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89 with the value of -t = 3.23> 1.96. Rapamune The higher the quality of the principal's leadership behaviors had become, then it increased the quality of the teachers' performance; (2) the quality of the principal's leadership behaviors on the level of student achievement where the estimated rate was 0.77 with the value of -t = 2.86> 1.96; and (3) the level of teacher performance on the level of learning achievement where the estimated rate was 0.92 with the value of -t = 4.45> 1.96. The structural model of learning outcomes showed that the loading factor of report cards had a greater effect of 0.995 when it compared to the school exam scores with an effect of 0.897. Effective principal leadership behaviors were limited to (a) the relationship between leaders and followers, (b) task structure, and (c) position power.Since the publication of a sham-controlled, randomized trial (AIR2) and subsequent marketing approval by the US Food and Drug Administration, we have significantly advanced our understanding of bronchial thermoplasty (BT)'s scientific basis, long-term safety, clinical efficacy and cost-effectiveness. In particular, the last 2 years have witnessed multiple research publications on several of these counts. In this review, we critically appraise our evolving understanding of BT's biologic underpinnings and clinical impact, offer an evidence-based patient workflow guide for the busy pulmonologist and highlight both current challenges as well as potential solutions for the researcher and the clinician.A 7-year-old spayed female ferret was presented to the Veterinary Teaching Hospital at the Western College of Veterinary Medicine for a slow-growing mass involving the base of the tail. Radiographs revealed a large, irregularly marginated mineralized mass centered on the fifth to seventh caudal vertebrae with osteolysis of the affected caudal vertebrae. A partial caudectomy was performed, and histopathology was consistent with a chordoma. This is the first case report describing the radiographic appearance of a chordoma in the proximal tail and only the second report to describe radiographic findings in a ferret.

To explore the associations of environmental endocrine disruptors on precocious puberty in girls.

This was a case-control study in which 30 girls with precocious puberty and 46 age- and race-matched prepubertal females were enrolled. The concentrations of 10 environment endocrine disruptors (bisphenol A, bisphenol B, butylparaben, propylparaben, ethvlparaben, methylparaben, mono-butyl phthalate, mono-2-ethylhexyl phthalate, monoethyl phthalate, and monomethyl phthalate) in urine and 10 steroid hormones (dihydrotestosterone, corticosterone, hydrocortisone, 11-deoxycortisol, 17α-hydroxy progesterone, 4-androstene-3,17-dione, estrone, deoxycorticosterone, pregnenolone, and dehydroepiandrosterone) in serum were detected with the liquid chromatography-mass spectrometry (LC-MS).

According to the Mann-Whitney U test, urinary levels of bisphenol A, monobutyl phthalate, and monomethyl phthalate were significantly higher in the precocious group than in the prepubertal group, and blood levels of hydrocortisone, 11-deoxycortisol, corticosterone, deoxycorticosterone, and pregnenolone were significantly lower in the precocious group than in the prepubertal group (p<0.05, VIP>1).

Our findings confirm the association between phthalate exposure and the incidence of precocious puberty in girls. Control and reduction of children exposure to phthalate esters should be considered as a health priority.

Our findings confirm the association between phthalate exposure and the incidence of precocious puberty in girls. Control and reduction of children exposure to phthalate esters should be considered as a health priority.Nickel exists primarily as a stable complex in electroless nickel plating wastewater, and the Ni recovery from it cannot be achieved solely through electrodeposition. As the electrocatalytic oxidation has excellent oxidation potential to break down the complex, an efficient and stable electrochemical system using the synergy of electrocatalytic oxidation and electrochemical deposition technology was developed for the recovery of nickel from electroless nickel plating wastewater. In the present study, the effects of initial pH, current density, and initial nickel ion concentration on the treatment performance of the electrochemical system was investigated. The highest Ni recovery (94.84%) and total organic carbon removal (63.94%) were achieved at a current density of 83.3 mA/cm2 , initial pH of 3.0, and initial Ni concentration of 0.01 M. At the same time, the recovered nickel product was confirmed by scanning electron microscopy, energy dispersive X-ray, X-ray powder diffraction, and X-ray photoelectron spectroscopy. Furthermore, the electrochemical system displayed good stability and economic benefits, thereby suggesting its excellent application potential for the treatment of electroless nickel plating wastewater. PRACTITIONER POINTS An efficient and stable electrochemical system was developed for the recovery of nickel from electroless nickel plating wastewater. In an acidic medium, the nickel recovery rate and TOC removal ratio were 94.84% and 63.94%, respectively. The system displayed good stability, thereby suggesting its excellent application potential for the treatment of nickel plating wastewater.The current study summarized the clinical characteristics of 8 patients with central nervous system anaerobic infections who visited the Second Hospital of Hebei Medical University from June 2019 to June 2021. Among the 8 patients, 7 cases had headache and fever as the first symptoms, and 1 case had left-sided limb weakness as the first symptom. Four patients had a previous history of diabetes (1 patient had a history of tooth extraction before the onset of the disease), 1 patient had a previous history of sinusitis, 1 patient had a history of tooth extraction before the onset of the disease, and 2 patients had chronic extensive periodontitis or periapical periodontitis. Five cases showed abnormal intracranial and/or meningeal enhancement on cranial magnetic resonance imaging (MRI), and 1 case showed swelling of the whole brain tissue on cranial computed tomography (CT). After treatment, symptoms of 4 cases were improved, symptoms of 1 case were aggravated, and 3 cases died. Anaerobic infections can occur in various parts of the bodythe central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin and soft tissues. It is generally believed that anaerobic bacteria rarely cause central nervous system infection, therefore, anaerobic culture of cerebrospinal fluid is usually not performed. Moreover, anaerobic culture is affected by many factors, and thus it is difficult to obtain positive results. Metagenomic next-generation sequencing can identify multiple pathogens (viral, bacterial, fungal, or parasitic) from samples based on DNA and/or RNA sequences and has advantages in diagnosing anaerobic infections of the central nervous system. Prompt empirical antimicrobial therapy is essential for the prognosis of the patients.The clinical treatment and follow-up results of 51 patients with cervical peripheral nerve tumors treated by microsurgery in the Department of Neurosurgery of Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to October 2021 were retrospectively analyzed. Total tumor resection was performed in 49 patients (96.1%), and 42 patients (82.4%) had no obvious neurological impairment. During the follow-up of the 45 cases, 43 cases had no recurrence in situ. Two cases had recurrence (residues from the initial surgery) and accepted the reoperation. Microsurgery of cervical peripheral nerve tumor, combined with intraoperative neurophysiological monitoring, can remove the tumor to the greatest extent and protect the important peripheral blood vessels and nerves. The clinical efficacy and follow-up results are good.Objective To explore the related factors affecting the outcome of treatment free remission (TFR) in patients with chronic myeloid leukemia (CML). Methods Clinical data of CML patients with automatic discontinuation of tyrosine kinase inhibitor (TKI) from the CML cooperative organization of Henan province between June 2, 2013 to March 27, 2021 and the follow-up time was ≥ 6 months were retrospectively analyzed. Log-rank test was used for univariate analysis and Cox proportional risk regression model was used for multivariate analysis. Results A total of 135 patients were enrolled, and 69 patients (51.1%) were femal and 66 patients (48.9%)were male. Median age was[M(Q1,Q3)] 49 years (38, 58)at discontinuation.Before discontinuation, 72 patients (53.3%) were on treatment with second-generation TKI, 63 patients (46.7%) were on treatment with IM, 17patients (12.6%) had a history of TKI reduction/withdrawal;median duration of treatment was months 84 (68, 108) for all patients;median time of TKI treatment to DMR wasre the protective factors of TFR in patients with TKI discontinuation.The CML patients who had sustained DMR more≥48 months before TKI discontinuation showed a better TFR.Objective To explore the value of low-dose indocyanine green (ICG) fluorescence imaging in laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods Clinical data of 198 patients with acute cholecystitis and had received LC in Changzhou No.2 People's Hospital from January 2020 to September 2021 were collected. In the fluorescence group (n=97), peripheral intravenous injection of ICG was performed 15 minutes before LC, while conventional white light was applied in the control group (n=101). The efficiency of bile duct discrimination, operation time, intraoperative bleeding and postoperative complications were compared between the two groups. Results Of the 198 patients, 86 were males and 112 females. The differences were not statisticly significant in age [52 (44, 63) vs 56 (46, 68) years, P>0.05], history of chronic inflammation [34(35.1%) vs 31(30.7%) cases, P>0.05] and other clinical baseline data between the two groups. Compared with the control group, the fluorescence group had higher efficiency of bile duct identification [18 (16,19) vs 38 (28,55) min,P less then 0.001], shorter operation time [45 (40,60) vs 80 (65,100) min,P less then 0.001], less intraoperative bleeding [10 (5,15) vs 60 (20,100) ml,P less then 0.001], and less postoperative liver function damage [alanine aminotransferase 35.0 (23.4,51.0) vs 98.3 (67.0,134.8)U/L,P less then 0.001]. In the control group, there was one case of biliary duct injury during operation, one case of postoperative biliary fistula, and one case of postoperative hemorrhage. No similar adverse event was found in fluorescence group. Conclusions ICG fluorescence imaging can improve the efficiency of LC for patients with acute cholecystitis. It is easy to operate and has a good clinical application value.Objective To investigate the case characteristics and factors related with failure of vaginal trial delivery in twin pregnancy. Methods A retrospective analysis was performed on the clinical data of patients with twin pregnancy who underwent vaginal trial delivery in Peking University Third Hospital from January 2016 to June 2021. There were 109 cases in the successful group (vaginal delivery of both fetuses) and 28 cases in the failed group (cesarean delivery of one or all fetuses), the differences between the two groups were compared and the related factors of vaginal trial failure in twin pregnancy were analyzed. Results There was no significant difference in age between the two groups[(32.4±3.8) years vs (31.3±3.3) years, P=0.163].The proportion of conception through assisted reproductive technology and induced labor in the successful group was significantly lower than that in the failed group(36.7% vs 60.7%, P less then 0.05;35.8% vs 60.7%, P less then 0.05). The average gestational age [(35.5±1.9) weeks vs (36.