Early Cretaceous Archaefructus eoflora sp. nov. with Bisexual Flowers from Beipiao, Western Liaoning, China

Recently, whether Archaefructus has bisexual multi-parted flowers or just inflorescences of unisexual flowers, and whether it is ancestral to all angiosperms or a derived eudicot have been debated. Here, from the same Yixian Formation, NE China, we report a new Archaefructus species, A. eoflora sp. nov., with the generic characteristics of dissected leaves and bisexual reproductive axes. It is entirely preserved with roots, rhizome, shoots and protogynous reproductive organs at different developmental stages. Its lateral and main fertile shoots form a pseudo-indeterminate pattern, while the reproductive branches on the main shoot form a cymose inflorescence. Subtended by 1-2 bract-like leaves, the section of stamen clusters changes into a much shorter section of carpels that have one row of orthotropous ovules. Significantly, one cluster bearing two carpels and one stamen between the two sections demonstrates a true bisexual flower, an important step of the origin of floral bisexuality, and the homology between the stamen and carpel. The complex reproductive axes represent a mix between flowers and inflorescences, and suggest that A. eoflora sp. nov. possesses the potential to evolve into a variety of diverse flower types as found in modern basal and early fossil angiosperms. A comparison with other two species also leads to a revision of the generic diagnosis.

Identification and evaluation of shale oil micromigration and its petroleum geological significance

Taking the Lower Permian Fengcheng Formation shale in Mahu Sag of Junggar Basin,NW China,as an example,core observation,test analysis,geological analysis and numerical simulation were applied to identify the shale oil micro-migration phenomenon.The hydrocarbon micro-migration in shale oil was quantitatively evaluated and verified by a self-created hydrocarbon expulsion potential method,and the petroleum geological significance of shale oil micro-migration evaluation was determined.Results show that significant micro-migration can be recognized between the organic-rich lamina and organic-poor lamina.The organic-rich lamina has strong hydrocarbon generation ability.The heavy components of hydrocarbon preferentially retained by kerogen swelling or adsorption,while the light components of hydrocarbon were migrated and accumulated to the interbedded felsic or carbonate organic-poor laminae as free oil.About 69% of the Fengcheng Formation shale samples in Well MY1 exhibit hydrocarbon charging phenomenon,while 31% of those exhibit hydrocarbon expulsion phenomenon.The reliability of the micro-migration evaluation results was verified by combining the group components based on the geochromatography effect,two-dimension nuclear magnetic resonance analysis,and the geochemical behavior of inorganic manganese elements in the process of hydrocarbon migration.Micro-migration is a bridge connecting the hydrocarbon accumulation elements in shale formations,which reflects the whole process of shale oil generation,expulsion and accumulation,and controls the content and composition of shale oil.The identification and evaluation of shale oil micro-migration will provide new perspectives for dynamically differential enrichment mechanism of shale oil and establishing a“multi-peak model in oil generation”of shale.

Tailoring MXene Thickness and Functionalization for Enhanced Room‑Temperature Trace NO_(2) Sensing

In this study,precise control over the thickness and termination of Ti3C2TX MXene flakes is achieved to enhance their electrical properties,environmental stability,and gas-sensing performance.Utilizing a hybrid method involving high-pressure processing,stirring,and immiscible solutions,sub-100 nm MXene flake thickness is achieved within the MXene film on the Si-wafer.Functionalization control is achieved by defunctionalizing MXene at 650℃ under vacuum and H2 gas in a CVD furnace,followed by refunctionalization with iodine and bromine vaporization from a bubbler attached to the CVD.Notably,the introduction of iodine,which has a larger atomic size,lower electronegativity,reduce shielding effect,and lower hydrophilicity(contact angle:99°),profoundly affecting MXene.It improves the surface area(36.2 cm^(2) g^(-1)),oxidation stability in aqueous/ambient environments(21 days/80 days),and film conductivity(749 S m^(-1)).Additionally,it significantly enhances the gas-sensing performance,including the sensitivity(0.1119Ωppm^(-1)),response(0.2% and 23%to 50 ppb and 200 ppm NO_(2)),and response/recovery times(90/100 s).The reduced shielding effect of the–I-terminals and the metallic characteristics of MXene enhance the selectivity of I-MXene toward NO2.This approach paves the way for the development of stable and high-performance gas-sensing two-dimensional materials with promising prospects for future studies.

Organic Matter Accumulation in the Upper Permian Dalong Formation from the Lower Yangtze Region,South China

The Late Permian was marked by a series of important geological events and widespread organic-rich black shale depositions,acting as important unconventional hydrocarbon source rocks.However,the mechanism of organic matter(OM)enrichment throughout this period is still controversial.Based on geochemical data,the marine redox conditions,paleogeographic and hydrographic environment,primary productivity,volcanism,and terrigenous input during the Late Permian in the Lower Yangtze region have been studied from the Putaoling section,Chaohu,to provide new insights into OM accumulation.Five Phases are distinguished based on the TOC and environmental variations.In Phase I,anoxic conditions driven by water restriction enhanced OM preservation.In Phase II,euxinic and cycling hydrological environments were the two most substantial controlling factors for the massive OM deposition.During Phase III,intensified terrestrial input potentially diluted the OM in sediment and the presence of oxygen in bottom water weakened the preservation condition.Phase IV was characterized by a relatively higher abundance of mercury(Hg)and TOC(peak at 16.98 wt%),indicating that enhanced volcanism potentially stimulated higher productivity and a euxinic environment.In Phase V,extremely lean OM was preserved as a result of terrestrial dilutions and decreasing primary productivity.Phases I,II and IV are characterized as the most prominent OM-rich zones due to the effective interactions of the controlling factors,namely paleogeographic,hydrographic environment,volcanism,and redox conditions.

Effect of ankle versus thigh tourniquets on post-operative pain in foot and ankle surgery

BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.

Natural gas exploration potential and favorable targets of Permian Fengcheng Formation in the western Central Depression of Junggar Basin,NW China

Based on the organic geochemical data and the molecular and stable carbon isotopic compositions of natural gas of the Lower Permian Fengcheng Formation in the western Central Depression of Junggar Basin,combined with sedimentary environment analysis and hydrocarbon-generating simulation,the gas-generating potential of the Fengcheng source rock is evaluated,the distribution of large-scale effective source kitchen is described,the genetic types of natural gas are clarified,and four types of favorable exploration targets are selected.The results show that:(1)The Fengcheng Formation is a set of oil-prone source rocks,and the retained liquid hydrocarbon is conducive to late cracking into gas,with characteristics of high gas-generating potential and late accumulation;(2)The maximum thickness of Fengcheng source rock reaches 900 m.The source rock has entered the main gas-generating stage in Penyijingxi and Shawan sags,and the area with gas-generating intensity greater than 20×10^(8) m^(3)/km^(2) is approximately 6500 km^(2).(3)Around the western Central Depression,highly mature oil-type gas with light carbon isotope composition was identified to be derived from the Fengcheng source rocks mainly,while the rest was coal-derived gas from the Carboniferous source rock;(4)Four types of favorable exploration targets with exploration potential were developed in the western Central Depression which are structural traps neighboring to the source,stratigraphic traps neighboring to the source,shale-gas type within the source,and structural traps within the source.Great attention should be paid to these targets.

Early-diverging Titanosauriform(Dinosauria,Sauropoda)Teeth from the Lower Cretaceous Yixian Formation of Southeastern Inner Mongolia,Northeast China

Three eusauropod teeth(SDUST-V1064,PMOL-AD00176,PMOL-ADt0005)are reported from the Lower Cretaceous Yixian Formation of Ningcheng,southeastern Inner Mongolia,China.Two of them(SDUST-V1064,PMOL-AD00176)are assigned to early-diverging titanosauriforms in having slightly mesiodistal expansion at the base of the tooth crown,a slenderness index value>2.0 and<4.0,and D-shaped cross section.Furthermore,SDUST-V1064 and PMOL-AD00176 are referred as an Euhelopus-like titanosauriform on the basis of having a sub-circular boss on the lingual surface and an asymmetrical crown-root margin which slants apically,respectively.CT scan data of SDUST-V1064 reveals new dental information of early-diverging titanosauriforms,for example,the enamel on the labial side thicker than that on the lingual side,an enamel/dentine ratio of 0.26 and a boss present on the lingual side of the dentine of the crown.

Surface and Deep Structure of the Hanshan-Wuwei Basins in the Lower Yangtze Region:Implications for Mesozoic Tectonic Evolution of the South China Block

Indicating the tectonic features of the Hanshan-Wuwei basin can reconstruct the framework of the basins formed in Mesozoic and further understand the Mesozoic tectonic evolution of the South China Block.Studies on surface structure,regional stress field and deep geophysical characteristics of the Mesozoic Hanshan-Wuwei basin in Lower Yangtze region were carried out.NE-NNE trending folds and faults developed in the northern margin of the basins.The reconstruction of tectonic stress fields indicates four stress stages dominating the basins'evolution including NW-SE compression,N-S compression,NW-SE extension and NWW-SEE compression.2D seismic profiles reveal coexistence of thrust,strike-slip and normal faults in the basin.Combined with regional geological studies,the geodynamic processes for the formation of the Hanshan-Wuwei basin can be divided into five stages:1)During the Late Triassic,EW trending foreland basin was formed by N-S compression;2)From Mid-Jurassic to Late Jurassic,continuous compression strengthened the foreland deformation and formed thrust nappes.In this stage,the integrated foreland basin was compartmentalized or fragmented,and transferred to the broken foreland basin;3)NE-trending sinistral strike-slip movement at the beginning of the Early Cretaceous;4)Regional extension resulted in normal faults and rift basins developing in the Late Cretaceous;5)The NWW-SEE compression at the end of the Late Cretaceous caused NW sinistral strike-slip faults to form,which partly transformed the rift basin.

Neural Network Robust Control Based on Computed Torque for Lower Limb Exoskeleton

The lower limb exoskeletons are used to assist wearers in various scenarios such as medical and industrial settings.Complex modeling errors of the exoskeleton in different application scenarios pose challenges to the robustness and stability of its control algorithm.The Radial Basis Function(RBF)neural network is used widely to compensate for modeling errors.In order to solve the problem that the current RBF neural network controllers cannot guarantee the asymptotic stability,a neural network robust control algorithm based on computed torque method is proposed in this paper,focusing on trajectory tracking.It innovatively incorporates the robust adaptive term while introducing the RBF neural network term,improving the compensation ability for modeling errors.The stability of the algorithm is proved by Lyapunov method,and the effectiveness of the robust adaptive term is verified by the simulation.Experiments wearing the exoskeleton under different walking speeds and scenarios were carried out,and the results show that the absolute value of tracking errors of the hip and knee joints of the exoskeleton are consistently less than 1.5°and 2.5°,respectively.The proposed control algorithm effectively compensates for modeling errors and exhibits high robustness.

Establishing the relationship between land use land cover,normalized difference vegetation index and land surface temperature:A case of Lower Son River Basin,India

The study explores the intricate interplay between land use land cover(LULC),normalized difference vegetation index(NDVI),and land surface temperature(LST)within the Lower Son River Basin in India from 1991 to 2020.The region’s ecological balance has been increasingly strained due to rapid urbanization and changing land use patterns.Through a combination of Landsat TM&OLI/TIRS satellite imageries and geospatial analysis techniques,this study unveils the intricate connection between land use and land cover changes,vegetation,and land surface temperature variations.The study area is classified into three altitudinal zones(Zone Ⅰ:39–300 m,Zone Ⅱ:301–600 m and Zone Ⅲ:601–1,247 m)to examine the changes in depth.The area has seen significant changes in LULC,vegetation and LST in all the three altitudinal zones.The findings hold significant implications for sustainable land management and environmental conservation strategies in the Lower Son River Basin.As per the result,103,438 ha of vegetation was converted into agriculture land and 82,572 ha of agricultural land was transformed into settlements from 1991 to 2020.This trend shows human pressure on the land resource in the study area.Minor increase in water body is seen which is attributed to commissioning of Bansagar dam.Zone Ⅰ has seen highest settlement growth while Zone Ⅲ experienced severe deforestation of around 15%.Zone Ⅱ and Ⅲ needs attention for holistic sustenance.Analysis of LST shows that it has increased by 0.82℃ from 1991 to 2020 which is a red flag.The study underscores the critical importance of balanced land use practices to preserve ecological integrity and mitigate the adverse effects of urbanization and climate change.

Model Parameters Identification and Backstepping Control of Lower Limb Exoskeleton Based on Enhanced Whale Algorithm

Exoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition.However,due to unknown model parameters such as the mass,moment of inertia and mechanical size,the dynamic model of exoskeletons is difficult to construct.Hence,an enhanced whale optimization algorithm(EWOA)is proposed to identify the exoskeleton model parameters.Meanwhile,the periodic excitation trajectories are designed by finite Fourier series to input the desired position demand of exoskeletons with mechanical physical constraints.Then a backstepping controller based on the identified model is adopted to improve the human-robot wearable comfortable performance under cooperative motion.Finally,the proposed Model parameters identification and control are verified by a two-DOF exoskeletons platform.The knee joint motion achieves a steady-state response after 0.5 s.Meanwhile,the position error of hip joint response is less than 0.03 rad after 0.9 s.In addition,the steady-state human-robot interaction torque of the two joints is constrained within 15 N·m.This research proposes a whale optimization algorithm to optimize the excitation trajectory and identify model parameters.Furthermore,an enhanced mutation strategy is adopted to avoid whale evolution’s unsatisfactory local optimal value.

Main controlling factor and mechanism of gas-in-place content of the Lower Cambrian shale from different sedimentary facies in the western Hubei area, South China

The Lower Cambrian shale gas in the western Hubei area,South China has a great resource prospect,but the gas-in-place(GIP)content in different sedimentary facies varies widely,and the relevant mechanism has been not well understood.In the present study,two sets of the Lower Cambrian shale samples from the Wells YD4 and YD5 in the western Hubei area,representing the deep-water shelf facies and shallowwater platform facies,respectively,were investigated on the differences of pore types,pore structure and methane adsorption capacity between them,and the main controlling factor and mechanism of their methane adsorption capacities and GIP contents were discussed.The results show that the organic matter(OM)pores in the YD4 shale samples are dominant,while the inorganic mineral(IM)pores in the YD5 shale samples are primary,with underdeveloped OM pores.The pore specific surface area(SSA)and pore volume(PV)of the YD4 shale samples are mainly from micropores and mesopores,respectively,while those of the YD5 shale samples are mainly from micropores and macropores,respectively.The methane adsorption capacity of the YD4 shale samples is significantly higher than that of the YD5 shale samples,with a maximum absolute adsorption capacity of 3.13 cm^(3)/g and 1.31 cm^(3)/g in average,respectively.Compared with the shallow-water platform shale,the deep-water shelf shale has a higher TOC content,a better kerogen type and more developed OM pores,which is the main mechanism for its higher adsorption capacity.The GIP content models based on two samples with a similar TOC content selected respectively from the Wells YD4 and YD5 further indicate that the GIP content of the deep-water shelf shale is mainly 34 m^(3)/t within a depth range of 1000—4000 m,with shale gas exploration and development potential,while the shallow-water platform shale has normally a GIP content of<1 m^(3)/t,with little shale gas potential.Considering the geological and geochemical conditions of shale gas formation and preservation,the deep-water shelf facies is the most favorable target for the Lower Cambrian shale gas exploration and development in the western Hubei area,South China.

Kinematics ofmandibular advancement devices(MADs):Why do some MADs move the lower jaw backward duringmouth opening?

Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to be opened.However,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper airway.Furthermore,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology.This means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in others.In this study,we report the behavior of well-known devices currently on themarket.To do so,we developed a kinematic model of the lower jawdevice assembly.Thismodelwas validated for all devices analyzed using a high-resolution camera system.Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.

Lower synaptic density and its association with cognitive dysfunction in patients with obsessive-compulsive disorder

Background Understanding synaptic alteration in obsessive-compulsive disorder(OCD)is crucial for elucidating its pathological mechanisms,but in vivo research on this topic remains limited.Aims This study aimed to identify the synaptic density indicators in OCD and explore the relationship between cognitive dysfunction and synaptic density changes in OCD.Methods This study enrolled 28 drug-naive adults with OCD aged 18-40 years and 16 healthy controls(HCs).Three-dimensional T1-weighted structural magnetic resonance imaging and 18F-SynVesT-1 positron emission tomography were conducted.Cognitive function was assessed using the Wisconsin Cart Sorting Test(WCST)in patients with OCD and HCs.Correlative analysis was performed to examine the association between synaptic density reduction and cognitive dysfunction.Results Compared with HCs,patients with OCD showed reduced synaptic density in regions of the cortico-striatothalamo-cortical circuit such as the bilateral putamen,left caudate,left parahippocampal gyrus,left insula,left parahippocampal gyrus and left middle occipital lobe(voxel p<0.001,uncorrected,with cluster level above 50 contiguous voxels).The per cent conceptual-level responses of WCST were positively associated with the synaptic density reduction in the left middle occipital gyrus(R^(2)=0.1690,p=0.030),left parahippocampal gyrus(R^(2)=0.1464,p=0.045)and left putamen(R^(2)=0.1967,p=0.018)in patients with OCD.Conclusions Adults with OCD demonstrated lower 18Flabelled difluoro analogue of 18F-SynVesT-1 compared with HCs,indicating potentially lower synaptic density.This is the first study to explore the synaptic density in patients with OCD and provides insights into potential biological targets for cognitive dysfunctions in OCD.

Monitoring and evaluation of the water quality of the Lower Neches River, Texas, USA

Increasing bacteria levels in the Lower Neches River caused by Hurricane Harvey has been of a serious concern.This study is to analyze the historical water sampling measurements and real-time water quality data collected with wireless sensors to monitor and evaluate water quality under different hydrological and hydraulic conditions.The statistical and Pearson correlation analysis on historical water samples determines that alkalinity,chloride,hardness,conductivity,and pH are highly correlated,and they decrease with increasing flow rate due to dilution.The flow rate has positive correlations with Escherichia coli,total suspended solids,and turbidity,which demonstrates that runoff is one of the causes of the elevated bacteria and sediment loadings in the river.The correlation between E.coli and turbidity indicates that turbidity greater than 45 nephelometric turbidity units in the Neches River can serve as a proxy for E.coli to indicate the bacterial outbreak.A series of statistical tools and an innovative two-layer data smoothing filter are developed to detect outliers,fill missing values,and filter spikes of the sensor measurements.The correlation analysis on the sensor data illustrates that the elevated sediment/bacteria/algae in the river is either caused by the first flush rain and heavy rain events in December to March or practices of land use and land cover.Therefore,utilizing sensor measurements along with rainfall and discharge data is recommended to monitor and evaluate water quality,then in turn to provide early alerts on water resources management decisions.

Hydrocarbon accumulation history in Lower Cretaceous in northern slope of Bongor Basin in Chad,Central Africa

Based on the analysis of the fluid inclusion homogenization temperature and apatite fission track on the northern slope zone of the Bongor Basin in Chad,this paper studied the time and stages of hydrocarbon accumulation in the study area.The results show that:(1)The brine inclusions of the samples from the Kubla and Prosopis formations in the Lower Cretaceous coexisting with the hydrocarbon generally present two sets of peak ranges of homogenization temperature,with the peak ranges of low temperature and high temperature being 75–105℃ and 115–135℃,respectively;(2)The samples from the Kubla and Prosopis formations have experienced five tectonic evolution stages,i.e.,rapid subsidence in the Early Cretaceous,tectonic inversion in the Late Cretaceous,small subsidence in the Paleogene,uplift at the turn of the Paleogene and Neogene,and subsidence since the Miocene,in which the denudation thickness of the Late Cretaceous and after the turn of the Paleogene and Neogene are~1.8 km and~0.5 km,respectively.The cumulative denudation thickness of the two periods is about 2.3 km;(3)Using the brine inclusion homogenization temperature coexisting with the hydrocarbon as the capture temperature of the hydrocarbon,and combining with the apatite fission track thermal history modeling,the result shows that the Kubla and Prosopis formations in the Lower Cretaceous on the northern slope of the Bongor Basin have the same hydrocarbon accumulation time and stages,both of which have undergone two stages of hydrocarbon charging at 80–95 Ma and 65–80 Ma.The first stage of charging corresponds to the initial migration of hydrocarbon at the end of the Early Cretaceous rapid sedimentation,while the second stage of charging is in the stage of intense tectonic inversion in the Late Cretaceous.

The concept of gene therapy for glaucoma:the dream that has not come true yet

Gene therapies,despite of being a relatively new therapeutic approach,have a potential to become an important alternative to current treatment strategies in glaucoma.Since glaucoma is not considered a single gene disease,the identified goals of gene therapy would be rather to provide neuroprotection of retinal ganglion cells,especially,in intraocular-pressure-independent manner.The most commonly reported type of vector for gene delivery in glaucoma studies is adeno-associated virus serotype 2 that has a high tro pism to retinal ganglion cells,res ulting in long-term expression and low immunogenic profile.The gene thera py studies recruit inducible and genetic animal models of optic neuropathy,like DBA/2J mice model of high-tension glaucoma and the optic nerve crush-model.Reported gene therapy-based neuroprotection of retinal ganglion cells is targeting specific genes translating to growth factors(i.e.,brain derived neurotrophic factor,and its receptor TrkB),regulation of apoptosis and neurodegeneration(i.e.,Bcl-xl,Xiap,FAS system,nicotinamide mononucleotide adenylyl transferase 2,Digit3 and Sarm1),immunomodulation(i.e.,Crry,C3 complement),modulation of neuroinflammation(i.e.,e rythropoietin),reduction of excitotoxicity(i.e.,Com KIlα)and transcription regulation(i.e.,Max,Nrf2).On the other hand,some of gene therapy studies focus on lowering intra ocular pressure,by impacting genes involved in both,decreasing aqueous humor production(i.e.,aquaporin 1),and increasing outflow facility(i.e.,COX2,prostaglandin F2a receptor,RhoA/RhoA kinase signaling pathway,MMP1,Myocilin).The goal of this review is to summarize the current stateof-art and the direction of development of gene therapy strategies for glaucomatous neuropathy.

Protocol for lower back pain management: Insights from the French healthcare system

In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.

Th17/Treg balance and macrophage polarization ratio in lower extremity arteriosclerosis obliterans

Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:A rat model of lower extremity ASO was established,and blood samples from patients with lower extremity ASO before and after surgery were obtained.ELISA was used to detect interleukin 6(IL-6),IL-10,and IL-17.Real-time RCR and Western blot analyses were used to detect Foxp3,IL-6,IL-10,and IL-17 expression.Moreover,flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ratio.Results:Compared with the control group,the iliac artery wall of ASO rats showed significant hyperplasia,and the concentrations of cholesterol and triglyceride were significantly increased(P<0.01),indicating the successful establishment of ASO.Moreover,the levels of IL-6 and IL-17 in ASO rats were pronouncedly increased(P<0.05),while the IL-10 level was significantly decreased(P<0.05).In addition to increased IL-6 and IL-17 levels,the mRNA and protein levels of Foxp3 and IL-10 in ASO rats were significantly decreased compared with the control group.The Th17/Treg and M1/M2 ratios in the ASO group were markedly increased(P<0.05).These alternations were also observed in ASO patients.After endovascular surgery(such as percutaneous transluminal angioplasty and arterial stenting),all these changes were significantly improved(P<0.05).Conclusions:The Th17/Treg and M1/M2 ratios were significantly increased in ASO,and surgery can effectively improve the balance of Th17/Treg,and reduce the ratio of M1/M2,and the expression of inflammatory factors.