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Background Although abnormal cerebrospinal fluid (CSF) protein can be used to predict the outcome of tuberculous meningitis (TBM) and diagnose TBM, normal CSF protein remains a concern in patients with TBM. This retrospective study aimed to assess the clinical characteristics associated with normal CSF protein, to resolve the dilemma of CSF protein in the management of childhood TBM. Methods Between January 2006 and December 2019, consecutive child patients (≤15 years old, a diagnosis of TBM, and tested for CSF protein) were included for analysis. CSF protein was tested on a chemistry analyzer using the pyrogallol red-molybdate method. Abnormal CSF protein was defined as >450 mg/L. Patient characteristics were collected from the electronic medical records. Then, characteristics associated with normal CSF protein were estimated in the study, using univariate and multivariate logistic regression analysis. Results A total of 125 children who met the criteria were enrolled during the study period. Twenty-nine patients had a normal CSF protein and 96 had an abnormal CSF protein. Multivariate analysis (Hosmer–Lemeshow goodness-of-fit test: χ2=2.486, df = 8, p = .962) revealed that vomiting (age- and sex-adjusted OR = 0.253, 95% CI: 0.091, 0.701; p = .008) and serum glucose (>5.08 mmol/L; age- and sex-adjusted OR = 0.119, 95% CI: 0.032, 0.443; p = .002) were associated with the normal CSF protein in childhood TBM. Conclusion In suspected childhood TBM, patients without vomiting or having low serum glucose are easy to present with normal CSF protein. Hence, when interpreting the level of CSF protein in children with such characteristics, a careful clinical assessment is required.KEY MESSAGESIn suspected childhood tuberculous meningitis, patients without vomiting or having low serum glucose are easy to present with normal CSF protein. Hence, when interpreting the level of CSF protein in children with such characteristics, a careful clinical assessment is required.

To explore the repair effect of lycium barbarum polysaccharide (LBP) on ovarian injuries induced by repeated superovulation in mice, a model of ovarian injury was established, and ovarian repair was assessed after intragastric administration of LBP. The oocyte quality and blastocyst rates of pronuclear embryos in vitro were observed. The levels of 8-hydroxydeoxyguanosine (8-OHdG) and lipid peroxide (LPO) in ovarian tissue were measured, and ovarian damage was assessed in paraffin sections. The groups with significant injury were selected according to the above observation, mice in the significant injury group were intragastrically administered with LBP (low dose, 25 mg/kg; medium dose, 35 mg/kg; and high dose, 45 mg/kg) for 30 days. The above measurements and anti-Müllerian hormone (AMH) expression were detected in the mouse ovaries and the breeding verification was carried out. Our results showed that repeated superovulation could cause mouse oocyte quality to drop, significant differences started from 4 superovulation events (P 0.05). The levels of 8-OHdG and LPO in the ovary increased gradually as the number of superovulation events increased, and significant differences were observed after 4-6 superovulations (P 0.05). The ratios of primordial follicles, primary, tertiary and mature follicles decreased and the ratio of atresia follicles increased as the number of superovulation events increased, especially in 4-6 superovulation groups. Thus, the groups of superovulation 4-6 events were considered as significant injury groups. LBP-medium dose groups significantly improved the number and quantity of oocytes and embryo blastocyst rate (P 0.05), significantly decreased 8-OHdG and LPO levels in mice ovary (P 0.05), also improved the ratios of all stages follicles and reduced the rate of atresia follicles, increased the numbers of litter size, live birth, weaning survival, and repaired the expression of AMH in ovary significantly (P 0.05). In conclusion, the degree of ovarian injury was affected by the number of superovulation. LBP repaired ovarian injuries most likely through scavenging oxidative products 8-OHdG and LPO and increasing AMH protein expression.

Background Until now, the influential factors associated with pleural adenosine deaminase (ADA) activity among children remain unclear. This retrospective study was therefore conducted aiming to investigate the factors associated with negative pleural ADA results in the diagnosis of childhood pleural tuberculosis (TB). Methods Between January 2006 and December 2019, children patients with definite or possible pleural TB were recruited for potential analysis. Then, patients were stratified into two categories: negative pleural ADA results group (experimental group, ≤40 U/L) and positive pleural ADA results group (control group, > 40 U/L). Univariate and multivariate logistic regression analyses were performed to estimate risk factors for negative pleural ADA results. Results A total of 84 patients with pleural TB were recruited and subsequently classified as experimental (n = 17) and control groups (n = 67). Multivariate analysis (Hosmer–Lemeshow goodness-of-fit test: χ2 = 1.881, df = 6, P = 0.930) revealed that variables, such as chest pain (age-adjusted OR = 0.0510, 95% CI: 0.004, 0.583), pleural total protein (≤45.3 g/L, age-adjusted OR = 27.7, 95% CI: 2.5, 307.7), pleural lactate dehydrogenase (LDH, ≤505 U/L, age-adjusted OR = 59.9, 95% CI: 4.2, 857.2) and blood urea nitrogen (≤3.2 mmol/L, age-adjusted OR = 32.0, 95% CI: 2.4, 426.9), were associated with negative pleural ADA results when diagnosing childhood pleural TB. Conclusion Our findings demonstrated that chest pain, pleural total protein, pleural LDH, and blood urea nitrogen were associated with a negative pleural ADA result for the diagnosis of pleural TB among children. When interpreting pleural ADA levels in children with these characteristics, a careful clinical assessment is required for the pleural TB diagnosis.

Right ventricular (RV) wall dissection following ventricular septal rupture related to inferior myocardial infarction (MI) is an extremely rare complication with a high mortality rate. We report the case of a 61-year-old man who was admitted to our hospital because of syncope and intermittent chest pain with a precordial murmur. Transthoracic echocardiography showed a rupture at the basal infero-posterior septum and RV free-wall dissection forming an echolucent cavity that extended beyond the septum and subsequently re-entered into RV chamber. The patient's overall cardiac and renal functions deteriorated and he died 24 days after the diagnosis. We present a literature review of the published cases of complex dissecting tracts through the septum and RV wall in ischemic context.

The prognostic factor for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) care remains unclear. Therefore, a retrospective study was conducted aiming to estimate the in-hospital mortality rate and the risk factors for mortality in a high-burden setting. All patients with culture-confirmed TB that were admitted to the ICU of the hospital between March 2012 and April 2019 were identified retrospectively. Data, such as demographic characteristics, comorbidities, laboratory measures and mortality, were obtained from medical records. The Cox proportional hazards regression model was used to identify prognostic factors that influence in-hospital mortality. A total of 82 ICU patients with confirmed TB were included in the analysis, and 22 deaths were observed during the hospital stay, 21 patients died in the ICU. In the multivariable model adjusted for sex and age, the levels of serum albumin and white blood cell (WBC) count were significantly associated with mortality in TB patients requiring ICU care (allP< 0.01), the hazard ratios were 0.8 (95% confidence interval (CI): 0.7–0.9) per 1 g/l and 1.1 (95% CI: 1.0–1.2) per 1 × 109/l, respectively. In conclusion, in-hospital mortality remains high in TB patients requiring ICU care. Low serum albumin level and high WBC count significantly impact the risk of mortality in these TB patients in China.

Although the progression of invasive aspergillosis (IA) shares some risk factors in the development of active pulmonary tuberculosis (PTB), however, the prevalence of IA in suspected PTB remains unclear. During a period of 1 year (from January 2016 to December 2016), consecutive patients with suspected PTB were included in a referral TB hospital. Data, including demographic information and underlying diseases, were collected from medical records. PTB were all confirmed by mycobacterial culture (Lowenstein–Jensen medium). IA were diagnosed as proven or probable according to the criteria of the 2008 EORTC/MSG definitions. A descriptive analysis was performed to estimate the corresponding prevalence. During the study year, 1507 patients have a positive mycobacterial culture, with a mean age of 45.6 (s.d.19.9) years old and a female:male ratio of 1:4. Among the 82 patients with non-tuberculous mycobacterial diseases, two patients (2.44%, 95% CI 0.67–8.46%) were diagnosed as IA (one proven and one probable); two probable IA patients (0.15%, 95% CI 0.04–0.55%) were diagnosed in PTB patients (n= 1315), and all were retreatment cases. In addition, all four IA patients (100%) exhibited cavities in both lobes on radiograph. In China, the prevalence of IA is low in active PTB patients. However, when high-risk factors for IA are encountered in PTB patients, further investigations are required and empirically treatment for IA might be warranted.

Background. In China, the prevalence of tuberculosis (TB) diseases and epidemiological trends in the TB forms among children are still unclear; a retrospective study was conducted aiming to assess it. Methods. Between January 2007 and September 2020, 1577 consecutive childhood TB patients (aged ≤ 15 years) were included in the study. Data, including demographic information and underlying diseases, were collected from medical records. Then, patients were categorized and reported according to the anatomical site of TB disease. To analyze the epidemiological trends in the proportion of each form of TB disease, a linear-by-linear association was used, and a P value of Results. During the fourteen-year study period, a total of 1577 children patients were enrolled, including 954 boys (60.5%) and 623 girls (39.5%), with a mean age of 9.26±5.18 years. Among the studied patients, 810 (51.4%) patients have pulmonary TB, 1137 (72.1%) have extrapulmonary TB, 372 (23.6%) have both conditions, and another 765 (48.5%) extrapulmonary cases presented in isolated form. Pleural TB (29.0%) and tuberculous lymphadenitis (23.7%) were the most frequent two forms of childhood TB. In addition, during the past decade, the proportions of pulmonary TB, pleural TB, and tuberculous lymphadenitis showed an increasing trend (all P<0.05). However, no significant trends in the proportions of other forms of TB disease, such as extrapulmonary TB (P>0.05), tuberculous meningitis (P>0.05), endobronchial TB (P>0.05), and disseminated TB (P>0.05), were found. Conclusion. Our findings suggest that childhood TB is facing new challenges, and the policy should be adjusted timely to fit the real situation.

Background Delay in diagnosis and treatment worsens the disease and clinical outcomes, which further enhances the transmission of tuberculosis (TB) in the community. Therefore, this study aims to assess treatment delay and its associated factors among childhood pleural TB patients in China. Methods Between January 2006 and December 2019, consecutive patients aged ≤15 years with definite or possible pleural TB were included for analysis. Treatment delay duration was defined as the time interval from the onset of symptoms to treatment initiation and was stratified into two categories: Results A total of 154 children with pleural TB were included, with a mean age of 12.4 ± 3.3 years. The median treatment delay was 30 days (interquartile range, 10–60 days) and 51.3% (n = 79) of patients underwent a treatment delay. Multivariate analysis revealed that heart rate (≤92 beats/min, age-adjusted OR = 2.503, 95% CI: 1.215, 5.155) and coefficient of variation of red cell distribution width (RDW-CV, ≥12.9%, age-adjusted OR = 4.705, 95% CI: 2.048, 10.811) were significant risk factors for treatment delays in childhood pleural TB. Conclusion Our findings suggested that a significant treatment delay occurs among children with pleural TB in China. Patients with a low heart rate or a high RDW-CV experienced delays in the initiation of anti-TB therapy. Therefore, well awareness of the associations between clinical characteristics and treatment delay may improve the management of children with pleural TB and enable us to develop preventive strategies to reduce the treatment delay.

Background The incidence of obesity-associated decline in male fertility has increased over the years. Lycium barbarum polysaccharide (LBP), a natural plant polysaccharide extracted from the Chinese herb L. barbarum has shown promising therapeutic effects in overcoming the same. Aim This study aimed to investigate the protective effect of LBP on the testes of obese mice. Methods Following administration of LBP to high-fat diet-induced obese mice for 35 days, serum, sperm, and testis samples were obtained for subsequent experiments. Biochemical analysis and sex hormone content determination were performed to observe changes in glycolipid metabolism and testosterone levels, respectively, in the blood. Hematoxylin and eosin staining were carried out to assess the pathological changes in the testicular tissue. Oxidative stress levels were detected using enzyme-linked immunosorbent assay and expression levels of endoplasmic reticulum stress markers were determined using western blot in the testicular tissue. Results Our results suggested that LBP reduced glucose levels and insulin resistance, increased testosterone levels and insulin sensitivity, and decreased testicular oxidative stress and pathological damage in obese mice. In addition, LBP down-regulated the expression of p-eIF2α, GRP78, and CHOP in the testicular tissues of obese mice. Conclusion Our results show that LBP is a potential novel drug for preventing male infertility caused by obesity.

To date, the burden of childhood spinal TB in China has not been estimated, and current treatment is hindered by a lack of evidence. This study aimed to review our experience of childhood spinal TB.We reviewed the medical records of paediatric patients (≤15 years) admitted for spinal TB (confirmed or possible) at Shandong Provincial Chest Hospital from January 2006 to December 2019. Demographic, clinical, laboratory and radiological data were collected from medical records and analysed retrospectively.Seventy-two patients were diagnosed with spinal TB. 45 were male (62.5%), and 27 female (37.5%), with a mean age of 8.42 ± 4.47 (SD) years. During this 14-year period, the overall prevalence of spinal TB among childhood TB was 4.5%. T-SPOT.TB, AFB smear, mycobacterial culture, TB RT-PCR and biopsies were positive in 29.6%, 14.3%, 23.3%, 43.8% and 88.5% of assayed patients, respectively. The overall surgical rate of the studied patients was 40.3%. The requirement of surgery in childhood spinal TB was associated with pulmonary TB (OR = 4.000, 95% CI: 1.197, 13.367).Spinal TB in children cannot be neglected. It remains a severe problem to public health, and more attention should be paid to initiating treatment early.A ce jour, la charge de la tuberculose (TB) vertébrale infantile en Chine n'a pas été estimée et le traitement actuel est entravé par un manque de données. Cette étude visait à passer en revue notre expérience de la TB vertébrale infantile. MÉTHODES: Nous avons examiné les dossiers médicaux des patients pédiatriques (≤15 ans) admis pour une TB vertébrale (confirmés ou possibles) au Shandong Provincial Chest Hospital de janvier 2006 à décembre 2019. Les données démographiques, cliniques, de laboratoire et radiologiques ont été recueillies à partir des dossiers médicaux et analysées rétrospectivement. RÉSULTATS: Soixante-douze patients ont reçu un diagnostic de TB vertébrale. 45 étaient de sexe masculin (62,5%) et 27 de sexe féminin (37,5%), avec un âge moyen de 8,42 ± 4,47 (DS) ans. Au cours de cette période de 14 ans, la prévalence globale de la TB vertébrale dans la TB infantile était de 4,5%. T-SPOT.TB, frottis de BAR, culture mycobactérienne, RT-PCR, TB et biopsies étaient positifs chez 29,6%, 14,3%, 23,3%, 43,8% et 88,5% des patients testés, respectivement. Le taux chirurgical global chez les patients étudiés était de 40,3%. La nécessité d'une intervention chirurgicale dans la TB vertébrale infantile était associée à la TB pulmonaire (OR: 4,000, IC95%: 1,197 - 13,367).La TB vertébrale chez l'enfant ne peut pas être négligée. Elle demeure un grave problème de santé publique et il faudrait accorder plus d'attention à l'initiation précoce du traitement.

The RTN4 gene plays a role in the development and progression of cancer. This case–control study aimed to investigate the association between the RTN4 gene polymorphism and its plasma level with the risk of nasopharyngeal carcinoma (NPC) in a Chinese population. RTN4 gene polymorphisms (rs2920891, rs17046583, rs117465650, rs10496040, and rs2588519) in 220 patients with NPC and 300 healthy controls were analyzed using Snapshot single-nucleotide polymorphism genotyping assays. The plasma level of RTN4 was measured using the enzyme-linked immunosorbent assay. The allele frequencies of RTN4 gene polymorphisms showed no significant difference between the patients and controls (P > .05). Nevertheless, the rs2920891 polymorphism in a dominant model (A/C+C/C) and codominant model (A/C) was significantly associated with the susceptibility to NPC (P = .017, odds ratio [OR] = 1.54, 95% confidence interval [CI] = 1.08–2.21 and P = .034, OR = 1.64, 95% CI = 1.13–2.38, respectively). The plasma level of RTN4 was significantly higher in patients with NPC in comparison with the controls (P

The aim of this study was to investigate the association of genetic polymorphisms in the promoter region of miR‐17‐92 with systemic lupus erythematosus (SLE). The gene polymorphism was analysed using SNaPshot in 312 SLE patients and 396 controls. Relative expression of miR‐17‐92 was measured by quantitative real‐time PCR. Association was found between rs9515692 and a decreased risk of SLE (CT vs CC: OR = 0.65, 95%CI, 0.46‐0.92, P = .014; CT+TT vs CC: OR = 0.64, 95%CI, 0.46‐0.90, P = .009; T vs C: OR = 0.69, 95%CI, 0.52‐0.92, P = .010, respectively). Haplotype analysis showed that C‐G‐G, C‐A‐A haplotypes were associated with an increased SLE risk (OR=4.46, 95%CI, 2.17‐9.17, P < 0.001; OR=2.33, 95%CI, 1.44‐3.76, P < 0.001, respectively). T allele and CT+TT genotypes in rs9515692 were associated with decreased risk of anti‐dsDNA in SLE (CT+TT vs CC: OR = 0.42, 95%CI = 0.24‐0.72, P = .002; T vs A: OR = 0.49, 95%CI = 0.31‐0.79, P = .003). Moreover, rs9515692 CT+TT genotypes had a higher level of miR‐17 as compared to CC genotype (P = .017). These findings suggest that the rs9515692 CT+TT genotypes were a protective factor for the susceptibility of SLE, probably by increasing the expression of miR‐17.

Interleukin (IL) 13 plays a critical role in inflammatory diseases, including systemic lupus erythematosus (SLE). This study aims to explore the potential association of IL-13 polymorphisms with the risk of SLE. We genotyped IL-13 rs20541, rs848 and rs1295686 using Snapshot SNP genotyping assays. Plasma IL-13 level was determined by enzyme-linked immunosorbent assay (ELISA). We found that rs20541 was associated with increased risk of SLE (CT vs. CC: adjusted OR=1.43, 95%CI, 1.04-1.99, P=.030; TT vs. CC: adjusted OR=1.73, 95%CI, 1.10-2.73, P=.018; CT/TT vs. CC: adjusted OR=1.50, 95%CI, 1.10-2.04, P=.010; T vs. C adjusted OR=1.34, 95%CI, 1.08-1.93, P=.031). CT and TT genotypes in rs20541 were associated with increased risk of renal disorder in SLE (CT vs. CC: adjusted OR=1.97, 95%CI, 1.18-3.28, P=.009; TT vs. CC: adjusted OR=2.42, 95%CI, 1.22-4.77, P=.011). Moreover, The concentration of IL-13 was significantly elevated in rs20541 CT/TT genotypes compared with CC genotype (P.001). These results suggest that rs20541 CT/TT genotypes may be a risk factor for SLE, probably by increasing the level of IL-13.

Objective We aimed to explore the effect of individualized medical nutrition guidance on pregnancy outcomes among older pregnant women. Methods This was a prospective study using a randomized controlled trial design. We selected 820 older pregnant women and randomly divided them into a study group and control group (410 women each). The control group was given routine health education and nutrition guidance; the study group was provided individualized medical nutrition guidance. Gestational diabetes mellitus, hypertensive disorders of pregnancy, vaginal delivery rate, postpartum hemorrhage rate, gestational body weight, neonatal birth weight, and neonate transfer to the neonatal intensive care unit (NICU) were compared between the groups. Results The incidence of gestational diabetes in the study group was significantly lower and the rate of vaginal delivery was significantly higher than those in the control group. The incidence of macrosomia, rate of neonatal transfer to the NICU, and rate of neonatal hyperbilirubinemia were significantly lower in the study group than those in the control group. Conclusions Individualized nutritional intervention for older pregnant women can effectively reduce the incidence of complications during pregnancy and childbirth and improve maternal and child outcomes.

Background: The Shanghai growth standards are higher than World Health Organization (WHO) growth standards, which may influence the feeding practices of the caregivers and increase the risk of overweight in these infants. This study aimed to compare the effects of different growth standards on childhood obesity in Shanghai metropolitan area. Methods: This was a cluster-randomized controlled trial conducted in 2 downtown areas with 19 community health service centers in Shanghai from November 2013 to December 2015. Randomization was done at the level of the community. Infants (health newborns) were assessed and monitored by the Shanghai growth standards (S-group) and the 2006 WHO growth standards (W-group), respectively. Measurements were taken at 1.0, 2.0, 4.0, 6.0, 9.0 and 12.0 months of age during follow-up period. Based on the values of length and weight measurements, according to the group’s growth standards, doctors provided the caregivers with corresponding clinical consultation. Changes in weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for length z-score (WLZ) between 2 groups were assessed using mixed regression models. Overweight was compared between 2 group at all follow-up measurements. Results: A total of 6509 infants (52.1% were boys) were in the W-group, and 8510 infants (51.4% were boys) were in the S-group. The overweight ratios between two groups were distinct at 9 months of age (3.4% in W-group and 4.3% in S-group) and 12 months of age (2.2% in W-group and 3.8% in S-group), and the differences were statistically significant (P= 0.020 and P< 0.001, respectively). Compared to W-group, the increase in WAZ (coefficient= 0.04, P= 0.004) and WLZ (coefficient= 0.09, P < 0.001) were significantly greater, and the LAZ was lower (coefficient = －0.04, P = 0.047) in S-group (W-group values were used as reference in mixed regression models). Conclusion: Compared to the Shanghai growth standards, the adoption of WHO 2006 growth standards would reduce the risk of infant overweight in Shanghai metropolitan area up to 1 year of age. Trial registration number: ChiCTR1800015371, http://www.chictr.org.cn/Chinese Clinical Trial Registry. Key words: Overweight; community health; infant; growth standards

Pulmonary arterial hypertension (PAH) is a destructive and rare disorder characterized by a progressive increase in pulmonary artery pressure and vasoconstriction, ultimately leading to right ventricular failure and death. 18β-Glycyrrhetinic acid (18β-GA) is an active ingredient in the commonly used Chinese herbal medicine radix glycyrrhizae, and it possesses antioxidant, anti-inflammatory, anti-tumor, and other pharmacological properties. This study aimed to determine whether 18β-GA has protective effects against monocrotaline (MCT)-induced PAH and whether it is associated with oxidative stress. The PAH of rats was induced by MCT (60 mg/kg) and oral administration of 18β-GA (100, 50, or 25 mg/kg/day), sildenafil (30 mg/kg), or saline for 21 consecutive days. The development of PAH was evaluated by hemodynamic parameters and right ventricular hypertrophy index. Hematoxylin and eosin staining, Masson trichrome staining, and electron microscopy were used to determine the degree of vascular remodeling and proliferation in lung tissue. Moreover, the antioxidant capacity and malondialdehyde levels in the lungs were measured according to the instructions provided by the test kits, and the expression levels of nicotinamide adenine dinucleotide phosphate oxidase-2 (Nox2) and Nox4 were detected through Western blot analysis. Results of our study indicated that 18β-GA treatment significantly improved the hemodynamic and pathomorphological data of the rats, reduced the changes in oxidative stress biomarkers, and inhibited Nox2 and Nox4 expression. Our research indicated that 18β-GA has a protective effect against MCT-induced PAH by inhibiting oxidative stress in rats.

OBJECTIVES: Delay in the treatment of pleural infection may contribute to its high mortality. In this retrospective study, we aimed to evaluate the diagnostic accuracy of pleural adenosine deaminase in discrimination between Gram-negative and Gram-positive bacterial infections of the pleural space prior to selecting antibiotics. METHODS: A total of 76 patients were enrolled and grouped into subgroups according to Gram staining: 1) patients with Gram-negative bacterial infections, aged 53.2±18.6 years old, of whom 44.7% had empyemas and 2) patients with Gram-positive bacterial infections, aged 53.5±21.5 years old, of whom 63.1% had empyemas. The pleural effusion was sampled by thoracocentesis and then sent for adenosine deaminase testing, biochemical testing and microbiological culture. The Mann-Whitney U test was used to examine the differences in adenosine deaminase levels between the groups. Correlations between adenosine deaminase and specified variables were also quantified using Spearman’s correlation coefficient. Moreover, receiver operator characteristic analysis was performed to evaluate the diagnostic accuracy of pleural effusion adenosine deaminase. RESULTS: Mean pleural adenosine deaminase levels differed significantly between Gram-negative and Gram-positive bacterial infections of the pleural space (191.8±32.1 U/L vs 81.0±16.9 U/L, p

It is assumed that the vehicles entering the intersection can establish real-time and effective interaction with the intersection control center under the V2X technology. The vehicle optimal control (VOC) algorithm was proposed in this paper. The algorithm comprehensively considers factors such as controllable area, prohibited lane change area, safe following distance, and safe lane change conditions. And based on the COM interface of vissim software, the control algorithm is implemented by C++ programming. Under the conditions of different intersection saturation and control area distance, the traditional method and V2X method control experiment are carried out respectively. The results show that when the saturation does not exceed 0.45, the VOC algorithm has the best effect on the effect of the intersection, and the highest speed increase is 27%, the delay is reduced by 67%, and the number of stops is reduced by 65%. When oversaturated, the algorithm does not have a significant effect on the improvement of the running effect. When the saturation is 0.45-0.6, 0.75-0.9, the optimal control distance is 200m, 300m, and the remaining saturation range is not sensitive to the control distance.

Although inflammation is emerging as a candidate risk factor in tumorigenesis of nasopharyngeal carcinoma (NPC). In particular, Interleukin (IL) 13 involved inflammatory diseases and cancers. Single nucleotide polymorphisms in IL-13 have been associated with multiple cancers. The study analyzed genetic polymorphisms in IL-13 aiming to investigate its’ potential susceptibility with the NPC. The genotyping of polymorphisms (rs20541, rs1295687 and rs2069744) was examined by Snapshot SNP and DNA sequencing. All SNPs were within Hardy-Weinberg equilibrium and each appeared in three genotypes in NPC and controls. Adjusted logistic regression showed that the TT genotype of rs20541 increased the risk of lymph node metastasis (TT vs. CC: OR = 2.87, 95%CI, 1.33–6.18, P = 0.007). CT/CC genotypes were associated with the decreased the risk of lymph node metastasis in NPC (CT/CC vs. TT: OR = 0.32, 95%CI, 0.16–0.65, P = 0.002). The concentration of IL-13 was significantly elevated in NPC patients compared with controls (P = 0.012). Moreover, significant differences were detected in the T-C-T haplotype distribution between NPC patients and controls (OR = 2.47, 95%CI, 1.06–5.78, P = 0.031). Our results, the first report, provide evidence that rs20541 polymorphisms may affect the lymph node metastasis of NPC patients in Chinese population.

The levels of serum S100B were elevated in patients with ischemic stroke (IS), which may be a novel biomarker for diagnosing IS. The aim of this study was to investigate the association of S100B polymorphisms and serum S100B with IS risk. We genotyped the S100B polymorphisms rs9722, rs9984765, rs2839356, rs1051169 and rs2186358 in 396 IS patients and 398 controls using polymerase chain reaction-single base extension (SBE-PCR). Serum S100B levels were measured by enzyme-linked immunosorbent assay (ELISA). Rs9722 was associated with an increased risk of IS (AA vs. GG: adjusted OR = 2.172, 95% CI, 1.175–4.014, P = 0.013; dominant: adjusted OR = 1.507, 95% CI, 1.071–2.123, P = 0.019; recessive: adjusted OR = 1.846, 95% CI, 1.025–3.323, P = 0.041; additive: adjusted OR=1.371, 95% CI, 1.109-1.694, P = 0.003). The A-C-C-C-A haplotype was associated with an increased risk of IS (OR = 1.325, 95% CI, 1.035–1.696, P = 0.025). In addition, individuals carrying the rs9722 GA/AA genotypes had a higher serum S100B compared with the rs9722 GG genotype in IS patients (P = 0.018). Our results suggest that the S100B gene rs9722 polymorphism may contribute to the susceptibility of IS, probably by promoting the expression of serum S100B.

In order to appraise the safety and reliability of bridges effectively, the comprehensive evaluation model based on analytic hierarchy process was established. The weight of evaluation index was calculated by using the model, and each evaluation index was given score by experts according to actual circumstances, and, on this basis, safety level of the bridge was obtained. And, afterwards, the model was applied to an engineering example for Huangjiaba Bridge. The results show that the evaluation level of bridge safety is third-level, with serious problems existing in this practical example, and the corresponding measures are proposed, which can provide scientific reference for bridge safety management.

Interleukin-8 (IL8) polymorphisms have been implicated in several cancers, but their roles in the pathogenesis of hepatocellular carcinoma (HCC) are largely unknown. The present study was designed to explore the association between IL8 polymorphism and the risk of HCC in a Chinese population. Four single nucleotide polymorphisms (SNPs) of the IL8 gene -251A/T, +781C/T, -353A/T and +678T/C were analyzed in 205 HCC patients and 208 healthy controls in a Chinese population. Serum levels of IL8 were detected in HCC patients and healthy controls. The association between IL8 polymorphisms and HCC risk was measured using the adjusted odds ratios (OR) and their 95% confidence intervals (CI) from multiple logistic regression analysis. Haplotype analysis and gene-environment interaction analysis was also performed. The serum level of IL8 was significantly higher in HCC patients compared with healthy controls (P0.001). After adjusting for confounding factors, no significant associations were found between -251A/T, +781C/T, -353A/T and +678T/C and HCC risk (all P0.05). Haplotype analysis showed that A(251)-C(781)-A(353)-C(678) conferred decreased risk of HCC onset (adjusted OR 0.31, 95% CI 0.13-0.77). No significant interaction effects were found between the four SNPs and HBV infection, cirrhosis, gender smoking and alcohol consumption (all P0.05). No association between -251A/T, +781C/T, -353A/T and +678T/C of the IL8 gene and the risk of HCC was found in this Chinese population, and the SNPs did not display any interaction with several environmental factors with regard to HCC risk. However, it appears that A(251)-C(781)-A(353)-C(678) is perhaps a protective haplotype for HCC.

Sir, In 2015, there were an estimated 10.4 million new tuberculosis (TB) cases worldwide, 1.4 million TB deaths, and 480,000 new multidrug-resistant TB cases, according to the WHO report.1 Early diagnosis and immediate initiation of treatment are essential for an effective TB control program. Delay in diagnosis is significant to both disease prognosis at the individual level and transmission within the community.2 To date, several new rapid TB tests (such as Xpert MTB/RIF Ultra, Real time-PCR) have been developed.3 However, sputum smear remains the only readily available TB diagnostic test throughout most of the low-income and middle-income countries. The National Institute for Health and Care Excellence guideline on TB recommends that multiple sputum samples (at least three, with one early morning sample) were collected for TB microscopy for patients with suspected pulmonary TB (PTB).4 Similar recommendation was made in China.5 However, in Brazil, two sputum samples, including one morning sputum sample, was recommended.6 Remarkably, these recommendations did not contain specific implications on performing multiple smears in 1 day or on different days for PTB. The Shandong Provincial Chest Hospital (SPCH) is a provincial TB referral hospital of approximately 800 beds. Each year, about 1000 patients with TB were diagnosed, with positive results on acid-fast bacilli (AFB) sputum smear examination. The SPCH TB reference laboratory had been accredited by ISO15189 in 2010 and is participating in an external …

Ellipse crack tip can be passivated when pulse current is perpendicular to crack surface of metal structure which can achieve the purpose of crack. In practice, it is hard that the loading current direction perpendicular to the crack surface because of the crack existence of different position and orientation. Theory and numerical simulation analyze the effect of crack arrest by electromagnetic heating based on metal structure with oblique-elliptical embedding crack. And current density and temperature distribution of crack tip are derived. The result shows that due to heat concentration around the oblique-elliptical embedding crack tip, the crack tip temperature exceeds the melting point of materials and small welded joints are formed by metal melting. Thermal compressive stress which is generated near the crack tip can prevent the crack propagation effectively. Thus, electromagnetic heating is proved to be an effective method of preventing general crack propagation.

Background We investigated the relationship between serum bilirubin and disease activity in patients with rheumatoid arthritis (RA). Methods We included a total of 173 consecutive RA patients without steroid treatment and 346 healthy subjects; the disease activity score in 28 joints (DAS28) was used to assess disease activity in patients with RA. Results Serum bilirubin concentrations were significantly lower in RA patients than in controls. Serum bilirubin was found to be negatively correlated with C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) ( r = − 0.165, P = 0.030; r = − 192, P = 0.012) in patients with RA. There was a negative correlation between the serum bilirubin and DAS28 score ( r = − 0.331, P P = 0.001) in the multiple linear regression analysis. Conclusions Serum bilirubin concentrations are lower in patients with RA compared to controls and correlate with disease activity in patients with RA.

Interleukin (IL) 16 plays a key role in inflammatory diseases as well as in tumorigenesis of osteosarcoma (OS). The aim of this study was to investigate the association of IL16 polymorphisms and plasma IL16 level with OS risk in a Chinese population. We genotyped IL16 rs4778889, rs11556218, and rs4072111 in 358 patients with OS and 402 controls using a polymerase chain reaction-restriction fragment length polymorphism assay. Plasma IL16 level was measured by enzyme-linked immunosorbent assay. Rs11556218 was associated with an increased risk of OS in heterozygote comparison (adjusted OR = 1.65, 95% CI, 1.23–2.21, P P P = 0.002). Moreover, rs11556218 TG/GG genotypes were associated with higher levels of IL16 as compared to TT genotype (P = 0.03). However, no significant association of rs4778889 and rs4072111 and OS was found. These findings suggest that rs11556218 TG/GG genotypes may be associated with increased susceptibility to OS, probably by increasing the production of IL16 level.

The expression of miR-143/miR-145 was up-regulated in ischemic stroke (IS), which may be used as biomarkers and/or therapeutic targets for IS. We aimed to investigate the association of rs4705342 and rs4705343 polymorphisms in the promoter of miR-143/145 with risk of IS. The study population comprised 445 patients with IS and 518 controls. The rs4705342 genotype was analyzed by using a TaqMan Assay and the rs4705343 genotype was determined by using a polymerase chain reaction-restriction fragment length polymorphism assay. Relative expression of miR-143/miR-145 was measured by quantitative real-time PCR. We found that the rs4705342 was associated with a decreased risk of IS (TC vs. TT: adjusted OR = 0.74, 95% CI, 0.57–0.97; CC vs. TT: adjusted OR = 0.53, 95% CI, 0.34–0.83). Haplotype analysis showed that the TC haplotype was associated with an increased risk of IS risk (OR = 1.33, 95% CI, 1.01–1.75), whereas the CT haplotype was associated with a decreased risk of IS risk (OR = 0.68, 95% CI, 0.50–0.92). Importantly, patients carrying the rs4705342TC/CC genotypes had a lower level of miR-145 (P = 0.03). We found for the first time that the rs4705342 CC was a protective factor for IS, probably by reducing the level of miR-145.

Project stakeholders are individuals or organizations that are closely related to the project. In agricultural development projects, there are multiple stakeholders that have complex interests. It is necessary to recognition the key stakeholders correctly and understand the role and power of the key stakeholders in agricultural development projects. This paper was firstly applied fuzzy inference system to identify the key stakeholders in agricultural development project, and put forward the appropriate management strategy to ensure the success of agricultural development project. Index Terms key stakeholders; fuzzy inference system; identification.

The findings of associations between IL-6 polymorphisms and risk of gastric cancer are controversial. We conducted a meta-analysis of the IL-6 gene to provide evidences for the current understanding of the genetic association with gastric cancer. We searched for relevant studies without language restriction in PubMed, EMBASE and Cochrane Library published up to November 2011. The strengths of the associations between IL-6 polymorphisms and gastric cancer risk were estimated by odds ratios (OR) with 95% confidence interval (95% CI). We identified seven case-control studies involving 1364 gastric cancer cases and 1748 controls for the analysis. Because of limited eligible data, our meta-analysis specifically focused on three SNPs of the IL-6 gene, -174 G/C, -572 G/C and -597 G/A. We found no significant associations of IL-6-174 G/C, -572 G/C and -597 G/A polymorphisms with gastric cancer risk in the overall population (all p>0.05). Subgroup analysis did not show significant associations in Asian population or Caucasian population either (all p>0.05). Begg's test and Egger's test suggested no evidence of publication (all p>0.05). Our findings showed that polymorphisms of IL-6-174 G/C, -572 G/C and -597 G/A are not associated with gastric cancer risk. However, the results should be interpreted with caution due to the limited number of studies available.

Optimization analysis of transmission system simulation models and discussion on the optimal matching of transmission equipments are carried out based on the existing tridimensional rail power driven container terminal transmission system network. Two-dimensional animation display of the transmission system is realized through multiple simulations utilizing simulation software. The simulation analysis indicates the average operating efficiency of the equipments such as quay crane and gantry crane have reached 82 percent. The simulation results have some valuable reference for the actual production and the realization of the tridimensional transmission system.

Object-Oriented Stochastic Petri Net (OOSPN) is utilized concerning the complexity of container terminal tridimensional rail transmission system network. It simplifies the structure and modeling with object-oriented and hierarchy idea, while the efficiency of each state is detected based on Stochastic Petri Net performance analysis. Thereby, it finds the system bottleneck which also provides reference for the improvement of the program. The efficiency indicators are obtained by analysis and construction of container terminal transmission system as well.

Intrusion Detection System (IDS) is an important and necessary component in ensuring network security and protecting network resources and network infrastructures. How to build a lightweight IDS is a hot topic in network security. Moreover, feature selection is a classic research topic in data mining and it has attracted much interest from researchers in many fields such as network security, pattern recognition and data mining. In this paper, we effectively introduced feature selection methods to intrusion detection domain. We propose a wrapper-based feature selection algorithm aiming at building lightweight intrusion detection system by using modified random mutation hill climbing (RMHC) as search strategy to specify a candidate subset for evaluation, as well as using modified linear Support Vector Machines (SVMs) iterative procedure as wrapper approach to obtain the optimum feature subset. We verify the effectiveness and the feasibility of our feature selection algorithm by several experiments on KDD Cup 1999 intrusion detection dataset. The experimental results strongly show that our approach is not only able to speed up the process of selecting important features but also to yield high detection rates. Furthermore, our experimental results indicate that intrusion detection system with feature selection algorithm has better performance than that without feature selection algorithm both in detection performance and computational cost.

To describe the demographics, clinical characteristics and microbiologic findings of infant (≤2 years old) tuberculosis (TB) in a high TB burden country. Between Feb, 2007 and Jun, 2015, 115 TB infants who admitted to our hospital were enrolled in the study. Their clinicopathological characteristics were reviewed and analyzed. The mean age was 10.1 ± 7.4 (SD) months, and 84 of 115 infants (73.0 %) were males. 23 patients (20.0 %) had isolated pulmonary TB, 18 patients (15.7 %) had pulmonary and extrapulmonary TB (EPTB), the remaining 74 patients (64.4 %) had exclusively EPTB. The most common site of EPTB was lymph node (n = 61), 54 cases were left axillary lymph node involvement. 49 of 51 patients (96.1 %) were validated by pathological examination, 5 of 57 patients (8.8 %) were positive on acid fast bacilli smear, and 27 of 103 patients (26.2 %) were confirmed by mycobacterial culture. 29 of 59 patients (49.2 %) were PPD positive, 14 of 30 patients (46.7 %) were T-SPOT.TB positive. The most common complaints of patients were lymph node swelling (53.0 %), fever (36.5 %), cough (28.7 %) and dyspnea (10.4 %). There was significant difference in the time before hospital admission among different types of tuberculosis (P

Background: To evaluate the performance of GenoType MTBDR plus assay for rapid detection of isoniazid (INH)- and rifampicin (RIF)-resistance in Mycobacterium tuberculosis (M.TB) isolates from diabetes mellitus (DM) patients, a retrospective study was conducted. Methods: Between May, 2012 and Sep, 2016, 227 tuberculosis (TB) patients with DM were enrolled in the study. Culture and phenotypic drug susceptibility test were performed in all cases. The GenoType MTBDR plus assay were done on sputum or culture specimens and carried out according to manufacturer’s instructions. The sensitivity, specificity, false positive ratio, false negative ratio and diagnostic odds ratio for detecting INH- and RIF-resistance by GenoType MTBDR plus assay were calculated using the phenotypic drug susceptibility test as the gold standard. Results: The total sensitivity, specificity, false positive ratio, false negative ratio and diagnostic odds ratio of GenoType MTBDR plus assay: (I) for RIF-resistance detection, were 96.7% (83.3%, 99.4%), 97.5% (94.2%, 98.9%), 38.1 (16.0, 90.7), 0.034 (0.005, 0.235) and 1,113.6 (125.6, 9,873.5), respectively; (II) for INH-resistance detection, were 82.1% (64.4%, 92.1%), 91.9% (87.3%, 95.0%), 10.2 (6.2, 16.8), 0.194 (0.088, 0.43) and 52.3 (17.5, 156.2), respectively; (III) for multiple drug resistance (MDR) detection, were 92.9% (68.5%, 98.7%), 96.2% (92.8%, 98.0%), 24.7 (12.3, 49.5), 0.074 (0.011, 0.491) and 333.1 (38.7, 2,868.7), respectively. Conclusions: GenoType MTBDR plus assay is highly sensitive and specific for rapid diagnosis of MDR-TB in DM patients. The application of this assay could be considered for some settings. Further studies were needed to assess the role and value of GenoType MTBDR plus assay in treatment for MDR-TB with DM patients.

Interleukin (IL)-27 is a novel cytokine secreted by stimulation of antigen-presenting cells. No previous studies currently reported the role of IL-27 in the carcinogenesis of osteosarcoma. We aimed to investigate the association of IL-27 polymorphisms and serum IL-27p28 with osteosarcoma risk in a Chinese population. One hundred and sixty osteosarcoma patients and 250 health controls were selected. IL-27 gene -964 A/G, 2905 T/G, and 4730 T/C polymorphisms were determined by using polymerase chain reaction-restriction fragment length polymorphism. Enzyme-linked immunosorbent assay were used to detect serum IL-27p28 levels. The serum IL-27p28 levels were significantly lower in osteosarcoma patients compared with those in controls (P 0.05). Stratification analysis also failed to show the associations between -964 A/G, 2905 T/G, and 4730 T/C polymorphisms and the clinical stage and metastasis of osteosarcoma (P > 0.05). Three possible haplotypes (A-964T2905T4730, G-964T2905T4730, and G-964G2905C4730) were identified, but no associations were found between them and the osteosarcoma risk (P > 0.05). This study indicates that the lower serum IL-27p28 levels may be associated with development and progression of osteosarcoma, but IL-27 gene -964 A/G, 2905 T/G, and 4730 T/C polymorphisms and their haplotypes are not associated with osteosarcoma risk.

Based on unsteady Navier-Stokes equations, dynamic response in vertical gust flow perturbation is investigated for the aircraft. The grid velocity method was introduced to simulate the gust influence in time domain. First, after applying this method to simulate typical NACA0006 airfoil gust response to a step change in the angle of attack, it is shown that the calculated lift responses of the airfoil agree well with calculated value in reference. This example verified the accuracy of the time domain simulation method. Furthermore, gust responses for the One-Minus-Cosine gust profile and Sin gust profile are analyzed for the flying wing aircraft. It is found that the response of airfoil aerodynamic was obvious during traveling the gust. The research of variation of aerodynamic force under the action of gust response is important to the gust load alleviation and aircraft design.

Considering atoms entering an interaction region with limited length, then continuously running away, we show the features of the optical gain and atomic grating structure in the collective atomic recoil laser (CARL).

In this letter, a new polarization state generator (PSG) is presented, which can generate an output with arbitrary state of polarization(SOP). This PSG consists of a linear polarizer, a rotatable quarter-waveplate, and a rotatable half-waveplate. The PSG can be used to study the polarization-related effects on optical components and on optical fiber communication systems.

Based on the nonlinear theory, through changing the design parameters, the stability of model curve rigid frame bridges with long-span during cantilever construction was analyzed; The results show that the central angle of the curve dominated the stability coefficient; The nonlinear stability coefficient of bridge is 35% of eigenvalue flexure. Data was collected for a large number of long-span rigid frame bridge which have been built. Through comparison and classifying, the results indicate that the types of piers and its design parameters (the central angle of curve , slenderness ratio of piers, and the main pier types, the number of tie-girder) are related to the stability coefficient. The simple and creditable formulas can be taken as reference in designs. Introduction Long-span curve bridges with high piers are continuous rigid frames in general, which are built by the method of sub-segmental cantilever construction. During the construction stage, the Trigid frames suffer less constrain; their inter-force and deformation are very complex (He and Xiang, 2003). The gravity centers of each section of the curve's supper-structure are not in one line, so that the piers are under eccentric compression. Torque, rotation angle and lateral displacements of piers and beams were formed by gravity. These characteristics make major long-span curved bridge design and construction more complex than a straight bridge (Wang and He, 2005, 2006). In this paper, based on non-linear mechanics, through analysis the stability of long-span high-pier curved bridges, the relationship of stability and curved bridge design parameters was pointed out, which provided the basis for the large span continuous rigid frame bridge design, construction and monitoring. Methods of non-linear analysis To solve the non-1inear mechanics problems, the incremental method is usually used. The structure's critical loads are divided into several increments, each increment load corresponding to the deflection curve can be regarded as the linearity approximation. Such linear treatment can be quite accurate to the original non-linear course. When the structures bear a group of loads, we assume the loads grow in fixed proportion. The critical proportion determines the critical loads. We can determine the critical loads by the critical proportion. The concrete constitutive uses formula(1): c f k3 = σ 2 0 0 2 0 0 ) / ( ) / )( 2 ( 1 ) / )( 1 ( ) / (

In the procedure of computed radiography imaging, we should firstly get across the characters of kinds of noises and the relationship between the image signals and noises. Based on the specialties of computed radiography (CR) images and medical image processing, we have study the filtering methods for computed radiography images noises. On the base of analyzing computed radiography imaging system in detail, the author think that the major two noises are Gaussian white noise and Poisson noise. Then, the different relationship of between two kinds of noises and signal were studied completely. By considering both the characteristics of computed radiography images and the statistical features of wavelet transformed images, a multiscale image filtering algorithm, which based on two-state hidden markov model (HMM) and mixture Gaussian statistical model, has been used to decrease the Gaussian white noise in computed images. By using EM (Expectation Maximization) algorithm to estimate noise coefficients in each scale and obtain power spectrum matrix, then this carried through the syncretized two Filter that are IIR(infinite impulse response) Wiener Filter and HMM, according to scale size ,and achieve the experiments as well as the comparison with other denoising methods were presented at last.

The new design about a CW, digital all-solid-stated LD pumped Nd:YVO4 controller is introduced. The stable output power of this digital laser controller which adopts Digital Signal Processor (TMS320C31) is approximately 20mW. The whole system is composed of constant- current source, protection circuit, pulse-width modulation circuit, Si-photo-detector and amplified circuit and Digital Signal Processor control system, etc. In terms of error deviation Based on nonlinear control curves of LD power output by Si-photo-detector, the region control can be obtained by means of the PID control algorithm in the software platform, that is, error amendment and high stability laser power output can be achieved. And the precision of temperature control can reduce from ±0.2°C to ±0.04°C. By adopted integral separated mode PID control algorithm, the LD output power instability (σ%) down to ±2%. By way of adopting the new digital design, the work to protect the laser diode, including the continuous adjustable output power with high accuracy and stability, is easily obtained. The internal-external modulation control of the laser power based on digital optical feedback can be accomplished with stable power output. At last, the bringing reasons of noise are analyzed and the solving methods are put forward in this paper.

Background The interferon-gamma release assay (IGRA) is more specific than the tuberculin skin test to discriminate between tuberculosis (TB) and nontuberculous mycobacterial (NTM) diseases. Here we performed a retrospective study to evaluate the performance of the T-SPOT.TB in patients with NTM diseases. Methods Between March, 2013 and Nov, 2015, a total of 58 patients with NTM diseases had a T-SPOT.TB performed were enrolled, 30 patients had definite NTM diseases, 28 had probable diseases. Their clinicopathological characteristics were reviewed and analyzed. Cultures for mycobacteria were performed. The indirect proportion method with Löwenstein–Jensen (L-J) medium was used for first-line drug susceptibility test. T-SPOT.TB assay was performed according to the manufacturer’s instructions. Data were expressed as mean ± standard deviation (continuous variables) and as numbers and percentages (categorical variables). The χ 2 test was used for comparisons between proportions. Results The average age was 51.8 ± 16.1 years (range 10 to 77 years), 58.6% (34/58) were male. 16.4% (9/55) were TB-PCR positive. 34 (58.6%) isolates were Mycobacterium intracellulare, ten (17.2%) were Mycobacterium chelonae and seven (12.1%) were Mycobacterium fortuitum. Fifty-two (89.7%) patients were NTM lung disease, five (8.6%) were pleural disease, and one (1.7%) lymphadenitis. The total positivity of T-SPOT.TB was 53.4% (31/58) among the whole group (probable and definite). For probable cases, the T-SPOT.TB assay was positive in 53.5% (15/28); for definite cases, 16 (53.3%) of 30 definite cases were positive. There was no statistical difference in the positivity rate between them (P