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In current healthcare systems, electronic medical records (EMRs) are always located in different hospitals and controlled by a centralized cloud provider. However, it leads to single point of failure as patients being the real owner lose track of their private and sensitive EMRs. Hence, this article aims to build an access control framework based on smart contract, which is built on the top of distributed ledger (blockchain), to secure the sharing of EMRs among different entities involved in the smart healthcare system. For this, we propose four forms of smart contracts for user verification, access authorization, misbehavior detection, and access revocation, respectively. In this framework, considering the block size of ledger and huge amount of patient data, the EMRs are stored in cloud after being encrypted through the cryptographic functions of elliptic curve cryptography (ECC) and Edwards-curve digital signature algorithm (EdDSA), while their corresponding hashes are packed into blockchain. The performance evaluation based on a private Ethereum system is used to verify the efficiency of proposed access control framework in the real-time smart healthcare system.

Human activity recognition plays a fundamental role in smart home systems and contributes to remote health monitoring for the elderly or disabled. However, the shallow architecture and heavy parameters of the current 3-D convolutional networks (3-D ConvNets) still restrict the recognition efficiency and spatiotemporal representations. For these issues, this article proposes a framework called LMFNet, which is mainly composed of a deep attentive 3-D residual network (A3D ResNet) and a multistage fusion strategy. Specifically, LMFNet changes the information flow of transmission in the C3D network and implements a residual learning method for efficient training. Besides, the two-stream-fused spatiotemporal attention 3-D ConvNets (2S- $\text{F}_{ST}$ A3DCN) are built based on the A3D ResNet. The experimental results show that the proposed LMFNet can achieve a higher recognition accuracy and satisfactory training efficiency compared with the existing methods.

This paper aims to address the human action recognition issue by using convolutional long short-term memory networks (Conv-LSTM) and fully-connected LSTM (FC-LSTM) with different attentions. To this end, the spatial-temporal dual-attention network (STDAN), which is mainly composed of feature extraction, attention and fusion modules, is designed. Different from the features of high-level fully-connected layer mostly used in previous work, the features of convolution and fully-connected layers of convolutional neural network (CNN) are both extracted in STDAN, which can enrich the initial level of video representation. Besides, the Conv-LSTM and FC-LSTM are employed to handle the long-duration sequential features with different temporal context information. To reinforce the spatial-temporal attention ability, a temporal attention module (TAM) and a joint spatial-temporal attention module (JSTAM) are implemented. Through the principle components analysis (PCA) and features fusion, the potential of STDAN is effectively explored and weighted. Finally, the experimental results show that the proposed STDAN has better recognition performance than existing state-of-the-art methods.

To describe our initial experience with laparoendoscopic radical prostatectomy (LRP) and a stepwise transition towards transurethral assisted laparoendoscopic single-site RP (TU-LESS RP). From Jan. 2007 to Dec. 2016, 195 patients underwent RP, of which 89 patients were performed by LRP (Group A), 106 by TU-LESS RP (Group B). The peri-operative data were collected and analyzed. All data referring to patient demographics, surgery, pathology, and peri-operative outcomes were recorded. The cosmetic result was investigated by the Patient Scar Assessment Questionnaire (PSAQ). Analysis of variance or Chi squared test were adopted to analyze the data. 195 procedures were completed successfully. The operation time (109.6 ± 31.9 vs. 151.5 ± 87.3, P = 0.025) and anastomosis time (10.1 ± 4.8 vs. 21.8 ± 9.9, P

This paper is dedicated to investigating the application of blockchain in eHealth systems. Unlike the previous work, patients here play a supervisory role and allow medical institutions to legally use their medical data without prior authorization but own the right to manage the medical data. This concept is able to protect the rights and interests of patients without affecting the normal diagnosis and research work of medical institutions. On this basis, a blockchain-based access control scheme for eHealth systems is proposed. To encourage patients to actively share their medical data, an incentive mechanism is also included. Finally, a case study on Ethereum is given to illustrate the feasibility and practicality of the proposed method.

Cloud-fog-edge computing especially cloud computing is providing a variety of services in many areas around the world and plays a vital role in cyber-physical-social systems (CPSS). Particularly, virtualization is one of main enabling technologies of cloud computing and realizes the dynamic deployment of computing tasks through the migration of virtual machines (VMs), so how to secure the virtual environment in the cloud is very crucial. The purpose of this paper is to address the issue of malware propagation among VMs under the infrastructure as a service (IaaS) architecture. Firstly, a dynamical propagation model is proposed to explore the important factors affecting the spread of malware, especially the impact of installing antivirus software in VMs. On this basis, a theoretical analysis for this model is investigated by means of differential dynamics, from which it is able to understand the dissemination behavior of malware under an infected cloud environment. Finally, some numerical simulations are conducted to verify the applicability and effectiveness of the proposed model.

Introduction Owing to the development of the laparoendoscopic single-site (LESS) procedure, transumbilical LESS nephroureterectomy (LESS-NU) has become a new approach for treating upper tract urothelial carcinoma. Aim The aim of this study is to introduce a modified LESS-NU procedure with bladder cuff excision for treating upper tract urothelial carcinoma (UTUC). We compared its clinical efficacy and postoperative outcomes in terms of follow-up time with traditional retroperitoneal laparoscopic nephroureterectomy (RL-NU). Material and methods From May 2014 to May 2019, we performed nephroureterectomy on 42 patients using the retroperitoneal approach and a modified LESS approach. A retrospective analysis was conducted for the evaluation of the clinical and postoperative outcomes between the two groups. Results The study included 25 LESS-NU and 17 RL-NU patients. All the procedures were completed successfully. The LESS-NU group had a significantly shorter mean operative time than the RL-NU group (204.4 min, 236.18 min, p = 0.005). The differences in skin incision length (2.88 cm, 8.94 cm, p < 0.001) and oral analgesic dose (n = 1.12, n = 2.75, p < 0.001) between LESS-NU and RL-NU were statistically significant. Conclusions Modified LESS-NU is a feasible and safe procedure. Compared with the retroperitoneal laparoscopic approach, the single-site approach did not alter the patients’ position. LESS-NU is a better procedure for treating UTUC than RL-NU in terms of cosmetic result and postoperative pain.

Background and Aims: Patients with light-chain cardiac amyloidosis (AL-CA) are characterized by high levels of serum carbohydrate antigen 125 (CA 125). However, studies have not explored the correlation between CA 125 and AL-CA. The aim of this study was to explore the clinical implications of an increase in CA 125 in patients with AL-CA.Methods and Results: A total of 95 patients diagnosed with AL-CA at the Second Xiangya Hospital were enrolled in this study. Out of the 95 patients with AL-CA, 57 (60%) patients had elevated serum CA 125 levels. The mean age was 59.7 ± 10.0 years with 44 (77.2%) men in the high serum CA 125 group, and 61.8 ± 9.6 years with 28 (73.7%) men in the normal group. Patients with high CA 125 showed higher rates of polyserositis (79.3% vs. 60.5%, p = 0.03), higher levels of hemoglobin (117.4 ± 21.9 g/L vs. 106.08 ± 25.1 g/L, p = 0.03), serum potassium (4.11 ± 0.47 mmol/L vs. 3.97 ± 0.40 mmol/L, p = 0.049), low-density lipoprotein-cholesterol (3.0 ± 1.6 mmol/L vs. 2.3 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (96.0 pg/mL vs. 91.9 pg/mL, p = 0.005). The median overall survival times for patients with high or normal serum CA 125 were 5 and 25 months, respectively (p = 0.045). Multivariate Cox hazard analysis showed that treatment without chemotherapy (HR 1.694, 95% CI 1.121–2.562, p = 0.012) and CA 125 (HR 1.002, 95% CI 1.000–1.004, p = 0.020) was correlated with high all-cause mortality. The time-dependent receiver operating characteristic (t-ROC) curve showed that the prediction accuracy of CA 125 was not inferior to that of cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and lactate dehydrogenase (LDH) based on the area under the curve.Conclusions: CA 125 is a novel prognostic predictor. High serum CA 125 values are correlated with low overall survival, and the accuracy of predicting prognosis is similar to that of traditional biomarkers in AL-CA.

Aiming at the multi-condition problem of Continuous Annealing Processes (CAP), this paper proposes a new method based on Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) models to identify multiple conditions in CAP. First, this work analyzes the parameters in CAP, selects the key variables that affect the working conditions, and then selects a piece of data in the CAP work process as the training data set to train the constructed LSTM_GRU neural network. This method realizes the recognition of different working conditions in CAP, which saves training time, simplifies internal calculations. Compared with the traditional method, this method avoids the recognition error caused by personal experience factors, and the model accuracy has greatly improved.

Males have a higher risk for cardiovascular diseases (CVDs) than females. Ambient fine particulate matter (PM) exposure increases CVD risk with increased reactive oxygen species (ROS) production and oxidative stress. Endothelial progenitor cells (EPCs) are important to vascular structure and function and can contribute to the development of CVDs. The aims of the present study were to determine if sex differences exist in the effect of PM exposure on circulating EPCs in mice and, if so, whether oxidative stress plays a role. Male and female C57BL/6 mice (8–10 weeks old) were exposed to PM or a vehicle control for six weeks. ELISA analysis showed that PM exposure substantially increased the serum levels of IL-6 and IL-1β in both males and females, but the concentrations were significantly higher in males. PM exposure only increased the serum levels of TNF-α in males. Flow cytometry analysis demonstrated that ROS production was significantly increased by PM treatment in males but not in females. Similarly, the level of circulating EPCs (CD34+/CD133+ and Sca-1+/Flk-1+) was significantly decreased by PM treatment in males but not in females. Antioxidants N-acetylcysteine (NAC) effectively prevented PM exposure-induced ROS and inflammatory cytokine production and restored circulating EPC levels in male mice. In sharp contrast, circulating EPC levels remained unchanged in female mice with PM exposure, an effect that was not altered by ovariectomy. In conclusion, PM exposure selectively decreased the circulating EPC population in male mice via increased oxidative stress without a significant impact on circulating EPCs in females independent of estrogen.

Introduction: Laparoendoscopic single-site (LESS) technique is a less invasive approach for radical cystectomy (RC), which is promising in reducing the incisional morbidity and improving the cosmesis of laparoscopic surgery. This study aimed to investigate the clinical and oncological outcomes for patients with malignant urinary bladder tumors that underwent the transurethral-assisted transumbilical LESS-RC. Methods: From December 2014 to June 2017, 47 patients underwent LESS-RC combined with unilateral or bilateral cutaneous ureterostomy were enrolled in this study. The urethra was used as a potential approach without additional incision, which could allow for trocar insertion through natural orifices. Assessments were also conducted on preoperative, perioperative, postoperative, pathologic, and functional outcome data. Results: Mean patient age was 73 years. Mean body mass index was 24.0 kg/m2. Median operating time and estimated blood loss measure 217 min and 178 mL, respectively. Four patients were diagnosed with positive lymph nodes. Two patients had positive surgical margins. No major perioperative complications occurred. Median postoperative follow-up time was 20.1 months. Two patients died due to their progressive disease. Conclusion: LESS can serve as a feasible and effective surgical procedure for RC to treat bladder cancer. With increasing experience and improvements, LESS-RC is promising to be a relatively acceptable alternative for minimally invasive surgery in some specific patients (with generally poor conditions that cannot be tolerated for a long time surgery, short life expectancy, advanced cancer, or associated with intestinal disease).

Online social networks have become extremely important in daily life and can be used to influence lives in dramatic ways. Two issues are the veracity and provenance of posted information, including rumors. There is a need for methods for tracing rumors (or any piece of information) to their most likely source in such networks. We consider the detection problem of single rumor source based on observed snapshots based on the susceptible-exposed-infected-recovered (SEIR) model. According to the SEIR model, all nodes in the network are formulated into four possible states: susceptible (S), exposed (E), infected (I), and recovered (R). Given an observed snapshot in the network, from which we can know the relevant graph topology and all infected nodes, but where nodes in susceptible, exposed, or recovered status cannot be distinguished, the purpose of our research is to identify the rumor source based on the observed snapshot and graph topology. We propose the concept of the optimal infection process and derive an estimator for the rumor source based on this optimal infection process. Subsequently, we prove that this estimator matches the rumor source with a high probability. The effectiveness of the proposed scheme is validated using experiments based on regular tree networks with different degrees. We further evaluate the performance of our scheme on two well-known synthetic complex networks and four real-world networks; the results suggest that our proposed scheme outperforms the traditional rumor centrality heuristics. The performance analysis on computational complexity demonstrates that our scheme has advantages in efficiency compared with other rumor centrality heuristics used in rumor detection methods.

The sex of a patient can affect the outcomes of several cardiovascular diseases, and men generally tend to experience earlier episodes of cardiovascular diseases compared with women. The progression of atherosclerosis during hyperlipidemia can be induced by reactive oxygen species (ROS) and oxidized-low-density lipoprotein (ox-LDL). By contrast, bone marrow (BM)-derived endothelial progenitor cells (EPCs) have been reported to serve a protective role against atherosclerosis. The aim of the present was to compare the effects of sex under conditions of hyperlipidemia on different populations of EPCs, and to identify the potential underlying mechanisms. EPC numbers and ROS levels in the blood and BM were measured using fluorescence activated cell sorting in male and female LDL receptor knock-out C57BL/6 mice maintained on a high-fat diet for 6 months, and in male and female wild type C57BL/6 mice following ox-LDL injection for 3 days. Female hyperlipidemic mice exhibited lower levels of plasma lipids, atherosclerotic plaque formation, intracellular EPC ROS formation and inflammatory cytokine levels. Furthermore, BM CD34+/ fetal liver kinase-1 (Flk-1+), CD34+/CD133+ and stem cell antigen-1+/Flk-1+, as well as all circulating EPCs, were maintained at higher levels in female hyperlipidemic mice. In addition, similar changes with regards to BM CD34+/Flk-1+, CD34+/CD133+, c-Kit+/CD31+ and circulating CD34+/Flk1+ and CD34+/CD133+ EPCs were observed in female mice following ox-LDL treatment. These sustained higher levels of BM and circulating EPCs in female mice with hyperlipidemia may be associated with reduced levels of ox-LDL as a result of reduced intracellular ROS formation in EPCs and decreased inflammatory cytokine production.

Aims: The level of serum carbohydrate antigen 125 (CA 125) elevated is a common finding in patients with cardiac amyloidosis in clinical practice. It is unclear whether CA 125 is correlated with cardiac amyloidosis. The aim of this study was to systematically evaluate the clinical implications of CA 125 elevation in patients with cardiac amyloidosis.Methods and Results: We enrolled 101 patients diagnosed with cardiac amyloidosis at the Second Xiangya Hospital, 41 patients with acute decompensated heart failure (AHF) and 39 patients with multiple myeloma (MM) who were confirmed to have no cardiac amyloidosis served as control group, respectively. In 101 patients with cardiac amyloidosis, 58 (57%) patients had elevated serum CA 125 levels, which the mean age was 61.2 ± 11.4 years. Patients with high CA 125 were more likely to present with polyserositis ( 79.3% vs 60.5%, p = 0.03) , higher levels of hemoglobin (117.22 ± 21.87 g/L vs. 106.07 ± 25.15 g/L, p = 0.01), serum potassium (4.17 ± 0.49 mmol/L vs. 3.98 ± 0.41 mmol/L, p = 0.05), low density lipoprotein-cholesterol (2.98 ± 1.65 mmol/L vs. 2.22 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (115 pg/mL vs. 59.52 pg/mL, p = 0.005) . The serum CA 125 levels were significantly higher in cardiac amyloidosis than AHF and MM. The median overall survival for patients with elevated and normal serum CA125 were 5 and 20 months, respectively (p = 0.012). According to multivariate Cox hazard analysis, CA 125 (HR 1.002, 95%CI 1.000-1.004, p = 0.020) contributed to all-cause mortality. The time-dependent receiver operating characteristic was used to reflect the accuracy of different biomarkers in predicting overall survival at various time points by the area under the curve (AUC). CA 125 has no worse prediction accuracy than cardiac troponin T, NT-proBNP and LDH according to the AUC.Conclusions: The prevalence of elevated serum CA 125 levels is more than 50% in patients with cardiac amyloidosis. As an independent prognostic predictor, highly serum CA 125 values indicated the lower overall survival and the accuracy of predicting prognosis was not inferior to the other biomarkers.

Objective: To compare the surgical and early oncological outcomes in patients with bladder cancer who had laparoendoscopic single-site radical cystectomy (RC) or laparoscopic RC. Materials and Meth...

This paper is dedicated to eliminating the impact of redundant information from emotional-unrelated regions on facial expression recognition (FER). To this end, a densely connected convolutional neural network with hierarchical spatial attention is proposed. Specifically, it can adaptively locate salient regions and focus on the emotional related features so that the facial expressions can be represented more efficiently. This superior performance is also verified by some experiments. Experimental results reveal that the proposed method can distinguish facial expression more accurately than existing state-of-the-art methods.

Congenital adrenal hyperplasia (CAH) is one of the most prevalent, and potentially severe, genetic inborn errors of steroid synthesis directly affecting metabolism. Most patients are diagnosed and treated at an early age. There have been very limited reports of adults with CAH-associated adrenal myelolipomas. We aimed to analyze two families with CAH-associated giant adrenal myelolipomas caused by defects inCYP21A2andCYP17A1genes. A total of 14 individuals from two unrelated families were identified with eitherCYP21A2orCYP17A1mutations. Of note, five patients were found with adrenal myelolipomas. Total DNA isolated from the peripheral blood of the two probands was screened for potential mutations in the following susceptibility genes of CAH:CYP21A2,CYP11B1,CYP17A1,HSD17B3,HSD3B2,ARMC5, andSTARusing target capture-based deep sequencing; and Sanger sequencing was conducted for the family members to detect the potential mutations. The following results were obtained. In family 1, molecular genetics sequencing revealed a compound heterozygous mutation (c.293-13C>G/c.518T>A, p.I173N) inCYP12A2in the patient and his brother. In family 2, all three female patients with adrenal myelolipomas were found to have a compound heterozygous mutation (c.1118A>T, p.H373L/c.1459_1467del9, p.D487_F489del) inCYP17A1. To avoid giant CAH-associated adrenal myelolipomas in adults, it is important to identify CAH early so that appropriate treatment can be initiated to interrupt the chronic adrenal hyperstimulation resulting from increased ACTH. Genetic testing and counseling could be useful in CAH.

Distributed Ledger Technologies (DLTs) and blockchain systems have received enormous academic, government, and commercial interest in recent years. This article surveys the integration of DLTs within another life-changing technology, the Internet of Things (IoT). IoT-based applications, such as smart home, smart transport, supply chain, smart healthcare, and smart energy, promise to boost the efficiency of existing infrastructures and change every facet of our daily life. This article looks into the challenges faced by such applications and reviews a comprehensive selection of existing DLT solutions to those challenges. We also identify issues for future research, including DLT security and scalability, multi-DLT applications, and survival of DLT in the post-quantum world.

Objective Our aim was to describe the surgical technique and report early outcomes of transurethral assisted laparoendoscopic single-site radical prostatectomy (LESS-RP) and cystectomy (LESS-RC) in a single institution. Materials and Methods Between December 2014 and March 2016, 114 cases were performed LESS-RP and LESS-RC, including LESS-RP (n=68), LESS-RC with cutaneous ureterostomy (LESS-RC/CU) (n=38) and LESS-RC with orthotopic ileal neobladder (LESS-RC/OIN) (n=8). Access was achieved via a single-port with four channels placed through a transumblical incision. After the apex of prostate was separated from the urethra, a self-developed port (“Zhu's port”) was inserted through the urethra to facilitate resection of prostate and urethrovesical anastomosis. The perioperative and postoperative data were collected and analyzed retrospectively. Patients were followed up postoperatively for evidence of long-term side effects. Results All the procedures were completed successfully. No conversion into conventional laparoscopic surgery was necessary. For LESS-RP, the average operative time was 152 min. Estimated blood loss was 117 ml. Mean hospital stay was 16.4 days after surgery. For LESS-RC/CU and LESS-RC/OIN, the average operative time was 215 min and 328 min, estimated blood loss was 175ml and 252ml, and mean hospital stay was 9.4 days and 18.2 days, respectively. Six patients required blood transfusion (5.26%). Intraoperative complications were occurred in two patients (1.75%), and postoperative complications in nine cases (7.89%). 14 out of 68 (20.6%) patients who underwent LESS-RP encountered positive surgical margins. Follow-up ranged from 10-30.6 months. In prostate cancer, good urinary control was observed in 35.3%,97.1% and 100% of the patients at 1 month, 6 months and 12 months after the operation.Biochemical recurrence(BCR) was observed in 11.8% patients. In bladder cancer, two patients had local recurrence and two patients had distant metastasis. Conclusion LESS-RP and LESS-RC are feasible and safe with the aid of transurethral port. Operating through the transurethral port might overcome the challenges posed by the single port laparoscopic approach. This article is protected by copyright. All rights reserved.

// Long Fan 1, * , Qingyi Zhu 2, * , Li Liu 3 , Cuicui Zhu 1 , Haojie Huang 4 , Shan Lu 1 and Ping Liu 1 1 Jiangsu Province Key Laboratory for Molecular and Medicine Biotechnology, Life Science College, Nanjing Normal University, Nanjing, Jiangsu, China 2 Department of Urology, Jiangsu Province Hospital of TCM, Nanjing, Jiangsu, China 3 Laboratory of Molecular Biology, Jiangsu Province Hospital of TCM, Nanjing, Jiangsu, China 4 Mayo Clinic Cancer Center, Mayo Clinic College of Medicine, Rochester, MN, USA * These authors have contributed equally to this work Correspondence to: Ping Liu, email: 08201@njnu.edu.cn Haojie Huang, email: huanghj86@gmail.com Keywords: androgen, androgen receptor, chemokine, CXCL13, prostate cancer Received: July 10, 2016 Accepted: May 09, 2017 Published: June 07, 2017 ABSTRACT Androgen receptor (AR) is a key transcription factor playing a critical role in prostate cancer (PCa) initiation and progression. However, the molecular mechanisms of AR action in prostate cancer are not very clear. CXCL13, known as B cell attracting chemokine1 (BCA-1), is a member of CXC chemokine family and relevant to cancer metastasis. This study shows that CXCL13 is an androgen-responsive gene and involved in AR-induced PCa cell migration and invasion. In clinical specimens, expression of CXCL13 in PCa tissues is markedly higher than that in adjacent normal tissues. In cultures, expression of CXCL13 is up-regulated by androgen-AR axis at both mRNA and protein levels. Furthermore, Chip-Seq assay identifies canonical androgen responsive elements (ARE) at CXCL13 enhancer and dual-luciferase reporter assays reveals that the ARE is highly responsive to androgen while mutations of the ARE abolish the reporter activity. Additional chromatin immunoprecipitation (ChIP) assays also identify that the ARE presents androgen responsiveness. In addition, CXCL13 promotes G2/M phase transition by increasing Cyclin B1 levels in PCa cells. Functional studies demonstrate that reducing endogenous CXCL13 expression in LNCaP cells largely weakens androgen-AR axis induced cell migration and invasion. Taken together, our study implicates for the first time that CXCL13 is an AR target gene and involved in AR-mediated cell migration and invasion in primary PCa.

The aim of this study was to present the authors' experience with technical recommendations for the treatment of concurrent large upper ureteral and renal stones.Between September 2014 and March 2016, laparoendoscopic single-site surgery (LESS) ureterolithotomy with renal stone extraction or holmium laser lithotripsy under flexible cystoscopy was performed on 15 patients who had concurrent upper ureteral and renal stones. The ureteral stone was treated with LESS ureterolithotomy. After the ureteral stone had been removed, a flexible cystoscope was inserted through one of the laparoscopic ports into the renal pelvis and collecting systems. Renal stones were extracted with a stone basket or broken by a holmium laser and then removed. The perioperative and postoperative data were collected and analyzed retrospectively. Patients were followed up postoperatively for evidence of long-term side-effects.Nine patients underwent LESS ureterolithotomy and flexible cystoscope-assisted renal stone extraction. Six patients underwent concomitant holmium laser lithotripsy because of larger renal stones. All procedures were completed successfully. The ureteral stones were 15-23 mm in diameter and the renal stones were 4-20 mm in diameter. The mean surgery time was 156 min. Estimated blood loss was 70 ml. Complete stone clearance was confirmed by postoperative imaging in all patients. The median length of hospital stay after surgery was 9.1 days. No intraoperative or postoperative complications occurred during a mean follow-up of 10.2 months.LESS ureterolithotomy with renal stone extraction or holmium laser lithotripsy under flexible cystoscopy can be considered an effective treatment for patients with concurrent large ureteral and renal stones.

In incurable castration-resistant prostate cancer (CRPC), resistance to the novel androgen receptor (AR) antagonist enzalutamide is driven mainly by AR overexpression. Here we report that the expression of interferon regulatory factor 8 (IRF8) is increased in primary prostate cancer but decreased in CRPC compared with normal prostate tissue. Decreased expression of IRF8 positively associated with CRPC progression and enzalutamide resistance. IRF8 interacted with AR and promoted its degradation via activation of the ubiquitin/proteasome systems. Epigenetic knockdown of IRF8 promoted AR-mediated prostate cancer progression and enzalutamide resistance in vitro and in vivo. Furthermore, IFNα increased expression of IRF8 and improved the efficacy of enzalutamide in CRPC by targeting the IRF8–AR axis. We also provide preliminary evidence for the efficacy of IFNα with hormonotherapy in a clinical study. Collectively, this study identifies IRF8 both as a tumor suppressor in prostate cancer pathogenesis and a potential alternative therapeutic option to overcome enzalutamide resistance. Significance: These findings identify IRF8-mediated AR degradation as a mechanism of resistance to AR-targeted therapy, highlighting the therapeutic potential of IFNα in targeting IRF8–AR axis in CRPC.

As a revolutionary and profound technology, the Internet of Things (IoT) has the potential to fundamentally transform our society by simply connecting sensors and smart devices to the Internet. It is no doubt that the security of communications between smart devices is an important issue in IoT. In this paper, we deal with the security scheme for communications between ESP8266 modules, which can provide embedded Wi-Fi capabilities at a low cost. Based on an existed security scheme for ESP8266, we proposed an enhanced mutual authentication mechanism and ECDH-key agreement on curve25519. Compared with the existed schemes, security analysis and performance evaluation show that the new scheme can resist various communication attacks, saying modification attacks, replay attacks, and man-in-the-middle attacks.

Compressed sensing (CS) is a signal processing framework, which reconstructs a signal from a small set of random measurements obtained by measurement matrices. Due to the strong randomness of measurement matrices, the reconstruction performance is unstable. Additionally, current reconstruction algorithms are relatively independent of the compressed sampling process and have high time complexity. To this end, a deep learning based stacked sparse denoising autoencoder compressed sensing (SSDAE_CS) model, which mainly consists of an encoder sub-network and a decoder sub-network, is proposed and analyzed in this paper. Instead of traditional linear measurements, a multiple nonlinear measurements encoder sub-network is trained to obtain measurements. Meanwhile, a trained decoder sub-network solves the CS recovery problem by learning the structure features within the training data. Specifically, the two sub-networks are integrated into SSDAE_CS model through end-to-end training for strengthening the connection between the two processes, and their parameters are jointly trained to improve the overall performance of CS. Finally, experimental results demonstrate that the proposed method significantly outperforms state-of-the-art methods in terms of reconstruction performance, time cost, and denoising ability. Most importantly, the proposed model shows excellent reconstruction performance in the case of a few measurements.

Security and efficiency are the two main challenges for designing a smart home system. In this paper, by incorporating Chinese remainder theorem (CRT) into the elliptic curve Diffie&ndash, Hellman (ECDH), a lightweight key agreement protocol for smart home systems is constructed. Firstly, one-way hash authentication is used to identify the sensor nodes instead of mutual authentication to reduce the authentication cost. Secondly, the CRT is introduced to enhance the security of the original ECDH key agreement. Security analysis showed that the proposed protocol can validate the data integrity and resist the replay attack, the man-in-middle attack, and other attacks. Performance analysis and experiments showed that the protocol achieves high security with low communication and computation costs, and can be implemented in smart home systems.

To evaluate the feasibility and clinical efficacy of a novel intraabdominal retractor device in laparoendoscopic single-site nephrectomy(LESS-N). Between February 2012 and February 2017, 98 patients underwent LESS-N in our institution, including 38 patients with benign renal disease and 60 patients with malignant renal disease. 39 were performed conventional LESS-N(C-LESS-N) and 59 were performed intraabdominal retractor-assisted LESS-N(IAR-LESS-N). Demographic data, and perioperative and postoperative data were collected and analyzed retrospectively. All the procedures were completed successfully. In C-LESS-N group, four patients were added one 5-mm additional trocar and two patients were converted to open surgery. In IAR-LESS-N group, no patients required additional trocars or conversion to open surgery. The mean operative time was lower in IAR-LESS-N group than that in C-LESS-N group (94.2 min vs 127.4 min, P

In today's complex battlefield environment, the interference signal parameter identification is the key to distinguish the interference signals, and the basis of winning information warfare. This paper first introduces the five traditional characteristic parameters that must be extracted in the signal sorting, and introduces the extraction methods and steps of the five parameters in detail. Then, from the point of distinguishing the parameter invariant signals and the parameter agile signals, presents two common signal sorting algorithms. Finally, the content of this paper is summarized.

Based on the assumption that external computers (particularly, infected external computers) are connected to the Internet, and by considering the influence of the Internet topology on computer virus spreading, this paper establishes a novel computer virus propagation model with a complex-network approach. This model possesses a unique (viral) equilibrium which is globally attractive. Some numerical simulations are also given to illustrate this result. Further study shows that the computers with higher node degrees are more susceptible to infection than those with lower node degrees. In this regard, some appropriate protective measures are suggested.

In reality, a portion of infected external computers could enter the Internet, and removable storage media could carry virus. To our knowledge, nearly all previous models describing the spread of computer virus ignore the combined impact of these two factors. In this paper, a new dynamical model is established based on these facts. A systematic analysis of the model is performed, and it is found that the unique (viral) equilibrium is globally asymptotically stable. Some simulation experiments are also made to justify the model. Finally, a result and some applicable measures for suppressing viral spread are suggested.

This paper aims to study the combined impact of external computers and network topology on the spread of computer viruses over the Internet. By assuming that the network underlying a recently proposed model capturing virus spreading behaviour under the influence of external computers follows a power-law degree distribution, a new virus epidemic model is proposed. A comprehensive study of the model shows the global stability of the virus-free equilibrium or the global attractivity of the viral equilibrium, depending on the basic reproduction number R0. Next, the impacts of different model parameters on R0 are analysed. In particular, it is found that (a) higher network heterogeneity benefits virus spreading, (b) higher-degree nodes are more susceptible to infections than lower-degree nodes, and (c) a lower rate at which external computers enter the Internet could restrain virus spreading. On this basis, some practical measures of inhibiting virus diffusion are suggested.

Based on the CMC antivirus strategy proposed by Chen and Carley, a mixing propagation model of computer viruses and countermeasures is suggested. This model has two potential virus-free equilibria and two potential endemic equilibria. The existence and global stability of these equilibria are fully investigated. From the obtained results it can be deduced that the CMC strategy is efficacious in deracinating viruses.

In reality, the external computers, in particular, external infected computers are connected to the Internet. Based on this reasonable assumption, a new computer virus propagation model is established. Different from all the previous models, this model regards the external computers as a single compartment to study. Through a qualitative analysis, it is found that (1) this model possesses a unique (viral) equilibrium, and (2) this equilibrium is globally asymptotically stable. Further study shows that, by taking effective measures, the number of infected computers can be made below an acceptable threshold.

This paper addresses the spreading behavior of computer viruses across the Internet. Taking into account the power-law degree distribution of the Internet, a novel epidemic model of computer viruses is proposed. The spreading threshold for the model is presented. The global asymptotic stability of the virus-free equilibrium is proved when the threshold is below the unity, whereas the permanence of the virose equilibrium is shown if the threshold exceeds the unity. The influences of different model parameters as well as the network topology on virus spreading are also analyzed. In particular, it is found that (1) a higher network heterogeneity is conducive to the diffusion of computer viruses, and (2) a scale-free network with lower power-law exponent benefits virus spreading.

Summary Introduction Cystine stone is the only clinical manifestation in patients with cystinuria, which is an autosomal recessive inheritable disease. However, clinical and genetic data vary among patients in different countries. Objective To investigate the characteristics of Chinese pediatric cystine stone patients. Patients and methods Thirteen pediatric patients with cystine stones were evaluated in our clinic between 2012 and 2015. Gene mutations in SLC3A1 and SLC7A9 were investigated. Metabolic evaluation was also performed. Thirteen pediatric patients with calcium oxalate stones were selected as controls. Results Of these patients, eight were males and five were females. Average age at detection of the first stone was 6.8 ± 5.2 years. Urinary stones in three of the 13 cystine patients were composed of cystine and calcium oxalate. The 63.6% of patients with upper urinary stones had bilateral stones. A total of 17 different missense mutations were identified, and 12 of these mutations were first reported in this study. Metabolic abnormalities could be detected in 77% of cystine stone patients. The most common metabolic abnormality was hyperoxaluria, followed by hypercalciuria and hypocitraturia. Compared with calcium stone patients, our cystine stone patients had a higher rate of bilateral stones, larger stone size, higher levels of serum BUN and Cr, urine citrate excretion (Table), and higher mean value of surgeries per patient. By contrast, the opposite was true for urine oxalate excretion and AP (CaOx) index EQ. The urine excretion of cystine was not correlated with other urinary constituents. Discussion Patients with cystinuria frequently suffer recurrent renal stones and may subsequently need a series of stone removal procedures during their lifetime. This condition is likely to affect their overall renal function. SLC3A1 and SLC7A9 have been extensively investigated, but a detection rate of 100% in cystinuric patients has yet to be obtained. In our study, we found 14 missense mutations in 18 of 26 alleles except four mutation polymorphisms. Most of the gene mutations found in our study were their first reports. Metabolic abnormalities were frequently found in cystine stone patients, but their risk of calcium oxalate stone formation was relatively lower than that of patients with calcium oxalate stones. Conclusions Cystine stone patients are at risk of impaired renal function and the formation of calcium oxalate stones. Most of the gene mutations identified in our patients were first reported in this study. Therefore, cystinuria possibly exhibits genetic and allelic heterogeneity in Chinese pediatric cystine stone patients. Table . Comparison of cystine stone patients and calcium stone patients. Cystine stone patients Calcium stone patients p Serum Cr, μmol/L 66.0 ± 26.9 45.9 ± 17.9 0.04 Urine oxalate, mg/24 h 28.2 ± 13.1 44.4 ± 21.6 0.03 Urine citrate, mg/24 h 302.6 ± 128.9 200.3 ± 122.6 0.05 SLC3A1 mutations K280R, D284Y, Y371Stop, F409L, P436L G458V, M467V, S556R SLC7A9 mutations C137R, A231T, Q237H, V277M, G319R, E334G, I366N, Y439stop

The laparoendoscopic single-site (LESS) technique is the latest technical innovation in laparoscopic surgery to undergo exponential development in urology. This study undertaken to illustrate our initial experience LESS radical prostatectomy (RP) and analyze early outcomes. Nineteen patients diagnosed with prostate cancer underwent LESS-RP in our institute. The patients were divided into two groups: conventional LESS and transurethral assistant LESS. Preoperative, perioperative, postoperative, pathologic, and functional outcomes data were assessed. With the help of a transurethral assistant, the mean operation and anastomosis time were decreased markedly. No focal positive margins were encountered. No prostate-specific antigen recurrence was detected 1 month postoperatively. Complete continence recovery (no pad) was observed in 32% of the patients at 1 month after the operation. No intraoperative and postoperative complications were reported. LESS-RP is a feasible and effective surgical procedure for treatment of prostate cancer. Moreover, transurethral assistant LESS could reduce the difficulty of LESS-RP and shorten the operation time.

Background: MicroRNAs (miRNAs) are a class of small non-coding RNAs (18-25 nucleotides) which post-transcriptionally regulate gene expression by negatively regulating the stability or translational efficiency of their target mRNAs. This study aimed to determine the function of miR-154-5p in prostate cancer (PCa) cells and identify the novel molecular targets regulated by miR-154-5p. Materials and Methods: The effects of forced miR-154-5p expression or E2F transcription factor 5 (E2F5) knockdown on PCa cells were evaluated by cell proliferation, flow cytometry, cell migration and invasion assays as well as by Western blot analysis. Dual-luciferase reporter assay was performed to verify the precise target of miR-154-5p. Results: The forced expression of miR-154-5p or E2F5 knockdown significantly restrained cell growth, as well as the migratory and invasive capabilities. Such expression also induced G1 cell cycle arrest of PCa cells in vitro. Hence, E2F5 is a direct target gene of miR-154-5p. Conclusions: miR-154-5p may play an important role as an inhibitor of proliferation, migration and invasion of PCa by targeting E2F5 in PCa cell lines.

Objective Analysis of the results of 37 million cases by using cervical liquid-based cytology screening, discussion the situation of cervical cancer and precancerous lesions in Guangdong province.

Square-lattice PCs are used to divide the incident light into several beams. Triangular-lattice graded- index PCs are combined to focus each branch. Thus, the beam splitter has functions of both beam splitting and focusing.

In this paper, we designed a hexagonal lattice photonic crystal (PC) which presents negative refraction behavior in the visible region. By varying the PC parameters, a graded index PC was obtained and used to focus a plane wave. Numerical calculation was adopted to demonstrate the negative refraction and focusing effect. Our calculation results demonstrated that the PC can realize focusing by negative refraction in visible region. Moreover, a broad band focusing ranging from 425 nm to 700 nm was observed with less chromatic aberration in the PC structure. The proposed structures provide an approach for designing the negative index imaging systems.

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This paper examines the propagation behavior of computer virus under human intervention. A dynamical model describing the spread of computer virus, under which a susceptible computer can become recovered directly and an infected computer can become susceptible directly, is proposed. Through a qualitative analysis of this model, it is found that the virus-free equilibrium is globally asymptotically stable when the basic reproduction numberR0≤1, whereas the viral equilibrium is globally asymptotically stable ifR0>1. Based on these results and a parameter analysis, some appropriate measures for eradicating the spread of computer virus across the Internet are recommended.

Hemoglobin (Hb) Q-Thailand, also known as G-Taichung, Mahidol, Kurashiki-I and Asabara, is an α-globin chain variant that results from a point mutation (GAC→CAC; Asp→His) at codon 74 of the α1-globin gene on chromosome 16p with a leftward single α-globin gene deletion (-α(4.2)). Co-inheritance of Hb Q-Thailand with α-thalassemia (mainly --(SEA)) results in thalassemia intermedia, termed Hb Q-H disease. The aim of the present study was to identify Hb Q-H disease in a Cantonese family. The presence of the Hb variant was confirmed by cellulose acetate electrophoresis. DNA analysis, based on polymerase chain reaction and sequencing, was developed to identify the α(Q-Thailand) mutation and common α-thalassemia gene deletions. Three cases of Hb Q-H disease and two Hb Q-Thailand carriers were found in the family. The 3-day-old proband with Hb Q-H disease did not show anemia (Hb 144 g/l), having 25.47% Hb F(Q) (α(Q)₂γ₂) in the total Hb; the other two cases of Hb Q-H disease manifested mild-to-moderate anemia. None required regular transfusions.