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Bariatric surgery for patients with severe obesity (body mass index (BMI) ≥ 50kg/m2) is technically challenging. Intragastric balloon (IGB) has been proposed for weight loss before bariatric surgery to reduce surgical risks but its efficacy remains unclear. We conducted a systematic review and meta-analysis of the effectiveness of IGB as bridging therapy and assess potential complications. Amongst 2419 citations, 13 studies were included. IGB resulted in a BMI reduction of 6.60 kg/m2 (MD=6.60, 95% CI: 5.06-8.15; I2=72%). The total post-procedural complication rate was 8.13% (95% CI: 4.04-13.17%), with majority being balloon intolerance. Overall, IGB is effective as a bridging therapy with adequate procedural safety profile, but further study is needed to evaluate the risk reduction for bariatric surgery and long-term weight-loss outcomes.

Perovskite-perovskite tandem solar cells have bright prospects to improve the power conversion efficiency (PCE) beyond the Shockley-Queisser (SQ) limit of single-junction solar cells. The star lead-based halide perovskites are well-recognized as suitable candidates for the front cell, thanks to their suitable band gap (∼1.8 eV), strong optical absorption, and high certified PCE. However, the toxicity of lead for the front cell and the lack of a narrow band gap (∼1.1 eV) for the rear cell seriously restrict the development of the two-junction tandem cell. To break through this bottleneck, a novel Dion-Jacobson (DJ)-type (n = 2) chalcogenide perovskite CsLaM2X7 (M = Ta, Nb; X = S, Se) has been found based on the powerful first-principles and advanced many-body perturbation GW calculations. Their excellent electronic, transport, and optical properties can be summarized as follows. (1) They are stable and environmentally friendly lead-free materials. (2) The direct band gap of CsLaTa2Se7 (0.96-1.10 eV) is much smaller than those of lead-based halide perovskites and very suitable for the rear cell in the two-junction tandem cell. (3) The carrier mobility in CsLaTa2Se7 reaches 1.6 × 103 cm2 V-1 s-1 at room temperature. (4) The absorption coefficients (3-5 × 105 cm-1) are 1 order higher than that of Si (104 cm-1). (5) The estimated PCEs of the Cs2Sb2Br8-CsLaTa2Se7 tandem cell (33.3%) and the concentrator solar cell (35.8% in 100 suns) are higher than those of the best recorded GaAs-Si tandem cell (32.8%) and the perovskite-perovskite tandem solar cell (24.8%). These energetic results strongly demonstrate that the novel lead-free chalcogenide perovskites CsLaM2X7 are good candidates for the rear cell of tandem cells.

An all-dielectric metamaterial absorber based on water resonator encapsulated in resin container is proposed. The absorber can afford the maximum absorption up to 98% at 190 GHz, as well as the wid...

Objectives To explore factors affecting the efficacy of Bernese periacetabular osteotomy for the treatment of hip dysplasia. Methods A retrospective study was conducted on 44 patients with hip dysplasia who underwent Bernese periacetabular osteotomy with a modified Smith‐Peterson approach between January 2017 and November 2019. Among them, 40 were women and four were men. The average age was 31.2 ± 9.4. Preoperative and postoperative imaging parameters were measured. The acetabular top tilt angle, lateral central edge angle, acetabular abduction angle, femoral head extrusion index, sphericity index of femoral head, Shenton line, Tonnis grade of osteoarthritis, joint congruency, p/a ratio, acetabular anteversion angle, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale scores, and modified Harris hip score (MHHS) were observed. MHHS were divided into three clinically relevant categories: poor (, This is a retrospective single‐center analysis that investigates factors affecting the efficacy of Bernese periacetabular osteotomy. A preoperative lateral center edge angle ≥4.5° was found to be the only significant factor in multivariate analysis that affected surgical outcome, highlighting it as a “must‐assess” factor in order to determine postoperative prognosis.

The prognostic nutrition index (PNI), based on the serum lymphocyte counts and albumin levels, has been introduced as a prognostic factor in various cancer. In the present study, we explore the prognostic significance of PNI in patients with renal cell carcinoma (RCC). A literature search of all publications was conducted using the Cochrane library, PubMed and Embase databases from inception to April 2020. A total of 12 studies consisting of 7,391 patients were enrolled in the present study. We found that low pretreatment PNI is significantly correlated to poor survival, including overall survival (OS) (

Multimode tumour ablation therapy is a treatment method that combines cryoablation with radiofrequency ablation, guided by medical imaging technology and based on precise planning, targeting, monitoring, and control of the thermal energy delivered, with the aim of achieving a whole-body antitumour immune response to malignant tumours. To develop standardized criteria for the application of multimode tumour ablation therapy to malignant hepatic tumours, to facilitate actualization of the criteria in various hospitals, and to ensure therapeutic efficacy and safety, the Society of Interventional Therapy of the Chinese Anti-Cancer Association and the Solid Tumor Theranostics Committee of the Shanghai Anti-Cancer Association assembled experts who specialize in oncology to discuss this treatment method and to arrive at a clinical practice consensus guideline for the indications, contraindications, and techniques of multimode tumour ablation therapy for malignant hepatic tumours.

Organic–inorganic hybrid Pb-based halide perovskites, especially the well-known MAPbI3, have shown great promise for photovoltaic applications due to their fast-growing power-conversion efficiency (PCE) and low manufacturing cost. However, their poor ambient stability and Pb-toxicity are still challenging issues for future commercialization. Here, by combining first-principles calculations with large-scale screening, we propose a Pb-free all-inorganic Dion–Jacobson perovskite CsSbCl4, which has an optimal bandgap (∼1.4 eV) in the first place. Our calculations also show that CsSbCl4 possesses high carrier mobility (∼102–104 cm2 V−1 s−1) and strong interband optical absorption (∼105 cm−1). Consequently, its spectroscopic limited maximum efficiency can reach up to ∼27%, similar to MAPbI3. Moreover, the TiO2/CsSbCl4/spiro-OMeTAD junction has a PCE of 20.07%, which can be further enhanced by optimizing parameters, such as absorber defect density. These favourable characteristics of CsSbCl4 make it a potential alternative to Pb-based halide perovskites in photovoltaic devices.

BACKGROUND: 5-Alpha-reductase inhibitors (5-ARIs) have been suggested as potential chemopreventive agents for prostate cancer (PCa). This study was conducted to evaluate the effect of 5-ARIs on the incidence and mortality of PCa. METHODS: The PubMed, Embase and Cochrane Library databases were searched comprehensively from database inception to October 2019. The clinical outcomes included the incidence of overall PCa, high-grade (Gleason8-10) PCa, metastatic PCa, overall survival (OS), and cancer-specific survival (CSS). RESULTS: Overall, 23 studies were included in the present study, representing 11 cohort studies, 5 case-control studies, and 8 randomized controlled trials. The use of 5-ARIs was associated with a decreased risk of overall PCa [relative risk (RR) =0.77; 95% CI: 0.67–0.88; P

Xu Hu,1,* Zhi-Qiang Yang,1,* Wei-Chao Dou,1,* Yan-Xiang Shao,1 Yao-Hui Wang,1 Thongher Lia,1 Xiang Li2 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 2Department of Urology, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiang Li Email hx_uro@sina.comPurpose: Several studies have revealed that albumin-to-alkaline phosphatase ratio (AAPR) was correlated to the survival of several cancers. To explore the impact of AAPR on the survival of non-metastatic renal cell carcinoma (RCC) patients following nephrectomy, the present study was conducted.Patients and Methods: A total of 648 patients were enrolled in the present study. The cut-off value of AAPR was determined based on the receiver-operating characteristic (ROC) analysis. Univariate and multivariate analyses were applied to identify prognostic factors. The discrimination and calibration of models for survival outcomes were evaluated based on the concordance index (C-index), ROC analysis and calibration curve.Results: The low AAPR (≤ 0.5) was associated with older age (P< 0.001), higher T stage (P=0.002), larger tumor size (P=0.014) and tumor necrosis (P=0.003). A high AAPR was significantly correlated to better OS (hazard ratio, HR=0.61; P=0.038) and CSS (HR=0.52; P=0.013) based on multivariate analysis. Integrating AAPR with UISS or SSIGN, the C-indexes of nomogram for OS (UISS: 0.790 vs 0.765; SSIGN: 0.861 vs 0.850) and CSS (UISS: 0.832 vs 0.805; SSIGN: 0.905 vs 0.896) increased. Moreover, the nomogram for OS and CSS was established based on the multivariate analysis. The C-indexes of nomogram for OS and CSS were 0.834 (95% CI 0.794– 0.874) and 0.867 (95% CI 0.830– 0.904), respectively.Conclusion: In conclusion, the high preoperative AAPR was a favorable prognostic factor for surgically treated non-metastatic RCC patients. AAPR also could improve the predictive value of well-established models. The nomogram that incorporatesAAPR had a good performance. More prospective studies with a large scale are essential to validate our findings.Keywords: albumin-to-alkaline phosphatase ratio, non-metastatic renal cell carcinoma, prognostic impact, nephrectomy

Searching for energetic photovoltaic absorbers is a favorable solution to the current energy crisis. As a star material for solar cells, MAPbI3 (MA = CH3NH3) has a suitable band gap, strong optical...

Objective: To demonstrate the feasibility of CT-CT fusion imaging for assessment of the cryoablation margins in visible hepatocellular carcinoma (HCC) on unenhanced CT images. Methods: This retrospective study analyzed 14 patients with 14 HCC lesions treated with CT-guided cryoablation. Nine lesions in nine patients who developed local tumor progression (LTP) during the follow-up period of at least 8 months were reviewed. The unenhanced CT data were used to retrospectively create fusion images of the intraoperative CT images on a workstation. The minimal ablative margin (MAM) was assessed on the fusion images. The concordance between the site of LTP and the MAM area was also assessed. Results: Eight of the nine lesions with LTP were in the subcapsular region of the liver. Seven of the nine cases were treated by cryoablation combined with transcatheter arterial chemoembolization. The median time required to fuse the images for the nine lesions was 5:17 min (range, 5:04–7:37 min). The site of LTP relative to the HCC lesion was craniocaudal in nine, dorsoventral in six, and lateral in seven lesions. In all lesions, the site of LTP was congruent with the MAM area. Conclusions: CT-CT fusion imaging enables a real-time intraoperative treatment evaluation for HCC lesions visible on unenhanced CT images. Fused imaging evaluation has proved to be an accurate and useful tool for assessment of the cryoablation margins. Keywords: Computed tomography, Fusion, Hepatocellular carcinoma, Cryoablation, Ablative margin

In this research, enrichment factor (EF) and pollution load index (PLI) were utilized to estimate the features of enrichment and contamination of PTEs in farmland soil. Furthermore, combining the spatial distribution characteristics of potentially toxic elements (PTEs) and positive matrix factorization (PMF) to distinguish and quantify the sources of PTEs in farmland soil, and then the potential ecological risk (PER) and human health risk (HHR) model based on PMF are applied to quantify the ecological and human health risks from different sources. Taking Puning District as an example, four sources of PTEs in farmland soil were quantitatively allocated. For ecological risk, the study area is at moderate ecological hazard level, and industrial activities were the greatest contributor. The mean E_r^i of Hg were 69.82, reaching medium ecological risk level. For human health risks, both adults and children have no evident non-carcinogenic risk in the study area. And natural source was the largest contributor to non-carcinogenic risk, followed by agricultural activities. With regard to carcinogenic risk, tolerable risks of soil PTEs in the study area were limited not only for adults but also for children. Furthermore, compared with adults, the health risks of children, whether non-carcinogenic or carcinogenic, were higher than those of adults, and the trends in health risks for children and adults were similar. A comprehensive scheme combining source contribution and risk assessment is conducive to quantitatively assess ecological risks, health risks and priority pollution sources, thereupon provide effective suggestions for protecting human health and preventing and controlling pollution.

Objective To explore the influencing factors of age at onset of pain and severe pain in patients with Hartofilakidis type I developmental dysplasia of the hip (DDH). Methods A retrospective study of 83 patients with DDH treated at our hospital from January 2017 to June 2021 was conducted. The age at onset of pain, patients’ demographic data, and radiographic parameters were collected. Multiple linear regression was used to determine the influencing factors of age at onset of pain. Cox regression analysis was used to determine the influencing factors of severe pain attacks. Results According to the results of multiple linear regression analysis, when the distance between the medial femoral head and the ilioischial line increased by one millimetre, the age at onset of pain decreased by 1.7 years (β = − 1.738, 95% CI − 1.914–[− 1.561], p β = − 0.334, 95% CI − 0.496–[− 0.171], p β]: = 0.947, 95% CI 0.898–0.999, p = 0.044). For each additional millimetre in the distance between the medial femoral head and the ilioischial line, the likelihood of severe pain increased by 2.4 times (Exp [β]: 2.417, 95% CI 1.653–3.533, p Conclusion Larger distances between the medial femoral head and the ilioischial line and sharp angle can lead to an earlier age at onset of pain in patients with DDH. Small LCEA and excessive distance between the medial femoral head and the ilioischial line are risk factors for severe pain.

Ethnopharmacological relevance Fructus Tribuli (FT) has been commonly used as a traditional medicine for thousands of years. With the diverse uses of FT, more attention has been paid to its hepatorenal toxicity. However, the compounds causing the hepatorenal toxicity of FT remain undetermined. Terrestrosin D (TED), a major spirostanol saponin isolated from FT, may exert hepatorenal toxicity. Aim of the study This study aimed to evaluate the potential hepatorenal toxicity of TED, and preliminarily explore the possible mechanism of TED-induced hepatorenal toxicity. Materials and methods Cytotoxicity assays, a repeated-dose 28-day in-vivo study, a toxicokinetic study, and a tissue distribution study were used to evaluate the potential hepatorenal toxicity of TED. Furthermore, network pharmacology was applied to preliminarily explore the possible mechanism of TED-induced hepatorenal toxicity. Results Both the in vitro and in vivo studies showed that the spirostanol saponin TED had potential hepatorenal toxicity. Nonetheless, hepatorenal toxicity induced by oral treatment with TED at a dosage range of 5 – 15 mg/kg daily for 28 consecutive days to Sprague-Dawley (SD) rats was reversible after 14 days of TED withdrawal. The toxicokinetic study demonstrated that the systematic exposure of SD rats to TED had an accumulation phenomenon and a dose-dependent trend after a 28-day repeated-dose oral administration. The tissue distribution study revealed that TED had a targeted distribution in the liver and kidneys accompanied by a phenomenon of accumulation in SD rats. Network pharmacology combined with molecular docking methods was used to screen for the key targets (HSP90AA1, CNR1, and DRD2) and the key pathways of TED-induced hepatorenal toxicity. Conclusions The spirostanol saponin TED, a major spirostanol saponin isolated from FT, had potential hepatorenal toxicity.

Separating P2O5 from steelmaking slag is the key to achieving optimum resource utilization of slag. If the P-concentrating 2CaO∙SiO2–3CaO∙P2O5 solid solution was effectively separated, it can be a potential phosphate resource and the remaining slag rich in Fe2O3 and CaO can be reutilized as a flux in steelmaking process. In this study, a low-cost method of selective leaching was adopted, and hydrochloric acid was selected as leaching agent. The dissolution behavior of quenched steelmaking slags with different composition in the acidic solution was investigated and the dissolution mechanism was clarified. It was found that the P dissolution ratio from each slag was higher than those of other elements, achieving an effective separation of P and Fe. The dissolution ratios of P, Ca, and Si decreased as the P2O5 content in slag increased. A higher Fe2O3 content in slag led to a lower P dissolution ratio. Increasing slag basicity facilitated the dissolution of P from slag. The residue mainly composed of matrix phase and the P2O5 content decreased significantly through selective leaching. The P dissolution ratio from slag was primarily determined by the P distribution ratio in the 2CaO∙SiO2–3CaO∙P2O5 solid solution and the precipitation of ferric phosphate in the leachate. The P-concentrating solid solution was effectively separated from quenched steelmaking slag, even though hydrochloric acid was used as leaching agent.

BACKGROUND The risk of chronic hepatitis B (CHB) infection is influenced by aberrant DNA methylation and altered nucleotide synthesis and repair, possibly caused by polymorphic variants in one-carbon metabolism genes. In the present study, we investigated the relationship between polymorphisms belonging to the one-carbon metabolic pathway and CHB infection. METHODS A case-control study using 230 CHB patients and 234 unrelated healthy controls was carried out to assess the genetic association of 24 single nucleotide polymorphisins (SNPs) determined by mass spectrometry. RESULTS Three SNPs, comprising rs10717122 and rs2229717 in serine hydroxymethyltransferase1/2 (SHMT2) and rs585800 in betaine-homocysteine S-methyltransferase (BHMT), were associated with the risk of CHB. Patients with DEL allele, DEL.DEL and DEL.T genotypes of rs10717122 had a 1.40-, 2.00- and 1.83-fold increased risk for CHB, respectively. Cases inheriting TA genotype of rs585800 had a 2.19-fold risk for CHB infection. The T allele of rs2229717 was less represented in the CHB cases (odds ratio = 0.66, 95% confidence interval = 0.48-0.92). The T allele of rs2229717 was less in patients with a low hepatitis B virus-DNA level compared to the control group (odds ratio = 0.49, 95% confidence interval = 0.25-0.97) and TT genotype of rs2229717 had a significant correlation with hepatitis B surface antigen level (p = 0.0195). Further gene-gene interaction analysis showed that subjects carrying the rs10717122 DEL.DEL/DEL.T and rs585800 TT/TA genotypes had a 2.74-fold increased risk of CHB. CONCLUSIONS The results of the present study suggest that rs10717122, rs585800 and rs2229717 and gene-gene interactions of rs10717122 and rs585800 affect the outcome of CHB infection, at the same time as indicating their usefulness as a predictive and diagnostic biomarker of CHB infection.

Objective To investigate the predictive factors of lymph node metastasis (LNM) and evaluate the usefulness of prediction nomograms. Methods This study analyzed data of 300 patients diagnosed with penile squamous cell carcinoma at West China Hospital (WCH) of Sichuan University (Chengdu, China) and 412 cases acquired from the Surveillance, Epidemiology, and End Results (SEER) program. Logistic regression analysis was performed on these cohorts to investigate the predictive factors of LNM. We evaluated a recently developed prediction nomogram for LNM, which was established based on the National Cancer Database (NCDB). Moreover, we developed a novel nomogram using cases from the WCH for the prediction of lymphatic metastasis. Results Logistic analysis identified that younger age at diagnosis, invasion of the penis body, poorer pT stage, cN stage, nuclear grade and the presence of lymph vascular invasion (LVI) were significantly correlated with LNM in WCH cases; however, only race, poorer T stage and cN stage were significantly associated with LNM among the cases from the SEER. Multivariate analysis demonstrated that younger age, poorer T stage, cN stage and nuclear grade were independent predictors of LNM. Receiver operating characteristic curve analysis of WCH cases showed that the tumor T stage 8th edition has better area under the curve than 7th stage (0.672 vs 0.636, respectively). Moreover, well AUC were seen in external validation of NCDB nomogram in WCH cohorts and SEER series (0.833 vs 0.795). The new nomogram included the aforementioned independent predictors and the bootstrap-corrected concordance was 0.876. Conclusion Younger diagnose age, poorer pT stage, cN stage, nuclear grade and LVI were the most important predictors of LNM in patients with penile cancer. 8th T stage performed better than 7th version in predicting LNM. NCDB nomogram have some application value in both WCH and SEER cases, and our novel model further improved the predictive accuracy.

Searching for promising visible-light photocatalysts for overall water splitting into hydrogen and oxygen is a very challenging task to solve the energy crisis and environment pollution. The widely-used tantalate and niobate perovskite photocatalysts have two drawbacks, i.e., the large energy band gap ( ∼ 3.2–4.6 eV) and low electron (hole) mobility 102 (101) cm2 V−1 s−1, which greatly limit their photocatalytic performance. Here, based on the powerful first-principles and accurate GW calculations, we design several novel two-dimensional (2D) Ruddlesden-Popper (RP) type (n = 1) perovskite oxynitrides A2BO3N (A = Ca, Sr, Ba and B = Ta, Nb) and their bonded heterostructures and comprehensively investigate their interlayer coupling, electronic structures, transport and photocatalytic characteristics. We find that 2D A2BO3N oxynitrides have a reduced direct band gap at Γ -point, especially for three-layer (3L) Ba2NbO3N and 1L-Sr2NbO3N/1L-Ba2NbO3N bonded heterostructure with the optimized band gap ∼ 2.0 eV. Compared with tantalate and niobate perovskite oxides, the electron (hole) mobility increases 1–2 orders of magnitude up to 103–104 (102–103) cm2 V−1 s−1. A fast electron-hole vertical transport across the heterointerface and remarkable electron-hole separation can be realized in 1L-Sr2NbO3N/1L-Ba2NbO3N bonded heterostructure due to its strong interface Ba-O and Sr-O bonds and type-II band offset. Compared with the well-known photocatalysts, such as BiVO4 and MoS2/g-C3N4, an improved optical absorption (8 × 104 cm−1) in A2BO3N is obtained in the visible region. The 2D RP-type perovskite oxynitrides 3L-Ba2NbO3N and 1L-Sr2NbO3N/1L-Ba2NbO3N are powerful visible-light photocatalysts for overall water splitting.

Summary Background Anthracycline dose optimisation in the treatment of diffuse large B-cell lymphoma has rarely been tested. We aimed to find out whether R-CEOP70 was non-inferior to R-CHOP50 with less cardiotoxicity, and whether R-CEOP90 had a superior efficacy to R-CHOP50 or R-CEOP70 with acceptable toxic effects. Methods In this multicentre, phase 3, randomised, controlled study (NHL-001), patients with newly diagnosed diffuse large B-cell lymphoma or follicular lymphoma grade 3B were enrolled from 20 centres of the Multicenter Hematology–Oncology Programs Evaluation System in China. Young patients (16–60 years) were randomly assigned 1:1:1 (block size of six) to six courses of R-CHOP50, R-CEOP70, or R-CEOP90, and older patients (61–80 years) were assigned 1:1 (block size of four) to R-CHOP50 or R-CEOP70. Patients were randomly assigned using computer-assisted permuted-block randomisation. Investigators and patients were not masked to treatment assignment. In the R-CHOP50 group, patients were given rituximab 375 mg/m2 intravenously on day 0, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 (maximum dose 2 mg) intravenously on day 1, and prednisone 60 mg/m2 (maximum dose 100 mg) orally from day 1–5; in the R-CEOP70 group, epirubicin 70 mg/m2 replaced doxorubicin; and in the R-CEOP90 group, high dose epirubicin 90 mg/m2 replaced doxorubicin. All patients received two additional courses of rituximab 375 mg/m2 intravenously every 21 days. Consolidation radiotherapy was given to patients with bulky disease at diagnosis or residual disease at the end of treatment. The primary endpoint was 2-year progression-free survival. The non-inferiority margin for R-CEOP70 versus R-CHOP50 was defined by hazard ratio [HR] as the upper limit of its 95% CI being no greater than 1·50. Analysis of efficacy and safety were of the intention-to-treat population. This study is registered with ClinicalTrials.gov , number NCT01852435 . Findings From May 15, 2013, to March 16, 2016, a total of 648 patients were enrolled, including 404 (62%) young patients (R-CHOP50 [n=135], R-CEOP70 [n=134], or R-CEOP90 [n=135]), and 244 (38%) older patients (R-CHOP50 [n=122] or R-CEOP70 [n=122]). Four patients were excluded from the study for consent withdrawal and one patient for misdiagnosis before treatment. The 2-year progression-free survival in the R-CHOP50 group was 72·5% (95% CI 66·6–77·6) and in the R-CEOP70 group was 72·4% ([66·5–77·5]; HR 1·00 [0·73–1·38]; p=0·99). The non-inferiority was met and adverse events were similar between the two groups. Fewer patients in the R-CEOP70 group (14 [13%] of 110) presented with over 10% decrease in left ventricular ejection fraction (LVEF) than those in the R-CHOP50 group (31 [29%] of 108) at 3 years after remission. For young patients, the 2-year progression-free survival in the R-CEOP90 group was 88·8% (82·1–93·1) and was significantly improved compared with the R-CHOP50 group (75·9% [67·7–82·3]; 0·44 [0·25–0·76]; p=0·0047) and the R-CEOP70 group (77·4% [69·4–83·7%]; 0·49 [0·27–0·86]; p=0·017). Grade 3–4 neutropenia occurred more frequently in the R-CEOP90 group (97 [72%] of 134) than in the R-CHOP50 group (87 [65%] of 133) and R-CEOP70 group (84 [63%] of 133) in young patients but without further increase of clinically significant infections. Fewer patients in the R-CEOP70 group (7 [11%] of 66) and in the R-CEOP90 group (10 [13%] of 79) presented with more than 10% decrease in LVEF than those in the R-CHOP50 group (17 [26%] of 66) at 3 years after remission. Interpretation R-CEOP70 could serve as an alternative regimen to R-CHOP50 with mild long-term cardiotoxicity. Young patients with diffuse large B-cell lymphoma might benefit from high-dose epirubicin. Epirubicin is an alternative drug to doxorubicin in regular R-CHOP with mild long-term cardiotoxicity. Funding National Natural Science Foundation of China, National Key Research and Development Program, Shanghai Commission of Science and Technology, Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support, Multicenter Clinical Research Project by Shanghai Jiao Tong University School of Medicine, Clinical Research Plan of Shanghai Hospital Development Center, and Chang Jiang Scholars Program.

Ethnopharmacological relevance Jianpi Yangzheng Xiaozheng Decoction (JPYZXZ) is an empirical compound prescription based on the theory of traditional Chinese medicine. JPYZXZ, which is “Qi-invigorating, spleen-strengthening and stasis-removing,” can improve the quality of life of gastric cancer patients and prolong their survival; however, the exact mechanism underlying the antitumor effects of this compound is still not clear. Aim of the study The aim of this study is to clearly define the effect of JPYZXZ and its components, Jianpi Yangzheng Decoction (JPYZ) and Xiao Zheng San Jie Decoction (XZSJ), on inhibiting the progression of gastric cancer. Materials and methods The effect of JPYZXZ and its components on the motility of gastric cancer MGC-803 cells was measured by MTT, adhesion, transwell assays and wound-healing assays. JPYZXZ, JPYZ and XZSJ were administered to 615 mice with gastric cancer xenografts, and their effect on the inhibition of subcutaneous transplantation was analyzed. THP-1 monocyte cells were used to establish tumor-associated macrophage (TAM) models. The polarized state of the TAMs was detected by Flow Cytometry, ELISA and Immunohistochemistry. The mRNA and protein expression of tumor epithelial-mesenchymal transition (EMT) and TAM-related genes was determined by Real-time PCR and Western Blot, respectively. Results We determined that both JPYZXZ and its components inhibited the progress of gastric cancer in vitro, and JPYZXZ was clearly more effective than JPYZ or XZSJ. The in vivo results demonstrated that the JPYZXZ and XZSJ group exhibited a significant decrease in the tumor weight compared to the control group. Further analysis indicated that JPYZXZ was more active than JPYZ or XZSJ in inhibiting the gastric cancer EMT transformation both in vivo and in vitro. However, JPYZ was more effective compared with JPYZXZ for inducing the phenotypic change in macrophages from M2 to M1. Conclusions Our results demonstrate that both JPYZXZ and its components prevent the progress of gastric cancer. JPYZXZ inhibits the gastric cancer EMT more effectively than JPYZ and XZSJ, but JPYZ primarily works to regulate the phenotypic change in macrophages from M2 to M1.

Colour fading is now a popular process used for imparting a vintage look to textile and fashion products, which enhances market value because of the current fashion trends. This study examined a non-aqueous colour fading process with the use of oxygen plasma-induced ozone treatment. An industrial scale machine and commercially available red sulpur-dyed cotton fabric (with 0.5 %, 1.5 % and 2.5 % colour depths) were used in this study. Since the colour fading process factors are inter-related to each other, a specific experiment approach, i.e. orthogonal method, was used for obtaining the optimum conditions in an industrial scale colour fading process. Three process factors used in the industrial scale colour fading process, i.e. (i) oxygen gas concentration (%); (ii) amount of water in fabric (%); and (iii) treatment time (minutes), would be studied in this paper. Through the orthogonal method, the optimum conditions for colour fading of the three colour depths of cotton fabric dyed by red sulphur dye were determined and their optimum conditions were same. The optimum conditions of the colour fading of the three colour depths were: (i) 70 % oxygen gas concentration; (ii) 35 % amount of water in fabric; and (iii) 30 minutes treatment time. Although colour fading conditions are the same, the order of importance of these process factors was different. Unlike the conventional colour fading process, oxygen plasma-induced ozone colour fading treatment can achieve uniform and even colour fading effect in the cotton fabric effectively.

Objective The study aimed to investigate the efficacy of computed tomography (CT)-guided cryoablation debulking of unresectable pelvic recurrent colorectal cancer (CRC). Patients and methods From January 2013 to April 2016, 30 patients (18 males and 12 females; aged 57.8±10.5 years) with unresectable pelvic recurrent CRC who had previously received radiotherapy or chemotherapy were included. A total of 35 tumors ranging from 1.2 to 6.3 cm underwent cryoablation. Tumor response was evaluated 1 month after cryoablation according to the Modified Response Evaluation Criteria in Solid Tumors. Logistic regression was used to analyze the risk factors for tumor response. Degree of pain palliation was also determined using the Numerical Rating Scale. Cox proportional hazard models were used to identify predictors of outcomes. Results Cryoablation was successfully performed in all patients. Complete response (CR) was achieved for 27 tumors in 23 patients and partial response was achieved for eight tumors in seven patients 1 month after cryoablation. The rate of CR was 77.14%, and tumor size was an independent risk factor for CR. Pain relief was satisfactory in 21 symptomatic patients (P

In the process of news interviews, the last mile of data transmission from the reporter terminal to the system collection center has been using wired transmission. It has poor mobility and weak scalability. According to this situation, a hardware design based on the AR9341 wireless node is proposed. It makes full use of the advantages of better wireless transmission scalability and more flexible mobility. Firstly, its RF module is discussed in detail, and signal quality is ensured by Impedance Matching and Differential Routing. Secondly, its memory module is described, and the transmission performance of the system is analyzed through the eye diagram of the DDR signal lines. Finally, the Spectrum, Constellation and error vector magnitude (EVM) are measured by the spectrum analyzer to test the quality of the wireless signal and verify the feasibility of the design.

Objective To investigate the genetic prognostic factors for the recurrence of non-muscle invasive bladder cancer. Materials and methods The patients underwent transurethral resection of bladder tumor and received bacillus Calmette–Guérin (BCG) or epirubicin. Next-generation sequencing was performed and alterations of genes, pathways, and tumor mutation burden were recorded. Associations between these clinicopathological and genetic variants were estimated, and prognostic factor identified. Results A total of 58 cases were included in our study, and 46 patients underwent treatment with BCG. FGFR3 was the most frequently altered gene (48%), and more commonly detected in intermediate-risk patients. Univariate Cox analysis demonstrated that 10 genes were significantly correlated with BCG failure, while NEB, FGFR1 and SDHC were independent recurrence predictors. Besides, epigenetic-related gene pathway mutations were negatively correlated with recurrence (hazard ratio: 0.198, P = 0.023). DNA damage response and repair gene alterations were positively correlated with tumor burden, while altered TP53 was most frequent among these genes and significant correlated with high tumor burden. Conclusion BCG instillation significantly reduced the rate of recurrence compared with epirubicin in this population. Potential biomarkers and therapeutic targets were found with the help of next-generation sequencing; correlations between DDR genes alterations and high tumor mutation burden were also demonstrated.

INTRODUCTION: Vascular cognitive impairment (VCI) and Alzheimer’s disease are the most common cognitive impairment diseases in the elderly. This study aimed to apply the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) scale to evaluate VCI in elderly patients and analyze its reliability and validity. METHODS: We enrolled 278 VCI patients admitted to our hospital, from June 2017 to June 2018. The basic clinical information of each patient was documented, and the Mini-Mental State Examination (MMSE) and the RBANS scales were suggested to complete. RESULTS: We found significant correlations between the RBANS total score and age, diabetes, hypertension, coronary heart disease and years of education. The internal consistency of the RBANS scale Cronbach αsuggested a good agreement with the total score and the single score at two time points. Moreover, the RBANS total score and the score of each dimension in the RBANS scale were positively correlated with the MMSE immediate memory, calculation ability, delayed memory, commanding ability, reading comprehension ability, command execution, sentence making, and pattern duplicating ability. CONCLUSION: In conclusion, the RBANS has good reliability and validity for the assessment of cognitive dysfunction in elderly VCI patients. It can be used as a routine clinical and research tool, for the simplicity in operation and superior acceptance.

A new concept of transforming a non-planar MUT to a planar MUT with an effective air gap is proposed in this paper. The air gap existing between the MUT and sensor usually make large error in measurement, but by sensing with a multiring sensor, the effect of the air gap can be eliminated. However, in the case of a non-planar MUT, the curved surface of MUTs make the multiring of the sensor sensed different thickness of air gap. Thus, the approach of above cannot be use to eliminate the frequency shift cause by the air gap, and this will cause a undesired error in the experiment. Therefore, a triple-ring complementary split-ring resonator (CSRR) is used to estimate the effective air gap that make the smallest difference of the three resonance frequencies. Finally, with the transforming equation, a non-planar porcine fat with 10 mm thickness, 20 mm radius of curvature and 0 mm air gap are transformed into an effective planar MUT with 0.646 mm planar air gap. The result compare to simulation only with an error of 0.067 mm.

Background Pathogens capable of impacting gastrointestinal tract tumor development are located in the oral cavity, but whether these oral bacteria are able to colonize the gastric mucosa in gastric cancer (GC) patients and whether Helicobacter pylori infection can influence this process remains to be established. Methods Microbial 16S rDNA deep sequencing was conducted to characterize bacteria present in paired gastric mucosa and tongue coating samples in 27 patients with superficial gastritis (SG) and 11 GC patients. Results While the overall composition of the gastric mucosa and tongue coating microbiomes differed substantially, certain bacteria were present in both of these communities. The co-occurrence of bacteria between the tongue coating and gastric mucosa differed significantly between SG and GC patients. Of the 15 most abundant shared oral bacteria genera (the core shared oral bacteria), which were associated with differences in microbiota composition between these tongue coating and gastric mucosa, three were enriched in the gastric mucosa of GC patients relative to SG patients, whereas, 12 were depleted in GC patient samples. Furthermore, the prevalence and relative abundance of these core shared oral bacteria in the gastric mucosa were also linked to H. pylori infection status, and the core shared oral bacteria were also associated with the overall composition of the gastric mucosal microbiome. Conclusions Helicobacter pylori infections are linked to the co-occurrence of bacteria in the oral microbiome and the gastric mucosal microbiome. Ectopic colonization of oral microbes may be a primary driver of H. pylori-induced gastric microbial dysbiosis in patients with GC.

Background The optimal regimen of instillation for patients with non-muscle invasive bladder cancer (NMIBC) and the recurrence-related factors are still needed to be clear. Methods The patients underwent transurethral resection of bladder tumor who diagnosed as intermediate or high risk NMIBC were randomized to receive bacillus Calmette–Guérin (BCG) 19, 15 times or epirubicin (EPI) 18 times (2:2:1). The primary end point was disease-free survival (DFS), the secondary end point was progression free survival (PFS). Associations between clinicopathological factors and prognosis were estimated, with accuracy of the prognostic models Spanish Urological Club for Oncological Treatment (CUETO) and European Organization for Research and Treatment of Cancer (EORTC) evaluated. Results A total of 93 patients (BCG19 for 35; BCG15 for 37 and EPI18 for 21) were included, with median follow-up time for 33.46 months. Recurrence and progression occurred in 22 and 8 of patients separately, and significant longer recurrence-free survival was noted in the BCG and primary bladder cancer groups. Higher general complication rate was seen in BCG group compared with EPI groups (83.33% and 61.90%, respectively; P = 0.022), but no grade 3–5 adverse events happened in both groups. Concordance indices for the CUETO and EORTC models were 0.766 and 0.741 for all our series and 0.812 and 0.817 for the BCG subgroup, respectively. Conclusion BCG instillation significantly reduced the rate of recurrence compared with epirubicin in this population. The EORTC and CUETO models exhibited high accuracies for the prediction of BCG treatment failure. Trial registration: This study was approved by Center for Drug Evaluation of National Medical Products Administration (CDENMPA, China) and Ethics Committee of our institute, with the whole process supervised. The registration number in CDE-NMPA was CTR20150840 (website of CDE: http://www.cde.org.cn/).

Background: Traditional laparoscopic No.12a lymph node dissection in radical gastrectomy for gastric cancer may damage the peripheral blood vessels, and is not conducive to the full exposure of the portal vein and the root ligation of the left gastric vein. We recommend a new surgical procedure, the portal vein approach, to avoid these problems. Methods: 25 patients with advanced gastric cancer underwent radical laparoscopic gastrectomy and No.12a lymph node were dissected by portal vein approach, including 7 cases with total gastrectomy, 18 cases with distal gastric resection, 14 males and 11 females. Operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of total lymph node dissection and No.12a lymph node dissection, No.12a lymph node metastasis rate and postoperative complications were statistically observed. Results: All the patients were operated successfully and No.12a lymph node were cleaned by portal vein approach. A total of 683 lymph nodes were dissected, with the average number of lymph nodes dissection and positive lymph nodes were (27.3 ± 12.7) and (3.8 ± 5.6) respectively. The average number of No.12a lymph node dissection was (2.4 ± 1.95) and the metastasis rate of No.12a lymph node was 16% (4/25). The average operation time of radical laparoscopic distal and total gastrectomy were (239.2 ± 51.4) min and (295.1 ± 27.7) min respectively. The mean intraoperative blood loss was (134.0 ± 65.7) ml, and postoperative first anal exhaust time was (2.24 ± 0.86) d. The mean time to fluid intake was (4.2 ± 1.7) d, and postoperative hospitalization time was (9.6 ± 5.0) d. Without portal vein injure, anastomotic leakage, gastrointestinal bleeding, intestinal obstruction and other complications were observed in all patient. Conclusion: Our results show that the laparoscopic No.12a lymph node dissection by portal vein approach for gastric cancer is safe, feasible and has certain clinical application value.

This study presents a noncontact measurement of biological tissues with the elimination of curved-surface air gap using a triple-ring complementary split-ring resonator (CSRR). The resonance frequency deviations are accessed to measure the thickness of the material under test (MUT), with multiple estimations to reduce the errors. An equivalent mapping is proposed to convert the curved-surface boundary to a simplified uniform air-gap method. The accuracy of the thickness measurement of the MUT improves under the existence of unknown curved air gap. This paper proposes a low-cost CSRR to measure the thickness of a curved porcine fat. The average absolute errors of measured results of a 3-mm porcine fat is 1.43 mm, which is acceptable for a lossy curved, rough-surfaced material. The provided technique shows an excellent solution of eliminating the influence of non-planar surface on measurement.

Plasmonic random lasers have been demonstrated in combining dye-doped cholesteric liquid crystals (DD-CLCs) and silver nanoparticles (AgNPs). The DD-CLC laser reveals the lowest threshold and highest slope efficiency through the localized surface plasmon resonance of AgNPs with the best coupling of the emission spectrum of lasing dye and resonance of electron oscillation on the metal surface. Thermal control of the DD-CLC lasers has been achieved to simultaneously shift the long- and short-edge lasing peaks. By the α -stable analysis, the DD-CLC random laser (RL) reveals heavy tail distribution with relatively low α ∼ 1.06 to show the Lévy behavior. Owing to its low spatial coherence, the DD-CLC RL has been demonstrated to produce a speckle-reduced image with a lower contrast of about 0.04.

The mechanisms of aspirin antithrombotic actions have not been fully elucidated. We re-analyzed the data from the project Aspirin Resistance in Patients with Ischemic Atherothrombotic Diseases from April 2008 to June 2010. A total of 530 subjects were classified into 3 groups, including 40 patients without aspirin use, 24 patients taking 25-50 mg/d aspirin, and 466 patients taking 75-100 mg/d aspirin over 1 month. By 1:1:1 propensity score matching adjusting 15 primary clinical covariates, 51 patients (n = 17 per group) comprised the final sample. Hemostasis-related parameters and high platelet reactivity as measured by arachidonic acid-induced and adenosine diphosphate-induced light transmission aggregometry were compared in the 3 groups. A dose-dependent relationship was observed between aspirin and decreased high platelet reactivity incidence (PAA < 0.001, PADP < 0.01, respectively), decreased monocyte ratio (P = 0.052), increased antithrombin activity (P < 0.001), and increased platelet distribution width (P < 0.05). Aspirin at 25-50 mg/d is related to the lowest red blood cell (RBC) count, whereas 75-100 mg/d aspirin showed the highest RBC count among the 3 groups (4.52 ± 0.35 × 1012/L vs. 4.35 ± 0.57 × 1012/L vs. 4.80 ± 0.59 × 1012/L, P = 0.046). Our finding demonstrated that aspirin exerts its antithrombotic effects at least by antiplatelet function, enhancing antithrombin activity and suppressing monocytes in vivo. In addition, 3 blood cell types, namely RBCs, monocytes, and platelets, are involved in the aspirin antithrombotic mechanism. The cellular response to aspirin partially enhances the antithrombotic effects while partially inhibiting the effects.

BackgroundAssociation between diabetes mellitus (DM) and risk of osteoarthritis (OA) can be confounded by body mass index (BMI), a strong risk factor for both conditions. We evaluate the association between DM or hyperglycaemia with OA using systematic review and meta-analysis.MethodsWe searched PubMed and Web of Science databases in English for studies that gave information on the association between DM and OA. Two meta-analysis models were conducted to address: (1) risk of DM comparing subjects with and without OA and (2) risk of OA comparing subjects with and without DM. As far as available, risk estimates that adjusted for BMI were used.Results31 studies with a pooled population size of 295 100 subjects were reviewed. 16 and 15 studies reported positive associations and null/ negative associations between DM and OA. 68.8% of positive studies had adjusted for BMI, compared with 93.3% of null/negative studies. In meta-analysis model 1, there was an increase prevalence of DM in subjects with OA compared with those without (OR 1.56, 95% CI 1.28 to 1.89). In meta-analysis model 2, there was no increased risk of OA (OR 1.14, 95% CI 0.98 to 1.33) in subjects with DM compared with those without, regardless of gender and OA sites. Comparing subjects with DM to those without, an increased risk of OA was noted in cross-sectional studies, but not in case-control and prospective cohort studies.ConclusionsThis meta-analysis does not support DM as an independent risk factor for OA. BMI was probably the most important confounding factor.

Background Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)/CHOP-like chemotherapy is widely used in peripheral T cell lymphoma (PTCL). Here we conducted a phase 2, multicenter, randomized, controlled trial, comparing the efficacy and safety of CEOP/IVE/GDP alternating regimen with CEOP in newly diagnosed PTCL. Methods PTCL patients, except for anaplastic large cell lymphoma-anaplastic lymphoma kinase positive, were 1:1 randomly assigned to receive CEOP/IVE/GDP (CEOP, cyclophosphamide 750 mg/m2, epirubicin 70 mg/m2, vincristine 1.4 mg/m2 [maximum 2 mg] on day 1, and prednisone 60 mg/m2 [maximum 100 mg] on days 1–5 every 21 days, at the first and fourth cycle; IVE, ifosfamide 2000 mg/m2 on days 1–3, epirubicin 70 mg/m2 on day 1, and etoposide 100 mg/m2 on days 1–3 every 21 days, at the second and fifth cycle; and GDP, gemcitabine 1000 mg/m2 on days 1 and 8, cisplatin 25 mg/m2 on days 1–3, and dexamethasone 40 mg on days 1–4 every 21 days, at the third and sixth cycle) and CEOP (every 21 days for 6 cycles). Analysis of efficacy and safety was of the intent-to-treatment population. The primary endpoint was a complete response rate at the end of treatment. Meanwhile, whole exome sequencing and targeted sequencing were performed in 62 patients with available tumor samples to explore prognostic biomarkers in this cohort as an exploratory post hoc analysis. Results Among 106 patients, 53 each were enrolled to CEOP/IVE/GDP and CEOP. With 51 evaluable patients each in two groups, a complete response rate of the CEOP/IVE/GDP group was similar to that of the CEOP group (37.3% vs. 31.4%, p = 0.532). There was no difference in median progression-free survival (PFS; 15.4 months vs. 9.2 months, p = 0.122) or overall survival (OS; 24.3 months vs. 21.9 months, p = 0.178). Grade 3–4 hematological and non-hematological adverse events were comparable. Histone modification genes were most frequently mutated (25/62, 40.3%), namely KMT2D, KMT2A, SETD2, EP300, and CREBBP. Multivariate analysis indicated that CREBBP and IDH2 mutations were independent factors predicting poor PFS and OS (all p KMT2D predicting poor PFS (p = 0.002). Conclusions CEOP/IVE/GDP alternating regimen showed no remission or survival advantage to standard chemotherapy. Future clinical trials should aim to develop alternative regimen targeting disease biology as demonstrated by recurrent mutations in epigenetic factors. Trial registration The study was registered on ClinicalTrial.gov (NCT02533700) on August 27, 2015.

The present study was performed to explore the prognostic value of prognostic nutritional index (PNI) in renal cell carcinoma (RCC) patients following nephrectomy.A total of 660 patients were included. PNI was calculated based on the following formula: serum albumin level (g/L) + 0.005 × total lymphocyte count (per mmThe patients in low PNI group were more likely to be older (P 0.001), have a larger tumor (P 0.001), higher pathological T stage (P 0.001), positive lymph node (P = 0.038), distant metastasis (P = 0.005), higher tumor grade (P 0.001) and tumor necrosis (P 0.001). Multivariable analysis revealed low preoperative PNI was an independent predictor of overall survival (OS) (P = 0.034) and progression-free survival (PFS) (P = 0.004) for all patients. Besides, low preoperative PNI was also significantly associated with poor OS (P = 0.008), cancer-specific survival (CSS) (P = 0.032) and PFS (P = 0.003) for non-metastatic RCC patients.The patients with lower preoperative PNI were associated with adverse factors. Furthermore, the low preoperative PNI was also associated with inferior oncological outcomes in RCC patients who underwent nephrectomy.

Few studies have concentrated on the prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou. A total of 335 participants aged ≥60 years were recruited by simple random sampling method. A structural equation model was applied to determine interrelationships between depression, falls and other variables. As high as 27.5% and 23.3% participants had reported depressive symptoms and falls, respectively. The path analysis showed the total effect (

In recent years, “seeing a doctor is difficult and expensive” has become China’s biggest medical problem. The health care system based on hospital and specialist has been unable to meet the growing...

Objective To investigate histopathologic changes of muscularis mucosae (MM) and submucosa in the gastric cardia. Methods We performed a histopathology study of 50 distal esophagectomies with proximal gastrectomies for esophageal squamous cell carcinoma as the study (non-cancerous cardiac) group and 60 gastrectomies for early gastric cardiac carcinoma as the cancer group. The gastroesophageal junction was defined as the distal end of squamous epithelium, multilayered epithelium, or deep esophageal glands or ducts. Gastric cardia (n = 110) was defined as the presence of cardiac and cardio-oxyntic mucosae distal to the gastroesophageal junction. Results The average thickness of MM and submucosa in the cardia was 1.04 and 1.41 mm, respectively, which was significantly thicker than that in distal stomach (n = 34) (0.22 and 0.99 mm) or distal esophagus (n = 92) (0.60 and 1.15 mm). In the cardia, thickened MM displayed frayed muscle fibers (93.3%) with a significantly higher prevalence of entrapped glands, cysts, and lymphoid follicles than in the distal stomach or distal esophagus. In the submucosa fatty changes, cysts, and abnormal arteries were significantly more common in the cardia than in the distal stomach or distal esophagus. Compared with the study group, the cardia in the cancer group showed significantly thicker MM (average 1.31 vs 0.72 mm) and submucosa (average 1.61 vs 1.16 mm), more frequent frayed MM (93.3% vs 60.0%), prolapse-like changes (50.0% vs 2.0%), and cysts (26.7% vs 4.0%). Conclusion MM and submucosa of the cardia were significantly thickened, especially in early gastric cardiac carcinomas.

The Q-switched pulse and mode-locked pulse were investigated in an all-normal dispersion Yb-doped fiber laser (YDFL) based on the topological insulators (TIs) with mixing of polyvinyl alcohol (PVA) to produce Bi2Se3 /PVA film or deposition on the end facet of fiber to manufacture TI-compatible fiber. Through the dark Bi 2Se3/PVA films with large nonsaturable loss, the YDFL was operated in the Q-switched state. The repetition rate and the duration of the Q-switched pulses increased and declined, respectively, with the pump power to show 2.2 μs duration and 137.8 kHz repetition rate at the highest pump power. Moreover, the mode-locked pulses, with a 16 MHz repetition rate and 380 ps pulsewidth, were generated at high pump power by using the light Bi2Se3/PVA film. By means of a Bi2Se3 compatible fiber, through optical deposition of the Bi2Se3 nanoplatelets on the end facet of the fiber, the mode-locked YDFL was generated at low-threshold pump power and revealed more stabilized operation state up to two hours.

To assess the impact of cardiac motion during percutaneous computed tomography (CT)-guided core needle biopsy (PCT-CNB) of small lung lesions near pericardium, focusing on safety and diagnostic accuracy. Seventy-eight PCT-CNBs were performed between March 2010 and June 2018 in 78 patients with small (≤ 20 mm) lung nodules, each within 10 mm of pericardium. Shifts in distance and length of interface separating lesions from pericardium were calculated and compared by cardiac chambers (left atrium, left ventricle, right atrium, or right ventricle). Risk factors for complications were subjected to univariate analysis, and diagnostic accuracy was assessed. The respective mean values were 0.8 ± 1.1 mm (range 0–5.1 mm) for shifts in distance and 1.5 ± 2.1 mm (range 0–10.8 mm) for length of interface. Neither parameter shifted significantly with respect to cardiac chambers (p > 0.05, both). Pneumothorax ensued in 28 patients (35.9%), and pulmonary hemorrhage occurred in 41 (52.6%). The overall sensitivity, specificity, and accuracy of PCT-CNB were 91.2%, 100%, and 93.2%, respectively. Our data indicate that cardiac motion has no impact on either the incidence of complications or the diagnostic accuracy of PCT-CNB in patients with small (≤ 20 mm) lung lesions near pericardium.

Clinical decision-making on endoscopic vs. surgical resection of early gastric cardiac carcinoma remains challenging because of uncertainty on risk of lymph node metastasis. The aim of this multicenter study was to investigate risk factors of lymph node metastasis in early gastric cardiac carcinoma. Guided with the World Health Organization diagnostic criteria, we studied 2101 radical resections of early gastric carcinoma for risk factors associated with lymph node metastasis, including tumor location, gross pattern, size, histology type, differentiation, invasion depth, lymphovascular, and perineural invasion. We found that the risk of lymph node metastasis was significantly lower in early gastric cardiac carcinomas (6.7%, 33/495), compared with early gastric non-cardiac carcinomas (17.1%, 275/1606) (p 0.0001). In early gastric cardiac carcinoma, no lymph node metastasis was identified in intramucosal carcinoma (0/193) and uncommon types of carcinomas (0/24), irrespective of the gross pattern, size, histologic type, differentiation, and invasion depth. Ulceration, size 3 cm, and submucosal invasion were not significant independent risk factors for lymph node metastasis. In 33 early gastric cardiac carcinomas with lymph node metastasis, either lymphovascular invasion or poor differentiation was present in 16 (48.5%) cases and together in six cases. By multivariate analysis, independent risk factors of lymph node metastasis in early gastric cardiac carcinoma included lymphovascular invasion (Odds Ratio (OR): 7.6, 95% Confidence Interval (CI): 2.8-20.2) (p 0.0001) and poor differentiation (OR: 6.0, 95% CI: 1.4-25.9) (p 0.05). In conclusion, lymph node metastasis was not identified in early gastric cardiac intramucosal carcinoma and uncommon types of carcinoma. The risk of lymph node metastasis was also significantly lower in tumors with submucosal invasion, especially for cases without lymphovascular invasion or poor differentiation. These results lend support to the role of endoscopic therapy in the treatment of patients with early gastric cardiac carcinoma.

The optimal screening or treatment strategies of solitary pulmonary nodules especially ground-glass opacities (GGOs) remain controversial. With CT-guided Hookwire localization, it is accurate to find the small lesions during video-assisted thoracoscopic surgery (VATS). In this study, we evaluate the efficiency and safety of CT-guided Hookwire localization of GGO-dominant (GGO component > 50%) pulmonary nodules before VATS and investigate the correlation between the radiologic features and pathology. From April 2008 to April 2014, a total of 273 patients with solitary GGO-dominant pulmonary nodules were included. Tumor size was 12.4 ± 5.7 mm in diameter, including 208 pulmonary adenocarcinomas and 65 benign nodules. Dislodgement occurred in six patients (2.20%) during surgery. Postoperative complications included asymptomatic needle track hemorrhage (27.1%), minimal pneumothorax (5.9%) and hemoptysis (0.4%). In 208 (76.2%) pulmonary adenocarcinomas, 82 nodules showed ≥90% GGO and 126 showed 50%≤GGO

OBJECTIVE To investigate risk factors (RF) of lymph node metastasis (LNM) in early gastric carcinoma (EGC) in 4 tertiary medical centers in Jiangsu Province. METHODS Among 10097 consecutive combined gastric cancer radical resections, 1903 EGCs were identified and reviewed, 283 excluded, and 1620 included for the study. All pathologic and some endoscopic reports were studied for demographic, tumor location, gross feature, the number of lymph nodes retrieved and involved. Two pathologists independently investigated pathologic features of tumor type, differentiation, invasion depth, lymphovascular invasion (LVI), and perineural invasion. The data were statistically analyzed to determine RF of LNM. RESULTS The average number of lymph nodes retrieved was 17.5 per case. LNM was diagnosed in 15.5%. By univariate analysis, significant RFs for LNM included age > 41 years, female gender, flat and depressed patterns, size over 1 cm, submucosal invasion, poor differentiation, poorly cohesive carcinoma, micropapillary adenocarcinoma, adenocarcinoma mixed with signet-ring cell carcinoma, LVI, perineural invasion, and distal gastric location. By multivariate analysis, independent RFs for LNM were size > 3 cm (OR: 1.9), poor differentiation (OR: 2.5), adenocarcinoma mixed with signet-ring cell carcinoma (OR: 1.7), LVI (OR: 5.8), and submucosal invasion (OR: 2.9). In contrast, size < 3 cm and ulcer were not significant RFs. Early cardiac carcinoma (OR: 0.4) had significantly lower risk. CONCLUSION Independent RFs for LNM in EGC in Chinese patients included tumor size > 3 cm, poor differentiation, submucosal invasion, adenocarcinoma mixed with signet-ring cell carcinoma, and LVI. Early cardiac carcinoma had significantly lower risk for LNM.

The learning objectives of environmental education emphasize investigation in real life to enhance students’ skills and experiences in solving practical problems. This study used the virtual reality (VR) technology to develop a virtual ecological environment for learning about the Taipei tree frog, supported by situated learning and game-based learning design to enhance students’ learning interest and motivation. Users can wear the head-mounted display (HMD) to explore the virtual environment for learning the Taipei tree frog’s ecological behavior, such as foraging and mating as well as its habitats and predators. A teaching experiment was conducted to investigate students’ learning effectiveness and the senses of presence and anxiety after using the virtual ecological environment. The experimental group (wearing the HMD) contained 40 students, the control group (using the desktop VR) contained 40 students, and both groups were used as samples to learn about the Taipei tree frog. The results indicated that using HMD VR and desktop VR could both enhance learning achievements, but the learning effectiveness of the former was significantly higher than that of the latter. The levels of anxiety for both groups were about the same, but the level of presence for the experimental group was higher than that of the control group because the HMD VR provided a more immersive experience than the desktop VR. The virtual ecological environment can save the time and effort of travelling to the natural habitat for observing the Taipei tree frog, and the design of role-playing game (RPG) can enhance learners’ interest and motivation. Therefore, it is a useful tool for promoting environmental education.

The concrete-infilled double steel corrugated-plate walls (CDSCWs) consist of two steel corrugated plates (SCPs), infilled concrete and two boundary elements. The two SCPs are connected by high-strength bolts and the spacing between the two SCPs is filled with concrete. The two vertical boundary elements are installed at both sides of CDSCWs. The sectional load-bearing performance of CDSCWs only under uniform compression has been investigated previously by the authors. But CDSCWs under a combination of compression and in-plane bending moment are applied in practice widely and commonly. Therefore, this paper presents the corresponding sectional load-capacity design method of CDSCWs under a combination of compression and in-plane bending moment. Firstly, an experimental investigation on sectional load-capacity of an I-shaped CDSCW specimen subjected to combined compression and in-plane bending moment is completed. The experimental results reveal a high axial load-bearing efficiency of the SCPs in the CDSCW specimen, and also validated the finite element (FE) model adopted in this study. Then, the FE numerical simulation is applied to systematically analyze the load-bearing performance of CDSCWs subjected to the combination of compression and in-plane bending moment. The coefficient φsp is introduced to consider the local buckling of compressive zone and the weakening effect of tensile-compressive transition zone in SCPs. The coefficient βc is introduced to consider the weakening effect of tensile-compressive transition zone in concrete and the adverse cooperative effect among SCPs, concrete and boundary elements owing to their different ultimate strains at the ultimate state of CDSCWs. As a result, the N-M correlation curve for predicting the sectional load-bearing capacity of CDSCWs under both the uniform compression and in-plane bending moment is then established and also verified by the experimental results.

In this paper, we experimentally demonstrate the performance of plasmonic silicon (Si) solar cells fabricated using silver (Ag), indium (In), and aluminum (Al) nanoparticles (NPs) of specific dimensions. The nanoparticles were produced using an anodic aluminum oxide (AAO) template as a deposition mask. AAO masks with a thickness of 700 nm and pore diameter of 100–110 nm were fabricated using a single-step anodization and pore widening process aimed at controlling the dimensions and coverage of the metallic NPs with a high degree of precision. Our ultimate objective was to facilitate a comparison of plasmonic effects induced by the various metallic NPs in Si solar cells. Scanning electron microscopy was used to examine the thickness, pore dimensions, and pore size distribution of the AAO template as well as the dimensions and coverage of the deposited metallic NPs. Measurements of optical reflectance and external quantum efficiency were used to characterize the plasmonic effects of the various metallic NPs. Measurements of photovoltaic current density-voltage under AM 1.5G simulation were used to confirm the enhancements in performance resulting from the plasmonic effects induced by the metallic NPs. Ag NPs increased the short-circuit current density (Δ J sc ) of the Si solar cells by 10.58% (from 29.49 to 32.61 mA/cm 2 ), In NPs increased Δ J sc by 7.81% (from 29.31 to 31.60 mA/cm 2 ), and Al NPs increased Δ J sc by 3.27% (from 28.73 to 29.67 mA/cm 2 ). When using metallic nanoparticles (average size of 106 nm and average coverage of 32.67%), the plasmonic effects in cells with Ag NPs exceeded the effects observed in cells fabricated using In-NPs or Al-NPs.

The characteristics of polarized random lasers (RLs), made from dye-doped twisted nematic liquid crystals (DD-TNLCs) in a wedge cell, have been investigated. Regardless of the multiple light scattering within disordered LCs inside the cell, the output polarization is compulsorily determined by the rubbing direction of PI on glass plate. Moreover, the output intensity of the RLs can be manipulated by the orientation of the linear pump polarization relative to the rubbing direction of polyimide on the incident glass plane. Through thermal control, the resonance characteristics of the RLs can be altered to generate the highest slope efficiency and lowest lasing threshold at 25 °C. The measured results indicate abundant and intriguing optical and physical properties of the DD-TNLC laser.

In this article, Ho3+ doped and Yb3+/ Ho3+ co-doped Y2WO6 phosphors were successfully prepared via high temperature solid method. Their structures were investigated with X-ray diffraction, the up-conversion (UC) excitation from a 980 nm diode laser, and the developed phosphor shown two UC emission bands in the visible region 540 and 643 nm. Based on the result, the intensity of the frequency up-conversion emission was enhanced significantly through co-doping with Yb3+ ions in the Y2WO6: Ho3+ phosphor. The dependence of emission intensity on the pump power indicated that the up-conversion emission was a two-photon process. At last, the energy level diagrams was discussed. The results show that Y2WO6 is a promising host material for UC phosphors.

The manufacture of products for the growing population results in large volume of wastewater that needs treatment. Advanced oxidation processes (AOPs) are popular for low cost, high efficiency and being eco-friendly in the degradation of toxic pollutants in the wastewater using the generated non-selective hydroxyl radical (•OH) for oxidation. Among the many AOPs, the Fenton process has been proven to be effective for treating recalcitrant organic compounds by using Fe2+ and H2O2 to produce the •OH. One disadvantage is the production of a large amount of sludge that needs further treatment and disposal. The fluidized-bed Fenton (FBF) process uses carriers that reduce the production of sludge by crystallizing the target pollutant onto the carrier surface. This paper is a comprehensive review of the recent development on FBF process application to industrial wastewater treatment. FBF process was used to treat industrial wastewaters like thin film transistor liquid crystal display manufacturing effluents, pharmaceutical products, textile, phenol and phenol derivatives-containing wastewater and other refractory organics in wastewater. This review highlights the advantages of FBF process over other technologies that are based on Fenton oxidation in terms of performance, operating conditions and factors affecting the removal efficiency. Included in this review are the reaction kinetics and mechanism involved and the carriers that were used. Finally, full-scale applications are collected and described. This review has shown the potential applicability of FBF technology to reduce the levels of recalcitrant organic contaminants in wastewater effluents.