Effects of acute normovolemic hemodilution and allogeneic blood transfusion on postoperative complications of oral and maxillofacial flap reconstruction: a retrospective study.

OBJECTIVE: Patients undergoing oral and maxillofacial flap reconstruction often need blood transfusions due to massive blood loss. With the increasing limitations of allogeneic blood transfusion (ABT), doctors are considering acute normovolemic hemodilution (ANH) because of its advantages. By comparing the differences in the (Δ) blood indices and postoperative complications of patients receiving ABT or ANH during the reconstruction and repair of oral and maxillofacial tumor flaps, this study's purpose was to provide a reference for the clinical application of ANH. METHODS: The clinical data of 276 patients who underwent oral and maxillofacial flap reconstruction from September 25, 2017, to October 11, 2021, in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, were retrospectively analyzed. According to the intraoperative blood transfusion mode, the patients were divided into two groups: ABT and ANH. The differences in the (Δ) blood indices and the incidence of postoperative complications between the groups were analyzed. RESULTS: Among the 276 patients who had ANH (124/276) and ABT (152/276), there were no differences in (Δ) Hb, (Δ) PT, or (Δ) FIB (P > 0.05), while (Δ) WBC, (Δ) PLT, (Δ) APTT and (Δ) D-dimer were significantly different (P < 0.05). The blood transfusion method was not an independent factor for flap crisis (P > 0.05). The wound infection probability in patients with high post-PTs was 1.953 times greater than that in patients with low post-PTs (OR = 1.953, 95% CI: 1.232 ∼ 3.095, P = 0.004). A normal or overweight BMI was a protective factor for pulmonary infection, and the incidence of pulmonary infection in these patients was only 0.089 times that of patients with a low BMI (OR = 0.089, 95% CI: 0.017 ∼ 0.462). Moreover, a high ASA grade promoted the occurrence of pulmonary infection (OR = 6.373, 95% CI: 1.681 ∼ 24.163). The blood transfusion mode (B = 0.310, ß = 0.360, P < 0.001; ANH: ln hospital stay = 2.20 ± 0.37; ABT: ln hospital stay = 2.54 ± 0.42) improved the length of hospital stay. CONCLUSION: Preoperative and postoperative blood transfusion (Δ) Hb, (Δ) PT, and (Δ) FIB did not differ; (Δ) WBC, (Δ) PLT, (Δ) APTT, and (Δ) D-dimer did differ. There was no difference in the effects of the two blood transfusion methods on flap crisis, incision infection or lung infection after flap reconstruction, but ANH resulted in a 3.65 day shorter average hospital stay than did ABT.

Prostaglandin-E1 infusion in persistent pulmonary hypertension of the newborn.

BACKGROUND: Neonates with persistent pulmonary hypertension of the newborn (PPHN) can present with hypoxia and right ventricular dysfunction with resultant inadequate oxygen delivery and end-organ damage. This study describes the use of prostaglandin-E1 (PGE) for ductal patency to preserve right ventricular systolic function and limit afterload in newborns with PPHN. METHODS: This is a retrospective cohort study that follows the hemodynamics, markers of end-organ perfusion, length of therapeutics, and echocardiographic variables of 57 newborns who used prostglandin-E1 in the setting of PPHN. RESULTS: Tachycardia, lactic acidosis, and supplemental oxygen use improved following PGE initiation. Fractional area change (FAC), to assess right ventricular systolic function, and pulmonary arterial acceleration time indexed to right ventricular ejection time (PAAT/RVET), to assess right ventricular afterload, also improved over three time points relative to PGE use (before, during, and after). CONCLUSIONS: Overall, we described the safety and utility of PGE in newborns with severe PPHN for stabilization while allowing natural disease progression.

Asymmetric and Skin-Mimicking Hydrogels with Wide Temperature Tolerance and Superior Elasticity for High-Performance Strain Sensors.

Wide temperature tolerance and superior mechanical properties are highly required for composite hydrogels in electronic applications such as electronic skins and soft robotics. In this work, a unique polyacrylamide-based and double-network hydrogel system is designed and fabricated by introducing graphene oxide and glycerol to improve mechanical properties as well as antifreezing and antiheating properties. Maximum stress of the graphene oxide-incorporated hydrogel increases rapidly to 500.0 kPa which is much higher than that of polymetric acrylamide/carboxymethylcellulose sodium hydrogel (281.7 kPa), probably due to the inhibition from graphene oxide in generation and propagation of cracks. With constantly adding glycerol, total elongation and antifreezing and heating properties of the composite hydrogels increase gradually. Especially, sample with 20 vol % of glycerol not only shows stable conductivity and wide temperature tolerance (-50 to 50 °C) but also has ideal strength-toughness match (597.6 kPa and 1263.4%), suggesting that synergistic effect of different layers in the asymmetric structure plays an active role in improvement of mechanical properties.

Fetal circulatory physiology and brain development in complex congenital heart disease: A multi-modal imaging study.

OBJECTIVE: Fetuses with complex congenital heart disease have altered physiology, contributing to abnormal neurodevelopment. The effects of altered physiology on brain development have not been well studied. We used multi-modal imaging to study fetal circulatory physiology and brain development in hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (TGA). METHODS: This prospective, cross-sectional study investigated individuals with fetal congenital heart disease and controls undergoing fetal echocardiography and fetal brain MRI. MRI measured total brain volume and cerebral oxygenation by the MRI quantification method T2*. Indexed cardiac outputs (CCOi) and vascular impedances were calculated by fetal echocardiography. Descriptive statistics assessed MRI and echocardiogram measurement relationships by physiology. RESULTS: Sixty-six participants enrolled (control = 20; HLHS = 25; TGA = 21), mean gestational age 33.8 weeks (95% CI: 33.3-34.2). Total brain volume and T2* were significantly lower in fetuses with cardiac disease. CCOi was lower in HLHS, correlating with total brain volume - for every 10% CCOi increase, volume increased 8 mm3 (95% CI: 1.78-14.1; p = 0.012). Echocardiography parameters and cerebral oxygenation showed no correlation. TGA showed no CCOi or aortic output correlation with MRI measures. CONCLUSIONS: In HLHS, lower cardiac output is deleterious to brain development. Our findings provide insight into the role of fetal cardiovascular physiology in brain health.

A Research on the Sharing Platform of Wild Bird Data in Yunnan Province Based on Blockchain and Interstellar File System.

Sharing scientific data is an effective means to rationally exploit scientific data and is vital to promote the development of the industrial chain and improve the level of science and technology. In recent years, the popularity of the open data platform has increased, but problems remain, including imperfect system architecture, unsound privacy and security, and non-standardized interaction data. To address these problems, the blockchain's decentralization, smart contracts, distributed storage, and other features can be used as the core technology for open data systems. This paper addresses the problems of opening, allocation-right confirmation, sharing, and rational use of wild-bird data from Yunnan Province, China. A data storage model is proposed based on the blockchain and interstellar file system and is applied to wild-bird data to overcome the mutual distrust between ornithology institutions in the collaborative processing and data storage of bird data. The model provides secure storage and secure access control of bird data in the cloud, thereby ensuring the decentralized and secure storage of wild-bird data for multiple research institutions.

Maximum surgical blood order schedule for flap reconstruction in oral and maxillofacial cancer patients.

BACKGROUND: We established a MSBOS for flap reconstruction in oral and maxillofacial cancer patients. METHOD: We enrolled 2080 cases of oral and maxillofacial flap reconstruction from January 1, 2010 to December 31, 2021. Patient data were collected, including age, sex, BMI, preoperative Hb levels, ASA grade, T stage, flap type, tumor location, and bone flap. Scoring criteria were established based on a multivariate model of independent risk variables and their odds ratios. Two flap-type groups were divided into low-risk, intermediate-risk and high-risk groups by the scoring criteria, and analyzed using univariate and multivariate logistic regression. Perioperative transfusion analysis identified independent risk factors at various Hb levels. The cumulative percentage of patients requiring perioperative blood transfusion for each surgical procedure was calculated to establish the MSBOS. RESULTS: (1) Regression analysis showed that BMI, tumor T staging, ASA grade, preoperative Hb level (male: Hb < 130 g/L, female: Hb < 120 g/L), and bone flap were independent risk factors for perioperative blood transfusion. (2) Regression analysis showed that independent risk factors for perioperative transfusion included the following: BMI, tumor T3-T4 stage, ASA III, IV grade, and free flap/pediculated flap/bone flap in patients with different Hb levels; T3-T4 stage, ASA grade III-IV in mildly anemic patients; and ASA grade III-IV in moderately anemic patients. (3) A MSBOS was established for flap reconstruction in head and neck cancer patients. CONCLUSION: A MSBOS for head and neck cancer procedures was reduced by approximately 30% perioperative blood preparation while ensuring that clinical blood use standards were met. It help optimize blood inventory, and save blood resources.

Antitumor Efficacy of Doxorubicin-Loaded Electrospun Attapulgite-Poly(lactic-co-glycolic acid) Composite Nanofibers.

Currently, cancer chemotherapeutic drugs still have the defects of high toxicity and low bioavailability, so it is critical to design novel drug release systems for cancer chemotherapy. Here, we report a method to fabricate electrospun drug-loaded organic/inorganic hybrid nanofibrous system for antitumor therapy applications. In this work, rod-like attapulgite (ATT) was utilized to load a model anticancer drug doxorubicin (DOX), and mixed with poly(lactic-co-glycolic acid) (PLGA) to form electrospun hybrid nanofibers. The ATT/DOX/PLGA composite nanofibers were characterized through various techniques. It is feasible to load DOX onto ATT surfaces, and the ATT/DOX/PLGA nanofibers show a smooth and uniform morphology with improved mechanical durability. Under neutral and acidic pH conditions, the loaded DOX was released from ATT/DOX/PLGA nanofibers in a sustained manner. In addition, the released DOX from the nanofibers could significantly inhibit the growth of tumor cells. Owing to the significantly reduced burst release profile and increased mechanical durability of the ATT/DOX/PLGA nanofibers, the designed organic-inorganic hybrid nanofibers may hold great promise as a nanoplatform to encapsulate different drugs for enhanced local tumor therapy applications.

Effective connectivity reveals distinctive patterns in response to others' genuine affective experience of disgust.

Empathy is significantly influenced by the identification of others' emotions. In a recent study, we have found increased activation in the anterior insular cortex (aIns) that could be attributed to affect sharing rather than perceptual saliency, when seeing another person genuinely experiencing pain as opposed to merely acting to be in pain. In that prior study, effective connectivity between aIns and the right supramarginal gyrus (rSMG) was revealed to represent what another person really feels. In the present study, we used a similar paradigm to investigate the corresponding neural signatures in the domain of empathy for disgust - with participants seeing others genuinely sniffing unpleasant odors as compared to pretending to smell something disgusting (in fact the disgust expressions in both conditions were acted for reasons of experimental control). Consistent with the previous findings on pain, we found stronger activations in aIns associated with affect sharing for genuine disgust (inferred) compared with pretended disgust. However, instead of rSMG we found engagement of the olfactory cortex. Using dynamic causal modeling (DCM), we estimated the neural dynamics of aIns and the olfactory cortex between the genuine and pretended conditions. This revealed an increased excitatory modulatory effect for genuine disgust compared to pretended disgust. For genuine disgust only, brain-to-behavior regression analyses highlighted a link between the observed modulatory effect and a few empathic traits. Altogether, the current findings complement and expand our previous work, by showing that perceptual saliency alone does not explain responses in the insular cortex. Moreover, it reveals that different brain networks are implicated in a modality-specific way when sharing the affective experiences associated with pain vs. disgust.

Effect of glutathione S-transferase gene polymorphisms on semen quality in patients with idiopathic male infertility.

OBJECTIVE: To investigate the relationship between glutathione S-transferase enzyme (GSTM1, T1, and P1) genetic variants and semen quality in men with idiopathic infertility. METHODS: Sperm characteristics were measured using computer-assisted sperm analysis. The malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC) activities were detected by spectroscopic analysis, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) was detected by enzyme-linked immunosorbent assay. RESULTS: This study included 246 idiopathic infertile men and 117 controls. The GSTM1(-), T1(-), and M1/T1(-/-) genotype frequencies significantly differed between the groups. The GSTM1(-) and T1(-) genotypes in idiopathic infertile men negatively correlated with sperm concentration, motility, mitochondrial membrane potential, and other parameters. However, these genotypes positively correlated with the amplitude of the lateral head displacement and NO and 8-OHdG levels. The GSTT1(-) genotype positively correlated with mean angular displacement and MDA activity. GSTM1(-) and T1(-) had a synergistic effect on semen quality. Sperm motility, normal morphology, straightness, and TAC were lower and amplitude of lateral head displacement and MDA were higher in the GSTP1(A/G + G/G) group than in the GSTP1(A/A) group among men with idiopathic infertility. CONCLUSIONS: GSTM1, T1, and P1 genetic variants may be risk factors for infertility by affecting the semen quality men with idiopathic oligoasthenospermia.

Neural dynamics between anterior insular cortex and right supramarginal gyrus dissociate genuine affect sharing from perceptual saliency of pretended pain.

Empathy for pain engages both shared affective responses and self-other distinction. In this study, we addressed the highly debated question of whether neural responses previously linked to affect sharing could result from the perception of salient affective displays. Moreover, we investigated how the brain network involved in affect sharing and self-other distinction underpinned our response to a pain that is either perceived as genuine or pretended (while in fact both were acted for reasons of experimental control). We found stronger activations in regions associated with affect sharing (anterior insula [aIns] and anterior mid-cingulate cortex) as well as with affective self-other distinction (right supramarginal gyrus [rSMG]), in participants watching video clips of genuine vs. pretended facial expressions of pain. Using dynamic causal modeling, we then assessed the neural dynamics between the right aIns and rSMG in these two conditions. This revealed a reduced inhibitory effect on the aIns to rSMG connection for genuine pain compared to pretended pain. For genuine pain only, brain-to-behavior regression analyses highlighted a linkage between this inhibitory effect on the one hand, and pain ratings as well as empathic traits on the other. These findings imply that if the pain of others is genuine and thus calls for an appropriate empathic response, neural responses in the aIns indeed seem related to affect sharing and self-other distinction is engaged to avoid empathic over-arousal. In contrast, if others merely pretend to be in pain, the perceptual salience of their painful expression results in neural responses that are down-regulated to avoid inappropriate affect sharing and social support.

Empathy enables us to share and understand the emotional states of other people, often based on their facial expressions. This empathic response involves being able to distinguish our own emotional state from someone else's, and it is influenced by how we recognize that person's emotion. In real life, knowing and identifying whether the facial expression we are witnessing reflects genuine or pretended pain is particularly important so that we can appropriately react to someone's emotions and avoid unnecessary personal distress. How our brains manage to do this is still heavily debated. Two areas, the anterior insular (aIns for short) and the mid-cingulate cortex, appear to be activated when someone 'feels' someone else's pain. However, these regions might just automatically be triggered by vivid emotional facial expressions, regardless of whether we really respond to that pain. To examine this question, Zhao et al. measured brain activity as healthy adults watched video clips of people either feeling or pretending to feel pain. The activation of aIns was particularly related to the emotional component that someone shared with another person's genuine pain, but not to pretended pain. This suggests that neurons in the aIns track a truly empathic response when seeing someone who is actually experiencing pain. Effective connectivity analyses which reflect how brain areas 'crosstalk' also revealed distinct patterns when people viewed expressions of genuine, as opposed to pretended pain. Zhao et al. focused on the interactions between the alns and the right supramarginal gyrus, a brain region which helps to distinguish another person's emotions from our own. This crosstalk tracked others' feelings when participants viewed expressions of genuine but not of pretended pain. Put together, these findings provide a more refined model of empathy and its neural underpinnings. This will help further our understanding of conditions such as autism or depression, in which a person's social skills and emotional processing are impaired.

Rare primary malignant peripheral nerve sheath tumor of the left testis: A case report.

Malignant peripheral nerve sheath tumor (MPNST) is a rare disease. The present study discusses the case of a 30-year-old male patient who presented with complaints of pain in the left testis and groin over 1 month. Ultrasonography and computed tomography (CT) imaging revealed the presence of a space-occupying lesion localized in the left testis. The mass was completely resected using an open surgical approach and was diagnosed as a primary MPNST of the left testis on postoperative histopathological examination. As this type of tumor is rare, there is currently no standard diagnostic or treatment method for MPNST. Pathological examination, enhanced CT imaging and immunohistochemical investigation are helpful for establishing the diagnosis and surgical resection is considered to be an effective treatment.

Cellulose nanocrystals in cancer diagnostics and treatment.

Cancer is currently a major threat to public health, being among the principal causes of death to the global population. With carcinogenesis mechanisms, cancer invasion, and metastasis remaining blurred, cancer diagnosis and novel drug delivery approaches should be developed urgently to enable management and treatment. A dream break-through would be a non-invasive instantaneous monitoring of cancer initiation and progression to fast-track diagnosis for timely specialist treatment decisions. These innovations would enhance the established treatment protocols, unlimited by evasive biological complexities during tumorigenesis. It is therefore contingent that emerging and future scientific technologies be equally biased towards such innovations by exploiting the apparent properties of new developments and materials especially nanomaterials. CNCs as nanomaterials have undisputable physical and excellent biological properties that enhanced their interest as biomedical materials. This article therefore highlights CNCs utility in cancer diagnosis and therapy. Their extraction, properties, modification, in-vivo/in-vitro medical applications, biocompatibility, challenges and future perspectives are precisely discussed.

An ensemble of neural networks provides expert-level prenatal detection of complex congenital heart disease.

Congenital heart disease (CHD) is the most common birth defect. Fetal screening ultrasound provides five views of the heart that together can detect 90% of complex CHD, but in practice, sensitivity is as low as 30%. Here, using 107,823 images from 1,326 retrospective echocardiograms and screening ultrasounds from 18- to 24-week fetuses, we trained an ensemble of neural networks to identify recommended cardiac views and distinguish between normal hearts and complex CHD. We also used segmentation models to calculate standard fetal cardiothoracic measurements. In an internal test set of 4,108 fetal surveys (0.9% CHD, >4.4 million images), the model achieved an area under the curve (AUC) of 0.99, 95% sensitivity (95% confidence interval (CI), 84-99%), 96% specificity (95% CI, 95-97%) and 100% negative predictive value in distinguishing normal from abnormal hearts. Model sensitivity was comparable to that of clinicians and remained robust on outside-hospital and lower-quality images. The model's decisions were based on clinically relevant features. Cardiac measurements correlated with reported measures for normal and abnormal hearts. Applied to guideline-recommended imaging, ensemble learning models could significantly improve detection of fetal CHD, a critical and global diagnostic challenge.

Pharmacological fMRI provides evidence for opioidergic modulation of discrimination of facial pain expressions.

The endogenous opioid system is strongly involved in the modulation of pain. However, the potential role of this system in perceiving painful facial expressions from others has not been sufficiently explored as of yet. To elucidate the contribution of the opioid system to the perception of painful facial expressions, we conducted a double-blind, within-subjects pharmacological functional magnetic resonance imaging (fMRI) study, in which 42 participants engaged in an emotion discrimination task (pain vs. disgust expressions) in two experimental sessions, receiving either the opioid receptor antagonist naltrexone or an inert substance (placebo). On the behavioral level, participants less frequently judged an expression as pain under naltrexone as compared to placebo. On the neural level, parametric modulation of activation in the (putative) right fusiform face area (FFA), which was correlated with increased pain intensity, was higher under naltrexone than placebo. Regression analyses revealed that brain activity in the right FFA significantly predicted behavioral performance in disambiguating pain from disgust, both under naltrexone and placebo. These findings suggest that reducing opioid system activity decreased participants' sensitivity for facial expressions of pain, and that this was linked to possibly compensatory engagement of processes related to visual perception, rather than to higher level affective processes, and pain regulation.

Effects of Vitamin D Supplementation on General and Central Obesity: Results from 20 Randomized Controlled Trials Involving Apparently Healthy Populations.

BACKGROUND: The obesity pandemic has been paralleled by a high prevalence of vitamin D deficiency (VDD). There is growing epidemiological evidence linking low vitamin D status with obesity events. In addition, observational studies also show that obesity may increase the risk of VDD. However, there is insufficient knowledge to understand whether there is a causality between the two. Moreover, the impact of vitamin D supplementation on obesity indices has shown inconsistent outcomes. OBJECTIVE: This meta-analysis aimed to assess whether vitamin D supplementation modified general and central obesity indices in apparently healthy populations. METHODS: A systematic retrieval of relevant randomized controlled trials (RCTs) was undertaken using Pubmed, Embase, Web of Knowledge and Chinese National Knowledge Infrastructure databases. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were used to assess the changes in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and 25-hydroxyvitamin D (25[OH]D) from baseline. RESULTS: Twenty RCTs involving 3,153 participants reporting either BMI, WC, WHR or 25(OH)D met the inclusion criteria. When compared with placebo, vitamin D supplementation had no significant decreases in BMI (WMD = -0.09 kg/m2, 95% CI -0.19 to 0.01, p = 0.08), WC (WMD = -0.71 cm, 95% CI -1.58 to 0.16, p = 0.112) or WHR (WMD = 0.00, 95% CI -0.01 to 0.01, p = 0.749). However, in the subgroups of females, Asia region studies and intervention duration ≥6 months, a beneficial and significant reduction in BMI and WC was noted (all p < 0.026). On the other hand, pooled results showed that there was a significant increase in serum 25(OH)D levels (WMD = 13.20 ng/mL, 95% CI 9.83-16.58, p < 0.001) after vitamin D intervention. No publication bias was found in our study. CONCLUSIONS: Overall, supplementation with vitamin D produced no significant effect on the BMI, WC or WHR of healthy adults.

Placebo Effect on Modulating Empathic Pain: Reduced Activation in Posterior Insula.

Little evidence exists to confirm whether the sensory-related neural activity that occurs when observing others in pain is highly responsive to empathy for pain. From a perspective of intervention, the present study employed placebo manipulation with a transferable paradigm to explore whether the sensory regional activation that occurs when viewing pictures of others in pain could be modulated by the placebo effect. We first performed a screening behavioral experiment for selecting placebo responders and then entered them into a functional magnetic resonance (fMRI) experiment in which they were exposed to the same conditions as before. Participants were informed that it was equally possible to be assigned to the treatment group (placebo manipulation) or the no-treatment group (control); they all, in fact, received treatment and placebo effect would be detected by comparing placebo conditions and no-placebo control condition. Each participant experienced a phase of reinforcing placebo belief with pain in self and a phase of testing transferable placebo effect on empathy for pain. As a result, we found significant activation in sensory areas, including the posterior insula (PI) and the postcentral gyrus, and in the middle cingulate cortex while participants observed pictures of others in pain. More importantly, for the first time, we observed relieved activation in the PI modulated by the placebo effect only associated with pain pictures but not with no-pain pictures. This suggests that sensory activity in the PI might be involved in the processing for empathic pain. This new approach sheds light on research and applications in clinical settings.

Clinical Utility of Echocardiography in Former Preterm Infants with Bronchopulmonary Dysplasia.

BACKGROUND: The clinical utility of echocardiography for the diagnosis of pulmonary vascular disease (PVD) in former preterm infants with bronchopulmonary dysplasia (BPD) is not established. Elevated pulmonary vascular resistance (PVR) rather than pulmonary artery pressure (PAP) is the hallmark of PVD. We evaluated the utility of echocardiography in infants with BPD in diagnosing pulmonary hypertension and PVD (PVR >3 Wood units × m2) assessed by cardiac catheterization. METHODS: A retrospective single center study of 29 infants born ≤29 weeks of gestational age with BPD who underwent cardiac catheterization and echocardiography was performed. PVD was considered present by echocardiography if the tricuspid valve regurgitation jet peak velocity was >2.9 m/sec, post-tricuspid valve shunt systolic flow velocity estimated a right ventricular systolic pressure >35 mm Hg, or systolic septal flattening was present. The utility (accuracy, sensitivity, and positive predictive value [PPV]) of echocardiography in the diagnosis of PVD was tested. Subgroup analysis in patients without post-tricuspid valve shunts was performed. Echocardiographic estimations of right ventricular pressure, dimensions, function, and pulmonary flow measurements were evaluated for correlation with PVR. RESULTS: The duration between echocardiography and cardiac catheterization was a median of 1 day (interquartile range, 1-4 days). Accuracy, sensitivity, and PPV of echocardiography in diagnosing PVD were 72%, 90.5%, and 76%, respectively. Accuracy, sensitivity, and PPV increased to 93%, 91.7%, and 100%, respectively, when infants with post-tricuspid valve shunts were excluded. Echocardiography had poor accuracy in estimating the degree of PAP elevation by cardiac catheterization. In infants without post-tricuspid valve shunts, there was moderate to good correlation between indexed PVR and right ventricular myocardial performance index (rho = 0.89, P = .005), systolic to diastolic time index (0.84, P < .001), right to left ventricular diameter ratio at end systole (0.66, P = .003), and pulmonary artery acceleration time (0.48, P = .05). CONCLUSIONS: Echocardiography performs well in screening for PVD in infants with BPD and may be diagnostic in the absence of a post-tricuspid valve shunt. However, cardiac catheterization is needed to assess the degree of PAP elevation and PVR. The diagnostic utility of echocardiographic measurements that correlate with PVR should be evaluated prospectively in this patient population.

Sharpening upconversion nanoparticles to reduce surface quenching.

Lanthanide-doped upconversion nanocrystals with different surface sharpness properties were synthesized to study the effects of surface sharpness on optical performance. Nanocrystals with hexagonal sharp surfaces showed a significant reduction in the number of surface defects and increased the luminescence intensity by 2.5 times compared to nanocrystals with spherical surfaces.

[Effect of acupoint thread-embedding therapy on the sitting ability of ataxia children with cerebral palsy].

OBJECTIVE: To investigate the effective of acupoint thread-embedding therapy for ataxia children with cerebral palsy. METHODS: A total of 70 ataxia children with cerebral palsy and a Gross Motor Function Measure (GMFM, Dimension B) score of <35 were enrolled and randomly divided into thread-embedding group and control group, with 35 children in each group, and 2 children in the thread-embedding group were lost to follow-up. The children in the control group were given routine rehabilitation treatment, including physical therapy, spleen-strengthening, kidney-nourishing, and Governor Vessel-regulating massage, vibroacoustic therapy, and scalp acupuncture, and those in the thread-embedding group were given thread-embedding therapy at the acupoints of Jianyu (LI15), Jianliao (SJ14), Tianzong (SI11), Tianshu (ST25), and HuatuoJiaji points (C4, L1 and L4) in addition to the treatment in the control group, with 6-8 acupoints selected each time, once a week. Each course of treatment was 4 weeks, with an interval of one week between two courses of treatment, and the children were treated for 3 courses. Level of sitting scale (LSS), incurvation reflex, and GMFM score were recorded to evaluate the improvement in sitting ability and clinical outcome. RESULTS: Both groups had significant improvements in LSS, incurvation reflex, and GMFM (Dimension A and B) score after treatment (P<0.01), and the thread-embedding group had significantly greater improvements than the control group (P<0.01). The thread-embedding group had a significantly higher overall response rate than the control group (90.9% [30/33] vs 68.5% [24/35], P<0.01). CONCLUSION: In addition to routine rehabilitation treatment, acupoint thread-embedding therapy can effectively suppress primitive reflex in ataxia children with cerebral palsy and significantly promote their sitting ability, and therefore, it is an effective acupuncture treatment method for ataxia children with cerebral palsy.