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BACKGROUND The objective of this study was to investigate the survival outcomes of surgical margin width in intrahepatic cholangiocarcinoma (ICC), and evaluate the efficacy of postoperative adjuvant therapy (p-AT) in ICC patients underwent narrow-margin hepatectomy (NMH).METHODS Between November 2011 and August 2017, patients who underwent hepatectomy for ICC were collected from 13 major hepatopancreatobiliary centers in China. The survival outcomes for patients who underwent wide margin hepatectomy (WMH) were compared with those who underwent NMH using the 1:1 propensity score matching (PSM). For patients who underwent NMH, the relationship between p-AT and overall survival (OS) and disease-free survival (DFS) were analyzed. RESULTS Among 478 included patients, 195(40.8%) underwent WMH whereas 283(59.2%) underwent NMH. PSM yielded 79 matched patients with similar baseline characteristics. Patients underwent WMH had a significant better OS and DFS compared with those underwent NMH (before PSM: Median OS 27 vs. 17 months, P 0.05; Stage III: OS, DFS, P >0.05). For patient underwent NMH, p-AT following NMH showed a better OS and RFS when compared to those who underwent NMH alone (OS, P = 0.05; DFS, p

TGFβ1 plays an important role in the metabolism of articular cartilage and bone; however, the pathological mechanism and targets of TGFβ1 in cartilage degradation and uncoupling of subchondral bone remodeling remain unclear. Therefore, in this study, we investigated the relationship between TGFβ1 and major protein-degrading enzymes, and evaluated the role of high levels of active TGFβ1 in the thickening of subchondral bone and calcification of articular cartilage.The expression of TGFβ1 and protein-degrading enzymes in clinical samples of articular cartilage and subchondral bone obtained from the knee joint of patients with osteoarthritis was detected by immunohistochemistry. The expression levels of TGFβ1, MMP-3, MMP-13 and IL-1β in cartilage and subchondral bone tissues were detected by absolute real-time quantitative RT-PCR. The expression of TGFβ1, nestin and osterix in subchondral bone was detected by Western blot analysis and immunohistochemistry. The degree of subchondral bone thickening was determined by micro-computed tomography (CT) imaging.Expression of TGFβ1 and cartilage-degrading enzymes was higher in the cartilage-disrupted group than that in the intact group. Furthermore, expression of TGFβ1, nestin and osterix was significantly higher in the OA group than that in the control group. Micro-CT imaging showed that in the OA group, the subchondral bone plate is thickened and the density is increased. The trabecular bone structure is thick plate-like structure, the thickness of the trabecular bone is increased and the gap is small.The data suggest that highly active TGFβ1 activates the expression of cartilage-degrading enzymes. Abnormally activated TGFβ1 may induce formation of the subchondral bone and expansion of the calcified cartilage area, eventually leading to degradation of the cartilage tissue.ZIEL: TGFβ1 spielt eine wichtige Rolle im Stoffwechsel von Gelenkknorpel und Knochen; jedoch bleiben der pathologische Mechanismus und die Ziele von TGFβ1 beim Knorpelabbau und Entkopplung des subchondralen Knochenumbaus unklar. Daher untersuchten wir in dieser Studie die Beziehung zwischen TGFβ1 und wichtigen proteinabbauenden Enzymen und der Rolle hoher Konzentrationen an aktivem TGFβ1 bei der Verdickung des subchondralen Knochens und Verkalkung des Gelenkknorpels.Die Expression von TGFβ1 und der Abbau von Enzymen in klinischen Proben von Gelenkknorpel und subchondralen Knochen aus dem Kniegelenk von Patienten mit Arthrose wurden immunhistochemisch nachgewiesen. Die Expressionsniveaus von TGFβ1, MMP-3, MMP-13 und IL-1β in Knorpel- und subchondralen Knochengeweben wurden durch absolute quantitative RT-PCR in Echtzeit nachgewiesen. Die Expression von TGFβ1, Nestin und Osterix im subchondralen Knochen wurde durch Western-Blot-Analyse und Immunhistochemie nachgewiesen. Der Grad der subchondralen Knochenverdickung wurde durch Mikrocomputertomografie (CT) bestimmt.Die Expression von TGFβ1 und knorpelabbauenden Enzymen war in der Gruppe mit Knorpelstörungen höher als in der intakten Gruppe. Weiterhin war die Expression von TGFβ1, Nestin und Osterix in der OA-Gruppe signifikant höher als in der Kontrollgruppe. Die Mikro-CT-Bildgebung zeigte, dass in der OA-Gruppe die subchondrale Knochenplatte verdickt und die Dichte erhöht ist. Die trabekuläre Knochenstruktur ist dick plättchenförmig, die Dicke des Trabekelknochens erhöht und die Lücke ist klein.Die Daten legen nahe, dass hochaktives TGFβ1 die Expression von knorpelabbauenden Enzymen aktiviert. Ungewöhnlich aktiviertem TGFβ1 kann die Bildung des subchondralen Knochens und Ausdehnung des verkalkten Knorpelbereichs induzieren, was zu einem Abbau des Knorpelgewebes führt.

IMPORTANCE: The COVID-19 pandemic fundamentally altered the delivery of health care in the United States. The associations between these COVID-19–related changes and outcomes in vulnerable patients, such as among persons with Alzheimer disease and related dementias (ADRD), are not yet well understood. OBJECTIVE: To determine the association between regional rates of COVID-19 infection and excess mortality among individuals with ADRD. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study used data from beneficiaries of 100% fee-for-service Medicare Parts A and B between January 1, 2019, and December 31, 2020, to assess age- and sex-adjusted mortality rates. Participants were 53 640 888 Medicare enrollees 65 years of age or older categorized into 4 prespecified cohorts: enrollees with or without ADRD and enrollees with or without ADRD residing in nursing homes. EXPOSURES: Monthly COVID-19 infection rates by hospital referral region between January and December 2020. MAIN OUTCOMES AND MEASURES: Mortality rates from March through December 2020 were compared with those from March through December 2019. Excess mortality was calculated by comparing mortality rates in 2020 with rates in 2019 for specific, predetermined groups. Means were compared using t tests, and 95% CIs were estimated using the delta method. RESULTS: This cross-sectional study included 26 952 752 Medicare enrollees in 2019 and 26 688 136 enrollees in 2020. In 2019, the mean (SD) age of community-dwelling beneficiaries without ADRD was 74.1 (8.8) years and with ADRD was 82.6 (8.4) years. The mean (SD) age of nursing home residents with ADRD (83.6 [8.4] years) was similar to that for patients without ADRD (79.7 [8.8] years). Among patients diagnosed as having ADRD in 2019, 63.5% were women, 2.7% were Asian, 9.2% were Black, 5.7% were Hispanic, 80.7% were White, and 1.7% were identified as other (included all races or ethnicities other than those given); the composition did not change appreciably in 2020. Compared with 2019, adjusted mortality in 2020 was 12.4% (95% CI, 12.1%-12.6%) higher among enrollees without ADRD and 25.7% (95% CI, 25.3%-26.2%) higher among all enrollees with ADRD, with even higher percentages for Asian (36.0%; 95% CI, 32.6%-39.3%), Black (36.7%; 95% CI, 35.2%-38.2%), and Hispanic (40.1%; 95% CI, 37.9%-42.3%) populations with ADRD. The hospital referral region in the lowest quintile for COVID-19 infections in 2020 had no excess mortality among enrollees without ADRD but 8.8% (95% CI, 7.5%-10.2%) higher mortality among community-dwelling enrollees with ADRD and 14.2% (95% CI, 12.2%-16.2%) higher mortality among enrollees with ADRD living in nursing homes. CONCLUSIONS AND RELEVANCE: The results of this cross-sectional study suggest that the COVID-19 pandemic may be associated with excess mortality among older adults with ADRD, especially for Asian, Black, and Hispanic populations and people living in nursing homes, even in areas with low COVID-19 prevalence.

Yao Huang,1– 3 Jianxing Zeng,2,4 Teng Liu,2 Xinju Lin,2 Pengfei Guo,4 Jinhua Zeng,1– 3 Weiping Zhou,5 Jingfeng Liu1– 4 1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, People’s Republic of China; 2Department of Hepatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, People’s Republic of China; 3The Liver Center of Fujian Province, Fujian Medical University, Fuzhou 350025, People’s Republic of China; 4Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, People’s Republic of China; 5The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, People’s Republic of ChinaCorrespondence: Jingfeng LiuDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, People’s Republic of ChinaTel/ Fax +86 591 8370 5927Email drjingfeng@126.comObjective: The aim of this study was to investigate predictive and prognostic significance of elevated carbohydrate antigen 125 (CA125) serum level preoperatively.Methods: A total of 3440 HCC patients were retrospectively enrolled into this study, and all of them underwent curative hepatectomy. The clinical and pathological variables together with CA125, AFP serum level were collected at diagnosis and postoperative care stages. A chi-square test was used to compare the differences between variables. Overall survival (OS) and recurrence-free survival (RFS) were measured with the Kaplan–Meier method. To estimate prognostic factors, a multivariate Cox regression analysis was performed.Results: Of the 3440 enrolled patients, 409 (11.9%) exhibited elevated preoperative serum CA125 level, and high preoperative serum CA125 level was significantly associated with younger age, female, higher ALBI grade, higher serum AFP level, blood transfusion, more operative bleeding loss, larger tumor size, multiple tumor, increased macro- or micro-vascular invasion, Edmondson grade III–IV, absence of tumor capsular, satellite nodules, liver cirrhosis, more advanced TNM stages and BCLC stages. HCC patients with high preoperative serum CA125 level usually had a shorter OS rate and experienced a higher probability of recurrence than those with normal preoperative serum level of CA125 (p< 0.0001). The multivariate analysis suggested that elevated serum CA125 level serves as an independent predictor of OS and RFS in HCC patients after surgical resection.Conclusion: Elevated preoperative serum CA125 correlated with many malignant characterizations of HCC and served as an independent prognostic factor of OS and RFS.Keywords: CA125, hepatocellular carcinoma, prognosis, hepatectomy

Eye absent homolog 4 (EYA4) has been demonstrated to be down‐regulated in hepatocellular carcinoma (HCC), but its biological function and the mechanism in HCC angiogenesis and metastasis remain largely unknown. Herein, we showed that EYA4 expression was frequently low in HCC tissue samples compared with matched adjacent non‐tumourous tissues. In the analysis of 302 HCC specimens, we revealed that decreased expression of EYA4 correlated with tumour differentiation status. Univariate and multivariate analyses identified EYA4 as an independent risk factor for recurrence‐free survival (RFS) and overall survival (OS) among the 302 patients. Functional assays showed that forced expression of EYA4 suppressed HCC cell migration, invasion and capillary tube formation of endothelial cells in vitro, as well as in vivo tumour angiogenesis and metastasis in a mouse model. Furthermore, mechanism study exhibited that EYA4 could inhibit HCC angiogenesis and metastasis by inhibiting c‐JUN/VEGFA pathway. Together, we provide proof that EYA4 is a novel tumour suppressor in HCC and a new prognostic biomarker and therapeutic target in HCC.

Traditional BVA quartz resonator has the characteristics of low aging and high Q, but the weakness in size and anti-vibration limits its application and popularization. This paper introduces a small BVA quartz resonator. By optimizing the internal structure and processing technology, the size of small BVA quartz resonator can be reduced to HC-40/U and the anti-vibration level reaches 15grams. At the same time, its other performance is comparable to traditional BVA quartz resonator.

With the depletion of fossil fuels and the increasing demand of energy for economic development, it is urgent to develop renewable energy technologies to sustain the economic growth. Electrospinning is a versatile and efficient fabrication method for one-dimensional (1D) nanostructured fibers of metals, metal oxides, hydrocarbons, composites, and so forth. The resulting nanofibers (NFs) with controllable diameters ranging from nanometer to micrometer scale possess unique properties such as a high surface-area-to-volume and aspect ratio, low density, and high pore volume. These properties make 1D nanomaterials more advantageous than conventional materials in energy harvesting, conversion, and storage devices. In this review, the key parameters for e-spinning are discussed and the properties of electrospun NFs and applications in solar cells, fuel cells, nanogenerators, hydrogen energy harvesting and storage, lithium-ion batteries, and supercapacitors are reviewed. The advantages and disadvantages of electrospinning and an outlook on the possible future directions are also discussed.

The structure and properties of Sm overlayer and Sm/Rh surface alloy have been investigated with Auger electron spectroscopy (AES), low energy electron diffraction (LEED), X-ray photoelectron spectroscopy (XPS), and temperature programmed desorption spectroscopy (TDS). The growth of Sm on Rh(100) at room temperature (RT) appears following the Stranski-Krastanov growth mode and only the trivalent state Sm is observed from XPS results. Thermal treatment of the Sm film at 900 K leads to the formation of ordered surface alloy which shows the c(5√2 × √2)R45° and c(2×2) LEED patterns. Annealing the Sm film at temperature above 400 K makes the binding energy (B.E.) of Sm 3d5/2 shift to higher energy by 0.7 eV, which indicates charge transfer from Sm to Rh(100) substrate, causing the increase of CO desorption temperature.

Sparse-array synthetic impulse and aperture radar(SIAR) has large sparse arrays and uses the technology of digital synthetic impulse and aperture of array. It can keep the advantage of traditional meter-wave radar and overcome most of its disadvantage.lt is a new kind of advanced digital array radar with synchronously multifunction, low probability of interception,capacity of long-time coherent integration of targets and fine doppler resolution , high feasibility of system processing.etc. Here ,the SIAR's ability of low-altitude target detection, low probabilities of interception and anti-jamming is researched for sufficiently understanding its main practical performance. (3 pages)

Based on the time-domain analysis, a time-domain mathematical model of three-phase three-wire active power filter (APF) current control loop is established; Predictive control equation and its optimal feasible solution with minimum objective function value are gotten, and the sliding-mode control strategy of current control loop is deduced. A novel optimization?sliding mode control strategy is proposed, with this control strategy the current tracking error can be reduced quickly and the chattering can be reduced effectively. The control performance under the proposed control strategy is analyzed. The proposed control strategy can improve current tracking speed and accuracy, provide both robustness response and a good dynamic response of the current tracking control, and has the characteristics of simple computation and easy application. The simulation and experiment results show its validity and feasibility.

The lack of consistent ordering of components resulted from independent component analysis poses a significant obstacle to the pervasive application of this method on fMRI data analysis. Based on the temporal correlation of physiological noise components of fMRI data and that of cerebrospinal fluid data, the ordering of independent spatial components is ranked using canonical correlation analysis. The proposed method can robustly identify the task-related spatial component without any prior information about the functional activation paradigm. The experimental results of analyzing the real fMRI data show the reliability of the presented method.

This paper describes a fully automatic method for enhancement and segmentation of three-dimensional(3D) cerebral vessels in MRA. We obtain the 3D dyadic B-spline wavelets by extending corresponding 1D wavelet. A 3D steerable filter is then developed based on 3D dyadic B-spline wavelets. One can adaptively steer the filter to an arbitrary direction. The oriented energy of filter response is introduced for detecting orientation strength of vessels in that direction. The points with maximum of local oriented energy across multiple scales are regarded as vessel points. This method was tested on real MRA data and promising results have been obtained. It could be suitable for other types of curvilinear structures such as cardiovascular vessels, bronchial tree.

Laser induced backside dry etching (LIBDE) is a novel technique, which applied in the micromachining and nanomachining of transparent dielectric materials used for optical elements by direct laser irradiation with the assistance of solid mediums as an absorbed layer. On the basis of exploring two different solid mediums, i.e. Al2O3 powder and alumina ceramic wafer as absorbers, LIBDE with 1064 nm central wavelength pulsed ytterbium doped fiber laser as the irradiation source was successfully applied for the fabrication of periodical microscaled structures on fused silica. The threshold of laser fluence to etch fused silica was 7.47 J/cm2 extrapolated from the experimental data. By using alumina ceramic wafer as the absorber, a microbinary dimensional transmittance grating with the constant of 25 μm was obtained on the silica. The depth of the trench is 4.2 μm, and the root mean square roughness of the trench bottom is below 40 nm according to the measurement of 3D profiler. Additionally, diffraction patte...