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Objective: To compare the clinical outcomes of patients with active immunoglobulin G (IgG) 4 related disease (IgG4-RD) receiving tocilizumab versus those receiving cyclophosphamide (CYC). Methods: This IgG4-RD registry study was a prospective cohort study conducted among patients with active IgG4-RD hospitalized at Zhongshan Hospital, Fudan University. Patients who were treated with tocilizumab or CYC along with glucocorticoids (GCs) were enrolled. All participants were followed up at the hospital clinic at 3 and 6 months after discharge. Primary clinical outcomes were measured via the IgG4-RD responder index (RI), complete response (CR), and partial response (PR), as well as side effects. Results: From January 2015 to June 2020, 29 patients enrolled. Fourteen and 15 patients were treated with tocilizumab and CYC, respectively. At the 6-month follow-up, disease activity parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IgG4, and IgG4-RD RI, decreased significantly in both groups. At 6 months, tocilizumab demonstrated its superiority, with 50% of patients achieving CR in the Tocilizumab group versus 20% in the CYC group. However, no statistical significance was identified ( p = 0.128). The GC dosage at 6 months was significantly lower in the tocilizumab group than in the CYC group [10 (9.4–15) mg/d versus 15 (15–15) mg/d, p = 0.025]. In the CYC group, two patients experienced lumbar vertebral compression fractures related to GCs. Other patients in both groups showed mild adverse effects. Conclusions: Tocilizumab could be a better steroid-sparing agent, with a comparable curative effect and tolerance, than CYC, in the treatment of IgG4-RD.

Critical limb ischemia (CLI), an end-stage manifestation of peripheral artery disease (PAD), still lacks effective therapeutic strategies. Recently, dental pulp-derived mesenchymal stem cells (DP-MSCs) have been attracting more and more attentions in therapeutic applications due to their high proliferation ability, powerful osteogenic differentiation potential, and effective anti-inflammatory effects. In this study, we compared the therapeutic effects of MSCs derived from different sources in a femoral artery-ligated preclinical ischemic model. We found that treatments with MSCs, including bone marrow- (BM-), adipose- (AD-), dental pulp- (DP-), and umbilical cord- (UC-) derived MSCs, improved limb functions, reduced inflammatory responses, increased angiogenesis, and promoted regeneration of muscle fiber. Among them, DP-MSCs and BM-MSCs produced much more impressive effects in restoring limb functions and promoting angiogenesis. The flow velocity restored to nearly 20% of the normal level at 3 weeks after treatments with DP-MSCs and BM-MSCs, and obvious capillary proliferation and collateral development could be observed. Although neovascularization was induced in the ischemic limb after ligation, MSCs, especially DP-MSCs, significantly enhanced the angiogenesis. In vitro experiments showed that serum deprivation improved the expression of angiogenic factors, growth factors, and chemokines in DP-MSCs and UC-MSCs, but not in BM-MSCs and AD-MSCs. However, DP-MSCs produced stronger therapeutic responses than UC-MSCs, which might be due to the higher expression of hepatocyte growth factor (HGF) and hypoxia-inducible factor-1 α (HIF-1α). We speculated that DP-MSCs might stimulate angiogenesis and promote tissue repair via expressing and secreting angiogenic factors, growth factors, and chemokines, especially HGF and HIF-1α. In conclusion, DP-MSCs might be a promising approach for treating CLI.

Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort.This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression.Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol3.55 mmol/L, low-density lipoprotein2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD.High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points • High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. • Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease.

This paper present the industrial case study on quality improvement of the post reflow cleaning process in an assembly industry. Ceramic carrier boards are widely used in industrial fields due to their good thermal conductivity, strength and insulation. In order to reduce the terminal volume, flexible plates are also widely used. For the high quality industry application, a number of manufacturing related issues needed to be addressed. Of all Potential defects, the PCBA pollution is most critical defect which will affect the long term reliability. The ceramic board and FPC was assembly with Sn96.5Ag3Cu0.5 solder paste an orthogonal experimental design was conducted to understand the relationship among the washing temperature, washing solution and the cleanness level. From the experiment we got the optimal post-reflow process conditions for achieving highest quality cleaning status, which meet the requirements of IPC standard.

Under the duplex framework of the rapid transformation of the conventional power grid to the energy Internet and the swift development of network attack technologies, the security and protection of the energy Internet are becoming increasingly precarious. The energy Internet attack prediction method has become a current research hotspot. The current research in this area is predominantly focused on security to protect and reduce losses, it is impossible to counter the attacks faced by the Energy Internet promptly, and there is a lack of online predictive security analysis methods and tools. Aiming at the shortcomings of traditional research and the current stage, this paper proposes an online prediction and analysis method of energy Internet security situation based on the combination of temporal convolutional neural network (TCN) and gated recurrent neural network (LSTM). This method which based on the security status data set can predict and analyse the region Energy Internet security, and the mean absolute error and mean squared error are 0.352 and 0.2714 respectively. The results show that the prediction performance of the algorithm has been improved, the stability is robust, and it can be applied to the energy Internet security situation prediction.

In recent years, the Ministry of Education of China attaches great importance to the reform of higher education quality. As an important link in the reform of higher education, curriculum development is bound to promote the development of "quality-centered connotative education". Zhejiang University, Changchun University of Science and Technology, Southern Airlines University and other colleges and universities carried out a full range of close cooperation, proposed integrated innovation teaching mode of the course based on network technology. Based on this model, the course of "Applied Optics" has been practiced for two years. The results show that the integrated innovation teaching mode can fully realize the integration amplification effect among multiple colleges and universities and the depth sharing all types of resources. Based on the principle of co-building and sharing, mutual help, comprehensively improve the teaching quality of domestic related courses and promote the comprehensive development of the curriculum to meet the needs of learning society.

We describe the case of a patient with Budd–Chiari syndrome who presented with an unusual membranous obstruction of the inferior vena cava complicated by massive portal vein thrombosis (PVT). The patient underwent percutaneous transluminal balloon angioplasty through the right groin and was prescribed oral warfarin for 6 months. Treatment resulted in the complete disappearance of the PVT. This therapeutic strategy should be considered in the management of other cases of this rare, complex disease.

Issues related to Wireless Sensor Networks (WSNs) are inseparable part of concerns in Big Data, due to they can provide a large amount of real-time data to the processing units. A service-oriented wireless sensor network aims to manage the procedure for data-provision by considering the term "service" as a user-specified requirement. In another words, it provides a user-friendly interface for various users with a unified middleware for different types of nodes to access all services smoothly. In the low level framework, one of the major problems is how to automatically select minimum number of nodes, with high data accuracy, to access desired services in the environment. Scholars provide different solutions by magnifying some specific aspects of WSNs. Intelligent Water Drops Algorithm is a new population-based optimization approach under the inspiration of water drops following in rivers which can make optimal or near optimal paths to the lakes or seas. In this paper, IWD algorithm is improved to solve node-selection problem by considering each water drop as an agent which is responsible to find the minimum number of sensor nodes with high data accuracy. Then based on the information from all of the Intelligent Water Drops, a decision function can choose the best solution. Experimental results prove the effectiveness of our approach.

Through the method of nonlinear optical frequency conversion method, 532nm, 355nm and 266nm laser wavelength can be attained by YAG1064nm laser. Mirror that works in this system must satisfy the requirements of high reflection in four bands. Based on the film design system to choose appropriate coating materials, adopting electron beam vacuum ion assisted deposition technique, through optimizing the parameters of the process, the film that reflectance is 99.8% at 1064nm , 99.6% at 532nm ,97.9% at 355nm and 96.8% at 266nm is prepared on the substrate of JGS1. Additionally, the laser induce damage threshold in the ultraviolet wave band is 1.432J/cm2 at 355nm , 0.923J/cm2 at 266nm. The results show that all the preparation of mirror meets the requirements well.

A 57-year-old man presented with a rare extrahepatic portal vein bifurcation scar stenosis involving the proximal splenic vein and superior mesenteric vein after a Whipple procedure. He was treated with endovascular coil embolization for the gastroesophageal varices and kissing stents for the portal vein bifurcation stenosis. This case illustrates a rarely seen complication after the Whipple procedure and a novel management strategy that can be considered in the management of this complex disease.

Limnoperna fortunei, the golden mussel, is a freshwater bivalve species native to the rivers and streams of China and Southeast Asia (Thailand, Korea, Laos, Cambodia, Vietnam, Indonesia), and has since become a major macrofouling pest. They also do harm to Japan, South America and other countries. They adhere to water intake facilities, resulting in major biofouling and environmental problems. Clogging of cooling water pipes has stopped raw water pumping to a water purification plant and caused the shutdown of a turbine dynamo-electric generator in a hydraulic power plant and also caused damage to all sorts of water supply systems inordinately. Substantial growth of L. fortunei is a new problem which seriously affected the water quality and water conditions in water supply system. A large number of L. fortunei not only reduced the flow area of the pipeline but also increased the pipe roughness, affecting the ability to water of the bar screen. While the respiration of L. fortunei dissolved oxygen in water, and their ammonia excretion and metabolism of nutrients caused deterioration of water quality.

The harm to raw water supply and treatment of Limnoperna fortunei is a new problem. It not only has influence on the ecosystem of water source and the water quality and resistance in the transmittion process, but also does harm to the facilities of water treatment. Through analysis of lots of literatures, the biological characters and damages of Limnoperna fortunei are summarized in this paper. Meanwhile, the author discusses the control technologies at home and abroad and makes suggestions on future study.

Objective: To study immune function of children viral myocarditis and to evaluate the clinical effect of Shuanghuanglian Powder (SHLP) by injection.Methods: The 62 patients of viral myocarditis were divided into two groups randomly, the SHLP group (n = 32) treated with conventional therapy plus SHLP and the conventional treatment group (n = 30) with conventional therapy alone. Their serum antibody of Coxsackie virus group B (COXB-IgM), T-lymphocyte subsets including CD3+, CD4+, CD8+ and CD4+/CD8+ were determined with ELISA and indirect immunofluorescent assay.Results: COXB-IgM was positive in 39 of the 62 patients, which was significantly different with those of normal controls (P< 0.001). Patients’ serum level of CD4+ cells and CD4+/CD8+ ratio decreased while CD8+ increased. After treatment, the recovery of symptoms, signs and immune function in patients of the SHLP group were significantly better than those in patients treated with conventional treatment alone (P

Congestion control algorithms of existing reliable multicast protocols are mainly derived from end-to-end model, which has high resource requirements and sometimes suppresses the package sending too much. Many-to-many reliable multicast requires efficient congestion control over a one-to-many model. It’s an important mechanism to use many-to-many multicast in LAN (Local Area Network) in distributed simulation. In this paper, a congestion control algorithm based on loss trend for many-to-many reliable multicast is proposed. It predicts future package loss of receivers on the analysis of historic loss and buffer variety, and then control the congestion by adjusting the sending rate in advance. This algorithm aims at the reliable multicast in LAN. The main idea of the algorithm is to lower the possibility of multicast package loss, and then the nodes can afford the cost of package recovery. It alleviates the congestion on the depression of package loss possibility by regulating the sending rate. Experiment results indicate that the algorithm can keep a high throughput of many-to-many reliable multicast with relatively real-time performance.

Wireless Sensor Networks (WSN) are often deployed in hostile or difficult scenarios, such as military battlefields and disaster recovery, where it is crucial for the network to be highly fault tolerant, scalable and decentralized. For this reason, peer-to-peer primitives such as Distributed Hash Table (DHT), which can greatly enhance the scalability and resilience of a network, are increasingly being introduced in the design of WSN’s. Securing the communication within the WSN is also imperative in hostile settings. In particular, context information, such as the network topology and the location and identity of base stations (which collect data gathered by the sensors and are a central point of failure) can be protected using traffic encryption and anonymous routing. In this paper, we propose a protocol achieving a modified version of onion routing over wireless sensor networks based on the DHT paradigm. The protocol prevents adversaries from learning the network topology using traffic analysis, and therefore p reserves the context privacy of the network. Furthermore, the proposed scheme is designed to minimize the computational burden and power usage of the nodes, through a novel partitioning scheme and route selection algorithm.