ABSTRACT Objective: The purpose of present study was to comprehensively explore the efficacy and safety of prothrombin complex concentrate (PCC) to treat massive bleeding in patients undergoing cardiac surgery. Methods: PubMed®, Embase, and Cochrane Library databases were searched for studies investigating PCC administration during cardiac surgery published before September 10, 2022. Mean difference (MD) with 95% confidence interval (CI) was applied to analyze continuous data, and dichotomous data were analyzed as risk ratio (RR) with 95% CI. Results: Twelve studies were included in the meta-analysis. Compared with other non-PCC treatment regimens, PCC was not associated with elevated mortality (RR=1.18, 95% CI=0.86–1.60, P=0.30, I2=0%), shorter hospital stay (MD=-2.17 days; 95% CI=-5.62–1.28, P=0.22, I2=91%), reduced total thoracic drainage (MD=-67.94 ml, 95% CI=-239.52–103.65, P=0.44, I2=91%), thromboembolic events (RR=1.10, 95% CI=0.74–1.65, P=0.63, I2=39%), increase in atrial fibrillation events (RR=0.73, 95% CI=0.52–1.05, P=0.24, I2=29%), and myocardial infarction (RR=1.10, 95% CI=0.80–1.51, P=0.57, I2=81%). However, PCC use was associated with reduced intensive care unit length of stay (MD=-0.81 days, 95% CI=-1.48– -0.13, P=0.02, I2=0%), bleeding (MD=-248.67 ml, 95% CI=-465.36– -31.97, P=0.02, I2=84%), and intra-aortic balloon pump/extracorporeal membrane oxygenation (RR=0.65, 95% CI=0.42–0.996, P=0.05, I2=0%) when compared with non-PCC treatment regimens. Conclusion: The use of PCC in cardiac surgery did not correlate with mortality, length of hospital stay, thoracic drainage, atrial fibrillation, myocardial infarction, and thromboembolic events. However, PCC significantly improved postoperative intensive care unit length of stay, bleeding, and intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in patients undergoing cardiac surgery. Objective (PCC Methods PubMed PubMed® Embase 10 2022 MD (MD 95 CI (CI RR (RR Results metaanalysis. metaanalysis meta analysis. analysis meta-analysis nonPCC non regimens RR=1.18, RR118 1 18 (RR=1.18 CI086160 0 86 60 CI=0.86–1.60 P030 P 30 P=0.30 I2=0%, I20 I I2=0% , I2 MD=2.17 MD217 MD= 2.17 2 17 (MD=-2.1 days CI=5.62–1.28, CI562128 CI= 5.62–1.28, 5 62 28 CI=-5.62–1.28 P022 22 P=0.22 I2=91%, I291 I2=91% 91 I2=91%) MD=67.94 MD6794 67.94 67 94 (MD=-67.9 ml CI=239.52–103.65, CI2395210365 239.52–103.65, 239 52 103 65 CI=-239.52–103.65 P044 44 P=0.44 RR=1.10, RR110 (RR=1.10 CI074165 74 CI=0.74–1.65 P063 63 P=0.63 I2=39%, I239 I2=39% 39 I2=39%) RR=0.73, RR073 73 (RR=0.73 CI052105 05 CI=0.52–1.05 P024 24 P=0.24 I2=29%, I229 I2=29% 29 I2=29%) CI080151 80 51 CI=0.80–1.51 P057 57 P=0.57 I2=81%. I281 I2=81% . 81 I2=81%) However MD=0.81 MD081 0.81 (MD=-0.8 CI=1.48– CI148 1.48– 48 CI=-1.48 0.13, 013 13 -0.13 P002 02 P=0.02 MD=248.67 MD24867 248.67 248 (MD=-248.6 CI=465.36– CI46536 465.36– 465 36 CI=-465.36 31.97, 3197 31 97 -31.97 I2=84%, I284 I2=84% 84 I2=84%) intraaortic intra aortic pumpextracorporeal pump RR=0.65, RR065 (RR=0.65 CI0420996 42 996 CI=0.42–0.996 P005 P=0.05 Conclusion 202 9 RR=1.18 RR11 (RR=1.1 CI08616 8 6 CI=0.86–1.6 P03 3 P=0.3 I2=0 MD=2.1 MD21 217 2.1 (MD=-2. CI=5.62–1.28 CI56212 562128 5.62–1.28 CI=-5.62–1.2 P02 P=0.2 I29 I2=91 MD=67.9 MD679 6794 67.9 (MD=-67. CI=239.52–103.65 CI239521036 2395210365 239.52–103.65 23 CI=-239.52–103.6 P04 4 P=0.4 RR=1.10 CI07416 7 CI=0.74–1.6 P06 P=0.6 I23 I2=39 RR=0.73 RR07 (RR=0.7 CI05210 CI=0.52–1.0 I22 I2=29 CI08015 CI=0.80–1.5 P05 P=0.5 I28 I2=81 MD=0.8 MD08 081 0.8 (MD=-0. CI=1.48 CI14 148 1.48 CI=-1.4 0.13 01 -0.1 P00 P=0.0 MD=248.6 MD2486 24867 248.6 (MD=-248. CI=465.36 CI4653 46536 465.36 46 CI=-465.3 31.97 319 -31.9 I2=84 RR=0.65 RR06 (RR=0.6 CI042099 99 CI=0.42–0.99 20 RR=1.1 RR1 (RR=1. CI0861 CI=0.86–1. P0 P=0. I2= MD=2. MD2 21 2. (MD=-2 CI=5.62–1.2 CI5621 56212 5.62–1.2 CI=-5.62–1. I2=9 MD=67. MD67 679 67. (MD=-67 CI=239.52–103.6 CI23952103 239521036 239.52–103.6 CI=-239.52–103. CI0741 CI=0.74–1. I2=3 RR=0.7 RR0 (RR=0. CI0521 CI=0.52–1. I2=2 CI0801 CI=0.80–1. I2=8 MD=0. MD0 08 0. (MD=-0 CI=1.4 CI1 14 1.4 CI=-1. 0.1 -0. MD=248. MD248 2486 248. (MD=-248 CI=465.3 CI465 4653 465.3 CI=-465. 31.9 -31. RR=0.6 CI04209 CI=0.42–0.9 RR=1. (RR=1 CI086 CI=0.86–1 P=0 MD=2 (MD=- CI=5.62–1. CI562 5621 5.62–1. CI=-5.62–1 MD=67 MD6 (MD=-6 CI=239.52–103. CI2395210 23952103 239.52–103. CI=-239.52–103 CI074 CI=0.74–1 RR=0. (RR=0 CI052 CI=0.52–1 CI080 CI=0.80–1 MD=0 CI=1. 1. CI=-1 -0 MD=248 MD24 (MD=-24 CI=465. CI46 465. CI=-465 31. -31 CI0420 CI=0.42–0. RR=1 (RR= CI08 CI=0.86– P= (MD= CI=5.62–1 CI56 562 5.62–1 CI=-5.62– MD=6 CI=239.52–103 CI239521 2395210 239.52–103 CI=-239.52–10 CI07 CI=0.74– RR=0 CI05 CI=0.52– CI=0.80– CI=1 CI=- - MD=24 CI=465 CI4 CI=-46 -3 CI042 CI=0.42–0 RR= CI0 CI=0.86 CI=5.62– CI5 56 5.62– CI=-5.62 CI=239.52–10 CI23952 239521 239.52–10 CI=-239.52–1 CI=0.74 CI=0.52 CI=0.80 CI=46 CI=-4 CI04 CI=0.42– CI=0.8 CI=5.62 5.62 CI=-5.6 CI=239.52–1 CI2395 23952 239.52–1 CI=-239.52– CI=0.7 CI=0.5 CI=4 CI=0.42 CI=0. CI=5.6 5.6 CI=-5. CI=239.52– CI239 2395 239.52– CI=-239.52 CI=0.4 CI=0 CI=5. 5. CI=-5 CI=239.52 CI23 239.52 CI=-239.5 CI=5 CI=239.5 CI2 239.5 CI=-239. CI=239. 239. CI=-239 CI=239 CI=-23 CI=23 CI=-2 CI=2

Abstract Objective Early diagnosis of Severity Mycoplasma Pneumoniae Pneumonia (SMPP) has been a worldwide concern in clinical practice. Two cytokines, soluble Triggering Receptor Expressed on Myeloid cells (sTREM-1) and Interferon-Inducible Protein-10 (IP-10), were proved to be implicated in bacterial infection diseases. However, the diagnostic value of sTREM-1 and IP-10 in MPP was poorly known. This study aimed to investigate the diagnostic value of sTREM-1 and IP-10 for SMPP. Methods In this prospective study, the authors enrolled 44 children with MPP, along with their clinical information. Blood samples were collected, and cytokine levels of sTREM-1 and IP-10 were detected with ELISA assay. Results Serum levels of sTREM-1 and IP-10 were positively correlated with the severity of MPP. In addition, sTREM-1 and IP-10 have significant potential in the diagnosis of SMPP with an Area Under Curve (AUC) of 0.8564 (p-value = 0.0001, 95% CI 0.7461 to 0.9668) and 0.8086 (p-value = 0.0002, 95% CI 0.6918 to 0.9254) respectively. Notably, the combined diagnostic value of sTREM-1 and IP-10 is up to 0.911 in children with SMPP (p-value < 0.001, 95% CI 0.830 to 0.993). Conclusions Serum cytokine levels of sTREM-1 and IP-10 have a great potential diagnostic value in children with SMPP. (SMPP practice cytokines sTREM1 sTREM 1 (sTREM-1 InterferonInducible Interferon Inducible Protein10 Protein 10 Protein-1 IP10, IP10 IP , (IP-10) diseases However sTREM- IP-1 known 4 information collected assay addition AUC (AUC 08564 0 8564 0.856 pvalue p 00001 0001 0.0001 95 07461 7461 0.746 0.9668 09668 9668 08086 8086 0.808 00002 0002 0.0002 06918 6918 0.691 0.9254 09254 9254 respectively Notably 0911 911 0.91 001 0.001 0830 830 0.83 0.993. 0993 0.993 . 993 0.993) (sTREM- Protein1 Protein- IP1 (IP-10 IP- 0856 856 0.85 0000 000 0.000 9 0746 746 0.74 0.966 0966 966 0808 808 0.80 0691 691 0.69 0.925 0925 925 091 91 0.9 00 0.00 083 83 0.8 099 0.99 99 (sTREM (IP-1 085 85 074 74 0.7 0.96 096 96 080 80 069 69 0.6 0.92 092 92 09 0. 0.0 08 8 (IP- 07 7 06 6 (IP

ABSTRACT The earliest fossil member of Bothrideridae, Alveoderes yamamotoi Li & Cai gen. et sp. nov., is reported from mid-Cretaceous amber of northern Myanmar. Alveoderes gen. nov. appears to be most similar to extant Deretaphrus in the 3-segmented antennal club and pronotal morphology, but is also distinctive among the whole Bothrideridae in having a large cavity (possible glandular opening) at each anterior pronotal angle. Our discovery of a definitive bothriderid beetle from the late Mesozoic highlights the antiquity of the family. A key to the extant and extinct genera of Deretaphrini is added. gen sp nov midCretaceous mid Cretaceous Myanmar 3segmented segmented 3 morphology possible opening angle family added

Abstract In this study, systematic pharmacological methods were used to reveal the potential pharmacological targets of baweixiaoyaosan in the treatment of major depressive disorder (MDD). We identified 133 potential active compounds through data mining and absorption, distribution, metabolism, and excretion evaluation systems. Then, the target of potential active compounds is predicted by a system model based on random forest and support vector machine methods. Next, construct herbal ingredient-target networks and target-disease networks for further analysis of multi-directional treatment methods. At the same time, we also performed gene ontology enrichment analysis, tissue location analysis, and pathway analysis on 76 potential targets. Finally, we conducted the Jun-Chen-Zuo-Shi compatibility analysis of the formula and scientifically explained the different functions of different herbs in the formula. In short, we found that the formula mainly exerts the effect of treating MDD through the four functional modules of inflammation inhibition, neuroprotection, monoamine neurotransmitter and liver. This research not only explores the mechanism of Traditional Chinese Medicine treatment of MDD from a multi-scale perspective, but also provides a reference for future research on BWXYS. It plays a role in promoting the widespread use of BWXYS. study MDD. . (MDD) 13 absorption distribution metabolism systems Then Next ingredienttarget ingredient targetdisease disease multidirectional multi directional time 7 Finally JunChenZuoShi Jun Chen Zuo Shi short inhibition neuroprotection liver multiscale scale perspective BWXYS (MDD 1

Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate. (ICVH (AFF diseases ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) 13141 13 141 13,14 System center diet, diet (diet activity index smoking glucose Association 005 0 05 0.05 5 544 54 4 54.4 women odds OR0.96 OR096 OR 0.96 96 [OR]:0.96 95 [95 CI0.801.16 CI080116 CI 0.80 1.16 80 1 16 CI]:0.80-1.16 p=0.70. p070 p p=0.70 70 p=0.70) OR0.33 OR033 0.33 33 (OR:0.33 CI0.15–0.74 CI015074 0.15–0.74 15 74 CI:0.15–0.74 p=0.007 p0007 007 OR1.88 OR188 1.88 88 (OR:1.88 CI1.19–2.98 CI119298 1.19–2.98 19 2 98 CI:1.19–2.98 analyses adequate separate (ELSA-Brasil 1314 14 13,1 00 0.0 54. OR0 OR0.9 OR09 096 0.9 9 [OR]:0.9 [9 CI0 801 CI0.801.1 CI08011 080 0.8 116 1.1 8 CI]:0.80-1.1 p07 p=0.7 7 OR0.3 OR03 033 0.3 3 (OR:0.3 CI0.15–0.7 CI01507 015074 0.15–0.7 CI:0.15–0.7 p=0.00 p000 OR1 OR1.8 OR18 188 1.8 (OR:1.8 CI1 CI1.19–2.9 CI11929 119298 1.19–2.9 CI:1.19–2.9 131 13, 0. OR0. 09 [OR]:0. [ CI0.801. CI0801 08 11 1. CI]:0.80-1. p0 p=0. 03 (OR:0. CI0.15–0. CI0150 01507 0.15–0. CI:0.15–0. p=0.0 p00 OR1. 18 (OR:1. CI1.19–2. CI1192 11929 1.19–2. CI:1.19–2. [OR]:0 CI0.801 CI080 CI]:0.80-1 p=0 (OR:0 CI0.15–0 CI015 0150 0.15–0 CI:0.15–0 (OR:1 CI1.19–2 CI119 1192 1.19–2 CI:1.19–2 [OR]: CI0.80 CI08 CI]:0.80- p= (OR: CI0.15– CI01 015 0.15– CI:0.15– CI1.19– CI11 119 1.19– CI:1.19– [OR] CI0.8 CI]:0.80 (OR CI0.15 01 0.15 CI:0.15 CI1.19 1.19 CI:1.19 [OR CI0. CI]:0.8 CI0.1 0.1 CI:0.1 CI1.1 CI:1.1 CI]:0. CI:0. CI1. CI:1. CI]:0 CI:0 CI:1 CI]: CI: CI]

Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente. (FFA cardiovasculares ELSABrasil. ELSABrasil ELSA Brasil (ELSA-Brasil) 1314 completos Minnesota centralizado dieta, dieta (dieta física corporal tabagismo jeju 005 0 05 0,05 5 anos 544 54 4 54,4 mulheres ajustados odds OR0,96 OR096 OR 0,96 96 (OR):0,96 95 IC95%0,801,16 IC95080116 IC IC95% 0,80 1,16 IC95 80 1 16 (IC95%):0,80-1,16 p=0,70. p070 p p=0,70 70 p=0,70) OR0,33 OR033 0,33 33 (OR:0,33 IC95%0,10,74 IC9501074 0,1 0,74 74 IC95%:0,1-0,74 p=0,007 p0007 007 OR1,88 OR188 1,88 88 (OR:1,88 IC95%1,192,98 IC95119298 1,19 2,98 19 2 98 IC95%:1,19-2,98 análises devido parte adequado separadamente (ELSA-Brasil 131 00 0,0 54, OR0 OR0,9 OR09 096 0,9 9 (OR):0,9 801 IC95%0,801,1 IC9508011 080 0,8 116 1,1 IC9 8 (IC95%):0,80-1,1 p07 p=0,7 7 OR0,3 OR03 033 0,3 3 (OR:0,3 10 IC95%0,10,7 IC950107 01 0, 074 0,7 IC95%:0,1-0,7 p=0,00 p000 OR1 OR1,8 OR18 188 1,8 (OR:1,8 192 IC95%1,192,9 IC9511929 119 298 2,9 IC95%:1,19-2,9 13 OR0, 09 (OR):0, IC95%0,801, IC950801 08 11 1, (IC95%):0,80-1, p0 p=0, 03 (OR:0, IC95%0,10, IC95010 07 IC95%:0,1-0, p=0,0 p00 OR1, 18 (OR:1, IC95%1,192, IC951192 29 2, IC95%:1,19-2, (OR):0 IC95%0,801 IC95080 (IC95%):0,80-1 p=0 (OR:0 IC95%0,10 IC9501 IC95%:0,1-0 (OR:1 IC95%1,192 IC95119 IC95%:1,19-2 (OR): IC95%0,80 IC9508 (IC95%):0,80- p= (OR: IC95%0,1 IC950 IC95%:0,1- IC95%1,19 IC9511 IC95%:1,19- (OR) IC95%0,8 (IC95%):0,80 (OR IC95%0, IC95%:0,1 IC95%1,1 IC951 IC95%:1,19 (IC95%):0,8 IC95%0 IC95%:0, IC95%1, IC95%:1,1 (IC95%):0, IC95%:0 IC95%1 IC95%:1, (IC95%):0 IC95%: IC95%:1 (IC95%): (IC95%) (IC95% (IC95 (IC9 (IC

Resumo Introdução Uma fístula anastomótica cervical refratária, que permanece sem cicatrização por mais de 2 meses sob cuidados conservadores, afeta gravemente a qualidade de vida do paciente e potencialmente causa estenose anastomótica após a cicatrização da fístula. É amplamente aceito que as fístulas anastomóticas cervicais refratárias devem ser submetidas a tratamentos mais agressivos. No entanto, quando e qual intervenção cirúrgica deve ser considerada ainda é incerto. Objetivo Avaliar o papel do retalho miocutâneo do peitoral maior no manejo de fístula anastomótica cervical refratárias com base em nossa experiência de 6 casos e uma revisão da literatura. Métodos Foram incluídos no estudo seis pacientes diagnosticados com fístula anastomótica cervical refratária após esofagectomia tratados com transferência de retalho miocutâneo do peitoral maior. Os dados clínicos, detalhes cirúrgicos e resultado do tratamento foram analisados retrospectivamente. Resultados Todos os pacientes sobreviveram às cirurgias. Um paciente com defeito anastomótico circunferencial, resultante da exploração cirúrgica, desenvolveu uma fístula leve no sítio neoanastomótico no 5° dia de pós-operatório, que foi resolvida após 7 dias de tratamento conservador. Esse paciente desenvolveu uma estenose anastomótica parcialmente aliviada por uma dilatação endoscópica anastomótica. Todos os outros 5 pacientes tiveram recuperações sem intercorrências após as cirurgias, restabeleceram a ingestão oral 10 ou 15 dias após a operação e toleraram dietas normais sem sequelas subsequentes no seguimento. Um paciente desenvolveu recorrência local e pulmonar e morreu 15 meses após a cirurgia, enquanto os outros 5 pacientes sobreviveram com bom controle tumoral durante o seguimento de 25 a 53 meses. Conclusão O resultado satisfatório do tratamento em nosso estudo demonstra que a reconstrução com o retalho miocutâneo do peitoral maior é uma modalidade de manejo confiável para as fístula anastomótica cervical refratárias após a esofagectomia, particularmente nos pacientes que apresentaram falha após o tratamento conservador das feridas cirúrgicas e com fechamento repetido delas.

Abstract Introduction A refractory cervical anastomotic fistula which postoperatively remains unhealed for more than 2 months under conservative care severely impacts the quality of life of the patient and potentially leads to anastomotic stricture after the fistula heals. It is widely accepted that, to avoid this complication, refractory cervical anastomotic fistulas should undergo more aggressive treatments. However, when and which surgical intervention should be considered is unclear. Objective This study was designed to evaluate the role of the pectoralis major myocutaneous flap in the management of refractory cervical anastomotic fistulas based on our experience of 6 cases and a literature review. Methods Six patients diagnosed with refractory cervical anastomotic fistula after esophagectomy treated using pectoralis major myocutaneous flap transfer were included in the study. The clinical data, surgical details, and treatment outcome were retrospectively analyzed. Results All patients survived the operations. One patient who had a circumferential anastomotic defect resulting from surgical exploration developed a mild fistula in the neo-anastomotic site in the 5th postoperative day, which healed after 7 days of conservative care. This patient developed an anastomotic stricture which was partially alleviated by an endoscopic anastomotic dilatation. All the other 5 patients had uneventful recoveries after operations and restored oral intake on the 10th-15th days after operation, and they tolerated normal diets without subsequent sequelae on follow-up. One patient developed both local and lung recurrence and died in 15 months after operation, while the other 5 patients survived with good tumor control during the follow-up of 25-53 months. Conclusion The satisfactory treatment outcome in our study demonstrates that pectoralis major myocutaneous flap reconstruction is a reliable management modality for refractory cervical anastomotic fistulas after esophagectomy, particularly for those patients who experienced persistent fistulas after conservative wound care and repeated wound closures.

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge–beliefs–behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health. OBJECTIVE diabetes constructed METHODS conducted 19 9 each education knowledge attitude behavior 3month month 3 postintervention RESULTS 2h h 2 glucoseglycosylated glycosylated p<0.05. p005 p p<0.05 . 0 05 (p<0.05) CONCLUSION smallgroup knowledgebeliefsbehaviors beliefs behaviors 1 p00 p<0.0 (p<0.05 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

Abstract Effects of NaHCO3 addition (0.2-0.8%) on the colour, shear force, and water distribution of raw and cooked marinated beef were investigated. The pH and cooking yield were found to be significantly increased (P < 0.05), and the shear force, L* and b* values were significantly decreased with increasing NaHCO3 amounts, except for samples with 0.6% and 0.8% NaHCO3, for which the cooking yield and shear force remained unaffected. Furthermore, the initial relaxation times T21 and T22 of marinated beef were, and the mobility of water in the raw marinated beef was reduced (P < 0.05) with increasing NaHCO3 content. This was due to the carbon dioxide production disrupting the beef structure during heating process. The mobility of water in the cooked marinated beef was found to be improved. In conclusion, NaHCO3 addition improved the water holding capacity and tenderness of marinated beef.

ABSTRACT Limnichidae are currently a moderately diverse beetle family with a sparse fossil record. Here we describe a new limnichid genus and species, Anomocephalobus liuhaoi Li, Jäch & Cai gen. et sp. nov., from the mid-Cretaceous amber from northern Myanmar. Anomocephalobus gen. nov. is tentatively assigned to the extant subfamily Cephalobyrrhinae, based on its transverse metacoxae, 5-segmented protarsi, and absence of grooves on the ventral surface for reception of legs, though its oval body shape is somewhat deviating from extant Cephalobyrrhinae. The generic placement of the recently described Erichia cretacea Yu, Ślipiński, Ren & Pang, 2018 is also discussed.

Abstract The purpose of this research was to evaluate HSYA’ effects and mechanisms to improve Scars Induced by Anticoagulant Injection by vivo and vitro study. New Zealand rabbits were divided into Normal control (NC), Anticoagulant, Anticoagulant+HSYA-Low, Anticoagulant+HSYA-Middle and Anticoagulant+HSYA-High. Measuring TGF-β1 and IL-1β concentration by Elisa assay; evaluating pathology and fibrosis level by HE and Masson staining, measuring collage I, collage III, TLR4 and NF-κB(p65) protein expression by IHC assay. Relative gene expression (Collage I, Collage III, TLR4 and NF-κB(p65)) were evaluated by RT-qPCR assay. Relative proteins expression (Collage I, Collage III, TLR4 and NF-κB(p65)) were evaluated by WB assay. And using TGF-β1 to stimulate cell to make cell model. Compared with NC group, TGF-β1 and IL-1β concentration were significantly increased (P < 0.001); The pathology and fibrosis level were significantly deteriorated, meanwhile, Collage I, Collage III, TLR4 and NF-κB(p65) proteins and gene expression were significantly up-regulation in Anticoagulant group (P < 0.001). With HSYA supplement, TGF-β1 and IL-1β concentration were significantly depressed, Pathology and fibrosis levels were significantly improved, Collage I, Collage III, TLR4 and NF-κB(p65) proteins and gene expressions were significantly improved with dose-dependent (P < 0.05). HSYA could improve anticoagulant injury induced subcutaneous scar via regulation TLR4/NF-κB(p65).

ABSTRACT The earliest fossil member of Teredidae, Delteredolaemus hei Li & Cai gen. et sp. nov., is reported from mid-Cretaceous Burmese amber. Delteredolaemus is assigned to the extant tribe Teredini, and shares a generally similar morphology with the extant genus Teredolaemus Sharp, 1885, although it can be distinguished from all other members in the tribe by the shape of the pronotum and mesoventral process, as well as the anteromedially tumid metaventrite.

Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente.

Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.

RESUMO No que se refere aos esportes competitivos, a organização científica do processo de treinamento e o cumprimento estrito das regras de treinamento são a única forma de êxito. O tênis é a base de todos os esportes. O tênis desenvolve competências físicas e motoras de uma forma abrangente e eficaz. O diagnóstico biomecânico é realizado principalmente com base na gravação da curva força-tempo de diferentes modos de movimento, e os dados gerados são processados pelo computador através de um dispositivo de medição especial. O objetivo principal deste estudo é usar a tecnologia de fusão de dados para analisar e avaliar vários fatores de lesão esportiva. Com base nisso, estabelece-se um modelo dinâmico de cadeia para o alerta precoce de fatores de risco de lesão esportiva, podendo fornecer uma referência para que os atletas evitem e reduzam o risco de lesão e garantam a normalidade dos treinos e das competições. No treinamento de tênis, aplica-se o monitoramento de treinamento científico para diagnosticar e monitorar a função física dos atletas e seu estado psicológico. Conduzir a gestão humanizada e científica do processo de treinamento.

ABSTRACT As far as competitive sports are concerned, scientifically organizing the training process and strictly following the training rules are the only way to success. Tennis is the foundation of all sports. It develops physical and motor skills in a comprehensive and effective manner. Biomechanical diagnosis is mainly carried out on the basis of force-time curve recording of different movement modes, and the generated data is processed by computer through a special measuring device. The main purpose of this study is to use data fusion technology to analyze and evaluate the injury factors involved in various sports. Based on this, a dynamic chain model for early warning of sports injury risk factors is established, which can provide a reference for athletes to avoid and reduce the risk of injuries and ensure normal training and competition. In tennis training, scientific training monitoring is applied to diagnose and monitor athletes’ physical function and psychological state. Conduct humanized and scientific management of the training process.

RESUMEN En lo que se refiere a los deportes competitivos, la organización científica del proceso de entrenamiento y el cumplimiento estricto de las reglas de entrenamiento son la única forma de éxito. El tenis es la base de todos los deportes. El tenis desarrolla competencias físicas y motoras de una forma abarcadora y eficaz. El diagnóstico biomecánico es realizado principalmente basándose en la grabación de la curva fuerza-tiempo de diferentes modos de movimiento, y los datos generados son procesados por la computadora por medio de un dispositivo de medición especial. El objetivo principal de este estudio es usar la tecnología de fusión de datos para analizar y evaluar varios factores de lesión deportiva. Sobre esa base, se establece un modelo dinámico de cadena para la alerta precoz de factores de riesgo de lesión deportiva, pudiendo proveer una referencia para que los atletas eviten y reduzcan el riesgo de lesión y garanticen la normalidad de los entrenamientos y de las competencias. En el entrenamiento de tenis, se aplica el monitoreo de entrenamiento científico para diagnosticar y monitorear la función física de los atletas y su estado psicológico. Conducir la gestión humanizada y científica del proceso de entrenamiento.

RESUMO Los estudiantes universitarios a menudo se encuentran bajo una gran presión y su salud física y mental es el centro de atención en la educación universitaria. Para cultivar talentos de alta calidad y aliviar la presión de los estudiantes universitarios, muchos colegios y universidades han establecido una variedad de cursos deportivos, incluidos cursos de tenis. Al analizar la influencia del tenis en la salud física y mental de los estudiantes universitarios, este estudio considera la situación de los estudiantes universitarios que participan en el tenis. Para ello usa la consulta de literatura, el diseño de cuestionarios y un método de medición experimental para construir el índice de evaluación de la salud física y la salud mental. Sobre esta base, este estudio evalúa la influencia del tenis en la salud física y mental de los estudiantes. Los resultados muestran que el tenis tiene un impacto positivo en la salud física y mental de los estudiantes universitarios. El tenis no solo puede mejorar la función cardiopulmonar y la fuerza muscular de los estudiantes universitarios, sino también cultivar la personalidad independiente de los estudiantes, eliminar la tendencia a la depresión, hacer que los estudiantes sean independientes, flexibles y activos, lo que favorece el desarrollo de la salud mental de los estudiantes. Se espera que este estudio pueda proporcionar alguna referencia para la investigación del ejercicio de salud física y mental de estudiantes universitarios basado en el tenis.

ABSTRACT College students are often under great pressure, and their physical and mental health is the focus of attention in college education. In order to cultivate high-quality talents and relieve the pressure of college students, many colleges and universities have set up a variety of sports courses, including tennis courses. Analyzing the influence of tennis on the physical and mental health of college students, this study studies the situation of college students participating in tennis by consulting literature, designing questionnaires and using an experimental measurement method, while it constructs the physical health evaluation index and mental health evaluation index of college students. On this basis, this study evaluates the influence of tennis on students’ physical and mental health. The results show that tennis has a positive impact on the physical and mental health of college students. Tennis can not only enhance college students’ cardiopulmonary function and muscle strength, but also cultivate students’ independent personality, eliminate depression tendency, make students independent, flexible and active, which is conducive to the development of students’ mental health. It is hoped that this study can provide some reference for the research of college students’ physical and mental health exercise based on tennis.

RESUMEN Estudantes universitários estão frequentemente sob grande pressão, e sua saúde física e mental é o foco da atenção na educação universitária. A fim de cultivar talentos de alta qualidade e aliviar a pressão dos estudantes universitários, muitas faculdades e universidades criaram diversos cursos de esporte, incluindo cursos de tênis. Analisando a influência do tênis na saúde física e mental dos estudantes universitários, este estudo investiga a situação dos estudantes universitários que praticam tênis através de consultas de literatura, elaboração de questionário e do método de medição experimental, enquanto constrói o índice de avaliação da saúde física e da saúde mental de avaliação dos estudantes universitários. Nesta base, o estudo avalia a influência do tênis na saúde física e mental dos estudantes. Os resultados mostram que o tênis tem um impacto positivo na saúde física e mental dos estudantes universitários. O tênis pode não só aumentar a função cardiopulmonar e a força muscular dos estudantes universitários, mas também cultivar a personalidade independente dos estudantes, eliminar a tendência de depressão, torna-los alunos independentes, flexíveis e ativos, o que favorece o desenvolvimento da saúde mental dos estudantes. Espera-se que este estudo possa fornecer alguma referência para a pesquisa do exercício de saúde física e mental dos estudantes universitários com base no tênis.

SUMMARY: Despite the existence of a large amount of actin in the axons, the concentration F-actin was quite low in the myelinated axons and almost all the F-actin were located in the peripheries of the myelinated axons. Until now, the ultrastructural localization of F-actin has still not been reported in the myelinated axons, probably due to the lack of an appropriate detection method. In the present study, a phalloidin-based FITC-anti-FITC technique was adopted to investigate the subcellular localization of F-actin in the myelinated axons. By using this technique, F-actin is located in the outer and inner collars of myelinated cytoplasm surrounding the intermodal axon, the Schmidt-Lanterman incisures, the paranodal terminal loops and the nodal microvilli. In addition, the satellite cell envelope, which encapsulates the axonal initial segment of the peripheral sensory neuron, was also demonstrated as an F-actin-enriched structure. This study provided a hitherto unreported ultrastructural view of the F-actin in the myelinated axons, which may assist in understanding the unique organization of axonal actin cytoskeleton.

RESUMEN: A pesar de la existencia de una gran cantidad de actina en los axones, la concentración de F-actina era bastante baja en los axones mielinizados y casi la totalidad de F-actina se localizaba en las periferias de los axones mielinizados. A la fecha aún no se ha reportado la localización ultraestructural de F-actina en los axones mielinizados, probablemente debido a la falta de un método de detección apropiado. En el presente estudio, se adoptó una técnica FITC-anti-FITC basada en faloidina para investigar la localización subcelular de F-actina en los axones mielinizados. Mediante el uso de esta técnica, la F-actina se localiza en los collares externo e interno del citoplasma mielinizado que rodea el axón intermodal, a las incisiones de Schmidt-Lanterman,a las asas terminales paranodales y a las microvellosidades nodales. Además, la envoltura de la célula satélite, que encapsula el segmento axonal inicial de la neurona sensorial periférica, también se demostró como una estructura enriquecida con F-actina. Este estudio proporcionó una vista ultraestructural de la F-actina en los axones mielinizados, que puede ayudar a comprender la organización única del citoesqueleto de actina axonal.