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We sought to provide clinical evidence of the potential influence of ovariectomy (OVX) on intervertebral disk degeneration.We retrospectively reviewed patients with a history of OVX who visited our hospital for lower back pain. In addition, 60 age-matched patients without OVX were randomly selected as control subjects. Next, the following demographic data were recorded and compared among groups: age, body mass index, duration of OVX, history of smoking, alcohol use, hypertension, diabetes, cardiocerebrovascular disease, hyperlipemia, osteoporosis, and degenerative spondylolisthesis. Next, the severity of lumbar disk degeneration, evaluated by the modified Pfirrmann grading system, was compared between groups. Data analyses were performed with SPSS 20.0. software.A total of 15 OVX (unilateral, n = 10; bilateral, n = 5) patients were included with a mean age of 62.40 ± 10.64. The average durations of OVX were 21.33 ± 9.24 years. There existed no remarkable intergroup differences in the demographic data (P0.05). Overall, the average Pfirrmann grading scores from L1/2 to L5/S1 presented as L1/2L2/3L3/4 ≤ L5/S1 ≤ L4/5, with no marked differences between groups (P0.05). Nevertheless, OVX groups displayed a relatively higher score at each level than non-OVX group. Moreover, the scores from L3/4 to L5/S1 were higher in the bilateral OVX group relative to the unilateral OVX group while they were equal at L1/2 and L2/3.Our findings demonstrated that OVX contributed to the progression of lumbar disk degeneration to some extent, but it appeared to be a long-term event.

In order to ensure indoor air quality safety, locating the airborne contaminant sources accurately and quickly is extremely important so that timely measures can be taken to undermine the spread of pollutant and even eliminate the negative effects. Previous studies have shown that the multi-zone model can greatly reduce the inverse calculation time. However, the multi-zone model cannot describe the details of the indoor velocity field, which limits its application in complex multi-zone or large space buildings. On the premise of the accuracy and computational speed, based on the joint probability method, this study adopted the coarse-grid CFD method to speed up the process of acquiring the indoor airflow field, together with the multi-zone model method, to perform the inverse calculation of indoor airborne contaminant source location. In the backward calculation process, we conducted the ‘transpose' of the velocity field to obtain adjoint matrix, instead of computing ‘negative' of the velocity vector to save the calculation time. A two-dimensional ventilation model was utilized to validate the method, which proved the accuracy and time-saving potential of it. This study provides theoretical and practical prospect for the real-time inverse calculation of locating the indoor airborne contaminant sources.

To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved. The elderly people enrolled in our study were divided into three groups according to the thyroid histopathology: malignant nodule group, benign nodule group, and normal group, and the clinical data and sleep quality were collected. Among the patients of surgery, 56 fresh thyroid tissues were collected for real-time PCR, immunohistochemistry and western blotting analysis of CLOCK, BMAL1, CRYs and PERs. Poor sleep quality, sleep latency and daytime dysfunction were the independent risk factors of malignant nodule after adjusted by other impacts. The expression levels of CLOCK, BMAL1 and PER2 in thyroid malignant group were significantly higher than benign and normal groups, while CRY2 was decreased, p

HIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants’ coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (− 0.56; − 0.2, t = − 4.48 p

Summary Background Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform health policy, has not been available. This study aimed to assess the prevalence, causes, and regional distribution of vision impairment and blindness in China in 1990 and 2019. Methods Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to estimate the prevalence of moderate and severe vision impairment and blindness in China and compare with other Group of 20 (G20) countries. We used GBD methodology to systematically analyse all available demographic and epidemiological data at the provincial level in China. We compared the age-standardised prevalences across provinces, and the changes in proportion of vision loss attributable to various eye diseases in 1990 and 2019. We used two different counterfactual scenarios with respect to population structure and age-specific prevalence to assess the contribution of population growth and ageing to trends in vision loss. Findings In 2019, the age-standardised prevalence was 2·57% (uncertainty interval [UI] 2·28–2·86) for moderate vision impairment, 0·25% (0·22–0·29) for severe vision impairment, and 0·48% (0·43–0·54) for blindness in China, which were all below the global average, but the prevalence of moderate and severe vision impairment had increased more rapidly than in other G20 countries from 1990 to 2019. The prevalence of vision loss increased with age, and the main causes of vision loss varied across age groups. The leading causes of vision impairment in China were uncorrected refractive error, cataract, and macular degeneration in both 1990 and 2019 in the overall population. From 1990 to 2019, the number of people with moderate vision impairment increased by 133·67% (from 19·65 to 45·92 million), those with severe vision impairment increased by 147·14% (from 1·89 to 4·67 million), and those with blindness increased by 64·35% (from 5·29 to 8·69 million); in each case, 20·16% of the increase could be explained by population growth. The contributions to these changes by population ageing were 87·22% for moderate vision impairment, 116·06% for severe vision impairment, and 99·22% for blindness, and the contributions by age-specific prevalence were 26·29% for moderate vision impairment, 10·91% for severe vision impairment, and −55·04% for blindness. The prevalence and specific causes of vision loss differed across provinces. Interpretation Although a comprehensive national policy to prevent blindness is in place, public awareness of visual health needs improving, and reducing the prevalence of moderate and severe vision impairment should be prioritised in future work. Funding China National Key Research and Development Programme and Beijing Municipal Special Funds for Medical Research on Public Welfare Development and Reform.

The air supply terminal located at the floor level attached to side-wall is widely used in large space buildings, leading to potential energy saving as well as significant vertical thermal stratification. The cooling load calculation of such system is challenging, especially the calculation of the load gained from unoccupied zone. This paper adopts experiment and computational fluid dynamics (CFD) methods to study the heat transfer upward and downward across the stratified surface in large space building with floor-level side wall air-supply system. Five experimental cases with different heat source power and exhaust airflow ratios are performed to study their effects on the indoor thermal environment. We investigate the same cases in CFD and verify the result of vertical temperature distribution and cooling load components. As a critical parameter in evaluating the thermal stratification environment of large space building, the inter-zonal heat transfer coefficient Cb is emphatically discussed. By comparing the Cb value obtained through the two methods, the accuracy of the microscopic method is verified by the heat balance method. The results show that the Cb value is mainly affected by the zonal division and air distribution, but less prominently by exhaust airflow ratio and heat source in the occupied zone.

Summary Background China has seen a remarkable epidemiological and demographic transition during the past three decades. We aimed to describe the prevalence of osteoarthritis as well as years lived with disability (YLDs) due to osteoarthritis in China, according to age, sex, and geographical location, from 1990 to 2017. Methods Data were obtained from systematic reviews of symptomatic osteoarthritis of the knee and hip in the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017). Three categories of sequelae (mild, moderate, and severe) of osteoarthritis were defined to indicate the degrees of severity and functional loss associated with the condition. A Bayesian meta-regression tool was applied to estimate the prevalence of osteoarthritis and the distribution of its severity. YLDs were calculated by multiplying the prevalence of osteoarthritis sequelae by their corresponding disability weights. All data were analysed by age–sex–province–year groups in China. Findings Around 26·1 million individuals in China had osteoarthritis in 1990, and this number rose to 61·2 million in 2017. The age-standardised prevalence of osteoarthritis increased from 2·9% (95% uncertainty interval 2·5–3·3) in 1990 to 3·1% (2·7–3·4) in 2017. The total YLDs due to osteoarthritis increased from 0·84 million (0·42–1·69) in 1990 to 1·97 million (0·98–3·94) in 2017, while the age-standardised YLD rate increased from 92·5 (45·7–185·6) per 100 000 people to 98·8 (49·4–197·6) per 100 000. Osteoarthritis prevalence and YLDs were higher in females than in males, and YLD rate increased with age. Osteoarthritis was the 24th most common cause of YLDs in China in 2017, accounting for 1·08% (0·64–2·02) of all YLDs. Interpretation Osteoarthritis is prevalent in China. Between 1990 and 2017, disease burden increased and varied greatly according to geographical location. Appropriate prevention and treatment strategies, predominantly those targeted at women, older people, and underdeveloped areas, must be developed to reduce the burden of the disease. Funding National Natural Science Foundation of China, China National Key Research and Development Programme.

Renal fibrosis leads to end-stage renal disease, but antifibrotic drugs are difficult to develop. Chronic kidney disease often results in muscle wasting, and thereby increases morbidity and mortality. In this work, adeno-associated virus (AAV)-mediated overexpressing miR-29a was hypothesized to counteract renal fibrosis and muscle wasting through muscle–kidney crosstalk in unilateral ureteral obstruction (UUO) mice. miR-29a level was downregulated in the kidney and skeletal muscle of UUO mice. The secretion of exosome-encapsulated miR-29a increased in cultured skeletal muscle satellite cells and HEK293 renal cells after stimulation with serum from UUO mice. This result was confirmed by qPCR and microRNA deep sequencing in the serum exosomes of mice with obstructed ureters. A recombinant AAV-miR-29a was generated to overexpress miR-29a and injected into the tibialis anterior muscle of the mice 2 weeks before UUO surgery. AAV-miR-29a abrogated the UUO-induced upregulation of YY1 and myostatin in skeletal muscles. Renal fibrosis was also partially improved in the UUO mice with intramuscular AAV-miR-29a transduction. AAV-miR-29a overexpression reversed the increase in transforming growth factor β, fibronectin, alpha-smooth muscle actin, and collagen 1A1 and 4A1 levels in the kidney of UUO mice. AAV-green fluorescent protein was applied to trace the AAV route in vivo, and fluorescence was significantly visible in the injected/uninjected muscles and in the kidneys. In conclusion, intramuscular AAV-miR-29a injection attenuates muscle wasting and ameliorates renal fibrosis by downregulating several fibrotic-related proteins in UUO mice.

Background China has more than 18% of the global population and over 770 million workers. However, the burden of disease attributable to occupational risks is unavailable in China. We aimed to estimate the burden of disease attributable to occupational exposures at provincial levels from 1990 to 2017. Methods We estimated the summary exposure values (SEVs), deaths and disability-adjusted life years (DALYs) attributable to occupational risk factors in China from 1990 to 2017, based on Global Burden of Disease Study (GBD) 2017. There were 18 occupational risks, 22 related causes, and 35 risk-outcome pairs included in this study. Meanwhile, we compared age-standardized death rates attributable to occupational risk factors in provinces of China by socio-demographic index (SDI). Results The SEVs of most occupational risks increased from 1990 to 2017. There were 323,833 (95% UI 283,780 - 369,061) deaths and 14,060,210 (12,022,974 - 16,125,763) DALYs attributable to total occupational risks in China, which were 27.9 and 22.1% of corresponding global levels, respectively. For attributable deaths, major risks came from occupational particulate matter, gases, and fumes (PGFs), and for the attributable DALYs, from occupational injuries. The attributable burden was higher in males than in females. Compared with high SDI provinces, low SDI provinces, especially Western China, had higher death rates attributable to total occupational risks, occupational PGFs, and occupational injuries. Conclusion Occupational risks contribute to a huge disease burden in China. The attributable burden is higher in males, and in less developed provinces of Western China, reflecting differences in risk exposure, socioeconomic conditions, and type of jobs. Our study highlights the need for further research and focused policy interventions on the health of workers especially for less developed provinces in China to reduce occupational health losses effectively.

In this paper, we present a dual-wavelength flash Raman (DFR) mapping method for measuring the thermal diffusivity of a suspended nanowire. A heating pulse is used to heat the nanowire sample, and a probing pulse of different wavelength is used to measure the increase in temperature. The laser absorption coefficient can be eliminated by normalization, and the thermal diffusivity of the sample can be extracted from the normalized temperature increase. An infinite heat conduction model is used in this method to avoid the influence of boundary thermal resistance. By changing the position of the probing laser center, the measurement sensitivity of thermal diffusivity can be further improved. The position of maximum sensitivity is influenced by the thermal diffusivity of the nanowire, width of the heating pulse, radius of the heating laser spot, and characteristic length of the sample. To comprehensively analyze the influences of the various parameters, obtain the best measurement conditions, and attain maximum sensitivity, we propose a dimensionless physical model to analyze the heat conduction of the suspended nanowire. Based on the analysis of the best dimensionless parameters, the corresponding appropriate measurement conditions can be determined. Sensitivity analysis shows that when the radius of the heating laser spot is 1% of the length of the nanowire, the sensitivity of the DFR mapping method can be more than four times that of the concentric DFR method for measuring the thermal diffusivity of the nanowire.

Patients with degenerative lumbar spondylolisthesis (DLS) often suffer from years of low back pain (LBP) due to instability of the lumbar spine and the reduction of disc height. Since January 2016, we have performed oblique lateral interbody fusion (OLIF) on 154 patients. Among these, 56 patients who suffered from DLS underwent OLIF with stand-alone cages. Forty-two patients with a follow-up time that exceeded 1-year were enrolled for this study. The forty-two patients were followed up for at least one year. Operation segments ranged from L3-4 to L4-5. All the patients were with 1-level fusion. The mean postoperative ventral-disc height and dorsal-disc height increased significantly compared with preoperative (P<0.05). A significant postoperative increase was also observed in the mean operative segmental lordotic angle and the whole lumbar lordotic angle (P<0.05). Compared with preoperative, the postoperative VAS significantly decreased with no significant increase in the VAS in the last follow-up. The LBP was significantly relieved. The mean postoperative VAS of LBP decreased significantly compared with the preoperative ((1.6 ± 0.8) vs. (7.8 ± 0.8)). Postoperative complications included psoas major abscess and intervertebral space infection (1/56). Except for one patient whose cage subsided during the last follow-up, the other patients had good cage position. The one whose cage collapsed complained no symptoms including LBP. OLIF with stand-alone cages should be considered as a safe and effective option which can effectively alleviate LBP for the treatment of DLS.

With the rapid growth of the aging population, pelvic floor dysfunction (PFD) has become a new type of high-incidence disorder. This disorder can be caused by injury, functional deterioration, or coordination disorders of pelvic support structures, such as pelvic floor muscles, connective tissues, and pelvic floor muscle fiber. The symptoms can include dyssynergic defecation, fecal incontinence, overactive bladder, urinary incontinence, pelvic organ prolapse, hemorrhoids, sexual dysfunction, chronic urinary retention, and chronic pelvic pain. PFD often presents itself as a combination of symptoms involving urological, gynecological, anorectal, and psychological aspects. Under such circumstances, the development of multidisciplinary integrative diagnosis for PFD has become a trend.

Summary Objective We examined whether auricular acupressure (AA) at four specifically preselected AA points can alleviate knee pain and decrease non-steroidal anti-inflammatory drugs (NSAIDs) consumption and its adverse effects for osteoarthritis patients. Methods Sixty-two patients (more than 40 years) with knee osteoarthritis of Kellgren–Lawrence grades of I or II upon radiographic classification were enrolled in this randomized, sham-controlled prospective study, and divided into two groups (AA group and control group). The AA group received true AA by embedding vaccaria seeds at four specific AA points (knee joint, shenmen, subcortex and sympathesis) ipsilateral to the knee osteoarthritis site, while the control group received four nonacupuncture points on the auricular helix. Visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, the number of patients who needed celecoxib pills and adverse effects were recorded. Results VAS and WOMAC scores in the AA group were significantly lower than that in the control group (P Conclusion Auricular acupressure plays a role in analgesic effect and can effectively decrease NSAIDs requirements without causing adverse events for the treatment of human knee osteoarthritis.

BACKGROUND Trigger finger is a very common disorder that occurs in both adults and children. Trigger finger presents mainly as pain and limited movement of the affected digit. This report describes a modified percutaneous needle release and an evaluation of its clinical efficacy to treat trigger thumb. MATERIAL AND METHODS Trigger thumb of 11 patients was released percutaneously using a specially designed needle (0.8×100 mm) with a planus tip. Complete release was ensured when no more grating sound was heard and the needle moved freely at the tip. Pain-related functional score was evaluated preoperatively and at 3 months postoperatively. Resolution of Notta's node, triggered or locked, Quinnell's criteria, and patient satisfaction were also assessed at 3 months after the operation. RESULTS After the percutaneous trigger thumb release, the overall visual analog scale (VAS) and pain-related functional scores declined significantly (P

All-solid-state lithium batteries (ASSLBs) using sulfide solid electrolytes (SSEs) offer an attractive option for energy storage applications. Lithium anode is the ultimate goal for ASSLBs, but lithium-indium (Li-In) alloy anode is more widely utilized in lab testing owing to the quite stable interface and elimination for the risk of short circuit. However, vigorous growth of Li-In dendrites in SSE is discovered in the present work when a full cell (LiNbO3 coated LiNi0.6Co0.2Mn0.2O2//Li6PS5Cl//Li-In) is cycled in high loading and high rate. Our study demonstrates that Li-In anode is unstable towards SSEs at high current, which induces Li-In dendrite growth enclosing electrolyte particles and eventually results in cell death after a long cycling. The morphology and growth mechanism of Li-In dendrites are revealed by scanning transmission electron microscopy-electron energy loss spectroscopy (STEM-EELS) analysis and density function theory (DFT) calculations. Moreover, the differences between Li and Li-In dendrites are systematically compared.

To achieve good result quality and short query response time, search engines use specific match plans on Inverted Index to help retrieve a small set of relevant documents from billions of web pages. A match plan is composed of a sequence of match rules, which contain discrete match rule types and continuous stopping quotas. Currently, match plans are manually designed by experts according to their several years’ experience, which encounters difficulty in dealing with heterogeneous queries and varying data distribution. In this work, we formulate the match plan generation as a Partially Observable Markov Decision Process (POMDP) with a parameterized action space, and propose a novel reinforcement learning algorithm Parameterized Action Soft Actor-Critic (PASAC) to effectively enhance the exploration in both spaces. In our scene, we also discover a skew prioritizing issue of the original Prioritized Experience Replay (PER) and introduce Stratified Prioritized Experience Replay (SPER) to address it. We are the first group to generalize this task for all queries as a learning problem with zero prior knowledge and successfully apply deep reinforcement learning in the real web search environment. Our approach greatly outperforms the well-designed production match plans by over 70% reduction of index block accesses with the quality of documents almost unchanged, and 9% reduction of query response time even with model inference cost. Our method also beats the baselines on some open-source benchmarks1.

Thyroid storm is a syndrome related to acute exacerbation of thyrotoxicosis for which timely diagnosis and treatment are crucial. Importance of antithyroid drug therapy in thyroid storm patients has been emphasised in clinical treatments for a long time. These patients should receive definitive therapy for their underlying hyperthyroidism to avoid recurrence after controlling thyroid storm. However, the curative effect of antithyroid medication is sometimes limited because of rare or serious side effects or failure to control disease progression, resulting in few treatment alternatives. We present a case of an old woman with thyroid storm and antithyroid drug intolerance, which was successfully managed using a combination of plasma exchange and thyroidectomy. It confirms the significant benefits of therapeutic plasma exchange (TPE) when clinical conditions do not allow routine treatment of thyroid storm. This procedure is safe and effective when performed preoperatively as a rescue measure for thyroid storm patients. Key Words: Thyroid storm, Drug intolerance, Plasma exchange, Total Thyroidectomy.

Summary Background Public health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount importance. This analysis uses data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to help inform decision making and monitor progress on health at the province level. Methods We used the methods in GBD 2017 to analyse health patterns in the 34 province-level administrative units in China from 1990 to 2017. We estimated all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), summary exposure values (SEVs), and attributable risk. We compared the observed results with expected values estimated based on the Socio-demographic Index (SDI). Findings Stroke and ischaemic heart disease were the leading causes of death and DALYs at the national level in China in 2017. Age-standardised DALYs per 100 000 population decreased by 33·1% (95% uncertainty interval [UI] 29·8 to 37·4) for stroke and increased by 4·6% (–3·3 to 10·7) for ischaemic heart disease from 1990 to 2017. Age-standardised stroke, ischaemic heart disease, lung cancer, chronic obstructive pulmonary disease, and liver cancer were the five leading causes of YLLs in 2017. Musculoskeletal disorders, mental health disorders, and sense organ diseases were the three leading causes of YLDs in 2017, and high systolic blood pressure, smoking, high-sodium diet, and ambient particulate matter pollution were among the leading four risk factors contributing to deaths and DALYs. All provinces had higher than expected DALYs per 100 000 population for liver cancer, with the observed to expected ratio ranging from 2·04 to 6·88. The all-cause age-standardised DALYs per 100 000 population were lower than expected in all provinces in 2017, and among the top 20 level 3 causes were lower than expected for ischaemic heart disease, Alzheimer's disease, headache disorder, and low back pain. The largest percentage change at the national level in age-standardised SEVs among the top ten leading risk factors was in high body-mass index (185%, 95% UI 113·1 to 247·7]), followed by ambient particulate matter pollution (88·5%, 66·4 to 116·4). Interpretation China has made substantial progress in reducing the burden of many diseases and disabilities. Strategies targeting chronic diseases, particularly in the elderly, should be prioritised in the expanding Chinese health-care system. Funding China National Key Research and Development Program and Bill & Melinda Gates Foundation.

Summary Background Injuries and violence account for a substantial proportion of the global burden of disease in adolescents, especially among low-income and middle-income countries (LMICs). We aimed to compare the prevalence of unintentional injuries and violence among young adolescents in LMICs. Methods We did a secondary analysis of data from the Global School-based Student Health Survey (GSHS) for adolescents aged 12–15 years from LMICs collected between 2009 and 2015. Survey data was collected using a standardised questionnaire. We used survey data to calculate the overall prevalence of serious injuries and violence (eg, physical attack, physical fighting) and bullying per country. We did a random-effects meta-analysis to calculate pooled overall and regional estimates. We also did subgroup analyses stratified by sex, age (12–13 years vs 14–15 years), and time period (2009–11 vs 2012–15). Logistic regression models adjusted for sex, weights, stratum, and primary sampling unit were used to analyse the differences in prevalence of serious injuries, violence, and bullying. Findings We included data from 68 LMICs, including 164 633 young adolescents (77 707 [47·2%] boys; 86 926 [52·8%] girls). The overall prevalence of physical attack, physical fighting, and serious injuries during the past 12 months were 35·6% (95% CI 30·7–40·5), 36·4% (29·9–42·9), and 42·9% (39·0–46·9), respectively. Prevalence varied by WHO region and was higher among boys than girls for injuries (47·8% vs 37·5%, p=0·00094), physical attack (41·0% vs 29·4%, p=0·001), and physical fighting (45·5% vs 26·9%, p Interpretation The prevalence of unintentional injuries and violence remain high among young adolescents in LMICs. These countries should prioritise the development of anti-violence and anti-injury programmes to improve health in their young adolescent populations. Funding National Natural Science Foundation of China, National Key R&D Program of China, Natural Science Foundation of Zhejiang Province, Sanming Project of Medicine in Shenzhen, K.C. Wong Magna Fund in Ningbo University, and Ningbo Scientific Innovation Team for Environmental Hazardous Factor Control and Prevention.

Bipolar redox organics have attracted interest as electrode materials for energy storage owing to their flexibility, sustainability and environmental friendliness. However, an understanding of their application in all-organic batteries, let alone dual-ion batteries (DIBs), is in its infancy. Herein, we propose a strategy to screen a variety of phthalocyanine-based bipolar organics. The self-polymerizable bipolar Cu tetraaminephthalocyanine (CuTAPc) shows multifunctional applications in various energy storage systems, including lithium-based DIBs using CuTAPc as the cathode material, graphite-based DIBs using CuTAPc as the anode material and symmetric DIBs using CuTAPc as both the cathode and anode materials. Notably, in lithium-based DIBs, the use of CuTAPc as the cathode material results in a high discharge capacity of 236 mAh g-1 at 50 mA g-1 and a high reversible capacity of 74.3 mAh g-1 after 4000 cycles at 4 A g-1 . Most importantly, a high energy density of 239 Wh kg-1 and power density of 11.5 kW kg-1 can be obtained in all-organic symmetric DIBs.

Bernard-Soulier syndrome (BSS) is an extremely rare autosomal recessive bleeding disorder clinically characterized by macrothrombocytopenia and a mucocutaneous bleeding tendency. A 1-year-old Chinese patient who was born to consanguineous parents was diagnosed with early onset of BSS. Gene sequencing and bioinformatics analysis were conducted. We identified a novel homozygous missense mutation (c.790T>C) in the GP1BAgene that causes an amino acid residue substitution of a cysteine with an arginine that might have a deleterious effect on the protein function as predicted by bioinformatics analysis. If a patient has clinical manifestations that include recurrent mucocutaneous bleeding, a mean platelet volume and platelet-large cell ratio above normal levels, and giant platelets on a peripheral smear and has consanguineous parents, a diagnosis of BSS can be suspected. In these situations, gene sequencing for mutations in the GPIb-IX-V complex is necessary.

Background How to maximally improve the drainage of intracranial and upper body venous and to reduce neurological complications during thoracic tumor‐causedsuperior vena cava replacement are still clinical problems to be solved. Methods We have innovatively used the bilateral jugular vein‐left femoral vein ECMO shunting to perform mediastinal tumor resection and superior vena cava replacement in a 50‐year‐old woman. Results During the operation, this technique maintained the patient's hemodynamic stability, improved the cerebral oxygen saturation and reduced the cerebral ischemia, hypoxia as well as the neurological complications. Conclusion It is indicated for patients with superior vena cava replacement who are unable to perform venous bypass (such as innominate vein to right atrial bypass) or venous shunting (such as differential pressure drainage from internal jugular vein to femoral vein).

Sandy areas in the northern China are the primary regions for potato production, but limited water resources and low water/fertilizer use efficiency limit the sustainable development of agriculture. Field experiments were conducted during 2016–2017 to investigate the effects of different drip irrigation frequencies, water amounts and fertilizer rates on the yield, quality, water and fertilizer productivity of potato in the sandy areas of northern China. The water and fertilizer treatments were evaluated using the TOPSIS method to obtain the optimal combination of irrigation frequency, water amount and fertilizer rate for multi-objective optimization. The irrigation frequency included once every 4 days (D4), once every 8 days (D8) and once every 10 days (D10). The irrigation levels consisted of full irrigation (1.0 ETc, ETc is the crop evapotranspiration), medium irrigation (0.8 ETc) and low irrigation (0.6 ETc). The fertilizer (N-P2O5-K2O) levels included low fertilization (F1, 100-40-150 kg ha−1), medium fertilization (F2, 150-60-225 kg ha−1) and high fertilization (F3, 200-80-300 kg ha−1). The results showed that there were significant effects of the irrigation frequency (IF), irrigation level (IL) and fertilization level (FL) on potato growth, yield, quality, water and fertilizer productivity. Using the same irrigation frequency and fertilization level, the highest tuber yield, starch content, vitamin C and partial factor productivity (PFP) were obtained under the full irrigation (1.0 ETc). However, the irrigation water use efficiency (IWUE) decreased as the water supply increased. In addition, these indicators under deficit irrigation increased with the increase in irrigation frequency at the same fertilization level, but the indicators of D8 were the highest under the full irrigation. Under the same irrigation frequency and irrigation level, the tuber yield and IWUE increased as the fertilization rate increased. However, the PFP decreased as the fertilizer rate increased. The trends in plant height, LAI, dry matter accumulation, plant yield and commodity tubers were similar to that in tuber yield. The starch content and vitamin C under deficit irrigation increased with the amount of fertilizer applied, but they increased first and then decreased with the increase in fertilizer rate under the full irrigation. The change in the content of reducing sugars was opposite to that of the starch. Based on the TOPSIS method, the multi-target optimum scheduling of potato was attained with the irrigation frequency of once every 8 days (D8), full irrigation(1.0 ETc and high fertilizer (N-P2O5-K2O) rate (F3, 200-80-300 kg ha−1). The obtained optimum combination of water and fertilizers can provide a scientific basis for irrigation and fertilization optimization and management in the sandy areas of northern China and in other regions with similar environments.

Prompt identification of an indoor air pollutant source location is important for the safety of building residents in gaseous contaminant leakage incidents. Using the computational fluid dynamics (CFD) method in such inverse modeling is time consuming, especially for naturally ventilated residential buildings, which have multiple rooms and require consideration both indoor and outdoor environments. This paper compares the results of the pollutant source location identification and the simulation time based on two different inverse modeling methods: the CFD method and joint modeling of the multizone and CFD methods, to discuss the consumption of the computing time, as well as the accuracy of the location identification result. An instantaneous airborne pollutant source is assumed in a typical residential apartment that utilizes natural ventilation. A CFD model with the computational domain of the whole apartment and surrounding environment is built, for which the adjoint probability method is applied to simulate the source location probability from limited sensor readings. Meanwhile, a multizone model of the apartment is built to simulate and identify the room in which the source is located using the adjoint probability method. The CFD method is applied to the identified room afterwards to identify the exact location of the source within that room. The joint simulation of CFD and the multizone model is verified by a scaled model experiment of the apartment. It is found that the joint simulation method can significantly reduce the computing time and provides a good alternative for real-time inverse tracking of the indoor airborne pollutant.

This paper presents an in-situ, non-contact, non-destructive “dual-wavelength laser flash Raman spectroscopy method” for measuring the thermal diffusivity. In this method, a heating pulse is used to heat the sample and another pulsed laser with a different wavelength and negligible heating effect is used as a probe to measure the sample temperature changes during the heating and cooling periods from the Raman peak shifts. The sample temperature rise and fall curves are measured by changing the delay between the heating pulse and the probing pulse with the thermal diffusivity then characterized by fitting the temperature curves. The time delay between the heating and probing pulses can be precisely controlled with a minimum step of 100 ps. Hence, the temperature variation can be scanned with an ultra-high temporal resolution of up to 100 ps, which significantly improves the measurement accuracy of transient thermal parameters. The measurement accuracy of this method has been verified using a bulk material model and experiments. The measured thermal diffusivity of a silicon sample has been obtained to be 8.8×10-5 m2/s with a 3% difference between the measured value and the average result for bulk silicon in the literature which verifies the reliability and accuracy of this method.

Uremic cardiomyopathy and muscle atrophy are associated with insulin resistance and contribute to chronic kidney disease (CKD)-induced morbidity and mortality. We hypothesized that restoration of miR-26a levels would enhance exosome-mediated microRNA transfer to improve muscle wasting and cardiomyopathy that occur in CKD. Methods: Using next generation sequencing and qPCR, we found that CKD mice had a decreased level of miR-26a in heart and skeletal muscle. We engineered an exosome vector that contained Lamp2b, an exosomal membrane protein gene fused with a muscle-specific surface peptide that targets muscle delivery. We transfected this vector into muscle satellite cells and then transduced these cells with adenovirus that expresses miR-26a to produce exosomes encapsulated miR-26a (Exo/miR-26a). Exo/miR-26a was injected once per week for 8 weeks into the tibialis anterior (TA) muscle of 5/6 nephrectomized CKD mice. Results: Treatment with Exo/miR-26a resulted in increased expression of miR-26a in skeletal muscle and heart. Overexpression of miR-26a increased the skeletal muscle cross-sectional area, decreased the upregulation of FBXO32/atrogin-1 and TRIM63/MuRF1 and depressed cardiac fibrosis lesions. In the hearts of CKD mice, FoxO1 was activated, and connective tissue growth factor, fibronectin and collagen type I alpha 1 were increased. These responses were blunted by injection of Exo/miR-26a. Echocardiograms showed that cardiac function was improved in CKD mice treated with Exo/miR-26a. Conclusion: Overexpression of miR-26a in muscle prevented CKD-induced muscle wasting and attenuated cardiomyopathy via exosome-mediated miR-26a transfer. These results suggest possible therapeutic strategies for using exosome delivery of miR-26a to treat complications of CKD.

Electrocatalysis for clean energy conversion, including water splitting (hydrogen and oxygen evolution) and oxygen reduction, has been considered as a pivotal strategy to alleviate the increasing energy crisis and environmental pollution derived from the overuse of nonrenewable fossil fuels. Since the current electrocatalysts are usually based on high-cost and scarce noble metal elements (Pt, Ru, and Ir), developing low-cost and earth-abundant catalysts is of great practical promise for realizing industry-scale applications. In this regard, electrocatalysts based on 3d transition metal elements (Mn, Fe, Co, and Ni, etc.) have been proposed as a class of prospective materials due to their abundance and high activity. In this work, recent advances in developing high-performance nanostructured electrocatalysts for sustainable clean energy conversion are briefly reviewed, with a particular focus on morphology design, composition tuning, surface engineering and metal coordination symmetry/geometry control. The latest studies indicate that carefully designed nanostructures based on 3d transition metal elements can attain comparable electrocatalytic performance to the commercial noble metal-based counterparts. This review may offer new insights into the rational design of nanostructures with further improved electrocatalytic activity and pathway selectivity to achieve the ultimate goal of realizing renewable electrochemical energy conversion.

The aberrant orchestration between the triple networks has been suggested as a backbone for some cognitive and clinical features of schizophrenia. The salience network (SN) plays a general role in switching between the central executive network (CEN) and the default mode network (DMN) mediated by dopamine activity. Whether the disease state and dopamine associated gene, catechol-O-methyltransferase (COMT), has an interactive effect on the function and structure of the triple network has not been understood. To this end, independent component analysis was used to identify the triple network. Then, cortical thickness and inter-regional resting state functional connectivity (RSFC) of the triple network was investigated in 55 first episode schizophrenia (FES) patients and 53 age-, gender-, and education- matched healthy controls. Finally, we investigated if there exist interactive effect between disease and COMT gene variation on the abnormal brain structure and function. Our results show that patients with FES exhibited significantly increased RSFC between anterior cingulate cortex and left dorsolateral prefrontal cortex (DLPFC) compared with healthy controls. The cortical thickness of the left DLPFC was thinner in FES patients. Significant interaction effect between COMT and disease was found in cortical thickness of the left DLPFC. Specifically, cortical thinning in this region was evident with the val homozygotes group of the COMT gene in FES. This findings suggest abnormal RSFC between CEN and SN and thinker cortical thickness in FES. And the val homozygotes of COMT may contribute to further cortical thinning in FES patients.

A number of studies have implicated that microRNAs (miRNAs) play a critical role in the development of gestational diabetes mellitus (GDM). However, the role of miR-657 in GDM remains vague up to date. We aim to investigate the modifying effect of miR-657 on GDM, which will provide new insight into the pathogenesis of GDM and may help to identify new diagnostic or therapeutic targets for GDM. Increased expression of miR-657 but decreased expression of interleukin-37 (IL-37) was observed in patients with GDM. Besides, negative association between miR-657 and IL-37 was demonstrated in this study. miR-657 could targetedly regulate IL-37 and enhance the proliferation of mononuclear macrophages. Moreover, miR-657 promoted the generation of inflammatory cytokines (IL-6 and tumor necrosis factor-α [TNF-α]) and activation of nuclear factor κB (NF-κB) in lipopolysaccharide-induced mononuclear macrophages, while its effect was significantly inhibited when exogenous recombinant IL-37 was administrated into cells. Accordingly, dysregulation of miR-657 contributes to the pathogenesis of GDM via IL-37/NF-κB signaling axis.

For decades, computational fluid dynamics (CFD) has been applied to built-environment related simulations such as those of building ventilation, indoor airflow, and contaminant transportation. The pressure–velocity decoupling algorithm employed in CFD to solve momentum equation(s) exerts significant influence on the convergence speed and computational resource requirement. In order to identify the opportunities to improve CFD performance for built-environment simulation, a review is conducted on the commonly used pressure–velocity decoupling algorithms in indoor environment CFD modeling, with the aim of summarizing the general status and trends of the application and development of the decoupling algorithms. The study categorizes the primary algorithms based on the advantages and disadvantages of each reviewed algorithm and the applications of each analyzed algorithm. The review indicates an explicit prevalence of the usage of the SIMPLE algorithm and its variants in indoor-environment CFD simulation, which is a combined outcome of the superiority of such algorithms and their wide availability in commonly used CFD software. However, each algorithm variant has applicable engineering fields unique to it. The study also identifies that a few less-commonly used algorithms in both research and commercial CFD software, such as the projection algorithm, reveal certain advantages in terms of convergence and accuracy performance. These algorithms exhibit significant potential for transforming the conventional pressure–velocity decoupling algorithm into approaches that can more efficiently solve flow-governing momentum equation(s), specifically for built-environment CFD simulation.

Background There is a lack of national report of the labour neuraxial analgesia (NA) rates in China in recent years, especially after the national promotion policy. The adverse maternal and perinatal outcomes associated with NA in China are also unknown. The aim of this study is to estimate the trends of NA rates from 2012 to 2019, to evaluate the effect of national policy on promoting NA and to identify the association between NA and adverse outcomes in China. Methods We used the individual data from China’s National Maternal Near Miss Surveillance System (NMNMSS) between 2012 and 2019, covering 438 hospitals from 326 urban districts or rural counties in 30 provinces across China. The analysis was restricted to singleton pregnant women who underwent vaginal delivery at or after 28 completed weeks of gestation. We estimate the trends of NA rates between 2012 and 2019, both at the national and provincial levels using Bayesian multilevel model. We also estimated the effect of the national pilot policy launched in 2018 using interrupted time-series analysis and identified the association between NA and adverse outcomes using modified Poisson regression combined with propensity score analysis. Results Over the study period, 620,851 of 6,023,046 women underwent vaginal delivery with NA. The estimated national NA rates increased from 8.4% in 2012 to 16.7% in 2019. Most provinces experienced the same rapid rise during this period. The national pilot policy accelerated the rise of the rates. No differences were observed between women with NA and without any analgesia in the incidence of uterine atony, placental retention, intrapartum stillbirths and 1- and 5-min Apgar scores lower than 7. However, women with NA had higher incidences of genital tract trauma (adjusted relative risk (aRR) 1.53, 95% confidence interval (CI) 1.04–2.26) and maternal near miss (aRR 1.35, 95% CI 1.08–1.69), only in hospitals which were not covered by the national pilot policy and usually lack of sufficient equipment and personnel. Conclusions The national policy can effectively increase the NA rate. However, as genital tract trauma and maternal near miss may increase in low-resource hospitals, but not in high-resource hospitals, further study is required to identify the reasons.

Background: Falls in older people have become a major public health concern worldwide but a comprehensive assessment of falls burden for older people in mainland China has not been undertaken. This study aims to investigate the falls burden of people aged 60 years and above at the national and subnational level in mainland China, and explore the trends from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Method: Using data from GBD 2019, we described the falls burden of older people by sex and age group in terms of incidence, mortality, and disability-adjusted life year (DALY) rates and evaluated these indicators at the subnational level from 31 provinces. The overall trend of falls burden was investigated across 31 provinces from 1990 to 2019, while the change of falls burden in different sexes, age groups and provinces were compared between 1990 and 2019. Findings: In 2019, the incidence rate of falls among people aged 60 years and above was 3799·4 new falls per 100 000 (95% uncertainty interval [UI] 3062·4–4645·0), while there were 39.2 deaths (95%UI 21·8–48·80) per 100 000, and 1238·9 DALYs (95%UI 920·5–1553·2) per 100 000 in mainland China. There was no significant difference in the falls burden between males and females. The incidence, mortality and DALY rates for people aged 80 years and above were significantly higher than other age groups. Large variations in incidence and DALY rates were observed across 31 provinces. Although there were no significant changes in the overall falls mortality in all provinces and DALY rates of 23 provinces from 1990 to 2019, there were large increases in the incidence rate in both males (82·9%, 95%UI 67·4%–100·0%) and females (77·0%, 95%UI 63·3%–91·8%) over the last three decades. The increases in the incidence rate varied from 50·0% (95%UI 42·2%–59·5%) for people aged 60–64 years to 123·8% (95%UI 105·4%–141·9%) for people aged 80 years and above. All provinces had significant increases in the incidence rate with Sichuan being the highest (148·5%, 95%UI 125·5%–171·4%) and Jilin the lowest (14·7%, 95%UI 3·6%–26·1%). Interpretation: Between 1990 and 2019, the incidence rate of falls increased substantially regardless of sex, age group and province, whereas the mortality and DALY rates of falls among older people remained relatively stable, suggesting improvements in outcomes of falls. Minor sex disparity in incidence and mortality rates was identified in the older population. The group at the highest risk of falls was males aged 80 years and above. Provincial inequality was found in the incidence and DALY rates of falls. Falls remain as an ongoing health burden for older people in mainland China, and there is an urgent need for introducing system wide, integrated and cost-effective measures to protect and support older people to minimise the risks and combat this growing burden as the population is aging. Funding: Bill & Melinda Gates Foundation. Declaration of Interest: We declare no competing interests.

Objective. To investigate the clinical significance of the mRNA expression of RRM1, TUBB3, and ERCC1 in non-small-cell lung cancer (NSCLC) tissues for the selection of adjuvant/postoperative chemotherapy regimens. Methods. Patients diagnosed with stage Ib-IIIa NSCLC were enrolled and randomly divided into a control group (undetected group) and an experimental group (detected group) after radical operation. The control group randomly received chemotherapy with gemcitabine plus cisplatin or paclitaxel plus cisplatin. The mRNA expression of RRM1, TUBB3, and ERCC1 was detected in the experimental group before chemotherapy, and based on the detected expression, the chemotherapy regimen of cisplatin plus gemcitabine or cisplatin plus paclitaxel was chosen. The disease-free survival (DFS) of the control group and experimental group was compared. Results. Pathological type, stage, gene expression detection, and treatment method were not significantly correlated with DFS ( P > 0.05 ). In the subgroups treated with gemcitabine, the median DFS was 17 months in the detected group and 10.5 months in the undetected group (hazard ratio = 0.2147, 95% confidence interval: 0.07909–0.5827, P = 0.0025 ). Multivariate regression analysis was performed to analyse whether gene expression detection was independently correlated with DFS in the subgroups treated with gemcitabine ( P = 0.025 ). In the detected group, the prognosis of patients with low expression of RRM1 was better than that of patients with high expression of RRM1 after paclitaxel treatment ( P = 0.0039 ). Conclusions. The selection of chemotherapy regimen based on mRNA expression of the RRM1, TUBB3, and ERCC1 genes may improve selection of candidate patients to receive clinical chemotherapy. However, large-scale prospective clinical studies are needed for in-depth investigation.

This research was to explore the adoption value of computed tomography (CT) images based on adaptive statistical iterative reconstruction (ASIR) algorithm in the evaluation of probiotics combined with ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy (ICP). A total of 82 patients with ICP were selected as the research subjects and they were randomly rolled into experimental group (380 mg probiotics enteric-soluble capsule twice a day, combined with 90 mg ursodeoxycholic acid soft capsule three times a day) and control group (90 mg ursodeoxycholic acid soft capsule three times a day), with 41 cases in each. The treatment course was four months. The ASIR algorithm was constructed and applied to the CT image analysis and diagnosis of ICP patients. The effects of filtering back projection (FBP) reconstruction and ASIR algorithm on CT image quality, denoising degree, and artifacts of ICP patients were compared. Moreover, blood indicator levels of ICP patients before and after treatment were assessed. The results showed that the SD values of liver and gallbladder (20.77 Hu and 27.58 Hu) in the reconstructed image of the ASIR algorithm were significantly lower than those of the FBP algorithm (40.58 Hu and 45.63 Hu) ( P < 0.05 ). The SNR values of the liver and gallbladder (3.68 and 2.05) of the reconstructed image were significantly higher than those of the FBP algorithm (1.91 and 1.19) ( P < 0.05 ). The overall image quality after ASIR reconstruction (3.92 points) was significantly better than that of the FBP algorithm (2.36 points), and the image noise score (3.21 points) reconstructed by the FBP algorithm was higher than that by the ASIR algorithm (1.83 points). The artifact score of FBP reconstructed image (4.47 points) was greatly higher than that of ASIR algorithm (2.26 points) ( P < 0.05 ). Before treatment, there was no remarkable difference in the indexes between the two groups of patients ( P > 0.05 ). After treatment, the γ-glutamyltransferase (γ-GT) and alkaline phosphatase (ALP) levels (327.55 U/L and 778.15 μmol/L) of the experimental group of ICP patients were higher than those of the control group (248.63 U/L and 668.43 μmol/L), with substantial difference between the two groups ( P < 0.05 ). The blood ammonia (BA) level (151.09 μmol/L) of the experimental group was lower than that of the control group (178.46 μmol/L), and the difference between the two groups was remarkable ( P < 0.05 ). To sum up, the CT image denoising degree based on ASIR algorithm was high, with few artifacts and good overall quality. Probiotics combined with ursodeoxycholic acid in the treatment of ICP can effectively improve the liver function and intestinal flora of patients, which was of great significance in the clinical diagnosis and treatment of the disease.

Objectives. To establish a novel animal model of intervertebral disc degeneration (IVDD) in rats and to investigate the effect of 17β-estradiol (E2) intervention in this model. Methods. This study was divided into two parts: animal model (four groups: Sham, ovariectomy (OVX), Puncture, and OVX+Puncture; three-time points: 4, 8, and 12 weeks; three female rats/group/time point) and drug intervention (Sham, OVX+Puncture+corn oil, and OVX+Puncture+E2; three female rats/group). The rats were analyzed by micromagnetic resonance imaging (MRI), hematoxylin and eosin (HE) staining, and safranin-O staining. Results. MRI and histological scores significantly differed among the four groups at the three-time points (all P < 0.05 ). IVDD progressed with time in the OVX, Puncture, and OVX+Puncture groups (all P < 0.05 ). The changes were the most obvious in the OVX+Puncture group. In the E2 intervention part, the Veh group had the worst MRI signals and histological scores ( P < 0.05 ). The MRI scores in the E2 group were less obvious compared to the Sham group ( P > 0.05 ). Also, the histological scores were significantly different between the Sham and E2 groups ( P < 0.05 ). Conclusions. The combination of ovariectomy and needle puncture can synergically induce IVDD in rat coccygeal discs. Estrogen treatment can effectively ameliorate IVDD progression in the newly established IVDD models.

In order to encourage innovative medicine to address Chinese unmet medical needs, China has changed its drug regulatory landscape to speed up access to new medicines. In order to understand the fast‐changing landscape and to enable planning of more global drug development programs and study designs in China, we reviewed 15 published clinical pharmacology‐related guidances by the National Medical Products Administration (NMPA), and compared them with reference guidances from the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), or the International Conference on Harmonization (ICH), to understand the similarities and differences, especially any China‐specific requirements, such as ethnic sensitivity analysis. Overall, by reviewing these clinical pharmacology‐related NMPA guidances, it is clear that NMPA guidances are very similar to FDA, EMA, and ICH guidances. There are no relevant differences in the major principles, but some differences in structure, contents, and focus were noted. The NMPA is adapting flexibility statements into newly published guidances. Ethnic sensitivity analysis needs to be implemented early in drug development plans. The NMPA encourages sponsors to conduct early clinical trials in China or include China early in multiregional clinical trials, and to obtain safety, efficacy, and pharmacokinetic data for ethnic sensitivity analysis. Depending on the stage of development, ethnic sensitivity analysis can be conducted using in vitro or literature data, other Asian clinical data, or Chinese clinical data.

Background The early diagnosis of non-small cell lung cancer is of great significance to the prognosis of patients. However, traditional histopathology and imaging screening have certain limitations. Therefore, new diagnostical methods are urgently needed for the current clinical diagnosis. In this study we evaluated the sensitivity and specificity of CanPatrol™ technology for the detection of circulating tumor cells in patients with non-small cell lung cancer (NSCLC). Methods CTCs in the peripheral blood of 98 patients with NSCLC and 38 patients with benign pulmonary diseases were collected by the latest typing of CanPatrol™ detection technology. A 3-year follow-up was performed to observe their recurrence and metastasis. Kruskal-Wallis test was used to compare multiple groups of data, Mann-Whitney U test was used to compare data between the two groups, and ROC curve analysis was used to obtain the critical value. The COX risk regression and Kaplan-Meier survival analysis were performed in the 63 NSCLC patients who were effectively followed up. Results The epithelial, epithelial-mesenchymal, and total CTCs were significantly higher in NSCLC patients than that in patients with benign lung disease (P P = 0.013). The AUC of the ROC curve of the total CTCs was 0.837 (95% CI: 0.76-0.914), and the cut-off value corresponding to the most approximate index was 0.5 CTCs/5 ml, at which point the sensitivity was 81.6% and the specificity was 86.8%. COX regression analysis revealed that the clinical stage was correlated with patient survival (P = 0.006), while gender, age, and smoking were not (P > 0.05). After excluding the confounders of staging, surgery, and chemotherapy, Kaplan-Meier survival analysis showed that patients in stage IIIA with CTCs ≥0.5 had significantly lower DFS than those with CTCs P = 0.022). Conclusions CTC positive can well predict the recurrence of NSCLC patients. CanPatrol™ technology has good sensitivity and specificity in detecting CTCs in peripheral blood of NSCLC patients and has a certain value for clinical prognosis evaluation.

Fluorinated graphene has a tunable band gap that is useful in making flexible graphene electronics. But the carbon–fluorine (C–F) bonds in fluorinated graphene can be easily broken by increased temperature or electron beam irradiation. Here, we demonstrate that the stability of fluorinated graphene is mainly determined by its C–F configuration. The double-sided fluorinated graphene has a much stronger stability than the single-sided fluorinated graphene under the same irradiation dose. Density functional theory calculations show that the configuration of double-sided fluorinated graphene has a negative and low formation energy, indicating to be an energetically stable structure. On the contrary, the formation energy of single-sided fluorinated graphene is positive, leading to an unstable C–F bonding that is easily broken by the irradiation. Our findings make a new step towards a more stable and efficient design of graphene electronic devices.

The heat dissipation of electronic devices has become an enormous challenge with the dramatic increasing of integrated transistors on a chip. Nanowires are viewed as promising materials for solving this problem. The accurate measurement of thermal diffusivity is a precondition for further applications. This paper presents a non-destructive method to measure the thermal diffusivity of a single supported nanowire, which is called dual-wavelength flash Raman (DFR) mapping method. This method has a 100 ps temporal resolution based on the minimum time delay between the heating and probing laser pulses and 50 nm spatial resolution based on the minimum step of the probing pulse. Compared with previously proposed concentric DFR method, the probing pulse can move along the nanwire length and the movable probing laser beam allowed temperature measurements at the most sensitive position,which improves the measurement accuracy by 50%. Moreover, instead of the normalizaiton temperature method in concentric DFR method, a temperature phase method was proposed for analyzing the temperature variation curves. The measurements on a single supported silicon nanowire verified the reliability of the DFR mapping method. One thousand virtual experiments showed that the uncertainty of this method can achieve ±5%.

Stratified air-conditioning (STRAC) has been deployed in large space buildings to achieve vertical thermal stratification with significant energy-saving potential. This research focuses on two typical STRAC systems: floor-level sidewall air-supply system (FSAS) and nozzle sidewall air-supply system (NSAS). By employing experiment and CFD methods, airflow pattern and heat transfer between the unoccupied and occupied zone under the two air supply systems are investigated in a reduced-scale laboratory. The geometric models of the prototype building, with a geometrical scaling factor of 4:1, are established according to similarity principles and studied by CFD simulation. The results demonstrate that the two scales have similar indoor thermal performances. The numerical simulation results of the prototype building provide and compare commonly used inter-zonal heat transfer coefficients of actual large space buildings with the two typical STRAC systems. For FSAS, heat conduction caused by temperature gradient dominates the inter-zonal heat transfer. In NSAS, both heat conduction due to temperature gradient and heat convection due to airflow contributes equally to this heat transfer. The inter-zonal heat transfer coefficient Cb is affected by the airflow pattern and zonal division, and closely associated with local turbulence intensity.

Background Restenosis is a serious problem in patients who have undergone percutaneous transluminal angioplasty. Endothelial injury resulting from surgery can lead to endothelial dysfunction and neointimal formation by inducing aberrant proliferation and migration of vascular smooth muscle cells. Exosomes secreted by mesenchymal stem cells have been a hot topic in cardioprotective research. However, to date, exosomes derived from mesenchymal stem cells (MSC-Exo) have rarely been reported in association with restenosis after artery injury. The aim of this study was to investigate whether MSC-Exo inhibit neointimal hyperplasia in a rat model of carotid artery balloon-induced injury and, if so, to explore the underlying mechanisms. Methods Characterization of MSC-Exo immunophenotypes was performed by electron microscopy, nanoparticle tracking analysis and western blot assays. To investigate whether MSC-Exo inhibited neointimal hyperplasia, rats were intravenously injected with normal saline or MSC-Exo after carotid artery balloon-induced injury. Haematoxylin-eosin staining was performed to examine the intimal and media areas. Evans blue dye staining was performed to examine re-endothelialization. Moreover, immunohistochemistry and immunofluorescence were performed to examine the expression of CD31, vWF and α-SMA. To further investigate the involvement of MSC-Exo-induced re-endothelialization, the underlying mechanisms were studied by cell counting kit-8, cell scratch, immunofluorescence and western blot assays. Results Our data showed that MSC-Exo were ingested by endothelial cells and that systemic injection of MSC-Exo suppressed neointimal hyperplasia after artery injury. The Evans blue staining results showed that MSC-Exo could accelerate re-endothelialization compared to the saline group. The immunofluorescence and immunohistochemistry results showed that MSC-Exo upregulated the expression of CD31 and vWF but downregulated the expression of α-SMA. Furthermore, MSC-Exo mechanistically facilitated proliferation and migration by activating the Erk1/2 signalling pathway. The western blot results showed that MSC-Exo upregulated the expression of PCNA, Cyclin D1, Vimentin, MMP2 and MMP9 compared to that in the control group. Interestingly, an Erk1/2 inhibitor reversed the expression of the above proteins. Conclusion Our data suggest that MSC-Exo can inhibit neointimal hyperplasia after carotid artery injury by accelerating re-endothelialization, which is accompanied by activation of the Erk1/2 signalling pathway. Importantly, our study provides a novel cell-free approach for the treatment of restenosis diseases after intervention.

Background Coronary artery disease (CAD) and depression cause great burden to society and frequently co-occur. The exact mechanisms of this comorbidity are unclear. FK506-binding protein 51 (FKBP51) is correlated with cardiovascular disease and depression. The aim of this study was to determine the role of the seven single nucleotide polymorphisms (SNPs) of FKBP5 that code FKBP51, namely, rs1360780 (C>T), rs2817032 (T>C), rs2817035 (G>A), rs9296158 (G>A), rs9470079 (G>A), rs4713902 (T>C), and rs3800373 (C>T) in a patient’s susceptibility to comorbid CAD and depression. Methods We enrolled 271 Northern Chinese Han patients with CAD, including 123 patients with depression and 147 patients without depression. We also included 113 healthy controls that match the patients’ sex and age. Genomic DNA from whole blood was extracted, and seven SNPs were assessed using MassArray method. Patient Health Questionnaire-9 was applied to access the depression. Results The GA genotype for rs9470079 was associated with a significantly decreased risk of CAD (odds ratio = 0.506, 95% confidence interval = 0.316–0.810, P = 0.005) when the GG genotype was used as reference. A statistically significant difference was observed among females but not among males in the rs9470079 genotype and allele frequency. Patients with CAD were further divided into CAD+D and CAD-D groups according to the presence of comorbid depression and were compared with the controls. Significant differences were found regarding the genotype and allele frequency of rs2817035 and rs9470079 in CAD+H groups compared with the control subjects in all groups and the female groups (P Conclusions The current study found a remarkable association between FKBP5 gene variations and the risk of comorbid CAD and depression in a north Chinese population. rs9470079 may be a potential gene locus for the incidence of comorbid CAD and depression.

We propose a compact 4 He magnetometer realizing magnetic field measurement and laser-frequency stabilization simultaneously in a single 4 He atomic cell. The frequency stabilization scheme is based on the asymmetric line shape of magnetic resonance which is induced by spatially inhomogeneous light shifts. We investigate the asymmetric line shape of the magnetic resonance signal theoretically and experimentally in laser pumped 4 He magnetometer with the magneto-optical double-resonance configuration. Notice that, due to the asymmetric line shape, the in-phase component of the magnetic resonance signal is shown to have a linear dependence with respect to the laser frequency detuning and is used to actively lock the laser frequency to the resonant point. The method reduces the complexity of the system and improves the stability of the magnetometer, making the laser-pumped 4 He magnetometer more compact and portable.

INTRODUCTION: Leptin (LEP) is a peptide hormone that acts via leptin receptor (LEPR) binding. Genetic evidence from different human populations has implicated LEP/LEPR in the pathogenesis of coronary artery disease (CAD), and suggests that certain LEP/LEPR gene polymorphisms may increase the risk of CAD. The aim of this study was to assess two single nucleotide polymorphisms (SNPs) in LEP genes (rs2167270 and rs7799039) and two in LEPR genes (rs6588147, rs1137100) for association with CAD. METHODS: We enrolled 271 North Chinese Han CAD patients, and 113 healthy age- and sex-matched controls. Genomic DNA was extracted from whole blood, and the four SNPs were assessed using a MassArray system. RESULTS: The G allele frequency at rs2167270 was significantly higher among CAD cases than among controls. The AG genotype at rs7799039 was associated with a significantly decreased risk of CAD unlike the AA genotype used as the reference. The A allele was significantly associated with the CAD patient group. Interestingly, statistically significant differences in genotype and allele frequency at LEP rs2167270 and rs7799039 existed among females but not among males. CONCLUSIONS: The current study detected a significant association between genetic variations at LEP rs7799039 and rs2167270 and the risk of CAD in a north Chinese population, and revealed that LEP rs2167270 and rs7799039 gene polymorphisms might act as predisposing factors for CAD.

Objective We investigated whether pre-anesthesia dynamic frontal-parietal functional connectivity was correlated with the observed interindividual differences in propofol susceptibility. Methods Three resting-state EEG datasets were used in the study (N = 29, N = 21 and N = 20). We estimated the pre-anesthesia strength and fluctuations of frontal-parietal functional connectivity by using sliding-window analysis. Propofol served as the sole anesthetic drug, and it was administered by using a target-controlled infusion system. Individual susceptibility to propofol was assessed by the induction time, from infusion onset until a bispectral index value of 60 was reached, for subjects in dataset-1 and dataset-2, and susceptibility was assessed by behavioral data for subjects in the external dataset. Results We observed in the three datasets that subjects with high susceptibility to propofol had lower pre-anesthesia strength and lower fluctuation of frontal-parietal functional connectivity than the low-susceptibility group at alpha band. Moreover, the induction time was significantly correlated with the estimated pre-anesthesia frontal-parietal functional connectivity measures. We also validated the robustness of these findings by using different window lengths in sliding-window analysis. Conclusions Subjects with weaker pre-anesthesia dynamic frontal-parietal communication are more likely to be anesthetized. Significance These observations suggest that the titration procedure for propofol should consider the pre-anesthesia brain functional state.

The turbulent characteristics of the inlet of a ventilation system have great influence on the airflow characteristics and indoor pollutant distribution. However, the significance of inlet turbulence has not been sufficiently addressed. In order to understand such influence, this paper uses the standard k-e model to simulate the airflow characteristics and indoor pollutant distribution of IEA20 benchmark test. The values of inlet turbulence intensity were changed from 4 to 20%. The simulation results are compared with the experimental data in the literature. At X = h/2, the difference between simulated values and experimental data increases with increasing turbulence intensity. At X = H − h/2, with the increase in air supply distance, the simulation value and the experimental data eventually show a certain error. The experimental data near the wall are negative, and the simulated values are positive. The effects of different turbulence length scales on the velocity field are also studied. This is further extended when considering the presence of indoor pollution sources.