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Purpose: The aim of this study was to investigate the role of miR-33-5p in abdominal aortic aneurysm progression, which regulated adenosine triphosphate-binding cassette transporter A1 (ABCA1)-mediated cholesterol efflux and lipid accumulation in THP-1 macrophage-derived foam cells through the PI3K/Akt pathway. Methods: Quantitative reverse transcription polymerase chain reaction was used to evaluate the expression level of miR-33-5p and ABCA1 mRNA in abdominal aortic aneurysm patient and normal person tissues. The relationship between miR-33-5p and ABCA1 was examined by dual luciferase report assay. High-performance liquid chromatography was used to evaluate the levels of cholesterol contents. Cholesterol efflux detection was performed by liquid scintillator. The expression of inflammatory cytokines was detected by quantitative reverse transcription polymerase chain reaction. Western blot was applied to determine the expression levels of ABCA1, PI3K (p-PI3K), and Akt (p-Akt). Results: The quantitative reverse transcription polymerase chain reaction analysis results revealed miR-33-5p overexpression in abdominal aortic aneurysm tissues, but the expression level of ABCA1 was lower in abdominal aortic aneurysm tissues than non-abdominal aortic aneurysm tissues. Subsequently, the dual luciferase report gene assay confirmed that ABCA1 was a target of miR-33-5p, and miR-33-5p-negative regulated ABCA1 expression. Moreover, the expression levels of p-PI3K, p-Akt, and ABCA1 were decreased in THP-1 cell transferred with ABCA1 siRNA, but knockdown of miR-33-5p had an opposite effect. Furthermore, knockdown of miR-33-5p decreased the expression of MMP-2, MMP-9, TNF-α, total cellular cholesterol, and promoted cholesterol efflux in THP-1-derived foam cells. Importantly, LY294002 (PI3K inhibitor) or si-ABCA1 completely inhibited the stimulatory effects of miR-33-5p inhibitor. Conclusion: This study has found that knockdown of miR-33-5p induced ABCA1 expression and promoted inflammatory cytokines and cholesterol efflux likely via activating the PI3K/Akt signaling pathway.

This paper presents a visualization modeling method of road 3D model for traffic simulation and driving simulation. With this method, the semi-automatic design of the road longitudinal curve can be realized, and the linearity test can be completed automatically according to the road design theory. The building block method has been used in this method to store the linear data of the road. Based on the constrained Delaunay triangulation theory, the automatic construction of the road 3D model and matching with the terrain model is realized. This paper introduces the main algorithms and data structure used in this method, and implements a 3D visualization modeling tool by using Qt, OSG and other software.

Cuffed endotracheal tubes (ETTs) have increasingly been used in small children. However, the use of cuffed ETTs in small children is still controversial. The goal of this meta-analysis is to assess the current evidence regarding the postextubation morbidity and tracheal tube (TT) exchange rate of cuffed ETTs compared to uncuffed ETTs in children. A systematic literature search in PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials up to November 2014 was conducted to identify randomized controlled trials (RCTs) and prospective cohort studies that compared the use of cuffed and uncuffed ETTs in children. The primary outcome was the incidence of postextubation stridor and the second outcomes were the TT exchange rate, need for re-intubation, and duration of tracheal intubation. All pooled data were estimated using random effects meta-analysis. Two RCTs and two prospective cohort studies including 3782 patients, in which 1979 patients for cuffed tubes and 1803 patients for uncuffed tubes, were included in our analysis. We found that the use of cuffed ETTs did not significantly increase the incidence of postextubation stridor (RR = 0.88; 95 % CI 0.67–1.16, p = 0.36), and the TT exchange rate was lower in patients receiving cuffed tubes intubation (RR, 0.07; 95 % CI 0.05–0.10, p

The fog images of Inland River often have low contrast. This paper introduces a optimized contrast enhancement algorithm. Firstly, divide the fog image by using the hierarchical searching method of quad-tree subdivision. Choose the brightest pixel as the atmospheric light in the final selected block. Then, combine the Mean Squared Error and the loss function. Next, get the optimal transmission value which can balance the contrast and the information loss. Then, fix the transmission with guide filter and adaptive window slide. Finally, restore the defogged image by solving the atmosphere attenuation model. Compared with the results obtained by several existing classical defogging methods, the experimental result shows that the proposed algorithm can effectively reduce the color distortion in sky region.

To achieve the robust tracking for a visual object under challenging conditions in the noisy,occlusion and the deformation,a novel visual object tracking method is proposed in this paper.By combining the Kernel Sparse Representation Classification(KSRC) and adaptive dictionary updating method under Normal Hedge framework,this method can handle tough situations like high inter-class similarities and drastically target appearance variations.Although the KSRC enhances classification performance,standard convex optimization is not fast enough for tracking in real time.Thus an efficient Kernel Random Coordinate Descent(KRCD) method is proposed to calculate the sparse coefficient vector,and the KRCD-SRC classification method is taken to calculate the loss value of each particle.In order to avoid the template drifting,the adaptive dictionary updating method is also given.At last,the states of the target are estimated by the Normal Hedge.Experiments show that the average computing frame rate of the proposed method is 14 frame/s when 50 particles are used.Extensive test results suggest that the proposed method outperforms several state-of-art tracking methods in many complex conditions.

Background Hybrid procedures with combined open extra-anatomical supra-aortic bypasses and endovascular surgery are less invasive for patients with complex aortic arch pathology. The aim of this paper is to report patients who developed retrograde type A aortic dissection following initially successful hybrid endovascular treatment. Methods Retrospective review of prospectively collected computerized departmental database. All patients with supra-aortic hybrid endovascular surgery and post-procedure retrograde type A dissection were identified. Patient demographics, comorbid conditions, perioperative parameters, procedural details and post-operative complications were collected. Results From May 2005 to July 2014, 163 patients underwent thoracic aortic endovascular procedures at our institution. From the 46 patients who had supra-aortic hybrid endovascular repair, six patients (6/46, 13% of all supra-aortic hybrid cases, 3 males) developed retrograde type A aortic dissection. All were elective cases, with 3 chronic dissecting aneurysms and 3 atherosclerotic aneurysms. All had one-stage hybrid procedures: 2 patients had carotid-carotid bypass grafts, one had carotid-carotid-left subclavian bypass graft, and 3 had bypass grafts from ascending aorta to innominate artery and left carotid artery. Five patients had Cook Zenith thoracic stent-grafts (Cook Medical, Bloomington, IN, USA), and one had Medtronic Valiant stent-grafts (Medtronic Vascular Inc, Santa Rosa, CA, USA). The retrograde type A dissection occurred with sudden symptoms at day 5, 6, 10, 20, 105 and 128, respectively. There were 3 immediate fatalities and 2 patients treated conservatively deemed unfit for reintervention (one died of pneumonia at 9 months, and one remained alive at 7 months post-complication). One patient underwent successful emergency open surgery and survived. Conclusions Supra-aortic hybrid procedures in treating aortic arch pathology may be at risk of developing retrograde type A dissection. This post-operative complication inevitably have poor outcome, even with early diagnosis and prompt treatment.

Background Tolerance to remifentanil during sevoflurane anesthesia may increase postoperative analgesic requirements. Low-dose naloxone not only has been shown to block the development of acute opioid tolerance but also to ameliorate undesired opioid-induced side effects. We hypothesized that naloxone prevents the acute opioid tolerance produced by a large dose of remifentanil, and reduces the incidence of opioid-induced side effects. Methods Seventy-two patients undergoing open colorectal surgery were randomly assigned to receive intraoperative remifentanil (1) small dose at 0.1 μg/kg/min; (2) large dose at 0.30 μg/kg/min; or (3) large dose at 0.30 μg/kg/min combined with low-dose naloxone at 0.25 μg/kg/h just after the induction. Cumulative morphine consumption, postoperative pain scores, incidence of opioid-related side effects, time to recovery of bowel function, and length of hospital stay were recorded. Results Cumulative morphine consumption at 24 h after surgery was higher in the large-dose remifentanil group (28 ± 12 mg) compared with the small-dose remifentanil group (17 ± 12 mg), and large-dose remifentanil–naloxone group (18 ± 9 mg), (P

Background Peripheral blood monocyte count is an easily assessable parameter of systemic inflammatory response. The aim of this study was to determine whether monocyte count was prognostic in hepatocellular carcinoma (HCC) following hepatic resection. Methods We retrospectively reviewed 351 patients with HCC treated with hepatic resection from 2006 to 2009. Preoperative absolute peripheral monocyte count, demographics, and clinical and pathological data were analyzed. Results On univariate and multivariate analysis, elevated monocyte counts (≥545/mm3), tumor size ≥5 cm, non-capsulation, and multiple tumors were associated with poor disease-free survival (DFS) and overall survival (OS). The 1-, 3- and 5-year DFS rates were 58%, 41% and 35%, respectively, for patients with monocyte counts

Spontaneous isolated subclavian artery dissecting aneurysm is rare. This is to our knowledge the first case in the world's literature to report a patient with subclavian artery dissecting aneurysm. Although the endovascular approach of treating subclavian artery pathologies is not challenging, the choice of using a covered stent for this patient was a new attempt in treating subclavian artery dissections. This case report highlights the possibility and safety of using covered stent in treating patients with subclavian artery dissecting aneurysms after reassuring the patency of the cerebral circulation system.

Towards the reactive compensation feature of distribution network and integral substation, this paper proposed an integration structure of distribution transformer and STATCOM (DT-STATCOM). It use the surplus capacity of transformer to compensate the reactive power; by setting the connect voltage flexible, it extended the switching devices selection; the integration structure reduce the volume and cost of compensation device. Based on the structure of DT-STATCOM, this paper proposed two novel reactive current detection method across the transformer's ports. Then the paper designed the decision control system using multi-lateral information. Simulation result showed that, the DT-STATCOM system had significant effect on dynamic reactive power compensation, transformer voltage support and imbalance inhibition.

Calibration of engine management systems requires considerable engineering resources during the development of modern engines. Common-rail diesel engine increases a greater level of system complexity and greatly increases test requirements to achieve successful calibrations. This study is about calibration of the 4JB1 high-pressure common-rail diesel engine based on a simulation model which built up in the GT-Power software. The model is verified by the comparison between simulation and experiment results on some operating points. The model can be applied to calibrate and optimize the injection parameters through the method of DoE (Design of Experiments), and get a set of injection parameters MAPs. From the experiment results, the simulation model can fulfill the calibration needs of the 4JB1 diesel engine. This method gets a set of pre-calibration MAPs off-line which is critical to reduce the development period and cost.

Situs inversus totalis is a rare autosomal recessive developmental anomaly. There are very few reports in the published literature of abdominal aortic aneurysm in patient with situs inversus totalis, all of whom underwent open aneurysm repair. This is the first case in the world's literature to describe a patient with situs inversus totalis who had a successful endovascular infrarenal aneurysm repair. Although endovascular infrarenal aneurysm repair should not be more challenging, the endovascular approach may decrease risk of potential errors because of unfamiliar anatomy. Technical considerations in performing endovascular procedures in patients with situs inversus totalis are discussed in this article.

Due to the existence of reverse recovery time of power diodes, the clamp diodes and di/dt-chokes diodes of three-level NPC inverter will enter the reverse recovery region at the same time, and the partial over-circuit phenomena will occur. This problem limits the output power of inverter system and do harm to the devices. To avoid this over-current problem, a new circuit implementation of 6kV three-level NPC inverter based on three phase individual DC-link is presented. Using this new circuit the partial over-current problem of traditional three-level NPC inverter can be solved. On the other hand, the security, stability and flexibility of three-level NPC inverter control system are much more complicated than traditional two-level system and low-voltage inverter. So the high reliability hardware and software based on layer organization structure has been put forward. This control scheme is realized with only a single FPGA chip and can provide an effective, flexible, and safe solution for high-power three-level NPC inverters. At last, some simulation and experimental results are presented to verify the advantages of the 6kV three-level NPC inverters.

In this paper, we develop an effective P2P-based multimedia content delivery networks model, which seeks to analyze system performance metrics: hit ratios and throughputs, which are affected by system parameters. We find out that there are three key bottlenecks that affect system performance metrics: the performance of the media content providers, the network bandwidth between nodes and disk I/O bandwidth of nodes. Numerical Analysis of system performance under typical configuration gives the impact of these bottlenecks on system performance. Moreover, the analysis method is also suitable for other P2P-based content delivery networks.

To meet the demand on precise control of electronic control in diesel engine, study on electronic control of cylinder pressure feedback in common rail diesel engine is made. On the basis of brief analysis for cylinder pressure physical meaning, mechanism and sketch of electronic control based on cylinder pressure feedback is presented, pressure characteristic variable orienting to control is provided, cylinder pressure feedback is obtained by means of fitting of multi-nominal. Electronic control system with dual micro-processor based on MPC555 and DSP56F807 is designed, hardware of pressure acquisition unit (PAU) is presented, include fiber-option pressure sensor, encoder and electric circuit. Hardware of electronic control unit (ECU) is designed, include power drive and signal processing circuit. Software for dynamic acquisition and control system is programed. Primary test in 4100 diesel engine with high pressure common rail system is made, testing result showed an effect of electronic control of common rail based on cylinder pressure feedback.

In this paper, the digital realization theory and key technologies of Multi-Level SPWM scheme implementation for the three-level neutral point clamped (NPC) inverter is presented. The digital asymmetrical regular sampling principle of SPWM is realized with only a single FPGA chip LFEC10 from LATTICE Inc. and the programming language is very high speed integrated circuit hardware description language (VHDL). This full digital circuit can provide an effective, flexible, and safe solution for high-power inverts. At last, some simulation and experimental results have been presented and discussed in this paper.

Background and Objectives The goal of this meta-analysis study was to assess the effects of fentanyl on emergence agitation (EA) under sevoflurane anesthesia in children. Subjects and Methods We searched electronic databases (PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials) for articles published until December 2014. Randomized controlled trials (RCTs) that assessed the effects of fentanyl and placebo on EA under sevoflurane anesthesia in children that the outcome were the incidence of EA, postoperative pain, emergence time or adverse effects were included in this meta-analysis. Results A total of 16 studies, including 1362 patients (737 patients for the fentanyl group and 625 for the placebo group), were evaluated in final analysis. We found that administration of fentanyl decreased the incidences of EA (RR = 0.37, 95% CI 0.27~0.49, P

To evaluate the use of percutaneous microwave coagulation therapy for hepatocellular carcinoma, particularly with tumor nodules larger than 2 cm in diameter.Fifty patients with 107 hepatocellular carcinoma nodules (mean diameter, 2.7 cm +/- 1.5 [SD]; range, 0.8-6.4 cm) were treated with percutaneous microwave coagulation therapy. Single electrode insertion was used in 46 nodules (43.0%) 2 cm or smaller, whereas multiple electrode insertion was applied in 61 (57.0%) nodules larger than 2 cm.At 1 month after therapy, technical success for tumors 2 cm or smaller and those larger than 2 cm was achieved in 45 (98%) and 56 (92%) nodules, respectively. After follow-up of 9 months or longer, local recurrence was found in one nodule (2%) sized 1.8 cm and in five nodules (8%) larger than 2 cm. At the end of the study, 26 (52%) of 50 patients were free of disease, and disease-free survival rates at 1 and 2 years were 55% and 41%, respectively. Overall survival rates at 1, 2, and 3 years were 96%, 83%, and 73%, respectively.Percutaneous microwave coagulation therapy is an effective and safe therapeutic modality for hepatocellular carcinoma. A multiple electrode insertion technique can enhance the effectiveness of this therapy in tumors 6 cm or smaller.

The complicated structure and high power density make the protection and control of high voltage power frequency control system difficult. This paper proposed the novel protection and control strategy covered different parts of the system. Taking advantage of microprocessor protection system realised the system-level protection covered the fault of rectifier input, DC link, inverter output and even the induction motor. Improve the main circuit to strengthen security and stability in device level. The paper also analysed the cooperation of the protective trip and PWM pulse blocking and validated the feasibility of dual breaker setting to restrain feedback energy.

Le situs inversus complet est une anomalie developpementale autosomique recessive rare. Il y a tres peu de rapports dans la litterature d’anevrysmes de l’aorte abdominale avec situs inversus complet, tous operes par voie ouverte. C’est le premier cas dans la litterature decrivant un patient avec situs inversus complet qui a eu une reparation endovasculaire reussie d’u anevrysme sous-renal. Bien que la reparation endovasculaire des anevrysmes sous-renaux ne soit pas etre plus agressive, l’approche endovasculaire peut diminuer le risque d’erreurs potentielles en raison de l’anatomie peu familiere. Des considerations techniques pour executer les procedures endovasculaires chez les patients avec un situs inversus complet sont discutees dans cet article.

AIM: To investigate the effect of low central venous pressure (LCVP) on blood loss during hepatectomy for hepatocellular carcinoma (HCC). METHODS: By the method of sealed envelope, 50 HCC patients were randomized into LCVP group (n = 25) and control group (n = 25). In LCVP group, CVP was maintained at 2-4 mmHg and systolic blood pressure (SBP) above 90 mmHg by manipulation of the patient’s posture and administration of drugs during hepatectomy, while in control group hepatectomy was performed routinely without lowering CVP. The patients’ preoperative conditions, volume of blood loss during hepatectomy, volume of blood transfusion, length of hospital stay, changes in hepatic and renal functions were compared between the two groups. RESULTS: There were no significant differences in patients’ preoperative conditions, maximal tumor dimension, pattern of hepatectomy, duration of vascular occlusion, operation time, weight of resected liver tissues, incidence of post-operative complications, hepatic and renal functions between the two groups. LCVP group had a markedly lower volume of total intraoperative blood loss and blood loss during hepatectomy than the control group, being 903.9 ± 180.8 mL vs 2 329.4 ± 2 538.4 (W = 495.5, P