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BACKGROUND: Our study aimed to characterize the imaging appearance of spinal fractures in ankylosing spondylitis (AS) and identify situations in which the use of magnetic resonance imaging (MRI) is necessary. METHODS: A total of 70 cases of spinal fractures associated with AS were retrospectively enrolled. Two radiologists independently reviewed the preoperative images. The location, type, ligament injury, neurological injury, and epidural hematoma following spinal fractures were assessed. RESULTS: Only one patient had a vertebral compression fracture, and 69 patients had 77 transverse fractures involving three columns. The most frequent injuries in AS patients were type B3 (N=32, 43.8%) spine fractures, followed by type C (N= 20, 27.4%) spine fractures. There were significant differences in fracture types of the different spine regions (H=14.1, P

Asthma is a prevalent chronic inflammatory airway disease that is characterised by airway remodelling and airway hyperresponsiveness. Abnormal proliferation and migration of airway smooth muscle cells (ASMCs) contribute to airway remodelling in asthma. However, the molecular mechanism underlying an increased ASMC mass in asthma remains elusive. Herein, we aimed at investigating the regulation of lncRNA PVT1 on ASMCs and focussing on the mechanism in the proliferation and migration.Expression levels of lncRNA PVT1 and miR-590-5p in the serum collected from 24 children with asthma and 10 control children were determined by qRT-PCR. ASMCs proliferation and migration prior to and post platelet-derived growth factor subunit B (PDGF-BB) stimulation were examined by CCK-8 test and transwell assay. Dual-luciferase reporter assay was performed to determine miR-590-5p interaction with lncRNA PVT1 and follistatin-like 1 (FSTL1). Expression of lncRNA PVT1, miR-590-5p, FSTL1, C-Myc, cyclin D1, and cyclin-dependent kinase 1 (CDK1) was tested by quantitative real-time PCR (qRT-PCR) and immunoblotting analysis.The expression level of lncRNA PVT1 was higher but the expression level of miR-590-5p was lower in the serum of children with asthma than in control children. The expression level of lncRNA PVT1 was negatively correlated with the expression level of miR-590-5p in asthma. LncRNA PVT1 was upregulated upon PDGF-BB stimulation. LncRNA PVT1 knockdown by its specific shRNA repressed PDGF-BB-induced promotion of proliferation and migration in ASMCs and triggered an elevated miR-590-5p along with declined C-Myc, cyclin D1, and CDK1. The effects of lncRNA PVT1 knockdown on PDGF-BB-induced ASMCs were lost upon miR-590-5p inhibition. MiR-590-5p targeted FSTL1 gene and declined its expression, thus suppressing ASMC proliferation and migration following PDGF-BB stimulation and downregulating C-Myc, cyclin D1, and CDK1 expressions. The effects of miR-590-5p on PDGF-BB-induced ASMCs were lost upon FSTL1 overexpression.These results support the notion that the lncRNA PVT1/miR-590-5p/FSTL1 axis modulates ASMCs proliferation and migration following PDGF-BB stimulation, providing a potential therapeutic target to attenuate airway remodelling in asthma.

Infection is one of the primary causes of death from immune thrombocytopenia (ITP), and the lungs are the most common site of infection. We identified the factors associated with hospitalization for community-acquired pneumonia (CAP) in nonsplenectomized adults with ITP and established the ACPA prediction model to predict the incidence of hospitalization for CAP. This was a retrospective study of nonsplenectomized adult patients with ITP from 10 large medical centers in China. The derivation cohort included 145 ITP inpatients with CAP and 1360 inpatients without CAP from 5 medical centers, and the validation cohort included the remaining 63 ITP inpatients with CAP and 526 inpatients without CAP from the other 5 centers. The 4-item ACPA model, which included age, Charlson Comorbidity Index score, initial platelet count, and initial absolute lymphocyte count, was established by multivariable analysis of the derivation cohort. Internal and external validation were conducted to assess the performance of the model. The ACPA model had an area under the curve of 0.853 (95% confidence interval [CI], 0.818-0.889) in the derivation cohort and 0.862 (95% CI, 0.807-0.916) in the validation cohort, which indicated the good discrimination power of the model. Calibration plots showed high agreement between the estimated and observed probabilities. Decision curve analysis indicated that ITP patients could benefit from the clinical application of the ACPA model. To summarize, the ACPA model was developed and validated to predict the occurrence of hospitalization for CAP, which might help identify ITP patients with a high risk of hospitalization for CAP.

We aimed to investigate the frequency, risk factors, and outcome of active tuberculosis (TB) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This retrospective, nested, case-control study reviewed data from 6236 patients who received allo-HSCT from January 2008 to December 2018 at a single center; thirty-three patients (0.5%) with active TB and 99 controls without active TB after allo-HSCT were identified. We performed propensity score matching by randomly selecting 3 controls for each identified active TB patient according to the time of transplantation and follow-up period. History of pretransplant active TB previously treated and inactive at time of transplantation (P.001) was an independent risk factor. No significant differences in overall survival (P= .342), nonrelapse mortality (P= .497), or incidence of relapse (P= .807) were found. Thirty (90.9%) patients were treated with 4-drug (isoniazid, rifampicin/three rifapentine, pyrazinamide, and ethambutol) or 3-drug combination first-line therapy, with a response rate of 76.7%. Twenty-six (78.8%) patients were treated with first-line and second-line combined therapy, and the response rate was 76.9%. Five (15.2%) patients developed hepatotoxicity. In conclusion, history of pretransplant active TB previously treated and inactive at time of transplantation was an independent risk factor of active TB after allo-HSCT. No significant differences in prognosis between the TB and control groups were found. More studies are needed to help develop standardized therapeutic strategies for patients with post-transplant TB.

ObjectivesTo investigate the potential of deep learning in assessing pneumoconiosis depicted on digital chest radiographs and to compare its performance with certified radiologists.MethodsWe retrospectively collected a dataset consisting of 1881 chest X-ray images in the form of digital radiography. These images were acquired in a screening setting on subjects who had a history of working in an environment that exposed them to harmful dust. Among these subjects, 923 were diagnosed with pneumoconiosis, and 958 were normal. To identify the subjects with pneumoconiosis, we applied a classical deep convolutional neural network (CNN) called Inception-V3 to these image sets and validated the classification performance of the trained models using the area under the receiver operating characteristic curve (AUC). In addition, we asked two certified radiologists to independently interpret the images in the testing dataset and compared their performance with the computerised scheme.ResultsThe Inception-V3 CNN architecture, which was trained on the combination of the three image sets, achieved an AUC of 0.878 (95% CI 0.811 to 0.946). The performance of the two radiologists in terms of AUC was 0.668 (95% CI 0.555 to 0.782) and 0.772 (95% CI 0.677 to 0.866), respectively. The agreement between the two readers was moderate (kappa: 0.423, pConclusionOur experimental results demonstrated that the deep leaning solution could achieve a relatively better performance in classification as compared with other models and the certified radiologists, suggesting the feasibility of deep learning techniques in screening pneumoconiosis.

Thrombocytopenia is associated with life-threatening bleeding and is common in myelodysplastic syndromes (MDS). Robust molecular prognostic biomarkers need to be developed to improve clinical decision making for patients with MDS with thrombocytopenia. Wilms tumor 1 (WT1) and preferentially expressed antigen in melanoma (PRAME) are promising immunogenic antigen candidates for immunotherapy, and their clinical effects on patients with MDS with thrombocytopenia are still not well understood. We performed a multicenter observational study of adult patients with MDS with thrombocytopenia from 7 different tertiary medical centers in China. We examined bone marrow samples collected at diagnosis for WT1 and PRAME transcript levels and then analyzed their prognostic effect for patients with MDS with thrombocytopenia. In total, we enrolled 1110 patients diagnosed with MDS with thrombocytopenia. Overexpression of WT1 and PRAME was associated with elevated blast percentage, worse cytogenetics, and higher Revised International Prognostic Scoring System (IPSS-R) risk. Further, both WT1 and PRAME overexpression were independent poor prognostic factors for acute myeloid leukemia evolution, overall survival, and progression-free survival. Together, the 2 genes overexpression identified a population of patients with MDS with substantially worse survival. On the basis of WT1 and PRAME transcript levels, patients with MDS with IPSS-R low risk were classified into 2 significantly divergent prognostic risk groups: a low-favorable group and a low-adverse group. The low-adverse group had survival similar to that of patients in the intermediate-risk group. Our study demonstrates that the evaluation of WT1/PRAME transcript analysis may improve the prognostication precision and better risk-stratify the patients.

The study aimed to compare the efficacy and safety of all-trans retinoic acid (ATRA) plus low-dose rituximab (LD-RTX) with LD-RTX monotherapy in corticosteroid-resistant or relapsed immune thrombocytopenia (ITP) patients. Recruited patients were randomized at a ratio of 2:1 into 2 groups: 112 patients received LD-RTX plus ATRA, and 56 patients received LD-RTX monotherapy. Overall response (OR), defined as achieving a platelet count of ≥30 × 109/L confirmed on ≥2 separate occasions (≥7 days apart), at least a doubling of the baseline platelet count without any other ITP-specific treatment, and the absence of bleeding within 1 year after enrollment, was observed in more patients in the LD-RTX plus ATRA group (80%) than in the LD-RTX monotherapy group (59%) (between-group difference, 0.22; 95% CI, 0.07-0.36). Sustained response (SR), defined as maintenance of a platelet count >30 × 109/L, an absence of bleeding, and no requirement for any other ITP-specific treatment for 6 consecutive months after achievement of OR during 1 year following enrollment, was achieved by 68 (61%) patients in the combination group and 23 (41%) patients in the monotherapy group (between-group difference, 0.20; 95% CI, 0.04-0.35). The 2 most common adverse events (AEs) for the combination group were dry skin and headache or dizziness. Our findings demonstrated that ATRA plus LD-RTX significantly increased the overall and sustained response, indicating a promising treatment option for corticosteroid-resistant or relapsed adult ITP. This study is registered at www.clinicaltrials.gov as #NCT03304288.

BACKGROUND: The weightings of iterative reconstruction algorithm can affect CT radiomic quantification. But, the effect of ASiR-V levels on the reproducibility of CT radiomic features between ultra-low-dose computed tomography (ULDCT) and low-dose computed tomography (LDCT) is still unknown. The purpose of study is to investigate whether adaptive statistical iterative reconstruction-V (ASiR-V) levels affect radiomic feature quantification using ULDCT and to assess the reproducibility of radiomic features between ULDCT and LDCT. METHODS: Sixty-three patients with pulmonary nodules underwent LDCT (0.70±0.16 mSv) and ULDCT (0.15±0.02 mSv). LDCT was reconstructed with ASiR-V 50%, and ULDCT with ASiR-V 50%, 70%, and 90%. Radiomics analysis was applied, and 107 features were extracted. The concordance correlation coefficient (CCC) was calculated to describe agreement among ULDCTs and between ULDCT and LDCT for each feature. The proportion of features with CCC >0.9 among ULDCTs and between ULDCT and LDCT, and the mean CCC for all features between ULDCT and LDCT were also compared. RESULTS: Sixty-three solid nodules (SNs) and 48 pure ground-glass nodules (pGGNs) were analyzed. There was no difference for the proportion of features in SNs among ULDCTs and between ULDCT and LDCT (P>0.05). The proportion of features in pGGNs were highest for ULDCT(70%) (vs.) (90%) (78.5%) and ULDCT(90%) vs. LDCT(50%) (50.5%). In SNs, the mean CCC for ULDCT(90%) vs. LDCT(50%) was 0.67±0.26, not different with that for ULDCT(50%) vs. LDCT(50%) (0.68±0.24) and ULDCT(70%) vs. LDCT(50%) (0.64±0.21) (P>0.05). In pGGNs, the mean CCC for ULDCT(90%) vs. LDCT(50%) was 0.79±0.19, higher than that for ULDCT(50%) vs. LDCT(50%) (0.61±0.28) and ULDCT(70%) vs. LDCT(50%) (0.76±0.24) (P

Self-powered realization for synchronous switching circuits is a hot spot for piezoelectric vibration energy harvesting. Two typical kinds of switches, bipolar junction transistor (BJT) or metal–oxide semiconductor field effect transistor (MOSFET) are popularly used without a clear understanding about the performance difference. In this paper, comparative investigations about adopting these two types of switches based on a case study are performed. It is determined that the performance difference comes from three aspects: the gate parasitic capacitance, the turning-on threshold, and the driven mechanism. In particular, the third one imposes a critical influence on the performance. Investigations are performed on the self-powered synchronous switching circuit of two possible methods: with electronic breakers or with external control units. The results from simulations and experiments show that the current-driven mechanism limits the available performance in the case of the BJT switch in comparison with the case of the MOSFET switch. The difference is especially obvious for the cases of large piezoelectric capacitance and open-circuit voltage. A preliminary design guideline is concluded that the MOSFET is probably a better choice with the same voltage and current ratings in most cases.

Background Dyslipidaemia and cognitive impairment are common in old adults and risks of both of them increase with increasing age. However, the relationship between lipids and cognitive impairment in longevous people is still unclear. This study aimed to assess the association between serum lipids and cognitive impairment in Chinese centenarians. Methods In a cross-sectional study, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were biochemically measured in 924 centenarians and cognitive functions were evaluated. Multiple logistic regression analysis was used to examine the associations of lipids with cognitive impairment and the risks for cognitive impairment associated with quartile of serum lipid concentrations. Results The results demonstrated HDL-C was an independent beneficial factor for cognitive impairment after controlling for the potential covariates (Odds ratio, OR = 0.350, 95% Confidence interval, CI = 0.159–0.774; P = 0.009). An inverse association of HDL-C with cognitive impairment was found (P for trend = 0.001) and the association remained significant after adjusting for possible cofounders (P for trend = 0.012). The OR of cognitive impairment for the lowest versus highest quartiles of HDL-C was 1.96 (95%CI, 1.09–3.45). Conclusions The results indicated that low HDL-C is likely to be harmful for cognitive functions in centenarians. The cognitive function of longevous persons with low HDL-C concentrations deserves more attention.

BackgroundDespite research efforts in this field for more than a century, the relationship between female fertility and longevity is unclear. This study was designed to investigate this relationship in Chinese oldest-old population.MethodsThe China Hainan Centenarian Cohort Study was performed in 18 cities and counties of Hainan. A total of 1,226 females, including 758 centenarian women and 468 women aged 80–99 years, were enrolled in this study. Using a standardized protocol, in-person interviews and blood analyses were conducted by a well-trained research team through home visits.ResultsCentenarian women had significantly lower number of children (NOC) and higher initial childbearing age (ICA) and last childbearing age (LCA) than women aged 80–99 years (p < 0.05 for all). Multivariate logistic regression analysis showed that NOC and testosterone (T) levels were positively associated with women aged 80–99 years, when centenarian women was considered as reference (p < 0.05 for all). ICA, LCA, and estradiol (E2) levels were negatively associated with women aged 80–99 years, when centenarian women was considered as reference (p < 0.05 for all).ConclusionsThe centenarians had crucial characteristics of less and delayed childbearing, indicating a negative relationship between female fertility and longevity in Chinese oldest-old population. Serum E2 levels were positively associated and serum T levels were negatively associated with longevity. The less and late childbearing might be a significant factor of longevity, and successful aging might be promoted by reducing and delaying female childbearing.

AIM To investigate whether whole-lesion histogram analysis of apparent diffusion coefficient (ADC) values derived from mono-exponential and bi-exponential diffusion-weighted imaging (DWI) can differentiate lung cancer from benign pulmonary lesions. MATERIALS AND METHODS Thirty-two patients with lung cancer and 17 patients with benign pulmonary lesions were included retrospectively. All patients underwent DWI before surgery or biopsy. ADC histogram parameters, including mean, percentile values (10th and 90th), kurtosis, and skewness, were calculated independently by two radiologists. The histogram parameters were compared between patients with lung cancer and benign lesions. Receiver operating characteristic curves were constructed to evaluate the diagnostic performance. RESULTS The ADCMean, ADC10th, DMean, D10th were significantly lower in lung cancer (1.187 ± 0.144 × 10−3; 0.440 ± 0.062 × 10−3; 1.068 ± 0.108 × 10−3; and 0.422 ± 0.049 × 10−3 mm/s) compared to benign lesions (1.418 ± 0.274 × 10−3; 0.555 ± 0.113 × 10−3; 1.216 ± 0.149 × 10−3; and 0.490 ± 0.044 × 10−3 mm/s; p CONCLUSION Whole-lesion histogram analysis of ADC values derived by mono-exponential and bi-exponential DWI using 3 T magnetic resonance imaging helps distinguish lung cancer from benign pulmonary lesions.

Elderly patients who undergo major abdominal surgery are being in increasing numbers. Intensive care unit (ICU) survival is critical for surgical decision-making process. Activities of daily living (ADL) are associated with clinical outcomes in the elderly. We aimed to investigate the relationship between ADL and postoperative ICU survival in elderly patients following elective major abdominal surgery. We conducted a retrospective cohort study involving patients aged ≥65 years admitted to the surgical intensive care unit (SICU) following elective major abdominal surgery. Data from all patients were extracted from the electronic medical records. The Barthel Index (BI) was used to assess the level of dependency in ADL at the time of hospital admission. ICU survivors group had higher Barthel Index (BI) scores than non-survivors group (P

AIM To evaluate the accuracy of ultra-low-dose computed tomography (ULDCT) with ASiR-V using a noise index (SmartmA) for pulmonary nodule detection and Lung CT Screening Reporting And Data System (Lung-RADS) classifications compared with low-dose CT (LDCT). MATERIALS and METHODS Two-hundred and ten patients referred for lung cancer screening underwent conventional chest LDCT (0.80 ± 0.28 mSv) followed immediately by ULDCT (0.16 ± 0.03 mSv). ULDCT was scanned using 120 kV/SmartmA with a noise index of 28 HU and reconstructed with ASiR-V70%. The types and diameters of all nodules were recorded. The attenuation of pure ground-glass nodules (pGGNs) was measured on LDCT. All nodules were further classified using Lung-RADS. Sensitivities of nodule detection on ULDCT were analysed using LDCT as the reference standard. Logistic regression was used to establish a prediction model for the sensitivity of nodules. RESULTS LDCT revealed 362 nodules and the overall sensitivity on ULDCT was 90.1%. The sensitivity for solid nodules (SNs) of ≥1 mm diameter was 96.6% (228/236) and 100% (26/26) for SNs of ≥6 mm diameter. For pGGNs of ≥6 mm, the overall sensitivity was 93% (40/43) and 100% (29/29) for nodules with a attenuation value −700 HU or more. The agreement of Lung-RADS classification between two scans was good. On logistic regression, diameter was the only independent predictor for sensitivity of SNs (p CONCLUSION ULDCT with ASiR-V using SmartmA is suitable for lung-cancer screening in people with a BMI ≤35 kg/m2 as it has a low radiation dose of 0.16 mSv, high sensitivity for nodule detection and good performance of Lung-RADS classifications.

The present study aimed to investigate dietary vitamin intake levels and their association with the prevalence of obesity, hypertension, dyslipidemia and hyperglycemia in centenarians in China. From June 2014 to December 2016, a total of 992 centenarians aged >99 years (177 males and 815 females; age range, 100-115 years) were enrolled through household visits in the cities and rural areas of Hainan province. Details regarding food intake were recorded by continuous collection of 7-day food frequency and 24-h dietary review, and dietary vitamin intake levels were calculated according to the Chinese Food Composition Table. The deficiency rates of vitamin A (VA), VE, VB(1), VB(2), niacin and VC among the centenarians were relatively high and the prevalence of metabolic syndrome (MS) was 53.67% (519/967). The dietary intake levels of VA, VE and PP were significantly higher among the healthy centenarians than among the centenarians with MS (P

Background Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is regarded as a curative therapy for majority of hematologic malignancies and some non-malignant hematologic diseases. Venous thromboembolism (VTE) has become increasingly recognized as a severe complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Objectives To show the characteristics of VTE after haploidentical donor hematopoietic stem cell transplantation (HID-HSCT) and make comparisons with matched related donor HSCT (MRD-HSCT). Patients/methods A retrospective nested case-control study design was used, cases with VTE and matched controls were selected, with 3534 patients underwent HID-HSCT and 1289 underwent MRD-HSCT. Results During follow-up, 114 patients with VTE were identified. The incidence of VTE in HID-HSCT group was similar to that of MRD-HSCT group (2.4% versus 2.3%, P = 0.92). In HID-HSCT group, VTE occurred at a median time of 92.5 days, which was earlier than MRD-HSCT group (243.5 days). For HID-HSCT, advanced disease status, cardiovascular risk factors, acute graft-versus-host disease (aGVHD), and relapse were the independent risk factors for VTE. For MRD-HSCT, cardiovascular risk factors, aGVHD, and relapse were associated with VTE. Overall survival (OS) of patients following HID-HSCT and MRD-HSCT were similar, but the OS in patients with VTE was significantly lower than patients without VTE. Conclusions There was no statistical difference in the incidence of VTE after HID-HSCT compared with MRD-HSCT. The development of VTE adversely impacted the OS after allo-HSCT.

Importance: There was little data on the distribution of blood glucose levels and diabetes prevalence for centenarians and the oldest-old. Objective: The aim of this study is to analyzed the distribution of blood glucose and diabetes prevalence for centenarians and oldest-old in China:Based on the China Hainan Centenarian Cohort Study (CHCCS) and China Hainan Oldest-old Cohort Study (CHOCS). Design, setting and participants A total of 1002 centenarians and 798 oldest-old were enrolled from 18 cities and counties in Hainan Province (one of the longevity provinces). Main Outcomes and Measures: The fasting blood glucose was tested and prevalence of diabetes was calculated. Results: The average age of centenarians was 102.77±2.55 years old, 82.0% were women. The average age of the oldest-old was 84.99±4.01 years old, 59.9% were women. The average blood glucose of centenarians was 5.12±1.44mmol/L and 4.80±1.27mmol/L, and more than 70% were between 3.00mmol/L and 5.99mmol/L. There was no statistical difference between different genders and age groups. A total of 9.5% of centenarians had diabetes and 8.1% had IFG. A total of 11.4% of the oldest-old had diabetes and 4.4% had IFG. Abdominal obesity and TG levels may be associated with diabetes prevalence. The corresponding ORs were 1.517(1.083-2.125) and 1.473(1.089-1.943) respectively of abdominal obesity among centenarians and the oldest-old respectively, and corresponding ORs 1.182(1.081-1.316) and 1.162(1.009-1.699) respectively of abdominal obesity among centenarians and the oldest-old respectively Conclusions and Relevance: In summary, the results based on CHCCS with the largest sample among centenarians and CHOCS showed that the blood glucose level and the prevalence of diabetes were at a lower level than those of adults or younger elderly. Funding Statement: This work was supported by National Natural Science Foundation (81703285,81773502,81703308), Beijing Nova Program (Z181100006218085), Excellent youth project (2018-yqpy-003); "3+1" project; National Clinical Research Center for Geriatrics Diseases（NCRCG-PLAGH-2017017）,Medical big data research project of PLA General Hospital (2018MBD-029, 2018MBD-030); National key research and development project (2016YFC1303603, 2018YFC2000400); National Science and technology resource sharing service platform plan project (YCZYPT[2018]07) Declaration of Interests: The authors declare that there is no duality of interest associated with this manuscript. Ethics Approval Statement: This study was approved by the Biomedical Ethics Committee of Chinese PLA general hospital, and written informed consent with signature or fingerprint was obtained from each respondent.

Objective: To examine the association between progesterone concentration in early pregnancy and duration of pregnancy and risk of preterm delivery. Methods: Women enrolled in the Born in Guangzhou Cohort Study from 2013–2014, with a singleton pregnancy, who had serum progesterone measured at least one time between 4 and 10 weeks of gestation were included. The association between progesterone concentration both continuous and as categorical variable (quartile) and the risk of preterm delivery was assessed with Cox proportional hazards regression. Differences of length of gestation in four progesterone concentration quartiles were assessed using the Log-rank test. Results: We studied 1860 mother-newborn pairs. The mean overall progesterone concentration was 65.7 ± 21.3 nmol/L, with mean progesterone concentrations in the four quartiles of 42.4 ± 6.2 nmol/L (n = 463), 56.2 ± 3.3 nmol/L (n = 462), 68.9 ± 4.5 nmol/L (n = 470), and 95.1 ± 15.3 nmol/L (n = 465). There was no significantly difference in duration of gestation in four progesterone concentration groups (p=.511). There was no relation between progesterone level and preterm delivery (adjusted hazard ratio (HR) per 10 nmol/l progesterone level 1.00 (95% confidence interval (CI) 0.90, 1.11)). After adjusting for potential confounders, the HR of any preterm delivery for quartiles 1, 2 and 3 versus the highest quartile of progesterone level (> 77.3 nmol/L) was 1.04 (95% CI 0.52, 2.07), 1.17 (95% CI 0.60, 2.28), and 1.46 (95% CI 0.76, 2.78), respectively. When analysis was done for spontaneous preterm delivery only, also no association with first trimester progesterone was found. Conclusion: Lower first trimester serum progesterone concentration is not associated with reduction of length of gestation or increased risk of preterm delivery.

Yao Yao,1,* Shihui Fu,2,* Qiuling Shi,3 Hao Zhang,4 Qiao Zhu,5 Fu Zhang,5 Fuxin Luan,5 Yali Zhao,5 Yao He1 1Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Department of Symptom Research, MD Anderson Cancer Center, Houston, TX, USA; 4Department of Health Policy and Management, Texas A&M University, College Station, TX, USA; 5Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People’s Republic of China *These authors contributed equally to this work Background: Functional dependence (FD) and vitamin D deficiency are common conditions in older adults. However, little is known about the relationship between FD and serum vitamin D status in centenarians. The current study was designed to evaluate the prevalence of FD and examine its relationship with serum vitamin D status among centenarians in China.Subjects and methods: A cross-sectional study of a large sample of Chinese centenarians including 180 men and 822 women was conducted from June 2014 to December 2016. Home interviews, physical examinations, and blood analyses were performed in 958 centenarians following standard procedures. FD was evaluated using the Barthel index of activities of daily living (ADL). Serum 25-hydroxyvitamin D (25OHD) concentrations were measured as a marker of vitamin D status.Results: The prevalence of centenarians with FD was 71.2%. Vitamin D deficiency, lack of tea consumption, lack of outdoor activities, visual impairment, and fracture were predictors of FD. Centenarians in the lowest quartile of serum 25OHD concentration had an approximately threefold greater likelihood of FD than those in the highest quartile in multiple logistic regression models (OR =2.88; 95% CI 1.75–4.73; P

Objective To assess potential risk factors in identifying women at risk for gestational diabetes mellitus (GDM). Methods The present study included data collected as part of a prospective cohort study, and included women with singleton pregnancies who underwent initial prenatal examination at a tertiary women and children's hospital in Guangzhou, China between February 1, 2012, and December 31, 2015. Maternal characteristics and medical history were investigated to evaluate associations with GDM. A risk factor scoring system for the prediction of GDM was generated using logistic regression. Results Overall, 1129 (13.5%) of 8381 women were diagnosed with GDM. Women older than 35 years had a 3.95‐fold increased risk of GDM (95% confidence interval 2.80–5.58) compared with women aged 16–25 years; obese women had a 6.54‐fold higher risk (95% confidence interval 3.50–12.23) compared with underweight women. A risk scoring system was established based on age, body mass index, family history of diabetes, weight gain, and history of GDM. Screening for women with a score of 12 or more would have reduced the number undergoing oral glucose tolerance testing by 2131 (25.4%) patients with a sensitivity of 87% for GDM detection. Conclusion The assessment of risk factors for GDM could provide a foundation for improving risk‐based screening strategies in this and similar populations.

Yao Yao,1,* Xianghui Chen,2,* Shengzheng Wu,2 Liang Guo,3 Hao Zhang,4 Qiao Zhu,5 Jie Tang,3 Fuxin Luan,5 Yali Zhao,5 Faqin Lv,2 Yao He1 1Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People’s Republic of China; 3Department of Ultrasonography, Chinese PLA General Hospital, Beijing, People’s Republic of China; 4Department of Health Policy and Management, Texas A&M University, College Station, TX, USA; 5Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People’s Republic of China *These authors contributed equally to this work Background: Thyroid nodules (TNs) are common thyroid lesions in older population. Few studies have focused on the prevalence of TNs and their relationship to lifestyle characteristics and dietary habits in centenarians. The current study aimed at determining the prevalence of TNs in Chinese centenarians by using high-resolution ultrasound (US) equipment and at investigating its relationship to lifestyle characteristics and dietary habits.Participants and methods: The current study was part of the China Hainan Centenarian Cohort Study that was conducted in Hainan, an iodine-sufficient region in People’s Republic of China. A total of 874 permanent residents aged ≥100 years (mean age =102.8±2.8 years) without any missing data were included in the analysis.Results: Among the participants, 649 of them were detected at least one TN under the US examinations. The overall prevalence rate of TNs was 74.3%. The prevalence of TNs was higher in participants who were women, had hypertension, had diabetes, and were underweight compared with their counterparts. Multivariate logistic regression analyses showed that being female, hypertensive, and diabetic; betel quid consumption; and red meat consumption were independent risk factors, while being underweight and nut consumption were independent protective factors for TNs.Conclusion: Our findings indicate that the presence of TNs was highly prevalent in Chinese centenarians, particularly in women. In addition to gender, having hypertension, having diabetes, and being underweight, the presence of TNs was independently associated with betel quid, red meat, and nut consumption. Further prospective studies are warranted to verify these associations in populations from different age strata, races, cultures, and iodine supplementation.Keywords: thyroid nodules, ultrasound, lifestyle, dietary, betel quid, red meat, nut, centenarians&nbsp

Purpose: To analyze the chest computed tomography (CT) manifestations of non-Mycobacterium tuberculosis (TB) induced granulomatous lung disease (GLD) with their clinical presentations and laboratory test results. Methods: A total of 55 patients had chest CT scan during a period from June 2010 to January 2016. We retrospectively compared the location, morphology and other specific features of the lesions that were pathologically diagnosed as non-TB induced GLD. Clinical presentations and laboratory results were also documented. Results: Infectious causes of GLD identified are mainly pulmonary cryptococcosis (n = 8, 14.5%) and pulmonary actinomycosis (n = 3, 5.5%). For non-infectious causes, the most common cause is pulmonary sarcoidosis (n = 27, 49.1%). Symptoms frequently observed include cough (n = 39, 70.9%) and expectoration (n = 30, 54.4%). Lesions due to GLD are mainly multiple and have bilateral distribution on chest CT. These findings are particularly prominent for non-infectious GLD. Lesions in non-TB induced infectious GLD are often unilateral. The morphology of lung lesions is mostly nodules, but lesions can also be masses, consolidations or ground-glass opacity based on the underlying etiology. Nodules are prominent in lungs affected by sarcoidosis along with thoracic lymphadenopathy. Nodules are also seen in non-TB induced infectious GLD, but they are rarely accompanied by hilar lymphadenopathy. Conclusion: Chest CT could be helpful in diagnosis of the underlying causes of the disease. Nevertheless, chest CT is still insufficient to provide a diagnosis alone due to its unsatisfactory specificity. Confirmation of the diagnosis still relies on histopathological exam of tissue samples. Keywords: Non-TB induced granulomatous lung disease, Chest computed tomography (CT), Pulmonary sarcoidosis, Pulmonary fungal infections, Pulmonary lesions

To reduce the influence of the measurement data noise on state of charge (SOC) estimation, a novel neural network method is proposed by combining an input data processing method with the conventional gated recurrent unit recurrent neural network (GRU-RNN) method. First, a denoising autoencoder neural network (DAE-NN) is introduced to extract the useful data features by reducing the noise and increasing the dimensions of the battery measurement data. Then, the feature-extracted data is utilized to train the GRU-RNN, which is widely used in SOC estimation. Notice that a good input data processing method plays a key role in the SOC estimation performance and the generalization ability. Therefore, it is not trivial to combine the data processing method (DAE-NN), and the SOC estimation method (GRU-RNN), which is named DAE-GRU. Compared with the traditional GRU-RNN, the new DAE-GRU method shows a better nonlinear mapping relation between the measurement data and the SOC because of the involvement of the DAE-NN. Finally, three different driving cycles are given in the experiment to cross-train and verify the proposed DAE-GRU, GRU-RNN and RNN. Compared with the GRU-RNN and the RNN, it is demonstrated that the proposed DAE-GRU has better accuracy and robustness in the SOC estimation.

An analytical model was developed for the prediction of small-mass-impact response including delamination effects in orthotropic composite plates, which mainly focuses on the relatively weak resistance of fiber reinforced polymer (FRP) laminates to small mass impact. Mode parameters of the delaminated structure obtained through perturbation-based dynamic analysis were substituted into the dynamic impact model. The alterations of the structural response caused by the occurrence of delamination were predicted by applying the premeasured delamination threshold load (DTL) to the developed model. The occurrence of delamination was clearly shown by a descent following a sudden rise on the velocity curve of the impact point. Impact tests with different initial energy were conducted on FRP laminated plates of varying thickness. The experimental results were well consistent with the analytical prediction. The validity of the proposed model was further confirmed using exploratory experiments with the velocity measurement point located nearby the impact point. The proposed model was more practically applicable than finite element modelling due to its efficiency in terms of time.

In this work, internal damage condition of concrete subjected to freeze-thaw (F-T) cycles was investigated by means of electrochemical impedance spectroscopy (EIS) technique. The equivalent circuit model was adopted to explain the EIS results according to the establishment of physical model simulating the internal micro structure of concrete. As a result, continuous decrease of resistance of continuous path was found out in the process of F-T cycle because of the expansion and propagation of internal cracking of concrete. This was also demonstrated by microscopic analysis obtained from environmental scanning electron microscope (ESEM) observation. Besides, damage degree calculated based on the decrease of resistance was introduced to evaluate the internal degradation condition of concrete suffering from F-T cycles.

Accurately estimating the state of charge (SOC) of the battery is the basis of battery management system. Based on a linear equivalent circuit model, this paper has introduced a switched battery model to model the complicated physical and chemical reactions properties. The SOC is determined by the battery electromotive force at a present battery state that is estimated through the $H_\infty$ switched observer for dealing with the inexact or unknown statistical properties of the modeling and measurement errors. The observer design criterion is presented to ensure the $H_\infty$ performance of the switched observer. Then, the proposed method is applied successfully to estimate the SOC by utilizing the current and terminal voltage. Finally, the experimental results have demonstrated that the proposed method can provide high accuracy and robustness for SOC estimation.

Background: To investigate the potential value of CT parameters to differentiate ground-glass nodules between noninvasive adenocarcinoma and invasive pulmonary adenocarcinoma (IPA) as defined by IASLC/ATS/ERS classification. Methods: We retrospectively reviewed 211 patients with pathologically proved stage 0-IA lung adenocarcinoma which appeared as subsolid nodules, from January 2012 to January 2013 including 137 pure ground glass nodules (pGGNs) and 74 part-solid nodules (PSNs). Pathological data was classified under the 2011 IASLC/ATS/ERS classification. Both quantitative and qualitative CT parameters were used to determine the tumor invasiveness between noninvasive adenocarcinomas and IPAs. Results: There were 154 noninvasive adenocarcinomas and 57 IPAs. In pGGNs, CT size and area, one-dimensional mean CT value and bubble lucency were significantly different between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate regression and ROC analysis revealed that CT size and one-dimensional mean CT value were predictive of noninvasive adenocarcinomas compared to IPAs. Optimal cutoff value was 13.60 mm (sensitivity, 75.0%; specificity, 99.6%), and −583.60 HU (sensitivity, 68.8%; specificity, 66.9%). In PSNs, there were significant differences in CT size and area, solid component area, solid proportion, one-dimensional mean and maximum CT value, three-dimensional (3D) mean CT value between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate and ROC analysis showed that CT size and 3D mean CT value were significantly differentiators. Optimal cutoff value was 19.64 mm (sensitivity, 53.7%; specificity, 93.9%), −571.63 HU (sensitivity, 85.4%; specificity, 75.8%). Conclusions: For pGGNs, CT size and one-dimensional mean CT value are determinants for tumor invasiveness. For PSNs, tumor invasiveness can be predicted by CT size and 3D mean CT value.

Purpose To estimate the CT findings of clinically confirmed pulmonary infection in patients with endotracheal intubation and mechanical ventilation. Materials and methods This retrospective study enrolled 48 intubated adult patients with clinically confirmed pulmonary infection and CT examination after intubation in our hospital. Patients were further divided into two groups according to the risk of aspiration. Difference in clinical characters and imaging manifestations were compared between the two groups. Results The most common CT findings of pulmonary infection in intubated patients were GGO (93.8%) and consolidation (89.6%), followed by lung nodule (56.3%), pleural effusion (56.3%), thickened bronchial wall (50.0%), small airway disease (45.8%), lymphadenopathy (39.6%) and atelectasis (33.3%), but cavity (14.6%) and bronchiectasis (8.3%) were less common. The semi-quantitative scoring results showed significantly higher extent of lung lesions in gravity dependent region for patients in high-risk aspiration group. However, no significant difference was found in low-risk aspiration group. The difference in frequency of cross sectional distribution patterns between gravity dependent and independent region was also statistically significant for patients in high-risk aspiration group, but not in low risk aspiration group. Conclusions CT has advantage in assessment of lesions type, gravity dependent and cross sectional distribution of pneumonia in intubated patients.

In order to explore the dynamic mechanical properties and damage evolution for concrete under the repeated impact loading, the large-diameter (74 mm) Split Hopkinson Pressure Bar (SHPB) was used to conduct the dynamic compression test. The damage was calculated by the Weibull statistical damage model, and the stress-strain curves of concrete were analyzed to study the repeated impact loading effects on the damage of concrete. Meanwhile, the fracture process of the concrete was simulated with the finite element software (LS-DYNA) and Johnson Holmquist Concrete (*MAT_JOHNSON_HOLMQUIST_CONCRETE) constitutive model. The results showed that the dynamic elastic modulus and the peak stress of the specimens decreased with the increased number of repeated impacts, while the peak strain increased. The damage of concrete increased with the increased strain, and the damage increased sharply after the “inflection point”. In addition, the results obtained by finite element simulation agree with the experimental results.

Trace elements are key regulators of metabolism and physiological pathways, and their levels change during aging. Hair, as a biological sample, has attracted much attention due to its ease of collection and slow substance metabolism. Also, trace elements in hair can reveal the distribution of essential nutrients and toxic elements in the body pools. Therefore, we investigated the lifestyle and dietary status by questionnaire and measured 8 trace elements in hair and 6 elements in blood of a sample of elders over 80 residing in Hainan province of China. Our data showed that the concentration of Se, Fe and Pb dropped as people grow older, but Mn rose. Changes in trace elements may affect enzyme activity and biological pathways, and are associated with many diseases, including cancer and chronic diseases. In addition, association between age-related diseases and trace elements are increasingly being reported, suggesting that approaches of combining nutrition with longevity studies in the further study will help us to identify the mechanisms whereby trace elements affect the aging process.

Background Previous studies reported that low level of oestradiol (E2) was associated with higher risk of cardiovascular disease (CVD). However, little study examined the relationship between E2 and CVD in longevous women, which were deficient in serum E2 for the post-menopausal status. Therefore, this study aims to explore the association between E2 and CVD risk factors in a group of female centenarians of Hainan, China. Methods A total of 413 female centenarians (aged from 100 to 115) from China Hainan Centenarian Cohort Study (CHCCS) were enrolled in this study. Home interviews were conducted to collected data on demographic characteristics, health-related lifestyles, and anthropometrics. The level of serum E2 was assessed in the Clinical Laboratory of Hainan branch of PLA General Hospital. The variables of CVD risk factors, including blood pressures, lipids and blood glucose, were measured through standard procedures. Results Significant negative correlations between levels of serum E2 and TC, HDL-C, and LDL-C were observed in this study. Compared with the highest group of E2, the odds ratio and 95% confidence intervals of high LDL-C in groups 3, 2 and 1 were OR1.94 (CI0.82–4.62), OR3.61 (CI1.27–10.25) and OR9.29 (CI2.08–41.53), respectively. Similarly, the prevalence of hypertension was decreased with the increase of serum E2. The odds ratio and 95% confidence intervals of stage-2 hypertension in groups 3, 2 and 1 versus highest E2 group were OR1.34 (CI0.49–3.72), OR1.36 (CI0.47–3.99) and OR1.38 (CI0.45–4.20), respectively. Conclusions This study examined the relationship between E2 and CVD risk factors in a group of community-based female centenarians. A negative correlations between serum E2 levels and CVD risk factors, i.e. high level of LDL-C, TC, and hypertension were observed in this population. Besides, the level of serum E2 is also negatively correlated with HDL-C. Further studies on the correlation between serum E2 and CVD risk factors, especially dyslipidemia, in longevous and post-menopausal women are warranted.

Purpose To evaluate the clinical value of ultralow-dose CT (ULDCT) with adaptive statistical iterative reconstruction-V (ASiR-V) in the detection of pulmonary nodules in a Chinese population. Method One hundred eighty-eight patients (16.41 ≤ BMI ≤ 29.87 kg/m2) with pulmonary nodules detected on low-dose chest CT (LDCT) underwent local ULDCT at the center of the chosen nodule with a scan length of 3 cm. LDCT was performed using the Assist kV (120/100 kV)/Smart mA mode and at 120 kV/2.8 mAs for ULDCT. After scanning, CT images were reconstructed with ASiR-V 50%. For both scans, nodule diameters were measured and reference standards were established for the presence and types of lung nodules found on LDCT. The sensitivity of ULDCT was compared against the standard, and logistic regression analysis was used to determine the independent predictors for nodule detection. Results Compared with LDCT (0.93 ± 0.32 mSv), a 89.7% dose decrease was seen with ULDCT, for which the calculated effective dose was 0.096 ± 0.006 mSv (P 0.05). Conclusions ULDCT can be used in the management of pulmonary nodules for people with BMI ≤ 30 kg/m2 at 10% radiation dose of LDCT.

Hepatic sinusoidal obstruction syndrome (SOS) has been rarely studied after haploidentical donor (HID) allogeneic hematopoietic stem cell transplantation (allo-HSCT). We performed a retrospective multicentre study on patients with SOS after allo-HSCT in China. The incidence, risk factors, and outcomes were compared between HID HSCT and matched related donor (MRD) HSCT. SOS developed in 0.4% of patients (HIDs: 0.4%, MRDs: 0.5%, p = 0.952) at a median time of 21.50 days (range, 1–55) after allo-HSCT (HIDs: 24 days, MRDs: 20 days, p = 0.316). For patients diagnosed with SOS, the 2-year cumulative incidence of relapse was 22.7% and 22.4% in patients receiving HID and MRD transplantation, respectively (p = 0.584). Overall survival (OS) at 2 year was 10.4% and 38.5% in the two groups (p = 0.113). The transplant-related mortality (TRM) at 100 days was 60.9% in the HID group and 38.5% in the MRD group (p = 0.178). According to the multivariate analyses, significant independent risk factors for the occurrence of SOS were delayed platelet engraftment (p = 0.007) and advanced disease status at the time of HSCT (p = 0.009). The outcomes of SOS after HID HSCT are similar to those after MRD HSCT.

This study aims to investigate the prevalence of vitamin D deficiency in Chinese centenarians and to identify the factors associated with vitamin D deficiency. Cross-sectional population-based study Hainan province in the south of China. 943 subjects aged 100 years old and older. Details on sociodemographics and lifestyle characteristics were collected using a structured questionnaire. Anthropometrics and blood samples were obtained. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentration < 20ng/mL (50nmol/L). The overall prevalence of vitamin D deficiency among these 943 centenarians was 39.9% (376 subjects) and the mean serum vitamin D concentrations were 22.7±9.5 (ng/mL). Female centenarians had higher prevalence of vitamin D deficiency than male (44.0% vs. 21.7%, P < 0.001). Multivariate logistic regression analyses showed that being female, urban residency, lower body mass index, higher serum parathyroid hormone levels, no fish consumption, and less sun exposure time were all significant and independent determinants of vitamin D deficiency. No significant associations of vitamin D deficiency with ethnic, education, geographic location, tea drinking, alcohol use, or smoking were found in this study. Vitamin D deficiency was common in Chinese centenarians, especially in women. Given that vitamin D deficiency is linked to numerous adverse health outcomes, dietary, outdoor activities and other intervention measures are needed to correct vitamin D deficiency in this population.

Clonorchiasis is an important food-borne parasitic disease in China because of the popularity in ingesting raw freshwater fish. To explore the epidemiology and determinants of clonorchiasis in children, a cross-sectional survey was implemented in two middle schools in Qiyang county, Hunan province, in southeastern China. Questionnaire survey and fecal examination were implemented. Questionnaires were fed back by 627 students, while stool samples were collected from 557 students, out of which 545 ones also provided questionnaire information. The percentage of students ingesting raw freshwater fish was 40.5% (254/627), while the prevalence with Clonorchis sinensis infection was 18.9% (105/557). Such factors contributed significantly to the students' practice in eating raw freshwater fish including boys, fathers' eating raw freshwater fish, mothers' eating raw freshwater fish, and preparation of raw freshwater fish at home, with an adjusted odds ratio of 1.9 (95% confidence intervals (95% CI): 1.3-2.8), 3.9 (95% CI: 2.3-6.5), 3.0 (95% CI: 1.8-4.8) and 2.8 (95% CI: 1.8-4.5), correspondingly. Ingestion of raw freshwater fish, fathers' eating raw freshwater fish and preparation of raw freshwater fish at home were risk factors of C. sinensis infection in students, and the adjusted odds ratio was 3.2 (95% CI: 1.9-5.5), 2.1 (95% CI: 1.1-3.9) and 1.8 (95% CI: 1.0-3.2), respectively. Thus, clonorchiasis was endemic in the surveyed schools due to the ingestion of raw freshwater fish, which is influenced by family environment. Education should be implemented in schools to promote behavioral change of eating raw freshwater fish.

We demonstrate a laser far field scattering method to detect droplets efficiently. The scattering from droplet include transmission and reflection patterns, and the relation between the intensity distributions of scattering and the surface tension, refractive index of the liquid droplet were derived out theoretically. In our experiment, the stable transmission and reflection patterns from droplets were collected clearly, and surface tension, the refractive index of the droplet were measured simultaneously. A new optical method for detecting the droplet was developed, and the correlation of the scattering patterns to the droplet shape was also established experimentally. Our work has potential applications in the field of interfacial phenomena.

This paper describes the design and testing of a shock absorber with an inward-folding composite tube that can be used as a structural component in its normal working state. Although more energy can be absorbed when the hollow of the tube is filled with composite debris, a higher load relative to the initial peak load will be produced. A variable structure based on two inclined energy absorbers was then proposed, and impact tests used to verify the reaction load calculation for two models experimentally. Results indicate that the variable structure had a greater compression ratio and a flatter load curve, demonstrating its potential for use in the struts of an aircraft cargo floor.

Terahertz emission properties of oxidized silver/copper micro thin film were investigated. Enhanced terahertz emission was observed from the oxidized micro thin film deposited on nanoparticles aggregation substrate due to the various directions of transient current surge. The amplitude of terahertz emission from the film was comparable to that from traditional non-external gallium arsenide. The sample, firstly, was synthesized by hydrothermal method to fabricate nanoparticles aggregation substrate. Next, the etched sample was treated by physical vapor deposition to grow silver/copper micro thin film and oxidized at 200 °C atmosphere environment. The space charge region was the dominant area for terahertz emission, built-in field at depletion layer played a key role in terahertz emission, and the contribution arising from optical rectification and photogalvanic was negligible due to the centrosymmetry structure; high band gap, low carriers concentration and mobility leads to the photon drag effect was not obvious; Because the differences of mobility and mass between hole and electron were not distinct, the Dember effect was also ineffective. The intensity of the terahertz emission was related to the thickness of the silver film because the silver film has a close relationship with the oxidation rate of the copper layer, leading to a dramatic influence on band gap structure, which produced a direct response on optical absorption at red zone. Compared with the planar substrate, the radiation of the nanoparticles substrate is 1.2 times that of the planar substrate, and the enhancement of the terahertz emission was ascribed to the various vibrated directions of photo-generated carriers. Our results could provide a potential portable terahertz emitter, which is economical, simple processing and operatable at room temperature.

In this paper, the extinction and near-field properties of Au–Au, Ag–Ag nanosphere homo-dimer and Au–Ag nanosphere hetero-dimer were studied by using the discrete dipole approximation method. The relation between extinction and interparticle spacing was investigated under y- polarization (perpendicular to dimer axis) and z-polarization (parallel to dimer axis) incidence. The results show that the both extinction peak position and enhancement factor of electric field are sensitive to interparticle spacing when the dimer is illuminated by z-polarization incidence. For Au–Ag hetero-dimer, double same-intensity extinction peaks in visible band were found by regulating interparticle space under z-polarization incidence, and the experience forum was obtained for realizing the double same-intensity peaks.

To study the effect and molecular mechanisms of amlodipine besylate combined with acupoint application of traditional Chinese medicine nursing on the treatment methods of renal failure and hypertension. A total of 60 cases of renal failure hypertension were randomly divided into the Control group and the Treatment group. The control group was treated with amlodipine besylate, while the treatment group was treated with amlodipine besylate combined with acupoint application of traditional Chinese medicine nursing. A rat model of renal failure hypertension was established. Rats were divided into the sham group, model group, NC group (treated with amlodipine besylate) and treatment group (treated with amlodipine besylate combined with acupoint application of traditional Chinese medicine nursing). Rats were given drugs at 10‑20 weeks of age to observe their general condition and detect changes of blood pressure, blood biochemical indices and urine index. The pathological changes of renal tissue were examined by hematoxylin and eosin staining, and the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)9 were detected by immunohistochemistry. Reverse transcription‑quantitative polymerase chain reaction was used to determine mRNA expression of phosphoinositide 3‑kinase (PI3K), protein kinase B (AKT) and endothelin (ET)‑1 and western blotting was used to detect the expression of phosphorylated (p)‑PI3K/PI3K, p‑AKT/AKT and p‑nuclear factor (NF)‑κB p65/NF‑κB p65 protein. Systolic and diastolic blood pressures in Treated group patients were significantly lower compared with in Control group patients. The systolic and diastolic blood pressure of rats were significantly decreased and blood urea nitrogen (BUN), carbapenem‑resistant Enterobacteriaceae (CRE), N‑acetyl‑β‑D‑glucosaminidase (NAG), urine protein (UP) and blood urea protein (BUP), contents were significantly decreased following amlodipine besylate treatment. The expression of VEGF and matrix metallopeptidase 9 protein were significantly decreased, but the expression of PI3K, AKT mRNA and p‑PI3K/PI3K, p‑AKT/AKT protein were significantly increased. ET‑1 mRNA and p‑NF‑κB p65/NF‑κB protein were significantly increased. The pathological alterations of renal tissue were improved and the pathological changes of glomerulus, tubule and interstitium were alleviated. Amlodipine besylate combined with acupoint application of traditional Chinese medicine nursing can effectively reduce the systolic pressure and diastolic pressure of patients, and improve the symptoms and signs of patients, which may be associated with the regulation of the expression of PI3K/AKT pathway, so as to regulate the expression of BUN, CRE, UP, BUP and NAG.

Background Hypovitaminosis D and depressive syndromes are common conditions in old adults. However, little is known about the relationship between vitamin D and depression in exceptional aged people. The objective of this study is to evaluate the relationship between vitamin D levels and depressive symptoms in Chinese longevous persons. Methods We used a dataset from a cross-sectional survey of a sample of Chinese longevous people with self-reported age 100 or older, including 175 men and 765 women, was conducted from June 2014 to December 2016 in Hainan Province, China. Data on demographics, lifestyle characteristics and health conditions were collected using a structured questionnaire. Anthropometrics and blood samples were obtained following the standard procedure. Depressive symptoms of the participants were assessed using a shortened version of the Geriatric Depression Scale (GDS-15). Serum vitamin D levels were measured using an automated radioimmunoassay. Results The prevalence of longevous persons with depressive symptoms among the sample was 32.2% (95% confidence interval: 29.7–34.7%). Serum vitamin D levels were lower in participants with depressive symptoms than in those without (20.8 ± 8.7 vs. 23.7 ± 9.7, ng/mL). Vitamin D deficiency was an independent risk factor for depression after controlling for the potential covariates (Odds ratio = 1.47, 95% Confidence interval = 1.08–2.00; p = 0.014). A negative relationship between serum vitamin D levels and depressive symptoms was also detected, and the relationship remained significant after adjusting for a wide range of other covariates. The multivariate adjusted odds ratio of depressive symptoms for the lowest versus highest quartiles of vitamin D levels was 1.73 (95% confidence interval: 1.10–2.72), and the adjusted odds ratio with a 5 ng/mL decrement of serum 25OHD levels was 1.10 (95% confidence interval: 1.01–1.19). Conclusions This study showed an inverse association between vitamin D levels and depressive symptoms among Chinese longevous persons. Depressive symptoms should be screened in longevous persons who had vitamin D deficiency. Further studies on vitamin D supplement and prevention along with treatment of depression are needed among very old population.

Introduction Late-onset hemorrhagic cystitis (LOHC) is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with an incidence ranging from 6.5% to 70% and leads to prolonged hospitalization and even death (Silva Lde P et al, Haematologica, 2010; LAM et al, Transpl Infect Dis, 2017). The pathogenesis of LOHC remains obscure, but in our previous study, viral infections and acute graft-versus-host disease (aGVHD) have frequently been shown to be associated with its development (Han et al., Am. J. Hematol, 2014). Therapeutic strategies for LOHC are still not standardized due to the complicated clinical background and given the paradoxical phenomenon that immunosuppressive agents, such as steroids, are necessary for aGVHD but cause an immunosuppressive state. We aimed to investigate the incidence, risk factors and outcomes of LOHC after allogeneic stem cell transplantation. Additionally, for the first time, we propose four therapeutic patterns and their impact on prognosis of LOHC to aid in clinical decision making. Methods This retrospective, nested, case-control study reviewed data from 2158 patients who received allo-HSCT from January 2014 to December 2018. In total, 364 (16.87%) patients were diagnosed with LOHC. Individual matching was performed by randomly selecting 3 controls from the same cohort for each identified LOHC patient according to the time of allo-HSCT. Standard basic measures included hyperhydration, forced diuresis, insertion of a vesical catheter for intermittent or continuous bladder irrigation and evacuation of clots. Patients with grade III-IV LOHC were divided into four groups according to immunosuppressant use (steroid, MMF and Basiliximab) 1 week before and after the onset of LOHC: an intensified-intensified (I-I) group, intensified-not intensified (I-N) group, not intensified-intensified (N-I) group and not intensified-not intensified (N-N) group. "Intensified" was defined as an increase in any immunosuppressant, and "not intensified" was defined as maintenance or tapering of all immunosuppressants. Data concerning the baseline characteristics, incidence, treatment patterns and outcomes were recorded. Results In total, 364 patients developed LOHC at a median of 29 days (range, 23-37.75 days), with a cumulative incidence of 16.87%. AML (HR =0.493 95% CI, 0.244-0.997; p=0.049), AA (HR =0.444, 95% CI,0.18-1.096; p=0.078), HLA match(HR =0.149, 95% CI, 0.036-0.616; p=0.009), days to platelet engraftment(HR =1.023, 95% CI, 0.998-1.049;p=0.069)and CMV viremia (HR =2.365, 95% CI, 1.179,4.733;p=0.015)were associated with LOHC. Only HLA match (HR =0.111, 95% CI, 0.014-0.878; p=0.037)remained significant in the multivariate analysis. 6.5%, 12.9%, 48.39% and 32.26% patients with III-IV LOHC were divided into I-I, I-N, N-I and N-N groups, respectively. There were no significant differences in overall survival (p=0.05) and the incidence of CMV viremia (p=0.187) among the four groups. The incidence of relapse (p=0.007) and the incidence of aGVHD (p=0.01) was highest in the I-I group, followed by the N-I, I-N and N-N groups. 50% of the patients in N-I group showed the improvement of LOHC, which is significantly highest among the four groups(p=0.000). However, no statistical significance was found regarding the CMV viremia turning shade or the improvement of aGVHD. Non-relapse mortality (NRM) was observed in 25% of patients without resolution of LOHC. NRM was 0% among patients without intensified immunosuppression but was 25%, 0% and 50% among those with intensified immunosuppression before LOHC, after LOHC and before and after LOHC, respectively. Conclusion The independent risk factors for LOHC after allo-HSCT were HLA mismatch. Avoiding intensified immunosuppression that damages endothelium or reactivates the related virus may improve transplant outcome. The N-N pattern could reduce the incidence of CMV viremia or aGVHD in the LOHC patients, and the N-I pattern might be more promising as a therapeutic strategy for LOHC. Disclosures No relevant conflicts of interest to declare. Disclosures No relevant conflicts of interest to declare.

To evaluate the utility of mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for differentiating the activity of sacroiliitis in ankylosing spondylitis (AS). AS patients were divided into active group (n = 30) and inactive group (n = 28) according to Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (CRP). In addition, 30 healthy volunteers were chosen as healthy group. Subjects were scanned by conventional MRI, diffusion-weighted imaging, and IDEAL-IQ sequence. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and fat fraction (FF) values were measured, and their relative values (rADC, rD, rD*, rf) were calculated by the formula ADC (D,D*,f)lesion/ADC (D,D*,f)reference, respectively. The ADC, D, rADC, and rD of active group were the highest among the three groups, followed by inactive and healthy group. However, D* and rD* showed no significant difference among the three groups. FF was significantly higher in inactive group than in healthy and active group. ADC and D had significantly higher AUCs than f for differentiating active group from healthy group, while FF had the highest AUC for distinguishing inactive sacroiliitis from healthy group. DWI and IDEAL-IQ imaging are helpful in quantitatively assessing the activity of sacroiliitis in AS patients.

Background Centenarians refer to a special group who have outlived most of their fellows. Body shape and abdominal obesity have been identified as cardiovascular disease (CVD) risk factors. Our study aimed to evaluate the relationship between body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) and CVD risk factors among male and female centenarians in Hainan province. Methods Five hundred thirty-seven centenarians aged between 100 and 115 (Mage = 107 years old) years participated in this study. Each participant received a standardized questionnaire and physical examination. We measured anthropometric variables (BMI, WC, WHR, WHtR, SBP and DBP) and serum lipid (TC, TG, HDL-C and LDL-C). Results 76.9% (n = 413) of the study subjects were female. TC, TG, LDL-C and HDL-C were significantly higher in female group than that of male group. BMI, WC and WHtR were well-correlated with the CVD risk factors. The anthropometric measures were negatively related with HDL-C levels and positively related with the other CVD risk factors. Conclusions Hainan centenarians were short in stature and underweight. Moreover, female centenarians were often pear-shaped, while male centenarians were often apple-shaped. Further, BMI, WC and WHtR were well-correlated with the serum lipid, and TC, TG, LDL-C and HDL-C were significantly higher in females than males. Also, BMI, WC and WHtR were closely related to the incidence of dyslipidemia in females, including high TG, high LDL-C and low HDL-C.

Computational drug repositioning helps to decipher the complex relations among drugs, targets, and diseases at a system level. However, most existing computational methods are biased towards known drugs-disease associations already verified by biological experiments. It is difficult to achieve excellent performance with sparse known drug-disease associations. In this article, we present a graph regularized transductive regression method (GRTR) to predict novel drug-disease associations. The proposed method first constructs a heterogeneous graph consisting of three interlinked sub-graphs including drugs, diseases and targets from multiple sources and adopts preliminary estimation of drug-related disease to initial unknown drug-disease associations for unlabeled drugs. Since the known drug-disease associations are sparse, graph regularized transductive regression is used to score and rank drug-disease associations iteratively. In the computational experiments, the proposed method achieves better performance than others in terms of AUC and AUPR. Moreover, the varying of parameters is shown to verify the importance of preliminary estimation in GRTR. Case studies on several selected drugs further confirm the practicality of our method in discovering potential indications for drugs.

Crane has the characteristics of complex structure, large volume and weight. Crane production is widely used in fixed-point assembly. But in the fixed-point assembly process, there will be assembly inefficient, complex distribution, to be more products and other issues arise. Therefore, the assembly line balance is one of the important issues in planning efficient assembly lines. On the basis of fully understanding the crane production line, the linear programming method was used to establish the mathematical model which can fully reflect the relationship between the production elements of the production line in this paper. And then using Lingo software to optimize the production line balance solution, the assembly line achieve a smooth production and improve the production efficiency.

The shear lag effect distribution, law of a single-box, three-room cantilever box girder under double-deck uniform loads is discussed through experimental research and analysis of the flexu...

Based on bridges routine examination, special detection is in-depth and meticulous testing that according to the disease characteristics, using some expertise technology and testing equipment for steel corrosion, concrete carbonization, the thickness of the protective layer and component quality to some key parts or typical bridge opening. Bridge condition of technology can be controlled more fully and accurately through a special bridge inspection, combined with conventional test results on the status of a comprehensive assessment of structures. This may provide technical data for the next bridge inspection count and load test, moreover, according to the variation of the data in the field test, it may dedicate variation characteristic and influencing factors for damage of structural durability from these special detections.