Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Multiple Solutions for a Class of Singular Boundary Value Problems of Hadamard Fractional Differential Systems with p-Laplacian Operator

This paper discusses the existence and multiplicity of positive solutions for a class of singular boundary value problems of Hadamard fractional differential systems involving the p-Laplacian operator. First, for the sake of overcoming the singularity, sequences of approximate solutions to the boundary value problem are obtained by applying the fixed point index theory on the cone. Next, it is demonstrated that these sequences of approximate solutions are uniformly bounded and equicontinuous. The main results are then established through the Ascoli-Arzelà theorem. Ultimately, an instance is worked out to test and verify the validity of the main results.

Effect of 1-butyl-3-methylimidazolium tetrafluoroborate on the formation rate of CO_2 hydrate

The effect of the addition of 1-butyl-3-methylimidazolium tetrafluoroborate （[C4mim][BF4]） on the formation rates of CO2 hydrates was investigate. The isothermal and isobaric methods were used to measure the formation rates of CO2 hydrates. As compared to those of pure water, the data of phase equilibrium changed greatly. The effects of pressure, temperature, and the concentration of [C4mim][BF4] aqueous solution on the formation rates of CO2 hydrates were investigated. With a constant concentration of [C4mim][BF4], the rate of gas consumption was enhanced with the lowering of experimental temperature. However, a decrease in pressure exerted an opposite effect on the rate of gas consumption. Moreover, the addition of [C4mim][BF4] raised the equilibrium pressure of hydrate formation at the same temperature.

Acute penetrating injury of the spinal cord by a wooden spike with delayed surgery:a case report

Rarely,penetrating injuries to the spinal cord result from wooden objects,creating unique challenges to mitigate neurological injury and high rates of infection and foreign body reactions.We report a man who sustained a penetrating cervical spinal cord injury from a sharpened stick.While initially tetraparetic,he rapidly recovered function.The risks of neurological deterioration during surgical removal made the patient reluctant to consent to surgery despite the impalement of the spinal cord.A repeat MRI on day 3 showed an extension of edema indicating progressive inflammation.On the 7~(th)day after injury,fever and paresthesias occurred with a large increase in serum inflammatory indicators,and the patient agreed to undergo surgical removal of the wooden object.We discuss the management nuances related to wood,the longitudinal evolution of MRI findings,infection risk,surgical risk mitigation and technique,an inflammatory marker profile,long-term recovery,and the surprisingly minimal neurological deficits associated with low-velocity midline spinal cord injuries.The patient had an excellent clinical outcome.The main lessons are that a wooden penetrating central nervous system injury has a high risk for infection,and that surgical removal from the spinal cord should be performed soon after injury and under direct visualization.

Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury:a prospective self-controlled study

Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury(SCI)subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale(AIS)Class A(AIS-A).A total of 320 clinically complete SCI subjects(271 male and 49 female),aged 16–60 years,received early(≤7 days,n=201)or delayed(8–30 days,n=119)surgical interventions to reduce intraspinal or intramedullary pressure.Fifteen days post-surgery,all subjects received a weight-bearing walking training with the“Kunming Locomotion Training Program(KLTP)”for a duration of 6 months.The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale(KLS).We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores.Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days,3 or 6 months indicating continued improvement in walking scores during the 6-month period.In conclusion,combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI,which generally shows little clinical recovery within the first year after injury and most are permanently disabled.This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital,China and registered at ClinicalTrials.gov(Identifier:NCT04034108)on July 26,2019.

Separation of ionic liquids from dilute aqueous solutions using the method based on CO_2 hydrates

Ionic liquids （ILs） have been regarded as the potential novel solvents for improved analytical- and process-scale separation methods.The development of methods for the recovery of ILs from aqueous solutions to escape contamination and recycle samples will ultimately govern the viability of ILs in the future industrial applications. Therefore, in this paper a new method for separation of ILs from their dilute aqueous solutions and simultaneously purification of water was proposed on the basis of the CO2 hydrate formation. For illustration, the dilute aqueous solutions with concentrations of ILs ranging from 2× 10^-3 mol% to 2×10^-1 mol% were concentrated. The results show that the separation efficiency is very impressive and that the new method is applicable to aqueous solutions of both hydrophobic and hydrophilic ILs. Compared to the literature separation method based on the supercritical CO2, the new method is applicable to lower concentrations, and more importantly, its operation condition is mild.

Investigation and Research on the Current Status of Fertilization in Facility Vegetables of Shandong Province

In order to clarify the current situation and main problems in facility vegetable fertilization and guide farmers to fertilize scientifically,an investigation on the yield and fertilization of facility vegetables( tomato,cucumber,eggplant and celery) was carried out in six districts and counties in Shandong Province from 2016 to 2017. The results showed that among the four vegetables,the yield levels of eggplant and celery varied slightly with the coefficient of variation between 7. 18% and 27. 63%,and the yield levels of tomato and cucumber varied greatly with the coefficient of variation between 33. 84% and 65. 15%. In terms of fertilization,the differences in N,P2O5 and K2O inputs in cucumber was the largest,and the maximum values of the nutrient inputs were 7. 95,8. 54 and 8. 77 times of the corresponding minimum values,respectively. The input amounts of N,P2O5 and K2O in tomato,cucumber and eggplant were 1. 47-2. 68,3. 93-7. 50 and1. 09-1. 51 times of the corresponding demands,respectively. The N and P2O5 inputs of celery exceeded the demands by 32. 00% and 79. 00%,respectively,while the K2O input was only 49. 00% of the demand. The ratios of N∶ P2O5∶ K2O input in the total application amount,organic fertilizer,base fertilizer and topdressing chemical fertilizer of facility vegetables were,respectively,1∶ 0. 84∶ 1. 02,1∶ 0. 84∶ 0. 80,1∶ 0. 99∶ 1. 05 and 1∶ 0. 77∶ 1. 25. The proportion of P2O5 input was too high,while the proportion of K2O input coming from the organic fertilizer was insufficient. The average proportions of organic fertilizer in N,P2O5 and K2O inputs were 43. 96%,43. 72% and 36. 99% respectively. The proportions of organic fertilizer in N and P2O5 inputs were reasonable,while that in K2O was lower.In N,P2O5 and K2O inputs of different vegetables,the proportions from organic fertilizer were reasonable in cucumber,higher in eggplant and lower in tomato and celery. The recommendations were presented in this paper that the inputs of N and P2O5 should be reduced,and the inputs of K2O and organic fertilizer should be increased,while farmers should choose fertilizer with low P2O5 and high K2O contents.

Amplification of terahertz/infrared field at the nodes of Ranvier for myelinated nerve

The myelination of axons was the last major evolution in the vertebrate nervous system.Myelin promotes the speed of action potential by two orders,and modulates the conduction of neurons,important for learning new skills.However,the intrinsic mechanism for high-speed information propagation in myelin in the nervous systems is still unclear.We propose that myelinated nerve fibres serve as dielectric waveguides for the high-frequency electromagnetic information in a certain mid-infrared to terahertz spectral range.Based on the structure characteristics of myelinated nerve composed of periodic nodes of Ranvier and myelin sheath,the energy for the signal propagation is supplied and amplified when crossing the nodes of Ranvier via a periodic relay.In this work,we exploit the quasi-quantum model of amplification for neural terahertz/infrared information at the nodes of Ranvier,and prove the existence of biomolecular ensemble for three-energy-level amplification,revealing the essential mechanism of high-speed electromagnetic information transmitting in myelinated nerves.

Spatial Raman mapping investigation of SERS performance related to localized surface plasmons

In this research,it reported a novel three-dimensional(3D)metallic hybrid system by introducing single-layer graphene(SLG)between silver nanoparticles(NPs)and silver nano-discs(NDs)arrays(Ag NPs/SLG/Ag NDs).By combining the plasmonic metallic nanostructures and the unique physical/chemical properties of graphene,Ag NPs/SLG/Ag NDs hybrid substrate was fabricated,and it exhibited extremely high surface-enhanced Raman scattering(SERS)performance.By tuning the diameter of Ag NDs,the SERS performance of Ag NPs/SLG/Ag NDs hybrid substrate has been systematically studied.The detection limit for rhodamine 6g(R6G)could reach the concentrations as low as 1×10^−12 mol/L,and the average enhancement factor(EF)of the Ag NPs/SLG/Ag NDs substrate could reach 5.65×10^8.These advantages indicated that the Ag NPs/SLG/Ag NDs hybrid substrate could be regarded as a candidate for organic molecules detection under extremely low concentration.Besides,spatial Raman mapping of Ag NPs/SLG/Ag NDs with 2.5μm diameter NDs showed the larger SERE signal existed around the rim of Ag NDs which was related to the localized surface plasmons.This phenomenon was contributed by a larger electromagnetic field which was tuned by Ag NPs and the edge of Ag NDs.This mechanism also has been confirmed by the electromagnetic simulation result.

Large-scale highly ordered periodic Au nano-discs/graphene and graphene/Au nanoholes plasmonic substrates for surface-enhanced Raman scattering

In this paper,the study of using masks to directly generate large area,highly ordered and periodical nanostructure has been exhibited.Periodic Au nano-discs(NDs)arrays have been fabricated on top of graphene by using holey SigN4 mask which is directly fixed on top of graphene and Au metal is deposited through the holes in mask by thermal evaporation method under vacuum condition.This fabrication method provides an easy,fast and cost efficiency way to generate periodical nanostructure.Also,Au nanoholes(NHs)structure has been studied by using holey SigN4 as a template.The surface-enhanced Raman scattering(SERS)sensitvities of periodical Au NDs/graphene and graphene/Au NHs hybrid structures have been systematically studied.The internal mechanisms could be explained by chemical mechanism effect of graphene and electromagnetic mechanism effect of metallic nano-structures.The enhancement factors have been systematically investigated by varying the diameter and the thickness of Au discs and Au NHs.Raman mappings of Au NDs with 2.5 um diameter ilustrate that the larger SERS enhancements exist in the rim of NDs which has good agreement with the electric field simulation result.The SERE enhancement factors of fluorescein obtained from Au NDs/graphene substrates shows an improvement factor of 500%in comparison of graphene substrate.The calculated SERS enhancement factors of graphene/Au NHs achieve 1,200%in comparison of graphene/planar Au film substrate.

Synchronization of switched Boolean networks with impulsive effects

This paper studies the state/output synchronization of switched Boolean networks （SBNs） with impulsive effects via the algebraic state space representation （ASSR） approach. First, an algebraic form is established for SBNs with impulsive effects via ASSR. Second, based on the algebraic form, some necessary and sufficient conditions are presented for the state/output synchronization of SBNs with impulsive effects under arbitrary switching signals. Third, two special kinds of switching signals, that is, free switching signal and feedback switching signal, are considered for the state synchroniza-tion of SBNs with impulsive effects. Finally, two illustrative examples are worked out to show the effectiveness of the obtained results.

Symptoms Burden and Health-related Quality of Life in Chinese Patients with Primary Biliary Cholangitis

Background and Aims:Primary biliary cholangitis(PBC)is a chronic liver disease that negatively affects the health-related quality of life(HRQoL)of patients.Furthermore,the HRQoL of Chinese patients has been neglected for a long time.The present study aimed to assess the HRQoL of Chinese patients with PBC and explore the clinical variables correlating to the improvement of itch and fatigue.Methods:This was an observational,cross-sectional study.The PBC-40 and itch numerical rating scales were used to evaluate the symptoms and HRQoL of patients.Results:A total of 383 patients were recruited,and 86.4%were female,with a median age of 55 years(range:49-63 years).We found that females had significantly higher scores than males in symptoms(p=0.033)and cognitive domains(p=0.021),and the fatigue domain was higher in elderly patients(p=0.007).Meanwhile,patients whose body mass index was<18.5 had the highest scores in the symptoms(p=0.009),fatigue(p=0.010),and cognitive(p=0.019)domains.Age at participation(odds ratio[OR]=1.068,p=0.015)and albumin level at 12 months after ursodeoxycholic acid treatment(OR=208.807,p=0.025)were independent factors that affected the improvement of the itch and fatigue domains,respectively.Conclusions:The HRQoL of Chinese patients with PBC was significantly impaired depending on sex,age,and body mass index.Age and albumin level were significantly associated with the improvement of itch and fatigue,respectively.Therefore,treatment and support aimed at these two factors can be provided to improve the HRQoL of patients.

浙江佛学院二期工程(弥勒圣坛)须弥山结构设计

浙江佛学院二期是用现代建筑语言进行建设的大型宗教建筑。须弥山及兜率天宫为本工程的核心部分,须弥山为混凝土剪力墙结构,外形为圆筒形状,高度为56.85 m,须弥山顶部设置大平台,由24榀平面悬挑桁架组成,桁架最大悬挑尺寸为22.5 m,悬挑桁架根部支撑于环向布置的24根钢骨混凝土柱上。兜率天宫为钢框架结构,高度为33 m,其最外侧钢柱通过混凝土环梁竖向转换,中间钢柱通过混凝土牛腿与须弥山混凝土筒体连接,最内侧钢柱落在大跨度钢梁上。本工程下部须弥山采用混凝土剪力墙结构,上部兜率天宫采用钢框架结构,上下部刚度差异大,是一种复杂的混合结构形式,且存在悬挑、转换、楼板开洞等特点。本项目分析中地震加速度按7度(0.1g)参数取值,阻尼比按混凝土0.05、钢结构0.03计算,场地特征周期0.20 s,水平地震影响系数最大值0.08,竖向地震按水平地震影响系数的0.65选取,混凝土剪力墙抗震等级三级,钢结构抗震等级三级。对须弥山与兜率天宫整体模型和仅考虑须弥山的分模型进行计算分析。结果表明:分模型计算结果与整体模型有较大出入,且分模型计算难于考虑钢结构与混凝土结构的相互影响。为确保设计安全可靠,应采用整体建模和分模型两种模型进行计算并按包络受力进行设计。须弥山大平台采用24榀平面悬挑钢桁架组成。计算结果表明,悬挑桁架刚度大,舒适度高,悬挑钢桁架一阶面外弹性屈曲荷载系数可达19.1,且根据幕墙安装要求,又增加了3道刚性系杆,悬挑钢桁架整体稳定性满足要求。为确保罕遇地震下受力安全可靠,在悬挑钢桁架根部采用增加混凝土环梁的方式进行构造加强。对结构进行了多遇地震时程分析和设防烈度地震、罕遇地震分析,结果表明:结构抗震性能满足设防烈度地震弹性要求;罕遇地震下层间位移角均满足GB 50011—2010《建筑抗震设计规范》要求,但罕遇地震下有部分构件屈服。对部分屈服构件进行加大截面处理,对转换部位承托兜率天宫的混凝土梁采用增大截面和配筋的方式进行加强。

A study of plasmon-driven catalytic 4-NBT to DMAB in the dry film by using spatial Raman mapping spectroscopy

Plasmon-driven catalytic reaction(PDCR)as a part of photocatalysis has attracted immense attention.Due to the collective oscillation of free electrons at the surface of metallic nanostructures,the charge distributions store energy from the incident light that could transfer energy to molecules that promote photocatalysis.As an environment-friendly and green photocatalysis process,PDCR illustrates a brilliant future.In this study,the PDCR efficiency of photo-reducing 4-nitro-benzenthiol(4-NBT)dry film to p,p'-dimercaptoazobenzene(DMAB)in ambient conditions has been studied by using Ag nanodiscs(NDs)and Ag nanoparticles(NPs)as catalysts.The distribution of catalytic efficiency of 4-NBT to DMAB using an individual Ag ND catalyst has been illustrated using spatial Raman mapping.The result is direct evidence that the PDCR efficiency has a positive correlation with plasmon-induced electromagnetic field intensity.Additionally,time-dependent surface-enhanced Raman scattering(SERS)experiments reveal that the PDCR of 4-NBT to DMAB is reciprocal.The discovery in this research will aid to improve the PDCR performance and modulate the catalysis reaction for a high reduction of 4-NBT in industrial.