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Background and purpose Cerebral amyloid angiopathy (CAA) is a well-recognized contributor to cognitive decline in the elderly. The posterior cortical predilection of CAA pathology would cause visuospatial dysfunction, which is still underexplored. We aimed to investigate whether the visuospatial dysfunction in CAA is associated with the posterior distribution of small vessel disease (SVD) imaging markers. Methods We recruited 60 non-demented CAA cases from a Chinese prospective cohort and 30 cases with non-CAA SVD as controls. We used the Visual Object and Space Perception (VOSP) battery to evaluate visuospatial abilities, and multivariable regression models to assess their associations with SVD imaging markers. Results There was visuospatial dysfunction, especially visual object perception impairment, in CAA compared to controls (Z-score of VOSP: -0.11 ± 0.66 vs. 0.22 ± 0.54, p = 0.023). The VOSP score in CAA was independently related to the fronto-occipital gradient of white matter hyperintensity volumes (coefficient = 0.03, 95% confidence interval [CI] = 0.003-0.05, p = 0.030) and mean fractional anisotropy values on diffusion tensor imaging (coefficient = 4.72, 95% CI = 0.97-8.48, p = 0.015), but not the severity of global SVD imaging markers or the gradient of lobar cerebral microbleeds with adjustments for age and global cognition score. Conclusions This finding suggests that the damage of posterior white matter rather than global disease severity may be a major contributor to visuospatial dysfunction in CAA.

The correlations between shear wave velocity (SWV) calculated from virtual touch tissue imaging quantification (VTIQ) technique and histological prognostic factors of invasive ductal carcinoma was investigated. A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study. SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy. The maximum values were recorded for statistical analysis. Medical records were reviewed to determine tumor size, histological grade, lymph node status and immunohistochemical results. Tumor subtypes were categorized as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative. The correlations between SWV and histological prognostic factors were analyzed. It was found that tumor size showed positive association with SWV (r=0.465, P

Based on the finite-difference-time-domain method and the plane-wave method, we study the imaging performance of two-dimensional hexagonal-structure photonic-crystal flat panel lens. First, the plane wave expansion method is used to verify that the structure has a negative refraction effect. The equivalent refractive index is – 1 when the normalized frequency is 0.251. The finite-difference-timedomain method is used to study the imaging performance of the structure for the small circular target (radius 1/12 wavelength). The simulation result shows that the imaging resolution of the target is greatly improved by a photonic-crystal flat lens with hexagonal structure. Then the side length of square air hole is changed to study the influence on the imaging performance. We find that the imaging resolution is different for different side lengths. The general trend is that the imaging resolution gradually increases, when the side length of hole increases (from 0.1 a to 0.5 a). There is an optimum resolution when the side length is 0.5 a. The result shows that the imaging performance of the lens can be optimized by changing the side length of holes. It provides a theoretical basis for the practical application of the photonic-crystal flat lens.

Surgery to treat drug-resistant epilepsy can be quite effective but remains substantially underutilized. A pilot study was undertaken to test the feasibility of using a non-invasive, non-ablative, approach to produce focal neuronal loss to treat seizures in a rodent model of temporal lobe epilepsy. In this study, spontaneous, recurrent seizures were established in a mouse model of pilocarpine-induced status epilepticus. After post-status epilepticus stabilization, baseline behavioral seizures were monitored for 30 d. Non-invasive opening of the blood–brain barrier targeting the hippocampus was then produced by using magnetic resonance-guided, low-intensity focused ultrasound, through which a neurotoxin (quinolinic acid) administered intraperitoneally gained access to the brain parenchyma to produce focal neuronal loss. Behavioral seizures were then monitored for 30 d after this procedure, and brains were subsequently prepared for histologic analysis of the sites of neuronal loss. The average frequency of behavioral seizures in all animals (n = 11) was reduced by 21.2%. Histologic analyses along the longitudinal axis of the hippocampus revealed that most of the animals (n = 8) exhibited neuronal loss located primarily in the intermediate aspect of the hippocampus, while sparing the septal aspect. Two other animals with damage to the intermediate hippocampus also exhibited prominent bilateral damage to the septal aspect of the hippocampus. A final animal had negligible neuronal loss overall. Notably, the site of neuronal loss along the longitudinal axis of the hippocampus influenced seizure outcomes. Animals that did not have bilateral damage to the septal hippocampus displayed a mean decrease in seizure frequency of 27.7%, while those with bilateral damage to the septal hippocampus actually increased seizure frequency by 18.7%. The animal without neuronal loss exhibited an increase in seizure frequency of 19.6%. The findings indicate an overall decrease in seizure frequency in treated animals. And, the site of neuronal loss along the longitudinal axis of the hippocampus appears to play a key role in reducing seizure activity. These pilot data are promising, and they encourage additional and more comprehensive studies examining the effects of targeted, non-invasive, neuronal lesions for the treatment of epilepsy.

Purpose To determine practice patterns of inferior vena cava filters (IVCFs), retrieval rates, and reasons why retrievable-IVCFs (R-IVCFs) are kept permanent. Methods A total of 399 patients who received IVCFs at Third Hospital of Hebei Medical University from January 2017 to December 2017 were registered and retrospectively studied. Date of demographics, baseline medical history, dwell time, reasons why R-IVCFs were kept permanent, and R-IVCFs thrombus were collected. Results A total of 399 IVCFs were placed during the study period including 27 permanent IVCFs and 372 R-IVCFs. Among all patients who received R-IVCFs, the mean dwell time was 18.25 ± 16.60 days, follow-up rate was 96.24% (358/372), and 337 R-IVCFs were attempted to be removed. Except one, 336 R-IVCFs were retrieved successfully (336/372, 90.32%). Sixty-four R-IVCFs thrombi were found during retrieval including 53 small-size thrombi (< 1 cm × 1 cm) and 13 large-size thrombi (>1 cm × 1 cm). Fifty-three R-IVCFs with small-size thrombi were removed successfully with no additional treatments. Twelve large-size thrombi were retrieved successfully after catheter-directed thrombolysis. Conclusions With good follow-up, the retrieval rate could be improved to 90.32%. The main reasons why R-IVCFs were kept permanent were to avoid losing follow-up and overcome inappropriate selections of indications or IVCF types. And R-IVCFs with thrombus could be removed safely.

OBJECTIVE Surgery can be highly effective for the treatment of medically intractable, neurological disorders, such as drug-resistant focal epilepsy. However, despite its benefits, surgery remains substantially underutilized due to both surgical concerns and nonsurgical impediments. In this work, the authors characterized a noninvasive, nonablative strategy to focally destroy neurons in the brain parenchyma with the goal of limiting collateral damage to nontarget structures, such as axons of passage. METHODS Low-intensity MR-guided focused ultrasound (MRgFUS), together with intravenous microbubbles, was used to open the blood-brain barrier (BBB) in a transient and focal manner in rats. The period of BBB opening was exploited to focally deliver to the brain parenchyma a systemically administered neurotoxin (quinolinic acid) that is well tolerated peripherally and otherwise impermeable to the BBB. RESULTS Focal neuronal loss was observed in targeted areas of BBB opening, including brain regions that are prime objectives for epilepsy surgery. Notably, other structures in the area of neuronal loss, including axons of passage, glial cells, vasculature, and the ventricular wall, were spared with this procedure. CONCLUSIONS These findings identify a noninvasive, nonablative approach capable of disconnecting neural circuitry while limiting the neuropathological consequences that attend other surgical procedures. Moreover, this strategy allows conformal targeting, which could enhance the precision and expand the treatment envelope for treating irregularly shaped surgical objectives located in difficult-to-reach sites. Finally, if this strategy translates to the clinic, the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders.

ObjectivesFor colorectal cancer patients, traditional biomarker deficient mismatch repair/microsatellite instability (dMMR/MSI) is an accurate predictor of immune checkpoint inhibitors (ICIs). Recent years, researchers considered tumor mutation burden (TMB) as another predictive biomarker which means the number of nonsynonymous mutations in cancer cells. Several studies have proven that TMB can evaluate the efficacy of ICI therapy in diverse types of cancer, especially in non-small cell lung cancer and melanoma. However, studies on the association between TMB and the response to ICI therapy in colorectal cancer alone are still lacking. In this study, we aim to verify the effect of TMB as a biomarker in predicting the efficacy of ICIs in colorectal cancer.MethodsWe searched the PubMed and Ovid MEDLINE databases up to May 1, 2021 and screened studies for eligibility. Thirteen studies published from 2015 to 2021 with 5062 patients were included finally. We extracted and calculated hazard ratios (HRs) and odds ratios (ORs) of overall survival (OS) and objective response rates (ORRs) and their 95% confidence intervals (95% CIs). Pooled HR and OR were evaluated to compare OS and ORR between TMB-high and TMB-low groups in colorectal cancer patients. Meanwhile, we assessed heterogeneity with the I2 statistic and p-values and performed publication bias assessments, sensitivity analyses, and subgroup analyses to search the cause of heterogeneity.ResultsThe TMB-high patient group had a longer OS than the TMB-low patient group (HR = 0.68, 95% CI: 0.51, 0.92, p = 0.013) among colorectal cancer patients receiving ICIs. In addition, the TMB-high patient group was superior in terms of ORR (OR = 19.25, 95% CI: 10.06, 36.82, p < 0.001) compared to the TMB-low patient group.ConclusionsIn conclusion, this meta-analysis revealed that TMB can be used as a potential predictive biomarker of colorectal cancer patients receiving ICI therapy. Nevertheless, this finding is not stable enough. Therefore, many more randomized controlled trials are needed to prove that TMB is reliable enough to be used clinically to predict the efficacy of immunotherapy in colorectal cancer. And the most relevant biomarker remains to be determined when TMB high overlaps with other biomarkers like MSI and TILs.

Aspect level sentiment classification is the process of discriminating the sentiment orientation of different aspects expressed in the text. Due to the non-standardization of Chinese comments, there are different levels of noise in the text, which affects the classification results of aspect level sentiment analysis. In this paper, an Aspect level sentiment classification method based on evaluation unit is proposed. Firstly, based on the results of part of speech analysis, dependency syntax analysis and semantic dependency analysis are used to obtain the relationships between words, so as to make relevant rules for viewpoint information recognition. Then, the redundant text is deleted by filtering the hypothetical and declarative statements of the key sentences, and the method of constructing the evaluation collocation table combined with the structure diagram of the comment object is completed to identify the implicit evaluation units. Finally, aspect - level sentiment classification is achieved based on sentiment dictionary.

PURPOSE Respiratory motion correction is necessary for the quantitative analysis of liver contrast-enhanced ultrasound (CEUS) image sequences. Most respiratory motion correction methods are based on the dual mode of CEUS image sequences, including contrast and grayscale image sequences. Due to free-breathing motion, the acquired two-dimensional (2D) ultrasound cine might show the in-plane and out-of-plane motion of tumors. The registration of an entire 2D ultrasound contrast image sequence based on out-of-plane images is ineffective. For the respiratory motion correction of CEUS sequences, the reference image is usually considered the standard for the deletion of any out-of-plane images. Most methods used for the selection of the reference image are subjective in nature. Here, a quantitative selection method for an optimal reference image from CEUS image sequences in the B mode and contrast mode was explored. METHODS The original high-dimensional ultrasound grayscale image data were mapped into a two-dimensional space using Laplacian Eigenmaps (LE), and K-means clustering was adopted. The center image of the larger cluster with a near-peak contrast intensity was considered the optimal ultrasound reference image. In the ultrasound grayscale image sequence, the images with the maximum correlations to the reference image in the same time interval were selected as the corrected image sequence. The effectiveness of this proposed method was then validated on 18 CEUS cases of VX2 tumors in rabbit livers. RESULTS Correction smoothed the time-intensity curves (TICs) extracted from the region of interest of the CEUS image sequences. Before correction, the average of the total mean structural similarity (TMSSIM) and the average of the mean correlation coefficient (MCC) from the image sequences were 0.45 ± 0.11 and 0.67 ± 0.16, respectively, and after correction, the average TMSSIM and MCC increased (P

In this study, a situation-based interactive e-book system was developed for improving children’s learning performance of numerical operations. To evaluate the effectiveness of the system, an exper...

China Railway Track System II slab track is widely applied to China high-speed railway. Under the high temperature conditions, it tends to produce different degrees of arch at the joints between prefabricated slabs, which will affect the track irregularity and safe operation of high-speed trains. In this paper, considering the buckling instability of track structure, the arching mechanism of the slab joints was investigated by establishing a 3D finite element model of the CRTSII slab track. Combined with the field investigation, the damage process of joint concrete and its effects on the arching instability were analyzed. The results show: 1) The construction of joint concrete is difficult to control on site, which leads to inferior quality compared to prefabricated slab. The worse quality of joint concrete corresponds to a smaller amplitude of temperature rise causing joints damage and a greater damage area. 2) When the amplitude of temperature rise of the slab is over 37 °C, various damage emerges in the narrow joint and the middle of wide joint, resulting in the eccentric compression. 3) The temperature gradient load will cause the propagation of interface gap between slab and CA mortar layer, which aggravates the arching instability of slab, especially when the height of gap exceeds 1.5 mm. This research is expected to provide guidance for the optimization design, maintenance and damage control of slab track.

BackgroundAcute ischemic stroke (AIS) leads to a substantial burden of disease among the elderly. There may be a delay in or a poor outcome of endovascular treatment (EVT) among AIS patients with large-vessel occlusion (LVO) during off-hours. By using a prospective, nationwide registry, we compared the workflow intervals and radiological/clinical outcomes between patients with acute LVO treated with EVT presenting during off- and on-hours.MethodsWe analyzed prospectively collected Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke (ANGEL-ACT) data. Patients presenting during off-hours were defined as those presenting to the emergency department from Monday to Friday between the hours of 17:30 and 08:00, on weekends (from 17:30 on Friday to 08:00 on Monday), and on national holidays. We used logistic regression models with adjustment for potential confounders to determine independent associations between the time of presentation and outcomes.ResultsAmong 1788 patients, 1079 (60.3%) presented during off-hours. The median onset-to-door time and onset-to-reperfusion time were significantly longer during off-hours than on-hours (165 vs 125 minutes, P=0.002 and 410 vs 392 minutes, P=0.027). However, there were no significant differences between patients presenting during off- and on-hours in any radiological/clinical outcomes (mRS score: 3 vs 3 points, P=0.204; mortality: 15.9% vs 14.3%, P=0.172; successful reperfusion: 88.5% vs 87.2%, P=0.579; sICH: 7.2% vs 8.4%, P=0.492).ConclusionsOff-hours presentation in the nationwide real-world registry was associated with a delay in the visit and reperfusion time of EVT in patients with AIS. However, this delay did not lead to worse radiological/clinical outcomes.RegistratonURL: https://www.clinicaltrials.gov; Unique identifier: NCT03370939.

ObjectiveImmediate early response 5 (IER5) plays a core role in cell cycle and response to irradiation. However, its role in glioma remains unclear. We aimed to evaluate its prognostic significance in glioma based on The Cancer Genome Atlas data resource.MethodsThe Kruskal–Wallis test, Wilcoxon signed-rank test, and logistic regression were employed to explore the relationship between IER5 expression and clinicopathological features. Kaplan–Meier and Cox regression analyses were implemented to investigate the relationship of IER5 with prognosis. A nomogram to estimate the impact of IER5 on prognosis was created based on the Cox multivariate data. We performed gene set enrichment analysis (GSEA) to determine the key signaling cascades associated with IER5. Immunohistochemistry was performed to examine IER5 expression in a tissue microarray (TMA) of glioma samples.ResultsImmediate early response 5 gene expression was elevated in glioma patients. The level of IER5 was significantly correlated with WHO grade [OR = 6.71 (4.34–10.68) for G4 vs. G2 and G3], IDH (isocitrate dehydrogenase enzyme) status [OR = 13.35 (8.92–20.46) for wild-type (WT) vs. mutated (Mut)], epidermal growth factor receptor status [OR = 8.42 (4.32–18.43) for Mut vs. WT], age [OR = 0.27 (0.18–0.41) for ≤ 60 years vs. >60 years], and histological type [OR = 7.13 (4.63–11.31] for glioblastoma vs. astrocytoma, oligoastrocytoma, and oligodendroglioma). Univariate analyses revealed that high IER5 expression was linked to short overall survival (OS) [hazard ratio (HR): 3.747; 95% confidence interval (CI): 2.847–4.933; and P < 0.001]. High IER5 expression was linked to poor OS in multivariate analyses (HR: 2.474; 95% CI: 1.552–3.943; and P < 0.001). TMA results showed that high IER5 protein levels were related to short OS (HR: 1.84; 95% CI: 1.10–3.07; and P = 0.021) and poor disease-specific survival (HR: 1.82; 95% CI: 1.09–3.04; and P = 0.023). GSEA showed that many tumor related pathways were enriched differentially in the IER5-high expression group. The C-index and calibration plots of the nomogram showed an effective estimation performance in glioma patients.ConclusionHerein, we established that IER5 plays a critical role in glioma progression and prognosis, which might be an important biomarker for the prognosis of glioma patients.

Peripheral artery disease (PAD) is a serious public health issue, characterized by circulation disorder of the lower extreme that reduces the physical activity of the lower extremity muscle. The artery narrowed by atherosclerotic lesions initiates limb ischemia. In the progression of treatment, reperfusion injury is still inevitable. Ischemia-reperfusion injury induced by PAD is responsible for hypoxia and nutrient deficiency. PAD triggers hindlimb ischemia and reperfusion (I/R) cycles through various mechanisms, mainly including mitochondrial dysfunction and inflammation. Alternatively, mitochondrial dysfunction plays a central role. The I/R injury may cause cells’ injury and even death. However, the mechanism of I/R injury and the way of cell damage or death are still unclear. We review the pathophysiology of I/R injury, which is majorly about mitochondrial dysfunction. Then, we focus on the cell damage and death during I/R injury. Further comprehension of the progress of I/R will help identify biomarkers for diagnosis and therapeutic targets to PAD. In addition, traditional Chinese medicine has played an important role in the treatment of I/R injury, and we will make a brief introduction.

Surgical intervention can be quite effective for treating certain types of medically intractable neurological diseases. This approach is particularly useful for disorders in which identifiable neuronal circuitry plays a key role, such as epilepsy and movement disorders. Currently available surgical modalities, while effective, generally involve an invasive surgical procedure, which can result in surgical injury to non-target tissues. Consequently, it would be of value to expand the range of surgical approaches to include a technique that is both non-invasive and neurotoxic. Here, a method is presented for producing focal, neuronal lesions in the brain in a non-invasive manner. This approach utilizes low-intensity focused ultrasound together with intravenous microbubbles to transiently and focally open the Blood Brain Barrier (BBB). The period of transient BBB opening is then exploited to focally deliver a systemically administered neurotoxin to a targeted brain area. The neurotoxin quinolinic acid (QA) is normally BBB-impermeable, and is well-tolerated when administered intraperitoneally or intravenously. However, when QA gains direct access to brain tissue, it is toxic to the neurons. This method has been used in rats and mice to target specific brain regions. Immediately after MRgFUS, successful opening of the BBB is confirmed using contrast enhanced T1-weighted imaging. After the procedure, T2 imaging shows injury restricted to the targeted area of the brain and the loss of neurons in the targeted area can be confirmed post-mortem utilizing histological techniques. Notably, animals injected with saline rather than QA do demonstrate opening of the BBB, but dot not exhibit injury or neuronal loss. This method, termed Precise Intracerebral Non-invasive Guided surgery (PING) could provide a non-invasive approach for treating neurological disorders associated with disturbances in neural circuitry.

Background: The mechanism underlying delirium, a common acute fluctuating mental state, may be related to the activation of a neuroinflammatory response. In this study, we attempted to investigate whether plasma inflammatory response markers, vascular and cerebrovascular injury-related markers, and neurodegeneration-associated markers were associated with emergence delirium (ED).Methods: Patients aged 50 years or above who underwent elective laparoscopic surgery under general anesthesia were included in this study. Delirium was assessed postoperatively with the Richmond Agitation Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale. Plasma samples were collected from ED patients and non-ED patients to test concentrations of inflammation markers, including interleukin 6 (IL-6), chitinase 3-like 1 (CHI3L1), S100 calcium-binding protein B (S100B), lipoprotein-associated phospholipase-A2 (Lp-PLA2), and macrophage migration inhibitory factor (MIF); vascular and cerebrovascular injury-related markers, including intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM-1); and neurodegeneration-associated markers, including alpha-synuclein (α-Syn) and β-secretase 1 (BACE1). Binary logistic regression analysis was performed to analyze the relationship between biomarkers and ED, and receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of biomarkers.Results: A total of 104 patients were included in this study, with an average age of 63.69 ± 7.21. IL-6 (OR = 2.73, 95% CI: 1.66–6.44, P = 0.022), S100B (OR = 4.74, 95% CI: 1.88–11.95, P = 0.001), and BACE1 (OR = 6.54, 95% CI: 2.57–16.65, P < 0.000) were independent biological indicators for the occurrence of ED.CHI3L1, Lp-PLA2, MIF, ICAM-1, VCAM-1, and α-Syn were unrelated to ED. Plasma BACE1 level had a possible diagnostic value for ED [area under curve (AUC) = 0.75, 95% CI: 0.66–0.85], whereas plasma IL-6 (AUC = 0.62, 95% CI: 0.51–0.73) and S100B (AUC = 0.65, 95% CI: 0.54–0.76) levels had little diagnostic value for distinguishing ED vs. non-ED.Conclusion: Higher levels of systemic inflammation marker IL-6, cerebral inflammation marker S100B, and neurodegeneration-associated marker BACE1 are related to ED. Plasma BACE1 may be a potential diagnostic biomarker for ED.

Surgery can be highly effective for treating certain cases of drug resistant epilepsy. The current study tested a novel, non-invasive, surgical strategy for treating seizures in a rat model of temporal lobe epilepsy. The surgical approach uses magnetic resonance-guided, low-intensity focused ultrasound (MRgFUS) in combination with intravenous microbubbles to open the blood-brain barrier (BBB) in a transient and focal manner. During the period of BBB opening, a systemically administered neurotoxin (Quinolinic Acid: QA) that is normally impermeable to the BBB gains access to a targeted area in the brain, destroying neurons where the BBB has been opened. This strategy is termed Precise Intracerebral Non-invasive Guided Surgery (PING). Spontaneous recurrent seizures induced by pilocarpine were monitored behaviorally prior to and after PING or under control conditions. Seizure frequency in untreated animals or animals treated with MRgFUS without QA exhibited expected seizure rate fluctuations frequencies between the monitoring periods. In contrast, animals treated with PING targeting the intermediate-temporal aspect of the hippocampus exhibited substantial reductions in seizure frequency, with convulsive seizures being eliminated entirely in two animals. These findings suggest that PING could provide a useful alternative to invasive surgical interventions for treating drug resistant epilepsy, and perhaps for treating other neurological disorders in which aberrant neural circuitries play a role.

The association between regional cerebral oxygen saturation (rSO2) and postoperative cognitive decline is controversial. In this study, we investigated the association between the real variability of regional cerebral oxygen saturation during cardiopulmonary bypass (CPB) and postoperative delayed neurocognitive recovery in patients undergoing heart valve surgery.A total of 71 patients who underwent cardiac valve surgery were enrolled in this study. Patients were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MOCA) on the day before surgery and the 7th day after surgery. The real variability of regional cerebral oxygen saturation (rSO2), real variability of the brain bispectral index of EEG (BIS), real variability of mean arterial pressure (MAP) and body temperature were monitored during CPB. Patients were divided into two groups according to neural cognitive function scores to explore the relationship between postoperative delayed neurocognitive recovery and the real variability of cerebral oxygen saturation, BIS, MAP, and body temperature during CPB.Twenty-seven patients were diagnosed with postoperative delayed neurocognitive recovery. The occurrence of postoperative delayed neurocognitive recovery after surgery was closely related to the large variability of rSO2 during the rewarming phase of CPB (P.05). Logistic analysis showed that preoperative arrhythmia, a lower level of serum albumin after surgery and greater rSO2 variability during the rewarming phase were risk factors for postoperative delayed neurocognitive recovery (P.05). In this study, there was no correlation between postoperative delayed neurocognitive recovery and BIS, MAP or body temperature variability (P.05).The real variability of rSO2 during the CPB rewarming phase was related to postoperative delayed neurocognitive recovery in patients who underwent cardiac surgery.

Carotid artery plaque is a measure of atherosclerosis and is associated with future risk of atherosclerotic cardiovascular disease (ASCVD), which encompasses coronary, cerebrovascular, and peripheral arterial diseases. With advanced imaging techniques, computerized tomography (CT) and magnetic resonance imaging (MRI) have shown their potential superiority to routine ultrasound to detect features of carotid plaque vulnerability, such as intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous cap (FC), and calcification. The correlation between imaging features and histological changes of carotid plaques has been investigated. Imaging of carotid features has been used to predict the risk of cardiovascular events. Other techniques such as nuclear imaging and intra-vascular ultrasound (IVUS) have also been proposed to better understand the vulnerable carotid plaque features. In this article, we review the studies of imaging specific carotid plaque components and their correlation with risk scores.

With the rapid development of the Internet, the advantages of e-commerce in marketing have become prominent. However, it is difficult for consumers to choose a variety of products of the same type. Consumers give feedback on the purchase process in the form of comments, and in this way influence other users' purchase decisions. This paper mainly divides the text comments of e-commerce from the three aspects of keywords, evaluation objects and emotional resources, and classifies them according to the constructed emotional dictionary. Specific experimental steps: Firstly, the tf - idf algorithm to extract of subjects of keywords. Secondly, by using the method of part of speech combining keywords similarity evaluation object extraction, and based on the characteristics of parts of speech and location rules set to extraction of emotional resources. Finally, based on the emotional resources to build a dictionary, and for the same emotional words to different evaluation objects with different polarity, constructing reverse dictionary. The experimental results verify that the emotion dictionary constructed in this paper has a good effect on the emotion classification of e-commerce text reviews.

A novel approach to reduce vibration was put forward by applying rubber concrete as backfill layer of the high-speed railway tunnel, and its feasibility was analyzed based on the vibration isolation theory. A three-dimensional spatial coupling model of vehicle-track-tunnel-rock mass was established by means of vehicle-track coupling dynamics theory. The dynamic response of the vehicle, track, and tunnel structure under common and rubber concrete backfill layer was compared. The vibration reduction performance and the characteristics of rubber concrete were discussed. The change in tunnel vibration under different elastic modulus and damping ratios of backfill layer was analyzed, and the vibration reduction effect of rubber concrete combined with damping cushion was studied. Results show that the influence of the rubber concrete backfill layer on the dynamic indices of vehicle and track structure can be neglected. Because of the application of rubber concrete, the vibration acceleration of tunnel decreases by about 40%, and 4–8 dB can be reduced in the corresponding frequency of 100–200 Hz. With decrease in the elastic modulus and increase in the damping ratio, the vibration of the tunnel decreases gradually. Moreover, the influence of damping ratio is more significant than that of elastic modulus. The combination of rubber concrete backfill layer and damping cushion demonstrates a superior effect in reducing vibration, which decreases the vibration level by 3–5 dB compared with setting the damping cushion only. The article is expected to provide theoretical guidance for the application of rubber concrete in the high-speed railway.

Dynamic behavior of a new type of track using the polyurethane foam solidified ballast in heavy haul railway tunnels is comprehensively investigated in this study. First, a dynamic model of the vehicle–track–tunnel interaction system was developed based on the multi-body system dynamics theory and finite element method. Then, the dynamic effects of the polyurethane foam solidified ballast track on the train and the surrounding infrastructures were calculated and compared to those of the traditional ballasted track. Moreover, the effects of the elastic modulus and the solidified area size of polyurethane foam solidified ballast on the dynamic behavior were analyzed. Results show that, compared to the traditional ballast bed, polyurethane foam solidified ballast decreases the track stiffness and the vibration acceleration of the tunnel, while does not affect the vehicle safety (derailment coefficient and the rate of wheel load reduction). A larger elastic modulus of polyurethane foam solidified ballast has little effects on the wheel–rail interaction and the vibration acceleration of the tunnel, while a smaller modulus results in amplification of the displacements of rails and sleepers. Considering the vehicle–track interaction and tunnel vibration, the optimal elastic modulus of polyurethane foam solidified ballast is suggested to be 60–80 MPa. In addition, smaller solidified area of polyurethane foam solidified ballast presents lower effects on the vibration reduction and rate of wheel load reduction, while larger area leads to a higher derailment coefficient and cost. Therefore, an optimal solidified area size of polyurethane foam solidified ballast with the top width of 0.85 m is recommended.

Interface damage, which even happens in construction phase, has become a major problem for China Railway Track System (CRTS-II) slab track. The slab track in construction stage is a block structure and sensitive to daily changing temperature. In order to reveal the temperature behavior of the slab track and provide meaningful information to the control of early interface damage, a three-dimensional finite element model of slab track was developed to study the deformation and interface stress of the slab track under daily changing temperature in this paper. The daily changing temperature was measured on a testing platform constructed in open field, and imported to the model using user-defined subroutines UTEMP. Based on the developed model, the effect of initial temperature and construction seasons were then investigated. The analysis indicates that the slab deformation and stress change with time obviously and the positions of maximum interface stresses are near the slab corner, which is consistent with the location of interface disease. Initial temperature has significant influence on the slab temperature behavior. The initial temperature at 14:00 induces the largest interface tensile stress exceeding the interface bonding strength, while the interface stresses are relatively small from 19:00 to 24:00. Therefore, it is suggested that CA mortar injection should be finished before midnight. Additionally, as the overall temperature variation and temperature gradient are very obvious in summer, spring and autumn, the grouting operation of CA mortar in these three seasons is required to pay equal attention.

The vibration effect of urban rail transit has gained attention from both academia and the industry sector. Long Elastic Sleeper Track (LEST) is a new structure for vibration reduction which has recently been designed and applied to Chinese subways. However, little research has been devoted to its vibration reduction effect. In this study, field tests were conducted during peak transit hours on Beijing Subway Line 15 to examine the vibration reduction effects of the common ballastless track and LEST on both straight and curved sections. The results demonstrate that although LEST increases the wheel-rail vertical forces, rail vertical displacements, and rail accelerations to some extent, these effects do not threaten subway operational safety, and vibrations of track bed and tunnel wall are positively mitigated. LEST has an obvious vibration reduction effect at frequencies above 40 Hz. In straight track, the vibration of bottom of the tunnel wall measured in one-third octave bands is reduced by 10.52 dB, while the vibration at point on the tunnel wall at 1.5 m height is reduced by 9.60 dB. For the curved track, the vibrations at those two points are reduced by 9.35 dB and 8.44 dB, respectively. This indicates that LEST reduces vibrations slightly more for the straight track than for the curved track.

With the vigorous developments in urban rail transport systems of China, the fractures of fasteners have been frequently found in some newly built routes. This could aggravate the repair and maintenance apart from direct reduction in the operational safety. In this study, the fractures of fastener were systematically investigated with an aim of revealing the fracture mechanism and proposing effective repairing methods. Firstly, a refinement model of fastener was established. Based on the model, static analysis and dynamic analysis were carried out on the fastening clip. The static analysis is used to analyze the stress and strain by using the non-linear contact theory, and the dynamic analysis is used to analyze the vibration mode and harmonic response in the service state. Moreover, the static and dynamic on-site tests were also conducted on a typical route section. Results show that the stress concentration in fastening clips caused by the unreasonable installation in the term of excessive inserting depths and the vibration fastener resonance resulting from the rail corrugation as well as its second-order natural frequency led to the fracture.

This study aimed at evaluating the diagnostic performance of quantitative shear wave elastography (SWE) in differentiating metastatic cervical lymph nodes from benign nodes in patients with thyroid nodules. One hundred and forty-one cervical lymph nodes from 39 patients with thyroid nodules that were diagnosed as papillary thyroid cancer had been imaged with SWE. The shear elasticity modulus, which indicates the stiffness of the lymph nodes, was measured in terms of maximum shear elasticity modulus (maxSM), minimum shear elasticity modulus (minSM), mean shear elasticity modulus (meanSM), and standard deviation (SD) of the shear elasticity modulus. All the patients underwent thyroid surgery, 50 of the suspicious lymph nodes were resected, and 91 lymph nodes were followed up for 6 months. The maxSM value, minSM value, meanSM value, and SD value of the metastatic lymph nodes were significantly higher than those of the benign nodes. The area under the curve of the maxSM value, minSM value, meanSM value, and SD value were 0.918, 0.606, 0.865, and 0.915, respectively. SWE can differentiate metastasis from benign cervical lymph nodes in patients with thyroid nodules, and the maxSM, meanSM, and SD may be valuable quantitative indicators for characterizing cervical lymph nodes.

Background The prevention of pneumonia is critical for patients with acute ischaemic stroke (AIS). The six subscales in the Braden Scale seem to be related to the occurrence of pneumonia. We aimed to evaluate the feasibility of using the Braden Scale to predict the occurrence of pneumonia after AIS. Methods We studied a series of consecutive patients with AIS who were admitted to the hospital. The cohort was subdivided into pneumonia and no pneumonia groups. The scores on the Braden Scale, demographic characteristics and clinical characteristics were obtained and analysed by statistical comparisons between the two groups. We investigated the predictive validity of the Braden Scale by receiver operating characteristic (ROC) curve analysis. Results A total of 414 patients with AIS were included in this study. Of those 414 patients, 57 (13.8%) patients fulfilled the criteria for post-stroke pneumonia. There were significant differences in age and histories of chronic obstructive pulmonary disease (COPD), dysphagia and Glasgow Coma Scale (GCS) score between the two groups, and the National Institutes of Health Stroke Scale (NIHSS) score in the pneumonia group was significantly higher than that in the no pneumonia group (P P CI = 0.828–0.937). With 18 points as the cutoff point, the sensitivity was 83.2%, and the specificity was 84.2%. Conclusion The Braden Scale with 18 points as the cutoff point is likely a valid clinical grading scale for predicting pneumonia after AIS at presentation. Further studies on the association of the Braden Scale score with stroke outcomes are needed.

Objective To compare clinical efficacy, safety and cost of AngioJet rheolytic thrombectomy (ART) plus catheter-directed thrombolysis (CDT) and manual aspiration thrombectomy (MAT) plus CDT for acute iliofemoral deep venous thrombosis (DVT). Methods This was a retrospective study. A total of 126 DVT patients met the inclusion criteria. Sixty-one patients were included in the ART group and sixty-five in the MAT group. Clinical parameters were used to compare the groups. Clinical outcomes, complications and various medical expenses were analyzed. Results Technical success rates were 100% in ART and MAT group. There was no significant difference in the rate of thrombus clearance (lysis grades II and III) between ART group (98.36%) and MAT group (100%) (P = 0.311). The incidence of venous damage was slightly higher in the MAT group (4.6%) than in the ART group (0%) (P = 0.245). The cost of the ART group ($8,291.7 ± 471.4) was significantly higher than that of the MAT group ($4,632.5 ± 441.7) (P Conclusions ART and MAT appear similar with good clinical outcomes for acute iliofemoral DVT. MAT substantially lowers mean cost per patient compared to ART.

In order to uphold the concept of high-quality service development and improve the service quality of hotel industry in Heilongjiang Province, on the basis of customer satisfaction theory and combined with the development status of hotel industry in Heilongjiang Province, this paper uses keyword extraction algorithm, AHP analytic hierarchy process and emotional analysis technology to extract 12000 Hotel commentary data on OTA platform from equipment and facilities, services, transportation location, catering, price and health care. Six levels and 20 indicators are used to construct the evaluation model of hotel customer satisfaction in Heilongjiang Province. It is found that the factors that have significant impact on high-star hotels are relatively not obvious. The analysis results show that the overall customer satisfaction of hotels in Heilongjiang Province is relatively high, but there are still some improvements. For high-star hotels, we should pay more attention to equipment, facilities and service factors. Middle and low star hotels should pay attention to traffic location and price factors. Finally, according to the conclusion of the model and local characteristics, the corresponding countermeasures and suggestions are proposed.

Mitochondria are highly dynamic double-membrane organelles which play a well-recognized role in ATP production, calcium homeostasis, oxidation-reduction (redox) status, apoptotic cell death, and inflammation. Dysfunction of mitochondria has long been observed in a number of human diseases, including cancer. Targeting mitochondria metabolism in tumors as a cancer therapeutic strategy has attracted much attention for researchers in recent years due to the essential role of mitochondria in cancer cell growth, apoptosis, and progression. On the other hand, a series of studies have indicated that traditional medicinal herbs, including traditional Chinese medicines (TCM), exert their potential anticancer effects as an effective adjunct treatment for alleviating the systemic side effects of conventional cancer therapies, for reducing the risk of recurrence and cancer mortality and for improving the quality of patients’ life. An amazing feature of these structurally diverse bioactive components is that majority of them target mitochondria to provoke cancer cell-specific death program. The aim of this review is to summarize the in vitro and in vivo studies about the role of these herbs, especially their bioactive compounds in the modulation of the disturbed mitochondrial function for cancer therapy.

A case of congenital renal arteriovenous fistula (AVF) complicating pregnancy with gross hematuria was managed successfully by superselective embolization with metallic coils. The patient was in the first trimester of her pregnancy at 12 weeks of gestation. The AVF was detected by color Doppler sonography and confirmed by renal arteriography. Because of its easy accessibility and absence of irradiation, ultrasound is the first choice for pregnant patients. Color Doppler ultrasound is effective in diagnosing AVF, and it is also helpful in the long-term followup after treatment. The cirsoid-type renal congenital arteriovenous fistula has a characteristic sonographic appearance with a cluster of tubular anechoic structures in the kidney, which produce continuous turbulent high-velocity flow signals and a burr-like boundary flow spectrum. When the sonographic features are present, the diagnosis of renal AVF should be made, after which renal arteriography can be performed to confirm it. Selective embolization provided a safe and effective treatment with minimal damage to the parenchyma and without compromising renal function.

Disturbances in the function of neuronal circuitry contribute to most neurologic disorders. As knowledge of the brain's connectome continues to improve, a more refined understanding of the role of specific circuits in pathologic states will also evolve. Tools capable of manipulating identified circuits in a targeted and restricted manner will be essential not only to expand our understanding of the functional roles of such circuits, but also to therapeutically disconnect critical pathways contributing to neurologic disease. This study took advantage of the ability of low-intensity focused ultrasound (FUS) to transiently disrupt the blood-brain barrier (BBB) to deliver a neurotoxin with poor BBB permeability (quinolinic acid [QA]) in a guided manner to a target region in the brain parenchyma. Ten male Sprague-Dawley rats were divided into two groups receiving the following treatments: (i) magnetic resonance-guided FUS + microbubbles + saline (n = 5), or (ii) magnetic resonance-guided FUS + microbubbles + QA (n = 5). Systemic administration of QA was well tolerated. However, when QA and microbubbles were systemically administered in conjunction with magnetic resonance-guided FUS, the BBB was disrupted and primary neurons were destroyed in the targeted subregion of the hippocampus in all QA-treated animals. Administration of vehicle (saline) together with microbubbles and FUS also disrupted the BBB but did not produce neuronal injury. These findings indicate the feasibility of non-invasively destroying a targeted region of the brain parenchyma using low-intensity FUS together with systemic administration of microbubbles and a neurotoxin. This approach could be of therapeutic value in various disorders in which disturbances of neural circuitry contribute to neurologic disease.

The lateral resistance of sleeper plays an important role in ensuring the stability of a railway track, which may change in the operation of railway, due to the fouling in the ballast bed. In this work, discrete element method was adopted to investigate the effect of fouling on the lateral resistance of sleeper. The shape information of ballast was captured by method of three-dimensional vision reconstruction. In order to calibrate the mechanical parameters and verify the models, a lateral resistance field test was carried out by using a custom-made device. The contact force distributions in the different parts of sleeper as well as the interaction between ballast and sleeper were discussed in depth. The results show that fouling of ballast bed evidently reduces the lateral resistance of sleeper and the decreasing degree is also related to the fouled position of ballast bed, in the order of shoulder > bottom > side. Therefore, the effect of fouling, especially the fouling in the ballast shoulder, on the lateral resistance of sleeper, should be taken into account in ballast track maintenance work.

The fabrication of TiO 2 @MnO 2 nanotube arrays (NTAs) structure is accomplished via a pulsed electrodeposition technique. The successful preparation of this structure is owing to the high current pulse used, which creates a sufficient nucleation trend on the wall of the entire TiO 2 nanotube layer, that results in the continuous deposition of MnO 2 along the nanotube walls. The synthesized TiO 2 @MnO 2 NTAs sample is found to exhibit excellent electrochemical behavior with high specific capacitance of 425.0 F g −1 and areal capacitance of 150.9 mF cm −2 , ranking in the top level ever achieved by a MnO 2 -TiO 2 composite. Furthermore, a symmetric supercapacitor device is assembled using two strips of the TiO 2 @MnO 2 NTAs electrode that yielded energy density as high as 7.4 Wh kg −1 , a much higher value than most of the values reported for symmetric MnO 2 //MnO 2 supercapacitors. The remarkable electrochemical properties of the TiO 2 @MnO 2 NTAs sample make it an attractive candidate for the application of constructing high-performance supercapacitors.

To evaluate the safety and efficacy of pharmacomechanical thrombolysis (PMT) performed for patients with relative contraindications. From June 2014 to December 2016, 112 patients with acute or subacute proximal deep vein thrombosis (DVT) were enrolled in this study. 60 patients (including 27 acute DVT patients and 33 subacute DVT patients) were treated with catheter-directed thrombolysis (CDT), and 52 patients with relative contraindications (including 25 acute DVT patients and 27 subacute DVT patients) with PMT. Assessment of venous recanalization was conducted using venography the time Inferior vena cava filter is removed, and complications were used to compare safety and efficacy between the groups. The outcomes of acute DVT patients no matter which kind of therapy performed, CDT or PMT, were significant better than subacute DVT patients (PCDT = .04 and PPMT = .01). However, there was no significant difference between CDT acute group and PMT acute group or between CDT subacute group and PMT subacute group (Pacute = .80 and Psubacute = .84). For complications of all patients, there was no mortality and major bleeding occurred. PMT could be a safe and effective management for DVT patients with relative contraindications, and the acute DVT may achieve better outcomes when they receive CDT or PMT.

In the present work, a novel photocatalytic fuel cell (PFC) system involving a dual heterojunction photoelectrodes, viz. polyaniline/TiO2 nanotubes (PANI/TiO2 NTs) photoanode and CuO/Co3O4 nanorods (CuO/Co3O4 NRs) photocathode, has been designed. Compared to TiO2 NTs electrode of PFC, the present heterojunction design not only enhances the visible light absorption but also offers the higher efficiency in degrading Rhodamine B–a model organic pollutant. The study includes an evaluation of the dual performance of the photoelectrodes as well. Under visible-light irradiation of 3 mW cm−2, the cell composed of the photoanode PANI/TiO2 NTs and CuO/Co3O4 NRs photocathode forms an interior bias of +0.24 V within the PFC system. This interior bias facilitated the transfer of electrons from the photoanode to photocathode across the external circuit and combined with the holes generated therein along with a simultaneous power production. In this manner, the separation of electron/hole pair was achieved in the photoelectrodes by releasing the holes and electrons of PANI/TiO2 NTs photoanode and CuO/Co3O4 NRs photocathode, respectively. Using this PFC system, the degradation of Rhodamine B in aqueous media was achieved to an extent of 68.5% within a reaction duration of a four-hour period besides a simultaneous power generation of 85 μA cm−2.

Background: Interhospital transfer is associated with significant treatment delays and worse clinical outcomes for AIS patients. Obtaining informed consent from patients results in treatment delay. However, there are few studies concerning referral delays and communication time in patients first enrolled in community hospitals and then transferred to county hospitals in China's county-level cities. We included AIS patients who received rt-PA or MT at our stroke center via either interhospital transfer or direct presentation and compared the clinical outcomes and time metrics between the direct presentation and transfer patients to analyze the impact of interhospital transfer delays in county-level cities and the time to obtain informed consent on AIS treatment. Methods: We retrospectively enrolled patients with AIS admitted to our stroke center from March 2014 to February 2018. Patients treated with rt-PA and MT were classified into the transfer and direct groups. We collected their general information and time points. Statistical analyses were conducted to examine differences in the clinical outcomes and time metrics between these groups. Results: A total of 160 patients were enrolled; 119 patients received IV-rt-PA (transfer group, n=28; direct group, n=91), and 44 received MT (transfer group, n=14; direct group, n=14). For the rt-PA, rt-PA (NIHSS scores ≥5) and MT subgroups, the baseline characteristics were mostly similar between the direct and transfer groups. Among patients treated with rt-PA, the direct group had shorter onset-to-door times and higher initial NIHSS scores and NIHSS scores on discharge but longer door-to-stroke unit, stroke unit-to-rt-PA (representing the time to obtain informed consent) and DNT times than did the transfer group. There were no significance differences in onset-to-IV-rt-PA times. Among patients with NIHSS scores ≥5 treated with rt-PA, the direct group had shorter onsetto-door times but longer door-to-stroke unit, stroke unit-to-rt-PA and DNT times. There were no significant differences in onset-to-IV-rt-PA times, initial NIHSS scores or NIHSS scores on discharge. Among patients treated with MT, the direct group had shorter onset-to-door time but longer door-to-stroke unit, stroke unit-to-puncture and door-to-puncture times.There were no significance differences in onset-to-puncture times, initial NIHSS scores and NIHSS scores on discharge. Conclusions Our research confirmed that in a stroke center of a county-level city hospital, the time to obtain informed consent delayed intravenous thrombolysis or endovascular treatment in AIS patients. Interhospital transfers effectively reduced the time to obtain informed consent, and overlapping communication and transit times provided positive significance of the referral. Cooperation should be established with community hospitals and ambulances to allow simultaneous communication and transit to reduce the AIS onset-to-treatment time. Funding: This work was funded by the Guidance plan for social development of Taizhou Municipal Science and Technology (ssf20160141). The funder had no role in the study design, data collection, data analysis, data interpretation, writing of the report, decision to publish, or preparation of the manuscript. Conflict of Interest: None of the authors report a conflict of interest. Ethical Approval Statement: The study was approved by the medical ethics committee of Jingjiang People’s Hospital.

To solve the traditional problem of knowledge acquisition bottleneck in e-commerce, an improved algorithm of attribute reduction based on discernibility matrix is proposed. The algorithm is used to attribute reduction for e-commerce consumer behavior prediction. With rule extraction model of rough sets, the rules of e-commerce consumer behavior prediction are acquired. Practical example of consumer behavior prediction shows that the proposed approach can be handled found knowledge effectively and can be converted the available rules easily. It has strong ability of fault tolerance and can improve the speed and quality of knowledge acquisition. The method has good practical value.

This study aimed at determining the optimal age group for high-intensity focused ultrasound (HIFU) experiments for producing lesions in rats. Younger rats have thinner skulls, allowing for the acoustic waves to propagate easily through the skull without causing burns of the skin and brain surface. Younger rats however, have a smaller brain that can make HIFU focusing in the brain parenchyma challenging because of the focus size. In this study, we conducted transcranial HIFU sonications in rat pups of different ages (from 9 to 43 d) with a 1.5MHz MR compatible transducer. The electric power was selected to always reach a target temperature of at least 50°C in the parenchyma. The thickness of the skull and of the brain parenchyma was measured using T2-weighted MR imaging. Results showed that the thickness of the brain parenchyma increased quickly from P9 to P12, reaching 8.5 mm at P16, and then increasing gradually along with age. The skull thickness increased gradually from P9 to P26, and then more quickly after P30. The ratio between brain parenchyma thickness and skull thickness decreased gradually with age. For the pups at 30 d, the temperature in the brain tissue adjacent to the skull increased to 48.9°C, and those from the rodents older than 33 d reached 60°C or higher, which can produce undesired irreversible damage in this location. We conclude that young rats aged 16-26 d are optimal for experiments producing transcranial HIFU lesions in rats with an intact skull.

This chapter presents the conclusions of the research based on the main findings stated in the previous chapters. The original contributions to the knowledge and the practical applications in real cases are also discussed. Future work arising from the research with regards to the impacts of chemical admixtures on cement mortars and concrete as well as a more general outlook are proposed.

The goal of our study was to determine if the timing of the tissue plasminogen activator (tPA) administration influenced its effect on blood-brain barrier (BBB) permeability and the subsequent risk of hemorrhagic transformation. Thirty spontaneously hypertensive male rats were subjected to a 90-minute unilateral middle cerebral artery occlusion. Six rats did not receive tPA treatment (vehicle control: Group 0), intravenous tPA was administered immediately after reperfusion (Group 1) or 4h after reperfusion (Group 2). Dynamic contrast enhancement (DCE) and gradient-echo (GRE) MR sequences were used to assess the dynamic evolution of BBB permeability and hemorrhagic transformation changes at the following time points: during occlusion, and 3h, 6h, and 24h post reperfusion. In all groups, BBB permeability values in the ischemic tissue were low during occlusion. In Group 0, BBB permeability values increased at 3h after reperfusion (p=0.007, compared with the values during occlusion), and further at 6h after reperfusion (p=0.004, compared with those at 3h post reperfusion). At 24h post reperfusion, the values decreased to a level relative to but still higher than those during occlusion (p=0.025, compared with the values during occlusion). At 3h after reperfusion, BBB permeability values in the ischemic tissue increased, but to a greater extent in Group 1 than in Group 0 (p=0.034) and Group 2 (p=0.010). At 6h after reperfusion, BBB permeability values in the ischemic tissue increased further in Group 2 than in Group 0 (p=0.006) and Group 1 (p=0.001), while Group 1 exhibited BBB permeability that were still abnormal but less than those observed at 3h (p=0.001). Group 2 tended to have a higher hemorrhage incidence (36.4%, 4/11) than Group 1 (10.0%, 1/10, p=0.311) and Group 0 (0%), and hemorrhages occurred around 6h after reperfusion when BBB permeability values were the highest. Mortality was higher in Group 2 (63.6%, 7/11) than in Group 0 (0%) and Group 1 (10.0%, 1/10, p=0.024). The findings suggest that the timing of tPA administration is of importance for its impact on BBB permeability and subsequent risk of hemorrhagic transformation.

This paper applies the rough set theory and artificial intelligence technology into the field of forestry diseases and pests. It proposed the model of forestry diseases and pests forecasting in the demonstration. Through the model validation and accuracy analysis, the accuracy of the result is high, and forecast results with the actual situation are match.. In addition, it proposed an improvement attribute reduction algorithm based on discernibility matrix. Reduced conditional attribute set of forestry diseases and pests forecasting based on the algorithm. Through the extraction and reduction of generation rules, obtained a new f forestry diseases and pests forecasting model based on rough set theory. By verifying, the model has achieved a good result.

The application of highly ordered TiO2 nanotube arrays (NTAs) for energy storage devices such as supercapacitors has been attractive and of great interest owing to their large surface area and greatly improved charge-transfer pathways compared to those of nonoriented structures. Modification of the semiconductor nature of TiO2 is important for its application in constructing high-performance supercapacitors. Hence, the present study demonstrates a novel method involving fabrication of self-doped TiO2 NTAs by a simple cathodic polarization treatment on the pristine TiO2 NTAs to achieve improved conductivity and capacitive properties of TiO2. The self-doped TiO2 NTAs at −1.4 V (vs SCE) exhibited 5 orders of magnitude improvement on carrier density and 39 times enhancement in capacitance compared to those of the pristine TiO2 NTAs. Impedance analysis based on a proposed simplified transmission line model proved that the enhanced capacitive behavior of the self-doped TiO2 NTAs was due to a decrease of charge-...

Background and Purpose— To investigate the effect of chronic hyperglycemia on cerebral microvascular remodeling using perfusion computed tomography. Methods— We retrospectively identified 26 patients from our registry of 2453 patients who underwent a perfusion computed tomographic study and had their hemoglobin A 1c (HbA 1c ) measured. These 26 patients were divided into 2 groups: those with HbA 1c >6.5% (n=15) and those with HbA 1c ≤6.5% (n=11). Perfusion computed tomographic studies were processed using a delay-corrected, deconvolution-based software. Perfusion computed tomographic values were compared between the 2 patient groups, including mean transit time, which relates to the cerebral capillary architecture and length. Results— Mean transit time values in the nonischemic cerebral hemisphere were significantly longer in the patients with HbA 1c >6.5% ( P =0.033), especially in the white matter ( P =0.005). Significant correlation ( R =0.469; P =0.016) between mean transit time and HbA 1c level was observed. Conclusions— Our results from a small sample suggest that chronic hyperglycemia may be associated with cerebral microvascular remodeling in humans. Additional prospective studies with larger sample size are required to confirm this observation.

Dopamine D2 receptor (DRD2) deficiency increases renal inflammation and blood pressure in mice. We show here that long-term renal-selective silencing of Drd2 using siRNA increases renal expression of proinflammatory and profibrotic factors and blood pressure in mice. To determine the effects of renal-selective rescue of Drd2 expression in mice, the renal expression of DRD2 was first silenced using siRNA and 14 days later rescued by retrograde renal infusion of adeno-associated virus (AAV) vector with DRD2. Renal Drd2 siRNA treatment decreased the renal expression of DRD2 protein by 55%, and DRD2 AAV treatment increased the renal expression of DRD2 protein by 7.5- to 10-fold. Renal-selective DRD2 rescue reduced the expression of proinflammatory factors and kidney injury, preserved renal function, and normalized systolic and diastolic blood pressure. These results demonstrate that the deleterious effects of renal-selective Drd2 silencing on renal function and blood pressure were rescued by renal-selective overexpression of DRD2. Moreover, the deleterious effects of 45-minute bilateral ischemia/reperfusion on renal function and blood pressure in mice were ameliorated by a renal-selective increase in DRD2 expression by the retrograde ureteral infusion of DRD2 AAV immediately after the induction of ischemia/reperfusion injury. Thus, 14 days after ischemia/reperfusion injury, the renal expression of profibrotic factors, serum creatinine, and blood pressure were lower in mice infused with DRD2 AAV than in those infused with control AAV. These results indicate an important role of renal DRD2 in limiting renal injury and preserving normal renal function and blood pressure.

Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV) in patients of carotid stenosis (CS) with or without contralateral carotid occlusion (CO) early after carotid endarterectomy (CEA).Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD) and Color Doppler Imaging (CDI) were performed before and early after CEA.Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA) and middle cerebral artery (MCA) on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA) retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA) of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO.Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA.

This study aimed to examine the preparation of cationic lipid microbubble (CLM), and evaluate its physical and chemical properties and toxicity, measure the gene transfection efficiency by ultrasound triggered microbobble destruction (UTMD) in combination with CLM. The CLM was prepared by the method of the thin film hydration, and its morphology was observed under the electron microscopy at 1st, 3rd, 7th, 10th, and 14th day after preparation, respectively. The size, Zeta potential and stability of CLM were tested. The acute toxicity of CLM was assessed. The green fluorescent protein gene (EGFP) transfection efficiency was evaluated. The experiment grouping was as follows: naked plasmid group (P group), ultrasonic irradiation plus naked plasmid group (P-US group), naked plasmid plus CLM group (P-CLM group), naked plasmid plus ultrasound and CLM group (UTMD group). The expression of EGFP was detected by fluorescent microscopy and flow cytometry. The results showed that CLMs were spherical in shape, with the similar size and good distribution degree under the light and electron microscopies. The size of CLMs was varied from 250.4±88.3 to 399.0±99.8 nm and the Zeta potential of CLMs from 18.80±4.97 to 20.1±3.1 mV. The EGFP expression was the strongest in the UTMD group, followed by the P-CLM group, P-US group and P group. Flow cytometry results were consistent with those of fluorescent microscopy. The transfection efficiency was substantially increased in the P-US group, P-CLM group and UTMD group as compared with that in the P group, almost 7 times, 10 times and 30 times higher than that in the P group respectively. It is suggested that CLMs prepared by the method of thin film hydration are uniform in diameter, and proved non-toxic. UTMD combined with CLM can significantly increase the transfection efficiency of EGFP to targeted cells.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

Genes could be used to treat atherosclerosis. The key problem is how to target a gene through the walls of arteries in free-flowing blood. TFPI-2 has been shown to suppress thrombosis and arterial re-stenosis, which indicates its potential function in gene therapy for atherosclerosis. The microbubble ultrasound contrast agent is widely applied in diagnostic imaging, and could be used for transferring genes into arteries. By transfecting TFPI-2 into arteries using SonoVue (a kind of microbubble ultrasound contrast agent), we identified TFPI-2 as an available factor for inhibiting the proliferation of vascular endothelial cells in vivo. Compared with adenovirus, SonoVue showed similar gene transfection efficiency, but the latter showed stronger inhibition of thrombosis and arterial re-stenosis with a high expression of TFPI-2 protein in vitro and in vivo. SonoVue was less damaging when transfecting genes into the arterial wall. These data indicate that transfecting human TFPI-2 into the arterial wall may suppress thrombosis and arterial re-stenosis, and reduce atherosclerosis.