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Partially stabilized zirconia （7YSZ） with a mass fraction of 7±1% yttrium oxide is a widely used ceramic material for thermal barrier coatings. However， its phase stability， sintering resistance， and mechanical properties decreased during the long-time operation above 1200 ℃. A new type of Sc2O3-Y2O3 co-doped ZrO2 thermal barrier coating ceramic material was proposed ， and a molar fraction of 7.5%Sc2O3-x%Y2O3-（92.5-x）%ZrO2（x=0，0.1，0.2，0.3） ceramics were prepared by solid-state reaction method. The effects of Y2O3 doping on the microstructural， phase evolution， and mechanical properties（including Vickers hardness， fracture toughness， elastic modulus and three-point bending strength）were explored by XRD， SEM， and other testing methods. The results show that the relative density of Sc2O3-Y2O3 doped ZrO2 ceramics sintered at 1450 °C for 3.5 h is more than 97%， and the phase structure is composed of tetragonal phase. Compared with 6-8YSZ ceramics， Sc2O3-Y2O3 doped ZrO2 ceramics exhibit similar Vickers hardness （13-14 GPa）， fracture toughness （6.5-7.0 MPa·m1/2）， elastic modulus （211-214 GPa）and three-point bending strength（520-850 MPa）. Fracture mechanism shows a mixture of transgranular and intergranular fracture modes， in which transgranular fracture is dominant.This ceramic can be explored as a potential thermal barrier coating material for high-temperature applications.

Convolutional neural networks （CNNs） struggle to efficiently capture contextual information of power equipment such as arresters and GIS inlet casings due to their limited receptive fields， thereby affecting detection performance. To address this issue， the paper introduces a Transformer-based voxel-graph attention network. Local attention and dilated attention mechanisms are proposed to respectively capture short-range and long-range feature correlations within image volume pixels， effectively expanding the attention scope while keeping computational costs unchanged. Additionally， submanifold voxel modules and sparse voxel modules are designed to extract feature information from non-empty voxel positions and empty voxel positions， respectively. Finally， through comparative analysis with mainstream models on the general datasets Waymo and KITTI， as well as on an image dataset from a transmission and transformation area in Yunnan Province， the superior performance of the proposed model in detecting power equipment is demonstrated.

BackgroundThe occurrence rate of dangerous behaviors in patients with severe mental disorders is higher than that of the general population. In China， there is limited research on the prediction of dangerous behaviors in community-dwelling patients with severe mental disorders， particularly in terms of predicting models using data mining techniques other than traditional methods.ObjectiveTo explore the influencing factors of dangerous behaviors in community-dwelling patients with severe mental disorders and testing whether the classification decision tree model is superior to the Logistic regression model.MethodsA total of 11 484 community-dwelling patients with severe mental disorders who had complete follow-up records from 2013 to 2022 were selected on December 2023. The data were divided into a training set （n=9 186） and a testing set （n=2 298） in an 8∶2 ratio. Logistic regression and classification decision trees were separately used to establish predictive models in the training set. Model discrimination and calibration were evaluated in the testing set.ResultsDuring the follow-up period， 1 115 cases （9.71%） exhibited dangerous behaviors. Logistic regression results showed that urban residence， poverty， guardianship， intellectual disability， history of dangerous behaviors， impaired insight and positive symptoms were risk factors for dangerous behaviors （OR=1.778， 1.459， 2.719， 1.483， 3.890， 1.423， 2.528， 2.124， P

With the continuous increase of renewable energy permeability， the randomness of new energy and the benefit game between different operators bring a great challenge to the economic dispatch of power system. For safety and economy improvement of microgrid system， the paper proposes an autonomous economic dispatch method for multi-microgird systems considering the complementarity between wind solar power. With the goal of optimal cost for operation economy of multi-microgrid and taking account of unit regulation cost under multiple scenarios， a typical scenario generation method of wind and photovoltaic power based on Copula theory is proposed. Analytical target cascading （ATC） is used to establish a two-layer optimization model to optimize microgrid and distribution networks autonomously and independently. The IEEE 33 bus system is taken as an example to compare the economic efficiencies of multi-microgrid systems that take account of wind-solar power correlation and multi-microgrid systems that take account of random scenarios only. Furthermore， the economic efficiencies are compared with that of the centralized dispatching method. It is verified that the dispatching method taking account of the complementarity between wind and solar power can improve system economy and enhance system robustness under extreme scenarios.

To avoid possible conflicts between the maintenance scheduling and the unit commitment for hydro-thermal power systems under the traditional non-collaborative optimization mode,a collaborative maintenance scheduling and unit commitment model for hydro-thermal systems is proposed,in which the total cost of the system and the adjustment cost of maintenance scheduling as an objective are minimized with considering the coupling characteristics of cascade hydropower. Furthermore,the model is transformed into a mixed integer linear programming (MILP) model. To improve the solution of the MILP model,the objective scaling ensemble approach is proposed,including two stages. In the first stage,the coefficients of integer variables in the objective are scaled and the integer variables that may take 0 are probed. In the second stage,the reduced MILP model is solved after determining and fixing the integer variables with a value of 0. Finally,a 6-unit hydro-thermal power system and an actual provincial 86-unit hydro-thermal power system are taken as test systems. The results show that the proposed model can obtain a more economical and reasonable maintenance scheduling and unit commitment scheme compared with the non-collaborative optimization mode,thus effectively improving the solution speed by the objective scaling ensemble approach.

[Introduction] Aiming at allocating renewable energy consumption responsibility weight problem among market subjects, an allocation method based on evolutionary game and stochastic optimization is proposed. [Method] First of all, each market subject was taken as a limited rational individual participate in the weakly linked evolutionary game, and the absorption weight undertaking scheme that minimizes its own cost in the evolutionary equilibriumwas obtained and the selection strategy tendency of each market subject under the probability interval of different rewards and punishments adopted by the government was obtained. Then, after getting the probability interval of different reward and punishment measures taken by the government, a stochastic optimization model was used to get the specific scheme of absorbing weight which couldminimize the cost of each subject in each probability interval. [Result] The effectiveness and practicability of the proposed method is verified by calculating the data of 170 market entities in a provincial power grid. [Conclusion] A new method and idea on the weight distribution method of renewable energy absorption responsibility is provided, and feasible suggestions for the government to strengthen the enthusiasm of market subjects in the absorption of renewable energyare put forward in this paper.

[Introduction] In order to improve the consumption level of renewable energy and measure the risks caused by the uncertainty of its output, this paper used the complementary and coordinated dispatch of different characteristics power as a means to improve the economy of system operation and promote the consumption of renewable energy. Aiming at fluctuation and uncertainty of renewable energy and load, the theory of conditional value-at-risk (CVaR) was introduced to evaluate risks caused by the uncertainty in system dispatching and operation. [Method] Using multi-scenario technology to simulate system uncertainty, a unit commitment and multi-scenario analysis reserve decision optimal dispatching model considering conditional value-at-risk (CVaR) was established, and the objective was to limit the risk level to an acceptable premise and minimize the system operation cost. Finally, the proposed model and method was implemented on GAMS (general algebraic modeling system) platform and solved with the mixed-integer linear programming CPLEX solver. [Result] Simulation calculations show that unit commitment and reserve decision of different types power can effectively improve system operation economy, reliability, and the consumption level of renewable energy. [Conclusion] The rationality and effectiveness of the presented model and method were validated by the numerical results of the improved IEEE 24 and the actual power grid system of a province.

In order to quantitatively assess the impact of new large-scale industrial projects in Zhanjiang City on its air quality, the article estimated the emissions of major air pollutants from new large-scale industrial projects since 2015, and quantitatively evaluated the impacts of their emissions on PM2.5 and ozone concentrations by using WRF-CMAx. The results showed that total emissions of SO2, NOx, PM10, PM2.5 and VOCs of the new projects were 1 415.8, 7 436.1, 1 417.3, 629.5 and 2 469.6 tons respectively, mainly from iron making, crude oil processing and petroleum products manufacturing industries, and distributed in the Dongdao Island. The simulation results showed that under meteorological conditions in 2021, the contribution of new projects to the average annual PM2.5 concentration of each national control monitoring points for ambient air quality was 0.136~0.283 µ g/m³, and the city's average value was 0.210 µ g/m³, with the biggest impact in July. The contribution to the maximum 8-hour sliding average of ozone and the maximum hourly ozone concentration were 0.042~ 4.557 µ g/m³ and 1.274~3.484 µ g/m³, the city average were 0.092 and 5.463 µ g/m³, and with the largest contribution in April and July, respectively. Under meteorological conditions in September 2022, the contribution concentration of the new projects to the average annual PM2.5 of each national control monitoring points for ambient air quality was 0.384~ 0.693 µ g/m³, and the average value of the city is 0.538 µ g/m³. The contribution to the maximum 8-hour sliding average of ozone and the maximum hourly ozone concentration were -0.008~1.113 µ g/m³ and 0.003~8.354 µ g/m³, and the city average was 0.389 and 1.573 µ g/m³, respectively. This study can provide scientific basis for the prevention and control of air pollution in Zhanjiang City. [ABSTRACT FROM AUTHOR]

[Introduction] As the guarantee for the stable of the power system, the marketization of the regulation auxiliary service has been put on the agenda. The energy-regulation joint optimization becomes a mode of market organization. This paper aims to study the combined optimization model of the electric energy-regulation market considering the performance difference of frequency modulation resources in the PJM market background. [Method] Regulation auxiliary service pricing adjustment model and the joint clearing model of electric energy and regulation market considering the difference of fast and slow regulation resources and regulation performance was proposed in this paper, which were applied to the simulation of a real power grid to compared with domestic electric energy - regulation step clearing market. Two typical scenarios were set up in wet season and dry season. The clearing of regulation resources, the influence on the electricity purchase cost in the spot market and the active degree of regulation market were studied in detail. [Result] In the stepwise clearing mode, the rapid regulation resource has obvious advantages and causes the increase of electricity purchase cost in the electricity market. In the electricity-regulation joint optimization model, the clearing results of fast and slow regulation resources are affected by the pricing adjustment strategy and the increase rate of electricity purchase costs in the power market is smaller than that in the stepwise model, and the clearing price and fluctuation degree in the regulation market are higher than that in the stepwise clearing mode model. [Conclusion] The combined optimization mode of electric-regulation modulation with reasonable price adjustment strategy is helpful to realize reasonable competition among units with different regulation performance and stimulate market vitality.

[Introduction] Based on the trend of consuming renewable energy sources (RES) through the market-based trading model, the “market electricity price + renewable energy certificate (REC) revenue” will become the main operation of energy generators in the future. Based on the research background of RES participating in spot power market, this paper studies the price of REC. [Method] Based on the optimized clearing model of the spot electric energy market, applying the theory of the life cycle costing (LCC) of RES generation and satisfying the internal rate of return (IRR) of the energy generators, we established the optimization model of coupling REC-electric energy market. Combined with the seasonal output characteristics of RES, the simulation and measurement methods of the seasonal curve and fluctuation interval of REC price are proposed. [Result] The price of REC for different types of RES are different, and the price of REC for different types of RES also has different climatic correlations. [Conclusion] Scientific and reasonable calculation of REC price can not only help RES generation enterprises make income assessment and more accurate investment decisions, but also provide relevant decision-making support for power market entities and trading centers.

Objective To investigate the adverse effects of low-concentration isocyanate exposure on airway inflammation and lung function and to explore the application of fractional exhaled nitric oxide (FeNO) in occupational health examinations of isocyanate-exposed workers. Methods From 2016 to 2017, a total of 192 workers exposed to isocyanates were selected as the exposure group, and 91 with similar age and gender composition (office and/or logistics personnel) without any exposure to occupational hazards (as references) were studied. Monitoring data of airborne isocyanate concentration in workplaces in the past 5 years were collected. The basic information of all workers was collected, and their lung function, FeNO, and salbutamol bronchial dilation tests were performed. The differences in various indicators among these two groups of workers were compared. Results The airborne isocyanate concentration in workplaces over the past 5 years was significantly lower than the national occupational exposure limit. The forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) of the exposed workers were higher than those of the reference group, while FEV1/FVC was lower than that of the reference group, and the differences were statistically significant (P < 0.001). There was no significant difference in FeNO levels between the exposed workers and the reference workers (P > 0.05). The FEV1/FVC ratio was higher in the exposed workers with exposure time < 7 years than workers with exposure time≥ 7 years (P < 0.05), while there was no significant difference in FeNO levels between these two groups (P > 0.05). There was no significant difference in various indicators of lung function among different workers grouped according to the FeNO levels (P > 0.05). Among 192 exposed workers, 13 had FeNO levels higher than 50 ppb (1 ppb = 1 × 10-9), and among 9 workers receiving bronchial dilation tests 3 workers were positive. Conclusions FEV1/FVC could better reflect the adverse effect of isocyanate, a type of asthmagens, on lung function. FeNO levels cannot indicate the occupational low -level isocyanate exposure, while positive changes shown by bronchial dilation tests in exposed populations occur earlier than changes in lung function. The combination of FeNO measurement and bronchial dilation tests could have certain predictive value for diagnosing and screening occupational asthma. [ABSTRACT FROM AUTHOR]

In order to understand the quality changes of different varieties of peeled fresh walnut during frozen storage, and provide reference and technical support for fresh walnut storage and preservation, five varieties of walnuts (' Qingxiang', 'Xiangling', 'Yuanlin', 'Liaohe No.7', 'Jinlong No.2') were used as test materials, and the effects of frozen storage (-6 °C) on sensory quality, rancidity quality of oil and antioxidant activity of different varieties of fresh walnuts were investigated. The results showed that frozen storage at -6 °C could be applied to different varieties of fresh peeled walnuts, after 8 months of frozen storage, the moldy index of five varieties of fresh peeled walnuts was below 0.1, and the kernel flavor score was all above 70, the rise of kernel acid value, peroxide value and saponification value could be effectively inhibited, the decline of iodine value, total phenol, total flavonoids and vitamin E contents were slowed down, and kernel quality was maintained better, and the order of differenct varieties of walnut kernel quality from high to low was: 'Qingxiang' >'Xiangling' > 'Yuanlin' > 'Liaohe No.7' > 'Jinlong No.2'. [ABSTRACT FROM AUTHOR]

From 2014 to 2019, the 90th percentile concentration of O3-8h, the annual average concentration of O3 and the over standard rate in Guangdong Province and the Pearl River Delta (PRD) all showed a fluctuating upward trend. The annual maximum value of O3-8h remained high year by year, and the pollution areas were mainly concentrated in the central and southwest regions of the PRD. The concentration of O3 in the PRD, Yangtze River Delta and Beijing-Tianjin-Hebei region kept rising. The concentration level in the PRD was between the other two regions. The main reason for heavy ozone pollution in Guangdong or the PRD was the huge emission of ozone precursors. VOCs emission intensity in the PRD ranked top in China. Background ozone concentration in China was increasing year by year. The emission of VOCs from natural sources was large in Guangdong Province, and the meteorological conditions of high temperature and strong sunshine were favorable for ozone generation. The adverse meteorological conditions such as the subtropical high and the peripheral subsidence airflow of typhoon systems in summer and autumn lead to the further aggravation of ozone pollution. [ABSTRACT FROM AUTHOR]

MPI collective communication operation is widely used in parallel scientific application, which has an important influence impact on the scalability of the program. Tianhe interconnect network supports the trigger communication operations, which can offload the messaging and processing work and improve the performance between nodes. Allreduce and Reduce algorithms under different tree topological structures are designed by using the triggered operations to lower the latency the reduction operation communication between nodes. Tests based on the actual system platform show that that, com pared with the point-to-point implementation of these two types of operations in MPICH, the offload algorithm based on trigger can reduce the running time by up to 59. 67 at different node scales. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical effect of "Feiyan Yihao" Chinese medicine granules in the treatment of cases of COVID-19. Methods A total of 98 patients with COVID-19 who were non-critical were collected and divided into a treatment group (55 cases) and a control group (43 cases) according to random number method. The control group was given conventional oxygen therapy, antiviral, anti-inflammatory, phlegm and other treatments. The treatment group was given "Feiyan Yihao" granules on the basis of the control group. TCM syndrome score, laboratory data, and total hospitalization days were compared between the two groups of patients before and after treatment. Results In terms of TCM syndrome score: the treatment group decreased from (16.44±8.2) points to (4.20 ±4.3) points, and the control group decreased from (17.56±8.3) points to (7.81 ±5.2) points. There was a statistical difference in groups before and after treatment (P<0.05), and between the groups after treatment (P<0.05). At the same time, the effective component ratio of the TCM syndrome scores in the treatment group was significantly better than that in the control group (P<0.05). In terms of laboratory indicators: after treatment, the patient's lymphocyte absolute count (LYM) increased, D-dimer (D-Dimer) and blood lactate dehydrogenase (LDH) decreased. Comparing before and after treatment, LYM and D-Dimer were statistically different in both groups (P<0.05), while LDH was only statistically different in the treatment group (P<0.05). The treatment group could rincrease of blood LYM (P<0.05) and reduce increase of blood LDH (P<0.05), and shorten the days of hospital stays (P<0.05).Conclusion "Feiyan Yihao" granules can improve TCM syndromes and laboratory indicators, and shorten the duration of hospitalization on patients with COVID-19. It has good clinical efficacy and is worthy of clinical popularization. [ABSTRACT FROM AUTHOR]

Objective To investigate the change of inflammatory factor and blood coagulation in patients with laparoscopic gastric cancer radical surgery. Methods Data of seventy-seven stomach cancer patients hospitalized in our hospital and received the surgical treatment from June 2012 to June 2014 were retrospectively analyzed. Thirty-eight of these patients underwent laparoscopic treatment (laparoscopic group) and 39 cases received laparotomy treatment (laparotomy group). The values of interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha (TNF-α) were analyzed at the time points of preoperation and 6 h, 24 h after the surgery in two groups. The levels of activated partial thromboplastin time (APTT), prothrombin time (PT), international standardization ration (INR), fibrinogen (FIB) and D dimer (D-D) were also analyzed at the same time points in two groups. The postoperative thrombosis and tumor recurrence rate were also analyzed in two groups of patients. Results There were no significant differences in the gender, age, the size of tumor, differentiation degree and TNM staging between two groups of patients. The serum levels of IL-6, IL-8 and TNF-α were significantly increased after surgery in two groups (P < 0.01), and which were significantly higher in laparotomy group than those of laparoscopic group (P<0.01). The levels of APTT, PT and INR were significantly lower after surgery in two groups of patients, and which were significantly lower in laparoscopic group than those of laparotomy group (P<0.05). The levels of FIB and D-D were significantly increased after operation in two groups of patients (P<0.05), which were significantly higher in laparoscopic group than those of laparotomy group (P<0.05). The postoperative recurrence of cancer was less in laparoscopic group than that of laparotomy group. But, the postoperative thrombosis was more in laparoscopic group than that of laparotomy group. Conclusion There was less release of inflammatory mediators and less effect on the body's immune function in patients with laparoscopic gastric cancer radical surgery. But, the surgery has a large influence in blood coagulation, we should pay attention to it in the clinical treatment. [ABSTRACT FROM AUTHOR]

A new multi-channel flash storage architecture based on intra-channel interleaving and inter-channel pipelining method was introduced. The theory of the multi-channel architecture was stated and the bottleneck of the throughput of NADN flash storage system was analyzed. Then, the bandwidth formula and speed-up ratio formula under the proposed two-level parallel method were derived. The reason of affecting the speed up rate was analyzed. In the end, the diagram of the multi-channel flash storage module based on proposed multi-channel architecture is given, which proves the validity and feasibility of the proposed method. [ABSTRACT FROM AUTHOR]

For the purpose of secondary infill development of original area of oilfield, some low-efficiency wells shall be plugged, while the low success rate of general plugging cannot meet the demand for development of original area. To solve this problem, the cement capping technique of progressive plugging is developed. Y441-112 packer, release sub and cement injector are developed to realize the function of plugging in layers and progress release and ensure that the cement slurry is injected into the process pipe string efficiently and safely. This technique solves the problems of uneven cement injection and bad plugging effect caused by interlayer pressure difference resulting from general squeeze and injection for shut-in. Currently, this technique has been applied in 34 wells and the success rate is 100%, with good plugging effect and meeting the demand for secondary reconstruction of original area. [ABSTRACT FROM AUTHOR]

Objective: To explore the types of NF1 gene variants and clinical characteristics among patients with Neurofibromatosis type I (NF1)., Methods: Clinical data of 12 patients diagnosed at Ningbo Women and Children's Hospital between December 2019 and May 2022 were retrospectively analyzed. The probands and their family members were subjected to high-throughput sequencing, and candidate variants were verified by Sanger sequencing and chromosome microarray analysis., Results: The 12 patients had ranged from 4 months to 27 years old, with a male-to-female ratio of 2 : 1. Cafè-au-lait spots were found in all patients. 83.3% of them also had axillary and/or inguinal freckling, 58.3% had neurofibromas, and 16.7% had congenital pseudarthrosis of the tibia. Five types of NF1 gene variants were identified in the patients, including 5 nonsense variants, 4 frameshift variants, 1 missense variant, 1 splice variant, 1 large deletion involving the whole gene. Six patients were found to harbor de novo variants, 2 had inherited the variants from their parents, and 4 were not verified for their parental origin. The c.3379del (p.Thr1127Glnfs*15) and c.6628&#95;6629del (p.Glu2210Thrfs*10) variants were unreported in literature and databases., Conclusion: Most NF1 patients may present with Cafè-au-lait spots initially and are due to pathogenic variant of the NF1 gene. High-throughput sequencing can efficiently identify such variants among the patients and enable the definite diagnosis.

Objective: To describe negative conversion and rebound of patients with severe and critical acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection after treatment with Nirmatrelvir/Ritonavir, and to analyze related factors associating with failure of SARS-CoV-2 negative conversion and relapse and prognosis., Methods: A single center retrospective cohort study was conducted. Patients aged ≥ 16 years old who were diagnosed with severe or critical SARS-CoV-2 infection and took Nirmatrelvir/Ritonavir for 5 days in Peking University First Hospital from December 7, 2022 to January 27, 2023, were included. General characteristics and clinical data were collected from electronic medical record system. The Kaplan-Meier curve of SARS-CoV-2 negative conversion was drawn. Factors with P < 0.10 were incorporated into multivariate Logistic regression model to analyze the relationship between the factors and persistent nucleic acid positive and rebound., Results: A total of 31 severe and 37 critical SARS-CoV-2 infection patients were included. The median duration from initiation of Nirmatrelvir/Ritonavir to negative conversion of SARS-CoV-2 for both was 6.0 days, and the negative conversion rate on day 15 was 93.5% and 86.5%, respectively. SARS-CoV-2 rebound was observed in 7 patients (11.3%), among whom were 1 severe patient and 6 critical patients. The above 7 patients with SARS-CoV-2 rebound and 6 patients with failure of SARS-CoV-2 negative conversion were compared with 55 patients with persistent negative conversion. Factors with P < 0.10, including the lowest lymphocyte count (LYM), the highest D-dimer, the highest procalcitonin (PCT), the lowest Ct value, cardiovascular diseases other than hypertension and coronary heart disease, were incorporated into multivariate Logistic regression analysis. The decreased LYM [odds ratio (OR) = 0.146, 95% confidence interval (95%CI) was 0.031-0.689, P = 0.015] and the increased PCT (OR = 2.008, 95%CI was 1.042-3.868, P = 0.037) were revealed to be independent risk factors of the failure of SARS-CoV-2 negative conversion or rebound. The proportion of mechanical ventilation and invasive ventilation were significantly higher in patients with persistent SARS-CoV-2 infection or rebound than those in patients with SARS-CoV-2 negative conversion (84.6% vs. 38.2%, 69.2% vs. 25.5%, both P < 0.01), but no significant difference in mechanical ventilation and invasive ventilation duration was observed. Compared with the patients with SARS-CoV-2 negative conversion, more patients with persistent SARS-CoV-2 infection or rebound were admitted to intensive care unit (ICU, 76.9% vs. 50.9%), and length of ICU stay in patients with persistent SARS-CoV-2 infection or rebound tended to be longer [days: 13.0 (10.3, 24.3) vs. 11.0 (5.3, 23.0), P > 0.05]., Conclusions: The decreased LYM and increased PCT are independent risk factors for the failure of SARS-CoV-2 negative conversion or rebound in patients with severe and critical SARS-CoV-2 infection. Attention should be paid to these patients for their poor prognosis.

The effective components of flavonoids in the &quot;Pueraria lobata-Hovenia dulcis&quot; drug pair have low bioavailability in vivo due to their unstable characteristics. This study used microemulsions with amphoteric carrier properties to solve this problem. The study drew pseudo-ternary phase diagrams through titration compatibility experiments of the oil phase with emulsifiers and co-emulsifiers and screened the prescription composition of blank microemulsions. The study used average particle size and PDI as evaluation indicators, and the central composite design-response surface method(CCD-RSM) was used to optimize the prescription; high-dosage drug-loaded microemulsions were obtained, and their physicochemical properties, appearance, and stability were evaluated. The results showed that when ethyl butyrate was used as the oil phase, polysorbate 80(tween 80) as the surfactant, and anhydrous ethanol as the cosurfactant, the maximum microemulsion area was obtained. When the difference in results was small, K&#95;(m )of 1∶4 was chosen to ensure the safety of the prescription. The prescription composition optimized by the CCD-RSM was ethyl butyrate(16.28%), tween 80(9.59%), and anhydrous ethanol(38.34%). When the dosage reached 3% of the system mass, the total flavonoid microemulsion prepared had a clear and transparent appearance, with average particle size, PDI, and potential of(74.25±1.58)nm, 0.277±0.043, and(-0.08±0.07) mV, respectively. The microemulsion was spherical and evenly distributed under transmission electron microscopy. The centrifugal stability and temperature stability were good, and there was no layering or demulsification phenomenon, which significantly improved the in vitro dissolution of total flavonoids.

Objective: To investigate the characteristics of wideband acoustic immittance（WAI） measurements in patients with unilateral Ménière's disease（MD） and evaluate the clinical value of WAI in diagnosis of MD. Methods: WAI was performed in 30 patients with unilateral MD（30 ears for symptomatic and 30 ears for asymptomatic） and in 26 healthy individuals（52 ears）（control group）. The WAI measurements, including the frequency first appearing two peaks in energy absorbance（EA） tympanogram, resonance frequency（RF）, the peak value of absorbance（PVA）, the integral area of absorbance（IAA）, EA curve at peak pressure, were analyzed. Results: ①The occurrence of two peaks in EA tympanogram in both the MD symptomatic and asymptomatic ear was observed in 27 ears（84.4%）, and 38 ears（70.4%） in the control group, with no significant difference in the frequency of first appearing in two peaks onset between the groups（all P >0.05）. ②The RF of the MD symptomatic ears was significantly lower than that of the asymptomatic ears（ t =-3.544, P =0.001） and that of the control subjects（ t =2.084, P =0.041）; there was no difference of RF between the MD asymptomatic ears and the control group（ P >0.05）. ③The PVA were significantly lower in both MD symptomatic（ t =4.240, P <0.01） and asymptomatic ears（ t =4.202, P =0.001） than in controls. ④The IAA in MD symptomatic（ t =3.295, P =0.001） and asymptomatic ears（ t =3.193, P =0.003） was significantly lower than in the control group. ⑤Comparison of the EA curve at peak pressure of the three groups: the EAs of MD symptomatic ears were lower than those of the control group at the range of 1 059-2 911 Hz（all P <0.05）; the EAs of MD symptomatic ears were lower than those of MD asymptomatic ears within 1 000 Hz and 1 834-2 119 Hz（all P <0.05）; the EAs of MD asymptomatic ears were lower than those of the control group at the range of 515-2 748 Hz（all P <0.05）. Conclusion: Symptomatic ears in unilateral MD patients show alterations in some WAI measurements compared to asymptomatic ears and/or controls, suggesting that middle ear mechanical fuction of the affected side may be modified due to the endolymphatic hydrops. The clinical significance of WAI needs to be further explored in the context of evaluating MD., 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 report on two children with Kabuki syndrome due to variants of the KMT2D gene and summarize their clinical and genetic characteristics., Methods: Two children who had presented at the Ningbo Women and Children's Hospital respectively on August 19 and November 10, 2021 were selected as the study subjects. Clinical data were collected. Both children were subjected to whole exome sequencing (WES), and candidate variants were validated by Sanger sequencing., Results: Both children had featured motor and language developmental delay, facial dysmorphism and mental retardation. Genetic testing revealed that both had harbored de novo heterozygous variants of the KMT2D gene, namely c.10205del (p.Leu3402Argfs*3) and c.5104C>T (p.Arg1702*), both of which were rated as pathogenic variants based on the guidelines from the American College of Medical Genetics and Genomics (ACMG)., Conclusion: The c.10205del (p.Leu3402Argfs*3) and c.5104C>T (p.Arg1702*) variants of the KMT2D gene probably underlay the pathogenesis in these two children. Above finding has not only provided a basis for their diagnosis and genetic counseling, but also enriched the spectrum of KMT2D gene variants.

Objective: To explore the strategies of prenatal diagnosis and genetic counseling for fetuses of two families with large deletions of 13q21., Methods: Two singleton fetuses who were diagnosed with chromosome 13 microdeletions by non-invasive prenatal testing (NIPT) at Ningbo Women and Children's Hospital in March 2021 and December 2021 respectively were selected as the study subjects. Chromosomal karyotyping and chromosomal microarray analysis (CMA) were carried on amniotic samples. Peripheral blood samples were collected from the two couples for CMA assay to determine the origin of abnormal chromosomes identified in the fetuses., Results: The karyotypes of the two fetuses were both normal. CMA revealed that they have respectively harbored heterozygous deletions spanning 11.935 Mb at 13q21.1q21.33 and 10.995 Mb at 13q14.3q21.32, which were respectively inherited from their mother and father. Both deletions had low gene density and lacked haploinsufficient genes, and were predicted to be likely benign variants based on database and literature search. Both couples had opted to continue with the pregnancy., Conclusion: The deletions of the 13q21 region in both families may be of benign variants. As the follow-up time was short, there was no sufficient evidence for the determination of pathogenicity, though our finding may still provide a basis for the prenatal diagnosis and genetic counseling.

Objective: To analyze the genetic etiology of a Chinese pedigree affected with short stature., Methods: A child with familial short stature (FSS) who had presented at the Ningbo Women and Children's Hospital in July 2020 and his parents and paternal and maternal grandparents were selected as the study subject. Clinical data of the pedigree was collected, and the proband was subjected to routine growth and development assessment. Peripheral blood samples were collected. The proband was subjected to whole exome sequencing (WES), and the proband, his parents and grandparents were subjected to chromosomal microarray analysis (CMA)., Results: The height of the proband and his father was 87.7cm (-3 s) and 152 cm (-3.39 s) respectively. Both of them were found to harbor a 15q25.3-q26.1 microdeletion, which has encompassed the whole of the ACAN gene which is closely associated with short stature. The CMA results of his mother and grandparents were all negative, and above deletion has not been included in population database and related literature, and was rated as pathogenic based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). After 14 months of rhGH treatment, the height of the proband has increased to 98.5 cm (-2.07 s)., Conclusion: The 15q25.3-q26.1 microdeletion probably underlay the FSS, in this pedigree. Short-term rhGH treatment can effectively improve the height of the affected individuals.

Objective: Through a retrospective large sample analysis of copy number variants in single center, we explored the technical standards for the interpretation and reporting of constitutional copy-number variants (CNVs) jointly proposed by the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen) in 2019, analyzing its impact on CNVs ratings and the improvement in the consistency of the classification of CNVs in clinical laboratories., Methods: 236 CNVs that assessed as pathogenic, uncertain significant (including likely pathogenic, uncertain and likely benign) by the 2011 ACMG guidelines between August 2018 and December 2019 in our center were re-analyzed. Four working group members of the center reclassified and evaluated 235 CNVs according to 2019 ACMG guidelines., Results: The consistency of clinical significance classification of CNVs was 91% and the α test coefficient was 0.98 among four working group members. Compared with the 2011 and 2019 ACMG technical standards for the CNVs classification, evaluation of pathogenicity and uncertain significant is basically consistent. 90% (45/50) of likely pathogenic and likely benign CNVs were Re-evaluated as variants of uncertain significance, and the difference is significant., Conclusion: The new version ACMG/ClinGen guidelines for the evaluation of CNVs developed semi-quantitative point-based scoring system and help to improve the consistency in clinical classifications. It can also make the interpretation of CNVs more standardized and transparent.

Objective: To explore the genetic etiology of Vici syndrome in a Chinese family., Methods: Whole exome sequencing (WES) technology was used to detect gene variants in a fetus of abnormal ultrasonic structure without abnormalities in routine chromosome karyotype analysis and SNP-array. Sanger sequencing and bioinformatics prediction were performed for the suspected variants of the fetus and parents., Results: The fetus and the elder sister have carried c. 2427delC (p.T809fs) and c.1886A>T (p.E629V) compound heterozygous variants of the EPG5 gene, which were respectively inherited from their mother and father. Neither variant was reported previously. According to ACMG guidelines, the c.2427delC variant was predicted as pathogenic, while the c.1886A>T variant was of uncertain significance. PolyPhen-2 and PROVEAN software indicated that c.1886A>T variant was probably damaging., Conclusion: The c.2427delC and c.1886A>T variants of the EPG5 gene probably underlie the pathogenesis of the Vici syndrome in this family. Above finding has enriched the variational spectrum of EPG5 gene and provided a basis for genetic counseling and prenatal diagnosis for the family.