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This study proposes four kinds of hybrid source–grid–storage systems consisting of photovoltaic and wind energy, and a power grid including different batteries and hydrogen storage systems for Sanjiao town. HOMER-PRO was applied for the optimal design and techno-economic analysis of each case, aiming to explore reproducible energy supply solutions for China's industrial clusters. The results show that the proposed system is a fully feasible and reliable solution for industry-based towns, like Sanjiao, in their pursuit of carbon neutrality. In addition, the source-side price sensitivity analysis found that the hydrogen storage solution was cost-competitive only when the capital costs on the storage and source sides were reduced by about 70%. However, the hydrogen storage system had the lowest carbon emissions, about 14% lower than the battery ones. It was also found that power generation cost reduction had a more prominent effect on the whole system's NPC and LCOE reduction. This suggests that policy support needs to continue to push for generation-side innovation and scaling up, while research on different energy storage types should be encouraged to serve the needs of different source–grid–load–storage systems. [ABSTRACT FROM AUTHOR]

Backgrounds and Purpose: This study was aimed at investigating the outcomes and predictors for the poor functional outcome after endovascular treatment (EVT) in a large, mostly Asian population. Methods: Between January 2014 and June 2016, acute stroke patients with anterior circulation occlusion and EVT were retrospectively enrolled from 21 stroke centers in China. The main outcomes were modified Rankin Scale (0-2 as functional independence, 3-6 as poor) at 90 days, symptomatic intracranial hemorrhage (sICH) at 72 h, and death at 90 days. Logistic regression was used to identify predictors for poor functional outcome at 90 days. Results: Of the 698 patients, 304 (43.6%) patients had functional independence at 90 days. The sICH rate was 15.5% (108/698) and mortality rate at 90 days was 25.4% (177/698). Age (OR 1.04, 95% CI 1.02-1.07), National Institutes of Health Stroke Scale score at admission (11-20 vs. ≤ 10, OR 2.38, 95% CI 1.23-4.59; ≥ 21 vs. ≤ 10, OR 3.66, 95% CI 1.72-7.80), baseline glucose level (OR 1.09, 95% CI 1.01-1.18), onset to groin puncture >6 h (OR 1.88, 95% CI 1.06-3.31), sICH (OR 15.49, 95% CI 5.16-46.43), and pneumonia (OR 3.15, 95% CI 1.86-5.32) were independent predictors of poor functional outcomes, while good recanalization (OR 0.26, 95% CI 0.13-0.54), preoperative Alberta Stroke Program Early CT Score 8-10 (OR 0.48, 95% CI 0.28-0.83), and good collateral flow (OR 0.50, 95% CI 0.32-0.79) were protective factors. Conclusions: This study provides evidence in real world to support the performance of EVT in acute anterior circulation stroke patients in Chinese population. Patients with small infarct core, successful recanalization, good collateral status, and short treatment delay without sICH or pneumonia may benefit from EVT. [ABSTRACT FROM AUTHOR]

China's tilapia industry has the most complete industrial chain in the world, but, in recent years, tilapia streptococcosis have frequently occurred, which has become a bottleneck restricting the development of tilapia industry. Although plenty of studies have been conducted on Streptococcus agalactiae (Group B Streptococcus , GBS) in tilapia, the mechanism of GBS invasion is still unclear. In order to further understand the invasion route, we used the qPCR method to study bacteria load in liver, intestine, gill, spleen, head kidney, kidney, and brain tissues of GIFT tilapia infected by a GBS virulent strain WC1535 at different infection time and the histological method to systematically analyze bacterial distribution and localization in above infected tissue. Through the dynamic analysis of bacteria load, the bacterial copy number of WC1535 reached the peak in each tissue at 24 h post-infection (hpi). Therefore, tissues at 24 hpi were taken as the research object to investigate the distribution and localization of WC1535 by paraffin section and electron microscopy. The results of tissue section showed that WC1535 existed in three forms in blood: free scattering without attachment to any structure, phagocytized by phagocytes (mainly macrophages) and a few red blood cells, and attached to the inner wall of blood vessels. The results of qPCR and tissue section both showed that the density of bacteria in head kidney, spleen and gill was high, at the same time, these tissues had abundant blood and capillaries, so this suggested that the S. agalactiae existed mainly in the blood of tilapia. There were almost no pathogens in the parenchymal cells of each tissue, but the surface of epithelial cells such as vascular endothelial cells and fibroblasts adhered a lot, which indicated that S. agalactiae had epithelial cell affinity. The results of electron microscopy showed that S. agalactiae can survive and proliferate intracellularly after being phagocytosed by macrophages, suggesting that macrophages might play as pathogen carriers or "Trojan horses" to achieve the immune escape, break the blood-brain barrier (BBB), and lead the meningitis in tilapia. Since GBS of tilapia can be internalized by macrophages, antibiotics with strong tissue distribution, cell penetration and good meningeal penetration are recommended for the treatment in the early stage of streptococcosis. • S. agalactiae strain WC1535 was widely distributed in different tissues of tilapia. • WC1535 distribution in tilapia had the characteristic of epithelial cell affinity. • WC1535 cells could localize and proliferate in the macrophages of tilapia. • The endocytic WC1535 in macrophages were surrounded by the membrane structure. • Histological evidence for breaking the blood-brain barrier of S. agalactiae. [ABSTRACT FROM AUTHOR]

• Reconstruction of PSM in Mu Us sandy land blocked the replenishment of precipitation to recharge deep soil moisture. • The capability of PSM forest to withstand drought is enhanced by the stem water storage. • The PSM stem water storage depletion and replenishment process occur at any time in the growing season. • The stem water replenishment and depletion are balanced, and the minor difference may be due to the stem growth. Desertification has long seriously threatened the ecological security of northern China, for which China has established the world's largest shelterbelt project. After 40 years of reconstruction of vegetation, the trend of desertification in northern China has been reversed. The shelterbelt forest project in northern China, however, at the same time, tells signs of degradation, and therefore its effectiveness has been questioned by scientists from various countries. In order to study the impact of the vegetation reconstruction process in the semi-arid area on the precipitation water redistribution process in this area, and how the reconstructed vegetation survives in dry season. This study selected the reconstruction Pinus sylvestris var. Mongolica (PSM) forest on Mu Us sandy land as the research object, and used new lysimeters, stem flow meters, miniature weather stations, etc. to monitor the deep soil water penetration, stem flux. The purpose of this current study is to find out how PSM forest changed the process of precipitation water redistribution in this area, and how PSM adjusts its own water storage capacity to adapt to the annual precipitation changes. In wet years such as 2017, DSR is only 0.4 mm, soil water storage is reduced by 16 mm, and evapotranspiration is 324.6 mm. In a wet year such as 2016, the DSR is 1.4 mm, the soil water storage is enlarged by 38.06 mm, and the evapotranspiration is 466.94 mm. The results showed that the water consumption of PSM in Mu Us area and the precipitation water replenishment in this area reached a balance but blocked precipitation to recharge deep soil water and groundwater. The rain-fed PSM stem can be used as a reservoir unit to supply water consumption and adjusting the evapotranspiration intensity to adapt to changes in annual precipitation. This research has advanced our understanding of the scale of reconstruction vegetation utilization of precipitation and the utilization mechanism of tree stem storage water in semi-arid areas. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore ethnic differences of acute ischemic stroke (AIS) in patients' characteristics, management and outcome in Chinese population in an institutional retrospective study., Methods: Data of consecutive patients with AIS treated at our center from January 2018 to December 2019 were retrospectively reviewed. Ethnic differences in demographics, risk factors, treatment, and outcomes were evaluated., Results: A total of 400 patients were included in the present analysis. Compared with Han patients, patients in ethnic group showed shorter interval between symptom onset and admission, lower baseline Glasgow coma scale (GCS) score, lower prevalence of diabetes, higher prevalence of medical history of anticoagulation or antiplatelet treatment, lower rates of partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarct (POCI). They were less likely to receive antiplatelet therapy and more likely to present higher risks of pulmonary infection. Furthermore, multivariable analysis revealed that the ethnic group was associated with unfavorable outcomes in AIS patients at discharge. In subgroup analysis after adjustment, only pulmonary infection remained an independent predictor of poor outcomes at discharge in ethnic group, while in Han group, baseline GCS score, total anterior circulation infarct (TACI), LACI and pulmonary infection were determined to be independent predictors of poor outcomes at discharge., Conclusions: Patients from ethnic minority groups presented distinctive characteristics in their baseline measurements, background cerebrovascular risk factors, treatment after admission, risk of in-hospital complications compared with Han patients. The ethnic difference of the AIS appeared to affect the neurological outcome., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: In acute ischemic stroke, there is uncertainty regarding the benefit and risk of administering intravenous alteplase before endovascular thrombectomy., Methods: We conducted a trial at 41 academic tertiary care centers in China to evaluate endovascular thrombectomy with or without intravenous alteplase in patients with acute ischemic stroke. Patients with acute ischemic stroke from large-vessel occlusion in the anterior circulation were randomly assigned in a 1:1 ratio to undergo endovascular thrombectomy alone (thrombectomy-alone group) or endovascular thrombectomy preceded by intravenous alteplase, at a dose of 0.9 mg per kilogram of body weight, administered within 4.5 hours after symptom onset (combination-therapy group). The primary analysis for noninferiority assessed the between-group difference in the distribution of the modified Rankin scale scores (range, 0 [no symptoms] to 6 [death]) at 90 days on the basis of a lower boundary of the 95% confidence interval of the adjusted common odds ratio equal to or larger than 0.8. We assessed various secondary outcomes, including death and reperfusion of the ischemic area., Results: Of 1586 patients screened, 656 were enrolled, with 327 patients assigned to the thrombectomy-alone group and 329 assigned to the combination-therapy group. Endovascular thrombectomy alone was noninferior to combined intravenous alteplase and endovascular thrombectomy with regard to the primary outcome (adjusted common odds ratio, 1.07; 95% confidence interval, 0.81 to 1.40; P = 0.04 for noninferiority) but was associated with lower percentages of patients with successful reperfusion before thrombectomy (2.4% vs. 7.0%) and overall successful reperfusion (79.4% vs. 84.5%). Mortality at 90 days was 17.7% in the thrombectomy-alone group and 18.8% in the combination-therapy group., Conclusions: In Chinese patients with acute ischemic stroke from large-vessel occlusion, endovascular thrombectomy alone was noninferior with regard to functional outcome, within a 20% margin of confidence, to endovascular thrombectomy preceded by intravenous alteplase administered within 4.5 hours after symptom onset. (Funded by the Stroke Prevention Project of the National Health Commission of the People's Republic of China and the Wu Jieping Medical Foundation; DIRECT-MT ClinicalTrials.gov number, NCT03469206.)., (Copyright © 2020 Massachusetts Medical Society.)

Importance: Several randomized clinical trials have recently established the safety and efficacy of endovascular treatment (EVT) of acute ischemic stroke in the anterior circulation. However, it remains uncertain whether patients with acute basilar artery occlusion (BAO) benefit from EVT., Objective: To evaluate the association between EVT and clinical outcomes of patients with acute BAO., Design, Setting, and Participants: This nonrandomized cohort study, the EVT for Acute Basilar Artery Occlusion Study (BASILAR) study, was a nationwide prospective registry of consecutive patients presenting with an acute, symptomatic, radiologically confirmed BAO to 47 comprehensive stroke centers across 15 provinces in China between January 2014 and May 2019. Patients with acute BAO within 24 hours of estimated occlusion time were divided into groups receiving standard medical treatment plus EVT or standard medical treatment alone., Main Outcomes and Measures: The primary outcome was the improvement in modified Rankin Scale scores (range, 0 to 6 points, with higher scores indicating greater disability) at 90 days across the 2 groups assessed as a common odds ratio using ordinal logistic regression shift analysis, adjusted for prespecified prognostic factors. The secondary efficacy outcome was the rate of favorable functional outcomes defined as modified Rankin Scale scores of 3 or less (indicating an ability to walk unassisted) at 90 days. Safety outcomes included symptomatic intracerebral hemorrhage and 90-day mortality., Results: A total of 1254 patients were assessed, and 829 patients (of whom 612 were men [73.8%]; median [interquartile] age, 65 [57-74] years) were recruited into the study. Of these, 647 were treated with standard medical treatment plus EVT and 182 with standard medical treatment alone. Ninety-day functional outcomes were substantially improved by EVT (adjusted common odds ratio, 3.08 [95% CI, 2.09-4.55]; P < .001). Moreover, EVT was associated with a significantly higher rate of 90-day modified Rankin Scale scores of 3 or less (adjusted odds ratio, 4.70 [95% CI, 2.53-8.75]; P < .001) and a lower rate of 90-day mortality (adjusted odds ratio, 2.93 [95% CI, 1.95-4.40]; P < .001) despite an increase in symptomatic intracerebral hemorrhage (45 of 636 patients [7.1%] vs 1 of 182 patients [0.5%]; P < .001)., Conclusions and Relevance: Among patients with acute BAO, EVT administered within 24 hours of estimated occlusion time is associated with better functional outcomes and reduced mortality.

Background: Previous randomised trials have shown an overwhelming benefit of mechanical thrombectomy for treating patients with stroke caused by large vessel occlusion of the anterior circulation. Whether endovascular treatment is beneficial for vertebrobasilar artery occlusion remains unknown. In this study, we aimed to investigate the safety and efficacy of endovascular treatment of acute strokes due to vertebrobasilar artery occlusion., Methods: We did a multicentre, randomised, open-label trial, with blinded outcome assessment of thrombectomy in patients presenting within 8 h of vertebrobasilar occlusion at 28 centres in China. Patients were randomly assigned (1:1) to endovascular therapy plus standard medical therapy (intervention group) or standard medical therapy alone (control group). The randomisation sequence was computer-generated and stratified by participating centres. Allocation concealment was implemented by use of sealed envelopes. The primary outcome was a modified Rankin scale (mRS) score of 3 or lower (indicating ability to walk unassisted) at 90 days, assessed on an intention-to-treat basis. The primary safety outcome was mortality at 90 days. Secondary safety endpoints included the rates of symptomatic intracranial haemorrhage, device-related complications, and other severe adverse events. The BEST trial is registered with ClinicalTrials.gov, NCT02441556., Findings: Between April 27, 2015, and Sept 27, 2017, we assessed 288 patients for eligibility. The trial was terminated early after 131 patients had been randomly assigned (66 patients to the intervention group and 65 to the control group) because of high crossover rate and poor recruitment. In the intention-to-treat analysis, there was no evidence of a difference in the proportion of participants with mRS 0-3 at 90 days according to treatment (28 [42%] of 66 patients in the intervention group vs 21 [32%] of 65 in the control group; adjusted odds ratio [OR] 1·74, 95% CI 0·81-3·74). Secondary prespecified analyses of the primary outcome, done to assess the effect of crossovers, showed higher rates of mRS 0-3 at 90 days in patients who actually received the intervention compared with those who received standard medical therapy alone in both per-protocol (28 [44%] of 63 patients with intervention vs 13 [25%] of 51 with standard therapy; adjusted OR 2·90, 95% CI 1·20-7·03) and as-treated (36 [47%] of 77 patients with intervention vs 13 [24%] of 54 with standard therapy; 3·02, 1·31-7·00) populations. The 90-day mortality was similar between groups (22 [33%] of 66 patients in the intervention vs 25 [38%] of 65 in the control group; p=0·54) despite a numerically higher prevalence of symptomatic intracranial haemorrhage in the intervention group., Interpretation: There was no evidence of a difference in favourable outcomes of patients receiving endovascular therapy compared with those receiving standard medical therapy alone. Results might have been confounded by loss of equipoise over the course of the trial, resulting in poor adherence to the assigned study treatment and a reduced sample size due to the early termination of the study., Funding: Jiangsu Provincial Special Program of Medical Science., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This pilot study designed to evaluate the efficacy and safety of NAD+ ADP-ribosyl transferase 1 (NART) agonist in comparison with Donepezil (DNP) in elderly Chinese patients with Alzheimer disease (AD). In the present clinical trial, Chinese elderly patients aged >65 years with a confirmed diagnosis of AD were enrolled. The patients received NART agonist (test, DAG-structured PKC blockers (GF109203X)) or DNP 10mg daily (reference) for 6 months. The efficacy and safety data were collected from 120 patients (60 patients in each group) every 3 weeks until 6 months. The primary endpoints were to assess the change in cognitive score from baseline in both the treatment group. The result of the present study showed that the patients treated with DNP and NART agonist have similar efficacy and safety profile. Considering the clinical benefit, improvement in sign and symptoms of was numerically greater in DNP-treated patients as compared to NART agonist. However, a statistical difference in terms of clinical benefit was similar between both the treatment groups. Overall, both the study drugs were found comparable in relieving the symptoms of AD. This indicates that NART is a potential target for the treatment of AD in China. The results of the present study may help to design a large clinical trial to evaluate the efficacy and safety of NART agonist in comparison with DNP in AD patients.

Objective: This study aimed to investigate the current condition of mortality-specific comorbidity among hospitalized patients with ischemic stroke., Methods: Five-year data of inpatients with ischemic stroke (IS) were extracted from the hospital medical database. A retrospective review of eighteen mortality-specific comorbidities in extensively validated Charlson Comorbidity Index (CCI) was carried out for each patient. In addition, the distribution of the CCI-based prognostic score was calculated., Results: A total of 10 331 (male 57.6%) cases with IS were recruited in the present study. The most prevalent mortality-specific comorbidities from high to low were as follows: peripheral vascular disease (35.1%), diabetes uncomplicated (25.2%),mild liver disease (18.3%), chronic pulmonary disease (14.7%), congestive heart failure (10.8%), atrial fibrillation or flutter (10.3%), diabetes complicated (9.1%), moderate or severe renal disease (7.5%), and dementia (7.1%). High prevalence of comorbidities in the elderly was also noted (31.1% patients with score ≥3). Spearman correlation analysis with a rho of 0.25 (P < 0.001) showed a mild correlation between the age- and the CCI-based prognostic score., Conclusion: High prevalence of peripheral vascular disease, diabetes, liver disease, chronic pulmonary disease, congestive heart failure, atrial fibrillation, or flutter as major contributors to mortality was presented in in-hospital patients with IS in our area. One-third of old patients with IS expose high mortality risk with the CCI score ≥3. Early prevention and management of the potential comorbidities are necessary to reduce the mortality., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The purpose was to study the clinical features and genetics of a large Chinese family with Charcot-Marie-Tooth (CMT) disease. A genome-wide linkage scan using Applied Biosystems v. 2.5 411 short tandem repeat (STR) markers was performed in this family. Mutation screening was conducted on connexin 32 (Cx32). Prediction of impact of the mutation and sequence alignments of Cx32 in 10 vertebrates were performed using Polyphen and Clustal W, respectively. Twelve family members were diagnosed as CMT type 1. An X-chromosome locus (DXS991) was linked to the phenotype of this family by the genome-wide linkage analysis. An H100Y mutation found in Cx32 was predicted to be possibly damaging to the function of Cx32, with a PSIC score difference of 1.758. The H100 of Cx32 is highly conserved among the 10 vertebrates. A large Chinese family had CMTX1 linked to Xq13.1 caused by an H100Y mutation in the Cx32 gene.

Purpose: To describe the clinical features of and identify a novel mutation in Bardet-Biedl syndrome 7 gene (BBS7) in a Chinese family., Methods: Nineteen individuals at risk for inheriting Bardet-Biedl syndrome (BBS) in a Chinese family participated in the study. Physical examination was performed and blood was drawn for DNA extraction. Linkage analysis was conducted for all known BBS loci, and mutation screening of BBS7 gene and BBS12 gene was performed., Results: A Chinese family with inherited BBS was identified. After performing linkage analysis on all 13 known loci, we found the disease phenotype of a Chinese family with BBS linked to a locus where BBS7 and BBS12 genes locate., Conclusions: This study describes a novel mutation in BBS7 causing BBS in a Chinese family. This is the first report that a mutation in a BBS gene causes BBS in a Chinese population. These results expand the spectrum of human disease associated with mutations of BBS7 since the initial three mutations in BBS7 were first identified in 2003.