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Background The Surgical Pleth Index (SPI) is an objective tool that can reflect nociception-antinociception balance and guide the use of intraoperative analgesics. Multimodal analgesia has been neglected in many previous studies. The aim of this study was to compare fentanyl consumption using SPI-guided analgesia versus conventional analgesia techniques under multimodal analgesia in laparoscopic cholecystectomy. Methods A total of 80 patients aged 18–65 years with American Society of Anaesthesiologists (ASA) grade I-II and a body mass index (BMI) of 18.5 to 30 kg/m2 who were scheduled for laparoscopic cholecystectomy under total intravenous anaesthesia from March 2020 to September 2020 were selected. Multimodal analgesia, including local infiltration of the surgical incision, nonsteroidal anti-inflammatory drugs and opioids, was adopted perioperatively. Fentanyl boluses of 1.0 µg/kg were administered to maintain the SPI value between 20 and 50 in the SPI group. By contrast, fentanyl boluses of 1.0 µg/kg were administered whenever the heart rate (HR) or mean arterial pressure (MAP) increased to 20 % above baseline or when the HR was greater than 90 beats per minute (bpm) in the control group. Preoperative and postoperative blood glucose, plasma cortisol and interleukin-6 (IL-6) levels were evaluated. Intraoperative haemodynamic events and propofol and fentanyl doses were noted. The extubation time, postoperative visual analogue scale (VAS) score, use of remedial analgesics and opioid-related adverse reactions were recorded. Results In total, 18 of 80 patients withdrew for various reasons, and data from 62 patients were finally analysed. Intraoperative fentanyl consumption was significantly lower in the SPI group than in the control group (177.1 ± 65.9 vs. 213.5 ± 47.5, P = 0.016). The postoperative extubation time was shorter in the SPI group than in the control group (16.1 ± 5.2 vs. 22.1 ± 6.3, P Conclusions Lower doses of fentanyl are required intraoperatively with shorter extubation times when SPI is used to guide intraoperative analgesia compared to conventional analgesia techniques under multimodal analgesia in laparoscopic cholecystectomy. Trial registration Chictr.org.cn ChiCTR2000030145. Retrospectively Registered (Date of registration: February 24, 2020).

Objective To investigate the risk factors for, and outcomes of, preoperative asymptomatic pulmonary embolism (PE) in patients ≥60 years old following delayed operation for hip fracture. Methods From March 2017 to December 2018, 90 patients aged ≥60 years with hip fracture who suffered a delay in surgery were recruited to this prospective study following admission to our hospital. Computed tomography pulmonary angiography (CTPA) was used to detect preoperative asymptomatic PE and calculated its incidence. Time from injury to admission, baseline characteristics, medical comorbidities, and blood biomarker levels were evaluated as potential risk factors. Logistic regression analysis was used to identify risk factors. Mortality and major bleeding events were recorded and compared between individuals with PE and without. Data were analyzed by t‐test, Mann–Whitney U test, χ 2 test, Fisher's exact test, and logistic regression analysis. Results The incidence of preoperative asymptomatic PE was 18.9% (17/90 patients). In the univariate analysis, the risk factors for preoperative asymptomatic PE were male sex, hypertension, cerebrovascular accident, smoking, plasma D‐dimer level, potassium level, urea level, creatinine level, and cysteine level. Multivariate logistic regression analysis showed that the risk of preoperative asymptomatic PE was higher in patients with hypertension (odds ratio [OR] = 10.048; 95% confidence interval [CI], 1.118–90.333), cerebrovascular accident (OR = 20.135; 95% CI, 1.875–216.164), smoking (OR = 48.741; 95% CI, 4.155–571.788), high plasma D‐dimer levels (OR = 1.200; 95% CI, 1.062–157.300), and high plasma potassium levels (OR = 12.928; 95% CI, 1.062–157.300). All patients were followed up for 21.0 months (range, 2 to 36 months). Mortality within the first year postoperatively was higher in patients with PE (29.41% vs 9.59%, P = 0.046). Conclusions In view of the high incidence of preoperative asymptomatic PE and the inferior prognosis in individuals with PE, routine CTPA examination for preoperative asymptomatic PE could be useful for patients aged ≥60 years with hip fracture for whom surgery is delayed., The overall incidence of preoperative asymptomatic PE was 18.9% in patients ≥60 years old following delayed operation for hip fracture. Individuals with preoperative asymptomatic PE have an inferior prognosis. Hypertension, cerebrovascular accident, smoking, high plasma D‐dimer levels, and high plasma potassium levels were associated with preoperative asymptomatic PE in these patients.

Evaluating patients with chronic venous leg ulcers (CVLUs) is essential to find the underlying etiology. The basic tenets in managing CVLUs are to remove the etiological causes, to address systemic and metabolic conditions, to examine the ulcers and artery pulses, and to control wound infection with debridement and eliminating excessive pressure on the wound. The first-line treatments of CVLUs remain wound care, debridement, bed rest with leg elevation, and compression. Evidence to support the efficacy of silver-based dressings in healing CVLUs is unavailable. Hydrogen peroxide is harmful to the growth of granulation tissue in the wound. Surgery options include a high ligation with or without stripping or ablation of the GSVs depending on venous reflux or insufficiency. Yet, not all CVLUs are candidates for surgical treatment because of comorbidities. When standard care of wound for 4 wk failed to heal CVLUs effectively, use of advanced wound care should be considered based on the available evidence. Negative pressure wound therapy facilitates granulation tissue development, thereby helping closure of CVLUs. Autologous split-thickness skin grafting is still the gold standard approach to close huge CVLUs. Hair punch graft appears to have a better result than traditional hairless punch graft for CVLUs. Application of adipose tissue or placenta-derived mesenchymal stem cells is a promising therapy for wound healing. Autologous platelet-rich plasma provides an alternative strategy for surgery for safe and natural healing of the ulcer. The confirmative efficacy of current advanced ulcer therapies needs more robust evidence.

Recommendations promoted worldwide have suggested a period of protection lasting more than 20 years against hepatitis B (HB) following primary immunization. Starting in 1987, universal HB vaccinations were carried out in Long An County, Guangxi Province, one of the earliest counties in which plasma-derived HB vaccine was delivered to newborns across China. Data collection targeted toward understanding the long term (26–33 years since primary immunization) immune effects of the plasma-derived HB vaccine was conducted in 2015; a second data collection was carried out in 2019 to assess seroconversion in the same cohort. This study qualitatively compared positive vs negative results and quantitatively assessed HB biomarkers – HB surface antigen (HBsAg), antibody to HBsAg (anti-HBs), HB e-antigen (HBeAg), antibody to HBeAg (anti-HBe), and antibody to HB core antigen (anti-HBc) – in serum 26–33 years after the full initial course of HB vaccination, then analyzed anti-HBs seroconversion using the two-phase sampling method in the same cohort and calculated the anti-HBs seroconversion rate from 2015 to 2019. The protective sero-conversion rate (anti-HBs ≥10mIU/mL) was 37.6% (192/511); the HBsAg-positive rate was 5.3% (27/511); the anti-HBs mean geometric titer (GMT) was 11.1 mIU/mL. Among the 143 participants involved in both 2015 and 2019 data collections, the seroconversion rate was 3.5% (5/143); two individuals had protective anti-HBs levels in 2015. These findings indicate that anti-HBs status can be seroconverted to a protective concentration level 4 years earlier in a high HBV epidemic region. The role of genomic mutations and the disappearance of immune memory and seroconversion should be investigated.

Among the various types of metal matrix composites, SiC particle-reinforced aluminum matrix composites (SiCp/Al) are finding increasing applications in many industrial fields such as aerospace, automotive, and electronics. However, SiCp/Al composites are considered as difficult-to-cut materials due to the hard ceramic reinforcement, which causes severe machinability degradation by increasing cutting tool wear, cutting force, etc. To improve the machinability of SiCp/Al composites, many techniques including conventional and nonconventional machining processes have been employed. The purpose of this study is to evaluate the machining performance of SiCp/Al composites using conventional machining, i.e., turning, milling, drilling, and grinding, and using nonconventional machining, namely electrical discharge machining (EDM), powder mixed EDM, wire EDM, electrochemical machining, and newly developed high-efficiency machining technologies, e.g., blasting erosion arc machining. This research not only presents an overview of the machining aspects of SiCp/Al composites using various processing technologies but also establishes optimization parameters as reference of industry applications.

Small-signal stability problems often occur when the inverter for renewable energy generation is connected to weak grid. A small-signal transfer function integrated model reflecting the interaction of grid impedance, phase locked-loop (PLL), and current control loop is established in this paper. Based on the established model, the oscillation mechanism of the grid-connected inverter system is revealed: the inductance current flowing through the grid impedance can produce a voltage disturbance, which will eventually affect the inductance current through PLL and current control loop. Therefore, the loop composed of the grid impedance and PLL can easily lead to the oscillation of the grid-connected inverter system under weak grid condition. To suppress the oscillation, a control parameters design method of the grid-connected inverter is proposed. Without changing the control method, the proposed control parameters design method can ensure the stable operation of the grid-connected inverter system under the very weak grid condition when the short-circuit ratio (SCR) is 2. Finally, the experimental results verify the correctness of the stability analysis and the effectiveness of the control parameters design method proposed in this paper.

BACKGROUND: To explore the expression and clinical significance of the cytokinesis-related gene NUF2 in kidney renal clear cell carcinoma (KIRC). METHODS: Gene expression profiles of KIRC patients were extracted from The Cancer Genome Atlas (TCGA) database. The differences in NUF2 mRNA expression between patients and controls, as well as the relationship between the clinical characteristics and overall survival of the patients, were analyzed. The expression of NUF2 protein in 83 cancer tissues and para-cancerous tissues was detected to analyze the relationship with clinical characteristics. Gene Set Enrichment Analysis (GSEA) was used to investigate the possible regulatory pathways of the NUF2 in the development of KIRC. RESULTS: NUF2 mRNA was significantly higher in patients with KIRC, and the prognosis of patients with high expression of NUF2 mRNA was significantly worse than those with low expression, and was related to the AJCC stage, T stage, lymph node metastases, and distant metastases. NUF2 mRNA was an independent prognostic risk factor for KIRC patients. The expression of NUF2 protein was significantly higher in KIRC patients than in paraneoplastic tissues and was markedly associated with the pathological grade. In addition, the high expression of NUF2 was associated with the upregulation of pathways such as homologous recombination and DNA replication. CONCLUSIONS: NUF2 may act as an independent prognostic biomarker for predicting the survival of KIRC patients.

Starting from the current design method and process of human-computer interaction system for manned spacecraft based on product, this paper analyzes the existing difficulties, puts forward the design process of human-computer interaction system for manned spacecraft based on user experience, aims to explore the new development process of human-computer interaction system for manned spacecraft, and introduces the implementation steps and methods of this process in detail. The design process based on user experience enables users to participate in the requirements analysis, prototype design, usability evaluation and other aspects of development, so as to reduce the risk of subsequent design changes, improve the usability and ease of use of the system, shorten the development cycle and reduce the research cost.

Objective This study aimed to investigate the effects of transforming growth factor β1 (TGF β1) and hepatocyte growth factor (HGF) on the expression of connective tissue growth factor (CTGF) in human atrial fibroblasts, and to explore the relationship of these factors in atrial fibrosis and atrial anatomical remodelling (AAR) of patients with atrial fibrillation (AF). Methods Fresh right auricular appendix tissue of 20 patients with rheumatic heart disease undergoing valve replacement surgery was collected during surgeries, 10 patients had sinus rhythm(SR), and 10 patients had chronic atrial fibrillation (CAF). Atrial fibroblasts were then cultured from the tissues with differential attachment technique and treated with either TGFβ1 (10 ng/mL) or HGF (100 ng/mL). CTGF mRNA levels were measured by RT‐PCR, and CTGF protein content was determined using immunofluorescence and Western blotting assays. Results CAF group had higher left atrial diameters (LADs) and higher CTGF mRNA expression in atrial fibroblasts compared with SR group. The CTGF protein content in CAF group was higher than that of SR group and positively correlated with LAD and AF duration. After CAF group was treated with TGFβ1, CTGF mRNA and protein expression were significantly down‐regulated, whereas when treated with HGF, expression was up‐regulated compared with SR group. Conclusions Increased CTGF expression was associated with enlarged LAD, atrial fibrosis and AAR in patients with AF. TGFβ1 and HGF regulate CTGF expression in human atrial fibroblasts with up‐regulation of mRNA and down‐regulation of protein, therefore, either promote or inhibit atrial fibrosis, which could be related to the incidence and persistence of AF.

The Dark Matter Particle Explorer (DAMPE) is a space-borne high-energy cosmic ray detector. The payload consists of five subsystems, including the Plastic Scintillator Detector (PSD), the Silicon-Tungsten tracKer converter detector (STK), the BGO (Bismuth Germanate) calorimeter, the NeUtron Detector (NUD), and the Data AcQuisition system (DAQ). The five subsystems work collaboratively to collect the information of cosmic rays. In order to systematically verify the performance of the payload before launching, we have developed a set of integrated test system for the ground tests of the payload based on the LabWindows/CVI (C programming language Virtual Instrument) platform. This system has realized the integrity and automation of the comprehensive ground tests of the payload, improved the security, reliability, and efficiency of the ground tests, and provided a guarantee for the successful delivery of the payload.

When classifying rock slices, due to the small particle size of the rock slices, the classification is difficult. When manual methods are used for identification, the efficiency is low and subject to subjective factors. Therefore, this paper proposes a rock based on residual network The method of classifying granular images. This method uses the ResNet50 and ResNet101 models in the residual network to realize the automatic extraction of image features, and establishes a classifier to realize the classification based on the size of the rock slice image. This experiment uses 10,000 rock slice images obtained from the Ordos Basin, and uses 8,000 of them as the training set The residual network model is used for training, and then another 2,000 images are used to test the model. The experimental results show that two networks The accuracy of the classification results of the structure in the test set reached 90.24% and 91.63%. By using the residual network model to classify based on the rock slice image, an efficient and accurate classification effect can be obtained.

The 1553B bus is widely used in spacecraft avionics system for its high reliability. The single point of failure (SPOF) of bus controller (BC) leads to the bus network paralysis. To improve the service continuity of the bus network, an autonomous inter-device bus control transfer protocol is proposed. The remote terminal (RT) address is used to identify device and initialize it with constant priority and timing parameters. In the situation of start-up and BC failure, the highest priority device autonomously acquires bus control, and the bus communication is self-repaired. After the fault device fixed, the bus control can be transferred under command control. In this paper, the realization scheme, the software implementation and the verification test of proposed protocol is introduced.

In this paper, an ISAR imaging algorithm based on signal separation is proposed for the target with rotating parts. Specifically, the echoes of the target subject and the rotating parts are separated by the sparse reconstruction method. Profited from the Doppler difference between the target subject signal and the rotating parts signal, establish the MMV model of the target subject signal in azimuth and the target subject ISAR image can be obtained after signal reconstruction. Meanwhile, the ISAR imaging and micro-Doppler signature extraction for rotating parts can be completed by inverse Radon transform. Simulations are given to validate the effectiveness of the proposed algorithm.

In this work, an ultra-wideband 2-bit coding metasurface is designed for radar cross section (RCS) reduction, the design process is presented in detail, in which a polarization conversion metasurface (PCM) is proposed at first. The proposed PCM can realize ultra-wideband circular polarization (CP) maintaining reflection; moreover, Pancharatnam-Berry (PB) phase will be generated in the co-polarized reflection coefficient by rotating the metallic patches in its unit cells. Thus based on the PCM, the four coding elements of a 2-bit coding metasurface are constructed by using PB phase, and an ultra-wideband PB 2-bit coding metasurface is proposed according to an appropriate coding sequence. The simulated and experimental results show that the coding metasurface has the obvious advantages of wideband and polarization-insensitive, compared with a metallic plate with the same size, it can achieve more than 10 dB RCS reduction in the frequency band from 9.8 to 42.6 GHz with a relative bandwidth of 125.2% under normal incidence with arbitrary polarizations.

Transcutaneous auricular vagus nerve stimulation (taVNS) has gained growing interest as a non-invasive and non-pharmacologic treatment option in various neurological and psychiatric disorders. Animal experiments and clinical trials confirm that taVNS at the auricular concha region has beneficial effects on depression. However, stimulation frequencies are selected empirically, and there is no evidence showing that any frequency is superior to the others. This study explores antidepressant-like effects of three frequencies of taVNS on rats subjected to chronic unpredictable mild stress (CUMS). Sprague-Dawley rats were randomly divided into five groups, i.e., the control, CUMS, 5 Hz-taVNS, 20 Hz-taVNS, and 100 Hz-taVNS groups. The three different frequencies were administered during the 30-min taVNS procedure once a day for 28 consecutive days. Rats exposed to CUMS showed signs of depression-like behaviors, including reduction in sucrose preference and increased immobility time in forced swimming and open field tests as well as significant dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis as detected by plasma corticosterone and adrenocorticotropic hormone concentration. The 28 days' taVNS sessions with three frequencies elicited quite different consequences. Although 20 Hz taVNS significantly reversed the depression-like behaviors and downregulated the hyperactivity of the HPA axis, neither 5 nor 100 Hz showed any antidepressant-like effect on CUMS-induced rat behavior. Based on these results, we propose that, out of the three frequencies for taVNS intervention on depression, 20 Hz may be the optimized frequency to have a better modulation effect on HPA axis function by activating the auricular vagus nerve.

Background: Hepatocellular carcinoma (HCC) is the cause of an overwhelming number of cancer-related deaths across the world. Developing precise and noninvasive biomarkers is critical for diagnosing HCC. Our research was designed to explore potentially useful biomarkers of host peripheral blood mononuclear cell (PBMC) in HCC by integrating comprehensive bioinformatic analysis. Methods: Gene expression data of PBMC in both healthy individuals and patients with HCC were extracted from the Gene Expression Omnibus (GEO) to identify differentially expressed genes (DEGs). The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were applied to annotate the function of DEGs. Protein-protein interaction analysis was performed to screen the hub genes from DEGs. cBioportal database analysis was performed to assess the prognostic significance of hub genes. The Cancer Cell Line Encyclopedia (CCLE) and The Human Protein Atlas (HPA) database analyses were performed to confirm the expression levels of the hub genes in HCC cells and tissue. Results: A total of 95 DEGs were screened. Results of the GO analysis revealed that DEGs were primarily involved in platelet degranulation, cytoplasm, and protein binding. Results of the KEGG analysis indicated that DEGs were primarily enriched in focal adhesion. Five genes, namely, myosin light chain kinase (MYLK), interleukin 1 beta (IL1B), phospholipase D1 (PLD1), cortactin (CTTN), and moesin (MSN), were identified as hub genes. A search in the CCLE and HPA database showed that the expression levels of these hub genes were remarkably increased in the HCC samples. Survival analysis revealed that the overexpression of MYLK, IL1B, and PLD1 may have a significant effect on HCC survival. The aberrant high expression levels of MYLK, IL1B, and PLD1 strongly indicated worse prognosis in patients with HCC. Conclusions: The identified hub genes may be closely linked with HCC tumorigenicity and may act as potentially useful biomarkers for the prognostic prediction of HCC in PBMC samples.

Many high-piled wharves were built in the last century, and some wharf members have been damaged over decades of operation. It is important to use effective means to evaluate the safety sta...

Background Researchers have discovered a large number of DNA methylation patterns in human cancer. These cancer-specific methylation patterns can provide information for the diagnosis, treatment, and prognosis of cancer. Methylation studies can find new biomarkers based on epigenetic analysis and apply these biomarkers to clinical oncology. Many studies on the association between RAASF1A methylation status and susceptibility to hepatitis B virus (HBV)/hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC) have reached controversial conclusions. Hence, the current review comprehensively assessed the correlation between Ras association domain family 1A (RASSF1A) methylation and the risk of the HCV/HBV-induced HCC. Methods The appropriated publications were extracted in EMBASE, PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure databases using STATA 5.0 software. The odds ratios (ORs) with 95 % confidence interval (95 % CI) of RASSF1A methylation were computed. Results A total of 1015 HBV/HCV-related HCC samples, 124 non-HBV/HCV-related HCC (NBNC-HCC) samples, and 1225 nontumorous controls were extracted and examined in this research. The frequency of the methylated RASSF1A in the HBV/HCV-related tumor cases displayed a significantly increased OR compared with the overall nontumor samples (OR = 19.372, 95 % CI = 11.060–33.931, P = 0.000). The frequency of the methylated RASSF1A in HBV/HCV-related neoplasm cases displayed a significantly increased OR compared with the non-HBV/HCV-related neoplasm (NBNC-neoplasm) samples (OR = 2.150, 95 % CI = 1.398–3.308, P = 0.000). Compared with normal, chronic hepatitis B or C, cirrhosis, and paracancerous samples, the pooled OR of the RASSF1A promoter methylation in the HBV/HCV-induced HCC samples was 62.785(95 % CI = 35.224–111.909), 25.07 (95 % CI = 13.85–45.36), 6.89 (95 % CI = 3.33–14.264) and 9.02 (95 % CI = 0.91–89.80), respectively. The rate of RASSF1A hypermethylation was robustly correlated with tumor size and vascular invasion, and the pooled OR was 0.346 (95 % CI = 0.210 – 0.569) and 0.081 (95 % CI = 0.022 – 0.303), respectively. Conclusion Results showed robust associations between RASSF1A gene methylation in promoter region and enhanced HBV/HCV-related HCC susceptibility, thereby revealing that RASSF1A methylation status may serve as an important indicator for HCC oncogenesis.

Derived from RNA, 5'-ribonucleotides, especially Inosine-5'-monophosphate (IMP) and guanosine-5'-monophosphate (GMP), can enhance the umami taste of soy sauce. In this study, the RNA content of three different salt-tolerant yeasts was examined. The most valuable strain was subjected to atmospheric and room-temperature plasma (ARTP) mutagenesis, which improved its RNA content by 160.54%. Regular fermentation with RNA-enhanced strain failed to increase the amount of 5'-ribonucleotides in the soy sauce due to hydrolysis by phosphatase. A two-stage fermentation strategy was then carried out. Aroma compounds were mainly synthesized in the first stage, and RNA-enriched biomass was massively produced in the second stage followed by heat treatment to inactivate phosphatase. After the proposed strategy was applied, IMP and GMP in the soy sauce reached 68.54 and 89.37 mg/L, respectively. Moreover, the amounts of key aroma compounds and organic acids significantly increased. Results may provide new insights for improving the quality of soy sauce through microorganism breeding and fermentation control.

Low dissipation, tunable coupling to other quantum systems, and unique features of phonons in the aspects of propagation, detection and others suggest the applications of quantized mechanical resonators in phonon-based quantum information processing (QIP) in a way different from their photonic counterpart. In this paper, we propose the first protocol of entanglement concentration for nonlocal phonons from quantized mechanical vibration. We combine the optomechanical cross-Kerr interaction with the Mach-Zehnder interferometer and, by means of twice optomechanical interactions and the photon analysis with respect to the output of the interferometer, achieve ideal entanglement concentration about less-entangled nonlocal phonon Bell and Greenberger-Horne-Zeilinger states. Our protocol is useful for preserving the entangled phonons for the use of high quality phonon-based QIP in future., 7 pages, 5 figures

Machine learning methods have become a promising method for rapid identification of transient stability and unstable generators of power systems. However, the transient unstable instances are always fewer than stable instances, which brings difficulties of transient instability identification. This paper presents a data augmentation approach to increase the number of unstable instances. Firstly, original data will be generated by time domain simulation considering the randomness and limitations of power systems. Then, the patient rule induction space (Prism) method is used to obtain the unstable rule set from the training data. After that, new instances can be generated by the unstable rules and time domain simulation. Then, the machine learning method is used to generate the transient stability prediction model and unstable generator identification model based these two kinds of instances. All the generated instances can be verified by time domain simulation. Comprehensive studies are conducted on the New England 10-machine 39-bus system to verify the effectiveness of the proposed approach.

To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas (IPAs).A retrospective analysis was made of the clinical data of 74 patients (75 procedures) with IPAs treated by different endoscopic endonasal approaches at the Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis, and complications in different Knosp classifications and Hardy stages. The transcavernous approach was used in 47 patients, the lateral-cavernous approach was used in 14 patients, the tuberculum sella planum approach was used in 8 patients, and the diaphragma sellae open or dorsum sellae cut approach was used in 6 patients.The gross total resection (GTR) rate was 70.7% (53 patients) and tumor residue rate was 29.3% (22 patients). GTR rate for pituitary adenoma according to Knosp classification was 89.3% in grade 3 and 28.6% in grade 4. The biology cure rate was 75.0% and 23.8%, respectively. There was significance between them (P 0.05). In addition, the GTR rate of Hardy stage was 90.5% in stage C, 90.0% in stage D, 26.1% in stage E, and the biology cure rate was 80.1%, 75.0%, and 13.0%, respectively. There was significance among them (P 0.05) Postoperative severe complications included 9 patients (12.0%) with cerebrospinal fluid leaks, 26 patients (34.7%)with electrolyte imbalance, 36 patients (48.0%) with transient diabetes insipidus, 22 patients (29.3%) with hypopituitarism, 2 patients (2.7%) with permanent hypopituitarism, and 2 patients (2.7%)with epistaxis. The follow-up lasted 2-41 months (average, 19.3 months). No patient experienced recurrence after GTR, 1 patient undergoing subtotal experienced recurrence and underwent reoperation, 3 patients underwent postoperative Gamma Knife treatment, and 2 patients with refractory IPA were given temozolomide and metformin chemotherapy.According to the invasiveness of IPA, choosing the appropriate endoscopic surgical approach is helpful in removing tumors and reducing complications.

Colorectal cancer (CRC) is a leading cause of cancer-related mortality. Recently, we identified a novel biomarker, canopy fibroblast growth factor signaling regulator 2 (CNPY2) isoform2, and subsequently investigated its expression and prognostic value in CRC patients. We initially generated CNPY2 isoform2 monoclonal antibodies and examined CNPY2 isoform2 expression in CRC cell lines and tissues using quantitative real-time polymerase chain reaction, western blot and immunohistochemistry analyses. We found that CNPY2 isoform2 expression significantly increased in tumor cell lines and tissues compared with that in normal colon epithelial cells and tumor-adjacent normal tissues. Survival analysis indicated that patients with low CNPY2 isoform2 expression had poorer 5-year overall survival (OS) in both the training cohort (41.7% vs. 77.7%, P = 0.007) and validation cohort (47.1% vs. 78.8%, P = 0.002). In multivariable analysis, CNPY2 isoform2 was identified as a predictor of 5-year OS in both the training cohort [hazard ratio (HR) = 5.001; 95% confidence interval (CI) 2.156–11.598, P < 0.001) and validation cohort (HR= 2.443; 95% CI 1.197- 4.983, P = 0.014). In conclusion, CNPY2 isoform2 represents as a novel and valuable prognostic indicator for CRC patients, while the oncologic function of CNPY2 requires further study.

A model natural gas consisting of hydrogen sulfide, nitrogen and oxygen mixture was used to simulate materials to test the performance of an amine-modified MCM-41 adsorbent prepared by the impregnation method. The adsorbent was characterised by X-ray diffraction analysis, Brunauer–Emmett–Teller analysis, Fourier-transform infrared spectroscopy, transmission electron microscopy and scanning electron microscopy. The results showed that more molecules are able to penetrate the pores following modification, resulting in rapid structural collapse, thus lowering the diffraction intensity. Although the capacity of amine-modified MCM-41 decreased the physical adsorption, chemisorption increased significantly. (3-Aminopropyl)trimethoxysilane/MCM-41 was found to exhibit a good performance for H2S desulfurisation. At 45 °C the breakthrough time was 186 min, the saturated sulfur capacity was 134.38 mg g−1 and the degree of desulfurisation was 54.19%. The adsorption isotherm and kinetics were investigated and the relevant parameters were obtained. The results showed that the adsorption isotherm could be well fitted by the Langmuir model and the maximum adsorption capacities increased with increase of temperature. The adsorption kinetics could be represented by the Bangham model, which suggested that chemical reaction seemed significant in the rate-controlling adsorption step. The adsorption process was spontaneous and exothermic.

Background The accuracy of des-γ -carboxyprothrombin (DCP) in the detection of hepatocellular carcinoma (HCC) in those infected hepatitis B virus (HBV) from cross-sectional or case-control studies is contradictory. Objective To resolve this contradiction using a prospective study. Methods Three hundred male individuals persistently infected with HBV were recruited from the Chinese cohort and followed up once per year from 2012 to 2015. Each subject was screened for HCC by measurements of serum alpha-fetoprotein (AFP), lectin-bound α -fetoprotein (AFP-L3), DCP concentrations and ultrasonographic examinations. Results Nineteen HCC cases were identified. The area under receiver operating characteristic (AUROC) at first, second and third visit for AFP, AFP-L3 and DCP ranges from 0.710-0.897, 0.566-0.637 and 0.520-0.595, respectively. The rate of elevated DCP is not significantly different between the HCC cases and controls (52.6% vs. 47.4%) (P > 0.05). The incidence of HCC in subjects with elevated DCP is not significantly higher than that of those with normal DCP (9.5% vs. 4.6%) (P > 0.05). The AUROC of combinations of these biomarkers was higher than that of AFP alone at the first visit. However, it was reduced at the second visit. At the third visit, the AUROCs of AFP + DCP and AFP + AFP-L3 + DCP, but not that of AFP + AFP-L3, were higher than that of AFP alone. Conclusions AFP but DCP or AFP-L3 remains a valuable biomarker for HCC in those chronically infected with HBV. The combination with AFP-L3 and DCP may not increase the accuracy of AFP in differentiating HCC cases from controls, among those infected with HBV.

We propose a heralded quantum repeater based on the scattering of photons off single emitters in one-dimensional waveguides. We show the details by implementing nonlocal entanglement generation, entanglement swapping, and entanglement purification modules with atoms in waveguides, and discuss the feasibility of the repeater with currently achievable technology. In our scheme, the faulty events can be discarded by detecting the polarization of the photons. That is, our protocols are accomplished with a fidelity of 100% in principle, which is advantageous for implementing realistic long-distance quantum communication. Moreover, additional atomic qubits are not required, but only a single-photon medium. Our scheme is scalable and attractive since it can be realized in solid-state quantum systems. With the great progress on controlling atom-waveguide systems, the repeater may be very useful in quantum information processing in the future.

Patient perceptions of teamwork have been a relatively undiscovered domain. Our study investigated the use of the Patients' Insights and Views of Teamwork (PIVOT) survey on an acute cardiology unit in an academic teaching hospital with patients receiving Rounding with Heart, an interprofessional bedside rounding initiative, and others receiving traditional rounding processes. Sixty-three subjects were surveyed during their hospital stay. We found a significant difference (p = .006) in PIVOT scores between those receiving interprofessional rounding and those not receiving this rounding structure. In an item-by-item analysis, four specific items were found to be significant which were supported by analysis of qualitative data. Observations of the structured interprofessional rounding process by our research team reveal themes that emerged from observations: (1) openness/inclusivity, (2) patient-centeredness, (3) attending role/shared leadership, (4) nonconfrontational learning, (5) efficacy, and (6) team at bedside. Our results indicate that patients may be able to recognize the teamwork in the structured bedside rounding process and that interfacing with the team may be an important component to patients. We conclude that patient perceptions of teamwork are a valuable informant to modeling collaborative practices, and there are key observable components to the structured rounding model that may foster collaboration among different disciplines.

// Jian’an Bai 1 , He Na 2 , Xiumei Hua 2 , Yaling Wei 2 , Tian Ye 1 , Yiqiang Zhang 3 , Guo Jian 4 , Weiwen Zeng 2 , Lijun Yan 2 , Qiyun Tang 2 1 Department of Gastroenterology, Sir Run Run Hospital Affiliated with Nanjing Medical University, Nanjing, China 2 Department of Gastroenterology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China 3 Department of Radiology, Linyi People's Hospital, Dezhou, China 4 Department of Orthopaedics, Linyi People’s Hospital, Dezhou, China Correspondence to: Qiyun Tang, email: tqy831@163.com Keywords: NENs, epidemiology, LDL-C, PCSK9, miR-224 Received: February 29, 2016 Accepted: December 16, 2016 Published: December 28, 2016 ABSTRACT Neuroendocrine neoplasms (NENs) represent relatively rare tumors. The lack of diagnostic, therapeutic method and prognostic factors makes them a challenge to us. We retrospectively reviewed the data of 205 NENs patients among which 157 cases were followed-up. Proprotein convertase subtilisin/kexin 9 (PCSK9), a regulator of low density lipoprotein cholesterol (LDL-C), was confirmed as a target gene of microRNA-224. We found an increased incidence of NENs from 2012 to 2015. Women were usually diagnosed at earlier stages than men ( P < 0.05). Tumor grading was associated with primary tumor site, especially esophagus and cardia NENs all at G3 ( P

To evaluate the effects of Wuziyanzong pill on the levels of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and the expressions of nuclear-associated antigen Ki67 (Ki67), androgen receptor (AR) in testes of young rats.Sixteen 20-day-old Wistar male rats were randomly divided into control and treatment group (n = 8). Rats in treatment group were administered Wuziyanzong pill by gavage; rats in control group administered the same volume of saline. After 10 days of treatment, the rats were killed, and then serum and testes were taken. The levels of FSH, LH and T were measured by radioimmunoassay (RIA). The histology of seminiferous tubule was observed by hematoxylin-eosin (HE) staining. The expression of Ki67 was detected by immunohistochemical assay (IHC). The mRNA level of Ki67, AR and CK-18 was detected with quantitative real-time polymerase chain reaction (Q-RT-PCR), the protein level of AR and CK-18 were tested by Western blot.Compared with control group, T level in treatment group increased significantly (P0.05). HE staining showed that both leydig cells and germ cells increased in treatment group. Expressions of Ki67 and AR became higher after treatment. There were no changes in CK-18 expression.Wuziyanzong pill can up-regulate AR level to promote germ cell proliferation and differentiation in young male rats.

Compared with conventional internal combustion engine vehicle, the vehicle with multi-wheel independent technology has apparent advantages on vehicle dynamics control and driving force distribution. The target system of this study is the vehicle driven by wheel hub motors (8×8). The model of some key components is built, including the vehicle dynamics, suspension, wheel hub motor, tires. The dynamic system model of 8×8 vehicle is modeled and co -simulated with Matlab/Simulink. The controller takes the vehicle longitudinal velocity and the yaw rate as the observation object. The rules have a greater advantage in the engineering applications. And the algorithm is fast, so it can improve the vehicle maneuverability in a certain extent.

Adiabatic quantum control is a very important approach for quantum physics and quantum information processing. It holds the advantage with robustness to experimental imperfections but accumulates more decoherence due to the long evolution time. Here, we propose a universal protocol for fast and robust quantum control in multimode interactions of a quantum system by using shortcuts to adiabaticity. The results show this protocol can speed up the evolution of a multimode quantum system effectively, and it can also keep the robustness very good while adiabatic quantum control processes cannot. We apply this protocol for the quantum state transfer in quantum information processing in the photon-phonon interactions in an optomechanical system, showing a perfect result. These good features make this protocol have the capability of improving effectively the feasibility of the practical applications of multimode interactions in quantum information processing in experiment., 7 pages, 6 figures. The text overlaps partially with arXiv: 1610.09938. A general way is given for the fast and robust quantum control on multimode interactions by using shortcuts to adiabaticity, not just the transitionless intra-cavity quantum state transfer in optomechanical systems in arXiv: 1610.09938 (an application of this way). That is, the goal and the method are changed largely

OBJECTIVESTo assess the efficacy and safety of Sancai powder in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with single oral metformin in a randomized controlled trial (RCT).METHODSA total of 132 patients with T2DM were enrolled in the study, who only took metformin (500–1000 mg/day) for at least three months and with inadequate glycemic control (7.0% ≤ hemoglobin A1c ≤ 9.0%) in the past three months. The patients stopped taking metformin with lifestyle interventions for three weeks, and 105 patients qualified for the program. They were randomly divided into the Sancai powder group and the metformin group (1500 mg/day). The follow-up period was for 12 weeks. Comparisons of several variables were analyzed.RESULTSNo significant differences were found between the two groups in hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) and 2 h post-meal glucose (2hPG), although they had decreased significantly (P < 0.01). Homeostasis model assessment of beta cell function index was significantly improved in Sancai powder group (P < 0.01), and there were significant differences in the changes of homeostasis model assessment of insulin resistance and insulin sensitivity index in the two groups (P < 0.05). Sancai powder significantly reduced triglyceride level (P < 0.05), although there was no significant difference in the body weight and body mass index in the two groups.CONCLUSIONSIn this 12-week study, Sancai powder could significantly reduce hemoglobin A1c, FPG and 2hPG levels, improved beta-cell function and insulin resistance of the T2DM inadequately controlled with metformin.

We present two schemes of Lau effect for an object, an electromagnetically induced grating generated based on the electromagnetically induced effect. The Lau interference pattern is detected either directly in the way of the traditional Lau effect measurement with a classical thermal light being the imaging light, or indirectly and nonlocally in the way of two-photon coincidence measurement with a pair of entangled photons being the imaging light.

The aim of this paper is to identify the fatigue crack initiation and small crack growth mechanisms of GH4169 at 650 °C in air. Results show that fatigue cracks tend to initiate at oxidized inclusions. The crack incubation period takes up more than 90% of the fatigue lifetime. The δ phase can improve the crack initiation life and the total fatigue lifetime. The similarity between small crack and long crack growth data at relatively high Δ K can be attributed to the similarity of propagation mode. Two three-stage models are proposed to describe the cracks initiation and propagation processes.

With the aggravation of air pollution, some cities in northern China have carried out the coal-to-electricity project in succession, replacing the traditional coal-fired heating with clean and pollution-free electric energy in winter heating period. In the process of project promotion, the regenerative electric boiler is widely used. In this context, this paper first analyzes the operating characteristics of regenerative electric boilers, and establishes a coal-to-electricity project evaluation model from the perspective of heating energy type conversion and distribution network construction based on optimization models that take into account different start-stop modes. And in the part of simulation examples, the actual data is used to evaluate and analyze the different load access methods, and the results verify the effectiveness of the model proposed in this paper. It can also guide the engineering practice and provide theoretical support for the introduction of DSM in the subsequent engineering.

Objective: Percutaneous transluminal balloon angioplasty (PTA) is recommended as the first choice to treat stenosis of Brescia-Cimino arteriovenous fistulas (B-C AVFs). The ability to predict which B-C AVFs are at risk for recurrent stenosis post-PTA would allow closer monitoring of patients, and possibly result in surgical intervention rather than repeat PTA. The purpose of this study was to identify predictive factors of primary patency after PTA in B-C AVFs. Methods: Patients diagnosed with B-C AVF primary stenosis and treated by PTA between November 2013 and March 2018 were included in the study. Patient and stenotic lesion characteristics and PTA procedure factors were included in the analysis. The Kaplan–Meier method was used to analyze the primary patency rate. Cox proportional hazard regression analysis was used to identify factors predictive of decreased primary patency. Results: 74 patients (35 males, 39 females) with a mean age of 61.68 ± 11.44 years (range, 36–84 years) were included in the study. The mean B-C AVF age was 16.34 ± 12.93 months (range, 2–84 months), and the median primary patency time was 7.79 ± 0.48 months. Cox proportional hazard regression analysis revealed stenosis location at the inflow artery [hazard ratio (HR)=3.83, 95% confidence interval (CI): 1.46–10.09] or anastomosis (HR = 1.90, 95% CI: 1.09–3.32), dilation >2 times during PTA (HR = 2.30, 95% CI: 1.22–4.34), and residual stenosis >30% (HR = 2.42, 95% CI: 1.26–4.63) were significantly associated with decreased patency. Conclusion: In conclusion, the primary patency rate of PTA for B-C AVF dysfunction is reduced by dilation >2 times, residual stenosis >30%, and stenosis located at the inflow artery or anastomosis. These results may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with AVF dysfunction. Advances in knowledge: A number of studies have been conducted to examine the predictors of primary patency after PTA, however, no definitive conclusions have been reached. Our study revealed that stenosis location at the inflow artery or anastomosis, dilation >2 times during PTA, and residual stenosis >30% were the predictors of primary patency after PTA, which may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with arteriovenous fistulas dysfunction.

The present study was designed to investigate the association between the effect of controlled fluid resuscitation on massive hemorrhage and expression of human neutrophil lipocalin (HNL). A total of 112 patients confirmed with traumatic hemorrhage were enrolled as study subjects and were randomly divided into the control group (n=56) and observation group (n=56). The control group was treated with rapid fluid resuscitation, and the observation group was treated with controlled fluid resuscitation. The success rate of resuscitation, incidence rate of complications, and HNL levels were compared both before and after resuscitation at multiple time intervals. The success rate of resuscitation showed a significant improvement while the incidence rate of complications were decreased. The HNL levels in both groups revealed increase after resuscitation at 3-10 h, thereby, they showed decline following peak point. However, the peak reduction in the observation group appeared earlier, while the HNL levels at 24 and 72 h were significantly lower than those in the control group. The study concluded that the effect of controlled fluid resuscitation on massive hemorrhage was superior to that of rapid fluid resuscitation. Moreover, controlled fluid resuscitation was also able to decrease the level of HNL as well as inflammatory response.