导航下神经内镜与显微手术治疗基底节脑出血的对比研究

目的探讨导航下神经内镜与显微手术治疗基底节脑出血的疗效及安全性。方法将60例高血压基底节脑出血患者分为导航内镜组(n=32)和显微手术组(n=28),比较两组患者的临床资料。结果导航内镜组手术时间(112.1±14.5)min,术中中位失血量100.0(92.5,140.0)mL,血肿清除率(93.6±3.7)%,术后24 h中位格拉斯哥昏迷评分(GCS)为9.0(8.0,12.0)分,较术前的9.0(8.0,11.8)分明显升高(Z=-3.50,P=0.000),血肿周围水肿体积(14.9±5.2)mL,无术后再出血患者,ICU中位入住时间0.0(0.0,0.0)d,ICU入住率15.6%,住院时间(12.4±2.5)d,气管切开率6.3%,肺部感染率9.4%,术后6个月格拉斯哥预后评分(GOS)中位数为4.0(4.0,5.0)分,与显微手术组比较,上述指标差异均有统计学意义(P<0.05)。结论导航下神经内镜基底节血肿清除术可明显缩短手术时间、提高血肿清除率、减少术中术后出血、防止正常脑组织损伤、降低并发症发生率、缩短ICU入住时间和住院时间,并改善高血压脑出血患者预后。

Tribological Performance of Bioimplants: A Comprehensive Review

Total joint replacements(TJR) have been a huge success for orthopaedic surgery in the past century and are gaining increasing importance today due to the aging population. However, the short longevity of artificial joints is one of the major problems in bioimplant industry and needs to be rectified since an increasing number of young people, with more active lifestyles, must receive TJR. Wear mechanisms are discussed in this paper to describe the root causes of the failures and to give some general ideas to increase the lifespan of artificial joints. The suitable material combination is of great importance for the wear resistance of bioimplants, and bioceramics will exert a crucial effect in their future progress. Other materials, such as metal alloys and polymers, are also discussed in this paper. Surface finish is another factor affecting the tribological performance of bioimplants. In recent years, surface texture technology has fascinated many researchers, and a good design of texture pattern requires a comprehensive understanding of wear mechanisms, material properties, and dynamic fluid theory. This review also covers a summary of in vitro wear tests, including simulators, lubricant, and testing parameters.

Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients

This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources： study casts （SC）, lateral cephalometric X-ray images （LX） and facial photographs （PH） were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from -0.08 to ＋0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component （R2=0.86, P〈0.000 1）, while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment （R2=0.96, P〈0.000 1）. Grading scores for SC＋LX and SC＋PH were highly significantly correlated with those for SC＋LX＋PH （r（SC＋LX）vs.（SC＋LX＋PH）=0.96, r（SC＋PH）vs.（SC＋LX＋PH）=0.97）, showing that either SC＋LX or SC＋PH is an excellent substitute for all three combined assessment,

颅内压监测并发中枢神经系统感染因素分析

目的探讨有创颅内压监测患者并发中枢神经系统感染的独立危险因素。方法收集2016年1月-2017年3月该院收治的行有创颅内压监测患者60例,其中并发中枢神经系统感染患者16例(感染组),通过问卷调查方法收集患者基本资料、手术情况及术后并发症发生情况,多因素Logistic回归分析有创颅内压监测患者并发中枢神经系统感染的独立危险因素。结果感染组与非感染组患者在年龄、性别、急诊手术、电解质、血糖、疾病类型、手术时间、术后GCS评分比较,差异无统计学意义(P>0.05);两组患者在引流管位置、引流管留置时间、探头位置、探头留置时间及并发症比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果表明,探头位置为有创性颅内压监测发生中枢神经系统感染的保护因素[Ol^R=0.101(95%CI:0.003,1.246)],并发症为有创性颅内压监测发生中枢神经系统感染的危险因素[Ol^R=5.894(95%CI:1.256,6.775)]。结论探头位置、并发症为有创性颅内压监测发生中枢神经系统感染的独立危险因素。

Effect of Planting Density,Fertilizer Level,and Number of Seedlings per Hole on Yield of Coix Lachryrma-jobi L.

In order to study high yield cultivation technology for Coix Lachryrma-jobi L.,and discuss the effect of planting density,fertilizer level,and number of seedlings per hole on yield of Coix Lachryrma-jobi L.,this paper took domesticated variety Xingren Small White Shell of Coix Lachryrma-jobi L. as an example. Using L9( 34) orthogonal design,it selected optimum combination of planting density,fertilizer level,and number of seedlings per hole to guide planting of Coix Lachryrma-jobi L.. Experiment indicated that the optimum planting density( spacing in the rows and spacing between rows) of Coix Lachryrma-jobi L. is 40 cm x 80 cm; the optimum fertilizer level is pure nitrogen 15 kg,pure phosphorus 15 kg and pure potassium 15 kg per mu; the optimum number of seedlings per hole is 5 seedlings per hole. Through variance analysis,it indicated that planting density exerts significance effect on the yield of Coix Lachryrma-jobi L.

Efficacy of second-course intra-arterial chemotherapy in children for advanced retinoblastoma recurrence after intra-arterial chemotherapy

Purpose: The present study determined the efficacy and toxicity of second-course intra-arterial chemotherapy(IAC) in advanced retinoblastoma(RB) recurrence in children following failed initial IAC. Materials and Methods: A total of 24 child patients with unilateral or bilateral intra-ocular advanced RB(IIRC Group D and Group E) undergoing second-course IAC treatment after initial intra-arterial chemotherapy between September 2011 and November 2016 were enrolled. Global salvage, ocular adverse events, and systemic adverse events were assessed. Results: Following second-course IAC, 15(62.5%) showed complete control at 34 months follow-up, while 8 cases(33.3%) failed the treatment and 1 patient with metastatic disease(4.2%) eventually died of brain metastasis after refusing treatment. Ocular adverse events included eyelid edema(n=12), ptosis(n=5), forehead erythema(n-5), enophthalmos(n=3), and cataract(n=2). None of the patients had systemic adverse events, such as stroke or sepsis. Also, no secondary neoplasms and technical complications were observed. Conclusion: Second-course IAC is a potential alternative to enucleation in children with advanced RB, who fail an initial course of IAC. However, patients with advanced RB should be managed at experienced centers in order to consider all the alternatives before enucleation.

Control strategy of maglev vehicles based on particle swarm algorithm

Taking a single magnet levitation system as theobject, a nonlinear numerical model of the vehicle–guidewaycoupling system was established to study the levitationcontrol strategies. According to the similarity in dynamics,the single magnet-guideway coupling system was simplifiedinto a magnet-suspended track system, and the correspondinghardware-in-loop test rig was set up usingdSPACE. A full-state-feedback controller was developedusing the levitation gap signal and the current signal, andcontroller parameters were optimized by particle swarmalgorithm. The results from the simulation and the test rigshow that, the proposed control method can keep the systemstable by calculating the controller output with the fullstateinformation of the coupling system, Step responsesfrom the test rig show that the controller can stabilize thesystem within 0.15 s with a 2 % overshot, and performswell even in the condition of violent external disturbances.Unlike the linear quadratic optimal method, the particleswarm algorithm carries out the optimization with thenonlinear controlled object included, and its optimizedresults make the system responses much better.

Successful esophagectomy in a patient with combined esophageal cancer and hemophilia B

Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.

Successful surgical strategy in a late case of Boerhaave's syndrome

Boerhaave's syndrome refers to the spontaneous transmural rupture of the esophagus.Primary repair may be performed in patients who present within 24 h of perforation,and such cases have the best outcomes as most complications have not yet developed.However,the treatment of late perforations remains controversial.Various approaches and strategies to repair late perforations have been described in the literature,but there is no uniform approach.We present a case of Boerhaave's syndrome in which the patient underwent surgical repair 48 h after the acute event and was subsequently treated successfully.The initial approach included direct esophageal repair,a drainage series,and nutritional support via a feeding jejunostomy.Although the repair site was subsequently disrupted,the patient showed complete healing of the perforation after three weeks.We consider that our surgical treatment strategy is safe and technically feasible,and appears to be a promising alternative approach for the treatment of patients with late Boerhaave's perforation.

Serum folate status among blood donors in south-central China

Folate deficiency has been confirmed to be related to various diseases.Unfortunately,there are few reports on the folate status of Chinese adults.This study aims to evaluate the serum folate status of blood donors in south-central China.In this study,248 blood donors were included.The information on subjects was collected by a brief questionnaire concerning alcohol consumption habits,smoking habits,fruit and vegetable consumption and physical activity.The serum folate concentration was measured by electrochemiluminescence immunoassay.The geometric mean serum folate concentration was 13.4 nmoll-1(95%CI,12.7-14.1).The prevalence of serum folate concentrations below 6.8 nmoll-1 was 5.2%(95%CI,2.5-8.0).There were significant differences in serum folate concentrations with respect to sex(p-values<0.05),age(p-values<0.05),fruit and vegetable consumption(p-values<0.05),and alcohol consumption habits(p-values<0.05).The concentration of serum folate increased with age(p-values<0.05)and fruit and vegetable consumption(p-values<0.05).Individuals with an age of 30 years or younger were nearly 3.5 times as likely as those aged over 30 years to have an insufficient level of serum folate(OR=3.48;95%CI:1.01-11.99).An age of 30 years or younger was a risk factor for folate deficiency.Most blood donors had sufficient serum folate concentrations in south-central China.National surveys of folate status should be implemented in China.

Screening and Analysis of Germplasm Resources of Wild Coix lacryma-jobi L. with High Content of Coixin

[Objectives] To screen and analyze germplasm resources of wild Coix lacryma-jobi L. with high content of coixin. [Methods] From the 150 kinds of collected wild C. lacryma-jobi L. germplasm resources, 24 kinds of excellent resources were screened and detected. Morphological statistics were carried out, and the content of coixin in the four organ of roots, stems, leaves and seeds were measured, and the approved cultivar white husk Liugu of C. lacryma-jobi L. was taking as the control. [Results] Among the organs of the plant of C. lacryma-jobi L., the roots had the highest content of coixin, so the roots of C. lacryma-jobi L. can be used as the medicinal parts of C. lacryma-jobi L. [Conclusions] The wild C. lacryma-jobi L.Y229, Y164, Y166, Y83, and Y84 stains had excellent yield, and their root coixin content was significantly higher than that of the control variety, so they can be used for cultivation as excellent germplasm, so as to obtain new variety(line) of C. lacryma-jobi L.with higher content of coixin.

基于网络药理学和分子对接探究色氨酸及其代谢物对阿尔茨海默病的作用机制

目的:采用网络药理学和分子对接技术探究色氨酸及其代谢物对神经变性疾病阿尔茨海默病(AD)的作用机制。方法:借助数据库及文献调研筛选色氨酸及其体内代谢物为研究对象,Swiss Target Prediction在线平台预测色氨酸及其代谢物作用靶点,通过GeneCards、OMIM、TTD数据库获取AD疾病靶点,利用Venny 2.1软件获取交集靶点。借助Cytoscape 3.9.1软件构建“目标化合物-靶点”网络图。使用String在线平台进行蛋白相互作用(PPI)分析,结合Cytoscape 3.9.1软件构建PPI网络图,通过度值、中介中心性、节点紧密度筛选关键靶点。采用DAVID数据库对交集靶点进行基因本体(GO)和京都基因与基因组百科全书(KEGG)通路富集分析。通过RCSB PDB和PubChem数据库获得靶点和化合物的结构,利用pymol软件和autodock vina软件进行分子对接。结果:筛选出色氨酸及其代谢物共11个目标化合物,包括邻氨基苯甲酸、犬尿酸、黄嘌呤酸、朱砂精酸、喹啉酸、色胺、血清素、褪黑素、N-甲酰犬尿氨酸、色氨酸、5-羟吲哚乙酸。筛选得到233个成分靶点基因,1824个疾病靶点基因以及80个交集基因,涉及作用于AD的GO分析475条,KEGG分析120条,涉及的关键靶点为MMP 9、NR3C1、PTGS 2、MAPK 1、EGFR等多个靶点,涉及多巴胺能突触、神经活性配体-受体相互作用、前列腺癌、cAMP信号通路、FOXO信号通路等通路。分子对接结果显示色氨酸及其代谢物与AD关键靶点结合活性较高且对接构象较稳定。结论:色氨酸及其代谢物通过多靶点、多通路发挥防治AD的作用。

Elevated Kallistatin promotes the occurrence and progression of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide,and the development of nonalcoholic steatohepatitis(NASH)might cause irreversible hepatic damage.Hyperlipidemia(HLP)is the leading risk factor for NAFLD.This study aims to illuminate the causative contributor and potential mechanism of Kallistatin(KAL)mediating HLP to NAFLD.221 healthy control and 253 HLP subjects,62 healthy control and 44 NAFLD subjects were enrolled.The plasma KAL was significantly elevated in HLP subjects,especially in hypertriglyceridemia(HTG)subjects,and positively correlated with liver injury.Further,KAL levels of NAFLD patients were significantly up-regulated.KAL transgenic mice induced hepatic steatosis,inflammation,and fibrosis with time and accelerated inflammation development in high-fat diet(HFD)mice.In contrast,KAL knockout ameliorated steatosis and inflammation in high-fructose diet(HFruD)and methionine and choline-deficient(MCD)diet-induced NAFLD rats.Mechanistically,KAL induced hepatic steatosis and NASH by down-regulating adipose triglyceride lipase(ATGL)and comparative gene identification 58(CGl-58)by LRP6/Gas/PKA/GSK3βpathway through down-regulating peroxisome proliferator-activated receptor(PPARy)and up-regulating kruppel-like factor four(KLF4),respectively.CGl-58 is bound to NF-kB p65 in the cytoplasm,and diminishing CGl-58 facilitated p65 nuclear translocation and TNFa induction.Meanwhile,hepatic CGl-58-overexpress reverses NASH in KAL transgenic mice.Further,free fatty acids up-regulated KAL against thyroid hormone in hepatocytes.Moreover,Fenofibrate,one triglyceride-lowering drug,could reverse hepatic steatosis by down-regulating KAL.These results demonstrate that elevated KAL plays a crucial role in the development of HLP to NAFLD and may be served as a potential preventive and therapeutic target.

Appropriately adapted properties of hot-extruded Zn-0.5Cu-xFe alloys aimed for biodegradable guided bone regeneration membrane application

Appropriately adapted comprehensive mechanical properties,degradation behavior and biocompatibility are prerequisites for the application of Zn-based biodegradable implants.In this study,hot-extruded Zn-0.5Cu-xFe(x=0.1,0.2 and 0.4 wt%)alloys were fabricated as candidates for biodegradable materials for guided bone regeneration(GBR)membranes.The hot-extrusion process and Cu alloying were expected mostly to enhance the mechanical properties,and the Fe alloying was added mainly for regulating the degradation.The microstructure,mechanical properties and in vitro degradation behavior were systematically investigated.The ZnCuFe alloys were composed of a Zn matrix and FeZn13 phase.With increasing Fe content,a higher FeZn13 phase precipitation with larger particles was observed.Since elongation declined significantly until fracture with increasing Fe content up to 0.4 wt%,the ZnCuFe(0.2 wt%)alloy achieved a good balance between mechanical strength and ductility,with an ultimate tensile strength of 202.3 MPa and elongation at fracture of 41.2%.Moreover,the addition of Fe successfully accelerated the degradation of ZnCuFe alloys.The ZnCuFe(0.2 wt%)alloy showed relatively uniform corrosion in the long-term degradation test.Furthermore,extracts of the ZnCuFe(0.2 wt%)alloy showed no apparent cytotoxic effects against L929 fibroblasts,Saos-2 osteoblasts or TAg periosteal cells.The ZnCuFe(0.2 wt%)alloy exhibited the potential to inhibit bacterial adhesion of Streptococcus gordonii and mixed oral bacteria.Our study provides evidence that the ZnCuFe(0.2 wt%)alloy can represent a promising material for the application as a suitable GBR membrane.

In vitro evaluation of artificial joints: a comprehensive review

Development of artificial joints is a great progress for joint replacement operations of human being, but the short longevity of prostheses has concerned both industries and researchers since the advent of modem implants. Thus, continuous improvements have been made alongside the clinical applications. The methodologies to inspect the potential properties of new designs have also seen many advances. The test machines have evolved from easy pin-on-disk configuration to the modem joint simulator. Besides, various wear traces provided by testing machines are investigated greatly, and multi-directional files are recommended as motion profiles for in vitro testing. The typical testing parameters, like sliding speed or loading profile, are discussed in this article, and their working mechanisms are described in detail. Meanwhile, the calf or bovine serum has been regarded as the gold standard for testing lubricant, and the future trend of fluid will be focused on investigating the effects of lubricant composites on the tribological properties. Hard particles and proteins are discussed as well, and their effects on the wear mechanisms are the focus. Finally, various approaches to measure the wear rate, wear factor and the thickness of lubricant film are presented, and suggestions are given for the development in future.

Mesoscopic Analysis of Deformation Heterogeneity and Recrystallization Microstructures of a Dual-Phase Steel Using a Coupled Simulation Approach

Microstructure-based numerical modeling of the deformation heterogeneity and ferrite recrystallization in a cold-rolled dual-phase(DP)steel has been performed by using the crystal plasticity finite element method(CPFEM)coupled with a mesoscale cellular automaton(CA)model.The microstructural response of subsequent primary recrystallization with the deformation heterogeneity in two-phase microstructures is studied.The simulations demonstrate that the deformation of multi-phase structures leads to highly strained shear bands formed in the soft ferrite matrix,which produces grain clusters in subsequent primary recrystallization.The early impingement of recrystallization fronts among the clustered grains causes mode conversions in the recrystallization kinetics.Reliable predictions regarding the grain size,microstructure morphology and kinetics can be made by comparison with the experimental results.The influence of initial strains on the recrystallization is also obtained by the simulation approach.

Small-signal Analysis of DC Microgrid and Multi-objective Optimization Segmented Droop Control Suitable for Economic Dispatch

To obtain a larger controllable range of output/input power of droop-control sources,a multi-objective optimization segmented droop control suitable for economic dispatch for a DC microgrid is proposed.According to the small-signal analysis,the worst point of the stability in the droop-control curve is determined through the analysis of a simplified model with multiple droop-control sources.By considering the worst points of stability as constraints,an elitist non-dominated sorting genetic algorithm is used to search the better turning points of the proposed droop-control curves after obtaining the new rated operation points from the system-layer economic dispatch.Simultaneously,optimization objectives,including the influence of eliminating the line resistance and capacity matching,are considered in the search process.Finally,the simulation results of the DC microgrid simulation model based on RT-Lab are presented to support the stability conclusion and proposed droop control.

Implementations of newly developed wheel and rail profile design methods

The developments of a series of wheel or CADF contact functions are briefly described. profile computer aided methods based on the RRDF Since 2001 the implementations of these methods are carded out according to different requirements for tramway vehicles, metro vehicles, and main line EMU vehicles etc. It is found that the main advantage of these new methods in wheel profile design is obtaining the proper wheel profiles to efficiently reduce the wears of wheel and rail and to improve the performances of both stability and curving performances. Moreover, post process of transfering a profile with discrete points to a profile with arc and line combinations is studied with a high precision.

Micro-scale Cellular Automaton Modeling of Interface Evolution During Reaustenitization from Pearlite Structure in Steels

A modified cellular automaton model is developed to depict the interface evolution inside the cementite plus ferrite lamellar microstructures during the reaustenitization of a pearlite steel. In this model, migrations of both the austenite- ferrite and austenite-cementite interfaces coupled with the carbon diffusion and redistribution are integrated. The capil- laxity effect derived from local interface curvatures is also carefully considered by involving the concentration given by the phase diagram modified by the Gibbs-Thomson effect. This allows the interface evolution from a transient state to a steady state under different annealing conditions and various interlamellar spacings to be simulated. The proposed cellular automaton approach could be readily used to describe the kinetics of austenite formation from the lamellar pearlites and virtually reveal the kinematics of the moving interfaces from the microstructural aspect.