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OBJECTIVETo investigate the effect of Sanhuangyilong decoction plus methotrexate (MTX) on Interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) in the serum and synovial fluid of rheumatoid arthritis (RA) patients with damp-heat-obstruction symptom pattern, Sanhuangyilong decoction and the role of TNF-α and IFN-γ in the development of RA.METHODSRA inpatients with damp-heat-obstruction symptom pattern (partly with knee joint effusion) were selected as the research subjects. Before the treatment, healthy subjects and osteoarthritis (OA) patients with knee joint effusion were assigned to the serum control group and the synovial fluid control group, respectively; during the treatment, RA patients with damp-heat-obstruction symptom pattern were divided into two groups: one is combined group that was administered Sanhuangyilong decoction plus MTX; the other group was MTX group that received MTX only. The expression levels of TNF-α and IFN-γ in the serum and synovial fluid were measured with enzyme-linked immunosorbent assay (ELISA) before and after the treatment, and the peripheral blood levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and disease activity score in 28 joints (DAS28) were determined.RESULTSBefore treatment, the serum levels of TNF-α and IFN-γ in the RA patients with damp-heat-obstruction symptom pattern were higher than those in healthy control group (P < 0.05). The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those in the serum of the RA patients (P < 0.05). The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those of the synovial fluid of the osteoarthritis patients (P < 0.05). The expression of TNF-α and IFN-γ in the serum and synovial fluid of the RA patients had no correlation with the inflammatory activity index ESR, CRP, or DAS28 (P > 0.05). After 2 weeks of treatment, the expression level of TNF-α and IFN-γ in the combined group had increased, although the difference was not statistically significant (P > 0.05); in contrast, ESR, CRP, and DAS28 decreased, and the difference was statistically significant (P < 0.01). After 4 weeks of therapy, TNF-alpha and IFN-γ, ESR, CRP, and DAS28 in the combined group decreased compared with the before-treatment levels (P < 0.01). After 2 w of treatment, the differences in the TNF-α and IFN-γ expression levels in the combined group were not statistically significant (P > 0.05) compared with that in the MTX group, although there were statistically significant differences in the ESR, CRP, and DAS28 (P < 0.05). After 4 weeks of treatment, differences in TNF-α, IFN-γ, ESR, CRP, and DAS28 in the combined group compared with MTX group were statistically significant (P < 0.01).CONCLUSIONSTNF-α and IFN-γ might be involved in the development of RA. The RA patients with damp-heat-obstruction symptom pattern show better benefits from the treatment of Sanhuangyilong decoction plus MTX, and the treatment is superior to that of using MTX only.

Amidst recent environmental challenges, Climate-Smart Agricultural (CSA) practices have been widely acknowledged as a prospective and effective alternative to sustainable food production. Despite the serious global concerns and appeal to implement Agenda 2030, the task for the widespread adoption of CSA-practices seems challenging in developing countries. To this end, this study examines the impact of two institutional characteristics – market structure, and interaction – on the uptake of six CSA practices in Pakistan, namely: integrated pest management, agroforestry, cover cropping, integrated crop-animal farming, traditional organic composting, and crop rotation and diversification. The data set for this work consisted of 600 new entry organic farmers collected from 12 districts of Punjab province, Pakistan. Results of the binary logistic regression models show that, inter alia, the institutional factors, contractual agreements, entrepreneurial support, and market orientation are related to the adoption of multiple CSA practices (≥3). The findings of the study suggest promoting the integrated role of entrepreneurial support, public and private partnership, and supportive institutional landscape for implementing CSA practices in Pakistan. Further, the study also proposes the implementation of revised contractual agreements by tracking CSA practices with lower uptake and introducing such practices as a package in the contractual agreements. The findings of the study provide several theoretical and practical implications for sustainability along with extending the existing literature on CSA, sustainable agriculture, organic farming, and institutional characteristics. Lastly, the study also shows some limitations each of which provides avenues for future research.

The shipping routes of the South China Sea (SCS) are of major significance in global trade and global economy. However, the shipping routes of the SCS are frequently threatened by both natural and manmade factors, such as complex submarine topography, extreme weather, and piracy. Previous studies of shipping safety in the SCS mainly focused on the individual ship safety and broader political policies. For this study, we applied spatial analysis to assess shipping safety along shipping routes. First, we extracted the main shipping routes from spatial analysis of the Voluntary Observing Ships data. Then, we used a qualitative review to choose influencing factors on ship safety in the SCS, for which data were available over a comparable time period. Further, annual and four seasonal criteria systems were developed. After factor normalization and mapping, the annual and seasonal navigation environment risk was evaluated along the shipping routes using the fuzzy analytic hierarchy process and geographic information science, and validated by comparison to actual incident reports. Our study shows that (1) the proposed method is a reasonable method of evaluation of navigation environment risk, at least in the SCS; (2) the majority of the shipping routes run from southwest to northeast, reflecting a linear-direction trend; (3) the risk of navigation environment in the SCS gradually decreases from the north to the south with a V-shape spatial distribution, and varies seasonally; and (4) in terms of shipping risk the four seasons are sorted in an ascending order: spring, winter, summer, and autumn.

Proton Monte Carlo (MC) simulations model the physics processes between protons and medium and yield more accurate dose calculation compared to proton stopping power based pencil beam convolution algorithm. MC simulation is also essential for prompt gamma and proton-induced isotope production for in vivo proton range detection. It requires the tissue element composition to be determined from patient CT images. We propose a new hierarchical clustering based approach in extracting the atomic composition in human tissues from Dual Energy CT (DECT) scans and a method for validation using MC simulations. 70 published human tissues samples were used for the theoretical study of this approach. The tissues were first clustered by their composition similarities using hierarchical clustering. For each tissue cluster, three base tissues were randomly selected. Other tissues in this cluster were the weighted sum of these base tissues, where the weights were derived by fitting the attenuation coefficients calculated from DECT X-ray spectrums. The derived tissue atomic compositions and effective atomic number were compared with the ground truth. Animal tissues were scanned using a DECT scanner. The tissues were then irradiated using a PBS proton beam. A double Gaussian proton source has been modeled in GEANT4. Using these images, source model and extraction method, Monte Carlo simulations will be run mimicking the experimental setup. The soft tissues and bones were clustered into 8 subcategories, with cophenetic correlation 0.895 and inconsistency coefficient (IC) > 1.15 ( IC max = 1.1547 ). The mean and standard deviations of the difference in the derived atomic compositions and the ground truth for H, C, N, O, Ca, P were 0.05% (±0.07%), 1.56% (±2.02%), 0.61% (±0.55%), 1.81% (±2.37%), 0.03% (±0.07%), 0.13% (±0.16%), respectively. The Z eff from derived elemental composition was within 0.04 from the true values. We have investigated a new approach to extract the atomic composition from DECT scans. The accuracy of the extraction was demonstrated for published tissue samples. This approach will be validated using the DECT scans of animal tissues and GEANT4 source model, by comparing the Zeff derived from this method against measurements from proton beam irradiations.

Recent years, microcomputers have been widely used in antibiotic fermentation processes. A lot of environmental variables, such as fermentation temperature, pressure, PH etc. have been successfully controlled by microcomputers. But some main variables in antibiotic fermentation processes, such as biomass concentration, concentration of antibiotics are still difficult to be controlled, because these main variables can not be measured on line directly. The antibiotic fermentation process is too complex and a suitable dynamic model is difficult to find. So, in an industrial penicillin fermentation process, the biomass concentration is controlled by the operator to adjust the feedrate of glucose. The feed rate is determined from experiences based on past experiments. In this work, a kind of expert system including hierarchical intelligent control is developed to identify the penicillin fermentation situations and make decisions to control the feedrate of glucose.