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Jian Wang,1,&ast; Zhan-Fang Zhu,2,&ast; Fu-Qiang Liu,3 Cun Liu,4 Ai-Mei Ou-Yang,1 Wei-Wei Chen,1 En-Guo Wang,1 Xi-Ming Wang5,6 1Department of Radiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, 250013, People’s Republic of China; 2Department of Internal Medicine, The Hospital of Xi’an Jiaotong University, Xi’an, 710049, People’s Republic of China; 3Department of Cardiovascular, Shaanxi Provincial People’s Hospital, Xi’an, 710068, People’s Republic of China; 4Department of Ultrasound, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, 250013, People’s Republic of China; 5Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, People’s Republic of China; 6Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi-Ming Wang Tel/Fax +86 531-68776846Email wangximing_dr@outlook.comObjective: Earlobe crease (ELC) has been considered as a skin sign of atherosclerosis, and its pathophysiological mechanism is still unclear. Our study aims to test the hypothesis that ELC patients with lower serum levels of the age-suppressing hormone Klotho, which is not only associated with premature aging but also with endothelial dysfunction, may be associated with atherosclerosis.Methods: A total of 135 patients aged 40– 68 years underwent coronary angiography. According to the presence or absence of coronary heart disease (CAD) and ELC, they were divided into three groups: CAD group and ELC group (ELC group, n = 45); no ELC group (non-ELC group, n = 45). There was no ELC or CAD in the control group (control group, n = 45). Serum Klotho concentration was obtained by enzyme-linked immunosorbent assay (ELISA).Results: The Klotho level in the ELC group was 365.6 ± 38.1 pg/mL, while the Klotho level in the non-ELC group was 568.8 ± 44.9 pg/mL. It is worth noting that the Klotho level of the ELC group was significantly lower than that of the non-ELC group (P < 0.001). The serum Klotho level of the control group was higher than that of the non-ELC group (593.3± 45.3 vs 568.8± 44.9 pg/mL, P = 0.702), but the difference was not statistically significant. Multiple logistic regression analysis showed that the Klotho level is a parameter that affects the appearance of ELC.Conclusion: Serum Klotho levels were considerably lower in patients with ELC. We concluded that the perturbations of Klotho in patients might be associated with ELC and with CAD.Keywords: earlobe crease, Klotho, atherosclerosis, premature aging

Background Coronary artery calcification (CAC) is an independent risk factor of major adverse cardiovascular events; however, the impact of CAC on in-hospital death and adverse clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective To explore the association between CAC and in-hospital mortality and adverse events in patients with COVID-19. Methods This multicenter retrospective cohort study enrolled 2067 laboratory-confirmed COVID-19 patients with definitive clinical outcomes (death or discharge) admitted from 22 tertiary hospitals in China between January 3, 2020 and April 2, 2020. Demographic, clinical, laboratory results, chest CT findings, and CAC on admission were collected. The primary outcome was in-hospital death and the secondary outcome was composed of in-hospital death, admission to intensive care unit (ICU), and requiring mechanical ventilation. Multivariable Cox regression analysis and Kaplan–Meier plots were used to explore the association between CAC and in-hospital death and adverse clinical outcomes. Results The mean age was 50 years (SD,16) and 1097 (53.1%) were male. A total of 177 patients showed high CAC level, and compared with patients with low CAC, these patients were older (mean age: 49 vs. 69 years, P

A prenatal diagnosis of coarctation of the aorta (CoA) is challenging. This study aimed to develop a coarctation probability model incorporating prenatal cardiac sonographic markers to estimate the probability of an antenatal diagnosis of CoA.We reviewed 89 fetuses as an investigation cohort with prenatal suspicion for CoA and categorized them into three subgroups: severe CoA: symptomatic CoA and surgery within the first 3 months; mild CoA: surgery within 4 months to 1 year (29); and false-positive CoA: not requiring surgery (45). Logistic regression was used to create a multiparametric model, and a validation cohort of 86 fetuses with suspected CoA was used to validate the model.The prediction model had an optimal criterion0.25 (sensitivity of 97.7%; specificity of 59.1%), and the area under the receiver operator curve was 0.85. The parameters and their cut-off values were as follows: left common carotid artery to left subclavian artery distance/distal transverse arch (LCCA-LSCA)/DT Index1.77 (sensitivity 62%, specificity 88%, 95% confidence interval [CI]: 0.6-0.8), and z-score of AAo peak Doppler-1.7 (sensitivity 77%, specificity 56%, 95% CI: 0.6-0.8). The risk assessment demonstrated that fetuses with a model probability60% should have inpatient observation for a high risk of CoA, whereas fetuses with a model probability15% should not undergo clinical follow-up.The probability model performs well in predicting CoA outcomes postnatally and can also improve the accuracy of risk assessment. The objectivity of its parameters may allow its implementation in multicenter studies of fetal cardiology.

In classical machine learning, a set of weak classifiers can be adaptively combined for improving the overall performance, a technique called adaptive boosting (or AdaBoost). However, constructing a combined classifier for a large data set is typically resource consuming. Here we propose a quantum extension of AdaBoost, demonstrating a quantum algorithm that can output the optimal strong classifier with a quadratic speedup in the number of queries of the weak classifiers. Our results also include a generalization of the standard AdaBoost to the cases where the output of each classifier may be probabilistic. We prove that the query complexity of the non-deterministic classifiers is the same as those of deterministic classifiers, which may be of independent interest to the classical machine-learning community. Additionally, once the optimal classifier is determined by our quantum algorithm, no quantum resources are further required. This fact may lead to applications on near term quantum devices.

Background: The risk factors for adverse events of Coronavirus Disease-19 (COVID-19) have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ≥ 2 comorbidities (hazard ratio [HR], 6.734; 95% CI; 3.239-14.003, p < 0.001), leukocytosis (HR, 9.639; 95% CI, 4.572-20.321, p < 0.001), lymphopenia (HR, 4.579; 95% CI, 1.334-15.715, p = 0.016) and CT severity score > 14 (HR, 2.915; 95% CI, 1.376-6.177, p = 0.005) on admission, while older age (HR, 2.231; 95% CI, 1.124-4.427, p = 0.022), ≥ 2 comorbidities (HR, 4.778; 95% CI; 2.451-9.315, p < 0.001), leukocytosis (HR, 6.349; 95% CI; 3.330-12.108, p < 0.001), lymphopenia (HR, 3.014; 95% CI; 1.356-6.697, p = 0.007) and CT severity score > 14 (HR, 1.946; 95% CI; 1.095-3.459, p = 0.023) were associated with increased odds of composite adverse outcomes. Conclusion: The risk factors of older age, multiple comorbidities, leukocytosis, lymphopenia and higher CT severity score could help clinicians identify patients with potential adverse events.

// Xiao-Shun He 1, * , Ling-Chuan Guo 1, * , Ming-Zhan Du 1, * , Shan Huang 1 , Ren-Peng Huang 1 , Sheng-Hua Zhan 1 , Dong-Mei Gu 1 , Wei-Shuo Liu 1 , Xi-Ming Wang 3 , Hua Wu 2 and Wen-Juan Gan 1 1 Department of Pathology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China 2 Pathology Center and Department of Pathology, Soochow University, Suzhou 215123, China 3 Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China * These authors have contributed equally to this work Correspondence to: Wen-Juan Gan, email: ganwenjuan@suda.edu.cn Hua Wu, email: wuhua@suda.edu.cn Xi-Ming Wang, email: wangximing1998@163.com Keywords: LncRNA NONHSAT062994, colorectal cancer, growth, Akt signaling Abbreviations: lncRNA, long noncoding RNAs (lncRNAs); qPCR, Quantitative PCR; CRC, Colorectal Cancer; ISH, In Situ Hybridization; FISH, fluorescent in situ hybridization Received: May 05, 2017 Accepted: June 28, 2017 Published: August 02, 2017 ABSTRACT The aberrant expression of long noncoding RNAs (lncRNAs) is implicated in cancer development and progression. However, the clinical significance and mechanism by which NONHSAT062994 regulates colorectal cancer (CRC) is unknown. We here reported that NONHSAT062994 was significantly downregulated in human CRC tissues and cell lines. Moreover, its expression was inversely correlated with tumor size and overall survival (OS) time in CRC patients. In CRC cells, the overexpression and knockdown of NONHSAT062994 inhibited and enhanced CRC cell growth, respectively, in vitro and in vivo . Mechanistically, NONHSAT062994 functioned as a tumor suppressor to inhibit CRC cell growth by inactivating Akt signaling. Notably, the NONHSAT062994 expression status was negatively correlated with the Akt downstream targets c-Myc and Cyclin D1 in clinical CRC samples. The current findings suggest that NONHSAT062994 plays a critical role in the development of CRC by regulating Akt signaling, and identified a candidate prognostic biomarker or potential therapeutic target for CRC patients.

The current study reports the case of a 15-year-old male who presented to The First Affiliated Hospital of Soochow University (Suzhou, Jiangsu, China) with a 3-day history of anergy and epistaxis. The patient was diagnosed with T-cell acute lymphoblastic leukemia according to the results of a bone marrow examination and received chemotherapy. During the agranulocytosis period, the patient developed pneumonia of the right upper lung (RUL). Once complete remission was achieved, the patient underwent a lobectomy of the RUL, together with amphotericin B therapy, following the confirmation of pulmonary mucormycosis by the histopathological results. The patient experienced 12 months of uneventful follow-up post-surgery.

Introduction: To summarize the vascular ultrasonographic features of intravenous leiomyomatosis (IVL) and assess the role of this method for the accurate diagnosis of patients with IVL. The current study was carried out in Shandong provincial hospital affiliated to Shandong university and Shandong medical imaging research institute, Shandong university of Jinan, Shandong province, P.R. China in 2017. Case Presentation: The 9 samples of IVL were collected from patients undergone surgery from July 2007 to December 2016 in the department of gynecology of the hospital. The clinical data, vascular ultrasonographic findings, and histologic results were retrospectively reviewed. Six patients underwent computed tomography (CT) and 3 patients were examined by magnetic resonance imaging (MRI). Clinical symptoms included lower extremity edema, chest congestion, and syncope. Any pelvic masses found were identified. On ultrasonography, the internal iliac vein, common iliac vein, and the inferior vena cava (IVC) were all involved with dilated veins and isoechoic masses noted in all 9 patients. The right ovarian vein was involved in 2 patients, and in 3 patients, masses had emerged in the IVC and spread into the right atrium, at times intruding into the tricuspid orifice during diastole. All 9 patients underwent a 1-stage thoracoabdominal surgical procedure. There was no documented recurrence of the masses in 7 patients and in the remaining 2 patients; solid pelvic masses were detected 3 or 6 months after the surgery. No intravascular masses were detected. Conclusions: Ultrasonography is performed to evaluate the features and path of extension of IVL. Patients diagnosed with uterine leiomyoma or hysterectomy were at greater risk of developing IVL. Vascular ultrasound could be used as an additional diagnostic tool for IVL screening and diagnosis in patients at an early age.

Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed. The incidence of complications during the perioperative period and changes in the WBC and PLT counts were recorded. A Chi-squared test was used to evaluate the associations between postoperative infection and preprocedural WBC count and between bleeding at the puncture site and preprocedural PLT count. The WBC count of the majority of the patients increased within 3 days and returned to the preprocedural level within 30 days after TACE. The PLT count decreased within 3 days and returned to the preprocedural level within 30 days after TACE. The major complications were liver decompensation (n=66), puncture site bleeding (n=45), infection (n=33), severe thrombocytopenia (n=8), upper gastrointestinal bleeding (n=6), tumor bleeding (n=4) and agranulocytosis (n=3). A Chi-squared test revealed that postoperative infection was not associated with preprocedural WBC count and puncture site bleeding was not associated with decreased PLT count due to hypersplenism. Therefore, TACE was found to be safe for HCC patients with preprocedural thrombocytopenia or leukopenia due to hypersplenism, with a low incidence of major complications during the perioperative period.

The performance of fuel economy and emissions reduction of hybrid electric vehicles (HEVs) strongly depends on the powertrains’ matching and its energy control strategy. The theoretic matching method only based on the theoretical equation of kinetic equilibrium, which is a traditional method, could not take fully use of the advantages of HEV under a certain driving cycle because it doesn’t consider the target driving cycle. In order to match the hybrid powertrain that operates more efficiently under the target driving cycle, the matching method based on driving cycle is presented. The powertrain of a hybrid electric bus is matched, modeled and simulated on the CRUISE, a forwards simulation platform from AVL. The simulation results show that the matching method based on driving cycle presented in this paper could not only meet the requirements of the power performance, but also operate efficiently under the target driving cycle.

Fuel cell hybrid electric vehicle (FCHEV) is one of the most efficient technologies to solve the problems of the energy shortage and the air pollution caused by the internal-combustion engine vehicles, and its performance strongly depends on the powertrains’ matching and its energy control strategy. The theoretic matching method only based on the theoretical equation of kinetic equilibrium, which is a traditional method, could not take fully use of the advantages of FCHEV under a certain driving cycle because it doesn’t consider the target driving cycle. In order to match the powertrain that operates more efficiently under the target driving cycle, the matching method based on driving cycle is studied. The powertrain of a fuel cell hybrid electric bus (FCHEB) is matched, modeled and simulated on the AVL CRUISE. The simulation results show that the FCHEB has remarkable power performance and fuel economy.

Atypical triplication anterior cerebral artery is a rare entity and the variation is an important factor leading to aneurysm. A patient with aneurysm that arises from the bifurcation of the distal anterior cerebral arteries is presented. The contralateral anterior cerebral artery is also presented, and there is no communication between the left and the right anterior cerebral artery. The findings from multiple slice CT angiography in this case are illustrated and discussed. The recognition of this variant is important for the therapy planning.

To perform a meta-analysis to compare 18FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. (“=”indicated no significant difference, P > 0.05; “>” indicated significantly higher, P BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases.

We consider a semiconductor quantum well in the excitation system. Applying the pertinent Hamiltonian, we investigate the second-order intensity correlation function and the entanglement properties between the cavity and exciton mode. It is found that nonclassical (antibunching) effect and sudden death effect occur in our system.

Objectives We sought to evaluate a moderate-potassium cardioplegic solution using adenosine and lidocaine as the arresting and protecting cardioprotective combination in pediatric cardiac surgery. Methods One hundred thirty-four patients with congenital heart disease were randomly allocated to one of 3 groups according to the cardioplegia formula used: the high-potassium (HP) group (K + , 20 mmol/L), 46 patients; the high-potassium adenosine–lidocaine (HPAL) group (K + , 20 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients; and the moderate-potassium adenosine–lidocaine (MPAL) group (K + , 10 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients. Hemodynamic data during the operation and postoperative data were recorded. Serum cardiac troponin I concentrations were examined at the time points of before cardiopulmonary bypass and 1, 3, 6, 12, and 24 hours after aortic crossclamp removal. Results At the end of cardiopulmonary bypass and modified ultrafiltration, the systolic and pulse pressures of the MPAL group were significantly increased compared with the respective values of the HP group. At the time points of 1 to 12 hours after reperfusion, the levels of serum cardiac troponin I were significantly decreased in the MPAL group compared with those in the HP and HPAL groups. Conclusions The MPAL cardioplegia formula was associated with better myocardial protective effects.

To study the clinical application of dual-energy CT (DECT) in the knee ligaments.Twelve cases (24 knees) were scanned using dual-energy CT for the knee. Two- and three-dimensional images were used for display in all cases by means of multi-planar reformation (MPR) and volume rendering technique (VRT). All images were ranked by two radiologists according to the grade of knee ligament displayed, the definition of edge and attachment points of the knee ligament.The partial ligaments of 24 knees, such as the patellar ligament, fibular collateral ligament, anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were clearly displayed; the tibial collateral ligament was not satisfactorily displayed. The transversal ligaments, such as lateral patellar retinaculum and medial patellar retinaculum, and the posterior ligament, such as oblique popliteal ligament could not be shown clearly.The dual-energy CT is a new and valuable tool to qualitatively display the main ligaments of the knee.

The effect of adenosine postconditioning on myocardial protection in cardiac surgery remains uncertain. The present study evaluated the safety, feasibility, and beneficial effect of adenosine postconditioning as an adjunct to predominantly used cold-blood cardioplegic myocardial protection method in the setting of heart valve replacement operations.Sixty patients with rheumatic heart valve disease undergoing heart valve replacement operations were randomized to an adenosine (1.5 mg/kg) or saline (as control) bolus injection through an arterial catheter immediately after the aorta cross-clamp was removed. The surgical indications were similar in both groups, and heart valve replacement was successful in all patients.The extubation time and postoperative hospital time were similar in both groups. Compared with the control group, however, the inotrope scores in the intensive care unit (ICU) were much lower (p0.01), and the ICU time was significantly shorter (p0.05) in adenosine group. More important, cardiac troponin I release was less in the adenosine group, especially at 12 and 24 hours after reperfusion (p0.01), and total cardiac troponin I release estimated with the area under curve was also significantly reduced during the first 24 hours after reperfusion (p0.01).A 1.5-mg/kg bolus administration of adenosine through an arterial catheter immediately after the aorta cross-clamp is removed is feasible and well tolerated in patients undergoing heart valve replacement. An adenosine postconditioning adjunct to high potassium cold blood myocardial protection is related to less troponin I release, less inotropic drug use, and shorter ICU stay.

Background:Metastasis to the penis from primary lung cancer is quite rare. To improve the understanding, we present a case diagnosed as penile metastasis from primary lung cancer and review the literature.Methods:One case report and retrospectively analysis penile cancer patient secondary fr

Intravenous leiomyomatosis is a rare disease, which appears histologically benign but is clinically aggressive. It is characterized by the intraluminal growth of leiomyomas in the intrauterine and systemic veins. Intravenous leiomyomatosis was reported to have originated in the uterus and extended into the right ventricle via the inferior vena cava (IVC). In these circumstances, it is fatal. Multislice compute tomography (MSCT) allows an early and accurate preoperative diagnosis, resulting in a higher rate of surgical resection and improved survival. The authors present 3 cases of intravenous leiomyomatosis with a history of uterine leiomyoma and hysterectomy. The lesions were found to have extended through the IVC into the right cardiac cavities and were confirmed to be intravenous leiomyomatosis by surgery.

In this paper, a class of novel biped mechanisms with three links and two planar lower joints (prismatic joint and revolute joint) are presented. Based on the topological structure of mechanisms, they are classified into three subgroups: 2R, 2P and 1P1R biped mechanisms. Each subgroup contains several mechanisms with the different locomotion manners which result from different layouts of joints. Their locomotion manners are simulated with the kinematic and dynamic simulation software. Prototypes of some selected walking mechanisms are built to demonstrate their mobility. These mechanisms offer options for designing simple and robust biped robots.

Objective To investigate the correlation between the degree of systolic compression of mural coronary artery (MCA) and the length and depth of myocardial bridging (MB) with dual-source computed tomography (DSCT). Methods The length and depth of MB were measured from diastolic phase. All datasets were reconstructed in 5% steps of R-R interval. The optimum phases were chosen where the maximal and minimal diameters were shown. The degree of systolic compression of MCA was calculated. The correlation between length and depth of MB and the degree of systolic compression of MCA were analyzed by Pearson test. Results The minimal diameters were found in 27 sites (90.0%) from 30% to 35% R-R interval, and the maximal diameters were found in 27 sites (90.0%) from 70% to 80% R-R interval. The correlation between systolic compression of MCA and length of MB was not significant ( r =0.096, P =.613); however, the correlation between systolic compression of MCA and the depth of MB was significant ( r =0.675, P Conclusion The minimal and maximal diameters of MCA are usually demonstrated in 30–35% and 70–80% R-R reconstruction interval, respectively. The degree of systolic compression of MCA correlates well with the depth of MB.

Objective To explore the clinical application of 64-slice spiral CT in the diagnosis of the Tetralogy of Fallot. Methods Eighteen patients with diagnosed Tetralogy of Fallot underwent cardiac CT angiography with 64-slice CT (CTA). Two- and three-dimensional images were used for diagnosing in all cases by means of MPR (coronal, sagital and oblique), cMPR, MIP and VRT. Results All patients had ventricular septal defect, pulmonary stenosis and hypertrophy of right ventricle. The morphologic features of Tetralogy of Fallot were equal to echocardiography. Patent ductus arteriosus (PDA) were detected on eight patients. Main coronary artery branches and partial sub-branches were visualized in all patients. Abnormal coronary arteries were found in seven cases: both left and right main coronary artery arising from the right aortic sinus one case, right main coronary artery and circumflex (CX) arising from the right aortic sinus one case, left anterior descending (LAD) and CX arising from left aortic sinus directly one case, left and right coronary artery arising from back and front of the aortic sinus, respectively, three cases. Pulmonary artery branch stenosis was found in 12 cases and branch pulmonary artery dilation noticed in 1 case. Double superior vena cava was also found in one case. According to the surgery the diagnostic accuracy of CT and Echocardiography was 95.45 and 83.33%, respectively. Conclusion Two- and three-dimensional 64-slice CTA not only show the overall anatomical structure of the heart, but also show coronary and pulmonary arteries. With these results, evaluation of coronary anomalies and pulmonary artery stenosis with 64-MSCT is extremely valuable for planning the operative procedure on the patients with Tetralogy of Fallot.