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Dosage is essential for studying the compatibility and effectiveness of traditional Chinese medicine. Danggui and Chuanxiong are widely used in traditional Chinese medicine for ailments and treatment of various disorders. 628 traditional Chinese medicine prescriptions containing Danggui and Chuanxiong were extracted from the self-built prescription database and screened for the three groups of prescriptions, i.e., irregular menstruation, sores, and stroke. We processed and tested the dosage of Danggui and Chuanxiong and selected the optimal copula function, Gumbel copula function, from the Archimedes function family and elliptical copula function family to establish the data model. To establish the presence of a correlation between the dose of Danggui and Chuanxiong, a graph of the joint distribution function of rank correlation coefficients, Kendall’s rank correlation coefficient and Spearman’s rank correlation coefficient, was used. Our results suggest that the model using the Gumbel copula function better reflects the correlation between the dose of Danggui and Chuanxiong. For irregular menstruation, sores, and strokes, Kendall’s rank correlation coefficients were 0.6724, 0.5930, and 0.7757, respectively, and Spearman’s correlation coefficients were 0.8536, 0.7812, and 0.9285, respectively. In all three prescription groups, the dose of Danggui and Chuanxiong was positively correlated, implying that, as the dosage of one drug increases, the dosage of the other increases as well. From the perspective of data mining and mathematical statistics, the use of the copula function model to evaluate the correlation between the prescribed dosage of the two drugs was innovative and provided a new model for the scientific interpretation of the compatibility of traditional drugs. This might also serve to guide the clinical use of traditional Chinese medicine.

Most previous risk-prediction models for gastrointestinal stromal tumors (GISTs) were based on Western populations. In the current study, we collected data from 23 hospitals in Shandong Province, China, and used the data to examine prognostic factors in Chinese patients and establish a new recurrence-free survival (RFS) prediction model. Records were analyzed for 5285 GIST patients. Independent prognostic factors were identified using Cox models. Receiver operating characteristic curve analysis was used to compare a novel RFS prediction model with current risk-prediction models. Overall, 4216 patients met the inclusion criteria and 3363 completed follow-up. One-, 3-, and 5-year RFS was 94.6% (95% confidence interval [CI] 93.8–95.4), 85.9% (95% CI 84.7–87.1), and 78.8% (95% CI 77.0–80.6), respectively. Sex, tumor location, size, mitotic count, and rupture were independent prognostic factors. A new prognostic index (PI) was developed: PI = 0.000 (if female) + 0.270 (if male) + 0.000 (if gastric GIST) + 0.350 (if non-gastric GIST) + 0.000 (if no tumor rupture) + 1.259 (if tumor rupture) + 0.000 (tumor mitotic count 10 per 50 HPFs) + 0.096 × tumor size (cm). Model-predicted 1-, 3-, and 5-year RFS was S(12, X) = 0.9926exp(PI), S(36, X) = 0.9739exp(PI) and S(60, X) = 0.9471exp(PI), respectively. Sex, tumor location, size, mitotic count, and rupture were independently prognostic for GIST recurrence. Our RFS prediction model is effective for Chinese GIST patients.

Higher vocational education has adopted the e-learning system, and scholars have achieved a lot of results in e-learning. However, how to introduce flow ex-perience theory, extract the behavioral intention characteristics of higher vocational students, and how to integrate job requirements and skill certificates into e-learning Design and application need to be discussed in depth. We propose a UTAUT model that combines flow experience, exploring the use of behavior intention as a mediator and flow experience as the target variable. More than 7000 students from City College of Huizhou participated in the questionnaire. The Structural Equation Modeling (SEM) SmartPLS3 software was used to investigate their flow experience to use the e-learning system. The results show that perceived usefulness and facilitating conditions have an important influence on their flow experience and behavioral intentions, both have a partial mediating effect on flow experience through behavioral intention. The e-learning system of higher vocational education should promote the flow experience level of students, and strengthen the elements of employment positions and skills certificates. Suggestion: The e-learning system of higher vocational education should promote the flow experience level of students, and strengthen the elements of employment positions and skills certificates. The model of intention to use e-learning systems for senior students is innovative and effective in practice.

Colleges and universities are the base and cradle of talent cultivation, the employment quality of college students is the key index to measure the educational achievements of colleges and universities, and student management is an important work throughout the college career, for it has important influence to the student employment quality. In the new situation of changing market structure and talent demand, the scale of colleges and universities is expanding, the enrollment rate of students is increasing, and the employment quality and management methods of college students are facing new challenges. This paper takes Heilongjiang Bayi Agricultural University as an example, based on the comprehensive quantitative analysis of the employment quality of college students to explore the optimization methods and strategies of college student management under the new situation.

Sudden death is unpredictable; it is the most serious disease of human beings. With the development of economy and society, people’s pace of work and life is accelerating, which results in long-term physical fatigue, excessive mental burden, and the accompanying bad emotions, such as depression and irritability. Due to the bad influence, the number of sudden deaths is increasing, which has brought huge disaster to the whole society and family. This chapter introduces the connotation, epidemiology, and classification of sudden death in detail.

With the development of today’s society, the pace of people’s work and life is accelerating. This common negative stress that people currently suffer is caused by long-term physical fatigue and excessive mental load, as well as the depression and irritability. The sudden death led by chronic fatigue has not only brought huge disasters to their families but also had serious negative effects on social production. This chapter mainly describes chronic fatigue stress and sudden death.

This paper studies the power cable of the point absorption wave energy converters (WECs). As bearing the cyclic loads induced by WECs motion, waves and ocean currents, cable is prone to damage and failure. Therefore, it is necessary to optimize the design of the power cable to improve its performances and ensure the service safety of the WECs system. The idea of setting buoyancy modules on different positions of the power cable is proposed in this paper. The length and weight of the power cable and the length and position of buoyancy modules are considered to optimize the design of the power cable in the numerical simulation. The optimal design is evaluated based on the maximum effective tension and curvature of the power cable and the captured power of the WEC. The schemes of the cable with buoyancy modules and without buoyancy modules are compared based on the maximum effective tension and curvature of the power cable and the captured power of the WEC. The results show that the cable performance is significantly improved after setting the buoyancy modules, but the improvement for the captured power of the WEC is little.

To search for an association between sepsis and mitochondrial genetic basis, we began our study. In this study, a proband harbouring mitochondrial T6459C mutation with sepsis and his Chinese Han pedigree including 7 members of 3 generations were enrolled. General information, blood parameters and mitochondrial full sequence scanning of all members were performed, and cellular functions, including cellular reactive oxygen species (ROS) levels, mitochondrial membrane potential (MMP), degrees of cell apoptosis and adenosine triphosphate (ATP) concentrations, were measured in members with and without the T6459C mutation. Through mitochondrial full sequence scanning and analysis of all members we found, the maternal members (I‐1, II‐1, II‐2 and II‐4) in this Chinese Han pedigree all had the mitochondrial T6459C mutation and were used as the mutation group. The non‐maternal members (II‐3, III‐1 and III‐2) did not have this mutation and were used as the non‐mutation group. The differences in all indicators, including the blood routine, blood biochemistry and coagulation function tests, between members in these two groups were not significant. Under the non‐stimulation condition, the mutation group had higher ROS levels (4210.42 ± 1043.35 vs 3387.78 ± 489.66, P = .028) and apoptosis ratios (P = .004) and lower ATP concentrations (P = .049) and MMP levels (P = .047) than the non‐mutation group. After 6 hours of simulated LPS stimulation, the mutation group had significantly increased ROS levels (5759.25 ± 2297.90 vs 3862.00 ± 1519.77, P = .045) compared with the non‐mutation group, whereas the mutation group continued to demonstrate higher ROS levels (P = .045) and apoptosis ratios (P = .003) and lower MMP levels (P = .005) and ATP concentrations (P = .010). We speculated that the mtDNA T6459C mutation might be the basis for the genetic susceptibility to sepsis.

Most previous risk-prediction models for gastrointestinal stromal tumors (GISTs) were based on Western populations. In the current study, we collected data from 23 hospitals in Shandong Province, China, and used the data to examine prognostic factors in Chinese patients and establish a new recurrence-free survival (RFS) prediction model.Records were analyzed for 5285 GIST patients. Independent prognostic factors were identified using Cox models. Receiver operating characteristic curve analysis was used to compare a novel RFS prediction model with current risk-prediction models.Overall, 4216 patients met the inclusion criteria and 3363 completed follow-up. One-, 3-, and 5-year RFS was 94.6% (95% confidence interval [CI] 93.8-95.4), 85.9% (95% CI 84.7-87.1), and 78.8% (95% CI 77.0-80.6), respectively. Sex, tumor location, size, mitotic count, and rupture were independent prognostic factors. A new prognostic index (PI) was developed: PI = 0.000 (if female) + 0.270 (if male) + 0.000 (if gastric GIST) + 0.350 (if non-gastric GIST) + 0.000 (if no tumor rupture) + 1.259 (if tumor rupture) + 0.000 (tumor mitotic count 6 per 50 high-power fields [HPFs]) + 1.442 (tumor mitotic count between 6 and 10 per 50 HPFs) + 2.026 (tumor mitotic count 10 per 50 HPFs) + 0.096 × tumor size (cm). Model-predicted 1-, 3-, and 5-year RFS was S(12, X) = 0.9926Sex, tumor location, size, mitotic count, and rupture were independently prognostic for GIST recurrence. Our RFS prediction model is effective for Chinese GIST patients.

Objective: To study the significance of c-myc and c-erbB-2 oncogene expression in gastric cancer. Methods: 81 gastric cancer specimens were detected for c-myc and c-erbB-2 oncogene amplification using non-radioactive in situ hybridization method. Results: The amplification rates for c-myc and c-erbB-2 were 67.9% and 50.6% respectively, and there were significant correlation in the amplification of these two genes (χ2 = 7.26, P < 0.01). Conclusions: The amplification of c-myc and c-erbB-2 may play an important role in gastric cancer development, and these two genes may have synergistic effect.

To summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors.Clinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses.Among 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors.The choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.

Objective: To study the relationship of c-erbB-2 oncogene expression with major pathological characteristics of gastric cancer (GC) progression. Methods: Eighty-one GC specimens were studied for c-erbB-2 oncogene amplification using non-radioactive in situ hybridization method. The c-erbB-2 overexpression status was correlated with tumor differentiation, tumor invasion and lymph node metastasis. Results: Among the 81 pathology confirmed GC patients, 41 (50.6%) were found to have c-erbB-2 overexpression in cancer tissues. The rate of c-erbB-2 overexpression was significantly higher in those with poor tumor differentiation (63.0%, 29/46) than in those with well differentiated tumor (34.3%, 12/35) (χ (2)=6.576, P

New trade-in services such as online trade-in, trade-in on e-commerce platforms and omni-channel trade-in, are emerging due to the development of e-commerce. To offer these new trade-in services, firms need to determine the optimal product price and rebate and decide whether to pay the rebate with a gift card (G) or cash (C). To address these challenges for firms, our paper considers a firm selling a new product to new consumers and offering a trade-in service to replacement consumers. In addition, we develop theoretical models to examine the optimal decisions in the cases of G and C and explore the optimal payment for the rebate. We reveal that G payment is a better choice for the firm only if the used product residual value is relatively low and the market size ratio between replacement and new consumers is relatively low; otherwise, the firm should choose C payment. Interestingly, replacement consumers’ preferred trade-in rebate payment (i.e., C payment) leads a lower trade-in demand than G payment and C payment may be harmful. In the extension, we consider a firm with online and offline sales channels and different types of replacement consumers who own different used products, and find that our main results regarding the optimal rebate payment still hold. Moreover, we find that in the context of a used product with a relatively medium residual value, firms with online and offline sales channels are more likely to choose G than firms with one sales channel; otherwise, firms are more likely to choose C.

To the Editor: We reported 2 cases of ectopic thyroid gland (ETG) masquerading as pituitary adenoma (PA). The first case was a 15-year-old boy with growth, and mental retardation whose height was 121 cm and weight was 44 kg on admission. Bone age development index was 40, while bone age showed 6–10 years old. Magnetic resonance imaging (MRI) revealed pituitary hyperplasia [Figure 1a]. Thyroid ultrasonography did not found thyroid on the anterior aspect of the neck and the normal position of thyroid gland. The peak value of growth hormone experiments was 1.8 μg/L. Gonad function indicated testosterone (T) 0.55 nmol/L, luteotropic hormone 150 mU/L. After treatment with eltroxin, the patient was 21 cm higher than before in one year and his intelligence improved significantly comparatively. MRI after treatment showed pituitary hyperplasia significantly regressed [Figure 1b]. The second case was a 27-year-old female with galactorrhea, amenorrhea, and infertility. MRI showed the signal was obviously abnormal (uniform strengthening) in the saddle pituitary, the size was 1.0 cm × 1.5 cm × 1.6 cm, which indicated the PA was huge [Figure 1c]. Thyroid function showed FT4 9.07 pmol/L, TSH >150 mU/L, and 15 minutes serum prolactin was 2.66 μg/L. Gonad function, 8 after midnight (AM) serum adreno-cortico-tropic-hormone, and 8 AM serum cortisol were normal. Thyroid ultrasonography did not found thyroid at the normal position. History revealed that the patient was found thyroglossal cyst in 15 years old and accepted total excision of thyroglossal duct cyst in 18 years old. Then eltroxin was prescribed, and the patient was pregnant successfully in 7 months. Now, her menstruation is normal, and galactorrhea is rarely happen. These two cases were ectopic thyroid masquerading as PA. At present, classification of PA is based on plasma hormone levels or immunohistochemical staining, clinical features are always complex and confusing. In these two cases, retardation, infertility, and amenorrhea were not arising from PA, while the primary ectopic thyroid was the culprit. It caused primary hypothyroidism, TSH cell proliferation, and compensatory pituitary gland hyperplasis. Figure 1 (a) Magnetic resonance imaging of the 15-year-old teenager with ectopic thyroid before the treatment showed pituitary hyperplasia (black arrow), sagittal T1-weighed contrast enhanced image; (b) magnetic resonance imaging of the 15-year-old teenager with ... ETG, the most frequent form of thyroid dysgenesis, refers to the presence of thyroid tissue in locations other than the normal anterior neck region.[1] It remains a rare disease.[1,2] Moreover, females account for 65–80% of ETG cases.[3] Although ETG has been understood gradually, diagnostic delay in ETG remains common, and this delay compounded with inappropriate therapeutic methods is responsible for the poor outcome in affected patients, especially in adolescents and women with childbearing age. When aberrant thyroid was totally excised, thyroid function would be absent or inadequate permanently. Substitute therapy would be essential, cost unpleasantly high and therapeutic period, unfortunately, life-long time. Thereby, thyroid function test and color Doppler ultrasonography are necessary when PA is considered. If ETG is suspected, preoperative analysis is of particular significance. A high index of clinical awareness and education of clinical practitioners will help a great deal in improving the ultimate outcome in patients with ETG. Financial support and sponsorship The work was supported by grants from the Chinese National Natural Science Fund (No. 30900543), the Clinical Science Fund of PLA General Hospital (No. 2013FC-TSYS-1028) and the Beijing Natural Science Fund (No. 7152136). Conflicts of interest There are no conflicts of interest.

Takotsubo cardiomyopathy (TTC) causes sudden cardiac death and has garnered increased attention worldwide in recent years. However, few studies have clearly classified the risk factors for this disease, including gender, race and morbidity, as well as the physical and mental stressors that can exacerbate the disease, particularly in young patients. To better analyze the characteristics of young TTC patients, we performed a systematic review of reported cases involving young patients.A computer-assisted search was performed using prominent electronic medical information sources to identify literature published between January 1965 and December 2013. Relevant studies containing clinical data of young TTC patients were included.Ninety-six records that included information about 104 cases were ultimately selected for our review. Several of the following results were noted: First, physical stress was more likely to exacerbate TTC than was mental stress in young patients. Second, more female than male TTC patients were noted among both young patients and the general population. Third, ethnicity appears to play no role in the disease, as no significant differences were noted among individuals of different races with respect to clinical characteristics, morbidity or stressors. Fourth, the clinical manifestations of TTC were similar to those of other cardiac diseases, including coronary heart disease. However, TTC may be detected using the combination of echocardiography and ventriculography.Clinicians should consider TTC if young patients present with symptoms similar to those of coronary heart disease so that harmful treatments such as coronary artery stent placement may be avoided. Moreover, the answers to questions regarding the clinical diagnostic criteria, etiology, pathophysiology, and the management of this syndrome in youth remain unclear; therefore, further research is needed.