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This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
A novel theoretical model for bubble dynamics is established that simultaneously accounts for the liquid compressibility, phase transition, oscillation, migration, ambient flow field, etc. The bubble dynamics equations are presented in a unified and concise mathematical form, with clear physical meanings and extensibility. The bubble oscillation equation can be simplified to the Keller–Miksis equation by neglecting the effects of phase transition and bubble migration. The present theoretical model effectively captures the experimental results for bubbles generated in free fields, near free surfaces, adjacent to rigid walls, and in the vicinity of other bubbles. Based on the present theory, we explore the effect of the bubble content by changing the vapour proportion inside the cavitation bubble for an initial high-pressure bubble. It is found that the energy loss of the bubble shows a consistent increase with increasing Mach number and initial vapour proportion. However, the radiated pressure peak by the bubble at the collapse stage increases with decreasing Mach number and increasing vapour proportion. The energy analyses of the bubble reveal that the presence of vapour inside the bubble not only directly contributes to the energy loss of the bubble through phase transition but also intensifies the bubble collapse, which leads to greater radiation of energy into the surrounding flow field due to the fluid compressibility.
Schistosomiasis, a parasite infectious disease caused by Schistosoma japonicum, often leads to egg granuloma and fibrosis due to the inflammatory reaction triggered by egg antigens released in the host liver. This study focuses on the role of the egg antigens CP1412 protein of S. japonicum (SjCP1412) with RNase activity in promoting liver fibrosis. In this study, the recombinant egg ribonuclease SjCP1412, which had RNase activity, was successfully prepared. By analysing the serum of the population, it has been proven that the anti-SjCP1412 IgG in the serum of patients with advanced schistosomiasis was moderately correlated with liver fibrosis, and SjCP1412 may be an important antigen associated with liver fibrosis in schistosomiasis. In vitro, the rSjCP1412 protein induced the human liver cancer cell line Hep G2 and liver sinusoidal endothelial cells apoptosis and necrosis and the release of proinflammatory damage-associated molecular patterns (DAMPs). In mice infected with schistosomes, rSjCP1412 immunization or antibody neutralization of SjCP1412 activity significantly reduced cell apoptosis and necroptosis in liver tissue, thereby reducing inflammation and liver fibrosis. In summary, the SjCP1412 protein plays a crucial role in promoting liver fibrosis during schistosomiasis through mediating the liver cells apoptosis and necroptosis to release DAMPs inducing an inflammatory reaction. Blocking SjCP1412 activity could inhibit its proapoptotic and necrotic effects and alleviate hepatic fibrosis. These findings suggest that SjCP1412 may be served as a promising drug target for managing liver fibrosis in schistosomiasis japonica.
Previous research indicates that parental emotion socialization (ES) practices play important roles in adolescents’ social and emotional development. However, longitudinal studies testing bidirectional effects are relatively scarce. Additionally, most studies have focused on people from Western societies. In the current 3-year, multi-informant, longitudinal study of Chinese adolescents and their parents, we investigated prospective bidirectional effects between parental positive ES practices and adolescents’ psychosocial adjustment (i.e., self-esteem and depressive symptoms). Adolescents (N = 710 at T1, 50% boys, Mage = 12.41, SD = 0.59) reported on parental positive ES practices and their own depressive symptoms and self-esteem when they were in 7th, 8th, and 9th grade. Mothers and fathers reported on their own use of positive ES practices at all three time points. We utilized a random intercept cross-lagged panel model to examine between- and within-family effects. Overall results showed robust effects of adolescent depressive symptoms on parental positive ES practices and bidirectional effects between parental ES and adolescent self-esteem. Effects differed by informants whether using adolescent-perceived data, or mother- or father-reported data. However, these child effects and bidirectional effects did not differ by adolescent sex. Our findings add to the understanding of parental ES and adolescent psychosocial adjustment.
As electrode materials, metal-organic frameworks always have low electrical conductivity and poor structural stability, which limits its applications in electrochemical fields. Here, Ni-BPDC/GO composites are synthesized using graphene oxide (GO) as a substrate and 4,4′-biphenyldicarboxylic acid (BPDC) as an organic ligand via a hydrothermal approach. The growth mechanism of the Ni-BPDC and Ni-BPDC/GO composites is proposed. In the composites, highly dispersed Ni-BPDC macro-nanostrips are supported on the GO surface in parallel. The presence of GO does not affect the growth and crystalline structure of Ni-BPDC. Compared with the Ni-BPDC, Ni-BPDC/GO composites exhibit higher specific capacitance, rate capability, and operating current density through lowering intrinsic resistance, charge-transfer resistance, and ion diffusion impedance. Moreover, the assembled Ni-BPDC/GO-3//reduced graphene oxide (rGO) asymmetric supercapacitor has large specific capacitance, good cycling stability, and high energy density (16.5 W h/kg at 250 W/kg). Hence, Ni-BPDC/GO composites are a potential electrode material for supercapacitors.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
Design:
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Setting:
Southwest China.
Participants:
Pregnant women (n 1910) in 2017.
Results:
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Conclusions:
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
Over the recent years, potential associations between Toxoplasma gondii (T. gondii) infection and cancer risk have attracted a lot of attention. Nevertheless, the association between T. gondii infection and oral cancer remains relatively unexplored. We performed a case–control study of 861 oral cancer patients and 861 control subjects from eastern China with the aim to detect antibodies to T. gondii by enzyme-linked immunosorbent assay (ELISA) in these patients. The results showed that oral cancer patients (21.72%, 187/861) had a significantly higher seroprevalence than control subjects (8.25%, 71/861) (P < 0.001). Among them, 144 (16.72%) oral cancer patients and 71 (8.25%) control subjects were positive for IgG antibodies to T. gondii, while 54 (6.27%) oral cancer patients and 9 (1.05%) controls were positive for IgM antibodies to T. gondii. In addition, multiple logistic analysis showed that T. gondii infection in oral cancer patients was associated with blood transfusion history, keeping cats at home, and oyster consumption. To our knowledge, this is the first study that provided a serological evidence of an association between T. gondii infection and oral cancer patients. However, further studies are necessary to elucidate the role of T. gondii in oral cancer patients.
Nyböite occurs as porphyroblasts in the Jianchang eclogite in the Donghai area, northeastern Jiangsu Province, eastern China. The Jianchang eclogite contains some inclusions of quartz after coesite in clinopyroxene, garnet and epidote. It has colourless to pale-violet pleochroism. A thin rim with violet pleochroism often develops around nyb6ite and is taramitic. It is further retrogressed by the symplectite which is mainly composed of hornblende, aegirine-augite and albite. Nyböite is associated with jadeitic pyroxene in the Jianchang eclogite, although other porphyroblastic amphiboles in other Donghai eclogites are barroisitic to katophoritic and are associated with omphacite.
Fe-Mg partitioning between garnet and clinopyroxene and the presence of coesite pseudomorphs indicate P-T conditions in the Jianchang eclogite of about 740 ± 60°C and more than 28 kbar. Similar P-T conditions were estimated for other porphyroblastic amphibole-bearing eclogites in the Donghai area. Nyböite can occur in the Na-Al-Fe-rich local bulk composition under the medium to high temperature and very high-pressure conditions. Retrograde rim amphibole is poorer in NaB, variable in Si content, and richer in NaA variable than the porphyroblastic amphibole in the Donghai area. This roughly implies a P-T path where P decreases without a large decrease of T.
As one of the major components of the Himalayan–Tibetan Orogeny, the Lhasa terrane plays a key role in understanding the origin and evolution of this giant orogenic belt and the opening and closure of the Tethys oceans. The eclogite-bearing Sumdo Complex in the central Lhasa terrane was recognized as the main suture of the Palaeo-Tethys Ocean between the north and south Lhasa sub-terranes. Despite the eclogite having been studied for a long time, no attempts have been applied to studying the country rocks, causing confusion in understanding the relationship between the eclogite and the adjacent schist. Petrological investigations and phase equilibrium calculations on the garnet-bearing mica schist of the Sumdo Complex have been performed to constrain its metamorphic evolution. The P–T conditions for three metamorphic stages are constrained as P1 (480–500°C, 2.6–2.7 GPa), P2 (580–600°C, 1.3–1.4 GPa) and R (530°C, 0.9 GPa), which represent the prograde, temperature peak and retrograde stages. Two possible P–T paths were constructed, which experienced isothermal decompression (PT1) or heating with a decompression process (PT2), corresponding to the growth and extinction of garnet porphyroblasts in the matrix. The LA-MC-ICP-MS U–Pb dating method yielded a metamorphic age of 229.7±3.5 Ma, which was interpreted as the age of amphibolite-facies metamorphism at c. 600°C, 1.2–1.4 GPa during the closure of the Palaeo-Tethys Ocean, resulting in the aggregation of the north and south Lhasa sub-terranes. The close relationship between the eclogite and garnet-bearing mica schist, and their similar P–T–t paths indicate an in situ tectonic evolution rather than tectonic juxtaposition during exhumation.
The role of the protozoan parasite Toxoplasma gondii in the pathogenesis of liver disease has recently gained much interest. The aim of this study was to determine the prevalence and risk factors associated with T. gondii infection in patients with liver disease from three cities in Shandong and Henan provinces, China. A case–control study was conducted from December 2014 to November 2015 and included 1142 patients with liver disease and 1142 healthy controls. Serum samples were collected from all individuals and were examined with enzyme-linked immunosorbent assay for the presence of anti-T. gondii IgG and IgM antibodies. Information on the demographics, clinical, and lifestyle characteristics of the participants was collected from the medical records and by the use of a questionnaire. The prevalence of anti-T. gondii IgG was 19·7% in patients with liver disease compared with 12·17% in the controls. Only 13 patients had anti-T. gondii IgM antibodies compared with 12 control individuals (1·14% vs. 1·05%, respectively). The highest seroprevalence was detected in patients with liver cancer (22·13%), followed by hepatitis patients (20·86%), liver cirrhosis patients (20·42%), and steatosis patients (20%). Multivariate logistic regression analysis indicated that consumption of raw meat (odds ratio (OR) = 1·32; 95% confidence interval (CI) 1·01–1·71; P = 0·03) and source of drinking water from wells (OR = 1·56; 95% CI 1·08–2·27; P = 0·01) were independent risk factors for T. gondii infection in liver disease patients. These findings indicate that T. gondii infection is more likely to be present in patients with liver disease. Therefore, efforts should be directed toward health education of populations at high risk of T. gondii infection and measures should be taken to protect vulnerable patients with liver disease.
We investigate theoretically the field-free orientation of CO molecules induced by a single-cycle THz laser pulse train. It is shown that the molecular orientation can be obviously enhanced by applying the pulse train. The laser intensity and pulse number have some effects on the molecular orientation. The high degree of field-free molecular orientation |⟨cosθ⟩|max=0.9246 is obtained at temperature T=0 K. The variations of the maximum orientation degree with the experimentally available pulse number and peak intensity are given. Temperature T has a considerable influence on the field-free molecular orientation. The maximal field-free molecular orientation at T=0, 10, 20 and 30 K for N=14 and E0=1.8 MV/cm are |⟨cosθ⟩|max=0.9188, 0.7338, 0.6055 and 0.5154 in order, and the corresponding effective duration times of molecular orientation are Δt=0.759, 0.432, 0.297 and 0.117 ps.
Identification of individuals within pairs of monozygotic (MZ) twins remains unresolved using common forensic DNA typing technology. For some criminal cases involving MZ twins as suspects, the twins had to be released due to inability to identify which of the pair was the perpetrator. In this study, we performed a genome-wide scan on whole blood-derived DNA from four pairs of healthy phenotypically concordant MZ twins using the methylated DNA immunoprecipitation sequencing technology to identify candidate DNA methylation markers with capacity to distinguish MZ twins within a pair. We identified 38 differential methylation regions showing within-pair methylation differences in all four MZ pairs. These are all located in CpG islands, 17 of which are promoter-associated, 17 are intergenic islands, and four are intragenic islands. Genes associated with these markers are related with cell proliferation, differentiation, and growth and development, including zinc finger proteins, PRRX2, RBBP9, or are involved in G-protein signaling, such as the regulator of G-protein signaling 16. Further validation studies on additional MZ twins are now required to evaluate the broader utility of these 38 markers for forensic use.
The current meta-analysis evaluated the association between vitamin B12 intake and blood vitamin B12 level and colorectal cancer (CRC) risk.
Design
The PubMed and EMBASE databases were searched. A dose–response analysis was performed with generalized least squares regression, with the relative risk (RR) and 95 % CI as effect values.
Setting
The meta-analysis included seventeen studies.
Subjects
A total of 10 601 patients.
Results
The non-linear dose–response relationship between total vitamin B12 intake and CRC risk was insignificant (P=0·690), but the relationship between dietary vitamin B12 intake and CRC risk was significant (P<0·001). Every 4·5 μg/d increment in total and dietary vitamin B12 intake was inversely associated with CRC risk (total intake: RR=0·963; 95 % CI 0·928, 0·999; dietary intake: RR=0·914; 95 % CI 0·856, 0·977). The inverse association between vitamin B12 intake and CRC risk was also significant when vitamin B12 intake was over a dosage threshold, enhancing the non-linear relationship. The non-linear dose–response relationship between blood vitamin B12 level and CRC risk was insignificant (P=0·219). There was an insignificant association between every 150 pmol/l increment in blood vitamin B12 level and CRC risk (RR=1·023; 95 % CI 0·881, 1·187).
Conclusions
Our meta-analysis indicates that evidence supports the use of vitamin B12 for cancer prevention, especially among populations with high-dose vitamin B12 intake, and that the association between CRC risk and total vitamin B12 intake is stronger than between CRC risk and dietary vitamin B12 intake only.
Studies in Western countries have repeatedly shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in China?
Method
Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 1970 clinically ascertained with recurrent MD and 2597 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression and regression coefficients by linear or Poisson regression.
Results
Any form of CSA was significantly associated with recurrent MD [OR 3.26, 95% confidence interval (CI) 1.95–5.45]. This association strengthened with increasing CSA severity: non-genital (OR 2.47, 95% CI 1.17–5.23), genital (OR 2.77, 95% CI 1.32–5.83) and intercourse (OR 13.35, 95% CI 1.83–97.42). The association between any form of CSA and MD remained significant after accounting for parental history of depression, childhood emotional neglect (CEN), childhood physical abuse (CPA) and parent–child relationship. Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes and an increased risk for generalized anxiety disorder (GAD; OR 1.92, 95% CI 1.39–2.66) and dysthymia (OR 2.16, 95% CI 1.52–3.09).
Conclusions
In Chinese women CSA is strongly associated with MD and this association increases with greater severity of CSA. Depressed women with CSA have an earlier age of onset, longer depressive episodes and increased co-morbidity with GAD and dysthymia. Although reporting biases cannot be ruled out, our results are consistent with the hypothesis that, as in Western countries, CSA substantially increases the risk for MD in China.
Gut hormones play key roles in the regulation of energy homeostasis. However, little is known about the long- and short-term effects of changing dietary fat content on gut hormones. We aim to examine the effects of changing dietary fat content on plasma gut hormone concentrations in diet-induced obese (DIO) and diet-resistant (DR) rats. After inducing obesity with a high-fat (HF) diet, male Sprague–Dawley rats were divided into three groups according to their body-weight gain: DIO; DR; control (CON). The DIO and DR rats were further divided in random into two groups. One continued on a HF diet and the other switched to a low-fat (LF) diet for an additional 4 weeks. Finally, each group was randomly divided into three subgroups (n 8): fasted; fasted-refed HF; fasted-refed LF diet groups. Replacing a HF diet with a LF diet for 4 weeks resulted in less fat mass, higher fasting and post-HF plasma ghrelin concentration and lower postprandial plasma cholecystokinin concentration in the DIO and DR rats. Acute switching dietary fat resulted in significantly higher post-HF plasma ghrelin concentrations than post-LF ghrelin concentrations in the DR rats on LF diet (DRLF) and DIO rats on LF diet (DIOLF) rats, and significantly higher post-HF obestatin concentrations than post-LF obestatin concentrations in the CON, DR rats on HF diet (DRHF) and DRLF rats. Dietary fat content appears to play a role in the gut hormone profile, which may consequently influence fat mass.
We investigate the global asymptotic stability for positive solutions to a class of general symmetric rational difference equations and prove that the unique positive equilibrium 1 of the general symmetric rational difference equations is globally asymptotically stable. As a special case of our result, we solve the conjecture raised by Berenhaut, Foley and Stević [‘The global attractivity of the rational difference equation yn=(yn−k+yn−m)/(1+yn−kyn−m)’, Appl. Math. Lett.20 (2007), 54–58].
MgxZn1−xO films were grown on quartz substrates at 773 K by using radio frequency magnetron sputtering with a mixture of argon and nitrogen as sputtering gases. The nitrogen concentration in the mixture is characterized by the nitrogen partial pressure ratio, which is determined by the ratio of nitrogen flow rate to the flow rates of nitrogen and argon. It was found that Mg concentration, structure, and band gap of the MgxZn1−xO film could be tuned by changing the nitrogen partial pressure ratio of the sputtering gases. The Mg concentration in the MgxZn1−xO film increases with increasing nitrogen partial pressure ratio. The MgxZn1−xO film consists of wurtzite phase at the ratios from 0% to 50%, mixture of wurtzite and cubic phases at the ratios between 50% and 83%, and cubic phase at 100%. The band gap of the MgxZn1−xO film with wurtzite and cubic structure increases as the ratio rises. The variation of the structure and band gap is attributed to change of the Mg concentration, which results from loss of the O and Zn atoms during growth process, the former is induced by reaction between N and O, and the latter by re-evaporation of Zn atoms due to high substrate temperature. The mechanism of the loss of the O and Zn atoms is discussed based on thermodynamics.
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