Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

小电流接地故障定位方法的综述

在我国,配电网大部分采用小电流接地系统。通过大量文献的研究,对目前小电流接地故障各种定位方法的工作原理进行分类和总结,并分析它们各自的特点。根据它们各自适应的场合提出目前故障定位存在的问题及今后发展的趋向。

Upregulation of kazrin F by miR-186 suppresses apoptosis but promotes epithelial-mesenchymal transition to contribute to malignancy in human cervical cancer cells

Objective：Previous studies have identified that kazrin is a constituent of desmosome and influences intercellular adhesion,growing development and morphology.We previously cloned another new isoform,kazrin F and found that it has anti-apoptotic effects on human glioma cell line.To further explore whether kazrin F is involved in tumorigenesis,we investigated its expression and role in cervical cancer（CC） cells.Methods：The role of kazrin F and miR-186 in CC was determined by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide（MTT） assay,colony formation,transwell,and apoptosis assays.Using enhanced green fluorescent protein（EGFP） reporter assays,reverse transcription-quantitative polymerase chain reaction（RT-qPCR） and western blot analysis,we identified kazrin F post-transcriptional regulation by miR-186.Results：We demonstrate that kazrin F is highly expressed in CC tissues compared with the adjacent noncancerous tissues and promotes cell proliferation,colony formation,migration and invasion in HeLa and C33 A cells by suppressing apoptosis and facilitating epithelial-to-mesenchymal transition（EMT）.Furthermore,miR-186 was confirmed as a regulator of kazrin F dysregulation.An EGFP reporter assay proved that miR-186 directly targets the 3＇-untranslated region（3＇UTR） of kazrin F and downregulates its expression,and miR-186 expression showed an inverse correlation with kazrin F levels in CC tissues.In addition,overexpression of miR-186 suppressed the malignant behaviors of CC cells.The ectopic expression of kazrin F rescued the inhibitory effects of miR-186.Conclusions：Our findings indicate that the upregulation of kazrin F due to downregulated miR-186 levels contributes to malignancy,and highlight the significance of kazrin F in CC tumorigenesis.

Study of brain morphology change in Alzheimer’s disease and amnestic mild cognitive impairment compared with normal controls

Background With an aggravated social ageing level, the number of patients with Alzheimer's disease (AD) is gradually increasing, and mild cognitive impairment (MCI) is considered to be an early form of Alzheimer's disease. How to distinguish diseases in the early stage for the purposes of early diagnosis and treatment is an important topic. Aims The purpose of our study was to investigate the differences in brain cortical thickness and surface area among elderly patients with AD, elderly patients with amnestic MCI (aMCI) and normal controls (NC). Methods 20 AD patients, 21 aMCIs and 25 NC were recruited in the study. FreeSurfer software was used to calculate cortical thickness and surface area among groups. Results The patients with AD had less cortical thickness both in the left and right hemisphere in 17 of the 36 brain regions examined than the patients with aMCI or NC. The patients with AD also had smaller cerebral surface area both in the left and right hemisphere in 3 of the 36 brain regions examined than the patients with aMCI or NC. Compared with the NC, the patients with aMCI only had slight atrophy in the inferior parietal lobe of the left hemisphere, and no significant difference was found. Conclusion AD, as well as aMCI (to a lesser extent), is associated with reduced cortical thickness and surface area in a few brain regions associated with cognitive impairment. These results suggest that cortical thickness and surface area could be used for early detection of AD.

晚发型老年抑郁症发病相关因素分析（英文）

背景:老年抑郁症是老年人常见且危害性大的精神疾病之一,但目前对晚发型老年抑郁症与之相关的社会、心理学及脑结构因素之间的联系的研究较少。目的 :探讨晚发型老年抑郁症(LOD)的相关因素。方法 :共纳入24例首次发病年龄大于60岁的晚发型老年抑郁症患者(诊断符合ICD-10抑郁症的诊断标准)和23例健康老人作为研究的对象。通过视觉评估量表:Fazekas量表评估脑白质高信号的严重程度,MTA量表评估内侧颞叶萎缩程度,结合一般人口学资料及社会学资料,寻找晚发型老年抑郁症的影响因素。结果:两组间的年龄(t=0.419, p=0.678)、性别(X^2=1.705,p=0.244)、教育程度(t=1.478, p=0.146)均无统计学差异。两组人群在脑白质高信号评分(WMH)、脑室旁高信号评分(PWMH)、宗教信仰(有或无)和家庭和睦(是或否)亚项上存在差异(X^2=7.817, p=0.008;Fisher精确检验:p=0.031;Fisher精确检验:p=0.265;Fisher精确检验:p=0.253),而逐步线性回归的结果显示,脑白质高信号评分、宗教信仰(有或无)和家庭和睦(是或否)是老年抑郁的相关因素。结论 :脑白质高信号是晚发型老年抑郁症的风险因素,而具有宗教信仰和/或家庭和睦是其保护性因素。

Blockage of the habenular nucleus can eliminate dyspnea induced by electrostimulation of the insular cortex

BACKGROUND： The insular cortex and habenular nucleus may be a regulatory center for obstructive sleep apnea syndrome, and dyspnea may be caused by insular cortex activity. The insular cortex is a cortical representation of obstructive sleep apnea syndrome. The habenular nucleus is a station for descending insular cortex activity. OBJECTIVE： Through actively stimulating the rat insular cortex, to observe rat respiratory movement, myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity, and to verify a hypothesis that the insular cortex is a superior-position regulation center, and the habenular nucleus is an inferior-position nervous nuclei of the insular cortex in patients with obstructive sleep apnea syndrome. DESIGN, TIME AND SETTING： The randomized, controlled animal study was performed at the Laboratory of Electrophysiology, Department of Physiology, Norman Bathune College of Medicine, Jilin University, China from September 2004 to June 2008. MATERIALS： We used L-glutamic acid （Dingguo Biological Product Research Center, Beijing, China）, lidocaine hydrochloride （Seventh Pharmacy Co., Ltd., Wuxi, China）, electric stimulator （Nihon Kohden, Japan）, and an AVL-OPTI blood gas analyzer （AVL Scientific Co., Roswell, GA, USA）. METHODS： The insular cortex of healthy adult Wistar rats underwent electrostimulation and L-glutamic acid stimulation to record changes in the myoelectric activity of genioglossus and respiratory movement. Some rats were injected with lidocaine to block the habenular nucleus before electrostimulation or L-glutamic acid stimulation. L-glutamic acid and lidocaine were injected by microelectrodes embedded in nuclear groups. MAIN OUTCOME MEASURES： Myoelectric activities of genioglossus, arterial partial pressure of oxygen, partial pressure of carbon dioxide and acidity-alkalinity were measured following apnea in rats undergoing electrostimulation in the insular cortex and following blockade of the habenular nucleus. RESULTS： Following electrostimulation and L-glutamic acid stimulation, rats developed apnea or respiratory rhythm disorders. Simultaneously, the amplitude of myoelectric activity of the genioglossus was reduced （P 〈 0.01 ）, and the electromyogram integral was decreased （P 〈 0.01）. Arterial blood gas analysis showed arterial blood acidosis, a decrease in pH （P 〈 0.05）, and an increase in the negative value of alkaline reserve （P 〈 0.01）. Lidocaine in the habenular nuclear blocked respiratory and other index changes after insular cortex stimulation. CONCLUSION： Dyspnea induced by stimulating the insular cortex may require the habenular nucleus. Paralysis of the habenular nucleus can completely eliminate insular cortex stimulation-induced dyspnea.

Role of 5-hydroxytryptamine expression in cerebellar Purkinje cells in obstructive sleep apnea syndrome

In the present study, electrical stimulation to the rat insular cortex induced apnea or respiratory disturbance, reduced amplitude of genioglossal electromyogram, and decreased electromyogram integrals. In addition, arterial blood gas analysis showed arterial blood acidosis, reduced pH values, increased alkali reserve negative values, decreased peripheral blood 5-hydroxytryptamine content, and increased 5-hydroxytryptamine expression in cerebellar Purkinje cells. Following lidocaine injection to block the habenular nucleus, abnormalities in breath, genioglossal electromyogram, and blood gas values disappeared, and peripheral blood 5-hydroxytryptamine content returned to levels prior to electric stimulation. However, 5-hydroxytryptamine expression in cerebellar Purkinje cells remained high. The results suggested that 5-hydroxytryptamine expression in Purkinje cells did not correlate with ventilation function involving insular cortex and habenular nucleus.

5-hydroxytryptamine-mediated apnea caused by the habenular nucleus

5-hydroxytryptamine contributes to the control of activities of the dilator muscle in the upper respiratory tract, and is derived from the raphe nuclei, in which the habenular nucleus exerts a sustaJned inhibitory effect. In the present study, respiratory motion curve of the genJoglossus muscle and peripheral 5-hydroxytryptamine changes were observed following L-glutamate stimulation of the habenular nucleus of adult Wistar rats. Results showed that the rats had apnea and decreased plasma 5-hydroxytryptamine content after the neurons in habenular nucleus were excited. Genioglossus muscle electromyogram amplitude and integral were significantly reduced. The genioglossus myoelectric activity and respiratory motion curve were similar to obstructive sleep apnea syndrome, thus confirming that the habenular nucleus is the key nucleus involved in the pathogenesis of obstructive sleep apnea syndrome, and is the primary regulated center in the raphe nuclei. Stimulation of the habenular nucleus may suppress 5-hydroxytryptamine release and result in apnea, which is similar to obstructive sleep apnea syndrome.

Separation of Biomass Pyrolysis Oil by Supercritical CO2 Extraction

Supercritical CO2 extraction was employed to separate simulated and real bio-oils. Effects of extraction pressure, temperature and adsorbents on distribution coefficient (or enrichment coefficient) of five representative compounds were investigated using a simulated bio-oil, which was composed of acetic acid (AC), propanoic acid (PA), furfural (FR), acetylacetone (AA) and 2-methoxyphenol (MP). The distribution coefficients of AA, FR and MP between super-critical CO2 phase and liquid phase were bigger than 1.5, while those of AC and PA characteristic of relatively strong polarity were less than 1. Temperature and pressure also had impacts on the distribution coefficients of AA, FR and MP, especially remarkable for AA. The extraction of simulated bio-oil spiked on three adsorbents shows that adsorbents influence extraction efficiency and selectivity by changing intermolecular forces. High extraction pressure and relative low temperature are beneficial to reduce the water content in the extract. In addition, the feasibility of supercritical CO2 extraction of real bio-oil was examined. After extraction in the extraction fraction total ketones increased from 14.1% to 21.15~25.40%, phenols from 10.74% to 31.32~41.25%, and aldehydes from 1.92% to 3.95~8.46%, while the acids significantly dropped from 28.15% to 6.92~12.32%, and water from 35.90% to 6.64~4.90%. In view of extraction efficiency, the optimal extraction temperature was determined to be 55℃. Extraction efficiency of the real bio-oil increased with rising pressure. The maximal extraction efficiency of real bio-oil on water-free basis could reach to 88.6%. After scCO2 extraction, the calorific value and stability of the extract fraction evidently increased and the acidity slight decreased with nearly 100% volatility below 140℃, suggesting potentially applicable as substitute for engine fuel.

Quadric SFDI for Laplacian Discretisation in Lagrangian Meshless Methods

In the Lagrangian meshless(particle)methods,such as the smoothed particle hydrodynamics(SPH),moving particle semi-implicit(MPS)method and meshless local Petrov-Galerkin method based on Rankine source solution(MLPG_R),the Laplacian discretisation is often required in order to solve the governing equations and/or estimate physical quantities(such as the viscous stresses).In some meshless applications,the Laplacians are also needed as stabilisation operators to enhance the pressure calculation.The particles in the Lagrangian methods move following the material velocity,yielding a disordered(random)particle distribution even though they may be distributed uniformly in the initial state.Different schemes have been developed for a direct estimation of second derivatives using finite difference,kernel integrations and weighted/moving least square method.Some of the schemes suffer from a poor convergent rate.Some have a better convergent rate but require inversions of high order matrices,yielding high computational costs.This paper presents a quadric semi-analytical finite-difference interpolation(QSFDI)scheme,which can achieve the same degree of the convergent rate as the best schemes available to date but requires the inversion of significant lower-order matrices,i.e.3×3 for 3D cases,compared with 6×6 or 10×10 in the schemes with the best convergent rate.Systematic patch tests have been carried out for either estimating the Laplacian of given functions or solving Poisson’s equations.The convergence,accuracy and robustness of the present schemes are compared with the existing schemes.It will show that the present scheme requires considerably less computational time to achieve the same accuracy as the best schemes available in literatures,particularly for estimating the Laplacian of given functions.

Expression and correlation of Ezrin and survivin in non-small cell lung cancer

Objective: The aim of this study was to explore expression and correlation of Ezrin and survivin in non-small cell lung cancer (NSCLC). Methods: Expression of Ezrin and survivin were detected and analyzed by Envision method of immu- nohistochemical staining in 86 NSCLC. Results: The strong expression rate of Ezrin in NSCLC was 60.5% and significantly correlated with lymph node metastasis (P < 0.05), but no associated with gender, histologic subtype, TNM stages, differen- tiation and smoking. Meanwhile, the positive expression rate of survivin in NSCLC was 65.1% and significantly correlated with TNM stages and lymph node metastasis (P < 0.05), but no associated with gender, histologic subtype, differentiation and smoking. And expression of Ezrin and survivin were positively correlated in NSCLC (r = 0.384). Conclusion: Ezrin and survivin may play synergetic roles in the process of carcinogenesis of NSCLC, and their expression may be significantly associated with NSCLC metastasis. Detection of Ezrin and survivin may be valuable for diagnosing lung cancer metastasis and providing evidence for clinical treatment.

Initiation Mechanism of Transverse Cracks in Wind Turbine Blade Trailing Edge

Transverse crack often occurs in the trailing edge region of the bladewhen subjected to the excessive edgewise fatigue load.In this paper a refined model was established through local mesh refinement methods in order to investigate the initiation mechanism of crack and its extension in blade trailing edge.The material stress around the crack in trailing edge region under different thicknesses is calculated based on the fracture mechanics theory.The factors affecting the fatigue robustness of blade trailing edge are concluded by investigating the results of finite element analysis and coupons test.Compared with the laminate,the lower fatigue strength of the adhesive is the cause of the transverse crack of the adhesive joint at the trailing edge.The increase of the adhesive thickness at the adhesive joint will significantly increase the stress concentration factor at the crack region and accelerate the crack extension of the laminate.In final,a practical design scheme to prevent crack initiation is given for the manufacture of the wind turbine blade.

An Advanced Control Strategy for Dual-Actuator Driving System in Full-Scale Fatigue Test of Wind Turbine Blades

A new dual-actuator fatigue loading system of wind turbine blades was designed.Compared with the traditional pendulum loading mode,the masses in this system only moved linearly along the loading direction to increase the exciting force.However,the two actuators and the blade constituted a complicated non-linear energy transferring system,which led to the non-synchronization of actuators.On-site test results showed that the virtual spindle synchronous strategy commonly used in synchronous control was undesirable and caused the instability of the blade’s amplitude eventually.A cross-coupled control strategy based on the active disturbance rejection algorithm was proposed.Firstly,a control system model was built according to the synchronization error and tracking error.Furthermore,based on arranging the transition process,estimating the system state and error feedback,and compensating disturbance,an active disturbance rejection controller was designed by adopting the optimal control function.Finally,on-site test results showed that the cross-coupled control strategy based on the active disturbance rejection algorithm could ensure the synchronization of two actuators.The maximum speed synchronization error of the two motors was less than 16 RPM,the displacement synchronization error of the two actuators was less than 0.25 mm and approaching zero after 4 seconds,and the peak value of vibration of the blade was less than 5 mm,which satisfied the fatigue test requirement.

体验式教学在精神科低年资护士保护性约束技能培训中的应用

目的探讨体验式教学在精神科低年资护士保护性约束技能培训中的应用效果。方法对60名精神科低年资护士采用体验式教学进行保护性约束技能培训,分为感知、体验、分享、交流、整合、应用6个环节,共8周完成。在培训前后分别运用护理关怀行为量表和病人关怀感知问卷对护士和患者进行测评,并在3个月以后调查临床实践效果,与去年同期做比较。结果实施体验式教学培训后,精神科低年资护士的护理关怀行为量表各项得分均明显高于培训前,患者的病人关怀感知问卷得分显著高于培训前,且差异均有统计学意义(P<0.001);培训后,患者的约束率有所下降,但与培训前比较,差异无统计学意义(P>0.05);约束护理合并症的发生率较培训前明显降低,差异有统计学意义(P<0.05)。结论体验式教学可以提高低年资护士约束护理中的人文关怀能力,降低约束护理合并症发生率。

Using unmanned aerial vehicles with thermal-image acquisition cameras for animal surveys:a case study on the Sichuan snub-nosed monkey in the Qinling Mountains

Following significant developments in technology,alternative devices have been applied in fieldwork for animal and plant surveys.Thermal-image acquisition cameras installed on unmanned aerial vehicles(UAVs)have been used in animal surveys in the wilderness.This article demonstrates an example of how UAVs can be used in high mountainous regions,presenting a case study on the Sichuan snub-nosed monkey with a detection rate of 65.19%for positive individual identification.It also presents a model that can prospectively predict population size for a given animal species,which is based on combined initial work using UAVs and traditional surveys on the ground.A great potential advantage of UAVs is significantly shortening survey procedures,particularly for areas with high mountains and plateaus,such as the Himalayas,the Qinghai-Tibet Plateau,Hengduan Mountains,the Yunnan-Gui Plateau and Qinling Mountains in China,where carrying out a traditional survey is extremely difficult,so that species and population surveys,particularly for critically endangered animals,are largely absent.This lack of data has impacted the management of endangered animals as well as the formulation and amendment of conservation strategies.

SMYD3-PARP16 axis accelerates unfolded protein response and mediates neointima formation

Neointimal hyperplasia after vascular injury is a representative complication of restenosis.Endoplasmic reticulum(ER)stress-induced unfolded protein response(UPR)is involved in the pathogenesis of vascular intimal hyperplasia.PARP16,a member of the poly(ADP-ribose)polymerases family,is correlated with the nuclear envelope and the ER.Here,we found that PERK and IRE1 a are ADPribosylated by PARP16,and this might promote proliferation and migration of smooth muscle cells(SMCs)during the platelet-derived growth factor(PDGF)-BB stimulating.Using chromatin immunoprecipitation coupled with deep sequencing(ChIP-seq)analysis,PARP16 was identified as a novel target gene for histone H3 lysine 4(H3 K4)methyltransferase SMYD3,and SMYD3 could bind to the promoter of Parp16 and increased H3 K4 me3 level to activate its host gene’s transcription,which causes UPR activation and SMC proliferation.Moreover,knockdown either of PARP16 or SMYD3 impeded the ER stress and SMC proliferation.On the contrary,overexpression of PARP16 induced ER stress and SMC proliferation and migration.In vivo depletion of PARP16 attenuated injury-induced neointimal hyperplasia by mediating UPR activation and neointimal SMC proliferation.This study identified SMYD3-PARP16 is a novel signal axis in regulating UPR and neointimal hyperplasia,and targeting this axis has implications in preventing neointimal hyperplasia related diseases.

Preparation and activity evaluation of NiMoB/-Al_2O_3 catalyst by liquid-phase furfural hydrogenation

Amorphous MoNiB/γ/-Al2O3 alloy catalysts were prepared by reducing NiCI2.6H20 and （NH4）6Mo7O24.4H2O supported on γ-Al2O3 with NaBH4 as reducing agent. Using liquid-phase hydrogenation of furfural （FFR） as a probe reaction, the activity of MoNiB/γ/Al2O3 was examined. Compared to NiB and NiMoB, NiMoB/γ-Al2O3 exhibited excellent activity and selectivity towards furfuryl alcohol （FFA）. After reaction for 3.0 h at 80 ℃ and 5.0 MPa in methanol, FFR conversion reached 99% with FFA yield of 91%. The effects of doping amount of Mo and calcination temperature before NaBH4 reduction on hydrogenation activity were also investigated. The optimum Mo/Ni atom ratio and calcination temperature were found to be 1：7 and 300 ℃, respectively. XRD patterns and SEM images indicated that NiMoB over the surface of γ-Al2O3 was amorphous and highly dispersed, which was responsible for the high thermal stability of the title catalyst.

Rapid detection of total nitrogen content in soil based on hyperspectral technology

Soil total nitrogen content(TN)is a crucial factor in boosting the growth of crops.Its sur-plus or scarcity will alter the quality and yield of crops to a certain extent.Traditional methods such as chemical analysis is complicated,laborious and time-consuming.A faster and more efficient method to detect TN should be explored to address this problem.The hyperspectral technology integrates conventional energy and spectroscopy which aids in the simultaneous collection of spatial and spectral information from an object.It has grad-ually proved its significance and gained popularity in the analysis of soil composition.This study discussed the possibility of using hyperspectral technology to detect TN,analyzed six spectral data preprocessing methods and five modeling methods:partial least squares(PLS),back-propagation(BP)neural network,radial basis function(RBF)neural network,extreme learning machine(ELM)and support vector regression(SVR)with evaluation index R^(2) and RMSE.Setting the content of chemical analysis as the control and comparing the errors from spectral analysis.According to the results,all five models can be used for TN detection,and the SVR model with R^(2) 0.9121 and RMSE 0.7581 turned to the best method.The study showed that the spectral model can detect TN quickly,providing a reference for the detection of elements in soil with favorable research significance.

政策不确定性提高了审计收费吗?——基于地方官员变更的实证检验

本文基于政策不确定性视角,利用地级市官员变更的"准自然实验",考察了政策不确定性对审计费用的影响。研究发现,地方官员变更导致的政策不确定性提高了审计收费,这一关系在不具有地方政治关联的样本组中更为显著。进一步研究发现,官员变更对审计费用的影响在政策不确定性程度较高、盈余操纵程度较大的样本组中更加明显。机理分析表明,政策不确定性降低了分析师跟踪数量,增加了信息环境不透明性,提升了企业的经营风险和审计师的审计投入,进一步提高了审计费用。本文对理解政治环境与企业微观行为及审计决策等方面具有一定的启示和借鉴意义。