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Objective To evaluate serum protein calponin 2 (CNN2) as a candidate biomarker for tubal ectopic pregnancy (EP). Design Retrospective study. Setting Single University affiliated tertiary hospital. Patient(s) Serum samples were obtained from 84 patients with EP, 39 with viable intrauterine pregnancy (vIUP), and 42 with miscarriage. Moreover, 10 fallopian tube and corresponding villous tissue samples from patients with EP, 6 villous tissue samples from patients with vIUP, and 10 villous tissue samples from patients with miscarriage were collected. Intervention(s) Serum CNN2 concentrations were measured using enzyme-linked immunosorbent assay; CNN2 expression in tissues was evaluated via immunohistochemistry and quantitative real-time polymerase chain reaction analysis. Main Outcome Measure(s) The diagnostic performance of serum CNN2 to discriminate an EP from vIUP and miscarriage. Result(s) CNN2 was highly expressed in villous stromal cells isolated from patients with EP, and CNN2 messenger ribonucleic acid expression was upregulated in villous tissues from women with EP compared with that in women with vIUPs and miscarriages. Serum CNN2 concentration was higher in women with EP than that in women with vIUP and miscarriage. The serum CNN2 predicted EP from vIUP and miscarriage with areas under the curve (AUCs) of 0.931 (95% confidence interval: 0.889–0.975). For discriminating EP from miscarriage only, the AUC was 0.906 (95% confidence interval: 0.835–0.977). In contrast, the AUCs for serum human chorionic gonadotropin were 0.809 and 0.637, respectively. Conclusion(s) Our data highlight the possibility of serum CNN2 as a single biomarker for the diagnosis of EP. Clinical Trial Registration Number ChiCTR 1900020483

Sheng Yin,1,* Wen Gao,2,* Peipei Shi,1 Meili Xi,1 Wenbin Tang,1 Jiarong Zhang1 1Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 2Department of Gynaecologic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiarong ZhangDepartment of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Fenglin Road, 180#, Xuhui District, Shanghai, 200032, People’s Republic of ChinaTel +86 21-64041990Email zhang.jiarong@zs-hospital.sh.cnPurpose: Minimally invasive surgery (MIS) is performed frequently in early-stage ovarian cancer patients, especially in ovarian clear cell carcinoma (OCCC). The aim of this study was to investigate whether primary laparoscopic surgery influences prognosis in patients with early-stage OCCC.Patients and Methods: Patients with International Federation of Gynecology and Obstetrics (FIGO) stage I OCCC were retrospectively reviewed in two hospitals between April 2010 and August 2020. Clinical data were abstracted, and patients were followed up until February 2021. Patients were divided into open surgery (laparotomy) and laparoscopy groups, and the Kaplan–Meier method was applied to compare progression-free survival (PFS) and overall survival (OS) between the groups. Statistical differences were determined by the Log rank test.Results: Eighty-nine patients were included in the study; 20 (22.5%) and 69 (77.5%) patients underwent laparoscopic and open surgery, respectively. The patients’ characteristics were well-balanced except that patients in the laparoscopy group tended to have smaller tumors and lower frequency of omentectomy and lymphadenectomy compared with the open surgery group. The median follow-up duration was 42.6 and 36.5 months in the laparoscopy and open surgery groups, respectively. Nine (10.1%) patients developed recurrence, and 4 (4.5%) died of the disease; all in the open surgery group. The estimated 2-year PFS rates were 100.0% and 90.1%, and the estimated 5-year OS rates were 100.0% and 91.9% in the laparoscopy and open surgery groups, respectively. No significant survival differences were found between the groups.Conclusion: Survival was not compromised when primary laparoscopic surgery was performed in early-stage OCCC patients. A well-designed randomized controlled trial is warranted.Keywords: laparoscopic surgery, early-stage ovarian clear cell cancer, prognosis

Background: Abnormal maternal lipid concentrations are associated with increased risk of preeclampsia. However, previous studies mainly focused on fasting lipid concentrations, scarce data have been published on the relationship between postprandial triglyceride (TG) concentrations in the second trimester and the risk of preeclampsia. Our aim is to evaluate the potential of triglyceride (TG) concentrations at the time of oral lipid tolerance test (OLTT) measurement in the second trimester to predict preeclampsia and to elucidate the lipid metabolic changes related to these diseases. Methods: This is a prospective cohort study of Pregnant women at 12-24 weeks of gestation undergone an OLTT in a university affiliated hospital between May 2019 and January 2020. Data were stratified into binaries according to the OLTT results. The receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off points of TG, HDL-C, LDL-C, sd-LDL, FFA, and BG for predicting preeclampsia.Results: 438 pregnant women were recruited to undergo an OLTT at 12-24 weeks of gestation. Among these, 24 women developed preeclampsia and 414 women remained normotensive. Women who subsequently developed preeclampsia had higher concentrations of 4-h postprandial TG than those who remained normotensive. In the linear logistic regression analyses of potential confounding factors, mid-trimester 4-h postprandial TG concentrations at the time of OLTT measurement were significantly higher in preeclamptic cases than in controls.Conclusions: Dyslipidemia in the second trimester of pregnancy, particularly postprandial hypertriglyceridemia, appears to be associated with an increased risk of preeclampsia. Mid-trimester 4-h postprandial TG concentration at the time of OLTT measurement may be a potential predictive marker of preeclampsia.

Most of the existing underwater acoustic communication networks use omni-directional transmission technology, which has problems such as poor communication concealment and low throughput, which severely limits network performance. The application of directional transmission technology to the underwater acoustic communication network can effectively solve the various problems existing in the omnidirectional underwater acoustic communication network, but there will also be new problems, such as the deafness problem. Aiming at the problems of low throughput, poor communication concealment and deafness, this paper proposes a deafness-free medium access control (DF-MAC) protocol for underwater acoustic communication networks with directional antennas. In the protocol, each node uses directional and omnidirectional modes to transmit data, and divides the underwater acoustic channel into two sub-channels. By sending a busy tone signal on one of the sub-channels, the neighboring node can distinguish whether the collision encountered is a normal data packet collision or a neighboring node collision, and then take different measures. This protocol can effectively solve the problem of deafness in the underwater acoustic communication network, increase network coverage, and improve communication concealment. The simulation results show that the proposed MAC protocol can significantly improve the throughput performance of the underwater acoustic communication network.

Aim To evaluate the value and feasibility of capillary glucose assessment, combined with other non-laboratory measures, in screening for diabetes and prediabetes in the community. Methods In this cross-sectional study, we assessed fasting capillary glucose, fasting plasma glucose, and both capillary glucose and plasma glucose values after 2-h oral glucose tolerance tests in a total of 3736 samples. We determined the optimal threshold of capillary glucose using receiver-operating characteristic curve analysis. The effect of screening methods using capillary glucose combined with other variables, such as age, BMI and waist circumference, was assessed according to area under the receiver-operating characteristic curve. Results There was a strong positive correlation between capillary glucose and venous plasma glucose. The area under the curve for the model using fasting capillary glucose to screen for impaired fasting glucose was 0.722, while that for the model using capillary glucose after a 2-h oral glucose tolerance test to screen for impaired glucose tolerance was 0.916. The area under the curve for the model using fasting capillary glucose to screen for diabetes was 0.835, while that for the model using 2-h oral glucose tolerance test capillary glucose was 0.912. The area under the curve for the model using fasting capillary glucose + 2-h oral glucose tolerance test capillary glucose to screen for diabetes was 0.945. The discriminatory capability of models using capillary glucose was somewhat improved by adding non-laboratory variables. Conclusions Capillary glucose could be an alternative for screening for diabetes and prediabetes, especially in low-resource areas.

Backgroud: The present study aimed to investigate the association between immune cells and gestational diabetes mellitus (GDM) and identify a reasonable predictor of insulin resistance in women with GDM. Objective: The clinical and biochemical characteristics of 124 women with GDM and 168 healthy pregnant women were compared. Methods: The percentage of immune cells in the blood of the subjects was analyzed by flow cytometry. Pearson’s correlation analysis revealed the correlation between the percentage of B lymphocytes and insulin resistance. A cutoff point was determined for the percentage of B lymphocytes, based on insulin resistance, using receiver operating characteristic (ROC) curves. Results: Compared to the healthy pregnant women, the percentages of B lymphocytes and IgA produced by B-cells were significantly different in women with GDM. The percentage of B lymphocytes was positively related to insulin resistance.The number of 14.05% of B lymphocytes was an optimal cutoff point that predicted the insulin resistance in women with GDM. Conclusion: The percentage of B lymphocytes was positively associated with insulin resistance, and hence, might serve as an appropriate predictor of insulin resistance in women with GDM.

Wireless sensor network (WSN) has the characteristics of large-scale, low cost, low power consumption and high network invulnerability, which can meet the needs of large-scale and fast networking of intelligent distribution communication system. Because the sensor nodes in WSN of intelligent distribution network have great differences in computing power, storage space, energy and so on, in order to achieve efficient and reliable communication links, it is more appropriate to use heterogeneous nodes for WSN networking of intelligent distribution network. In this paper, the node design method, node deployment method and network routing protocol of intelligent distribution network WSN based on heterogeneous nodes are systematically studied. The transmission success rate basically meets the demand of more than 80%.

IntroductionThe role of low-dose aspirin combined with low-molecu�lar-weight heparin (LMWH) in the treatment of preeclampsia (PE) remains unclear. We aimed to assess the efficacy and safety of low-dose aspirin combined with LMWH in PE treatment, to provide evidence for clinical PE management.Material and methodsWe searched PubMed and other databases for ran�domized controlled trials (RCTs) on the effects and safety of low-dose aspi�rin and LMWH in the treatment of PE up to January 31, 2021. Two research�ers strictly followed the inclusion and exclusion criteria to independently conduct the literature screening, data extraction and quality evaluation. We used RevMan 5.3 statistical software for synthesized analysis.ResultsA total of 8 RCTs involving 861 patients were included. The syn�thesized outcome indicated that the differences in systolic blood pressure (MD = –10.61, 95% CI: –13.19 – –8.02), diastolic blood pressure (MD = –9.24, 95% CI: –14.49– –4.00), 24-hour urinary protein (MD = –2.24, 95% CI: –3.97– –0.50), prothrombin time (MD = 1.42, 95% CI: 0.53–2.32), ac�tivated partial thromboplastin time (MD = 2.91, 95% CI: 2.06–3.75), FIB (MD = –1.24, 95% CI: –1.32– –1.15), and adverse perinatal outcomes (MD = 0.41, 95% CI: 0.20–0.85) between the two groups were statistically significant (all p < 0.05), while the difference in the adverse reactions of pregnant women (MD = 0.44, 95% CI: 0.18–1.10) between the two groups was not statistically significant (p = 0.08). No publication bias was detected in all the synthesized outcomes (all p > 0.05).ConclusionsLow-dose aspirin combined with LMWH treatment of PE may be advantageous to improve blood pressure, 24-hour proteinuria and coagu�lation function, and it may reduce the adverse reactions in pregnant women without increasing adverse perinatal outcomes.

Medium access control (MAC) protocol is an important link for achieving networks function in any wireless networks, an efficient and reliable MAC protocol is crucial for an effective underwater acoustic sensor networks (UASNs). Significant differences between UASNs and terrestrial sensor networks (TSNs) render the traditional MAC protocols applied on land inapplicable underwater. Existing MAC protocols for UASNs use the omnidirectional antenna, which wastes energy, restricts the network&rsquo, s coverage range, and brings about unnecessary interferences in neighbor nodes. This paper proposes a dual channel MAC protocol for UASNs based on directional antenna (DADC-MAC), which increases the network coverage range, efficiently utilizes space, and reduces node interference compared to the omnidirectional antenna. The DADC-MAC protocol divides the channel into a data transmission channel and busy prompt message channel, the node uses the former to transmit the control frame and DATA package while the sending node and receiving node use the latter channel to inform the neighbor nodes of on-going communications to prevent DATA package collision. A neighbor discovery mechanism and directional network allocation vector are applied to resolve hidden terminal and deafness problems. Simulation results show that the DADC-MAC protocol could improve network throughput and reduce end-to-end delay, is efficient, performs well, and is well suited to both symmetrical and asymmetrical UASNs topology.

Background. Whether elevated triglyceride (TG) levels during pregnancy were a biomarker for postpartum abnormal glucose metabolism (AGM) in women with previous gestational diabetes mellitus (GDM) remained unknown. The aim of this study was to investigate the association between TG levels during the second trimester and postpartum AGM in GDM women. Methods. This was a retrospective cohort study including 513 GDM women. A 75 g oral glucose tolerance test (OGTT) was performed, and lipid levels were determined during pregnancy and the postpartum period. GDM patients were categorized into tertiles according to their TG levels at 24–28 weeks of gestation (TG<2.14 mmol/L, TG: 2.14–2.89 mmol/L, and TG>2.89 mmol/L). A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Results. During pregnancy, women in the high TG tertile showed higher HbA1c levels (5.47±0.58% versus 5.28±0.49%, p=0.006), higher total cholesterol (TC) levels (5.85±1.23 mmol/L versus 5.15±0.97 mmol/L, p=0.026), and higher HOMA-IR (2.36 (1.62-3.45) versus 1.49 (0.97-2.33), p<0.001) than the participants in the low TG tertile. After delivery, the prevalence rates of AGM based on above tertiles of TG levels during pregnancy were 26.90%, 33.33%, and 43.27%, respectively (p=0.006). High TG tertile during the second trimester was associated with the presence of postpartum AGM (adjusted OR: 2.001, 95% CI: 1.054-3.800, p=0.034). Conclusions. The elevated midtrimester TG levels were not only accompanied by higher glucose and lipid levels and more severe insulin resistance at the time of the measurement but were a biomarker for postpartum AGM as well.

Background and purpose Patients with Parkinson's disease (PD) have difficulty performing self-initiated movements. The neural mechanism of this deficiency remains unclear. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate the functional connectivity of the subthalamic nucleus (STN) during self-initiated movement in patients with PD. Materials and methods fMRI were acquired from patients with PD and age- and sex-matched healthy control subjects during a self-initiated right hand tapping task. We selected the bilateral sensorimotor subregions of the STN as regions of interest for our connectivity analysis. Results and conclusions We found that the STN contralateral to voluntary hand movement exhibited enhanced connectivity with the midbrain, thalamus, putamen, and so on in patients with PD compared to control subjects. In contrast, the STN ipsilateral to the hand movement exhibited enhanced connectivity with the midbrain and insula in PD patients compared to control subjects. Connectivity between the STN contralateral to the hand movement and the primary motor cortex and supplementary motor area was positively correlated with the severity of bradykinesia. Our findings suggest that STN-related connectivity in the hyperdirect and indirect basal ganglia pathways is strengthened during self-initiated movement in patients with PD. These disrupted network connections may contribute to bradykinesia.

Objective: experience in post-implantation care and pipeline maintenance in patients with acute respiratory distress syndrome. Methods:2020Admitted on 27 July1 Cases of severe pneumonia were transferred to severe ventilator on August 6 and to critical ECMO on August 10. Results: after active treatment, especially for the late stage of ECMO pipeline, the vital signs of the patients improved obviously and the condition gradually stabilized. Conclusion: The nursing care before and after the establishment of ECMO pipeline in patients with acute respiratory distress syndrome, the matters needing attention and the working experience after the establishment, It can provide a reference for the treatment of severe infectious diseases in the future.

Objective To study the risk factors for recurrent ectopic pregnancy (REP). Design A retrospective case–control study. Setting A university medical centre. Population 554 women with a history of ectopic pregnancy (EP) were included. Among them were 181 women with current EP, 184 women with current intrauterine pregnancy (IUP) and 189 nonpregnant women (NonP). Methods The three groups were matched at a ratio of 1:1 with respect to current age, age of initial EP and gestational week of initial EP. Socio-demographic characteristics, reproductive history, gynaecological and surgical history, and experience of contraception were compared among the three groups. A multivariable logistic regression analysis was used to adjust for confounders and calculate adjusted odds ratios (AORs). Results The risk of REP increased with history of infertility (AOR = 3.84, 95%CI 2.16–6.86) in REP women compared with IUP controls. Compared with NonP controls, salpingotomy (AOR = 3.04, 95%CI 1.21–36.51) for previous EP was a risk factor for REP. Multiparous women were less likely to suffer REP when compared with NonP women (AOR = 0.36, 95%CI 0.18–0.62) or IUP controls (AOR = 0.35, 95%CI 0.20–0.62). Current use of an intrauterine device (IUD) (REP versus NonP, AOR = 0.02, 95%CI 0.00–0.08) or condoms (REP versus NonP, AOR = 0.16, 95%CI 0.07–0.38) significantly reduced the risk of REP compared with those not using any contraception. Similarly, previous use of condoms also prevented REP compared with those with no previous condom use (REP versus NonP, AOR = 0.20, 95%CI 0.08–0.49; REP versus IUP, AOR = 0.40, 95%CI 0.22–0.71). Conclusions Women with history of infertility or salpingotomy should be alert for the recurrence of EP. Multiparous women are less likely to suffer REP. We propose the use of condoms for effective prevention of REP. Tweetable abstract History of infertility and salpingotomy for last EP are risk factors for recurrent EP.

Layered semiconductors have received increased attention recently due to the potential as high-performance thermoelectric materials. The quaternary layered compound SrFZnSb adopts ZrSiCuAs-type structure with insulating [Sr2F2]2+ layers and conductive [Zn2Sb2]2+ layers alternately stacked along the c-axis. As a narrow band-gap p-type semiconductor, SrFZnSb has a higher electrical conductivity and smaller Seebeck coefficient in comparison with isostructural thermoelectric compound BiOCuSe. Thermal properties measurements for pristine SrFZnSb reveal that its total thermal conductivity drops to 1.33 W m−1 K−1 at 773 K with the lattice thermal conductivity fitting the law of T−1. The maximum thermoelectric figure of merit ZT for SrFZnSb reaches 0.17 at 773 K. In addition, SrFZnSb presents the bulk thermal expansion coefficient of 1.2–1.5 × 10−5 K−1 within the temperature range of 300–700 K, smaller than 6.74 × 10−5 K−1 for BiOCuSe.

Transforming growth factor-β1 (TGFβ1) has been identified as a major pathogenic factor underlying the development of diabetic nephropathy (DN). However, the current strategy of antagonizing TGFβ1 has failed to demonstrate favorable outcomes in clinical trials. To identify a different therapeutic approach, we designed a mass spectrometry-based DNA-protein interaction screen to find transcriptional repressors that bind to the TGFB1 promoter and identified Yin Yang 1 (YY1) as a potent repressor of TGFB1. YY1 bound directly to TGFB1 promoter regions and repressed TGFB1 transcription in human renal mesangial cells. In mouse models, YY1 was elevated in mesangial cells during early diabetic renal lesions and decreased in later stages, and knockdown of renal YY1 aggravated, whereas overexpression of YY1 attenuated glomerulosclerosis. In addition, although their duration of diabetic course was comparable, patients with higher YY1 expression developed diabetic nephropathy more slowly compared to those who presented with lower YY1 expression. We found that a small molecule, eudesmin, suppressed TGFβ1 and other profibrotic factors by increasing YY1 expression in human renal mesangial cells and attenuated diabetic renal lesions in DN mouse models by increasing YY1 expression. These results suggest that YY1 is a potent transcriptional repressor of TGFB1 during the development of DN in diabetic mice and that small molecules targeting YY1 may serve as promising therapies for treating DN.

Gestational diabetes mellitus (GDM) imparts a high risk of developing postpartum diabetes and is considered to be an early stage of type 2 diabetes mellitus (T2DM). In this study, a 75-g oral glucose tolerance test was performed on 472 women with GDM at 6-8 weeks after delivery. The clinical and metabolic characteristics were compared between the patients with normal glucose tolerance (NGT) and abnormal glucose metabolism (AGM). These data were then compared between pre-diabetic and diabetic patients. A total of 37.7% of the women with GDM continued to have abnormal glucose levels after delivery. Compared with the women who reverted to normal, HOMA-IR was significantly higher in AGM. A multiple stepwise regression analysis revealed that age, the postpartum body mass index (BMI), low density lipoprotein-cholesterol (LDL-C), 2 h glucose load plasma glucose (2 h PG), triglycerides (TG), hemoglobin A1c (HbA1c), 1 h glucose load plasma insulin (INS) level, and 2 h INS level were independent risk factors for the development of insulin resistance after delivery. This study has identified a high prevalence of AGM after GDM. Insulin resistance appears to be the major contributor. Any treatment to reduce the postpartum BMI and lipids level may be beneficial to decrease insulin resistance.

Background Resting-state functional magnetic resonance imaging (RS-fMRI) has frequently been used to investigate local spontaneous brain activity in Parkinson's disease (PD) in a whole-brain, voxel-wise manner. To quantitatively integrate these studies, we conducted a coordinate-based (CB) meta-analysis using the signed differential mapping method on 15 studies that used amplitude of low-frequency fluctuation (ALFF) and 11 studies that used regional homogeneity (ReHo). All ALFF and ReHo studies compared PD patients with healthy controls. We also performed a validation RS-fMRI study of ALFF and ReHo in a frequency-dependent manner for a novel dataset consisting of 49 PD and 49 healthy controls. Findings Decreased ALFF was found in the left putamen in PD by meta-analysis. This finding was replicated in our independent validation dataset in the 0.027–0.073 Hz band but not in the conventional frequency band of 0.01–0.08 Hz. Conclusions Findings from the current study suggested that decreased ALFF in the putamen of PD patients is the most consistent finding. RS-fMRI is a promising technique for the precise localization of abnormal spontaneous activity in PD. However, more frequency-dependent studies using the same analytical methods are needed to replicate these results. Trial registration: NCT NCT03439163. Registered 20 February 2018, retrospectively registered.

Parkinson’s disease (PD) patients have difficulty in performing a dual-task. It has been suggested that the cerebellum is important in dual-tasking. We used functional MRI to investigate the role of the cerebellum in performing a dual motor and cognitive task in PD patients. We have examined whether there are any areas additionally activated for dual-task performance, and compared the neural activity and functional connectivity pattern in the cerebellum between PD patients and healthy controls. We found that the right cerebellar vermis and left lobule V of cerebellar anterior lobe were additionally activated for dual-task performance in healthy controls and for motor task in PD patients. We didn’t find any cerebellar regions additionally activated while performing dual-task in PD patients. In addition, the right cerebellar vermis had enhanced connectivity with motor and cognitive associated networks in PD patients. PD patients have limited cerebellar resources that are already utilized for single tasks and, for dual tasks, cannot augment as necessary in order to integrate motor and cognitive networks.

Due to the reason of iterative calculation, there are some drawbacks for existing image segmentation methods based on region growing, such as large computation cost and low real-timing. Membrane computing is a novel class of computing models inspired by the structure and function of living cells, also known as P systems, which have the advantage of distributed and parallel computing. In order to overcome the drawbacks of existing image segmentation methods based on region growing, a regionbased image segmentation method based on P systems is proposed in this paper. A tissue-like P system designed specially applies evolution rules and communication rules to achieve an adaptive region growing for image segmentation. The proposed image segmentation method based on tissue-like P systems is evaluated in several standard gray-scale images and compared with the traditional image segmentation method based on region growing.

Aim: The BRCA1 promoter is hypermethylated in ovarian cancer patients. We postulated that this hypermethylation might be involved in ovarian cancer progression. Methods: To confirm our hypothesis, tissue and serum samples were collected from ovarian carcinoma patients and categorized according to tumor stage. Healthy or benign ovarian disease tissue samples and corresponding serum samples were used as controls. Breast and ovarian cancer susceptibility gene 1 (BRCA1) promoter methylation levels were detected by real-time polymerase chain reaction (PCR). Real-time PCR was also used to evaluate BRCA1 gene expression, and Western blot was performed to assay the expression of BRCA1 protein. Results: BRCA1 showed hypomethylation in 30 normal ovarian and 30 benign ovarian tumors, but showed hypermethylation or methylation in ovarian cancer patients. There was also a significant difference in the BRCA1 promoter methylation levels between different ovarian cancer stages. Compared to stage I and the control groups, there were higher BRCA1 promoter methylation frequencies in stage II and III ovarian cancers. BRCA1 methylation correlated with the loss of BRCA1 expression. BRCA1 promoter in stage I tumors showed hypomethylated. Conclusion: Promoter hypermethylation may act as a biomarker for sporadic ovarian cancer progression, but is unlikely to be helpful in the early diagnosis of ovarian cancer.

Objectives To evaluate the technical feasibility and anatomical and functional outcomes of laparoscopically assisted sigmoid colon vaginoplasty (LASV) in women with Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome. Design A retrospective review of prospectively collected data. Setting Shanghai First People’s Hospital, Shanghai Jiao Tong University. Population Twenty-six women with MRKH syndrome. Methods A record was made of mean operating time, length of hospital stay, perioperative complications and the anatomical and functional outcomes of surgery. Main outcome measures The perioperative results, complications and anatomical and functional outcomes of LASV (with median 20 months follow up, range 5–48 months). Results The mean operating time and hospital stay were 238 minutes and 9.8 days, respectively. The mean fall in haemoglobin was 2.0 g/dl. The only significant perioperative complications were one case with blood transfusion and three cases with infection (one with urinary tract and two with adjunctive incision). A functioning vagina 10 to 15 cm in length and 4 cm in width was created in all women. Introital stenosis occurred in only two women (2 months later). Twenty-two women subsequently had intercourse and 20 women (91%) were satisfied with the surgery and subsequent sexual activity. Conclusions LASV is an effective approach for women with MRKH syndrome. Both the anatomical and functional outcomes are satisfactory.

S100A11 is a calcium-binding protein implicated in a variety of biological functions and is overexpressed in many human cancers. However, S100A11 expression level in ovarian cancer has not been well characterized. High-grade serous ovarian cancer (HGSC) is the most common and lethal type of ovarian cancer. The aim of the present study was to investigate S100A11 expression and its clinical significance in HGSC. S100A11 expression was evaluated by Western blot in 45 snap-frozen specimens (15 normal ovarian epithelia, 15 normal fallopian tube epithelia, and 15 HGSCs) and by immunohistochemistry in 211 paraffin-embedded specimens (40 normal fallopian tube epithelia, 54 normal ovarian epithelia, and 117 HGSCs). S100A11 expression was extremely elevated in HGSC compared with normal epithelial tissues and was positively correlated with FIGO stage (P=0.014), ascitic fluid volume (P=0.009), and residual disease (P=0.004) of HGSC patients. Higher S100A11 expression was associated with poorer disease-free (P=0.004) and overall (P=0.006) survival, whereas multivariate analysis revealed S100A11 to be an independent prognostic factor for disease-free (P=0.019) and overall (P=0.027) survival in patients with HGSC. In conclusion, S100A11 overexpression correlates with an aggressive malignant phenotype and may constitute a novel prognostic factor for HGSC.

In this paper, we studied the time-frequency domain characters of divers in lake trail and proposed some experimental results. The diver we invited in the trail was equipped with open-circuit SCUBA. We recorded the breathing sound of the diver in different motion state and analyzed its characters both in time and frequency domain. We extracted some key characteristics and practical parameters for the diver detection and identification. The results we obtained from the trail support the passive diver detection.

TDMA is an ideal choice for solving the data collision in underwater acoustic communication networks, but it needs the global clock synchronization, which is hard to realize in underwater environment. Further, the asymmetrical energy consumption of the main node and the sub nodes will reduce the network lifetime. To address these problems, we presented a relative clock based and energy sense MAC protocol. In this protocol, global clock synchronization is not needed, all nodes mapped the network schedule on its local clock according to the relative propagation delay and worked on it. The gateway is changed dynamically according to its energy level, in order to prolong the network lifetime. The performance and the engineering feasibility of this protocol were demonstrated by simulations and lake trail.

This paper presents some experimental results of underwater acoustic communication networks both in a lake trial and a sea trial. Three specially designed MAC protocols are introduced and tested: full-duplex based protocol (FD-MAC), relative clock based protocol (RC-MAC) and collision free protocol (CF-MAC). The FD-MAC protocol was implemented on a full-duplex modem; a vector hydrophone was used to improve the receiving gain, and dual-mode communication and acoustic baffle technology were applied to reduce the local emission interference. Experimental results show that the exposed/hidden terminal problems can be well resolved. The RC-MAC protocol was an improved TDMA protocol suited for centralized networks in the underwater environment; neither global clock synchronization nor the periodical broadcast of a synchronized signal is needed. The net schedule was arranged by the gateway according to the propagation delays, and the sub nodes were working on their local clock by mapping the net schedule to their local time line separately. The working slot for each sub node can be customized according to the information flow to improve the network throughput, and the main node and sub node can be reversed to prolong the network lifetime. Experimental results show that this protocol was easy to implement and worked well. The CF-MAC protocol was designed for the regional underwater observation networks. This protocol avoids channel contentions by using the top-down channel assignment. In this scheme, temporary channel access is assigned by the gateway/AUV using a require-data-send signal (RDS). RDS is used to wake up the specific node and cannot be heard by the other nodes. Two types of acknowledgement signal were designed to shorten the poll duration and to save energy. The practicability of this protocol was validated by experiments. All modems used in these trials were designed and implemented by our lab.

Objective To determine whether the recently published A global reference for fetal-weight and birthweight percentiles (Global Reference) improves small- (SGA), appropriate- (AGA), and large-for-gestational-age (LGA) definitions in predicting infant mortality. Design Population-based cohort study. Setting The US Linked Livebirth and Infant Death records between 1995 and 2004. Population Singleton births with birthweight >500 g born at 24–41 weeks of gestation. Methods We compared infant mortality rates of SGA, AGA, and LGA infants classified by three different references: the Global Reference; a commonly used birthweight reference; and Hadlock's ultrasound reference. Main outcome measures Infant mortality rates. Results Among 33 997 719 eligible liveborn singleton births, 25% of preterm and 9% of term infants were classified differently for SGA, AGA, and LGA by the Global Reference and the birthweight reference. The Global Reference indicated higher mortality rates in preterm SGA and preterm LGA infants than the birthweight reference. The mortality rate was considerably higher in infants classified as preterm SGA by the Global Reference but not by the birthweight reference, compared with the corresponding infants classified by the birthweight reference but not by the Global Reference (105.7 versus 12.9 per 1000, RR 8.17, 95% CI 7.38–9.06). Yet, the differences in mortality rates were much smaller in term infants than in preterm infants. Black infants had a particularly higher mortality rate than other races in AGA and LGA preterm and term infants. Conclusions In respect to the commonly used birthweight reference, the Global Reference increases the identification of infant deaths by improved classification of abnormal newborn size at birth, and these advantages were more obvious in preterm than in term infants.

Energy consumption and channel access time are two of the most crucial design issues in underwater acoustic communication networks since prolonging the network lifetime and improving the network throughput depends on the efficient energy resource management and channel access rules. This paper proposes an improved CSMA protocol for the underwater acoustic communication networks which are characterized by long propagation delays. This protocol shortens the hand-shaking procedure by arranging the sending time in stagger according to the distance between the sender and the receiver. Nodes do not need to be synchronized, are half-duplex, and use the same transmission power. This protocol achieves a throughput much higher than that of the traditional CSMA protocol, while offering similar savings in energy. We have evaluated performance, efficiency and engineering feasibility of this protocol by both software simulations and semi-physical platform tests.

This paper designed a conflict-free Media Access Control (MAC) protocol for the regional underwater observation networks, which avoids channel contentions by using the top-down channel assignment. In this scheme, temporary channel access is assigned by the gateway or Autonomous Underwater Vehicle (AUV) using a require-data-send signal (RDS). RDS is used to wake up the specific node and can not be heard by the other nodes. We designed two types of acknowledgement (ACK) signal to shorten the poll duration and save energy. If data received correctly, ACK1 will be sent to sleep the transmitting node and wake up the next node to transmit data. Otherwise, ACK2 will be sent to require the error data to be retransmitted. Theoretical analysis and simulation results show that this protocol provides a better performance than ALOHA and CSMA protocols. Finally, we conducted a Lake Trails to validate the practicability of this protocol.

Acoustic modem is one of the key components of underwater acoustic communication, in order to adapt to the complex and changeable acoustic environment and complete the underwater sensor network, an intelligent modem management platform is needed to achieve the parameter adjustment and the network protocol operation, while the commercial underwater acoustic modems which are already in use are hard to meet this requirement. in this paper, we designed and implemented an intelligent underwater acoustic modem management platform, based on the chip ARM6410. the platform supports the executable program written by users, and can complete the functions of modem state control, data storage and forwarding, and network protocol implementation. Experiments on testing capability of the platform were conducted in the yellow sea, results show that the management platform performs well.