In this experiment, a ZnO-fibre complex was prepared using the hydrothermal methods of "water solubility," "coupling agent," and "high temperature and high pressure". Binding rate, antibacterial activity, microstructure, and the infrared spectrum were measured using biomimetic digestion, bacterial proliferation tests, and ultra-fine electron microscopes. At first, ZnO-fibre complexes were prepared with different ratios of material and water. They was divided into five groups with ratios of 1:0, 1:4, 1:6, 1:8, and 1:10, respectively. The ZnO-fibre complexes were prepared with different coupling agents on the basis of experiment 1. They were divided into four groups. The ratio for material and water in the control group was 1:0, and in the treatment group, was 1:4. Treatment groups 2 and 3 had 10% guar gum or 10% bamboo fibre polymer composites (BFP) added on the basis of group 1. A ZnO-fibre complex was successfully prepared by adding 10% BFP at a ratio of material:water of 1:4, at a high temperature of 120 °C and a high pressure of 0.3 MPa for 20 min. The ZnO-binding rate reached 99.05%. The zinc oxide may bind to the carbonyl group of bamboo powder and adhere to the surface of and gaps in the bamboo fibre. The growth inhibition rate of Escherichia coli, Salmonella, and Staphylococcus aureus was double that of the common ZnO additive and Zn concentration. It is expected to be used as a slow-release ZnO additive.

Abstract Objectives The differentiation between Vestibular Migraine (VM) and Meniere's Disease (MD) is difficult because of overlapping symptoms. The study aimed to compare the clinical characteristics and vestibular function test results between VM and MD patients. Methods Seventy-one patients with definite VM and 31 patients with definite unilateral MD were included. All patients received Caloric Test (CT), Video Head Impulse Test (vHIT) and Vestibular Evoked Myogenic Potential (VEMP) test within 7 days after visiting the hospital. Results of these tests were compared between groups. Results Most VM patients (64.0%) experienced spontaneous internal vertigo, while most MD patients (66.7%) experienced spontaneous external vertigo. MD patients had more severe vestibular symptoms and autonomic responses compared to VM patients during attacks (p= 0.03, p= 0.00, respectively). The nystagmus intensity of CT-induced was greater in VM patients than in MD patients (p= 0.003). More VM patients had CT intolerance and Central Positional Nystagmus (CPN) compared to MD patients (p= 0.002, p = 0.006, respectively). More MD patients had CT(+) and vHIT saccades wave compared to VM patients (p< 0.001, p= 0.002, respectively). The non-elicitation rate of cervical VEMP was higher, and the ocular VEMP amplitudes were lower in MD patients than in VM patients (p = 0.002, p= 0.018). Conclusions Vestibular symptoms during attacks combined with the results of vestibular function tests may be used to differentiate between VM and MD. The diverse nature of vestibular symptoms (especially internal vertigo), history of motion sickness and CT intolerance may provide clues to the diagnosis of VM, whereas spontaneous external vertigo, CT(+) with vHIT(-), and the presence of saccades may provide clues to the diagnosis of MD. Level of evidence: 4.

Abstract Objective: To investigate the clinical features of patients with definite vestibular migraine (dVM). Methods: A total of 91 patients with vestibular symptoms accompanied by migraines/migrainelike symptoms were enrolled and diagnosed according to the criteria of the Bárány Society and the International Headache Society. Baseline data were collected. Videonystagmography and immune-related laboratory tests were performed. Results: Among the 91 patients, 62 (68.1%) had dVM (11 men, 51 women). Among dVM patients, migraine occurred earlier than vestibular symptoms in 42 (67.7%) patients. Spontaneous vertigo occurred in 41 (66.1%) patients. Induced vertigo occurred in 21 (33.9%) patients. Motion sickness occurred in 33 (53.2%) patients. Central oculomotor dysfunction was observed in 11 (17.7%) patients. Caloric test revealed unilateral horizontal semicircular canal dysfunction in 12 (19.4%) patients. Severe intolerance during the test occurred in 44 (71.0%) patients with dVM. 12 (19.4%) patients showed abnormal immune-related indicators. Conclusion: dVM is more common in women. The onset of migraine precedes that of vestibular symptoms, which are often accompanied by photophobia and phonophobia. Motion sickness and severe caloric test intolerance can contribute to the diagnosis of dVM. Immunological indicators are abnormal in some patients with dVM, dVM may be secondary or an accompanying disorder, but the causal relationship needs further investigation. Level of evidence: IV.

Resumo Introdução A vertigem posicional paroxística benigna multicanal é considerada um tipo raro e controverso nas novas diretrizes de diagnóstico da Bárány Society, porque o nistagmo é mais complicado ou atípico, o que é digno de mais estudos. Objetivo Com base nos critérios diagnósticos para a vertigem posicional paroxística benigna multicanal proposta pela International Bárány Society, o estudo teve como objetivo investigar as características clínicas, o diagnóstico e o tratamento da vertigem posicional paroxística benigna multicanal. Método Foram incluídos 41 pacientes com vertigem posicional paroxística benigna multicanal e diagnosticados pelo teste de Dix-Hallpike, roll test ou e teste straight head hanging A redução manual foi feita de acordo com o envolvimento dos canais semicirculares. Resultados Entre os 41 casos, 19 (46,3%) pacientes apresentaram nistagmo de batimento ascendente vertical com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal horizontal-posterior. Onze (26,8%) pacientes apresentaram nistagmo vertical de batimento ascendente com componente de torção de um lado e nistagmo vertical de batimento descendente com ou sem componente de torção do outro lado durante o teste de Dix-Hallpike ou teste straight head hanging e foram diagnosticados com vertigem posicional paroxística benigna do canal posterior-anterior. Nove (26,8%) pacientes apresentaram nistagmo vertical com batimento descendente com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal anterior-horizontal. Dois (4,9%) pacientes apresentaram nistagmo de torção geotrópico vertical de batimento ascendente em ambos os lados e foram diagnosticados com vertigem posicional paroxística benigna de canal posterior bilateral. Foi revelada alta correlação entre os lados com função vestibular reduzida ou perda auditiva e o lado afetado pela vertigem posicional paroxística benigna multicanal (coeficiente de contingência = 0,602, p = 0,010). Durante o seguimento de uma semana, o nistagmo/vertigem foi significativamente aliviado ou desapareceu em 87,8% (36/41) dos pacientes. Conclusões A vertigem posicional paroxística benigna de canal horizontal e posterior foi o tipo mais comum. A vertigem posicional paroxística benigna multicanal que envolveu canal anterior também não foi incomum. Testes calóricos e audiometria tonal pura podem ajudar na determinação do lado afetado. A redução manual foi eficaz na maioria dos pacientes com vertigem posicional paroxística benigna multicanal.

Abstract Introduction Multi-canal benign paroxysmal positional vertigo is considered to be a rare and controversial type in the new diagnostic guidelines of Bárány because the nystagmus is more complicated or atypical, which is worthy of further study. Objective Based on the diagnostic criteria for multi-canal benign paroxysmal positional vertigo proposed by International Bárány Society, the study aimed to investigate the clinical characteristics, diagnosis and treatment of multi-canal benign paroxysmal positional vertigo. Methods A total of 41 patients with multi-canal benign paroxysmal positional vertigo were included and diagnosed by Roll, Dix-Hallpike and straight head hanging tests. Manual reduction was performed according to the involvement of semicircular canals. Results Among the 41 cases, 19 (46.3%) patients showed vertical up-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with posterior-horizontal canal. 11 (26.8%) patients showed vertical up-beating nystagmus with torsional component on one side and vertical down-beating nystagmus with or without torsional component on the other side during Dix-Hallpike test or straight head hanging test and were diagnosed with posterior-anterior canal benign paroxysmal positional vertigo 9 (26.8%) patients showed vertical down-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with anterior-horizontal canal 2 (4.9%) patients showed vertical geotropic torsional up-beating nystagmus on both sides and were diagnosed with bilateral posterior canal benign paroxysmal positional vertigo. High correlation between the sides with reduced vestibular function or hearing loss and the side affected by Multi-canal benign paroxysmal positional vertigo was revealed (contingency coefficient = 0.602, p = 0.010). During one-week follow up, nystagmus/vertigo has been significantly alleviated or disappeared in 87.8% (36/41) patients. Conclusion Posterior-horizontal canal benign paroxysmal positional vertigo was the most common type. Multi-canal benign paroxysmal positional vertigo involving anterior canal was also not uncommon. Caloric tests and pure tone audiometry may help in the determination of the affected side. Manual reduction was effective in most of Multi-canal benign paroxysmal positional vertigo patients.

Abstract Accumulating reports have showed that altered expression of blood-circulating (miRNAs) can serve as diagnostic biomarkers of cancer, but descriptions of serum exosomal miRNAs in AML are still lacking. The present study was designed to measure serum exosomal miR-21 levels in AML patients and explore its correlation with clinical variables and prognosis. In this study, blood samples were collected from 135 AML patients and 60 controls. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect serum exosomal miR-21 expression levels. The data showed that serum exosomal miR-21 levels were significantly higher in AML patients than those in healthy controls. In addition, serum exosomal miR-21 levels were significantly decreased at one month and three months after their treatment. Further receiver operating characteristic (ROC) curve analysis showed that serum exosomal miR-21 level could identify AML patients from normal controls with relative high sensitivity and specificity. Moreover, serum exosomal miR-21 upregulation was closely associated with worse clinical features and shorter survival. In multivariate Cox regression analysis, serum exosomal miR-21 expression showed a significance correlation with survival. In conclusion, serum exosomal miR-21 could be used to predict the diagnosis and prognosis of AML patients.

ABSTRACT Objective: Recently, several studies have found that obesity had a protective effect against varicocele, but no meta-analysis has confirmed this finding. Therefore, we conducted this meta-analysis to investigate the association between body mass index (BMI) and varicocele. Material and Methods: We searched for studies in PubMed, Science Direct and the Cochrane Library from inception until February 2018. The association between BMI and varicocele was assessed by pooling the odds ratios (ORs). Results: Eleven eligible studies with a total study population of 1.376.658 participants were included in our analysis. According to BMI, the subjects were defined as belonging to the obese, overweight and underweight groups. Our results showed that the obese group had a lower risk of varicocele when compared with the normal weight group (odds ratio [OR] 0.46, 95% confidence intervals [CIs] 0.37-0.58). Additionally, an overweight BMI had a protective effect against varicocele (OR 0.70, 95% CIs, 0.56-0.86). However, underweight patients had a more than 30% higher risk of varicocele (OR 1.31, 95% CI, 1.04-1.64). Furthermore, there was no publication bias in any of the analyses. Conclusions: Our study demonstrates that BMI is negatively associated with the presence of varicocele.

Abstract Background: Acupuncture, a therapy of traditional Chinese medicine, is confirmed to exert the therapeutic action on polycystic ovary syndrome (PCOS). However, the detailed therapeutic mechanisms of acupuncture in PCOS remain ambiguous. In this study, we further investigated whether electroacupuncture (EA) alleviated PCOS-like symptoms in rats via regulating a metabolic regulator, sterol regulatory element binding protein-1 (SREBP1). Methods: The PCOS-like rat model was built by hypodermic injection with dehydroepiandrosterone (DHEA). The rats were subjected to EA intervention (ST29 and SP6 acupuncture points) for 5 weeks. Primary granulosa cells were isolated from control and PCOS-like rats for evaluating insulin resistance, mitochondrial dysfunction and oxidative stress in vitro. Results: The expression of SREBP1 was increased in PCOS-like rats, which was suppressed by EA treatment. In addition, lentivirus-mediated overexpression of SREBP1 restrained EA treatment-induced improvement in pathological changes, serum hormone levels and insulin resistance in rats. In addition, overexpression of SREBP1 repressed insulin-stimulated phosphorylation of insulin receptor β (IR) and AKT in primary granulosa cells. Moreover, upregulation of SREBP1 further exacerbated mitochondrial dysfunction and oxidative stress in granulosa cells isolated from PCOS-like rats. Mechanically, EA treatment suppressed SREBP1 expression through inducing the activation of AMP-activated protein kinase (AMPK) signaling pathway in PCOS-like rats. Conclusion: EA intervention alleviated PCOS-like symptoms in rats via improving IR, mitochondrial dysfunction and oxidative stress through regulating SREBP1, a lipid metabolism regulator. Our findings illuminate the novel protective mechanisms of EA in the treatment of PCOS.

Abstract Background: Neuronal apoptosis plays a critical event in the pathogenesis of early brain injury after subarachnoid hemorrhage (SAH). This study investigated the roles of Tauroursodeoxycholic acid (TUDCA) in attenuate neuronal apoptosis and underlying mechanisms after SAH. Methods: Sprague-Dawley rats were subjected to model of SAH and TUDCA was administered via the internal carotid injection. Small interfering RNA (siRNA) for TGR5 were administered through intracerebroventricular injection 48 h before SAH. Neurological scores, brain water content, Western blot, TUNEL staining and immunofluorescence staining were evaluated. Results: TUDCA alleviated brain water content and improved neurological scores at 24 h and 72 h after SAH. TUDCA administration prevented the reduction of SIRT3 and BCL-2 expressions, as well as the increase of BAX and cleaved caspase-3.Endogenous TGR5 expression were upregulated after SAH and treatment with TGR5 siRNA exacerbated neurological outcomes after SAH and the protective effects of TUDCA at 24 h after SAH were also abolished by TGR5 siRNA. Conclusions: Our findings demonstrate that TUDCA could attenuated neuronal apoptosis and improve neurological functions through TGR5/ SIRT3 signaling pathway after SAH. TUDCA may be an attractive candidate for anti-apoptosis treatment in SAH.

The current study was designed to investigate the perinatal risk factors for low 1-min Apgar scores in term neonates. We retrospectively analyzed the maternal and neonatal clinical data of 10,550 infants who were born through vaginal delivery from 37 weeks 0 days to 41 weeks 6 days of single gestation from January 2013 to July 2018. Because the 1-min Apgar score reflects neonatal status at birth, we analyzed the risk factors for low (score <7) 1-min Apgar scores through logistic regression. Among these 10,550 neonates, 339 (3.2%) had low (score <7) 1-min Apgar scores. Among them, 321 (94.7%) were admitted to the neonatology department for further observation or treatment. Multivariate analysis revealed that educational background, body mass index, gestational age, pathological obstetrics, longer duration of the second stage of labor, forceps delivery or vacuum extraction, neonatal weight, neonatal sex, and meconium-stained amniotic fluid were independent risk factors for 1-min Apgar scores <7. Neonates who had low 1-min Apgar scores were more frequently admitted to the neonatology department for further observation or treatment. Early detection of risk factors and timely intervention to address these factors may improve neonatal outcomes at birth and reduce the rate of admission to the neonatology department.

We aimed to explore the imbalance between the T helper 17 γδT cells (γδT17) and the regulatory γδT cells (γδTreg) in asthmatic mice. Male Balb/c mice were randomly divided into the normal control group and the asthmatic model group. The asthmatic model group mice were intraperitoneally injected with the mixture of ovalbumin (OVA)/Al(OH)3 and then activated by exposure of the animals to OVA atomization. Airway hyperresponsiveness (AHR) was determined by a non-invasive lung function machine. Hematoxylin and eosin and Alcian blue-periodic acid Schiff staining were done for histopathological analysis. Interleukin (IL)-17 and IL-35 levels in bronchoalveolar lavage fluid were detected by ELISA. The percentage of IL-17+ γδT cells and Foxp3+ γδT cells in spleen cells suspension were detected and the transcription levels of RORγt and Foxp3 in the lung tissue were determined. Compared with the normal control, the severity of airway inflammation and AHR were higher in the asthmatic mice. Furthermore, mice in the asthmatic group displayed significant increases of IL-17+ γδT cells, expression of IL-17A, and RORγt, whereas control mice displayed marked decreases of Foxp3+ γδT cells, expression of IL-35, and transcription factor Foxp3. In addition, the mRNA expression of RORγt was positively correlated with the percentage of IL-17+γδT cells, and the mRNA level of Foxp3 was positively correlated with the percentage of Foxp3+ γδT cells. The imbalance of γδT17/γδTreg in the asthmatic mice may contribute to the pathogenesis of OVA-induced asthma.

Abstract Objective Hand hygiene (HH) is a critical component for controlling hospital-acquired infection (HAI). The present study was designed to develop an intervention approach to improve compliance with HH among healthcare workers in a hospital setting. Methods The HH intervention study was conducted in Guizhou Provincial People's Hospital, Guiyang, China and organized by its Department of HAI Management. It was an observational, prospective, quasiexperimental (before-after intervention) study. The study was divided into two phases: the baseline phase and the intervention phase. The investigative team included clinical monitoring staff and infection control practitioners who received a series of instructions on HH compliance, monitoring skills, and measurement of the use of HH products. Results Based on 27,852 observations in a 17-month period, the rate of compliance with HH improved from 37.78% at baseline to 75.90% after intervention. Significant improvement in compliance and an increase in consumption of HH products was observed after intervention. The per patient-day consumption of alcohol-based hand rub products and handwash agents increased by 4.75 mL and 4.55 mL, respectively. The consumption of paper towels increased 3.41 sheets per patient-day. During the same period, the prevalence rate of HAI decreased 0.83%. Conclusions This study demonstrates that a significant improvement in compliance with HH can be achieved through a systemic, multidimensional intervention approach involving all categories of healthcare workers in a hospital setting, which may result in a decrease of the HAI rate.

ABSTRACT PURPOSE: To determine whether Toll-like receptor 7 (TLR7) is the potential targets of prevention or progression in the renal ischemia/reperfusion (I/R) injury of STZ-induced diabetic rats. METHODS: Thirty six Sprague-Dawley rats were randomly arranged to the nondiabetic (ND) or diabetic group (DM), with each group further divided into sham (no I/R injury), I/R (ischemia-reperfusion) and CD (given by Chloroquine) group. Preoperatively, Chloroquine (40 mg/kg, intraperitoneal injection.) was administrated 6 days for treatment group. I/R animals were subjected to 25 min of bilateral renal ischemia. Renal function, histology, apoptosis, cytokines, expression of TLR7, MyD88 and NF-κB were detected. RESULTS: The serum levels of blood urea nitrogen, creatinine, IL-6 and TNF-α, apoptotic tubular epithelial cells, expression of TLR7, MyD88 and NF-κB were significantly increased in DM+I/R group, compared with ND+I/R group (p<0.05). All these changes were further improved by TLR7 inhibition Chloroquine except Paller scores (p<0.05). CONCLUSION: Toll-like receptor 7 inhibition attenuates the acute renal ischemia/reperfusion injury of STZ-induced diabetic in SD rats.

Abstract Zea mays L. has been the most cultivated crop and the crop with the largest yield in China since 2012. We constructed a bacterial artificial chromosome (BAC) library for the maize inbred line Qi319, which may be used as a key source for disease-resistant maize breeding in China. The BAC contains 270,720 clones, with an average insert size of 90 kb. The coverage of the library is about 10.43 genome equivalents when considering a haploid genome size of 2300 Mb, providing a 99.99% likelihood of isolating any maize gene or sequence in the library. An average of 12 clones were obtained by polymerase chain reaction screening by using primer pairs linked to the genes for resistance to maize southern rust and rough dwarf. The results indicate that the library can satisfy the requirements for recovering specific sequences. The library is available to researchers to whom it may be of interest.

The aim of this study was to establish whether the use of an extramedullary or intramedullary tibial cutting guide leads to superior mechanical leg axis and implant positioning. A meta-analysis of six randomized controlled trials including 350 knees was performed. For the mechanical axis, frontal tibial component angle and tibial slope, there were no significant differences in the mean values or the number of outliers (±3°) between the extramedullary and intramedullary groups. A reduced tourniquet time was associated with the intramedullary guide. No significant difference in the complication rate was noted between the two groups. Neither extramedullary nor intramedullary tibial alignment was more accurate in facilitating the tibial cut. Use of an intramedullary guide results in a shorter tourniquet time and exhibits a similar complication rate as the extramedullary guide.

Thymosin alpha 1 (Tα1) has been shown to have beneficial effects on numerous immune system parameters, but little is known about the effects of Tα1 on patients with gastric carcinoma. The objective of this study was to determine the effect of Tα1 on subpopulations of Th1, Th2, Th17, and regulatory T cells (Tregs) in vitro, and to evaluate its efficacy as an immunoregulatory factor in patients with gastric carcinoma. We compared the effect of Tα1 on the frequency of CD4+ and CD8+ T cells, especially the CD4+CD25+Foxp3+ Tregs in peripheral blood mononuclear cells (PBMCs) from gastric carcinoma patients (N = 35) and healthy donors (N = 22). We also analyzed the changes in the proliferation of PBMCs in response to treatment with Tα1, and examined the production of Th1, Th2, and Th17 cytokines by PBMCs and tumor-infiltrating lymphocytes. The treatment of PBMCs from gastric cancer patients, with Tα1 (50 µg/mL) alone increased the percentage of CD4+CD25+Foxp3+ (suppressive antitumor-specific Tregs) from 1.68 ± 0.697 to 2.19 ± 0.795% (P < 0.05). Our results indicate that Tα1 increases the percentage of Tregs and IL-1β, TNF-α, and IL-6 in vitro.