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ObjectiveTo evaluate the current status of hypertension prevention and control management operation mechanisms in Chinese mainland, explore the impact of their improvement on hypertension prevention and control effects, and provide a reference for enhancing hypertension prevention and control management. MethodsPolicy documents related to hypertension prevention and control from January 1 2000 to December 31, 2018 in 31 provinces (municipalities and autonomous regions) in Chinese mainland were collected. The current status of hypertension prevention and control management operation mechanisms in Chinese mainland was systematically evaluated according to the appropriate public health system evaluation model and standard. A logistic regression model was used to analyze the impact of the improvement of management operation mechanisms on hypertension prevention and control effects. ResultsIn 2018, the appropriateness of hypertension prevention and control management operation mechanisms in Chinese mainland was 43.68%, with an increase of 21.64% compared to 2000, but there was still a gap of 48.61% from the appropriate standard. Among them, the appropriateness of coordination and incentive mechanisms was the lowest (14.03%), and the appropriateness of planning and evaluation mechanisms was the highest (63.04%). In terms of specific positioning, the coverage of medium and long-term plans (100.00%) and the completeness of content and form (94.45%) were relatively high, while the feasibility of management mechanisms was only 9.76%. The results of logistic regression analysis showed that the improvement of management operation mechanisms helped control blood pressure in hypertensive patients (OR = 1.012, P = 0.007) and maintain the stability of patients’ blood pressure (OR = 1.010, P = 0.029). Conclusion From 2000 to 2018, the construction of hypertension prevention and control management mechanisms in Chinese mainland tended to be improved, effectively promoting the improvement of hypertension prevention and control management levels. However, it is still necessary to further establish and improve coordination and incentive mechanisms and clarify the division of departmental responsibilities.

ObjectiveTo examine the variation in clearly documented assignment of departmental responsibilities for major epidemic prevention and control in the Chinese mainland before and after the outbreak of COVID-19. MethodsOfficial policy documents related to major epidemic prevention and control issued by administrative agencies of 31 provincial level administrative divisions from 2000 through 2020 were systematically retrieved online from websites of the agencies. The extracted information on the coverage, clarification and assessability of the assigned departmental responsibilities for major epidemic prevention and control were analyzed; T-test and paired rank sum test were adopted in statistical analysis. ResultsBased on relevant information extracted from the 3 864 policy documents retrieved, the nationwide average proportion of the departments with officially assigned responsibility versus all departments at provincial level increased significantly from 80.93% (18.61/23.00) in 2019 to 89.62% (20.61/23.00) in 2020 (P < 0.05); the average proportion of the departments with the assessable responsibility versus all departments with the assigned responsibility increased from 26.16% (4.81/18.61) to 30.93% (6.39/20.61) and the average proportion of the departments with the specified responsibility versus all departments with the assigned responsibility also increased significantly from 44.00% to 54.58%; but the average proportion of the departments with clearly specified responsibility was not significantly improved. In 2020, the nationwide average proportion of the provincial departments with officially assigned responsibility increased significantly to 87.10% and 20.97% for the professional departments and the key support departments (P < 0.05), while the proportion for other support departments was not significantly different from that in 2000. ConclusionThe degree of clearly documented assignment of departmental responsibilities for major epidemic prevention and control in China has been significantly improved after the outbreak of COVID-19 epidemic but the assessability of the assigned departmental responsibilities need to be improved.

ObjectiveTo analyze the change in service capacity against major epidemics before and after coronavirus disease 2019 (COVID-19) in China for the promotion of the capacity. MethodsVia systematic search on the official websites and the law documents website of Peking University (PKULAW), we collected totally 1 756 policy documents relevant to major epidemic prevention and control issued during 2002 – 2020 by government departments and professional public health institutions in 31 provincial-level administrative divisions of China. Contents about the coverage and assessability of service capacity of major epidemic prevention and control were extracted from the documents and indexes for evaluating national and regional coverage and assessability were calculated based on the extracted contents. Paired signed-rank test was used to analyze changes in the indexes before and during COVID-19 epidemic. ResultsThe coverage of major epidemic prevention and control services has reached 100% in the Chinese mainland in 2019. In comparison to those in 2019 before the emergence of COVID-19 epidemic, the national assessability indexes (%) for service capability of major epidemic prevention and control of pre-, ongoing- and post-stage increased in 2020 by 29.78% (65.59% vs. 50.54%) , 17.54% (72.04% vs. 61.29% ) and 4.34% (38.71% vs. 37.10%). the assessment index for service capability of major epidemic prevention and control of pre-stage increased from 78.79% to 89.39% for eastern region and that of ongoing-stage increased from 65.00% to 76.67% for western region (both P < 0.05); but there was no significant increase in regional assessment index for service capability of major epidemic prevention and control of post-stage. The national assessment index for service capacity of major epidemic prevention and control of whole process increased significantly from 66.00% in 2019 to 73.78% in 2020 after the emergence of COVID-19 epidemic (P < 0.001). ConclusionThe overall service capacity of major epidemic prevention and control has improved after the emergence of COVID-19 epidemic in the Chinese Mainland but the service capacity needs to be improved in central and western regions; in addition, the post-event assessment on the service capacity should be concerned for the promotion of the service capacity.

ObjectiveTo analyze changes in the coverage of incentive measures for promoting major epidemic prevention and control in documents published by governmental and professional departments in the Chinese Mainland before and after coronavirus disease 2019 (COVID-19) epidemic of 2020.MethodsThrough systematically searching websites of government departments and professional institutions in 31 provincial-level administrative divisions (PLADs) of the mainland of China, we retrieved totally 3 864 documents (including laws, regulations, standards, rules, proposals, plans, and guidelines) relevant to major epidemic prevention and control published from 2000 through 2020. The paragraphs related to incentive and disciplinary measures for promoting the containment of major epidemic were extracted to calculate region- and institution-specific coverage of the measures in the retrieved documents. Wilcoxon paired rank sum test was adopted to evaluate differences in the coverage of the established measures before and after COVID-19 epidemic of 2020 among various economic regions and administrative/professional institutions. ResultsThe average coverage of disciplinary measures for the retrieved documents increased from 74.19% before 2020 to 76.34% in 2020, with a significant increase of 2.90% (P < 0.05); while, the average coverage incentive measures was 22.85% for the documents published in 2020, significantly increased in comparison with no incentive measure presented in all the documents published before 2020 (P < 0.001). Compared to those before 2020, the national average combined coverage of incentive and disciplinary measures increased significantly by 11.83%, 30.77%, 42.11%, and 89.66% in 2020, for the documents published by administrative departments, public health institutions, health care institutions, and primary health care institutions, respectively; the national average coverage increased from 37.10% before 2020 to 49.60% in 2020 for the documents published by all the institutions, with an increment of 33.70%; and for the documents published by all the institutions in the PLADs of eastern, central and western region, the coverage increased significantly by 47.47%, 27.54% and 25.00% (all P < 0.05). ConclusionAfter COVID-19 epidemic of 2020, the coverage of incentive and disciplinary measures for promoting major epidemic prevention and control increased significantly in the documents published by governmental and professional departments in the mainland of China and the increase was much higher for the coverage of incentive measures.

Breast tumors adversely affect the holistic well-being of women. Histopathological images are a critical substantiation for doctors to diagnose breast tumor types. The structure of various types of tumor cells exhibits significant correlations, thereby posing challenges to the diagnosis using conventional methods. In this work, the enhanced EfficientNet was employed for the diagnosis of breast tumors, which enabled the network model to learn the features of the disease automatically and improve the accuracy of the diagnosis of breast tumor types. Firstly, the convolutional block attention module was used to extract effective features. Secondly, the group convolution and channel shuffle operations were introduced to improve the feature representation ability of the model. Thirdly, the Hard-Swish activation function was applied to improve the convergence speed of the model. Finally, Experiments showed that the improved EfficientNet network achieved 98.4% accuracy in eight classifications on the BreakHis dataset, which was expected to act a decision aid tool in breast tumor diagnostic research.

Objective: This study aimed to reduce the setting time of yogurt, improve the texture of yogurt and evaluate the effect of pea peptides on the quality of coagulated yogurt. Methods: Different amounts（0, 0.50%, 0.75%, 1.00%, 1.25%, 1.50%）of pea peptides were added into milk powder to prepare pea peptide yogurt, and then the setting time, titer acidity, and texture properties of the yogurt were investigated. Results: The results showed that when the amount of pea peptides added was less than or equal to 1.25%, the yogurt setting time could be significantly shortened. When the amount of pea peptide added was 1%, the effect was significant by shortening the coagulation time for 32 min. The addition of pea peptides significantly increased the acidity of yogurt. When the addition amount of pea peptides was less than 1%, the springiness and chewiness of the yogurt were significantly reduced, and the gumminess, cohesiveness, and resilience were significantly increased, which improved the textural properties of the yogurt. Conclusion: The addition of pea peptides to the yogurt fermentation substrate can shorten the fermentation period and enhance the quality of the final product.

ObjectiveTo evaluate the capacity for hypertension prevention and control and to identify strengths, shortcomings and key control points of the capacity-building in 31 provincial-level administrative divisions (PLADs) in China.MethodsPolicy documents, information reports, and research literature on hypertension prevention and control in 31 PLADs of China published from January 1995 through December 2019 were systemically collected via searching relevant websites and statistical yearbooks for evaluating on hypertension prevention and control capacity across the 31 PLADs according to the standards for appropriate public health system. Normative gap analysis was used to explore strengths and shortcomings of the capacity-building and multiple linear regression and sensitivity analysis were used to clarify key control points of the capacity-building. ResultsThe average index for the appropriateness of hypertension prevention and control capacity-building was 47.10% among 31 PLADs of China in 2019, and the average annual increasing rate of the capacity-building was 18.75% from 2000 to 2019, showing a significant upward trend (Z = 6.067, P < 0.001). The strengths of hypertension prevention and control capacity-building for the PLADs include more complete organizational structure established, comprehensive coverage of medium- and long-term plans, and sound management and monitoring mechanisms; while the shortcomings are insufficient allocation of human and financial resources and low implementation of multi-dimensional management mechanisms such as management and coordination, medium- and long-term goals and evaluation criteria. The identified key control points for the five aspects in hypertension prevention and control capacity-building are effective motivation of personnel for resource allocation, the coordination for organizational framework, the coverage of incentive measures for management mechanism, practicable assessment criteria for management process evaluation, and the balance between supply and demand of medical service for service offering, with the estimated increment of 23.14%, 66.40%, 15.77%, 23.43% and 7.06%, respectively, in the indexes for the appropriateness of the capacity-building under the conditions of the five key control points being well managed. ConclusionThe capacity for hypertension prevention and control has been improved continuously in 31 PLADs of China during 2000 – 2019 but several aspects in hypertension prevention and control capacity-building still need to be improved for the promotion of the capacity-building.

The status and role of airport agglomeration in China's airport system is becoming increasingly important, and air transport networks have received attention from multidisciplinary fields such as transportation planning, transport geography, and transport economics. Based on the analysis of the structural characteristics of airport agglomeration in China's air transport network, this study innovatively constructs an evaluation framework for the co-opetition relationship of airport agglomeration with the help of graph theory, set theory, and industrial economics theoretical methods. Considering the topological connectivity and weighted strength of connected airports, this study establishes a quantitative evaluation model for the co-opetition relationship of the airport agglomeration's air transport network from the perspectives of the overall and interactive markets. The Guangdong-Hong Kong-Macao Greater Bay Area's airport agglomeration is a world-class airport agglomeration with the largest aviation traffic volume and a relatively mature market in China. Three large airports, Guangzhou (CAN), Hong Kong (HKG), and Shenzhen (SZX), occupy the leading positions in the Greater Bay Area. In recent years, the air transport network of the Guangdong-Hong Kong-Macao Greater Bay Area's airport agglomeration has mainly expanded to medium- and long-distance routes. With the construction-based evaluation method, we found the following: (1) From the perspective of overall market competition index, the co-opetition market of airport agglomeration in the Greater Bay Area is dominated by a complete monopoly market and a weak cooperative market. In 2019, the complete monopoly market accounted for 33.8%, a decrease of 4.1% compared with 2015. The market with weak cooperation accounted for 42.3%, and market share remained relatively stable. The market with weak competition accounted for 15.8% of the market, and the market share remained relatively stable. The market with strong competition accounted for 6.3%, a decrease of 4.5% from 2015. Based on the calculation and analysis of the weighted strength of connected airports, there are significant differences in the co-opetition indices of similarly connected airports. The level of competition in the overall market has intensified. (2) From the perspective of interactive competition, the interactive co-opetition market within the airport group in the Greater Bay Area is dominated by strong and weak cooperation markets. From the co-opetition index of airports connecting with the Greater Bay Area, there are ten pairs of airports belonging to the strong cooperation markets in 2019, i.e. between Guangzhou and Huizhou, Macau and Foshan, Hongkong and Zhuhai airports, a decrease of six compared with 2015. The weak cooperation markets in 2019 included ten pairs of airports, such as Guangzhou and Hong Kong, Hong Kong and Shenzhen, Macau and Huizhou, an increase of six pairs of airports compared with 2015. Based on the weighted strength of connected airports, this study analyzes the interactive competition patterns. In 2019, the strong cooperation markets included eight pairs of airports, including Guangzhou-Foshan, Guangzhou-Huizhou, and Hong Kong-Huizhou, a decrease of two pairs compared with 2015. The weak cooperation markets include eight pairs of airports, such as Guangzhou-Macau, Hong Kong-Shenzhen, and Macau-Shenzhen, a decrease of two pairs compared with 2015. The weak competitive markets include four pairs of airports, namely, Guangzhou-Hong Kong, Hong Kong-Macau, and Shenzhen-Zhuhai, an increase in three pairs of airports compared with 2015. In general, the co-opetition market pattern of the Greater Bay Area turns from a cooperative overall to a competitive transformation.

Traditional food is an important part of traditional culture and the development of traditional food culture is an important means of rural revitalization. Although the authenticity of food culture is becoming a point of discussion in domestic research, there are still some limitations. The existing studies do not further subdivide food into traditional and local foods, while traditional food is more consistent with the object of authenticity research. On the basis of distinguishing the concepts of local and traditional foods, this study selected smelly mandarin fish, a native traditional food in tourist destinations, as the research object to explore tourists' perception of the authenticity of traditional food and its influence on dining satisfaction and behavioral intention in tourist destinations. With Hongcun as the location of this study, data were collected through a questionnaire survey and semi-structured interview. The AMOS structural equation model was constructed by analyzing three authenticity dimensions—dining environment, service, and food—and two dimensions—satisfaction and behavioral intention. The results show that tourists' perception of authenticity in the three dimensions has a significant, direct, and positive impact on dining satisfaction and a significant, indirect, and positive impact on behavioral intention. Among them, environmental authenticity has the greatest impact on dining satisfaction, followed by service and food authenticity. Through the analysis of the interview text, this study explains the structure of the influence of tourists' three dimensions of perception on satisfaction and behavioral intention. Combined with interviews with the host group, this paper discusses the differences in the perception and attitude of the host and the main characteristics of reshaping the destination's traditional food culture. This study believes that even if the object of experience is the traditional food of the destination closely related to authenticity, public tourists still pay more attention to the overall dining environment and service atmosphere, and the food itself has the lowest impact on satisfaction. This paper finds that the local traditional food culture presents the characteristics of de-traditionalization and de-localization. In the food culture reproduction of destination, because tourists pay particular attention to the environment, operators will be more willing to build the environment atmosphere to an extent that overlooks the importance of the food itself. Local customers pay more attention to the "authentic" taste of food, and the differences between hosts and customers as well as the orientation of tourist needs of production have led to the hosts'low identification with the authenticity of staged foods. Future studies should fully consider the particularity of traditional food as a specific object and reshape the food culture to make customers more satisfied. The contribution of this study is to sort out the classification basis of traditional food, study the impact of the perception of authenticity of traditional food culture on dining satisfaction and behavioral intention, analyze the impact and main characteristics of the perception difference between hosts and guests on the reconstruction of destination traditional food culture, and put forward the prospect of further study.

In this paper, the research on the active components, dry processing methods, extraction of functional components and processed products of Flos Lonicerae at home and abroad in recent years were summarized and discussed, and the development direction of Flos Lonicerae in the future was prospected.

Objective To explore the expression, clinical significance and molecular mechanism of miR-3934-5p in hepatocellular carcinoma (HCC). Methods HCC tissues and adjacent normal tissues were collected from 53 HCC patients diagnosed in our hospital from September 2013 to August 2014. Real-time quantitative PCR (RT-qPCR) was performed to detect the level of miR-3934-5p in the above tissues and human liver cell line L02 and HCC cell lines. The Cancer Genome Atlas (TCGA) database was used to analyze the expression of miR-3934-5p in normal liver tissues and HCC tissues; Chi-square test with Kaplan-Meier survival curve were applied to analyze the correlation of miR-3934-5p and clinicopathological characteristics and survival prognosis; RT-qPCR and Western blotting were adopted to detect transfection efficiency; CCK-8 assay, colony formation assay and EdU assay were employed respectively to evaluate the activity and proliferation of HCCLM3 cells; Spearman correlation analysis was applied to study the correlation between LACTB mRNA and miR-3934-5p expression in HCC tissues; TargetScan database was used to predict the downstream target genes of miR-3934-5p, and the prediction results was verified by luciferase reporter assay. Results MiR-3934-5p was highly expressed in the liver cancer tissues and cells (P < 0.05), and its high expression was significantly correlated with tumor size (P=0.040), tumor multiplicity (P=0.013), vascular invasion (P=0.006), and TNM stage (P=0.017); Compared to the low miR-3934-5p expression group, the HCC patients with high expression had poorer survival prognosis. CCK-8 assay, colony formation assay and EdU assay confirmed that knocking down miR-3934-5p notably inhibited the proliferation of HCCLM3 cells (P < 0.05). LACTB had been proved to be the direct target of miR-3934-5p, and mediated the biological effect of miR-3934-5p on HCC cells. Conclusion MiR-3934-5p promotes the proliferation of HCC cells by targeting tumor suppressor gene LACTB.

The COVID-19 epidemic spread globally at the start of 2020, resulting in a wide range of diffusion of infectious diseases. At present, SARS-CoV-2 is still prevalent worldwide, and it is of great practical significance to strengthen the study on the COVID-19 epidemic. Based on the COVID-19 confirmed cases and incidence, this article explored both the temporal and spatial distribution pattern of COVID-19 in Hunan Province and its influencing variables between January 21 and February 28, 2020 by using ArcGIS 10.3 and GeoDetector. The results show that: 1) The epidemic evolved with temporal phasing. The epidemic in Hunan Province can be divided into four basic stages: the diffusion period, peak period, decay period, and the stagnant period.The first COVID-19 confirmed case of 84.47% affected counties was imported from Wuhan;2) The epidemic spread as a result of transportation convenience. The confirmed COVID-19 cases were concentrated near major railway lines, which were also high-incidence areas. The epidemic occurred "early in prefecture-level cities and frequently in urban areas"; 3) the extent of the epidemic has distance attenuation. The COVID-19 cases and high-incidence areas were mainly distributed in the middle, north, and northeast of Hunan, in regions in proximity to Wuhan; 4) the epidemic was distributed with spatial aggregation. The agglomeration level of cases and incidences increased first and then remained high. The hot spots identified are in Changzhutan and Yueyang City, while the cold spots are in Xiangxi Prefecture; 5) the epidemic prevalence was of variable interaction. Wind-free, cold and dry weather was more conducive to the spread of the epidemic; population density, road network density and GDP were the main factors affecting the epidemic spatial differentiation; and the strongest variable interaction happened between natural and social factors. 6) the influencing variables of the COVID-19 epidemic have spatial heterogeneity. The impacts of spatial distance and population density have spatial heterogeneity on both the reported cases the total infections rates of COVID-19, spatial distance has the greatest impact in northeast Hunan, and population density has the greatest impact in northwest and northern Hunan; but the mobility of population and the number of health technicians only have spatial heterogeneity of impacts on the reported cases of COVID-19, the impact of population mobility is diminishing from north to south in Hunan, and the influence of the number of health technicians decreases gradually with the Changsha-Zhuzhou-Xiangtan city agglomeration as the core to the outer circle.The paper's conclusions are consistent with other scholars' studies in other regions, confirming that the epidemic not only spreads significantly in neighboring areas, but there are also "jump spreads" to distant cities that rely on the transportation network in Hunan. It is evident that restricting the entry of residents of affected areas plays a key role in COVID-19 prevention and control, and moreover, allocating plentiful health technicians, executing rigorous transport quarantine, and adopting compatible preventing measures with local and temporal conditions, are the top priorities in effectively responding to the impact of the COVID-19 epidemic.

The cementing casing of large diameter well has large outer diameter and mass, and is lowered by welding connection. The special specification, size and connection mode require the casing to adopt special technology. Through-hole tools and lifting tools are processed separately according to casing specifications; the core of the method includes the development of the buoyancy plug and the casing anti-extrusion control. The buoyancy plug enables mud buoyancy to ensure that the rig is able to lower the mass casing with little lift while facilitating subsequent cementing; in the process of using mud buoyancy, anti-extrusion control ensures that the empty section of casing does not collapse under mud pressure in the well. It has been proved by practice that the key technology of large diameter casing can be handled well to ensure safe casing running without damage.

For the purpose of ensuring the normal operation of river-crossing pipeline, it is necessary to detect the burial depth periodically. In view of the inaccurate result caused by unstable electromagnetic signals during the detection of directional drilling crossing pipeline due to its large covering, the One-Pass underwater pipeline inspection system was optimized by changing the calibration method of electromagnetic signals in the crossing pipelines with different buried depth to improve the detection accuracy of directional drilling crossing pipeline. The consequences show that the higher degree of compliance of the results calculated according to the calibration data of the optimized electromagnetic signal with the actual situations indicates that the optimized One-Pass inspection system can satisfy the detection requirements for laying status of the directional drilling crossing pipeline within a water depth of 40 m. The research results could be used to guide the detection of the laying status of river-crossing pipeline by directional drilling, and they are of important significance to ensure the safety operation of river-crossing pipeline.

Objective To explore the best indication for veneers and to improve the repair success rate by investi⁃ gating the effects of different types of dentin exposure on the shear bond strength of cast porcelain veneers with two new veneer bonding systems. Methods Bonding interfaces with 0%, 25%, 50%, 75% and 100% dentin exposure were de⁃ signed and fabricated. The bonding interfaces were divided into groups A, B, C, D and E. Sixty 4⁃mm x 4⁃mm x 2⁃mm (length x width x thickness) ceramic specimens were bonded by using two bonding systems, The VN⁃A, VN⁃B, VN⁃C, VN⁃D and VN⁃E groups were bonded with Variolink bonding system, and the PF⁃A, PF⁃B, PF⁃C, PF⁃D and PF⁃E were bonded with Panavia F bonding system (six specimens per group). The bonded specimens were stored in a distilled water bath at (37 + 1)℃ for 24 hours. The fracture load was tested by a universal testing machine, and the fracture type was observed by scanning electron microscopy. Results The VN⁃A (25.14 ± 3.40 MPa), VN⁃B (22.54 ± 4.48 MPa), VN⁃C (19.59 ± 2.21 MPa), PF⁃A (20.61 ± 2.42 MPa), PF⁃B (18.08 ± 4.11 MPa), PF⁃C (17.06 ± 2.29 MPa) groups’shear bond strengths were above 17 MPa. The VN⁃A group had the highest shear bond strength value. There was no statistically significant difference in bond strength between the VN⁃A group and the VN⁃B and VN⁃C groups(P > 0.05) or the PF⁃A and PF⁃B groups (P > 0.05); however, the differences between VN⁃A and the VN⁃D and VN⁃E groups (P < 0.05) and between PF⁃A and the PF⁃C and PF⁃D and PF⁃E groups (P < 0.05) were statistically significant. The differences between the VN⁃A group and PF⁃A group (P < 0.05) were statistically significant. The fracture modes of the VN⁃A, PF⁃A, VN⁃B, PF⁃B, and VN⁃C groups mainly included resin cement cohesive failure and mixed failure; the VN⁃D, VN⁃E, PF⁃C, PF⁃D and PF⁃E groups were dominated by interface failure and mixed failure. Conclusion When the dentin exposure is greater than 50%, the shear bond strength value of the veneer was significantly affected. To ob⁃ tain a better clinical effect, the dentin exposure rate should be less than 25%.

The laser hardening process is carried out on the tooth surface of 40 Cr rack with module of 2. 5 in high precision linear guide by utilizing a 3 k W diode laser. The single beam laser and dual beam laser hardening process are researched separately. The results show that,when using the single beam laser,the reflected energy have little effect on the microhardness of tooth surface,but the hardened surface will be tempered by the heat conducted from the other side. Compared with the single beam laser,the dual beam laser has many advantages such as lower laser power,more efficiency and more uniform distribution of microhardness.

For the operating performance of listed corporations reflects the value of stock investment to a certain extent, financial index reflecting the operating performance of listed corporations was taken as the evaluation index of stock investment value, and for the first time the parallel clustering algorithms for big data both K-means and fuzzy K-means of Mahout were used to cluster nearly 2 600 stock of China’s A shares market according to their financial index, afterwards the clustering results of these two algorithms under different distance metrics were compared.Experimental results show that the clustering quality of K-means algorithm adopting Tanimoto distance metric is the best.Therefore, this result can be used as the final result of the division of stock, which can provide a reference for the investment decision.

The gear strength is one of most important part in mechanical design. Several crisis problem will be mainly discussed which often confused and misunderstood about the calculation of the gear strength including the failure mode of gear,bending fatigue strength design,contact fatigue strength design,etc. The development of gear strength design in history and the current situation of it are also referred. This can be referenced for gear and other mechanical design or teaching,beside,it can also help the designer or student to get a deeper comprehensive and a better improvement on gear design and its background.

Adaptive filtering methods based on least-mean-square (LMS) error criterion have been commonly used in auscultation to reduce ambient noise. For non-Gaussian signals containing pulse components, such methods are prone to weights misalignment. Unlike the commonly used variable step-size methods, this paper introduced linear preprocessing to address this issue. The role of linear preprocessing in improving the denoising performance of the normalized least-mean-square (NLMS) adaptive filtering algorithm was analyzed. It was shown that, the steady-state mean square weight deviation of the NLMS adaptive filter was proportional to the variance of the body sounds and inversely proportional to the variance of the ambient noise signals in the secondary channel. Preprocessing with properly set parameters could suppress the spikes of body sounds, and decrease the variance and the power spectral density of the body sounds, without significantly reducing or even with increasing the variance and the power spectral density of the ambient noise signals in the secondary channel. As a result, the preprocessing could reduce weights misalignment, and correspondingly, significantly improve the performance of ambient-noise reduction. Finally, a case of heart-sound auscultation was given to demonstrate how to design the preprocessing and how the preprocessing improved the ambient-noise reduction performance. The results can guide the design of adaptive denoising algorithms for body sound auscultation.

Objective: To conduct a systematic description and meta-analysis of the treatment of unilateral vocal cord paralysis（UVCP） with recurrent laryngeal nerve reinnervation through literature search, and to analyze the therapeutic effect of recurrent laryngeal nerve reinnervation on improving vocal function in UVCP. Methods: Electronic databases Pubmed, Web of Science, EMBASE, Cochrane Library, CNKI, and Wanfang databases were searched using relevant keywords and screened in strict accordance with the inclusion and exclusion criteria, and quality evaluations were conducted. Reported treatment outcomes were measured by relevant data extracted from literature, such as auditory perception assessment（GRBAS）, voice handicap index（VHI）, maximal phonation time（MPT）, jitter, shimmer, and noise harmonic ratio（NHR）, etc. Meta-analysis was performed by Revman5.3 and heterogeneity was analyzed using fixed effects or random effects models. Results: Eight articles were included in this study, all of which showed that the postoperative maximum phonation time of patients was significantly prolonged compared to preoperative, while the postoperative GRBAS score, Jitter, Shimmer, and NHR decreased compared to preoperative with statistical significance. Conclusion: The innervation of the internal laryngeal muscle was obtained through the reinnervation of the recurrent laryngeal nerve, which effectively improved the patient's vocal function and had a good long-term therapeutic effect. Although there was no difference in the efficacy of surgical methods for reconstructing the recurrent laryngeal nerve, the anastomosis between ansa cervicalis nerve and the recurrent laryngeal nerve is more ideal. Further randomized controlled studies with longer follow-up periods and larger samples will increase the credibility of their effectiveness., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

A 54-year-old female patient presented with recurrent cough and sputum production over the past year and was hospitalized several times. CT examination revealed exudative lesions in both lungs, which were partially absorbed after treatment. However, they recurred shortly after discharge, and the patient had to be readmitted. In the past year, the patient had been hospitalized six times, and her throat swabs were positive for SARS-CoV-2 at four different points in time. After receiving anti-infective and antiviral treatment in other hospitals, the above symptoms were relieved. The patient tested negative for SARS-CoV-2, but symptoms recurred soon after. Eventually, the diagnosis of Goods syndrome was made based on the presence of B-cell loss, decreased immunoglobulin levels, an inverted CD4+/CD8+ ratio on admission, and a previous history of thymoma.

This study aimed to explore the intervention effect of Chuanxiong-Chishao herb pair(CX-CS) on a myocardial infarction-atherosclerosis(MI-AS) mouse model and investigate its effect on the expression profile of circular RNAs(circRNAs)/long non-coding RNAs(lncRNAs) in ischemic myocardium and aorta. Sixty male ApoE~(-/-) mice were randomly assigned to a model group, high-, medium-, and low-dose CX-CS groups(7.8, 3.9, and 1.95 g·kg~(-1)), and a positive drug group(metoprolol 26 mg·kg~(-1) and simvastatin 5.2 mg·kg~(-1)), with 12 mice in each group. Male C57BL/6J mice were assigned to the sham group. The mice in the model group and the groups with drug intervention were fed on a high-fat diet for 10 weeks, followed by anterior descending coronary artery ligation. After that, the mice were fed on a high-fat diet for another two weeks to induce the MI-AS model. The mice in the sham group received normal feed, followed by sham surgery without coronary artery ligation. Mice in the groups with drug intervention received CX-CS or positive drug by gavage for four weeks from the 9th week of high-fat feeding, and those in the model group and the sham group received an equal volume of normal saline. Whole transcriptome sequencing was performed on the heart and aorta tissues of the medium-dose CX-CS group, the model group, and the sham group after administration. The results showed that the medium-and high-dose CX-CS groups showed improved cardiac function and reduced myocardial fibrosis area, and the medium-dose CX-CS group showed significantly reduced plaque area. CX-CS treatment could reverse the expression of circRNA＿07227 and circRNA＿11464 in the aorta of AS model and circRNA expression(such as circRNA＿11505) in the heart of the MI model. Differentially expressed circRNAs between the CX-CS-treated mice and the model mice were mainly enriched in lipid synthesis, lipid metabolism, lipid transport, inflammation, and angiogenesis in the aorta, and in angiogenesis, blood pressure regulation, and other processes in the heart. CX-CS treatment could reverse the expression of lncRNAs such as ENSMUST00000162209 in the aorta of the AS model and TCONS＿00002123 in the heart of the MI model. Differentially expressed lncRNAs between the CX-CS-treated mice and model mice were mainly enriched in lipid metabolism, angiogenesis, autophagy, apoptosis, and iron death in the aorta, and in angiogenesis, autophagy, and iron death in the heart. In summary, CX-CS can regulate the expression of a variety of circRNAs and lncRNAs, and its intervention mechanism in coronary heart disease may be related to the regulation of angiogenesis and inflammation in ischemic myocardium, as well as lipid metabolism, lipid transport, inflammation, angiogenesis in AS aorta.

We reported a 28-year-old male patient who had been admitted to a local hospital for several times in the past four years because of recurrent fever and cough. Each chest CT scan during hospitalization showed consolidation accompanied by exudation and mild pleural effusion. After treatment, the consolidation apparently absorbed, but similar symptoms recurred within half a year, and the new consolidation appeared. For this reason, he was diagnosed with tuberculosis or bacterial pneumonia several times in other hospitals, and was hospitalized two to three times a year. Finally, he was diagnosed with chronic granulomatous disease (CGD) with CYBB gene mutation through whole-exome sequencing.

Objective: To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods: This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome（recurrence, canceration, recurrence-free survival, and canceration-free survival） in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results: The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence（ P <0.05）, and smoking index and lesion range were significantly associated with canceration （P <0.05）. Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence（ P <0.05）, and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration（ P <0.05）. The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer（ P <0.05）. Conclusion: Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the effect of primary and acquired resistance to anti-human epidermal growth factor receptor 2 (HER-2) on the overall survival of patients with HER-2 positive advanced breast cancer. Methods: The clinical characteristics of HER-2 positive patients with advanced breast cancer admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1998 to December 2018 were collected, and their neoadjuvant/adjuvant and advanced three-line chemotherapy were summarized. Among them, targeted drugs for HER-2 included trastuzumab, pertuzumab, T-DM1, RC48-ADC, lapatinib, pyrotinib, allitinib, sipatinib, seratinib. Based on the duration of benefit from anti HER-2 treatment, the patients were divided into two groups: primary anti HER-2 resistance group and acquired anti HER-2 resistance group. In this study, the overall survival (OS) was used as the main end point. Kaplan-Meier analysis and Cox proportional risk regression model were used to analyze the effects of different drug resistance mechanisms on the overall survival. Results: The whole group of 284 patients were included. The median age of recurrence and metastasis was 48 years old, 155 (54.6%) were hormone receptor (HR) positive and 129 (45.4%) were HR negative, 128 cases (45.1%) were premenopausal and 156 cases (54.9%) were postmenopausal, 277 cases (97.5%) had a score of 0-1 in ECoG PS and 7 cases (2.5%) had a score of more than 2 in the first diagnosis of relapse and metastasis. There were 103 cases (36.3%) in the primary drug resistance group and 181 cases (63.7%) in the secondary drug resistance group. The median overall survival time of the two groups was 24.9 months and 40.4 months, respectively, with statistical significance ( P <0.001). Conclusion: Primary resistance to HER-2 is one of the factors of poor prognosis in HER-2 positive breast cancer, and its mechanism needs to be further explored.

Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P =0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P =0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance ( P =0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant ( P =0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.

Objective: To explore the characteristics of sleep-disordered breathing (SDB) in chronic heart failure patients waiting for heart transplantation and the changes of SDB after transplantation. Methods: From September 2018 to December 2019, 34 patients with chronic heart failure were prospectively enrolled into this study, who were hospitalized for waiting for heart transplantation in the departments of cardiovascular medicine and cardiovascular surgery, Renmin Hospital of Wuhan University. All of them received portable sleep physiological monitoring. The characteristics of their SDB were analyzed before and after heart transplantation. Results: Of the 34 patients waiting for heart transplantation, 22 had central sleep apnea, 4 had obstructive sleep apnea and 8 had no SDB. The cycle length of Cheyne-Stokes respiration was negatively correlated with left ventricular ejection fraction. After heart transplantation, 15 patients received repeat sleep physiological monitoring and their results showed that the SDB was significantly improved, with the elimination of Cheyne-Stokes respiration. Conclusions: Patients waiting for heart transplantation had a high prevalence of SDB, with Cheyne-Stokes respiration with central sleep apnea as the main type. However, heart transplantation may eliminate the Cheyne-Stokes respiration in patients with chronic heart failure.

In clinic, intima and media thickness are the main indicators for evaluating the development of atherosclerosis. At present, these indicators are measured by professional doctors manually marking the boundaries of the inner and media on B-mode images, which is complicated, time-consuming and affected by many artificial factors. A grayscale threshold method based on Gaussian Mixture Model (GMM) clustering is therefore proposed to detect the intima and media thickness in carotid arteries from B-mode images in this paper. Firstly, the B-mode images are clustered based on the GMM, and the boundary between the intima and media of the vessel wall is then detected by the gray threshold method, and finally the thickness of the two is measured. Compared with the measurement technique using the gray threshold method directly, the clustering of B-mode images of carotid artery solves the problem of gray boundary blurring of inner and middle membrane, thereby improving the stability and detection accuracy of the gray threshold method. In the clinical trials of 120 healthy carotid arteries, means of 4 manual measurements obtained by two experts are used as reference values. Experimental results show that the normalized root mean square errors (NRMSEs) of the estimated intima and media thickness after GMM clustering were 0.104 7 ± 0.076 2 and 0.097 4 ± 0.068 3, respectively. Compared with the results of the direct gray threshold estimation, means of NRMSEs are reduced by 19.6% and 22.4%, respectively, which indicates that the proposed method has higher measurement accuracy. The standard deviations are reduced by 17.0% and 21.7%, respectively, which indicates that the proposed method has better stability. In summary, this method is helpful for early diagnosis and monitoring of vascular diseases, such as atherosclerosis.

The outbreak of 2019 novel coronavirus disease (COVID-19) is spreading rapidly. In order to prevent cluster outbreaks, the government strengthened the management and control of personnel mobility, which had a great impact on the examination and treatment of breast cancer patients. This paper discusses how to realize scientific health management of breast cancer patients outside the hospital based on the existing epidemic situation, characteristics of breast cancer patients and public health safety factors. The breast cancer patients should synthetically consider the epidemic prevention situation of inhabitance, the disease stage and previous therapeutic schedule to decide the next therapeutic schedule. If necessary, after professional discussion and communication between doctors and patients online or offline, the hospital visiting time should be delayed through seeking alternative treatment schemes, and psychological counseling for patients should be paid attention to at the same time.

Objective: To compare clinical characteristics between patients with chronic obstructive pulmonary disease (COPD) and COPD -OSA overlap, and to analyze the risk factors for OSA in patients with COPD. Methods: A total of 431 patients with COPD were divided into a COPD-OSA group with AHI>15 events/h or a COPD group with AHI ≤ 15 events/h according to the results of polysomnography, and their clinical characteristics were summarized. Risk factors for OSA overlap in COPD patients were identified by univariate and multivariate logistic regression analyses. Results: There were no significant differences in gender composition, dyspnea scale (mMRC) score, the numbers of acute exacerbations and hospitalizations in the last year, prevalence of coronary heart disease, or cor pulmonale or diabetes mellitus in the two groups (all P> 0.05). Age, BMI, neck circumference, smoking index, COPD assessment test (CAT) score, the values of FEV(1) or FEV(1)%, FEV(1)/FVC ratios, and the prevalence of hypertension in the COPD-OSA group with AHI>15 events/h were significantly higher than in the COPD group with AHI ≤15 events/h, while the duration of COPD and the proportion of severe COPD were lower than the COPD group with AHI≤ 15 ( P< 0.05). The scores of Charlson Comorbidity Index, Epworth Sleepiness Scale (ESS) and Sleep Apnea Clinical Score (SACS) in the COPD-OSA group were significantly higher than in the COPD group with AHI≤ 15, with all P values<0.05. Risk factors for AHI>15 OSA coinciding in patients with COPD included BMI, neck circumference, ESS, SACS and CAT ( P< 0.05). Furthermore, BMI, ESS and CAT were independent risk factors for OSA in COPD patients ( P< 0.05). Compared with mild or moderate COPD cases, patients with severe COPD (FEV(1)%<50%) had a lower risk of having OSA (β=-0.459, OR= 0.632, 95% CI 0.401-0.997, P= 0.048). Conclusions: Compared to COPD patients with AHI ≤ 15 events/h, OSA-COPD overlap patients (AHI>15 events/h) had a worse quality of life, more daytime sleepiness and higher prevalence of hypertension. BMI, ESS and CAT were independent risk factors for AHI>15 OSA in patients with COPD. The risk of having OSA in severe COPD patients was lower than cases with mild or moderate COPD.

Objective: To compare the histopathological features of the synovium between rheumatoid arthritis (RA) and osteoarthritis (OA)., Methods: We retrospectively analyzed the synovial specimens obtained after synovial surgery in 72 cases of RA and 24 cases of OA. Two independent pathologists reviewed the sections of the synovial tissues with HE staining, quantitatively scored the degree of fibroblast-like synoviocyte (FLS) hyperplasia, vascular hyperplasia, fibroplasia, and lymphocyte infiltration, and examined the presence plasma cell infiltration. The pathological morphology of the synovial tissues was evaluated in relation with the clinical data of the patients., Results: Pannus formation was also detected in the synovium of OA patients, which showed a lesser degree of OA-FLS hyperplasia, fibrosis and lymphocyte infiltration and a significantly lower rate of plasma cell infiltration compared with the pannus in RA patients. Vascular proliferation was also milder in the pannus of OA patients than in RA pannus, but the difference was not statistically significant. In OA patients, the pannus could be observed under a microscope and was difficult to distinguish from that in RA patients., Conclusions: Pannus formation occurs also in the synovium of OA patients but with milder FLS hyperplasia, fibrosis and lymphocyte infiltration and a lower rate of plasma cell infiltration compared with the pannus in RA patients. These differences in the pannus between OA and RA can be of potential value in the diagnosis and treatment of the patients.

Objective: To investigate the adrenocortical function changes of patients with advanced solid tumors who received the anti- programmed cell death protein-1 (PD-1) antibody, SHR-1210 therapy. Methods: The clinical data of 98 patients with advanced solid tumors who were enrolled in a prospective phase I trial of SHR-1210 therapy at our institution between April 27, 2016 and June 8, 2017 were collected. The levels of plasma adrenocorticotropic hormone (ACTH) and cortisol were evaluated in 96 patients. The clinical manifestations, laboratory tests and radiologic data were collected to define the immune-related adrenal insufficiency. Results: Until December 14th, 2018, no SHR-1210 related primary adrenal insufficiency occurred, and the incidence of immune-related secondary adrenal insufficiency was 1.0% among the 96 patients, which was identified as grade 2. No patient developed grade 3-4 adrenal insufficiency. The main clinical manifestations of the patient who was diagnosed as secondary adrenal insufficiency were grade 2 fatigue, anorexia and headache.The patient developed fatigue and anorexia at the 267th day after receiving the first dose of SHR-1210, the hypocortisolism occurred on the 279th day, and the headache emerged on the 291th day. The anorexia of patient who treated by physiological replacement doses of glucocorticoid since the 457th day was attenuated.The patient whose cortisol level was still below the normal limit continued to accept the hormone replacement therapy up to 776 days after the initial administration of SHR-1210. Conclusions: The incidence of SHR-1210 related adrenal insufficiency of patients with advanced solid tumors is low, and the symptoms can be effectively ameliorated by hormone replacement therapy. The potential adverse outcome of adrenal insufficiency following immunotherapy should be noticed by clinicians to avoid the occurrence of adrenal crisis.

Surface electromyography (sEMG) has been widely used in the study of clinical medicine, rehabilitation medicine, sports, etc., and its endpoints should be detected accurately before analyzing. However, endpoint detection is vulnerable to electrocardiogram (ECG) interference when the sEMG recorders are placed near the heart. In this paper, an endpoint-detection algorithm which is insensitive to ECG interference is proposed. In the algorithm, endpoints of sEMG are detected based on the short-time energy and short-time zero-crossing rates of sEMG. The thresholds of short-time energy and short-time zero-crossing rate are set according to the statistical difference of short-time zero-crossing rate between sEMG and ECG, and the statistical difference of short-time energy between sEMG and the background noise. Experiment results on the sEMG of rectus abdominis muscle demonstrate that the algorithm detects the endpoints of the sEMG with a high accuracy rate of 95.6%.

Objective: To investigate the clinical characteristics, the medicine application and to evaluate the disease activity in patients with osteoarthritis (OA) in China., Methods: This was a cross-sectional study. Totally 1 066 cases of OA from 40 hospitals in China from April to October 2017 were retrospectively enrolled. Demographic characteristics, clinical data, medicine application, and joint function were evaluated. All the data were analyzed by SPSS software 19.0. t test, Mann-Whitney U test and chi-square test were used for statistical analysis., Results: In the 1 066 cases, the male-to-female ratio was 1:3.6 and the average age was (61.9±11.0) years, with an age range from 36 to 94 years. The incidence of knee OA, hip OA, and hand OA were respectively 81.9% (873/1 066), 14.1% (150/1 066), and 36.3% (387/1 066). In the study, 242 (22.7%) cases had two kinds of joint areas involved and three joint areas were involved in 51 cases (4.8%), and 56.6% (603/1 066) of the patients used more than one kind of non-steroid anti-inflammatory drugs (NSAIDs) while 61.2% (652/1 066) used disease modifying osteoarthritis drugs (DMOADs), including glucosamine (37.5%, 400/1 066), chondroitin sulfate (2.0%, 21/1 066), diacetate (5.9%, 63/1 066), and the combination of these drugs (15.8%, 168/1 066). 8.6% (92/1 066) patients only took analgesics to relieve the pain, not using any kind of NSAIDs or DMOADs. And 232 patients (21.7%) had intra-articular injections, including 9.2% (98/1 066) sodium hyaluronate, 4.5%(48/1 066) glucocorticoid, and 8.1% (86/1 066) combination of the two drugs. The proportion of the patients taking topical drugs accounted for 26.5% (283/1 066) and physical therapy accounted for 15.8% (168/1 066). Compared with those who suffered from knee OA, the patients who suffered from hip OA had more severe disease assessment. Moreover, there were significant differences in pain (Z=-7.625, P<0.001), morning stiffness (Z=-6.229, P<0.001), and joint function (Z=-6.777, P<0.001) between the two groups of the patients who suffered from knee or hip OA with The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. Furthermore, patients with hip OA took more analgesics (χ 2 =24.838, P<0.001)., Conclusion: Oral NSAIDs and DMOADs are wildly used in patients with OA in China. However, the treatment of some patients still need to be improved. Patients with hip OA are more seriously ill and require aggressive treatment.

Objective: Percutaneous radiofrequency thermocoagulation (RFT) of the Gasserian ganglion is an effective treatment for refractory trigeminal craniofacial pain.In the present study, we assessed the feasibility of accessing the Gasserian ganglion through the foramen ovale with neuronavigation guidance in the patients of trigeminal craniofacial pain. Method: We retrospectively analyzed forty-four patients with type Ⅰ trigeminal neuralgia who had undergone percutaneous RFT treatment in our hospital from June 2014 to December 2016.The patients were divided into fluoroscopy group and navigation group according to the intraoperative guiding manners for foramen ovale cannulation.We compared groups in terms of the duration of the whole RFT procedure and times of intraoperative fluoroscopy.We also analyzed the immediate and late outcome accessing by Barrow Neurological Institute (BNI) pain scale, as well as the complication rates in groups. Result: There were 32 patients in the fluoroscopy group and 12 in the navigation group.The duration of the surgical procedure in navigation group was less than that in fluoroscopy group (46±12 min versus 67±16 min, P =0.00), and times of intraoperative fluoroscopy was reduced (6.3±2.2 versus 1.3±1.6, P =0.00). The learning curve of navigation-aid RFT was not steep in the present study overall.There was no significant difference between groups regarding pain reduction at the immediate ( P =0.07) or late follow-up ( P =0.400) time points.However, the rate of pain reduction to BNI-Ⅰ grade was greater in navigation group ( P =0.026). No significant difference in the complication rate between both groups, and no serious complications were observed in the both groups. Conclusion: Neuronavigation may be encouraged in trigeminal Gasserian ganglion RFT with better operating efficiency and less radiation exposure.The immediate and late therapeutic effects for craniofacial pain control were positive, whereas further studies are necessary.

Objective: To assess the incidence and characteristics of thyroid dysfunction during anti-Programmed cell death 1 receptor (PD-1) antibody SHR-1210 therapy in patients with advanced solid tumor. Methods: The medical records of 98 patients who initiated SHR-1210 treatment between April 27, 2016 and June 8, 2017 in the phase 1 trial to evaluate the safety, efficacy, and pharmacokinetics of SHR-1210 in patients with advanced solid tumors were retrospectively reviewed. Serological tests of thyroid stimulating hormone (TSH) and free thyroxine (fT4) were measured at baseline and prior to each SHR-1210 administration. Results: A total of 86 patients had normal thyroid function before the first dose of SHR-1210 treatment. Nine out of 86 (10.5%) patients developed new onset hypothyroidism from euthyroid state. 12 patients presented thyroid dysfunction at baseline, 10 of whom were subclinical hypothyroid and 2 were hypothyroidism. Four out of 10 patients developed hypothyroidism from subclinical hypothyroid. Most patients with hypothyroidism were asymptomatic. Thyroid dysfunction occurred early (median, 55days) after the initiation of SHR-1210. The severity of hypothyroidism were all grade 1-2. No grade 3-4 hypothyroidism occurred. No patients discontinue the treatment of SHR-1210 due to clinical impact of the thyroid dysfunctions. Conclusions: Thyroid-related adverse events were common during anti-PD-1 antibody SHR-1210 treatment . The incidence of hypothyroidism is lower in patients with euthyroid state than in patients with thyroid dysfunction at baseline during SHR-1210 treatment . Thyroid function can be improved after thyroid hormone replacement. During SHR-1210 treatment, it is necessary to pay attention to monitor the thyroid function, especially in the patients with thyroid dysfunction at baseline. Trial registration: Chinese Clinical Trial Registry, 2016L01455.

Objective: To investigate the relationship between the radioresistance of pancreatic cancer cell SW1990 and the induction of the Epithelial-Mesenchymal Transition (EMT). Methods: The radio-resistant pancreatic cancer cell SW1990-R were established by using the method of radiating pancreatic cancer cell SW1990 step by step and repeatedly. Then the changes of the morphology of the cell was observed by inverted phase contrast microscope, the radioresistance of SW1990-R was detected by colony-forming assay, and the apoptosis rate of the two cell lines after radiation were measured by flow cytometry. Then invasiveness and EMT-related genes was measured by trans-well test and qRT-PCR. Finally, the model of transplanted tumor on nude mouse was used to confirm the relationship between the radioresistance of pancreatic cancer cell SW1990 and the induction of EMT. Results: Compared with SW1990, SW1990-R had a lower radiosensitivity (survival fraction in 2 Gy, SF 2 : 0.326 3±0.007 3 vs 0.840 8±0.001 9, P <0.05) and lower apoptosis rate[(6.12±1.27) % vs (16.87±1.73)%, P <0.05]. Meanwhile, the invasive ability of SW1990-R were significant higher than that of SW1990 cell. According to the result of both in vivo and in vitro experiment, SW1990-R had a higher expression level of Vimentin and Snail, and lower expression level of E-cadherin when compared with SW1990. Conclusion: Compared with SW1990, the radio-resistant pancreatic cancer cell SW1990-R can induce the Epithelial-mesenchymal transition.

Objective: To investigate the effects of proteasome beta 5 subunit (PSMB5) on proliferation and bortezomib (BTZ) chemo-sensitivity of multiple myeloma (MM) and its related molecular mechanisms. Methods: We used two MM cell lines, RPMI 8226 and BTZ drug-resistant cell line RPMI 8226/BTZ100 (hereinafter referred to as BTZ100) , as the research object. PSMB5 was overexpressed or knocked down in two myeloma cell lines via lentivirus transfection. CCK8 assay was used to detect the impact of PSMB5 on cell viability and bortezomib sensitivity in human myeloma cells; Using flow cytometry to test the effects of PSMB5 on apoptosis rate of human myeloma cells under the treatment of bortezomib; Apoptosis-related gene expression of Bax, Bcl-2, p-Akt and cleaved caspase-3 were detected by Western blot. Results: ①PSMB5 overexpression and knockdown were successfully constructed in RPMI 8226 and BTZ100 cells. ②PSMB5 expression was positively correlated with cell proliferation of RPMI 8226 and BTZ100 cells ( P <0.05) . ③The cell viability was lower after PSMB5 knockdown in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (7.01±0.47) and (9.64±0.55) nmol/L respectively, t =6.289, P =0.003]. The cell viability was higher after PSMB5 overexpression in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (10.99±0.58) and (9.51±0.37) nmol/L respectively, t =3.724, P =0.020) . PSMB5 expression was negatively correlated with the sensitivity of RPMI 8226 cells to BTZ. The results of BTZ100 cells were similar. ④The expression of PSMB5 was negatively correlated with the apoptosis of RPMI 8226 and BTZ100 under the treatment of BTZ. ⑤Meanwhile, PSMB5 knockdown could increase the expression of pro-apoptosis gene Bax and cleaved caspase-3 and decrease the expression of anti-apoptotic gene Bcl-2 and p-Akt. PSMB5 over-expression has the opposite results. Conclusion: PSMB5 knockdown could improve the bortezomib sensitivity of MM cells via activation of apoptosis signaling. PSMB5 may be a potential therapeutic target for MM.

Automatic classification of different types of cough plays an important role in clinical.In the previous research of cough classification or cough recognition,traditional Mel frequency cepstrum coefficients(MFCC)which extracts feature mainly from low frequency band is usually used as feature expression.In this paper,by analyzing the distributions of spectral energy of dry/wet cough,it is found that spectral difference of two types of cough exits mainly in middle frequency band and high frequency band.To better reflect the spectral difference of dry cough and wet cough,an improved method of extracting reverse MFCC is proposed.In this method,reverse Mel filter-bank in which filters are allocated in reverse Mel scale is adopted and is improved by placing filters only in the frequency band with high spectral energy.As a result,features are mainly extracted from the frequency band where two types of cough show both high spectral energy and distinguished difference.Detailed process of accessing improved reverse MFCC was introduced and hidden Markov models trained by 60 dry cough and 60 wet cough were used as cough classification model.Classification experiment results for 120 dry cough and 85 wet cough showed that,compared to traditional MFCC,better classification performance was achieved by the proposed method and the total classification accuracy was raised from 89.76%to 93.66%.

Objective: To determine the expression profile and potential roles of CD24 in oral squamous cell carcinoma and explore the values of CD24 function as a potential target of clinical therapy., Methods: Semi-quantitative immunohistochemistry was used to construct the expression profile of CD24 in 78 human oral tissues and 59 Hamster buccal pouch tissues. Real-time RT-PCR and Western blot were used to analyze the CD24 expression levels in oral DOK4 cells, oral cancer CAL-27 and WSU-HN6 cells. Then these two cancer cell lines were selected to evaluate the effect of all-trans retinoic acid (ATRA) and CD24 antibody on CD24 expression, and the proliferation and tumorsphere formation capacity of these two cell lines., Results: CD24 expression was found significantly elevated in both human and animal tissues compared with normal and benign tissues (P<0.05), as well as in oral cancer CAL-27 and WSU-HN6 cells compared with DOK cells (P<0.05). CAL-27 and WSU-HN6 cells possess increased proliferative and specific tumorsphere formation capability compared with DOK cells (P<0.05). Both ATRA and CD24 antibody were able to effectively inhibit the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells (P<0.05). Among them ATRA at least involved partially in the proliferation by down-regulating the CD24 expression (P<0.05), while CD24 antibody blocking had no effect on the CD24 expression., Conclusion: CD24 was upregulated in oral cancer and functioned as a potential factor that promoted the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells. Both ATRA and CD24 antibody might effectively inhibit the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells and function as a potential therapy target.

The liver, kidney and muscle samples from seven cetaceans were digested by microwave digestion, and trace elements amounts of V, Cd, Cu, Zn, As, Cr, Ni, Mn, Se, Hg and Pb were determined by inductively coupled plasma mass spectrometry (ICP-MS), and the health risk assessment for Zn, Cu, Cd, Hg, Se in the liver was conducted. The results of international lobster hepatopancreas standard (TORT-2) showed acceptable agreement with the certified values, and the relative standard deviation (RSD) of eleven kinds of trace elements were less than 3.54%, showing that the method is suitable for the determination of trace elements in cetaceans. The experimental results indicated that different tissues and organs of the dolphins had different trace elements, presenting the tissue specificity. There is a certain inter-species difference among different dolphins about the bioaccumulation ability of the trace elements. The distribution of trace elements in whales presented a certain regularity: the contents of most elements in liver, kidney were much higher than the contents of muscle tissues, Cu, Mn, Hg, Se, and Zn exhibit the higher concentrations in liver, while Cd was mainly accumulated in kidney. And according to the health risk assessment in liver, the exceeding standardrate of selenium and copper in seven kinds of whales was 100%, suggesting that these whales were suffering the contamination of trace elements. The experimental results is instructive to the study of trace elements in cetaceans, while this is the first report for the concentrations in organs of Striped dolphin, Bottlenose dolphin, Fraser's Dolphin and Risso's dolphin in China, it may provide us valuable data for the conservation of cetaceans.

Cough recognition provides important clinical information for the treatment of many respiratory diseases. A new Mel frequency cepstrum coefficient (MFCC) extracting method has been proposed on the basis of the distributional characteristics of cough spectrum. The whole frequency band was divided into several sub-bands, and the energy coefficient for each band was obtained by method of principle component analysis. Then non-uniform filter-bank in Mel frequency is designed to improve the extracting process of MFCC by distributing filters according to the spectrum energy coefficients. Cough recognition experiment using hidden Markov model was carried out, and the results

Objective: To study the effect of chronic intermittent hypoxia-induced inflammatory cytokines and reoxygenation on glucose transporter 4 (GLUT-4) expression in rat skeletal muscles., Methods: Twenty-four male Sprague-Dawley rats were randomly assigned to blank control group, chronic intermittent hypoxia (CIH) group, and reoxygenation group. At the end of the experiment, fasting blood glucose (FBG), fasting blood insulin (FINS) and serum inflammatory cytokine levels were measured with glucose oxidase-peroxidase, insulin radioimmunoassay and ELISA, respectively. Homeostasis model assessment (IRI) was used to evaluate insulin resistance in the rats, and GLUT-4 protein expression in the skeletal muscles was measured with Western blotting., Results: Compared with the blank control group, CIH resulted in significantly increased fasting blood glucose, blood insulin levels and insulin resistance index (IRI) (P<0.05); fasting blood glucose was significantly elevated in reoxygenation group (P<0.05). Inflammatory cytokines levels (IL-6 and TNF-α) were significantly higher in CIH group than in the blank control and reoxygenation groups (P<0.05), and were higher in reoxygenation group than in the blank control group. GLUT-4 expression in the skeletal muscles was significantly reduced after CIH (P<0.05) but increased after subsequent reoxygenation (P<0.05)., Conclusion: CIH can cause increased release of inflammatory cytokines to lower GLUT-4 protein expression in the skeletal muscles, which contributes to insulin resistance in adult rats.

Objective: To study the effect of Erigeron Breviscapus (EB) at different concentrations and different intervention time points on the mRNA and protein expression of OPG/RANKL/RANK in MG63 osteoblast-like cells and RAW264. 7 pre-osteoclast cells cultured in vitro, thus exploring roles EB played in bone rebuilding and its mechanisms., Methods: MG63 osteoblast-like cells and RAW264.7 pre-osteoclast cells were cultured in vitro. The 3rd passage cells were divided into the control group and different experimental groups. Total RNA and protein were respectively isolated from cells treated with different concentrations of EB (0, 0.001, 0.01, 0.1, and 1.0 mg/mL) for 48 h. Meanwhile, the protein was extracted from 0 and 1 mg/mL EB groups at 12, 24, and 48 h respectively. Expression of OPG mRNA and RANKL mRNA in MG63 osteoblast-like cells, and expression of RANK mRNA in RAW264.7 pre-osteoclast cells were detected by semi-quantitative RT-PCR. Expression of OPG protein and RANKL protein in MG63 osteoblast-like cells, and expression of RANK protein in RAW264. 7 pre-osteoclast cells were detected by Western blot., Results: Along with increased EB concentration, expression of OPG mRNA and protein in MG63 osteoblast-like cells was gradually lowered (P < 0.05) after 48-h intervention of EB, the expression of RANKL mRNA and protein in MG63 osteoblast-like gradually increased (P < 0.05); the expression of RANK mRNA in RAW264.7 pre-osteoclast cells increased (P < 0.05). But the expression of RANK mRNA was slightly lower in the 0.1 mg/mL EB group than in the 0.01 mg/mL EB group, and the expression of RANK protein in RAW264.7 pre-osteoclast cells gradually increased (P < 0.05). After treatment with 1 mg/mL EB for 12, 24, 48 h, the expression of OPG protein in MG63 osteoblast-like cells gradually decreased as time went by (P < 0.05), and the expression of RANKL protein in MG63 osteoblast-like and RANK protein in RAW264.7 pre-osteoclast cells gradually increased (P < 0.05). The expression of RANKL protein in RAW264.7 pre-osteoclast cells increased as time went by (P < 0.05)., Conclusion: EB could inhibit the expression of OPG in osteoblasts in a dose- and time-dependent manner, promote the expression of RANKL in osteoblasts and the secretion of RANK in pre-osteoclast, indicating EB might play roles in promoting bone resorption.

To investigate the effect of low power helium neon laser (He-Ne laser) on the telomere length of human fetal lung diploid fibroblast (2BS) cell, we used the laser (gamma = 632. 8 nm, P = 2 mW) to treat the young 2BS cells. Cell growth and proliferation was observed through MTT method after treating with low power laser. The relative telomere length of 2BS cells was detected by fluorescence real-time quantitative PCR (q-PCR). The results showed that the cells of the treated groups grew better than the untreated groups. The telomere DNA length of the old 2BS cells, treated by low power He-Ne laser when they were young, was longer than that of untreated group. The results of the present study indicated that the low power He-Ne laser might decrease shortening rate of telomere and delay the aging of cells. Therefore, this study provides the experimental basis for us to further investigate the effect of low power laser on cell aging at the gene level.

Objective: To make a chronic intermittent hypoxia (CIH) animal model and explore the relationships of oxidative stress and the injury of aorta endothelial cell on the CIH rat model., Method: Twenty-four sex maturation rat were randomly Divided into unhandled control group(normal feeding for 4 weeks, UC group), CIH group (CIH for 4 weeks), reoxygenation group (normal feeding for 4 weeks after CIH for 4 weeks, RH group). Determined the activity of superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) in blood serum of all groups. Dislodged rat's aorta, observed the appearance of aorta endothelial cell and the expression of endothelial nitric oxide synthase (eNOS)., Result: Compared with UC group, in CIH group the activities of SOD and NO were significantly lower, but MDA significantly higher (all of P < 0.05 respectively), the appearance of aorta endothelial cell changed, the expressions of eNOS lower. There were not significantly change in UC group and RH group (P > 0.05)., Conclusion: Oxidative stress played a role in the injury of aorta endothelial cell on ob chronic intermittent hypoxia rat modle.

Objective: To determine the correlation of serum soluble CD14 (sCD14) level with the injury of vascular endothelial cells and chronic low grade inflammation in newly diagnosed Type 2 diabetes (T2DM)., Methods: ELISA was used to examine serum sCD14 and serum soluble E-selectin (sE-selectin) level, while immunoturbidimetric assay was used to detect serum high sensitivity C reactive protein (hsCRP)., Results: The levels of serum sCD14, sE-selectin, and hsCRP in newly diagnosed T2DM group were higher than those in the euglycemic group [sCD14: (300.7+/-136.6) ng/mL vs. (273.3+/-86.0) ng/mL); sE-selectin: (21.3+/-7.7) ng/mL vs. (32.9+/-11.4) ng/mL; hsCRP: (1.45+/-1.21) mg/L vs. (2.37+/-1.45)mg/L], and there was a significant difference in the latter two parameters between the 2 groups(P<0.01). In the patients with newly diagnosed T2DM, after matching blood pressure, blood sugar, and blood lipid, the levels of serum sCD14, sE-selectin, and hsCRP in the obese group were higher than those in the non-obese group. There was no significant difference in the former 2 parameters between the 2 groups. The serum sE-selectin was correlated with fasting blood sugar (r=0.369, P<0.001), 2-hour postprandial blood sugar (r=0.421, P<0.001), glycosylated hemoglobin (r=0.291, P=0.005), sCD14(r=0.312, P=0.002), and homeostasis model assessment-insulin resistance(r=0.247, P=0.018) in the newly diagnosed T2DM group. Stepwise regression ana-lysis showed that the serum sCD14 was one of the chief influencing factors on serum sE-selectin., Conclusion: Serum sCD14 levels tend to increase in newly diagnosed T2DM patients, especially in the obese diabetic patients, which is one of the chief influencing factors to induce the injury of vascular endothelial cells. The innate immunity mediated by Toll-like receptor 4 may take part in the injury of vascular endothelial cells in newly diagnosed T2DM patients.

The endpoint detection of cough signal in continuous speech has been researched in order to improve the efficiency and veracity of manual recognition or computer-based automatic recognition. First, using the short time zero crossing ratio(ZCR) for identifying the suspicious coughs and getting the threshold of short time energy based on acoustic characteristics of cough. Then, the short time energy is combined with short time ZCR in order to implement the endpoint detection of cough in continuous speech. To evaluate the effect of the method, first, the virtual number of coughs in each recording was identified by two experienced doctors using the graphical user interface (GUI). Second, the recordings were analyzed by automatic endpoint detection program under Matlab7.0. Finally, the comparison between these two results showed: The error rate of undetected cough is 2.18%, and 98.13% of noise, silence and speech were removed. The way of setting short time energy threshold is robust. The endpoint detection program can remove most speech and noise, thus maintaining a lower rate of error.

Objectives: To explore the effect of transient continuous subcutaneous insulin infusion (CSII) on ß cell function, insulin resistance and vascular endothelial injury in newly diagnosed type 2 diabetic patients and its potential mechanism., Methods: Ten patients with newly diagnosed type 2 diabetes mellitus (T2DM) accepted CSII for two weeks. Intravenous glucose tolerance test (IVGTT) and hyperinsulinemia euglycemia clamp test were performed before and after CSII. Serum soluble E-selectin (sE-selectin) was used to evaluate the injury of vascular endothelial cell, while serum high sensitivity C reactive protein (hsCRP) and soluble CD₁₄ (sCD₁₄) were both used to assess inflammatory condition., Results: (1) Compared with those before treatment, the blood glucose levels of IVGTT, the area under the curve of the blood glucose, glycosylated hemoglobin, TC and LDL-C in the patients were decreased after CSII (P < 0.05 or 0.01). (2) Compared with those before treatment, the insulin levels of IVGTT (except the fasting insulin), the area under the curve of insulin and acute insulin response were all increased after CSII (P < 0.05 or 0.01). (3) Compared with that before treatment, the glucose infusion ratio in the clamp test [(3.46 ± 1.66) mg x kg⁻¹ x min⁻¹ increased to (7.14 ± 2.37) mg x kg⁻¹ x min⁻¹] and HOMA-beta elevated, while HOMA-IR declined (P < 0.05 or 0.01 in all). (4) Compared with those before treatment, the levels of serum sE-selectin, sCD₁₄ and hsCRP were decreased (P < 0.01, except for hsCRP)., Conclusion: Transient intensive insulin therapy in patients with newly diagnosed T2DM is useful to restore beta cell function, attenuate insulin resistance, repair vascular endothelial injury and improve the disorder of blood sugar and lipid. The mechanism may be related with the inhibition of inflammation in patients.

Objective: To analyze the feature of cranial nerve involvement in nasopharyngeal carcinoma (NPC) and its relationship with the prognosis., Method: A total of 1892 patients who were diagnosed as NPC in our hospital from January 2002 to December 2003, of which the cranial nerve involvement was 183 (9.6%) patients, were analyzed the effect of cranial nerve involvement on the prognosis., Result: The percentage of cranial nerve involvement was 9.4%. The 5 year overall survival rate was 61.0%, disease free survival rate was 55.3%, local relapse free survival rate was 75.2% and distant metastasis free survival rate was 73.4%. Periods of cranial nerve involvement, clinical stage, the diameter of the lymph nodes, involvement of cavernous sinus, and the level of the recovery of cranial nerve involvement were significantly associated with prognosis in univariate analysis(P < 0.05). With multivariate analysis, the recovery level of cranial nerve involvement was the independent factor that affected the 5-year overall survival (RR = 2.087). The diameter of the lymph nodes and involvement of cavernous sinus were the independent factors that affected the 5-year distant metastasis-free survival (RR = 1.954 and 2.136, respectively)., Conclusion: Periods of cranial nerve involvement and the level of the recovery of cranial nerve involvement were significantly correlated with prognosis. Involvement of cavernous sinus could increase the rate of distant metastasis.