Biportal Endoscopic Spinal Cord Stimulation Paddle Lead Implantation: Technical Note and Preliminary Clinical Results.

OBJECTIVE: This study aims to elucidate a novel, minimally invasive surgical technique using a biportal endoscope for the implantation of spinal cord stimulation (SCS) paddle leads and to report the preliminary results of its clinical application. MATERIALS AND METHODS: The perioperative data of patients who underwent the biportal endoscopic SCS paddle lead implantation in our department were collected; the surgical procedure was delineated, and the clinical outcomes were assessed. RESULTS: From February 2022 to December 2023, six patients underwent biportal endoscopic SCS paddle lead implantation. The median follow-up time was nine months (range one to three months). The median intraoperative blood loss was 30 mL (range 25-50 mL), and the median operative time was 87.5 minutes (range 75-110 minutes). One patient experienced severe neck pain during the operation, whereas the other five patients experienced no surgical complications. One patient was found to have a slight lead migration three months after surgery, which did not affect the therapeutic effect. The median visual analogue scale (VAS) of the surgical area was 0.5 (range 0-2), 2.5 (range 1-4), and 0.5 (range 0-1) during the operation and one day and one week after the operation, respectively. The median VAS of the six patients' primary disease was 8 (range 7-9) before surgery and 2.5 (range 1-4) at the last postoperative follow-up (pain reduction ≥50%). CONCLUSION: Paddle lead systems for SCS can be implanted successfully using a biportal endoscopic technique.

Not to follow because of distrust: perceived trust modulates the gaze cueing effect.

In social life, people spontaneously form stable trustworthiness impressions from faces. However, the precise role of extracting trustworthiness information remains unclear. This study aims to elucidate whether discerning facial trustworthiness influences social interactions. Specifically, it explores the gaze cueing effect (GCE), wherein individuals exhibit quicker responses to targets appearing in the direction of gaze compared to other locations. Given conflicting perspectives in existing literature regarding the potential modulation of trustworthiness on the GCE, two plausible hypotheses are proposed to explain divergent result patterns. The reflexive hypothesis posits that the GCE operates automatically. In contrast, the flexible hypothesis underscores the potential modulatory role of trustworthiness in the GCE. To provide a comprehensive understanding of whether trustworthiness modulates the GCE, we employed face stimuli incorporating trustworthiness information within Posner' s cue-target task. The findings of Experiment 1 revealed that the perception of trustworthiness indeed influenced the GCE. Specifically, when facial stimuli were perceived as trustworthy, they elicited a more pronounced GCE compared to untrustworthy stimuli. This modulation effect was replicated using a different stimulus set in Experiment 2. In Experiment 3, we employed the same stimuli as in Experiment 2, setting the trustworthiness information to baseline as a control experiment. The results demonstrated that the trustworthiness modulation effect disappeared, indicating its specificity to the trustworthiness attribute of the stimuli rather than other characteristics. Collectively, these findings lend support to the flexible hypothesis, highlighting that the extraction of trustworthiness information plays a pivotal role in modulating the GCE, consequently influencing social interactions.

Achieving net zero energy heating by integrating the building envelope as a thermal battery.

Photovoltaic (PV) heating is a promising technology for achieving fossil fuel-free heating and carbon neutrality in the building sector. Cost-effective energy storage plays a critical role in PV heating to solve the temporal mismatch between supply and demand. Herein, we propose the concept of using a building envelope as an active energy-storage device for a PV heating system, thus transforming the building envelope into a thermal battery. Experimental results show that the energy storage capacity of 142 kW h/m2, which is higher than that of conventional thermal storage systems. We developed a top-down macro performance assessment model to quantify the contribution of a PV heating system using a building envelope as energy storage. By our estimation, the envelope-embedded system can reduce heating-related CO2 emissions by 7435.7 tons annually in northern China. Our study provides insights into innovative energy-saving building energy storage systems that can help achieve global carbon neutrality and sustainability.

Using scalp EEG to predict seizure recurrence and electrical status epilepticus in children with idiopathic focal epilepsy.

PURPOSE: Some individuals with idiopathic focal epilepsy (IFE) experience recurring seizures accompanied by the evolution of electrical status epilepticus during sleep (ESES). Here, we aimed to develop a predictor for the early detection of seizure recurrence with ESES in children with IFE using resting state electroencephalogram (EEG) data. METHODS: The study group included 15 IFE patients who developed seizure recurrence with ESES. There were 17 children in the control group who did not experience seizure recurrence with ESES during at least 2-year follow-up. We used the degree value of the partial directed coherence (PDC) from the EEG data to predict seizure recurrence with ESES via 6 machine learning (ML) algorithms. RESULTS: Among the models, the Xgboost Classifier (XGBC) model achieved the highest specificity of 0.90, and a remarkable sensitivity and accuracy of 0.80 and 0.85, respectively. The CATC showed balanced performance with a specificity of 0.85, sensitivity of 0.73, and an accuracy of 0.80, with an AUC equal to 0.78. For both of these models, F4, Fz and T4 were the overlaps of the top 4 features. CONCLUSIONS: Considering its high classification accuracy, the XGBC model is an effective and quantitative tool for predicting seizure recurrence with ESES evolution in IFE patients. We developed an ML-based tool for predicting the development of IFE using resting state EEG data. This could facilitate the diagnosis and treatment of patients with IFE.

[Application of brain functional connectivity and nonlinear dynamic analysis in brain function assessment for infants with controlled infantile spasm]. / 脑功能连接及非线性动力学分析在发作控制的婴儿痉挛症患儿脑功能评估中的应用.

OBJECTIVES: To investigate the role of brain functional connectivity and nonlinear dynamic analysis in brain function assessment for infants with controlled infantile spasm (IS). METHODS: A retrospective analysis was performed on 14 children with controlled IS (IS group) who were admitted to the Department of Neurology, Anhui Provincial Children's Hospital, from January 2019 to January 2023. Twelve healthy children, matched for sex and age, were enrolled as the control group. Electroencephalogram (EEG) data were analyzed for both groups to compare the features of brain network, and nonlinear dynamic indicators were calculated, including approximate entropy, sample entropy, permutation entropy, and permutation Lempel-Ziv complexity. RESULTS: Brain functional connectivity showed that compared with the control group, the IS group had an increase in the strength of functional connectivity, and there was a significant difference between the two groups in the connection strength between the Fp2 and F8 channels (P<0.05). The network stability analysis showed that the IS group had a significantly higher network stability than the control group at different time windows (P<0.05). The nonlinear dynamic analysis showed that compared with the control group, the IS group had a significantly lower sample entropy of Fz electrode (P<0.05). CONCLUSIONS: Abnormalities in brain network and sample entropy may be observed in some children with controlled IS, and it is suggested that quantitative EEG analysis parameters can serve as neurological biomarkers for evaluating brain function in children with IS.

Historical production and release inventory of PCDD/Fs in China and projections upon policy options by 2025.

Using the source identification and classification methodology described in UNEP standardized toolkit for dioxin releases, combined with research data over the past decade, the production and release of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) from 6 major sectors in China were inventoried from 2003 to 2020, and were projected until 2025 based on current control measures and relevant industrial plans. The results showed that after ratification of the Stockholm Convention, China's production and release of PCDD/Fs began to decline after peaking in 2007, demonstrating the effectiveness of preliminary control measures. However, the continual expansion of manufacturing and energy sectors, along with the lack of compatible production control technology, reversed the declining trend of production after 2015. Meanwhile, the environmental release continued to decrease, but at a slower rate after 2015. If subject to current policies, production and release would remain elevated with an expanding gap in between. This study also established the congener inventories, revealing the significance of OCDF and OCDD in terms of both production and release, and that of PeCDF and TCDF in terms of environmental impacts. Lastly, through comparison with other developed countries and regions, it was concluded that room for further reduction exists, but can only be achieved through strengthened regulations and improved control measures.

Hollow CoS2 anchored on hierarchically porous carbon derived from Pien Tze Huang for high-performance supercapacitors.

The development of electrode materials with a high specific capacitance, power density, and long-term stability is essential and remains a challenge for developing supercapacitors. Cobalt sulfides (CoS2) are considered one of the most promising and widely studied electrode materials for supercapacitors. Herein, CoS2 and hierarchical porous carbon derived from Pien Tze Huang waste are assembled into a cobalt sulfide/carbon (CoS2/PZH) matrix composite using a one-step hydrothermal method to resolve the challenges of supercapacitors. The resulting CoS2/PZH composite material exhibits a hierarchical porous structure with hollow CoS2 embedded in a PZH framework. The uniform dispersion of the hierarchical porous structure CoS2/PZH is achieved due to the PZH framework, while the uniform decoration of the porous PZH with the hollow CoS2 prevents the PZH from stacking easily. Moreover, the excellent synergistic effect of the hierarchical porous and hollow structure of CoS2/PZH can shorten the electron/ion diffusion channels, expose additional active sites, and provide stable structures for subsequent reactions. As a result, the CoS2/PZH composite material displays a high initial specific capacity of 447.5 F g-1 at 0.5 A g-1, a high energy density of 22.38 W h kg-1, and long-term cycling stability (a retention rate of 92.3% over 10 000 cycles at 5 A g-1).

Intracellular Delivery of Micron-Sized Magnetic Particles through a Virus Infection Pathway.

Micron-sized magnetic particles (M-MPs) have low toxicity, strong magnetic signals, and long-term retention capability, which are significant advantages for their application in biomedical imaging. Unfortunately, M-MPs are only internalized by few cell types, such as macrophages and phagocytes, and because of this lack of active intracellular delivery, their applications are restricted. The emergence of self-assembled virus-like particles (VLPs) offers a viable approach to drive M-MPs into cells, although the specific mechanism has not been revealed. In this study, we investigated in detail the intracellular pathway of M-MPs mediated by VLPs using a fluorescence co-localization method. The results indicated that the intracellular movement of M-MPs was consistent with the virus infection pathway, specifically caveolae-dependent endocytosis, transportation through microtubules, and accumulation in the endoplasmic reticulum. This study provides experimental support for the active transport of M-MPs into other cell types, thereby further extending their applications.

Effect of low-dose radiation on thyroid function and the gut microbiota.

BACKGROUND: The thyroid-gut axis has a great influence on the maintenance of human health; however, we know very little about the effects of low-dose ionizing radiation (LDR) on thyroid hormone levels and gut microbiota composition. AIM: To investigate the potential effects of low-dose X-ray radiation to male C57BL/6J mice. METHODS: Peripheral blood was collected for enzyme-linked immunosorbent assay (ELISA), and stool samples were taken for 16S ribosomal RNA (rRNA) gene sequencing after irradiation. RESULTS: We found that LDR caused changes in thyroid stimulating hormone (TSH) levels in the irradiated mice, suggesting a dose-dependent response in thyroid function to ionizing radiation. No changes in the diversity and richness of the gut microbiota were observed in the LDR-exposed group in comparison to the controls. The abundance of Moraxellaceae and Enterobacteriaceae decreased in the LDR-exposed groups compared with the controls, and the Lachnospiraceae abundance increased in a dose-dependent manner in the radiated groups. And the abundances of uncultured_bacterium_g_Acinetobacter, uncultured_bacterium_ o_Mollicutes_RF39, uncultured_bacterium_g_Citrobacter, and uncultured_ bacterium_g_Lactococcus decreased in the radiated groups at the genus level, which showed a correlation with radiation exposure and diagnostic efficacy. Analysis of functional metabolic pathways revealed that biological metabolism was predicted to have an effect on functional activities, such as nucleotide metabolism, carbohydrate metabolism, and glycan biosynthesis and metabolism. Furthermore, Kyoto Encyclopedia of Genes and Genomes pathway annotation also suggested that changes in the gut microbiota were related to processing functions, including translation, replication and repair. CONCLUSION: LDR can change thyroid function and the gut microbiota, and changes in the abundances of bacteria are correlated with the radiation dose.

Facile fabrication of self-supporting porous CuMoO4@Co3O4 nanosheets as a bifunctional electrocatalyst for efficient overall water splitting.

Research shows that redox complementarity and synergism among the ingredients of heterogeneous catalysts can enhance the performance of the catalyst. In this research, a porous CuMoO4@Co3O4 nanosheet electrocatalyst is prepared, which is uniformly decorated on nickel foam (NF) by hydrothermal reactions and the impregnation method. The CuMoO4@Co3O4 is an efficient bifunctional catalyst with prominent electrocatalytic activity and durability. It requires overpotentials of only 54 and 251 mV to obtain current densities of 10 and 50 mA cm-2 for the cathodic hydrogen evolution reaction (HER) and the anodic oxygen evolution reaction (OER) in 1.0 mol L-1 KOH, corresponding to Tafel slope values of 98.8 and 87.4 mV dec-1, respectively. Furthermore, the CuMoO4@Co3O4 shows excellent stability of 120 h chronopotentiometry at a current density of 100 mA cm-2 for the HER/OER. Notably, an alkaline electrolyzer (with CuMoO4@Co3O4 as the HER and OER electrodes) can deliver a current density of 10 mA cm-2 at a low voltage of 1.51 V. The catalytic activity of CuMoO4@Co3O4 can be attributed to the structure of the porous nanosheets and the synergistic effect between CuMoO4 and Co3O4.

Comparison of Postoperative Outcomes Between Percutaneous Endoscopic Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spinal Stenosis.

Objective: This study aimed to compare postoperative outcomes in surgical and patient-reported outcomes (PROs) between percutaneous endoscopic lumbar interbody fusion (PE-LIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar spinal stenosis (LSS). Methods: We reviewed a total of 89 patients undergoing single-level surgery for lumbar spinal stenosis from January 2018 to July 2021. The cases were categorized as PE-LIF (Group PE-LIF, 41 cases) or MIS-TLIF (Group MIS-TLIF, 48 cases) approach. Parameters obtained at baseline through at least six months of follow-up were collected. The surgical outcomes involving the operative time, estimated blood loss, postoperative bed staying time, and length of hospital stays were analyzed. PROs included the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), modified MacNab standard evaluation, intervertebral fusion rate, and postoperative complications. Results: A total of 89 patients were included in this analysis involving 41 patients who underwent PE-LIF and 48 patients who underwent MIS-TLIF. The 2 groups were similar in gender, age, body mass index, follow-up time and surgery levels (P > 0.05), and were not significantly different in the length of hospital stays (P > 0.05). PE-LIF had a significantly longer operative time, greater fluoroscopy time, lower estimated blood loss and shorter bed rest time than MIS-TLIF. Both groups improved significantly from baseline for the VAS and ODI scores. PE-LIF was associated with a lower VAS score for back pain at three-day after surgery. There were no significant differences between PE-LIF and MIS-TLIF in the excellent or good rates and intervertebral fusion rates at the last follow-up (P > 0.05). As for related complications, there were no significant complications occurred, and no significant differences were seen in the complications between both groups (P > 0.05). Conclusions: To summarize, PE-LIF and MIS-TLIF are both safe and effective for LSS. PE-LIF has a definite short-term curative effect with less trauma.

Nasal delivery of broadly neutralizing antibodies protects mice from lethal challenge with SARS-CoV-2 delta and omicron variants.

Multiple new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have constantly emerged, as the delta and omicron variants, which have developed resistance to currently gained neutralizing antibodies. This highlights a critical need to discover new therapeutic agents to overcome the variants mutations. Despite the availability of vaccines against coronavirus disease 2019 (COVID-19), the use of broadly neutralizing antibodies has been considered as an alternative way for the prevention or treatment of SARS-CoV-2 variants infection. Here, we show that the nasal delivery of two previously characterized broadly neutralizing antibodies (F61 and H121) protected K18-hACE2 mice against lethal challenge with SARS-CoV-2 variants. The broadly protective efficacy of the F61 or F61/F121 cocktail antibodies was evaluated by lethal challenge with the wild strain (WIV04) and multiple variants, including beta (B.1.351), delta (B.1.617.2), and omicron (B.1.1.529) at 200 or 1000 TCID50, and the minimum antibody administration doses (5-1.25 â€‹mg/kg body weight) were also evaluated with delta and omicron challenge. Fully prophylactic protections were found in all challenged groups with both F61 and F61/H121 combination at the administration dose of 20 â€‹mg/kg body weight, and corresponding mice lung viral RNA showed negative, with almost all alveolar septa and cavities remaining normal. Furthermore, low-dose antibody treatment induced significant prophylactic protection against lethal challenge with delta and omicron variants, whereas the F61/H121 combination showed excellent results against omicron infection. Our findings indicated the potential use of broadly neutralizing monoclonal antibodies as prophylactic and therapeutic agent for protection of current emerged SARS-CoV-2 variants infection.

Effects of typical sludge treatment on microplastics in China-Characteristics, abundance and micro-morphological evidence.

Microplastics (MPs) are emerging pollutants that are enriched in sludge. They enter soil through sludge soil amendment, landfill, and discard, which will cause inescapable environmental pollution risks. Sludge treatment technology commonly used in China include anaerobic digestion (AD), thermal drying (TD), thermal hydrolysis (TH) and aerobic composting (AC). In this study, characteristics of MPs in sewage sludge from four representative large cities in China (Zhengzhou, Chongqing, Guangzhou, and Guilin) were analyzed. Effects of four representative sludge treatment technology on sludge MPs were also studied. In addition, the amount of MPs input to soil from sludge in China was estimated. The abundance range of sludge MPs of representative cities in China was 1448-11,125 n∙kg-1 DW. Previous studies indicate that this abundance range is low among other domestic cities and is close to that of European countries. MPs were predominantly fiber-shaped, accounting for 46.66%; 56.5% MPs were white and transparent, and 62.5% were polypropylene and polyethylene. The abundance of MPs in the sludge increased after TH, indicating that MPs broke into smaller particles. However, the other three treatment methods had no significant influence on the abundance of MPs. Scanning electron microscopy analysis showed that the micro-morphology of sludge MPs surface were rougher after AD, and MPs cracked following TD and TH. Furthermore, broken edges were more blurred after TH, and surfaces of MPs were damaged and eroded after AC. The input quantities of MPs in sludge to soil was deduced to be 1013 particles per year. These results are important for controlling the potential risk of sludge MPs in China.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games.

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11% of the athletes incurred at least one injury and nearly 3% incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3%) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5%) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65%). CONCLUSION: Overall, 11% of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2% of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games / 世界急诊医学杂志（英文）

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11％ of the athletes incurred at least one injury and nearly 3％ incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3％) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5％) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65％). CONCLUSION: Overall, 11％ of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2％ of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Preventive surgery for asymptomatic spinal lipomas in children.

AIM: To explore the clinical effect and significance of preventive surgery of asymptomatic spinal lipo-mas in children. MATERIAL AND METHODS: We retrospective analysis of clinical data of 168 cases with asymptomatic spinal lipoma from April 2001 to June 2019 in our hospital. The patients were aged from 1.5 months to 15 years (the average age was 7 months), and there were no neurological symptoms such as pain, incontinence, and / or bilateral lower limb dysfunction before surgery. The surgical proce-dure included: completely removed the lipomas in subcutaneous and extramedullary tissues of the spinal cord, subtotal resection of intraspinal fat, cutting and separating the spinal cord including the medullary cones from the dura sac to release the tethered cord. RESULTS: For the 168 children with spinal lipomas included in the study, complete resection was undertaken for the dorsal spinal lipomas , subtotal resection was taken for the transitional and chaotic spinal lipomas .Subcutaneous effusion caused by cerebrospinal fluid leakage occurred in 5 cases after surgery, which was cured after multiple puncture and aspiration. Six patients developed mild in-continence immediately after the operation, 5 of whom completely returned to normal within 1 month, and 1 had no relief of symptoms.159 of the 168 patients were followed up for 3 to 19 years (the median follow-up time was 76 months). Long-term postoperative symptoms occurred in 13 patients (7.7%), including 12 cases of spinal cord retethering and 1 case of lipoma enlargement. CONCLUSION: Preventive surgery can reduce the incidence of neurological dysfunction in children with asymp-tomatic spinal lipomas in the future.

Combined treatment with FABP4 inhibitor ameliorates rosiglitazone-induced liver steatosis in obese diabetic db/db mice.

Rosiglitazone has been reported to exert dual effects on liver steatosis, and it could exacerbate liver steatosis in obese animal models, which was suggested to be closely related to the elevated hepatic expression of FABP4. This study aimed to investigate whether combined treatment with FABP4 inhibitor I-9 could alleviate rosiglitazone-induced liver steatosis in obese diabetic db/db mice. Male C57BL/KsJ-db/db mice were orally treated with rosiglitazone, rosiglitazone combined with I-9 daily for 8 weeks. The liver steatosis was evaluated by triglyceride content and H&E staining. The expression of hepatic lipogenic genes or proteins in liver tissue or in FFA-treated hepatocytes and PMA-stimulated macrophages were determined by real-time quantitative polymerase chain reaction (RT-qPCR) or western blotting. Results showed that combined treatment with I-9 decreased rosiglitazone-induced increase in serum FABP4 level and expression of lipogenic genes in liver, especially FABP4, and ameliorated liver steatosis in db/db mice. Rosiglitazone-induced intracellular TG accumulation and increased expression of FABP4 in the cultured hepatocytes and macrophages were also suppressed by combined treatment. We concluded that combined treatment with FABP4 inhibitor I-9 could ameliorate rosiglitazone-exacerbated elevated serum FABP4 level and ectopic liver fat accumulation in obese diabetic db/db mice without affecting its anti-diabetic efficacy.

The atmospheric concentrations and emissions of major halocarbons in China during 2009-2019.

Due to the characteristics of ozone-depleting and high global warming potential, chlorofluorocarbons (CFCs), hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs) have been restricted by the Montreal Protocol and its amendments over the world. Considering that China is one of the main contributors to the emission of halocarbons, a long-term atmospheric observation on major substances including CFC-11 (CCl3F), CFC-12 (CCl2F2), HCFC-22 (CHClF2), HCFC-141b (CH3CCl2F), HCFC-142b (CH3CClF2) and HFC-134a (CH2FCF3) was conducted in five cities (Beijing, Hangzhou, Guangzhou, Lanzhou and Chengdu) of China during 2009-2019. The atmospheric concentrations of CFC-11, CFC-12, HCFC-141b and HCFC-142b all showed declining trends on the whole while those of HCFC-22 and HFC-134a were opposite. A paired sample t-test showed that the ambient mixing ratios of HCFC-22 and HFC-134a in cities were 41.9% and 25.7% higher on average than those in suburban areas, respectively, while the other substances did not show significant regional differences. The annual emissions of halocarbons were calculated using an interspecies correlation method and the results were generally consistent with the published estimates. Discrepancies between bottom-up inventories and the estimates in this study for CFCs emissions were found. Among the most consumed ozone depleting substances (ODSs) in China, CFCs accounted for 75.1% of the ozone depletion potential (ODP)-weighted emissions while HCFCs contributed a larger proportion (58.6%) of CO2-equivalent emissions in 2019. China's emissions of HCFC-141b and HCFC-142b contributed the most to the global emission (17.8%-48.0%). The elimination of HCFCs in China will have a crucial impact on the HCFCs phase-out in the world.

Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA), a global health problem with a survival rate ranging from 2 to 22% across different countries, has been a leading cause of premature death for decades. The aim of this study was to evaluate the trends of survival after OHCA over time and its relationship with bystander cardiopulmonary resuscitation (CPR), initial shockable rhythm, return of spontaneous circulation (ROSC), and survived event. METHODS: In this prospective observational study, data of OHCA patients were collected following the "Utstein style" by the Beijing, China, Emergency Medical Service (EMS) from January 2011 (data from February to June in 2011 was not collected) to October 2016. Patients who had a cardiac arrest and for whom an ambulance was dispatched were included in this study. All cases were followed up to determine hospital discharge or death. The trend of OHCA survival was analyzed using the Chi-square test. The relationship among bystander CPR, initial shockable rhythm, ROSC, survived event, and OHCA survival rate was analyzed using multivariate path analyses with maximum standard likelihood estimation. RESULTS: A total of 25,421 cases were transferred by the Beijing EMS; among them, 5042 (19.8%) were OHCA (median age: 78 years, interquartile range: 63-85, 60.1% male), and 484 (9.6%) received bystander CPR. The survival rate was 0.6%, which did not improve from 2012 to 2015 (P = 0.569). Overall, bystander CPR was indirectly associated with an 8.0% (ß = 0.080, 95% confidence interval [CI] = 0.064-0.095, P = 0.002) increase in survival rate. The indirect effect of bystander CPR on survival rate through survived event was 6.6% (ß = 0.066, 95% CI = 0.051-0.081, P = 0.002), which accounted for 82.5% (0.066 of 0.080) of the total indirect effect. With every 1 increase in survived event, the possibility of survival rate will directly increase by 53.5% (ß = 0.535, 95% CI = 0.512-0.554, P = 0.003). CONCLUSIONS: The survival rate after OHCA was low in Beijing which has not improved between 2012 and 2015. The effect of bystander CPR on survival rate was mainly mediated by survived event. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-12002149 (2 May, 2012, retrospectively registered). http://www.chictr.org.cn/showproj.aspx?proj=7400.

Research progress on renin-angiotensin system in ALI/ARDS / 中国职业医学

Acute lung injury(ALI) is an acute hypoxic respiratory insufficiency syndrome. It tends to develop into acute respiratory distress syndrome(ARDS). Renin angiotensin system(RAS) has been proved to be closely related to the development of ALI/ARDS. The classic axis of RAS, angiotensin converting enzyme(ACE)-angiotensin(Ang) Ⅱ-Ang Ⅱtype 1 receptor(AT1R) axis, induces ALI/ARDS by inducing excessive inflammatory response, damaging alveolar barrier function, triggering coagulation dysfunction and other mechanisms. ACE2-Ang(1-7)-MAS axis of RAS can antagonize ACE-Ang Ⅱ-AT1R axis, and improve ALI/ARDS by inhibiting inflammatory response, antagonizing oxidative stress and reducing pulmonary vascular permeability. ACE inhibitors, drugs to reduce the level of Ang Ⅱ, AT1R blockers, AT2R stimulants, recombinant ACE2,mesenchymal stem cells with ACE2 overexpression, Ang1-7 and lipoxin A4 have been proved to improve ALI/ARDS in animal experiments. These results provide a new target for prevention and treatment of ALI/ARDS and improvement of prognosis.