in impedance in each well was continuously monitored by the instrument at 6-min intervals for 24 h. ORSA strains from blood cultures could multiply in the oxacillin-containing medium, and a time point (detection time [DT]) at which an accelerating change of impedance occurred in the medium was obtained, with an average of 5.5 h. The growth of oxacillin-sensitive S. aureus (OSSA) strains was largely inhibited, and no DT was obtained for these strains within an incubation period of 24 h. For 96 positive blood cultures (38 ORSA and 58 OSSA) tested, 36 and 57 were found to be oxacillin resistant and oxacillin sensitive, respectively, by the impedance method. The impedance method had a sensitivity and specificity of 94.7 and 98.3%, respectively, for the detection of ORSA and had an agreement of 96.9% with the disc diffusion method. Comparable results were obtained by the testing of 235 clinical stock cultures of S. aureus (149 ORSA and 86 OSSA). The impedance test is simple for detecting ORSA in blood cultures and may allow proper antimicrobial treatment almost 36 h before the results of the conventional culture methods are available.

Spatial fidelity of image amplification in photorefractive crystals

We numerically studied the spatial fidelity of coherent image amplification by two-wave mixing configurations in photorefractive BaTiO(3):Ce using a three-dimensional analysis. The results are given for the case when the input one-dimensional rectangular amplitude of the image-bearing extraordinary beam is finite in the plane of incidence and when the amplitude is finite in the orthogonal plane. The fidelity and the gain versus the angle between the propagating direction of the image-bearing beam and the crystal c axis, the pump-to-image intensity ratio, and the input beamwidth, are analyzed.

Fanning effects in photorefractive crystals

A model to describe the fanning effect based on the beam-coupling mechanism in photorefractive crystals is presented. The intensity distribution of the fanning beam in a 45 degrees -cut BaTiO(3) crystal is measured experimentally. The results show good quantitative agreement with theory.

Effects of iron limitation on production of a siderophore, outer membrane proteins, and hemolysin and on hydrophobicity, cell adherence, and lethality for mice of Vibrio parahaemolyticus

Vibrio parahaemolyticus is one of the most important enteropathogens in Taiwan, Japan, and other coastal regions. The pathogenesis of V. parahaemolyticus disease is not clearly understood. The expression of some factors by V. parahaemolyticus in iron-rich and iron-limited media was analyzed. In the clinical hemolytic strains, the production of a siderophore, two outer membrane proteins (77 and 80 kDa), and thermostable direct hemolysin was significantly enhanced in iron-limited culture, and hemolytic activities, cell hydrophobicity, HEp-2 cell adherence, and lethality for mice were also enhanced. The environmental nonhemolytic strain CCRC12958 that was cultured in iron-limited medium exhibited lethal activity for mice, and other factors except hemolysis were also enhanced like the responses of clinical strains were. These results suggested that a virulent factor(s) of V. parahaemolyticus may be induced or enhanced under iron-limited conditions. The iron-regulated factors reported in this paper may be important in the pathogenesis of V. parahaemolyticus disease.

Quasi-periodic motion in a hybrid optical bistable system with a short delay

The dynamical behavior of a hybrid optical bistable system with a short delay is calculated numerically in detail. The quasi-periodic motion and frequency locking of the system are observed experimentally.

Self-focusing and self-trapping in new types of Kerr media with large nonlinearities

Self-focusing and self-trapping of light in common liquid media such as Chinese tea, Chinese herbal medicine, and solutions of chlorophyll have been observed. These materials are found to be new types of natural Kerr media, and their nonlinear coefficients have been determined. Laser-heating-induced self-phase modulation in these materials has also been observed.

Laser-heating-induced self-phase modulation, phase transition, and bistability in nematic liquid crystals

A quantitative discussion of the laser-heating-induced self-phase modulation in nematic liquid crystals is given. The process of the laser-heating-induced nematic-isotropic transition is analyzed. The intrinsic optical bistability due to the nematic-isotropic phase transition is observed and analyzed.

Feedback-induced first-order Freedericksz transition in a nematic film

It is shown that optical-electrical feedback can transform the Freedericksz transition in a nematic film from second order to first order. The criteria that indicate whether the Freedericksz transition is first or second order are obtained. The hysteresis accompanying the first-order transition versus the feedback intensity is discussed. The feedback-induced first-order Freedericksz transition has been observed experimentally. The experimental results are in good agreement with the theoretical analysis.