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Objective To investigate if preoperative electrocardiogram scores and perioperative surgical methods could predict new-onset atrial fibrillation during lung surgery. Design Retrospective observational case-control study. Setting The First Affiliated Hospital of Nanjing Medical University, China. Participants Eighty adult patients (40 with new-onset atrial fibrillation, 40 without) who underwent lung surgery. Interventions The authors compared and analyzed the relationship among preoperative electrocardiogram scores, clinical variables, and surgical variables with new-onset atrial fibrillation during lung surgery. Measurements and Main Results Clinical data and demographics involving 80 adult patients (40 with new-onset atrial fibrillation, 40 without) who underwent lung surgery were retrieved from the Medical Records of the First Affiliated Hospital of Nanjing Medical University. Patients with prior atrial fibrillation were excluded. Preoperative electrocardiograms were collected from medical records and checked by two independent blinded researchers. Preoperative clinical variables (age, sex, body mass index, American Society of Anesthesiologists Class) were selected for a multivariate preoperative clinical model (model C). Perioperative surgical methods (thoracoscopy or open-chest surgery, lymph node dissection, left or right pneumonectomy, extent of pulmonary resection) were selected for a multivariate surgical methods model (model S). Five electrocardiogram variables (PR interval, P-wave duration, the longest interval measured between the onset of Q-wave and the J-point (QRS) duration, left atrial enlargement, and left ventricular hypertrophy) were included in a multivariate electrocardiogram model (model E). A combined clinical and electrocardiogram model (Model CE) and a combined univariate significant variables model (Model CSE) were formed. Left atrial enlargement, QRS duration, American Society of Anesthesiologists Class, and open-chest surgery were risk factors of new-onset atrial fibrillation. The result showed that the predictive ability of Model E was significantly higher than Models C and S. Model CSE showed the highest prediction of all models. Fifty percent of patients with one risk element will develop new-onset atrial fibrillation, and 100% of patients with two or more risk elements of Model CSE will develop new-onset atrial fibrillation. Conclusions Preoperative electrocardiogram markers can be used together with surgical methods as strong predictors to identify those patients at a high risk for new-onset atrial fibrillation during lung surgery.

BACKGROUND: Digestive endoscopy and surgery are the primary invasive methods for the clinical treatment of necrotizing pancreatitis. However, there are relatively few studies evaluating the effectiveness and safety of these two methods. METHODS: Randomized controlled trials (RCTs) on endoscopic and surgical treatment of necrotizing pancreatitis published from January 2000 to December 2020 were searched in the PubMed, Medline, Embase, China Biology Medicine Disc (CBM), and WanFang databases. The Cochrane System Review Manual was adopted to evaluate the quality of the included literature, and Review Manager 5.3 was used for data analysis. RESULTS: Ten articles were included in this meta-analysis, involving a total of 401 patients, including 188 in the endoscopy group and 213 in the surgery group. Meta-analysis results revealed that the clinical remission rate (CRR) [odds ratio (OR) =1.30, 95% confidence interval (CI): 0.58–2.92, P=0.52], new organ failure rate (OFR) (OR =0.53, 95% CI: 0.26–1.09, P=0.08), abdominal bleeding rate (ABR) (OR =0.62, 95% CI: 0.33–1.15, P=0.13), and intensive care unit (ICU) stay time (IST) [mean deviation (MD) =−7.33, 95% CI: −16.76 to 2.11, P=0.13] were not significantly different between the endoscopy and surgery groups. In the endoscopy group, the mortality rate (OR =0.56, 95% CI: 0.31–1.02, P=0.05), intestinal fistula rate (IFR) or gastrointestinal perforation rate (GPR) (OR =0.50, 95% CI: 0.26–0.99, P=0.05), and pancreatic fistula rate (PFR) (OR =0.09, 95% CI: 0.04–0.23, P

Single-agent immune checkpoint inhibitors (ICIs) like pembrolizumab or atezolizumab have been approved as first-line monotherapy for advanced non-small cell lung cancer (NSCLC) patients with PD-L1 ≥ 50%. However, emerging evidences have showed that ICI combinations (chemoimmunotherapy or dual-agent ICIs) argue to offer a higher response rate. In this network meta-analysis, we aimed to evaluate the efficacy and toxicity of first-line single-agent ICIs versus ICI combinations for advanced NSCLC patients with PD-L1 ≥ 50%. PubMed, Embase, Cochrane Library and the Clinicaltrials.gov were systematically searched to extract eligible literature until December 2020. Outcomes included overall survival (OS), progression free survival (PFS), objective response rate (ORR) and treatment related adverse events (TRAEs) of grades 3–5. Fourteen studies with 3448 patients were included. The results showed that chemotherapy plus ICIs significantly improved PFS and ORR compared to chemotherapy, and sinti-chemo (HR: 0.31, 95% CI: 0.20–0.49) and pembro-chemo (OR: 4.2, 95% CI: 2.6–6.7) ranked first. In terms of OS, cemiplimab provided the best benefit versus chemotherapy (HR: 0.57, 95% CI: 0.43–0.77), followed by atezolizumab and pembro-chemo. In the subgroup analysis of histological type, pembro-chemo and sinti-chemo showed the best benefit of PFS in squamous and nonsquamous NSCLC, respectively, while there was no significant difference between ICI combinations with single-agent ICIs in OS. Moreover, the addition of chemotherapy to ICIs elevated toxicity compared to chemotherapy. The study suggested that chemotherapy plus ICIs might improve PFS and ORR than single-agent ICIs for advanced NSCLC patients with PD-L1 ≥ 50%. However, it did not lead to OS benefit.

We evaluated whether real-time ultrasound-guided epidural block is more suitable for overweight parturients undergoing analgesic labor than traditional palpation positioning. Sixty overweight at-term pregnant women (body mass index ≥30 kg/m2) with singleton pregnancy, prepared for vaginal delivery with epidural analgesia, were randomly allocated into two groups. The parturients in the anatomical landmark catheterization group received paramedian epidural anesthesia using the anatomical landmark-guided technique, while real-time ultrasound-guided positioning was performed in the ultrasound-guided-catheterization group. Total procedure duration, time to identify the puncture site and perform the puncture, first attempt success rate, number of attempts, number of needle-redirections, intervertebral-space-change rate, satisfaction score, and complications were compared between the groups. Procedure duration and time to identify the puncture site were significantly shorter in the anatomical landmark catheterization group (440.1 ± 97.2 s vs. 521.9 ± 68.4 s, p < 0.001 and 24.9 ± 13.6 s vs. 112.2 ± 15.6 s, p < 0.001, respectively). There was no significant difference in the time to perform the puncture (385.3 ± 89.7 s vs. 365.1 ± 73.0 s, p = 0.341). The first attempt success rate was lower while the number of attempts and number of needle-redirections were higher in the anatomical landmark catheterization group (p < 0.05). The intervertebral-space-change rate was similar across the groups. Satisfaction was significantly lower in the ultrasound-guided catheterization group (p = 0.009). Complication occurrence, e.g., catheterization difficulty or bleeding during catheterization, dural puncture, and lower-back pain, was similar across the groups. Real-time ultrasound-guided paramedian epidural anesthesia improved the first attempt success rate and reduced the number of attempts and number of needle-redirections in overweight parturients undergoing analgesic labor. However, the longer total procedure duration and time to identify the puncture site might dissatisfy parturients.

For emerging infectious disease with infectivity in incubation period, this paper studies the effect of quarantine measures for close contacts on the transmission of emerging infectious disease with the help of the differential equation model. The results show that as long as measures where close contacts are quarantined are taken, when to take measures is a very important factor. Under a given quarantine intensity, there is a phase transition structure about the start time of taking measures. Only when the start time of taking measure is earlier than the first critical moment of phase transition, the final cumulative number of patients and deaths can be stabilized in low level, so as to control the spread of epidemics. At the same time, whenever quarantine measures are taken, even if the quarantine intensity is not strong enough, the peak value of existing infectious individuals will decrease and the duration when the number of existing infectious individuals is high will be shortened, and the final cumulative number of patients and deaths will be significantly reduced.

Sequences similarity analysis is one of the major topics in bioinformatics. It helps researchers to reveal evolution relationships of different species. In this paper, we outline a new method to analyze the similarity of proteins by Discrete Fourier Transform (DFT) and Dynamic Time Warping (DTW). The original symbol sequences are converted to numerical sequences according to their physico-chemical properties. We obtain the power spectra of sequences from DFT and extend the spectra to the same length to calculate the distance between different sequences by DTW. Our method is tested in different datasets and the results are compared with that of other software algorithms. In the comparison we find our scheme could amend some wrong classifications appear in other software. The comparison shows our approach is reasonable and effective., Highlights • We propose a novel method to extract the features of the sequences based on physicochemical property of proteins. • We apply the Discrete Fourier Transform (DFT) and Dynamic Time Warping (DTW) to analyze the similarity of proteins. • Different datasets are used to prove our model's effectiveness.

During the transmission of COVID-19, the hospital isolation of patients with mild symptoms has been a concern. In this paper, we use a differential equation model to describe the propagation of COVID-19, and discuss the effects of intensity of hospital isolation and moment of taking measures on development of the epidemic. The results show that isolation measures can significantly reduce the epidemic final size and the number of dead, and the greater the intensity of measures, the better, but duration of the epidemic will be prolonged. Whenever isolation measures are taken, the epidemic final size and the number of dead can be reduced. In early stage of the epidemic, taking measures one day later has little impact, but after a certain period, if taking measures one day later, the epidemic final size and the number of dead increase sharply. Taking measures as early as possible makes the maximum number of patients appear later, which is conducive to expanding medical bed resources and reducing the pressure on medical resource demand. As long as possible, high-intensity isolation measures should be taken in time for patients with mild symptoms.

Retinopathy of prematurity (ROP) is a potentially blinding condition caused by disruption of retinal vascularization and metabolism. This study aims to identify altered metabolites from plasma in patients with treatment-requiring ROP (TR-ROP) compared with controls. An untargeted metabolomics analysis was performed to reveal the metabolomic profiles of the plasma between TR-ROP patients (n = 38) and age-matched infants (n = 23). The Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted to explore the potential signaling pathways of the changed metabolites. Under positive ion mode, a total of 29 metabolites were significantly altered in plasma between TR-ROP patients and controls, and 23 altered metabolites were identified under negative ion mode. KEGG analyses indicated that “protein digestion and absorption” and “aminoacyl-tRNA biosynthesis” were the most enriched pathways of the altered metabolites. These results demonstrated that metabolomic profiles changed in plasma of TR-ROP, and the altered metabolites could be served as potential biomarkers for the diagnosis and prognosis of TR-ROP patients. Besides, the metabolomic profiles might provide clues to discover novel therapeutic strategies in ROP treatment.

Rumor spreading has a profound influence on daily lives. There are several factors influencing rumor spreading. In this paper, we assume that there are two kinds of individuals in the crowd: those who do not know the rumors and those who learn about the rumors. And in the latter category, there are two attitudes toward rumors: those who are convinced of rumors and those who hold an objective attitude. Those convinced and objective individuals form a public opinion environmental factor conducive to the spread of rumors. Based on the public opinion environmental influence whose intensity decays with time, a model with two attitudes toward rumors is established. With numerical simulations, we illustrated the conversion state of three categories because of public opinion environmental factors, analyzing the sensitivity of the model. The results showed that it is beneficial to control the rumor propagation when controlling the influence of those who are convinced of rumors and those who hold an objective attitude rather than constraining one of them individually. And it was commonsensical that increasing the attenuation intensity of the two attitude rumors was also an effective way conducive to the control.

BACKGROUND Despite the magnitude of occupational hand injuries, there are no authoritative guidelines for hand injury prevention, and little research has been done to investigate the epidemiology of acute occupational hand injuries in South China or other developing areas. In this study, the epidemiology of acute occupational hand injuries treated in emergency departments (EDs) in Foshan City, South China, was examined and data were supplied to assist with preventive strategies in similar developing regions. METHODS A multicenter study was prospectively designed and conducted in 5 large hospital EDs in Foshan City from July 2010 to June 2011. An anonymous questionnaire was designed specifically to collect the data for this study. RESULTS A total of 2142 patients with acute occupational hand injury completed the questionnaire within the 1-year study period. Results indicated that most occupational hand injuries were caused by machinery. Hand injury type and site of the injury did not correspond to age, but were related to gender and job category. July and August 2010 were the peak periods of admission to EDs, while January and February 2010 were the trough periods. CONCLUSION Epidemiological data enhance our knowledge of acute occupational hand injuries and could play a role in the prevention and treatment of future occupational hand injuries.

During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1) have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings.

Social factors, such as public opinion, values, ethics, moral standards, could guide people’s behavior to some degree. In this paper, we introduce social orientation as a motivator factor into the Nowak model, and discuss the variation of cooperation proportion under the function of motivator factor and betrayal temptation. Results show that motivator factors can promote cooperation proportion, and there is a motivator factor threshold. And a jump point is present in the value, on each side of which cooperation proportion has a small change. Reduction of betrayal temptation can also promote cooperation proportion, and there is a betrayal temptation threshold. And the value is corresponding with a jump point. And cooperation proportion changes very little on each side of the value. In addition, when betrayal temptation and motivator factor both play a role in a system, there are always cooperators and defectors in coexistence.

Graphical representation of DNA sequences provides a simple and intuitive way of analyzing and sorting various gene sequences. It is attractive to researchers to propose much more appropriate methods. In this study, a new graphical representation is presented. The method adopts the CMI coding to represent four nucleotides-A, G, C and T. Our approach considers not only the sequences’ structure but also the chemical structure for DNA sequence. We take several sets of data to test our method. The results of our experiment demonstrate that our representation is effective.

In this paper, basing on the prisoner’s dilemma model proposed by M.A.Nowak, we present a model to research the action of temptation to defect in prison’s dilemma model. Firstly, we determine whether a player changes its strategy depends on a Fermi equation which is related to the payoffs of the player and its neighbors. If the player changes its strategy next time step, it will select the strategy adopted by the one who gets the highest payoff among its neighbors as its own strategy. Form the results we find that when four neighbors are considered, the density of cooperators will present a downtrend. Well, when eight neighbors are considered, the density of cooperators will decline at the beginning and increase suddenly afterwards. When twelve neighbors are considered, if the density of cooperators is reduced to zero, cooperation will appear again. Thus, the increase of temptation to defect may promote cooperation.

We investigate how wealth transfer that happens at the end of an agent’s life affects its final distribution based on a multi-agent dynamic model. We discuss two kinds of wealth transfers: to a single agent and to charities. The first kind of bequest is common in our realistic world and is always regarded by the public as unequal inheritance. The bequests to charities will be gathered and then equally redistributed among the survivors in our model. We find that when all the decedents choose the second kind of bequest, the final distribution is the Gibbs exponential function. When all the decedents choose the first kind of bequest, the result is condensation that a single individual accumulates all the available wealth. When an increasing portion of decedents choose the one-heir bequests, the exponential distribution evolves towards a power law shape (accompanied by deteriorating inequality). This shape firstly appears from the intermediate range of wealth and extends towards the top end of the simulated distribution, while the distribution remains exponential for high values of the wealth. At the same time, the Gini coefficient increases and the wealth accumulation becomes serious. At last, we analyze the source of the inequality. We find that not only unequal inheritances, but also equal division of the charity’s wealth can relatively contribute to an inequality of wealth distribution.

Background: Circulating miRNAs in serum may serve as promising diagnostic biomarkers for patients with gastric cancer. Methods: Using qRT-PCR-based Exiqon panel, we identified 58 differentially expressed miRNAs from three gastric cancer pool samples and one normal control (NC) pool in the initial screening phase. Identified miRNAs were further validated in the training (49 gastric cancer vs. 47 NCs) and validation phases (154 gastric cancer vs. 120 NCs) using qRT-PCR. The expression levels of the miRNAs were also determined in tissues, arterial serum, and exosomes. Results: Consequently, six serum miRNAs (miR10b-5p, miR132-3p, miR185-5p, miR195-5p, miR-20a3p, and miR296-5p) were significantly overexpressed in gastric cancer compared with NCs. The areas under the receiver operating characteristic curve of the six-miRNA panel were 0.764 and 0.702 for the training and validation phases, respectively. miR10b-5p and miR296-5p were significantly upregulated in gastric cancer tissues (n = 188). In addition, patients who did not receive adjuvant chemotherapy with high expression of miR10b-5p or miR296-5p in tissues tended to suffer worse overall survival. Furthermore, the expression levels of miR10b-5p, miR195-5p, miR20a-3p, and miR296-5p were significantly elevated in exosomes from gastric cancer serum samples (n = 30). Conclusions: We identified a six-miRNA panel in serum for the detection of gastric cancer. Impact: Our findings provide a novel serum miRNA signature for gastric cancer diagnosis, and will serve as the basis of the application of circulating miRNAs in clinical for the detection of gastric cancer in the future. Cancer Epidemiol Biomarkers Prev; 26(2); 188–96. ©2016 AACR.

// Mingjie Lu 1, * , Tongshan Wang 1, * , Mingfeng He 2, * , Wenfang Cheng 3 , Ting Yan 4 , Zebo Huang 1 , Lan Zhang 1 , Huo Zhang 1 , Wei Zhu 1 , Yichao Zhu 5, 6 , Ping Liu 1 1 Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China 2 Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China 3 Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China 4 Safety Assessment and Research Center for Drug, Pesticide and Veterinary Drug of Jiangsu Province, Nanjing Medical University, Nanjing 211166, PR China 5 Department of Physiology, Nanjing Medical University, Nanjing 211166, PR China 6 State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, PR China * These authors have contributed equally to this work Correspondence to: Wei Zhu, email: zhuwei@njmu.edu.cn Yichao Zhu, email: zhuyichao@njmu.edu.cn Ping Liu, email: liu-ping@csco.org.cn Keywords: miR-3622b-5p, ERBB2, cancer, proliferation, apoptosis Received: July 18, 2016 Accepted: January 10, 2017 Published: February 01, 2017 ABSTRACT Over-expression or amplification of ERBB2 is observed in multifarious carcinomas. However, the molecular mechanism of ERBB2 downregulation in ERBB2-positive cancers remains obscure. This experiment investigated the suppressive role of miR-3622b-5p in ERBB2-positive breast and gastric cancers. The luciferase activity of ERBB2 3’-untranslated region-based reporters constructed in HEK-293T, SK-BR-3 and MCF-10A cells suggested that ERBB2 was the target gene of miR-3622b-5p. Over-expressed miR-3622b-5p reduced the protein level of ERBB2, weakened the activation of mTORC1/S6, and induced the apoptosis of ERBB2-positive cancer cells. MiR-3622b-5p was significantly down-regulated in breast and gastric cancer tissues. This down-regulation in ERBB2-positive breast and gastric cancer tissues was more obvious than that in ERBB2-negative breast and gastric cancer tissues. MiR-3622b-5p turned ERBB2-positive cancer cells more vulnerable to the apoptosis induced by cisplatin and 5-fluorouracil. Taken together, miR-3622b-5p is involved in the proliferation and apoptosis of human ERBB2-positive cancer cells via targeting ERBB2/mTORC1 signaling pathway.

In 2000, Sznajd-weron and Sznajd introduced a model for the simulation of a closed democratic community with a two-party system, and it is found that a closed community has to evolve either to a dictatorship or a stalemate state. In this paper, we continued to study on this model. All the neighboring individuals holding the same opinion is defined as a team, which will influence its nearest neighbor's decision and realize the opinion evolution. After some time-steps, a steady state appeared and the stalemate state in original model is eliminated. Moreover, the demand of time-steps has decreased dramatically. In addition, we also analyzed the effect of the various dispersal degree of the initial opinion on the opinion converging at the probability of one steady state. Finally we analyzed the effect of noise on convergence and found that the ability of anti-noise was increased about 1000 times compared with Sznajd model.

Nowadays in the rural areas of China, peasants can make their own choices to go to the city for a new job or stay in the rural area. A decision is made based on working ability and the information a peasant gets. A multivariate evolutionary model of this problem is established and the numerical simulation shows that going to the city brings about a rise in the peasants’ income, and also that such a rise, as well as the number of peasants going to the city, is influenced by the capacity of the cities and income gap between agricultural and non-agricultural industries.

Backgrounds: Post-stroke fatigue is a common and devastating malady of post-stroke patients. Bo's abdominal acupuncture is an effective therapeutic tool of Chinese medicine and widely used in practice in China. In this clinical study, we evaluated the therapeutic efficacy and safety of Bo's abdominal acupuncture for post-stroke fatigue. Methods: sixty participants with post-stroke fatigue were recruited and randomized to observational and acupuncture groups. The patients of acupuncture group were treated with Bo's abdominal acupuncture and rehabilitation exercise. The patients of observational group were treated with rehabilitation exercise. Two scoring systems, such as fatigue severity scale and stroke-specific quality of life scale, were used to analyze the therapeutic efficacy and safety of Bo's abdominal acupuncture, administered before and after treatment. Results: After four weeks, the patients with acupuncture displayed milder post-stroke fatigue in comparison with patients without acupuncture. Conclusion: Bo's abdominal acupuncture and rehabilitation exercise markedly mitigate post-stroke fatigue.

Wireless sensor networks play an important role in the industry. The electronic energy is a key factor of the operation of WSN. In this paper, we propose a new model based on GPSR protocol to simulate the WSNs. We discuss how the WSN is influenced by the sink node, including the location of sink node and the moment for sink node’s movement. We also consider the lifetime in different energy-limited conditions. We find some locations for sink nodes where the lifetime of WSN will be prolonged efficiently. The consequence in our work may be helpful to the research of continuous move of sink node in WSNs.

Armando Ticona Bustillos and Paulo Murilo C. de Oliveira first combined learning strategy with Penna model using a third bit string to represent knowledge. There are two forms of learning strategy in their model: individual learning through trial-and-error and social learning through copying knowledge from others. Based on the Bustillos-Oliveira model, we propose a new learning strategy:. (1) Individual learning ability depending on knowledge, through which the individual learning ability is not a constant but in direct proportion to the knowledge level of individual;. (2) Double-direction Social learning, under this, not only the young can learn from the elder, but also the elder can learn from the young;. (3) The age-dependent learning capacity, we make the learning capacity a variable in inverse proportion to the age, unlike which has been represented in Bustillos and Oliveira's model as a constant. Under this new learning strategy represented above, we get different result in the level of knowledge of individuals from B-O model.

A cellular automata model of learning in a close ecosystem on the basis of Penna model with intelligence is set up. We use the Penna model with intelligence to describe the individual. The individuals are set in a lattice of L × L and the rules of learning is expressed by cellular automata. Then, we present the results of our simulations and discuss the evolution of intelligence and knowledge respectively. From the results we find that the intelligence for the living individuals is more than that for the dead individuals. It can be concluded the effect of natural selection on the evolution of intelligence.

An evolutionary model based on Bit-String with intelligence and learning is constructed. Each individual is represented by five bit strings. Four of them relate to genes and the other denotes the knowledge from learning. The four strings relative to genes will be divided into two parts — Bit-String A and Bit-String B. Bit-String A denotes the health of an individual, at the same time Bit-String B can describe intelligence. For an individual, the cross reproduction method is used in this model. After that we explain how knowledge is represented in our model. The probability of learning is affected by intelligence. In order to study how the accumulated knowledge influences the survival process by the effect of food and space restrictions, we modify the Verhulst factor. Then, we present the results of our simulations and discuss the evolution of population, intelligence and knowledge respectively. In addition, an equation to calculate the intelligence quotient is given based on intelligence and knowledge. We discuss the distribution of intelligence quotient.

An evolutionary model based on bit-strings with intelligence is set up in this paper. In this model, gene is divided into two parts which relative to health and intelligence. The accumulated intelligence influences the survival process by the effect of food and space restrictions. We modify the Verhulst factor to study this effect. Both asexual and sexual model are discussed in this paper. The results show that after many time steps, stability is reached and the population self-organizes, just like the standard Penna model. The intelligence made the equilibrium to be reached larger both in asexual model and sexual model. Compared with asexual model the population size fluctuates more strongly in the sexual model.

We report resuscitation of a near-drowning child by a bystander in a rural south China township. Resuscitation was performed on a 6-year-old, otherwise healthy boy who was witnessed drowning in a river, with submersion for approximately 12 min. Following several resuscitation attempts, spontaneous breathing was established at the scene and the boy was transferred to a nearby hospital. He developed pneumonia but recovered completely on the ward and was discharged without any neurologic disabilities. This case shows that early bystander resuscitation is an important factor for survival after submersion. The search for an ideal approach to resuscitation must continue, and all members of society must work together towards this goal.

The aim of the study is to validate of the use of plasma B-type natriuretic peptide (BNP) point-of-care test platform in preliminary recognition of cardioembolic stroke patients in the emergency department (ED).In our ED, emergency physicians prospectively assessed consecutive adult patients with acute phase of ischemic stroke and measured plasma BNP by point-of-care test platform on admission. The included patients with plasma BNP concentration more than 66.50 pg/mL were presumed to be classified as the cardioembolism (CE) subtype and were then followed up. Stroke neurologists evaluated patients' functional outcome at hospital discharge and also made discharge diagnosis and stroke etiologic subtypes according to Trial of ORG 10172 in Acute Stroke Treatment criteria: large artery atherosclerosis, CE, small artery occlusion, stroke of other determined etiology, and stroke of other undetermined etiology.In this study, 172 of 262 acute ischemic stroke patients met the study criteria (mean age, 71.18 ± 11.65 years; 53.49% female). Of the 172 patients, 38.95% were diagnosed with large artery atherosclerosis at discharge; 26.16%, with CE; 24.42%, with small artery occlusion; and 10.47%, with stroke of other determined etiology or stroke of other undetermined etiology. Age, previous cardiac disease, atrial fibrillation, length of hospital stays, Scandinavian Stroke Scale score on admission less than or equal to 25, and modified Rankin Scale greater than or equal to 3 or death at discharge were all significantly higher in the CE patients compared to other subtypes (P.01). The mean BNP concentration was significantly higher in the CE group than in other 3 subtypes (P.01). The plasma BNP level greater than 66.50 pg/mL had good corresponding diagnostic performance in preliminary recognition of cardioembolic stroke patients (sensitivity, 75.56%; specificity, 87.40%).In this study, we found that the plasma BNP level greater than 66.50 pg/mL as a reference index had good corresponding diagnostic performance in preliminary recognition of cardioembolic stroke patients. However, the single BNP biomarker panel cannot be used to confidently identify CE subtype as a diagnosis and must be taken in context with clinical assessment and judgment before making management decisions.

This paper discusses the impact on human health caused by the addition of antibiotics in the feed of food animals. We use the established transmission rule of resistant bacteria and combine it with a predator-prey system to determine a differential equations model. The equations have three steady equilibrium points corresponding to three population dynamics states under the influence of resistant bacteria. In order to quantitatively analyze the stability of the equilibrium points, we focused on the basic reproduction numbers. Then, both the local and global stability of the equilibrium points were quantitatively analyzed by using essential mathematical methods. Numerical results are provided to relate our model properties to some interesting biological cases. Finally, we discuss the effect of the two main parameters of the model, the proportion of antibiotics added to feed and the predation rate, and estimate the human health impacts related to the amount of feed antibiotics used. We further propose an approach for the prevention of the large-scale spread of resistant bacteria and illustrate the necessity of controlling the amount of in-feed antibiotics used.

Objective: To observe the clinical therapeutic efficacy and safety of Bo's abdominal acupuncture combined with rehabilitation exercise in treating shoulder pain after stroke. Methods: seventy patients with shoulder pain after stroke were equally randomized into treatment group and control group. The treatment group was given Bo's abdominal acupuncture and rehabilitation exercise, while the control group was offered rehabilitation exercise alone. Treatment was conducted for 2 weeks. The outcome measure was Visual Analogue Scale(VAS), Upper extremity section of Fugl-Meyer Assessment (FMA) and Functional Independence Measure(FIM) administered before and after treatment. Results: VAS, FMA and FIM showed significant improvements in both groups after treatment. The treatment group showed significant improvement on the VAS scale of compared with that in the control group. No significant difference was observed on the FMA and FIM between the two groups. No serious adverse events were reported in this study. Conclusion: Both Bo's abdominal acupuncture and rehabilitation exercise had effects on shoulder functional recovery but that Bo's abdominal acupuncture combined with rehabilitation exercise showed more effective in relieving the shoulder pain than that rehabilitation exercise alone.

Background Zoledronic acid is a potent inhibitor of osteoclast-mediated bone resorption and has been widely used in bone metastasis malignancies and postmenopausal osteoporosis as a preventive therapy against skeletal-related events. The purpose of this study was to evaluate the clinical outcome of zoledronic acid as an adjuvant therapy for patients with early stage breast cancer. Patients and methods Entries in the PubMed and EMBASE databases up to 12 July 2013 were systematically reviewed. Online abstracts from the proceedings of the Annual Meetings of the American Society of Clinical Oncology (ASCO) (1992–2013) and the San Antonio Breast Cancer Symposium (SABCS) (2004–2013) were also reviewed. Primary endpoints included overall survival (OS) and disease-free survival (DFS), while secondary endpoints included bone metastasis-free survival (BMFS), distant metastasis-free survival (DMFS), and fracture-free rate (FFR). Results A total of eight studies including 3,866 subjects and 3,864 controls met our search criteria and were evaluated. The use of zoledronic acid was found to improve OS (relative risk (RR), 0.88; 95% confidence interval (CI), 0.77–1.01; p- value = 0.06) and DMFS (RR, 0.77; 95% CI, 0.60–1.00; p- value = 0.05). Furthermore, statistically significant benefits were associated with BMFS (RR, 0.81; 95% CI, 0.66–0.99; p- value = 0.04) and FFRs (RR, 0.75; 95% CI, 0.61–0.92; p- value = 0.007). In contrast, there was no significant difference in DFS with the application of zoledronic acid (RR, 0.88; 95% CI, 0.72–1.09; p- value = 0.24). Sensitivity analysis further identified the improvement of 5-year OS for the adjuvant zoledronic acid therapy in early stage breast cancer patients (RR, 0.86; 95% CI, 0.75–0.99; p- value = 0.03), while a borderline statistically significant benefit was observed for 5-year DFS (RR, 0.90; 95% CI, 0.81–1.00; p- value = 0.06). Conclusion Zoledronic acid as an adjuvant therapy appears to improve the 5-year OS rate for early stage breast cancer patients, and was associated with a protective effect for the bone metastases and fractures evaluated in more than 7,000 patients. However, further research is needed to confirm our findings, and sub-group analyses according to menopause status or hormone status may provide further insight.

We consider a dynamic group composed with a constant number of people and the people will change periodically. Every member in the community owns a value of confidence — a mechanism that measures the agent’s coherence to his or her own attitude. Based on Cellular Automata, the opinions of all agents are synchronously updated. As long as the updating frequency and updating proportion are appropriate, the open system can reach a democracy-like steady state. The majority of agents in the community will hold the same opinion.