Search

Objective Arthrodesis, usage of metallic implants for internal fixation, is commonly employed as the primary treatment modality for Müller‐Weiss disease (MWD). Nevertheless, the efficacy of the current methods of fixation leaves room for improvement. Inadequate fixation strength and the risk of fixation failure are both critical concerns requiring attention. This study explored the clinical effects of implementing a modified fixation technique in talonavicular arthrodesis for the treatment of MWD. Methods A total of 14 cases diagnosed with MWD undergoing talonavicular (TN) arthrodesis from January 2021 toMarch 2023 were included in the retrospective study. The fixation method for fusion involved the use of screws, with additional support from the shape‐memory alloy (SMA) staple. Relevant clinical outcomes and complications were evaluated preoperatively and postoperatively. Paired‐samples t‐test was used for all data comparisons. Results Radiographic evidence confirmed solid fusion, and follow‐up evaluations showed satisfactory results in all cases. The American Orthopedic Foot and Ankle Society (AOFAS) scores were elevated from 32.21 ± 4.0 (range: 22–38) preoperatively to 86.5 ± 2.7 (range: 81–90) postoperatively (p

Abstract Aiming at the problem of efficient and reliable transmission for communication system in complex electromagnetic environment, an anti‐interference decision‐making method for communication waveform based on collaborative filtering (CF) is proposed here. The required minimum signal‐to‐noise ratio to meet a specific bit error rate is adopted as a key indicator to evaluate the performance of certain waveform–channel combinations. The main challenge that is solved is to predict transmission performance ratings that cannot be obtained in practice. With CF of waveform features and interference features, the missing training data can be accurately predicted. The convergence speed and prediction accuracy of the proposed algorithm are verified by simulation, and the influence of different feature quantities and different data deficiency degrees on the stability and accuracy of the algorithm is discussed.

Abstract Pyroptosis may play an important role in the resistance of ovarian cancer (OC) to chemotherapy. However, the mechanism by which pyroptosis modulation can attenuate chemotherapy resistance has not been comprehensively studied in OC. Here, we demonstrated that RAS‐associated C3 botulinum toxin substrate 1 (RAC1) is highly expressed in OC and is negatively correlated with patient outcomes. Through cell function tests and in vivo tumor formation tests, we found that RAC1 can promote tumor growth by mediating paclitaxel (PTX) resistance. RAC1 can mediate OC progression by inhibiting pyroptosis, as evidenced by high‐throughput automated confocal imaging, the release of lactate dehydrogenase (LDH), the expression of the inflammatory cytokines IL‐1β/IL‐18 and the nucleotide oligomerization domain‐like receptor family pyrin domain‐containing 3 (NLRP3) inflammasome. Mechanically, RNA‐seq, gene set enrichment analysis (GSEA), coimmunoprecipitation (Co‐IP), mass spectrometry (MS), and ubiquitination tests further confirmed that RAC1 inhibits caspase‐1/gasdermin D (GSDMD)‐mediated canonical pyroptosis through the P21‐activated kinase 4 (PAK4)/mitogen‐activated protein kinase (MAPK) pathway, thereby promoting PTX resistance in OC cells. Finally, the whole molecular pathway was verified by the results of in vivo drug combination tests, clinical specimen detection and the prognosis. In summary, our results suggest that the combination of RAC1 inhibitors with PTX can reverse PTX resistance by inducing pyroptosis through the PAK4/MAPK pathway.

Abstract The strain clamps and leading wires are important components that connect conductors on overhead transmission lines and conduct current. During operation, poor contact between these components can cause abnormal overheating, leading to electric failures and threatening power system reliability. Recently, the use of unmanned aerial vehicles equipped with infrared thermal imagers for strain clamp and leading wire maintenance has become increasingly popular. Deep learning‐based image recognition shows promising prospects for intelligent fault diagnosis of overheating faults. A pre‐treatment method is proposed based on dynamic histogram equalisation to enhance the contrast of infrared images. The DeepLab v3+ network, loss function, and existing networks with different backbones are compared. The DeepLab v3+ network with ResNet101 and convolutional block attention module added, and the Focal Loss function achieved the highest performance with an average pixel accuracy of 0.614, an average intersection over union (AIoU) of 0.567, an F1 score of 0.644, and a frequency weighted intersection over union of 0.594 on the test set. The optimised Atrous rates has increased the AIoU by 12.91%. Moreover, an intelligent diagnosis scheme for evaluating the defect state of the strain clamps and leading wires is proposed and which achieves a diagnostic accuracy of 91.0%.

Abstract Objective Fluorine‐18‐fluorodeoxyglucose–positron emission tomography (FDG‐PET) is routinely used for presurgical evaluation in many epilepsy centers. Hypometabolic characteristics have been extensively examined in prior studies, but the metabolic patterns associated with specific pathological types of drug‐resistant epilepsy remain to be fully defined. This study was developed to explore the relationship between metabolic patterns or characteristics and surgical outcomes in type I and II focal cortical dysplasia (FCD) patients based on results from a large cohort. Methods Data from individuals who underwent epilepsy surgery from 2014 to 2019 with a follow‐up duration of over 3 years and a pathological classification of type I or II FCD in our hospital were retrospectively analyzed. Hypometabolic patterns were quantitatively identified via statistical parametric mapping (SPM) and qualitatively analyzed via visual examination of PET‐MRI co‐registration images. Univariate analyses were used to explore the relationship between metabolic patterns and surgical outcomes. Results In total, this study included data from 210 patients. Following SPM calculations, four hypometabolic patterns were defined including unilobar, multi‐lobar, and remote patterns as well as cases where no pattern was evident. In type II FCD patients, the unilobar pattern was associated with the best surgical outcomes (p = 0.014). In visual analysis, single gyrus (p = 0.032) and Clear‐cut hypometabolism edge (p = 0.040) patterns exhibited better surgery outcomes in the type II FCD group. Conclusions PET metabolic patterns are well‐correlated with the prognosis of type II FCD patients. However, similar correlations were not observed in type I FCD, potentially owing to the complex distribution of the epileptogenic region. Plain Language Summary In this study, we demonstrated that FDG‐PET was a crucial examination for patients with FCD, which was a common cause of epilepsy. We compared the surgical prognosis for patients with different hypometabolism distribution patterns and found that clear and focal abnormal region in PET was correlated with good surgical outcome in type II FCD patients.

Abstract Background Marfan syndrome (MFS) is a rare genetic disorder caused by mutations in the Fibrillin‐1 gene (FBN1) with significant clinical features in the skeletal, cardiopulmonary, and ocular systems. To gain deeper insights into the contribution of epigenetics in the variability of phenotypes observed in MFS, we undertook the first analysis of integrating DNA methylation and gene expression profiles in whole blood from MFS and healthy controls (HCs). Methods The Illumina 850K (EPIC) DNA methylation array was used to detect DNA methylation changes on peripheral blood samples of seven patients with MFS and five HCs. Associations between methylation levels and clinical features of MFS were analyzed. Subsequently, we conducted an integrated analysis of the outcomes of the transcriptome data to analyze the correlation between differentially methylated positions (DMPs) and differentially expressed genes (DEGs) and explore the potential role of methylation‐regulated DEGs (MeDEGs) in MFS scoliosis. The weighted gene co‐expression network analysis was used to find gene modules with the highest correlation coefficient with target MeDEGs to annotate their functions in MFS. Results Our study identified 1253 DMPs annotated to 236 genes that were primarily associated with scoliosis, cardiomyopathy, and vital capacity. These conditions are typically associated with reduced lifespan in untreated MFS. We calculated correlations between DMPs and clinical features, such as cobb angle to evaluate scoliosis and FEV1% to assess pulmonary function. Notably, cg20223687 (PTPRN2) exhibited a positive correlation with cobb angle of scoliosis, potentially playing a role in ERKs inactivation. Conclusions Taken together, our systems‐level approach sheds light on the contribution of epigenetics to MFS and offers a plausible explanation for the complex phenotypes that are linked to reduced lifespan in untreated MFS patients.

Abstract Objective To assess seizure semiology and disease evolution in a large number of hypothalamic hamartoma (HH) patients. Methods Seizure semiology and associated medical records for 78 patients with HH‐related epilepsy were retrospectively reviewed. Potential predictors of seizure types were assessed through univariate and binary logistic regression analyses. Results 57 (73.1%) patients presented with gelastic seizures at the onset of epilepsy, of whole 39 (68.4%) experienced additional seizure types with a mean latency interval of 4.59 years. Automatism, version, and sGTCs were increasingly common with disease evolution. The intraventricular size of HH was significantly negatively correlated with the disease evolution interval (r = −0.445, p = 0.009). A significantly higher rate of patients with automatism in the DF‐II group relative to the DF‐III group was found in both χ2 (X = 6.07, p = 0.014) and logistic regression analyses (B = 3.196, p = 0.020). Interpretation Gelastic seizures are the most common initial seizure type in HH patients, but variable semiologies occur with disease evolution. The intraventricular HH lesion size is an important determinant of epilepsy evolution. DF‐II HH lesions contribute to a higher chance of automatism evolution. The present study furthers our understanding of the dynamic organization of the seizure network affected by HH.

Abstract Logging while drilling is to transmit down‐hole measurement data to the surface timely and accurately to ensure the normal production. Drilling data transmission system includes mud pulse and electromagnetic wave. The transmission rate of these methods is only tens of bits per second. To solve the problems of slow transmission rate, low accuracy and long waiting time for drilling data, an acoustic wireless communication system based on orthogonal frequency division multiplexing (OFDM) is developed. The hardware and software design of the acoustic wireless communication system has been completed, and experiments have been carried out. The communication channel is drilling fluid, a frequency selective fading channel with Gaussian white noise and obvious multipath effect. OFDM can be used to solve the adverse effects of these problems on signal transmission. Schmidl–Cox algorithm is used for signal synchronization. Error control coding adopts CRC32 algorithm. The experimental results show that the transmission rate of BPSK mapped OFDM signal can reach 250 kbit/s when the bit error rate is 10−3. Compared with the traditional wireless communication system, an acoustic wireless communication system based on drilling fluid has the advantages of high data transmission rate, low bit error rate and strong anti‐multi‐path fading ability.

Abstract One major characteristic of tumor cells is the aberrant activation of epigenetic regulatory elements, which remodel the tumor transcriptome and ultimately promote cancer progression and drug resistance. However, the oncogenic functions and mechanisms of ovarian cancer (OC) remain elusive. Here, super‐enhancer (SE) regulatory elements that are aberrantly activated in OC are identified and it is found that SEs drive the relative specific expression of the transcription factor KLF5 in OC patients and poly(ADP‐ribose) polymerase inhibitor (PARPi)‐resistant patients. KLF5 expression is associated with poor outcomes in OC patients and can drive tumor progression in vitro and in vivo. Mechanistically, KLF5 forms a transcriptional complex with EHF and ELF3 and binds to the promoter region of RAD51 to enhance its transcription, strengthening the homologous recombination repair (HRR) pathway. Notably, the combination of suberoylanilide hydroxamic acid (SAHA) and olaparib significantly inhibits tumor growth and metastasis of PARPi‐resistant OC cells with high KLF5. In conclusion, it is discovered that SEs‐driven KLF5 is a key regulatory factor in OC progression and PARPi resistance; and potential therapeutic strategies for OC patients with PARPi resistance and high KLF5 are identified.

Abstract Background To explore the prognosis predicting ability of the combined factors, Epstein–Barr virus DNA change level (EBVCL) and tumor volume reduction ratio (TVRR) after inductive chemotherapy (IC), in locally advanced nasopharyngeal carcinoma (LANPC). Methods From 2010 to 2018, 299 LANPC patients were included in this retrospective study. Receiver operating characteristic (ROC) curve analysis was performed to acquire the best critical values. According to the best critical values of EBVCL and TVRR, patients were stratified into low‐ and high‐risk groups. Kaplan–Meier and ROC curve analyses were utilized to verify the prognostic ability of the new predictor (EBVCL+TVRR). The prognostic values among EBVCL+TVRR, EBVCL, TVRR, TNM stage, and the RECIST 1.1 criteria were compared by ROC curve. The primary end points were overall survival (OS), progression‐free survival (PFS), distant metastasis‐free survival (DMFS), and locoregional failure‐free survival (LRFFS). Results ROC curve analyses of TVRR on three‐year survival showed the best critical values of TVRR was 32.72% for OS, 30.21% for PFS and LRFFS, 29.87% for DMFS. The best critical value of EBVCL was 127 copies/ml for OS, and 87.7 copies/ml for PFS, DMFS, and LRFFS. The three‐year OS, PFS, DMFS, and LRFFS for low‐ and high‐risk groups were 97.7% versus 78.3% (hazard ratio [HR] = 0.2398; 95% confidence interval [CI]: 0.1277–0.4502; p

Abstract Objective Focal cortical dysplasia (FCD) represents an essential cause of drug‐resistant epilepsy with surgery as an effective treatment option. This study aimed to identify the important predictors of favorable surgical outcomes and the impact of the interictal scalp electroencephalogram (EEG) patterns in predicting postsurgical seizure outcomes. Methods We retrospectively evaluated 210 consecutive patients between 2015 and 2019. They were diagnosed with FCD by pathology, underwent resection, and had at least one year of postsurgical follow‐up. Predictors of seizure freedom were analyzed. Results Based on the information at the latest follow‐up, seizure outcome was classified as Engel Class I (seizure‐free) in 81.4% and Engel Class II‐IV (non‐seizure‐free) in 18.6% of patients. There were 43, 105, and 62 cases of FCD type I, type II, and type III, respectively. The interictal EEG showed a repetitive discharge pattern (REDP) in 87 (41.4%) patients, polyspike discharge pattern (PDP) in 41 (19.5%), and the coexistence of REDP and PDP in the same location in 32 (15.2%) patients. The analyzed patterns in order of frequency were repetitive discharges lasting 5 seconds or more (32.4%); polyspikes (16.7%); RED type 1 (11.4%); continuous epileptiform discharges occupying >80% of the recording (11.4%); RED type 2 (6.2%); brushes (3.3%); focal, fast, continuous spikes (2.4%); focal fast rhythmic epileptiform discharges (1.43%); and frequent rhythmic bursting epileptiform activity (1.4%). The coexistence of REDP and PDP in the same location on scalp EEG and complete resection of the assumed epileptogenic zone (EZ) was independently associated with favorable postsurgical prognosis. Significance Resective epilepsy surgery for intractable epilepsy caused by FCD has favorable outcomes. Interictal scalp EEG patterns were revealed to be predictive of excellent surgical outcomes and may help clinical decision‐making and enable better presurgical evaluation.

Abstract A crucial component of the musculoskeletal system, the tendon is one of the most commonly injured tissues in the body. In severe cases, the ruptured tendon leads to permanent dysfunction. Although many efforts have been devoted to seeking a safe and efficient treatment for enhancing tendon healing, currently existing treatments have not yet achieved a major clinical improvement. Here, an injectable granular hyaluronic acid (gHA)‐hydrogel is engineered to deliver fibromodulin (FMOD)—a bioactive extracellular matrix (ECM) that enhances tenocyte mobility and optimizes the surrounding ECM assembly for tendon healing. The FMOD‐releasing granular HA (FMOD/gHA)‐hydrogel exhibits unique characteristics that are desired for both patients and health providers, such as permitting a microinvasive application and displaying a burst‐to‐sustained two‐phase release of FMOD, which leads to a prompt FMOD delivery followed by a constant dose‐maintaining period. Importantly, the generated FMOD‐releasing granular HA hydrogel significantly augmented tendon‐healing in a fully‐ruptured rat's Achilles tendon model histologically, mechanically, and functionally. Particularly, the breaking strength of the wounded tendon and the gait performance of treated rats returns to the same normal level as the healthy controls. In summary, a novel effective FMOD/gHA‐hydrogel is developed in response to the urgent demand for promoting tendon healing.

Abstract Introduction The development of pancreatic ductal adenocarcinoma (PDAC) is closely tied with the immune system. C‐C motif chemokine ligands (CCL) were proved to lead to immune recruitment and training. Thus, we reckoned CCL2 to be the kernel of immune suppression in PDAC tissues. Methods We compared normal pancreatic tissues with PDAC tissues according to The Cancer Genome Atlas (TCGA) and clinical samples. Flow cytometry was used to identify M‐MDSCs. We further demonstrated immune suppression of M‐MDSCs according to proliferation rates of CD8+ T cells/CD4+ T cells. Levels of reactive oxygen species (ROS) and Arginase were also tested by flow cytometry, enzyme‐linked immunosorbent assay, and western blot analysis. We also analyzed the specific mechanisms by cluster analysis after CCL2 stimulating M‐MDSCs. Results We found that CCL2 highly increased in PDAC tissues. CCL2 is positively related to CD33 and CD14, markers of monocytic myeloid‐derived suppressor cells (M‐MDSCs). We have demonstrated that CCL2 recruited M‐MDSCs into PDAC tissues both in vitro and in vivo. M‐MDSCs recruitment is accompanied by sustained immune suppression. Furthermore, we have found that M‐MDSCs impeded T cell proliferation and produced high levels of ROS and Arginase, which can be enhanced by CCL2. Mechanistically, CCL2 stimulated M‐MDSCs led to a significant upregulation of genes, a large part of which accumulated in the mitogen‐activated protein kinase signaling pathway. Treatment of aloesin, MAPK signaling inhibitor, relieved the associated immunosuppressive phenotype induced by CCL2. Conclusions Our study indicates that PDAC cells produced CCL2, which promoted localized M‐MDSC recruitment and immune suppression, thereby promoting tumor progression.

Abstract Background Identifying patients who may develop severe coronavirus disease 2019 (COVID‐19) will facilitate personalized treatment and optimize the distribution of medical resources. Methods In this study, 590 COVID‐19 patients during hospitalization were enrolled (Training set: n = 285; Internal validation set: n = 127; Prospective set: n = 178). After filtered by two machine learning methods in the training set, 5 out of 31 clinical features were selected into the model building to predict the risk of developing severe COVID‐19 disease. Multivariate logistic regression was applied to build the prediction nomogram and validated in two different sets. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to evaluate its performance. Results From 31 potential predictors in the training set, 5 independent predictive factors were identified and included in the risk score: C‐reactive protein (CRP), lactate dehydrogenase (LDH), Age, Charlson/Deyo comorbidity score (CDCS), and erythrocyte sedimentation rate (ESR). Subsequently, we generated the nomogram based on the above features for predicting severe COVID‐19. In the training cohort, the area under curves (AUCs) were 0.822 (95% CI, 0.765–0.875) and the internal validation cohort was 0.762 (95% CI, 0.768–0.844). Further, we validated it in a prospective cohort with the AUCs of 0.705 (95% CI, 0.627–0.778). The internally bootstrapped calibration curve showed favorable consistency between prediction by nomogram and the actual situation. And DCA analysis also conferred high clinical net benefit. Conclusion In this study, our predicting model based on five clinical characteristics of COVID‐19 patients will enable clinicians to predict the potential risk of developing critical illness and thus optimize medical management.

Abstract A plethora of both acute and chronic conditions, including traumatic, degenerative, malignant, or congenital disorders, commonly induce bone disorders often associated with severe persisting pain and limited mobility. Over 1 million surgical procedures involving bone excision, bone grafting, and fracture repair are performed each year in the U.S. alone, resulting in immense levels of public health challenges and corresponding financial burdens. Unfortunately, the innate self‐healing capacity of bone is often inadequate for larger defects over a critical size. Moreover, as direct transplantation of committed osteoblasts is hindered by deficient cell availability, limited cell spreading, and poor survivability, an urgent need for novel cell sources for bone regeneration is concurrent. Thanks to the development in stem cell biology and cell reprogramming technology, many multipotent and pluripotent cells that manifest promising osteogenic potential are considered the regenerative remedy for bone defects. Considering these cells' investigation is still in its relative infancy, each of them offers their own particular challenges that must be conquered before the large‐scale clinical application.

Objective To evaluate and compare the clinical and radiographic outcomes of proximal fibular osteotomy (PFO) in treating medial knee osteoarthritis (KOA) patients with upper fibular curvature and non‐curvature. Methods A retrospective cohort study was performed. From January 2016 to January 2017, a total of 51 patients (nine males and 42 females) at a mean age of 63.7 years (range 48–79 years) with medial KOA who underwent PFO procedure at the Third Hospital of Hebei Medical University were included in the study. The patients were divided into the two groups, namely curvature group (28 patients, six males and 22 females, aged 62.6 ± 7.7 years) and non‐curvature group (23 patients, three males and 20 females, aged 64.5 ± 7.6 years). Perioperative parameters and Kellgren‐Lawrence classification were recorded and analyzed in the two groups, respectively. All patients were followed up at 1, 3, 6, and 12 months at the first year of post‐operation, and then every 6 months from the second year of post‐operation. A telephone survey with standard questionnaire survey, including Visual Analog Scale (VAS) score and Hospital for Special Surgery (HSS) scoring system, was used to evaluate postoperative clinical outcomes. Radiological results were assessed using the femorotibial angle (FTA), hip‐knee‐ankle angle (HKA), and settlement value of medial tibial platform (MTP) in the two groups. Results The average follow‐up periods of the curvature group and the non‐curvature group were 34.8 ± 6.1 and 33.9 ± 5.4 months, respectively. There were no significant differences between the two groups of demographic data in terms of number of patients, age, body mass index (BMI), gender, KOA side, and Kellgren‐Lawrence classification (P > 0.05). The VAS scores of the curvature group and non‐curvature group were (3.53 ± 1.62 vs 3.68 ± 1.43 at 1 month, 3.46 ± 0.79 vs 3.57 ± 0.66 at 3 months, and 2.43 ± 0.88 vs 2.83 ± 0.94 at 6 months, both P > 0.05), while significant differences were found from 12 months post‐operation (1.54 ± 0.72 vs 2.03 ± 0.85 at 12 months, and 1.04 ± 0.69 vs 1.74 ± 0.75 at 24 months, both P 0.05), while significant differences were found from 12 months post‐operation (90.64 ± 4.32 vs 87.71 ± 5.63 at 12 months, and 92.93 ± 2.07 vs 90.06 ± 2.08 at 24 months, both P

Objective To evaluate and analyze the potential relationship between periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the independent risk factors for the development of periosteal reaction associated with medial compartment KOA. Methods This is a retrospective comparative study. From January 2019 to December 2019 at the Third Hospital of Hebei Medical University, a total of 363 patients (726 knees) with medial compartment KOA were enrolled in this study according to our inclusion and exclusion criteria, including 91 males and 272 females, with an mean age of 57.9 ± 12.8 years (range, 18–82 years). Among these patients, 206 patients (412 knees) were allocated to the periosteal reaction group (44 males and 162 females) and 157 patients (314 knees) were allocated to the non‐periosteal reaction group (47 males and 110 females). The classification of KOA severity was based on Kellgren and Lawrence (K‐L) grading system. The malalignment of the lower extremities in coronal plane was evaluated as medial proximal tibial angle (MPTA), hip‐knee‐ankle angle (HKA), and lateral distal femoral angle (LDFA). Patients demographics and radiographic parameters were recorded in the two groups. Intra‐observer and inter‐observer reliabilities of all radiological measurements were analyzed by intraclass correlation coefficients (ICCs). Univariate analyses were conducted for comparison of differences with continuous variables between patients with periosteal reaction and without periosteal reaction. Multivariate logistical regression analysis was performed to determine the independent risk factors of radiographic parameters for periosteal reaction. Results The overall incidence of periosteal reaction associated with medial compartment KOA was 56.7%. Furthermore, we observed that the incidence of periosteal reaction significantly increased with age and correlated with K‐L grade progression (P 0.05), LDFA (OR 0.990; 95% CI 0.899–1.089; P > 0.05), and JSW (OR 1.005; 95% CI 0.865–1.167; P > 0.05). Conclusions In this retrospective study, patients with lower HKA and higher JLCA were identified as independent risk factors for the development of periosteal reaction, which occurred most commonly adjacent to the lateral of proximal tibia diaphysis, and thus we concluded that periosteal reaction may be an anatomical adaptation for medial compartment KOA based upon these results.

MicroRNA (miRNA) have been emerged as prognostic biomarkers in diffuse large B‐cell lymphoma (DLBCL). To understand the potential underlying mechanisms and translate these findings into clinical prediction on lymphoma progression, large patient cohorts should be evaluated. Here, using miRNA PCR array, we analyzed the miRNA expression profiles in serum samples of 20 DLBCL patients at diagnosis, remission and relapse. Four candidate miRNA were identified and subsequently evaluated for their ability to predict relapse and survival. A prognostic model based on four circulating miRNA (miR21, miR130b, miR155 and miR28) was established and tested in a training cohort of 279 patients and in a validation cohort of 225 patients (NCT01852435). The prognostic value of the 4‐circulating miRNA model was assessed by univariate and multivariate analyses. The novel 4‐circulating miRNA prognostic model significantly predicted clinical outcome of DLBCL, independent of International Prognostic Index in the training cohort [hazard ratio (HR) = 2.83, 95% CI 2.14–3.51, P

Abstract Background This study aimed to evaluate the efficacy and safety of apatinib with a low dose of 250 mg/d in the treatment of platinum‐resistant or platinum‐refractory ovarian cancer patients. Methods Patients with platinum‐resistant or platinum‐refractory ovarian carcinoma treated with 250 mg/d apatinib in our institution from November 2016 to December 2017 were retrospectively reviewed. The tumor response and progression were evaluated according to the standard by incorporating the levels of CA125 and Response Evaluation Criteria in Solid Tumors 1.1. CTCAE 4.03 was used to evaluate adverse events (AEs). Results Fifty‐two eligible patients were enrolled in per‐protocol (PP) analysis and 65 patients (including 13 lost to follow‐up) were included in the intention‐to‐treat (ITT) analysis. In PP analysis, 18 patients (34.6%) had partial response (PR), 22 patients (42.3%) had stable disease (SD), and the disease control rate (DCR) was 61.5%. Median progression‐free survival (PFS) was 4.0 months (95% CI, 2.83‐5.17 m), and median overall survival (OS) was 25.33 months (95% CI, 17.74‐32.92 m). The objective response rate and DCR for patients in ITT analysis were 27.7% and 49.2%, respectively. The top three treatment‐related AEs were hypertension, hand‐foot syndrome, and leukopenia. Eight patients (15.4%) in PP population had grade 3 treatment‐related AEs. Previous chemotherapy lines, number of recurrences, and AEs did not affect the efficacy of apatinib. Age older than 60 was associated with higher rates of disease control and prolonged PFS (P

Derived disaster is a common concept in emergencies such as earthquakes. With the progress of society, the incidence of fractures caused by high‐energy trauma has increased year by year. After the first injury, the possibility of derived injury caused by the original injury also increases rapidly. Orthopaedic surgeons, especially trauma orthopaedic surgeons, lack sufficient understanding and recognition of this kind of injury. The purpose of this article is to present a case series of an often missed injury pattern that is associated with an original injury. The diagnosis of derived injury may go unrecognized in a considerable number of cases and delayed treatment decreases the success rate of soft tissue repairing; therefore, a high index of suspicion and a proper early diagnosis is of paramount importance. We also describe the current surgical management used by the authors, and propose the concept of “derived injury”, studying its clinical significance in traumatic orthopaedics.

Abstract Background Glucose‐6‐phosphate dehydrogenase (G6PD) is an essential enzyme that protects red blood cells from oxidative damage. Although G6PD‐deficient alleles appear to confer a protective effect of malaria, the link with clinical protection against Plasmodium infection is conflicting. Methods A case–control study was conducted on Bioko Island, Equatorial Guinea and further genotyping analysis used to detect natural selection of the G6PD A‐ allele. Results Our results showed G6PD A‐ allele could significantly reduce the risk of Plasmodium falciparum infection in male individuals (adjusted odds ratio [AOR], 0.43; 95% confidence interval [CI], 0.20–0.93; p

In recent years, wireless charging technology for electric vehicles has aroused widespread concern in the industry. The technology has the advantages of flexibility and convenience, safe operation and low maintenance cost, and is one of the development trends of charging and discharging technology for electric vehicles in the future. The author summarises the current research status from the most crucial aspects of the magnetic coupling structure of wireless charging systems of electric vehicles, which are the transmission coil structure and the resonance compensation network. Finally, the author put forward the urgent problem to be solved at present is the interoperation problem of the magnetic coupling mechanism in different technical routes. Finally, a magnetic field analysis model based on finite element calculation is established, which provides a tool for the interoperability research of magnetic coupling mechanism.

The main difference between flexible high-voltage direct current (HVDC) system and the traditional HVDC system is that there are two control degrees of freedom in the flexible HVDC system that is the amplitude and phase angle of the output voltage. While, there is only one control degrees of freedom in the traditional HVDC system which is the amplitude of the output voltage. Therefore, compared with the traditional HVDC system, there will not be the problem of commutation failure in the flexible HVDC system, and the control systems of the rectifier side and the inverter side being operated independently make the reliability of the system greatly improved. This article analyses and compares the main methods of reliability assessment. Analysing and comparing the reliability parameters of the two systems by using the state enumeration method, and using the economic characterisation to make the comparison more intuitive.