Search

Hyaluronic acid (HA) intra-articular injection after arthroscopic knee surgery has been widely applied but its efficacy and safety remain controversial. The aim of this systematic review is to analyze the efficacy and safety of HA intra-articular injection after arthroscopic knee surgery, and to compare the efficacy of HA with different molecular weights.We conducted a systematic literature search in PubMed, Embase, Google scholar and the Cochrane library from inception to 16 September 2022 for English-written articles, in order to identify randomized controlled trials that evaluated the clinical efficacy and/or safety of HA intra-articular injection after arthroscopic knee surgery. Then we meta-analyzed the outcomes of patients given intra-articular HA injections postoperatively and control patients. We also evaluated the influence of HA with different molecular weights. In every calculation, sensitive analysis was performed. The visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and adverse events were selected as the primary outcome measurements, while Lysholm, International Knee Documentation Committee (IKDC) and Tegner score were selected as the secondary outcome measurements. Publication bias of every outcome was evaluated using egger test.Fifteen studies involving 951 knees were included and 12 of them were used to performed the meta-analysis. The results showed no significant difference between the HA group and control group according to VAS, whether assessed at less (P = 0.90) or more than 6 months (P = 0.55). Besides, there were no statistical differences between the HA group and control group according to subgroup analysis (Ps = 0.77, 0.91 and 0.81 in anterior cruciate ligament reconstruction, meniscectomy and overall groups, respectively). Compared to control group, the overall effect of WOMAC score showed no significant differences (P = 0.25), nor did in two subgroups (P = 0.37 and P = 0.22). Outcomes measured by Lysholm (P = 0.13), IKDC (P = 0.86) and Tegner (P = 0.42) scores showed no significant differences, either. The analysis of the risk of adverse events indicated no increase in HA groups (P = 0.06). We found no significant differences between high- and low-molecular-weight HA at 6 (P = 0.96) or 12 months (P = 0.93) postoperatively. Two studies failed to pass the sensitive analysis and the reasons were discussed detailly and acceptable publication bias was observed.Although HA injection after arthroscopic knee surgery is safe, the available evidence does not support its efficacy in pain relief and functional recovery. Therefore, the application of HA injection after arthroscopic knee surgery is not recommended.

A method was used to fabricate a fully inkjet-printed gas sensor matrix on photographic paper. An electrode matrix comprising 36 interdigital electrodes in a high-density layout that is easy to integrate has been fabricated using a combination of insulating ink and commercial silver ink. Molecular-imprinted polymer (MIP) inks were then made using a simple solution mixing method, and these inks were printed together with carbon black ink on the electrode matrix to complete production of the sensor. Finally, experimental dynamic sensing of volatile organic compounds verifies that for detection of gases corresponding to the MIP template molecules, the MIP layer offers improvements in both sensitivity and selectivity when compared with non-imprinted polymer layers. The matrix can produce a response of more than 20% to 3 ppm propenoic acid gas through adjustment of the printing times for the carbon black layer and the MIP layer.

Tumor-induced osteomalacia, a rare and intriguing paraneoplastic syndrome that is usually caused by a phosphaturic mesenchymal tumor, leads to severe pain and hypophosphatemia. However, during clinical practice, most patients suffer from significant delay of diagnosis and treatment because the symptoms are similar to those of some very common diseases, such as osteoporosis and osteoarthritis. Moreover, physical complaints from postmenopausal women usually exacerbate the possibility of such delays. We describe a case of a postmenopausal woman with crippling bone pain and weakness, who had been diagnosed with a case of simple osteoporosis and osteoarthritis for 3 years, even with fine-needle aspiration biopsy of the offending phosphaturic mesenchymal tumor. After surgical removal of the 2 × 3-cm2 tumor in her sole, we observed immediate relief of her systemic symptoms, with visual analogue scale improvement from 5 of 10 preoperatively to 2 of 10 5 days after surgery. There were no signs of recurrence during 2-year follow-up. This case highlights the significance of thorough history-taking as a fundamental tool for diagnosis even in the era of advanced technology, and that the awareness of tumor-induced osteomalacia should be raised. Otherwise, such a small localized soft tissue mass would seldom be associated with the severe systemic symptoms.

Binary code similarity detection, whose goal is to detect similar binary functions without having access to the source code, is an essential task in computer security. Traditional methods usually use graph matching algorithms, which are slow and inaccurate. Recently, neural network-based approaches have made great achievements. A binary function is first represented as an control-flow graph (CFG) with manually selected block features, and then graph neural network (GNN) is adopted to compute the graph embedding. While these methods are effective and efficient, they could not capture enough semantic information of the binary code. In this paper we propose semantic-aware neural networks to extract the semantic information of the binary code. Specially, we use BERT to pre-train the binary code on one token-level task, one block-level task, and two graph-level tasks. Moreover, we find that the order of the CFG's nodes is important for graph similarity detection, so we adopt convolutional neural network (CNN) on adjacency matrices to extract the order information. We conduct experiments on two tasks with four datasets. The results demonstrate that our method outperforms the state-of-art models.

Objective The purpose of this study was to observe feasibility of nano calcium-deficient hydroxyapatite-multi (amino acid) copolymer (n-CDHA-MAC) membrane tubes in repairing goat femurs’ large defects. Methods Twelve goats were divided into two groups, whose femurs were created 30 mm segmental bone defects and then implants were performed. In experimental group, the bone defect of right femur was reconstructed by n-CDHA-MAC membrane tube, while left side was reconstructed by allogenic bone tube in control group. Every three goats were sacrificed at 4, 8, 16, 24 weeks after operation respectively. General observation, X-ray analysis, histology, Scanning electron microscope (SEM) examination and protein level comparison of BMP-2 were conducted to evaluate the effects of repairing segmental bone defects. Results All goats recovered well from anesthesia and surgical interventions. The radiographic evaluations showed that periosteal reaction outside of the membrane tubes and allogenic bone tubes were observed 4 weeks after surgery. At 16 weeks, callus was continuously increased in experimental group, which was more obvious than control group. At 24 weeks, callus outside of the membrane tubes connected together. Histologic evaluation showed fibro-cartilage callus was evolved into bony callus in experimental group, which was more obvious than control group at 8 and 16 weeks. The protein expression level of BMP-2 increased at 4, 8 weeks and peaked at 16 weeks in experimental groups. There were statistical differences at 8 and 16 weeks ( P 0.05). Conclusions This novel surface degradation n-CDHA-MAC membrane tube has good ability to maintain enough membrane space, which can provide long-term and stable biomechanical support for large bone defects and integrate well with the surrounding bone.

Background and PurposePelvic tumor involving Type I + IV resections are technically challenging, along with various reconstructions methods presenting unsatisfactory outcomes and high complication rates. Since predominating studies preferred adopting pedicle screw-rod system (PRSS) to address this issue, we designed a novel three-dimensional-printed, multimodality imaging (3DMMI) based endoprosthesis with patient-specific instrument (PSI) assistance to facilitate the surgical reconstruction of pelvic tumor involving Enneking Type I + IV resection. We aimed to investigate the clinical effectiveness of this novel endoprosthesis and compare it with PRSS in Type I + IV reconstruction.MethodsWe retrospective studied 28 patients for a median follow-up of 47 months (range, 10 to 128 months) in this study with either 3D-printed endoprosthesis reconstruction (n = 10) or PRSS reconstruction (n = 18) between January 2000 and December 2017. Preoperative 3DMMI technique was used for tumor evaluation, PSI design, virtual surgery, and endoprosthesis fabrication. Clinical, oncological outcomes, functional assessments, and complications were analyzed between the two groups.ResultsMinor surgical trauma with mean operative duration of 251 ± 52.16 minutes (p = 0.034) and median intraoperative hemorrhage of 2000ml (range, 1600, 4000ml) (p = 0.032) was observed in endoprosthesis group. Wide margins were achieved in 9 patients of the endoprosthesis group compared with 10 in the PRSS group (p = 0.09). The 1993 version of the Musculoskeletal Tumor Society score (MSTS-93) was 23.9 ± 3.76 in endoprosthesis group, which was higher than PRSS group (p = 0.012). No statistical significance was found in relapse between two groups (p = 0.36). Complications were observed in two patients in endoprosthesis group compared with 12 patients in PRSS group (p = 0.046).ConclusionThe novel design of this 3D-printed endoprosthesis, together with 3DMMI and PSI assisted, is technically accessible with favorable clinical outcomes compared with PRSS. Further study is essential to identify its long-term outcomes.

Background Klippel-Trénaunay syndrome (KTS) is a complex congenital vascular disorder, typically accompanied by port-wine stains, varicose veins, and limb hypertrophy. This paper reports a rare and unusual clinical condition of periosteal reaction in a pediatric case of KTS. Although periosteal new bone formation is not rare in children, as is KTS, their dual occurrence or the presentation of the former due to KTS has not been previously documented. Our objective in this study is to highlight the potential association between periosteal new bone formation and KTS, as well as to help physicians consider this association when bone neoplasm has been ruled out. Case presentation A 7-year old girl, initially presented with a persistent mild swelling in her left shank, with no abnormalities in the X-ray of the tibiofibular. However, after a few consults and examinations, 7 weeks later, a 17 cm-long periosteal new bone formation along the left tibia and diffused dilated vessels in the left shank were revealed by the radiological examination. Not knowing the true nature of the fast-growing lesion in a typical case of KTS was worrying. Therefore, a core needle biopsy was performed. The test demonstrated a possible parosteal hemangioma. Following further investigation through an excisional biopsy, and a pathological analysis, hyperplasia of the bone tissues with no tumor cells was revealed. Thereafter, an elastic stocking treatment was prescribed. During the first two-year follow-up, recurrence of the mass or sign of progression of KTS was not observed. Conclusions Periosteal new bone formation is a potential manifestation of KTS. Based on the conclusive pathological results of the excisional biopsy, invasive examinations and surgeries could be avoided in future KTS-subperiosteal lesion manifestations.

Xiang Fang,1,* Zeping Yu,1,* Yan Xiong,1 Fang Yuan,2 Hongyuan Liu,3 Fan Wu,4 Wenli Zhang,1 Yi Luo,1 Liuhong Song,5 Chongqi Tu,1 Hong Duan1 1Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Radiology, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Department of Orthopedics, Sichuan Provincial Fifth People’s Hospital, Chengdu, Sichuan, People’s Republic of China; 4Department of Orthopedics, Fourth People’s Hospital of ZiGong, Sichuan, People’s Republic of China; 5Department of Orthopedics, People’s Hospital of Pengzhou, Sichuan, People’s Republic of China *These authors contributed equally to this work Purpose: We sought to assess the early clinical outcome of 3D-multimodality image (3DMMI)-based virtual surgical planning for resection and reconstruction of malignant giant pelvic tumors.Patients and methods: In this retrospective case-control study, surgery was planned and performed with 3DMMI-based patient-specific instruments (PSI) in 13 patients with giant pelvic malignancy and without 3DMMI-based PSI in the other 13 patients. In the 3DMMI group, 3DMMI was utilized, taking advantages of computed tomography (CT), contrast-enhanced CT angiography (CTA), contrast-enhanced magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance neurography (MRN), which could reveal the whole tumor and all adjacent vital structures. Based on these 3DMMI, virtual surgical planning was conducted and the corresponding PSI was then designed. The median follow-up was 8 (3–24) months. The median age at operation was 37.5 (17–64) years. The mean tumor size in maximum diameter was 13.3 cm. Surgical margins, intraoperative and postoperative complications, duration of surgery, and intra-operative blood loss were analyzed.Results: In the non-3DMMI group, the margins were wide in six patients (6/13), marginal in four (4/13), wide-contaminated in two (2/13), and intralesional in one (1/13). In the 3DMMI group, the margins were wide in 10 patients (10/13), marginal in three (3/13), and there were no wide-contaminated or intralesional margins. The 3DMMI group achieved shorter duration of surgery (P=0.354) and lower intraoperative blood loss (P=0.044) than the non-3DMMI group.Conclusion: The 3DMMI-based technique is advantageous to obtain negative surgical margin and decrease surgical complications related to critical structures injury for malignant giant pelvic tumor. Keywords: surgical planning, 3D-multimodality image, pelvic tumor, patient-specific instruments, surgical margin

Xiang Fang,1 Hongyuan Liu,1 Yan Xiong,1 Wenli Zhang,1 Yi Luo,1 Fan Wu,2 Yong Zhou,1 Liuhong Song,3 Zeping Yu,1 Chongqi Tu,1 Hong Duan1 1Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Orthopedics, Fourth People’s Hospital of ZiGong, ZiGong, Sichuan, People’s Republic of China; 3Department of Orthopedics, People’s Hospital of Pengzhou, Pengzhou, Sichuan, People’s Republic of China Purpose: Arthrodesis is one of the most widely accepted surgical recommended methods for tumors of the talus, but it may be associated with poor limb functions. The aim of this study was to present a novel reconstruction with ankle function preserved after en bloc talus tumor resection.Patient and method: A 43-year-old female with mesenchymal sarcoma of the talus was admitted in West China Hospital. Total talar replacement with three-dimensional (3D) printed modular prosthesis was prepared for reconstruction. The 3D printed modular prosthesis was designed exactly as the mirror image of the contralateral talus with complete filling of the sinus tarsi and subtalar joint space. The upper modular component of prosthesis was made of ultra high molecular weight polyethylene, and the lower component, titanium alloy. Pre-drilled holes in three directions were prepared for screw fixation of the subtalar joint.Results: The patient underwent en bloc talus resection through anterior approach, followed by reconstruction with the 3D printed prosthesis. The whole procedure took 2 hours, and intra-operative blood loss was 50 mL. At the last follow-up, our patient was disease free and she could walk almost normally without any aid or pain. The Musculoskeletal Tumor Society score was 26/30. The American Orthopedic Foot and Ankle Society score was 91/100. The range of motion for dorsiflexion and plantar flexion was 40°. And no abnormalities were observed in the roentgenograph.Conclusion: Total talar replacement with a 3D printed modular prosthesis may be an effective procedure for patients with tumors of the talus as it could maintain ankle function. Keywords: bone tumors, sarcoma, reconstructive surgery, ultra high molecular weight polyethylene, limb salvage, en bloc resection

The purpose of this study was to explore the indications for the two most frequently applied surgical procedures for benign lesions in the proximal femur. We retrospectively reviewed 142 patients with benign lesions in the proximal femur from January 2010 to January 2015. Internal fixation (IF) was adopted in 110 patients, while endoprosthetic replacement (EPR) was applied in 32 patients. Clinical data, including operation time, blood loss, hospitalization time, and hospitalization expenses, were compared between the groups. Limb mobilization was evaluated by the Musculoskeletal Tumor Society Score-93 (MSTS-93) and Harris Hip Score (HHS). Local recurrences and complications were statistically compared. The average follow-up was 66 months (range 32–84 months). In the EPR group, operation time and hospitalization time were significantly shorter (p

User modeling is an essential task for online recommender systems. In the past few decades, collaborative filtering (CF) techniques have been well studied to model users' long term preferences. Recently, recurrent neural networks (RNN) have shown a great advantage in modeling users' short term preference. A natural way to improve the recommender is to combine both long-term and short-term modeling. Previous approaches neglect the importance of dynamically integrating these two user modeling paradigms. Moreover, users' behaviors are much more complex than sentences in language modeling or images in visual computing, thus the classical structures of RNN such as Long Short-Term Memory (LSTM) need to be upgraded for better user modeling. In this paper, we improve the traditional RNN structure by proposing a time-aware controller and a content-aware controller, so that contextual information can be well considered to control the state transition. We further propose an attention-based framework to combine users' long-term and short-term preferences, thus users' representation can be generated adaptively according to the specific context. We conduct extensive experiments on both public and industrial datasets. The results demonstrate that our proposed method outperforms several state-of-art methods consistently.

Background: Emerging published studies have indicated that adiponectin is involved in tumorigenesis of breast cancer. However, the results of available studies were inconsistent. The aim of this updated meta-analysis was to assess the association of adiponectin with breast cancer. Materials and methods: PubMed, EMBASE, Wanfang databases, and the China National Knowledge Infrastructure (CNKI) were systematically searched from inception to June 2018. The mean difference (MD) with 95% confidence interval (CI) were estimated and pooled to investigate the effect sizes. Results: Twenty-seven eligible articles that met the study criteria were included in the current meta-analysis. Overall, there was an evident inverse association between serum adiponectin levels and breast cancer (MD = −0.29, 95%CI = (−0.38, −0.21), P

Yan Xiong,1 Zeping Yu,1 Yun Lang,1 Juanyu Hu,1 Hong Li,2 Yonggang Yan,2 Chongqi Tu,1 Tianfu Yang,1 Yueming Song,1 Hong Duan,1 Fuxing Pei11Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Biomechanical Engineering, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaObjective: To study the degradation and basic fibroblast growth factor (bFGF) release activity of bFGF – poly(lactic-co-glycolic-acid) microsphere (bFGF-PLGA MS) under stress in vitro, including the static pressure and shearing force-simulating mechanical environment of the joint cavity.Method: First, bFGF-PLGA MSs were created. Meanwhile, two self-made experimental instruments (static pressure and shearing force loading instruments) were initially explored to provide stress-simulating mechanical environment of the joint cavity. Then, bFGF-PLGA MSs were loaded into the two instruments respectively, to study microsphere degradation and drug release experiments. In the static pressure loading experiment, normal atmospheric pressure loading (approximately 0.1 MPa), 0.35MPa, and 4.0MPa pressure loading and shaking flask oscillation groups were designed to study bFGF-PLGA MS degradation and bFGF release. Inthe shearing force loading experiment, a pulsating pump was used to give the experimental group an output of 1,000mL/min and the control group an output of 10mL/min to carry out bFGF-PLGA MS degradation and drug release experiments. Changes of bFGF-PLGA MSs, including microsphere morphology, quality, weight-average molecular weight of polymer, and microsphere degradation and bFGF release, were analyzed respectively.Results: In the static pressure loading experiment, bFGF-PLGA MSs at different pressure were stable initially. The trend of molecular weight change, quality loss, and bFGF release was consistent. Meanwhile, microsphere degradation and bFGF release rates in the 4.0 MPa pressure loading group were faster than those in the normal and 0.35 MPa pressure loading groups. It was the fastest in the shaking flask group, showing a statistically significant difference (P

An optical sensing gadget using fluorescence of carbon dots (CDs) was developed to realize the in-field detection of 2,4,6-trinitrophenol (TNP) in tap water and lake water samples. Fluorescent CDs were prepared through a one-step hydrothermal synthetic route. The fluorescence spectra demonstrated that the CDs could specifically discriminate TNP from other nitroaromatic explosives in an aqueous medium. The fluorescence of the CDs was quenched linearly with the concentration of TNP in the range from 1 to 100 μM, with a detection limit of 0.48 μM (3σ/k). The detection mechanism was ascribed to the synergistic effect of the inner filter effect and electron transfer. In addition, a portable sensing gadget based on a high-precision RGB color sensor and a micro control unit was developed. With use of the sensing gadget and the CDs, TNP detection in tap water and lake water samples was realized. Importantly, the portable sensing gadget combined with highly stable, low-toxicity, and sensitive CDs might have great potential for application in extensive in-field sensing situations. Graphical abstract Carbon dots synthesized with 4-(diethylamino)salicylaldehyde as the initial material were used for 2,4,6-trinitrophenol (TNP) detection. TNP quenches the fluorescence of carbon dots, and the mechanism is ascribed to the synergistic effect of the inner filter effect and electron transfer. A portable sensing gadget based on a 32-bit micro control unit was successfully applied for in-field TNP detection.

Background Chondroblastoma is a rare benign cartilaginous tumor, which primarily occurs in children and adolescents. Chondroblastoma commonly originates in the epiphyseal plate of long bones. An aggressive curettage treatment is recommended to manage lesion, which may jeopardize an open epiphyseal plate and result in limb shortening and deformity as the limb grows and develops. The purpose is to observe surgical effects of chondroblastoma on open epiphyseal plate of long bones in children and adolescents and explore influences on limb growth and development. Methods We retrospectively reviewed 18 cases of long bone chondroblastoma with open epiphyseal growth plate during March 2004 to October 2010 in our center. Seven females and 11 males with mean age of 11.6 ± 2.0 years old (8–15 years) were included. Patients, who suffered from trauma and pathological fracture of the epiphyseal plate or congenital diseases such as poliomyelitis, congenital dementia, and cartilage malnutrition, were excluded. All patients were treated with meticulous intralesional curettage and inactivity with alcohol followed by bone grafts. All cases were followed up 8.2 ± 1.7 years (5–11.5 years). Results All had no local recurrence and distance metastasis. The length of the affected limb was short, 18.47 ± 7.22 mm (1.5–30 mm). There was no obvious relativity with tumor activity (P = 0.061). Meanwhile, there were obvious relativity with the greatest dimension of the lesion (TGD) (P = 0.003), the vertical dimension between edge of lesion and epiphyseal line (TVD) (P = 0.010), and area ratio of lesion to local epiphysis (lesion/growth plate) (P = 0.015). The MSTS93 (Revised Musculoskeletal Tumor Society Rating Scale 93) and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) had been significantly improved (P

Endoprosthetic replacement (EPR) and intramedullary nailing (IMN) are the two most commonly applied surgical methods used to treat proximal metastatic lesions; however, indication of the above procedures remains controversial. The aim of the present study was to evaluate the clinical, functional and oncological outcomes of patients who underwent EPR compared to IMN for the treatment of proximal femur metastases to investigate the surgical indication for patients. The records of patients (n=88) with pathological fractures secondary to metastatic tumors of the proximal femur admitted between January 2005 and December 2014 to West China Hospital, Sichuan University (Chengdu, China) were retrospectively studied. A total of 57 patients were treated with EPR (34 males and 23 females; mean age, 62.5 years) and 31 patients were stabilized with IMN (19 males and 12 females; mean age, 60.2 years). Patients were analyzed regarding surgery time, blood loss, hospital stay, Musculoskeletal Tumor Society (MSTS) score, survival, recurrence and complications. The median follow-up period was 12.9 (range, 3-98) months. The median survival time in EPR was 10.0 months and 7.5 months in IMN. The surgery time was 142.6±22.7 min in the EPR group and 98.7±19.5 min in the IMN group (P=0.001). Significantly less blood loss was observed in the IMN group (345.2±66.4 ml) than in the EPR group (631.5±103.6 ml; P=0.001). The median hospital stay in the EPR group was 8 (quartile range, 7-9) days and 5 (quartile range, 5-6) days in the IMN group (P=0.001). Local recurrence rate was 10.5% (6/57) in the EPR group and 25.8% (8/31) in the IMN group (P=0.074). The complication rates were 10.5% (6/57) in the EPR group and 29.0% (9/31) in the IMN group (P=0.038). MSTS-93 score was higher in IMN compared with EPR at 6 weeks postoperatively (P=0.001), while the EPR group demonstrated a higher score at 6 months postoperatively (P=0.001). EPR has the advantage of better functional outcomes and higher life quality in the long term, with lower complication rates in treating metastatic lesions of the proximal femur with pathological fractures. EPR is recommended for patients with relatively good general condition and prognosis. IMN is best indicated when the patient's life expectancy is extremely limited.

Xiang Fang,1,* Weili Kong,2,* Zeping Yu,1 Jianqing Qiu,3 Hong Duan11Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workWith interest, we read the article by Gago-Veiga et al published in Journal of Pain Research in October 2018.1 Migraine attacks, encompassing a wide range of symptoms, greatly undermine the quality of life for patients. Premonitory symptoms usually precede and alert the patients of the attack. The objectives of this prospective study1 were to illuminate if any good predictor or specific combination of premonitory symptoms exists for prediction of migraine attacks. A total of 34 patients recording 229 attacks were analyzed: 67.6% were able to predict at least one attack, while only 35.3% were able to predict >50% of attacks.The positive predictive value was 85.1%. The authors concluded some specific symptoms were predictive, even though only a few were good predictors (predicting >50% of attacks).Authors’ replyAna B Gago-Veiga, Josué Pagán, Kevin Henares, Patricia Heredia, Nuria González-García, María- Irene De Orbe, Jose L Ayala, Mónica Sobrado, Jose VivancosHeadache Unit, Department of Neurology, Instituto de Investigación Sanitaria Hospital Universitario de la Princesa, Madrid 28006, SpainWe value Fang et al’s comments, and thank them for the insights provided on our recent work. We understand someof the comments, but we would like to let you know why we decided to present the results in the most suitable way fromthe perspective of the analysis performed using machine-learning techniques.View the original paper by Gago-Veiga and colleagues.

In a multi-terminal high-voltage direct current based on voltage source converter, the proactive hybrid HVDC breaker is an important component in DC grids to isolate a DC fault. From the DC breaker design point, it is crucial to realize a fast fault current breaking. Hybrid HVDC breaker based on delay slope method for breaking signal has more fast action. Especially for overhead lines of DC grid, automatic reclosing control method is adopted in this paper. A wind farm ring topology model, 8-terminal HDC based on voltage source converter, is build on PSCAD/EMTDC simulation platform. Simulations are given to demonstrate effectiveness of the delay slope method and automatic reclosing control strategies. In last, it is pointed out the existing problems in automatic reclosing of Hybrid HVDC breaker.

A novel, selective and sensitive liquid chromatography-tandem mass spectrometry method has been developed and validated for the simultaneous determination of phytoestrogens and their key metabolites in human urine in this study. This method includes internal standard (IS) screening, analytical sample preparation procedure establishment, and linear range investigation. The analytical sample was extracted by liquid-liquid extraction from urine sample. The phytoestrogens and related key metabolites were separated with Agilent Zorbax Eclipse XDB-C18 chromatographic column using methanol and water as mobile phase. The Quattro premier MICROMASS mass spectrometer in negative ion selected reaction monitoring (SRM) mode using electrospray ionization was applied to detect the phytoestrogens and key metabolites. To validate the developed liquid chromatography-tandem mass spectrometry method, the intra- and inter-day precisions, specificity, sensitivity, reproducibility, and sample detective concentration range were evaluated. This is the first reported phytoestrogens analysis and validation study that demonstrates the feasibility of using liquid chromatography-electrospray ionization mass spectrometry to simultaneously analyze ten analytes including both phytoestrogens and their key metabolites in urine samples collected for epidemiological studies in human.

In this study, we explored the effects of soy isoflavone extracts on the growth of estrogen-dependent human breast cancer (MCF-7) tumors implanted in ovariectomized athymic mice. The ovariectomized athymic mice were implanted with MCF-7 cells. They were fed with low, moderate and high doses of soy isoflavone extracts, at dietary concentrations of 6.25, 12.5 and 25 g/kg, respectively. The expression of ki-67 was detected by immunohistochemistry. The pS2 expression in tumors was analyzed by real-time PCR. Estrogen level in the serum was measured by chemiluminescence enzyme immunoassay. Compared with the control group, dietary soy isoflavone extracts had a significant stimulatory effect on MCF-7 tumor growth in mice (P 0.05). In conclusion, in the tested dietary concentration range soy isoflavone extracts had a stimulatory effect on tumor growth. 6.25 and 12.5 g/kg doses of soy isoflavone extracts can increase the cell proliferation in tumors and induce estrogen-responsive pS2 expression.

Aims and Background Sixty patients with breast cancer were randomly assigned to oral glutamine or placebo pre-neoadju-vant chemotherapy (CEF regimen). Methods and Study Design Oral glutamine supplementation was continued for at least 12 days. Patients kept a daily record of diarrhea and stomatitis. The plasma glutamine level, intestinal permeability (lactulose-mannitol test), and tumor size were analyzed. The expression of Ki-67 and PCNA antigens in breast carcinoma was assessed. Results The plasma glutamine level was significantly higher in the glutamine group than in the placebo group (420.39 ± 52.39 mmol/L vs 309.76 ± 42.34 mmoi/L, P Conclusions Prophylactic oral glutamine could ameliorate the neoadjuvant chemotherapy-induced increase in intestinal permeability, but had no significant positive clinical effect on stomatitis and diarrhea and did not interfere with the antitumor effect of chemotherapy.

Honeycomb annular seals are an attractive design alternative due to their superior static and dynamic performance. However, their implementation in industrial practice has been delayed by the following characteristics: a) manufacturing time can be appreciable, and b) they can seriously damage the shaft if rubbing occurs. To minimize these problems, “hole-pattern” gas damper seals, which are formed by simply drilling holes into an annular smooth seal, were manufactured and tested. The hole-pattern damper seal stator can be made of high-strength plastic materials which are less likely to damage a shaft during rubbing. The experimental results presented demonstrate that, compared to a honeycomb seal, a hole-pattern damper seal with 3.18 mm hole diameters and a high percentage of hole surface has achieved: (a) an average of 12 percent reduction in leakage rate, and (b) considerably higher effective damping, especially under high speeds and low inlet pressure ratio conditions.Copyright © 1997 by ASME