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The Industrial Internet of Things (IIoT) is one of the main catalysts towards the realization of the Industry 4.0 paradigm, thus it is regarded as an essential element in future industrial systems – which can assist in reducing energy consumption and in enhancing product life-cycle management. In this study, an industrial multi-energy scheduling framework (IMSF) is proposed, with the aim of optimizing the usage of renewable energy and reducing the energy costs. The proposed method addresses the management of multi-energy flows in industrial integrated energy systems – incorporating multi-energy storage, renewable energy generation, energy conversion, and energy trading in a synchronous manner. The method considers the typical energy load of the industrial users, the energy price of the national grid and the trading platform, and the trade-off between investment costs and benefits from the various sub-systems. As this results in a complex system of systems, an artificial intelligence method is proposed to treat the problem, using reinforcement learning based differential evolution (RLDE), that can determine the optimal mutation strategy and associated parameters in an adaptive way. Case studies on real-world data evidence the effectiveness of the IMSF and the RLDE algorithm in reducing the energy costs in industrial environments.

Local and general anesthesia are the main techniques used during percutaneous kyphoplasty (PKP); however, both are associated with adverse reactions. Monitored anesthesia with dexmedetomidine may be the appropriate sedative and analgesic technique. Few studies have compared monitored anesthesia with other anesthesia modalities during PKP. Our aim was to determine whether monitored anesthesia is an effective alternative anesthetic approach for PKP. One hundred sixty-five patients undergoing PKP for osteoporotic vertebral compression fractures (OVCFs) were recruited from a single center in this prospective, non-randomized controlled study. PKP was performed under local anesthesia with ropivacaine (n = 55), monitored anesthesia with dexmedetomidine (n = 55), and general anesthesia with sufentanil/propofol/sevoflurane (n = 55). Perioperative pain was assessed using a visual analogue score (VAS). Hemodynamic variables, operative time, adverse effects, and perioperative satisfaction were recorded. The mean arterial pressure (MAP), heart rate, VAS, and operative time during monitored anesthesia were significantly lower than local anesthesia. Compared with general anesthesia, monitored anesthesia led to less adverse anesthetic effects. Monitored anesthesia had the highest perioperative satisfaction and the lowest VAS 2 h postoperatively; however, the monitored anesthesia group had the lowest MAP and heart rate 2 h postoperatively. Based on better sedation and analgesia, monitored anesthesia with dexmedetomidine achieved better patient cooperation, a shorter operative time, and lower adverse events during PKP; however, the MAP and heart rate in the monitored anesthesia group should be closely observed after surgery.

Background. Many doctors ignored the possibility that there is still a spinal cord compression (SCC) need for decompression after atlantoaxial reduction. Reduction can be achieved on kinematic magnetic resonance imaging (MRI); thus, we want to analyze the role of kinematic MRI in reducible atlantoaxial dislocation and make a preoperative decision whether to perform decompression. Methods. 36 patients with atlantoaxial reduction on preoperative kinematic MRI in extension postures were enrolled retrospectively. Grouping was based on the condition of SCC after atlantoaxial reduction preoperatively. Group A: patients with SCC after atlantoaxial reduction on dynamic cervical MRI were treated with C1 laminectomy for decompression and atlantoaxial fixation. Group B: patients with no significant SCC, according to dynamic MRI, underwent only atlantoaxial fixation. Clinical outcomes were evaluated using JOA score for spinal cord function. Radiological outcomes were assessed by measuring spinal cord diameter on MRI. Results. The mean follow-up time was 17.1 months. Postoperative JOA score and percentage of SCC in both groups were significantly better than its preoperative score. There were no significant statistical differences in the JOA score at 12 months after surgery and the JOA improvement rate between two groups. All patients in the two groups had a lower percentage of SCC on preoperative extension MRI, compared with neutral MRI. No significant statistical differences in the spinal decompression improvement rate were observed between the two groups. Conclusions. Decompression should be performed in patients who still have significant SCC on preoperative kinematic MRI. Kinematic MRI could be used to assess SCC and decide whether to perform decompression preoperatively.

Acute lung injury (ALI) and its severe form acute respiratory distress syndrome (ARDS) are known as the common causes of respiratory failure in critically ill patients. Myeloid differentiation 2 (MD2), a co-receptor of toll like receptor 4 (TLR4), plays an important role in LPS-induced ALI in mice. Since MD2 inhibition by pharmacological inhibitors or gene knockout significantly attenuates ALI in animal models, MD2 has become an attractive target for the treatment of ALI. In this study we identified two chalcone-derived compounds, 7w and 7x, as new MD2 inhibitors, and investigated the therapeutic effects of 7x and 7w in LPS-induced ALI mouse model. In molecular docking analysis we found that 7w and 7x, formed pi-pi stacking interactions with Phe(151) residue of the MD2 protein. The direct binding was confirmed by surface plasmon resonance analysis (with KD value of 96.2 and 31.2 μM, respectively) and by bis-ANS displacement assay. 7w and 7x (2.5, 10 μM) also dose-dependently inhibited the interaction between lipopolysaccharide (LPS) and rhMD2 and LPS-MD2-TLR4 complex formation. In mouse peritoneal macrophages, 7w and 7x (1.25−10 μM) dose-dependently inhibited LPS-induced inflammatory responses, MAPKs (JNK, ERK and P38) phosphorylation as well as NF-κB activation. Finally, oral administration of 7w or 7x (10 mg ·kg(−1) per day, for 7 days prior LPS challenge) in ALI mouse model significantly alleviated LPS-induced lung injury, pulmonary edema, lung permeability, inflammatory cells infiltration, inflammatory cytokines expression and MD2/TLR4 complex formation. In summary, we identify 7w and 7x as new MD2 inhibitors to inhibit inflammatory response both in vitro and in vivo, proving the therapeutic potential of 7w and 7x for ALI and inflammatory diseases.

This study aimed to compare the outcomes of thoracolumbar burst fractures in patients with osteoporosis without neurologic symptoms according to the surgical approach. The patients in group A underwent percutaneous balloon kyphoplasty, those in group B underwent minimally invasive percutaneous reduction and internal fixation, and those in group C underwent open reduction with bone graft fusion and internal fixation. Fracture reduction was assessed by X-ray. The operative time in group A was shorter than that in groups B and C, with less intraoperative blood loss and shorter hospital stay. The intraoperative blood loss was less in group B than in group C, with shorter hospital stay. The postoperative visual analog scale scores were lower than the preoperative scores in each group. Cobb's angle of the injured vertebra in the last follow-up was larger in group A than in groups B and C. Regarding complications, in group A, nine patients developed postoperative bone cement leakage that required no specific treatment. In group B, one patient developed subcutaneous hematoma that healed well after treatment. The screw channel was loosened in two patients without symptoms; the screws were removed 1 year later. In group C, delayed incision healing was found in five patients. All three surgical approaches safely and effectively relieved the lower back pain in patients with thoracolumbar burst fracture with osteoporosis but without neurologic symptoms.

Background Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. However, there are no clear surgical treatment criteria for patients with these different symptoms. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches. Methods We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. I, old vertebral fracture with no apparent instability, vertebral augmentation; II, old vertebral fracture with local instability, posterior reduction fusion internal fixation; III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation; IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion; V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results All 238 patients were followed up for 12–38 months, with an average follow-up of 18.5 months. After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant (P ˂ 0.05). Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E. Conclusion In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.

Background As the population ages, osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. Therefore, the aim of our study was to investigate the treatment of symptomatic old osteoporotic vertebral compression fractures. Methods A retrospective study was designed to enroll patients with symptomatic old OVCFs from June 2013 to 2016. According to the complexity of the disease, the patients were divided into I to V grades, and the surgical methods were developed according to the grades. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results VAS score, ODI score and SI of all patients were significantly improved as compared with that before surgery, and the results of the final follow-up were statistically significant in comparison to preoperative outcome (P˂0.05). All the 16 patients with nerve injury showed significant improvement after surgery. The AISA grade were improved from grade C (14 cases), grade D (2 case) to grade D (4 cases) and grade E (12 cases). Conclusion Old OVCFs are difficult to treat. Graded surgery can better restore spinal stability and improve clinical outcomes.

This is a meta-analysis of controlled trials.To assess the overall condition of adjacent segment of cervical disk arthroplasty (CDA) compared with anterior cervical discectomy and fusion (ACDF).With the increase in CDA and ACDF, surgeons are taking more attention to adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis). There are more and more meta-analyses comparing the efficacy of CDA with ACDF, however, there are few meta-analyses referring to adjacent segment parameters, and investigators are still unable to arrive at the same conclusion.Several important databases were searched for controlled trials comparing CDA and ACDF before February 2016 according to PRISMA guidelines. The analysis parameters included follow-up time, operative segments, cervical range of motion (ROM), adjacent segment motion, ASDeg, ASDis and adjacent segment reoperation. The risk of bias scale and Newcastle-Ottawa Scale were used to assess the papers. Subgroup analysis and sensitivity analysis were used to analyze the reason for high heterogeneity.Forty-one controlled trials fulfilled the inclusion criteria, including 36 English papers and 5 Chinese. The average follow-up time of all included patients was 39 months. Compared with ACDF, the rate of adjacent segment reoperation in the CDA group was significantly lower (P0.01), and the advantage of CDA group increased with the increasing of follow-up time according to subgroup analysis. The rate of ASDeg in CDA was significantly lower than that of ACDF (P0.01). There was no statistical difference between upper and lower ASDeg using the same surgical method (P0.05). CDA provided a greater cervical ROM than did ACDF (P0.01). There was a lower adjacent segment ROM and the rate of ASDis in CDA compared with ACDF (P0.05).Compared with ACDF, the advantages of CDA were lower ASDeg, ASDis, adjacent segment reoperation and adjacent segment motion; and higher cervical ROM. However, there was no statistical difference between upper and lower adjacent segment ROM/ASDeg using the same surgery.

Many meta-analyses have been performed to study the efficacy of cervical disc arthroplasty (CDA) compared with anterior cervical discectomy and fusion (ACDF); however, there are few data referring to adjacent segment within these meta-analyses, or investigators are unable to arrive at the same conclusion in the few meta-analyses about adjacent segment. With the increased concerns surrounding adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis) after anterior cervical surgery, it is necessary to perform a comprehensive meta-analysis to analyze adjacent segment parameters.To perform a comprehensive meta-analysis to elaborate adjacent segment motion, degeneration, disease, and reoperation of CDA compared with ACDF.Meta-analysis of randomized controlled trials (RCTs).PubMed, Embase, and Cochrane Library were searched for RCTs comparing CDA and ACDF before May 2016. The analysis parameters included follow-up time, operative segments, adjacent segment motion, ASDeg, ASDis, and adjacent segment reoperation. The risk of bias scale was used to assess the papers. Subgroup analysis and sensitivity analysis were used to analyze the reason for high heterogeneity.Twenty-nine RCTs fulfilled the inclusion criteria. Compared with ACDF, the rate of adjacent segment reoperation in the CDA group was significantly lower (p.01), and the advantage of that group in reducing adjacent segment reoperation increases with increasing follow-up time by subgroup analysis. There was no statistically significant difference in ASDeg between CDA and ACDF within the 24-month follow-up period; however, the rate of ASDeg in CDA was significantly lower than that of ACDF with the increase in follow-up time (p.01). There was no statistically significant difference in ASDis between CDA and ACDF (p.05). Cervical disc arthroplasty provided a lower adjacent segment range of motion (ROM) than did ACDF, but the difference was not statistically significant.Compared with ACDF, the advantages of CDA were lower ASDeg and adjacent segment reoperation. However, there was no statistically significant difference in ASDis and adjacent segment ROM.

BACKGROUND The aim of this study was to analyze reasons why open surgery was done after percutaneous vertebroplasty and kyphoplasty. MATERIAL AND METHODS Patients (587 vertebral bodies) treated with percutaneous vertebroplasty or kyphoplasty in the Xi'an Honghui Hospital of Shanxi Province from January 2008 to January 2012 were retrospectively analyzed and 13 patients were enrolled in the study. These 13 patients had serious adverse events after percutaneous vertebroplasty or kyphoplasty. Their average age was 64.5 years old. Nine patients had spinal cord injury and 4 had nerve root injury. All the patients underwent open surgery within 4-12 h after definitive diagnosis. RESULTS All 13 cases were followed up (average time 14.1 months, range 3-47 months). Reasons for open surgery included cement extravasation (6 cases, 46.2%), puncture mistake (3 cases, 23.1%), and false selection of indications (4 cases, 30.8%). At last follow-up, skin feeling was better than that before open surgery in 4 cases with nerve root injury, and muscle strength recovered to grade 5 (3 cases) and grade 4 (1 case). In 9 cases with spinal cord injury, 7 patients improved and 2 remained at the same ASIA level. CONCLUSIONS The main reasons for open surgery after percutaneous vertebroplasty and kyphoplasty were cement extravasation (the most common reason), puncture mistake, and false selection of indications.

We put forward an assessment system of thoracolumbar osteoporotic fracture (ASTLOF) evaluating the severity of thoracolumbar osteoporotic fracture. This study was to investigate its efficacy in guiding clinical practice.Three hundred and eighty-one patients with thoracolumbar vertebral osteoporosis fracture admitted to the hospital from January 2010 to December 2011 were enrolled in the study. All cases were evaluated by ASTLOF including evaluation of morphological changes, MRI, bone mineral density and pain. The patients were treated with different methods according to ASTLOF score. All patients were followed up on a regular basis. The treatment results were assessed by VAS and ODI.All patients were followed up with an average of 20.1 (range: 6-30) months. There were 91 cases of ASTLOF score4 points. Their average VAS score decreased from 8.0 ± 1.7 points to 2.0 ± 1.3 with statistical significance (P0.05) and the average ODI score decreased from 69.5 ± 2.8 to 38.1 ± 1.5 (P0.05). One hundred and thirty-two cases were with ASTLOF score=4, with the average VAS score decreased from 8.2 ± 1.4 to 1.9 ± 1.2 (P0.05) and the average ODI score decreased from 71.5 ± 3.7 to 36.2 ± 2.5 (P0.05). There were 158 cases of ASTLOF score ≥ 5, with the VAS score decreased from 8.0 ± 1.7 to 2.0 ± 1.3 and the ODI score decreased from 69.5 ± 2.8 to 38.1 ± 1.5.ASTLOF based on the severity of thoracolumbar osteoporotic fracture was suggested to be helpful in guiding clinical practice.

Buck-IPT system is composed of a front power regulation buck circuit and a behind inductive power transfer circuit (IPT), which is higher-order, multi-operating-mode, compound nonlinear system. Aiming at dynamic problems such as large inductor current and slow response in the start-up progress, this paper proposes a dynamic characteristic optimization control method. Firstly, this paper proposes a reduced second-order time-varying model considering the inverter's equivalent load characteristic. And then, Based on this model, a sliding-mode control using the exponential reaching law is applied to optimize the start-up process of the Buck-IPT system. Finally, the simulation and experiment results have verified that the proposed method can realize good dynamic performance with fast response, limited-current of front inductor, no overshoot of front capacitor voltage.

A well-defined three-dimensional (3-D) reconstruction of bone-cartilage transitional structures is crucial for the osteochondral restoration. This paper presents an accurate, computationally efficient and semi-automated algorithm for the alignment and segmentation of two-dimensional (2-D) serial to construct the 3-D model of bonecartilage transitional structures. Entire system includes the following five components: (1) image harvest, (2) image registration, (3) image segmentation, (4) 3-D reconstruction and visualization, and (5) evaluation. A computer program was developed in the environment of Matlab for the semi-automatic alignment and automatic segmentation of serial sections. Semi-automatic alignment algorithm based on the position’s cross-correlation of the anatomical characteristic feature points of two sequential sections. A method combining an automatic segmentation and an image threshold processing was applied to capture the regions and structures of interest. SEM micrograph and 3-D model reconstructed directly in digital microscope were used to evaluate the reliability and accuracy of this strategy. The morphology of 3-D model constructed by serial sections is consistent with the results of SEM micrograph and 3-D model of digital microscope.

Our aim was to investigate the causes of and treatment strategies for surgical complications of thoracic spinal stenosis.Between May 1990 and May 2010, 283 patients with thoracic spinal stenosis were treated in our department. Three physicians were assigned to patient follow-up. Patient medical records and radiographs were reviewed. Complications were categorised as perioperative, mid- to long-term and donor-site.Follow-up was completed for 254 patients; 249 patients survived. Follow-up time ranged from one to 19 years, with a mean of six years and two months. There were 107 cases with complications an incidence rate of 42.1%. Eleven cases were pulmonary infection, seven transient nerve-root injury, three pulmonary injury and one vertebral canal haematoma, all of which resolved. Thirteen cases of spinal cord injury postoperatively were treated using dehydration and corticosteroid therapy; eight recovered to the preoperation level, and five deteriorated. Eleven cases resulted in dural injury, and four led to cerebrospinal fluid leakage. There were five cases of wound-fat liquefaction and one of wound infection. Seven cases with deep venous thrombosis of the lower limb resolved by elevating the affected limb and administration of low-molecular-weight dextran. Seven cases of delayed wound healing recovered following change of dressings and antibiotic administration. Four cases of delayed bone-graft fusion recovered by extending the external fixation time. One case of bone-graft absorption was treated by iliac bone grafting and bracing. Two cases of internal fixation breakage were treated by removing the internal fixation.Thoracic spinal stenosis surgery may result in various complications but has a good prognosis with proper treatment. The key points in reducing complications are the surgeon's familiarity with operative imperatives and the appropriate surgical approach.

STUDY DESIGN A prospective self-controlled study. OBJECTIVE The aim of the present study was to compare the application and clinical outcomes of transposterior arch lateral mass screw and lateral mass screw fixation of the atlas in the treatment of atlantoaxial instability. SUMMARY OF BACKGROUND DATA Atlas posterior screw fixation techniques comprise transposterior arch lateral mass screw fixation and lateral mass screw fixation. Previous studies have focused mainly on the feasibility of the anatomy and the biomechanics of the methods. METHODS From June 2006 to February 2011, 66 patients with atlantoaxial instability were randomly assigned for treatment with transposterior arch lateral mass screw or lateral mass screw fixation of the atlas, combined with axis pedicle screw fixation. Patients were followed up regularly. The operation time, blood loss, intraoperative complications, Japan Department of Orthopedics Association Score, visual analog scale score, and bone fusion rates were recorded. RESULTS The operation was successful in all 66 cases, with all patients showing improvement in clinical symptoms. There were significant differences in operation time and blood loss between the 2 groups (P

Disorders in occipitocervical region are difficult to treat. Complications often occur after fusion surgery and may be life-threatening in severe cases. This study is to investigate the causes and treatment strategies for the postoperative complications of occipitocervical fusion. Between May 1985 and May 2011, 316 patients with various occipitocervical diseases underwent occipitocervical surgery, with or without internal fixation. Two physicians were assigned for patients follow-up. Their medical records and radiographs were reviewed and the postoperative complications, including those at the occipitocervical region and donor site, were analyzed. Three hundred cases were followed up from 24 months to 26 years with an average of 9 years and 8 months, and the follow-up rate was 94.9 %. There were 16 cases with complications after surgery in the uninstrumented fusion group; the incidence was 33.3 %. These included 11 patients (22.9 %) with complications in occipitocervical region and five patients (11.9 %) with donor-site complications. 45 complications presented in the instrumented fusion group, the incidence was 17.9 %. These included 30 patients (11.9 %) with complications in occipitocervical region and 15 patients (5.9 %) with donor-site complications. Perioperative complications included vertebral artery injury, spinal cord injury, nerve root injury, suffocation, cerebrospinal fluid leakage, and infection. Mid- to long-term complications included bone-graft displacement or absorption, aggravated vertebral dislocation, improper screw placement, spinous process fracture, and internal fixation breakage. Donor-site complications were hematoma, pain and infection. The surgery of occipitocervical fusion carries a relative high risk for complications, especially if no instrumentation is used. The key points in reducing complications are the surgeon’s familiarity with the anatomy of occipitocervical region and the appropriate internal fixation.

The problem and its resolvent about redundancy of co-linear points in estimating the fundamental matrix (FM) which is a basic tool in scene analysis are developed, based on the application in computer vision of epipolar geometry and perspective geometric invariants. The redundancy means that, on a line, there are at most three points that can be used as matching points to estimate the FM, the others are the redundant points. Its proof in theory and experimental results show that the accuracy and stability of FM are distinctly improved by eliminating the redundant points.© (1997) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.