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The occurrence and development of severe novel Coronavirus pneumonia (COVID-19) follows the pathogenesis characteristics and transmission law of the pestilential diseases, "pathogenic warm attacks the lungs first, and goes to the pericardium reversely", which belongs to the category of "wrongly-treated pattern" or "unfavorable pattern". The disease progressed rapidly. At first, the epidemic virus invaded the lungs, then blocked the lungs, leading to the critical stage of inner blocking causing collapse. Modern medicine believes that severe disease involves a series of pathophysiological changes, such as viral damage, immune inflammatory response, endothelial cell damage, thrombosis, and renin-angiotensin-aldosterone system (RAAS) disorders. Regarding the treatment of severe COVID-19, the first proposal is to prevent the occurrence of severe disease, When necessary, it is not limited to wee (defense), qi, ying (nutrient) and blood levels. and prior treatment should be given before development of patterns ; This article summarizes the role and value of the methods of detoxification and cooling blood, purging the lungs and opening the bowels, and strengthening spleen and eliminating dampness in the treatment of severe COVID-19. In combination with modern medical research, the possible mechanism of action of the above three treatments was also analyzed. [ABSTRACT FROM AUTHOR]

The small modular helium-xenon cooled reactor has the advantages of simple and compact system structure, short construction cycle, light weight and small volume, which is very suitable for energy supply in remote area and small nuclear propulsion device. The research on accident characteristics and protection control strategies is very important to ensure the safe and reliable operation of the reactor system and mitigate the consequences of the accident. Therefore, the safety characteristics analysis program of helium-xenon cooled reactor system is developed based on Modelica language, and the transient verification of typical working conditions is carried out. The maximum relative error of the verification results was 7.91 %. Through the program, the unprotected transient conditions and corresponding protection control strategy transient conditions of external load loss accident, partial loss of heat sink accident, main valve accidental closing accident and Brayton unit efficiency step decline accident are simulated. The results show that the loss of all external loads will lead to rotation speed overspeed. The introduction of negative reactivity or bypass control can effectively control the rotation speed rise, but the introduction of negative reactivity is better than bypass control. Under unprotected control, the partial loss of the heat sink, the accidental closing of the main valve and the step down of the Brayton unit efficiency will all lead to the rapid decline of the rotation speed and mass flow rate, and there is a risk of the reactor temperature exceeding the limit. The rotation speed and mass flow rate can be effectively stabilized by load following to prevent the temperature exceeding the limit. • Analyzed the unprotected characteristics of helium-xenon reactor system under various accidents. • Provide parameter basis for accident identification. • Design protection and control strategies for different accident conditions. • Analyzing the transient characteristics and effectiveness of protection and control strategies. [ABSTRACT FROM AUTHOR]

The decipherment of ancient Chinese scripts, such as oracle bone and bronze inscriptions, holds immense significance for understanding ancient Chinese history, culture, and civilization. Despite substantial progress in recognizing oracle bone script, research on the overall recognition of ancient Chinese characters remains somewhat lacking. To tackle this issue, we pioneered the construction of a large-scale image dataset comprising 9233 distinct ancient Chinese characters sourced from images obtained through archaeological excavations. We propose the first model for recognizing the common ancient Chinese characters. This model consists of four stages with Linear Embedding and Swin-Transformer blocks, each supplemented by a CoT Block to enhance local feature extraction. We also advocate for an enhancement strategy, which involves two steps: firstly, conducting adaptive data enhancement on the original data, and secondly, randomly resampling the data. The experimental results, with a top-one accuracy of 87.25% and a top-five accuracy of 95.81%, demonstrate that our proposed method achieves remarkable performance. Furthermore, through the visualizing of model attention, it can be observed that the proposed model, trained on a large number of images, is able to capture the morphological characteristics of ancient Chinese characters to a certain extent. [ABSTRACT FROM AUTHOR]

• A natural circulation system was established using the revised system analysis program. • Study the influence of the height difference between the hot and cold sections and the hydraulic diameter of the pipeline on the mass flow rate of natural circulation. • Analyze helium xenon mixture gas's residual heat removal characteristics through the revised helium xenon system characteristic analysis program Thank you for your suggestions. Helium-Xenon (He-Xe) gas mixtures are characterized by stable physical properties, easy compression, and excellent thermodynamic performance, making them suitable for thermal cycle coolant for underwater reactors. Due to the unattended deep sea, and harsh and complex operating environment, the residual heat removal characteristics are directly related to reactors' safety characteristics and stable and reliable operation ability. Therefore, studying the He-Xe gas mixture residual heat removal characteristics can provide an essential guarantee for reactor safety analysis. This article optimizes the physical property calculation model of the He-Xe gas mixture in the Brayton Cycle Reactor System Analysis Program (BRESA) and obtains a system property analysis program suitable for calculating the natural circulation of the He-Xe gas mixture. And a natural circulation system for the He-Xe mixed gas cooling reactor was constructed using the modified BRESA. Numerical calculations and theoretical analysis were conducted on the He-Xe gas mixture's natural circulation flow process and residual heat removal characteristics. The study of the transient factors of temperature, flow rate, and other related parameters in the system circuit found that when the reactor is shut down, relying on the natural circulation system can effectively output the residual heat of the reactor core to ensure reactor safety. The relevant research results have important theoretical and scientific significance for the safety assessment and evaluation of the Brayton cycle reactor system. [ABSTRACT FROM AUTHOR]

Although Helium–Xenon mixture cooled small reactor has been widely concerned, there is no mature thermal calculation software that can be applied to Helium–Xenon mixture cooled small reactor in China. In this paper, a semi empirical formula used to predict the physical properties of binary inert gas mixtures is used to establish a physical property calculation model of Helium–Xenon mixture gas mixtures, and the flow and heat transfer calculation model, turbine model and compressor model are modified and improved, so as to achieve the calculation of the Brayton cycle system. The function of the original system analysis program is expanded and improved, and the simulation program for he xenon mixed gas reactor system is developed. At the same time, the closed Brayton cycle system is established by using the system analysis program developed in this paper, and the calculation results are compared with the design values. The maximum relative error is 6.9%. The steady-state operation results of the model are in good agreement with the design operation parameters, which proves the applicability of the improved simulation model. The steady-state response characteristics analysis, the introduction of positive and negative reactivity accidents and the calculation of transient conditions such as step load drop of the reactor were carried out. The overall trend is the same as the literature survey results. The results show that the system analysis program developed in this paper is suitable for the analysis of the Brayton cycle system of Helium–Xenon mixture cooled small reactor. [ABSTRACT FROM AUTHOR]

Acute-on-chronic liver failure (ACLF) is a clinical syndrome associated with high short-term mortality in patients with chronic liver disease. Chronic hepatitis B is the main cause of ACLF (HBV-ACLF) in China and other Asian countries. To improve disease management and survival for patients with ACLF, we aimed to discover novel biomarkers to enhance HBV-ACLF diagnosis and prognostication. We performed a metabolomics profiling of 1,024 plasma samples collected from patients with HBV-related chronic liver disease with acute exacerbation at hospital admission in a multi-year and multi-center prospective study (367 ACLF and 657 non-ACLF). The samples were randomly separated into equal halves as a discovery set and a validation set. We identified metabolites associated with 90-day mortality in the ACLF group and the progression to ACLF within 28 days in the non-ACLF group (pre-ACLF) using statistical analysis and machine learning. We developed diagnostic algorithms in the discovery set and used these to assess the findings in the validation set. ACLF significantly altered the plasma metabolome, particularly in membrane lipid metabolism, steroid hormones, oxidative stress pathways, and energy metabolism. Numerous metabolites were significantly associated with 90-day mortality in the ACLF group and/or pre-ACLF in the non-ACLF group. We developed algorithms for the prediction of 90-day mortality in patients with ACLF (area under the curve 0.87 and 0.83 for the discovery set and validation set, respectively) and the diagnosis of pre-ACLF (area under the curve 0.94 and 0.88 for the discovery set and validation set, respectively). To translate our discoveries into practical clinical tests, we developed targeted assays using liquid chromatography-mass spectrometry. Based on novel metabolite biomarkers, we established tests for HBV-related ACLF with higher accuracy than existing methods. NCT02457637 and NCT03641872. Acute-on-chronic liver failure (ACLF) is a clinical syndrome associated with high short-term mortality affecting 25% of patients hospitalized with cirrhosis. Chronic hepatitis B is the main etiology of ACLF in China and other Asian counties. There is currently no effective therapy. Early diagnosis and accurate prognostication are critical for improving clinical outcomes in patients with ACLF. Based on novel metabolite biomarkers, we developed liquid chromatography-mass spectrometry tests with improved accuracy for the early diagnosis and prognostication of HBV-related ACLF. The liquid chromatography-mass spectrometry tests can be implemented in clinical labs and used by physicians to triage patients with HBV-related ACLF to ensure optimized clinical management. [Display omitted] • Metabolomics uncovered profound metabolic perturbations associated with HBV-related ACLF in patient plasma. • We identified novel metabolite biomarkers that can be used to enhance ACLF prognostication and early diagnosis. • We developed and validated LCMS-based clinical tests with improved accuracy for ACLF prognostication and early diagnosis. [ABSTRACT FROM AUTHOR]

The new energy promoting community has recently witnessed a surge of developments in photovoltaic power generation technologies. To fulfill the grid code requirement of photovoltaic inverter under low-voltage ride-through (LVRT) condition, by utilizing the asymmetry feature of grid voltage, this paper aims to control both restraining negative sequence current and reactive power fluctuation on grid side to maintain balanced output of inverter. Two mathematical inverter models of grid-connected inverter containing LCL grid-side filter under both symmetrical and asymmetric grid are proposed. PR controller method is put forward based on inverter model under asymmetric grid. To ensure the stable operation of the inverter, grid voltage feedforward method is introduced to restrain current shock at the moment of voltage drop. Stable grid-connected operation and LVRT ability at grid drop have been achieved via a combination of rapid positive and negative sequence component extraction of accurate grid voltage synchronizing signals. Simulation and experimental results have verified the superior effectiveness of our proposed control strategy. [ABSTRACT FROM AUTHOR]

Defect detection in power scenarios is a critical task that plays a significant role in ensuring the safety, reliability, and efficiency of power systems. The existing technology requires enhancement in its learning ability from large volumes of data to achieve ideal detection effect results. Power scene data involve privacy and security issues, and there is an imbalance in the number of samples across different defect categories, all of which will affect the performance of defect detection models. With the emergence of the Internet of Things (IoT), the integration of IoT with machine learning offers a new direction for defect detection in power equipment. Meanwhile, a generative adversarial network based on multi-view fusion and self-attention is proposed for few-shot image generation, named MVSA-GAN. The IoT devices capture real-time data from the power scene, which are then used to train the MVSA-GAN model, enabling it to generate realistic and diverse defect data. The designed self-attention encoder focuses on the relevant features of different parts of the image to capture the contextual information of the input image and improve the authenticity and coherence of the image. A multi-view feature fusion module is proposed to capture the complex structure and texture of the power scene through the selective fusion of global and local features, and improve the authenticity and diversity of generated images. Experiments show that the few-shot image generation method proposed in this paper can generate real and diverse defect data for power scene defects. The proposed method achieved FID and LPIPS scores of 67.87 and 0.179, surpassing SOTA methods, such as FIGR and DAWSON. [ABSTRACT FROM AUTHOR]

In recent years, non - invasive methods for assessment of hepatic fibrosis have attracted more and more attention, and the application of non - invasive diagnostic techniques such as serum markers and transient elastography (FibroScan) for hepatic fibrosis is reviewed. Anti - fibrosis treatments should integrate etiological treatment, anti - inflammatory and liver - protecting therapy, and inhibiting the synthesis of extracellular matrix and degrading excessively deposited extracellular matrix. Antiviral treatment is the basis for resisting hepatic fibrosis due to chronic viral hepatitis. In this aspect, traditional Chinese medicine (TCM) has advantages in inhibiting the synthesis of extracellular matrix and degrading excessively deposited extracellular matrix, because it effects on multiple links, at multiple levels, and against multiple targets. So integrated traditional Chinese and Western medicine therapy is a promising treatment strategy. However, the benefit of integrative therapy against hepatic fibrosis stiil needs to be supported by rigorously designed, multicenter, large - sample clinical studies, and the mechanism of anti - fibrosis TCM treatment deserves further studies. [ABSTRACT FROM AUTHOR]

Recent studies have found that endotoxin not only activates immune response, exacerbates liver injury, and induces liver failure, but also plays an important role in the development of hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and other fatal complications. T e recent progress in research on the pathogenesis of intestinal endotoxemia (IETM) and its impact on the development and progression of liver failure is reviewed and summarized. It is suggested that seeking effective methods to prevent and control IETM holds promise as the key to treating severe liver disease and liver failure successfully [ABSTRACT FROM AUTHOR]

Objective and accurate assessment of liver fibrosis in patients with chronic hepatitis B ( CHB) helps to choose the correct therapeutic scheme and guide the clinical treatment. In recent years, the noninvasive diagnostic models for liver fibrosis have ben constantly emerging, but no consensus has been reached in this regard. The research advances in noninvasive regression models for liver fibrosis in patients with CHB are reviewed according to different staging methods for liver fibrosis, and the existing models are analyzed in terms of problems and shortages. It is thought that further studies should be done to establish simpler, more effective models that have higher diagnostic values. [ABSTRACT FROM AUTHOR]

Abstract: A copper-catalyzed reaction of amine with but-2-ynedioate gives rise to pyrrole-2,3,4,5-tetracarboxylates in moderate to good yields. The reaction proceeds in the presence of dioxygen with the formation of three bonds during the process. [Copyright &y& Elsevier]

A three-component reaction of triethoxysilanes,sulfur dioxide,and hydrazines catalyzed by copper(II) acetate is reported, leadingto N-aminosulfonamides in good yields.Not only triethoxy(aryl)silanes but also triethoxy(alkyl)silanesare compatible during the process of insertion of sulfur dioxide.Additionally, diethoxydiarylsilanes are suitable underthe conditions as well. [ABSTRACT FROM AUTHOR]

This paper presents a review of research progress on photovoltaic direct current arc detection based on VOSviewer bibliometric analysis. This study begins by introducing the basic concept and hazards of photovoltaic DC arcing faults, followed by a summary of commonly used arc detection techniques. Utilizing VOSviewer, the relevant literature is subjected to clustering and visualization analysis, offering insights into research hotspots, trends, and interconnections among different fields. Based on the bibliometric analysis method of VOSviewer software, this paper analyzes the articles published in the last 10 years (2014–2023) on photovoltaic DC fault diagnosis. We analyzed the specific characteristics of 2195 articles on arc failures, including year of publication, author, institution, country, references, and keywords. This study reveals the development trend, global cooperation model, basic knowledge, research hotspots, and emerging frontier of PV DC arc. Future research directions and development trends for photovoltaic DC arc detection are proposed which provides valuable references for further studies and applications in this domain. This comprehensive analysis indicates that photovoltaic DC arc detection technology is expected to find broader applications and greater promotion in the future. [ABSTRACT FROM AUTHOR]

Abstract: A silver(I)-catalyzed reaction of 2-alkynylaryl aldimine with trimethyl(trifluoromethyl)silane is reported. This reaction proceeds efficiently under extremely mild conditions to generate 1-(trifluoromethyl)-1,2-dihydroisoquinolines in good yields. A three-component reaction of 2-alkynylbenzaldehyde, amine, with trimethyl(trifluoromethyl)silane is presented as well. [Copyright &y& Elsevier]

Objective was to estimate the 5-year cumulative risk of HCC in patients with HBC by utilizing an artificial neural network (ANN). Methods: We conducted this study with 1589 patients hospitalized at Beijing Ditan Hospital of Capital Medical University and People's Liberation Army Fifth Medical Center. The training cohort consisted of 913 subjects from Beijing Ditan Hospital of Capital Medical University, while the validation cohort comprised 676 subjects from People's Liberation Army Fifth Medical Center. Through univariate analysis, we identified factors that independently influenced the occurrence of HCC, which were then used to develop the ANN model. To evaluate the ANN model, we assessed its predictive accuracy, discriminative ability, and clinical net benefit using metrics such as the area under the receiver operating characteristic curve (AUC), concordance index (C-index), calibration curves. Results: In total, we included nine independent risk factors in the development of the ANN model. Remarkably, the AUC of the ANN model was 0.880, significantly outperforming the AUC values of other existing models including mPAGE-B (0.719) (95% CI 0.670– 0.768), PAGE-B (0. 710) (95% CI 0.660– 0.759), FIB-4 (0.693) (95% CI 0.640– 0.745), and Toronto hepatoma risk index (THRI) (0.705) (95% CI 0.654– 0.756) (p< 0.001 for all). The ANN model effectively stratified patients into low, medium, and high-risk groups based on their 5-year In the training cohort, the positive predictive value (PPV) for low-risk patients was 26.2% (95% CI 25.0– 27.4), and the negative predictive value (NPV) was 98.7% (95% CI 95.2– 99.7). For high-risk patients, the PPV was 54.7% (95% CI 48.6– 60.7), and the NPV was 91.6% (95% CI 89.4– 93.4). These findings were validated in the independent validation cohort. Conclusion: The ANNs model has good individualized prediction performance and may be helpful to evaluate the probability of the 5-year risk of HCC in patients with HBC. [ABSTRACT FROM AUTHOR]

Number connection test A (NCT-A) and digit symbol test (DST), the preferential neuropsychological tests to detect minimal hepatic encephalopathy (MHE) in China, haven't been standardized in Chinese population. We aimed to establish the norms based on a multi-center cross-sectional study and to detect MHE in cirrhotic patients. NCT-A and DST were administered to 648 healthy controls and 1665 cirrhotic patients. The regression-based procedure was applied to develop demographically adjusted norms for NCT-A and DST based on healthy controls. Age, gender, education, and age by education interaction were all predictors of DST, while age, gender, and education by gender interaction were predictors of log10 NCT-A. The predictive equations for expected scores of NCT-A and DST were established, and Z-scores were calculated. The norm for NCT-A was set as Z ≤ 1.64, while the norm for DST was set as Z ≥ − 1.64. Cirrhotic patients with concurrent abnormal NCT-A and DST results were diagnosed with MHE. The prevalence of MHE was 8.89% in cirrhotic patients, and only worse Child–Pugh classification (P = 0.002, OR = 2.389) was demonstrated to be the risk factor for MHE. The regression-based normative data of NCT-A and DST have been developed to detect MHE in China. A significant proportion of Chinese cirrhotic patients suffered from MHE, especially those with worse Child–Pugh classification. [ABSTRACT FROM AUTHOR]

Background & Aims: Current guidelines on the management of bacterascites are limited. This multicentre, retrospective study investigated the clinical features and outcomes of cirrhosis patients with bacterascites. Methods: Two series of cirrhosis patients were evaluated. The first included 418 patients with ascites‐positive cultures at 11 hospitals during 2012‐2018. Clinical characteristics and outcomes were recorded. The second included 208 patients with sterile ascites from a prospective cohort (NCT02457637). Clinical features and outcomes of cirrhotic patients with or without bacterascites were investigated. Results: In the first series, bacterascites was diagnosed in 254/418 (60.8%) patients, and culture‐positive spontaneous bacterial peritonitis (SBP) in 164/418 (39.2%) patients. Gram‐positive bacteria were more prevalent in bacterascites patients than in culture‐positive SBP patients (59.1% vs 22.0%; P <.001). For patients with acute‐on‐chronic liver failure (ACLF) in bacterascites and culture‐positive SBP groups, the 28‐day transplant‐free mortality (41.3% vs 65.5%; P =.015) and the prevalence of in‐hospital acute kidney injury (AKI) (84.8% vs 75%; P =.224). For patients without ACLF in the bacterascites (n = 208) and culture‐positive SBP groups (n = 108), the 28‐day transplant‐free mortalities were 13% vs 13.9% (P =.822), the probabilities of progression to ACLF within 28 days were 10.1% vs 14.8% (P =.216) and the prevalences of in‐hospital AKI were 14.4% vs 30.6% (P =.001). Bacterascites patients had higher 28‐day mortality than those patients with sterile ascites, after propensity score matching (18.4% vs 8.6%; P =.010). Conclusion: Bacterascites patients had non‐negligible poor clinical outcomes, including in‐hospital AKI, progression to ACLF and 28‐day mortality. Future studies are warranted to expedite the diagnosis of bacterascites and optimize antibiotic treatment. [ABSTRACT FROM AUTHOR]

• Sudden power imbalances bring system frequency and voltage issues. • Load participation has the potential to provide frequency/voltage support. • Network dynamics as optimization algorithms. • Performance of the method in the presence of high renewable penetration. Recently, more frequency and voltage stability issues have been caused by the uncertain load demand and intermittent renewable energy generation in smart grids. This has put significant pressure on turbine governor action. One potential solution is load participation in primary control. In this study, we investigate a general class of local load control (LLC) to provide grid frequency and voltage support while minimizing the pre-defined disutility to utilities and clients. Our approach relies only on local frequency and voltage measurements. We prove that the network dynamics under optimality conditions solve the dual problem of the disutility function adaptively, providing a principled way to guide forward engineering in local load control design. Simulation-based comparative study of choosing different types of disutility functions is conducted on response performance concerning frequency/voltage nadir and steady-state error. Moreover, the effectiveness and rationality of the proposed approach are verified in MATLAB/SIMULINK under various scenarios, including load variations, renewable power output fluctuations, and different penetrations of renewable energy. [ABSTRACT FROM AUTHOR]

Background and aim: Although antiviral treatments have been shown to affect the recurrence and long-term survival of patients with hepatocellular carcinoma (HCC) who have high viral loads, the effect of different responses to antiviral therapy on the clinical outcomes remains unclear. This study aimed to assess the effect of primary non-response (no-PR) to antiviral therapy on the survival or prognosis of patients with HCC with a high load of hepatitis B virus (HBV) DNA. Methods: A total of 493 HBV-HCC patients hospitalized at Beijing Ditan Hospital of Capital Medical University were admitted to this retrospective study. Patients were divided into two groups based on viral response (no-PR and primary response). Kaplan–Meier (KM) curves were used to compare the overall survival of the two cohorts. Serum viral load comparison and subgroup analysis were performed. Additionally, risk factors were screened and the risk score chart was created. Results: This study consisted of 101 patients with no-PR and 392 patients with primary response. In the different categories based on hepatitis B e antigen and HBV DNA, no-PR group had a poor 1-year overall survival (OS). In addition, in the alanine aminotransferase < 50 IU/L and cirrhosis groups, primary nonresponse was related to poor overall survival and progression-free survival. Based on multivariate risk analysis, primary non-response (hazard ratio (HR) = 1.883, 95% CI 1.289–2.751, P = 0.001), tumor multiplicity (HR = 1.488, 95% CI 1.036–2.136, P = 0.031), portal vein tumor thrombus (HR = 2.732, 95% CI 1.859–4.015, P < 0.001), hemoglobin < 120 g/L (HR = 2.211, 95% CI 1.548–3.158, P < 0.001) and tumor size ≥ 5 cm (HR = 2.202, 95% CI 1.533–3.163, P < 0.001) were independent risk factors for 1-year OS. According to the scoring chart, patients were divided into three risk groups (high-, medium-, and low-risk groups) with mortality rates of 61.7%, 30.5%, and 14.1%, respectively. Conclusions: The level of viral decline at 3 months post-antiviral treatment may predict the OS of patients with HBV-related HCC, and primary non-response may shorten the median survival time of patients with high HBV-DNA levels. [ABSTRACT FROM AUTHOR]

The procedure causes the formation of C-N and C-O bonds in one pot and allows the access to a broad spectrum of the desired target compounds with a view to preparing natural product-like libraries. [ABSTRACT FROM AUTHOR]

An abstract of the article "A Tandem Reaction of 2-Alkynylbenzaldoximes with Cyclic Ethers Co-Catalyzed by Silver(I) Triflate and Copper(II) Acetate" is presented.

The article presents chemical equations for the article "A Copper-Catalyzed Three-Component Reaction of Triethoxysilanes, Sulfur Dioxide, and Hydrazines" by X. Wang and others, published in the periodical "Organic Letters" in 2014.

The article presents chemical equations related to the article "An Approach to 1-Phosphorylated Isoquinolines Through Silver(I)-Catalyzed Tandem Reaction Involving C?N and C?P Bond Formation" by X. Wang and Z. Wang published in the periodical "Tetrahedron" in 2014.

An abstract of the article "Generation of 1-(Trifluoromethyl)-1,2-dihydroisoquinolines via a Silver(I)-Catalyzed Reaction of 2-Alkynylaryl Aldimine with Trimethyl(trifluoromethyl)silane" by Xianbo Wang, Guanyinsheng Qiu, Ling Zhang, and Jie Wu is presented.

An abstract of the article "Synthesis of Pyrrole-2,3,4,5-tetracarboxylates via a Copper-Catalyzed Reaction of Amine with But-2-ynedioate," by Ling Zhang and colleagues is presented.

BACKGROUND: It has been discovered that lncRNA ARAP1-AS1 is upregulated and operates as a tumor promoter in many cancers. However, its pattern of expression and potential mechanism in lung adenocarcinoma (LUAD) is still unknown. METHODS: The levels of lncRNA ARAP1-AS1, miR-8068, and CEACAM5 expressions in LUAD cell lines and tissues were assessed by conducting western blot and RT-qPCR analyses. MiR-8068's potential targeting relationships with lncRNA ARAP1-AS1 and CEACAM5 were ascertained by performing bioinformatics analysis. The interaction of lncRNA ARAP1-AS1 with miR-8068 was validated by means of by RIP and luciferase reporter experiments. CCK-8, cell adhesion, and Transwell migration experiments were conducted to study how lncRNA ARAP1-AS1 affects LUAD cell migration, adhesion, and proliferation. To confirm the function of lncRNA ARAP1-AS1 in vivo, a tumor formation experiment was executed. RESULTS: An elevated expression of lncRNA ARAP1-AS1 was observed among the LUAD cells and tissues. The overexpression of lncRNA ARAP1-AS boosted cell proliferation, adhesion, and migration in LUAD and also favored in vivo tumor growth. MiR-8068 was found to be lncRNA ARAP1-AS1's target gene. MiR-8068 overexpression partially antagonized lncRNA ARAP1-AS1's promotive effect on proliferation, viability, and adhesion. Meanwhile CEACAM5 could alleviate the miR-8068-induced inhibition of tumor growth. The negative correlation of miR-8068 with lncRNA ARAP1-AS1 or CEACAM5 was also revealed. CONCLUSION: To upregulate CEACAM5 expression lncRNA ARAP1-AS1 targeted miR-8068, thus promoting the progression of LUAD. This indicates that the lncRNA ARAP1-AS1/miR-8068/CEACAM5 axis has potential as a therapeutic target in LUAD treatment. [ABSTRACT FROM AUTHOR]

Background: Liver cirrhosis patients are at risk for esophagogastric variceal bleeding (EGVB). Herein, we aimed to estimate the EGVB risk in patients with liver cirrhosis using an artificial neural network (ANN). Methods: We included 999 liver cirrhosis patients hospitalized at the Beijing Ditan Hospital, Capital Medical University in the training cohort and 101 patients from Shuguang Hospital in the validation cohort. The factors independently affecting EGVB occurrence were determined via univariate analysis and used to develop an ANN model. Results: The 1-year cumulative EGVB incidence rates were 11.9 and 11.9% in the training and validation groups, respectively. A total of 12 independent risk factors, including gender, drinking and smoking history, decompensation, ascites, location and size of varices, alanine aminotransferase (ALT), γ-glutamyl transferase (GGT), hematocrit (HCT) and neutrophil-lymphocyte ratio (NLR) levels as well as red blood cell (RBC) count were evaluated and used to establish the ANN model, which estimated the 1-year EGVB risk. The ANN model had an area under the curve (AUC) of 0.959, which was significantly higher than the AUC for the North Italian Endoscopic Club (NIEC) (0.669) and revised North Italian Endoscopic Club (Rev-NIEC) indices (0.725) (all P < 0.001). Decision curve analyses revealed improved net benefits of the ANN compared to the NIEC and Rev-NIEC indices. Conclusions: The ANN model accurately predicted the 1-year risk for EGVB in liver cirrhosis patients and might be used as a basis for risk-based EGVB surveillance strategies. [ABSTRACT FROM AUTHOR]

The layout of nuclear-powered spacecraft is very different from the layout of nuclear reactors used on Earth, so the design principle is also different. Taking nuclear-powered spacecraft as the object, this paper studies the coverage of the shadow area formed by the shield and distribution of neutron fluence and photon dose in the shadow area. In this paper, a nuclear power spacecraft model with a width of 6 m and a length of 25 m is built. The Monte Carlo method is used to calculate the transport of neutrons and photons, and the distribution of neutrons and photons in space is obtained. The coverage of the shadow area formed by shields with different widths is obtained, and the main factors affecting the width and angle of the shadow area are summarized. When the diameter of the shield decreases, the width of the shadow area also decreases, and the angle of the shadow area decreases, which greatly reduces the area of the shadow area. The distribution of neutron fluence and photon dose in the shadow area is obtained. At the end of the truss, the maximum value of the photon dose is 1.03 × 10-4 Gy∙s-1, and the average value is 6.42 × 10-5 Gy∙s-1. The maximum value of the neutron fluence rate is 1.01 × 104 n∙cm-2∙s-1, and the average value is 6.18 × 103 n∙cm-2∙s-1. And the influence of spacecraft structure on radiation is analyzed. The truss and droplet emitters have a greater impact on photons, and the heat sink and droplet emitters have a greater impact on neutrons. Based on the above work, a local shield scheme is proposed to reduce the mass. After being blocked by local shield, the photon dose is reduced to 1/10 and the neutron fluence rate is reduced to 1/6. [ABSTRACT FROM AUTHOR]

Background and Aims: The accuracy of model for end‐stage liver disease (MELD) and MELD with sodium (MELD‐Na) scores in reflecting the clinical outcomes of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. This study aimed to evaluate the performance of scores in predicting 90‐day mortality in patients with cirrhosis and PVT. Methods: Post hoc analysis was performed in two prospective cohorts (NCT02457637 and NCT03641872). The correlation between the MELD/MELD‐Na score and 90‐day liver transplantation (LT)‐free mortality was investigated in patients with cirrhosis with and without PVT. Results: In this study, 2826 patients with cirrhosis were included, and 255 (9.02%) had PVT. The cumulative incidence of 90‐day LT‐free mortality did not significantly differ between patients with and without PVT (log‐rank P = 0.0854). MELD [area under the receiver operating curve (AUROC), 0.649 vs. 0.842; P = 0.0036] and MELD‐Na scores (AUROC, 0.691 vs. 0.851; P = 0.0108) were compared in patients with and without PVT, regarding the prediction of 90‐day LT‐free mortality. In MELD < 15 and MELD‐Na < 20 subgroups, patients with PVT had a higher 90‐day LT‐free mortality than those without PVT (7.91% vs. 2.64%, log‐rank P = 0.0011; 7.14% vs. 3.43%, log‐rank P = 0.0223), whereas in MELD ≥ 15 and MELD‐Na ≥ 20 subgroups, no significant difference was observed between patients with and without PVT. Conclusions: The performance of MELD and MELD‐Na scores in predicting 90‐day LT‐free mortality of patients with cirrhosis was compromised by PVT. MELD < 15 or MELD‐Na < 20 may underestimate the 90‐day LT‐free mortality in patients with PVT. [ABSTRACT FROM AUTHOR]

Background the incidence of acute-on-chronic liver disease (AoCLD) is increasing. Objective to investigate the clinical features and risk factors of AoCLD and construct an effective prognostic nomogram model for older patients with AoCLD. Methods data from 3,970 patients included in the CATCH-LIFE study were used, including 2,600 and 1,370 patients in the training and validation sets, respectively. Multivariate Cox regression analyses were performed to identify predictive risk factors in older individuals, and an easy-to-use nomogram was established. Performance was assessed using area under the curve, calibration plots and decision curve analysis (DCA). Results of the 3,949 patients with AoCLD, 809 were older with a higher proportion of autoimmune-related abnormalities, hepatitis C viral infection and schistosomiasis. In the older patient group, the incidence of cirrhosis, hepatic encephalopathy (HE), infection, ascites and gastrointestinal bleeding; neutrophil-to-lymphocyte ratio (NLR), aspartate-to-alanine transaminase ratio (AST/ALT), creatinine and blood urea nitrogen levels were higher, whereas incidence of acute-on-chronic liver failure, white blood cell, platelet and haemoglobin levels; albumin, total bilirubin (TB), AST and ALT levels; international normalised ratio (INR), estimated glomerular filtration rate and blood potassium levels were lower than in the younger group. The final nomogram was developed based on the multivariate Cox analysis in training cohort using six risk factors: ascites, HE grades, NLR, TB, INR and AST/ALT. Liver transplantation-free mortality predictions were comparable between the training and validation sets. DCA showed higher net benefit for the nomograph than the treat-all or treat-none strategies, with wider threshold probabilities ranges. Conclusions our analysis will assist clinical predictions and prognoses in older patients with AoCLD. [ABSTRACT FROM AUTHOR]

The acute‐on‐chronic liver failure (ACLF) development is highly dynamic. Currently, no satisfactory algorithm identifies patients with HBV at risk of this complication. The aim of the study was to characterize ACLF development in hospitalized HBV‐related patients without previous decompensation and to test the performance of traditional prognostic models in ruling out ACLF development within 28 days on admission we conducted a cohort study. Two multi‐center cohorts with hospitalized HBV‐related previous compensated patients were analyzed. Performances of MELD, MELD‐Na, CLIF‐C AD, and CLIF‐C ACLF‐D in ruling out ACLF development within 28 days were compared and further validated by ROC analyses. In the derivation cohort (n = 892), there were 102 patients developed ACLF within 28 days, with profound systemic inflammatory levels and higher 28‐day mortality rate (31.4% vs. 1.0%) than those without ACLF development. The MELD score (cut‐off = 18) achieved acceptable missing rate (missed/total ACLF development) at 2.9%. In the validation cohort (n = 1656), the MELD score (<18) was able to rule out ACLF development within 28 days with missing rate at 3.0%. ACLF development within 28 days were both lower than 1% (0.6%, derivation cohort; 0.5%, validation cohort) in patients with MELD < 18. While in patients with MELD ≥ 18, 26.6% (99/372, derivation cohort) and 17.8% (130/732, validation cohort) developed into ACLF within 28 days, respectively. While MELD‐Na score cut‐off at 20 and CLIF‐AD score cut‐off at 42 did not have consistent performance in our two cohorts. MELD < 18 was able to safely rule out patients with ACLF development within 28 days in HBV‐related patients without previous decompensation, which had a high 28‐day mortality. [ABSTRACT FROM AUTHOR]

Primary biliary cirrhosis (PBC) is an autoimmune liver disease characterized by chronic and progressive cholestasis, which has a tendency to develop cirrhosis. The pathogenesis of PBC is complicated and still unclear. This paper reviews the atest research progress in mmunological mechanisms and therapies for PBC in recent years, which focuses on the relationship between the development of PBC and autoantibodies, immune cells, and mportant cytokines. The review ndicates that immunological factors play a key role in pathogenesis of PBC, and further research on mmunological mechanisms might be quite mportant for the dentification of pathogenesis and clinical treatment of PBC. [ABSTRACT FROM AUTHOR]

Motivated by the complex production management with difficulties in error-prone assembly system and inaccurate supply chain inventory, this paper designs a novel manufacturing execution system (MES) architecture for intelligent monitoring based on wireless sensor network (WSN). The technical perspective includes analysis on the proposed manufacturing resource mutual inductance method under active sensing network, appreciation technology of multisource information, and dynamic optimization technology for manufacturing execution processes. From business perspective, this paper elaborates the impact of RFID investment on complex product by establishing a three-stage supply chain model that involves two suppliers carrying out Stackelberg games (manufacturer and retailer). The optimal cost threshold values of technology investment are examined for both the centralized and the decentralized scenarios utilizing quantitative modeling methods. By analyzing and comparing the optimal profit with or without investment on WSN, this paper establishes a supply chain coordination and boosting model. The results of this paper have contributed significantly for one to make decision on whether RFID should be adopted among its members in supply chain. The system performance and model extension are verified via numerical analyses. [ABSTRACT FROM AUTHOR]

Herein, the SiC ceramic aerogels with in-situ growth of SiC nanowires (SiC w /SiC CAs) have been synthesized by polymer‐derived ceramics (PDCs) method. The morphology, microstructure, and phase composition of the as-prepared samples were systematically investigated through SEM, XRD, TEM, Raman spectrum, FT-IR spectrum, and XPS spectrum techniques. The results showed that the as-obtained SiC w has a diameter of about 80 nm and a length of 1–3.5 μm. In addition, the formation mechanism and evolution process of growth SiC w were systematically studied using a VLS growth mechanisms. The way in this work could be expanded to synthesize other Si-based porous ceramic aerogel nanostructed with nanowires. [ABSTRACT FROM AUTHOR]

Aim. This study aims to evaluate whether adjuvant traditional Chinese medicine (TCM) can improve the survival of patients with primary liver cancer (PLC). Methods. A total of 1,859 patients with PLC at Beijing Ditan Hospital between August 2008 and September 2017 were included. The patients were divided into TCM and control groups according to whether the patients took TCM for ≥3 months. There were 1,111 patients in the TCM group and 748 in the control group. Univariate and multivariate Cox regression analyses were used to analyze the factors affecting the 3-year survival of patients with PLC. To reduce selection bias, 1 : 1 propensity score matching (PSM) was performed between the two groups. The overall survival outcomes were evaluated using the Kaplan–Meier (K–M) survival curve, and the log-rank test was used to compare the differences in survival curves. Results. After multivariate Cox regression analysis, TCM was an independent favorable factor for the 3-year survival of patients with PLC (adjusted hazard ratio (aHR) 0.359, 95% confidence interval (CI) 0.292–0.441, P < 0.001). Before and after PSM, the 3-year overall survival rates were 33.3% and 54% in the control group and 79.7% and 69.7% in the TCM group, respectively. The 3-year mortality risk in the TCM group was lower than that in the control group for different PLC subgroups. Conclusions. TCM adjuvant therapy increased the 3-year overall survival rate of patients with PLC. [ABSTRACT FROM AUTHOR]

Non invasive load monitoring (NILM) is beneficial for enhancing the monitoring capability of the distribution network and is crucial for improving the safety of smart grid operation. However, household appliances involve a variety of devices and a large amount of data, making it difficult to achieve high-precision load identification. Especially when a large amount of loads are running simultaneously, problems such as feature overlap and reduced distinguish ability may occur, and thus increasing the difficulty of load identification. To solve these problems, this paper proposes a new NILM method based on dynamic time warping (DTW) optimization and event detection. Firstly, a feature extraction algorithm of STFT-SSAE is constructed by using short-time Fourier transform (STFT) to extract time–frequency features from the load, and then by sparse stack autoencoder (SSAE) to extract important features from time–frequency information. Secondly, the above features are input into Bi-LSTM and DTW models respectively, and a new probabilistic model is established. A Bi-LSTM-DTW load recognition architecture is built by combining the two models. Finally, the load identification model of SSAE-Bi-LSTM based on DTW optimization (DOSL) is trained by the preset combined data, which ensures the high confidence of the DOSL model in various complex operating scenarios. This paper introduces the public data set PLAID for experimental verification. The results show that the selected load features has good discrimination, and the proposed algorithm has the best identification effect with the accuracy rate of 0.9412. The proposed algorithm is also validated for generalization ability on the public dataset UK-DALE, with a identification accuracy rate of 0.9306, and the error of different datasets is only about 1%. • A complete multiple house-hold appliances NILM framework. • A novel STFT-SSAE algorithm for load feature extraction. • Bi-LSTM-DTW load identification architecture combined with output probability vector. [ABSTRACT FROM AUTHOR]

Two novel donor-acceptor (D-A) copolymers containing dithienosilole (DTS) donor unit and ketone modified thieno[3,4- b]thiophene (TT) acceptor unit, namely, poly{4,4′-bis(2-ethylhexyl)dithieno[3,2-b:2′,3′- d]silole-5,5′-diyl-alt-1-(thieno[3,4- b]thiophen-2-yl)-2-ethylhexan-1-one} (PDTSTT) and poly{4,4′-bis(2-ethylhexyl)dithieno[3,2- b:2′,3′- d]silole-5,5′-diyl-alt-1-(4,6-bis(4-ethylhexylthien-2-yl)thieno[3,4- b]thiophen-2-yl)-2-ethylhexan-1-one} (PDTSDTTT), were synthesized for the application in polymer solar cells (PSCs), and the effects of thiophene bridge on the structural geometry and photovoiltaic performance have been investigated. The polymer PDTSTT and PDTSDTTT have the electrochemical bandgaps of 1.54 and 2.02 eV, together with low-lying HOMO energy levels of −5.47 and −5.37 eV, respectively. Molecular geometry simulation result shows that compared with PDTSTT, the insertion of thiophene bridge in PDTSDTTT can well relieve the steric hindrance between the TT and DTS unit, as confirmed by the reduced dihedral angle between DTS and DTTT unit. Under the illumination of AM 1.5G, 100 mW/cm2, the PSC based on PDTSDTTT/PC61BM (1:1, w: w) demonstrates a power conversion efficiency of 1.0%, which is significantly improved in comparison with the device based on PDTSTT/PC61BM (1:2, w: w) under the same experimental condition. This is because the enhanced planarity and increased effective conjugation of the main chain in PDTSDTTT promote the more favorable morphology for charge transportation, although PDTSTT possesses the broader absorption band than PDTSDTTT. [ABSTRACT FROM AUTHOR]

This paper investigates the adaptive event-triggered dynamic output feedback control problem for vehicle active suspension systems with nonlinearity and uncertainty based on interval type-2 fuzzy method. Firstly, considering the dynamic behaviors of the spring and shock absorber are highly nonlinear, a fuzzy suspension model is established to capture the nonlinearity and uncertainty of the suspension systems based on interval type-2 Takagi-Sugeno fuzzy rules. Secondly, in order to decrease the transmission burden, an event-triggered mechanism is employed to decide whether the sampled signal is transmitted or not with an adaptive triggering threshold. Thirdly, by combining the fuzzy dynamic output feedback control law with event-triggered mechanism, a co-design method of fuzzy controller and event generator is proposed to improve the suspension performances and save network resources simultaneously. Finally, experimental tests under multiple pavement are implemented to verify that the proposed method can improve the performance of ride comfort and reduce communication burden simultaneously, despite the existence of unmeasurable states and nonlinearities. [ABSTRACT FROM AUTHOR]

In this paper, a numerical simulation method is used to study the process of multiple droplets impact on the wall of a liquid droplet radiator in a space environment. The effects of droplet spacing, droplet velocity, wall properties and other factors on the evolution of droplet impact on the wall are analyzed. The results show that the critical Reynolds number of droplets without splashing decreases and then remains unchanged as the droplet spacing of silicone oil increases. Thin liquid film promotes droplet splashing, while thick liquid film inhibits droplet splashing. The larger the initial incident velocity of the droplets, the larger the number of splashing droplets and the smaller their diameters. The critical Reynolds number of silicone oil droplets decreases monotonously with the increase of the inclination angle between the wall and the vertical direction. Finally, a 15° frustum of a cone model is chosen to simulate the actual working process of the liquid droplet radiator to verify the conclusions. The results of the study can provide guidance for the optimal design of droplet collectors. • Studying how droplet features and wall properties affect droplet impact on surface. • Analyzing how liquid film thickness affects splashing type and droplet state. • Exploring how surface tension and viscosity impact splash formation. • Identifying droplet collector parameters based on dimensionless number variation. • Results offer theoretical support for optimal droplet collector design. [ABSTRACT FROM AUTHOR]

Microbial co-culture has proven to be an effective way to improve the ability of microorganisms to biocontrol. However, the interactive mechanisms of co-cultural microbes, especially between fungi and bacteria, have rarely been studied. By comparative analysis of morphology, transcriptomics and metabolomics, the interactive mechanisms of a sequential co-culture system of Trichoderma asperellum HG1 and Bacillus subtilis Tpb55 was explored in this study. The results revealed that co- culture has no significant effect on the growth and cell morphology of the two strains, but lead to mycelium wrinkling of HG1. RNA-seq analysis showed that co-culture significantly upregulated the HG1 genes concerning amino acid degradation and metabolism, proteolysis, resisting environmental stress, cell homeostasis, glycolysis, the glyoxylate cycle, and the citric acid (TCA) cycle, while Tpb55 genes related to cell homeostasis, spore formation and membrane fluidization were significantly upregulated, but genes associating to TCA, glycolytic cycles and fatty acid β -oxidation were significantly downregulated. Metabolomic results revealed that some amino acids related to energy metabolism were significantly altered in HG1, whereas palmitic acid, which is related to cell membrane functions, was upregulated in Tpb55. These results indicated that HG1 could interfere with carbon metabolism and cell membrane fluidity, but accelerate spore formation of Tpb55. Biophysical assays further convinced that co-culture could decrease ATP content and inhibit ATPase activity in HG1, and could promote spore formation and reduce the cell membrane fluidity of Tpb55. In addition, co-culture also accelerated the production of intracellular anti-oomycete compound octhilinone. The above results indicate that HG1 and Tpb55 are mainly in a competitive relationship in the co culture system. These findings provide new insights for understanding the interaction mechanism between co cultured microbes. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction: Acute-on-chronic liver failure (ACLF) patients are susceptible to invasive fungal infections. We evaluated the prognosis and antifungal options in ACLF patients with invasive pulmonary aspergillosis (IPA). Methods: ACLF patients with IPA from 15 hospitals were retrospectively screened from 2011 to 2018, and 383 ACLF patients without lung infections were included from a prospective cohort (NCT02457637). Demographic, laboratory, clinical data, and 28-day outcomes were documented in the two cohorts. Results: ACLF patients with probable IPA (n = 145) had greater 28-day mortality (33.6% vs. 15.7%, p < 0.001) than those without (n = 383). The respiratory failure-associated 28-day mortality was greater in ACLF patients with IPA than in those without before (17.1% vs. 0.3%, p < 0.001) and after (16.0% vs. 0.0%, p < 0.001) propensity score matching in 116 pairs. IPA patients with lung injury had greater 28-day all-cause mortality (66.5% vs. 24.2%, p < 0.001) and IPA-associated mortality (45.8% vs. 8.1%, p < 0.001) than patients without lung injury (PaO2/FiO2 ≥ 400 mmHg). Antifungal therapy was prescribed to 139 of 145 patients, and 102 patients were treated with voriconazole alone (n = 59) or sequential/combined therapy (n = 43) with varying loading doses (100–800 mg) and daily maintenance doses (0–800 mg). A proposed optimal voriconazole regimen (loading dose, 200 mg twice daily; daily maintenance dose, 100 mg) achieved comparable short-term survival and optimal trough drug concentrations (1–5 μg/mL) on therapeutic drug monitoring in 26 patients. Conclusion: Presence of IPA increases the short-term mortality of ACLF patients mainly due to respiratory failure. An optimal voriconazole regimen is needed for such critical patients. [ABSTRACT FROM AUTHOR]

Introduction: Spontaneous fungal ascites infection is a rare but devastating complication of cirrhosis. We aimed to analyse the clinical features, short-term mortality, and treatment of spontaneous fungal ascites infection in patients with cirrhosis. Methods: We retrospectively studied ten patients with cirrhosis and spontaneous fungal ascites infections, and the clinical characteristics and outcomes were obtained. Result: The patients' mean age was 64 ± 13 years, and seven of the ten patients were men. Cirrhosis was primarily caused by infection with the hepatitis B virus. Candida albicans was the most frequently isolated fungus isolated from the ascites fluid. Three of the ten patients fulfilled the criteria of acute-on-chronic liver failure (ACLF) at baseline, and three of the remaining seven patients developed ACLF during hospitalisation. Of the ten patients, six had acute kidney injury (AKI), and six died within 28 days. Three patients did not receive antifungal treatment during hospitalisation because they died undiagnosed because of delays in the reporting of laboratory results. Conclusion: Patients with spontaneous fungal ascites infection had high incidence of AKI and 28-day mortality. Fungal cultures of ascitic fluid from patients with cirrhosis should be recommended to ensure optimal clinical management, especially in patients with severe liver disease and who received inadequate empirical antibacterial therapy. Hence, future studies should focus on the early diagnosis of fungal infection in patients with cirrhosis. [ABSTRACT FROM AUTHOR]

Background. Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute deterioration of liver function and high short-term mortality. Clusterin, with biological functions similar to small heat shock proteins, can protect cells from apoptosis induced by various stressors. The aim of this study was to detect the level of serum clusterin in hepatitis B virus- (HBV-) related ACLF and to assess the predictive value of clusterin for the short-term prognosis of HBV-ACLF. Methods. We detected serum clusterin by ELISA in 108 HBV-ACLF patients, 63 HBV-non-ACLF patients, and 44 normal controls. Results. Serum clusterin was markedly lower in HBV-ACLF patients (median, 51.09 μg/mL) than in HBV-non-ACLF patients (median, 188.56 μg/mL) and normal controls (median, 213.45 μg/mL; all P < 0.05). Nonsurviving HBV-ACLF patients who died within 90 days had much lower clusterin levels than did surviving patients, especially those who died within 28 days (nonsurvival group vs. survival group: 39.82 ± 19.34 vs. 72.26 ± 43.52 , P < 0.001 ; survival time ≤ 28 vs. survival time > 28 : median 28.39 vs. 43.22, P = 0.013). The results showed that for identifying HBV-ACLF, the sensitivity of clusterin (93.7%) was similar to the sensitivities of the international normalized ratio (INR; 94.4%) and total bilirubin (TBIL; 94.8%), but its specificity (90.7%) was higher than that of prothrombin activity (PTA; 65.8%) and TBIL (69.8%) and was similar to INR (88.9%). As the concentration of clusterin increased, the mortality of HBV-ACLF patients decreased significantly from 59.3% to 7.0%. Clusterin had better ability for predicting the prognosis of HBV-ACLF patients than did the model for end-stage liver disease (MELD) score and the chronic liver failure consortium (CLIF-C) ACLF score (MELD vs. clusterin: P = 0.012 ; CLIF-C ACLF vs. clusterin: P = 0.031). Conclusion. Serum clusterin is a potential biomarker for HBV-ACLF which can be used to assess clinical severity and the short-term prognosis of patients with this disease and may help clinicians identify HBV-ACLF with greater specificity and improved prognostic accuracy than existing prognostic markers. [ABSTRACT FROM AUTHOR]

Background. Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute deterioration of liver function and high short-term mortality. Clusterin, with biological functions similar to small heat shock proteins, can protect cells from apoptosis induced by various stressors. The aim of this study was to detect the level of serum clusterin in hepatitis B virus- (HBV-) related ACLF and to assess the predictive value of clusterin for the short-term prognosis of HBV-ACLF. Methods. We detected serum clusterin by ELISA in 108 HBV-ACLF patients, 63 HBV-non-ACLF patients, and 44 normal controls. Results. Serum clusterin was markedly lower in HBV-ACLF patients (median, 51.09 μg/mL) than in HBV-non-ACLF patients (median, 188.56 μg/mL) and normal controls (median, 213.45 μg/mL; all P < 0.05). Nonsurviving HBV-ACLF patients who died within 90 days had much lower clusterin levels than did surviving patients, especially those who died within 28 days (nonsurvival group vs. survival group: 39.82 ± 19.34 vs. 72.26 ± 43.52 , P < 0.001 ; survival time ≤ 28 vs. survival time > 28 : median 28.39 vs. 43.22, P = 0.013). The results showed that for identifying HBV-ACLF, the sensitivity of clusterin (93.7%) was similar to the sensitivities of the international normalized ratio (INR; 94.4%) and total bilirubin (TBIL; 94.8%), but its specificity (90.7%) was higher than that of prothrombin activity (PTA; 65.8%) and TBIL (69.8%) and was similar to INR (88.9%). As the concentration of clusterin increased, the mortality of HBV-ACLF patients decreased significantly from 59.3% to 7.0%. Clusterin had better ability for predicting the prognosis of HBV-ACLF patients than did the model for end-stage liver disease (MELD) score and the chronic liver failure consortium (CLIF-C) ACLF score (MELD vs. clusterin: P = 0.012 ; CLIF-C ACLF vs. clusterin: P = 0.031). Conclusion. Serum clusterin is a potential biomarker for HBV-ACLF which can be used to assess clinical severity and the short-term prognosis of patients with this disease and may help clinicians identify HBV-ACLF with greater specificity and improved prognostic accuracy than existing prognostic markers. [ABSTRACT FROM AUTHOR]

Background: Individuals with hepatocellular carcinoma (HCC) are at risk of tumor recurrence after surgical resection, which affects their survival. The aim of the present study was to establish a model for predicting tumor progression in patients with HCC. Methods: To develop and validate the efficacy of a novel prognostic model, a retrospective cohort with HCC (n = 1005) at Beijing Ditan Hospital was enrolled from January 2008 and June 2017. Furthermore, a prospective cohort (n = 77) was recruited to validate the association between thyroid-stimulating hormone (TSH) levels and tumor progression in patients with HCC. Results: The model used in predicting the progression of HCC included four variables (namely, Barcelona Clinic Liver Cancer [BCLC] stage, presence of portal vein tumor thrombus, alpha-fetoprotein level, and TSH level). The AUROC of the 1-year progression-free survival (PFS) model was 0.755 and 0.753 in the deriving cohort and validation cohort, respectively, and these values were significantly higher than those of the Child–Pugh score, Model for End-stage Liver Disease (MELD), tumor–lymph node–metastasis (TNM) staging system, Okuda classification, and CLIP score. A simple assessment using a nomogram showed the 1-year PFS rate of patients with HCC. In the prospective cohort, the KM curve showed that the high TSH level group had a shorter PFS than the low TSH level (p = 0.001). Conclusion: The prognostic model of HCC progression was superior to other well-known classical tumor scoring systems. A high TSH level was correlated to poor outcome, particularly those with advanced HCC. [ABSTRACT FROM AUTHOR]

Aim. Fuzhenghuayu (FZHY) capsule can inhibit the progression of cirrhosis. This study explored whether FZHY can reduce the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy. Methods. A retrospective review of 842 patients with HBC between 2011 and 2015 was performed, including 270 treated with FZHY combined with nucleos (t) ide analogues (NAs) and 572 with NAs alone. The incidence of HCC was compared between the FZHY (n = 259) and control (n = 259) groups using 1 : 1 propensity score (PS) matching. The incidence of HCC in patients with HBC with different Child-Turcotte-Pugh (CTP) classifications and Toronto HCC risk index (THRI) scores was analyzed using Kaplan–Meier curves. Results. The 5-year cumulative incidence of HCC before and after PS matching was 151 (17.9%) and 86 (16.6%), respectively. In PS-matched samples, the multivariate Cox proportional-hazards model indicated that the FZHY group demonstrated a significantly lower risk for HCC than the control group (adjusted hazard ratio [aHR] = 0.32, 95% CI 0.19–0.53 P < 0.001). The risk of HCC diminished with increased duration of FZHY use. The stratified analysis revealed that the FZHY group, regardless of CTP classification, benefited significantly from FZHY therapy. Patients in the medium- and high-THRI risk groups were the dominant population for FZHY. Conclusions. FZHY combined with NAs was associated with a significantly lower risk of HCC than NAs alone in patients with HBC, which supports the integration of FZHY with antiviral treatment into clinical practice. [ABSTRACT FROM AUTHOR]

Objectives:Fufang Banmao (FFBM) capsule, a type of Chinese medicinal formulation, has decades of history in treating hepatocellular carcinoma (HCC). This retrospective study aimed to observe the effect of FFBM capsules on the 6-month survival of patients with advanced HCC and Vp3–4 portal vein tumor thrombosis (PVTT) who received supportive therapy alone. Design: In total, 320 HCC/Vp3–4 PVTT patients underwent treatment with supportive therapy, of whom 95 took FFBM capsules and were treated with supportive therapy (FFBM group) and 225 received supportive therapy alone (control group). Comparisons of the 6-month overall survival (OS) rate of the two groups were performed. Propensity score matching (PSM) was used to match the characteristics between individuals in the two groups. A nomogram was built based on independent predictive factors for OS. Results: Cox multivariate analysis revealed that hepatic encephalopathy, aspartate transaminase (AST) and γ-glutamyl transpeptidase levels, Child–Pugh class, prothrombin time, α-fetoprotein level, largest tumor diameter, and use of FFBM capsules were independent predictive factors of OS. Variceal bleeding, alanine transaminase, AST, total bilirubin, and Barcelona Clinic for Liver Cancer stage were different at baseline in the FFBM and control groups. Analysis revealed no significant adverse effects or toxicities relevant to the medications. After PSM (1:1), 95 patient pairs were analyzed as FFBM versus control. The OS probability was remarkably higher for patients in the FFBM group than in those in the control group at 6 months (p < 0.0001). The median survival time was 4 months in the FFBM group and 2.2 months in the control group. Kaplan–Meier analysis showed significant statistical differences in the 6-month OS rates in the patients with total nomogram scores ≥84 (p < 0.0001). Conclusions: Given the satisfying survival outcomes, the results suggested that FFBM capsules should be administered to patients with HCC/Vp3–4 PVTT in the high-risk group (score ≥84). FFBM capsules have the potential for improving patient survival time in those with advanced HCC and Vp3–4 PVTT who receive supportive therapy alone, especially those in the high-risk group (score ≥84). [ABSTRACT FROM AUTHOR]