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Digital intraoral scanning is a hot topic in the field of oral digital technology. In recent years, digital intraoral scanning has gradually become the mainstream technology in orthodontics, prosthodontics, and implant dentistry. The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression. However, the operators are less familiar with the intraoral scanning characteristics, imaging processing, operator scanning method, oral tissue specificity of the scanned object, and restoration design. Thus far, no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad. To deal with the problems encountered in oral scanning and improve the quality of digital scanning, we collected common expert opinions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence. We also describe the scanning strategies under different oral impression requirements. The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images, adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy. The scanning trajectories mainly include the E-shaped, segmented, and S-shaped methods. When performing fixed denture restoration, it is recommended to first scan the abutment and adjacent teeth. When performing fixed denture restoration, it is recommended to scan the abutment and adjacent teeth first. Then the cavity in the abutment area is excavated. Lastly, the cavity gap was scanned after completing the abutment preparation. This method not only meets clinical needs but also achieves the most reliable accuracy. When performing full denture restoration in edentulous jaws, setting markers on the mucosal tissue at the bottom of the alveolar ridge, simultaneously capturing images of the vestibular area, using different types of scanning paths such as Z-shaped, S-shaped, buccal-palatal and palatal-buccal pathways, segmented scanning of dental arches, and other strategies can reduce scanning errors and improve image stitching and overlap. For implant restoration, when a single crown restoration is supported by implants and a small span upper structure restoration, it is recommended to first pre-scan the required dental arch. Then the cavity in the abutment area is excavated. Lastly, scanning the cavity gap after installing the implant scanning rod. When repairing a bone level implant crown, an improved indirect scanning method can be used. The scanning process includes three steps: First, the temporary restoration, adjacent teeth, and gingival tissue in the mouth are scanned; second, the entire dental arch is scanned after installing a standard scanning rod on the implant; and third, the temporary restoration outside the mouth is scanned to obtain the three-dimensional shape of the gingival contour of the implant neck, thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration. For dental implant fixed bridge repair with missing teeth, the mobility of the mucosa increases the difficulty of scanning, making it difficult for scanners to distinguish scanning rods of the same shape and size, which can easily cause image stacking errors. Higher accuracy of digital implant impressions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius. The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases, the scanning accuracy decreases accordingly, especially when performing full mouth implant restoration impressions. The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal morphology inside the mouth and the lack of relatively obvious and fixed reference objects, which results in insufficient accuracy. When designing restorations of this type, it is advisable to carefully choose digital intraoral scanning methods to obtain model data. It is not recommended to use digital impressions when there are more than five missing teeth.

A new adsorbent(DES@ZIF@MG) was prepared by grafting deep eutectic solvents(DES) onto metal organic framework ZIF/magnetic reduced graphene oxide(MG) for the adsorption of methamphetamine. A series of structural characterization analyses (SEM, FT-IR, BET, VSM, TGA) were facilitated to explore the microscopic morphology and physicochemical properties of DES@ZIF@MG. The adsorption performances of methamphetamine onto the adsorbent were investigated by adsorption kinetics, isotherms, and adsorption effect experiments(pH, ionic strengths, and humic acid). The results showed that the adsorption of methamphetamine onto DES@ZIF@MG was consistent with the pseudo-second-order model and the Langmuir model, indicating that the adsorption process was an energetically homogeneous adsorption dominated by chemisorption. The XPS characterization illustrated that the adsorption process of methamphetamine by DES@ZIF@MG mainly involved hydrogen bonding, π-π interaction, electrostatic interaction, and chelation.

Methotrexate (MTX) is a therapeutic drug that is widely used in clinic for treatment of a variety of cancers. However, MTX has limited selectivity and serious cytotoxicity, at the same time, there are problems such as narrow therapeutic window and large individual variability in metabolism and excretion of MTX. Therefore, blood concentration monitoring is required for MTX administration in clinical practice. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has the advantages of strong specificity, good separation characteristics, high sensitivity and fast detection speed, which has become the internationally recognized “gold standard” for blood concentration monitoring of drugs. In this study, an isotope dilution mass spectrometry method was developed for accurate measurement of MTX in serum by the house-made QLIT-6610MD quadrupole-linear ion trap liquid chromatography-mass spectrometer. Unlike the traditional triple quadrupole QqQ tandem mass spectrometer, the quadrupole-linear ion trap (Q-LIT) mass spectrometer adopts the quadrupole-linear ion trap direct axial coupling design, i.e., a single linear ion trap is used to replace the QqQ tandem mass spectrometer’s back-end fragmentation cell and the quadrupole, and no other components are installed between the quadrupole and linear ion trap, which greatly streamlines the quality and efficiency of the mass spectrometer while ensuring the original performance of the instrument. With this unique configuration, the QLIT-6610MD instrument uses a simultaneous fragmentation and accumulation technique, which remarkedly reduces matrix-induced interferences and effectively reduces space charge effects. Serum samples were pretreated with methanol to precipitate proteins and the supernatants were measured by QLIT-6610MD spectrometer. The linear correlation coefficient (R2＞0.999 0) is obtained for MTX in the range of 10-5 000 μg/L. The limit of quantification is 10 μg/L. The precision of the quality control is better than 6.94%, and the recoveries of spiked serum samples are 86.39%-97.84% with a coefficient of variation less than 8.04%. We used the QLIT-6610MD and AB QTRAP 6500+ liquid chromatography-mass spectrometers to analyze 70 clinical serum samples for comparison of the performance of the house-made instrument by means of Pearson’s coefficient and BLand-ALtman method. The results showed that the QLIT-6610MD mass spectrometry achieves a similar level of performance to AB ATRAP 6500+ instrument, and provides a new domestic instrument option for clinical mass spectrometry. In addition, this study explores the possibility applying the multi-stage fragmentation technique (MSn) to determine MTX in serum, gaining fundamental data for future studies.

To investigate the effects of ultrasound treatment combined with pH adjustment on the gelling properties of composite gels prepared from ginkgo seed protein isolate (GSPI) and whey protein isolate (WPI), the physicochemical properties and molecular behavior of the GSPI and WPI mixture and the texture, water-holding capacity (WHC) and microstructure of the heat-induced gel of the protein mixture were characterized. Results showed that ultrasonic treatment at 25%, 45%, or 65% power alone did not significantly influence protein solubility. However, ultrasonic treatment combined with lower pH (pH 4.0) markedly decreased protein hydrophobicity, and increased surface sulfhydryl group content and the sol’s particle size. The results of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Fourier transform infrared (FTIR) spectroscopy showed that ultrasonic treatment affected protein structure and aggregation behavior. The heat-induced composite gel formed at lower pH had poor textural properties, whereas the composite gel formed at higher pH (especially at pH 5.0) exhibited improved textural properties and higher WHC. The textural properties and WHC of the composite protein gel were significantly improved with increasing ultrasonic power, which was attributed to the fact that ultrasonic treatment strengthened the interaction between hydroxyl groups in GSPI and WPI, promoting protein aggregation and cross-linking and improving the structural compactness of the composite gel. Overall, ultrasound treatment combined with pH adjustment could be an effective method for improving the functional properties of the composite protein gel.

ObjectiveThis study aimed to investigate the association between eating out frequency and taste preferences among urban Chinese adults.MethodsA convenient sampling method was employed to select 1 957 adult residents aged 18 to 65 from four urban areas with complete survey data on eating out frequency and taste preferences. The study analyzed the current patterns of eating out and taste preferences and used a multifactor logistic regression model to assess the correlation between eating out frequency and taste preferences.ResultsThe study found that 35.8% of participants ate out less than once a week， 33.5% ate out 1-3 times a week， 18.3% ate out 4-6 times a week， and 12.4% ate out seven or more times a week. Gender differences were observed in taste preferences， with men having significantly higher rates of salty and oily taste preferences compared to women， while women had a higher preference rate of sweet taste. After controlling for relevant confounding factors， urban female residents who ate out 1-3 times a week had a 59% increased risk of salty taste preference （OR = 1.59） compared to those who ate out less than once a week. Similarly， urban female residents who ate out 1-3 times a week， 4-6 times a week， and seven or more times a week had an increased risk of sweet taste preference by 51% （OR = 1.51）， 71% （OR = 1.71）， and 77% （OR = 1.77）， respectively. Moreover， urban female residents who ate out 1-3 times a week and seven or more times a week had an increased risk of spicy taste preference by 54% （OR = 1.54） and 78% （OR = 1.78）， respectively. Compared with urban male residents who ate out less than one time a week， urban male residents who ate out 4-6 times a week have an increased risk of oily and spicy tastes by 61% （OR=1.61） and 85% （OR=1.85）， respectively.ConclusionThe study suggests that the frequency of eating out among urban residents may be associated with their taste preferences. Therefore， there is a need to enhance nutrition education and awareness to encourage the development of healthier eating habits.

In the driverless transport and operation system of surface mine, the roadside perception system is used to assist driverless vehicles by providing road condition information. The driverless system currently applied in mine trucks realizes roadside perception based on the multi-sensor fusion technology, consisting of cameras, laser radars and millimeter wave radars. However, this system has several drawbacks, such as high system cost, a complicated structure and poor robustness. In this regard, this paper proposes a roadside perception approach based on an improved DeepSORT algorithm. This approach involves using cameras to acquire image data on vehicles and pedestrians in the mine, which are accurately identified by the YOLOv5s algorithm. Then, the improved DeepSORT algorithm tracks the identified objects in real-time, enabling statistical analysis to provide various functions, including vehicle traffic statistics, abnormal parking detection and pedestrian intrusion detection. The proposed approach was tested at the No. 8 intersection of Xiwan Surface Mine of Shaanxi Shenyan Coal Co., Ltd. The results show that using a single sensor approach can effectively achieve the recognition and tracking of vehicles and pedestrians at mine intersection, reduce the complexity of the roadside perception system and save costs compared to the roadside perception technology based on multi-sensor fusion.

Objective To explore and construct an optimization strategy for large-scale nucleic acid collection mode in the emergency conditions of putting the makeshift COVID-19 hospitals into use. Methods A self-pre- and post- control study was conducted on 542 COVID-19 patients in the makeshift hospital located in National Exhibition and Convention Center (Shanghai) in April 2022. According to the elution period with an interval of 1 week, nucleic acid collection was carried out in red-zone package mode, in-cabin and out-cabin linkage mode and integrated precision sampling mode, and the consuming time of work was recorded. The electronic survey used to detect the satisfaction of patients. At the same time, the results of the levels of teamwork, patient cooperation and satisfaction of 106 medical staff participating in nucleic acid testing under the above different sampling modes were collected. Results The work consumption time of the integrated precision sampling mode was significantly shorter than that of the other two sampling modes (P < 0.01), the percentage patient satisfaction rate in the integrated precision sampling mode was higher than that of the other two sampling modes (P < 0.05), and the team cooperation, patient cooperation, and the percentage of satisfaction of medical staff were significantly higher than those of the other two sampling modes (P < 0.01) in the integrated precision sampling mode. Conclusion The integrated precision sampling mode can significantly shorten the sampling time in large-scale nucleic acid collection, effectively improve the degree of cooperation between doctors and patients in sampling work and increase the satisfaction of patients and medical staff during the sampling process.

In the intelligent driving system of transport vehicles in open-pit mines, the data fusion of camera and LiDAR plays a vital role in the detection, recognition and tracking of obstacles. Aiming at the problem of camera and LiDAR spatial coordinate unity, that is establishing the correspondence between 2D coordinate system of image and 3D coordinate system of point cloud, this paper proposes a camera and LiDAR calibration method based on chessboard calibration board. Firstly, Zhang Zhengyou Calibration Method is used to calibrate the camera internal parameters, and the internal parameter matrix and distortion coefficient are obtained.Then the camera and LiDAR respectively extract the corner coordinates of the calibration plate edge, and multiple groups of the three-dimensional coordinates of point cloud and two-dimensional coordinates of the image are obtained. Based on multiple groups of feature point pairs, the external parameter matrix is obtained by EPnP algorithm. In order to verify the calibration accuracy, this paper projects the point cloud on the image plane and compares its point pair accuracy. Experimental results show that, this method can obtain the position and pose relationship between cameras and LiDAR, and the projection error is less than 3 pixels, which solved the problem of camera and LiDAR space calibration of transport vehicles in open-pit mines.

Objective To understand the willingness and influencing factors of participating in early screening among ethnic minority patients with breast cancer in rural areas. Methods Between January 2022 and June 2022, a phenomenological research method was conducted and 12 patients with breast cancer were selected for a semi-structured retrospective interview, and the Colaizzi phenomenological data analysis method was used for analysis. Results Four main themes were extracted: lack of correct understanding of breast cancer; Lack of awareness of early screening and self-examination; Single access to get breast cancer information; Reasons for reluctance to screen. Conclusion The participation in early screening was not optimistic among ethnic minority patients with breast cancer in rural areas. Relevant health departments should strengthen the popularization of breast cancer knowledge and improve the participation rate of early screening among ethnic minority women in rural areas, and improve the awareness of medical treatment for women, thereby reducing the mortality. (目的 了解农村地区少数民族乳腺癌患者参与早期筛查的意愿和影响因素。方法 于2022年1月—6月运用现象学研究方法, 采用目的抽样的方法选取12例乳腺癌患者进行半结构式回顾性深入访谈, 采用Colaizzi现象学资料分析法进行分析。结果 共提炼出4个主题: 缺乏对乳腺癌的正确认识; 缺乏早期筛查和自查的意识; 获取乳腺癌信息的途径单一; 不愿意筛查的原因。结论 农村地区少数民族乳腺癌患者早期筛查的情况不容乐观, 相关部门应加强普及乳腺癌的相关知识及提高少数民族农村妇女早期筛查的参与率和就医意识, 从而降低死亡率。)

Taking the black sesame compound honey pill as the research object, the acid value and peroxide value are used as evaluation indicators to investigate the influence of different storage temperatures on its quality; on this basis, the shelf life of the black sesame compound honey pill under naked packaging conditions is predicted by constructing an Arrhenius model. In order to further extend the shelf life, four different packaging forms were set up to package the black sesame compound honey pill, and the effects of different packaging methods on its storage quality such as moisture, texture, and physical and chemical properties were investigated at the same time. The results showed that: compared with the control group, nitrogen filling, shelling and wax sealing have a certain effect on preventing the black sesame compound honey pill from decreasing moisture and increasing hardness and acid value. The packaging form of wax paper + pill shell + wax seal + tin foil paper + polyethylene plastic bag has the best effect. The research results provide a reference for the storage of honey pill products.

Insufficient data, lack of expertise in AI application development, and weak device computing capabilities have severely restricted the rapid engineering implementation of rail transit intelligent products. In order to solve these problems, this paper proposes an AI open platform for rail transit. It builds connection between model training, edge computing and cloud-edge collaboration, and provides full-process AI application development solutions. In the cloud, this platform builds an AI development tool chain including data annotation, algorithm design, model training and application generation. It also provides an efficient model inference framework at the edge. Data collection and model deployment are implemented through the cloud-edge collaboration mechanism. Since unmanned mining trucks use autonomous driving technology similar to rail transit, this paper takes the visual perception application of unmanned mining trucks as an example for verification. The result shows that using AI open platform for application development can effectively reduce application development and deployment time, from 3~4 months normal period to present 1 month.The mean average precision of the visual detection model for stones, mining truck and other targets reaches 0.988, achieving excellent perceptual performance.

Universities are the important source of original innovation in aviation and astronautics,and play an important role in the development and progress of aerospace technology. In order to analyze the development of Chinese universities in the field of aerospace,the aerospace engineering journals included in JCR are taken as the data source,the papers published by Chinese universities from 2011 to 2020 are selected,and the CiteSpace software is used to visually analyze the paper publication,institution cooperation,keyword co-occurrence and keyword clustering in the field of aerospace. The research status,cooperation relationship and future research hotspots of Chinese universities in the field of aerospace are summarized. By combining the research situation in the field of aviation and astronautics in universities in China,the study in this paper provides the important reference value for the planning layout and innovation development of Chinese aviation and astronautics.

Objective To analyze the research status of nursing sensitivity indicators in China, and identify possible problems, so as to provide reference for future related research. Methods bliometric analysis method was used to review the existing literature, and CNKI-CJFD, Wanfang Database and CBMdisc were used as data sources to search the related researches of nursing sensitive indicators, and analyze the publication date, region, author, fund support, journals and keywords. Results A total of 572 valid documents on nursing sensitive indicators were retrieved and published in 149 journals. The number of published documents showed an increasing trend, but the fund papers were low, the degree of interdisciplinary was poor, and the quality of documents needed to be improved. Conclusion The research on nursing sensitive indicators has gradually attracted the attention of researchers, and the research quality, breadth and depth, scientific systematicness and other aspects need to be further studied. (目的 分析我国护理敏感指标的研究现状, 明确可能存在的问题, 为今后相关研究进一步提供参考。方法 应用文献计量学分析方法回顾现有文献, 以中国期刊全文数据库、万方数据库和中国生物医学文献数据库为数据来源, 检索护理敏感指标相关研究的文献, 对文献年代、地区、作者、基金支持、期刊、关键词等方面进行分析。结果 检索获得572篇护理敏感指标有效文献, 发表在149种期刊上, 文献年发表量呈增长趋势, 但基金论文较低, 学科交叉程度欠佳、文献质量有待继续提高。结论 护理敏感指标相关研究逐渐受到研究人员的关注与重视, 在研究质量、广度与深度以及科学系统性等方面有待继续研究。)

This paper summarized the practice in the management of medical waste disposal during the COVID-19 epidemic. Plan and targeted strategies were made based on the considerations regarding the layout of medical waste disposal, transport process, the main points of transport routes in fever clinics, isolation (under observation) wards and laboratory in the hospital. This paper is dedicated to provide reference for other medical institutes to establish and practice a timely, orderly, efficient and harmless disposal of medical waste when dealing with severe infectious diseases. (本文总结医院在新型冠状病毒肺炎疫情期间医疗垃圾处理的管理实践经验, 包括发热门诊、隔离(留观)病房和实验室产生的医疗垃圾的存储布局、转运流程、转运路线及处理要点等, 以期为其他医疗机构在应对烈性传染病时确保医疗垃圾得到及时、有序、高效、无害化处置提供借鉴。)

Objective To explore the feasibility of picture naming training in improving naming ability of patients with semantic dementia (SD). Methods A total of 14 cases of semantic dementia whose the first symptom was semantic memory impairment were given picture naming training 30 min/time, twice a day, for 5 d from October 2018 to December 2020 at Xuanwu Hospital, Capital Medical University. One day before and one day after the end of training, Picture Naming Test and Boston Naming Test (BNT) were used to evaluate the naming ability. Results After training, Picture Naming Test score (65.79 ± 34.54 vs. 49.79 ± 30.85; t = ⁃ 3.297, P = 0.001) and BNT score [6.50 (4.75, 14.00) vs. 5.00 (3.00, 11.50); Z = ⁃ 2.007, P = 0.045] were higher than before training. Conclusions Picture naming training can effectively improve the naming ability of patients with semantic dementia.

In order to study the influence of different ventilation times on the fire of cable roadway in coal mine and provide reference for fire prevention and control of cable roadway in industrial and mining areas, a full-scale model of a cable roadway was established by FDS fire simulation software.Four ventilation conditions of 0, 2, 4 and 6 ventilation times per hour were simulated.The low velocity N-S equation driven by heat was solved by numerical method, and the smoke distribution, air concentration distribution and roof temperature change of fire source were obtained under the four working conditions.The relationship between the farthest ventilation distance and ventilation frequency was determined by analyzing the simulation data.The minimum smoke diffusion distance on the upwind side of the fire source was calculated to be 50.8 m.The simulation results show that: on the upwind side of the fire source, when the wind speed is less than 1.70 m/s, the time when the smoke reaches the farthest diffusion distance increases with the increase of wind speed; when the wind speed is greater than 1.70 m/s, the time when the flue gas reaches the farthest diffusion distance decreases with the increase of wind speed; the upwind side of the fire source is located at the upper part of the fire source, and the high temperature flue gas cannot diffuse and accumulate continuously, while the lower part has less smoke, which can not block the effect of wind flow.The results show that the air content difference between the upper and lower parts is more obvious when it is carried to the downwind side by the air flow, while in the downwind side of the fire source, the air flow is consistent with the smoke diffusion direction, and the air flow accelerates the smoke diffusion, making the air content in the upper and lower parts of the downwind side at a more uniform level; the ventilation frequency has no obvious effect on the time of reaching the stable temperature of the fire source ceiling, but has a certain impact on its temperature.

The high mining costs of mines have led to the imbalance between the supply and demand of the total mineral resources in China and the dependence on imports to a large extent. Therefore, it is of great significance to expand the mining scale of mineral resources and reduce the mining costs to improve the self-sufficiency rate of mineral resources and strengthen social support and economic development in China. The caving mining method, especially the block caving method, has the following two main characteristics: one is that caved ores, surrounded by overlying rocks, are drawn from the drawpoint and the other one is that ground pressure is managed by filling goaf with overlying rocks. It is a low-cost and efficient large-scale underground mining method and has been widely used in metal mines around the world. To further reveal the far-field field migration and evolution mechanism of caved ore and rock in metal mine, through physical test, numerical simulation, and theoretical analysis, isolated-drawpoint draw models were constructed to study the flow characteristics of near/far-field flow characteristics of caved ore and rock. Based on the discrete element software PFC3D and rigid block model, the numerical draw model was constructed for the first time. The reliability and superiority of the rigid block model in the study of flow characteristics of caved ore and rock were proved by comparative analysis between near-field physical draw test results and simulated results. Moreover, the variation law of the IMZ (Isolated Movement Zone), the stress evolution law and its mechanical mechanism in the particle flow system under far-field conditions were quantitatively studied. The key research results prove that: 1) The shapes of IMZ under near/far-field conditions conform to the upside-down drop shape theory. In the initial draw stage, the maximum width of IMZ increases rapidly with the increase of height in the form of power function; while in the following draw stage, the maximum width of IMZ increases almost linearly with the height increase. 2) There is an obvious stress arch effect during the flow of caved ore and rock. With the range expansion of the caved ore and rock, the vertical stress in a certain range outside the IMZ decreases obviously, while the horizontal stress gradually increases and surges before the arrival of IMZ. Furthermore, the horizontal and vertical stresses within the IMZ drop sharply to a lower level.

Objectives The resonance changer （RC） is designed under rigid boundary condition and then applied to the elastic coupling boundary condition. This paper explores the influence of changes in boundary conditions on RC parameter design and its vibration reduction effect.Methods Considering the characteristics of the shafting rotor, a dynamic model of a shafting-hull coupling system with a RC is established. Based on the transfer matrix method, the vibration and force transfer characteristics of the system are analyzed. The structural parameters of the RC are designed according to the shafting longitudinal vibration characteristics under rigid boundary conditions, then applied to the hull.Results The results show the feasibility of the above parameter design and application scheme. The influence of the anti-resonance vibration isolation mechanism on the system can be divided into the stiffness region, anti-resonance region and mass region. Through sensitivity analysis, it is proposed that the structural parameters of the RC are adjustable.Conclusions The results of this study can provide valuable references for the application of RC to full-sized ships.

The rapid development of cross-border e-commerce, especially since Chengdu was listed as an Integrated Pilot Zone for Cross-Border E-Commerce in 2016, has led to a rising trade value of agricultural products in the metropolis. This upward trend is also attributed to the China-Europe Railway Express and the Chengdu International Aviation Hub Integrated Functional Area, two infrastructure systems that have opened more international logistics channels for agricultural products in Sichuan province. However, the development of crossborder logistics has failed to respond to the rapid growth of cross-border e-commerce for agricultural products. This problem has given rise to longer delivery cycles, higher costs, and reduced product quality, hindering the development of cross-border e-commerce for agricultural products. Currently, most research efforts are focused on selecting a logistics mode which has created an urgency is to establish a logistics system. To that end, we must utilize the opportunities and preferential policies brought about by the Belt and Road Initiative to advance the establishment of a cross-border logistics system for agricultural products, which will create more channels for selling Sichuan’s agricultural products overseas. This article analyzes the current situation of the cross-border logistics system for agricultural products produced by the province and studies the potential relationships between a logistics system and cross-border trade of agricultural products. It seeks to build a logistics system that meets the demands of cross-border transactions using economic theories focused on cross-border e-commerce and logistics. Such a logistic system will help shorten long delivery cycles, cut delivery costs, and guarantee the quality of agricultural products. Also, it can contribute to the rapid development of cross-border e-commerce of agricultural products and solve problems in developing the agricultural products logistics system of Sichuan province.

The basis and premise of developing intelligent agriculture is digitization, especially digitization of agricultural land resources utilization, agricultural land ownership, agricultural production and other agricultural elements. At present, China's agriculture digitization is at a low level, the spatial information of agricultural land resources are applied few. It is necessary to accelerate the application of the big data with respect to agricultural land for agricultural production information collecting and agricultural policy implementing to promote the development of China's intelligent agriculture. One typical case is "food production function zone" and "important agricultural product production protection zone"(Two-Zone) demarcation. In order to realize the study on the technologies of "Two-Zone" demarcation, in this research, the following work was conducted . Firstly, the basic concept of the multi-source spatial data with respect to agricultural land was elaborated, and the existing multi-source spatial data with respect to agricultural land were summarized into four categories. Then, the workflows of "Two-Zone" demarcation was summed up. Considering the topological requirements of digital mapping for "Two-Zone" and the business requirements of intelligent management for agricultural production in "Two-Zone", a three-level spatial structure of "zone-patch-plot" was designed for "Two-Zone" demarcation. The key technology of digital mapping was proposed, based on the analysis of the functions of "Two-Zone" and the "zone-patch-plot" spatial structure, which integrate existing multi-source farmland spatial data depending on the relevance of spatial distribution and semantic attributes and then realize "Two-Zone"'s spatial distribution map at a specific spatial scale. The key technology of establishing the database for "Two-Zone" demarcation was also proposed, which realizes the abstraction of the geographical space entity delimited by "Two-Zone" from the perspective of spatial information structure. Therefore, the key technologies of "Two-Zone" demarcation based on multi-source agricultural land spatial data was scientifically designed, through the key work such as data acquisition, digital mapping and database construction. Finally, the key scientific problems in the technical links were extracted, which shown that "Two-Zone" demarcation requires a comprehensive consideration of data sources and user requirements, and it is necessary to analyze the availability of data with respect to multi-source agricultural land, decreasing the influence derived from the bias and partial loss of data with respect to multi-source agricultural land. Further consideration about statuses of the land use and crop planting in the farmland of "Two-Zone" is also needed. This study will provide a basic support for the intelligent management of agricultural land resources in the "Two-Zone".

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With rice cultivars Yangdao 6 (Indica) and Wuyujing 3 (Japonica) as test materials, the effects of relatively high temperature (RHT, mean temperature 30 ° C) at grain-filling stage (GFS) on the starch viscosity profile and magnesium (Mg) and potassium (K) contents of rice grain were studied in a phytotron. Four temperature treatments were installed, i.e., RHT at whole GFS, RHT at early GFS and optimum temperature at later GFS, optimum temperature at early GFS and RHT at later GFS, and optimum temperature (CK, mean temperature 23 ° C) at whole GFS. The results showed that RHT at GFS significantly influenced the characteristic values of rice grain' s starch viscosity profile, e.g., the values of gelatinization temperature, final viscosity, consistency, and setback increased, while those of peak viscosity, hot viscosity, and breakdown decreased, with Yangdao 6 and Wuyujing 3 followed the similar pattern. The RHT increased the contents of Mg, K, and N, especially of K, resulting in a marked decrease of Mg/K and Mg/(N * AC * K) in the grain. The grain's amylase content (AC) of the two cultivars showed contrasting in response to temperature treatments. Wuyujing 3 performed decrease, while Yangdao 6 exhibited increase in AC values. The RHT at whole GFS affected the starch viscosity profile and the Mg and K contents most greatly, followed by the RHT at early GFS, and the RHT at later GFS. The period within 20 days after flowering was the key period during which temperature affected the grain's starch viscosity profile and Mg and K contents. The Mg/K and Mg/ (N * AC * K) in rice grain significant correlated with the characteristic values of starch viscosity profile, which could be used as the reference indices of rice eating quality. [ABSTRACT FROM AUTHOR]

Aiming at the three assembly process difficulties of pin hole connection between cases,planetary wheel bearing,planetary gear train of wind power increasing gearbox with the technical structure of planetary closed differential transmission,the deeply analysis of the assembly technical requirement of transmission twist pin between cases,the planetary wheel bearing,planetary gear structure is carried out.The technology solution is put forward and verified.

Wind power gearbox assembly process quality has a decisive influence on the wind power gearbox assembly quality,it has important significance for improving the reliability of wind power gearbox.Aiming at the three assembly process difficulties problems of the two-stage planetary level parallel axis structure of wind power gearbox about planetary wheel,planet wheel axial momentum assurance and the measurement,body up and down box after box,surface level degree guarantee.Firstly,the deeply analysis planetary gear assembly parts matching relationship,the principle of bearing axial clearance control,the structure of rear housing,and then,the solution is put forward.Finally,the process scheme is verified.

D-mannose is a natural hexose with great economic and application values in the food, medicine, and cosmetic fields. However, most biosynthesis methods of D-mannose rely on Escherichia coli as the host, which poses safety issues during the production process and imposes limitations on subsequent applications. This study compared the enzyme properties of mannose isomerases from multiple sources to select the most suitable source. B . subtilis 168/pMA5- EcMIaseA was constructed with "generally recognized as safe" (GRAS) Bacillus subtilis as the host and used as a whole-cell catalyst to synthesize D-mannose from d-fructose. Optimizing the conversion conditions such as culture temperature, pH, and substrate concentration increased the yield of D-mannose. The results showed that the conversion rates reached 27.75% and 27.22% and the yields of D-mannose were 138.74 g/L and 163.30 g/L after 6 h whole-cell transformation with d-fructose at the concentrations of 500 g/L and 600 g/L, respectively, in a 5 L fermentor. This study achieves the highest yield of D-mannose produced under the catalysis by recombinant B . subtilis that has ever been reported and provides a basis for the industrial production and application of D-mannose.

Objective: To evaluate the role of volume management guided by extravascular lung water index(EVLWI) in improving the clinical outcomes and cardiac function for patients with cardiogenic shock. Methods: This study was a single-center, prospective cohort study. Patients with cardiogenic shock admitted to the Department of Cardiovascular Medicine, Shanghai East Hospital from July 2022 to December 2023 were enrolled. Patients were matched 1∶1 by propensity score and divided into EVLWI group and control group. In the control group, the volume management strategy was determined by the attending physician based mainly on conventional factors, including clinical features, biochemical assessments, and certain blood pressure measurements. In EVLWI group, the volume management plan was formulated by integrating conventional factors with EVLWI derived from pulse index continuous cardiac output (PiCCO) monitoring. Baseline clinical data, in-hospital treatment, and hemodynamic data were collected. Major adverse cardiovascular events and cardiac function related parameters were compared at 30 d after treatment between the two groups. Baseline EVLWI levels were compared between the non-survivors and the survivors in the EVLWI group. The receiver operating characteristic curve was plotted to assess the accuracy of baseline EVLWI and central venous pressure in predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, and subgroup analysis was performed according to ischemic/non-ischemic etiology and with/without use of inotropic drugs. Kaplan-Meier curve was used for survival analysis, with log-rank tests comparing all-cause mortality, cardiac death, and readmission rate for heart failure at 30 d after treatment. Results: A total of 200 patients with cardiogenic shock were enrolled, aged (71.35±12.82) years, 144(72%) males, EVLWI group and control group 100 patients each. Compared with the control group, EVLWI group had lower all-cause mortality (16%(16/100) vs. 42%(42/100), log-rank P <0.01), cardiac death (14%(14/100) vs. 34%(34/100), log-rank P <0.01), and readmission rate for heart failure (4%(4/100) vs. 12%(12/100), log-rank P =0.03) at 30 d after treatment. Subgroup analysis showed that EVLWI-guided volume management was associated with lower all-cause mortality at 30 d after treatment in patients with cardiogenic shock of ischemic or non-ischemic etiology and with or without inotropic drugs (all P <0.05). In EVLWI group, baseline EVLWI levels were higher in non-survivors than those in survivors [(15.99±6.47) ml/kg vs.(9.75±2.55) ml/kg, P <0.01]. The baseline EVLWI could predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, with an area under the receiver operating characteristic curve of 0.84 (95% CI : 0.75-0.94, P <0.01), while the baseline central venous pressure had no predicting value ( AUC =0.54, 95% CI : 0.40-0.69, P =0.60). The optimal cutoff value of EVLWI in pridicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock was >10.3 ml/kg. With the optimization of hemodynamic parameters, left ventricular ejection fraction was improved in EVLWI group, and serum levels of N-terminal pro-brain natriuretic peptide, creatinine, alanine aminotransferase and lactic acid were decreased (all P <0.05). Conclusion: EVLWI-guided volume management exerts a beneficial effect on therapeutic decision-making and improves clinical outcomes and cardiac function in patients with cardiogenic shock.

Objective: To investigate the effect of immune checkpoint inhibitors on reducing residual lymph node metastasis in patients with gastric cancer. Methods: The cohort of this retrospective study comprised patients from Nanfang Hospital of Southern Medical University and the First Affiliated Hospital of Xiamen University who had undergone systemic treatment prior to gastrectomy with D2 lymphadenectomy and had achieved Grade 1 primary tumor regression (TRG1) from January 2014 to December 2023. After exclusion of patients who had undergone preoperative radiotherapy, data of 58 patients (Nanfang Hospital: 46; First Affiliated Hospital of Xiamen University: 12) were analyzed. These patients were allocated to preoperative chemotherapy (Chemotherapy group, N =36 cases) and preoperative immunotherapy plus chemotherapy groups (Immunotherapy group, N =22 cases). There were no significant differences between these groups in sex, age, body mass index, diabetes, tumor location, pathological type, Lauren classification, tumor differentiation, pretreatment depth of invasion by primary tumor, pretreatment lymph node stage, pretreatment clinical stage, mismatch repair protein status, number of preoperative treatment cycles, or duration of preoperative treatment (all P >0.05). The primary outcome measure was postoperative lymph node downstaging. Secondary outcomes included postoperative depth of invasion by tumor, number of lymph nodes examined, and factors affecting residual lymph node metastasis status. Results: Lymph node downstaging was achieved significantly more often in the Immunotherapy group than the Chemotherapy group (pN0: 90.9% [20/22] vs. 61.1% [22/36]; pN1: 4.5% [1/22] vs. 36.1% [13/36]; pN2: 4.5% [1/22) vs. 0; pN3: 0 vs. 2.8% [1/36], Z =-2.315, P =0.021). There were no significant difference between the two groups in number of lymph nodes examined (40.5±16.3 vs. 40.8±17.5, t =0.076, P =0.940) or postoperative depth of invasion by primary tumor (pT1a: 50.0% [11/22] vs. 30.6% [11/36]; pT1b: 13.6% [3/22] vs. 19.4% [7/36]; pT2: 13.6% [3/22] vs. 13.9% [5/36]; pT3: 13.6% [3/22] vs. 25.0% [9/36]; pT4a: 9.1% [2/22] vs. 11.1% [4/36], Z =-1.331, P =0.183). Univariate analysis revealed that both preoperative treatment regimens were associated with residual lymph node metastasis status in patients whose primary tumor regression was TRG1 (χ 2 =6.070, P =0.014). Multivariate analysis incorporated the following factors: pretreatment depth of invasion by primary tumor, pretreatment lymph node stage, pretreatment clinical stage, number of preoperative treatment cycles, and preoperative treatment duration. We found that a combination of immunotherapy and chemotherapy administered preoperatively was an independent protective factor for reducing residual lymph node metastases in study patients whose primary tumor regression was TRG1 (OR=0.147, 95%CI: 0.026-0.828, P =0.030). Conclusion: Compared with preoperative chemotherapy alone, a combination of preoperative immunotherapy and chemotherapy achieved greater reduction of residual lymph node metastases in the study patients who achieved TRG1 tumor regression in their primary lesions.

Objective: To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. Methods: This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. Results: The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Conclusions: Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident.

Objective: To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications. Methods: This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression. Results: The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P <0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P =0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P <0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P =0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P <0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P =0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P <0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P <0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P =0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P =0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P =0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P <0.001). Conclusion: Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Objective: To establish a method for the simultaneous determination of 6 benzodiazepine sedatives residue in aquatic products by high performance liquid chromatography-triple quadrupole mass spectrometry., Methods: The samples were extracted with acetonitrile and purified by C&#95;(18 )solid phase extraction column. The sample solution was separated by Waters ACQUITY UPLC BEH C&#95;(18 )column(2.1 mm×50 mm, 1.7 μm) using 0.1% formic acid and methanol as mobile phase for gradient elution, determined in multiple reaction monitoring mode and quantified by internal standard method., Results: Six benzodiazepine sedatives had a good linear relationship in the range of 1.0-50.0 μg/L with r&gt;0.9990, the limits of detection and limits of quantification were 0.3 and 1.0 μg/kg. Average recoveries for the analytes at 3 spiked levels ranged from 74.2%-108.0% with relative standard deviations of 1.1%-6.7%(n=6)., Conclusion: The method is simple, rapid, sensitive and accurate, which is suitable for simultaneous determination of 6 benzodiazepine sedatives residue in aquatic products.

Background: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration., Methods: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases., Results: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05)., Conclusions: The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.

Rapid serial visual presentation (RSVP) is a type of psychological visual stimulation experimental paradigm that requires participants to identify target stimuli presented continuously in a stream of stimuli composed of numbers, letters, words, images, and so on at the same spatial location, allowing them to discern a large amount of information in a short period of time. The RSVP-based brain-computer interface (BCI) can not only be widely used in scenarios such as assistive interaction and information reading, but also has the advantages of stability and high efficiency, which has become one of the common techniques for human-machine intelligence fusion. In recent years, brain-controlled spellers, image recognition and mind games are the most popular fields of RSVP-BCI research. Therefore, aiming to provide reference and new ideas for RSVP-BCI related research, this paper reviewed the paradigm design and system performance optimization of RSVP-BCI in these three fields. It also looks ahead to its potential applications in cutting-edge fields such as entertainment, clinical medicine, and special military operations.

Objective: To investigate the mechanism of parthenolide for inducing necroptosis and ameliorating CD8 + T cell exhaustion in colorectal cancer (CRC) and construct liposome nanoparticles for targeted delivery of parthenolide., Methods: The inhibitory effect of parthenolide on proliferation of different CRC cell lines was examined using CCK8 assay, and ROS LDH detection and Western blotting were used to analyze the cell death pathways. In a mouse model bearing subcutaneous MC38 cell xenografts, the effects of 5 and 15 mg/kg parthenolide on tumor growth and CD8 + T cell depletion were observed. In a mouse model bearing orthotopic CRC cell xenograft in the ileocecal region, free parthenolide (100 μg/mL) or low (100 μg/mL) and high doses (200 μg/mL) of liposome nanoparticles loaded with parthenolide were injected via the tail vein, and the changes in CD8 expression in the xenografts were analyzed using immunohistochemistry., Results: Treatment with parthenolide dose-dependently lowered the viability of the CRC cell lines SW480, DLD1, HCT116 and MC38 cells, and its effect was obviously antagonized by Nec-1. Immunoblotting analysis showed that parthenolide treatment resulted in increased RIP3 and MLKL phosphorylation in the CRC cells. In the mouse model bearing subcutaneous xenografts, parthenolide treatment at the high dose, but not at the low dose, significantly increased the number of infiltrating CD3 + CD8 + T cells and PD1 hi TIM3 + T cell percentage ( P <0.01) and lowered the percentage of PD1 lo TIM3 - T cells in the tumor tissue ( P <0.01). In the mouse models bearing orthotopic CRC xenograft, intravenous injection of the liposomes loaded with parthenolide, especially at the high dose, significantly increased CD8 expression in the tumor tissue ( P <0.01)., Conclusion: Parthenolide induces necroptosis in CRC and increases infiltrating CD8 + T cells to ameliorate CD8 + T cell exhaustion in the tumor. Liposome nanoparticles for targeted delivery of parthenolide produce stronger, anti-tumor effect.

Objective: To examine the application effect of body mechanics principles in the process of health workers doffing personal protective equipment (PPE)., Methods: A total of 360 health workers from a Fangcang shelter hospital, also known as alternate care site, in Shanghai were involved in a centralized 1-day training concerning essential skills for taking off PPE. The training was focused on integrating body mechanics principles, including expanding the support surface, lowering the center of gravity, reducing the shift in the the center of gravity, using the principle of leverage, and creating the appropriate operating space, in the PPE doffing process. Through remote video monitoring and recording, observations were made of the physical stability, pollution risks, and operational smoothness of the health workers when they applied body mechanics principles in their actions., Results: The results of binary logistic regression showed that, compared with the actions taken without applying body mechanics principles, performing the operation of the body leaning forward and then slightly leaning backward was positively correlated with stability in the doffing process (odds ratio [O R ]=3.291, 95% confidence interval [ CI ]: 1.627-6.656), negatively correlated with pollution risks ( OR =0.203, 95% CI : 0.100-0.412), and positively correlated with operational smoothness ( OR =20.847, 95% CI : 8.061-53.916); performing the operation of taking off the boot sleeve in a horse-riding stance, with one foot standing ahead of the other, was positively correlated with stability ( OR =5.299, 95% CI : 1.041-26.957), negatively correlated with pollution risks ( OR =0.079, 95% CI : 0.009-0.692), and positive correlated with operational smoothness ( OR =16.729, 95% CI : 1.238-226.077); performing the operation of taking off the boot sleeve by lifting the heel and then the toes was positively correlated with stability ( OR =19.361, 95% CI : 8.391-44.671), negatively correlated with pollution risks ( OR =0.181, 95% CI : 0.084-0.393), and positively correlated with operational smoothness ( OR =10.977, 95% CI : 3.764-32.008); performing the operation of the leaning forward and keeping the face looking forward when taking off the mask was positively correlated with stability ( OR =2.935, 95% CI : 1.412-6.101), negatively correlated with pollution risks ( OR =0.123, 95% CI : 0.059-0.258), and positively correlated with operational smoothness ( OR =18.126, 95% CI : 6.665-49.297)., Conclusion: In the process of medical staffs doffing PPE, correct and proper mechanical postures and actions can effectively assist medical staffs to maintain balance and stability and reduce the risks of infection, which has major significance and should be widely incorporated in personal protection skills training and applied in clinical practice., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Background: The morbidity and mortality rates of lung cancer remain high worldwide, and lung adenocarcinoma is one of the most important tissue subtypes of lung cancer. Epidermal growth factor receptor (EGFR) mutation is an important driver gene mutation for lung adenocarcinoma. In recent years, immune checkpoint inhibitors (ICIs), such as programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors, have achieved remarkable efficacy in some lung cancer patients. Patients with EGFR mutations enjoyed limited benefits from immunotherapy according to recent studies. This study aimed to explore the relationship between EGFR mutation status and the spatial distribution as well as infiltration number of various immune cells in patients with EGFR mutant lung adenocarcinoma., Methods: This study included 62 lung adenocarcinoma patients who underwent surgery. Through multi-point sampling of surgically removed tumor tissues in different areas, 223 tumor tissue samples were finally obtained. We aquired EGFR mutations status including variant allele frequency (VAF) and mutation subtype in each tumor tissue by genetic test. Afterwards, hematoxylin-eosin (HE) staining, immunohistochemical staining and multiplex fluorescence immunohistochemistry staining have been performed, therefore the infiltration of various immune cells and the distribution of tertiary lymphoid structure (TLS) in tumor tissues were obtained by calculating the immunohistochemical score., Results: Compared with EGFR wild-type patients, patients with EGFR-mutant lung adenocarcinoma had more infiltration of CD68+ macrophages and major histocompatibility complex (MHC) class II antigen-presenting cells and higher spatial distribution heterogeneity of MHC class II antigen presenting cells in tumor tissues, while CD56+ natural killer cells and CD8+ T cells had lower infiltration. Tumor tissues with higher EGFR VAF were associated with lower cell infiltration such as CD3+ T cells, CD20+ B cells, CD56+ natural killer cells, CD68+ macrophages, CD8+ T cells, and only CD3+ T cells showed a lower spatial distribution heterogeneity. For the two common subtypes of EGFR mutations in Chinese population, tumor tissues with EGFR exon 19 deletion mutations have lower immune cell infiltration but higher spatial distribution heterogeneity of CD3+ T cells, CD56+ natural killer cells, CD68+ macrophages, and CD8+ T cells than that in EGFR exon 21 L858R mutant tumor tissues. Prognostic analysis found that patients with EGFR mutations with high degree of CD3+ T cells, CD20+ B cell infiltration and larger numbers of TLS formation and high spatial distribution heterogeneity of CD8+ T cell had longer disease-free survival., Conclusions: EGFR-mutated lung adenocarcinoma had a unique "non-inflammatory" tumor microenvironment with low infiltration of immune cells, and there was also heterogeneity in the tumor microenvironment among the tumors with different mutation subtypes and mutation abundance. These differences were not only reflected in the number but also the spatial distribution of immune cell infiltration. Hence, further studies on the immune microenvironment of EGFR-mutant lung adenocarcinoma were of great significance for improving the efficacy of immunotherapy in EGFR-mutant lung adenocarcinoma patients in the future.

Objective: To evaluate the effects on short-term clinical outcomes and long-term quality of life of laparoscopic-assisted radical proximal gastrectomy with esophageal gastric tube anastomosis versus total gastrectomy with Roux-en-Y anastomosis for adenocarcinoma of the esophagogastric junction. Methods: This was a propensity score matching, retrospective, cohort study. Clinicopathological data of 184 patients with adenocarcinoma of the esophagogastric junction admitted to two medical centers in China from January 2016 to January 2021 were collected (147 in the First Affiliated Hospital of Xiamen University and 37 in the Affiliated Hospital of Qinghai University). All patients had undergone laparoscopic-assisted radical gastrectomy. They were divided into two groups based on the extent of tumor resection and technique used for digestive tract reconstruction. A proximal gastrectomy with reconstruction by esophageal gastric tube anastomosis group comprised 82 patients and a total gastrectomy with reconstruction by Roux-en-Y anastomosis group comprised 102 patients. These groups differed significantly in the following baseline characteristics: age, preoperative hemoglobin, preoperative albumin, tumor length, tumor differentiation, and tumor TNM stage (all P <0.05). To eliminate potential bias caused by unequal distribution between the two groups, 1∶1 matching was performed by the nearest neighbor matching method. The 13 matched variables comprised sex, age, height, body mass, body mass index, preoperative glucose, preoperative hemoglobin, preoperative total protein, preoperative albumin, neoadjuvant radiotherapy, tumor length, degree of differentiation, and pathological TNM stage. Postoperative complications, postoperative nutritional status, incidence of reflux esophagitis 1 year after surgery, and quality of life were compared between the two groups. Results: After propensity score matching, 60 patients each were enrolled in the proximal gastrectomy with esophageal gastric tube anastomosis and total gastrectomy with Roux-en-Y anastomosis groups. The baseline characteristics were comparable between these groups (all P >0.05). There were no significant differences between the two groups in operative time, intraoperative bleeding, time to semifluid diet, postoperative hospital days, tumor length, and total hospital costs ( P >0.05). Patients in the proximal gastrectomy with esophageal gastric tube anastomosis group had earlier postoperative gastric tube and abdominal drainage tube removal time than those in the total gastrectomy with Roux-en-Y anastomosis group ( t =-2.183, P =0.023 and t =-4.073, P <0.001, respectively). In contrast, significantly fewer lymph nodes were cleared and significantly fewer lymph nodes were positive in the proximal gastrectomy with esophageal gastric tube anastomosis group than in the total gastrectomy with Roux-en-Y anastomosis group ( t =-5.754, P <0.001 and t =-2.575, P =0.031, respectively). The incidence of early postoperative complications was 43.3% (26/60) in the total gastrectomy with Roux-en-Y anastomosis group; this is not significantly higher than the 26.7% (16/60) in the proximal gastrectomy with esophageal gastric tube anastomosis group (χ 2 =3.663， P =0.056). The incidences of pulmonary infection (31.7%, 19/60) and pleural effusion (30.0%, 18/60) were significantly higher in the total gastrectomy with Roux-en-Y anastomosis group than in the proximal gastrectomy with esophageal gastric tube anastomosis group (13.3%, 8/60 and 8.3%, 5/60, respectively); these differences are significant (χ 2 =8.711, P =0.003 and χ 2 =11.368, P =0.001, respectively). All early complications were successfully treated before discharge. The incidence of long-term postoperative complications was 20.0% (12/60) in the total gastrectomy with Roux-en-Y anastomosis group and 35.0% (21/60) in the proximal gastrectomy with esophageal gastric tube anastomosis group; this difference is not significant (χ 2 =3.386， P =0.066). The incidence of reflux esophagitis was 23.3% (14/60) in the proximal gastrectomy with esophageal gastric tube anastomosis group; this is significantly higher than the 1.7% (1/60) in the total gastrectomy with Roux-en-Y anastomosis group (χ 2 =12.876, P <0.001). Body mass index had decreased significantly in both groups 1 year after surgery compared with preoperatively; however, the difference between the two groups was not significant ( P >0.05). The differences in hemoglobin and albumin concentrations between 1 year postoperatively and preoperatively were not significant (both P >0.05). Quality of life was assessed using the Visick grade. Visick grade I dominated in both groups. The percentage of patients with Visick II and III in the total gastrectomy with Roux-en-Y anastomosis group was 11.7% (7/60), which is significantly lower than the 33.3% (20/60) in the proximal gastrectomy with esophageal gastric tube anastomosis group (χ 2 =8.076, P =0.004). No patients in either group had a grade IV quality of life. Conclusions: Both proximal gastrectomy with esophageal gastric tube anastomosis and total gastrectomy with Roux-en-Y anastomosis laparoscopic-assisted radical surgery for adenocarcinoma of the esophagogastric junction are safe and feasible. However, both procedures have their own advantages and disadvantages in terms of postoperative complications. The incidence of reflux esophagitis is higher after proximal gastrectomy with esophageal gastric tube anastomosis, whereas the long-term quality of life is lower than that of patients after total gastrectomy with Roux-en-Y anastomosis.

Under the new pattern of high-quality development, the 2021 Briefing Report on Quality Control of Medical Devices in Shanghai Hospitals at All Levels will be subjected to secondary data processing, and the radar map analysis method will be used to visually evaluate the quality control effects and differences of medical devices in different types of hospitals in Shanghai. Analyze the quality level of medical device management in hospitals at all levels in Shanghai, study the key parts that affect the quality effect, and provide more theoretical basis for the effective control of medical device management quality. From the radar chart, the overall medical device level of tertiary hospitals is higher than that of secondary hospitals, and the overall coverage area is also larger. The overall quality balance of tertiary specialized hospitals needs to be improved urgently, mainly focusing on medical consumables and on-site inspection. There is a big gap in the quality control level of medical devices in other second-level hospitals, but the preparations for quality control training are more comprehensive. Hospital medical device management should pay more attention to specialized hospitals, low-level hospitals and socially run hospitals, and continuously improve the quality control system. At the same time, strengthen the standardization of medical device management and standardization of quality control, and promote the healthy and stable development of medical devices.

Objective: To determine the efficacy of eltrombopag for primary immune thrombocytopenia (ITP) in adults and the predictive factors for treatment-free response (TFR) . Methods: Clinical data of adults with ITP who received eltrombopag from June 14, 2013 to May 31, 2021 in the Hematology Department of Ruijin Hospital affiliated with Shanghai Jiao Tong University Medical College were retrospectively analyzed. The initial dose of eltrombopag was 25 mg/d, and the maximum dose was 75 mg/d; the dose was adjusted to maintain the platelet count to within 50-150×10(9)/L. Treatment was discontinued according either to the protocol, on the patient's wishes or doctor's judgment (prescription medication), or based on clinical trials. The efficacy of eltrombopag and factors for TFR among patients who achieved complete response and those who discontinued treatment were analyzed. Results: Overall, 106 patients with ITP (33 men and 73 women) were included in the study. The median age of patients was 50 (18-89) years. There were 2, 10, and 94 cases of newly diagnosed, persistent, and chronic ITP, respectively. The complete response rate was 44.3% (47/106), the response rate was 34.0% (36/106), and the overall response rate was 78.3% (83/106). Meanwhile, 83 patients who responded to treatment discontinued eltrombopag; of these, 81 patients were evaluated. Additionally, 17 patients (21.0%) achieved TFR. The median follow-up duration of patients who achieved TFR was 126 (30-170) weeks. The recurrence rate was 17.6% (3/17), and the relapse-free survival rate was 76.5%. The results of univariate analysis revealed that non-recurrence after discontinuation of other treatments for ITP ( P =0.001), and platelet count and eltrombopag dose of ≥100×10(9)/L ( P =0.007) and ≤25 mg/d ( P =0.031), respectively, upon discontinuation of eltrombopag were predictors of TFR; these effects were attributed to prolonged effective duration of eltrombopag. Multivariate analysis showed that there was a correlation between non-recurrence and prolonged effective duration after discontinuation of other treatments for ITP ( P =0.002) . Conclusion: Eltrombopag is effective for patients with ITP as it can result in TFR. Predictors for TFR include non-recurrence after discontinuation of concomitant ITP treatment, and platelet count and eltrombopag dose of ≥100 × 10(9)/L and ≤25 mg/d upon discontinuation of treatment, respectively.

Objective: To study the electrophysiological properties of parvalbumin (PV) neurons in the auditory cortex (AC) and its descending auditory projection area in the tail of the striatum (TS)., Methods: The stimulation response of PV neuron step current was recorded in PV-Cre-Ai14 mice using in vitro patch clamp technique, and the release characteristics and waveform characteristics of PV neuron action potentials (APs) were analyzed using Clampfit and MATLAB software. The release characteristics of the APs included AP onset, rheobase, average firing rate, F/I slope and spike frequency adaptation (SFA); the waveform characteristics included peak and post potential characteristics., Results: The PV neurons of the TS and the AC had significantly different electrophysiological characteristics. In terms of peak potential characteristics, the PV neurons in the TS presented with smaller half peak width ( P < 0.001) and larger amplitude ( P < 0.01) with larger maximum ascending slope ( P < 0.01) and maximum descending slope ( P < 0.05). For post potential characteristics, the PV neurons in the TS showed a greater post hyperpolarization ( P < 0.01) with a shorter time for recovery of the resting potential ( P < 0.01). The firing characteristics of the PV neurons of the TS featured a higher AP rheobase ( P < 0.01), a larger F/I slope ( P < 0.01), a greater firing onset delay ( P < 0.001), and a larger SFA ( P < 0.01)., Conclusion: The PV neurons in the TS and the AC of mice show significantly different electrophysiological characteristics in processing auditory information.

Background: At present, robotic surgery is widely used in thoracic surgery, which has higher maneuverability, precision, and stability, especially for small space complex operations and reconstructive surgery. The advantages of robotic lung segment resection under full orifice artificial pneumothorax are obvious., Methods: Based on a large number of clinical practices, we established a set of surgical methods for 4-arm robotic lung segment resection under a port-only artificial pneumothorax. 98 cases of robotic lung segment resection were performed with this method from January 2019 to August 2022. The clinical experience was summarized., Results: Robotic lung segment resection under port-only artificial pneumothorax has obvious advantages in the anatomy of lung segment vessels and bronchi. It is characterized by less bleeding, shorter operation time, adequate exposure, and flexible operation., Conclusions: This surgical model we propose optimizes the operation mode and technique of lung segment resection, makes each step procedural, reduces collateral damage, and is easy to learn and master, which is believed to cure more lung cancer patients with less trauma.

Objective: To examine the clinical efficacy of 3 anti-reflux methods of digestive tract reconstruction after proximal gastrectomy for gastric cancer. Methods: The clinical data and follow-up data of gastric cancer patients who underwent anti-reflux reconstruction after proximal gastrectomy in 11 medical centers of China from September 2016 to August 2021 were retrospectively collected, including 273 males and 65 females, aging of (63±10) years (range: 28 to 91 years). Among them, 159 cases were performed with gastric tube anastomosis (GTA), 107 cases with double tract reconstruction (DTR), and 72 cases with double-flap technique (DFT), respectively. The duration of operation, length of postoperative hospital stay and early postoperative complications (referring to Clavien-Dindo classification) of different anti-reflux reconstruction methods were assessed. Body mass index, hemoglobin and albumin were used to reflect postoperative nutritional status. Reflux esophagitis was graded according to Los Angeles criteria based on the routinely gastroscopy within 12 months after surgery. The postoperative quality of life (QoL) was evaluated by Visick score system. The ANOVA analysis, Kruskal-Wallis rank sum test, χ 2 test and Fisher's exact test were used for comparison between multiple groups, and further comparison among groups were performed with LSD, Tamhane's test or Bonferroni corrected χ 2 test. The mixed effect model was used to compare the trends of Body mass index, hemoglobin and albumin over time among different groups. Results: The operation time of DFT was significantly longer than that of GTA and DTR ((352±63) minutes vs. (221±66) minutes, (352±63) minutes vs. (234±61) minutes, both P <0.01). The incidence of early complications with Clavien-Dindo grade Ⅱ to Ⅴ in GTA, DFT and DTR groups was 17.0% (27/159), 9.7% (7/72) and 10.3% (11/107), respectively, without significant difference among these three groups (χ 2 =3.51, P =0.173). Body mass index decreased more significantly in GTA than DFT group at 6 and 12 months after surgery (mean difference=1.721 kg/m 2 , P< 0.01; mean difference=2.429 kg/m 2 , P <0.01). body mass index decreased significantly in DTR compared with DFT at 12 months after surgery (mean difference=1.319 kg/m 2 , P =0.027). There was no significant difference in hemoglobin or albumin fluctuation between different reconstruction methods perioperative. The incidence of reflux esophagitis one year after surgery in DTR group was 12.9% (4/31), which was lower than that in DFT (45.9% (17/37), χ 2 =8.63, P =0.003). Follow-up of postoperative quality of life showed the incidence of Visick grade 2 to 4 in DFT group was lower than that in GTA group (10.4% (7/67) vs. 34.6% (27/78), χ 2 =11.70, P =0.018), while there was no significant difference between DFT and DTR group (10.4% (7/67) vs. 22.2% (8/36, P >0.05). Conclusions: Compared with GTA and DTR, DFT is more time-consuming, but there is no significant difference in early complications among three methods. DFT reconstruction is more conducive to maintain postoperative nutritional status and improve QoL, especially compared with GTA. The risk of reflux esophagitis after DTR reconstruction is lower than that of DFT.

Objective: To explore the clinical value of mismatch negativity and P3a combined with electroencephalogram (EEG) reactivity to predict the prognosis of patients after severe brain injury. Methods: The clinical data of patients with severe brain injury who were admitted to the neurosurgical intensive care unit of Xiangya Hospital of Central South University from October 2019 to July 2020 were retrospectively analyzed. All patients underwent evaluation of auditory mismatch negativity (MMN), P3a, and EEG reactivity (EEG-R) within 28 days after the onset of coma. Patients were divided into two groups using the 3-month Glasgow Outcome Scale (GOS) after coma onset, a GOS score of 3-5 was defined as a favorable outcome, and GOS grades 1-2 were defined as an unfavorable outcome. The correlation between clinical indicators and prognosis was analyzed, and the predictive values of statistically significant indicators and the cut-off values were determined using the receiver operating characteristic (ROC) curve. Results: A total of 48 patients were enrolled in the study, including 35 males and 13 females (age range:18-68 years old). Twenty-nine of the patients had a favorable outcome and 19 had an unfavorable outcome. The Glasgow Coma Scale (GCS), EEG-R, absolute amplitude of MMN at Fz (FzMMNA), and amplitude of P3a at Cz (CzP3aA) were significantly correlated with the prognosis of comatose patients ( P <0.001). Multivariate logistic regression analysis revealed that only EEG-R, FzMMNA, and CzP3aA were independent predictors for the prognosis of comatose patients after severe brain injury (all P <0.05), with the area under the curve (AUC) of 0.757 (0.613-0.900), 0.912 (0.830-0.994) and 0.887 (0.793-0.981), respectively. The combination of FzMMNA and CzP3aA and the combinationof EEG-R, FzMMNA and CzP3aA increased the value of AUC to 0.942 (0.879-1.000) and 0.964 (0.920-1.000), respectively. Moreover, a cut-off value of 1.27 μV and 2.64 μV for FzMMNA and CzP3aA, respectively, yielded the best sensitivity and specificity for the prognosis prediction of patients with severe brain injury [FzMMNA: 89.66%(26/29) and 84.21%(16/19); CzP3aA:82.76%(24/29) and 84.21%(16/19)]. Conclusion: This study indicates that the combination of EEG-R, FzMMNA, and CzP3aA may serve as a favorable prognostic indicator for comatose patients after severe brain injury.

Objective: To investigate the clinicopathologic and molecular genetic characteristics of myxoid pleomorphic liposarcoma (MPLPS). Methods: Six cases of MPLPS diagnosed and consulted in Fujian Provincial Hospital from 2015 to 2021 were collected for histomorphological observation, immunohistochemistry, and fluorescence in situ hybridization (FISH) detection of DDIT3 (CHOP) gene translocation and MDM2/CDK4 gene amplification. Results: There were four males and two females, aged 26-74 years (mean 53.8 years). The tumor size was 3.8-16.0 cm (mean 11.8 cm). All six cases had similar histopathologic features, showing overlapping histologic morphology of myxoid liposarcoma and pleomorphic liposarcoma. Four cases (4/6) were positive for S-100 protein, and the Ki-67 index was 50%-95%. All cases (6/6) were negative for DDIT3 (CHOP) translocation and MDM2/CDK4 amplification by FISH. TP53 (p.R248w) germline mutation was found in one case. Conclusions: MPLPS is a rare subtype of liposarcoma, characterized by overlapping morphology of myxoid liposarcoma and pleomorphic liposarcoma. Genetically, a few of them have TP53 gene germline mutations, but they lack of DDIT3 (CHOP) translocation or MDM2/CDK4 amplification.

Objective: To analyze mortality and its trend of chronic respiratory diseases (CRD) in China from 1990 to 2019. Methods: Based on the provincial results of China from the 2019 Global Burden of Disease (GBD) study, the average annual percent change (AAPC) of standardized mortality rates of different CRDs were analyzed by using Joinpoint 4.8.0.1, and the age-standardized mortality rate of CRD was calculated by using the GBD 2019 world standard population. Based on the comparative risk assessment theory of GBD, the attributable deaths due to 12 CRD risk factors were estimated, including smoking, indoor air pollution, occupational gas exposure, particulates and smog exposure, environmental particulate pollution, low temperature, passive smoking, ozone pollution, occupational exposure to silica, occupational asthma, high body mass index, high temperature and occupational exposure to asbestos. Results: From 1990 to 2019, the number of deaths and standardized mortality of chronic obstructive pulmonary disease (COPD) showed a downward trend ( P <0.001). The number of COPD deaths decreased from 1 244 000 (912 000 - 1 395 000) in 1990 to 1 037 000 (889 000 - 1 266 000) in 2019. AAPC=-0.9% (95% CI : -1.5% - -0.3%), P <0.001; The standardized mortality rate decreased from 217.9/100 000 (163.3/100 000 - 242.0/100 000) in 1990 to 65.2/100 000 (55.5/100 000 - 80.1/100 000) in 2019. AAPC= -4.2% (95% CI :-5.2% - -3.2%), P <0.001. The number of deaths from asthma decreased from 40 000 (30 000 - 58 000) in 1990 to 25 000 (20 000 - 31 000) in 2019. AAPC=-2.0% (95% CI : -2.6% - -1.4%), P <0.001; The standardized mortality rate of asthma decreased from 6.4/100 000 (4.7/100 000 - 9.5/100 000) in 1990 to 1.5/100 000 (1.2/100 000 - 1.9/100 000) in 2019. AAPC=-5.1% (95% CI : -5.8% - -4.4%), P <0.001. The number of pneumoconiosis deaths decreased from 11 000 (8 000 - 14 000) in 1990 to 10 000 (8 000 - 14 000) in 2019, AAPC=-0.2%(95% CI :-0.4% - 0.1%), P =0.200; The standardized mortality rate of pneumoconiosis decreased from 1.4/100 000 (1.0/100 000 - 1.7/100 000) in 1990 to 0.5/100 000 (0.4/100 000 - 0.7/100 000) in 2019. AAPC=-3.1% (95% CI : -3.4% - -2.8%), P <0.001. The number of deaths from pulmonary interstitial diseases and pulmonary sarcoidosis increased from 3 000 (3 000 - 6 000) in 1990 to 8 000 (6 000 - 10 000) in 2019, AAPC=3.5% (95% CI : 2.7% - 4.2%), P <0.001; The corresponding standardized mortality rate changed little from 1990 to 2019, and AAPC was not statistically significant.The age-standardized mortality rates of different CRDs were higher in men than those in women. In 1990 and 2019, the mortality rates of COPD, asthma, pneumoconiosis and interstitial pulmonary disease and pulmonary sarcoidosis increased with age. In 2019, the population attributable fractions (PAFs) for smoking, environmental particulate pollution, occupational gas exposure, particulate and smog exposure, low temperature exposure and passive smoking were 71.1% (68.0% - 74.3%), 24.7% (20.1% - 30.0%), 19.3% (13.0% - 25.4%), 15.7% (13.6% - 18.3%) and 8.8% (4.5% - 13.1%) respectively in men, and the PAFs for environmental particulate pollution, smoking, low temperature exposure, occupational gas exposure, particulate and smog exposure, and passive smoking were 24.1% (19.6% - 29.3%), 21.9% (18.7% - 25.2%), 16.4% (14.0% - 19.2%), 15.6% (10.2% - 21.1%) and 14.7% (7.9% - 21.3%) respectively in women. Conclusions: During 1990-2019, the overall death level of CRD decreased significantly in China, but it is still at high level in the world. Active prevention and control measures should be taken to reduce the death level caused by CRD.

Objective: To investigate the clinicopathological features and differential diagnoses of paratesticular liposarcoma. Methods: The cases were collected from 2012-2020, from the archives of the Department of Pathology, Peking University Third Hospital, with diagnosis confirmed by histology, immunostaining and FISH tests. Results: Totally 19 patients were enrolled (including 11 in-hospital patients and 8 consultant cases). The patients aged 37-84 years (mean 57 years). The preoperative clinical diagnoses were spermatic cord/inguinal masses (nine patients), scrotal masses (seven patients), and inguinal hernia (three patients). Six lesions recurred after local resection, including one case extending from pelvic liposarcoma. Histologically, there were 10 cases of well-differentiated liposarcoma (WDLPS) and nine cases of dedifferentiated liposarcoma (DDLPS). WDLPSs mostly showed the combined features of lipoma-like, inflammatory and sclerosing subtypes (six patients); the other four WDLPSs had pure lipoma-like subtype features. DDLPSs were low-grade (three patients) or high-grade (six patients), with the morphology resembling myxofibrosarcoma, inflammatory myofibroblastoma, spindle cell sarcoma, pleomorphic undifferentiated sarcoma and pleomorphic liposarcoma. Intense inflammatory cells infiltration was commonly observed in five WDLPSs and two DDLPSs. Ossification was observed in three tumors. Immunohistochemically, the tumors were positive for MDM2 (8/10) and CDK4 (10/10), which were expressed in lipo-differentiating cells, spindle cells in WDLPS, and in dediffferentiated components. S-100 was only expressed by lipocytes (10/10). CD34 expression was positive and diffuse in the stromal cells of WDLPSs and focal or diffuse in dedifferentiated areas (10/10). FISH tests with an MDM2 gene probe were positive (12/12). Conclusions: Paratesticular liposarcoma may be overlooked by both clinicians and pathologists. WDLPS and DDLPS predominate, showing various histologic divergences. The presence of amplification of the 12q14-q15 region (containing the MDM2 and CDK4 genes) is helpful for making the correct diagnosis.

Objective: To evaluate the effectiveness of autologous costal cartilage-based open rhinoplasty in the correction of secondary unilateral cleft lip nasal deformity., Methods: Between January 2013 and June 2020, 30 patients with secondary unilateral cleft lip nasal deformity were treated, including 13 males and 17 females; aged 14-41 years, with an average of 21.7 years. Among them, 18 cases were cleft lip, 9 cases were cleft lip and palate, and 3 cases were cleft lip and palate with cleft alveolar. The autologous costal cartilage-based open rhinoplasty was used for the treatment, and the alar annular graft was used to correct the collapsed alar of the affected side. Before operation and at 6-12 months after operation, photos were taken in the anteroposterior position, nasal base position, oblique position, and left and right lateral positions, and the following indicators were measured: rhinofacial angle, nasolabial angle, deviation angle of central axis of columella, nostril height to width ratio, and bilateral nasal symmetry index (including nostril height, nostril width, and nostril height to width ratio)., Results: The incisions healed by first intention after operation, and no complications such as acute infection occurred. All 30 patients were followed up 6 months to 2 years, with an average of 15.2 months. During the follow-up, the patients' nasal shape remained good, the tip of the nose and columella were basically centered, the back of the nose was raised, the collapse of the affected side of nasal alar and the movement of the feet outside the nasal alar were all lessened than preoperatively. The basement was elevated compared to the front, and no cartilage was exposed or infection occurred. None of the patients had obvious cartilage absorption and recurrence of drooping nose. Except for the bilateral nostril width symmetry index before and after operation, there was no significant difference ( t =1.950, P =0.061), the other indexes were significantly improved after operation when compared with preoperatively ( P <0.05). Eleven patients (36.7%) requested revision operation, and the results were satisfactory after revision. The rest of the patients' nasal deformities were greatly improved at one time, and they were satisfied with the effectiveness., Conclusion: Autologous costal cartilage-based open rhinoplasty with the alar annular graft is a safe and effective treatment for secondary unilateral cleft lip nasal deformity.

Objective: To understand the geographical variations and temporal trends of all-cause mortality rate and life expectancy in China at national and subnational levels during 2005-2018. Methods: Using data from National Cause-of-death Reporting System, China National Maternal and Child Health Surveillance System, Under-reporting Surveys, and related social determinants covariates, we estimated all-cause mortality rate and life expectancy at national and subnational levels in China during 2005-2018. We depicted the geographical variations and temporal trends between provinces on mortality rate and life expectancy. We then decomposed changes in national and subnational deaths into three explanatory components: change due to age-specific mortality rate, change due to the population structure by age, and change due to growth of the total population. Results: In 2018, it was estimated that there were 10 482 297 total deaths (95% CI : 9 723 233-11 466 875 deaths) in China, with 6 113 926 men (95% CI : 5 773 158-6 572 407 men) and 4 368 241 women (95% CI : 3 950 075-4 894 468 women). The all-cause mortality rate was 755.54 per 100 000 (95% CI : 701.49 per 100 000-825.78 per 100 000), with 861.78 per 100 000 (95% CI : 813.75 per 100 000-926.40 per 100 000) in men and 642.73 per 100 000 (95% CI : 581.20 per 100 000-720.15 per 100 000) in women, while age-standardized all-cause mortality rate was 652.27 per 100 000 (95% CI : 599.22 per 100 000-721.71 per 100 000), with 806.38 per 100 000 (95% CI : 755.10 per 100 000-874.31 per 100 000) in men and 503.37 per 100 000 (95% CI : 450.50 per 100 000-572.01 per 100 000) in women. In 2018, it was estimated that the life expectancy in the whole country was 77.15 years old (95% CI : 75.92-78.11 years old), with 74.81 (95% CI: 73.57-75.76) in men and 79.87 (95% CI : 78.61-80.91) in women. Developed areas as Shanghai, Beijing, Jiangsu, and Zhejiang owned comparatively higher life expectancy, while undeveloped areas like Tibet, Guizhou, Xinjiang, and Qinghai showed lower levels. During 2005-2018, there was a 29.87% increase in total deaths at the national level, with 27.74% in men and 31.29% in women. Changes due to age-specific mortality rate, the population structure by age, and the growth of the total population constituted -35.74%, 7.34%, and 58.28% of the total increase, respectively. Conclusions: From 2005 to 2018, the all-cause mortality rate increased while the age-standardized mortality rate decreased substantially among Chinese residents. Change due to population structure by age was the dominant driver. An upward trend of life expectancy was observed in all provinces, with marked differences between the provinces.

Objective: To explore the potential influences and applicability of different spatial weight matrices used in analyzing spatial autocorrelation of cardiovascular disease (CVD) mortality in China. Methods: Using data from the National Cause-of-death Reporting System, we used adjacency-based Rook and Queen contiguity and distance-based K nearest neighbors/distance threshold. We then conducted global and local spatial autocorrelation analysis of CVD mortality at the county level in China, 2018. Results: All four categories and 26 types of spatial weight matrices had detected significant global and local spatial autocorrelation of CVD mortality in China. Global Moran's I statistics reached its peak when using first-order Rook (0.406), first-order Queen (0.406), K nearest neighbors including five spatial units (0.409), and distance threshold with 100 kilometers (0.358). Meanwhile, apparent local spatial autocorrelation was found in CVD mortality. Substantial disparities were observed when detecting "High-High clusters", "Low-Low clusters", "High-Low clusters" and "Low-High clusters" of CVD mortality spatial distribution by using different weight matrices. Conclusions: Using different spatial weight matrices in analyzing the spatial autocorrelation of CVD mortality, we could understand the spatial distribution characteristics of CVD mortality in-depth at the county level in China. In this way, adequate supports could also be provided on CVD premature death control and rational medical resource allocation regionally.

Objective: To understand the distribution patterns of the place of death (PoD) among individuals with cardiovascular disease (CVD) in the provinces of China in 2018. Relationships between CVD deaths in healthcare/medical institutions and individual demographics, social-economic status (SES), the underlying cause of death, and local cultural factors were also explored. Methods: Using data from the National Cause-of-death Reporting System, we examined potential, influential factors of CVD deaths in healthcare/medical institutions through multilevel logistic regression. Results: In 2018, there were 853 832 CVD deaths in disease surveillance points in the country, with 661 625 (77.49%) home deaths and 156 441 (18.32%) occurring in healthcare and medical institutions. Factors including sex, age, nationality, marital status, education level, occupation, the underlying cause of death, criterion for diagnosis, and urban/rural residency, were significantly influential on CVD deaths in healthcare/medical institutions. Meanwhile, spatial variations were shown at factors the subnational level, with 45.39% related to factors at the individual level. Conclusion: Home was the dominant place for CVD deaths in the country, with substantial spatial variations in PoD between provinces. The probability of dying in healthcare/medical settings was comparatively higher among CVD patients with superior socioeconomic status and who lived in urban areas. Adequate information should be collected and included in further studies on exploring influential factors of PoD. Since both social factors, individual preferences, and acute and chronic CVD deaths are critical, it is necessary to enhance treatment capacity. A booming approach incorporating home/hospice care with on-site medical services might also improve the quality of end-of-life care among CVD patients in China.

The difficulty of transanal total mesorectal excision (TME) is to find the correct dissection plane of perirectal space. As a complex new surgical procedure, the fascial anatomic landmarks of transanal approach operation are more likely to be ignored. It is often found that dissection plane is false after the secondary injury occurs during the operation, which results in the damage of pelvic autonomic nerves. Meanwhile, the mesorectum is easily damaged if the dissection plane is too close to the rectum. Thus, the safety of oncologic outcomes could be limited by difficulty achieving adequate TME quality. The promotion and development of the theory of perirectal fascial anatomy provides a new thought for researchers to design a precise approach for transanal endoscopic surgery. Transanal total mesorectal excision based on fascial anatomy offers a solution to identify the transanal anatomic landmarks precisely and achieves pelvic autonomic nerve preservation. In this paper, the authors focus on the surgical experience of transanal total mesorectal excision based on the theory of perirectal fascial anatomy, and discuss the feature of perirectal fascial anatomy dissection and technique of pelvic autonomic nerve preservation during transanal approach operation.