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Background: We aimed to analyze contralateral patent processus vaginalis (CPPV) in the laparoscopic high ligation of the vaginal process, treat eligible children surgically, and evaluate the clinical long-term outcomes. Methods: A total of 300 children with unilateral inguinal hernia or unilateral hydrocele treated in our hospital were selected for laparoscopic high ligation of the vaginal process, during which CPPV was analyzed. The 300 children were randomly divided into two groups of 150. In the study group (n = 58), 11 children met the requirements of high ligation and were treated with simultaneous surgery. The 53 children in the control group received simultaneous treatment. The prevalence of CPPV was compared between children with unilateral indirect inguinal hernia and unilateral hydrocele, left and right patent processus vaginalis (PPV), and different ages. After surgery, both groups were followed up for one year. The recurrence rate of contralateral indirect inguinal hernia or hydrocele was compared. Significant differences were assessed between the two groups receiving different treatments. Results: The prevalence of CPPV was 23% in children with unilateral indirect inguinal hernia and 49% in children with unilateral hydrocele. The prevalence of CPPV in children with unilateral hydrocele was significantly higher than that in children with inguinal hernia (P = 0.00). The prevalence of CPPV was 42% in children with left PPV and 33% in children with right PPV, without a statistically significant difference (P = 0.19). The prevalence of CPPV was 63% in children aged 1 - 2 years, which was significantly higher than that in other age groups (χ2 = 7.46, P = 0.01). The prevalence of CPPV was 14% in children aged > 6 years, which was significantly lower than that in other age groups (χ2 = 4.43, P = 0.04). A postoperative one-year follow-up showed that the recurrence rate was 9% in the study group and 1% in the control group, without a statistically significant difference (P = 0.25). Conclusions: The prevalence of CPPV decreases with age. Hydrocele combined with CPPV is more common. For younger children with hydrocele, it is very important to explore the contralateral side during surgery. Moreover, the transformation of CPPV to indirect inguinal hernia or hydrocele occurs rarely, and only eligible children can receive simultaneous treatment during surgery.

Railway bridges are a vital element of railway infrastructures, and their safety can directly affect the regional economy and commuter transportation. However, railway bridges are often subjected to severe loading and working conditions, caused by rising traffic levels and heavier vehicles, and increases in train running speeds makes the bridges extremely susceptible to degradation and failure. One of the promising tools for evaluating the overall safety and reliability of railway bridges is the bridge structural health monitoring (SHM) system, which not only monitors the structural conditions of bridges and maintains the safety of train operations, but also helps to expand the lifespan of bridges by enhancing their durability and reliability. While a multitude of review papers on SHM and vibration-based structural damage detection methods have been published in the past two decades, there is a paucity of literature that provides a review or overview on the SHM of railway bridges. Some of the review papers have become obsolete and do not reflect the state-of-the-art research. Therefore, the main goal of this article is to summarize state-of-the-art SHM techniques and methods that have been widely used and popular in recent years. First, two state-of-the-art SHM sensing technologies (i.e. fiber optic sensing (FOS) technology and computer vision-based (CV) technology) are reviewed, including the working principles of various sensors and their practical applications for railway bridge monitoring. Second, two state-of-the-art machine learning algorithms (i.e. convolutional neural networks (CNN) and transfer learning (TL)) and their applications for railway bridge structural condition assessment are exemplified. Third, the principle of digital twin (DT) and its applications for railway bridge monitoring are presented. Finally, issues related to the future direction and challenges of the monitoring technologies and condition assessment methods of railway bridges are highlighted.

// Mingyang Ma 1 , Shuyao Hua 2 , Gang Li 3 , Sumei Wang 2 , Xue Cheng 2 , Songqing He 4, 5, 6 , Ping Wu 2 , Xiaoping Chen 1 1 Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province for the Clinical Medicine Research Center of Hepatic Surgery, Key Laboratory of Organ Transplantation, Ministry of Education and Ministry of Public Health, Wuhan 430030, China 2 Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China 3 Department of Surgery, Liyuan Hospital, Huazhong University of Science and Technology, Wuhan 430077, China 4 Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China 5 Laboratory of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin 541001, China 6 Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair, Guilin 541001, China Correspondence to: Songqing He, email: hsqhaoren@aliyun.com Ping Wu, email: wpingwp@mails.tjmu.edu.cn Keywords: hepatocellular carcinoma, hypoxia-inducible factors, prolyl hydroxylase domain-containing proteins, asparaginyl hydroxylase factor inhibiting HIF-1, prognostic factor Received: October 21, 2016 Accepted: January 09, 2017 Published: January 16, 2017 ABSTRACT Hypoxia-inducible factors (HIFs) are key regulators in oxygen homeostasis. Their stabilization and activity are regulated by prolyl hydroxylase domain (PHD)-1, -2, -3 and factor inhibiting HIF (FIH). This study investigated the relation between these oxygen sensors and the clinical behaviors and prognosis of hepatocellular carcinoma (HCC). Tissue microarray and RT-PCR analysis of tumor tissues and adjacent non-tumor liver tissues revealed that mRNA and protein levels of both PHD3 and FIH were lower within tumors. The lower expression of PHD3 in tumor was associated with larger tumor size, incomplete tumor encapsulation, vascular invasion and higher Ki-67 LI ( p < 0.05). The lower expression of FIH in tumor was associated with incomplete tumor encapsulation, vascular invasion, as well as higher TNM stage, BCLC stage, microvascular density and Ki-67 LI ( p < 0.05). Patients with reduced expression of PHD3 or FIH had markedly shorter disease-free survival (DFS), lower overall survival (OS), or higher recurrence ( p < 0.05), especially early recurrence. Patients with simultaneously reduced expression of PHD3 and FIH exhibited the least chance of forming tumor encapsulation, highest TNM stage ( p < 0.0083), lowest OS and highest recurrence rate ( p < 0.05). Multivariate analysis indicated that a lower expression of FIH independently predicted a poor prognosis in HCC. These findings indicate that downregulation of PHD3 and FIH in HCC is associated with more aggressive tumor behavior and a poor prognosis. PHD3 and FIH may be potential therapeutic targets for HCC treatment.

Background To evaluate the clinical significance of low-frequency electrical stimulation in preventing urinary retention after radical hysterectomy. Methods A total of 91 women with stage IA2–IB2 cervical cancer, who were treated with radical hysterectomy and lymphadenectomy from January 2009 to December 2012, were enrolled into this study and were randomly divided into two groups: trail group (48 cases) and control group (43 cases). Traditional bladder function training and low-frequency electrical stimulation were conducted in the trail group, while patients in the control group were only treated by traditional bladder training. The general condition, rate of urinary retention, and muscle strength grades of pelvic floor muscle in the perioperative period were compared between these two groups. Results The incidence of postoperative urinary retention in the electrical stimulation group was 10.41%, significantly lower than that in the control group (44.18%), and the difference was statistically significant (P

The purpose of this study was to explore the positive effects of Jian-Pi-Zhi-Dong Decoction (JPZDD) on Tourette syndrome (TS) by investigating the expression of gamma-aminobutyric acid (GABA) and its type A receptor (GABAAR) in the striatum of a TS mice model. The model was induced by 3,3′-iminodipropionitrile (IDPN) treatment; then mice were divided into 4 groups (n=22, each); control and IDPN groups were gavaged with saline and the remaining 2 groups were gavaged with tiapride and JPZDD. We recorded the stereotypic behaviors of TS mice and measured the content of GABA in striatum by HPLC and GABAAR expression by immunohistochemistry and real-time PCR. Our results showed that JPZDD inhibited the abnormal behaviors of TS model mice and decreased GABA levels and GABAAR protein and mRNA expression in the striatum of TS model mice. In brief, the mechanism by which JPZDD alleviates TS symptoms may be associated with GABAAR expression downregulation in striatum which may regulate GABA metabolism.

Marked accumulation of arachidonic acid (AA) and intracellular Ca2+ and Na+ overloads are seen during brain ischemia. In this study, we show that, in neurons, AA induces cytosolic Na+ ([Na+](cyt)) and Ca2+ ([Ca2+](cyt)) overload via a non-selective cation conductance (NSCC), resulting in mitochondrial [Na+](m) and [Ca2+](m) overload. Another two types of free fatty acids, including oleic acid and eicosapentaenoic acid, induced a smaller increase in the [Ca2+](i) and [Na+](i). RU360, a selective inhibitor of the mitochondrial Ca2+ uniporter, inhibited the AA-induced [Ca2+](m) and [Na+](m) overload, but not the [Ca2+](cyt) and [Na+](cyt) overload. The [Na+](m) overload was also markedly inhibited by either Ca2+-free medium or CGP3715, a selective inhibitor of the mitochondrial Na+(cyt)-Ca2+(m) exchanger. Moreover, RU360, Ca2+-free medium, Na+-free medium, or cyclosporin A (CsA) largely prevented AA-induced opening of the mitochondrial permeability transition pore, cytochrome c release, and caspase 3-dependent neuronal apoptosis. Importantly, Na+-ionophore/Ca2+-free medium, which induced [Na+](m) overload, but not [Ca2+](m) overload, also caused cyclosporin A-sensitive mitochondrial permeability transition pore opening, resulting in caspase 3-dependent apoptosis, indicating that [Na+](m) overload per se induced apoptosis. Our results therefore suggest that AA-induced [Na+](m) overload, acting via activation of the NSCC, is an important upstream signal in the mitochondrial-mediated apoptotic pathway. The NSCC may therefore act as a potential neuronal death pore which is activated by AA accumulation under pathological conditions.

The role of the π sites in the adsorption of anionic platinum precursor (PtCl 6 2− ) on the carbon surface was studied. A set of carbon supports was prepared by the oxidative treatments of a commercial carbon black in liquid or thermal treatment in a nitrogen gas flow. The supports obtained had similar physical structure, but were different in their surface chemistry, e.g., the types and the amount of the surface functional groups. The Pt/C catalysts were prepared by the impregnation of the supports with an aqueous solution of hexachloroplatinic acid. N2 adsorption, acid-base titration, X-ray photoelectron spectrometry (XPS), ICP, and TEM were used to characterize the supports and the catalysts. It was found that the absence of the surface acidic groups led to a higher platinum loading amount on the supports; and platinum loading amount would decrease when the higher H2PtCl6 impregnating solution concentration was used. The π sites in the basal planes play a more important role than the surface acidic groups in PtCl 6 2− ions adsorption on the carbon surface. Upon impregnation, the delocalized π electrons form coordination bonds with the platinum precursors, and further cause the reduction of Pt(IV) complex to Pt(II) complex, which was strongly chemisorbed on the surface of the supports. PtCl 6 2− ions adsorbing at the surface acidic groups would easily desorb during the washing process. However, when the impregnating solution was used at a higher concentration, a large amount of H3O+ was firstly adsorbed in the π sites, leading to a decrease of the amount of strong PtCl 6 2− ions adsorption on the supports.

Objective: To treat obstructive azoospermia by using sperm recovered from percutaneous vasal sperm aspiration in IUI. Design: Clinical study. Setting: Institutional clinic in Jinan. Patient(s): Six men with obstructive azoospermia, three of whom were treated with percutaneous vasal sperm aspiration and IUI; sperm recovered from this procedure were used for IUIs. Intervention(s): Spermatozoa used for intrauterine injection were retrieved by percutaneous vasal sperm aspiration and incubated at 37°C for 40 to 60 minutes. Main Outcome Measure(s): Normal pregnancy. Result(s): Intrauterine insemination was performed in three patients for one or two cycles, with motile spermatozoa. There was one successful term delivery. Conclusion(s): Percutaneous vasal sperm aspiration can be used successfully to recover sperm in men with obstructive azoospermia for use in IUI. The technique is simple and less traumatic than an open surgical procedure.

This study evaluated the clinical value of the combined detection of serum cathepsin L (CL), heparanase (Hpa), and matrix metalloproteinase-9 (MMP-9) for determining the degree of ovarian cancer invasion and metastasis before surgery.Enzyme-linked immunosorbent assays were used to measure the serum content of CL, Hpa, and MMP-9 in 217 patients with untreated ovarian cancer before surgery, 100 patients with benign ovarian tumors, and 101 healthy women as controls. In addition, the degrees of invasion and metastasis were assessed by the 'gold standard' of clinicopathological diagnosis. The associations of the preoperative serum CL, Hpa, and MMP-9 levels with the clinicopathological factors and metastatic status were analyzed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the usefulness of these markers for determining the degree of ovarian cancer invasion before surgery.The serum CL, Hpa, and MMP-9 levels were significantly higher (p=0.001) in patients with malignant ovarian cancer compared with patients with benign ovarian tumors and healthy controls. The serum CL level was significantly higher in patients with epithelial ovarian carcinoma compared with non-epithelial ovarian carcinoma (p=0.048), whereas the serum levels of Hpa (p=0.109) and MMP-9 (p=0.544) did not differ significantly between these two groups. The serum CL, Hpa, and MMP-9 levels correlated with the degree of differentiation and the FIGO staging (p0.05). The serum CL (p=0.030) and MMP-9 (p=0.010) levels were significantly associated with peritoneal metastasis, and the serum Hpa level (p=0.042) was associated with distant metastasis. A ROC curve analysis revealed sensitivity of 60.9%, 69.6%, and 72.2%, and specificity of 57.4%, 67.2%, and 68.9% for the preoperative serum levels of CL, Hpa, and MMP-9, respectively, as tumor markers for the degree of extra-pelvic metastasis.Elevated serum CL, Hpa, and MMP-9 levels are correlated with malignant invasion and progression in ovarian cancer. The combined detection of serum CL, Hpa, and MMP-9 may be useful for determining the extent of ovarian cancer metastasis before surgery.

AIM: To investigate and evaluate the pathological features and diagnostic value of focal nodular hyperplasia (FNH) with multi-section spiral computed tomography (MSCT) and postprocessing. METHODS: A total of 25 patients with FNH who had undergone MSCT and postprocessing were included in the investigation. All patients had been pathologically or clinically confirmed with FNH. A number of 75 cases of hepatic carcinomas, hemangiomas and adenomas were randomly selected at a same period for a comparative study. RESULTS: There was a single focus in 22 cases and multiple foci in 3 cases. On the plain scan, 17 lesions showed hypodensity, 7 isodensity and 4 hyperdensity (the case with fatty liver). With contrast, 28 lesions were enhanced evenly or in the nodules in the arterial phase; 13 lesions still showed hyperdensity, 11 lesions isodensity and 4 lesions hypodensity in the parenchymatous phase; in the delayed phase only 5 lesions showed hyperdensity but 9 lesions showed isodensity or slight hypodensity and 14 lesions showed hypodensity. Twelve lesions of 28 had central asteroid scars. Thickened feeding arteries in postprocessing were seen in 24 lesions, and were integrated into the parenchymatous lesions with a gradual and smooth course. On the contrary, there were no artery penetrated into the lesion found in any of comparative hepatic tumors. CONCLUSION: Doctors could make a correct diagnosis and differentiation of FNH on evaluation of the characteristic appearance on MSCT with postprocessing.

To manage male infertility with obstructive azoospermia by means of percutaneous epididymal sperm aspiration (PESA) and intrauterine insemination (IUI).Ninety azoospermic patients with congenital bilateral absence of the vas deferens (BAVD, n=58) or bilateral caudal epididymal obstruction (BCEO, n=32) requesting for fine needle aspiration (FNA), PESA and IUI were recruited. The obstruction was diagnosed by vasography and determination of the fructose, carnitine and alpha-glucosidase levels in the seminal fluid.The mean sperm motility, density, abnormal sperm and total sperm count of the caput epdidymis were 16 %+/-22 %, (12+/-31) x 10(6)/mL, 55 %+/-36 % and (16+/-14) x 10(6), respectively. In the 90 couples, a total of 74 PESA procedures and 66 cycles of IUI were performed. Three pregnancies resulted, including one twin pregnancy giving birth to two healthy boys, one single pregnancy with a healthy girl and another single pregnancy aborted at week 6 of conception. The pregnancy rate per IUI cycle was 4.5 %.The birth of normal, healthy infants by IUI using PESA indicates that the caput epididymal sperm possess fertilization capacity. The PESA-IUI programme is a practical and economical procedure for the management of patients with obstructive azoospermia.

Objective To explore the effectiveness of percutaneous vasal sperm aspiration (PVSA) in combination with intrauterine insemination (IUI) to treat infertile men with anejaculation. Design Clinical study. Setting Department of reproductive endocrinology and andrology of a family planning research clinic. Patient(s) Twenty-six anejaculatory infertile men. Intervention(s) Spermatozoa obtained from the vas deferens by percutaneous aspiration were incubated in sperm preparation medium. Main outcome measure(s) Sperm quality by PVSA and pregnancy outcome. Result(s) Thirty-four PVSA-IUI procedures were performed in 26 men with anejaculation. Nineteen pregnancies were achieved (pregnancy rate, 73.1%). Mean (±SD) values for sperm variables were as follows: motility, 78.6% ± 14.2%; progressive motility, 60.4% ± 11.2%; density, 37.6 ± 13.2 × 10 6 cells/mL; total count, 35.2 ± 13.2 × 10 6 cells; and abnormal sperm, 18.6% ± 7.6%. Conclusion(s) Percutaneous vasal sperm aspiration may obtain high-motility sperm, and PVSA plus IUI is an effective treatment for male infertility with anejaculation.

Objective To observe the therapeutic effects of moxibustion for chronic cough in children. Methods 68 child cases of chronic cough were treated by moxibustion. Results 54 cases were cured, 13 cases improved, and one case failed. The cure rate was 79.2%, with a total effective rate of 98.5%. Conclusion The moxibustion therapy has definite therapeutic effect for children chronic cough.