Effect of hip fracture on prognosis of acute cerebral infarction

OBJECTIVES: Hip fractures are a worldwide public health problem. The incidence of hip fracture is high among the elderly, and it is an important cause of death and disability in this population. This observational study aimed to investigate the effect of acute hip fracture on the recovery of neurological function and the prognosis of patients with acute cerebral infarction, as well as whether surgical treatment of combined acute fracture can improve the prognosis of patients. METHODS: Thirty patients with acute cerebral infarction combined with acute hip fracture, who were hospitalized in two hospitals between January 1, 2013 and December 31, 2019, were included. The patients did not undergo surgical treatment. The control group included patients with common acute cerebral infarction without hip fracture admitted in the same period. The neurological function recovery, hospitalization period, half a year recovery rate, incidence of complications, and one-year mortality rate between the two groups were compared. Eleven patients with acute cerebral infarction combined with hip fracture, who underwent surgical treatment, were selected and compared with those in the non-surgery group. RESULTS: Compared with patients with common acute cerebral infarction, the National Institutes of Health Stroke Scale score of those with acute cerebral infarction combined with hip fracture was higher (7.2±5.4 vs. 5.6%±4.3, p=0.034), the hospitalization period was prolonged (16.1±8.9% vs. 12.2±5.3, p=0.041), and the half a year recovery rate was lower (26.7% vs. 53.3%, p=0.016). Additionally, the incidence of pulmonary infection and lower extremity deep vein thrombosis was increased (30% vs. 11.7%, p=0.03; 6.7% vs. 0, p=0.043). The one-year mortality rate of patients with hip fracture was higher than that of patients with common cerebral infarction (23.3% vs. 6.7%, p=0.027). Compared with the non-surgical group, the good recovery rate after half a year of surgical treatment of the group with cerebral infarction and acute hip fracture had an increasing trend, while the hospitalization cycle, incidence of complications, and one-year mortality rate were all decreased, although this was not statistically significant. CONCLUSIONS: Acute cerebral infarction combined with hip fracture leads to worse neurological recovery, prolonged hospitalization period, increased complications, decreased patient prognosis, and increased one-year mortality. Surgical treatment improves the prognosis of patients with acute cerebral infarction. These findings may provide insights into the management of acute cerebral infarction

Auto-tuning for cascade PID height position controller of rotorcraft

In this article, we present a method for tuning controller parameters for cascade PID based on the step response performance characteristics of a closed loop system with application to an unmanned aerial vehicle(UAV). With specifically designed system identification procedures, a neural network mapping is obtained automatically when the UAV is flying around the target height. With this network system model, a gradual regression and optimization algorithm is proposed to tune the controller. The regression model primly illustrated the relation between PID parameters with controller performance, and the construction for optimization cost function takes the physical significance of step response performance of flying machine into account. Experimental data collected from fight experiment when auto-tuner is implemented on a quadrotorcraft demonstrate the efficiency of the proposed method

Surgical Treatment and Follow-up Results of Pituitary ACTH Microadenoma: 18 Years' Experience

ObjectiveTo review retrospectively our clinical experience with surgical treatment and follow-up of pituitary adrenocorticotropic hormone (ACTH) microadenomas at Rui Jin Hospital of Shanghai Second Medical University.MethodsEighty-seven patients with ACTH microadenomas underwent surgery via the transsphenoidal approach. Preoperative computed tomography and/or magnetic resonance imaging revealed microadenomas in only 46 patients and was negative in the remaining 41 patients, which were classified as microadenoma grade 0. High-dose dexamethasone (Dx) suppression testing was positive in 86% of patients and low-dose Dx suppression testing was negative in all patients.ResultsHistological confirmation of ACTH microadenoma was made in all 87 cases, with a minimum tumour size of only 1 to 2 mm in diameter. The remission rate was 82% for grade I and 92% for grade 0 microadenomas during 2 to 18 years of follow-up.ConclusionsNeuroimaging studies have limited value in diagnosing ACTH grade 0 microadenoma. Clinical manifestation combined with positive Dx suppression testing is decisive in these circumstances. Surgical intervention could achieve a high relief rate for ACTH microadenomas, especially in grade 0 group

Multi-objective Optimization of Space-Air-Ground Integrated Network Slicing Relying on a Pair of Central and Distributed Learning Algorithms

As an attractive enabling technology for next-generation wireless communications, network slicing supports diverse customized services in the global space-air-ground integrated network (SAGIN) with diverse resource constraints. In this paper, we dynamically consider three typical classes of radio access network (RAN) slices, namely high-throughput slices, low-delay slices and wide-coverage slices, under the same underlying physical SAGIN. The throughput, the service delay and the coverage area of these three classes of RAN slices are jointly optimized in a non-scalar form by considering the distinct channel features and service advantages of the terrestrial, aerial and satellite components of SAGINs. A joint central and distributed multi-agent deep deterministic policy gradient (CDMADDPG) algorithm is proposed for solving the above problem to obtain the Pareto optimal solutions. The algorithm first determines the optimal virtual unmanned aerial vehicle (vUAV) positions and the inter-slice sub-channel and power sharing by relying on a centralized unit. Then it optimizes the intra-slice sub-channel and power allocation, and the virtual base station (vBS)/vUAV/virtual low earth orbit (vLEO) satellite deployment in support of three classes of slices by three separate distributed units. Simulation results verify that the proposed method approaches the Pareto-optimal exploitation of multiple RAN slices, and outperforms the benchmarkers.Comment: 19 pages, 14 figures, journa

MALAT1 Activates the P53 Signaling Pathway by Regulating MDM2 to Promote Ischemic Stroke

Background/Aims: This study focused on evaluating the effect of MALAT1 and MDM2 on ischemic stroke through regulation of the p53 signaling pathway. Materials: Bioinformatics analysis was performed to identify abnormally expressed lncRNAs, mRNAs and their associated pathways. Oxygen-glucose deprivation/reoxygenation (OGD/R) in cells and middle cerebral artery occlusion/reperfusion (MCAO/R) in mice were performed to simulate an ischemic stroke environment. Western blot and qRT-PCR were used to examine lncRNA expression and mRNA levels. Fluorescence in situ hybridization (FISH) LncRNA was used to locate mRNA. MTT and flow cytometry were performed to examine cell proliferation and apoptosis. Finally, immunohistochemistry was used to observe the expression of genes in vivo. Results: MALAT1 and MDM2, which exhibit strong expression in stroke tissues, were subjected to bioinformatics analysis, and the p53 pathway was chosen for further study. MALAT1, MDM2 and p53 signaling pathway-related proteins were all up regulated in OGD/R cells. Furthermore, Malat1, Mdm2 and p53 pathway related-proteins were also up regulated in MCAO/R mice. Both MALAT1 and MDM2 were localized in the nuclei. Down regulation of MALAT1 and MDM2 enhanced cell proliferation ability and reduced apoptosis, resulting in decreased infarct size in MCAO/R brains. Conclusion: These results indicate that MALAT1/MDM2/p53 signaling pathway axis may provide more effective clinical therapeutic strategy for patients with ischemic stroke

Antioxidant activity of Chinese ant extract preparations.

Chinese ant extract preparations (CAEP) are a Chinese traditional medicine which is mainly used as a health food or drink for the treatment of rheumatism, rheumatoid arthritis, chronic hepatitis, sexual hypofunction, and antiaging in China. The effects on free radicals were examined by electron spin resonance spectrometry using the spin trapping agent 5.5-dimethyl-1-pyrroline-1-oxide (DMPO). Superoxide radicals (3.35 x 10(15) spins/ml) were quenched 50% by the extract at 0.5 mg/ml. The CAEP extract at 0.7 mg/ml inhibited 50% of hydroxyl radicals (52.0 x 10(15) spins/ml) generated by the Fenton reaction. Against DPPH radical, the scavenging action of CAEP was observed at 1.8 mg/ml of the extract and 50% of the DPPH radicals (8.14 x 10(15) spins/ml) were quenched. In vitro tests showed that CAEP inhibited the production of thiobarbituric acid-reactive substances, an index of lipid peroxidation, in rat brain homogenate.</p

Pulsed Laser Beam Welding of Pd\u3csub\u3e43\u3c/sub\u3eCu\u3csub\u3e27\u3c/sub\u3eNi\u3csub\u3e10\u3c/sub\u3eP\u3csub\u3e20\u3c/sub\u3e Bulk Metallic Glass

We used pulsed laser beam welding method to join Pd43Cu27Ni10P20 (at.%) bulk metallic glass and characterized the properties of the joint. Fusion zone and heat-affected zone in the weld joint can be maintained completely amorphous as confirmed by X-ray diffraction and differential scanning calorimetry. No visible defects were observed in the weld joint. Nanoindentation and bend tests were carried out to determine the mechanical properties of the weld joint. Fusion zone and heat-affected zone exhibit very similar elastic moduli and hardness when compared to the base material, and the weld joint shows high ductility in bending which is accomplished through the operation of multiple shear bands. Our results reveal that pulsed laser beam welding under appropriate processing parameters provides a practical viable method to join bulk metallic glasses

In Vivo

Aim. Dermatophytosis is one of the main fungal diseases in humans and animals all over the world. Galla chinensis, a traditional medicine, has various pharmacological effects. The goal of this study was to evaluate the treatment effect of Galla chinensis solution (GCS) on dermatophytosis-infected dogs (Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes, resp.). Methods. The treatment effects of GCS were evaluated by mycological cure rates and clinical score comprised of three indices, including inflammation, hair loss, and lesion scale. Results. The results showed that, in the three models of dermatophytosis, GCS significantly (P<0.05) improved skin lesions and fungal eradication. GCS (10% and 5%) had higher efficacy compared to the positive control (Tujingpi Tincture). The fungal eradication efficacy exceeds 85% after treatment with GCS (10%, 5%, and 2.5%) on day 14. Conclusion. The GCS has antidermatophytosis effect in dogs, which may be a candidate drug for the treatment of dermatophytosis

Carbapenem-resistant Citrobacter freundii harboring blaKPC−2 and blaNDM−1: a study on their transferability and potential dissemination via generating a transferrable hybrid plasmid mediated by IS6100

IntroductionThe increase in clinical Enterobacteriaceae with dual carbapenemase has become a serious healthcare concern. It is essential to characterize the transferability and potential dissemination of blaKPC−2- and blaNDM−1-coharboring carbapenem-resistant Citrobacter freundii (CRCF).MethodsFour blaKPC−2- and blaNDM−1-coharboring CRCF strains were collected from our surveillance of the prevalence of carbapenem-resistant Enterobacteriaceae. The isolates were assessed using species identification, antimicrobial susceptibility testing, conjugation assays, whole-genome sequencing, plasmid stability, and fitness costs. Clonality, genome, plasmidome, and phylogeny were analyzed to reveal potential dissemination.ResultsThree ST523 blaKPC−2- and blaNDM−1-coharboring CRCF strains, collected from the same hospital within 1 month, exhibited high homology (both identity and coverage &gt;99%), implying clonal dissemination and a small-scale outbreak. Moreover, the blaKPC−2 and blaNDM−1 genes were coharbored on an IncR plasmid, probably generated by a blaKPC−2-harboring plasmid acquiring blaNDM−1, in these three strains. Importantly, the IncR plasmid may form a transferable hybrid plasmid, mediated by IS6100 via transposition, with another IncFII plasmid included in the same C. freundii strain. Furthermore, the blaKPC−2 and blaNDM−1 of the fourth CRCF strain are located on two different non-transferable plasmids lacking complete transfer elements. Additionally, throughout the course of the 10-day continuous passage, the genetic surroundings of blaNDM−1 in four CRCF strains were gradually excised from their plasmids after the 8th day, whereas they maintained 100% retention for blaKPC−2. Genome and plasmidome analyses revealed that blaKPC−2- or blaNDM−1-harboring C. freundii were divergent, and these plasmids have high homology to plasmids of other Enterobacteriaceae.ConclusionClonal dissemination of ST523 blaKPC−2- and blaNDM−1-coharboring CRCF strains was detected, and we first reported blaKPC−2 and blaNDM−1 concomitantly located on one plasmid, which could be transferred with mediation by IS6100 via transposition. Continued surveillance should urgently be implemented