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Based on the current situation and problems of transportation "last mile" transportation distribution, this paper establishes a path optimization model based on user distribution methods from the perspective of market preference for transportation distribution methods, designs an Adaptive Large Neighborhood Search (ALNS) algorithm, and builds a user portrait based on the solution algorithm and the construction method. Based on the solution algorithm and the user portrait construction method, the solution scenario is established, and the distribution route and transportation distribution method are planned based on five real location data. Through the analysis of the solution scenarios, it can be obtained that after the optimization of the model, the transportation distribution cost of enterprises can be reduced, and the satisfaction of the transportation distribution service quality can be improved. The higher the complaint cost, the lower the total transportation and distribution cost, and the higher the satisfaction rate; the higher the time window penalty cost, the higher the total distribution cost, and the lower the satisfaction rate. Through several model comparisons, it is found that the optimized model has obvious advantages in transportation cost and good performance in transportation service satisfaction. To further strengthen the promotion and application of the distribution path optimization model, countermeasures are proposed in three aspects: establishing a unified end transportation information service platform, increasing the investment in end transportation path optimization, and strengthening the formulation of supporting policies to realize the optimization of end distribution services.

Bud dormancy activity is a crucial developmental event for growth and survival in woody perennials, and phytohormones play vital roles in this process. In the present study, endodormant and ecodormant vegetative buds were collected from Populus tomentosa and the transcriptomes from two periods were then analyzed and compared using RNA sequencing, aiming at exploring the associations between plant hormones and bud endodormancy release. Among 91,447 assembled unigenes, 7117 were differentially expressed during the transition from endodormancy to ecodormancy. Enrichment analyses revealed that many differentially expressed genes (DEGs) were assigned to hormone-related pathways, indicating the involvement of hormones during endodormancy release. Subsequently, various genes involved in hormone metabolism, transport, and signal transduction were identified and discussed. These hormones include abscisic acid, gibberellin, ethylene, auxin, and cytokinin. In addition to the five traditional hormones, we examined the differential expression patterns of genes in the brassinosteroid- and jasmonate-related pathways. All expression changes in the identified genes further demonstrated that phytohormones participate in endodormancy release. This is the first systematic investigation of the expression patterns of hormone-associated genes in endodormancy release in P. tomentosa at molecular level. This work provides important insights into the associations between hormones and dormancy in perennial trees, and will be beneficial for further studies on the complex mechanisms of bud dormancy.

Background Postoperative thrombocytopenia has been reported to be correlated with adverse events, but the prognostic value of baseline thrombocytopenia is unclear. This study was undertaken to evaluate the relationship between preoperative thrombocytopenia and adverse outcomes in patients with type B aortic dissection who underwent thoracic endovascular aortic repair (TEVAR). Methods A total of 825 patients with acute and sub-acute type B aortic dissection undergoing were TEVAR at a multidisciplinary aortic center were enrolled between January 2010 and December 2017. Patients were stratified on the basis of presence (n=149) or absence (n=676) of thrombocytopenia (platelet count, Results In the enrolled cohort, thrombocytopenia occurred in 149 (18.1%) patients. Patients with thrombocytopenia were older, were more commonly acute stage of TBAD, higher D-dimer level and had higher rates of abdominal vessel involvement and pericardial effusion. During the hospitalization period, 26 patients (3.2%) died, which was significantly higher in the thrombocytopenic group (8.1% versus 2.1%; P=0.001) Multivariate analyses revealed that thrombocytopenia was independently associated with in-hospital mortality (Table). During long-term follow-up (median duration 44.2 months), A total of 62 deaths were reported after discharge, including 40 (64.5%) aortic-related and unknown deaths, of which 12 and 50 patients for thrombocytopenia and non-thrombocytopenia group, respectively. Kaplan-Meier estimated rates of long-term all-cause mortality were higher for thrombocytopenia (log-rank test, P=0.014). Similar results were observed in a subset of aortic-related death (P=0.004) as well as aortic-related and unknown death (P=0.006), not non-aortic related death (P=0.878) (Figure 1). Conclusion Platelet counts, as simple and inexpensive indexes, were reliable to be used as a preoperative risk assessment tool for patients with type B aortic dissection undergoing thoracic endovascular aortic repair. Figure 1. Long-term Mortality Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

Background This study aimed to analyze the impact of the timing of intervention from presentation of symptoms to TEVAR and its relation to major complications for uncomplicated TBAD. Methods We retrospectively analyzed the data of 390 patients who underwent TEVAR for acute, subacute and chronic uncomplicated type B aortic dissection from January, 2010 to December 2017. Standard univariate and survival methods were used. The primary outcome of interest was in-hospital mortality. The Secondary outcomes of interest was long-term death and in-hospital adverse events, including postoperative coma, postoperative endoleak, postoperative stroke, postoperative spinal cord ischemia, postoperative limb ischemia, postoperative mesenteric ischemia/infraction. Results Of the 390 TEVARs for uncomplicated TBAD, 145 were performed within 14 days of presentation of symptoms (acute), 172 between 14 hours and 90 days (sub-acute), and 73 were beyond 90 days (chronic). Demographic characteristics were similar among groups (Table 1). A slight increase of in-hospital death, post-operative endoleak and limb ischemia, were observed in the acute intervention group compared with the sub-acute group (4.8% vs 2.3%, 11.7% vs 9.3%, 2.8% vs 2.3%, respectively). The chronic group patients had a highest rates of post-operative endoleak. However, there are no significantly differences between the three groups (Table 2). During long-term follow-up (median duration 36.9 months, interquartile range, 22.5–67.7 months), overall survival was similar among groups (log-rank test, P=0.280) (Figure). Conclusion TEVER performed for uncomplicated TBAD within 14 days to the presentation of symptoms, as compared with TEVAR between 14 hours and 90 days or beyond 90 days, neither appear to increase the risk of in-hospital complications nor long-term mortality. Long-term All-cause Mortality Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

Background Acute type B aortic intramural hematoma (IMH) with ulcer-like projections (ULP) is associated with various adverse aortic-related events (AAE) and recommended for preventive endovascular repair as alternative. However, we have no therapeutic criterion on which to decide preventive treatment. Objectives The purpose of this study was to determine the prognostic value and risk stratification of ULP in patients with acute type B IMH for proper treatment. Methods A retrospective study was conducted on 61 consecutive patients with acute type B IMH and with present of ULP from January 2015 to December 2018 in our center. All patients were treated medically initially and CT scans were performed on admission and during follow-up period. Results During a median follow-up of 4.5 months (range, 0.3 to 49.8 months) from onset, 36 patients (59.0%) had composites of adverse aortic events, including 1 patient died for aortic rupture, 6 patients converted to endovascular repair, 6 progressed into aortic dissection, and 28 developed to aortic enlargement. A cutoff value to estimate risk is 6.0 mm for maximal ULP width (72.2% sensitivity and 84.0% specificity) and 4.0 mm for maximal ULP depth (94.4% sensitivity and 52.0% specificity). Patients with widest (P=0.005) or deepest ULP (P=0.019) in aortic arch and proximal descending thoracic aorta had significant poorer aorta-related event-free survival rates. On multivariate analysis, maximal ULP width ≥6.0 mm [hazard ratio (HR) = 2.569, 95% confidence interval (CI):1.157 to 5.705, P=0.020], maximal ULP depth ≥4.0 mm (HR=5.198, 95% CI: 1.154 to 23.420, P=0.032) and widest ULP in aortic arch and proximal descending thoracic aorta (HR=2.363, 95% CI: 1.012 to 5.517, P=0.047) were independently associated with AAE. ULP with both risk location (widest ULP in aortic arch and proximal descending thoracic aorta) and size (maximal ULP width ≥6.0 mm) were significantly associated with a poorer aortic-related event-free survival rate than others (both P Conclusions Maximal ULP width ≥6.0 mm, maximal ULP depth ≥4.0 mm and widest ULP in aortic arch and proximal descending thoracic aorta are predictive for progression of acute type B aortic intramural hematoma. For patients with ULP in both risk location and size, preventive endovascular treatment should be considered. Figure 1 Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

Considering the side effects of etomidate, it requires additional anesthetics to reduce the side effects and improve efficacy. Ketamine is often used as an adjunct anesthetic. We hypothesized that etomidate combined with fentanyl was more effective than etomidate combined with ketamine in the anesthesia of pediatric strabotomy. To prove our hypothesis, a prospective randomized controlled clinical study was performed, in which 35 children with strabotomy received etomidate plus ketamine (group A) for anesthesia induction and maintenance and 35 children with strabotomy received etomidate combined with fentanyl (group B). Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), anesthesia effect, and emergence agitation and pain were observed before anesthesia induction (T1), after anesthesia induction (T2), at the beginning of the operation (T3), after 10-min operation (T4), and at the end of the operation (T5). Children in group B had significantly lower MAP and HR from T3 to T5, decreased BIS from T2 to T4, better anesthesia effect, and smaller emergence agitation and pain scores at 10 min after entering into postanesthesia care unit (PACU) compared with group A (p 0.05). The mean emergence agitation score in group B was significantly lower than that in group A when the maximum emergence in group B was at 20 min after entering into PACU (p 0.05). In conclusion, etomidate combined with fentanyl plays a good efficacy in anesthesia of pediatric strabotomy compared with etomidate plus ketamine.

We investigated the expression level of p53 upregulated modulator of apoptosis (PUMA), myeloid cell leukemia-I (MCL-1), and p53 in renal cell carcinoma (RCC) and para-carcinoma tissues, as well as their clinical significance. The expression levels of PUMA, MCL-1, and p53 in RCC and para-carcinoma tissues were measured using immunohistochemical and quantitative real-time PCR methods. Correlations between protein expression and pathological characteristics were analyzed. Renal clear cell carcinoma showed elevated MCL-1 and p53 protein expression (P > 0.05) and reduced PUMA expression as compared to that in para-carcinoma tissues. Spearman ranking correlation analysis showed that expression of PUMA, MCL-1, and p53 in was negatively correlated with RCC (r = -0.504, P = 0.001; r = -0.413, P = 0.008). We also observed significant correlation between MCL-1 expression and tumor differentiation (P < 0.05), where MCL-1 expression was significantly higher in well-differentiated adenocarcinoma as compared to that in medium or lowly differentiated adenocarcinoma. In addition, p53 expression was highly correlated with TNM staging (P < 0.05). Single factor analysis on COX's proportional hazard model indicated that postoperative survival rate and prognosis of renal clear cell carcinoma was highly correlated with TNM staging (P < 0.05). Quantitative real-time PCR analysis indicated higher expression of PUMA, MCL-1, and p53 in cancer tissues as compared to that in para-carcinoma tissues (P < 0.05).The expression of PUMA, MCL-1, and p53 can reflect the biological behavior of renal cell carcinoma, and can be used to indicate tumor invasion, progression, and prognosis.

Introduction: In China, the perspective of residents and care staff towards the climate of the nursing homes are unknown due to lack of studies in this area.

Doubling method is the technical barriers in maize haploid breeding. It was very important to establish the independent intellectual property rights for doubling method. In this experiment, the maize haploid inducer, TG15, was used for producing maternal haploids. Also, haploids were obtained from two kinds of maternal genotypes involved in the experiment, including high-oil type and common type. Significant differences were observed among offspring of various genotypes in the recovery of haploid fertilization. In 21 hybrid offspring haploids, the average powder rate was 8.28%, and the seed setting rate was 4.98%. The experimental results showed that when the hybrids were treated with 0.08% colchicine, the average powder rate and seed setting rate of offspring haploids were 35.53 and 20.30%, respectively, which were significantly higher than the hybrids with natural recovery ability. This study primarily established the doubling method of haploids called "bud seedling method" in China which was very practicably in maize doubled haploid breeding.

The purpose of this study was to explore cytokine expression patterns and cytogenetic abnormalities of mesenchymal stem cells (MSCs) from the bone marrow microenvironment of Chinese patients with myelodysplastic syndromes (MDS). Bone marrow samples were obtained from 30 cases of MDS (MDS group) and 30 healthy donors (control group). The expression pattern of cytokines was detected by customized protein array. The karyotypes of MSCs were analyzed using fluorescence in situ hybridization. Compared with the control group, leukemia inhibitory factor, stem cell factor (SCF), stromal cell-derived factor (SDF-1), bone morphogenetic protein 4, hematopoietic stem cell (HSC) stimulating factor, and transforming growth factor-β in the MDS group were significantly downregulated (P

Trace amounts of gangliosides were found in rabbit skeletal muscle sarcoplasmic reticulum and their main part was shown, by high performance thin layer chromatography, to be GM3. Addition of GM3 to the soybean phospholipids used for reconstitution of proteoliposomes markedly increased ATP hydrolysis as well as Ca 2+ uptake activity of sarcoplasmic reticulum Ca 2+ -ATPase incorporated into the proteoliposomes. Conformation changes of Ca 2+ -ATPase induced by GM3 were also observed by intrinsic fluorescence and circular dichroism measurements.