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Ke Jiang,1 Genpeng Li,1 Wenjie Chen,1 Linlin Song,1 Tao Wei,1 Zhihui Li,1 Rixiang Gong,1 Jianyong Lei,1 Hubing Shi,2 Jingqiang Zhu1 1Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China; 2State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu 610041, Sichuan, People’s Republic of ChinaCorrespondence: Jianyong LeiThyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of ChinaTel/Fax +86-28-85423822Email leijianyong11@163.comHubing ShiState Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu 610041, Sichuan, People’s Republic of ChinaEmail shihb@scu.edu.cnBackground: Lymph node metastasis (LNM) is associated with increased risk of recurrence and poor prognosis in papillary thyroid cancer (PTC). Novel non-invasive biomarkers for the prediction of LNM in PTC patients are still urgently needed. In this study, the relationship between the expression of plasma exosomal microRNAs (miRNAs) and LNM was analyzed. Further, we aimed to explore if exosomal miRNAs can serve as indicators of LNM in PTC patients.Methods: A total of 64 PTC patients who underwent total thyroidectomy and neck dissection from June 2018 to July 2018 in West China Hospital were enrolled in this study. Plasma exosomes were isolated by exoRNeasy Serum/Plasma Maxi Kit. The levels of selected exosomal miRNAs were detected by real-time quantitative PCR (qRT-PCR). Cox proportional hazard analyses and receiver operating characteristic (ROC) curves were conducted to evaluate the predictive efficiency. Furthermore, PTC cell lines with transfection of miRNA mimics/inhibitors were used to verify the functions of exosomal miRNAs.Results: 49 PTC patients with LNM and 15 without LNM were included in the present study. Exosomal miR-146b-5p and miR-222-3p were both significantly upregulated in patients with LNM (P values were 0.008 and 0.015, respectively). ROC analyses revealed that the areas under the curves (AUCs) of miR-146b-5p and miR-222-3p for LNM prediction were 0.811 and 0.834, respectively. Moreover, the AUC increased to 0.895 when the two miRNAs used together. Wound healing assays and transwell assays showed that miR-146b-5p and miR-222-3p significantly enhanced the migration and invasion ability of PTC cells in vitro.Conclusion: Plasma exosomal miR-146b-5p and miR-222-3p could serve as potential biomarkers for LNM in PTC.Keywords: papillary thyroid cancer, lymph node metastasis, exosomal miRNAs, biomarkers

Since the establishment of the China (Heilongjiang) pilot free trade zone, the development of cross-border e-commerce with Russia has continued to increase speed and quality. With its geographical advantages and its comparative advantages in the Internet field, Heilongjiang Province promoted the rapid development of the Internet economy in Russia, fostered a new digital trade format represented by cross-border e-commerce, and promoted online and offline collaborative promotion of customs clearance logistics and financial services. The paper expounds foundation and development status of Heilongjiang Province’s cross-border e-commerce, analyzes in integrated development of digital economy with the Heilongjiang Province’s cross-border e-commerce with Russia, and further puts forward prospects and recommendations.

As one of the nine border provinces in the country, Heilongjiang Province has 2,981 kilometres of RussianRussian border and 25 national first-class ports. In the past five years, Heilongjiang Province, based on the prominent geographical position in the core of Northeast Asia, has actively promoted the national strategy of the Belt and Road Initiative, deepened on open cooperation with countries in the Northeast Asia, and focused on developing economic cooperation and trade with Russia while building a new pattern of openness to the outside world. This paper in detail elaborates the progress of Heilongjiang Province’s participation in the Belt and Road Initiative (BRI) in aspect of “five links” construction, namely, policy coordination, connectivity of infrastructure, unimpeded trade, financial integration and closer people-to-people ties, since the implementation of the Belt and Road Initiative in 2013, and further proposes feasible countermeasures.

AIMS The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely adopted since its introduction. In this study, we aimed to report our experience using this reporting system at a College of American Pathologists (CAP)-accredited hospital laboratory in a large series of Chinese patients. METHODS All patients who underwent preoperative ultrasound-guided thyroid fine-needle aspiration (FNA) from January 2011 to August 2016 were retrospectively analyzed. Thyroid FNAs were classified according to the Bethesda System. For patients who underwent subsequent surgery at our institution, the diagnostic performance of the preoperative FNA was further analyzed according to four different calculation criteria. All of the follicular variants of papillary thyroid carcinoma specimens were reviewed to exclude NIFTP (noninvasive follicular thyroid neoplasm with papillary-like nuclear features). RESULTS A total of 13 351 thyroid FNAs were included in this analysis. Of the 12 530 sampled patients, 3594 (28.7%) underwent thyroidectomy, and the malignancy rates for each cytological category were as follows: 66.7% unsatisfactory, 14.2% benign, 53.5% undetermined significance, 30.2% follicular neoplasm, 82.0% suspicious, and 99.1% malignant. Only 12 (0.36% of all PTC) patients were reclassified as having NIFTP. The sensitivities of the preoperative FNAs were all above 95.0% and were as high as 99.0%. The specificities ranged from 50.3% to 63.9%, depending on which criteria were used. The positive predictive value was 95.4% for criteria 1 and 2 and was 94.2% for criteria 3 and 4. The negative predictive values ranged from 64.5% to 85.8%. The diagnostic accuracies all exceeded 90.0%, with the highest being 94.8%. CONCLUSION This study revealed the great efficacy and accuracy of TBSRTC in a large Chinese population for the first time.

Self-piercing riveted (SPR) connections are gradually being used in cold-formed steel structures due to higher tensile strength, shear strength and connection efficiency compared to those of self- drilling connections. With the purpose of investigating the flexural behavior of truss beams with SPR connections and studying the effects of height and span, as well as diagonal web arrangement, on their flexural stiffness and ultimate bearing capacity, the symmetric vertical static load test was conducted for 5 cold-formed thin-walled truss beam specimens with SPR connections. The finite element software was adopted to simulate the test models, and the more parameters were additionally analyzed. The research indicated that the failure modes of the specimens can be divided into two types: the local strength failure mode occurred when the upper chord flange plate was cracked, the other one occurred when the rivets at joints of truss beams were stripped from the plate. The span-height ratio, spacing of web members, chord thickness and number of rivets had great influence on the flexural stiffness and ultimate bearing capacity of truss beams with SPR connections, while the thickness of web members and the arrangement of diagonal web members had less influence. The truss beam was a simply supported beam with a weak web. A theoretical formula was proposed to calculate the equivalent flexural stiffness of the truss beam with SPR connections based on parametric analysis, and it agreed with the experiment results, so the proposed theoretical formula is valid and can be applied to practical engineering.

In order to introduce self-piercing rivet (SPR) technique to component connections of thin-walled steel structures, 78 SPR joints were tested to evaluate their quality and the shear strength. Parameters included in this test program were the sheet thickness, and the rivet. Based on test results, the research developed an empirical formula between the combination thicknesses of sheet and rivet length, and proposed quality evaluation standard of SPR connections and a new design method of shear strength. The test results showed that sheet thickness and sheet thickness ratio had a great effect on failure mode, and rivet length was a key factor on shear properties of SPR connections. The proposed quality evolution standard and design calculation method of shear strength in this paper had certain reasonability and reliability.

With the purpose of introducing a new connection to cold-formed steel structure, this paper presents an experimental investigation of cold-formed steel (CFS) shear walls with self-piercing riveted (SPR) connections under monotonic and reversed cyclic loading. The effects of loading type (Monotonic and Cyclic), rivet spacing at the steel sheet edges, rivet number at CFS framing joints, axial compression ratio, and the steel sheathing types (steel sheet sheathing and corrugated steel sheathing) on mechanical behavior and failure modes of CFS shear walls were investigated. The shear strength, initial stiffness, and ductility of CFS shear walls with SPR connections were evaluated by comparing to the results of CFS shear walls with self-drilling screw connections under the same condition. Lateral loading, safety factor, and resistance factor under the wind and seismic loads were determined in accordance with test results of CFS shear wall with SPR connections. The research indicated that the rivet spacing at the sheet edges was a key factor affecting failure modes and mechanical properties of CFS shear walls. The relationship of shear strength and ultimate deformation decreased linearly with the increase of the rivet spacing. Compared to CFS shear walls with self-drilling screw, CFS shear walls with SPR have significantly improved shear strength and stiffness. Safety factor and resistance factor recommended by AISI Seismic Design Standard are conservative for the wind and seismic design of CFS shear wall using SPR connections.

Linlin Song,1 Jianyong Lei,1 Ke Jiang,1 Yali Lei,2 Yuting Tang,2 Jingqiang Zhu,1 Zhihui Li,1 Huairong Tang2 1Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China; 2Health and Management Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of ChinaCorrespondence: Huairong TangHealth and Management Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of ChinaTel/Fax +86-28-85422933Email thrhuaxi11@163.comBackground and Aim: The relationship between subclinical hypothyroidism (SHYPO) and sleep quality is still unclear. Our objective was to compare the sleep quality between SHYPO patients and a control group with normal thyroid function.Methods: A total of 2224 patients with SHYPO and 12,622 euthyroid (EUTH) control group patients were included in the present study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The sleep outcomes were compared to explore the association between SHYPO and sleep quality. Furthermore, we tried to identify the risk factors of poor sleep in SHYPO patients.Results: Compared to the EUTH control patients, SHYPO patients had a higher PSQI score (6.83 ± 2.67 vs 6.64 ± 2.63, p =0.004) and a higher proportion of poor sleepers (67.09% vs 64.75%, p =0.033). Moreover, subjects with SHYPO were associated with poorer sleep (Odd Ratio (OR) 1.120, 95% Confidence Intervals (CI) 1.016 to 1.235, p =0.023), longer sleep latency (OR 1.162, 95% CI 1.053 to 1.282, p =0.003), and shorter sleep duration (OR 1.148, 95% CI 1.019 to 1.293, p =0.023) after adjusting for potential confounders. Furthermore, we found that lower age, lower body mass index, and women were risk factors for poor sleep quality in SHYPO patients.Conclusion: Our findings suggest a relationship between SHYPO and poor sleep quality in a large Chinese population.Keywords: subclinical hypothyroidism, sleep quality, PSQI

Linlin Song,1,2 Jingqiang Zhu,1 Zhihui Li,1,3 Tao Wei,1,3 Rixiang Gong,1,3 Jianyong Lei1 1Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China; 2West China School of Medicine, Sichuan University, Chengdu 610065, People’s Republic of China; 3Thyroid and Breast Surgery Center, Chengdu Shang Jin Nan Fu Hospital, Chengdu 611700, People’s Republic of ChinaCorrespondence: Jianyong LeiThyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of ChinaTel +86 288 542 3822Fax +86 288 542 3822Email leijianyong11@163.comBackground and Aims: The prognosis of papillary thyroid carcinoma (PTC) is highly variable, even for high-risk cases. The predictive and prognostic role of the lymphocyte-to-monocyte ratio (LMR) has been reported in other cancers. The aim of our present study was to explore the value of LMR prognostic prediction in high-risk PTC patients.Patients and Methods: Two hundred and twenty-four PTC high-risk cases at West China Hospital were randomized into a training set (112 cases) and testing set (112 cases), while 48 cases in Shang Jin Nan Fu Hospital were included as the external validation set.Results: A lower preoperative LMR correlated with larger tumor size, advanced N and M stages, and an increased number of multiple PTC cases in the training, testing, and validation sets (all P