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Background: Cervical anastomotic leakage (CAL) is one of the most common complications that occur minimally invasive esophagectomy (MIE). It is associated with high postoperative mortality. Some risk factors still remained controversial and so accurate prediction of risk groups for CAL remained very difficult. This study aimed to identify the risk factors of CAL after McKeown MIE to predict the accuracy of the technique as early as possible. Material and Methods: A total of 129 patients with esophageal cancer who underwent McKeown MIE at the Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, between January 2018 and June 2019 were retrospectively reviewed. Multivariate logistic regression analysis was used to identify the risk factors for CAL and receiver operating characteristic (ROC) curve analysis was used to predict the accuracy for each quantitative data variable and determine the cutoff value. Results: There were statistically significant differences between Group CAL and Group NCAL in FEV1 (p = 0.031), neoadjuvant chemotherapy (p = 0.001), intraoperative minimum PaCO2 (p = 0.002), and hospital stays (p 45.5 mmHg (p = 0.002) demonstrated good accuracy. Conclusion: FEV1, neoadjuvant chemotherapy, and intraoperative minimum PaCO2 in arterial blood gas (ABG) were considered as risk factors of CAL after McKeown MIE for esophageal cancer. Preoperative FEV1 45.5 mmHg in ABG showed good accuracy in predicting risk factors for CAL.

The study focused on the risk factors of postoperative arrhythmia and lung infection and the preventive effects of targeted low-molecular-weight heparin (LMWH) on the occurrence of deep venous thrombosis (DVT) in patients with esophageal/cardia cancer. In this article, 82 patients who were pathologically diagnosed with esophageal/cardia cancer and underwent surgical treatment were selected as the research subjects. According to the different preoperative treatment methods, the patients were divided into the control group (without anticoagulant drugs before the operation, 44 cases) and the anticoagulation group (anticoagulant drugs were administered before the operation, 38 cases), and they were compared for basic clinical indicators and disease history. Logistic regression analysis was performed to analyze the risk factors of adverse events, and the Wells and Autar scale scores were calculated. Different groups were compared for the operation time, blood loss, and postoperative drainage volume during the operation. D-dimer was detected on the first 1, 3, 5, and 7 days after the operation, and the lower extremity venous color Doppler ultrasound was performed on the 1st and 7th days after the operation. The results showed that age ≥65 years, abnormal preoperative ECG, preoperative coronary heart disease (CHD), preoperative chronic obstructive pulmonary disease (COPD), operative time ≥4 h, and preoperative blood sodium P < 0.01 . It suggested that age, preoperative disease history, hospital stay, and operation time were risk factors for postoperative adverse events in patients with esophageal/cardia cancer. The targeted anticoagulant LMWH has a significant preventive effect on the occurrence of lower extremity DVT in patients with esophageal/cardia cancer, providing an effective reference for the prognosis and prevention of esophageal/cardia cancer.

ObjectivesTo develop a radiomics model based on contrast-enhanced CT (CECT) to predict the lymphovascular invasion (LVI) in esophageal squamous cell carcinoma (ESCC) and provide decision-making support for clinicians.Patients and MethodsThis retrospective study enrolled 334 patients with surgically resected and pathologically confirmed ESCC, including 96 patients with LVI and 238 patients without LVI. All enrolled patients were randomly divided into a training cohort and a testing cohort at a ratio of 7:3, with the training cohort containing 234 patients (68 patients with LVI and 166 without LVI) and the testing cohort containing 100 patients (28 patients with LVI and 72 without LVI). All patients underwent preoperative CECT scans within 2 weeks before operation. Quantitative radiomics features were extracted from CECT images, and the least absolute shrinkage and selection operator (LASSO) method was applied to select radiomics features. Logistic regression (Logistic), support vector machine (SVM), and decision tree (Tree) methods were separately used to establish radiomics models to predict the LVI status in ESCC, and the best model was selected to calculate Radscore, which combined with two clinical CT predictors to build a combined model. The clinical model was also developed by using logistic regression. The receiver characteristic curve (ROC) and decision curve (DCA) analysis were used to evaluate the model performance in predicting the LVI status in ESCC.ResultsIn the radiomics model, Sphericity and gray-level non-uniformity (GLNU) were the most significant radiomics features for predicting LVI. In the clinical model, the maximum tumor thickness based on CECT (cThick) in patients with LVI was significantly greater than that in patients without LVI (PPConclusionsThe combined model incorporating radiomics features and clinical CT predictors may potentially predict the LVI status in ESCC and provide support for clinical treatment decisions.

Background: Liver transplant is frequently performed at night due to the unpredictability of organ procurement and reduction of Cold Ischemia Time (CIT). Previous study reported a doubled mortality Hazard Ratio (HR) of early death and increased postoperative complications in nighttime liver transplant. This study aims to evaluate the impact of nighttime operation on patients’ survival and postoperative complications by using meta-analysis. Methods: We performed a systematic review of the PubMed database and identified five eligible studies. Three time points (30 days, 90 days and 1 year) were explored in patients’ survival by using pooled HR. Four types of postoperative complications (vascular, biliary tract, wound and primary graft non-function) were investigated by using pooled Odds Ratio (OR). Publication bias was also performed. Results: Our study results were contradicting with the previous report and yielded no significant difference with a HR=0.98 (95% CI=0.89-1.06) on 30 days, HR=1.12 (95% CI=0.89-1.35) on 90 days and HR=1.07 (95% CI=0.95-1.18) on 1 year in nighttime procedure. Consistent with the result of patients’ survival, no significant result was found in postoperative complications evaluation as well. None of the four complications demonstrated significant result. And we failed to detect any significant publication bias. Conclusions: Based on current evidence, nighttime liver transplantations do not degrade patients’ survival or increase postoperative complications risk compared with daytime operations.

The mobile robot is moved by receiving instructions through wireless communication, and the particle filter is used to simultaneous localization and mapping. Aiming at the problem of the degradation of particle filter weights and loss of particle diversity, which leads to the decrease of filter accuracy, this paper uses the plant cell swarm algorithm to optimize the particle filter. First of all, combining the characteristics of plant cells that affect the growth rate of cells when the auxin content changes due to light stimulation realizes the optimization of the particles after importance sampling, so that they are concentrated in the high-likelihood area, and the problem of particle weight degradation is solved. Secondly, in the process of optimizing particle distribution, the auxin content of each particle is different, which makes the optimization effect on each particle different, so it effectively solves the problem of particle diversity loss. Finally, a simulation experiment is carried out. During the experiment, the robot moves by receiving control commands through wireless communication. The experimental results show that the algorithm effectively solves the problem of particle weight degradation and particle diversity loss and improves the filtering accuracy. The improved algorithm is verified in the simultaneous localization and mapping of the robot, which effectively improves the robot’s performance at the same time positioning accuracy. Compared with the classic algorithm, the robot positioning accuracy is increased by 49.2%. Moreover, the operational stability of the algorithm has also been improved after the improvement.

Background: Esophageal cancer (EC) is a common human malignancy worldwide. Esophageal squamous cell carcinoma (ESCC) is the predominant subtype in China. The tumorigenesis mechanism in ESCC is unclear. The aim of this study was to identify key transcription factors (TFs) in ESCC and elucidate the mechanism of it. Methods: A total of ten published microarray datasets of ESCC was downloaded from the Gene Expression Omnibus (GEO). Then, bioinformatics analyses including differentially expressed genes (DEGs) analysis, gene ontology (GO) annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, TFs-genes regulatory network construction was performed. Quantitative real-time polymerase chain reactions (qRT-PCR) were used to detect the expression levels of TFs and DEGs in ESCC. The association between stage and TFs and the association between survival and TFs were evaluated based on The Cancer Genome Atlas (TCGA), respectively. Results: A total of 1,248 dysregulated genes were selected as DEGs in ESCC. A total of 26 TFs and corresponding target-genes were identified. The ESCC-specific transcriptional regulatory network was constructed. The network was consisted of 882 edges and 631 nodes. BRCA1, SOX10, ARID3A, ZNF354C and NFIC had the highest connectivity with DEGs, and regulated 92, 89, 82, 79 and 78 DEGs in the network, respectively. All these 1,248 DEGs were significantly enriched in cell cycle, DNA replication and oocyte meiosis pathways. The qRT-PCR results were consistent with our microarray analysis. High expression of SREBF1 and TFAP2A were significantly correlated with the longer overall survival time of patients with ESCC. Conclusions: BRCA1, SOX10, ARID3A, ZNF354C and NFIC might be the key TFs in carcinogenesis and development of ESCC by regulating their corresponding target-genes involved in cell cycle, DNA replication and oocyte meiosis pathways. SREBF1 and TFAP2A may be two potential prognostic biomarkers of ESCC.

Objective. Esophageal carcinoma (EC) is a frequently common malignancy of gastrointestinal cancer in the world. This study aims to screen key genes and pathways in EC and elucidate the mechanism of it.Methods. 5 microarray datasets of EC were downloaded from Gene Expression Omnibus. Differentially expressed genes (DEGs) were screened by bioinformatics analysis. Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein-protein interaction (PPI) network construction were performed to obtain the biological roles of DEGs in EC. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to verify the expression level of DEGs in EC.Results. A total of 1955 genes were filtered as DEGs in EC. The upregulated genes were significantly enriched in cell cycle and the downregulated genes significantly enriched in Endocytosis. PPI network displayed CDK4 and CCT3 were hub proteins in the network. The expression level of 8 dysregulated DEGs including CDK4, CCT3, THSD4, SIM2, MYBL2, CENPF, CDCA3, and CDKN3 was validated in EC compared to adjacent nontumor tissues and the results were matched with the microarray analysis.Conclusion. The significantly DEGs including CDK4, CCT3, THSD4, and SIM2 may play key roles in tumorigenesis and development of EC involved in cell cycle and Endocytosis.

Objective Research purpose: This research aims at giving an comprehensive summary of the current situation of physical training of Chinese ice hockey team and helps to grasping the key points of their physical training, innovating the specific training methods, and improving the competitive performance of sports teams. Methods Research methods: “Literature research” is the main method of this research. The authors have consulted CNKI, WWW, Wiper net, Knowledge Base of Sports Resources, EBSCO host and some other databases and analyzed 45 valuable articles in total. Results Research result: The research results can be analyzed from three aspects--physical stamina requirement of players, training theories or methods, and physical fitness evaluation of players. 1 Physical stamina requirement of players Ice hockey is an aperiodic sport with a repeated alternately of high, medium and low intensity, which is characterized by intermittent high intensity exercise and high antagonism. The sports’ mode is 70: 2: 30, which means players have 70 seconds to play and two minutes to rest each time, and the whole match will take 30 minutes. The blood urea, creatine kinase and serum testosterone of players will significantly change after the competition. Most of their heart rate will be above 70 percent of the maximum rate and some athletes’ blood lactic acid value will reach to 17.1 mmol / L. Therefore physical stamina training is necessary for them. 2 Training theories or methods 2.1 Characteristics of physical training load and periodicity Athletes’ physical training presents periodic changes. Specifically, their competitive state presents a pattern of formation, maintenance and temporarily fading with the change of training load. According to the theory of cycle and the principle of competitive sports training, some domestic researchers have established an annual cyclical training structure for the national women hockey team, and have achieved ideal results in practice. The annual cyclical training structure consists of 5 levels, 3 periods, 7 phases, 9 middle cycles and several different types of small cycles. In preparation for the 21st Vancouver Winter Olympics, the national women hockey team have accepted 482.5 hours physical training , accounting for 47 percent of the total training volume. 2.2 Strength quality The special strength of ice hockey consists of maximum strength, speed strength and endurance strength. Both land and ice strength training are included, which have their own advantages and disadvantages. During the preparation period, Canadian fast strength training method, which is a kind of land strength training, can be used in general strength training stage, and the combination of land and ice training methods can be adopted in special strength training stage. And the method of simulating competition scene with the combination of special tactics is usually needed for the purpose of developing special strength. Step compression, impact exercise, waist load and skate weighting can effectively enhance the special strength while hooting strength requires special training methods. 2.3 Speed quality The speed of ice hockey include “simple and complex reaction speed”, “thinking process speed”, “starting speed”, “paragraph speed”, “fast braking of action”, “fast completion of technical action and convergence speed of action”. Therefore speed training should strictly control the training mode, frequency, interval time, and the stability of speed and the mechanism of energy metabolism system should be considered firstly. The usually methods are: repeated training, speed changing training, race and game training. 2.4 Endurance quality The endurance quality of hockey athletes consists of general endurance and special endurance quality. The general endurance training mainly needs aerobic methods, while the specific endurance training includes aerobic and anaerobic mixed training, anaerobic phosphate training and anaerobic glycolysis training. Endurance training is carried out at all stages of the season and both ice training and land training are needed. Methods of developing general endurance include uniform running, intermittent running, fartleke running, swimming and ball games. 3 Assessment and diagnostic methods of ice hockey player The physical fitness of athletes is mainly monitored by testing method, which mainly tests general physical fitness and special physical fitness, and such tests are carried out at different stages. There are also researchers on the physical characteristics of athletes in aspects of the body shape, function and quality . Conclusions Research conclusion:The purpose of ice hockey physical training is to improve sports performance, enhance energy supply ability of metabolic system, and reduce injury. Such training should accord with its special characteristics and adopt the periodic training structure arrangement. And also should focus on the strength, speed, endurance, reasonable proportion of training arrangement on ice and land. The current physical fitness evaluation which includes general and special physical fitness still needs further study.

This study aims to assess the early effects of operatively and nonoperatively managed vertebral compression fractures (VCFs) in elderly polytrauma patients. A multi-center retrospective cohort study of operative treatment [vertebroplasty (VP) or kyphoplasty (KP)] versus nonoperative treatment (bed rest). A total of 40 patients received operative treatment and 59 patients received nonoperative treatment. The mean length of hospital stay was 15.53 ± 6.994 days in the operative and 19.54 ± 12.012 days in the nonoperative group (P = 0.039). The incidence of complication was higher in the nonoperative group than the operative group (P = 0.009), especially the incidence of bed rest complication (P = 0.024). Mortality rate was not significant difference between two groups (P = 0.172). For VCFs in elderly polytrauma patients, VP or KP can reduce length of hospital stay and complications, especially bed rest complication compared with nonoperative treatment.

The aim of this study was to compare the efficacy between SBRT and surgery based on the Propensity-Matched Analysis.Publications on comparison SBRT and Surgery for early stage non- small cell lung cancer (NSCLC) from 2011 to 2017 were collected. Propensity score matching was used to achieve comparable treatment hazard ratios of the overall survival (OS), local control survival (LC), regional control survival (RC), loco-regional control survival (LRC), distant control survival (DC), disease-free survival (DFS), and progression-free survival (PFS) between SBRT and Surgery. The major outcomes measures were hazard ratios (HRs). Meta-analysis Revman 5.3 software was used to analyze the combined Pooled HRs using fixed- or random-effects models according to the heterogeneity.Eleven studies met our inclusion criteria. The LC, L-R C, DC, DFS and PFS rates of patients with early-stage lung cancer who were treated with SBRT are equal to surgical results. While, patients with surgery achieved superior OS compared with SBRT.In this study we carried out a meta-analysis, which controls the acceptable level of the efficacy in the propensity score to match patients. The surgery had obvious OS advantages in this meta-analysis. However, these conclusions would be proven by further studies incorporating comorbidity data, and outcomes from randomized control study. The final decision for the optimal treatment of a patient with early-stage NSCLC can be substantiated by a personalized treatment model.

With the ever increasing global energy demand and diminishing petroleum reserves, current advances in drilling technology have resulted in numerous directional wells being drilled as operators strive to offset the ever-rising operating costs. In as much as deviated-well drilling allows drillers to exploit reservoir potential by penetrating the pay zone in a horizontal, rather than vertical, fashion, it also presents conditions under which the weighting agents can settle out of suspension. The present work is categorized into two parts. In the first part, governing equations were built inside a two-dimensional horizontal pipe geometry and the finite element method utilized to solve the equation-sets. In the second part, governing equations were built inside a three-dimensional horizontal annular geometry and the finite volume method utilized to solve the equation-sets. The results of the first part of the simulation are the solid concentration, mixture viscosity, and a prediction of the barite bed characteristics. For the second part, simulation results show that the highest occurrence of barite sag is at low annular velocities, nonrotating drill pipe, and eccentric drill pipe. The CFD approach in this study can be utilized as a research study tool in understanding and managing the barite sag problem.

With the increment of the oil-field extract strength and the pipeline infusion load, the pipeline damage had become more serious and the effective use of cycle got shorter. Pipeline damage mainly appeared pipeline corrosion. The pipeline corrosion mainly occured in the place of pipe's repaired mouth and mending of blemishes. In this paper, through failure analysis of the pipe's Heat Shrinkable Wraparound Sleeve (HHWS) repaired mouth, we found the failure modes and failure causes of the repaired mouth of the existing pipeline and new pipeline, and grasped the failure mechanism. Then, improvement measures and suggestions were proposed to prevent failure, ensure safety, improve quality of the pipe's repaired mouth, slow or prevent pipeline corrosion and extend pipeline life.

Objective: The aim of this study was to evaluate the effect of anti-osteoporosis treatment on radiological and functional results following anterior cervical discectomy and fusion (ACDF). Methods: Medical records of 59 patients (Mean age 68.1 years, 36 males and 23 females) who had ACDF surgery between January 2010 and December 2013 were retrospectively reviewed. Antiosteoporotic treatment group consisted of 31 patients and non-antiosteoporotic treatment group consisted of 28 patients. The height of intervertebral space (HIS), cervical alignment (CA), segmental angle (SA), and Visual Analogue Scale (VAS) were compared between the groups, preoperatively, postoperatively, and at final follow-up. Results: There were significant differences at final follow-up between the 2 groups in SA (p=0.03), HIS (p=0.03), and VAS (p=0.03) for upper limb pain, in favor of antiosteoporotic treatment. Conclusion: Anti-osteoporotic treatment appear to improve the radiological and functional results following following anterior cervical discectomy and fusion.

In this paper, we demonstrated a data-rate-regulable laser communication system model with moderate data rate which can be up to several hundred kilobits per second (kbps) while data rate is regulable. We use continuous-wave (cw) blue laser (λ =443nm) which can be driven with TTL-level as the transmitter. Although continuous-wave (cw) blue laser are readily available, they cannot be easily modulated at high frequency (less than 2 MHz). After comparing the current commonly used modulation method of optical communication and specially analyzed the key technology for underwater/undersea wireless optical communication (UWOC) according to the situation of our lab. We put forward an improved "return to zero" On-Off Keying (RZ-OOK) modulation method to complete the UWOC system model. The improved RZ-OOK modulation method is easier and more flexible in some cases.

With the increasing acceptance of cloud data center and virtualization technology by enterprises and industries, the security concern becomes the key hindrance to the development and deployment of cloud computing. Security auditing is a good way to deal with the threats faced by a cloud data center. But traditional auditing is no longer suitable for the new cloud environment. In this paper, we design, implement and evaluate the CDCAS, a novel cloud data center auditing system, which matches the demand of the scalability and efficiency of a cloud data center. In this system, we design one distributed and autonomous agent model which can be controlled by a set of rules dynamically generated to fit its use scenario. We then build the log analysis model which uses the signature based method and correlative analysis algorithm to extract security events from collected log with agreeable false positives. We evaluate our system both on real world and simulation to validate its efficiency. And our system is also deployed by the cloud data center of a well-known financial institution, and performs well.

The goal for treating osteoarthritis (OA) is finding ways to decrease joint pain and dysfunction and prevent and slow the cartilage degeneration. Extracorporeal shock-wave therapy (ESWT) has been found to improve motor dysfunction and ameliorate pain with OA in animals. However, few studies have found that it can prevent and slow joint degeneration in vivo. The aim of study was to investigate the effect of ESWT on OA in rabbit.A total of 30 male New Zealand white rabbits were divided into 3 groups: control, OA induced by anterior cruciate ligament transaction (ACLT), and ALCT plus ESWT. The animals were killed at 4 and 8 weeks. Nitric oxide (NO) level was measured in the synovial cavity of knee joints, and cartilage sections were graded macroscopically by a Mankin scoring system. Chondrocyte apoptosis was investigated by flow cytometry and the expression of active caspase 3 by indirect immunohistochemistry.ESWT significantly reduced the NO level in the synovial cavity of knee joints (P0.05) and chondrocyte apoptosis (P0.05) of rabbits with OA. ESWT treatment significantly decreased the severity of cartilage lesions at both times as compared to rabbits with OA alone (P0.05).ESWT reduced the progression of OA in rabbits. This effect may be related to decreased level of NO and is likely mediated by reduced chondrocyte apoptosis. ESWT may be a useful treatment for knee OA.

To evaluate the predictive capabilities of K-E turbulence models, three turbulence models (the standard K-E model, the RNG K-E model and the Realizable K-E model) in conjunction with a fully-developed boundary condition and a standard wall function were applied to the prediction of a fully-developed two-dimensional jet impinging within a semi-confined space. The convection term and the dissipation term in the control equations were discretized by Second Order Upwind scheme and Central Differencing scheme. The numerical results, including the time-averaged velocities and the turbulence intensities, were compared with the experimental data reported by Yoshida. It was found that the numerical results were in qualitative agreement with the experimental data. The differences between the numerical and experimental results can be attributed to the fundamental assumptions of the turbulence models, experimental error and the treatment of the low Reynolds number zone near the impingement wall.