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Objective Data on preoperative immunotherapy combined with chemotherapy in potentially resectable lung squamous cell carcinoma (LUSC) remain scarce. This study was designed to investigate the safety and efficacy of preoperative immunotherapy and chemotherapy for stage IIIA-IIIB LUSC. Methods This study consecutively enrolled stage IIIA-IIIB LUSC who received preoperative immunotherapy combined with chemotherapy between January 2019 and July 2021. Patients received two to four cycles of immunotherapy combined with platinum-based doublet chemotherapy (platinum + paclitaxel) before surgery. Patients were assessed radiographically every one to two cycles until surgery. Postoperative pathological evaluation was also performed. Follow-up was performed until at least 3 months after surgery. Results Sixty-five patients with stage IIIA-IIIB LUSC were enrolled. The objective response rate was 78.46% (51/65), and no patients had progressive disease. Fifty-seven patients underwent surgery, and 55 patients achieved R0 resection. There were no perioperative deaths. The rate of pathological complete response (pCR) was 31.58% (18/57) and major pathological response was 68.42% (39/57). The incidence of grade 3 and 4 adverse reactions was 21.21 and 1.54%, respectively. Conclusion Perioperative immunotherapy combined with chemotherapy followed by surgical resection for male patients with stage IIIA-IIIB LUSC was effective with a tolerable toxicity profile.

Immunotherapy, chemotherapy and surgery all have significant roles in the management of small-cell lung cancer (SCLC). Neoadjuvant immunotherapy combined with chemotherapy followed by surgery has shown encouraging efficacy for resectable SCLC with a good tolerability and considerable survival benefit. However, there are still few data on whether surgery for stage I-IIIA SCLC can be performed after immunotherapy with chemotherapy. Therefore, we investigated the safety and effectiveness of neoadjuvant immunotherapy combined with chemotherapy followed by surgery in patients with stage I-IIIA SCLC in the hope of adding new ideas to the treatment of SCLC.The study group comprised 19 patients with stage I-IIIA SCLC who received neoadjuvant immunotherapy and chemotherapy between 2019 and 2021. Patients received 2-4 cycles of immunotherapy combined with platinum-containing dual-drug chemotherapy (platinum + paclitaxel) before surgery. Imaging evaluation was performed every two cycles until surgery. Tumor response to neoadjuvant therapy, neoadjuvant treatment related adverse events, perioperative and postoperative complications, surgical resection rate, and degree of tumor regression were evaluated. We obtained follow-up data from the patients' regular examination or treatment in hospital. If we can't complete it, contacting patients by telephone or WeChat would be adopted by us. The follow-up was not terminated until 3 months after surgery.The objective response rate (ORR) was 84.2% (16/19), and no patients had progressive disease (PD). Of the 10 patients who underwent surgery, and approximately 9 (90.0%) had R0 resection. There were no perioperative deaths, and 1 case of pyothorax. The rate of pathological complete remission (pCR) and major pathological response (MPR) was 30.0% (3/10), and 40.0% (4/10) respectively. Grade 3-4 adverse reactions comprised 1 case of anemia and 1 case of constipation.Neoadjuvant immunotherapy combined with chemotherapy followed by surgical resection for patients with stage I-IIIA SCLC is effective and safe with a high ORR and MPR rate, as well as a high R0 resection rate and a tolerable toxicity profile. Whether this regimen gives a survival benefit should be confirmed by further follow-up and larger, randomized controlled trials are required to confirm our findings.

Objective Pleuroperitoneal communication (PPC) is an uncommon but serious complication of continuous ambulatory peritoneal dialysis (CAPD). At present, there are many kinds of treatment options, with different effects. We describe our single-institutional experiences in the minimally invasive surgery of pleuroperitoneal communication complicating continuous ambulatory peritoneal dialysis in detail. Methods Our study consecutively enrolled twelve pleuroperitoneal communication patients complicating CAPD. All patients underwent direct closure of the defective diaphragm and mechanical rub pleurodesis under video-assisted thoracoscopy. What’s more, pseudomonas aeruginosa injection was infused into the thoracic cavity postoperatively to further promote pleural adhesion, which was the innovation of our study. The follow-up date was not ended until termination of the study. Results After 1.0-8.3 months (mean: 3.6 months) of CAPD, all twelve patients occurred hydrothorax in the right side. And all these patients received surgery 7-179 days (mean: 38.3 days) after onset. The mean operation time was 63.4 min (range, 27–150 min). Bleblike lesions situated on the diaphragm were discovered in all patients and three patients also had obvious hole on the surface of diaphragm. Pseudomonas aeruginosa injection was infused into the thoracic cavity postoperatively, and three cases occurred fever with remission after 2–3 days of symptomatic treatment. The time from surgery to restarting CAPD ranged from 14 to 47 days, with an average of 22.3 days. There was no recurrence of hydrothorax and transformation to hemodialysis during the follow-up period (mean: 9.0 months). Conclusions Video-assisted thoracoscopic direct closure of the defective diaphragm and mechanical rub pleurodesis plus chemical pleurodesis using pseudomonas aeruginosa injection postoperatively is a safe and effective option for the treatment of pleuroperitoneal communication complicating continuous ambulatory peritoneal dialysis with 100% success rate.

Purpose This paper aims to establish a multi-input equilibrium manifold expansion (EME) model for gas turbine (GT). It proposes that the extension of model input dimension is realized based on similarity theory and affine structure in the framework of single-input EME model. The study aims to expand the scope of application of the EME model so that it can be used for the control or fault diagnosis of GTs. Design/methodology/approach In this paper, the concepts of corrected equilibrium manifold expansion (CEME) model and multi-cell equilibrium manifold expansion (MEME) model are first proposed. This paper uses theoretical analysis and simulation experiments to demonstrate the effectiveness of the bilayer equilibrium manifold expansion (BEME) model, which is a combination of the CEME and the MEME models. Simulation experiments include confirmatory experiments and comparative experiments. Findings The paper provides a new sight into building a multiple-input EME (MI-EME) model for GTs. The proposed method can build an accurate and robust MI-EME model that has superior performance compared with widely used nonlinear models including Wiener model (WM), Hammerstein model (HM), Hammerstein–Wiener model (HWM) and nonlinear autoregressive with exogenous inputs (NARX) network model. In terms of accuracy, the maximum error percentage of the proposed model is just 1.309%, far less than WM, HM and HWM. In terms of the stability of model calculation, the range of the mean error percentage of the proposed model is just a quarter of that of NARX network model. Originality/value The paper fulfills the construction of a novel multi-input nonlinear model, which has laid a foundation for the follow-up research of model-based GT fault detection and isolation or GT control.

OBJECTIVES To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for differentiation of benign and malignant thyroid nodules. METHODS A retrospective analysis of the conventional ultrasound and CEUS data of 388 nodules in 355 patients who had undergone thyroid nodule resection was conducted. All nodules had clear pathological results. The CEUS observation indexes included the enhancement degree in the arterial phase (no enhancement, scant punctate-linear enhancement, mild enhancement, moderate enhancement, and high enhancement) and wash-out patterns (rapid wash-out, slow wash-out, and isochronous wash-out). Chi-square test between groups and receiver operating characteristic curves (ROC) were used to determine the malignant (+1 point) and benign (-1 point) observation indexes that were statistically significant for the differentiation between benign and malignant thyroid nodules. The CEUS and C-TIRADS malignant and benign indexes were combined to score and draw the ROC curve, which was compared with the ROC curve scored by C-TIRADS alone to compare the diagnostic efficacy of the two methods for differentiating between benign and malignant thyroid nodules. RESULTS Among the CEUS observation indexes, mild enhancement and rapid wash-out were malignant indexes, while isochronous wash-out was a benign index. The best diagnostic cut-off value for the differentiation of benign and malignant thyroid nodules using the C-TIRADS score and the C-TIRADS and CEUS combined score (C-TIRADS + CEUS score) was 2. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the two methods were 79.97, 75.48, 82.9, 70.5%, and 89.7, 72.9, 83.3, 82.5%, respectively. The area under the curve values were 0.840 and 0.877 (P

Background Esophageal cancer (EC) is a malignant tumor with high mortality. Nomogram is an important tool used in clinical prognostic assessment. We aimed to establish a novel nomogram to predict the overall survival (OS) of EC patients after radical esophagectomy. Methods Data pertaining to the survival, demography, and clinicopathology of 311 EC patients who underwent radical esophagectomy were retrospectively investigated. The nomogram was established based on Cox hazard regression analysis. The calibration curves and Harrell's concordance index (C‐index) were used to verify the predictive accuracy and ROC curves were used to assess the efficacy of the nomogram. Kaplan–Meier curves showed the prognostic value of the related risk classification system. Pearson correlation test was performed to determine the correlation between the risk classification system and TNM staging. Results The median OS and 5‐year survival rates in the primary and validation cohorts were 44 months and 29.8%, and 52 months and 27.1%, respectively. We used six independent prognostic factors—age, Sex, AGR, PRL, N stage, and PNI—in the nomogram. The C‐index of nomogram was 0.75 and 0.70 in the primary and validation cohorts, respectively. Calibration curves indicated high consistency between actual and predicted OS. ROC curves showed that nomogram has a better efficacy compared with TNM staging in both cohorts. Patients were divided into three risk groups according to the total nomogram score, the median OS in each group was significantly different in both cohorts. Furthermore, the risk classification system was strongly correlated with the T and N staging system and exhibited a better OS prediction capability. Conclusions We established a novel and practical nomogram with a subordinate risk classification system to predict the OS of patients after radical esophagectomy. Compared with AJCC staging, this nomogram had preferable clinical capability in terms of individual prognosis assessment., We built and validated a novel nomogram to predict OS in radical esophageal cancer resection patients, the nomogram showed considerable prognostic capability especially compared with AJCC staging. Furthermore, a related risk classification system was generated for clinical evaluation.

BACKGROUND: This study aims to identify the feasibility of uniportal video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) compared with multiportal VATS in the resection of mediastinal lesions. METHODS: Patients who underwent mediastinal lesion resection were enrolled and allocated to the uni-VATS, tri-VATS, and RATS groups according to the surgical approach. Propensity score-matched (PSM) analysis was performed between the VATS and RATS groups as well as the uni-VATS and tri-VATS groups. The operative and recovery parameters were compared. RESULTS: Totally, 274 patients were enrolled. There was no difference in the operative parameters among the groups. Compared with multiportal VATS, uniportal VATS and RATS had a significantly shorter chest tube placement time (2.43±0.88 vs. 1.78±1.22 vs. 2.21±1.11 days, P

A number of kinesin proteins (KIFs) have been implicated in the development of multiple cancers. However, little is known about the expression and function of KIF15 in human breast cancer. Herein, we detected KIF15 expression in breast cancer tissues and paired adjacent normal tissues using immunohistochemistry and quantitative real-time polymerase chain reaction analysis, and the correlation of KIF15 expression with clinicopathological parameters was evaluated statistically. The role of KIF15 in cell proliferation, migration, tumor growth and metastasis of breast cancer cells was investigated in vitro and in vivo, and we explored potential molecular mechanisms underlying the effects of KIF15 in breast cancer through western blot analysis. The results revealed that increased KIF15 expression in breast cancer tissues were positively related with tumor size, lymph node metastasis and TNM stage, and higher KIF15 expression predicts a worse prognosis of patients with breast cancer. Furthermore, KIF15 knockdown markedly attenuated breast cancer cell proliferation, migration, tumor growth and metastasis in vitro and in vivo, and silenced KIF15 expression significantly inhibited the expression of phosphorylated AKT, phosphorylated JNK, and cyclin D1, while both p53 and p21 protein expressions were strongly enhanced. These results suggest that KIF15 is a potential oncogene in human breast cancer.

Although significant progress has been made in the treatment of lung cancer, it remains the leading cause of cancer‑associated mortality. Liriopesides B (LPB) is a natural product isolated from the tuber of Liriope platyphylla, whose effective substances have exhibited antitumor activity in several types of cancer. However, the functions of LPB in non‑small cell lung cancer (NSCLC) require further investigation. Therefore, the present study aimed to investigate whether LPB influences the pathogenic effects of NSCLC. In the present study, it was demonstrated that LPB reduced proliferation, and induced apoptosis and cell cycle arrest in non‑small cell lung cancer cells. CCK‑8 and colony formation assays demonstrated that LPB decreased cell viability and proliferation of H460 and H1975 cells in a dose‑dependent manner. Flow cytometry revealed that LPB significantly induced apoptosis of NSCLC cells, along with changes in the expression of apoptosis‑associated proteins, including an increase in Bax, caspase‑3, and caspase‑8 expression, and a decrease in Bcl‑2 and Bcl‑xl expression. LPB inhibited the progression of the cell cycle from the G1 to the S phase. Furthermore, autophagy was increased in cells treated with LPB. Finally, the expression of programmed death‑ligand 1 was significantly decreased by LPB. In conclusion, the results of the present study highlight a potential novel strategy for the clinical treatment of NSCLC.

This article aims to discuss the influence of compressor inlet guide vane (IGV) position on gas turbine switching control system gain tuning problem. The distinction between IGV and normally reckoned working conditions is differentiated, and an improved double-layer linear parameter varying (LPV) model is proposed to estimate the protected parameters under various IGV positions. Controller gain tuning is conducted with single and multi-objective intellectual optimization algorithms. Simulation results reveal that normally used multi-objective optimization procedure is unnecessary and time-consuming. While with the comprehensive indicator introduced in this paper, the calculation burden can be greatly eased. This improvement is especially advantageous when tuning work is carried out under multiple IGV positions.

Background Ex vivo lung perfusion (EVLP) is a relatively new technique that can be used to assess and repair the donor lungs, increasing the utilization of high-risk lungs. However, its effect on outcomes of lung transplantation patients is uncertainty. This meta-analysis is conducted to assess the impact of EVLP on donor lungs and outcomes of recipients compared with the standard lung transplantation. Material/methods We systematically searched for studies comparatively analyzing the efficacy of EVLP and standard cold storage in lung transplantation. The hazard ratio (HR), relative risk (RR), and weighted mean difference (WMD) were used as the effect size (ES) to evaluate the survival outcomes, categorical variables, and continuous variables respectively. Results A total of 20 published articles (including 2574 donors and 2567 recipients) were eligible. The chest x-ray manifestations and PaO₂/FiO₂ 100% were more deficient in the EVLP group than the standard group. EVLP improved the function of high-risk donor lungs with the conversion rate ranging from 34% to 100%. The EVLP group had a lower incidence of primary graft dysfunction 3, but longer intensive care unit stay. Other clinical outcomes between the 2 groups were similar. Conclusions The pooled results indicated that EVLP could be used to assess and improve high-risk donor lungs and had non-inferior postoperative outcomes compared with the standard cold storage. EVLP not only increased the utilization of marginal donors, but also could extend preservation time and reduce the total ischemia time of donors.

ObjectiveTo compare the long-term prognosis effects of non-esophagectomy and esophagectomy on patients with T1 stage esophageal cancer.MethodsAll esophageal cancer patients in the study were included from the National Surveillance Epidemiology and End Results (SEER) database between 2005-2015. These patients were classified into non-esophagectomy group and esophagectomy group according to therapy methods and were compared in terms of esophagus cancer specific survival (ECSS) and overall survival (OS) rates.ResultsA total of 591 patients with T1 stage esophageal cancer were enrolled in this study, including 212 non-esophagectomy patients and 111 esophagectomy patients in the T1a subgroup and 37 non-esophagectomy patients and 140 esophagectomy patients in the T1b subgroup. In all T1 stage esophageal cancer patients, there was no difference in the effect of non-esophagectomy and esophagectomy on postoperative OS, but postoperative ECSS in patients treated with non-esophagectomy was significantly better than those treated with esophagectomy. Cox proportional hazards regression model analysis showed that the risk factors affecting ECSS included race, primary site, tumor size, grade, and AJCC stage but factors affecting OS only include tumor size, grade, and AJCC stage in T1 stage patients. In the subgroup analysis, there was no difference in either ECSS or OS between the non-esophagectomy group and the esophagectomy group in T1a patients. However, in T1b patients, the OS after esophagectomy was considerably better than that of non-esophagectomy.ConclusionsNon-esophagectomy, including a variety of non-invasive procedures, is a safe and available option for patients with T1a stage esophageal cancer. For some T1b esophageal cancer patients, esophagectomy cannot be replaced at present due to its diagnostic and therapeutic effect on lymph node metastasis.

Background: Asymptomatic subacute thyroiditis (aSAT) without inflammatory features is often difficult to distinguish from papillary thyroid carcinoma (PTC), even with ultrasonography. Under certain circumstances, a fine-needle aspiration biopsy (FNAB) is performed, which is known to increase the patient’s physical pain. Objectives: To investigate the value of quantitative contrast-enhanced ultrasonography (CEUS) in discriminating aSAT from PTC nodules. Patients and Methods: A total of 30 aSAT and 23 PTC patients were systematically reviewed. Quantitative CEUS parameters, including the rise time (RT), time to peak (TTP), maximum intensity (IMAX), as well as their extension indicators (ΔRT and ΔTTP), were determined in various nodule areas (total, central, peripheral, and control regions of nodules). Chi-square test and independent-samples t-test were performed to compare significant differences between PTC and aSAT. A receiver operating characteristics (ROC) curve analysis was also performed to assess the diagnostic efficacy of each parameter, as well as diagnostic efficacy indices, including sensitivity and specificity, in discriminating aSAT from PTC nodules. Results: Compared to the PTC group, patients with aSAT had a longer ∆RT1 (RT of the control area − RT of the whole area; 0.12 ± 0.69 vs. -0.2 ± 0.57, P = 0.03) and ∆RT3 (RT of the control area − RT of the central area; 0.43 ± 0.72 vs. 0.04 ± 0.94, P = 0.049). Besides, compared to the PTC group, the aSAT group had a shorter RT in the total area (RT1: 4.05 ± 1.56 vs. 4.91 ± 2.09, P = 0.045); a shorter TTP in the total (TTP1: 4.91 ± 1.76 vs. 7.30 ± 3.92, P = 0.005), peripheral (TTP2: 5.06 ± 1.97 vs. 7.00 ± 3.48, P = 0.01), and central (TTP3: 4.90 ± 1.68 vs. 7.57 ± 4.41, P = 0.004) areas; and a lower IMAX in the peripheral area (IMAX2: 0.74 ± 0.36 vs. 1.09 ± 0.57, P = 0.009). Based on the ROC curve analysis, the area under the curve was significantly larger for TTP1 as compared to RT1 (P = 0.027). Conclusion: Conventional ultrasound and CEUS examinations were inadequate in distinguishing PTC from aSAT. Overall, a quantitative analysis may indicate more biological characteristics of nodules, which can be helpful in the differential diagnosis.

Schizandrin A (SchA) can be extracted from the vine plant Schisandra chinensis and has been reported to confer various biologically active properties. However, its potential biological effects on non‑small cell lung cancer (NSCLC) remain unknown. Therefore, the present study aims to address this issue. NSCLC and normal lung epithelial cell lines were first treated with SchA. Cell viability and proliferation were measured using CellTiter‑Glo Assay and colony formation assays, respectively. PI staining was used to measure cell cycle distribution. Cell cycle‑related proteins p53, p21, cyclin D1, CDK4, CDK6, cyclin E1, cyclin E2, CDK2 and DNA damage‑related protein SOX4 were detected by western blot analysis. Annexin V‑FITC/PI staining, DNA electrophoresis and Hoechst 33342/PI dual staining were used to detect apoptosis. JC‑1 and DCFH‑DA fluorescent dyes were used to measure the mitochondrial membrane potential and reactive oxygen species concentrations, respectively. Apoptosis‑related proteins caspase‑3, cleaved caspase‑3, poly(ADP‑ribose) polymerase (PARP), cleaved PARP, BimEL, BimL, BimS, Bcl2, Bax, caspase‑9 and cleaved caspas‑9 were measured by western blot analysis. Dansylcadaverine was used to detect the presence of the acidic lysosomal vesicles. The expression levels of the autophagy‑related proteins LC3‑I/II, p62/SQSTM and AMPKα activation were measured using western blot analysis. In addition, the autophagy inhibitor 3‑methyladenine was used to inhibit autophagy. SchA treatment was found to reduce NSCLC cell viability whilst inhibiting cell proliferation. Low concentrations of SchA (10‑20 µM) mainly induced G1/S‑phase cell cycle arrest. By contrast, as the concentration of SchA used increases (20‑50 µM), cells underwent apoptosis and G2/M‑phase cell cycle a13rrest. As the treatment concentration of SchA increased from 0 to 50 µM, the expression of p53 and SOX4 protein also concomitantly increased, but the expression of p21 protein was increased by 10 µM SchA and decreased by higher concentrations (20‑50 µM). In addition, the mRNA and protein expression levels of Bcl‑like 11 (Bim)EL, BimL and BimS increased following SchA application. SchA induced the accumulation of acidic vesicles and induced a marked increase in the expression of LC3‑II protein, suggsting that SchA activated the autophagy pathway. However, the expression of the p62 protein was found to be increased by SchA, suggesting that p62 was not degraded during the autophagic flux. The 3‑methyladenine exerted no notable effects on SchA‑induced apoptosis. Taken together, results from the present study suggest that SchA exerted inhibitory effects on NSCLC physiology by inducing cell cycle arrest and apoptosis. In addition, SchA partially induced autophagy, which did not result in any cytoprotective effects.

Transforming potentially resectable advanced esophageal squamous cell carcinoma (ESCC) into resectable ESCC through preoperative induction therapy is an important component of ESCC comprehensive treatment. Immune checkpoint inhibitor (ICI) therapy has been shown to have significant effects in the treatment of advanced ESCC, but its role in the neoadjuvant treatment of potentially resectable ESCC is unclear. This study aims to investigate the safety and effectiveness of camrelizumab combined with chemotherapy in the neoadjuvant treatment of ESCC.We recruited consecutive patients with potentially resectable ESCC who received preoperative camrelizumab in combination with chemotherapy. Data including demographic data, clinicopathological characteristics, neoadjuvant treatment regimens, lesion changes observed by imaging, and surgical details were retrospectively collected through specially designed forms. Toxic effects of neoadjuvant therapy on hematology, gastrointestinal tract, liver, kidney, skin, and thyroid were also collected. Imaging assessments were performed every 1-2 treatment cycles. Follow-up is based on the patient's regular admission to the hospital for examination and treatment, at least 3 months after surgery.A total of 66 patients with locally advanced ESCC were included in this study, including 8 patients with stage II, 29 patients with stage III, and 29 patients with stage IVA. The objective response rate (ORR) of the neoadjuvant immunotherapy combined with chemotherapy was 75.76% (50/66), and no one developed disease progression. A total of 60 patients underwent surgery, and the R0 resection rate was 98.3% (59/60). The pathological complete remission (pCR) rate and the major pathological response (MPR) rate was 6.7% (4/60) and 20% (12/60), respectively. There were 14 cases of treatment-related adverse reactions3, but no perioperative deaths occurred.Neoadjuvant immunotherapy combined with chemotherapy followed by surgical resection may be an available treatment for patients with locally advanced ESCC.

As one of the core components of gas turbines, the combustion system operates in a high-temperature and high-pressure adverse environment, which makes it extremely prone to faults and catastrophic accidents. Therefore, it is necessary to monitor the combustion system to detect in a timely way whether its performance has deteriorated, to improve the safety and economy of gas turbine operation. However, the combustor outlet temperature is so high that conventional sensors cannot work in such a harsh environment for a long time. In practical application, temperature thermocouples distributed at the turbine outlet are used to monitor the exhaust gas temperature (EGT) to indirectly monitor the performance of the combustion system, but, the EGT is not only affected by faults but also influenced by many interference factors, such as ambient conditions, operating conditions, rotation and mixing of uneven hot gas, performance degradation of compressor, etc., which will reduce the sensitivity and reliability of fault detection. For this reason, many scholars have devoted themselves to the research of combustion system fault detection and proposed many excellent methods. However, few studies have compared these methods. This paper will introduce the main methods of combustion system fault detection and select current mainstream methods for analysis. And a circumferential temperature distribution model of gas turbine is established to simulate the EGT profile when a fault is coupled with interference factors, then use the simulation data to compare the detection results of selected methods. Besides, the comparison results are verified by the actual operation data of a gas turbine. Finally, through comparative research and mechanism analysis, the study points out a more suitable method for gas turbine combustion system fault detection and proposes possible development directions.

Issues of gain scheduling control for aero-engines are addressed in this paper. An aero-engine is a system with high nonlinearity, and the requirement on controlling performance is high. Linear Parameter Varying (LPV) synthesis is commonly used to satisfy the requirements. However, the designing procedure of an LPV synthesis controller is complex, and may lead to undesirable design results when the variation rate of scheduling parameter is relatively fast. In this paper, an improved gain scheduling design procedure that can guarantee reliable stability and performance is developed. The method allows arbitrary variation of scheduling parameters, and is a modification for conventional LPV synthesis control. Special cases where traditional LPV synthesis control can still work are also discussed. The modified design procedure is evaluated on a small turbofan engine. Simulations show that for conditions where conventional scheduling fail to stabilize the plant, the proposed modification can ensure reliability and achieve desired performance.

Background: Esophageal cancer (EC) is a malignant tumor with dreadful mortality, nomogram is a prognosis tool of great significance in therapeutic guidance and assessment. We aimed to establish a newly-built nomogram for OS prediction of EC patients with radical esophagectomy.Methods: A total of 311 EC patients underwent radical esophagectomy were retrospectively investigated with their survival and demographic and clinicopathological data. Patients were randomly divided into the primary and validation cohorts. The establishment of nomogram was based on Cox hazard regression analysis in primary cohort, the calibration curves and Harrell’s concordance index were performed to verify the predictive accuracy while ROC curves was adopted to reflect the efficacy of nomogram. Kaplan–Meier curves showed the clinical significance of risk classification system and Pearson correlation test was utilized to show the correlation between risk classification system and TNM staging.Results: The median OS and 5-year survival rate are 44 months and 29.8% in primary cohort. In validation cohort, they are 52 months and 27.1%, respectively. In Cox hazard regression analysis, we extracted six independent prognostic factors—age, gender, AGR, PRL, N stage, PNI—to establish the nomogram. The C-index of nomogram is 0.75 in primary cohort and 0.70 in validation cohort. Calibration curves indicated high consistency between accurate and predicted OS in both primary and validation cohorts. ROC curves showed a better efficacy of nomogram compared with AJCC T and N stage. The area under curve (AUC) of primary cohort is 0.801 and 0.727 in validation cohort. Patients in primary cohort were divided into three risk groups according to the nomogram score, the median OS between each group was significantly different. Analogical results were obtained in validation cohort. Furthermore, the risk classification system was strongly correlated to AJCC TNM staging system in total cohort (r2=0.647, PConclusions: We established a neotype nomogram and a relevant risk classification system with verified accuracy and efficacy in OS prediction of EC patients after radical esophagectomy. They may provide feasible value in prognosis assessment and treatment guidance prospectively.

During recent decades, the equilibrium manifold expansion (EME) model has been considered as a powerful identification tool for complex industrial systems with the aim of system control and simulation. Based on a two-step “dynamic and static” identification method, an approximate nonlinear state-space model is built by using multiple polynomials. However, the existing identification method is only suitable for single-input (SI) systems, but not for multi-input (MI) systems, where EME models cannot guarantee global calculation stability. For solving such a problem, this paper proposes a corrected equilibrium manifold expansion (CEME) model based on gas turbine prior knowledge. The equilibrium manifold is extended in dimension by introducing similarity equations instead of the high dimensional polynomial fitting. The dynamic similarity criterion of similarity theory guarantees the global stability of the CEME model. Finally, the comparative test between the CEME model and the existing MI-EME model is carried out through case studies involving data that are generated by a general turbofan engine simulation. Simulations show superior precision and calculation stability of the proposed model in capturing nonlinear behaviors of the gas turbine engine.

In this paper a novel fault detection, isolation, and identification (FDI&amp, E) scheme using a coupling diagnosis method with the integration of the model-based method and unsupervised learning algorithm is proposed and developed for monitoring gas turbine sensor faults, which represents an integration of Square Root Cubature Kalman Filters (SRCKF) and an improved Density-Based Spatial Clustering of Application with Noise (DBSCAN) algorithm. A detection indicator produced by SRCKF with a specific hypothesis is used for extracting sensor fault features against process and measurement noise, as well as operating conditions. Then, an improved DBSCAN is implemented based on a voting scheme to detect and isolate the faulty sensors. Finally, a residual-based fault estimation scheme is proposed to track sensor fault evolution and help to judge the types of faults. Moreover, the observability of the model involved is analyzed to verify the stable operation of the FDI&amp, E scheme. Various experiments for single and concurrent sensor fault scenarios in a dual-spool gas turbine prototype during a whole flight mission are conducted to demonstrate the effectiveness of the proposed FDI&amp, E scheme. Moreover, comparative studies confirm the superiority of our proposed FDI&amp, E scheme than the existing methods in terms of promptness and robustness of the sensor FDI.

Background Although lobectomy with mediastinal lymph node dissection (MLND) is the first option for early-stage non-small cell lung cancer (NSCLC) patients, the time trends of MLND in stage IA NSCLC patients who undergo a lobectomy are not clear still. Methods We included stage IA NSCLC patients who underwent lobectomy or lobectomy with MLND between 2003 and 2013 in the SEER database. The time trend of MLND was compared among patients who underwent a lobectomy. Results For stage T1a patients, the lobectomy group and lobectomy with MLND group had no differences in postoperative overall survival (OS) (P = 0.34) or lung-cancer specific survival (LCSS) (P = 0.18) between 2003 and 2013. For stage T1b patients, the OS (P = 0.01) and LCSS (P = 0.01) were different between the lobectomy group and the lobectomy with MLND group in the period from 2003 to 2009; however, only OS (P = 0.04), not LCSS (P = 0.14), was different between the lobectomy group and the lobectomy with MLND group between 2009 and 2013. For T1c patients, the OS (P = 0.01) and LCSS (P = 0.02) were different between the two groups between 2003 and 2009 but not between 2009 and 2013 (P = 0.60; P = 0.39). From the Cox regression analysis, we found that the factors affecting OS/LCSS in T1b and T1c patients were age, sex, year of diagnosis, histology, and grade, in which year of diagnosis was the obvious factor (HR = 0.79, CI = 0.71–0.87; HR = 0.73, CI = 0.64–0.84). Conclusions There was a time trend in prognosis differences between the lobectomy group and lobectomy with MLND group for T1b and T1c stage NSCLC patients.

The incidence of papillary thyroid carcinomas (PTCs) has increased rapidly during the past several decades. Until now, the mechanisms underlying the tumorigenesis of PTCs have remained largely unknown. Next-generation-sequencing (NGS) provides new ways to investigate the molecular pathogenesis of PTCs. To characterize the somatic alterations associated with PTCs, we performed whole-exome sequencing (WES) of PTCs from 23 Chinese patients. This study revealed somatic mutations in genes with relevant functions for tumorigenesis, such as BRAF, BCR, CREB3L2, DNMT1, IRS2, MSH6, and TP53. We also identified novel somatic gene alterations which may be potentially involved in PTC progression. Gene set enrichment analysis revealed that the cellular response to hormone stimulus, epigenetic modifications, such as protein/histone methylation and protein alkylation, as well as MAPK, PI3K-AKT, and FoxO/mTOR signaling pathways, were significantly altered in the PTCs studied here. Moreover, Protein-Protein Interaction (PPI) network analysis of our mutated gene selection highlighted EP300, KRAS, PTEN, and TP53 as major core genes. The correlation between gene mutations and clinicopathologic features of the PTCs defined by conventional ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) were assessed. These analyses established significant associations between subgroups of mutations and respectively taller-than-wide, calcified, and peak time iso- or hypo-enhanced and metastatic PTCs. In conclusion, our study supplements the genomic landscape of PTCs and identifies new actionable target candidates and clinicopathology-associated mutations. Extension of this study to larger cohorts will help define comprehensive genomic aberrations in PTCs and validate target candidates. These new targets may open methods of individualized treatments adapted to the clinicopathologic specifics of the patients.

Primary lung cancer and metastatic lung cancer are common malignant tumors of the lung and are the main cause of cancer-related death. Advanced lung cancer and lung metastatic cancer are mainly treated by systemic therapy, and local treatment is also an effective treatment for the refractory or recurrent lesions in the lungs after systemic treatment. ¹²⁵I radioactive particle implantation, as an efficient conformal radiotherapy, has a certain control effect on localized lung cancer. The purpose of this study was to investigate the clinical efficacy and safety of computed tomography (CT) guided percutaneous puncture of lung tissue with ¹²⁵I radioactive particle implantation in the treatment of advanced lung cancer and lung metastatic cancer.Continuouslycollectedthe clinical and pathological data of 105 patients with advanced lung cancer and metastatic lung cancer treated by ¹²⁵I radioactive seed implantation in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2014 to November 30, 2018. The patients were followed until March, 2019. The clinical efficacy and complications of seedimplantation were analyzed.A total of 105 patients were included in the study, 78 patients with advanced lung cancer and 27 patients with lung metastases. The median survival time after seed therapy was 395 days. The 1-year survival rate was about 78.1%, and the 2-year survival rate was about 56.1%. Seed implantation for advanced lung cancer is equivalent to lung metastasis. Seed combined with radiofrequency ablation, microwave ablation, and chemotherapy did not improve seed treatment. However, particle combined with external radiation therapy has a significant survival disadvantage compared with simple seed therapy.The CT-guided ¹²⁵I radioactive seed implantation has controllable complications and can be used as a safe and effective treatment for advanced lung cancer and lung metastases.【中文题目：CT引导下¹²⁵I粒子植入术对晚期肺癌及肺转移癌的治疗作用】 【中文摘要：背景与目的 原发性肺癌及肺转移癌均为常见肺部恶性肿瘤，是主要的癌症相关死亡原因。晚期肺癌及肺转移癌以全身治疗为主，局部治疗对全身治疗后肺部残存的顽固性病灶或复发病灶为一种有效治疗手段。¹²⁵I放射性粒子植入作为一种高效的适形放疗，对肺部局限性癌灶具有一定的控制作用。本研究旨在探讨计算机断层扫描（computed tomography, CT）引导下经皮穿刺肺组织间¹²⁵I放射性粒子植入治疗晚期肺癌和肺转移癌的临床效果及安全性。方法 连续性收集2014年1月1日-2018年11月30日浙江大学医学院附属第一医院胸外科行¹²⁵I放射性粒子植入术治疗的105例晚期肺癌和肺转移癌患者的临床病理资料，术后随访至2019年3月。观察粒子植入术的临床疗效及并发症发生情况。结果 本研究共纳入105例患者，晚期肺癌患者78例，肺转移癌患者27例。粒子治疗患者术后中位生存时间为395天，术后1年生存率约为78.1%，术后2年生存率约为56.1%。粒子植入治疗晚期肺癌的效果与肺转移癌的效果相当。粒子联合射频消融、微波消融、化疗并没有提高粒子治疗效果。但是粒子联合外放射治疗较单纯粒子治疗具有显著生存劣势。结论 CT引导下¹²⁵I放射性粒子植入术并发症可控，可以作为晚期肺癌和肺转移癌的一种安全有效的治疗方法。】 【中文关键词：¹²⁵I粒子；晚期肺癌；肺转移癌；临床评价】.

The study aimed to explore whether cancer-related pain and opioids use are associated with the survival of cancer patients, and perform a cohort study and a meta-analysis to quantify the magnitude of any association. A retrospective cohort study was performed to analyze the impact of pain level, and opioids use on cancer-specific survival (CSS) in advanced cancer patients. Patients and relevant medical records were selected from the registry of the Radiation and chemotherapy division of Ningbo First Hospital between June 2013 and October 2017. Hazard ratios (HRs) and 95% confidential intervals (CIs) for CSS by opioids use were calculated by univariate and multivariate Cox regression analyses. The systematic review included relevant studies published before October 2018. The combined HRs and 95% CIs for overall survival (OS) and progression-free survival (PFS) were calculated using random-effect models. A total of consecutive 203 cancer patients were included in the cohort study. Kaplan–Meier curves indicate a negative association between CSS and cancer-related pain or opioids requirement, but less evidence of an association with the dose of opioids use. Multivariate models revealed that the pain level and opioids requirement were associated with shorter CSS, after adjusting for significant covariates. The results of the meta-analysis indicated that postoperative opioids use had a poor effect on PFS, and opioids use for cancer-related pain was associated with poor OS in cancer patients, while intraoperative opioids use was not associated with cancer survival. We concluded that cancer-related pain and opioids requirements are associated with poor survival in advanced cancer patients, and postoperative opioids use and opioids use for cancer-related pain may have an adverse effect on the survival of cancer patients.

Aims: SQSTM1/p62, as an autophagy marker, is a key molecule involved in the autophagy process. Recent studies have demonstrated that p62 has a close relationship with tumorigenesis and progression, but the impact of p62 on patients' survival has not been comprehensively understood. Therefore, we conducted this study to assess the expression level of p62 in tumor cells and the prognostic role of p62 expression in various malignant tumors. Methods: We searched PubMed, PubMed Central (PMC), Embase, Ovid and Web of Science databases and identified 30 eligible studies containing 14,072 patients to include in the meta-analysis. The p62 mRNA and protein expression profiles in various tumor tissues and normal tissues were presented according to the Human Protein Atlas (HPA) and the Gene Expression Profiling Interactive Analysis (GEPIA). We also tested the association between p62 mRNA level and patients' survival based on the Cancer Genome Atlas (TCGA) and the Human Protein Atlas (HPA) databases. Results: The expression levels of p62 mRNA and protein varied in different tissues. The p62 proteins were elevated and mainly located in the cytoplasm in some types of tumor compared with the normal tissues. The pooled results indicated that p62 overexpression in tumor tissues was associated with a worse prognosis. In the subgroup analysis, a significant relationship was observed between cytoplasmic p62 accumulation and both overall survival (HR 1.53, 95% CI: 1.03-2.27, P < 0.05) and disease-specific survival (HR 1.60, 95% CI: 1.15-2.24, P < 0.01). The relationship between p62 and worse survival was more evident in early stage tumors. P62 mRNA expression had no significant effect on the patient's survival except of liver cancer. Conclusions: The findings of this meta-analysis highlight the role of p62 as a useful prognostic biomarker for some types of tumor according to different clinicopathologic features, which may contribute to the selection of effective treatment methods for different malignant tumors.

Data-driven model has been employed as a powerful tool for identification of complex industrial systems with nonlinear dynamics, such as gas turbines (GT). In this study, a methodology based on data and prior knowledge fusion was developed to improve the equilibrium manifold expansion model to be a multi-input-multi-output (MIMO) model for offline system identification of a two-spool gas turbine. The methodology is evaluated through a case study involving data that are generated by general gas turbine simulation. Simulations show good precision of the proposed model in capturing the nonlinear behavior of the gas turbine.

Objective: Esophagectomies are associated with high mortality and various complications. Previous studies reported on the short-term outcomes were heterogeneous and inconsistent in comparing minimally invasive esophagectomy (MIE) with traditional open esophagectomy (OE). The objective of this study is to compare the short-term outcomes between MIE and OE calculated using Comprehensive Complication Index (CCI) which incorporates all complication severities. Materials and Methods: We did expertise-based randomized controlled trial from September 2014 to October 2015. A total of 144 patients with resectable cancer were randomly selected to be treated by OE or MIE. The CCI was calculated using the Clavien-Dindo classification grade of all postoperative complications collected. Demographic characteristics, preoperative clinical assessment, postoperative complications, and CCI of patients were compared between both groups. Results: Among the 144 patients included in this study, 97 underwent OE and 47 underwent MIE. Demographics, preoperative clinical assessment, and inpatient mortality in both cohorts were almost identical. Eighty-four patients (86.6%) of OE group and 26 patients (55.3%) of MIE group suffered from complications. A significant difference was observed in blood transfusion (P = 0.04), moderate and severe pain (P < 0.01), and diarrhea (P = 0.03) between two groups. There was an obvious statistical significance of CCI between OE and MIE groups (P = 0.036). Conclusions: The CCI is a promising scoring system that could be used to assess the severity of complications after esophagectomy. MIE could improve the short-term outcomes by reducing some mild and moderate complications.

Hot components operate in a high-temperature and high-pressure environment. The occurrence of a fault in hot components leads to high economic losses. In general, exhaust gas temperature (EGT) is used to monitor the performance of hot components. However, during the early stages of a failure, the fault information is weak, and is simultaneously affected by various types of interference, such as the complex working conditions, ambient conditions, gradual performance degradation of the compressors and turbines, and noise. Additionally, inadequate effective information of the gas turbine also restricts the establishment of the detection model. To solve the above problems, this paper proposes an anomaly detection method based on frequent pattern extraction. A frequent pattern model (FPM) is applied to indicate the inherent regularity of change in EGT occurring from different types of interference. In this study, based on a genetic algorithm and support vector machine regression, the relationship model between the EGT and interference was tentatively built. The modeling accuracy was then further improved through the selection of the kernel function and training data. Experiments indicate that the optimal kernel function is linear and that the optimal training data should be balanced in addition to covering the appropriate range of operating conditions and ambient temperature. Furthermore, the thresholds based on the Pauta criterion that is automatically obtained during the modeling process, are used to determine whether hot components are operating abnormally. Moreover, the FPM is compared with the similarity theory, which demonstrates that the FPM can better suppress the effect of the component performance degradation and fuel heat value fluctuation. Finally, the effectiveness of the proposed method is validated on seven months of actual data obtained from a Titan130 gas turbine on an offshore oil platform. The results indicate that the proposed method can sensitively detect malfunctions in hot components during the early stages of a fault, and is robust to various types of interference.

Vegetation effectively prevents soil erosion. However the relationship between plant diversity and soil erosion remains ambiguous under various environmental conditions. To explore the role that plant diversity plays in soil erosion, this study was conducted in the Three-River-Source region, located in the hinterlands of the Qinghai–Tibet Plateau, China. After examining 99 plots within the study area, and analyzing the soil 137Cs inventory within the plots, we found that with a greater number of plants distributed within an aggregation pattern, there was greater interception of the soil particles by the vegetation patch. This phenomenon results in a more developed vegetation patch that can support greater vegetation coverage and higher plant diversity than it previously could. Although a positive correlation exists between plant diversity and vegetation coverage, the relationship between the extent of soil erosion and plant diversity is modulated by the vegetation pattern. When plants are distributed in a relatively homogeneous pattern, vegetation coverage decreases with increasing plant diversity, which leads to increased soil erosion. When plants are distributed between a homogenous and a heterogeneous pattern, no relationship is found between plant diversity and soil erosion. With a heterogeneous plant distribution, vegetation coverage increases with plant diversity, and soil erosion is inhibited under such conditions.