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Objectives The present study investigated immune disorders and CCR7 expression in primary immune thrombocytopenia (ITP) patients and analyzed their changes and clinical significance before and after treatments. Methods Flow cytometry was used to detect the proportion of different immune cell subsets in the peripheral blood of 42 patients with ITP and 20 normal controls at different time points. Treatments included first-line drugs, such as glucocorticoids and intravenous immunoglobulin, and second-line therapy, such as interleukin-11 and Thrombopoietin receptor agonists (TPO-RA). Results An elevated CD4/CD8 ratio and a decreased NK cells and CD4+CD25+CD127 low regulatory T cells (Tregs) were found in pretreatment ITP patients compared to healthy controls. The newly diagnosed group had a higher CD4/CD8 ratio and more NK cells than in the relapsed group. Tregs of the remission group were higher than those of the recurrence group. The CD4+CCR7+, CD8+CCR7+, CCR7+ subset of B cells and NK cells showed higher increases in the newly diagnosed and the relapsed group compared to controls and remission group.CD4+CCR7+ and CD8+CCR7+ subset in the relapsed group were slightly higher than the newly diagnosed. The CCR7+ subsets of CD4+ T cells, CD8+ T cells, NK cells and B cells were lower in the remission group compared to the relapsed group. Higher level of the CD8+CCR7+ subset and lower NK cells were found in the remission group compared to the controls. The ratio between the CD4+CCR7+ subset and CD8+CCR7+ subset was lower in the ITP patients than in normal controls. There was a negative correlation between the CD8+CCR7+ subset and platelet count in the ITP patients. Conclusion ITP patients with CCR7 had immune disorders and high heterogeneity, and CCR7 was found to be involved in the pathogenesis of ITP. Further studies are needed to investigate the effective treatment for ITP by targeted regulation of CCR7.

Aim:To pilot study the therapeutic effect of dexmedetomidine-induced sleep balance treatment (DISBT) on the chronic refractory primary insomnia patients. Methods:Forty-two patients with chronic refractory primary insomnia were randomly divided into two groups by random number table. Patients in DISBT group were given DISBT for 3 days, while patients in the control group were given conventional treatment for 3 day. Pittsburgh sleep quality index (PSQI), the hyperarousal scale (HAS), and Hamilton anxiety scale (HAMA) were evaluated and compared between the pre-treatment and post-1-week-treatment. Sleep architecture and electroencephalogram (EEG) spectrum were also recorded and compared pre-treatment and post-treatment. Results:The scores of PSQI and HAMA in both groups after treatment were lower than those before treatment (P < 0.05), DISBT group-reduced degree were higher than those of the control group (P < 0.05). Sleep architecture of Stage 2 sleep proportion, EEG spectrum beta, and gamma relative power value in DISBT group were lower than those before treatment (P < 0.05), Stage 3 sleep proportion and delta relative power value were higher than those before treatment (P < 0.05); Sleep architecture of Stage 2 sleep proportion,beta, and gamma relative power value in control group were higher than those before treatment (P < 0.05); rapid eye movement sleep, Stage 3 sleep proportion, and delta relative power value were lower than those before treatment (P < 0.05). The total scores of the hyperarousal scale (HAS) in both groups after treatment were lower than those before treatment (P < 0.05), DISBT group-reduced degree were higher than those of the control group (P < 0.05), the extreme score, introspectiveness score, react score of HAS in control group after treatment had no statistical significance compared to those before treatment (P > 0.05), the extreme score, introspectiveness score, react score of HAS in DISBT group after treatment were lower than those before treatment (P < 0.05). Conclusion:DISBT effectively reduced the insomnia patient cortex hyperarousal level, corrected disorder of sleep-awakening pathways and easedup insomnia symptom. It is an effective method for chronic refractory primary insomnia.

To explore the role of adiponectin-resistin (AR) index as a better indicator of obesity-related hypertension.This study continued a case control study that had finished recruiting 153 subjects divided as four characteristic groups. Fasting serum resistin levels (FSR) and Fasting serum adiponectin levels (FSA) were tested by ELISA. And, other related anthropometric clinical and metabolic data were collected. Analyzation on correlations between research index and differences between groups were done by SPSS. AR index's performance was also validated by the receiver operating characteristic (ROC) curves, the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI).The AR index was defined as 1+ logThe AR index was more strongly associated with increased risk of obesity-related hypertension than the solely index of FSR or FSA and was useful for early diagnosis of obesity-related hypertension.

Background Synchronous liver metastasis (SLM) is an indicator of poor prognosis for colorectal cancer (CRC). Nearly 50% of CRC patients develop hepatic metastasis, with 15%-25% of them presenting with SLM. The evaluation of SLM in CRC is crucial for precise and personalized treatment. It is beneficial to detect its response to chemotherapy and choose an optimal treatment method. Aim To construct prediction models based on magnetic resonance imaging (MRI)-radiomics and clinical parameters to evaluate the chemotherapy response in SLM of CRC. Methods A total of 102 CRC patients with 223 SLM lesions were identified and divided into disease response (DR) and disease non-response (non-DR) to chemotherapy. After standardizing the MRI images, the volume of interest was delineated and radiomics features were calculated. The MRI-radiomics logistic model was constructed after methods of variance/Mann-Whitney U test, correlation analysis, and least absolute shrinkage and selection operator in feature selecting. The radiomics score was calculated. The receiver operating characteristics curves by the DeLong test were analyzed with MedCalc software to compare the validity of all models. Additionally, the area under curves (AUCs) of DWI, T2WI, and portal phase of contrast-enhanced sequences radiomics model (Ra-DWI, Ra-T2WI, and Ra-portal phase of contrast-enhanced sequences) were calculated. The radiomics-clinical nomogram was generated by combining radiomics features and clinical characteristics of CA19-9 and clinical N staging. Results The AUCs of the MRI-radiomics model were 0.733 and 0.753 for the training (156 lesions with 68 non-DR and 88 DR) and the validation (67 lesions with 29 non-DR and 38 DR) set, respectively. Additionally, the AUCs of the training and the validation set of Ra-DWI were higher than those of Ra-T2WI and Ra-portal phase of contrast-enhanced sequences (training set: 0.652 vs 0.628 and 0.633, validation set: 0.661 vs 0.575 and 0.543). After chemotherapy, the top four of twelve delta-radiomics features of Ra-DWI in the DR group belonged to gray-level run-length matrices radiomics parameters. The radiomics-clinical nomogram containing radiomics score, CA19-9, and clinical N staging was built. This radiomics-clinical nomogram can effectively discriminate the patients with DR from non-DR with a higher AUC of 0.809 (95% confidence interval: 0.751-0.858). Conclusion MRI-radiomics is conducive to predict chemotherapeutic response in SLM patients of CRC. The radiomics-clinical nomogram, involving radiomics score, CA19-9, and clinical N staging is more effective in predicting chemotherapeutic response.

Mei-Xiang Zhan,1,2,* Li Tang,3,* Yun-Fei Lu,4,* Huang-Hui Wu,1,* Zhi-Bin Guo,1 Zhong-Mou Shi,1 Chen-Long Yang,1 Yi-Qing Zou,1,2 Fei Yang,1,2,5 Guo-Zhong Chen1,2 1Department of Anesthesiology and Perioperative Medicine, Clinical Medical College, (900 Hospital of the Joint Logistic Support Force), Fujian Medical University, Fuzhou, Fujian, 350025, People’s Republic of China; 2Department of Anesthesiology and Perioperative Medicine, Dongfang Hospital, Xiamen University, Fuzhou, Fujian, 350025, People’s Republic of China; 3Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 4Department of Anesthesiology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People’s Republic of China; 5Laboratory of Pain Research, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, 350122, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guo-Zhong Chen; Fei YangDepartment of Anesthesiology and Perioperative Medicine, 900 Hospital of the Joint Logistic Support Force, Fujian Medical University, #156 West 2 nd Ring Road North, Gulou District, Fuzhou, 350025, People’s Republic of ChinaEmail cgzssq2000@sina.com; yangfeimedbrain@outlook.comIntroduction: Ulinastatin, a broad-spectrum serine protease inhibitor, has been widely used to treat various diseases clinically. However, so far, the antinociceptive effect of ulinastatin remains less studied experimentally and the underlying mechanisms of ulinastatin for pain relief remain unclear. This study aimed to find evidence of the analgesic effect of ulinastatin on acute somatic and visceral pain.Methods: The analgesic effect of ulinastatin on acute somatic and visceral pain was evaluated by using formalin and acetic acid-induced writhing test. The analgesic mechanism of ulinastatin was verified by detecting the peripheral inflammatory cell infiltration and spinal glial activation with hematoxylin-eosin (H&E) and immunohistochemistry staining.Results: We found that both of intraperitoneal (i.p.) pre-administration and post-administration of ulinastatin could reduce the total number of flinching and the licking duration following intraplantar formalin injection in a dose-related manner. However, the inhibitory effect of ulinastatin existed only in the second phase (Phase 2) of formalin-induced spontaneous pain response, with no effect in the first phase (Phase 1). The formalin-induced edema and ulcer were also improved by i.p. administration of ulinastatin. Moreover, i.p. administration of ulinastatin was also able to delay the occurrence of acetic acid-induced writhing and reduced the total number of writhes dose-dependently. We further demonstrated that ulinastatin significantly decreased the local inflammatory cell infiltration in injured paw and peritoneum tissue under formalin and acetic acid test separately. The microglial and astrocytic activation in the spinal dorsal horn induced by intraplantar formalin and i.p. acetic acid injection were also dramatically inhibited by i.p. administration of ulinastatin.Conclusion: Our results for the first time provided a new line of evidence showing that ulinastatin could attenuate acute somatic and visceral pain by inhibiting the peripheral and spinal inflammatory reaction.Keywords: Ulinastatin, formalin, somatic pain, visceral pain, inflammation, antinociception

The self-expressiveness property of the data, i.e., each sample is linearly represented as a combination of other samples, has recently aroused much attention in the community of data mining and machine learning and shown great promising for subspace clustering. However, real-world data are usually contaminated by noise and outliers. The true similarity between samples directly learned from the original data may deviate from the intrinsic structure of the data, and subsequent clustering results will be severely affected. Hence naively taking a corrupted dictionary, i.e., data itself, will not always obtain the desired clustering performance. To address the above issues, this paper proposes a robust principal component analysis induced self-representation clustering method via adaptively learning the similarity graph from the clean data in the self-representation framework, where the original data are recovered, and the representation coefficients are obtained simultaneously in a unified framework. Specifically, we jointly integrate a nonnegative constraint and a distance regularization into the proposed framework, which guarantees the learned affinity matrix can simultaneously capture the global and local structure of data. Experimental results on both synthetic data and several famous multimedia datasets demonstrate that the proposed method performs much better against state-of-the-arts.

Avascular necrosis (AVN) of the bones remains a major clinical challenge. Fractures in the talus, the scaphoid, and the neck of the femur are especially challenging to heal due to the low blood vessel network and the lack of collateral blood supply. These fractures are associated with high rates of nonunion and increased infections that require repeated operations. Conventional treatments by autografting or allografting bone replacement and synthetic bone implants have limitations, including the invasiveness of operative procedures, tissue supply insufficiency, and the risk of host rejection. The advancement in tissue engineering has revealed the potential of stem cells as restorative agents for bone injuries. The administration of mesenchymal stem cells (MSCs) into the talus, the scaphoid, and the neck of the femur could produce enhanced osteogenesis via the manipulation of MSC culture conditions. In this study, we used hydroxyapatite as the nanomaterial, and hypoxic milieu to enhance MSC differentiation capacity into the osteogenic lineage, allowing for more rapid and efficient bone cell replacement treatment. Our results demonstrate 1% oxygen and 12.5 μg/mL of hydroxyapatite (HAP) as the optimal conditions to incorporate the osteogenic medium for the osteogenic induction of MSCs. We also established a proof of concept that the addition of HAP and hypoxic conditions could augment the osteoinductive capacity of MSCs. We also developed an accurate mathematical model to support future bone cell replacement therapy.

To build models based on conventional logistic regression (LR) and machine learning (ML) algorithms combining clinical, morphological, and hemodynamic information to predict individual rupture status of unruptured intracranial aneurysms (UIAs), afterwards tested in internal and external validation datasets.Patients with intracranial aneurysms diagnosed by computed tomography angiography and confirmed by invasive cerebral angiograph or clipping surgery were included. The prediction models were developed based on clinical, aneurysm morphological, and hemodynamic parameters by conventional LR and ML methods.The training, internal validation, and external validation cohorts were composed of 807 patients, 200 patients, and 108 patients, respectively. The area under curves (AUCs) of conventional LR models 1 (clinical), 2 (clinical and aneurysm morphological), and 3 (clinical, aneurysm morphological and hemodynamic characteristics) were 0.608, 0.765, and 0.886, respectively (all p 0.05). The AUCs of ML models using random forest (RF), multilayer perceptron (MLP), and support vector machine (SVM) were 0.871, 0.851, and 0.863, respectively. There were no difference among AUCs of conventional LR, RF, and SVM (all p 0.05/6), while the AUC of MLP was lower than that of conventional LR (p = 0.0055).Hemodynamic parameters play an important role in the prediction performance of the models. ML methods cannot outperform conventional LR in prediction models for rupture status of UIAs integrating clinical, aneurysm morphological, and hemodynamic parameters.• The addition of hemodynamic parameters can improve prediction performance for rupture status of unruptured intracranial aneurysms. • Machine learning algorithms cannot outperform conventional logistic regression in prediction models for rupture status integrating clinical, aneurysm morphological, and hemodynamic parameters. • Models integrating clinical, aneurysm morphological, and hemodynamic parameters may help choose the optimal management.

Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the Mini-Nutritional Assessment-Short Form (MNA-SF) to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound healing indicators and MNA-SF score. This was a prospective observational and cross-sectional study. This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8–11 points), and malnutrition (0–7 points). At the same time, we measured and compared the wound healing indicators among the three groups of patients, and detected the correlation. The results showed gender had a slight influence on the score of nutritional status, while age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

Background: In clinical settings, burn wounds are frequently encountered. Since burn wounds are a form of physical injury, they can have long-term adverse effects on the human body. It has been a significant challenge to treat burn wounds completely. Since traditional treatment strategies have been unable to heal burn wounds completely, they lack the efficacy to cure the wounds without long-term effects, such as heavy scarring. Reportedly, platelet-rich plasma (PRP) has shown potential to accelerate wound healing. Yet, there are no conclusive reports on a methodological comparative study of research that has assessed the medical benefits of PRP for treating individuals carrying burn wounds. Thus, the present meta-analysis and systematic study aims to assess the medical benefits of PRP for treating patients carrying burn wounds. Methods: The authors will conduct a comprehensive search for randomized controlled trials that evaluate the safeness and efficiency of PRP to treat burn wounds. The search includes 3 Chinese language databases (WanFang database, Chinese BioMedical Literature database, and China National Knowledge Infrastructure) and 4 English language databases (Cochrane Library, EMBASE, Web of Science, and MEDLINE). These electronic databases will be searched from their establishment till May 2021. A pair of independent authors will be selecting eligible studies for extracting data. The same authors will employ the Cochrane risk of bias tool to evaluate the bias risk. We will make use of RevMan (version: 5.3) software to complete data synthesis. Results: The present protocol will establish practical and targeted results evaluating the efficacy and safeness of using PRP to treat burn wounds. The current study also provides a reference for clinical use of PRP. Conclusion: Stronger evidence about the effectiveness and safety of using PRP to treat and heal burn wounds will be provided for clinicians to refer. Ethics and dissemination: Ethics approval is unrequired. Registration number: March 31, 2021.osf.io/whauj. (https://osf.io/whauj/).

Background Mixed evidence challenges preoperative alpha-fetoprotein (AFP) as an independent prognostic factor for patients with hepatocellular carcinoma (HCC) after hepatectomy. Results Daily post-operative decrease of AFP by 9% as compared to the preoperative level (A09) were selected as the Cut-off. The Kaplan-Meier curve showed that A09 was significantly different for OS (P=0.043) and RFS (P=0.03). A decrease in risk by 54% was observed for OS and 32% for RFS in the at-risk population (A09>9%). A better concordance was observed after adding A09 into TNM and BCLC staging systems. Moreover, a consistent concordance was observed in the internal (FDZS5:0.63; FDZS3:0.608) and external (FDZS5:0.85; FDZS3:0.762) validation cohorts, suggesting its prognostic value in HCC population with elevated AFP. Conclusions Decrease in perioperative serum AFP rather than preoperative AFP is an independent prognostic factor for HCC patients after hepatectomy. Cut-off A09 significantly discriminates overall and recurrence-free survival and could be interpret into TNM and BCLC staging systems to improve the stratification power for HCC patients with elevated AFP. Methods Kaplan-Meier curve depicted the differences of overall survival (OS) and recurrence-free survival (RFS). Nomogram and concordance were employed to evaluate the superiority of the current staging system.

Oxidative stress plays a vital role in the initiation and progression of age-related neurodegenerative diseases. Ameliorating oxidative damage is therefore considered as a beneficial strategy for the treatment of age-related neurodegenerative disorders. Probucol (Prob), a lipid-lowering prototype agent, was reported to treat cardiovascular diseases, chronic kidney disease and diabetes mellitus. However, whether Prob has an effect on age-related neurodegenerative diseases remains unknown. In the study, it was found that Prob ameliorated D-galactose (D-gal) induced cognitive deficits and neuronal loss in the hippocampal CA1 region. Moreover, Prob alleviated ROS and MDA levels by elevating SOD, GSH-PX and HO-1 mRNA and protein expressions, and improving plasmic and cerebral SOD and GSH-PX activities in D-gal treated mice. Furthermore, Prob promoted the dissociation of Keap1/Nrf2 complex leading to the accumulation of Nrf2 in nucleus, implying that the improved anti-oxidant property of Prob is mediated by Keap1/Nrf2 pathway. The study firstly demonstrates the favorable effects of Prob against cognitive impairments in a senescent mouse model, rendering this compound a promising agent for the treatment or prevention of age-related neurodegenerative disease.

Objective: To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity. Methods: A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table, with 28 cases in each group. The tuina group was treated mainly with tuina at the head and abdomen, while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and Gastrodia Decoction). The course of treatment was 30 d. The scores of headache index, traditional Chinese medicine syndrome scale, and the therapeutic efficacy were observed. Results: There were 2 dropouts in each group during treatment. The total effective rate was 92.3% in the tuina group, significantly higher than 76.9% in the Chinese medicine group (P

Background: Cutaneous melanoma is a highly malignant tumor which tends to metastasize in the early stage and leads to poor prognosis. Hematogenous and lymphatic metastasis are common in the dissemination of melanoma. Rapamycin, an mTOR inhibitor, was reported to have anti-angiogenic and anti-lymphangiogenic properties. Aim: The aim of this study was to investigate if rapamycin can inhibit the formation of blood vessels and lymphatic vessels in melanoma. Methods: A melanoma xenograft model was generated by subcutaneously transplanting A375 human melanoma cells into the back of immunodeficient mice. Two weeks after cell transplantation, rapamycin was injected intraperitoneally every other day seven times. Then, tumors were harvested. Hematoxylin-eosin (H-E) staining, immunohistochemical staining, Western blot, and quantitative PCR were performed to observe the pathological structure of the tumor, the distribution of blood vessels and lymphatic vessels, and the expression of mTOR signal pathway, VEGF-A/VEGFR-2, and VEGF-C/VEGFR-3. Results: The results showed that CD34(+) blood vessels and LYVE-1(+) lymphatic vessels decreased in the peritumor and intratumor region in rapamycin-treated tumors. Expression of p-4EBP1 and p-S6K1 proteins was downregulated. Expression of both proteins and mRNAs of VEGF-A/VEGFR-2 and VEGF-C/VEGFR-3 was downregulated. Conclusion: In conclusion, rapamycin suppresses angiogenesis and lymphangiogenesis in melanoma by blocking the mTOR signal pathway and subsequently downregulating the expression of VEGF-A/VEGFR-2 and VEGF-C/VEGFR-3. Therefore, targeted therapy via mTOR signal pathway may control the hematogenous and lymphatic metastasis of melanoma, and even prolong patients' survival time.

Objective: To evaluate the therapy effect on patients with sacral extradural meningeal cysts with nerve root fibers by wrapping a man-made dura around reconstructed nerve sleeve. Patients and methods: In order to avoid the cysts residue and recurrence postoperative, wrapping a man-made dura around reconstructed nerve sleeve, a new operating method, was performed in 24 patients with 42 cysts. After the nerve sleeve being reconstructed, wrapping and suturing a man-made dura around the nerve sleeve was performed. The Improved Japanese Orthopedic Association (IJOA) scoring system was used to evaluate preoperative and postoperative neurological function. Results: Among 24 patients, 14 were females, and 10 males. Three-month after open surgery, no cyst residue or recurrence was grasped in any patient. The mean IJOA score was 18.8 ± 1.32 preoperatively and 19.6 ± 0.65 postoperatively, which was a significant difference between the preoperative and postoperative scores (t = −3.82, P = 0.001). These results indicate a significant improvement in neurological function after surgery. Conclusion: Based on reconstruction the nerve sleeve, wrapping with man-made dura and forming double nerve sleeve was safety and effective operating method for treatment the sacral extradural meningeal cysts with nerve root fibers. Keywords: Sacral canal, Spinal meningeal cysts, Nerve root fibers, Reconstructed nerve root sheath, Wrapping nerve sleeve, Residue, Recurrence, Clinical outcomes

A linear random search algorithm (LRSA) is developed to determine the critical value of takeoff weight limited to the safe flight track sinkage and an engineering estimation method (EEM) is proposed to calculate the sinkage of carrier aircraft launch in real time. Based on the analysis of free flight after leaving the carrier, the equations are established to participate into engineering estimation of flight track sinkage. Thanks to the proposed search algorithm, the maximum takeoff weight of carrier aircraft with safe catapult launch flight track sinkage is generated in few steps. The results of sinkage estimation and the search algorithm are in good agreement with that of aircraft catapult launch simulation. The main contribution of this manuscript is the establishment of simple and accurate engineering estimation for carrier aircraft launch flight track sinkage and the development of robust and efficient search algorithm for the critical value with safe catapult criteria.

Fungi play an irreplaceable role in drug discovery in the course of human history, as they possess unique abilities to synthesize diverse specialized metabolites with significant medicinal potential. Trichoderma are well-studied filamentous fungi generally observed in nature, which are widely marketed as biocontrol agents. The secondary metabolites produced by Trichoderma have gained extensive attention since they possess attractive chemical structures with remarkable biological activities. A large number of metabolites have been isolated from Trichoderma species in recent years. A previous review by Reino et al. summarized 186 compounds isolated from Trichoderma as well as their biological activities up to 2008. To update the relevant list of reviews of secondary metabolites produced from Trichoderma sp., we provide a comprehensive overview in regard to the newly described metabolites of Trichoderma from the beginning of 2009 to the end of 2020, with emphasis on their chemistry and various bioactivities. A total of 203 compounds with considerable bioactivities are included in this review, which is worth expecting for the discovery of new drug leads and agrochemicals in the foreseeable future. Moreover, new strategies for discovering secondary metabolites of Trichoderma in recent years are also discussed herein.

Objectives To construct MRI-based radiomics logistic model in differentiating solid pseudopapillary neoplasm (SPN) from three differential diseases containing adenocarcinoma, neuroendocrine tumor (NET), and cystadenoma of pancreas. Materials and methods A total of 21 SPNs and 140 differential diseases were enrolled. The MRI images of T1WI, T2WI, DWI, and contrast-enhanced (CE) sequences were taken to delineate the volume of interest, and the corresponding radiomics features were calculated. After the preprocess of data balance and image standardize, the data was divided into training set (6 SPNs and 42 differential diseases) and validation set (15 SPNs and 98 differential diseases) with a proportion of 7:3, randomly. Then after feature selection, four MRI-based logistic models included T1WI, T2WI, DWI, CE, and sum logistic models (Log-T1WI, Log-T2WI, Log-DWI, Log-CE, and Log-sum) were established. The receiver operation curve (ROC) was depicted to evaluate the efficacy of each model. Results To the single MRI sequence, the AUCs of Log-T1WI, Log-T2WI, Log-DWI, and Log-CE were similar. Seemingly the AUCs of Log-T2WI were slightly higher with 0. 876 (95%CI, 0.797-0.956) in the training set and 0.853 (95%CI, 0.708-0.998) in the validation set. The Log-sum of four MRI sequences displayed better differentiating efficiency, with AUCs of 0.929 (95%CI, 0.877-0.980) in the training set and 0.925 (95%CI, 0.845-1.000) in the validation set. The Log-Ra/Clin model combined clinical information and radiomics showed the highest AUC of 0.962 (95%CI, 0.919-0.985). Conclusions MRI-based radiomics analysis helped to discern SPNs from radiologically misdiagnosed adenocarcinoma, neuroendocrine tumor, and cystadenoma of pancreas. The efficacy of single sequence logistic model was similar. The Log-sum combined four sequences and Log-Ra/Clin combined clinical information and radiomics demonstrated the better performance in distinction.

Background: Nearly 10% of all patients who visit the emergency department report severe abdominal pain. Out of these, almost one-third are not diagnosed accurately. The conventional practice to care for such inpatients involves actively managed observation and repetitive clinical assessments at regular intervals. The aim of this study is to assess the clinical therapeutic effects of opioid analgesia in the treatment of severe abdominal pain in kids and adolescents. Methods: A comprehensive electronic search will be done on Web of Science, EMBASE, PubMed, WanFang database, Chinese National Knowledge Infrastructure, and the Cochrane Library from their establishment to May 2021. The search will identify and retrieve all randomized controlled trials that describe the clinical therapeutic effects of opioid analgesia to treat severe abdominal pain in adolescents and children. Two independent authors will shortlist studies that meet the inclusion criteria, extract data from selected studies, and evaluate the risk associated with bias in the selected articles. We will use RevMan (v: 5.3) to conduct all the data synthesis. Results: This meta-analysis will conduct a high-quality synthesis on present evidence related to the usage of opioid analgesia to treat severe abdominal pain in both kids and adolescents. Conclusion: Our findings will summarize the present evidence and help judge whether opioid analgesia is an effective and safe line of treatment for severe abdominal pain. Ethics and dissemination: This study will use pre-published data, and as such, it does not require ethics approval. OSF registration number: May 29, 2021.osf.io/fp9ym (https://osf.io/fp9ym/).

Multimodal clustering has become a fundamental and important problem in the data mining community since the development of multimedia technology over the last two decades has led to a tremendous increase in unlabeled multimodal data. Although a panoply of multimodal subspace clustering methods shows promising performance via fusing information from different views of multimodal data, most of them consist of two sequential steps, i.e., learning a consensus affinity matrix from the original data and then feeding the resulting affinity matrix into the framework of spectral clustering. However, this leads to the suboptimal clustering performance due to the following limitations: 1) the two steps of learning the affinity matrix and clustering are carried out independently; 2) the affinity matrix may be unreliable; 3) the post-processing requirement, such as K-means. To address these issues, we propose a novel multimodal subspace clustering method via adaptively learning a similarity graph on a latent low-rank representation space. In particular, the number of connected components of the learned graph is precisely equal to the number of clusters, i.e., the optimal solution of the associated problem directly reveals the clustering structure of data. Extensive evaluations on several benchmark multimodal datasets demonstrate that the proposed approach outperforms state-of-the-art methods.

Public transport is an important part of urban development and management. Urban bus and trolleybus are parts of urban public transport and one of the most basic modes of travel provided by the government for the public, which are related to the immediate interests of the public. Urban bus and trolleybus network is the layout of bus and trolleybus on the road network. The more reasonable the bus network layout is, the higher the service level of bus and trolleybus will be. However, there are few researches on the evaluation of bus and trolleybus line network in China at present, a systematic evaluation index system has not yet been established, which makes it difficult to systematically and effectively evaluate the line network. In this paper, the evaluation indexes suitable for each city are selected from the perspective of the performance of bus and trolleybus line network and the bus and trolleybus operation effect to establish an evaluation index system of bus and trolleybus line network, including 11 indexes. At the same time, the paper gives the recommended collection method of each index, such as GIS, big data of bus credit card and electronic payment. The research results provide a reference for the planning, construction and management of bus and trolleybus, and provide a basis for improving the urban bus and trolley bus service and urban management.

In order to effectively monitor the battery usage status of electric vehicle, this paper designs a high-precision voltage monitoring circuit applied to multi-series battery packs, which based on the 0.18μm, 40V high voltage BCD process. According to the characteristics of the voltage superposition and battery distinction in the series battery pack, this circuit uses the voltage conversion circuit with the matched negative feedback technology to achieve effective “scaling” of the battery's absolute high voltage to ground-based analog signals. Under the typical/slow/fast process corners, -40°C~85°C and1.5V~31.5V, the simulation results show that the monitoring error of single cell voltage is 1.92mV, and the relative error rate is less than 0.043%, showing out of the strong robustness.

Background To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients. Methods We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A, three-port LRP; group B, conventional four-five-port LRP; group C, open RP (ORP); and group D, robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages. Results All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases of conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0 days, the mean hospitalization was 5.1 days, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization, and transfusion in group A were statistically significant among the majority of the other groups (p < 0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased. Conclusions Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization, and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice.

To study the effects of ice accretion on the longitudinal aerodynamic characteristics of an aircraft, a two-part method for predicting longitudinal aerodynamic derivatives of iced aircraft is proposed. For the aircraft with a flight test, a parameter identification system based on maximum likelihood criterion and a longitudinal nonlinear flight dynamics model is established. For the aircraft without a flight test, an engineering prediction method of aerodynamic derivatives based on an individual component CFD calculation and narrow strip theory is established. According to the flight test data of DHC-6 Twin Otter aircraft from NASA, the longitudinal aerodynamic parameters of both clean and artificially iced aircraft are obtained. Additionally, the longitudinal aerodynamic derivatives of the iced aircraft are calculated. Then, the correctness of the prediction method is verified by comparing the calculated results with the identification results. The comparison of these results shows that the prediction method is correct and accurate, and it can be used to calculate the effects of icing on the aircraft longitudinal aerodynamic parameters.

All-trans-retinoic acid (atRA), the active metabolite of vitamin A, is an essential signaling molecule in all chordates. Global knockouts of the atRA clearing enzymes Cyp26a1 or Cyp26b1 are embryonic lethal. In adult rodents, inhibition of Cyp26a1 and Cyp26b1 increases atRA concentrations and signaling. However, postnatal knockout of Cyp26a1 does not cause a severe phenotype. We hypothesized that Cyp26b1 is the main atRA clearing Cyp in postnatal mammals. This hypothesis was tested by generating tamoxifen-inducible knockout mouse models of Cyp26b1 alone or with Cyp26a1. Both mouse models showed dermatitis, blepharitis, and splenomegaly. Histology showed infiltration of inflammatory cells including neutrophils and T lymphocytes into the skin and hyperkeratosis/hyperplasia of the nonglandular stomach. The mice lacking both Cyp26a1 and Cyp26b1 also had a reduced lifespan, failed to gain weight, and showed fat atrophy. There were significant changes in vitamin A homeostasis. Postnatal knockout of Cyp26b1 resulted in increased atRA concentrations in the skin while the postnatal knockout of both Cyp26a1 and Cyp26b1 resulted in increased atRA concentrations in the liver, serum, skin, spleen, and intestines. This study demonstrates the paramount role of Cyp26b1 in regulating retinoid homeostasis in postnatal life.

Noninvasive assessment of severity of liver fibrosis is crucial for understanding histology and making decisions on antiviral treatment for chronic HBV in view of the associated risks of biopsy. We aimed to develop a computer-assisted assessment system for the evaluation of liver disease severity by using machine leaning classifier based on physical-layer with serum markers. The retrospective data set, including 920 patients, was used to establish Decision Tree Classifier (DTC), Random Forest Classifier (RFC), Logistic Regression Classifier (LRC), and Support Vector Classifier (SVC) for liver fibrosis severity assessment. Training and testing samples account for 50% of the data set, respectively. The best indicator combinations were selected in random combinations of 24 indicators including 67 108 760 group indicators by four different machine learning classifiers. The resulting classifiers prospectively tested in 50% testing patients, and the sensitivity, specificity, overall accuracy, and receiver operating characteristics (ROC) were used to compare four classifiers to existed 19 models. Results show that the RFC-based classifier system, with 9 indicators, is feasible to assess severity for liver fibrosis with diagnostic accuracy (greater than 0.83) superior to existing 19 models. Additional studies based on a large data set with full serum markers and imaging information are necessary to enhance diagnostic accuracy and to expand clinical application.

In the era of big data, multi-view clustering has drawn considerable attention in machine learning and data mining communities due to the existence of a large number of unlabeled multi-view data in reality. Traditional spectral graph theoretic methods have recently been extended to multi-view clustering and shown outstanding performance. However, most of them still consist of two separate stages: learning a fixed common real matrix (i.e., continuous labels) of all the views from original data, and then applying K-means to the resulting common label matrix to obtain the final clustering results. To address these, we design a unified multi-view spectral clustering scheme to learn the discrete cluster indicator matrix in one stage. Specifically, the proposed framework directly obtain clustering results without performing K-means clustering. Experimental results on several famous benchmark datasets verify the effectiveness and superiority of the proposed method compared to the state-of-the-arts.

The vortex beam has attracted much attention due to its great potential applications in communication and medicine area. To compare with the regular light, the vortex beam carrying the orbital angular momentum can greatly increase information capacity in communication. In this paper, a new method is presented to generate terahertz vortex beam based on the complementary open-rings metamaterial. The structure is composed of a metasurface-dielectric-metasurface, which top and bottom layer are both complementary open rings, and the dielectric layer is polyimide. And the vortex beam generators with topological charge of 1 and 2 have been designed according to the phase principle of Pancharatnam-Berry (P-B), which based on the different orientation of open ring unit cells. The amplitude and phase of the cross-polarized transmitted beam were manipulated by rotating the orientation of the complementary open rings, while ensure the amplitude of the transmitted beam stays unchanged, and the phase of the cross-polarized transmitted beam cover the range of 1*2π (where l is the topological charge). The vortex beam characteristics has been studied when circularly polarized light incident on the measurface of vortex beam generators with the CST MICROWAVE STUDIO. The simulation results show that the transmitted beam are well meet the characteristic of vortex beam, which the transmittance of cross-polarized vortex beam is as high as 64% at 1.48 THz while the phase can cover the range of 1*2π. That is, the presented transmissive vortex beam generators can convert incident circularly polarized beam into a cross-polarized vortex beam carrying orbital angular momentum. The approach demonstrated in this paper which is high conversion efficiency, simple structure, quick response, and has potential applications in the field of terahertz communication.

The aim of the present study is to confirm the correlation between fibrinogen and the severity of cerebral white matter hyperintensities (WMHs) among nondiabetic patients with noncardiogenic acute ischemic stroke.A cross-sectional study of 170 consecutive patients with noncardiogenic acute ischemic stroke who underwent magnetic resonance imaging and vascular imaging was conducted. WMHs were classified into periventricular hyperintensity (PVH) and deep and subcortical WMH (DSWMH) using Fazekas rating scale. After adjustment for fibrinogen and other vascular risk factors, we determined which factors were independent of WMHs.After adjustment for the vascular risk factors, prior ischemic stroke (odds ratio [OR] 4.153, 95% confidence interval [CI] 1.077-16.020, P = .039), fibrinogen level (OR 2.114, 95% CI 1.034-4.322, P = .040), and glycosylated hemoglobin A1c (OR .633, 95% CI .423-.947, P = .026) were independently and positively associated with PVH (P .05); prior ischemic stroke (OR 2.841, 95% CI 1.469-5.493, P = .002), lipoprotein(a) (OR 1.002, 95% CI 1.000-1.005, P = .047), and fibrinogen levels (OR 1.788, 95% CI 1.170-2.732, P = .007) were independently and positively associated with DSWMH (P .05).Our study demonstrated that prior ischemic stroke and higher fibrinogen are associated with WMHs, regardless of PVH and DSWMH, in nondiabetic patients with noncardiogenic acute ischemic stroke. In addition, lipoprotein(a) might be an independent predictor of DSWMH in patients with noncardiogenic acute ischemic stroke.

It is widely accepted that the performance of carbon foams can be regulated by the tailoring of pore cell structures to meet the requirements of various applications. However, no theory has been used to date for guiding such regulation. In this work, carbon foams were prepared by saturating vitrinite concentrate with nitrogen gas under high pressure. The influence of key factors on the pore cell structure of carbon foams was investigated systematically. The results showed that the mean cell diameter and the bulk density of carbon foams can be regulated, respectively, in the ranges 140–440 µm and 0.29–0.75 g/cm3, which indicates that vitrinite concentrate separated from fat coal is highly suitable for the preparation of carbon foams. The variation trends of the pore cell structures were well explained by combining the homogeneous nucleation mechanism of microcellular polymer with the viscosity of the fusant formed from vitrinite concentrate. The inherent reason for all the variation trends is related to the gas nuclei density and viscosity of the fusant. More importantly, a strategy is suggested to successfully accomplish the design and regulation of the pore structure of carbon foams by taking into account the homogeneous nucleation mechanism and viscosity of the fusant.

A gear reducer is of critical importance to the performance of many transmission systems in automotive, marine, and aerospace applications. In the preliminary design phase, the pursuits of minimum volume, maximum surface fatigue life and maximum load capacity essentially becomes a multi-objective optimization problem. In this paper, a novel metaheuristics algorithm, Crow Search Algorithm (CSA), is extended to a multi-objective decision scenario based on the strategy embedded in the preference-inspired co-evolutionary algorithm using weights (PICEA-w). The proposed algorithm combines the nature of diversity, the rapid convergence of CSA and the efficient adaptive weights from PICEA-w. The genetic operator applied in the original PICEA-w aims to generate the offspring that is replaced by the food survey strategy of CSA with augmented efficiency. A hoisting transmission optimization problem from heavy cable shovel excavator is solved. Comparisons with other methods are provided to illustrate the effectiveness of the proposed optimization algorithm.

Purpose The purpose of this paper is to reduce the acoustic noise of helicopter ducted tail rotor. Design/methodology/approach To predict the noise accurately, a thin-body boundary element method (BEM)/Ffowcs Williams–Hawkings method is developed in this paper. It is a hybrid method combining the BEM with computational aeroacoustics and can be used efficiently to predict the propagation of sound wave in the duct. Findings Compared with the experimental results, the proposed method of acoustic noise is rather desirable. Practical implications Then several geometry parameters are modified to investigate the noise reduction of ducted tail rotor by using the numerical prediction method. Originality/value The aerodynamic and acoustic performance of different modification tasks is discussed. These results demonstrate the validity of design parameters modification of ducted tail rotor in acoustic noise reduction.

The concept of moment resisting frames with K-type external braces is proposed to increase the lateral stiffness, which has short external span and large lateral stiffness. In order to investigate the lateral stiffness, overstrength coefficient and the reduction factor of K-type external brace under horizontal load, ABAQUS was applied to study the different slenderness ratios (from50 to 150) of K-type external steel braced frames. The results showed that the lateral load and displacement curve can be divided into elastic stage, the buckling of the compressive brace-yield of the tensile brace stage and plastic stage. The overstrength of K-bracing is related to the potential bearing capacity of the frame when the compressive brace buckled, and the potential growth of the tensile brace. The overstrength coefficient increases with increasing of the brace slenderness ratio. The range of recommended values of slenderness ratios of K-type external steel braces and design values of unbalanced force of column sections are proposed.

Noninvasive detection of blood components is the most ideal and effective method to prevent and detect many clinical diseases. However, the accuracy of noninvasive detection based on the spectrum is not always satisfactory. The influence of various interferences in measurement limits the accuracy of the analysis. The dynamic spectrum theory can theoretically eliminate the individual differences and measurement environment influence and improve measurement accuracy. The concentration of globulin is closely related to the status of the immune system, which is of great significance for clinical diagnosis. This paper improves the signal-to-noise ratio from all links of dynamic spectrum data processing to realize the noninvasive detection of globulin. Through reasonable pretreatment, extraction, quality evaluation, and variable screening, the valid information of the spectrum gets maximum utilization. Finally, using the partial least squares prediction model to predict globulin concentration. The results show that the model established by dynamic spectrum treated by this method has a good predictive performance for globulin. The correlation coefficient of the prediction set is 0.962, the root-mean-square error of the prediction set is only 1.058 g/L, the correlation coefficient of the calibration set is 0.996, and the root-mean-square error of the calibration set is 0.332 g/L. The experimental results show that reasonable data processing of dynamic spectrum can effectively improve the signal-to-noise ratio of the data, make the established model have good prediction accuracy and performance, and realize the high-precision prediction globulin. This paper provides a complete research idea and method for the noninvasive detection of blood components. It is hopeful to realize the noninvasive quantitative detection of trace components in blood.

Eliminating minimal residual disease (MRD) in order to prevent relapse is an unmet need in acute myeloid leukemia (AML). One of the success stories is acute promyelocytic leukemia (APL), a unique subtype of AML. The use of arsenic trioxide (ATO) in combination with all-trans retinoic acid (ATRA) has essentially eliminated disease relapse ( Taken together these findings support a model in which ATO changes the bone marrow niche and it's ability to metabolize retinoids and thus, sensitizes MRD in AML to targeted therapy. Figure 1 Figure 1. Disclosures Mathews: Christian Medical College: Patents & Royalties: US 2020/0345770 A1 - Pub.Date Nov.5, 2020; AML: Other: Co-Inventor. Ghiaur: Syros Pharmaceuticals: Consultancy; Menarini Richerche: Research Funding.

Background: Osteoporosis is a common condition that affects bones. Osteoporotic vertebral compression fracture (OVCF) is a highly prevalent complication related to osteoporosis. Each year, OVCF affects nearly 700,000 individuals. Nowadays, there are many surgical methods to treat OVCF, and each has distinct advantages. Among them, the efficacy and safeness of vertebroplasty are yet to be established. The present article will systematically ascertain the effectiveness and security of using vertebroplasty to treat OVCF. Methods: All articles related to the research topic published from establishment to July 2021 will be retrieved from the following e-databases Medline, Cochrane library, PubMed database, China National of Knowledge Infrastructure, Web of Science, Embase database, and WanFang database. The collected articles will be related to the use of vertebroplasty to treat OVCF. All included articles will adhere to the standards, and will be screened by 2 independent authors. After extracting the data in the article, Review Manager 5.3 software will be used for data analysis. Results: This study will assess the efficacy and safety of using vertebroplasty to treat OVCF by pooling the results of each study. Conclusion: Our findings will present strong evidence to help determine whether vertebroplasty therapy is efficient and safe for OVCF patients.

Neuropathic pain is a common chronic pain condition with major impact on quality of life. However, its physiopathologic mechanism remains unknown and pain management is still a challenge. Accumulating evidence indicated that C-X-C chemokine receptor type 4 (CXCR4) played a critical role in the process of pain. Thus, the present study aimed to investigate whether intervertebral foramen injection of CXCR4 antagonist, plerixafor, was able to relieve neuropathic pain and explore the possible underlying mechanism. Chronic compression of the dorsal root ganglion (CCD) was established as a typical model of neuropathic pain. The results indicated that CCD induced multiple pain-related behaviors and the expression of CXCR4, Nav1.8 and Nav1.9 was significantly increased in compressed dorsal root ganglion (DRG) neurons. Knocking down CXCR4 expression could significantly reduce neuropathic pain and intervertebral foramen plerixafor injection (IVFP) dramatically decreased the up-regulation of Nav1.8 and Nav1.9 and attenuated neuropathic pain. The analgesic duration of IVFP was maintained at least for 24 h which was much longer than intervertebral foramen injection of Nav1.8 blocker and local anesthetics. Therefore, our study provided evidence that IVFP could reduce the expression of Nav1.8 and Nav1.9 in DRG neurons which might contribute to, at least in part, the analgesic effect of plerixafor on CCD-induced neuropathic pain. It is concluded that IVFP was an effective and applicable treatment approach for neuropathic pain.

IntroductionPatients with obstructive sleep apnoea (OSA) are more sensitive to postanaesthesia respiratory depression. Whether different anaesthetic regimens (intravenous-based or inhalational-based general anaesthesia) affect the postanaesthesia respiratory depression is controversial. Although desflurane has been reported that presents favourable rapid recovery profile in special patients including whom with OSA, the strong clinical evidence of the benefit on postanaesthesia respiratory depression is far from being revealed. This study aims to fill this knowledge gap by investigating the postanaesthesia respiratory depression in postanaesthesia care unit (PACU) in patients with OSA after major abdominal surgery, followed by desflurane-based anaesthesia compared with propofol-based anaesthesia.Methods and analysisEight hundred and fifty-four patients with OSA scheduled for elective major abdominal surgery will be randomly 1:1 assigned to desflurane-based (n=427) or propofol-based anaesthesia (n=427) using a computer-generated randomisation scheme with permuted block size maintained by a centralised randomisation centre. Patients will be assessed before and a consecutive 3 days after their surgery according to the standardised tasks. Demographic data as well as surgical and anaesthesia information will be collected for the duration of the procedure. Incidence of postanaesthesia respiratory depression in PACU as well as anaesthesia recovery, emergence delirium, postoperative nausea and vomiting, rescue analgesia, duration of PACU and hospital stay, and any other adverse events will be assessed at the given study time point. Investigators performing postoperative follow-up are not involved in both anaesthesia implementation and postoperative care.Ethics and disseminationThis study protocol has been approved by the ethics board at Xiang’an Hospital of Xiamen University (XAHLL2019003). The results of this study will be published in a peer-review journal and presented at national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.Trial registration numberChiCTR2000031087.

Ulinastatin is a broad-spectrum protease inhibitor widely used for the treatment of various inflammation-related diseases owing to its recognized excellent anti-inflammatory and cytoprotective properties. However, whether ulinastatin can relieve postoperative pain remains unclear. In this study, we evaluated the analgesic effects of ulinastatin administered either as a single agent or in combination with sufentanil in a validated preclinical rat model of postoperative pain induced by plantar incision. We found that incisional surgery on the hind paw of these rats induced sustained ipsilateral mechanical pain hypersensitivity that lasted for at least 10 days. A single intraperitoneal (i.p.) injection of ulinastatin prevented the development and reversed the maintenance of incision-induced mechanical pain hypersensitivity in a dose-dependent manner. However, ulinastatin had no effect on the baseline nociceptive threshold. Moreover, repeated i.p. injections of ulinastatin persistently attenuated incision-induced mechanical pain hypersensitivity and promoted recovery from the surgery. The rats did not develop any analgesic tolerance over the course of repeated injections of ulinastatin. A single i.p. injection of ulinastatin was also sufficient to inhibit the initiation and maintenance of incision-induced hyperalgesic priming when the rats were subsequently challenged with an ipsilateral intraplantar prostaglandin E2 injection. Furthermore, the combined administration of ulinastatin and sufentanil significantly enhanced the analgesic effect of sufentanil on postoperative pain, which involved mechanisms other than a direct influence on opioid receptors. These findings demonstrated that ulinastatin had a significant analgesic effect on postoperative pain and might be a novel pharmacotherapeutic agent for managing postoperative pain either alone or as an adjuvant.

// Hai Rong Ma 1 , Ping Lei Pan 2 , Li Qin Sheng 1 , Zhen Yu Dai 3 , Gen Di Wang 2 , Rong Luo 2 , Jia Hui Chen 2 , Pei Rong Xiao 2 , Jian Guo Zhong 2 and Hai Cun Shi 2 1 Department of Neurology, Traditional Chinese Medicine Hospital of Kunshan, Kunshan, PR China 2 Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China 3 Department of Radiology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China Correspondence to: Jian Guo Zhong, email: yc3yjgzhong@163.com Hai Cun Shi, email: yc3yhcshi@gmail.com Keywords: Alzheimer’s disease, arterial spin labeling, default mode network, meta-analysis, seed-based d mapping Received: May 18, 2017 Accepted: September 20, 2017 Published: October 04, 2017 ABSTRACT Many studies have applied arterial spin labeling (ASL) to characterize cerebral perfusion patterns of Alzheimer’s disease (AD). However, findings across studies are not conclusive. A quantitatively voxel-wise meta-analysis to pool the resting-state ASL studies that measure regional cerebral blood flow (rCBF) alterations in AD was conducted to identify the most consistent and replicable perfusion pattern using seed-based d mapping. The meta-analysis, including 17 ASL studies encompassing 327 AD patients and 357 healthy controls, demonstrated that decreased rCBF in AD patients relative to healthy controls were consistently identified in the bilateral posterior cingulate cortices (PCC)/precuneus, bilateral inferior parietal lobules (IPLs), and left dorsolateral prefrontal cortex. The meta-regression analysis showed that more severe cognitive impairment in the AD samples correlated with greater decreases of rCBF in the bilateral PCC and left IPL. This study characterizes an aberrant ASL-rCBF perfusion pattern of AD involving the posterior default mode network and executive network, which are implicated in its pathophysiology and hold promise for developing imaging biomarkers.

ZnO films with carrier concentration as low as 5.0 × 10 13 cm −3 have been prepared via a lithium and nitrogen codoping method, and ultraviolet photodetectors have been fabricated from the films. The photodetectors can be used to detect weak signals with power density as low as 20 nw/cm 2 , and the detectivity and noise equivalent power of the photodetector can reach 3.60 × 10 15 cmHz 1/2 /W and 6.67 × 10 −18 W −1 , respectively, both of which are amongst the best values ever reported for ZnO based photodetectors. The high-performance of the photodetector can be attributed to the relatively low carrier concentration of the ZnO:(Li,N) films.

Accumulating studies assessing the impacts of hot spot mutations on conventional interferon (IFN) efficacy come to discrepant conclusions; studies regarding the mutations in S and RT regions are also unclear. The present study aimed to evaluate the impacts of HBV mutations on the efficacy of conventional IFN.A total of 126 patients who received conventional IFN treatment for 48 weeks were enrolled. Biochemical and serological parameters were routinely tested. The sequences of HBV from 78 serum samples were amplified by nested-PCR; mutations were identified with sequence scanner V1.0 after ABI 3730xl direct sequencing, HBV genotypes were determined according to RT gene sequences utilizing NCBI Genotyping Tool which was based on phylogenetic analysis.The baseline DNA levels of virological response (VR) group were significantly lower than those of no VR group [7.13+/-0.76 vs 7.69+/-0.56 lg (copies/mL), P=0.001]. The baseline ALT levels were significantly higher in the HBeAg clearance group (204.72+/-88.65 vs 162.80+/-85.81 IU/L, P0.05) and HBeAg seroconversion group (204.89+/-95.68 vs 166.75+/-84.43 IU/L, P0.05). Females and lower BMI levels (20.01+/-2.33 vs 21.65+/-3.66 kg/m2, P0.05) were prone to acquired biochemical response (BR). PC-W28STOP (ntG1896A) was significantly higher in the combined response (CR) group than that in the no CR group (91.7% vs 39.7%, P=0.001). Multivariate logistic regression analysis showed that baseline DNA, PC-P159T (ntC2288A), BCP-N118T (ntA1726C) and BCP-L134L (ntA1775C/G/T) influenced VR independently. PC-G182C (ntG2357T), PC-S64A/T (ntT2003G/A) and BMI were independent influence factors for HBeAg clearance, HBeAg seroconversion and BR, respectively. The new predicting model concluded that baseline DNA and new mutations for VR were established successfully, and ROC analysis showed that AUC was 0.842 (P0.001) with a sensitivity of 0.652 and a specificity of 0.933.PC-P159T (ntC2288A), BCP-N118T (ntA1726C), BCP-L134L (ntA1775C/G/T), PC-G182C (ntG2357T) and PC-S64A/T (ntT2003G/A) were novel identified mutations that impacted IFN therapeutic efficacy. These novel mutations could serve as important predictors before conventional IFN treatment.

// Xiaojiang Zhang 1, * , Shuzheng Lv 1 , Chengjun Guo 1 , Conghong Shi 2, * , Yunpeng Chi 1 , Lin Zhao 1 , Guozhong Wang 1 , Zhisheng Wang 1 1 Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China 2 Baotou Fourth Hospital, Baotou, Inner Mongolia, 014030, China * These authors contributed equally to this work Correspondence to: Shuzheng Lv, email: lvsszz552@163.com Keywords: PPARG, CYP1A1, coronary artery disease, SNP, interaction Received: February 17, 2017 Accepted: March 06, 2017 Published: March 14, 2017 ABSTRACT Aims: To observe the influence of the peroxisome proliferator-activator receptor-G ( PPAR-G ) gene and cytochrome P4501A1 ( CYP1A1 ) single-nucleotide polymorphisms (SNPs), and interactions among several SNPs on coronary artery disease (CAD) risk. Methods: A total of 1106 participants (including 583 males and 523 females) including 550 CAD patients and 556 control subjects were recruited in this study, and the mean age for these participants was 55.5 ± 11.8 years old. Logistic regression was used to observe association of SNP within PPARG and CYP1A1 with CAD risk and GMDR model was used to screen the best interaction combinations. Results: CAD susceptibility was higher in those with homozygous mutant of rs10865710, rs1805192 and rs4646903 than those with wild-type homozygotes, OR (95%CI) were 1.47 (1.15–1.92), 1.69 (1.27–2.09) and 1.72 (1.35–2.32), respectively. We also found a significant two-locus model involving rs1805192 and rs4646903 ( p = 0.0107), and the cross-validation consistency of this locus model was 10 of 10, the testing accuracy of this model is 62.17%. Logistic regression shown that CAD risk was the highest in those with rs1805192- Pro/Ala or Ala/Ala and rs4646903- AG+GG genotype, and was lowest in those with rs1805192- Pro/ Pro and rs4646903- AA genotype, OR(95%CI) = 3.56 (1.91–5.42). Conclusions: Polymorphism in rs10865710, rs1805192 and rs4646903 and interaction between rs1805192 and rs4646903 were related with increased CAD susceptibility.

Objectives To evaluate the radiation dose and image quality of cerebral CT angiography (CTA) at 70kVp with 30mL iodinated contrast agent. Methods One hundred patients were prospectively classified into two groups: Group A (n=50), 120kVp cerebral CTA with 60mL iodinated contrast agent reconstructed by filtered back projection (FBP) and Group B (n=50), 70kVp with 30mL iodinated contrast agent reconstructed by sinogram-affirmed iterative reconstruction (SAFIRE). CT values, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the internal carotid artery (ICA) and middle cerebral artery (MCA) were measured. Subjective image quality was evaluated. Effective dose (ED) was calculated. Results The mean CT values of the ICA and MCA of Group B were higher than those of Group A (all P 0.001). The mean noise of Group A was lower than that of Group B ( P 0.001). SNR ICA , SNR MCA and CNR ICA , CNR MCA of Group A were higher than Group B (all P 0.001). There was no difference in vessel sharpness, noise, and overall quality between the two groups (all P >0.05). ED of Group B (0.2±0.0mSv) was lower than Group A (1.3±0.1 mSv) (p Conclusion Cerebral CTA with iterative reconstruction at 70kVp and 30mL iodinated contrast agent is feasible, allowing for substantial dose reduction compared with conventional cerebral CTA protocol.

To evaluate the relationship between hemodynamics and vessel wall remodeling patterns in middle cerebral artery (MCA) stenosis based on high-resolution magnetic resonance imaging and computational fluid dynamics (CFD). Forty consecutive patients with recent ischemic stroke or transient ischemic attack attributed to unilateral atherosclerotic MCA stenosis (50–99%) were prospectively recruited. All patients underwent a cross-sectional scan of the stenotic MCA vessel wall. The parameters of the vessel wall, the number of patients with acute infarction, translesional wall shear stress ratio (WSSR), wall shear stress in stenosis (WSSs), and translesional pressure ratio were obtained. The patients were divided into positive remodeling (PR) and negative remodeling (NR) groups. The differences in vessel wall parameters and hemodynamics were compared. Correlations between the parameters of the vessel wall and hemodynamics were calculated. Of the 40 patients, 16 had PR, 19 had NR, and the other 5 displayed non-remodeling. The PR group had a smaller lumen area (p = 0.004), larger plaque area (p < 0.001), normal wall index (p = 0.004), and higher WSSR (p = 0.004) and WSSs (p = 0.023) at the most narrowed site. The PR group had more enhanced plaques (12 vs 6, p = 0.03). The number of patients with acute stroke in the PR group was more than that in the NR group (11 vs 4, p = 0.01). The remodeling index (r = 0.376, p = 0.026) and plaque area (r = 0.407, p = 0.015) showed a positive correlation with WSSR, respectively. Hemodynamics plays a role in atherosclerotic plaques and vessel wall remodeling. Individuals with greater hemodynamic values might be more prone to stroke. • Stenotic plaques in middle cerebral artery with positive remodeling have smaller lumen area and larger resp. higher plaque area, normal wall index, translesional wall shear stress ratio, and wall shear stress than negative remodeling. • The remodeling index and plaque area are positively correlated with translesional wall shear stress ratio. • Hemodynamic may help to understand the role of positive remodeling in the development of acute stroke.