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Background. Transcatheter closure of aneurysmal perimembranous ventricular septal defect (pmVSD), pmVSD near the aortic valve, and intracristal VSD (icVSD) with symmetrical or asymmetrical ventricular septal defect occluders still presents significant challenges. We report our experience with transcatheter closure of pmVSD and icVSD using Amplatzer duct occluder II (ADO II) in children. Method. We retrospectively analyzed all children, who presented to our hospital consecutively between March 2014 and June 2020 for attempted transcatheter closure of pmVSD or icVSD with the ADO II device. Standard safety and last-follow-up outcomes were assessed and compared. Results. In total, 41 patients underwent transcatheter closure of VSD with the ADO II (28 in pmVSD and 13 in icVSD groups) with a median age of 3.5 years (total range: 0.9 to 12 years) and median weight of 15.0 kg (total range: 10.0 to 43.0 kg). Implantation was successful in 40/41 patients (97.5%, 27/28 in pmVSD group, 13/13 in icVSD group). One patient with mild aortic valve prolapse in pmVSD group developed new-onset moderate aortic regurgitation after a 4/4 mm ADO II was deployed; however, this resolved after the device was retrieved and successfully replaced with a 5 mm zero eccentric VSD occluder. There was no procedure-related mortality. After a median follow-up of six months (total range: 6 to 72 months), complete closure rates were 85.1% and 76.9% among pmVSD and icVSD groups, respectively. In the pmVSD group, one case of new-onset moderate tricuspid regurgitation was observed at six months, and there was one case of severe tricuspid regurgitation that had progressed from mild tricuspid regurgitation at 12 months. No serious complications were noted in the icVSD group. Conclusion. ADO II provides a safe and reproducible alternative for the closure of perimembranous and intracristal ventricular septal defects with a diameter less than 5 mm in young children.

Objective This study aims to investigate the status of fertility preservation (FP) in young breast cancer patients. Materials and methods A clinical database of six women with breast cancer who wished to undergo FP before starting chemotherapy were analyzed between January 2018 and December 2019 in our hospital. Among the six women, three were unmarried and three were married. Results Three patients chose oocyte preservation and obtained 23, 7, and 17 MII oocytes, respectively. One patient chose embryo freezing, and three embryos were frozen. Fertility preservation failed for two patients, one of whom had premature ovulation, while the other patient abandoned egg retrieval on the human chorionic gonadotropin (HCG) day. Conclusion The present results indicate that oocyte and embryo cryopreservation are effective optional methods for young breast cancer patients. However, a lack of knowledge, the urgency of cancer treatment, and financial constraints are causes for a low access rate regarding this process.

We have developed a general method, dubbed the split beam method, to solve Euler–Bernoulli equations for cantilever beams under multiple loading conditions. This kind of problem is, in general, a difficult inhomogeneous eigenvalue problem. The new idea is to split the original beam into two (or more) effective beams, each of which corresponds to one specific load and bears its own Young’s modulus. The mode shape of the original beam can be obtained by linearly superposing those of the effective beams. We apply the split beam method to simulating mechanical responses of an atomic force microscope probe in the “dynamical” operation mode, under which there are a stabilizing force at the positioner and a point-contact force at the tip. Compared with traditional analytical or numerical methods, the split beam method uses only a few number of basis functions from each effective beam, so a very fast convergence rate is observed in solving both the resonance frequencies and the mode shapes at the same time. Moreover, by examining the superposition coefficients, the split beam method provides a physical insight into the relative contribution of an individual load on the beam.

Background The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation (LT). However, splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly. Aim To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism. Methods Between October 2015 and February 2019, 762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital. Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism. Among these patients, 41 received partial splenectomy during LT (PSLT group), and 43 received only LT (LT group). Patient characteristics, intraoperative parameters, and postoperative outcomes were retrospectively analyzed and compared between the two groups. Results The incidence of postoperative hypersplenism (2/41, 4.8%) and recurrent ascites (1/41, 2.4%) in the PSLT group was significantly lower than that in the LT group (22/43, 51.2%; 8/43, 18.6%, respectively). Seventeen patients (17/43, 39.5%) in the LT group required two-stage splenic embolization, and further splenectomy was required in 6 of them. The operation time and intraoperative blood loss in the PSLT group (8.6 ± 1.3 h; 640.8 ± 347.3 mL) were relatively increased compared with the LT group (6.8 ± 0.9 h; 349.4 ± 116.1 mL). The incidence of postoperative bleeding, pulmonary infection, thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group, respectively. Conclusion Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.

An integrated device of solar cell and photocatalysis (p-Si fronted solar cell/ CoSi2/WO3) has been used as photoanode for water splitting. The WO3 had been synthesized by co-electrodeposition of CoW on the p-Si fronted solar cell and followed by the annealing and acid treatment. The XRD and SEM show the amorphous structure for both as-depostion and after treatment samples. After the treatment, XPS and the ellipsometer spectroscopy shows that the CoSi2 and WO3 was formed with the band gap of 1.32 eV and 2.67 eV, respectively. Without additional power, we had demonstrated that the p-Si fronted solar cell/CoSi2/WO3 can achieve ~ 0.046 mA/cm2 photocurrent.

Background: Complex lower limb reconstruction following severe trauma remains a challenge for reconstructive surgeons. We here introduce a modified recipient blood flow-preserved cross-leg anterolateral thigh flap procedure and evaluate its clinical efficacy.Methods: Between January 2013 and December 2019, 22 patients (range 10 to 64 years old) with unilateral lower limb injuries underwent the modified recipient blood flow-preserved cross-leg anterolateral thigh flap procedures. Among them, 16 cases were traffic accidents, 5 cases were stubborn ulcers, and 1 case was degloving injury. The arterial pedicle of flap was prepared as Y-shaped fashion and microanastomosed to contralateral posterior tibial artery in a flow-through style. A split-thickness skin graft was applied to wrap the vascular pedicle after anastomosis. The flap was designed as single or bilobed fashions according to the shape of defects. The tissue defects ranged from 12 × 6 to 21 × 18 cm2. The vascular pedicle was divided 4 weeks after vascular anastomosis. Doppler ultrasound was performed to evaluate the blood flow of the recipient posterior tibial artery during postoperative follow-up.Results: All of 22 flaps survived. The flap sizes ranged from to 14 × 7.5 to 24 × 21 cm2. Eighteen flaps were designed as single fashion, and four flaps were bilobed fashion. Twenty patients underwent fasciocutaneous flap transplantation, and two underwent musculocutaneous flap transplantation. Two cases developed local lysis of the flap, and the wound healed after further debridement. Direct suture of the donor-site incision were performed in 16 cases, while additional full-thickness skin grafting were performed in remaining 6 cases. Further bone transport procedure was performed in 15 patients with severe tibia bone defects. Blood flow of recipient posterior tibial arteries were all confirmed during follow-up. The postoperative follow-up ranged 18 to 84 months, and no long-term complications were observed.Conclusions: The modified recipient blood flow-preserved cross-leg anterolateral thigh flap procedure is an ideal method to repair large tissue defects without sacrificing major artery of uninjured lower limb.

Correlation analysis has been widely applied for process detection and alarm analysis. However, traditional correlation analysis methods have been found inefficient due to the influence of process time delays on analysis results. In this paper, we propose an alarm correlation analysis method based on block matching similarities. By converting alarm data sequences to time node sequences, the block matching similarity (BMS) method is able to reduce the calculation burden of the correlation analysis. Considering time delays between the alarm variables, the improved maximal correlation coefficient method is presented to reduce the effect of time delays and to improve the accuracy of the correlation analysis. A numerical case and the Tennessee Eastman process are employed to demonstrate the effectiveness and efficiency of the proposed method.

Mammalian target of rapamycin (mTOR) inhibitor as an attractive drug target with promising antitumor effects has been widely investigated. High quality clinical trial has been conducted in liver transplant (LT) recipients in Western countries. However, the pertinent studies in Eastern world are paucity. Therefore, we designed a clinical trial to test whether sirolimus can improve recurrence-free survival (RFS) in hepatocellular carcinoma (HCC) patients beyond the Milan criteria after LT. This is an open-labeled, single-arm, prospective, multicenter, and real-world study aiming to evaluate the clinical outcomes of early switch to sirolimus-based regimens in HCC patients after LT. Patients with a histologically proven HCC and beyond the Milan criteria will be enrolled. The initial immunosuppressant regimens are center-specific for the first 4-6 weeks. The following regimens integrated sirolimus into the regimens as a combination therapy with reduced calcineurin inhibitors based on the condition of patients and centers. The study is planned for 4 years in total with a 2-year enrollment period and a 2-year follow-up. We predict that sirolimus conversion regimen will provide survival benefits for patients particular in the key indicator RFS as well as better quality of life. If the trial is conducted successfully, we will have a continued monitoring over a longer follow-up time to estimate indicator of overall survival. We hope that the outcome will provide better evidence for clinical decision-making and revising treatment guidelines based on Chinese population data. Trial register: Trial registered at http://www.chictr.org.cn: ChiCTR2100042869.

Background. With the rapid development of transcatheter techniques and instruments, transcatheter occlusion for patients with perimembranous ventricular septal defect (pVSD) and aortic valve prolapse (AVP) was constantly being tried, while the efficacy and safety of pVSD with AVP remain controversial. Objective. The aim of this study was to evaluate long-term efficacy and safety of transcatheter occlusion of pVSD with AVP. Methods. We retrospectively analyzed 164 children with pVSD and AVP who underwent transcatheter occlusion between January 2013 and November 2014. AVP was divided into 3 degrees according to right coronary leaflet morphology at end-diastole during aortic root angiography. Patient demographic and clinical data were collected. Results. There were 97 males and 67 females (median age, 40.0 (30.0–62.7) months; average weight, 16.94 ± 9.02 kg). Mild (n = 63), moderate (n = 89), and severe (n = 12) AVP success rates were 93.7%, 89.9%, and 58.3%, respectively. Immediately after procedure, there was no new-onset aortic regurgitation (AR) above trivial degree, residual shunt above mild degree, or complications requiring medication or operation, except for 1 patient who developed transient complete atrioventricular block. During follow-up, 1 mild AVP patient aggravated from mild to moderate AR and 1 moderate AVP patient aggravated from trivial to moderate AR. The new-onset AR in mild, moderate, and severe AVP was 2%, 1.8%, and 20%, respectively. AR disappeared in 17 patients. Residual shunt occurred in 9 patients after procedure, 4 of which disappeared during the follow-up period. No serious complications occurred in any patient during follow-up. Five-year cardiovascular event-free survival rates for mild, moderate, and severe AVP were 89.6%, 94.5%, and 80.0%, respectively. Conclusion. Transcatheter occlusion of pVSD with mild and moderate AVP has a high success rate and few complications, which is safe and effective in long-term follow-up. Transcatheter occlusion of pVSD with severe AVP has low success rates and high AR incidence. Therefore, transcatheter occlusion of pVSD with AVP is recommended for mild to moderate, but not severe, AVP.

Background The present study aims to use two different kinds of filling materials, oxidized regenerated cellulose and gelatin sponge, to repair defects of breast-conserving surgery due to breast cancer, and compare the clinical efficacy, cosmetic effect and complication rate among groups. Methods A total of 125 patients, who had breast -conserving surgery due to breast cancer, were enrolled into the present study. Postoperative efficacy was assessed by a doctor and patient, according to the Harvard/NSABP/RTOG Breast Cosmetic Grading Scale. Results Among these patients, 41 patients received conventional breast-conserving surgery, and 84 patients received breast-conserving surgery plus filling implantation (41 patients in the oxidized regenerated cellulose group and 43 patients in the gelatin sponge group). All patients had small to medium sized breasts (cup size A and B). The average weight of tumor tissues was 56.61 ± 11.57 g in the conventional breast-conserving surgery group, 58.41 ± 8.53 g in the oxidized regenerated cellulose group, and 58.77 ± 9.90 g in the gelatin sponge group. The difference in pathological factors, average operation time, length of stay and local infection rate was not statistically significant among the three groups. 18 patients in the oxidized regenerated cellulose group and 15 patients in the gelatin sponge group were evaluated to have a good cosmetic effect by the surgeon and patient, while 12 patients in the conventional breast-conserving surgery group were evaluated to be have good cosmetic effect by the surgeon and patient. The cosmetic effects in the oxidized regenerated cellulose group and gelatin sponge group were comparable, and these were superior to those in the conventional breast-conserving surgery group. Conclusion The use of oxidized regenerated cellulose and gelatin sponge is a feasible approach for defect repair after breast-conserving surgery.

The trend of globalization has become the primary development of higher education institutions. The fad of international exchanges drives various countries’ emphases on and participation in the flo...

Gastric cancer (GC) is a globally important disease. Targeted therapies licensed to treat gastric cancer include trastuzumab, which targets HER2, and nivolumab or pembrolizumab, which block PD-1/PD-L1. The main challenge of tumor molecule-targeted drugs is resistance. Based on the multicomponent and multitarget characteristics of Traditional Chinese Medicine (TCM) and our previous research on Guiqi Baizhu Prescription (GQBZP) in targeting HER2/PD-L1, we used different cell models to verify the effect of quercetin targeting of HER2 and formononetin targeting of PD-L1. The results show that quercetin can inhibit MKN-45 cell proliferation by targeting HER2 to inhibit the PI3K-AKT pathway, and formononetin can regulate T-cell function by inhibiting the PD-1/PD-L1 pathway. We also used gastric cancer MKN-45 cells in a T lymphocyte co-culture model to show that quercetin and formononetin co-treatment can regulate T cell function and inhibit MKN-45 cell proliferation. More importantly, quercetin with formononetin treatment had a greater effect than treatment with either quercetin or formononetin alone. We believe that quercetin and formononetin may be useful to target HER2 and inhibit PD-1/PD-L1 in gastric cancer.

Biliverdin (BV), one of the heme oxygenase-1 (HO-1) catalytic products, has been demonstrated to have protective effects in liver ischemia reperfusion injury (IRI). The present study aimed to explore the effects of BV on cerebral IRI, and to investigate the potential mechanisms thereof. Adult male SD rats, weighing 200–240 g, were randomly divided into sham (group S), cerebral ischemia reperfusion control (group C) and BV (group BV) groups. Rats in group C underwent transient middle cerebral artery occlusion (tMCAO) and received 2 ml normal saline; rats in group BV received BV (35 mg/kg) intraperitoneally 15 min prior to reperfusion and 4 h after reperfusion, then twice a day thereafter for 5 days. Group S served as the control. Neurological Severity Scores (NSS) were evaluated at days 1–5 following reperfusion. Staining with 2, 3, 5-triphenyltetrazolium chloride was performed to determine the cerebral infarction at 48 h post reperfusion. mRNA expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β, inducible nitric oxide synthase (iNOS) and HO-1 in the ischemic cerebral cortex were detected via reverse transcription-quantitative polymerase chain reaction at 3, 6, 12 and 24 h after reperfusion. Western blotting was used to detect the protein expression levels at 3 h after reperfusion. Compared with group S, the NSS, cerebral infarct volume, and the mRNA and protein expression levels of TNF-α, IL-6, IL-1β, iNOS and HO-1 of Group C were significantly increased (P

Objectives. We aimed to explore the radiologic characteristics and interventional strategies for perimembranous ventricular septal defect (pmVSD) with aneurysm. Methods. 257 patients who underwent transcatheter closure of pmVSD with aneurysm were included in our study. We retrospectively reviewed the left ventricular opening of the aneurysm (a), diameter of the midsegment of the aneurysm (b), and diameter of the right ventricular opening of the aneurysm (c). If there were multiple defects within the aneurysm, the largest defect was denoted as c1 and so forth. We developed a novel VSD classification method in which pmVSD with aneurysm was classified into three types (A, B, and C). When a >b ≥ c, it was classified as type A, when b > a ≥ c, it was type B, and when c > a ≥ b, it was type C; c/c1 described the relationship among defects. Results. All of the 257 cases of pmVSD with aneurysm were defined using left ventriculography: type A, 60, type B, 58, and type C, 139. Transcatheter closure was attempted in 244 patients and succeeded in 227 cases (success rate was 93.0%; 227/244). Forty symmetric VSD occluders and 13 asymmetric VSD occluders were used for type A aneurysm occlusion; 31 symmetric VSD occluders, 19 asymmetric VSD occluders, and one Amplatzer duct occluder II (ADOII) were used for type B; 59 VSD symmetric occluders, 59 asymmetric VSD occluders, three eccentric VSD occluders, and two ADOII were used for type C. Within 24 hours after procedure, 2.2% patients had postprocedural residual shunt, and 2.2% experienced malignant arrhythmia (including type II second-degree AVB, cAVB, and CLBBB). Two hundred and twelve patients completed follow-up (93%, 212/227). No new severe complications were reported during follow-up, except in one patient who underwent surgery (removal of the device, VSD repair, and tricuspid valvuloplasty) due to severe postprocedural tricuspid regurgitation. Conclusions. It is safe and effective to apply this method for the classification of pmVSD with aneurysm and its interventional strategy.

Purpose. To investigate the influences of atropine on changes in anterior segment geometry, as measured by ultrasound biomicroscopy in children. Methods. A prospective observational study was performed. Anterior segment parameters were obtained by UBM before and after the instillation of 1% atropine. Univariate linear regression was performed to identify the variables contributing to the changes in the trabecular meshwork-iris angle (TIA). Results. The study included 21 boys and 37 girls with a mean age of 10.79 ± 2.53 years. Anterior chamber parameters including the central anterior chamber depth, TIA, angle opening distance at 500 μm from the scleral spur, iris thickness 750 μm and 1500 μm from the scleral spur, trabecular-ciliary angle (TCA), trabecular-ciliary process distance, sclera-iris angle (SIA), and sclera-ciliary process angle significantly increased after cycloplegia ( P < 0.05 ). In contrast, the lens vault, iris cross-sectional area, and maximum ciliary muscle thickness significantly decreased after cycloplegia. Univariate analysis identified the change in TCA and the change in SIA and the TIA before mydriasis as determinants of the change in TIA. Conclusions. Atropine causes statistically significant changes in various anterior segment parameters in children. The change in anterior chamber angle is associated with the change in TCA and the change in SIA and the TIA before mydriasis.

Background:. Pulmonary artery hypertension associated with congenital heart disease (PAH-CHD) occurs predominantly among patients with uncorrected CHD. Treatment of severe pediatric PAH-CHD remains a major intractability. This study evaluated the predictors and prognoses of children with PAH-CHD who underwent surgical correction. Methods:. The data for 59 children with severe PAH-CHD who underwent surgical correction, with or without postoperative medication, between May 2011 and June 2015 at the Guangdong Provincial People's Hospital were analyzed retrospectively. A regression analysis, receiver-operating characteristic (ROC) curves, and Kaplan-Meier curves were used for survival analysis. Results:. Fifty-nine children with severe PAH-CHD underwent heart catheterization and correction, with or without specific anti-PAH drugs postoperatively, were included in this study. The pulmonary pressure, heart function, and ending events were observed and median observation period was 49 ± 20 months. Twenty-eight patients (50%) received at least one additional anti-PAH drug after correction. The survival rate after 2 years was 91.5% (54/59); two patients were in a critical condition, and three were lost to follow-up. Twelve patients (29%) still received over one additional PAH-specific therapy at follow-up, whereas 42 (75%) had successfully stopped drug treatment. Two patients (3.5%) died and one underwent a second thoracotomy to remove the ventricular septal defect patch. Acute vasoreactivity test (AVT) criteria had limited efficacy in predicting pediatric PAH-CHD, whereas pulmonary vascular resistance (PVR) ≤ 6.65 Wood units (WU)/m2 or PVR/systemic vascular resistance (SVR) ≤ 0.39 during AVT indicated a good prognosis after surgical correction with an AUC of 98.3% (95% confidence interval [CI]: 96.0–100%), 98.4% (95% CI: 96.0–100%) sensitivity of 100%, 100% and specificity of 82.1%, 92.9%, respectively. Conclusions:. Although the criteria for positive AVT currently used are unsuitable for pediatric patients with PAH-CHD, PVR and PVR/SVR during AVT are excellent predictors of outcome in pediatric PAH-CHD. Surgery aided by anti-PAH drugs is an effective strategy and should be recommended for severe pediatric PAH-CHD with PVR ≤ 6.65 WU/m2 and PVR/SVR ≤ 0.39 after iloprost aerosol inhalation.

Background: Percutaneous balloon pulmonary valvuloplasty (PBPV) is the preferred therapy for pulmonary valve stenosis (PVS). This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim of this study was to evaluate factors associated with immediate therapeutic outcomes and restenosis during medium-term follow-up. Methods: The study included 158 infants with PVS who underwent PBPV from January 2009 to July 2015. Demographic characteristics and patient records were reviewed, including detailed hospitalization parameters, hemodynamic data before and immediately after balloon dilation, cineangiograms, and echocardiograms before PBPV and at each follow-up. All procedures were performed by more than two experienced operators. Results: Immediately after balloon dilation, the pressure gradient across the pulmonary valve decreased from 73.09 ± 21.89 mmHg (range: 43-151 mmHg) to 24.49 ± 17.00 mmHg (range: 3-92 mmHg; P < 0.001) and the right ventricular systolic pressure decreased from 95.34 ± 23.44 mmHg (range: 60-174 mmHg) to 52.07 ± 18.89 mmHg (range: 22-134 mmHg; P < 0.001). Residual transvalvular pressure gradients of 67.31 ± 15.19 mmHg (range: 50-92 mmHg) were found in 8.2% of patients, indicating poor therapeutic effects; 6.4% of patients had variable-staged restenosis at follow-up and 3.8% underwent reintervention by balloon dilation or surgical repairs. Further analysis demonstrated that the balloon/annulus ratio showed statistically significant differences (P < 0.05) among groups with different therapeutic effects and between the restenosis and no-stenosis groups. Binary logistic regression analysis further revealed that higher balloon/annulus ratio (odds ratio: 0.005, 95% confidence interval: 0-0.39) was an independent protective factor for restenosis. The rate of severe complications was 1.9%. Conclusions: PBPV is a definitive therapy for infants with PVS based on its effectiveness, feasibility, and safety. Restenosis upon medium-term follow-up is relatively rare. Key words: Balloon Valvuloplasty; Cardiac Catheterization; Infants; Pulmonary Valve Stenosis

The increasing demand of mobile multimedia services has motivated the use of new communication technologies that could improve the utilization of spectrum resource. In this paper, we study a mobile communication network that adopts phased array technology to improve the reuse of spatial spectrum resource, in which each base station (BS) communicates with multiple mobile users (MUs) simultaneously in the same frequency channel by applying beamforming. We understand from analysis that in such a network, the parallel communications supported by phased array technology could produce interference to each other. Moreover, the interference level largely depends on the angles of beams. We then propose a novel networking method that let a MU select a proper BS according to both distance, which largely decides receiving power, and the beam angle, which is the main factor that decides co-channel interference, as compared to conventional networking scheme that requests a MU to select a proper BS simply according to distance. Both analysis results and simulation results show that the proposed scheme obtains advantage over the conventional scheme in terms of the network throughput.

This study aims to explore the expression of RORγt, BATF, and IL-17 in Chinese vitiligo patients with 308 nm excimer laser treatment. One hundred and sixty-four vitiligo patients treated with 308 nm excimer laser were enrolled as Case group and 137 health examiners as Control group. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to detect the expressions of RORγt, BATF, and IL-17. Expression of RORγt, BATF, IL-17A, and IL-17F were higher in Case group than Control group, with the diagnostic accuracy of 88.04, 87.38, 97.34, and 89.04%, respectively. Pearson correlation analysis showed a positive correlation in RORγt, BATF, IL-17A, and IL-17F mRNAs in vitiligo patients. Moreover, their expressions were higher in active vitiligo patients than stable ones. Besides, the expressions of RORγt, BATF, IL-17A, and IL-17F in vitiligo skin were significantly higher than those in non lesional skin and normal controls. After treatment, their expressions were significantly decreased. Active vitiligo and the high expressions of RORγt, BATF, and IL-17F were the independent risk factors for the ineffectiveness of 308 nm excimer laser treatment. The expressions of RORγt, BATF, IL-17 were significantly enhanced in vitiligo patients, which were correlated with the activity of vitiligo and 308 nm excimer laser therapeutic effects.

The electric vehicle charging load forecasting is influenced by many factors and full of randomness and complexity based on the charging operation history data and according to the different types of charging power of different charging behavior, we propose Monte Carlo simulation calculation method which extracts the initial state of charge and the start time of charging. The behavior of different charging methods and different vehicles are classified according to the charging requirements, we selected the starting time and duration of charging as the key factors affecting the charging load time distribution, combined with the statistical analysis of users’ charging behavior, to establish the charging load time distribution model. On this basis, we divided the charging load areas to establish the time and space distribution model of charging load. Through the examples analysis, we predicted the temporal and spatial distribution of the load level of the electric vehicle in Chongqing. The analysis results show that with the development of electric vehicle in Chongqing, the charging load will have great influence on the operation and planning of power grid. The charging load has obvious peak to valley difference, and the potential of load regulation is great.

The aim of the present study was to assess the function of dermoscopy in evaluating the therapeutic efficacy of tacrolimus ointment plus 308-nm excimer laser combination therapy in patients with localized vitiligo. A total of 147 patients with localized vitiligo (progressive disease, n=92; stable period, n=55) were enrolled and received combination therapy for 12 weeks. The condition of the skin lesions was monitored by dermoscopy and visual observation. At the initial visit, skin lesions were observed in 61 progressive and 19 stable patients. Residual perifollicular pigmentation was more abundant in progressive-stage patients than in stable-stage patients, whereas the presence of perilesional hyperpigmentation was obviously lower in patients with progressive vitiligo. After 12 weeks of combination therapy, marked differences in residual perifollicular pigmentation were identified between the progressive- and stable-stage patients. Dermoscopy and visual observation indicated that the 12-week treatment efficacy in patients with progressive disease was significantly higher than in those with stable disease and that assessment by dermoscopy was superior to visual observation at 8 or 12 weeks of treatment. Binary logistic regression analysis revealed that the disease stage, vitiliginous areas and disease course were risk factors associated with the treatment efficacy of the combination therapy. In conclusion, dermoscopy may be used as an effective means of vitiligo therapy assessment to provide an accurate and scientific evaluation of treatment efficacy for localized vitiligo patients.

AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

This paper reports our recent work on nanofabrication of air-spaced field-plate (ASFP) gates with ultra-short foot-print using one step electron beam lithography (EBL) combined with reactive ion etch (RIE) for which are suitable for GaN based high electron mobility transistors (HEMTs). Electron beam lithography on a tri-layer stack with PMMA350K/PMMA100K/Al/UVIII is carried out to form the required profile in resist. A low damage RIE dry-etch process is developed to create two different kinds of shapes in the 100 nm SiNx layer which serves as a footprint definition and mechanical support to the field-plate. The process enables us to fabricate air spaced field-plates with 60 nm foot-print and 50 nm air gap. Its advantages over traditional field-plates as well as T shape gate are discussed.

Osteomyelitis caused by nontuberculous mycobacteria (NTM) can have severe consequences and a poor prognosis. Physicians therefore need to be alert to this condition, especially in immunocompromised patients. Although the pathogenesis of NTM osteomyelitis is still unclear, studies in immunodeficient individuals have revealed close relationships between NTM osteomyelitis and defects associated with the interleukin-12–interferon-γ–tumor necrosis factor-α axis, as well as human immunodeficiency virus infection, various immunosuppressive conditions, and diabetes mellitus. Culture and species identification from tissue biopsies or surgical debridement tissue play crucial roles in diagnosing NTM osteomyelitis. Suitable imaging examinations are also important. Adequate surgical debridement and the choice of appropriate, combined antibiotics for long-term anti-mycobacterial chemotherapy, based on in vitro drug susceptibility tests, are the main therapies for these bone infections. Bacillus Calmette–Guerin vaccination might have limited prophylactic value. The use of multiple drugs and long duration of treatment mean that the therapeutic process needs to be monitored closely to detect potential side effects. Adequate duration of anti-mycobacterial chemotherapy together with regular monitoring with blood and imaging tests are key factors determining the recovery outcome in patients with NTM osteomyelitis.

In RFID system, when multiple tags transmit information in the same wireless channel simultaneously, data collisions usually occur which will reduce the identifying efficiency of RFID systems. To resolve this problem, several Dynamic Frame-Slotted ALOHA (DFSA) methods have been proposed. However, these methods are generally not capable of achieving expected performance when the number of tags is much larger or smaller than the initial frame size. Aiming to this problem, a Rapid DFSAI (RDFSAI) method was put forward based on the DFSA with interrupt (DFSAI) in this paper. Firstly, whether the frame size is adjusted or not is judged by comparing the system efficiency with the reference system efficiency. Secondly, the multiple factor of the frame size is determined by the ratio between the collision and empty slots, which leads to a seriels of different multiple factors or. As a result, the proposed RDFSAI elevates the adjustment speed of frame size and reduces the unnecessary empty and collision slots effectively. Simulation results indicate that the RDFSAI method appears better performance than the conventional methods even the tag number is increased up to 1600.

A new method is proposed to distinguish the contributions of the low-frequency noise (LFN) from the channel and the source/drain Schottky contacts in MOS devices. The method is applied to back-gated nMOSFETs with MoS2 channel and Al2O3 gate dielectric. To avoid a possible noise signal contamination from the top MoS2 surface by oxygen or water molecules absorption, the nMOSFETs with multilayer MoS2 are fabricated, and the measurements are carried out in the vacuum. The trap density Not at the MoS2/Al2O3 interface is derived for the first time using the proposed method. It is found that the Not responsible to LFN depends strongly on the surface potential, ranging from $4\times 10^{10}$ cm $^{\mathrm {-2}}$ in the weak over-drive region to $5\times 10^{11}$ cm $^{\mathrm {-2}}$ in the strong over-drive region.

In this work the effect of argon filling ratio and air space thickness on the heat transfer coefficient of double-glazing was studied. The heat transfer coefficient of double-glazing was measured by heat flow meter method (based on standards ISO10291, ISO 10292, ISO8301 and DIN EN 12939), during this process the testings of argon filling ratio and emissivity of coated glass surface were involved. For the thermal performance of double-glazing, the influence of various factors on heat transfer coefficient was analyzed. The comparison was conducted between coated double-glazing (one glass pane coated with low-emissivity) and non-coated double-glazing. Within the thickness of air space in the range of 9–18 mm, the higher the air space thickness, the higher the filling ratio of argon gas, the better the thermal insulation performance achieved. Under the same gas filling ratio, the heat transfer coefficient of coated double-glazing (emissivity is 0.13) which is much lower than that of non-coated double-glazing, can effectively meet the requirement of building energy efficiency in China.

Dams can effectively alleviate great debris flow hazards to downstream regions, so they has been widely applied to prevention and control engineering of debris flow disaster now. A kind of steel-concrete combined structure with steel braces was presented based on conventional gravity dams, and the superiority of the new structure in terms of impact resistance was verified contrastively by means of model experiments under solid impact. The results show that braces can restrain cracks and reduce their width, thus the extent of damage in impact areas is alleviated effectively. Compared with the conventional dam, the dynamic strains and acceleration peak values of the dam with braces both observably reduce, and the highest reduction ranges of them may be up to 69.2% and 47.8% respectively, so the deformation and vibration are limited by the braces. The dynamic displacement peak values of the new-type dam are significantly less than the conventional dam, and the average reduction range of this index can reach to about 46%, so the structural stiffness has been enhanced by a large margin.

We retrospectively analyzed 252 patients with end-stage liver disease who had undergone LDLT from January 2009 to September 2015. Of these, 25 had a GRWR of

The significant changes enabled by the fog computing had demonstrated that Internet of Things (IoT) urgently needs more evolutional reforms. Limited by the inflexible design philosophy; the traditional structure of a network is hard to meet the latest demands. However, Information-Centric Networking (ICN) is a promising option to bridge and cover these enormous gaps. In this paper, a Smart Collaborative Caching (SCC) scheme is established by leveraging high-level ICN principles for IoT within fog computing paradigm. The proposed solution is supposed to be utilized in resource pooling, content storing, node locating and other related situations. By investigating the available characteristics of ICN, some challenges of such combination are reviewed in depth. The details of building SCC, including basic model and advanced algorithms, are presented based on theoretical analysis and simplified examples. The validation focuses on two typical scenarios: simple status inquiry and complex content sharing. The number of clusters, packet loss probability and other parameters are also considered. The analytical results demonstrate that the performance of our scheme, regarding total packet number and average transmission latency, can outperform that of the original ones. We expect that the SCC will contribute an efficient solution to the related studies.

With rapid development of renewable generator, Application of storage plays important role in improving energy efficiency. At first different kinds requirement of storage is analysed with detail case in paper. The trend of storage for future is Prospect. Then demand of new energy for power system is analysed and calculated. A decomposition model for Energy storage for renewable power generation is established. Some suggestion will be given for energy storage for GuangDong power gird co.Ltd.

To study the injury index to driver in front crash, this article uses the MADYMO software to establish the driver constraint system model which including car bodies, safety belts and 50% dummy for impact simulation. The simulation values are close to test ones after contrasted with the vehicle impact test. The influence of design parameters including the D-ring friction coefficient of seat belt, airbag strap and steering column on driver HIC, T3MS, THPC are researched by this model. The results show that: The smaller D-ring friction and a longer airbag strap length and steering column crushing can effectively improve the driver safety.

In order to analyze the construction processing for No.1 shaft of Weihe Tunnel on Baoji-Lanzhou Passenger-dedicated Railway, a two-dimensional numerical model for the simulation of the shaft was built with the finite difference method. Mohr-Coulomb model was chosen as the soil constitutive model. The result shows that the maximum lateral displacement appears at the upper part of the shaft, and the lateral displacement is in effective constraint at the shaft’s bottom. After the construction, the maximum uplift at the shaft’s bottom is in the center, while the uplift decreases from the shaft’s center to its both sides. The maximum pressure stress turns up at the bottom sides of the shaft, and the maximum tensile stress appears at the middle of the shaft.

The thesis takes a three-lane tunnel construction in Zhejiang as an example. Simulating the course of dynamic construction of large-span tunnel on geology condition of four-grade rock mass and shallow buried by FLAC 3D software ,it carries out comparative and stress situation in the runnel surrounding rocks .Getting the displacement and stress changes rule of the construction by using benching with a small pilot tunnel tunneling method can guide the construction scientifically.

Nuclear tracer technology is quantitative and it has a high priority, which provides a unique method for understanding the mechanism of urban soil and water loss.137Cs +210Pbexcombination tracer was applied to study the characterization and evaluation of soil Erosion in Shenzhen. The results indicate that the following: 1)Disturbances from urbanization has greatly changed surface soil in Shenzhen.137Cs background inventory in Shenzhen range at 99 Bq/m2-653 Bq/m2. 2)210Pbexbackground inventory increase with altitude rise, which is attributed to the movement of water vapor. 3)Soil erosion in Shenzhen has a wide distribution area and exacerbated by severe human disturbance. Land development and steep orchard are key factors that influence urban soil and water loss. 4)Shenzhen should strictly carry out projects for soil and water conservation, such as returning steep slopes into forests and grasslands, and other ecological management reforms.

A single-carrier hole-only device of ITO/MoO3/NPB/Al was used to measure the hole mobility of NPB layer, where NPB is a hole transport material. The hole mobility of NPB at different electric fields was obtained from the hole transit time (τdc) which was extracted from the negative differential susceptance (ΔB) as a function of frequency. To eliminate the impact of the contact resistance on the mobility measurement, an equivalent circuit model has been introduced to calculate the capacitance and the conductance of the NPB layer. By fitting the Nyquist plot of the impedance spectroscopy using the equivalent circuit, the contact resistance can be extracted from the impedance measurements. It is found that the mobility at low electric field is lower than what was reported in literature after the consideration of the contact resistance. It is also found that the calculated hole mobility of the NPB layer follows the Poole-Frenkels rule.

In the Bill of Quantities mode, the bidder must take risks of his tender offer. This paper researched on the uncertainty of construction projects costs, proposed Monte Carlo simulation method and procedure to simulate the construction projects costs on the basis of the construction projects costs conform to the characteristics of normal distribution, and also put forward a method to calculate risks of the tender offer in accordance with the established bidding strategy, which are helpful to the risk management and control of project contracting enterprises.

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500.

The traditional methods to adjust voltage in distribution network reactive power optimization is discretization，and it is difficult to realize the continuous voltage adjustment. A reactive power optimization model and algorithm in distribution network with wind farm is proposed. The network loss，deviation of voltage and stability of voltage are taken into account in the multi-objective reactive power optimization model. The quantum particle swarm optimization（QPSO）algorithm has been used to solve the reactive power optimization problem. The algorithm described particle state by wave function, not only increase the diversity of population，but also avoid premature convergence. The comparison of the simulation result between QPSO and PSO on the modified IEEE 33-bus system demonstrated the effectiveness and advantage of quantum particle swarm optimization.

With the Process of urbanization is accelerated unceasingly, more and more people are centralizing to city. This means that the needs of urban infrastructure are increasing. But the traditional mode of financing is hard to meet the demands of construction funds, especially, the non-profit and quasi-profit municipal infrastructure. Analyzing and studying on the financing mode of western developed countries, this paper targeted and optimized the financing structure of city municipal infrastructure construction based on the item division theory, and looked forward to help to solve financing problems of municipal infrastructure construction in China.

The numerical simulation calculation on round steel-tubes reinforced with CFRP sheets was done through the large-scale finite element software ANSYS. In this research, four factors were comparatively analyzed so as to obtain the influence of them on ultimate axial tensile bearing capacity of steel-tubes. These four factors are longitudinal reinforcement length rate , thickness , elastic modulus and circumferential reinforcement ways of CFRP sheets. The results show that the ultimate axial tensile bearing capacity of steel-tubes strengthened with CFRP sheets is enhanced significantly and the reinforcement effect is very good.

The anti-allergic drug, N-(3,4-dimethoxycinnamonyl) anthranilic acid (3,4-DAA), is a synthetic anthranilic acid derivative that has been used therapeutically in Japan for many years. In this study, to investigate the effects of 3,4-DAA in allograft immunorejection model, liver orthotopic transplants were performed using inbred male Dark Agouti donors and Lewis rat recipients (allografts). The levels of indoleamine 2,3-dioxygenases (IDO) enzymic activities in five groups, allografts (control), dimethyl sulphoxide-treated group (vehicle control), 200 mg·kg–1·day–1 of 3,4-DAA-treated group and 200 mg·kg–1·day–1 of 3,4-DAA + 5 mg·ml–1 of 1-methyl-D-tryptophan (1-MT)-treated group were confirmed by determination of L-kynurenine (L-Kyn) concentrations. The serum alanine aminotransferase levels in 3,4-DAA-treated rats significantly decreased compared with those in mock and control group, whereas treatment of 1-MT in allografts led to the opposite effect. Administration of 3,4-DAA reduced histological severity of allograft immunorejection, decreased serum levels of cytokines tumour necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ), and raised serum levels of interleukin-10 (IL-10), suggesting that 3,4-DAA has both anti-inflammatory and anti-immunorejection properties through IDO in immune regulation and may therefore be useful in filling an unmet need, in the treatment of allograft immunorejection. Copyright © 2011 John Wiley & Sons, Ltd.

Less developed countries (LDCs) are struggling with an increasing burden of breast cancer. It is important to identify what interventions might be most effective and feasible in reducing overall breast cancer mortality in a resource constrained settings. Mammography screening (MS) utilized in developed countries cannot be equally applied to LDCs. We provide a summary of the status of existing and past MS program attempts in LDCs, and try to determine the prerequisites under which any developing country is ready to benefit from a MS program. We make the case for a "mixed" portfolio of tools to reduce breast cancer mortality with MS reserved only for those sub-populations that meet the criteria. We hope our review will provide a background for policy makers to apply rigorous criteria before attempting to implement costly MS program and before judiciously evaluating additional competed programs in their countries.

In pancreaticobiliary maljunction (PBM), the sphincter of Oddi can not control bile and pancreatic juice flow, which may lead to two-way reflux of bile and pancreatic juice, thus causing chronic inflammation, thickening, fibrosis and metaplasia of the common bile duct wall. These pathophysiological changes have been linked to disruption of the epithelium barrier in the common bile duct. We hypothesized that the expression of tight junction-associated proteins may be dysregulated in the common bile duct in PBM. In the current study, we sought to analyze the expression of tight junction-associated proteins in the common bile duct epithelium of pediatric patients with PBM. Specimens of the common bile duct were collected from 12 pediatric patients with PBM and 10 non-PBM controls. The expression of the tight junction-associated proteins occludin and claudin-1 in the epithelium was examined by immunohistochemistry. The Image-Pro Plus v. 6.0 image analysis software was used to calculate the mean qualifying score (MQS) of imunostained sections of common bile duct epithelium. Total protein extracts of common bile duct were analyzed by Western blotting assays to examine expression of occludin, claudin-1 and myosin light chain kinase (MLCK). Spearman correlation analysis was used to analyze the relation between MLCK and occludin, MLCK and claudin-1. Immunostained sections of the common bile duct epithelium showed significantly higher MQS in pediatric patients than controls for occludin (44.11 ± 13.82 vs. 11.30 ± 9.58, P = 0.0034) and claudin-1 (63.44 ± 23.59 vs. 46.10 ± 7.84, P = 0.0384). Western blotting also showed significantly higher expression of occludin, claudin-1 and MLCK in the common bile duct of patients than of controls (P = 0.0023, 0.0015, 0.0488). Spearman correlation analysis showed that MLCK expression correlated positively with the expression of occludin (r s = 0.61538, P = 0.0032) and claudin-1 (r s = 0.7972, P = 0.0019). Occludin and claudin-1 are up-regulated in the common bile duct epithelium of pediatric PBM patients. MLCK may be involved in the process of up-regulation of the tight junction-associated proteins in PBM.

Background/Aims : Chronic ethanol consumption results in the induction of hepatic cytochrome P4502E1 (CYP2E1) in man, which is believed to play an important role in the pathogenesis of alcoholic liver disease. However, the amount and duration of alcohol intake associated with CYP2E1 induction is not known but limited information is available on the disappearance of CYP2E1 following alcohol withdrawal. Methods : To study these questions, five healthy male volunteers received ethanol daily (40g/day) over 4 weeks. CYP2E1 induction was monitored by using the chlorzoxazone test before and every week following the start of alcohol ingestion. In addition, CYP2E1 was also determined in five alcoholics 1, 3, 8 and 15 days following ethanol withdrawal and in five patients with non-alcoholic liver disease. Results : A significant CYP2E1 induction occurred 1 week following the ingestion of 40g ethanol per day and increased further after 4 weeks. The disappearance of CYP2E1 was found to be significant 3 days following ethanol withdrawal and further decreased up to day 8. Thereafter, no significant change occurred and CYP2E1 activities were comparable with those in patients with non-alcoholic liver disease. Conclusions : These data show a significant and quick induction of CYP2E1 activity, already at moderate alcohol consumption, which may be of importance in the pathogenesis of alcoholic liver disease, of ethanol, drug and vitamin A interactions and in alcohol associated carcinogenesis.

Objective: To report a rare case of brucellosis with myelo-dysplastic syndrome (MDS). Clinical Presentation and Intervention: A 70-year-old woman presented with pancytopenia and fever of unknown origin (FUO). The initial diagnosis was brucellosis; the woman was treated with doxycycline and rifampin against Brucella melitensis but was later diagnosed as suffering from MDS. She was immediately transferred to the Department of Hematology for further evaluation. Conclusion: This study highlights the rarity of brucellosis with MDS, and we recommend that brucellosis with MDS be considered in patients presenting with pancytopenia and FUO.

Mesenchymal hamartomas of the liver (MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography (CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen included intraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg (dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.