Convolutional neural network for brachial plexus segmentation at the interscalene level.

BACKGROUND: Regional anesthesia with ultrasound-guided brachial plexus block is widely used for patients undergoing shoulder and upper limb surgery, but needle misplacement can result in complications. The purpose of this study was to develop and validate a convolutional neural network (CNN) model for segmentation of the brachial plexus at the interscalene level. METHODS: This prospective study included patients who underwent ultrasound-guided brachial plexus block in the Anesthesiology Department of Beijing Jishuitan Hospital between October 2019 and June 2022. A Unet semantic segmentation model was developed to train the CNN to identify the brachial plexus features in the ultrasound images. The degree of overlap between the predicted segmentation and ground truth segmentation (manually drawn by experienced clinicians) was evaluated by calculation of the Dice index and Jaccard index. RESULTS: The final analysis included 502 images from 127 patients aged 41 ± 14 years-old (72 men, 56.7%). The mean Dice index was 0.748 ± 0.190, which was extremely close to the threshold level of 0.75 for good overlap between the predicted and ground truth segregations. The Jaccard index was 0.630 ± 0.213, which exceeded the threshold value of 0.5 for a good overlap. CONCLUSION: The CNN performed well at segregating the brachial plexus at the interscalene level. Further development could allow the CNN to be used to facilitate real-time identification of the brachial plexus during interscalene block administration. CLINICAL TRIAL REGISTRATION: The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry (ChiCTR2200055591), the site url is https://www.chictr.org.cn/ . The date of trial registration and patient enrollment is 14/01/2022.

Relationship between primary caregivers' social support function, anxiety, and depression after interventional therapy for acute myocardial infarction patients.

BACKGROUND: An acute myocardial infarction (AMI) is often treated with direct coronary intervention and requires home-based rehabilitation. Caregivers of patients with AMI need adequate social support to maintain high-quality care; however, their social support function is low, and relevant indicators for intervention must be identified. AIM: To analyze the correlation between social support for primary caregivers, their anxiety, and depression, when caring for patients with AMI after interventional therapy. METHODS: Using convenience sampling, we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy. The Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to assess the primary caregivers. A Pearson's correlation analysis was used to analyze the correlations between the SSRS, SAS, and SDS, and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the pre-dictive ability of the SAS and SDS for low social support function in primary caregivers. RESULTS: Considering the norm among Chinese people, AMI caregivers' objective support, subjective support, support utilization, and SSRS scores were lower, while their SAS and SDS scores were higher. The SSRS scores of female caregivers were higher than those of the male caregivers (t = 2.123, P = 0.035). The Pearson correlation analysis showed that objective support, subjective support, support utilization, and SSRS total scores were significantly correlated with both SAS (r = -0.414, -0.460, -0.416, -0.535) and SDS scores (r = -0.463, -0.379, -0.349, -0.472). Among the 300 AMI caregivers, 56 cases (18.67%) had a low level of support function (SSRS ≤ 22 points). Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers, regardless of adjustment for other variables (P < 0.05). SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84, sensitivity was 67.9 and 71.4, and specificity was 84.0 and 70.9, respectively. CONCLUSION: The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.

Synergistic Effects of Multiple Environmental Factors on Degradation of Silicone Rubber Seals under Marine Atmosphere.

In this research, the degradation behavior and failure mechanism of silicone rubber seal rings under the synergistic effects of multiple factors in the marine atmosphere are fully investigated. Firstly, four aging factors of air, temperature, compressive stress, and chemical medium were determined by analyzing the service environment profile of silicone rubber seal under a marine atmosphere environment. Secondly, to better simulate the actual service environment of silicone rubber and shorten the test period, an artificially accelerated aging test was designed and carried out in the laboratory. In this paper, temperature is utilized as the accelerating stress. According to the results of the pre-test, the accelerating stress level is finally determined to be 110-150 ∘C. In addition, the compression set applied is consistent with the constant compression permanent deformation value of 28% of the silicone rubber in the actual service process. Finally, through the macroscopic physical properties and microstructure analysis of the samples before and after aging, the corresponding test results are given, and the failure mechanism is analyzed and discussed in detail. Through the above test results and discussion, it can be concluded that the aging process of multi-factor coupling on the lower silicone rubber seal ring is uneven, and its aging process is not a simple superposition of multiple environmental factors. More importantly, the above test data and results are of great significance for evaluating the service life of silicone rubber seals, which can be utilized in the future to improve the reliability and durability of related equipment in the marine environment.

[Seasonal Variations and Source Apportionment of Carbonaceous Components in Luoyang: Implication for Brown Carbon Contribution].

A total of 98 samples were collected to analyze the seasonal variation and source apportionment of carbonaceous components, especially brown carbon (BrC), of PM2.5in Luoyang during 2018-2019. The concentrations of organic carbon (OC) and elemental carbon (EC) ranged from (7.04±1.82) µg·m-3to(23.81±8.68) µg·m-3and (2.96±1.4) µg·m-3to (13.41±7.91) µg·m-3, respectively, showing the seasonal variation of being high in winter and low in summer; the carbonaceous fraction and secondary organic aerosol percentages were higher by 8.33%-141.03% and by 0.77%-63.14%, respectively, compared with that in 2015. The light absorption cross section (MAC) values showed different seasonal variations with the concentration of carbonaceous fraction, shown in descending order as autumn (7.67 m2·g-1)>winter (5.65 m2·g-1)>spring (5.13 m2·g-1)>summer (3.84 m2·g-1). The MAC values ranged from 3.84 to 7.67 m2·g-1 at 445 nm, which was lower than that in coal ash. Seasonal variation in light absorption and the contribution of BrC to total light absorption (babs,BrC,405 nm, babs,BrC,405 nm/babs,405 nm) in descending order was winter (31.57 Mm-1, 33%), autumn (11.40 Mm-1, 25%), spring (4.88 Mm-1, 23%), and summer (2.12 Mm-1, 21%). The proportion of carbonaceous components decreased as haze episodes evolved, whereas the contribution of light absorption of BrC increased, highlighting the important contribution of BrC to the total light absorption. The results of PMF and correlation coefficients of babs,BrC,405 nm and PM2.5 components indicated that motor vehicles and secondary nitrate contributed 27.7% and 24.0%, respectively. Our findings have significant scientific implications for the deep controlling of carbonaceous aerosol, especially for BrC, in Luoyang in the future.

Upregulation of galectin-3 in influenza A virus infection promotes viral RNA synthesis through its association with viral PA protein.

BACKGROUND: Influenza is one of the most important viral infections globally. Viral RNA-dependent RNA polymerase (RdRp) consists of the PA, PB1, and PB2 subunits, and the amino acid residues of each subunit are highly conserved among influenza A virus (IAV) strains. Due to the high mutation rate and emergence of drug resistance, new antiviral strategies are needed. Host cell factors are involved in the transcription and replication of influenza virus. Here, we investigated the role of galectin-3, a member of the ß-galactoside-binding animal lectin family, in the life cycle of IAV infection in vitro and in mice. METHODS: We used galectin-3 knockout and wild-type mice and cells to study the intracellular role of galectin-3 in influenza pathogenesis. Body weight and survival time of IAV-infected mice were analyzed, and viral production in mouse macrophages and lung fibroblasts was examined. Overexpression and knockdown of galectin-3 in A549 human lung epithelial cells were exploited to assess viral entry, viral ribonucleoprotein (vRNP) import/export, transcription, replication, virion production, as well as interactions between galectin-3 and viral proteins by immunoblotting, immunofluorescence, co-immunoprecipitation, RT-qPCR, minireplicon, and plaque assays. We also employed recombinant galectin-3 proteins to identify specific step(s) of the viral life cycle that was affected by exogenously added galectin-3 in A549 cells. RESULTS: Galectin-3 levels were increased in the bronchoalveolar lavage fluid and lungs of IAV-infected mice. There was a positive correlation between galectin-3 levels and viral loads. Notably, galectin-3 knockout mice were resistant to IAV infection. Knockdown of galectin-3 significantly reduced the production of viral proteins and virions in A549 cells. While intracellular galectin-3 did not affect viral entry, it increased vRNP nuclear import, RdRp activity, and viral transcription and replication, which were associated with the interaction of galectin-3 with viral PA subunit. Galectin-3 enhanced the interaction between viral PA and PB1 proteins. Moreover, exogenously added recombinant galectin-3 proteins also enhanced viral adsorption and promoted IAV infection in A549 cells. CONCLUSION: We demonstrate that galectin-3 enhances viral infection through increases in vRNP nuclear import and RdRp activity, thereby facilitating viral transcription and replication. Our findings also identify galectin-3 as a potential therapeutic target for influenza.

Design, Synthesis and Molecular Docking of 1,3,4-Oxadiazole-2(3H)-thione Derivatives Containing 1,4-Benzodioxane Skeleton as Potential FabH Inhibitors.

Fatty acid biosynthesis is essential for bacterial survival. Of these promising targets, ß-ketoacyl-acyl carrier protein (ACP) synthase III (FabH) is the most attractive target. A series of novel 1,3,4-oxadiazole-2(3H)-thione derivatives containing 1,4-benzodioxane skeleton targeting FabH were designed and synthesized. These compounds were determined by 1 H-NMR, 13 C-NMR, MS and further confirmed by crystallographic diffraction study for compound 7m and 7n. Most of the compounds exhibited good inhibitory activity against bacteria by computer-assisted screening, antibacterial activity test and E. coli FabH inhibitory activity test, wherein compounds 7e and 7q exhibited the most significant inhibitory activities. Besides, compound 7q showed the best E. coli FabH inhibitory activity (IC50 =2.45 µΜ). Computational docking studies also showed that compound 7q interacts with FabH critical residues in the active site.

Examining the impact perceptual learning artificial-intelligence-based on the incidence of paresthesia when performing the ultrasound-guided popliteal sciatic block: simulation-based randomized study.

OBJECTIVE: To explore the impact of artificial-intelligence perceptual learning when performing the ultrasound-guided popliteal sciatic block. METHODS: This simulation-based randomized study enrolled residents who underwent ultrasound-guided sciatic nerve block training at the Department of Anesthesiology of Beijing Jishuitan Hospital between January 2022 and February 2022. Residents were randomly divided into a traditional teaching group and an AI teaching group. All residents attended the same nerve block theory courses, while those in the AI teaching group participated in training course using an AI-assisted nerve identification system based on a convolutional neural network instead of traditional training. RESULTS: A total of 40 residents were included. The complication rates of paresthesia during puncture in the first month of clinical sciatic nerve block practice after training were significantly lower in the AI teaching group than in the traditional teaching group [11 (4.12%) vs. 36 (14.06%), P = 0.000093]. The rates of paresthesia/pain during injection were significantly lower in the AI teaching group than in the traditional teaching group [6 (2.25%) vs. 17 (6.64%), P = 0.025]. The Assessment Checklist for Ultrasound-Guided Regional Anesthesia (32 ± 3.8 vs. 29.4 ± 3.9, P = 0.001) and nerve block self-rating scores (7.53 ± 1.62 vs. 6.49 ± 1.85, P < 0.001) were significantly higher in the AI teaching group than in the traditional teaching group. There were no significant differences in the remaining indicators. CONCLUSION: The inclusion of an AI-assisted nerve identification system based on convolutional neural network as part of the training program for ultrasound-guided sciatic nerve block via the popliteal approach may reduce the incidence of nerve paresthesia and this might be related to improved perceptual learning. CLINICAL TRIAL: CHiCTR2200055115 , registered on 1/ January /2022.

Effects of Rotational Speed on Joint Characteristics of Green Joining Technique of Dissimilar Polymeric Rods Fabricated by Additive Manufacturing Technology.

Friction welding (FW) FW of dissimilar polymer rods is capable of manufacturing green products swiftly and economically. In this study, a green manufacturing technique of joining dissimilar polymer rods was proposed, and the effects of rotational speed on the joint characteristics of friction-welded dissimilar polymer rods fabricated by the fused deposition modeling process were investigated experimentally. The shore surface hardness test, impact test, three-point bending test, and differential scanning calorimetry analysis were carried out on the weld joints. The impact energy for FW of polylactic acid (PLA) and PLA, PLA and acrylonitrile butadiene styrene (ABS), PLA and PLA filled with glass fiber (GF), PLA and PLA filled with carbon fiber (CF), PLA and polycarbonate (PC), and PLA and polyamide (PA) rods can be increased by approximately 1.5, 1.5, 1.3, 1.3, 2.1, and 1.5 times by increasing the rotational speed from 330 rpm to 1350 rpm. The bending strength for FW of PLA and PLA, PLA and ABS, PLA and PLA filled with GF, PLA and PLA filled with CF, PLA and PC, and PLA and PA rods can be increased by approximately 1.3, 1.7, 1.3, 1.2, 1.2, and 1.2 times by increasing the rotational speed from 330 rpm to 1350 rpm. However, the surface hardness of the weld bead is not proportional to the rotational speed. The average surface hardness of the weld bead was increased by approximately 5% compared to the surface hardness of the welding base materials.

Protective effects of chlorogenic acid on isoflurane-induced cognitive impairment of aged mice.

Postoperative cognitive dysfunction (POCD) is characterized by impairment in cognitive functions in patients following anesthesia and surgery. Chlorogenic acid (CGA) is a plant-derived compound possessing numerous bioactive properties. The aim of this study was to investigate the therapeutic potential of CGA in isoflurane (ISO)-induced cognitive dysfunction of aged mice, and further identify the mechanisms involved in the protective effects of CGA. A total of 80 male C57BL/6 mice, 20-month-old, were randomly divided into control group, isoflurane group (ISO), and ISO + 30 mg/kg CGA group and ISO + 60 mg/kg CGA. CGA was given orally once daily for 7 days to the mice and they were exposed to ISO (1.5%; 4 h). The open-field and Morris water maze tests were used to investigate the cognitive function of mice. Pretreatment with CGA significantly attenuated ISO-induced cognitive impairment. The levels of IL-1ß, TNF-α, IL-6, nuclear p65 NF-kB, cleaved caspase-3, and Bax were significantly increased, while the levels of IkBα and Bcl-2 were decreased in the hippocampus 24 h after the ISO anesthesia. All the mentioned effects induced by ISO were reversed by CGA pretreatment. Furthermore, ISO exposure induced marked downregulation of SOD, CAT, HO-1, and NQO-1 and elevation of MDA and nuclear translocation of Nrf2 in the hippocampus tissue. All these parameters were reversed by CGA treatment. Importantly, the higher dose of CGA (60 mg/kg) showed a greater neuroprotective effect. In conclusion, these findings suggest that CGA attenuates the ISO-induced cognitive impairment via its anti-inflammatory, anti-oxidative, and anti-apoptotic properties in aged mice.

Critical Salt Loading in Flexible Poly(vinyl alcohol) Sensors Fabricated by an Inkjet Printing and Plasma Reduction Method.

We report a low-temperature inkjet printing and plasma treatment method using silver nitrate ink that allows the fabrication of conductive silver traces on poly(vinyl alcohol) (PVA) film with good fidelity and without degrading the polymer substrate. In doing so, we also identify a critical salt loading in the film that is necessary to prevent the polymer from reacting with the silver nitrate-based ink, which improves the resolution of the silver trace while simultaneously lowering its sheet resistance. Silver lines printed on PVA film using this method have sheet resistances of around 0.2 Ω/□ under wet/dry and stretched/unstretched conditions, while PVA films without prior treatment double in sheet resistance upon wetting or stretching the substrate. This low resistance of printed lines on salt-treated films can be preserved under multiple bending cycles of 0-90° and stretching cycles of 0-6% strain if the polymer is prestretched prior to inkjet printing.

Effect of low-frequency high-intensity ultrasound (HIU) on the physicochemical properties of chickpea protein.

The aim of this study was to improve the functional properties of chickpea protein for its potential application in the food industry. The effects of low frequency high intensity ultrasound (HIU) at different power (0-300 W) and time (15-30 min) on the rheological properties, gelation, thermal stability, solubility and microstructure of chickpea protein were tested and analyzed. Based on the analysis, it was found that HIU caused the disruption of non-covalent bonds between protein chains leading to the unfolding of chickpea. The HIU-treated chickpea isolate protein aggregates were smaller and more uniformly dispersed, with increased orderly structure, thermal stability, and exposure of hydrophobic and charged groups originally buried in the interior. The experimental results also showed that the effect of HIU did not become more pronounced with increasing power and time, as the power exceeding 150 W for 30 min led to the formation of new polymers by the interactions between the exposed non-covalent groups, which were more ordered and homogeneous than those without HIU.

Weld Strength of Friction Welding of Dissimilar Polymer Rods Fabricated by Fused Deposition Modeling.

Friction welding (FRW) is a promising method for joining cylindrical components of dissimilar and similar polymers or metals. In particular, FRW is capable of generating defect-free welds. Fused deposition modeling (FDM) has been widely employed in the automotive industry, ranging from lightweight tools, testing models, and functional parts. Conventionally, dissimilar parts fabricated by FDM are joined by glue. However, distinct disadvantages of this approach include both low joining strength and low joining efficiency. Hitherto, little has been reported on the characterizations of weld strength of FRW of dissimilar parts fabricated by FDM. In addition, FRW of dissimilar polymeric materials is a difficult task because different polymers have different physical, rheological, and mechanical properties. In this study, the effects of welding revolution on the weld strength of friction welding dissimilar parts fabricated by FDM are investigated experimentally. It was found that the average flexural strength of dissimilar polymer rods fabricated by FRW is about 1.52 times that of dissimilar polymer rods fabricated by gluing. The highest flexure strength can be obtained by FRW using polylactic acid (PLA) and PC (polycarbonate) rods. The average impact strength of dissimilar polymer rods fabricated by FRW is about 1.04 times that of dissimilar polymer rods joined by gluing. The highest impact strength can be obtained by FRW using PLA to PLA rods.

Design, Synthesis and Molecular Docking of Novel Quinazolinone Hydrazide Derivatives as EGFR Inhibitors.

A series of novel quinazolinone hydrazide derivatives were designed and synthesized as EGFR inhibitors. The results indicated that most of the aimed compounds had potential anti-tumor cell proliferation and EGFR inhibitory activities. In the comprehensive analysis of all the tested compounds, the target compound 9c showed the best anti-tumor cell proliferation activity, (IC50 =1.31 µM for MCF-7, IC50 =1.89 µM for HepG2, IC50 =2.10 µM for SGC), and IC50 =0.59 µM for the EGFR inhibitory activity. Docking results showed that compound 9c could ideally insert the active site and interact with the critical amino acid residues (Val702, Lys721, Met769, Asp831) in the active site.

Wavelength-switchable and multi-pulse bound state based on a hybrid mode-locked mechanism.

Relying on the nonlinear multimode interference in multimode fibers and the nonlinear polarization rotation, these two mode-locked techniques are combined in our proposed fiber laser. Stable optical soliton and multi-pulse regimes with a constant frequency of 11.44 MHz have been generated experimentally. Through altering intra-cavity conditions, bound-state pulses with diverse properties are observed. To the best of our knowledge, the obtained bound-state pulse constituted by more than thirty sub-pulses is achieved for the first time. Moreover, the center wavelength of bound-state pulse could be switched in a certain range covering the entire C band.

Multiple Color Emission of Mechanoluminescence and Photoluminescence from SrZnSO: Bi3+ for Multimode Anticounterfeiting.

Mechanoluminescence materials that emit light under mechanical stimulation have attracted widespread attention in sensing, anticounterfeiting, and imaging applications. In this study, a series of Sr1-xBixZnSO (0.001 ≤ x ≤ 0.1) samples was synthesized by the method of high temperature solid-state reaction. It is worth noting that the distortion degree of the SrO3S3 octahedron was increased with increasing Bi3+ concentration, and the color manipulated Sr1-xBixZnSO which can emit different photoluminescence (blue to dark blue and finally red) and mechanoluminescence (orange to red) colors is obtained. Moreover, the deep traps can stably store and provide electronic supplements in shallow traps released under mechanical stimulation. Therefore, devices made of SrZnSO:Bi3+ phosphor and polydimethylsiloxane (PDMS) can be used as thermo-mechano-opto three-mode anticounterfeiting. The ML intensity is linear to the external load and can be utilized for stress sensing or imaging.

Effects of Different Mold Materials and Coolant Media on the Cooling Performance of Epoxy-Based Injection Molds.

Metal additive manufacturing techniques are frequently applied to the manufacturing of injection molds with a conformal cooling channel (CCC) in order to shorten the cooling time in the injection molding process. Reducing the cooling time in the cooling stage is essential to reducing the energy consumption in mass production. However, the distinct disadvantages include higher manufacturing costs and longer processing time in the fabrication of injection mold with CCC. Rapid tooling technology (RTT) is a widely utilized technology to shorten mold development time in the mold industry. In principle, the cooling time of injection molded products is affected by both injection mold material and coolant medium. However, little work has been carried out to investigate the effects of different mold materials and coolant media on the cooling performance of epoxy-based injection molds quantitatively. In this study, the effects of four different coolant media on the cooling performance of ten sets of injection molds fabricated with different mixtures were investigated experimentally. It was found that cooling water with ultrafine bubble is the best cooling medium based on the cooling efficiency of the injection molded parts (since the cooling efficiency is increased further by about 12.4% compared to the conventional cooling water). Mold material has a greater influence on the cooling efficiency than the cooling medium, since cooling time range of different mold materials is 99 s while the cooling time range for different cooling media is 92 s. Based on the total production cost of injection mold and cooling efficiency, the epoxy resin filled with 41 vol.% aluminum powder is the optimal formula for making an injection mold since saving in the total production cost about 24% is obtained compared to injection mold made with commercially available materials.

Wireless Monitoring of Vascular Pressure Using CB-PDMS Based Flexible Strain Sensor.

Rising pressure within a vascular graft can signal impending failure caused by stenosis or thrombosis, and early detection can improve surgical salvage outcomes. To enable regular graft pressure monitoring, we developed a thin flexible pulsation sensor (FPS) with wireless data readout. A conductive polymer sensing layer is attached to a flexible circuit board and then encapsulated by polydimethylsiloxane (PDMS) for biocompatibility. Due to the FPS' outstanding flexibility in comparison to natural arteries, veins, and synthetic vascular grafts, it can be wrapped around target conduits to monitor blood pressure for short-term surgical and long-term implantation purposes. In this study, we analyze the power spectrum of the FPS data to determine the ideal bandwidth of the wireless FPS device to preserve heart rate and hemodynamic waveforms while rejecting noise. The strain response of FPS wrapped around silicone tube, vascular graft and artery was simulated using COMSOL®, showing a linear relationship between pressure and FPS strain. The optimized bandpass filter of 0.2-10 Hz was simulated and implemented on a flexible polyimide circuit board. The circuit board also included a low- power microcontroller for data conversion and transmission via simple 4-MHz on-off keying. The performance of the prototype was evaluated by recording wireless data from a vascular phantom under different pressure and flow settings. The results indicate that the peak-to-peak FPS voltage responds linearly to RMS blood pressure and systolic-diastolic pressure.Clinical Relevance- Early detection of a failing vascular graft could leverage sensors for near real-time monitoring. The presented wireless flexible sensor measures and transmits vessel distension data as a proxy for internal lumen pressure.

Evaluation of Clopidogrel Safety in Geriatric Patients with Hip Fracture: A Retrospective Study.

OBJECTIVE: To evaluate the risk of bleeding in elderly patients undergoing early hip fracture surgery with/without clopidogrel administration. METHODS: This was a retrospective study, and patients over 65 years with fresh hip fracture were enrolled. For the patients taking clopidogrel, early surgical treatment was performed without 5-7 days waiting time. The patients were divided into groups according to their fracture type and the surgical method. Within each fracture/surgery group, the patients were further divided into subgroups according to whether they had clopidogrel administration. The patients' age, gender, American Society of Anesthesiologists (ASA) score, hemoglobin level at admission, and the time from admission to surgery were compared in the different groups. The bleeding outcomes, such as intraoperative blood loss and blood transfusion status, as well as secondary outcomes, such as operation duration and length of hospital stay, were also compared in these groups. RESULTS: There were no statistically significant differences in patients' baseline characteristics and outcomes, including intraoperative blood loss, blood transfusion rate, operation duration and length of hospital stay, between the clopidogrel-administrated patients and the control patients. However, the percentage of patients taking general anesthesia was significantly higher in clopidogrel group than that in control group (P = 0.01). Similar intraoperative blood loss was found in the subgroups of hemi-hip replacement, internal fixation for intertrochanteric fracture of the femur (fracture type A1-2, short pin), and internal fixation of femoral neck fracture with cannulated nails. For the internal fixation of femoral neck fracture with cannulated nails, the blood loss is significantly less in both subgroups than that with other two surgical methods. Moreover, the total hip arthroplasty, with the highest bleeding risk among all the surgical methods involved, was rarely chosen to treat geriatric hip fracture in this study. CONCLUSION: This study indicated that compared with patients without clopidogrel administration, elderly patients with hip fractures who receive clopidogrel as long-term anti-platelet therapy are relatively safe for surgery in less than 5-7 days after discontinuation of clopidogrel.

Targeting Intra-Pulmonary P53-Dependent Long Non-Coding RNA Expression as a Therapeutic Intervention for Systemic Lupus Erythematosus-Associated Diffuse Alveolar Hemorrhage.

Diffuse alveolar hemorrhage (DAH) in systemic lupus erythematosus (SLE) is associated with significant mortality, requiring a thorough understanding of its complex mechanisms to develop novel therapeutics for disease control. Activated p53-dependent apoptosis with dysregulated long non-coding RNA (lncRNA) expression is involved in the SLE pathogenesis and correlated with clinical activity. We examined the expression of apoptosis-related p53-dependent lncRNA, including H19, HOTAIR and lincRNA-p21 in SLE-associated DAH patients. Increased lincRNA-p21 levels were detected in circulating mononuclear cells, mainly in CD4+ and CD14+ cells. Higher expression of p53, lincRNA-p21 and cell apoptosis was identified in lung tissues. Lentivirus-based short hairpin RNA (shRNA)-transduced stable transfectants were created for examining the targeting efficacy in lncRNA. Under pristane stimulation, alveolar epithelial cells had increased p53, lincRNA-p21 and downstream Bax levels with elevated apoptotic ratios. After pristane injection, C57/BL6 mice developed DAH with increased pulmonary expression of p53, lincRNA-p21 and cell apoptosis. Intra-pulmonary delivery of shRNA targeting lincRNA-p21 reduced hemorrhage frequencies and improved anemia status through decreasing Bax expression and cell apoptosis. Our findings demonstrate increased p53-dependent lncRNA expression with accelerated cell apoptosis in the lungs of SLE-associated DAH patients, and show the therapeutic potential of targeting intra-pulmonary lncRNA expression in a pristane-induced model of DAH.

Evolutions of Q-switched mode-locked square noise-like pulse with different cavity lengths.

A $Q$-switched mode-locked square noise-like pulse (QMLSNLP) is generated in a nonlinear polarization rotation passively mode-locked fiber laser. When the pump power changes from 154 mW to 414 mW, the frequency of the $Q$-switched envelope varies from 21.7 kHz to 38.9 kHz, while the duration of the $Q$-switched envelope decreases from $5.1\,\,{\unicode{x00B5}\rm s}$ to $3.2{\unicode{x00B5}\rm s}$, correspondingly. In the meantime, QMLSNLP keeps the fundamental repetition rate constant, and the pulse duration increases from 3.4 ns to 6.7 ns. By inserting different lengths of single-mode fiber into the ring cavity, the evolutions of QMLSNLP are measured and analyzed. According to the cavity parameters and experimental results, impacts of the cavity length on QMLSNLP are investigated in detail.