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OBJECTIVE The published studies regarding the relationships between zinc finger 365 (ZNF365) polymorphisms and inflammatory bowel disease (IBD) risk in Caucasians have yielded conflicting results. Therefore, we performed a meta-analysis to clarify this issue. METHODS The Electronic databases of PubMed, Web of Science, Wiley Online Library, and EMBASE were searched for eligible studies up to 31 November 2020. The quality of eligible studies was evaluated using the Newcastle-Ottawa Scale. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) under different genetic models were calculated to assess the strength of associations. RESULTS A total of 22 relevant case-control studies with 9542 ulcerative colitis (UC) patients and 13,886 controls, as well as 13,651 Crohn's disease (CD) patients and 15,256 controls, were involved in our meta-analysis. rs10761659 polymorphism significantly decreased CD and UC risk (except for the heterozygous model and the dominant model in UC), and rs10995271 polymorphism was significantly associated with UC (except for the heterozygous model and dominant model) rather than CD. CONCLUSIONS The meta-analysis demonstrated that the rs10761659 polymorphism might be a protective factor for both UC and CD in Caucasians, while the rs10995271 polymorphism might be a risk factor for UC rather than CD in Caucasians.

A continuously tunable injection pulse-seeded terahertz parametric generator based on KTP crystal has been demonstrated in this work. The terahertz tuning range was from 2.80 THz to 6.24 THz and the maximum terahertz output was 4.59 μJ at 4.42 THz. Compared with the traditional KTP terahertz parametric oscillator with discontinuous frequency tuning, the KTP ips-TPG has significance improvement in the tuning range and THz output energy.

OBJECTIVE Subjective socioeconomic status (SES) is a well-established psychosocial determinant of adolescents' self-report health. However, whether low subjective SES is associated with stress-related physiological risks (e.g., dysregulations in the hypothalamic-pituitary-adrenal axis activity) remains uncertain. This study examined the impact of subjective SES with different reference groups (i.e., perception of family SES relative to other students in the school versus other people in the city) on adolescents' diurnal cortisol profiles. METHODS A sample of 255 adolescents (aged 11-14 years; 53.7% boys) completed a battery of psychological scales, including school-referenced subjective SES and city-referenced subjective SES. Diurnal cortisol was assessed by collecting saliva samples four times a day across two consecutive days. Four cortisol parameters (cortisol at awakening, cortisol awakening response [CAR], cortisol slope, and total cortisol secretion [area under the curve with respect to ground {AUCg}]) were derived. RESULTS Higher levels of school-referenced subjective SES were associated with higher cortisol levels at awakening (β = 0.0483, standard error [SE] = 0.0219, p = .028), steeper cortisol slopes (β = -0.0036, SE = 0.0017, p = .034), and higher cortisol AUCg (b = 0.50, SE = 0.24, p = .036), but not with CAR (p = .77), after adjusting for covariates. In contrast, city-referenced subjective SES was not associated with any of the cortisol parameters (cortisol at awakening [p = .90], CAR [p = .74], cortisol slope [p = .84], and cortisol AUCg [p = .68]). CONCLUSIONS Our findings highlight the importance of the reference group for subjective SES and provide a further understanding of socioeconomic disparities in adolescents' stress physiology.

Purpose: To develop and validate a gene-related nomogram for predicting the risk of lymph node (LN) metastasis preoperatively in patients with colorectal cancer (CRC). Methods: RNA-seq data of 581 CRC and 51 normal cases with clinical features were downloaded from TCGA database. In the evaluation cohort with 381 CRC cases, the LASSO regression was used to reduce dimensionality of gene signatures extracted to build gene score. A gene-related nomogram was performed based on the multivariable logistic regression analysis. The performance of the nomogram was assessed by the discrimination, calibration, and clinical usefulness not only in the evaluation, but also in the validation cohort with 200 CRC cases. Results: A total of 12,590 differentially expressed genes were selected, in which 59 candidates associated with LN metastasis in differentially expressed genes set were screened by LASSO to form the gene score. Based on the analysis of multivariate logistic regression, the gene-related nomogram showed good calibration and discrimination not only in the evaluation cohort (concordance-index 0.93; 95%CI 0.91-0.96), but also in the validation cohort (concordance-index 0.70; 95%CI 0.63-0.78). The decision curve analysis of the gene-related nomogram also provides constructive guidance for the design of operation plan, preoperatively. Conclusions: The presented genes nomogram may predict the LN metastasis in CRC patients, preoperatively. And 59 hub genes were defined related to LN metastasis of CRC, which can serve as treatment targets for the further study. Preoperative biopsy and gene analysis are needed to develop the operation plan in clinical practice.

Glaucoma represents a major cause of blindness, generally associated with elevated intraocular pressure (EIOP). The aim of the present study was to investigate whether microRNA-149 (miR-149) affects retinal ganglion cells (RGCs) and the underlying mechanism based on a mouse model of chronic glaucoma with EIOP. The successfully modeled mice were administered with mimics or inhibitors of miR-149. Next, the number of RGCs, ultrastructural changes of RGCs, and purity of RGCs in the retinal tissues were detected. Moreover, the RGCs were collected and subsequently treated with 60 mmHg pressure and transfected with a series of plasmids aiding in the regulation of the expression of miR-149 and betacellulin (BTC). The levels of miR-149, BTC, phosphatidylinositol 3-kinase (PI3K), and Akt were subsequently determined. Finally, RGC viability and apoptosis were detected accordingly. Dual luciferase reporter gene assay provided validation, highlighting BTC was indeed a target gene of miR-149. The downregulation of miR-149 is accompanied by an increased number of RGCs and decreased ultrastructural RGC alterations. Additionally, downregulated miR-149 was noted to increase the levels of BTC, PI3K, and Akt in both the retinal tissues and RGCs, whereas the silencing of miR-149 was observed to promote the viability of RGC and inhibit RGC apoptosis. Taken together, the results of the current study provided validation suggesting that the downregulation of miR-149 confers protection to RGCs by means of activating the PI3K/Akt signaling pathway via upregulation of BTC in mice with glaucoma. Evidence presented indicated the promise of miR-149 inhibition as a potential therapeutic strategy for glaucoma treatment.

Background The development of prophylactic interventions for major depressive disorder (MDD) is an important issue in clinical practice. We aimed to compare the relative efficacy of nonpharmacological interventions for relapse prevention in adult patients with MDD. Methods Randomized controlled trials investigating nonpharmachological interventions for relapse prevention were included. A Bayesian network meta-analysis was performed. Hazard ratios are reported as effect sizes with 95% credible intervals. Global inconsistency, local inconsistency, heterogeneity, and transitivity were evaluated. Confidence for the results comparing the active treatment with control conditions or antidepressant medicine (ADM) was assessed. Results Thirty-six trials were included. Most nonpharmacological interventions were various forms of psychotherapy; others were noninvasive neurostimulation techniques (3 studies with electroconvulsive therapy and 1 study with transcranial magnetic stimulation). Psychotherapy as a monotherapy following ADM or psychotherapy produced significantly better outcomes than control conditions, and there was no significant difference between psychotherapy and ADM. The combination of psychotherapy and ADM was superior to either treatment alone. The results were similar for patients with at least 3 previous episodes. Neurostimulation techniques were also superior to controls, either as a monotherapy or combined with ADM. Conclusions Our study provided evidence that psychotherapy as a monotherapy following ADM or psychotherapy was effective and performed as well as ADM for relapse prevention. Neurostimulation techniques also showed promising results but more studies are needed to confirm their efficacy. These findings may be informative for clinical practice and inspire future research.

Background The efficacy and safety of PCSK-9 inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China is unknown. Objective To describe the real world effectiveness of initiated with PCSK-9 inhibitors combined with statins compared with statins among patients with very high risk of ASCVD and underwent percutaneous coronary intervention (PCI). Methods This is a prospective study, enrolled patients from 32 hospitals between January to June 2019. The lipid control rate and incidence of cardiovascular events over 6 months were compared between two groups. A propensity score-matched analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for cardiovascular events. Results In a total of 3063 patients, 89.91% had received moderate or high-intensity statin therapy before PCI, but only 9.47% had LDL levels below 1.4mmol/L at baseline. In the PSM selected patients, LDL level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81% (P

Membrane distillation is a new membrane separation technology, which has the advantages of simple equipment, high interception rate, mild operating conditions. However, high energy consumption and low thermal efficiency limit the large-scale application of membrane distillation technology, so efficiency optimization is always an important direction of membrane distillation technology research. In this paper, recent studies on membrane distillation technology to reduce energy consumption and improve thermal efficiency are reviewed, with emphasis on renewable energy utilization, industrial waste heat utilization and latent heat recovery, providing references for its further development.

Background: The objectives were to explore the real world treatment of T3 breast cancer (maximum diameter of tumor bigger than 5 centimeters). Materials and Methods: We selected T3 breast cases diagnosed from 2011 to 2017 in the CSCO BC database. These cases were categorized into two groups: non-NAC group and NAC group. Adjusted hazard ratios for known predictors of event free survival (EFS) using Kaplan-Meier and Cox proportional hazards regression. Results: The study included 868 patients: 49.0%(425/868) of patients chose NAC after diagnosis, 51.0%(443/868) chose surgery as their initial therapeutic strategy(non-NAC group). Compared with non-NAC group, patients in NAC group were correlated with clinical positive lymph nodes, hormonal receptor(HR) negative and human epidermal receptor growth factor 2(HER2) positive. For non-NAC group, only 87.1%(386/443) of patients were pathologic T3 after surgery, the overestimation of clinical examination of tumor lesion was 12.9%(57/443). In addition, there was no significance of EFS between the NAC group and non-NAC group(HR=0.82, 95%CI: 0.64-1.05). However, for T3 breast cancer patients with positive lymph nodes, HR negative and HER2 positive tumors, the NAC group had a better survival than the non-NAC group. Cox proportional analysis showed that lymph node negative, HER2 negative status and neoadjuvant chemotherapy were associated with a longer survival time. Conclusion: As the initial option for T3 breast cancer patients with positive lymph nodes, HR negative and HER2 positive tumors, neoadjuvant chemotherapy is the first therapy.

Breast cancer is the most frequent cancer among females and the second most common cause of cancer deaths worldwide. Tumor-associated macrophages (TAMs) are the most abundant immune cell population in the tumor microenvironment, including breast cancer. Breast cancer stem cells (BCSCs) play an important role in regulating breast cancer growth and metastasis, which still remains an obstacle for successful treatment of breast cancer and requires further investigation, as well as the potential therapeutic strategies. Cytokine array validated that C-X-C motif chemokine ligand 8 (CXCL8) is a pivotal chemokine secreted by TAMs, and CXCL8 could enhance breast cancer migration, invasion ability, and epithelial-mesenchymal transition (EMT) in both animal and human breast cancer. In this study, the clinical data firstly indicated that high CXCL8 expression was significantly associated with metastasis and tumor growth in breast cancer patients. Then, we showed that TAMs-released CXCL8 could markedly elevate the migration, invasion and EMT events in breast cancer cells, as well as the self-renewal of BCSCs in vitro. These processes were markedly abrogated by the treatment of Danirixin, a reversible and selective antagonist of CXC chemokine receptor 2 (CXCR2). Consistently, the in vivo analysis confirmed that CXCL8 suppression using Danirixin effectively reduced the tumor growth, lung metastasis and repressed the self-renewal of BCSCs. Collectively, TAMs/CXCL8 could enhance BCSCs self-renewal and breast cancer metastasis, and these effects could be markedly abolished by Danirixin treatment, suppressing breast cancer progression consequently. Therefore, Danirixin could be considered as a novel and effective therapeutic strategy for breast cancer treatment without obvious toxicity to major organs.

Purpose To investigate the prognosis of single hormone receptor–positive (HR+) breast cancer (estrogen receptor [ER] positive and progesterone receptor [PR] negative, and ER−PR+) compared to double HR+ (ER+PR+) and double HR− (ER−PR−) tumors. Methods We included 531,605 cases of invasive breast cancer between 1990 and 2012 from the US Surveillance, Epidemiology, and End Results (SEER) database for study and classified cases into 4 phenotypes according to expression of ER and PR: ER+PR+, ER+PR−, ER−PR+, and ER−PR−. Results Overall, 66,091 ER+PR− tumors and 9320 ER−PR+ tumors were identified. The clinical characteristics of the ER+PR− group were similar to those of the double HR+ group, while those of the ER−PR+ and double HR− groups were similar. Overall survival of patients with single HR+ tumors was intermediate between that of double HR+ and double HR− tumors. However, we observed no differences in disease-specific survival between ER−PR+ and ER−PR− patients. In multivariate analysis, outcomes were similar. Relative to the double HR+ patient group, risk of death in the ER+PR− group was higher (hazard ratio, 1.422, 95% confidence interval, 1.394-1.452). However, risk of death was comparable between ER−PR+ and ER−PR− patients (hazard ratio, 1.03; 95% confidence interval, 0.98-1.08). Multivariate Cox proportional analysis showed that survival times of patients in the younger age bracket ( Conclusion Disease-specific survival of single HR+ tumor cases was longer than that of double HR− tumors but poorer than double HR+ tumors. However, differences in disease-specific survival were not significant between the ER−PR+ and ER−PR− groups.

Apolipoprotein B mRNA editing enzyme catalytic subunit 3B (APOBEC3B) mRNA expression is associated with the poor prognosis of estrogen receptor positive (ER+) breast cancer. However, the clinical relevance of APOBEC3B protein expression in patients with breast cancer remains unclear. The present study evaluated the association of APOBEC3B protein expression with clinicopathological features, as well as survival outcomes of patients with breast cancer. Furthermore, the association between APOBEC3B protein expression and tumor infiltrating lymphocytes (TILs) was investigated. APOBEC3B protein expression in 120 patients with breast cancer was evaluated via immunohistochemistry, using a constructed tumor microarray, and TILs were analyzed by hematoxylin and eosin staining. The relevance of APOBEC3B mRNA expression in breast cancer was assessed using a Kaplan-Meier Plotter online tool, as well as the Tumor Immune Estimation Response and The Cancer Genome Atlas databases. The present study assessed APOBEC3B expression in 116 patients with breast cancer and demonstrated that protein expression was significantly associated with ER and progesterone receptor expression, as well as different subtypes of breast cancer. Notably, APOEBC3B protein expression was significantly associated with TILs. Overall, high expression levels of APOBEC3B protein and high levels of TILs were indicative of longer disease-free survival rate. High APOBEC3B mRNA expression was associated with poor relapse-free survival rate, overall survival rate and distant metastasis-free survival rate in patients with breast cancer, particularly for the Luminal A subtype. APOBEC3B mRNA expression was also indicated to be associated with the immune status of patients with breast cancer. Overall, the results of the present study demonstrated that APOBEC3B mRNA and protein expression levels presented different prognostic values in the survival of patients with breast cancer. However, both APOBEC3B mRNA and protein expression levels were associated with TILs in breast cancer. Therefore, APOBEC3B may be a prognostic biomarker for breast cancer.

Psychotropic drugs are frequently used for functional dyspepsia (FD); however, the efficacy of these drugs for treating FD remains controversial. We aimed to comprehensively compare the relative efficacies of different psychotropic drugs for FD in adults.To conduct this study, we searched the PubMed, Embase, and Cochrane Library databases on March 10, 2019, and conducted a frequentist network meta-analysis on the search results. The primary outcome was treatment efficacy estimated by the proportion of patients who achieved a certain percentage decrease in symptoms or who dropped below the threshold of the global FD symptom scores. The secondary outcome was acceptability, defined as all-cause discontinuation. Odds ratios (ORs) were reported with 95% confidence intervals (CIs).We deemed 10 trials to be eligible for analysis, and these trials included 970 participants and 10 psychotropic drugs. Flupentixol + melitracen (F + M) (OR, 10.00; 95% CI, 1.59 to 62.73), tandospirone (3.24, 1.38 to 7.60), imipramine (2.21, 1.02 to 4.79), and amitriptyline (1.71, 1.06 to 3.09) were significantly superior to placebo. According to the surface under the cumulative ranking curve, the most effective treatment was F + M (89.0%), whereas the least effective was R137696 (13.6%). In terms of acceptability, escitalopram (0.32, 0.11 to 0.92) was ranked as the worst drug (12.6%), followed by imipramine and sertraline.The present network meta-analysis suggests that F + M, tandospirone, imipramine, and amitriptyline are more effective than placebo as treatment for FD. Our results indicate that among the ten psychotropic drugs included, F + M is likely to be the most effective drug for alleviating dyspepsia symptoms.

A high-sensitive terahertz detector operating at room temperature was demonstrated based on parametric up-conversion. A nanosecond 1064-nm Nd:YAG laser was used to pump the parametric up-conversion detector and the up-conversion from terahertz wave to NIR laser was realized in a lithium niobate crystal. The minimum detectable terahertz energy of 9 pJ was realized with the detection dynamic range of 54 dB, which was three orders of magnitude higher than that of commercial Golay cell. The detectable terahertz frequency range of the detection system was 0.90 Thz–1.83 THz. Besides, the effects of pump energy and effective gain length on the detection sensitivity were studied in experiment. The results showed that higher pump energy and longer effective gain length are helpful for improving the detection sensitivity of parametric up-conversion detector.

A simulation model of the current rotary drilling rig (RDR) system was built according to the basic configuration of the TR160D-type rotary drilling rig, and the test-rig based on the working principle of the RDR system was built. The results show that simulation model of the RDR system was accurate and reasonable by means of comparative analysis between theoretical computation and test data. The working principle and logic threshold control method of the HDR system were presented to reduce the fuel consumption and improve energy-saving efficiency via the analysis of energy flow of the RDR system, which mainly includes engine, electric motor/generator, super capacitor, AC–DC rectifier/DC–AC inverter and torque coupler, etc. Finally, the comparative analysis of the fuel economy between the RDR and the hybrid drilling rig (HDR) system was completed in the same overall typical operating conditions. The results show that energy-saving efficiency of HDR system is at 18.8% and total fuel economy efficiency of HDR reaches 15.9% relatively in a typical operating condition.

Gun barrels life closely related to the gun barrels temperature variation. On the basis of analyzing gun barrels temperature various characteristics and rules during machine-guns firing, according to gun barrels life factors and their impact on gun barrels life, test programs under different shooting combined conditions and gun barrels temperature field testing programs are designed. Through the gun barrels temperature dynamic tests and test results during shooting, analyze and put forward the relationship between gun barrels temperature rising and firing specification. Which provides the experimental basis for choice of machine-gun barrels life stresses and analysis of the life-ended rules.

Aims This study sought to explore the relationship between plasma galectin-3 (Gal-3) and persistent atrial fibrillation (PsAF), and investigate whether Gal-3 predicts clinical outcomes in patients with PsAF undergoing catheter ablation. Methods Fifty consecutive PsAF patients without coexisting structural heart disease undergoing first-time catheter ablation and 46 healthy controls were included. Blood samples were collected on admission for analysis of plasma Gal-3. Pre-ablation clinical and laboratory data were also recorded. Persistent atrial fibrillations patients were followed after ablation and AF recurrence was defined as episodes of AF or atrial tachycardia lasting >30 s after the blanking period. Results Plasma Gal-3 concentrations were higher in PsAF patients than in healthy controls ( P < 0.001). In PsAF group, those with AF recurrence had higher plasma Gal-3 than did those without recurrence ( P = 0.007). Both Gal-3 (hazard ratio 1.28, P = 0.006) and left atrial diameter (LAD) (hazard ratio 1.1, P = 0.025) were independent predictors of AF recurrence after ablation. Moreover, adding Gal-3 to LAD had an incremental predictive value for ablation outcomes (global χ 2 of LAD alone: 8.2; LAD and Gal-3 concentrations: 15.7; P = 0.006). Conclusion Plasma Gal-3 concentrations are elevated in PsAF patients without structural heart disease and independently predict AF recurrence after ablation. Plasma Gal-3 concentration may be helpful in identifying appropriate candidates for AF ablation.

Pouched Mitral Isthmus and Ablation Block Background Previous studies have described the impact of mitral isthmus (MI) anatomy on the likelihood of achieving MI linear block in patients with native mitral valves (NMV) who underwent atrial fibrillation (AF) ablation. However, none have investigated that issue in AF patients with mechanical mitral valve replacements (MMVR). Methods and Results Twenty-nine consecutive patients who developed symptomatic persistent AF post-MMVR and referred for ablation were enrolled. Twenty-nine patients with NMV who underwent ablation of persistent AF during the same period were matched. With preprocedural cardiac computed tomographic imaging, MI anatomical features of all the participants were analyzed. Pouched MI was observed in 19 (65.5%) MMVR patients versus to 6 (20.7%) controls (P = 0.001). Bidirectional linear block across MI was achieved in 21 (72.4%) MMVR patients and 22 (75.9%) in the controls (P = 0.764). In the multivariable analysis, pouched MI was an independent predictor of incomplete MI block. Conclusions Pouched MI accounts for the majority of AF patients with MMVR and may be associated with incomplete bidirectional linear block of MI.

Atrial fibrillation (AF) is commonly found in patients with structural heart disease (SHD), including atrial septal defect (ASD). The feasibility and safety of ablation for AF in patients with unrepaired ASD is seldom reported. This study aims to evaluate and compare the long-term efficacy of AF ablation in patients with and without ASD. From January 2008 to December 2012, 18 consecutive patients were identified with medically refractory AF and an unrepaired ASD under catheter ablation. For each ASD patient, four control subjects were matched from our database. There were no significant differences between groups in terms of age, sex, type of AF, LA diameter, LVIDD, and EF. The mean procedural and fluoroscopy times were not different between the groups (p = NS). After a median follow-up of 20 months, the patients in the ASD group had 44.4 % AF recurrence after a single procedure compared with 34.7 % in the control group (p = 0.11). The mean LA diameter in non-recurrent patients was smaller than in recurrent patients (p = 0.03). In univariate Cox proportional hazards analyses, the factor found to have a significant association with arrhythmia recurrences was left atrial diameter (hazard ratio 1.059, 95 % confidence interval 1.002 to 1.120, p = 0.03). These results indicate that in patients with AF and an ASD amenable to percutaneous closure, a staged approach with radiofrequency ablation of AF preceding closure is a rational strategy.

Background/Aims: Alcohol abuse exerts deleterious effects on the internal organs of the body, and alcohol-related gastritis is a common disease for which prompt treatment is essential to prevent the condition from growing worse. However, the therapeutic methods have some adverse effects. Determining the pathogenic mechanisms of alcoholic gastritis is therefore essential. Methods: The MTT assay was developed in order to determine the optimal concentration of alcohol needed to treat gastric mucosal cells. The effects of alcohol on the gastric mucosal cells were determined by qRT-PCR and western blot. The release of IL-1β and IL-18 were determined by ELISA assay. The immunofluorescence assay was used to detect caspase-1 activation levels, while immunohistochemical assay and HE staining were performed to identify the effectiveness of the caspase-1 inhibitor on alcoholic gastritis. The TUNEL assay was used to determine DNA fragmentation. Results: Here, we clarified that ethanol treatment could cause cell DNA damage, activate caspase-1, and promote the generation and release of IL-1β and IL-18. In other words, ethanol could induce pyroptosis. Interestingly, a caspase-1 inhibitor could significantly suppress pyroptosis, decrease the release of inflammatory cytokines induced by ethanol, and cause no side effects in vivo and in vitro. Conclusion: Collectively, our results showed that pyroptosis is involved in the pathogenesis of alcohol-induced gastritis and that caspase-1 inhibitor Ac-yvad-cmk could effectively decrease the damage caused by alcohol, making it a potentially promising agent for the treatment of alcoholic gastritis.

This thesis, under the guiding of electromagnetic and ultrasonic theory, tries to do numerical simulation based on the Fluent simulation software. The composite flowmeter (CFM) improves the accuracy of metrology on water flow and equipment itself with self-calibration and inter-calibration function. The aim is to calculate the average velocity of fluid on the cross-section at the electrode and the stability of flow field by researching on the influence of transducer. The result shows when the distance between two transducers is close, influences the flow field near the electrode, but when the product of two transducers distance and pipe diameter is around 4000, the average fluid velocity is close to the pre-selected fluid velocity and without any swirl. After comprehensive thinking on the structure influence of excitation coil, the transducer should been equipped on the same longitudinal section with the electrode.

Background Symptomatic prolonged sinus pauses on termination of atrial fibrillation (AF) are an accepted indication for pacemaker implantation. We evaluated the outcome of AF ablation in patients with paroxysmal AF-related tachycardia-bradycardia syndrome and compared the efficacy of catheter ablation with permanent pacing plus antiarrhythmic drugs (AADs). Methods and results Patients with prolonged symptomatic sinus pauses on termination of AF were retrospectively analyzed. Forty-three consecutive patients who underwent catheter ablation (ABL group) were compared to 57 patients who underwent permanent pacing plus AADs (PM group). All 43 patients in the ABL group fulfilled Class I indication for pacemaker implantation at baseline but they actually underwent AF ablation. Reevaluation after 20.1 ± 9.6 months of follow-up showed that 41 patients (95.3%) did no longer need a pacemaker (Class III indication). Total cardiac-related rehospitalization was not significantly different between the two groups (P = 0.921). Tachycardia-related hospitalization was significantly higher in the PM group than the ABL group (14.0% and 0%, P = 0.029). More patients in the PM group were on AADs (PM 40.4%, ABL 4.7%, P Conclusions In patients with paroxysmal AF-related tachycardia-bradycardia syndrome, AF ablation seems to be superior to a strategy of pacing plus AAD. Pacemaker implantation can be waived in the majority of patients after a successful ablation.

The handover technology is one of the most important technologies for the quality of real-time operation in mobile Internet. However, current IP-level mobility protocols have difficulties meeting the stringent handover delay requirements. In this paper, we propose an enhanced handover scheme in a heterogeneous mobile environment with the support of the Media Independent Handover (MIH) Services. The proposed scheme can reduce the handover latency in Mobile IPv6 greatly. The simulations were carried out by using NS-2 to compare the handoff performance between WiMAX and WLAN IEEE 802.11b. The results show that the proposed scheme can get better handover performance in terms of handover latency.

With the rapid economic development, and the competition between enterprises increasingly fierce, the rising costs make many businesses difficult, there have been companies into a small profit or even the edge of bankruptcy. Cost risk is inevitable in the course of business for every enterprise. Establishing the cost management early warning system can prevent the risk of cost control effectively, and help enterprises to improve the level of integrated management.

Fibroadenoma of the breast is a common benign disease, occurring mainly in females younger than 30 years of age. Infant fibroadenoma is extremely rare. Here, we report on a 16-month-old female with a 6 month history of unilateral progressive breast enlargement. Upon clinical evaluation, a palpable mass was observed in the upper and outer quarter of the right breast. The single tumor was solid and well circumscribed. Various clinical examinations were performed, including determination of hormone levels, ultrasound, mammography, magnetic resonance imaging, as well as the collection of a fine needle aspiration. The results showed that the sex hormones were present at normal levels. The size of the tumor was approximately 3 × 3 × 3 cm. Enlarged lymph nodes were not detected in the axillary region or any other regions. The tumor was removed surgically and fibroadenoma was diagnosed post-operatively. The patient was followed up for 38 months and no tumor recurrence was observed.

e12019 Background: Age of patients play a key role in outcome of breast cancer, and therefore influences choice of treatment. In most studies, "young" is defined as being below 40 or 35 years. However, there are conflicts concerning definition of younger and older patients. In this study, we aim to establish a more appropriate age cut-off between “younger” and “older” breast cancer patients. Methods: A total of 5984 female breast cancer patients recruited in the Breast Cancer Registry of the Affiliated Hospital of Qingdao University during 2008 to 2014 were enrolled. Patients were divided into 11 groups by every 5 years’ age difference. The clinical characteristics and overall survival (OS) were compared among these age groups. Results: Among the five groups under age 45 (n = 1771, 30.0%), larger proportion of patients underwent breast conservation surgery in the “30-34” group (p = .027), and more patients were found with family history in the “25-29” group than in other groups (p = .029). No significant difference was found in OS (p = .059), clinicopathological stage, lymph node status, ER/PR status, HER2 status, or Ki-67 status among those five groups. For patients above 45 (n = 4813, 70.0%), differences were found in OS (p = .001) and significant differences with clinicopathological features (lymph node status, ER/PR status, HER2 status and Ki-67 status) were shown between younger and the older age groups (p = .001) among the six groups, except for family history (p = .066). Conclusions: Clinicopathological characteristics and survival status are similar among breast cancer patients under 45 years and vitiate among older patients. Age 45 is an appropriate cut-off for clinical grouping of breast cancer patients by age .

e12530 Background: Palbociclib is an oral small-molecule inhibitor of cyclin-dependent kinases 4 and 6 and has improved the progression-free survival of estrogen receptor positive, metastatic breast cancer (MBC). Its application in other cancers is also undergoing clinical evaluation. Neutropenia, especially high grade (grade 3 or 4), is one of the major side-effects of palbociclib, and the incidence was reported too vary in different studies. In order to better understand the overall risk of palbociclib associated neutropenia, we conducted a systematic review and meta-analysis. Methods: We conducted a systematic literature search (including Medline, Web of Science to November, 2016 and abstracts presented at the ASCO annual meetings from 2009 to 2016). Eligible studies include prospective clinical trials of patients with cancer treated with palbociclib on a 125mg daily 3/4 week schedule and have available data on neutropenia. The incidence and relative risk (RR) of neutropenia were calculated using a random-effects or fixed-effects model, depending on the heterogeneity of the included studies. Results: Eight studies published between 2012 and 2016 included a total of 1515 patients with cancer were eligible for analysis. For patients treated with palbociclib, the overall incidence of all-grade and high grade neutropenia were 77.4% (95% CI 70.9-82.8%) and 60.9% (57.8–63.8%), respectively. Surprisingly, the incidence of neutropenia was significantly different between MBC patients and non-MBC patients (all grade: RR 1.26 [95% CI 1.01–1.56], p = 0.041; high-grade: RR 1.57 [1.23–2.00], p = 0.000) who received palbociclib. Palbociclib was associated with a significantly increased risk of all-grade neutropenia in patients with cancer with an RR of 15.03 (10.17–22.21, p < 0.001) compared with controls. Conclusions: Patients with cancer who received palbociclib have a significant risk of developing neutropenia, especially MBC patients. It is strongly recommended to monitor these patients who are treated with palbociclib to adjust dose, treatment intervals, and avoid infections.

The classification of luminal breast cancer has been a popular topic regarding its heterogeneity with distinct biological features and clinical outcomes. This study aimed to assess the power of proliferative indices (Ki67 and histological grade) to determine various clinicopathological characteristics and survival in luminal disease. A total of 541 patients with stage I–III luminal breast cancer were enrolled. Subtypes were determined using proliferative indices and were compared with clinicopathological variables and short-term survival. The significance of various treatments was evaluated in a subgroup of pN0 (lymph node negative) patients. Histological grade, independent of other variables, was a better predictor in the ER/PR+, human epidermal growth factor receptor 2 (Her-2) subgroup (p = 0.011) and the pN0 subgroup (p = 0.044) compared with Ki67, which only showed significance in the ER/PR+, Her-2 subgroup (p = 0.008). Neither grade nor Ki67 was associated with outcomes in the luminal Her-2 class. In pN0 patients, various treatments did not show significance in short-term survival. Histological grade outperformed Ki67 as a determinant for the stratification of luminal class regarding short-term survival. Chemotherapy most likely did not provide additional benefit to pN0 patients with luminal breast cancer compared with endocrine therapy.

The handover technology is one of the most important technologies for the quality of real-time operation. In Hierarchical Mobile IPv6 (HMIPv6), duplicate address detection (DAD) process is necessary for confirming uniqueness of IPv6 address when Mobile Node moves to a new network. It is desirable to reduce DAD delay especially if nodes wish to run real-time application on the mobile IPv6 networks. In this paper, an enhance handover scheme in hierarchical MIPv6 networks by utilizing Passive Duplicate Address Detection (PDAD) to identify duplicate addresses is proposed. Using PDAD, a node examines incoming routing protocol packets to develop hints about address controversies. The simulations are performed using NS-2 to compare the handoff performance. The results show that the proposed scheme can get better performance in terms of packet loss and handoff delay

Next-generation wireless networks should be able to coordinate and integrate different communication systems. It has been a challenging problem to support a seamless handover in these diverse wireless network environments. The design of an All-IP wireless network requires an efficient and flexible handover management. In this paper we propose an efficient mechanism to support soft-handover management over heterogeneous wireless networks. The proposed mechanism exploits IPv6 protocols futures and coexists with MIPv6. It can provide data transmission continuity for delayed constrained applications and allow efficient micro mobility management.

Mobile IPv6 provides IPv6 nodes with the ability to use home address to keep the connection while roaming between different subnet. The handover performance of mobile IPv6 is one of the key factors which guarantee the QoS of mobile Internet. In this paper, we propose an enhanced handover scheme in a heterogeneous mobile environment with the support of the Media Independent Handover (MIH)Services and Advance Duplicate Address Detection (A-DAD).The proposed scheme can reduce the handover latency in Mobile IPv6 greatly. We perform a simulation on handover between WiMAX and WLAN IEEE 802.11b with the proposed scheme in Mobile IPv6 to get handover performance in terms of handover latency.

Handover in future wireless communication systems must be seamless. However, current IP-level mobility protocols have difficulties meeting the stringent handover delay requirements. At the same time they do not give sufficient control to the network to optimize the handover process and they do not deal well with slow connection setups of some wireless technologies. In this paper, we propose an enhanced handover scheme in a heterogeneous mobile environment with the support of the Media Independent Handover (MIH) Services and Advance Duplicate Address Detection (A-DAD). The proposed scheme can reduce the handover latency in Mobile IPv6 greatly. We perform a simulation on handover between WiMAX and WLAN IEEE 802.11b with the proposed scheme in Mobile IPv6. The results show that the proposed scheme can get better handover performance in terms of handover latency.

Mobile IPv6 (MIPv6) describes how mobile node can change its point of attachment from one access router to another. The handover performance of mobile IPv6 is one of the key factors which guarantee the QoS of mobile Internet.Mobility management issues are solved by separating macro mobility(inter-domain) generally using Mobile IP and micro mobility(intra-domain). In recent years, many enhancements for macro-mobility protocols have been proposed, designed and implemented in Mobile IPv6. Hierarchical Mobile IPv6(HMIPv6) is one of them that is designed to reduce the amount of signaling required and to improve handover speed for mobile connections. This paper presents a comparative study of the Hierarchical Mobility IPv6 and Mobile IPv6 protocols.The architecture and operation of each protocol is studied and are evaluated based on the Quality of Service (QoS) parameter:handover latency. The simulation was carried out by using the Network Simulator-2. The simulation results show that,HMIPv6 performs best under macro-domain mobility compared to MIPv6. The MIPv6 suffers large handover latency.

Handover latency in Mobile IPv6 plays an important role in the performance of a given network scenario. It results in packet losses and severe End-to-End performance degradation due to throttling and retransmissions in TCP scenario. This paper presents a comparative study of some different mobility management scheme for reducing handover latency and packet loss in mobile IPv6 environment. We describe the different types and classification of handover and present the Macro-Mobility and the Micro-Mobility solutions, including a number of proposals to reduce handover latency for mobile IPv6. The discussion regarding the performance of each proposed methods and the comparison of the performance between each method also are brought up.

Mobile communication is increasingly oriented towards the usage of all IP networks as fixed network components. Handover latency in Mobile IPv6 plays an important role in the performance of a given network scenario.It results in packet losses and severe End-to-End performance degradation due to throttling and retransmissions in TCP scenario. This paper present and discuss the handover process of mobile IPv6, provide an analysis of the MIPv6 handover procedure and some handover test results. The test shows that FMIPv6 can get better performance than MIPv6 in reducing handoff latency.

Spontaneous coronary artery dissection (SCAD) is a very rare but potentially fatal condition, which often causes acute myocardial infarction and sudden cardiac death. Spontaneous coronary artery dissection associated with pseudoaneurysm has been rarely reported mostly managed with coronary artery bypass grafting. We report a female patient with SCAD and pseudoaneurysm who was treated by successful percutaneous coronary intervention.

An all-optic polarization controller for single-mode fIber is presented in this paper. The polarization control is achieved without any mechanical electronical or magnetic component. This device may be used to replace the polarizer in a fiber-optic current sensing system so as to reduce the loss as well as the harmful effects of the random changes of the fiber polarization on the sensing system.