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Myocardial work (MW) derived from the left ventricular pressure-strain loop is a novel and noninvasive method for assessing left ventricular function that accounts for loading conditions. We aimed to explore whether global MW combined with treadmill exercise stress could detect significant coronary artery disease (CAD) in patients with angina pectoris.Eighty-five patients with angina pectoris and no prior CAD history were included. All patients underwent treadmill exercise stress echocardiography and coronary angiography. Global MW was constructed from speckle-tracking echocardiography indexed to the brachial systolic blood pressure. The association between MW parameters and the presence of significant CAD was assessed with logistic regression. The discriminative power of MW parameters to detect CAD was assessed with receiver operative characteristic curve, net reclassification improvement, and integrated discrimination improvement analysis.Twenty-five patients had a positive exercise echocardiogram, while significant coronary artery stenosis (≥70% in one or more major epicardial vessels or ≥50% in the left main coronary artery) was observed in 41 patients. The global wasted work (GWW) and global work efficiency (GWE) were significantly higher or lower, respectively, in patients with significant CAD compared with those of nonsignificant CAD at the peak exercise and during recovery periods (P .05 for all). Multivariate logistic regression analysis demonstrated that peak GWE and recovery GWW could predict significant CAD. Peak GWE had the highest area under the receiver operating characteristic curve (AUC) among all global MW parameters (AUC = 0.836). Furthermore, a model comprising peak GWE and recovery GWW performed better for the identification of significant CAD than peak GWE alone (AUC = 0.856).Peak GWE could detect significant CAD. The new model, incorporating peak GWE and recovery GWW, not only identified but also provided additional value for estimating the probability of significant CAD. Global MW parameters combined with exercise stress perform as an accurate noninvasive screening before the invasive diagnostic technique.

Aim: There lacks a predictive model for overall survival (OS) of node-negative perihilar cholangiocarcinoma (PHC). This study aimed at developing and validating a prognostic nomogram to predict OS of node-negative PHC after resection. Methods: We established a nomogram via multivariate regression analysis by using the design cohort (n = 410, obtained from Surveillance, Epidemiology, and End Results database), and its external verification was done in the validation cohort (n = 100, the First Affiliated Hospital of Sun Yat-sen University). Predictive accuracy of the nomogram was assessed by concordance-index (C-index), calibration curves, and decision curve analysis (DCA). Performance of the nomogram was compared with the American Joint Committee on Cancer (AJCC) staging system. Results: Multivariate regression analysis revealed that age, tumor grade, and the count of examined lymph nodes were independent prognostic factors for OS of node-negative PHC. The nomogram had a C-index of 0.603 and 0.626 in design cohort and validation cohort, respectively, which was better than that of AJCC staging system (both p

Background:. Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial. The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect. We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients. Methods:. Medline, Embase, and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials (RCTs) and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival (OS) compared with general anesthesia. Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual (eighth edition), and the combined hazard ratio (HR) from random-effects models was used to evaluate the effect of regional anesthesia. Results:. A total of three RCTs and 34 cohort studies (including 64,691 patients) were identified through the literature search for inclusion in the analysis. The risk of bias was low in the RCTs and was moderate in the observational studies. The pooled HR for recurrence-free survival (RFS) or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined (RFS, HR = 1.12, 95% confidence interval [CI]: 0.58–2.18, P = 0.729, I2 = 76%; OS, HR = 0.86, 95% CI: 0.63–1.18, P = 0.345, I2 = 48%). Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence (HR = 0.87, 95% CI: 0.78–0.96, P = 0.008, I2 = 71%) and improve OS (HR = 0.88, 95% CI: 0.79–0.98, P = 0.022, I2 = 79%). Conclusions:. RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers. The selection of anesthetic methods should still be based on clinical evaluation, and changes to current practice need more support from large, well-powered, and well-designed studies.

Symmetry is an important property of human faces. Many researchers exploit symmetry to improve face recognition. In this paper, we explore the symmetry of faces under the framework of PCA (Principal Component Analysis). Unlike previous studies that manipulate facial symmetry by averaging the two halves, we argue that well-estimated symmetrical faces lie in a low-dimensional subspace. Inspired by this, a PCA-like model, referred to as Mirror PCA, is proposed to extract low-rank symmetrical features of faces, as well as their principal directions. Although the optimization problem is non-convex, a suboptimal solution could be found under existing optimization frameworks such as ADMM, PGD, etc. A number of experiments are conducted to verify the effectiveness and robustness of our method.

The coin-tap method performs nondestructive testing by measuring the width of the tapping response pulse on the surface of the material. Existing studies have shown that defects in the material will cause the width of the tapping response pulse to increase. However, experiments have confirmed that different detection positions in the defective area will show different values of the width of the tapping response pulse, and the physical laws behind it have not been studied yet. To discuss its physical meaning, a mathematical model of the defective area is established, a method for calculating the width of the tapping response pulse is proposed, and a composite honeycomb structure with preset defects is used for data testing. Both the test results and the calculation results show that the pulse width of the tapping response will decrease with the increase of the defect depth and the deviation of the tapping position from the defect center. The consistency between the calculated results and the experimental results shows that the established defect model and pulse width calculation method can better explain the distribution law of the pulse width of the tapping response in the defective area.

The tolerance of parts has an important impact on the quality of mechanical products. Optimizing the tolerance of parts can improve the quality and performance of mechanical products. For complex mechanical system, the number of parts is large, and the structure is extremely complex. It is inconvenient to use traditional method for tolerance modeling and analysis. In order to simplify the difficulty of modeling and analysis of complex mechanical system, the meta-action theory is introduced into the field of tolerance analysis. The structure of the mechanical system is decomposed into basic meta-actions by the “function-motion-action” (FMA) method. Then, taking the meta-action as the basic unit, the tolerance modeling and analysis are carried out. By ensuring the assembly accuracy of meta-action, the assembly accuracy and performance of the whole machine are ensured. The modular analysis of mechanical system is realized, and the difficulty and complexity of analysis are reduced. The manufacturing cost of products includes parts machining cost and assembly cost. In order to accurately evaluate the comprehensive manufacturing cost of products, the FMECA method is used to calculate the assembly difficulty coefficient, and the traditional cost-tolerance model is modified to obtain the comprehensive production cost model. Finally, the effectiveness of the proposed method is illustrated by an engineering example.

Background The study aimed at establishing a nodal staging score (NSS) to quantify the likelihood that pathologic node-negative gallbladder cancer (GBC) patients are indeed free of lymph node (LN) metastasis. Methods Clinicopathological data of 1374 GBC patients with T1b-T2 stages were collected from the Surveillance, Epidemiology and End Result database (design cohort [DC], n = 1289) and the First Affiliated Hospital of Sun Yat-sen University (validation cohort [VC], n = 85). NSS was derived from the count of examined LNs (ELNs) and T stage by using a beta-binomial model, and represented the probability that a node-negative patient is correctly staged. The prognostic value of NSS in node-negative GBC was evaluated by survival analysis. Results The probability of missing a nodal disease in node-negative GBC patients with T1b-T2 stages (pT1bN0 and pT2N0) decreased as the number of ELNs increased. NSS increased as the number of ELNs increased. For pT1bN0 and pT2N0 patients, examination of 5 and 27 lymph nodes could ensure an NSS of 90.0%, respectively. Multivariate analysis revealed that NSS was an independent predictor for overall survival in pT1bN0 and pT2N0 GBC patients (DC, HR:0.53, 95%CI: 0.42–0.66, p Conclusion NSS could evaluate the adequacy of nodal staging and predict the prognosis in pT1bN0 and pT2N0 GBC patients, and hence was helpful to guide their treatment strategies.

Ceramic aerogels, which present a unique combination of low thermal conductivity and excellent high-temperature stability, are attractive for thermal insulation under extreme conditions. However, most ceramic aerogels are constructed by oxide ceramic nanoparticles and thus are usually plagued by their brittleness and structural collapse at elevated temperatures (less than 1000 °C). Despite great progress achieved in this regard recently, it still remains a big challenge to design and fabricate intriguing ceramic aerogels with enhanced mechanical strength and remarkable thermal stability at ultrahigh temperature up to 1400 °C. To this end, we herein report a facile and scalable strategy to manufacture ceramic nanorod aerogels (CNRAs) with hierarchically macroporous and mesoporous structures by the controllable assembly of Al2O3 nanorods and SiO2 nanoparticles. Subsequently, the high-temperature annealing treatment of CNRAs significantly maximizes mechanical strength and promotes thermal tolerance. The obtained CNRAs demonstrate the integrated properties of super-strong heat resistance (up to 1400 °C), low thermal conductivity (0.026 W/m·K at 25 °C and 0.089 W/m·K at 1200 °C), high mechanical robustness (compressive strength 1.5 MPa), and low density (0.146 g/cm3). We envision that this novel nanorod-assembled ceramic aerogels offer considerable advantages than most of the state-of-the-art ceramic aerogels for thermal superinsulation upon exposure to extremely harsh environments.

Delayed gastric emptying (DGE) is the main complication after pancreaticoduodenectomy (PD), but the mechanism is still unclear. The aim of this study was to elucidate the role of complete resection of the gastric antrum in decreasing incidence and severity of DGE after PD.Sprague-Dawley rats were divided into three groups: expanded resection (ER group), complete resection (CR group), and incomplete resection (IR group) of the gastric antrum. The tension (g) of remnant stomach contraction was observed. We analyzed the histological morphology of the gastric wall by different excisional methods after distal gastrectomy. Moreover, patients underwent PD at our department between January 2012 and May 2016 were included in the study. These cases were divided into IR group and CR group of the gastric antrum, and the clinical data were retrospectively analyzed.The ex vivo remnant stomachs of CR group exhibited much greater contraction tension than others (P0.05). The contraction tension of the remnant stomach increased with increasing acetylcholine concentration, while remained stable at the concentration of 10 × 10The complete resection of the gastric antrum is associated with decreased incidence and severity of DGE after PD. Gastric electrophysiological and physiopathological disorders caused by damage to gastric smooth muscles might be the mechanism underlying DGE.

Motivated by the existing circuit model of quantum convolutional neural network, a new quantum convolutional neural network circuit model is devised, which is combined with quantum chaotic map to construct a symmetric cryptosystem. Quantum chaotic map produces key stream for encryption and decryption. The cryptosystem simulates the basic process of communication. Theoretical analysis manifests that the cryptosystem is effective. Additionally, simulation experiments based on MNIST data set show that the cryptosystem is secure. Furthermore, the proposed cryptosystem can be applied not only for image data, but for text data. Therefore, the grid data can be encrypted by utilizing the cryptosystem.

Rapid diagnostic tests as an attractive alternative to enzyme immunoassay could identify hepatitis C virus (HCV) infected persons more expeditiously. The availability of high performing and quality-assured rapid diagnostic tests are essential to scale-up HCV screening. The study was undertaken to evaluate the performance of seven domestic HCV rapid diagnostic tests kits. The kits were evaluated by using HCV serum panels, including HCV basic panel, analytical specificity panel, mixed titre performance panel, characteristic panel, seroconversion panel, and genotype qualification panel. The results showed that clinical sensitivity, clinical specificity and analytical specificity of seven rapid diagnostic tests kits ranged from 94% (95% CI: 83.2-98.6) to 100% (95% CI: 91.5-100). Furthermore, specimens with HCV genotypes 1b, 2a, 3a, 4a, 5a, 6 could be detected by HCV rapid diagnostic tests kits, whereas specimens with genotypes 1a and 2b could not be detected. Additionally, most HCV rapid diagnostic tests kits had great performance in diagnosing different titres and/or different bands samples, but some low S/CO value specimens may not be fully detected by few rapid diagnostic test kits. In conclusion, seven HCV rapid diagnostic tests reagents presented high sensitivity, specificity, good anti-interference and detection ability of early infection, which could meet the requirements of clinical HCV antibody screening.

Background: Non-small cell lung cancer (NSCLC) is one of the most leading cause of tumor related mortality worldwide. However, the prognosis of NSCLC remained to be poor and the mechanisms remained to be further investigated. Objective: This study aimed to evaluate whether GPRIN1 could be a potential biomarker for NSCLC. Methods: The Cancer Genome Atlas (TCGA, https://cancergenome.nih.gov/) and GEO database(http://www.ncbi.nlm.nih.gov/geo) were used to analyze the GPRIN1 expression between normal and human cancers. The protein-protein interaction among centromere proteins was determined using STRING database (http://www.bork.emblheidelberg.de/STRING/). GraphPad Prism 5.0 software was utilized for the independent and paired samples’ t-test or ANOVA to analyze the difference of GPRIN1 expression between two groups. Results: This study showed GPRIN1 was overexpressed and correlated to shorter OS time in human cancers. In NSCLC, we found that GPRIN1 was up-regulated in NSCLC samples compared to normal lung tissues by analyzing TCGA and GEO datasets. Bioinformatics analysis indicated that this gene was involved in regulating cancer proliferation and metabolism. Finally, we identified key targets of GPRIN1 in NSCLC by constructing PPl networks, including MCM3, KIF20A, UHRF1, BRCA1, KIF4A, HMMR, KIF18B, KIFC1, ASPM, and NCAPG2. Conclusion: These analyses showed GPRIN1 could act as a prognosis biomarker in patients with NSCLC.

Objective To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication. Methods A total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hedĭng (EX-LE2鹤顶), Neixīyan (内膝眼EX-LE4), Dubi (犊鼻ST35), Xuehai (血海SP10), Liangqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment. Results (1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P Conclusion The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.

There lacks an ideal model for accurately predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD). This study aimed at developing a nomogram with high accuracy in predicting CR-POPF after PD. A total of 1182 patients undergoing PD in the First Affiliated Hospital of Sun Yat-sen University (FAHSYSU, n = 762) and Fudan University Shanghai Cancer Center (FUSCC, n = 420) between January 2010 and May 2018 were enrolled. The patients from FAHSYSU were assigned as testing cohort, and those from FUSCC were used as external validation cohort. Univariate and multivariate logistic regression analyses were performed to determine the predictive factors for CR-POPF. Nomogram was developed on the basis of significant predictors. The performance of nomogram was evaluated by area under receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis. In testing cohort, 87 out of 762 patients developed CR-POPF. Three predictors were significantly associated with CR-POPF, including body mass index ≥24.0 kg/m2, pancreatic duct diameter

In order to effectively remove mercury from raw natural gas, a preparation method of columnar sulfur-impregnated activated petroleum coke was proposed and mercury adsorption experiments were conduc...

For cogeneration of heat and power in off-grid areas and suburbs, particularly under emergency conditions, a micro combined heat and power (μCHP) system based on a stove-powered thermoelectric generator (SPTEG) was designed and tested. A strategy, which interlinks heat collection, thermoelectric (TE) module wiring, electricity conditioning and storing, and temperature control, is proposed for the simultaneous augmentation of electric power to over 200 W and heating power to over 9.8 kW. Temperature distributions, power load features, battery charging curves, heat collection, power generation, TE efficiencies, and material cost analysis were explored and discussed in detail. Results revealed that the SPTEG based μCHP (SPTEG-μCHP) system is a potential solution for improving the living conditions in off-grid areas and suburbs, especially under emergency conditions. However, further works should be carried out to investigate the heat collection aspect.

Objectives: We performed this meta-analysis to assess the correlation of retinal vein occlusion (RVO) and chronic kidney disease (CKD). Methods: We searched PubMed, Embase, Web of Science and Cochrane Library for population-based studies reporting the CKD as associated factor to RVO, central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Then we pooled the data for analysis. Results: After screening potential literature, 12 eligible studies with 23,656,214 individuals were finally included in quantitative synthesis. The pooled prevalence (95% confidence interval [CI]) of CKD in RVO group was 10.9% (95% CI: 6.6%, 15.1%). The pooled prevalence of any RVO in end stage renal disease (ESRD) group was 1.8% (95% CI: 1.6%, 2.1%). The prevalence of CKD was significantly higher in subjects diagnosed with RVO than non-RVO participants (odds ratio [OR]: 3.30; 95% CI: 2.28, 4.76; p Conclusion: The prevalence of CKD increases in RVO patients, especially in CRVO. And in turn, the prevalence of RVO also increases in ESRD patients. The data support a correlation of RVO and CKD.

Well Zhongqiu 1 obtained highly productive oil-gas stream in the footwall of Zhongqiu structure, marking the strategic breakthrough of Qiulitag structural belt in the Tarim Basin. However, the oil and gas sources in Zhongqiu structural belt and the reservoir formation process in Zhongqiu 1 trap remain unclear, so study on these issues may provide important basis for the next step of oil and gas exploration and deployment in Qiulitage structural belt. In this study, a systematic correlation of oil and gas source in Well Zhongqiu 1 has been carried out. The oil in Well Zhongqiu 1 is derived from Triassic lacustrine mudstone, while the gas is a typical coal-derived gas and mainly from Jurassic coal measures. The oil charging in Well Zhongqiu 1 mainly took place during the sedimentary period from Jidike Formation to Kangcun Formation in Neogene, and the oil was mainly contributed by Triassic source rock; large-scale natural gas charging occurred in the sedimentary period of Kuqa Formation in Neogene, and the coal-derived gas generated in the late Jurassic caused large-scale gas invasion to the early Triassic crude oil reservoirs. The Zhongqiu 1 trap was formed earlier than or at the same period as the hydrocarbon generation and expulsion period of Triassic-Jurassic source rocks. Active faults provided paths for hydrocarbon migration. The source rocks-faults-traps matched well in time and space. Traps in the footwall of the Zhongqiu structural fault have similar reservoir-forming conditions with the Zhongqiu 1 trap, so they are favorable targets in the next step of exploration.

Since 2015, both the educational policymakers and practitioners in China passionately have sought to raise the educational quality, especially in Chinese rural schools. Series of significant and instructive reforms were designed to boost educational quality comes from China, where in 2015 the central government enacted an overwhelming educational policy to reform rural teacher development. China’s politics on reforming rural teacher development differ from similar reforms elsewhere in Asia countries due to the strong role of centralized top-down power representatives, various types of policy formation pathways and the final consulted settlement with the national and local teacher committees. This study also emphasizes the discussion on the complicated roles of distributive education politics and policy networks in contemporary Chinese education system.

Objective To explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease. Methods Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yīfēng (翳风 TE17) and Qiānzheng (牵正 EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House–Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side. Results After 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56±4.25, 34.13±4.28, and 7.46±1.53 respectively, significantly increased in comparing with 11.69±2.45, 12.98±3.34, and 2.62±1.41 respectively before treatment (all P Conclusion Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.

BackgroundCombined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare subtype of primary liver cancers. Its prognostic factors remain unclear. The study aimed to evaluate its long-term outcome and prognostic factors by retrospectively reviewing the series of cHCC-CC after curative resection from our institute.MethodsA total of 55 pathologically confirmed cHCC-CC patients undergoing curative resections between January 2003 and January 2018 at the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) were included. The clinicopathological and follow-up data were retrieved. Overall survival (OS) and recurrence-free survivals (RFS) were analysed by Kaplan–Meier curve. The independent prognostic factors were determined by using univariate and multivariate Cox analyses.ResultsThere were 41 males and 14 females, with a median age of 51.0 (interquartile range, 44.0–60.0) years. The 1-, 3-, and 5-year OS and RFS rates in cHCC-CC were 80.0%, 25.5%, and 16.4%, respectively, and 52.7%, 21.8%, and 10.9%, respectively. The median OS and RFS were 24.9 and 14.5 months, respectively. Univariate and multivariate analyses revealed that elevated alpha-fetal protein (AFP) and/or CA19-9, vascular invasion, local extra-hepatic invasion, and lymph-node metastasis (LNM) were independent unfavorable prognostic factors for OS and RFS (all P ConclusionsElevated AFP and/or CA19-9, vascular invasion, local extra-hepatic invasion, and LNM were independent unfavorable prognostic factors for long-term survival of cHCC-CC undergoing curative resections. Patients with normal levels of AFP and CA19-9 had better prognosis.

Excessive consumption of fossil fuels and its negative global effects have resulted in increasing interest in biomass energy. This paper presents an experimental study on biomass gasification react...

A computational hemodynamics method was employed to investigate how the morphotype and functional state of aortic valve would affect the characteristics of blood flow in aortas with pathological dilation, especially the intensity and distribution of flow turbulence. Two patient-specific aortas diagnosed to have pathological dilation of the ascending segment while differential aortic valve conditions (i.e., one with a stenotic and regurgitant RL bicuspid aortic valve (RL-BAV), whereas the other with a quasi-normal tricuspid aortic valve (TAV)) were studied. When building the computational models, in addition to in vivo data-based reconstruction of geometrical model and boundary condition setting, the large eddy simulation method was adopted to quantify potential flow turbulence in the aortas. Obtained results revealed the presence of complex flow patterns (denoted by time-varying changes in vortex structure), flow turbulence (indicated by high turbulent eddy viscosity (TEV)), and regional high wall shear stress (WSS) in the ascending segment of both aortas. Such hemodynamic characteristics were significantly augmented in the aorta with RL-BAV. For instance, the space-averaged TEV in late systole and the wall area exposed to high time-averaged WSS (judged by WSS> two times of the mean WSS in the entire aorta) in the ascending aortic segment were increased by 176% and 465%, respectively. Relatively, flow patterns in the descending aortic segment were less influenced by the aortic valve disease. These results indicate that aortic valve disease has profound impacts on flow characteristics in the ascending aorta, especially the distribution and degree of high WSS and flow turbulence.

BACKGROUND The accuracy of the current staging system for predicting the overall survival (OS) of patients with ampullary carcinoma (AC) is still unsatisfactory, especially in node-negative (N0) patients. We aimed at establishing a nomogram to accurately predict OS in N0 AC. METHODS This study enrolled 697 N0 AC patients from the Surveillance, Epidemiology, and End Results database (design cohort [DC], n = 697) and the First Affiliated Hospital of Sun Yat-sen University (validation cohort [VC], n = 112), who underwent surgical resection. The nomogram was established by using prognostic factors determined by univariate and multivariate regression analyses. RESULTS The nomogram for OS was developed by using four independent prognostic factors, including age, grade, T stage, and a number of examined lymph nodes. The C-index of a nomogram for OS in DC and VC was 0.665 and 0.731, respectively. Calibration curves showed good consistency of the nomogram. The nomogram had a better accuracy in predicting OS compared with conventional staging system (P

Objective: Renal fibrosis is the most common manifestation of chronic kidney disease (CKD). Noting that existing treatments of renal fibrosis only slow disease progression but do not cure it, there is an urgent need to identify novel therapies. Hydrogen sulfide(H2S) is a newly discovered endogenous small gas signaling molecule exerting a wide range of biologic actions in our body. This review illustrates recent experimental findings on the mechanisms underlying the therapeutic effects of H2S against renal fibrosis and highlights its potential in future clinical application. Data sources: Literature was collected from PubMed until February 2019, using the search terms including "Hydrogen sulfide," "Chronic kidney disease," "Renal interstitial fibrosis," "Kidney disease," "Inflammation factor," "Oxidative stress," "Epithelialto-mesenchymal transition," "H2S donor," "Hypertensive kidney dysfunction," "Myofibroblasts," "Vascular remodeling," "transforming growth factor (TGF)-beta/Smads signaling," and "Sulfate potassium channels." Study selection: Literature was mainly derived from English articles or articles that could be obtained with English abstracts. Article type was not limited. References were also identified from the bibliographies of identified articles and the authors’ files. Results: The experimental data confirmed that H2S is widely involved in various renal pathologies by suppressing inflammation and oxidative stress, inhibiting the activation of fibrosis-related cells and their cytokine expression, ameliorating vascular remodeling and high blood pressure, stimulating tubular cell regeneration, as well as reducing apoptosis, autophagy, and hypertrophy. Therefore, H2S represents an alternative or additional therapeutic approach for renal fibrosis. Conclusions: We postulate that H2S may delay the occurrence and progress of renal fibrosis, thus protecting renal function. Further experiments are required to explore the precise role of H2S in renal fibrosis and its application in clinical treatment. Key words: Hydrogen sulfide; Renal interstitial fibrosis; Chronic kidney disease

Depth segmentation has attracted much attention in fields ranging from industrial monitoring to image understanding. However, it remains difficult to segment objects positioned at different depths with high speed and high accuracy. This paper proposes a novel depth segmentation scheme based on the phase-shift invariance of the segmentation lines and a simple optimization framework that exploits simple image processing algorithms to enhance its performance in noisy environments. Without the need for precalibration or complementary cues, this approach performs depth segmentation effectively by changing the pattern sequence selectively during the step of postprocessing. First, the structural configuration and special properties of the phase-shifting algorithm are described, following which an optimization framework is established to allow data matting and labeling. Simulation and experimental results show that this approach can perform depth segmentation efficiently despite the influence of environmental noise. Moreover, the processing is of low cost, only needing to detect the intersections of discontinuities among three different wrapped phase maps. Most significantly, this method is robust to variations in environmental noise, camera exposure, and object color and texture.

Background Sarcoidosis is a multi-system, idiopathic, inflammatory disorder that affects the lungs in over 90% of patients. The incidence of bone lesions in sarcoidosis is only 1-13%. Case report This study describes a 60-year-old woman with a previous history of thyroid cancer, and a more recent diagnosis of lung cancer with suspicious metastatic lesions, which were confirmed to be sarcoidosis. Conclusion This case suggests that pulmonary neoplasms and pulmonary sarcoidosis can coexist and be easily confused. When lung cancer is accompanied by symmetric hilar lymph node enlargement and multiple lung nodules, sarcoidosis should be considered in addition to metastasis, and a biopsy should be performed for confirmation.

The risk factors of bronchiectasis in patients with chronic obstructive pulmonary disease have not yet been established. This systematic review and meta-analysis aimed to investigate and identify potential risk factors for patients with chronic obstructive pulmonary disease accompanied by bronchiectasis. We reviewed eight electronic journal databases from their inception to November 2019 for observational studies with no language restrictions. The Newcastle-Ottawa Scale was applied to evaluate the quality of the literature. Binary variables were pooled using odds ratios and continuous variables using the standardized mean difference with 95% confidence intervals. The confidence of evidence was assessed according to the grading of the recommendations assessment, development, and evaluation method. Eight case-control studies met the inclusion criteria. Tuberculosis history, smoking history, hospitalization stays, admissions in the past year, and duration of symptoms were considered risk factors. In addition, the ratio between the forced expiratory volume in 1s and forced vital capacity, the percentage of forced expiratory volume in 1s, the forced expiratory volume in 1s as a percentage of the predicted value, purulent sputum, purulent mucus sputum, positive sputum culture, Pseudomonas aeruginosa infection, arterial oxygen pressure, daily dyspnea, C-reactive protein, leukocytes, and the percentage of neutrophils were found to be closely related to bronchiectasis. However, these were not considered risk factors. The evidence of all outcomes was judged as ‘‘low’’ or ‘‘very low.’’ Additional prospective studies are required to elucidate the underlying risk factors and identify effective preventive interventions.

Natural gases in China are mainly coal-derived gas, with assistance from oil-typed gas. At present, many genetic identification methods, from hydrocarbon composition and isotope to light hydrocarbon and biomarker indexes, have been formed, but combined methods from non-hydrocarbon gases are lacking. Based on compositions and isotopes geochemical characteristics and the differences of non-hydrocarbon nitrogen gas in coal-derived gas and oil-typed gas, and combining the isotopic geochemical characteristics of non-hydrocarbon helium, the comprehensive identification methods of coal-derived gas and oil-typed gas for hydrocarbon gases according to the associated non-hydrocarbon gases of nitrogen and helium are established and the preliminary applications have been engaged. The main recognitions are as follows:1)Coal-derived gas generally has relatively lower nitrogen abundance, mainly distributed from 0 to 31.2% with main frequency from 0 to 2%. Oil-typed gas, on the other hand, usually has relatively higher nitrogen abundance, mainly distributed from 1.1 to 57.1% with main frequency from 2 to 16%. 2) Coal-derived gas generally has relatively heavier nitrogen isotope values, mainly distributed from -8 to 19.3‰ with main frequency from -8 to 8‰.Oil-typed gas usually has relatively lower nitrogen isotope values, mainly distributed from -10.6 to 4.6‰ with main frequency from -8 to 4‰.3)The geochemical characteristic differences of coal-derived gas and oil-typed gas are mainly due to the fact that the sapropel parent material is relatively rich in nitrogen element and rich in light δ14N, while the humic parent material is relatively poor in nitrogen element and rich in heavy δ15N. The differences on thermal maturity of source rocks, the redox conditions of source rock sedimentary environment, and the salinity of water body are also important effective factors.4)Differences on nitrogen abundances and isotopes in coal-derived gas and oil-typed gas have great significance in genetic identification. The genetic identification chart of R/Ra-δ15N for organic and inorganic nitrogen in natural gas and the comprehensive joint identification charts of R/Ra-δ15N-N2 of nitrogen and helium for coal-derived gas and oil-typed gas have been established, and are of great reference in investigating the origins and sources of natural gas and guiding natural gas exploration in China.

Aiming at the lightweight requirements for high-orbit satellite harness, this paper analyzes the key factors affecting the harness weight and puts forward two lightweight design schemes. One is for the signal transmission cable, which accounts for about 70% of the total mass of the whole satellite harness, using lightweight conductor AWG28 wires instead of AWG26 wires in a high-orbit satellite, and design the special assembly process. After optimization, the whole satellite harness weight is reduced 9.92kg. Another is using the domestic C55/x3 series, which is a lightweight insulated material aerospace wire, and designing the installation and protective measures for high-orbit satellite harness. Application results show that the whole satellite harness weight is reduced 6.21kg than before. The two lightweight design schemes presented in this paper are feasible and effective on the premise of ensuring technical performance, reliability and security design.

Purpose. A specific and efficacious method for treatment of pneumonia-derived sepsis is lacking. Chengqi decoction has been used for treatment of pneumonia-derived sepsis, but a clinical trial on patients with pneumonia-derived sepsis is lacking, a gap in the literature that we sought to fill. Patients and Methods. 282 patients with pneumonia-derived sepsis admitted to the intensive care unit of our hospital were selected. They were divided into the treatment group (141 cases) and control group (141 cases). Both groups underwent conventional treatment, but Chengqi decoction (in the form of enema) was given to the treatment group. Mortality, morbidity (abdominal distension and gastrointestinal bleeding), duration of antibiotic use, and use of vasoactive agents were documented 28 days after the drug was used. Results. The treatment group reduced mortality and morbidity (abdominal distension) ( P < 0.05 ). After adjustment for significant covariates, 28-day survival was similar for the whole group (hazard ratio (HR): 0.48; 95% confidence interval (CI): 0.23–0.97; P = 0.037 ), for the subgroup (n = 120) with Acute Physiology and Chronic Health Evaluation II score ≥25 (HR: 0.180; 95% CI: 0.032–0.332; P = 0.039 ) and for the subgroup (n = 66) with N-terminal B-type natriuretic peptide

Methamphetamine (METH) is a major psychostimulant drug of abuse worldwide, and its neurotoxicity has been studied extensively. In addition to neurotoxicity, METH can also induce hepatotoxicity. The underlying mechanism of intestinal microorganisms in METH-induced hepatotoxicity remains unclear. In this study, mice have received antibiotics intragastrically or PBS once each day for 1 week, followed by METH or saline. The antibiotics attenuated METH-induced hepatotoxicity as evidenced by histopathological observation and biochemical analysis; furthermore, they alleviated METH-induced oxidative stress. The effect of antibiotics on METH-induced hepatotoxicity was investigated using RNA-sequencing (RNA-seq). The RNA-seq results demonstrated that antibiotics could regulate 580 differentially expressed genes (DEGs), of which 319 were upregulated after METH treatment and then downregulated with antibiotic pretreatment and 237 were first downregulated after METH administration and then upregulated after antibiotic pretreatment, in addition to 11 upregulated and 13 downregulated ones simultaneously in METH and antibiotic-pretreated groups. RNA-seq analyses revealed that TLR4 is one of the hub genes. Western blot analysis indicated that antibiotics inhibited the increase of TLR4, MyD88 and Traf6 induced by METH. This research suggests that antibiotics may play an important role in preventing METH-induced liver injury by regulating oxidative stress and TLR4/MyD88/Traf6 axis, though further investigation is required.

Background This study aims to investigate the clinical significance and prognostic value of mucinous component (MC) in colorectal adenocarcinoma (AC). Methods Patients with colorectal AC and AC with MC (ACMC) (1–100%) underwent surgical resection between January 2007 and February 2018 were retrospectively reviewed. Propensity score matching (PSM) was performed according to a 1:1 ratio. Receiver-operating characteristic (ROC) curve was used to identify the optimal cut-off value of MC ratio for prognostic prediction. The clinicopathological features and 3-year overall survival (OS) of AC patients, mucinous adenocarcinoma (MAC) (MC > 50%) patients, and ACMC (1–50%) patients were compared before and after matching. Multivariable analysis was used for analyzing independent risk factors related to prognosis. Results A total of 532 patients were enrolled in this study. Patients with AC, MAC, and ACMC (1–50%) exhibited different clinicopathological features. However, their 3-year OS rates were similar (82.00% vs. 74.11% vs. 81.48%, P = 0.38). After matching, ROC curve determined 70% as the optimal cut-off value. And patients with ACMC > 70% had a much poorer 3-year OS compared with ACMC (1–70%) patients and AC patients (47.37% vs. 86.15% vs. 79.76%, P 70% was revealed as a risk factor for poor survival in univariate analysis (HR = 1.643, 95%CI = 1.025–2.635, P = 0.039), though not an independent risk factor in multivariable analysis (HR = 1.550, 95%CI = 0.958–2.507, P = 0.074). Conclusions MAC is usually diagnosed at an advanced stage. MAC has a similar survival with AC and ACMC (1–50%) patients before and after matching. Patients with ACMC > 70% exhibited a much poorer OS, and should be given more clinical attention.

Abuse of methamphetamine (METH), an illicit psychostimulant, is a growing public health issue. METH abuse during pregnancy is on the rise due to its stimulant, anorectic, and hallucinogenic properties. METH can lead to multiple organ toxicity in adults, including neurotoxicity, cardiovascular toxicity, and hepatotoxicity. It can also cross the placental barrier and have long-lasting effects on the fetus. This review summarizes neurotoxicity, cardiovascular toxicity, hepatotoxicity, toxicity in other organs, and biomonitoring of prenatal METH exposure, as well as the possible emergence of sensitization associated with METH. We proposed the importance of gut microbiota in studying prenatal METH exposure. There is rising evidence of the adverse effects of METH exposure during pregnancy, which are of significant concern.

Neuropathic pain (NeuP) is an important clinical problem accompanying negative mood symptoms. Neuroinflammation in the amygdala is critically involved in NeuP, and the dopamine (DA) system acts as an important endogenous anti-inflammatory pathway. Electroacupuncture (EA) can improve the clinical outcomes in NeuP, but the underlying mechanisms have not been fully elucidated. This study was designed to assess the effectiveness of EA on pain and pain-related depressive-like and anxiety-like behaviors and explore the role of the DA system in the effects of EA. Male Sprague-Dawley rats were subjected to the chronic constrictive injury (CCI) model to induce NeuP. EA treatment was carried out for 30 min once every other day for 3 weeks. The results showed that CCI caused mechanical hyperalgesia and depressive and anxiety-like behaviors in rats and neuroinflammation in the amygdala, such as an increased protein level of TNFα and IL-1β and activation of astrocytes. EA treatment significantly improved mechanical allodynia and the emotional dysfunction induced by CCI. The effects of EA were accompanied by markedly decreased expression of TNFα, IL-1β, and glial fibrillary acid protein (GFAP) in the amygdala. Moreover, EA treatment reversed CCI-induced down-regulation of DA concentration, tyrosine hydroxylase (TH) expression, and DRD1 and DRD2 receptors. These results suggest that EA-ameliorated NeuP may possibly be associated with the DA system to inhibit the neuroinflammation in the amygdala.

In the provincial electricity-heat integrated energy system with combined heat and power (CHP) as the coupling point in northern China, the configuration of heat storage tank (HST) in CHP plants for power-heat decoupling is an effective way to release operation flexibility of CHP units and improve the renewable energy accommodation capacity of the system. In order to give full play to the function of HST, this paper analyzes the mechanism of HST’s heat supply reserve transforming to unit’s generating reserve and establishes the corresponding model. In order to adapt to the day-to-day volatility and uncertainty of wind power, a heuristic day-time coordinated operation strategy is proposed. The HST stores heat as much as possible in the period of no power curtailment of renewable energy generation and releases heat according to the demand during the period of power curtailment of renewable energy generation. And an economic dispatch model of the electricity-heat integrated energy system is established considering the reserve benefits of the HST under the proposed operation strategy. Case studies are carried out based on actual grid data to verify the effectiveness of the proposed model and the benefits in saving fuel, accommodating renewable energy generation, and saving capacity.

In recent years, optic-fiber sensors have been required to simultaneously measure the structure's crack and environmental temperature in the infrastructure monitoring system. We proposed and experimentally demonstrated a distributed optic-fiber sensor based on the Raman loop configuration and fiber loss characteristic for detecting the temperature and structure's crack. Among them, the Raman loop configuration with reference fiber is proposed to detect the temperature profile along the sensing fiber. It can eliminate the influence of external physical perturbation on the temperature measurement results, and do not require pre-calibration process before measurement. The temperature experimental results show that the temperature accuracy and spatial resolution can reach up to 0.28 °C and 1.2 m with the response time of 1.04 s. In addition, the information of crack is extracted by using the loss characteristics of Stokes, which is based on optical time domain reflectometry. The experiment results indicate that the fiber loss coefficient keeps a good linear variation between the crack ranges of 1.6 mm and 5.6 mm. The studies achieve the temperature and crack measurement only by one fiber.

Background: The protective role of green tea against cancer is still unknown.Objectives: To investigate the association between green tea consumption and esophageal cancer risk through meta-analysi...

Objective. In this randomized, nonblinded, controlled study, the feasibility and precision of “targeted percutaneous vertebroplasty” (“targeted PVP”) for osteoporotic vertebral compression fracture (OVCF) was evaluated. Methods. A total of 42 patients, aged 50 to 87 years, with OVCF were randomly divided into 2 groups: A and B. Group A underwent “targeted PVP,” and group B underwent traditional PVP with the guidance of C-arm fluoroscopy. Fluoroscopy times for skin puncture points (FTSPP), total radiation doses (TRD), total fluoroscopy times (TFT), and operation time were set as the main evaluation indicators. Results. FTSPP (1.52 ± 0.51 in group A vs 6.62 ± 2.58 in group B, U < .001), TRD (6.26 ± 1.51 in group A vs 11.32 ± 4.21 in group B, P < .001), TFT (16.57 ± 2.79 in group A vs 26.05 ± 6.18 in group B, P < .001), and operation time (20.05 ± 3.38 in group A vs 25.43 ±5.11 in group B, U < .001) were statistically different in the 2 groups. The incidence of cement leakage that occurred in group A (1/21, 4.76%) was significantly less than that in group B (9/21, 42.9%, P < 0.05). Conclusions. “Targeted PVP” may achieve (1) less skin positioning fluoroscopy times, less total fluoroscopy times and dose, shorter operation time, which is more precise than traditional PVP; (2) less incidence of cement leakage; and (3) visualization of the fractured vertebra, which is probably more valuable for the treatment of complicated OVCF patients.

This study examines the association of sleep quality with job burnout among Chinese coal mine staff. 3832 subjects were selected from a coal mine group located in Shanxi Province in China. Job burnout was evaluated by the Maslach Burnout Inventory-General Survey and sleep quality was acquired with a self-reported questionnaire. We used the inverse probability of treatment weighting with propensity score to mimic the randomization and to minimize bias in estimations. Sensitivity analysis was conducted to test the robustness of our findings. We identified that good sleep quality was significantly associated with lower risk of job burnout (OR: 0.70; 95%CI, 0.60 to 0.82, p = 6.02e-06), with 0.21 decrease in the score of exhaustion (95%CI,−0.29 to −0.12, p = 5.00e-06), and with 0.13 decrease in the score of cynicism (95%CI,−0.21 to −0.04, p = 3.73e-03). Sensitivity analysis demonstrated that the results were robust to the choice of estimation models, as well as unmeasured confounding. Stratification analysis demonstrated that the associations of sleep quality with job burnout were largely heterogeneous for male and female workers. This study implicated that good sleep quality benefits the workers in relief of job burnout. Further research may be warranted in support of a definite causal relationship and intervention strategy.

Utility tunnel is one of the important infrastructures for the planning and building of smart city. It is of great significance to improve the efficiency of maintenance and overhaul of urban pipelines. Based on the disadvantages of the design of utility tunnel pipelines and the properties of traditional Wireless Sensors Network (WSN) protocols, the remote hybrid clustering routing protocol (RHCRP) was proposed. This protocol improved the nodes layout and cluster head (CH) election to adapt to the pipeline requirements. By comparing with traditional WSNs (low-energy adaptive clustering hierarchy algorithm (LEACH) and stable election protocol (SEP), etc.), RHCRP effectively prolonged the WSN lifetime by 50% compared with LEACH. RHCRP also to increase the cluster head quantities by 110.8% to LEACH and 57.6% to SEP, respectively. The proposed method is promising in utility tunnel WSN applications.

A novel three-dimensional ball-flower-like g-C3N4/NiO (GN) photocatalyst was firstly fabricated by a simple two-step calcination method for enhanced degradation capability. Our investigation focuses on the construction of p–n heterojunction and specific ball-flower-like structure to overcome limitations of single-component semiconductors, such as low surface area, poor light response and fast recombination of the photogenerated electrons and holes. Detailed photocatalytic experiments revealed that the novel ball-flower-like GN (50%) exhibited much higher activity for the removal of TC and Cr6+ than single g-C3N4, NiO and traditional layered GN. The trapping experiments proved that the superoxide radicals ( $$ ^{ \cdot } {\text{O}}_{2}^{ - } $$ ), holes (h+) and electrons (e−)were the main active species in the photodegradation process. Moreover, three different degradation pathways and fourteen intermediate products of TC were also determined by the LC/MS analysis and these intermediates could be further degraded completely into CO2, H2O, $$ {\text{NH}}_{4}^{ + } $$ , carboxylic acids and any other inorganic intermediates. These results will benefit the fabrication of other 3D p–n heterojunction photocatalysts and their potential application in treatment of organic pollutants.