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Abstract Background Residential mobility is believed to influence the occurrence and development of cancer; however, the results are inconclusive. Furthermore, limited studies have been conducted on Asian populations. This study aimed to evaluate the relationship between residential mobility and liver cancer risk among Chinese women. Methods We enrolled 72,818 women from urban Shanghai between 1996 and 2000, and then followed them until the end of 2016. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the association between residential mobility and liver cancer risk. A linear trend test was conducted by ranking variables. A sensitivity analysis was also conducted, excluding participants with follow-up times of less than 2 years, to prevent potential bias. Results During the 1,269,765 person-years of follow-up, liver cancer was newly diagnosed in 259 patients. Domestic migration (HR = 1.47, 95% CI, 1.44–1.50), especially immigration to Shanghai (HR = 1.47, 95% CI, 1.44–1.50) was associated with an increased risk of liver cancer. In addition, migration frequency, age at initial migration and first immigration to Shanghai had linear trends with an increased liver cancer risk (P trend

For the force problem of the flexible thin-walled bearing in harmonic reducers, the inadequacy of the previous single-factor analysis of the bearing is analyzed； and in order to explore the influence of other components on the bearing force of the shaft, theoretical analysis is conducted through the whole machine model, the deformation of the flexible wheel and the coordination process of the raceway roller deformation are explored, and the force state of the thin-walled flexible bearing is obtained as a whole. By verifying the stress and deformation of the whole machine model by Workbench software, the results show that the force state of the bearing simulation is consistent with the theoretical calculation.

Abstract Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by the infiltration of inflammatory cells and demyelination of nerves. Mitochondrial dysfunction has been implicated in the pathogenesis of MS, as studies have shown abnormalities in mitochondrial activities, metabolism, mitochondrial DNA (mtDNA) levels, and mitochondrial morphology in immune cells of individuals with MS. The presence of mitochondrial dysfunctions in immune cells contributes to immunological dysregulation and neurodegeneration in MS. This review provided a comprehensive overview of mitochondrial dysfunction in immune cells associated with MS, focusing on the potential consequences of mitochondrial metabolic reprogramming on immune function. Current challenges and future directions in the field of immune-metabolic MS and its potential as a therapeutic target were also discussed.

Summary: Background: Previous metabolic profiling of liver cancer has mostly used untargeted metabolomic approaches and was unable to quantitate the absolute concentrations of metabolites. In this study, we examined the association between the concentrations of 186 targeted metabolites and liver cancer risk using prediagnostic plasma samples collected up to 14 years prior to the clinical diagnosis of liver cancer. Methods: We conducted a nested case–control study (n = 322 liver cancer cases, n = 322 matched controls) within the Shanghai Men's Health Study. Conditional logistic regression models adjusted for demographics, lifestyle factors, dietary habits, and related medical histories were used to estimate the odds ratios. Restricted cubic spline functions were used to characterise the dose–response relationships between metabolite concentrations and liver cancer risk. Findings: After adjusting for potential confounders and correcting for multiple testing, 28 metabolites were associated with liver cancer risk. Significant non-linear relationships were observed for 22 metabolites. The primary bile acid biosynthesis and phenylalanine, tyrosine and tryptophan biosynthesis were found to be important pathways involved in the aetiology of liver cancer. A metabolic score consisting of 10 metabolites significantly improved the predictive ability of traditional epidemiological risk factors for liver cancer, with an optimism-corrected AUC increased from 0.84 (95% CI: 0.81–0.87) to 0.89 (95% CI: 0.86–0.91). Interpretation: This study characterised the dose–response relationships between metabolites and liver cancer risk, providing insights into the complex metabolic perturbations prior to the clinical diagnosis of liver cancer. The metabolic score may serve as a candidate risk predictor for liver cancer. Funding: National Key Project of Research and Development Program of China [2021YFC2500404, 2021YFC2500405]; US National Institutes of Health [subcontract of UM1 CA173640].

The formation of an internal fistula between the biliary system and the gastrointestinal tract is a rare condition with various etiologies, predominantly associated with recurrent chronic inflammation of the biliary system and tumors. Patients with this condition may lack specific clinical manifestations, presenting with symptoms such as abdominal pain, fever, jaundice, or may show no clinical signs at all. Common types of internal fistulas include cholecystoduodenal fistula, cholecystocolonic fistula, and choledochoduodenal fistula. Among these, the right hepaticoduodenal fistula is extremely rare and seldom reported in clinical literature. We herein report a case of right hepaticoduodenal fistula and analyze its mechanism, treatment principles, and preventive measures through a literature review.

Aiming at the problem of energy consumption caused by the asymmetric hub bearing friction and in order to more accurately analyze the influence of structural parameters on the friction torque, an improved analysis model of friction torque of asymmetric hub bearing considering pretightening force is established and verified by experiments, by using the coordinate transformation method. Assuming that the structural parameters of the right row of asymmetric hub bearings remain unchanged, the influence of the structural parameters of the left row (main bearing row) on the bearing friction torque is studied. The results show that there is an optimal overturning moment to minimize the friction moment of asymmetric hub bearings. With the increase of center distance, when the overturning moment is less than the optimal overturning moment, the friction moment of asymmetric hub bearings increases, and when the overturning moment is greater than the optimal overturning moment, the friction torque of asymmetrical hub bearings decreases. The friction torque of asymmetrical hub bearings decreases when the curvature radius coefficient of left row groove and the number of steel balls of left row are appropriately increased. The friction torque of asymmetrical hub bearings increases when the diameter of the left row of pitch circle and the diameter of the left row of steel ball of asymmetrical hub bearings increase. When overturning moment M1 is equal to 30 000 N·mm, the influence weights of left row structural parameters of asymmetric hub bearings on friction torque are as follows: curvature radius coefficient of the left row groove is greater than the number of steel balls in the left row; the number of steel balls in the left row is greater than the diameter of the pitch circle in the left row; the diameter of the pitch circle in the left row is greater than the diameter of steel balls in left row; the diameter of steel balls in left row is greater than the center distance.

Considering misalignment angles will appear during the actual installation of angular contact ball bearings and truncated contact ellipse will be produced due to bearing excessive external load, a bearing limit bearing capacity analysis model containing misalignment angle is put forward. By improving the algorithm, the number of equations and the difficulty of solving the model are reduced. Then the correctness of the algorithm is verified by comparing it with literature and Romax software. Finally, the angular contact ball bearing 7008C is taken as the research object and the influence of different parameters on the ultimate load carrying capacity is analyzed. The results show that increasing the misalignment angle and radial force, increasing the number of rolling elements, and reducing the diameter of rolling elements will weaken the ultimate axial force and the ultimate overturning moment to a certain extent, and increasing the curvature radius coefficient and shoulder height can significantly improve the ultimate axial force and the ultimate overturning moment. However, the minimum shoulder height restricts the bearing ultimate load carrying capacity.

Aiming at the RV reducer spindle force problem, and based on the Romax force analysis of the main bearing, it is found that due to the different magnitude and span of the impact parameters, the influence degree of each parameter on the spindle bearing force cannot be determined. Based on this, a fuzzy comprehensive evaluation method is proposed. The results show that the number of cycloidal wheel pins and the radius of cycloidal wheel pitch have the greatest influence on the force of the main bearing. The entropy weight method and grey relational degree are used to verify the influence degree of each parameter on the bearing capacity of the spindle. The results obtained by the fuzzy comprehensive evaluation method are consistent with the results obtained by the entropy weight method and grey relational analysis method, which verify the effectiveness of the fuzzy comprehensive evaluation method.

The value of CT-guided puncture with methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses was explored. A total of 113 patients with 146 nodules and masses were treated with methylene blue mixed with autologous blood for preoperative localization and thoracoscopic surgery in the Department of Thoracic Surgery, the First Affiliated Hospital of Fujian Medical University between October 2021 and October 2022. The localization effect, complications, and pathological conditions were observed. The localization success rate was 98.63% (144/146). The localization failed nodules and masses could still be located by looking for needle eyes and reading films. The whole group successfully completed thoracoscopic surgery. The average interval of operation after puncture was 22.16 ± 6.22 h. There was a small amount of suspicious hemothorax after puncture. There was no pneumothorax after puncture in the whole group. There were no hemoptysis, irritating dry cough, and other reactions. The overall complication rate was 2.65%, and no special treatment was given. It is safe and effective to use methylene blue mixed with autologous blood for CT-guided preoperative puncture and localization of small pulmonary nodules and masses.

For solving the problems of poor structural stability and machining difficulties of non-metallic insulating rings in space conductive slip rings, Al2O3 ceramic coatings were deposited on 2A12 aluminum alloy substrate by atmospheric plasma spraying technology to replace non-metallic insulating materials, and the phase composition, microscopic morphology, microhardness, bonding strength, and insulation performance of the coating were studied. Results showed that the main phase of Al2O3 spherical powder prepared by agglomeration sintering of original nanoparticles was α-Al2O3. After spraying, Al2O3 in the coating existed as α phase and γ phase, and the coating bonded well with the substrate, and the porosity of the coating was relatively lower. Moreover, the as-prepared coating had a uniform and dense microstructure, with no obvious macroscopic cracks or large pores inside the coating. Although no sealing treatment was used, the coating still presented high insulation performance in insulation resistance tests with a DC voltage of 1 000 V in atmospheric environments, which could meet the service requirements of space conductive slip ring insulating rings.

The refinement of thyroid surgery has become a standardized requirement and a symbol of improved technical level in thyroid surgery. Endoscopic equipment magnifies the surgical field of view in high definition, making it more conducive to perform the surgery meticulously. Here we explored the key points of refined surgery based on the technical points of endoscopic thyroid surgery. We also focused on the establishment of endoscopic operation space, exposure of thyroid tumors, and protection of key organs and tissues. With regard to the establishment of endoscopic operation space, the separation of subcutaneous layer should show the view of “red sky and yellow ground”, which means the gap between the platysma muscle and the deep layer of the superficial fascia. The subcutaneous dissection area should be present as “long tunnel, small cavity”, and the shape from the bilateral sternoclavicular joints to the bilateral areola, which seems like the fan-shape with “thin neck and wide bottom”. With regard to the exposure of thyroid tumors, the key technical points include the dissociating and traction of anterior cervical muscles. Three spaces [the median space (the white line space of the neck), the inner space (the space between the thyroid surgical capsule and the anterior cervical muscles) and the outer space (the space between the anterior cervical muscles and the sternocleidomastoid muscle)] need to be fully dissociated. Furthermore, the assistant with special sutures or hooks to fully dissociate the anterior cervical space and the use of a reasonable grasping method as well as a suitable energy platform to prevent thyroid bleeding. With regard to the protection of key organs and tissues, nerve monitoring technology helps to find and locate the recurrent laryngeal nerve. In addition, careful manipulation at the entrance to the larynx is the key to avoid the damage of recurrent laryngeal nerve. Lymph negative imaging techno-logy helps to identify the parathyroid gland. Accurate identification of the anatomical type of the parathyroid gland and meticulous dissection of the intermembrane space of the parathyroid gland is benefit to protect the blood supply of the parathyroid gland in situ. To achieve the refinement and minimally invasive surgery, it is necessary to improve the surgical instruments and materials. What is more important, surgeons should update their surgical concepts, be well acquainted with anatomical relationships and constantly improve surgical techniques.