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We tested the hypothesis of whether maternal residential proximity to municipal solid waste incinerator (MSWI) sites could significantly affect birth outcomes. This retrospective birth cohort study conducted at the International Peace Maternity and Infant Hospital, Shanghai, China, included 59,606 mothers with singleton live births during 2014-2018. Multivariate generalized linear models were used to examine associations between residential proximity to MSWI sites and birth outcomes. Small for gestational age (SGA) was significantly more common among children with maternal residential proximity to MSWI sites (odds ratio [OR]=1.20, 95% confidence interval [CI]: 1.07-1.34). Maternal prepregnancy body mass index (BMI) influenced this association. Infants of underweight mothers (prepregnancy BMI

Concurrent mutations of epidermal growth factor receptor (EGFR) and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) in non-small cell lung cancer (NSCLC) are rare, and the presence of concurrent mutations may complicate treatment. Herein, we report a case of primary lung adenosquamous carcinoma with concurrent EGFR 21 (L858R) and PIK3CA (H1047R/E545K) mutations, and the results of a literature review to help management and treatment. A 49-year-old female was admitted our department for coughing and excessive sputum production for more than 1 month. Computed tomography (CT) of the chest identified a lesion, and a CT-guided needle biopsy was performed. Pathological examination and immunohistochemistry (IHC) staining confirmed a diagnosis of primary lung adenosquamous carcinoma. Amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) gene sequencing demonstrated mutations in both EGFR 21 (L858R) and PIK3CA (H1047R/E545K) mutations in adenocarcinoma (AC) component. She was treated with pemetrexed plus platinum-based chemotherapy and an EGFR-tyrosine kinase inhibitor (TKI). Disease progression occurred with gefitinib or osimertinib as maintenance therapy. A repeat CT-guided needle biopsy was performed, and generation sequencing (NGS) revealed EGFR 21 (L858R) and PIK3CA (H1047R/E545K) mutations. Anlotinib monotherapy was then administered as the third-line treatment, and there was a PR. The patient is currently still receiving treatment and follow-up. To our knowledge, there is little evidence that anlotinib is beneficial when there are concurrent EGFR and PIK3CA mutations. PIK3CA mutations are associated with poor therapeutic effects and short survival time. Concurrent EGFR and PIK3CA mutations do not respond to EGFR-TKI treatment. Chemotherapy should be given in combination with a TKI and can prolong the progression-free survival (PFS) and overall survival (OS) of patients with lung cancer.

BACKGROUND Primary small cell esophageal carcinoma (PSCEC) is aggressive and rare, with a worse prognosis than other subtypes esophageal carcinoma. No definitive and optimum standard guidelines are established for treating it. Herein, we report a case of PSCEC, including a current literature review of PSCEC. CASE SUMMARY A 79-year-old male was diagnosed PSCEC with multiple lymph node metastasis thorough computed tomography, positron emission tomography-computed tomography, endoscopy and pathology. Surgery was not suitable for this patient. He was treated with etoposide 100 mg/m2 and cisplatin 25 mg/m2 on days 1-3, every 3 wk for 4 cycles. The tumor and lymph nodes became smaller and dysphagia and vomiting symptoms improved. The patient could not tolerate subsequent chemotherapy (CT) because of hematological toxicity; therefore, we performed immunotherapy (durvalumab, 1500 mg) every 4 wk. At present the patient has received 12 cycles immunotherapy over about 1 year. He is still receiving treatment and follow-up. CONCLUSION PSCEC with multiple lymph nodes metastasis does not always indicate surgery. CT may extend survival time and improve the quality of life in the absence of surgery. Immunotherapy or immunotherapy plus CT may also work as a treatment for PSCEC.

The recently emerging laser-induced graphene (LIG) technology, with one-step processing and designable features, has been widely used in the fabrication of wearable/portable electronics. Herein, by taking inspiration from kirigami, we designed a stretchable supercapacitor (SC) step by step through controlling laser induction and cutting process on the polyimide (PI) film, with the use of one single CO2 laser source. Firstly, the carbonized basic geometric units of lines were produced on PI films to investigate the processing-structure relationships. Then, the complex photothermal conversion and heat transfer progress involved in the carbonized process were simulated by a photothermal model. Both experimental and theoretical results suggested that the laser power, scan rate and focus condition have great influence on the size, shape and morphology of the carbonized lines. Finally, we optimized the parameters of laser induction and cutting process to fabricate the kirigami-inspired SCs with reliable electrochemical properties and editable mechanical flexibility, showing great potential in the field of flexible electronics.

Background: Mondor's disease (MD) is a rare benign and self-limited entity characterized by superficial thrombophlebitis of a vein in special regions. It may be secondary to trauma, malignancy, surgery, excessive physical activity or hyperviscosity. Diagnosis of MD is often based on history and physical examination. Case presentation: Here we present a rare case of Mondor's disease of chest wall with a pain and subcutaneous cord-like induration of right lateral chest. Ultrasonography revealed a superficial venous thrombosis of right thoracoepigastric vein. After treatment of aspirin for 2 weeks, chest pain was obviously relieved, and the lesion completely resolved approximately 6 weeks after presentation. Conclusions: Mondor’s disease could spontaneously resolved after several weeks and excessive medical intervention should be avoided.

Rare diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) was first diagnosed in the early 1950s, but was not fully recognized and named until 1992. Literatures reported that DIPNECH usual was multiple and diffuse bilateral nodules, rare patients demonstrate the single nodule or ground glass nodule (GGN). We diagnosed one patient because of intermittent dry cough at least one year, Chest computed tomography (CT) found a purity GGN (pGGN) in the anterior segment, right upper lung lobe, and bronchoscopy didn’t have any tumor in the bronchus in 2014. Continue follow-up 4 years, the nodule enlarged and became a mixed GGN (mGGN) in 2018 on chest CT. A diagnostics video-assisted thoracotomy with wedge resection in right upper lung lobe was performed. The pathology revealed that it was filled with neuroendocrine differentiation cells without penetration terminal bronchiole submucosal layer, immunohistochemical (IHC) staining were positive for CD-56, Cg-A, TTF, Syn and ki-67 (about 5%), leading to diagnosis of DIPNECH. A regular review of the chest CT showed no signs of tumor recurrence postoperative more than 1 year every 6 months, and we will continue follow-up. In conclusion, DIPNECH keeps stable evolution over several years, which is misdiagnosed and underdiagnosed usually. Patient who showed GGN on chest CT and had cough, dyspnea, wheezing, less frequently hemoptysis and so on, we should think of DIPNECH. Diagnosis depended on pathology and IHC staining, regular follow-up will lead to patient a long-term survival postoperative.

Primary thymic atypical carcinoid (TAC) is a kind of neuroendocrine tumors of the mediastinum, which has a poor prognosis due to its invasive behavior, metastasis and postoperative recurrence. We present a relatively rare case who came to hospital because of chest pain and tightness from a large mediastinal mass of 115 mm × 95 mm compressing left brachiocephalic veins, pericardium and upper-lobe of left lung. Although the operation was rather challenging, we performed complete resection including local lymph node dissection by open median sternotomy. The pathology of combining hematoxylin/eosin staining and immunohistochemical was confirmed to be primary TAC, grade 2 according to 2015 WHO Classification of Tumors of the Thymus. After radical surgery, the case underwent 6 cycles of platinum-based adjuvant chemotherapy. To date, the man has survived over 11 months without recurrence and distant metastasis. In conclusion, open surgery is a safe and effective method for locally advanced TAC and radical resection combination with adjuvant chemotherapy may lead to a long-term survival.

Key Points Question Are elevated maternal total bile acid concentrations associated with low birth weight and risk of intrauterine growth restriction (IUGR)? Findings In this retrospective cohort study that included 68 245 singleton pregnancies, elevated maternal serum total bile acid concentration was associated with an increased risk of low birth weight and IUGR, and this risk appeared to be higher when coexisting with hypertensive disorders in pregnancy. Meaning These findings suggest that clinicians should monitor bile acid concentration during the follow-up for pregnancies with potential IUGR., This cohort study investigates the association between maternal serum total bile acid concentrations during pregnancy and the risk of intrauterine growth restriction., Importance Bile acids play essential roles in metabolic modulation. Excessive serum total bile acid (sTBA) levels during pregnancy are associated with adverse perinatal outcomes; however, their association with the risk of intrauterine growth restriction (IUGR) remains unclear. Objective To investigate the association between maternal sTBA concentration during pregnancy and the risk of IUGR. Design, Setting, and Participants This retrospective cohort study included pregnant individuals who delivered live singleton neonates and had regular antenatal examination records available at a hospital-based center in Shanghai, China, from 2014 to 2018. Data were analyzed from July to November 2020. Exposures Maternal sTBA concentration during pregnancy. Main Outcomes and Measures Fetal birth weight and probability of low birth weight (LBW) and IUGR. Results This study included 68 245 singleton pregnancies with live births for analysis. The mean (SD) age of the pregnant individuals was 30.5 (3.8) years, 67 168 patients (98.4%) were Han, and 50 155 (73.5%) were nulliparous. Nonlinear regression models suggested that there was an inverted J-shaped association between maternal sTBA level during pregnancy and fetal birth weight, with a steep decrease in birth weight at high sTBA levels (estimated mean [SE] birth weight for sTBA of 40.8 ug/mL, 2879 [39.9] g) and greater birth weights at lower sTBA levels (estimated mean [SE] birth weight for sTBA 0.4 μg/mL, 3290 [3.9] g; and for 4.1 μg/mL, 3334 [1.6] g). Lower birth weight and a higher incidence of IUGR were observed in patients with gestational hypercholanemia (sTBA ≥4.08 μg/mL) compared with those without gestational hypercholanemia (birth weight: estimated adjusted mean [SE], 3309 [3.32] vs 3338 [0.80] g; P = .005; incidence of IUGR: 62 of 4467 [1.4%] vs 312 of 63 778 [0.5%]; P

Background Bronchiolar adenoma (BA) is a recently proposed diagnostic terminology, which is considered as the expansion of the concept of ciliated muconodular papillary tumors. BA is considered to be a benign neoplasm, but a few previous cases have been reported with the possibility of malignant transformation. Therefore, the genetic and histological nature of BA is controversial so far. We describe a rare case of multiple BAs with malignant transformation and CCNE1 (cyclin E1) mutation to increase the understanding of this disease. Case description A 56-year-old woman was admitted to our hospital due to two ground-glass nodules (GGNs) in the left lung detected by chest CT without symptom. The pure GGN located in the upper lingual segment about 6 mm in diameter and another mixed GGN located in the dorsal segment about 7 mm. The two GGNs have been found a year ago without treatment, and the mixed GGN become larger to 8 mm with vacuole sign in the next year health checkup. We performed a wedge resection of the two nodules completely by video-assisted thoracoscopy (VATS). Postoperative pathology indicated that the pure GGN was atypical bronchial adenoma, while the mixed GGN was atypical bronchial adenoma with malignant transformation which was missed in frozen section. Gene mutations analysis by next-generation sequencing (NGS) showed CCNE1 gene mutation in both lesions, and her-2 mutation was identified in the mixed GGN. The programmed cell death 1 ligand 1 (PD-L1) expression analysis of tumor cells showed 0% and less than 1% in the pure GGN and the mixed GGN, respectively. Conclusion BA is generally considered to be a benign tumor. The present study indicated that BA may be carcinogenic in atypical cases with some driver genes mutation and we should be vigilant for its potentiality of malignant transformation in clinical practice.

Although deep neural networks (DNNs) have achieved tremendous performance in diverse vision challenges, they are surprisingly susceptible to adversarial examples, which are born of intentionally perturbing benign samples in a human-imperceptible fashion. It thus poses security concerns on the deployment of DNNs in practice, particularly in safety- and security-sensitive domains. To investigate the robustness of DNNs, transfer-based attacks have attracted a growing interest recently due to their high practical applicability, where attackers craft adversarial samples with local models and employ the resultant samples to attack a remote black-box model. However, existing transfer-based attacks frequently suffer from low success rates due to overfitting to the adopted local model. To boost the transferability of adversarial samples, we propose to improve the robustness of synthesized adversarial samples via adversarial transformations. Specifically, we employ an adversarial transformation network to model the most harmful distortions that can destroy adversarial noises and require the synthesized adversarial samples to become resistant to such adversarial transformations. Extensive experiments on the ImageNet benchmark showcase the superiority of our method to state-of-the-art baselines in attacking both undefended and defended models.

Introduction Chondroblastoma is a rare, benign locally but aggressive bone tumor. It accounts for Case presentation A case of a 24-year-old male with a chondroblastoma located on the 6th posterior left rib. Computed tomography (CT) demonstrated a rib tumor that was a well-defined oval lesion of 20 mm × 18 mm, with lytic bone destruction. The imaging first diagnosis was Langerhans cell histiocytosis (LCH), a giant cell tumor, or other type of neoplasm. The whole tumor and a part of partial rib were resected by video-assisted thoracoscopy surgery (VATS). Pathological and immunohistochemical (IHC) examination made a diagnosis of chondroblastoma. Compared with traditional open thoracic surgery, VATS can achieve the same effects and cause less injury to patient. No postoperative adjuvant therapy was given, and had followed up 23 months after surgery, there was no recurrence or metastasis. Conclusion Chondroblastoma has a risk of recurrence and metastasis, surgery plays an important role in the treatment of chondroblastoma, VATS can achieve the same outcome as traditional open thoracic surgery with less pain and lung function. Close follow-up is needed postoperative.

IntroductionChildhood overweight and obesity (OWO) is a primary global health challenge. Childhood OWO prevention is now a public health priority in China. The Sino-Canadian Healthy Life Trajectories Initiative (SCHeLTI), one of four trials being undertaken by the international HeLTI consortium, aims to evaluate the effectiveness of a multifaceted, community-family-mother-child intervention on childhood OWO and non-communicable diseases risk.Methods and analysisThis is a multicentre, cluster-randomised, controlled trial conducted in Shanghai, China. The unit of randomisation is the service area of Maternal Child Health Units (N=36). We will recruit 4500 women/partners/families in maternity and district level hospitals. Participants in the intervention group will receive a multifaceted, integrated package of health promotion interventions beginning in preconception or in the first trimester of pregnancy, continuing into infancy and early childhood. The intervention, which is centred on a modified motivational interviewing approach, will target early-life maternal and child risk factors for adiposity. Through the development of a biological specimen bank, we will study potential mechanisms underlying the effects of the intervention. The primary outcome for the trial is childhood OWO (body mass index for age ≥85th percentile) at 5 years of age, based on WHO sex-specific standards. The study has a power of 0.8 (α=0.05) to detect a 30% risk reduction in the proportion of children with OWO at 5 years of age, from 24.4% in the control group to 17% in the intervention group. Recruitment was launched on 30 August 2018 for the pilot study and 10 January 2019 for the formal study.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the International Peace Maternity and Child Health Hospital in Shanghai, China, and the Research Ethics Board of the Centre Intégré Universitaire de Santé et Services Sociaux de l’Estrie–CHUS in Sherbrooke, Canada. Data sharing policies are consistent with the governance policy of the HeLTI consortium and government legislation.Trial registration numberChiCTR1800017773.Protocol versionNovember 11, 2020 (Version #5).

Aims. To explore the effects of Biejiaxiaozheng pills on carbon tetrachloride-induced hepatic fibrosis in rats through the NF-κB/Nrf2 pathway and to explore the possible antifibrotic mechanisms of the drug. Material and Method. A rat model of hepatic fibrosis was established via CCl4 induction. Liver function and antioxidant indices were detected using commercial kits. Hematoxylin-eosin and Masson staining were used to detect pathological changes in hepatic tissues. ELISA was used to measure plasma TNF-α, IL-β, and IL-6 levels. RT-PCR was used to measure changes in TNF-α, IL-β, and IL-6 levels in hepatic tissues. Changes in p65, P-p65, Nrf2, and HO-1 protein expression were detected using western blotting. Results. In rats with hepatic fibrosis, Biejiaxiaozheng pills effectively improved liver function, alleviated fibrosis in hepatic tissues, and significantly reduced collagen accumulation. The pills significantly downregulated inflammatory cytokine expression in hepatic tissues by suppressing p65 phosphorylation and reduced plasma inflammatory cytokine levels to some extent. The pills upregulated Nrf2 and HO-1 expression in hepatic tissues, enhanced antioxidant potential, and upregulated plasma antioxidant levels. Conclusion. Biejiaxiaozheng pills improved hepatic fibrosis symptoms and lesions in rats, likely by inhibiting the NF-κB pathway and promoting the Nrf2 pathway.

This essay discusses the reasons why infrastructure investment is attractive to pension funds investors and four different selected vehicles and their pros and cons. The long-term nature of infrastructure assets investments can be matched with long-term liabilities of pension funds. Pension funds investors tend to prefer a cautious and conservative investment strategy which is consistent with the characteristics of infrastructure assets. I choose the Sizewell C nuclear power plant project and two unlisted infrastructure funds as examples of direct equity investment vehicle and private infrastructure funds vehicle respectively. This essay also covers telecommunication and digital infrastructure sector that has good development trends and the same characteristics as traditional infrastructure. The individual and business demand for more efficient internet connection and 5G upgrades have been Stimulating the demand for digital infrastructure since these infrastructure assets are the basis of any data transmission and communication.

LAC, a Ring-LWE based scheme, has shortlisted for the second round evaluation of the National Institute of Standards and Technology Post-Quantum Cryptography (NIST-PQC) Standardization. FPGAs are widely used to design accelerators for cryptographic schemes, especially in resource-constrained scenarios, such as IoT. Sparse Polynomial Multiplication (SPM) is the most compute-intensive routine in LAC. Designing an accelerator for SPM on FPGA can significantly improve the performance of LAC. However, as far as we know, there are currently no works related to the hardware implementation of SPM for LAC. In this paper, the proposed efficient and scalable SPM accelerator fills this gap. More concretely, we firstly develop the Dual-For-Loop-Parallel (DFLP) technique to optimize the accelerator's parallel design. This technique can achieve 2x performance improvement compared with the previous works. Secondly, we design a hardware-friendly modular reduction algorithm for the modulus 251. Our method not only saves hardware resources but also improves performance. Then, we launch a detailed analysis and optimization of the pipeline design, achieving a frequency improvement of up to 34%. Finally, our design is scalable, and we can achieve various performance-area trade-offs through parameter $p$ . Our results demonstrate that the proposed design can achieve a very considerable performance improvement with moderate hardware area costs. For example, our medium-scale architecture for LAC-128 takes only 783 LUTs, 432 FFs, 5BRAMs, and no DSP on an Artix-7 FPGA and can complete LAC's polynomial multiplication in 8512 cycles at a frequency of 202MHz.

With the growing prevalence of convolutional neural networks (CNNs), there is an urgent demand to explain their behaviors. Global explanations contribute to understanding model predictions on a whole category of samples, and thus have attracted increasing interest recently. However, existing methods overwhelmingly conduct separate input attribution or rely on local approximations of models, making them fail to offer faithful global explanations of CNNs. To overcome such drawbacks, we propose a novel two-stage framework, Attacking for Interpretability (AfI), which explains model decisions in terms of the importance of user-defined concepts. AfI first conducts a feature occlusion analysis, which resembles a process of attacking models to derive the category-wide importance of different features. We then map the feature importance to concept importance through ad-hoc semantic tasks. Experimental results confirm the effectiveness of AfI and its superiority in providing more accurate estimations of concept importance than existing proposals.

The widespread deployment of deep models necessitates the assessment of model vulnerability in practice, especially for safety- and security-sensitive domains such as autonomous driving and medical diagnosis. Transfer-based attacks against image classifiers thus elicit mounting interest, where attackers are required to craft adversarial images based on local proxy models without the feedback information from remote target ones. However, under such a challenging but practical setup, the synthesized adversarial samples often achieve limited success due to overfitting to the local model employed. In this work, we propose a novel mechanism to alleviate the overfitting issue. It computes model attention over extracted features to regularize the search of adversarial examples, which prioritizes the corruption of critical features that are likely to be adopted by diverse architectures. Consequently, it can promote the transferability of resultant adversarial instances. Extensive experiments on ImageNet classifiers confirm the effectiveness of our strategy and its superiority to state-of-the-art benchmarks in both white-box and black-box settings.

The aim of this research was to study the alteration of three key tight junction proteins, to explore whether they were involved in the occurrence of prelabor rupture of the membrane (PROM) and to determine the correlation with intrauterine infection.A total of 208 women were enrolled between January 2015 to December 2018, including those with preterm and term PROM (PROM group) and normal pregnancies with intact fetal membrane (control group). We investigated the expressions of three key TJ molecules (Zonula occludens-1, Occludin and Claudin-5) in fetal membranes. The localization and expression of Zonula occludens-1 (ZO-1) in the amnion and chorion were studied by immunohistochemistry assay. The associations between ZO-1 expression levels and extent of inflammatory reactions as well as other obstetric characteristics were further studied using Spearman's rank correlation test and Mann-Whitney U test.ZO-1 was significantly downregulated in PROM group compared with control group (P 0.001), whereas no significant changes were found for Occludin and Claudin-5. ZO-1 expression was reduced in the chorion and amnion layers in PROM group compared with that in control group, which showed a significant difference (P 0.01), but no significant differences were observed between the preterm PROM and term PROM groups (P 0.05). The expression levels of ZO-1 in the chorion were negatively correlated with the stage/grade of acute chorioamnionitis (P 0.05).Our study suggests that inflammation-related downregulation of ZO-1 might be a pivotal event in the occurrence of PROM, which helps to clarify the mechanism of membrane rupture caused by infection.

Thymic lymphoid hyperplasia with Graves' disease (GD) is not uncommon in adults. Generally, cases are newly diagnosed with GD when they refer to the department of endocrinology in hospital, and an anterior mediastinal mass is found on a computed tomography scan by accident. Almost half of them receive thymectomy due to the concern about thymoma or thymic carcinoma. In the past literature, an enlarged thymus can gradually shrink after treatment of antithyroid drugs. In this paper, a 28-year-old woman presented to our hospital with a 11-month history of dizziness, left hand convulsion and paralysis, without chest pain, difficulty swallowing, dyspnea. Chest computed tomography revealed an anterior mediastinal mass without obvious nodules. However, in this case, the mass did not shrink obviously after regularly taking antithyroid drugs. In order to figure out the diagnosis of the mass, we performed a thoracoscopic thymic resection, and the pathologic result was thymic lymphoid hyperplasia. There is no thymus gland tissue left on a repeated CT scan four months later after surgery. In this report, we discuss the optimal therapeutic strategy for this rare case. In conclusion, if an anterior mediastinal mass in GD patients did not shrink obviously upon treatment of antithyroid drugs, minimally invasive surgery should be taken into consideration seriously to exclude the possibility of malignancy.

BACKGROUND: Dedifferentiated liposarcoma in the mediastinum is an extremely rare malignant neoplasm. A few previous case reports indicate that surgical resection is the major treatment, but frequent recurrence occurs locally. Due to its rarity, its clinical characteristics, optimal treatment and clinical outcomes remain unclear. Here, we report a case of multifocal recurrent dedifferentiated liposarcoma in the posterior mediastinum treated by combining surgery with (125)I brachytherapy, and summarize its clinical features, treatment and prognosis. CASE SUMMARY: A 75-year-old man was admitted to our hospital with a history of gradual dysphagia for one year and aggravated dysphagia for 3 mo. Contrast-enhanced computed tomography (CT) revealed several large cystic-solid masses with lipomatous density, and calcification in the posterior-inferior mediastinum. The patient received a wide excision by video-assisted thoracoscopic surgery. Pathological analysis confirmed the tumors were dedifferentiated liposarcomas. The tumor locally relapsed 24 mo later, and another operation was performed by video-assisted thoracoscopic surgery. Fifteen months after the second surgery, the tumor recurred again, and the patient received CT-guided radioactive seeds (125)I implantation. After 8 mo, follow-up chest CT showed an enlarged tumor. Finally, his condition exacerbated with severe dysphagia and dyspnea, and he died of respiratory failure in July 2018. CONCLUSION: We reviewed the literature, and suggest that surgical resection provides beneficial effects for dedifferentiated liposarcoma in the mediastinum, even in cases with local recurrence. (125)I brachytherapy may be beneficial for recurrent unresectable patients.

Aim: In-Stent Restenosis (ISR) is the major reason for recurrent ischemia and amputation after endovascular treatment of Peripheral Artery Disease (PAD). Our previous study demonstrated that miR-140-3p is significantly down-regulated in PAD arteries. However, expression and function of miR-140-3p in ISR of human PAD are currently unclear. The aim of this study is to determine the miR-140-3p expression and its regulative role in ISR of PAD. Methods: The RNA level was determined by quantitative real-time polymerase chain Reaction (qRT-PCR) and in situ hybridization. Primary cultured ASMCs were isolated from human femoral arterial of the healthy donors or ISR patients. Cell proliferation was determined by Edu incorporation and CCK-8 assay. Apoptosis was determined by Annexin-V/PI Double-Staining assay and TUNEL assay. A rat carotid artery balloon angioplasty model was used to investigate the effect of miR-140-3p on restenosis. Results: MiR-140-3p was significantly down-regulated in PAD and ISR arteries than normal arteries. Primary cultured ISR ASMCs exhibited elevated proliferation and down-regulated miR-140-3p than normal ASMCs. Transfection of miR-140-3p mimic attenuated PDGF-BB-induced proliferation in cultured ASMCs and induced apoptosis. Luciferase reporter assay indicated that miR-140-3p transfection significantly down-regulated C-Myb and BCL-2 in ISR ASMCs by targeting to their 3′-UTRs. MiR-140-3p transfection induced anti-proliferation and apoptosis in ASMCs, which were ameliorated by over-expression of C-Myb or BCL-2. Moreover, the animal study showed that miR-140-3p can reduce restenosis following angioplasty via targeting C-Myb and BCL-2. Conclusions: The result suggests that miR-140-3p regulates ASMC function via targeting C-Myb and BCL-2 in the process of ISR in PAD. The novel findings may offer a hopeful therapeutic target for human PAD.

Recent studies have illuminated that blocking Ca2+ influx into effector cells is an attractive therapeutic strategy for lung injury. We hypothesize that T-type calcium channel may be a potential therapeutic target for acute lung injury (ALI). In this study, the pharmacological activity of mibefradil (a classical T-type calcium channel inhibitor) was assessed in a mouse model of lipopolysaccharide- (LPS-) induced ALI. In LPS challenged mice, mibefradil (20 and 40 mg/kg) dramatically decreased the total cell number, as well as the productions of TNF-α and IL-6 in bronchoalveolar lavage fluid (BALF). Mibefradil also suppressed total protein concentration in BALF, attenuated Evans blue extravasation, MPO activity, and NF-κB activation in lung tissue. Furthermore, flunarizine, a widely prescripted antimigraine agent with potent inhibition on T-type channel, was also found to protect mice against lung injury. These data demonstrated that T-type calcium channel inhibitors may be beneficial for treating acute lung injury. The important role of T-type calcium channel in the acute lung injury is encouraged to be further investigated.

Rationale: Primary schwannoma is extremely rare in the trachea, and its optimal treatment has not yet been established. Previous literature have indicated that traditional resection by thoracotomy is an effective surgical procedure but with huge trauma, and endoscopic excision is a minimally invasive surgical method but with possibility of recurrence. Window resection was usually utilized for selected patients with trachea invasion by thyroid carcinoma, but video-assisted thoracoscopic window resection for trachea schwannoma has not been reported previously. Patient concerns: A 23-year-old woman was admitted to hospital due to dyspnea, coughing and wheezing that had persisted for 2 months with aggravation for 1 week. Diagnoses: Chest computed tomography (CT) scan revealed a well-circumscribed soft-tissue mass located on the right lateral posterior wall of the trachea. Bronchofibroscopy (BFS) showed a whitish, smooth and round mass with a wide base in the trachea. Immunohistochemical staining demonstrated cells labeled with Vim (+), S-100 (+), SOX-10 (+), SMA (–), CK (–). Histopathological examinations showed that the mass was a schwannoma. Interventions: The tumor was nearly completely excised via BFS, but relapsed 2 times at 12 days and 3 weeks after endoscopic resection. Finally, the patient underwent video-assisted thoracoscopic window resection of trachea. Outcomes: The patient recovered rapidly and no recurrence was observed over 6 months of follow-up. Lessons: The treatment of tracheal schwannoma depends on the characteristics of tumor and the condition of patient. Surgical resection is a preferred alternative for sessile or transmural tumors and recurrence after endoscopic excision. Tracheal window resection by video-assisted thoracoscopy is beneficial for some appropriate patients with a small and sessile tumor.

The exceptional performance of Deep neural networks (DNNs) encourages their deployment in safety-and dependability-critical systems. However, DNNs often demonstrate erroneous behaviors in real-world corner cases. Existing countermeasures center on improving the testing and bug-fixing practice. Unfortunately, building a bug-free DNN-based system is almost impossible currently due to its black-box nature, so anomaly detection is imperative in practice. Motivated by the idea of data validation in a traditional program, we propose and implement Deep Validation, a novel framework for detecting real-world error-inducing corner cases in a DNN-based system during runtime. We model the specifications of DNNs by resorting to their training data and cast checking input validity of DNNs as the problem of discrepancy estimation. Deep Validation achieves excellent detection results against various corner case scenarios across three popular datasets. Consequently, Deep Validation greatly complements existing efforts and is a crucial step toward building safe and dependable DNN-based systems.

Employing deep learning algorithms in real-world applications becomes a trend. However, a bottleneck that impedes their further adoption in safety-critical systems is the reliability issue. It is challenging to develop reliable neural network models as the theory of deep learning has not yet been well-established and neural network models are very sensitive to data perturbations. Inspired by the classic paradigm of N-version programming for fault tolerance, this paper investigates the feasibility of developing fault-tolerant deep learning systems through model redundancy. We hypothesize that if we train several simplex models independently, these models are unlikely to produce erroneous results for the same test cases. In this way, we can design a fault-tolerant system whose output is determined by all these models cooperatively. We propose several independence factors that can be introduced for generating multiple versions of neural network models, including training, network, and data. Experimental results on MNIST and CIFAR-10 both verify that our approach can improve the fault-tolerant ability of a deep learning system. Particularly, independent data for training plays the most significant role in generating multiple models sharing the least mutual faults.

Rationale: Anaplastic lymphoma kinase (ALK) inhibitors have been approved for patients with ALK-rearrangement lung cancer. The effect is superior to the standard first-line therapy of pemetrexed plus platinum-based chemotherapy. However, ALK inhibitors are associated with rare and sometimes fatal adverse events. Organizing pneumonitis (OP) is a rare and serious adverse event usually caused by ceritinib, and it is easily misdiagnosed as infectious pneumonia, metastasis, or cancer progression. Patient concerns: A 56-year-old female presented with chest tightness and dyspnea for more than 10 days. She was previously healthy with no significant medical history. Workup including chest computed tomography (CT), pathological examination of a biopsy specimen, and next-generation sequencing was consistent with a diagnosis of IVA ALK-rearrangement lung adenocarcinoma. She was treated with pemetrexed plus platinum-based chemotherapy and crizotinib concurrently, followed by maintenance therapy with crizotinib alone and she had an almost complete response. However, about 26 months after beginning treatment she developed multiple brain metastases. Crizotinib was discontinued and she was begun on ceritinib. After about 3 months the brain metastases had almost complete response. After 5 months of ceritinib, however, multiple patchy lesions appeared in the bilateral upper lungs. Diagnoses: Treatment with antibiotics had no effect and blood and sputum cultures are negative. A CT-guided biopsy of the upper lung was performed, and pathological hematoxylin-eosin staining and immunohistochemical studies were consistent with OP. Interventions: Ceritinib was discontinued, she was begun on prednisone 0.5 mg/kg orally every day, and regular follow-up is necessary. Outcomes: CT of the chest 2 and 4 weeks after beginning prednisone showed the lung lesions to be gradually resolving, and she was continued on prednisone for 2 months and gradually reduced the dose of prednisone every 2 weeks. No related adverse events were occurred in patient. Lessons: OP must be differentiated from infectious pneumonia, metastasis, or cancer progression. The mechanism of OP is still unknown and needs further research. Biopsy plays a role in making a diagnosis of OP. In our patient, discontinuing ceritinib and treating her with prednisone resulted in a good outcome.

Defective BiOBr nanosheets with ultrathin thickness and surface-confined pits have been synthesized through a dual control of cetyltrimethylammonium bromide (CTAB) and polyvinyl pyrrolidone (PVP). The photocatalytic activity of the obtained defective BiOBr nanosheets was evaluated for the removal of rhodamine B (RhB), ciprofloxacin (CIP) and oxygen evolution from water. The as-prepared defective BiOBr nanosheets displayed significantly increased activity for pollutant degradation and oxygen evolution. The enhanced photocatalytic activity was ascribed to the improved light harvesting, suppression of charge recombination, and an increase in the number of active sites for photocatalytic reaction. The electronic structure of the defective BiOBr ultrathin nanosheets with confined pits has been tuned and thus varied the photocatalytic mechanism for pollutant degradation. The active species have changed from hole for BiOBr nanoplates to superoxide radical (O2.−) and hole for defective BiOBr nanosheets determined by ESR analysis and trapping experiments.

Background MicroRNA-223 (miR-223) is a hematopoietic lineage cell-specific microRNA. However, a significant amount of miR-223 has been identified in vascular smooth muscle cells (VSMCs) and vascular walls that should not have endogenous miR-223. Objectives This study sought to determine the sources of miR-223 in normal and atherosclerotic arteries and the role of miR-223 in atherogenesis. Methods The levels and sources of miR-223 in blood cells (leukocytes and platelets), serum, blood microparticles, VSMCs, and vascular walls were determined. Both in vivo and in vitro studies were conducted to evaluate miR-223 secretion by blood cells and the ability of miR-223 to enter VSMCs and vascular walls. Subsequent changes in and the effects of miR-223 levels on serum and arteries in atherosclerotic animals and patients were investigated. Results Blood cells were able to secrete miR-223 into serum. MicroRNA-223 from blood cells was the most abundant cell-free miRNA in blood. Blood cell–secreted miR-223 could enter VSMCs and vascular walls, which produced strong biological effects via its target genes. In both atherosclerotic apolipoprotein-E knockout mice and patients with atherosclerosis, miR-223 levels were significantly increased in serum and atherosclerotic vascular walls. The atherosclerotic lesions in apolipoprotein-E knockout mice were exacerbated by miR-223 knockdown. The effect of miR-223 on atherogenesis was verified using miR-223 knockout mice. Conclusions Blood cell–secreted miR-223 enters vascular cells and walls, and appears to play important roles in VSMC function and atherogenesis. As a novel endocrine genetic signal between blood cells and vascular cells, miR-223 may provide a novel mechanism and new therapeutic target for atherosclerosis.

Trihydrophobin 1 (TH1) is a member of the negative elongation factor complex, which is involved in transcriptional pausing. Although the negative elongation factor complex attenuates the estrogen receptor α-mediated transcription, little is known about the relationship between TH1 and tumor progression. Here, we report that the protein level of TH1 was negatively correlated with the aggressiveness of human breast cancer. Immunohistochemical analysis revealed that TH1 expression in clinical stage III-IV primary breast cancer tissues was statistically significantly lower than that in stage I-II breast tissues (P < 0.01), and especially inversely associated with lymph node metastasis (P < 0.001). Furthermore, we showed that overexpression of TH1 in MDA-MB-231 breast cancer cells inhibited, and knockdown of TH1 in MCF-7 cells enhanced, cell proliferation and migratory ability. Moreover, upregulation of TH1 in MDA-MB-231 cells resulted in the decrease of cyclin D1, β-catenin, and ERK activity, and the increase of p21. In contrast, knockdown of TH1 in MCF-7 cells enhanced the expression of cyclin D1 and β-catenin, increased the activity of ERK, and downregulated the expression of p21. Additionally, overexpression of TH1 in MDA-MB-231 cells prevented. However, knockdown of TH1 in MCF-7 cells induced a number of molecular and cellular alterations associated with epithelial-mesenchymal transition. Taken together, our results suggest that TH1 might play an important role in regulation of proliferation and invasion in human breast cancer, and could be a potential target for human breast cancer treatment.

Jian Zhang,1,* Jie Liu,2,* Huiguo Chen,1 Weibin Wu,1 Xiaojun Li,1 Yonghui Wu,1 Kai Zhang,1 Lijia Gu1 1Department of Thoracic Surgery, 2Department of Pharmacy, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China *These authors contributed equally to this work Purpose: We aimed at assessing the overall efficacy of angiogenesis inhibitor (AI)-containing regimens in the treatment of advanced non-small-cell lung cancer (NSCLC) according to histological types.Methods: Studies from PubMed and Web of Science, and abstracts presented at American Society of Clinical Oncology (ASCO) meeting up to October 31, 2014 were searched to identify relevant studies. Eligible studies included prospective randomized controlled trials (RCTs) evaluating AIs in advanced NSCLC with survival data according to patients’ histologies. The endpoints were overall survival (OS) and progression-free survival (PFS). Statistical analyses were conducted by using either random effects or fixed effect models according to the heterogeneity of included studies.Results: A total of 10,035 patients with advanced NSCLC from 13 RCTs were identified for analysis. The pooled results demonstrated that AI-containing regimens significantly improved the PFS (HR, 0.84, 95% confidence interval (CI): 0.78–0.91, P

Chronic and excessive alcohol consumption can lead to alcoholic liver disease (ALD), which is characterized by a spectrum of liver disorders, including fatty liver, alcoholic steatohepatitis (ASH), fibrosis/cirrhosis and hepatocellular carcinoma (HCC). The mechanism of the progression from alcoholic steatosis to steatohepatitis and fibrosis is still not fully understood. As a nuclear receptor, farnesoid X receptor (FXR) plays a critical role in maintaining hepatic lipid and bile acid homeostasis. To clarify the role of FXR in the progression of steatohepatitis, we studied the effect of ethanol feeding on FXR-deficient mice. Wild-type and FXR-deficient mice were fed with Lieber-DeCarli ethanol liquid diet or an isocaloric control diet. We found that FXR-deficient mice fed with ethanol diet developed more severe liver injury and steatosis, even progressed to steatohepatitis and moderate fibrosis. Whereas, wild-type (WT) mice only developed mild level of steatosis, with rarely observed inflammatory foci and collagen accumulation. We also found that ethanol induced hepatic bile acid accumulation and NF-κB activation in FXR-deficient mice, which could be attenuated by ursodeoxycholic acid (UDCA). Thus, FXR deficient mice were more prone to develop alcoholic steatohepatitis and fibrosis upon ethanol diet feeding. Our results highlight the role of FXR in hepatoprotection during ALD development. Moreover, attenuating alcoholic liver cholestasis would be beneficial in preventing the progression of hepatic hepatitis in patients with ALD.

Material removal accuracy has a direct impact on the machining precision and efficiency of ion beam figuring. By analyzing the factors suppressing the improvement of material removal accuracy, we conclude that correcting the removal function deviation and reducing the removal material amount during each iterative process could help to improve material removal accuracy. Removal function correcting principle can effectively compensate removal function deviation between actual figuring and simulated processes, while experiments indicate that material removal accuracy decreases with a long machining time, so a small amount of removal material in each iterative process is suggested. However, more clamping and measuring steps will be introduced in this way, which will also generate machining errors and suppress the improvement of material removal accuracy. On this account, a free-measurement iterative process method is put forward to improve material removal accuracy and figuring efficiency by using less measuring and clamping steps. Finally, an experiment on a φ 100-mm Zerodur planar is preformed, which shows that, in similar figuring time, three free-measurement iterative processes could improve the material removal accuracy and the surface error convergence rate by 62.5% and 17.6%, respectively, compared with a single iterative process.

The successive approximation register analog to digital converter (SAR ADC) technique is not yet mature in China mainly because of the imperfect analog module of the SAR ADC. The purpose of this design was to optimize the analog module by designing and making a 8-bit 1MHz SAR ADC and testing a 12-bit SAR ADC theoretically and by simulation. The design of the 1MHz SAR DAC, which consists of analog circuit and digital circuit, was designed according to the positive design method and the specific standard. And the ADC circuit was designed according to the sub-module layout. By the time the project design was finished, its hardware which was made of discrete components by welding printed circuit board (PCB) was debugged. The hardware’s physical properties were analyzed by using a SAR DAC test platform created in LabVIEW8.6 interfaced with data acquisition cards. This designed SAR ADC can be applied to sensor interface, data acquisition system, portable test instrument, low power control system and some aspects of communication. Its absolute average error is about 1% in the laboratory tests which meet the expectations of high accuracy requirement. When it was used in the ropeway project of agriculture engineering project, it reached a good accuracy of 91.5%. It is recommended that PCB automatic routing function be used to reduce the error and interference in the further study from the tests result.

Adaptive Front-lighting System (AFS) technology is the next generation of automotive adaptive headlights system. It enables driver to see the bend of the road fully before turning, improving the road safety and the pedestrians’ safety. With the LIN communication module, MASTER node angle collection module and steering gear control module, the system implements the AFS. The MASTER is responsible for obtaining the angle signal using the angle sensor KMA200 and initiating communication while the SLAVE node is responsible for adjusting of the Front-light. The Master will load information into the data field and send it to the SLAVE. Messages are filtered and the message of which the ID field and the local ID is consistent, data field will be read, as a PWM control of the steering gear parameters. Experimental results show that the AFS system has a satisfactory accuracy and it can be used in the Citrus Orchards. The system can improve the safety of the citrus conveyers at night and in any bad weather.

Automotive electric horn is an indispensable electrical component of the vehicle safety system. Practical application shown again and again that by better use of the horn, drivers can reduce the operating frequency of deceleration, breaking. At the same time the system has an impact on improving the driving safety and improving the speed of the vehicle. In recent years, low-cost, long life, high reliability, durability and environmental adaptability have become the development direction of the automotive electric horn. Consequently this paper describes a study on a durability test bench of the automotive electric horn based on the industry standards and prospects, using a programmable logic controller (PLC) intelligent control module to provide an intelligent and reliable electric horn test program. After a long-term testing, the result shows that the experimental accuracy of the solution has a high accuracy and has basically reached the expected control effect. This durability test bench has a very high feasibility.

Control area network (CAN) is an international protocol of field bus and universal serial bus (USB) is developing more and more widely. On the other hand, the USB technology combined with the CAN application is still in the development stage, so this research has broad prospects. The USB-based CAN bus system hardware consists of a CAN module, a USB communication module and a micro controller. It has been designed for real-time display and can save the CAN bus message. In addition it has been debugged in actual measurement accompanied by the Kvaser USB CAN II. The test results show that the system can correctly receive all messages frame from Kvaser CanKing. Finally the system has been applied to the project of citrus orchard for transmission of data of the citrus and tree parameters.

Both controller area network (CAN) and wireless local area network (WLAN) bus technologies are developing rapidly nowadays. But the study on WLAN technology with CAN bus data is relative to be less researched. So a WLAN CAN bus data test system was present in this paper. The system hardware consists of two control modules, each of which consistently allows link test to the CAN bus network. Each hardware of the module is composed by a microcontroller STC12C5410AD, a CAN bus control unit MCP2515, a CAN bus transceiver MCP2551 and a RF wireless module RF903. During the test process, the CAN bus analyzer, Kvaser USBCAN II, receives and dispatches the CAN messages. Test results showed that the system’s error score was approximately zero when messages are transmitted and the system can message transmission from one side of CAN panel point to the other side. The communication of the system is suitable for the CAN treaty standard and it can allow wireless message transmission to other suitable networks meeting the CAN treaty standard as well. Finally the system has been applied to the project for hill citrus leaf area index (LAI) acquisition.

With the system functions growing rich and the design growing difficulty, using ECU in-loop simulation as development platform of entire system can test the rationality and reliability of the control system design step by step in advance. Thus it greatly enhances the development quality of control system, reduces risk and increases the success rate of the design. Engine ECU hardware in-loop simulation system using National Instruments Company’s PXI system, CompactRIO, and LabVIEW, designs kinds of different test and simulation functions, including AI test, DC output test, PWM output test, sine wave output test, digital switch test, PWM input test, to compare and analyze the error of the multi-meter, oscilloscope, data acquisition cards. After error analysis, the system can replace traditional instruments to calibrate ECU online for the errors are in the measure accuracy range which relative error is less than 3.9%, and the high-speed updating rate can sample the input and output signals of ECU. Finally, virtual ECU in-loop test and real ECU in-loop test are done to develop alternative fuel engine ECU.

A measurement system of dynamic resistance of vehicle electronic line connector based on PXI Express(PXIe) technology was established. The system hardware was composed of PXIe box, PXIe high speed digitalizer, PXIe arbitrary waveform generator, high precision currency source and so forth. And the system operating interface was designed by LabVIEW, the virtual instrumentation software, with direct test results displayed on screen. This system can automatically measure dynamic impedance avoiding leaking the unqualified data which lead to imprecise test, and it can meet with the automotive manufactory and supplier real-time monitor requirement. Measurement result shows the maximum sampling rate is 100 million per second and can record at least 3 hours.

Leaf area index (LAI) is a critical structural parameter in evaluating physiology and biology of vegetation canopy and ecosystem, which makes its quick and precise measurement necessary though still unrealized owing to the different LAI definitions, diverse suggestions and measurement variance. And virtual plant, virtual reality and virtual instruments (VI) provide new tools in agricultural measurement based on increasing development of computer technology. By integrating virtual plants, virtual reality and virtual instrument technologies, a fruiter LAI realtime measurement system was established to test LAI of real Litchi and LAI of manmade Litchi made with 3D digitalizer base on the real one. One the one hand, LAI system compiles OpenGL and VC++ with LabVIEW for computer model simulating, and on the other hand, system analyzes, saves and displays data such as PAR, temperatures, and sensor position, then calculates the LAI and output motor control order to realize the sensor movement. Hereinto, a kind of useful random distribution arithmetic was created and distributed leaves were visualized and shadowed. Additionally, LAI arithmetic for Litchi was test for optimal sampling parameters. After calibration and comparison, the LAI system is satisfied to our project requirement.

Introduction Nomograms are statistical predictive models that can provide the probability of a clinical event. Nomograms have better performance for the estimation of individual risks because of their increased accuracy and objectivity relative to physicians’ personal experiences. Recently, a nomogram for predicting the likelihood that a thyroid nodule is malignant was introduced by Nixon. The aim of this study was to determine whether Nixon’s nomogram can be validated in a Chinese population. Materials and Methods All consecutive patients with thyroid nodules who underwent surgery between January and June 2012 in our hospital were enrolled to validate Nixon’s nomogram. Univariate and multivariate analyses were used to identify the risk factors for thyroid carcinoma. Discrimination and calibration were employed to evaluate the performance of Nixon’s model in our population. Results A total of 348 consecutive patients with 409 thyroid nodules were enrolled. Thyroid ultrasonographic characteristics, including shape, echo texture, calcification, margins, vascularity and number (solitary vs. multiple nodules), were associated with malignance in the multivariate analysis. The discrimination of all nodules group, the group with a low risk of malignancy (predictive proportion

ObjectivesThis study evaluated the effect of high selective bilateral vagotomy of hilus pulmonis with video-assisted thoracoscopy on asthma.MethodsEight dogs with skin sensitive to Ascaris suum antigens were randomly divided into groups A and B. Asthma was induced by aerosol inhalation of A suum antigens. Respiratory rate and peak airway pressure were significantly increased (P .05). Dogs in group B still had typical symptoms, and respiratory rate and peak airway pressure were increased and dynamic compliance decreased significantly (P