Publications by authors named "Chi Xu"

249 Publications

When Total Joint Arthroplasty After Septic Arthritis Can Be Safely Performed.

JB JS Open Access 2021 Apr-Jun;6(2). Epub 2021 May 13.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.

Background: Patients undergoing total joint arthroplasty (TJA) following septic arthritis are at higher risk for developing periprosthetic joint infection (PJI). Minimal literature is available to guide surgeons on the optimal timing of TJA after completing treatment for prior native joint septic arthritis. This multicenter study aimed to determine the optimal timing of TJA after prior septic arthritis and to examine the role of preoperative serology in predicting patients at risk for developing PJI.

Methods: A total of 207 TJAs were performed after prior septic arthritis from 2000 to 2017 at 5 institutions. Laboratory values, prior treatment, time from the initial infection, and other variables were recorded. Bivariate analyses were performed to identify the association between the time from septic arthritis to TJA and the risk of developing subsequent PJI. A subanalysis was performed between patients who underwent TJA in 1 setting (n = 97) compared with those who underwent 2-stage arthroplasties (n = 110). Receiver operating characteristic (ROC) curve analysis was performed for serum markers prior to TJA in predicting the risk of a subsequent PJI.

Results: The overall PJI rate was 12.1%. Increasing time from septic arthritis treatment to TJA was not associated with a reduction of PJI, whether considering time as a continuous or categorical variable, for both surgical treatment cohorts (all p > 0.05). Although the ROC curve analysis found that the optimal threshold for timing of TJA from the initial treatment was 5.9 months, there was no difference in the PJI rate when the overall cohort was dichotomized by this threshold and when stratified by 1-stage compared with 2-stage TJA. There was no significant difference in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level prior to conversion TJA between patients who subsequently developed PJI and those who did not.

Conclusions: Serum markers have limited value in predicting subsequent PJI in patients who undergo TJA after prior septic arthritis. There was no optimal interim period between septic arthritis treatment and subsequent TJA; thus, delaying a surgical procedure does not appear to reduce the risk of PJI.

Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.2106/JBJS.OA.20.00146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154388PMC
May 2021

Evaluating global ecosystem water use efficiency response to drought based on multi-model analysis.

Sci Total Environ 2021 Jul 11;778:146356. Epub 2021 Mar 11.

State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, China.

Drought has serious consequences on terrestrial ecosystems, particularly for their carbon and water processes. As an important indicator to examine the balance of ecosystem water and carbon cycles, ecosystem water use efficiency (WUE) has been widely used to investigate ecosystem responses to drought. However, the response of WUE to drought and the role of different ecosystem processes in controlling the response of WUE to drought are not well studied. In this paper, we used four WUE datasets from different remote sensing-driven (RS-driven) models and three drought indices (Standardized Precipitation Evapotranspiration Index, soil moisture anomaly index and water storage anomaly-based drought index) to comprehensively investigate the response of WUE to drought and its dominant ecosystem processes during the period of 2001-2018. The results showed the WUE datasets from four different RS-driven models had discrepancies in WUE temporal trends, particularly in tropical and subtropical forest and semi-arid regions. The Spearman correlation analysis revealed that the positive correlations between WUE and drought accounted for more than half of global vegetated lands, while negative relationship mainly occurred in the high latitude regions. We further explored the dominant ecosystem processes (represented by GPP and ET) in controlling WUE response to drought, and found ET controlled WUE-drought relationship in the high latitude areas and semi-arid/sub-humid regions, while GPP dominated it in tropical forest regions. Additionally, the effects of GPP and ET on controlling WUE response to drought were examined to change with different drought indices, especially in the semi-arid regions. Our study suggests multi-model analysis tend to reduce uncertainties in analyzing WUE response to drought caused by a single WUE data. Moreover, our results highlight the different role of ecosystem processes in controlling WUE response to drought and provide new information for the underlying mechanism of drought impacts on ecosystem water and carbon cycles.
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http://dx.doi.org/10.1016/j.scitotenv.2021.146356DOI Listing
July 2021

The change of coagulation profile in two-staged arthroplasty for periprosthetic joint infection patients: a retrospective cohort study.

J Orthop Surg Res 2021 May 18;16(1):319. Epub 2021 May 18.

Department of Orthopedic Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, People's Republic of China.

Aims: Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty. We performed a retrospective cohort study to evaluate (1) the change of coagulation profile in two-staged arthroplasty patients and (2) the relationship between coagulation profile and the outcomes of reimplantation.

Method: Between January 2011 and December 2018, a total of 202 PJI patients who were operated on with two-staged arthroplasty were included in this study initially. This study continued for 2 years and the corresponding medical records were scrutinized to establish the diagnosis of PJI based on the 2014 MSIS criteria. The coagulation profile was recorded at two designed points, (1) preresection and (2) preimplantation. The difference of coagulation profile between preresection and preimplantation was evaluated. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of the coagulation profile and change of coagulation profile for predicting persistent infection before reimplantation.

Results: The levels of APTT, INR, platelet count, PT, TT, and plasma fibrinogen before spacer implantation were significantly higher than before reimplantation. No significant difference was detected in the levels of D-dimer, ACT, and AT3 between the two groups. The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 (95% CI 0.511, 0.823) and 0.667 (95% CI 0.526, 0.808), respectively.

Conclusion: The coagulation profile before preresection is different from before preimplantation in two-staged arthroplasty and the coagulation markers may play a role in predicting infection eradication before reimplantation when two-stage arthroplasty is performed.

Level Of Evidence: Level III, diagnostic study.
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http://dx.doi.org/10.1186/s13018-021-02477-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130413PMC
May 2021

A Novel Biomarker to Screen for Malnutrition: Albumin/Fibrinogen Ratio Predicts Septic Failure and Acute Infection in Patients Who Underwent Revision Total Joint Arthroplasty.

J Arthroplasty 2021 Apr 30. Epub 2021 Apr 30.

Department of Orthopaedics, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Background: This study aimed to investigate the efficacy of the albumin/fibrinogen ratio (AFR) in the assessment of malnutrition and to compare its ability to predict early postoperative periprosthetic joint infection (PJI) in patients with aseptic revisions.

Methods: Four hundred sixty-six patients undergoing revision total hip or knee arthroplasty between February 2017 and December 2019 were recruited in this retrospective study. We compared the differences in nutritional parameters between patients undergoing revision for septic and aseptic reasons. We used multivariate logistic regression and assessed the association between nutritional parameters and risk of PJI. 207 patients with aseptic revision were then evaluated for the incidence of acute postoperative infection within 90 days. The predictive ability of nutritional markers was assessed by receiver operating characteristic curves.

Results: In the multivariate logistic regression analysis, low albumin level (adjusted OR 1.56, 95% CI 1.16-2.08, P = .003), low prognostic nutritional index (PNI) (adjusted OR 1.57, 95% CI 1.01-2.43, P < .043), and low AFR (adjusted OR 2.54, 95% CI 1.92-3.36, P < .001) were independently associated with revision surgery for septic reasons. In accordance with the receiver operating characteristic analysis, the AFR exhibited a greater area under the curve value (0.721) than did the prognostic nutritional index and albumin. An elevated AFR (≥11.7) was significantly associated with old age, joint type, high Charlson comorbidity index, high American Society of Anesthesiologist, and diabetes (P < .05).

Conclusion: Our findings demonstrated AFR may be an effective biomarker to assess nutrition status and predict acute PJIs after revision TJA.
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http://dx.doi.org/10.1016/j.arth.2021.04.027DOI Listing
April 2021

Drug discovery in rheumatoid arthritis with joint effusion identified by text mining and biomedical databases.

Ann Palliat Med 2021 May 7;10(5):5218-5230. Epub 2021 May 7.

Department of Orthopedic Surgery, Chinese PLA General Hospital, Beijing, China; .

Background: Rheumatoid arthritis is a long-term systemic disease that primarily affects multiple synovial joints throughout the body. Some patients with severe joint effusion even require repeated arthrocentesis or arthroscopic debridement to relieve symptoms, which causes them much suffering mentally and physically. This text-mining study was designed to find potential drugs that target key genes in this disease.

Methods: Firstly, we performed text mining by two keywords ("rheumatoid synovitis" and "joint effusion") to get a common set of genes. Secondly, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis performed on these genes, and protein-protein interaction (PPI) network was constructed. Subsequently, the significant genes clustered in the PPI network were chose to execute gene-drug interaction analysis for potential drug discovery.

Results: Through text mining, 68 overlapping genes were identified as an initial set of key genes. Construction of the initial gene set's PPI network showed that 25 genes clustered in a significant gene module. Ultimately, 8 out of 25 genes could be targetable by a total of 19 drugs.

Conclusions: The final 8 genes (PTGS2, TNF, VEGFA, IL1B, CCL2, VWF, IL6, and ESR1) and 19 drugs may provide significant therapeutic value for rheumatoid arthritis patients with joint effusion.
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http://dx.doi.org/10.21037/apm-20-2631bDOI Listing
May 2021

Alteration of twinfilin1 expression underlies opioid withdrawal-induced remodeling of actin cytoskeleton at synapses and formation of aversive memory.

Mol Psychiatry 2021 May 7. Epub 2021 May 7.

Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China.

Exposure to drugs of abuse induces alterations of dendritic spine morphology and density that has been proposed to be a cellular basis of long-lasting addictive memory and heavily depend on remodeling of its underlying actin cytoskeleton by the actin cytoskeleton regulators. However, the actin cytoskeleton regulators involved and the specific mechanisms whereby drugs of abuse alter their expression or function are largely unknown. Twinfilin (Twf1) is a highly conserved actin-depolymerizing factor that regulates actin dynamics in organisms from yeast to mammals. Despite abundant expression of Twf1 in mammalian brain, little is known about its importance for brain functions such as experience-dependent synaptic and behavioral plasticity. Here we show that conditioned morphine withdrawal (CMW)-induced synaptic structure and behavior plasticity depends on downregulation of Twf1 in the amygdala of rats. Genetically manipulating Twf1 expression in the amygdala bidirectionally regulates CMW-induced changes in actin polymerization, spine density and behavior. We further demonstrate that downregulation of Twf1 is due to upregulation of miR101a expression via a previously unrecognized mechanism involving CMW-induced increases in miR101a nuclear processing via phosphorylation of MeCP at Ser421. Our findings establish the importance of Twf1 in regulating opioid-induced synaptic and behavioral plasticity and demonstrate its value as a potential therapeutic target for the treatment of opioid addiction.
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http://dx.doi.org/10.1038/s41380-021-01111-3DOI Listing
May 2021

A Fully Coplanar D-A Polymeric Semiconductor with Promoted Charge Separation Kinetics for Photochemistry.

Angew Chem Int Ed Engl 2021 May 4. Epub 2021 May 4.

Fuzhou University, Chemistry, 523 Gongye Rd, Gulou, 350000, Fuzhou, CHINA.

Charge generation and separation have been regarded as the main constraints limiting the photocatalytic activity of polymeric photocatalysts. Herein , two new linear polyarylether-based polymers (PAE-CPs) with different linking patterns between their donor and acceptor motifs have been tailor-made to investigate the influences of different linking patterns on the charge generation and separation process. Theoretical and experimental results unravel that compared to the traditional single-stranded linking pattern, the double-stranded linking pattern theoretically helps to strengthen donor-acceptor interaction of PAE-CPs and generate the coplanar structure to facilitate the charge generation and separation, as well as red-shift light absorption. With these prominent advantages, the PAE-D with double-stranded linking pattern assumes a greatly enhanced photocatalytic activity than the single-stranded linking pattern analogue (PAE-S), facilitating the rational design and modification of organic semiconductors for charge-induced reactions.
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http://dx.doi.org/10.1002/anie.202103992DOI Listing
May 2021

Magnetic nanomaterials as sorbents for trace elements analysis in environmental and biological samples.

Talanta 2021 Aug 16;230:122306. Epub 2021 Mar 16.

Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry, Wuhan University, Wuhan, 430072, China. Electronic address:

This review focuses on magnetic nanomaterials as sorbents for trace elements analysis in environmental and biological samples. The design and preparation of magnetic nanomaterials with specific functional groups for trace elemental analysis are summarized, along with relevant adsorption mechanism. The application of these magnetic sorbents in different operation modes for the quantification of trace elements and their species in environmental and biological samples are discussed. The trend of development in this field is also prospected.
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http://dx.doi.org/10.1016/j.talanta.2021.122306DOI Listing
August 2021

Positive frozen section during reimplantation increases the risk of treatment failure in two-stage exchange arthroplasty even in patients with normal ESR and CRP.

Bone Joint J 2021 May;103-B(5):916-922

Medical School of Chinese PLA, Beijing, China.

Aims: It can be extremely challenging to determine whether to perform reimplantation in patients who have contradictory serum inflammatory markers and frozen section results. We investigated whether patients with a positive frozen section at reimplantation were at a higher risk of reinfection despite normal ESR and CRP.

Methods: We retrospectively reviewed 163 consecutive patients with periprosthetic joint infections (PJIs) who had normal ESR and CRP results pre-reimplantation in our hospital from 2014 to 2018. Of these patients, 26 had positive frozen sections at reimplantation. The minimum follow-up time was two years unless reinfection occurred within this period. Univariable and multivariable logistic regression analyses were performed to identify the association between positive frozen sections and treatment failure.

Results: Treatment failure occurred in eight (30.77%) of the 26 PJI patients with positive frozen sections at reimplantation, compared with 13 (9.49%) of 137 patients with negative results. In the multivariate analysis, positive frozen section increased the risk of failure (odds ratio 4.70; 95% confidence interval (CI) 1.64 to 13.45). The mean number of months to reinfection was lower in the positive frozen section group than in the control group (p = 0.041). While there were nine (34.62%) patients with positive frozen section and 25 (18.25%) patients with negative frozen section who had prolonged antibiotic use (p = 0.042), the mean duration of antibiotic use was comparable in two groups. Synovial white blood cell count (p = 0.137) and polymorphonuclear leucocyte percentage (p = 0.454) were not associated with treatment failure in logistic regression model.

Conclusion: Positive frozen section at reimplantation was independently associated with subsequent failure and earlier reinfection, despite normal ESR and CRP levels pre-reimplantation. Surgeons should be aware of the risk of treatment failure in patients with positive frozen sections and carefully consider benefits of reimplantation. Cite this article:  2021;103-B(5):916-922.
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http://dx.doi.org/10.1302/0301-620X.103B5.BJJ-2020-0703.R3DOI Listing
May 2021

Global inequality remotely sensed.

Proc Natl Acad Sci U S A 2021 May;118(18)

Environmental Sciences, Wageningen University, 6700 AA Wageningen, The Netherlands;

Economic inequality is notoriously difficult to quantify as reliable data on household incomes are missing for most of the world. Here, we show that a proxy for inequality based on remotely sensed nighttime light data may help fill this gap. Individual households cannot be remotely sensed. However, as households tend to segregate into richer and poorer neighborhoods, the correlation between light emission and economic thriving shown in earlier studies suggests that spatial variance of remotely sensed light per person might carry a signal of economic inequality. To test this hypothesis, we quantified Gini coefficients of the spatial variation in average nighttime light emitted per person. We found a significant relationship between the resulting light-based inequality indicator and existing estimates of net income inequality. This correlation between light-based Gini coefficients and traditional estimates exists not only across countries, but also on a smaller spatial scale comparing the 50 states within the United States. The remotely sensed character makes it possible to produce high-resolution global maps of estimated inequality. The inequality proxy is entirely independent from traditional estimates as it is based on observed light emission rather than self-reported household incomes. Both are imperfect estimates of true inequality. However, their independent nature implies that the light-based proxy could be used to constrain uncertainty in traditional estimates. More importantly, the light-based Gini maps may provide an estimate of inequality where previously no data were available at all.
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http://dx.doi.org/10.1073/pnas.1919913118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106331PMC
May 2021

Occurrences, congener group profiles, and risk assessment of short- and medium-chain chlorinated paraffins in cup instant noodles from China.

Chemosphere 2021 Apr 16;279:130503. Epub 2021 Apr 16.

State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China.

Dietary intake is an important route of human exposure to chlorinated paraffins (CPs). Cup instant noodles are widely popular food and millions packet of instant noodles are consumed every year. To investigate the levels, congener groups, and health risk of SCCPs and MCCPs in each component of cup instant noodles, samples of nine common brands were collected and analyzed by comprehensive two dimensional gas chromatography coupled with mass spectrometry. The mean concentrations in the noodles were 1.2 × 10 ng/g wet weight (ww) (SCCPs) and 1.2 × 10 ng/g ww (MCCPs), the mean concentrations in the seasoning were 1.4 × 10 ng/g ww (SCCPs) and 1.3 × 10 ng/g ww (MCCPs), and the mean concentrations in the soup were 5.6 × 10 ng/L (SCCPs) and 5.4 × 10 ng/L (MCCPs). The SCCP to MCCP ratio were similar in the soup and soup container, which means CPs in the soup might be migrated from the soup container. Seasoning and noodles from the same brands have similar congener profiles of SCCPs and MCCPs, which may be raised from the manufacturing process or food packaging materials. The dominant SCCP congener groups were CCl in noodles and seasoning, and CCl in soup. The dominant MCCP congener groups were CCl in noodles and seasoning, and CCl in soup. A preliminary health risk assessment indicated that the current intakes of SCCPs and MCCPs through cup instant noodles in China did not pose a significant risk to human health.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130503DOI Listing
April 2021

Effect of Lignin Modifier on Engineering Performance of Bituminous Binder and Mixture.

Polymers (Basel) 2021 Mar 29;13(7). Epub 2021 Mar 29.

School of Civil Engineering and Transportation, South China University of Technology, Wushan Road, Tianhe District, Guangzhou 510000, China.

Lignin accounts for approximately 30% of the weight of herbaceous biomass. Utilizing lignin in asphalt pavement industry could enhance the performance of pavement while balancing the construction cost. This study aims to evaluate the feasibility of utilizing lignin as a bitumen performance improver. For this purpose, lignin derived from aspen wood chips (labeled as KL) and corn stalk residues (labeled as CL) were selected to prepare the lignin modified bituminous binder. The properties of the lignin modified binder were investigated through rheological, mechanical and chemical tests. The multiple stress creep recovery (MSCR) test results indicated that adding lignin decreased the J of based binder by a range of 8% to 23% depending on the stress and lignin type. Lignin showed a positive effect on the low temperature performance of asphalt binder, because at -18 °C, KL and CL were able to reduce the stiffness of base binder from 441 MPa to 369 MPa and 378 MPa, respectively. However, lignin was found to deteriorate the fatigue life and workability of base binder up to 30% and 126%. With bituminous mixture, application of lignin modifiers improved the Marshall Stability and moisture resistance of base mixture up to 21% and 13%, respectively. Although, adding lignin modifiers decreased the molecular weight of asphalt binder according to the gel permeation chromatography (GPC) test results. The Fourier-transform infrared spectroscopy (FTIR) test results did not report detectable changes in functional group of based binder.
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http://dx.doi.org/10.3390/polym13071083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037787PMC
March 2021

Seepage Time Soft Sensor Model of Nonwoven Fabric Based on the Extreme Learning Machine Integrating Monte Carlo.

Sensors (Basel) 2021 Mar 29;21(7). Epub 2021 Mar 29.

School of Information Science and Technology, Beijing University of Chemical Technology, Beijing 100029, China.

Nonwoven fiber materials are materials with multifunctional purposes, and are widely used to make masks for preventing the new Coronavirus Disease 2019. Because of the complexity and particularity of their structure, it becomes difficult to model the penetration and flow characteristics of liquid in nonwoven fiber materials. In this paper, a novel seepage time soft sensor model of nonwoven fabric, based on Monte Carlo (MC), integrating extreme learning machine (ELM) (MCELM) is proposed. The Monte Carlo method is used to expand data samples. Then, an ELM method is used to establish the prediction model of the dyeing time of the nonwoven fiber material overlaps with the porous medium, as well as the insertion degree and height of the different quantity of hides. Compared with the back propagation (BP) neural network and radial basis function (RBF) neural network, the results show that the prediction model based on the MCELM method has significant power in terms of accuracy and prediction speed, which is conducive to the precise and rapid manufacture of nonwoven fiber materials in practical applications between liquid seepage characteristics and structural characteristics of porous media. Furthermore, the relationship between the proposed models has certain value for predicting the behavior and use of nonwoven fiber materials with different structural characteristics and related research processes.
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http://dx.doi.org/10.3390/s21072377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037967PMC
March 2021

Laser Speckle Contrast Imaging for the Objective Assessment of Blood Perfusion in Keloids Treated With Dual-Wavelength Laser Therapy.

Dermatol Surg 2021 Apr;47(4):e117-e121

Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Most of the widely used methods for the assessment of keloid treatment are subjective grading scales based on the opinion of an individual clinician or patient. There is a growing need for objective methods to evaluate keloid treatment.

Objective: This study aimed to evaluate the value of laser speckle contrast imaging (LSCI) as an objective method for the assessment of dual-wavelength laser therapy for keloids.

Methods: This prospective study included 21 patients with 54 keloids. All patients were treated with a combined 585-nm pulsed dye laser and 1,064 nm neodymium-doped yttrium aluminum garnet dual-wavelength laser at 4 weeks to 6 weeks intervals. Keloids were assessed using the Vancouver Scar Scale (VSS) and LSCI.

Results: The total VSS score significantly decreased after 4 sessions of treatment (p < .05). Blood perfusion in keloids as measured by LSCI was significantly reduced after treatment (p < .05). The improvement of chest keloids in terms of the total VSS score and blood perfusion was significantly greater than that of scapular keloids (p < .05). There was a positive correlation between decreased perfusion and reduced total VSS score (R2 = 0.84).

Conclusion: Blood perfusion in keloids significantly decreased after dual-wavelength laser therapy. Laser speckle contrast imaging is a promising objective method for assessing the improvement of keloids treated with laser therapy.
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http://dx.doi.org/10.1097/DSS.0000000000002836DOI Listing
April 2021

Highly elevated levels, infant dietary exposure and health risks of medium-chain chlorinated paraffins in breast milk from China: Comparison with short-chain chlorinated paraffins.

Environ Pollut 2021 Jun 10;279:116922. Epub 2021 Mar 10.

State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China.

Short-chain chlorinated paraffins (SCCPs) are persistent organic pollutants which are toxic to human. Median-chain chlorinated paraffins (MCCPs) have similar toxicity to SCCPs. The productions of chlorinated paraffins (CPs) in China were 1 million tons in 2013 and remained high after that, which may lead to high risks for human exposure to CPs. To investigate temporal trends and health risks of SCCPs and MCCPs in breast milk in China, samples (n = 2020) were collected from urban and rural areas of 11 Chinese provinces in 2017 and mixed into 42 pooled samples. SCCPs and MCCPs were analyzed by two-dimensional gas chromatography with electron-capture negative-ionization mass spectrometry (GC × GC-ECNI-MS). The MCCP concentrations (median (range)) were 472 (94-1714) and 567 (211-1089) ng g lipid in urban and rural areas, respectively, which showed continuously rapidly increasing during 2007-2017. The SCCP concentrations (median (range)) were 393 (131-808) and 525 (139-1543) ng g lipid in urban and rural areas, respectively. The results showed SCCP levels decreased in urban areas between 2007 and 2017. Significant increases in MCCP/SCCP ratios might arise from extensive manufacturing and use of MCCPs. The median estimated dietary intake via breast milk in urban and rural samples were 1230 and 2510 ng kg d, respectively, for SCCPs and 2150 and 1890 ng kg d, respectively, for MCCPs. Preliminarily risk assessment showed that SCCPs posed a significant health risk to infants via breastfeeding. The high MCCP levels should also be of concern because of continuous growth and negative effect on infants. Correspondence analysis indicated congeners with higher carbon and chlorine numbers in dietary tend to accumulate in breast milk.
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http://dx.doi.org/10.1016/j.envpol.2021.116922DOI Listing
June 2021

[Levels and Risk Assessment of Short and Medium-Chain Chlorinated Paraffins in Soil from Paper Mill Area].

Huan Jing Ke Xue 2021 Mar;42(3):1131-1140

State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.

Short-chain chlorinated paraffins are persistent organic pollutants, and chlorinated paraffins were widely used as sizing agent in the paper industry. In order to investigate the levels and risk assessment of short-chain and medium-chain chlorinated paraffins in the paper mill plant, the surface soil and soil of different depths were collected.The concentrations, congener group profiles of short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in soil were determined by two-dimensional gas chromatography coupled with electron capture-negative ion mass spectrometry. The SCCPs and MCCPs concentrations were 42-3853 ng·g and 34-2091 ng·g. The chlorine contents were 59.9%-61.9% and 48.7%-52.8%. The concentrations of SCCPs and MCCPs were different in the soil collected in different sampling site. The concentration of SCCPs and MCCPs were relatively higher in soil of sewage treatment area and coating area. The CP levels in soil from the paper mill plant were at a high level compared with those in other regions. CCl and CCl were the main congener groups in most soil samples. The results of principal component analysis showed that the CP52 commercial products may be sources of SCCPs and MCCPs in the soil. The risk quotient (RQ) for SCCPs and MCCPs were assessed in soil of paper mill plant. The results showed that the RQ values for SCCPs in soil ranged from 0.01 to 0.73 which are the medium risk, and the RQ values for MCCPs in soil ranged from 0 to 0.07, which are the low risk. The human exposure values of children and adults are lower than TDI[10 μg·(kg·d)] in both cases. The health risks caused by non-dietary exposure under paper mill area are low.
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http://dx.doi.org/10.13227/j.hjkx.202011004DOI Listing
March 2021

Broadband cholesteric liquid crystal lens for chromatic aberration correction in catadioptric virtual reality optics.

Opt Express 2021 Feb;29(4):6011-6020

A planar and broadband cholesteric liquid crystal (CLC) lens is designed, fabricated, and hybridized with a refractive lens to form a catadioptric pancake lens for virtual reality (VR) displays. Due to their opposite optical dispersion behaviors, the chromatic aberration of the assembled pancake lens is dramatically suppressed, as verified by both ray-tracing analysis and experimental results. The demonstrated catadioptric pancake lens has great potential for next-generation VR displays.
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http://dx.doi.org/10.1364/OE.419595DOI Listing
February 2021

Polarized Water Driven Dynamic PN Junction-Based Direct-Current Generator.

Research (Wash D C) 2021 24;2021:7505638. Epub 2021 Jan 24.

College of Microelectronics, College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China.

There is a rising prospective in harvesting energy from the environment, as in situ energy is required for the distributed sensors in the interconnected information society, among which the water flow energy is the most potential candidate as a clean and abundant mechanical source. However, for microscale and unordered movement of water, achieving a sustainable direct-current generating device with high output to drive the load element is still challenging, which requires for further exploration. Herein, we propose a dynamic PN water junction generator with moving water sandwiched between two semiconductors, which outputs a sustainable direct-current voltage of 0.3 V and a current of 0.64 A. The mechanism can be attributed to the dynamic polarization process of water as moving dielectric medium in the dynamic PN water junction, under the Fermi level difference of two semiconductors. We further demonstrate an encapsulated portable power-generating device with simple structure and continuous direct-current voltage output of 0.11 V, which exhibits its promising potential application in the field of wearable devices and the IoTs.
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http://dx.doi.org/10.34133/2021/7505638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877395PMC
January 2021

Semi-Supervised Joint Learning for Hand Gesture Recognition from a Single Color Image.

Sensors (Basel) 2021 Feb 2;21(3). Epub 2021 Feb 2.

CRRC Zhuzhou Electric Locomotive Co., Ltd. 1 TianXin Road, Zhuzhou 412000, China.

Hand gesture recognition and hand pose estimation are two closely correlated tasks. In this paper, we propose a deep-learning based approach which jointly learns an intermediate level shared feature for these two tasks, so that the hand gesture recognition task can be benefited from the hand pose estimation task. In the training process, a semi-supervised training scheme is designed to solve the problem of lacking proper annotation. Our approach detects the foreground hand, recognizes the hand gesture, and estimates the corresponding 3D hand pose simultaneously. To evaluate the hand gesture recognition performance of the state-of-the-arts, we propose a challenging hand gesture recognition dataset collected in unconstrained environments. Experimental results show that, the gesture recognition accuracy of ours is significantly boosted by leveraging the knowledge learned from the hand pose estimation task.
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http://dx.doi.org/10.3390/s21031007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867369PMC
February 2021

Electroacupuncture Alleviates Chronic Pain-Induced Anxiety Disorders by Regulating the rACC-Thalamus Circuitry.

Front Neurosci 2020 11;14:615395. Epub 2021 Jan 11.

Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.

Anxiety is a common comorbidity associated with chronic pain, which results in chronic pain complexification and difficulty in treatment. Electroacupuncture (EA) is commonly used to treat chronic pain and anxiety. However, the underlying mechanisms of the EA effect are largely unknown. Here, we showed that a circuitry underlying chronic pain induces anxiety disorders, and EA can treat them by regulating such circuitry. Using chemogenetic methods, we found that chemogenetic activation of the rostral anterior cingulate cortex (rACC) glutamatergic output to the thalamus induced anxiety disorders in control rats. Then, chemogenetic inhibition of the rACC-thalamus circuitry reduced anxiety-like behavior produced by intraplantar injection of the complete Freund's adjuvant (CFA). In this study, we examined the effects of EA on a rat model of CFA-mediated anxiety-like behaviors and the related mechanisms. We found that chemogenetic activation of the rACC-thalamus circuitry effectively blocked the effects of EA on chronic pain-induced anxiety-like behaviors in CFA rats. These results demonstrate an underlying rACC-thalamus glutamatergic circuitry that regulates CFA-mediated anxiety-like behaviors. This study also provides a potential mechanistic explanation for EA treatment of anxiety caused by chronic pain.
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http://dx.doi.org/10.3389/fnins.2020.615395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829552PMC
January 2021

S-oxiracetam Facilitates Cognitive Restoration after Ischemic Stroke by Activating α7nAChR and the PI3K-Mediated Pathway.

Neurochem Res 2021 Apr 22;46(4):888-904. Epub 2021 Jan 22.

Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.

S-oxiracetam (S-ORC), a nootropic drug, was used to protect against ischemic stroke by lessening the blood brain barrier dysfunction and inhibiting neuronal apoptosis. However, the potential effects of S-ORC in the recovery of cognitive functions after ischemic stroke and the underlying mechanisms remains unclear. In this study, middle cerebral artery occlusion/reperfusion (MCAO/R) in rats was used as the animal model. By using Y-maze test, Morris water maze, triphenyl tetrazolium chloride (TTC) staining, terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTp) nick end labeling (TUNEL) assay, hematoxylin and eosin, immunohistochemical staining and western blot to evaluate the protective effect of S-ORC on cognitive recovery, we were able to confirm that S-ORC ameliorated spatial learning impairment, tissue loss, and hippocampal neuronal apoptosis and injury induced by MCAO/R in rats. These cognitive effects were achieved by restoring the normal function of synaptophysin and increasing PSD95 expression in the hippocampus. Furthermore, we found that methyllycaconitine, the antagonist of α7 nicotinic acetylcholine receptor (α7nAChR), and LY294002, the inhibitor of phosphoinositide 3-kinase (PI3K), were able to block the cognitive effects of S-ORC after MCAO/R in rats. In conclusion, α7nAChR and PI3K are key molecules that mediated the signaling pathway leading to S-ORC-induced cognitive restoration after MCAO/R.
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http://dx.doi.org/10.1007/s11064-021-03233-0DOI Listing
April 2021

Kappa opioid receptor controls neural stem cell differentiation via a miR-7a/Pax6 dependent pathway.

Stem Cells 2021 05 15;39(5):600-616. Epub 2021 Jan 15.

Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Although the roles of opioid receptors in neurogenesis have been implicated in previous studies, the mechanism by which κ-opioid receptor (OPRK1) regulates adult neurogenesis remains elusive. We now demonstrate that two agonists of OPRK1, U50,488H and dynorphin A, inhibit adult neurogenesis by hindering neuronal differentiation of mouse hippocampal neural stem cells (NSCs), both in vitro and in vivo. This effect was blocked by nor-binaltorphimine (nor-BNI), a specific antagonist of OPRK1. By examining neurogenesis-related genes, we found that OPRK1 agonists were able to downregulate the expression of Pax6, Neurog2, and NeuroD1 in mouse hippocampal NSCs, in a way that Pax6 regulates the transcription of Neurog2 and Neurod1 by directly interacting with their promoters. Moreover, this effect of OPRK1 was accomplished by inducing expression of miR-7a, a miRNA that specifically targeted Pax6 by direct interaction with its 3'-UTR sequence, and thereby decreased the levels of Pax6, Neurog2, and NeuroD1, thus resulted in hindrance of neuronal differentiation of NSCs. Thus, by modulating Pax6/Neurog2/NeuroD1 activities via upregulation of miR-7a expression, OPRK1 agonists hinder the neuronal differentiation of NSCs and hence inhibit adult neurogenesis in mouse hippocampus.
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http://dx.doi.org/10.1002/stem.3334DOI Listing
May 2021

Potential predictive value of serum targeted metabolites and concurrently mutated genes for EGFR-TKI therapeutic efficacy in lung adenocarcinoma patients with sensitizing mutations.

Am J Cancer Res 2020 1;10(12):4266-4286. Epub 2020 Dec 1.

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China.

There is a discrepancy in the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment for advanced lung adenocarcinoma (LUAD) patients with sensitizing mutations (). Molecular markers other than remain to be investigated to better predict EGFR-TKI efficacy. Here, 49 LUAD patients with (19 deletions or 21 L858R mutations) who received the first-generation EGFR-TKI icotinib therapy were included and stratified into 25 good-responders with a progression-free survival (PFS) longer than 11 months and 24 poor-responders with a PFS shorter than 11 months. We conducted targeted metabolomic detection and next-generation sequencing on serum and tissue samples, respectively. Subsequently, two metabolomic profiling-based discriminant models were constructed for icotinib efficacy prediction, 10 metabolites overlapped in both models ensured high credibility for distinguishing good- and poor-responders. Seven of the 10 metabolites displayed significant differences between the two groups, which belong to lipids including ceramides (Cers), lysophosphatidylcholines (LPCs), lysophosphatidylethanolamines (LPEs), sphingomyelins (SMs), and free fatty acids (FAs). Briefly, LPC 16:1, LPC 22:5-1, and LPE 18:2 decreased in poor-responders, while Cer 36:1-3, Cer 38:1-3, SM 36:1-2 and SM 42:2 increased in poor-responders. In parallel, we identified 6 co-mutated genes (, , , , , and ) which were significantly correlated with a shorter PFS. Additionally, 4 efficacy-related metabolites (Cer 36:1-3, Cer 38:1-3, SM 36:1-2, and LPC 16:1) showed significant differences between the mutant and wild-type of 4 efficacy-related genes (, , , and ). SM 36:1-2 elevated while LPC 16:1 decreased in , , and mutant groups compared to the wild-type groups. Cer 36:1-3 increased in the and mutant groups, and Cer 38:1-3 only rose in the mutant group. Furthermore, we observed a causal-mediator-network-based interrelation between the 4 concurrently mutated genes and the 4 metabolites related metabolic genes in glycerophospholipid metabolism and sphingolipid metabolism pathways. This study demonstrated that lipids metabolism and concurrently mutated genes with were associated with the icotinib efficacy, which provides novel perspectives in classifying clinical responses of LUAD patients and reveals the potential of non-invasive pretreatment serum metabolites in predicting EGFR-TKI efficacy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783757PMC
December 2020

What is the performance of novel synovial biomarkers for detecting periprosthetic joint infection in the presence of inflammatory joint disease?

Bone Joint J 2021 Jan;103-B(1):32-38

Department of Orthopedics, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Aims: The aim of this study was to further evaluate the accuracy of ten promising synovial biomarkers (bactericidal/permeability-increasing protein (BPI), lactoferrin (LTF), neutrophil gelatinase-associated lipocalin (NGAL), neutrophil elastase 2 (ELA-2), α-defensin, cathelicidin LL-37 (LL-37), human β-defensin (HBD-2), human β-defensin 3 (HBD-3), D-dimer, and procalcitonin (PCT)) for the diagnosis of periprosthetic joint infection (PJI), and to investigate whether inflammatory joint disease (IJD) activity affects their concentration in synovial fluid.

Methods: We included 50 synovial fluid samples from patients with (n = 25) and without (n = 25) confirmed PJI from an institutional tissue bank collected between May 2015 and December 2016. We also included 22 synovial fluid samples aspirated from patients with active IJD presenting to Department of Rheumatology, the first Medical Centre, Chinese PLA General Hospital. Concentrations of the ten candidate biomarkers were measured in the synovial fluid samples using standard enzyme-linked immunosorbent assays (ELISA). The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves.

Results: BPI, LTF, NGAL, ELA-2, and α-defensin were well-performing biomarkers for detecting PJI, with areas under the curve (AUCs) of 1.000 (95% confidence interval, 1.000 to 1.000), 1.000 (1.000 to 1.000), 1.000 (1.000 to 1.000), 1.000 (1.000 to 1.000), and 0.998 (0.994 to 1.000), respectively. The other markers (LL-37, HBD-2, D-dimer, PCT, and HBD-3) had limited diagnostic value. For the five well-performing biomarkers, elevated concentrations were observed in patients with active IJD. The original best thresholds determined by the Youden index, which discriminated PJI cases from non-PJI cases could not discriminate PJI cases from active IJD cases, while elevated thresholds resulted in good performance.

Conclusion: BPI, LTF, NGAL, ELA-2, and α-defensin demonstrated excellent performance for diagnosing PJI. However, all five markers showed elevated concentrations in patients with IJD activity. For patients with IJD, elevated thresholds should be considered to accurately diagnose PJI. Cite this article: 2021;103-B(1):32-38.
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http://dx.doi.org/10.1302/0301-620X.103B1.BJJ-2019-1479.R3DOI Listing
January 2021

Patient's Perception on Leg Length Discrepancy After Total Hip Arthroplasty in Patients with Unilateral Crowe Type IV Developmental Dysplasia of the Hip.

Patient Prefer Adherence 2020 16;14:2469-2475. Epub 2020 Dec 16.

Department of Orthopaedics, General Hospital of Chinese People's Liberation Army, Beijing 100853, People's Republic of China.

Purpose: The study assessed the correlation among the patients' perception of leg length discrepancy (LLD) after total hip arthroplasty (THA) in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH) and the four methods of measuring the leg length in the full-length standing anteroposterior radiographs.

Methods: Sixty patients with unilateral Crowe type IV DDH were recruited in this retrospective study between January 2012 and January 2019. Four methods of measurement were used: 1) TD-TP: distance between the inferior aspect of teardrop (TD) and the midpoint of tibial plafond (TP); 2) CH-TP: distance between the center of the hip (CH) or acetabular cup and the TP; 3) GT-TP: distance between the apex of greater trochanter (GT) and the TP; and 4) FL+TL: the sum of femoral length (FL) and tibial length (TL).

Results: Association was found among the patients' perception on LLD with difference in TD-TP (OR=1.157), and the difference in FL+TL (OR=1.166). The area under the curve of the difference in FL+TL and the difference TD-TP (0.704 and 0.679) was significantly higher than those of the difference in CH-TP and the difference in GT-TP (0.564 and 0.483). With the calculated threshold of LLD set at 9.0 mm, the sensitivity and specificity of the difference in TD-TP and the difference in FL+TL were 57.7%, 79.4% and 61.5%, 79.4%, respectively.

Conclusion: Patients' perception on LLD had good correlation and reliability on the difference of FL+TL and the difference of TD-TP on both sides in the full-length standing anteroposterior radiographs after THA in patients with unilateral Crowe type IV DDH. The calculated threshold of the difference in FL+TL and the difference in TD-TP was set at 9.0 mm to assess the patients' perception on LLD.
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http://dx.doi.org/10.2147/PPA.S285545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751778PMC
December 2020

Mandatory Physical Education Classes of Two Hours per Week Can Be Comparable to Losing More than Five Kilograms for Chinese College Students.

Int J Environ Res Public Health 2020 12 8;17(24). Epub 2020 Dec 8.

School of Life Sciences, Nanjing University, Nanjing 210023, China.

Despite releases of governmental guidelines for promoting physical fitness among the youth in China, the performance of college students in fitness tests has been declining over the past three decades. Obesity and physical inactivity have been proposed as two main causes. However, their relative importance for improving physical fitness remains unclear. To address this knowledge gap, we collected longitudinal data spanning four consecutive years on the physical fitness test for students from Nanjing University, China. Physical education classes of two hours per week were mandatory for the first two years. Using mixed effects models, we quantify the within-subject effects of weight, muscular endurance, sex, and mandatory physical education courses, among other variables, on physical fitness total score. We found that, in spite of the dominance of normal weight among the students, losing weight was positively associated with the total score, with significant sex differences in the associations. Compulsory exercise provided by physical education classes per week had strong positive impacts on the total score, comparable to losing weight of roughly 15-17 kg for males and 5-10 kg for females. Half sex difference in the total score was explained by male students' poor performance in the muscular endurance represented by pull-ups. Our results suggest that college students in China should engage in physical activity of higher levels to improve their physical fitness, with a heightened awareness of extra fat under normal weight and insufficient muscular endurance.
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http://dx.doi.org/10.3390/ijerph17249182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763176PMC
December 2020

N-doped honeycomb-like porous carbon derived from biomass as an efficient carbocatalyst for HS selective oxidation.

J Hazard Mater 2021 02 3;403:123806. Epub 2020 Sep 3.

Dalian National Laboratory for Clean Energy (DNL), Dalian Institute of Chemical Physics, Chinese Academy of Science, 457 Zhongshan Road, Dalian, 116023, China. Electronic address:

3D interconnected porous N-doped carbocatalyst derived from the waste air-laid paper plays as an efficient metal-free catalyst for HS removal in super-Claus reaction. The honeycomb-like porous nitrogen-doped carbons are fabricated through a facile impregnation of alkaline solution and NH post-treatment method. The experiments prove that NH post-treatment is an efficient way to improve the catalytic performance, which resulting in outstanding reactivity and stability with highest sulfur formation rate of 496.6 gkg h and sulfur yield of 86.7 % in feed gas with high concentration (ca. 10,000 ppm) of HS for selective oxidation. Significantly, the optimized pyridinic-N content and defect degree endow the N-doped porous carbon (NPC700) with highest catalytic activity according to the Raman and XPS results. The high surface area and abundant porous structure also contribute to the high catalytic performance by increasing the exposure degree of active site and offering additional active surface. Based on the XPS, SEM, TEM and EDS mapping results, the N-doped porous carbon are proved to be stable catalysts since the morphology and surface chemical environment remain similar after the oxidative desulfurization process.
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http://dx.doi.org/10.1016/j.jhazmat.2020.123806DOI Listing
February 2021

6DoF Pose Estimation of Transparent Object from a Single RGB-D Image.

Sensors (Basel) 2020 Nov 27;20(23). Epub 2020 Nov 27.

CRRC Zhuzhou Electric Locomotive Co., Ltd. 1 TianXin Road; Zhuzhou 412000, China.

6DoF object pose estimation is a foundation for many important applications, such as robotic grasping, automatic driving, and so on. However, it is very challenging to estimate 6DoF pose of transparent object which is commonly seen in our daily life, because the optical characteristics of transparent material lead to significant depth error which results in false estimation. To solve this problem, a two-stage approach is proposed to estimate 6DoF pose of transparent object from a single RGB-D image. In the first stage, the influence of the depth error is eliminated by transparent segmentation, surface normal recovering, and RANSAC plane estimation. In the second stage, an extended point-cloud representation is presented to accurately and efficiently estimate object pose. As far as we know, it is the first deep learning based approach which focuses on 6DoF pose estimation of transparent objects from a single RGB-D image. Experimental results show that the proposed approach can effectively estimate 6DoF pose of transparent object, and it out-performs the state-of-the-art baselines by a large margin.
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http://dx.doi.org/10.3390/s20236790DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729467PMC
November 2020

A pathological complete response to neoadjuvant chemotherapy and immunotherapy in a non-small cell lung cancer patient.

Transl Lung Cancer Res 2020 Oct;9(5):2157-2160

Department of Thoracic Surgery, Fujian Medical Union Hospital, Fuzhou, China.

Lung cancer is the leading cause of cancer-related mortality worldwide. Patients with locally advanced non-small cell lung cancer (NSCLC) have lower overall survival. Studies have shown that some patients with unresectable stage III NSCLC develop disease progression after initial chemoradiotherapy, and new treatment is needed to improve the prognosis of these patients. The rapid development of therapy has greatly changed and continued to renew the treatment strategy of advanced NSCLC. However, the clinical treatment for patients with the wild-type gene remains problematic, and chemotherapy with platinum are not yet considered satisfactory. Herein, we are reporting a case of a patient with wild-type gene mutation locally advanced NSCLC who was treated with neoadjuvant therapy by using combined targeted anti-PD-1 immunotherapy and chemotherapy. The percentage of tumor cells with membranous PD-L1 staining (tumor proportion score) was 90% or greater. After receiving all three cycles of treatment, the patient underwent video-assisted right upper lung lobectomy and wedge resection plus radical mediastinal lymph node dissection. Pathological section samples showed a pathological complete response. This experience has led us to believe that the subgroup of patients with unresectable advanced NSCLC may benefit from this strategy and may have an opportunity for radical surgery.
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http://dx.doi.org/10.21037/tlcr-20-770DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653127PMC
October 2020

Factors associated with blood loss in ankylosing spondylitis patients with hip involvement undergoing primary total hip arthroplasty: a cross-sectional retrospective study of 243 patients.

J Orthop Surg Res 2020 Nov 18;15(1):541. Epub 2020 Nov 18.

Department of Orthopaedics, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Background: Total hip arthroplasty (THA) can cause considerable blood loss and perioperative transfusion in ankylosing spondylitis (AS) patients. This study aimed to identify the factors related to blood loss in AS patients with hip involvement undergoing THA.

Methods: We analyzed 243 AS patients with advanced hip involvement undergoing primary THA from 2012 to 2017. Bilateral THA was performed by a one-stage operation during one general anesthesia session. The patients were divided into three groups according to the grade of blood loss, as determined by the Advanced Trauma Life Support hypovolemic shock classification system. Ordinal logistic regression was used to identify factors associated with blood loss in the patients.

Results: The proportion of patients who were male, underwent bilateral THA, had a hip range of motion (ROM) = 0°, had a BASRI-hip score of 4, underwent iliopsoas and adductor release, and underwent autologous or allogenic transfusion increased significantly with the grade of blood loss, while that of the patients who received tranexamic acid (TXA) decreased significantly (P < 0.05). The preoperative hemoglobin (Hb) level, hematocrit level, and operating time also increased significantly with the grade of blood loss (P < 0.05). The ordinal logistic regression results identified the factors related to blood loss during THA in AS patients with hip involvement to be the male sex (odds ratio [OR] = 3.287; 95% confidence interval [CI] 1.022, 10.567), bilateral THA (OR = 13.896; 95% CI 4.950, 39.011), hip ROM = 0° (OR = 2.513; 95% CI 1.277, 4.946), an elevated erythrocyte sedimentation rate (ESR) level (OR = 3.042; 95% CI 1.320, 7.014), an elevated preoperative Hb level (OR = 1.043; 95% CI 1.017, 1.070), a long operating time (OR = 1.009; 95% CI 1.003, 1.016), and the administration of TXA (OR = 0.252; 95% CI 0.134, 0.472).

Conclusions: The male sex, bilateral THA, a hip ROM = 0°, an elevated ESR level, a high preoperative Hb level, and a long operating time are risk factors associated with blood loss in AS patients with hip involvement undergoing THA, while the administration of TXA is a protective factor. These results might help determine the risk of bleeding in the perioperative assessment and develop more efficient blood management strategies for THA in AS patients with hip involvement.
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http://dx.doi.org/10.1186/s13018-020-02064-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672842PMC
November 2020