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Objective With increasing difficulty in phosphate ore prospecting, there are an increasing number of geological exploration reports. The manual recognition of geological information related to phosphate rock mineralization in massive documents is time-consuming and inefficient. It cannot meet the needs of knowledge sharing, dissemination and intelligent management of geological reports. Methods To quickly obtain the ore-forming geological knowledge hidden in the phosphate ore reports, this work intends to establish an automatic recognition method for ore-forming geological entities based on the extreme learning machine network(XLNET) model. First, BIO labelling of entities was carried out to establish a geological entity dictionary, and XLNET was used as the underlying preprocessing model to learn the bidirectional semantics of sentences. Then, the BILSTM-Attention-CRF(bidirectional long short term memory(BILSTM)-self attention layer(Attention)-conditional random field(CRF)) model was used to realize intelligent classification of multiple text labels. Finally, the ore-forming conditions and ore-forming model of phosphate ore in the reports were roughly predicted by locating the distribution position of phosphate ore entities in the report. Results Comparing this model with the other three models, these results show that the accuracy rate, recall rate and F1 value of this model are close to 90%, which are 2%, 5% and 6% higher than those of the previous three models, respectively. Conclusion This study provides a more efficient method for automatic geological entity recognition for geological researchers in the Kaiyang phosphate mine.

The World Health Organization (WHO) 2017 classifications for neuroendocrine neoplasms (NENs) subdivided grade 3 pancreatic neuroendocrine neoplasms (pNENs) into G3 well-differentiated pancreatic neuroendocrine tumors (G3 pNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (pNECs), according to the mitotic count, Ki-67 index, and cell differentiation. As a new category, G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice. Therefore, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

Abstract Introduction Bronchobiliary fistulas are rare and difficult to treat. Peacock first reported this entity in 1850 while treating a patient with hepatic encopresis. Case presentation A 67-year-old Chinese male patient presented to the outpatient clinic with a complaint of coughing up phlegm with chest tightness for 4 days with symptoms of intermittent bilirubin sputum with a sputum volume of about 500 ml per day but no symptoms of abdominal pain or jaundice and no yellow urine or steatorrhea. The examination revealed cyanosis of the lips and mouth, barrel chest, low breath sounds on the right side, and a large number of wet rales heard in both lungs. The imaging investigations were suggestive of bronchobiliary fistula. Therefore, the patient was operated on and discharged with no perioperative complications. Conclusion Bronchobiliary fistula should be considered diagnostically in patients with known liver disease who also experience trauma or medical treatment and cough up bile-colored sputum, regardless of the presence of concurrent infections, and in conjunction with radiological expertise to identify it. Here, we report a case of bronchobiliary fistula and a brief review of the literature on it.

Yield and its components are greatly affected by climate change. Adjusting the sowing date is an effective way to alleviate adverse effects and adapt to climate change. Aiming to determine the optimal sowing date of summer maize and clarify the contribution of climatic variables to grain yield and its components, a consecutive 4-year field experiment was conducted from 2016 to 2019 with four sowing dates at 10-day intervals from 5 June to 5 July. Analysis of historical meteorological data showed that more solar radiation (SR) was distributed from early June to mid-August, and the maximum temperature (Tmax) > 32°C appeared from early July to late August, which advanced and lasted longer in 1991–2020 relative to 1981–1990. Additionally, the precipitation was mainly distributed from early June to late July. The climate change in the growing season of summer maize resulted in optimal sowing dates ranging from 5 June to 15 June, with higher yields and yield stability, mainly because of the higher kernel number per ear and 1,000-grain weight. The average contribution of kernel number per ear to grain yield was 58.7%, higher than that of 1,000-grain weight (41.3%). Variance partitioning analysis showed that SR in 15 days pre-silking to 15 days post-silking (SS) and silking to harvest (SH) stages significantly contributed to grain yield by 63.1% and 86.4%. The extreme growing degree days (EDD) > 32°C, SR, precipitation, and diurnal temperature range (DTR) contributed 20.6%, 22.9%, 14.5%, and 42.0% to kernel number per ear in the SS stage, respectively. Therefore, we concluded that the early sowing dates could gain high yield and yield stability due to the higher SR in the growing season. Meanwhile, due to the decreasing trend in SR and increasing Tmax trend in this region, in the future, new maize varieties with high-temperature resistance, high light efficiency, shade tolerance, and medium-season traits need to be bred to adapt to climate change and increased grain yield.

Many management strategies are available for pancreatic neuroendocrine neoplasms with liver metastases. However, a lack of biological, molecular, and genomic information and an absence of data from rigorous trials limit the validity of these strategies. This review presents the viewpoints from an international conference consisting of several expert working groups. The working groups reviewed a series of questions of particular interest to clinicians taking care of patients with pancreatic neuroendocrine neoplasms with liver metastases by reviewing the existing management strategies and literature, evaluating the evidence on which management decisions were based, developing internationally acceptable recommendations for clinical practice, and making recommendations for clinical and research endeavors. The review for each question will be followed by recommendations from the panel.

Introduction The surgical intervention approach to insulinomas in proximity to the main pancreatic duct remains controversial. Standard pancreatic resection is recommended by several guidelines; however, enucleation (EN) still attracts surgeons with less risk of late exocrine/endocrine insufficiency, despite a higher postoperative pancreatic fistula (POPF) rate. Recently, the efficacy and safety of preoperative pancreatic stent placement before the EN have been demonstrated. Thus, a multicentre open-label study is being conducted to evaluate the efficacy and safety of stent placement in improving the outcome of EN of insulinomas in proximity to the main pancreatic duct.Methods and analysis This is a prospective, randomised, open-label, superiority clinical trial conducted at multiple tertiary centres in China. The major eligibility criterion is the presence of insulinoma located in the head and neck of the pancreas in proximity (≤2 mm) to the main pancreatic duct. Blocked randomisation will be performed to allocate patients into the stent EN group and the direct EN group. Patients in the stent EN group will go through stent placement by the endoscopist within 24 hours before the EN surgery, whereas other patients will receive EN surgery directly. The primary outcome is the assessment of the superiority of stent placement in reducing POPF rate measured by the International Study Group of Pancreatic Surgery standard. Both interventions will be performed in an inpatient setting and regular follow-up will be performed. The primary outcome (POPF rate) will be tested for superiority with the Χ2 test. The difference in secondary outcomes between the two groups will be analysed using appropriate tests.Ethics and dissemination The study has been approved by the Peking Union Medical College Hospital Institutional Review Board (K23C0195), Ruijin Hospital Ethics Committee (2023-314), Peking University First Hospital Ethics Committee (2024033-001), Institutional Review Board of Xuanwu Hospital of Capital Medical University (2023223-002), Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2023LSK-473), Institutional Review Board of Tongji Medical College Tongji Hospital (TJ-IRB202402059), Ethics Committee of Tongji Medical College Union Hospital (2023-0929) and Shanghai Cancer Center Institutional Review Board (2309282-16). The results of the study will be published in an international peer-reviewed journal.Trial registration number NCT05523778.

In clinical practice, pancreatic neuroendocrine neoplasms (pNENs) with a diameter smaller than 2 cm are commonly referred to as small pNENs. Due to their generally favorable biological characteristics, the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial. In response to this, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs, which is based on evidence-based medicine and expert opinions. This consensus covers various topics, including concepts, disease assessment, treatment selection, follow-up, and other relevant aspects.

BackgroundPancreatic cancer is one of the deadliest cancer, with a 5-year overall survival rate of 11%. Unfortunately, most patients are diagnosed with advanced stage by the time they present with symptoms. In the past decade, microbiome studies have explored the association of pancreatic cancer with the human oral and gut microbiomes. However, the gut microbial antibiotic resistance genes profiling of pancreatic cancer patients was never reported compared to that of the healthy cohort.ResultsIn this study, we addressed the gut microbial antibiotic resistance genes profile using the metagenomic data from two online public pancreatic cancer cohorts. We found a high degree of data concordance between the two cohorts, which can therefore be used for cross-sectional comparisons. Meanwhile, we used two strategies to predict antibiotic resistance genes and compared the advantages and disadvantages of these two approaches. We also constructed microbe-antibiotic resistance gene networks and found that most of the hub nodes in the networks were antibiotic resistance genes.ConclusionsIn summary, we describe the panorama of antibiotic resistance genes in the gut microbes of patients with pancreatic cancer. We hope that our study will provide new perspectives on treatment options for the disease.

Objective:. Different SSTR2 antagonists have been developed. This study aims to evaluate the impact of different peptides and chelators on the diagnostic performance of SSTR2 antagonists in well-differentiated NETs. Methods:. In this prospective study, participants were equally randomized into 2 arms: arm A, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-DOTA-LM3 PET/CT scan on the second day; arm B, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-NODAGA-JR11 PET/CT scan on the second day. Biodistribution in normal organs, lesion detection ability, and tumor uptakes were compared within each arm. Results:. A total of 40 participants (age, 49.5 ± 13.4, 21 men), 20 in each arm, were recruited in the study. In arm A, 68Ga-DOTA-LM3 showed lower background. However, the lesion detection ability (overall lesion detected, 445 vs 548; P = .005) and the lesion uptake (overall lesions SUVmax, 19.8 ± 17.2 vs 35.3 ± 28.8; P < .001) was significantly lower than those of 68Ga-NODAGA-LM3. In arm B, both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 showed similar biodistribution and lesion uptake (SUVmax, 28.5 ± 23.8 vs 25.0 ± 20.0; P < .001) despite minor differences. The lesion detection ability was the same between these 2 tracers (overall lesion detected, 503 vs 503). Conclusions:. The diagnostic performance of SSTR2 antagonists was sensitive to chelators. Both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 outperformed 68Ga-DOTA-LM3 with higher lesion uptake and detection ability, of which 68Ga-NODAGA-LM3 had marginally but significantly higher lesion uptake.

Summary: The high-throughput sequencing at single-cell resolution requires high-quality samples of inputted 100–10,000 cells with at least 80%–90% viability according to the applied platform. Here, we present a protocol for single-cell isolation from normal and neoplastic human pancreas. We describe steps for sample harvesting, procurement, tissue digestion, and cell purification. Subsequently, isolated cells can be further applied to single-cell profiling, for example, single-cell RNA sequencing and single-cell ATAC-seq using 10× Genomics platform.For complete details on the use and execution of this protocol, please refer to Peng et al. (2019)1 and Li et al. (2021).2 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract In recent decades, immune checkpoint blockade and chimeric antigen receptor T cell (CAR-T) therapy are two milestone achievements in clinical immunotherapy. However, both show limited efficacies in most solid neoplasms, which necessitates the exploration of new immunotherapeutic modalities. The failure of CAR-T and immune checkpoint blockade in several solid neoplasms is attributed to multiple factors, including low antigenicity of tumor cells, low infiltration of effector T cells, and diverse mechanisms of immunosuppression in the tumor microenvironment. New adoptive cell therapies have been attempted for solid neoplasms, including TCR-T, CAR-natural killer cells (CAR-NK), and CAR-macrophages (CAR-M). Compared to CAR-T, these new adoptive cell therapies have certain advantages in treating solid neoplasms. In this review, we summarized the 40-year evolution of adoptive cell therapies, then focused on the advances of TCR-T, CAR-NK, and CAR-M in solid neoplasms and discussed their potential clinical applications.

Background:. Pancreaticoduodenectomy (PD) has been widely applied in general hospitals in China; however, there is still a lack of unified standards for each surgical technique and procedure. This survey is intended to investigate the current status of digestive tract reconstruction after PD in university hospitals in China. Method:. A cross-sectional survey was conducted among the members of the Young Elite Pancreatic Surgery Club of China by using the Questionnaire for Digestive Tract Reconstruction after Pancreaticoduodenectomy. The questionnaire was disseminated and collected by point-to-point communication via WeChat public platforms. Results:. A total of 73 valid questionnaires were returned from 65 university hospitals in 28 provincial divisions of mainland China. The respondents who performed PD surgery with an annual volume of over 100 cases accounted for 63%. Generally, laparoscopic PD was performed less often than open PD. Child and Whipple reconstructions accounted for 70% and 26%, respectively. The sequence of pancreatoenteric, biliary-enteric, and gastrointestinal reconstruction accounted for 84% of cases. In pancreatoenteric anastomosis, double-layer anastomosis is the most commonly employed type, accounting for approximately 67%, while single-layer anastomosis accounts for 30%. Of the double-layer anastomoses, duct-to-mucosa/dunking (94%/4%) pancreatojejunostomy was performed with duct-mucosa using the Blumgart method (39%) and Cattel-Warren (29%), with continuous/interrupted sutures in the inner layer (69%/31%) and continuous/interrupted sutures in the outer layer (53%/23%). In single-layer anastomosis, continuous/interrupted sutures accounted for 41%/45%. In hepatojejunostomy, single-layer/double-layer suture accounted for 79%/4%, and continuous/interrupted suture accounted for 75%/9%. Forty-six percent of the responding units had not applied double-layer biliary-intestinal anastomosis in the last 3 years, 75% of the responding surgeons chose the anastomosis method according to bile duct diameter, with absorbable/non-absorbable suture accounting for 86%/12%. PD/pylorus-preserving PD accounted for 79%/11% of gastrojejunostomy (GJ) cases, the distance between GJ and hepaticojejunostomy < 30, 30–50, and > 50 cm were 11%, 75%, and 14%, respectively. Antecolic/retrocolic GJ accounted for 71%/23% of cases. Twenty-two percent of GJ cases employed Braun anastomosis, while 55% and 19% of GJ cases used linear cutting staplers/tube-type staplers, respectively; 60%/14% were reinforced/not reinforced via manual suturing after stapler anastomosis. Manual anastomosis in GJ surgery employed absorbable/non-absorbable sutures (91%/9%). Significant differences in reconstruction techniques were detected between different volumes of PD procedures (100/year), regions with different economic development levels, and between north and south China. Conclusion:. Digestive tract reconstruction following PD exists heterogeneity in Chinese university hospitals. Corresponding prospective clinical studies are needed to determine the consensus on pancreatic surgery that meets the clinical reality in China.

Objective:. Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP. Methods:. We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method. Results:. We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases. Conclusion:. In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.

Abstract Objective To investigate the clinical characteristics of patients with multiple endocrine neoplasia type 1 (MEN1)-related insulinoma and their relationship with specific biochemical changes and to summarize the features of treatment options for the Chinese population with this disease and the impact on long-term prognosis. Methods “MEN1” and “insulinoma” were used when searching the Peking Union Medical College Hospital (PUMCH) medical record retrieval system to obtain clinical information about patients. We identified patients diagnosed with MEN1-associated insulinoma based on endocrinological, radiological, and pathological examinations, and subsequently analyzed their clinical data. Results A total of 55 patients with MEN1-associated insulinoma were included, including 29 (52.7%) men and 26 (47.3%) women. The parathyroid gland was the most commonly affected (78.2%), followed by the pituitary gland (69.1%) and adrenal gland (16.4%). Insulinoma was the first manifestation of MEN1 in at least 23.6% (13/55) of patients. Nineteen (34.5%) patients presented with initial symptoms of hypoglycemia before the age of 22 years. Among the 24 Patients with high serum calcium (Ca) had significantly lower serum insulin levels than those with normal serum Ca levels (p

BackgroundInsulinoma is a rare type of pancreatic neuroendocrine tumor with low incidence and low-malignant features. While very few insulinomas present with malignant behaviours, such as lymph node and liver metastasis, only a few studies have focused on this field owing to the limitation of samples. Existing evidence suggests that metastatic insulinoma largely derive from non-functional pancreatic neuroendocrine tumor. However, we found a portion of metastatic insulinomas may derive from non-metastatic insulinomas and explored their clinicopathological signatures and genetic characteristics.MethodsFour metastatic insulinoma patients with synchronous liver metastasis or lymph node metastasis at the Peking Union Medical College Hospital between October 2016 and December 2018 were enrolled, and whole exon and genome sequencing were performed on fresh frozen tissues and peripheral blood samples. Clinicopathological information and genomic sequencing results were collected and matched to explore the characteristics of the metastatic insulinomas.ResultsThese four metastatic insulinoma patients underwent surgery or interventional therapy, and their blood glucose levels immediately increased and maintained within standard range after treatment. For these four patients, the proinsulin/insulin molar ratio

Abstract. Objective:. In 2015, the Chinese Pancreatic Association of the Chinese Society of Surgery of the Chinese Medical Association launched a national multicenter online system for registration of surgical treatment of pancreatic cancer in China, called China Pancreas Data Center (CPDC). With continued effort, the CPDC has developed over time. Herein, we report the general results of the CPDC from January 2016 to January 2020 to present the real-world situation of surgical treatment of pancreatic cancer in China. Methods:. The data of the CPDC from January 2016 to January 2020 were retrieved and analyzed in this real-world study, including the data on patient demographics, comorbidities, diagnostic modalities, neoadjuvant treatment, surgical procedures, postoperative complications and treatment, pathological examinations, postoperative adjuvant treatment, survival, and risk factors. Results:. A total of 13,595 cases from 70 centers in 28 provinces were retrieved for analysis. This study reported the largest cohort of patients who underwent surgical treatment for pancreatic cancer in China to date. More cases were derived from the Eastern regions, among which Shanghai, Beijing, and Zhejiang ranked in the top three. The peak age of the patients ranged from 60 to 69 years. The ratio of males to females was 1.5:1. Overall, 64.3% of the tumors were located in the head and neck of the pancreas, and 35.7% in the body and tail of the pancreas. Of the patients, 23.0% underwent positron-emission tomography-computed tomography, 21.6% underwent endoscopic ultrasound, and 4.8% underwent preoperative biopsy. Two percent of the patients underwent neoadjuvant treatment, while 68.9% underwent R0 surgical resection (margin free of tumor cells). Of the latter, 78.6% of the operations were open procedures, 12.6% were laparoscopic procedures, 2.9% were robotic procedures, and 3.7% were converted to open procedures. The in-hospital mortality rate after surgery was 0.4%. The incidence of grade 2 and grade 3 postoperative pancreatic fistulas was 25.5% and 2.5%, respectively. The incidence of complications based on the Clavien-Dindo classification was 17.9% of grade II, 4.3% of grade IIIa, 1% of grade IIIb, and 0.6% of grade IV. Of the patients, 28.9% underwent postoperative adjuvant chemotherapy. The 1-year, 2-year, and 3-year overall survival of these patients were 77%, 51%, and 38%, respectively. In the 8542 patients who underwent R0 resection, the 1-year, 2-year, and 3-year overall survival and disease-free survival were 77%, 54%, and 43%, and 68%, 49%, and 41%, respectively. The factors related to the prognosis of these patients were also identified after uni- and multi-variate analyses. Conclusion:. The surgical quality, safety, and long-term survival of the patients in CPDC are similar to those of international high-volume pancreatic centers. However, neoadjuvant and postoperative adjuvant chemotherapy should be improved.

Meteorites are an essential reference for human exploration of the universe and its cosmic evolution and an essential research object for searching for extraterrestrial life. Ways to quickly identify and screen suspected meteorite samples have become the foundation and prerequisite for research on high-value meteorite samples. Therefore, this paper proposes a Raman mapping-assisted micro-laser induced breakdown spectroscopy (micro-LIBS) technology for field detection of suspected meteorite material composition without sample pre-processing, with a high detection speed and cost-effectiveness, to realize the detection of element composition and molecular structure. Raman mapping carries out multispectral imaging with high spectral resolution of the region of interest. The fusion of Raman mapping and optical microscopy images can provide mineral categories and spatial distribution characteristics in regions of interest. A quantitative analysis model for Fe, Mg, and Na elements was constructed based on the multidimensional scaling–back propagation neural network (MDS-BPNN) algorithm. The determination coefficient of the model test set was better than 0.997, and the root mean square error was better than 0.65. The content of Fe, Mg, and Na elements in the meteorite was preliminarily evaluated, providing a reference for further analysis of element information in spectral image fusion data. The Raman–LIBS combined technology has significant application potential in rapidly evaluating suspected meteorite samples. Without high-end precision instruments or field research, this technology can provide scientists with significant reference value atomic and molecular spectral information. At the same time, this technology can be extended to other petrology research. We offer a fast, efficient, cost-effective, and reliable analysis scheme for reference.

Abstract. Objective:. Pancreatic cancer is one of the most aggressive digestive system malignant tumors, and its clinical diagnosis and treatment are still challenging. To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China, we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021. Methods:. In this cross-sectional questionnaire-based, observational study, online questionnaires with real-name authentication were used to gather data from 500 clinicians, 50 pharmacists, and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide. Results:. A total of 485 valid questionnaires were obtained from the clinicians, majority of whom were from economically better developed regions or cities of China. There were multi-disciplinary team treatment (MDT) clinics for pancreatic cancer patients in 60% of the hospitals. Minimally invasive surgeries could be performed in all the surveyed hospitals. However, open surgery was still the mainstream choice in most cases. Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer. A total of 50 valid questionnaires were collected from pharmacists, 48% of them are not satisfactory with the efficacy of the chemotherapeutic drugs, and myelosuppression, liver, and renal damage were the most concerning side effects. In total, 1011 valid questionnaires were collected from the patients. Approximately, 48.4% of the patients did not know about pancreatic cancer before becoming ill. Over 80% of pancreatic cancer patients reported poor to very poor health-related quality of life, and the estimated overall medical expenses were within ¥400,000 ($58823.53) in 80% of the patients. Clinicians, pharmacists, and patients believe that popularizing scientific knowledge of pancreatic cancer, constructing MDT clinics and fast-lane system, and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer. Conclusions:. The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals. Minimally invasive pancreatic surgery has developed rapidly in China; however, open surgery is still the mainstream choice for pancreatic cancer. The proportion of adjuvant treatment has been significantly improved, and the gemcitabine-based regimen is the most commonly used first-line regimen. Most of the public still lacks the general knowledge of pancreatic cancer, needing further popularization. The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients. The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.

Abstract. Aiming to keep pace with the renewal of international guidelines and refine the domestic treatment system of pancreatic cancer, the Chinese Pancreatic Surgery Association, Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association launched this Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020 edition). Based on the Grading of Recommendations Assessment, Development, and Evaluation system, the guidelines have conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis, surgery strategy, etc. The guidelines have quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in neoadjuvant therapy of pancreatic cancer. The guidelines have highlighted the role of multiple disciplinary team and represented the conversion of treatment concepts in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice, and improve the survival of patients.

PurposeAn end-of-fast insulin level ≥ 3 µIU/ml, C-peptide level ≥ 0.6 ng/ml, and proinsulin level ≥ 5 pmol/l with end-of-fast glucose level ≤ 3.0 mmol/l have been established as the criteria for endogenous hyperinsulinemic hypoglycemia. However, all these criteria have been proposed based on patients in Western populations. This study aimed to determine the optimal criteria using a large series of Chinese patients.MethodsThis retrospective study comprised 144 patients with surgically proven insulinoma and 40 controls who underwent a 72-h fasting test at the Peking Union Medical College Hospital(PUMCH) from 2000 to 2020. Receiver operating characteristic curves were used for analysis.ResultsIn this series of patients, the optimal diagnostic criteria for endogenous hyperinsulinemic hypoglycemia were insulin ≥ 5.5 μIU/ml, C-peptide ≥ 0.7 ng/ml, and proinsulin ≥ 12 pmol/l with end-of-fast glucose ≤ 2.8 mmol/l; the sensitivity and specificity were 99% and 100% for insulin, 100% and 100% for C-peptide, and 93% and 100% for proinsulin, respectively. The diagnostic efficacy of the criteria based on Western populations was then tested. The sensitivity and specificity of end-of-fast insulin ≥ 3 μIU/ml, C-peptide ≥ 0.6 ng/ml, and proinsulin ≥ 5 pmol/l with end-of-fast glucose ≤ 3.0 mmol/l were 100% and 83%, 100% and 80%, and 97% and 78%, respectively.ConclusionsNew and optimized diagnostic criteria for endogenous hyperinsulinemic hypoglycemia in Chinese populations have been proposed, and these criteria yield satisfactory accuracy.

Abstract A random modulation strategy is proposed to suppress the torque ripple of asynchronous motor for electric vehicle in this article. First, the models of harmonic torque and torque ripple are established. The reason of harmonic generation and its effect on torque are analysed. Second, the random position pulse width modulation (PWM) strategy with different random quantities is introduced. The problem of the increasing harmonic content near the integer multiple of the switching frequency in the modulation process is solved. Subsequently, the influences of different random quantity distributions and random number ranges on harmonic suppression are studied. The different structures of random pulse position space vector PWM strategy based on uniform probability density are designed. The specific harmonic content is dispersed and the torque ripple is suppressed. Finally, the precise test platform based on cSPACE is established. The influence of different random PWMs on motor at various speeds is compared. Experimental results verify the validity of the proposed approach.

Abstract. Acute pancreatitis (AP) is a common acute abdominal condition of the digestive system. In recent years, treatment concepts, methods, and strategies for the diagnosis of AP have advanced, and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients. On the basis of previous guidelines and expert consensus, this guideline adopts an evidence-based, problem-based expression; synthesizes important clinical research data at home and abroad in the most recent 5 years; and forms 29 recommendations through multidisciplinary expert discussion, including diagnosis, treatment, and follow-up. It is expected to provide evidence support for the treatment of AP in the clinical setting in China.

Abstract. The incidence of pancreatic cancer has been rising worldwide, and its clinical diagnosis and treatment remain a great challenge. To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years, Chinese Pancreatic Association, the Chinese Society of Surgery, Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China (2014) after reviewing evidence-based and problem-oriented literature published during 2015–2021, mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer, conversion strategies for locally advanced pancreatic cancer, treatment of pancreatic cancer with oligo metastasis, adjuvant and neoadjuvant therapy, standardized processing of surgical specimens and evaluation of surgical margin status, systemic treatment for unresectable pancreatic cancer, genetic testing, as well as postoperative follow up of patients with pancreatic cancer. Forty recommendation items were finally proposed based on the above issues, and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation, Assessment, Development, and Evaluation system. This guideline aims to standardize the clinical diagnosis and therapy, especially surgical treatment of pancreatic cancer in China, and further improve the prognosis of patients with pancreatic cancer.

Abstract. Objective:. Pancreatic cancer (PC) is a highly lethal malignancy with an immunosuppressive environment. Yet, current immune checkpoint inhibitor monotherapies have shown limited efficacy in PC, prompting the need for combination therapies. Herein, we hypothesized that combinations of Notch signaling inhibitor and anti-ligand programmed death-ligand 1 (PD-L1) antibody immunotherapy would show synergistic efficacy. Methods:. The baseline expression of PD-L1 and HES1 was measured in PC cell lines, single-cell RNA-seq data of PC (GSA: CRA001160), and cBioPortal databases. In an in vitro study, MIA PaCa2 and SW1990 were used to explore the mechanism between Notch signaling and PD-L1. To study the effects in vivo, a subcutaneous tumor model was established using Pan02 cells treated with either anti-PD-L1 monoclonal antibody and/or Notch inhibitor DAPT. The study performed involving human samples was approved by the Ethics Committee of Peking Union Medical College Hospital (approval No. S-K460, approval date: April 23, 2018). Animal studies were approved by the Animal Research Ethics Committee of Peking Union Medical College Hospital (approval No. XHDW-2019-049, approval date: November 28, 2019). Results:. The Notch signaling inhibitor upregulated PD-L1 expression in PC tumor cells both in vitro and in vivo. Notch effector HES1 knockdown produced PD-L1 upregulation in both MIA PaCa2 and SW1990 cells. Combined DAPT and anti-PD-L1 antibody treatment of Pan02 subcutaneous tumor model resulted in significantly reduced tumor weights compared to that with monotherapy, as well as significantly reduced Ki67 than that in the monotherapy group and control group. Flow cytometry analysis revealed significantly increased CD8+ T cell infiltration in tumors of the combination group compared with those of the monotherapy group. Conclusion:. Notch signaling blockade might enhance the antitumor effect of anti-PD-L1 therapy in PC.

Digital PCR is the most advanced PCR technology. However, due to the high price of the digital PCR analysis instrument, this powerful nucleic acid detection technology is still difficult to be popularized in the general biochemistry laboratory. Moreover, one of the biggest disadvantages of commercial digital PCR systems is the poor versatility of reagents: each instrument can only be used for a few customized kits. Herein, we built a low-cost digital PCR system. The system only relies on low-cost traditional flat-panel PCR equipment to provide temperature conditions for commercial dPCR chips, and the self-made fluorescence detection system is designed and optically optimized to meet a wide range of reagent requirements. More importantly, our system not only has a low cost (

Summary: Healthy adipose tissue is crucial to maintain normal energy homeostasis. Little is known about the role of murine double minute 2 (MDM2), an E3 ubiquitin ligase and has been highlighted in oncopathology, in adipose tissue. Our results indicated that MDM2 expression was associated with nutritional status. Mdm2 adipocyte-specific knock-in (Mdm2-AKI) mice exhibited exacerbated weight gain, insulin resistance, and decreased energy expenditure. Meanwhile, chronic high-fat diet (HFD) exposure caused obvious epididymal white adipose tissue (eWAT) dysfunction, such as senescence, apoptosis, and chronic inflammation, thereby leading to hepatic steatosis in Mdm2-AKI mice. Mechanically, MDM2 could interact with six-transmembrane epithelial antigen of prostate 4 (STEAP4) and inhibit STEAP4 expression through ubiquitin-mediated STEAP4 degradation. Thereinto, the K18 and K161 sites of STEAP4 were ubiquitin-modificated by MDM2. Finally, STEAP4 restoration in eWAT of Mdm2-AKI mice on a HFD rescued MDM2-induced adipose dysfunction, insulin resistance, and hepatic steatosis. Summary, the MDM2-STEAP4 axis in eWAT plays an important role in maintaining healthy adipose tissue function and improving hepatic steatosis.

Abstract. Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Abstract High performance mid‐infrared photodetectors play an irreplaceable role in optical communication, security monitoring, biological, and medical imaging and so on. Two‐dimensional (2D) materials have demonstrated great potential for infrared photodetection application. In recent years, the research on 2D materials based mid‐infrared photodetectors has underwent a fast growth. In this review, we summarize recent advances in the 2D materials based photodetectors, with an emphasis on mid‐infrared photodetection. In the first section, we start with a brief discussion on the potential advantages of 2D materials for mid‐infrared photodetection. Next, we focus on the development of 2D mid‐infrared photodetectors, and then discuss the challenges of this rapidly‐growing field. Following this, we review the solutions for improving the device performances and point out the issues remained to be solved. Finally, the future directions in this area are discussed and general advices are provided for the future development of high‐performance mid‐infrared photodetectors based on 2D materials.

The sustainable high yield of crops is critically important under the current situation of global climate warming. In order to improve regional yield, it is urgent to clarify the limiting factors of local grain yield and change the traditional planting measurements to adapt to the warming climate and make full use of climate resources. Long-term field experiments over seven years from 2014 to 2021 were conducted with the same maize cultivar (i.e., Luyu9105) with seven planting density treatments: 3.0 × 104 (D1), 4.5 × 104 (D2), 6.0 × 104 (D3), 7.5 × 104 (D4), 9.0 × 104 (D5), 10.5 × 104 (D6), and 12.0 × 104 (D7) plants per hectare in Taihe and Hefei, which belong to the southern Huang-Huai-Hai (SHHH) and southeast (SE) maize-producing areas in China. According to the field experiment data, differences in grain yield, ear number, kernel number per spike, and 1000-kernel weight of different treatments were analyzed. The utilization efficiency of climate resources in Taihe and Hefei was calculated using daily solar radiation, mean temperature, and precipitation data. The results showed that Taihe had 7.8% higher solar radiation during the growing season of maize than Hefei, while accumulated temperature ≥10 °C (AT10) was 3.9% lower than Hefei. The grain yields of different planting densities in Taihe were 9.7~23.6% higher than in Hefei. The agronomic optimal planting density (AOPD) was 8.6 × 104 plants ha−1 in Taihe and 8.0 × 104 plants ha−1 in Hefei. Compared to the actual grain yields, when the agronomic optimal planting densities were adopted, the simulated yield increased by 51.3% and 59.6%, respectively. The radiation utilization efficiency, temperature utilization efficiency, and precipitation utilization efficiency in Taihe were 12.9%, 24.6%, and 26.7% higher than the values of Hefei, respectively, and D4 and D5 treatments had significantly higher climatic resource utilization efficiency than D1 and D2 treatment. The grain yield was negatively correlated with accumulated temperature ≥10 °C and positively correlated with solar radiation. The multiple linear regression model among solar radiation, accumulated temperature was ≥10 °C, and grain yield was y = 0.550R−0.562AT10 + 14,593.6 (R = 0.379). Accumulated temperature ≥10 °C was the main climatic factor affecting the grain yield due to the higher occurrence probability of a maximum temperature ≥35 °C. Overall, in the future, increasing planting density and alleviating heat stress may enhance grain yield. These results could provide cultivation measurements with regional characteristics to adapt to the local climate and maximize the utilization efficiency of climatic resources.

The coupling relationship between space electronics systems is complex, and the signals of optoelectronic load cables are susceptible to interference, especially the early anomalous weak signals on a ground surface used for immediate remote sensing, which are more susceptible to coupling interference between cables. Ensuring a good grounding state for the cable shield is vital for reducing the interference suffered by cables and increasing the electromagnetic compatibility of the system. In this paper, we propose a shielding grounding optimization method for a spaceborne multi-cable shield, including a cable model and parameter extremization and parameter scanning simulation performed using CST, data processing and truth table transformation conducted using MATLAB, and logic expression extraction carried out using Multisim. The method can sort and classify the shielding effects of all the grounding states of multi-cable shields in batches, and ultimately output logical expressions specifying the mapping relationship between the shield grounding state and shielding effect, allowing the optimal shield grounding state to be quickly identified. Finally, the method was applied to a satellite-borne scanning mirror drive control system, and the effectiveness and accuracy of the method were verified by experimental tests.

ABSTRACT The genus Nocardia includes ubiquitous environmental saprophytes and the most frequently isolated aerobic actinomycete human pathogen responsible for localized or disseminated infection. Herein, the species distribution and antimicrobial susceptibility profiles of 441 nonrepetitive Nocardia strains are reported, collected from 21 provinces/cities in China over 13 years (from 2009 to 2021). These isolates were identified to species level by mass spectrometry or targeted DNA sequencing. The susceptibility profiles of Nocardia species for 15 antibiotics were determined by the broth microdilution method. Among these Nocardia isolates, Nocardia farcinica was the most commonly isolated species (39.9%, 176 of 441), followed by Nocardia cyriacigeorgica (28.6%, 126), Nocardia abscessus (6.6%, 29), and Nocardia otitidiscaviarum (5.9%, 26). Furthermore, 361 Nocardia strains (81.9%) were collected from lower respiratory tract (sputum, lung tissue, and bronchoalveolar lavage fluid), 50 (11.3%) were collected from skin and soft tissues, 9 were collected from blood, 9 were collected from eye, 4 were collected from cerebrospinal fluid and brain abscesses, and 2 were collected from pleural effusion. All of the Nocardia strains were susceptible to linezolid, followed by amikacin (99.3%) and trimethoprim-sulfamethoxazole (TMP-SMX) (99.1%). The antibiotic resistance profiles of other antibiotics varied tremendously among different Nocardia species. This demonstrated that accurate species identification and/or antibiotic susceptibility testing should be performed before the usage of these antibiotics. In summary, this is the largest study on the species and antibiotic resistance profiles of the genus Nocardia circulating in China, and our data will contribute to a better understanding of clinical nocardiosis. IMPORTANCE The genus Nocardia has the potential to cause nocardiosis, which might be underrecognized and underdiagnosed. Herein, the demographical features of 441 nonrepetitive nocardiosis cases and species distribution of their Nocardia strains in China, 2009 to 2021, are summarized. The susceptibility profiles for 15 antibiotics against all of the above Nocardia strains were also determined by the broth microdilution method. To date, this is the largest study on the genus Nocardia contributing to nocardiosis in China. Our study will be helpful for understanding the species diversity of Nocardia isolates distributed in China and for decision-making in the context of nocardiosis diagnosis and treatment.

Pancreatic neuroendocrine neoplasms (pNENs) are a group of heterogeneous neoplasms originating from pancreatic neuroendocrine cells. In recent years, with the development of diagnostic technology, the incidence has increased in the past decades. The surgical treatment for pNEN with synchronous hepatic metastasis (sHM) is complicated, and the indications and prognosis are still controversial. This review provides a comprehensive update of current evidence and progress in guideline recommendations for pNEN-sHM to improve surgical management.

Polymerase chain reaction (PCR) technology is an essential technology for point-of-care testing (POCT) application. To realize the simple, portable and fast detection of bacteria has always been an important technology. In this paper, we developed a pipeline-based oil-bath PCR method, to achieve the PCR amplification and detection for bacteria. We assembled a small-sized system with a uniform temperature environment and a stable heating module. By comparing the PCR performance with the other two existing pipeline-based methods on the reactions of both DNA fragment of H7N9 avian influenza and Escherichia Coli, the results show that the pipeline-based oil-bath PCR method is fully capable of the amplification and detection of both DNA fragment and bacteria. At the meanwhile, we performed two sets of tests, the experiment of pipeline diameter change and bacterial concentration gradient, to verify the sensitivity and universality of this method. The results show that the pipeline-based oil-bath PCR method developed by us not only gets rid of the complicated preparations, offers advantages of simple operation, low-cost and user-friendly, but also provides a stable and portable foundation for our later work.

The convenient division of aqueous samples into droplets is necessary for many biochemical and medical analysis applications. In this article, we propose the design of a cost-effective droplet generator for potential bio-chemical application, featuring two symmetric tubes. The new droplet generator revisits the relationship between capillary components and liquid flow rates. The size of generated droplets by prototype depends only on generator dimensions, without precisely needing to control external flow conditions or driving pressure, even when the relative extreme difference in flow rate for generating nL level droplets is over 57.79%, and the relative standard deviation (RSD) of the volume of droplets is barely about 9.80%. A dropper working as a pressure resource is used to verify the rapidity and robustness of this principle of droplet generation, which shows great potential for a wide range of droplet-based applications.

Objective To investigate the roles of and relationship between microRNA (miR)-330-3p and S100 calcium-binding protein B (S100B) in an animal model of cartilage injury. Methods This study included 30 New Zealand male rabbits randomly divided into three groups: an intervention group, a model group and a sham surgery control group. Modelling was performed in the intervention and model groups, but in the sham surgery group, only the skin was cut. After modelling, the intervention and model groups were injected with the miR-330-3p overexpression vector GV268-miR-330-3p or the control GV268-N-ODN vector, respectively, twice a week for 7 weeks. Results Levels of interleukin-1β and tumour necrosis factor-α in the synovial fluid were significantly higher in the model group than in the intervention and control groups. The level of miR-330-3p in the cartilage tissue was significantly higher in the control group than in the model group but it was significantly lower compared with the intervention group. Levels of S100B, fibroblast growth factor receptor 1 and fibroblast growth factor-2 in the cartilage tissue of rabbits in the model group were significantly higher compared with the control and intervention groups. Conclusion These findings demonstrate that the upregulation of miR-330-3p can inhibit the expression of S100B.

The COVID-19 pandemic poses a threat to global health. Due to its high sensitivity, specificity, and stability, real-time fluorescence quantitative (real-time PCR) detection has become the most extensively used approach for diagnosing SARS-CoV-2 pneumonia. According to a report from the World Health Organization, emerging and underdeveloped nations lack nucleic acid detection kits and polymerase chain reaction (PCR) instruments for molecular biological detection. In addition, sending samples to a laboratory for testing may result in considerable delays between sampling and diagnosis, which is not favorable to the timely prevention and control of new crown outbreaks. Concurrently, there is an urgent demand for accurate PCR devices that do not require a laboratory setting, are more portable, and are capable of completing testing on-site. Hence, we report on HDLRT-qPCR, a new, low-cost, multiplexed real-time fluorescence detection apparatus that we have developed for on-site testing investigations of diverse diseases in developing nations. This apparatus can complete on-site testing rapidly and sensitively. The entire cost of this instrument does not exceed USD 760. In order to demonstrate the applicability of our PCR instrument, we conducted testing that revealed that we achieved gradient amplification and melting curves comparable to those of commercially available equipment. Good consistency characterized the testing outcomes. The successful detection of target genes demonstrates the reliability of our inexpensive PCR diagnostic technique. With this apparatus, there is no need to transport samples to a central laboratory; instead, we conduct testing at the sampling site. This saves time on transportation, substantially accelerates overall testing speed, and provides results within 40 min.

Objective:. The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms (pNENs) undergoing surgery in China. Methods:. This is a multicenter cross-sectional study performed in China. Data from patients with pNENs undergoing surgery at 33 high-volume medical centers, where the number of pancreatectomies exceeds 20 cases per year, were collected and analyzed between March 1, 2016 and February 28, 2017. Results:. In total, 392 patients with pNENs were enrolled. The male to female ratio was 1.4. The majority of patients were aged between 40 and 70 years. 65.6% of the patients had non-functional tumors. Among those with functional tumors, the percentages of insulinomas, gastrinomas, glucagonomas, and vasoactive intestinal peptide-secreting tumors were 94.8%, 1.5%, 2.2%, and 1.5%, respectively. Multidisciplinary team (MDT) discussion was conducted for 39.0% of the patients. Minimally invasive surgery was performed on 31.1% of the 392 patients. The incidence of grade B/C pancreatic fistula formation was 4.4%. A total of 89.0% of the surgeries achieved R0 resection, and 41.6% of the tumors were well differentiated. Lymph node metastasis was present in 8.9% of the patients. The percentages of patients with grades G1, G2, and G3 disease were 49.2%, 45.7%, and 5.1%, respectively. Conclusion:. This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in China. MDT consultation for pNENs has not been widely implemented in China. Although the incidence of surgical complications is relatively low, minimally invasive procedures should be further promoted. This study shows us how to improve the outcomes of these patients.

Abstract. Pancreatic cystic disease is being increasingly identified in patients, and many relevant papers have been published in this field. A bibliometric analysis was previously performed to identify the most influential studies in many subject areas, and the top 100 most cited papers on pancreatic cystic disease were analyzed in this study. The Web of Science database was searched for all papers related to pancreatic cystic disease on June 9, 2018. The top 100 most cited papers were selected and listed in descending order based on the total number of citations (TCs). The author, journal, institution, country of origin, and research focus were further analyzed. The most cited papers were published between 1975 and 2015. Intraductal papillary mucinous neoplasm was the most commonly studied subtype (36%), followed by pancreatic pseudocyst (16%), solid pseudopapillary neoplasm (9%), and mucinous cystic neoplasm (7%). The average number of TCs was 282, and the average citation index value was 21. Thirty-eight journals published the top 100 papers; Annals of Surgery (n = 14) and Gastrointestinal Endoscopy (n = 11) published the most papers. Most papers were published in the United States of America (59%), with the majority from Johns Hopkins Medical Institution (15%). Canto MI from Johns Hopkins Medical Institution authored the largest number of most cited papers (n = 8). This study reviews the significant achievements and developmental trends in pancreatic cystic disease.

Abstract. Objective:. The aim of this study is to investigate the current status of pancreatic cancer patients undoing surgical treatment in China and to find ways to improve the survival of these patients in the future. Methods:. This study is a national, multicenter, cross-sectional study in China. Information regarding pancreatic cancer patients undergoing surgical treatment from 34 high-volume tertiary IIIA level hospitals was collected and analyzed from the March 1, 2016 to the February 28, 2017. Results:. In total, 2200 pancreatic cancer patients were enrolled from 34 tertiary IIIA level hospitals in 16 provinces across China. The male-to-female ratio was 1.5. More than 80% of the patients were between 50 and 70 years old. The top 4 symptoms were epigastric discomfort, abdominal pain, jaundice, and weight loss. Carbohydrate antigen 19-9 and carcinoembryonic antigen were elevated in 70.9% and 27.1% of patients, respectively. A multidisciplinary team (MDT) discussion was carried out for 35.0% of patients before surgery. The proportion of minimally invasive pancreatic surgeries was approximately 20%. A total of 83.4% of the operations achieved R0 resection, and the incidence of grade 3/4 postoperative complications was 7.7%. Only 13.4% of the patients received postoperative adjuvant chemotherapy. The percentage of pathological stage I tumors was only 24.5%. Conclusion:. The majority of pancreatic cancer patients undergoing surgical resection in China are in an advanced stage. The MDT consultations for pancreatic cancer have not been widely carried out. R0 resection has been achieved in most cases, with relatively low incidence of serious complications, but minimally invasive pancreatic surgery should be further promoted. The application of postoperative chemotherapy remains low. This national, multicentre, cross-sectional study comprehensively presents the current status of pancreatic cancer patients undergoing surgical treatment and shows the road to improve survival of these patients in the future.

In order to solve the problem of torque ripple caused by current harmonic of induction motors (IMs) in electric vehicles (EVs) drive system, this paper presents a novel control method in the feedback channel based on morphological filters (MFs) to suppress the current harmonics. First, an analytical model of current harmonics is established, and the current harmonic composition to be filtered in the feedback channel of motor control systems is provided. Second, on the basis of filtering requirements on the feedback channel and the basic idea of mathematical morphology, a hybrid digital MF is designed. The MF is subsequently added on the current loop to suppress the current harmonic components. The shape, width and height of the structural elements of the filter are optimized by parameters comparison methods to improve the performance of the filter in harmonic suppression. Finally, compared with the method based on Butterworth Filter and without filters, simulation and experimental results verify the feasibility and effectiveness of the proposed method for suppressing harmonics.

A current distribution method based on Gaussian process is proposed in this paper. This method can improve the accuracy of current distribution of induction motors for electric vehicles in whole speed range, and achieve high-performance output torque. First, a vector control system based on current distribution model is designed based on control requirement analysis of induction motor. Second, the mathematical model of output torque and current is established. And the current distribution law of the optimal electromagnetic torque under various operating conditions is qualitatively analyzed. Third, the experimental platform is built to obtain the discrete data of current distribution in whole speed range and the rotor time constants at different temperatures. Finally, the Gaussian process is introduced to establish the regression model based on current discrete data. The regression model distributes the current reasonably and accurately, which is embedded in the control system. Experimental results verify the effectiveness of the proposed method.

Abstract. Aims:. Catechol-O-methyltransferase (COMT) plays a role in many kinds of cancer, and its high expression in pancreatic cancer has been found to be related to better prognosis. However, the expression and biological significance of COMT in multistep pancreatic cancerogenesis is not clear. Main methods:. Six LSL-KrasG12D-positive and Pdx1-Cre-positive mice (KrasG12D mice), 6 wild-type mice and 1 human tissue microarray were used in this study. COMT protein expression was measured by immunohistochemistry, and DNA chips were made for use in COMT mRNA assays. Key findings:. The expression of COMT in pancreatic intraepithelial neoplasias (PanINs) from KrasG12D mice was significantly higher than that in normal pancreatic tissue from wild-type mice, both in terms of protein level and mRNA expression. The median COMT immunohistochemistry expression scores in human PanIN-1 and PanIN-2 were 70 and 160, respectively, which were significantly lower than the score of 170 observed in pancreatic ductal adenocarcinoma (PDAC) (P = .024 and .037, respectively) and significantly higher than the score of 25 observed in pancreatitis (P = .01 and .008, respectively). Significance:. In the development of pancreatic cancer from chronic pancreatitis and in the transition of PanIN to PDAC, we observed significantly increased expression of COMT. These data predict that the overexpression of COMT is an early event in the multistep process of pancreatic cancerogenesis.

Abstract. A consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency (PEI) after pancreatic surgery was developed based on the latest references, combined with China's actual situation. More than 20 Chinese excellent experts participated in this work and contributed many thorough discussions. This consensus discusses the definition, epidemiology, diagnosis, treatment, and follow-up of PEI after pancreatic surgery. The authors hope this consensus will promote the standard procedure of diagnosis and treatment of PEI in China.

Abstract. Objectives:. The aim of this multicenter, prospective, registry study was to summarize the epidemiology of Chinese patients with locally advanced and end-stage gastroenteropancreatic neuroendocrine tumors (GEP-NETs) as well as the diagnostic methods and treatment strategies used for these patients. Methods:. GEP-NET patients from 11 departments of 8 hospitals in China were prospectively enrolled for a pre-defined period (June 30, 2011 to May 29, 2012). The patients’ demographic, pathological, and treatment data were recorded, analyzed, and released on June 29, 2015. Results:. Seventy-nine eligible patients were enrolled, and most of these patients were classified according to the World Health Organization 2010 classifications. The most common primary tumor site was the pancreas. The liver was the most common site of metastases, followed by the lymph nodes. The majority of the patients underwent surgical interventions. Patients also received local treatment, medication, or chemotherapy. Conclusion:. The pancreas was the most common primary tumor site of locally advanced and end-stage GEP-NETs. Surgical interventions are currently the most common treatment strategy.

Introduction Several previous studies have reported the incidence of new-onset diabetes mellitus (NODM) after pancreatectomy. Nevertheless, the results were inconsistent. The true rate of NODM after distal pancreatectomy (DP) is still unknown.Research design and methods The aim of this study was to investigate the incidence of and the risk factors for NODM after DP. This study enrolled patients who underwent DP between January 2004 and February 2016 at Peking Union Medical College Hospital. Patients with preoperative diabetes mellitus or diagnosed with pancreatic cancer were excluded. The primary outcome was NODM.Results A total of 485 patients were enrolled. The median (IQR) of follow-up duration was 30.95 (9.26–180.30) months. The accumulative incidence of NODM was 8.9% at postoperative 6 months, 14.0% at postoperative year one, 22.3% at year three, 27.1% at year five, and 35.5% at year ten. Multivariate analysis showed that the risk of postoperative NODM was positively correlated with age (HR 1.029 (1.013–1.045), p

Programmed mini-pumps play a significant role in various fields, such as chemistry, biology, and medicine, to transport a measured volume of liquid, especially in the current detection of COVID-19 with PCR. In view of the cost of the current automatic pipetting pump being higher, which is difficult to use in a regular lab, this paper designed and assembled a three-dimensional programmed mini-pump with the common parts and components, such as PLC controller, motor, microinjector, etc. With the weighting calibration before and after pipetting operation, the error of the pipette in 10 μL (0.2%), 2 μL (1.8%), and 1 μL (5.6%) can be obtained. Besides, the contrast test between three-dimensional programmed mini-pump and manual pipette was conducted with the ORF1ab and pGEM-3Zf (+) genes in qPCR. The results proved that the custom-made three-dimensional programmed mini-pump has a stronger reproducibility compared with manual pipette (ORF1ab: 24.06 ± 0.33 vs. 23.50 ± 0.58, p = 0.1014; pGEM-3Zf (+): 11.83.06 ± 0.24 vs. 11.50 ± 0.34, p = 0.8779). These results can lay the foundation for the functional, fast, and low-cost programmed mini-pump in PCR or other applications for trace measurements.

Traditional qPCR instrument is combined with CMOS and a personal computer, and a photoelectric feedback automatic fluorescence detection system is designed to realize quantitative real-time PCR. The key to reaction efficiency lies in how to ensure that the temperature of the detection reagent completely matches the set temperature. However, for most traditional real-time fluorescent PCR systems, the temperature cycling is controlled by detecting the temperature of the heating well plate. It cannot directly measure the temperature in the reaction reagent PCR tube, which will cause the deviation in the actual temperature of the reagent to be as expected. Therefore, in this paper, we raise a method of directly detecting the temperature in the reaction tube of the reagent during the temperature cycling is adopted. According to the deviation from the expected value, the set temperature of the PCR instrument is adjusted to make the actual temperature of the reagent closer to the expected value. Through this method, we also realized the temperature calibration and optimization of the TEC circulation system we built. Experiments show that this low-cost, portable real-time quantitative PCR system can detect and analyze pathogens in situ.

The novel coronavirus SARS-CoV-2 and the disease caused by it, COVID-19, have spread to virtually all countries worldwide within just a few months. The economic and sanitary impact has been enormous. In March 2020, the World Health Organization declared COVID-19 a pandemic. How to effectively prevent and control SARS-CoV-2 transmission while providing care to surgical patients during the pandemic is a crucial topic. In order to minimize the risk of cross-infection between patients and physicians, many hospitals have taken measures to limit outpatient services, elective hospitalizations, and the number of operations. Based on the prevention and control measures stipulated by major medical institutions in China, this overview provides recommendations for surgeons from three aspects: outpatient treatment, ward management and perioperative protection. Telemedicine should be encouraged as a means of social distancing. Outpatient examination should be selected. Reasonable spatial arrangement and effective environmental disinfection are important for ward management. Patient selection for surgery and timing of operations should be carefully discussed within multi-disciplinary teams. Appropriate personal protective equipment should be worn adapted to the situational risk.On December 31, 2019, China reported to the WHO Country Office a pneumonia of unknown cause detected in Wuhan [1,3]. Subsequently, the disease later named COVID-19 affected a substantial proportion of the population in Wuhan and spread to other areas of China. Relying on a nationwide shutdown and mandatory quarantine, China has effectively curtailed the domestic outbreak. However, due to the high transmissibility of SARS-Cov-2 and the mobility of people, COVID-19 spread to the rest of the world. Many hospitals worldwide were faced with confirmed and suspected SARS-Cov-2 infections, putting a huge strain on the safety of patients and employees. Consequently, surgical patients who seek medical care during the COVID-19 pandemic present significant challenges. This paper summarizes medical care and infection prevention and control in general surgery patients during the COVID-19, pandemic in the light of the current situation in China. It provides reference for surgeons and decision makers in health care in other countries suffering from the COVID-19 pandemic.