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Objective To explore the effect of age at diagnosis as a continuous variable on survival and treatment choice of patients with early-stage endometrial carcinoma (EC). Materials and methods We retrospectively analyzed data from patients with early-stage EC from January 1999 to December 2015 in multiple institutions in China. All patients received primary hysterectomy/bilateral salpingo-oophorectomy and adjuvant radiotherapy for EC confirmed pathology of stage I and II disease (FIGO 2009 staging). All patients were divided into low-risk, intermediate-risk, high-intermediate-risk and high-risk groups according to ESMO-ESGO-ESTRO risk classification. Results The median follow-up time was 57months, and the 5-year cancer-specific survival (CSS) was 95.7%. Age as a continuous variable was an independent prognostic factor for CSS. With an increase in age, the hazard ratio (HR) for CSS increases gradually. Other independent prognostic factors included myometrial invasion (MI), grade, and chemotherapy. In the stratified analysis of age, the HRs of age on CSS in patients >70y were 5.516, 5.015, 4.469, 4.618, 5.334, and 5.821 after adjusting for cancer characteristics, local treatment, chemotherapy and treatment-related late toxicity. In patients 66-70-year-old, the HRs were 2.509, 2.074, 2.101, 2.091, 2.157 and 1.621 after adjusting for the above covariates. In patients ≤65y, there was no significant difference in the HR of age on CSS after adjustment. Conclusion Age as a continuous variable is an independent prognostic factor and 65 year-old may be the best cut-off point for CSS in patients with early-stage EC in the Asian population. Quality of life should be given greater weight in the choice of therapeutic schedule for those patients >70 y.

A hard X-ray pinhole camera system has been recently built at the HL-2A tokamak to measure the evolution of space-time distribution of fast electrons in the energy range of 20 to 200 keV. The camer...

The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine125 seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.

Study question Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology? Summary answer Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate. What is known already Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood. Study design, size, duration A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer. Participants/materials, setting, methods Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables. Main results and the role of chance A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P Limitations, reasons for caution Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed. Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious. Trial registration number n/a

An unusual communication between the lingual and mylohyoid nerves has been identified as one reason for incomplete mandibular anaesthesia, and for neuropathy. However, its anatomical features and function are poorly understood and its relations with neighbouring structures, which are valuable in reducing the side effects of surgical operations, have not been sufficiently described. The aim of this study, therefore, was to describe the communication between the nerves and to assess the implications for oral and maxillofacial surgery. We explored the communication between the mylohyoid nerves of 62 embalmed, and 16 fresh, hemifaces. The diameter, length of the communication, and other variables were measured, and the junctions with the two nerves microdissected. The nervous communications of fresh specimens and relative nerves were stained histochemically for acetylcholinesterase. Of the 62 embalmed specimens, 19 had a communication that pierced the mylohyoid muscle, and staining showed that this was a sensory nerve. Our results suggest that the sensory communication between the lingual and mylohyoid nerves pierces the mylohyoid muscle and connects these otherwise unrelated nerves, thereby contributing to the likelihood of operative side effects.

Background For stage I to II high-risk endometrioid adenocarcinoma patients, the optimal adjuvant radiotherapy modality remains controversial. The present study sought to optimize the treatment of pelvic external beam radiation (EBRT) with/or vaginal brachytherapy (VBT) for high-risk endometrioid adenocarcinoma patients in multiple radiation oncology centers across China. Methods This article retrospectively reviewed stage I to II patients with resected endometrioid adenocarcinoma treated at 13 radiation centers from 1999 to 2015. Patients were eligible if they had high-risk features (stage IB Grade 3 disease or stage II Grade 1–3 disease) on the basis of ESMO-ESGO-ESTRO risk group consensus. Results A total of 218 patients were included. Fifty-one patients received EBRT, 25 patients received VBT, and 142 patients were administered EBRT combined with VBT. The three groups were comparable in baseline characteristics, except the proportion of stage IB and Grade 3 disease in the VBT group was significantly higher and their age was older. Survival analysis showed that OS, DFS, LRFS and DMFS were significantly different among the three groups. Two out of three groups were compared with each other, and results demonstrated that DFS, LRFS and DMFS were worse in the VBT group than in the EBRT or EBRT + VBT group. The 3-year OS rates were 95.2, 85.2 and 95.1% in the EBRT, VBT and EBRT + VBT groups, respectively (p = 0.043). There was no significant difference in survival outcomes between EBRT group and EBRT + VBT group. A propensity matching analysis was performed to eliminate group differences. The results demonstrated that DFS and LRFS were significantly improved in the pelvic radiation group compared to the VBT group. Distant failure accounted for most of the failure patterns. Patients in the VBT group had significantly increased local and regional recurrence rates than patients in the EBRT or EBRT + VBT group. Acute and chronic radiation-induced toxicities were well tolerated for all patients. Conclusion For patients with postoperative stage I to II high-risk endometrioid adenocarcinoma, compared with VBT alone, radiotherapy modalities including EBRT significantly improved DFS, LRFS and DMFS with tolerable adverse effects. Overall survival was not significantly different between EBRT and EBRT + VBT modalities.

Purpose/Objective(s) For stage I to II high-risk endometrioid adenocarcinoma patients, the optimal adjuvant radiotherapy modality remains controversial. The present study sought to optimize the treatment of pelvic external beam radiation (EBRT) with/or vaginal brachytherapy (VBT) for high-risk endometrioid adenocarcinoma patients in multiple radiation oncology centers across China. Materials/Methods This article retrospectively reviewed stage I to II resected endometrioid adenocarcinoma patients treated at 13 radiation centers from Jan. 1999 to Dec. 2015. Patients were eligible if they had high-risk features (stage IB Grade 3 disease or stage II Grade 1-3 disease) on the basis of ESMO-ESGO-ESTRO risk group consensus. Results A total of 218 patients were included in the analysis. Lymphadenectomy was achieved in 87.2% of all patients. Fifty-one patients received adjuvant EBRT (EBRT group), 25 patients received VBT (VBT group), and 142 patients were administered EBRT combined with VBT (EBRT + VBT group). The three groups were comparable in baseline characteristics, except that the proportion of stage IBand Grade 3 disease in the VBT group was significantly higher and their age was older (P Conclusion For patients with postoperative stage I to II high-risk endometrioid adenocarcinoma, compared with VBT alone, pelvic radiation significantly improved DFS, LRFS and DMFS with tolerable adverse effects. Survival outcomes were not significantly different between the EBRT and EBRT + VBT modalities. Author Disclosure W. Wang: None. L. Zou: None. T. Wang: None. Z. Liu: None. J. He: None. X. Sun: None. W. Zhong: None. F. Zhao: None. X. Li: None. S. Li: None. H. Zhu: None. Z. Ma: None. S. Sun: None. M. Jin: None. F. Zhang: None. X. Hou: None. L. Wei: None. K. Hu: None.

Aims To compare the cost-effectiveness of stereotactic ablative body radiation therapy (SABR) with radiofrequency ablation and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC). Materials and methods Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life and costs were obtained from published sources and the SABR Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio with respect to quality-adjusted life-years. The robustness of the results was examined in a sensitivity analysis. Analyses were conducted from a National Health Service and Personal Social Services perspective. Results In the base case analysis, which assumed that all three interventions were associated with the same cancer progression rates and mortality rates, SABR was the most cost-effective intervention for both patient cohorts. This conclusion was sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20 000 per quality-adjusted life-year, the probability that SABR is cost-effective was 57% and 50% in liver oligometastases and HCC, respectively. Conclusions Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and radiofrequency ablation.

Purpose/Objective(s) The aim of this study was to analyze survival outcomes and patterns of recurrence over time according to the radiotherapy mode in different risk groups and to provide reference for further optimization of treatment choices Materials/Methods 1,298 stage I or Ⅱ EC patients receiving adjuvant radiotherapy from 13 centers in China were included between January 2000 to January 2017. The enrolled patients were categorized as low-risk (LR), intermediate-risk (IR), high-intermediate-risk (HIR) and high-risk groups (HR) according to ESMO-ESGO-ESTRO classification, while the radiotherapy modality consisted of the external beam radiotherapy (EBRT)and vaginal brachytherapy (VBT)alone. The key outcome of interest was the overall survival and time-dependent recurrence patterns. Disease-free interval (DFI) events were defined as time to first site recurrences, classifying as vaginal, regional (including intra-pelvic sites, or regional lymph nodes such as para-aortic lymph nodes) and distance metastasis. Competing risks regression analysis were applied to compare the time-to the first recurrence patterns according to the risk groups and radiotherapy modality. And hazard curves describe the change of failure rate over time. Results The median follow-up of 51 months. The 10-year overall survival rates of LR, IR, HIR, and HR were 90 %,85%,84% and 83%, respectively (P = 0.018). In all, 91 of 1,298 patients developed recurrences including 8 vaginal relapses, 17 regional recurrences and 66 distant metastases. And the 5-year disease-free survival rates were 96%, 92.8%, 89% and 85% for the four risk groups, respectively (P 0.1). For the subgroup analysis, the patients received EBRT in the HIR and HR group had higher 10-year rate of distant metastasis than the VBT alone (Gray's test, P = 0.004). And the EBRT group had a tendency of lower incidence of locoregional recurrence (1.66% vs 3.54% for VBT, Gray's test, P = 0.105). Conclusion This study demonstrated the differential susceptibility to distant metastasis based on the risk classification and radiotherapy modality. Defining different patterns of EC recurrence over time in details can improve EC care through surveillance guidelines and can guide the design of clinical studies. Author Disclosure K. Ren: None. L. Zou: None. T. Wang: None. X. Li: None. H. Zhu: None. S. Sun: None. M. Jin: None. F. Zhang: None. X. Hou: None. L. Wei: None. K. Hu: None.

PURPOSE/OBJECTIVE(S) To explore the effect of age at diagnosis as a continuous variable on survival and treatment choice of patients with early-stage endometrial carcinoma (EC). MATERIALS/METHODS We retrospectively analyzed data from patients with early-stage EC from January 1999 to December 2015 in multiple institutions in China. All patients received primary hysterectomy/bilateral salpingo-oophorectomy and adjuvant radiotherapy for EC confirmed pathology of stage I and II disease (FIGO 2009 staging). All patients were divided into low-risk, intermediate-risk, high-intermediate-risk and high-risk groups according to ESMO-ESGO-ESTRO risk classification. This retrospective study was approved by the Ethics Review Committee of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences [Protocol number S-K139]. The clinical trial ID of the study is ChiCTR-PRC-17010712. Evaluation of all data met the requirements of the Helsinki Declaration. RESULTS The median follow-up time was 57months, and the 5-year cancer-specific survival (CSS) was 95.7%. Age as a continuous variable was an independent prognostic factor for CSS. With an increase in age, the hazard ratio (HR) for CSS increases gradually. Other independent prognostic factors included myometrial invasion (MI), grade, and chemotherapy. In the stratified analysis of age, the HRs of age on CSS in patients >70y were 5.516, 5.015, 4.469, 4.618, 5.334, and 5.821 after adjusting for cancer characteristics, local treatment, chemotherapy and treatment-related late toxicity. In patients 66-70-year-old, the HRs were 2.509, 2.074, 2.101, 2.091, 2.157 and 1.621 after adjusting for the above covariates. In patients ≤65y, there was no significant difference in the HR of age on CSS after adjustment. CONCLUSION Age as a continuous variable is an independent prognostic factor and 65 year-old may be the best cut-off point for CSS in patients with early-stage EC in the Asian population. Adjuvant radiotherapy can reduce the HR of age on CSS for patients >65 years. AUTHOR DISCLOSURE S. Sun: None. L. Zou: None. T. Wang: None. Z. Liu: None. J. He: None. X. Sun: None. W. Zhong: None. F. Zhao: None. X. Li: None. S. Li: None. H. Zhu: None. Z. Ma: None. W. Wang: None. J. Meng: None. F. Zhang: None. X. Hou: None. L. Wei: None. K. Hu: None.

Purpose This study was conducted to describe the imaging features of intracranial psammomatous meningioma (IPM). Materials and methods Twenty-three patients with a histopathological diagnosis of IPM between January 2007 and August 2016 were retrospectively reviewed. Twenty-two patients underwent contrast-enhanced MRI scanning, and 16 underwent non-enhanced CT. Results A total of 23 adult patients (3 men, 20 women; mean age, 55.3 ± 7.0 years) with 30 IPMs, including 3 patients with multiple IPMs, were recruited. Twenty tumours (66.7%) were located at the cerebral convexity. The mean size of the lesions was 2.42 ± 0.92 cm (range, 1.2–4.8 cm). All tumours had a regular shape. On CT scans, 13 masses (13/22) were totally replaced with calcifications, and calcifications were observed in 21 cases (21/22) with higher density. There were 22 cases (22/30) of IPMs presenting adjacent hyperostosis, while 8 cases (8/30) presented no skull changes that were not close to the skull. Nearly half of the cases (14/29) showed mixed hypo- and hyperintensity on T2-weighted images and DWI. PTBE was present in 8 tumours and absent in the other 22, among which only 4 tumours were accompanied by severe oedema. Conclusions These radiological findings may facilitate correct diagnosis for IPMs and thus presurgical planning, prognosis evaluation and treatment of meningiomas.

In this study, the clinical outcomes of horizontal ridge augmentation using half-columnar bone grafts from the ramus (group I: 27 patients, 32 implants) versus rectangular bone grafts from the symphysis (group II: 19 patients, 27 implants) were compared; grafts were combined with organic bovine bone and collagen membrane. Cone beam computed tomography images were obtained preoperatively, immediately after restoration (baseline), and 1 year after loading. Four months after grafting, horizontal bone resorption at the alveolar crest did not differ significantly between the two groups (P = 0.291). At 4 mm apical to the alveolar crest, horizontal bone resorption in group I was significantly less than that in group II (P = 0.041). One year after loading, horizontal bone resorption in group I was lower than that in group II, with no significant difference. The residual thickness of the labial bone at the implant site in group I was significantly higher than that in group II. Horizontal ridge augmentation with either a half-columnar autogenous graft from the ramus or a rectangular autogenous graft from the symphysis can provide acceptable results in aesthetic regions. The half-columnar group demonstrated better graft stability both at 4 months after augmentation and 1 year after loading.

A room temperature ethanol sensor based on Au-modified zinc oxide microwires (Au/ZnO MWs) is demonstrated. Au nanoparticles (Au NPs) were immobilized via ion sputtering onto the surface of CVD-fabricated ZnO microwires (ZnO MWs) to serve as sensitizers. Au modification was characterized by scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, and photoluminescence. Gas-sensing tests indicated that the modified microwires exhibited an enhanced performance relative to the unmodified ZnO microwires over a wide gas concentration range, with very stable repeatability, fast recovery time and high sensing response and selectivity. A sensing mechanism is described in terms of localized surface plasmon resonance (LSPR) effect of Au NPs. The superior sensing characteristics indicate the device's potential applications as room-temperature gas sensor, and a straightforward and economical fabrication also makes it very attractive for more widespread use.

Shenshan sub-bituminous coal has been extracted with water at 200°C and 2 MPa. The resulting soluble mixture was separated into a deposit and a water-soluble fraction. The gas chromatography/mass spectrometry detectable species in both the deposit and the water-soluble fraction can be classified into linear molecules and cyclic molecules using the scaffold tree approach. The linear molecules consist of alkanes, acids, alkenes, alkanols, esters, ketones, aldehydes, ethers, nitrogen-containing organic compounds, and sulfur-containing organic compounds. The chemical structures of the cyclic molecules are more complicated and provide insight into the carbon skeleton structures and bridging linkages of the soluble molecules.

Exercise is considered a protective factor in the prevention of type 2 diabetes, although its role as a sole treatment for pre-diabetes remains unknown. The present meta-analysis compared the effect of exercise-only with exercise-diet interventions on plasma glucose levels among a pre-diabetic population.A literature search was conducted using PubMed, EMBASE and Cochrane databases. The Cochrane Collaboration tool was used to assess the quality of each trial. Two reviewers independently performed quality assessment of all included articles. A random effects model was used to calculate the pooled effect.A total of 4021 participants from 12 studies were included in this meta-analysis, 2045 of them were in the intervention group and 1976 were in the control group. Compared with the exercise-only interventions, the exercise-diet interventions showed a significant effect on decreasing fasting plasma glucose (FPG) levels, with a weighted mean difference (WMD) =-0.22 mmol/l, 95% confidence interval (CI): -0.25, -0.18 (Z=12.06, P0.05). The subgroup effect of exercise-only interventions did not produce a statistically significant result (WMD=-0.09 mmol/l, 95% CI: -0.18, 0.00, Z=1.91, P0.05). According to the intervention periods, the pooled effect in the ⩾2-year group was the highest, and its WMD (95% CI) was -0.24 mmol/l (-0.43,-0.05). The pooled effects were statistically significant among the elderly and those of American and European descent, with WMD (95% CI) being -0.19 mmol/l (95% CI: -0.22, -0.15), -0.17 mmol/l (-0.21,-0.12) and -0.22 mmol/l (-0.27, -0.17), respectively.Evidence from published trials indicates that exercise-diet interventions showed a significant effect on decreasing FPG levels.

Objective: Due to the weak ascending aorta, it is extremely challenging to establish an anterograde selective cerebral perfusion (ASCP) model in rabbits, especially when cardioplegic arrest is required. Herein, the aim of this study was to establish a rabbit ASCP model with cardiac arrest being easily performed and being similar to the clinical scenario. Materials and methods: Twenty-two adult New Zealand white rabbits were selected for ASCP model establishment and another 22 rabbits were utilized for blood donation. The cardiopulmonary bypass (CPB) circuit consisted of a roller pump, a membrane oxygenator, a heat-cooler system and a blood reservoir, which were connected by silicone tubing. The total priming volume of the circuit was 70 ml. Cannulations on the right and left subclavian arteries were used for arterial inflow and cardioplegia perfusion, respectively. Venous drainage was conducted through the right atrial appendage. ASCP was initiated by clamping the innominate artery; the flow rate was maintained 10 ml/kg/minute and sustained for 60 minutes. After 120 minutes of reperfusion, the rabbits were sacrificed. The mean arterial pressure, heart rate, electrocardiogram and urine output were monitored. Arterial blood samples were analyzed at the following time points: after anesthesia, immediately after CPB, after aorta cross-clamping and cardioplegia perfusion, 5 min after the re-opening of the aorta and at CPB termination. Results: ASCP modeling was performed successfully on 18 rabbits and 4 rabbits unsuccessfully. Vital signs and blood gas indictors changed in an acceptable range throughout the experiments. One rabbit had ventricular fibrillation after re-opening of the ascending aorta. Obvious hemodilution occurred after the perfusion of cardioplegia, but the hematocrit improved after CPB termination. Conclusion: By using cannulation of the subclavian artery rather than the aorta and with a low priming volume, we established a modified rabbit model of ASCP with cardioplegic arrest. The model has excellent repeatability and operability, which is similar to the clinic process and is suitable for the study of cerebral, cardiac and renal protection.

AIM The aim of this study was to explain the effects of miRNA-145 in the pathogenesis of preeclampsia. METHODS Collecting the placental tissue of 40 severe preeclampsia patients and 20 normal pregnant women, and observation of the pathological findings by HE staining. Measuring the miR-145 by RT-PCR. EVCT were divided into NC group; MC group and miRNA group. The EVCT cells of MC and miRNA groups were simulated by hypoxia in vivo by CoCl2. Measuring the proliferation rate of different groups by MTT testing. The cells apoptosis rates were measured by flow cytometry; evaluating PI3K, Akt, mTOR and P53 gene and protein expression of three groups by RT-PCR and WB. RESULTS Compared to the normal pregnant placental tissue. The miR-145 expression of preeclampsia pregnant placental tissue was significantly decreased (p < 0.05). In the cell experiments, the proliferation rate was significantly increased, and the cell apoptosis rate was significantly reduced in MC group compared to the MC group (p

As a desmoplastic reaction, tissue fibrosis played crucial roles in solid tumor progression, chemo-resistance, and consequently heralded poor clinical outcome. Previous studies implied the effects of marrow fibrosis on prognosis for acute lymphoblastic leukemia were disputable. In this study, we aimed to investigate the potential role of bone marrow fibrosis on clinical survival in acute myeloid leukemia (AML) patients. Bone marrow fibrosis (evaluated as reticulin fiber density, RFD) in bone marrow sections was evaluated at diagnosis via computer technology. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of RFD for relapse and survival status. Kaplan–Meier method was used to estimate survival rates per subgroup between patients with different RFD. Cox proportional hazard regression was used to model the overall survival. High RFD at diagnosis in bone marrow sections from primary AML might predict early relapse and shorter survival (P = 0.003 and 0.001, respectively). The optimal cutoff value of RFD at diagnosis was determined to be 7.2%. Furthermore, the Kaplan–Meier analysis indicated that patients with high marrow RFD had shorter relapse-free survival (RFS) and overall survival (OS) than patients with low RFD (P = 0.007 and 0.000, respectively). Multivariate analysis suggested that similar with cytogenetics, marrow RFD at diagnosis was an independent prognostic factor for RFS [HR 0.564, 95% confidence interval (CI) 0.338–0.940, P = 0.028] and OS (HR 0.457, 95% CI 0.225–0.929, P = 0.031) in primary AML patients. Our data suggest that marrow RFD before treatment should be seemed as prognostic factor in primary AML, it may provide valuable clues for developing new targeted therapy.

The efficacy and safety of sublingual immunotherapy (SLIT) in house dust mite-induced allergic asthma (AA) have yet to be firmly established, especially in adult patients. Our objective is to evaluate the efficacy of SLIT with Dermatophagoides farinae drops in adult patients with AA. One hundred and thirty-four adult patient data with house dust mite (HDM)-induced AA who had been treated for 2 years were collected. These patient data that we collected were divided into the SLIT group (n = 85) and control group (n = 49). All patients were treated with low to moderate dose of inhaled glucocorticoid and long-acting β2 agonists. Patients in the SLIT group were further treated with D. farinae drops. Clinical scores including the total asthma symptom score (TASS), total asthma medicine score (TAMS), asthma control test (ACT), and peak flow percentage (PEF%) were assessed before treatment and at yearly visits. The presence of adverse events (AEs) were recorded once a month. Before treatment, the PEF% in the SLIT group was significantly lower than that in the control group (p

The classical Weissinger’s L-method is generalized to the lifting problem for steadily advancing curved wings subject to the wing-in-ground (WIG) effect above a large body of water in subsonic flow, and the free surface defines the boundary between the air and water. Unlike the traditional analysis of the lifting problem, the essential techniques focus on finding the three-dimensional free surface Green’s function generated by the isolated horseshoe vortex in the upper layer of the stratified fluid where the air is regarded as weakly compressible and the water is incompressible. The numerical calculation is implemented using Weissinger’s L-method. Finally, the effects of the curved geometry on WIG effect in the vicinity of a free surface in subsonic flow are discussed. Extensive numerical examples are carried out to show the lift properties for three-dimensional swept and dihedral wings operating in the vicinity of a free surface as a function of the sweep or dihedral angle for different clearance-to-chord ratios and Mach numbers. Interestingly, for high Froude numbers, the free surface effectively becomes rigid, and it can safely be treated as a solid surface.

The current study focuses on establishing a theoretical lifting surface model for predicting the hydrodynamic loads acting on the three-dimensional hydrofoil with winglets, which is considerably influenced by the proximity to the free surface through finding the three-dimensional Green’s function for the planar and vertical horseshoe vortices operating below a free surface. The hydrofoil surface is decomposed into a finite number of elements along the span direction and the chord directions, each of which can then be represented by a horseshoe vortex. The linearized free surface boundary condition is applied to analyze the influence of the free surface on the hydrofoil as well as the winglets. The thickness problem is considered using the source distribution among the hydrofoil and winglets surfaces and the analytical Green’s function that satisfies the linearized free surface boundary condition is used. As a sample application, numerical examples were conducted to show the performance of the hydrodynamic characteristics for the hydrofoil with winglets as a function of the Froude number. It was concluded that there are significant efficiency benefits from using winglets inside the free surface proximity effect. These results are substantiated by the comparison with the available published data.

The paper presents three-dimensional numerical studies on the aerodynamic characteristics of two different modified NACA0012 airfoils with different wavy surfaces using the large eddy simulations. Two types of wavy airfoils are investigated with wavy airfoil-A having a sinusoidal waviness on upper and lower surfaces with a constant chord length, while wavy airfoil-B having sinusoidal variation in both of the leading and trailing edges as well as on the upper and lower surfaces along the spanwise direction. The force characteristics and the flow structures are captured and compared with a corresponding standard NACA0012 airfoil with a Reynolds number of Re=1.6×10 5 . The flow structures and surface pressure distributions on wavy airfoils were found to be significantly different from those on a conventional NACA0012 airfoil. For angles of attack less than the baseline stall angle of a NACA0012 airfoil, a slight decrease of lift coefficient was observed for both types of wavy airfoils, while the lift coefficient for the wavy airfoil-B increases up to 20% greater than that of a NACA0012 airfoil when the angle of attack is larger than the baseline stall angle of 13°. The flow over the leading edge of wavy airfoil-B remained attached at post stall angles of attack. In general, the wavy airfoil-A just exhibits a suppression the airfoil’s fluctuation force, while the wavy airfoil-B demonstrates an advantageous aerodynamic effect on the control of loss of lift in the post stall regime of a conventional NACA0012 airfoil.

With the advancement of ultrasonic technology in recent years, sonography has become a common medical diagnostic tool, as it has elevated output sonic intensity and elongated exposure time. This study investigates the effect of ultrasound on human chorionic villus cell apoptosis during early pregnancy. Transvaginal ultrasound was performed for a total of 60 women who had undergone induced abortion at our hospital. They were randomly divided into the control, short ultrasound (10 min), and long ultrasound (20 min) groups (N = 20 each). Twenty-four hours after ultrasonic exposure, chorionic villus tissues were extracted during induced abortion, and were tested for cell apoptosis using flow cytometry. Bax and B cell lymphoma-2 (Bcl-2) protein levels were also quantified by immunohistochemistry. We found that the long ultrasound group had significantly higher cell apoptosis rates compared to the short ultrasound group, which in turn had higher rates compared to the control group (P < 0.05 in both cases). Bax protein levels were elevated in both the long and short ultrasound groups (P < 0.05). Bcl-2 proteins in two ultrasound groups, however, were downregulated as compared to those in the control group (P < 0.05). It is therefore possible that transvaginal sonography can potentiate the apoptosis of human chorionic villus cells by increasing the Bax/Bcl-2 protein ratio.

Previous studies examining the association between interleukin-6 (IL-6) -174G/C polymorphism and psoriasis risk have produced inconsistent results. The aim of this study was to offer a comprehensive review of the association between IL-6 -174G/C polymorphism and psoriasis risk through a meta-analysis. Literature search of PubMed and Embase databases was conducted to identify all eligible studies published before October 29, 2015. Four case-control studies involving 651 psoriasis cases and 552 controls were included in this meta-analysis. Data were extracted, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the associations. Combined analysis revealed a significant association between this polymorphism and psoriasis risk under the recessive model (OR = 1.69, 95%CI = 1.12-2.55, P = 0.013 for GG vs GC + CC), and the heterozygous comparison model (OR = 1.70, 95%CI = 1.29-2.23, P < 0.001 for GG vs GC). However, no significant association was observed under the allelic model (OR = 1.37, 95%CI = 0.99-1.89, P = 0.060 for G vs C), the dominant model (OR = 1.25, 95%CI = 0.92-1.71, P = 0.152 for GG + GC vs CC), and the homozygote comparison model (OR = 1.62, 95%CI = 0.79-3.32, P = 0.186 for GG vs CC). We conclude that the IL-6 -174G/C polymorphism contributes to psoriasis risk. However, further studies should be performed to validate our results.

Unmanned Aerial Vehicles (UAVs) have been widely used to acquire high quality terrain images of the areas of interest, particularly when such a task could potentially risk human life or even impossible as the areas cannot be accessed easily by surveyors. Once the images have been obtained, traditional photogrammetric processing process can be used to establish a relative orientation model and then, absolute orientation model with the procedures of space resection and intersection. In many such applications, the geo- referenced images which are stitched together to represent the geospatial relationships for the feature objects are sufficient. A fast or near real-time processing approach for UAV images using GPS/INS data has being investigated for years. One beneficial application of such approach is the capability of quick production of geo-referenced images for various engineering or business activities, such as urban and road planning, the site selection of factories and bridges, etc. In this paper, we have proposed a new fast processing approach for the UAV images collected with an integrated GPS/INS/Vision system. The approach features that the corresponding points between images have been determined, and then coordinate transformation is carried out to implement image stitching. The accuracy of corresponding points normally affects the quality of stitched images, but the results of our experiments revealed that the image stitching errors were obvious even the accuracy of corresponding points was high. The stitching errors could be caused by the changes of surface elevation.

BACKGROUND This study was designed to investigate the effect of a novel surgical method on cardia sphincter function and complication rates after Heller's cardiomyotomy for patients with achalasia. METHODS Forty-eight patients (19 males, mean age 34.0 +/- 10.5 years, range, 12-58) were included in this study. A spindle diaphragm valve was used in the surgery to rebuild the cardiac sphincter function. The efficacy of the surgery was determined by clinical assessment of symptoms and lower esophageal sphincter pressure (LESP) measurements. Barium meal examination was also used to evaluate the efficacy. RESULTS The mean LESP before surgery was 41.3 +/- 11.6 mmHg. It was reduced to 16.8 +/- 3.7 mmHg and 17.5 +/- 2.5 mmHg 3 and 12 months after surgery (P < 0.01). All patients were free of symptoms such as swallow difficulties or acid reflux during the follow up. However, barium swallow examination showed that 1 patient had mild reflux after the surgery. Clinical symptom scores on swallow difficulties/obstruction was reduced from 2.5 +/- 0.65 before surgery to 0.06 +/- 0.24 12 months after the surgery (P < 0.01). CONCLUSION A spindle diaphragm valve used with Heller's cardiomyotomy was associated with a very low incidence of post-surgical complications, such as gastroesophageal reflux. This technique may be used in treating all patients with achalasia.

The turbulent flows around two fixed unyawed and yawed wavy cylinders in tandem arrangement at a subcritical Reynolds number of 3900 were studied using three-dimensional large eddy simulation. A range of spacing (L) between the cylinders from 1.5Dm to 5.5Dm with yaw angles of α=0°, 30° were investigated so as to identify the effects of cylinder spacing ratio and yaw angle as well as the coupling effects of the two wavy cylinders in tandem. The instantaneous near wake flow patterns around the cylinders were captured. Flows around circular cylinders with the same configurations were also obtained for comparison. The effects of the vortex shedding from the upstream cylinder on the fluid-dynamic forces acting on the downstream one were examined. Results show that vortex shedding behind the upstream wavy cylinder occurs at a further downstream position compared with that of the circular upstream cylinder. This leads to the weakening of the effect of bodies' vibration of the cylinders as well as an evident reduction of drag. With a yaw angle of 30°, the vortex formation lengths behind both the upstream and downstream cylinders decrease, typically for the wavy cylinders configuration. However, the effects of drag reduction and the control of bodies' vibration still exist except for the spacing ratio of L/Dm=3.5, which is in the critical spacing ratio regime for two wavy cylinders in tandem.

We carried out a urinary metabolomic study to gain insight into low estimated GFR (eGFR) in patients with non-proteinuric type 2 diabetes.Patients were identified as being non-proteinuric using multiple urinalyses. Cases (n = 44) with low eGFR and controls (n = 46) had eGFR values60 and ≥60 ml min(-1) 1.73 m(-2), respectively, as calculated using the Modification of Diet in Renal Disease formula. Urine samples were analysed by liquid chromatography/mass spectrometry (LC/MS) and GC/MS. False discovery rates were used to adjust for multiple hypotheses testing, and selection of metabolites that best predicted low eGFR status was achieved using least absolute shrinkage and selection operator logistic regression.Eleven GC/MS metabolites were strongly associated with low eGFR after correction for multiple hypotheses testing (smallest adjusted p value = 2.62 × 10(-14), largest adjusted p value = 3.84 × 10(-2)). In regression analysis, octanol, oxalic acid, phosphoric acid, benzamide, creatinine, 3,5-dimethoxymandelic amide and N-acetylglutamine were selected as the best subset for prediction and allowed excellent classification of low eGFR (AUC = 0.996). In LC/MS, 19 metabolites remained significant after multiple hypotheses testing had been taken into account (smallest adjusted p value = 2.04 × 10(-4), largest adjusted p value = 4.48 × 10(-2)), and several metabolites showed stronger evidence of association relative to the uraemic toxin, indoxyl sulphate (adjusted p value = 3.03 × 10(-2)). The potential effect of confounding on the association between metabolites was excluded.Our study has yielded substantial new insight into low eGFR and provided a collection of potential urinary biomarkers for its detection.

The principal objective of this investigation is to facilitate minimum variance distortionless response (MVDR) beamforming technique for a cylindrical conformal array geometry. An array of directional radiating elements is postulated to cover a surface typical of the cylinder of an aircraft or missile. Borrowing the analysis of conformal array antennas, the authors first derive a deterministic expression that describes the beam pattern of arbitrary weighted cylindrical conformal array. Then, making use of the MVDR beamforming, we derive the beamformer for uniform linear array (ULA) of directional antennas which are different from the traditional omnidirectional elements. Thus, the pattern of a directional element is synthesized by the antennas on the same ring array, and we design the MVDR beamformer, which uses MVDR beamforming for ULA of the synthesized pattern. To demonstrate the validity of the method, and cylinder arrays are constructed and experimental results agree well with theoretical expectations.

We previously reported better psychomotor development at 30 months of age in infants whose mothers received a docosahexaenoic acid (DHA) (22:6n-3) supplement for the first 4 months of lactation. We now assess neuropsychological and visual function of the same children at 5 years of age.Breastfeeding women were assigned to receive identical capsules containing either a high-DHA algal oil (∼200 mg/d of DHA) or a vegetable oil (containing no DHA) from delivery until 4 months postpartum. Primary outcome variables at 5 years of age were measures of gross and fine motor function, perceptual/visual-motor function, attention, executive function, verbal skills, and visual function of the recipient children at 5 years of age.There were no differences in visual function as assessed by the Bailey-Lovie acuity chart, transient visual evoked potential or sweep visual evoked potential testing between children whose mothers received DHA versus placebo. Children whose mothers received DHA versus placebo performed significantly better on the Sustained Attention Subscale of the Leiter International Performance Scale (46.5 ± 8.9 vs 41.9 ± 9.3, P.008) but there were no statistically significant differences between groups on other neuropsychological domains.Five-year-old children whose mothers received modest DHA supplementation versus placebo for the first 4 months of breastfeeding performed better on a test of sustained attention. This, along with the previously reported better performance of the children of DHA-supplemented mothers on a test of psychomotor development at 30 months of age, suggests that DHA intake during early infancy confers long-term benefits on specific aspects of neurodevelopment.

A method of generating 1.57 μm pulse-series eye-safe laser based on optical parametric oscillator (OPO) was developed. The 1.57 μm pulse-series OPO was pumped by a Q-switched Nd:YAG laser with a variable reflectivity unstable resonator. Every pulse-series includes three micro-pulses, and the pulse repetition rates, pulse numbers and pulse intervals were adjustable. The maximum output energy of the 3-micro-pulse-series was 274 mJ. The optical-optical efficiency of the OPO was about 40%.

Proposed herein is a new vibration-reduction technique for multi-adjacent-building systems subjected to earthquake excitations. Based on a three-building model, three different connecting methods are presented for reducing the seismic response of the multi-building system. After the equation of motion is derived, a numerical example is employed to demonstrate the seismic performances of the controlled systems. The vibration-reduction mechanism, the vibration-reduction effect, and the influential parameters are also studied. Numerical results show that the method of coupling adjacent structures is a viable and attractive vibration-reduction strategy for seismically excited structures.

This paper presents the results of an investigation on the effects of wavy cylindrical tubes in a staggered heat exchanger tube bundle. Experimental measurements and large eddy simulation (LES) technique were used to study the turbulent flow characteristics in a staggered tube bundle arrangement at a sub-critical Reynolds number of Re = 7500. The aim of this investigation is to compare the flow characteristics of a new configuration of cylindrical tubes with that of a similar arrangement which comprises purely circular cylinders. The first row of circular tubes is replaced by a row of wavy cylindrical tubes. The result of the experiment shows that the mean velocity distributions and turbulence intensity, obtained by the present LES method, are in good agreement with the Laser Doppler Anemometer (LDA) measurements. The wake patterns around the second row of cylinders become more well organized upon the introduction of wavy cylinders of optimal wavelength ( λ/D m = 6). The turbulent kinetic energy behind the first row of tubes is also reduced. The power density spectra of the vortex shedding in the tube bundle are evidently suppressed. As a result, the fluctuating forces of the tube bundles are weakened. However, the drag is not noticeably reduced by such modification.

The 2D cellular automata (CA) random model is applied to occupant evacuation considering the influence of human psychology and behavior. Thereby, we put forward some new viewpoints on the performance-based design of building exits: the exit width must be bigger than a certain critical value to ensure a dilute state of evacuation; the optimal value of the exit separation f is independent of the exit width d, but is related to the total width of the building D: f≈0.3D; a symmetrical layout of the exits should be applied; Bad random factors will occur and lead to a prolonged and fluctuated evacuation time when the value of f is too small.

The cross-flow around four cylinders in an in-line square configuration with the spacing ratio (L/D) 1.5, 2.5, 3.5 and 5.0 have been investigated experimentally using Laser Doppler Anemometer (LDA) and Digital Particle Image Velocimetry (DPIV). The experiments were carried out in a closed-loop wind tunnel with Reynolds number 1.128× 104 to 1.982× 104. Mean velocity distributions are obtained by LDA. The full field instantaneous and averaged velocity and vorticity components are measured by DPIV The present experimental study indicated that several distinct flow patterns exist. Distinct vortex shedding of the upstream cylinders was suppressed forL/D < 3.5 atRe=1.128× 104. The flow patterns are affected by the spacing ratio andRe. In order to capture the details of the 3-D vortices structures and obtain all the instantaneous physical information, 3-D numerical simulations of the cross-flow around the four cylinders in an in-line square configuration with the spacing ratio 1.5 and 3.5, andRe=1.50× 104 are carried out using large eddy simulation (LES). The numerical results are in good agreement with the experimental results. These results provided full field instantaneous information of the flow structures, velocity field and vorticity field of cross-flow around the four cylinders in an in-line square configuration.

We report on the development, installation, and operation of the first three of seven stations deployed at the ARIANNA site’s pilot Hexagonal Radio Array (HRA) in Antarctica. The primary goal of the ARIANNA project is to observe ultrahigh energy ( $ > 100~\hbox{PeV}$ ) cosmogenic neutrino signatures using a large array of autonomous stations, each 1 km apart on the surface of the Ross Ice Shelf. Sensing radio emissions of 100 MHz to 1 GHz, each station in the array contains RF antennas, amplifiers, 1.92 G-sample/s, 850 MHz bandwidth signal acquisition circuitry, pattern-matching trigger capabilities, an embedded CPU, 32 GB of solid-state data storage, and long-distance wireless and satellite communications. Power is provided by the sun and buffered in LiFePO ${}_4$ storage batteries, and each station consumes an average of 7 W of power. Operation on solar power has resulted in $ \geq$ 58% per calendar-year live-time. The station’s pattern-trigger capabilities reduce the trigger rates to a few milli-Hertz with 4-sigma voltage thresholds while retaining good stability and high efficiency for neutrino signals. The timing resolution of the station has been found to be 0.049 ns, RMS, and the angular precision of event reconstructions of signals bounced off of the sea–ice interface of the Ross Ice Shelf ranged from 0.14 to 0.17 $^\circ $ .

The initial results from continuing long-term monitoring of a 67 km of an aerial fiber optic cable installed on a 500 kV power line cable (total fiber length of 134km) using BOTDA are presented. The effects of thunderstorms and rime ice on the cable were identified by monitoring strain on OPGW fibers. Variations of strain between day and night on the OPGW cable were observed and can potentially be exploited.