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Aims: To investigate the diagnostic value of dual-energy computed tomography (DECT) in Acute Gouty Arthritis (AGA) or patients presenting suspected gouty arthritis. Methods: This retrospective study was performed in a single centre from May 2017 to August 2018. Two hundred and twenty-six patients with an initial diagnosis of AGA in the preceding 15 days were included. All patients were referred for a DECT scan of the affected joints. The diagnosis criteria of gout with the American College of Rheumatology Classification Standard were regarded as the reference standard. Results: After filtration, two hundred patients were included in the present study. The sensitivity, specificity, positive predictive value, and negative predictive value of DECT in the diagnosis of all AGA were 83.83%, 60.61%, 91.5%, and 42.55%, respectively. When AGA was subdivided according to the joint site, the sensitivity, specificity, positive predictive value, and negative predictive value were 80.68%, 61.11%, 91.03%, and 39.29% in feet, 93.55%, 40%, 93.55%, and 40% in knees and 87.5%, 71.43%, 91.3%, and 62.5% in ankles, respectively. Conclusions: DECT had a high sensitivity for the diagnosis of AGA. However, the specificity was limited, particularly for the diagnosis of acute gouty knee arthritis. Prospective multicenter studies of large samples will enhance the application of DECT among AGA patients in the future.

Background The study sought to compare Coronary Artery Disease Reporting and Data System (CAD-RADS) classification with traditional coronary artery disease (CAD) classifications and Duke Prognostic CAD Index for predicting the risk of all-cause mortality in patients with suspected CAD. Methods 9625 consecutive suspected CAD patients were assessed by coronary CTA for CAD-RADS classification, traditional CAD classifications and Duke Prognostic CAD Index. Kaplan–Meier and multivariable Cox models were used to estimate all-cause mortality. Discriminatory ability of classifications was assessed using time dependent receiver-operating characteristic (ROC) curves and The Hosmer–Lemeshow goodness-of-fit test was employed to evaluate calibration. Results A total of 540 patients died from all causes with a median follow-up of 4.3 ± 2.1 years. Kaplan–Meier survival curves showed the cumulative events increased significantly associated with CAD-RADS, three traditional CAD classifications and Duke Prognostic CAD Index. In multivariate Cox regressions, the risk for the all-cause death increased from HR 0.861 (95% CI 0.420–1.764) for CAD-RADS 1 to HR 2.761 (95% CI 1.961–3.887) for CAD-RADS 4B&5, using CAD-RADS 0 as the reference group. The relative HRs for all-cause death increased proportionally with the grades of the three traditional CAD classifications and Duke Prognostic CAD Index. The area under the time dependent ROC curve for prediction of all-cause death was 0.7917, 0.7805, 0.7991for CAD-RADS in 1 year, 3 year, 5 year, respectively, which was non-inferior to the traditional CAD classifications and Duke Prognostic CAD Index. Conclusions The CAD-RADS classification provided important prognostic information for patients with suspected CAD with noninvasive evaluation, which was non-inferior than Duke Prognostic CAD Index and traditional stenosis-based grading schemes in prognostic value of all-cause mortality. Traditional and simplest CAD classification should be preferable, given the more number of groups and complexity of CAD-RADS and Duke prognostic index, without using more time consuming classification.

Background: To explore the effects of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of HCC patients with Portal Vein Tumor Thrombus (PVTT) undergoing resection, and to develop a PA-TACE-related nomogram for predicting survival individually. Patients and Methods: Two hundred and ninety-three consecutive HCC patients with PVTT under R0 hepatectomy were recruited. Forty-seven cases had recurrence within one month after surgery. The remaining 246 cases consisted of 90 PA-TACE and 156 non-PA-TACE cases. COX regression analysis was performed for overall survival (OS) or recurrence-free survival (RFS) of these 246 cases, allowing the derivation of independent factors that were integrated into the nomogram. C-index, calibration curves, and risk stratification were performed to evaluate the performance and discriminative power of the nomograms. Results: In 246 patients without recurrence within one month after surgery, the OS and RFS for the PA-TACE group were significantly better than those for the non-PA-TACE group (P

Hoverable Flapping Wing Micro Air Vehicle (FWMAV) is a new concept aircraft which imitates the flight mode of hummingbirds or insects. It has excellent mobility, flexibility, concealment, and can demonstrate hovering, forward flight and other maneuvers, which has attracted wide attention. In this research, a prototype of hoverable FWMAVs is designed and built for the research of control method, and the research on flight attitude estimation and attitude control algorithm are carried out. The hardware devices such as flight control board and remote control are designed and developed independently, also we devised the software control system to realize the communication between software and hardware, then the algorithm is verified on the experimental platform. The prototype of the aircraft weighs 27.24g, and can take off under the flapping frequency of 20Hz. On the experimental platform, relying on the hardware control circuit and software control algorithm, it can realize the attitude control of roll and pitch, and demonstrate hovering flight for two minutes.

Background: The coronary artery disease reporting and data system (CAD-RADSTM) was recently introduced for standard reporting. We aimed to evaluate the utility of an automatic post-processing and reporting system based on CAD-RADS in suspected CAD patients.Methods: The clinical evaluation was encompassed 346 patients who underwent coronary computed tomography angiography (CCTA). We compared deep learning (DL)-based CCTA with Readers for classification of CAD-RADS with commercially-available automated segmentation and manual post-processing in a prospective validation cohort. Results: Compared with invasive coronary angiography (ICA), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of DL model for diagnosis of CAD were 79.02%, 86.52%, 89.50%, 73.94% and 82.08%, respectively. There was no significant difference between the DL-based and Readers-based CAD-RADS grading in CCTA. The consistency test showed that the Kappa value between the model and Readers was 0.775 (95% CI: 0.728-0.823, P < 0.001), 0.802 (95% CI: 0.756-0.847, P95% CI: 0.750-0.843, P < 0.001), respectively. This system reduces the time consumed from 14.97 ± 1.80 min to 5.02 ± 0.8 min (P < 0.001).Conclusion: The standardized report of DL-based CAD-RADS in CCTA can accurately evaluate suspected CAD patients with time-saving, and has good consistency with the radiologists.

Background: Nonalcoholic fatty liver disease has attracted considerable attention with continuously increasing morbidity. Objective: To evaluate the aortic distensibility in patients with non-diabetic and hypertension-type Nonalcoholic Fatty Liver Disease (NAFLD) through Dual-Source Computed Tomography (DSCT). Method: 120 patients with NAFLD (experimental group) and 30 healthy subjects (control group) were consecutively enrolled in the study. In the two groups, aortic distensibility was calculated as D = ΔA/(A0 ×Δp). Record fasting insulin, fasting blood glucose, fasting lipid status, age, heart rate, waist circumference, systolic blood pressure, and diastolic blood pressure. Calculate homeostasis model assessment of insulin resistance (HOMA-IR) and Body Mass Index (BMI). A comparative analysis between the two groups was carried out, followed by a correlation analysis between D value and risk factors. Results: D value and liver attenuation of the patients in the NAFLD group were significantly reduced relative to those in the control group (2.24±0.63×10-3 mmHg-1 vs. 3.19±0.86×10-3 mmHg-1, P Conclusion: Patients with NAFLD suffer from a reduction in aortic distensibility, and insulin resistance may play a significant role in the early atherosclerosis stage.

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 μg/mL (interquartile range [IQR] 1.90-14.31 μg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 μg/mL; IQR, 7.12-21.66 vs median, 2.44 μg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.

This study sought to evaluate the association of breast arterial calcification (BAC) on breast screening mammography with the Coronary Artery Disease-Reporting and Data System (CAD-RADS) based on Deep Learning-coronary computed tomography angiography (CCTA). This prospective single institution study included asymptomatic women over 40 who underwent CCTA and breast cancer screening mammography between July 2018 and April 2019. CAD-RADS was scored based on Deep Learning (DL). Mammograms were assessed visually for the presence of BAC. A total of 213 patients were included in the analysis. In comparison to the low CAD-RADS (CAD-RADS P = 0.036), diabetes (P = 0.017), and chronic kidney disease (P = 0.006). They also had a significantly higher level of LDL-C (P = 0.024), while HDL-C was lower than in the low CAD-RADS group (P = 0.003). BAC was also significantly higher in the high CAD-RADS group (P = 0.002). In multivariate analysis, the presence of BAC [odd ratio (OR) 10.22, 95% CI 2.86–36.49, P

To study chest CT images and clinical characteristics of COVID-19 pneumonia in pregnant patients to examine any correlation.Between December 31, 2019 and March 7, 2020, 23 hospitalized pregnant patients with confirmed COVID-19 were enrolled in the study. Clinical presentations were collected retrospectively from records, including laboratory testing, chest CT imaging, and symptoms. Descriptive analysis and correlation of patients' clinical and CT characteristics were performed. Laboratory results from time of first admission and CT absorption (defined as reduction in lesion area, decrease in density, and absorption of some solid components) were compared between symptomatic and asymptomatic patients.Fifteen (65.2%) patients were asymptomatic with patchy ground-glass opacity in a single lung lobe. Eight (34.8%) patients were symptomatic with multiple patchy ground-glass shadows, consolidation, and fibrous stripes. Differences in lymphocyte percentage and neutrophil granulocyte rate between first admission and CT absorption were significant (P0.001). Median absorption time was shorter in the asymptomatic group compared with the symptomatic group (5 vs 10 days; P0.001). Median hospitalization time between asymptomatic and symptomatic patients was 14 vs 25.5 days; P0.001. Median absorption time and length of hospitalization for all patients was 6 days (IQR 5-8) and 17 days (IQR 13-25), respectively.Radiological findings and clinical characteristics in pregnant women with COVID-19 were similar to those of non-pregnant women with COVID-19. Median absorption time and length of hospitalization in asymptomatic patients were significantly shorter than in symptomatic patients. Lymphocyte percentage and neutrophil granulocyte rate may be used as laboratory indicators of CT absorption.

A new method to reduce the stimulated Raman scattering (SRS) in inertial confinement fusion conditions is proposed by changing the incident light phase discretely. The proposal is first examined by three-wave coupling equations and then verified by Vlasov simulations. A remarkable decreasing in SRS reflectivity is observed when the period of phase changing is less than 2 π / γ , where γ is the growth rate of SRS. By contrast, some simulations with continuously changing phase of incident light are carried out to compare their influence on SRS. In addition, the proposal may suppress the stimulated Brillouin scattering.

The physical simulation system is an important means to study the mechanism of coal and gas outburst. The small- and medium-sized coal and gas outbursts account for the largest proportion in China. So, the paper focuses on small- and medium-sized coal and gas outbursts based on key physical rules and their statistical characteristics. According to the geometric parameters statistical data of more than 100 caverns, the proportion of outburst caverns whose depth is less than 5 m is 80%, and whose depth is more than 6 m is 13%. The ratio of depth and cavern outlet’s diameter is 2.58–7.31. There are statistical relationship of 2 times between coal’s and cavern’s volume, and between gas emission volume per ton and gas content in seam. Then, the cavern of coal and gas outburst is simplified as an ellipsoid, and the shape of cavern outlet is simplified as a circle. The cavern’s and the prototype’s geometrical parameters of small and medium coal and gas outbursts were deduced. The depth of cavern is 5 m, width is 4 m, and diameter of cavern outlet is 0.68–1.94 m. The depth of coal and outburst prototype is 12.3 m, width is 6.5 m, and diameter of cavern outlet is 0.68 m. In order to guarantee the movement similarity, according to the relationships among statistical data of outburst coal particle’s size, cavern outlet’s size, and height of tunnel, the minimum cavern outlet’s size was calculated. Select 10 times the coal particle’s size (5 mm) as the smallest size. Then, maximum geometric similarity ratio of coal and gas outburst was deduced, and it is 13.6. The minimum geometrical parameters of coal and outburst similar model were obtained. Its depth is 0.9 m, width is 0.48 m, and diameter of cavern outlet is 50 mm. According to the results, the physical simulation system was developed. The results provide support to carry out physical simulation experiment of coal and gas outburst.

Background: Elevated level of D-dimer was reported in some patients with COVID-19 pneumonia on admission, especially in severe COVID-19 patients However, it wa

Background: Left ventricular diastolic dysfunction (LVDD) is a common abnormality among patients in T2DM. Aim: We aimed to evaluate the feasibility of coronary computed tomography angiography (CCTA) for the assessment of LVDD in type 2 diabetes mellitus (T2DM) patients. Methods: 80 consecutive T2DM patients who were referred for a clinically dual-source CCTA examination to evaluate suspected coronary artery disease and also underwent 2D echocardiography within 7 days of CCTA inclusion and exclusion criteria, were performed. Correlation between CCTA and echocardiography was tested through linear regression and Bland-Altman analysis. Results: In total, 60 T2DM patients were included for the analysis. Pearson correlation showed good correlation for E (r = 0.28; P = 0.028), E/A (r = 0.69; P < 0.01); E (r = -0.06; P = 0.776), E/A (r = 0.54; P = 0.003) and E (r = 0.64; P < 0.01), E/A (r = 0.83; P < 0.01) in three groups, respectively. Overall, diagnostic accuracy for assessment in CCTA of diastolic dysfunction was 79.76% (95% CI: 68%-91%), 71.43% (95% CI: 58%-85%) and 87.50 (95% CI: 79%-96%) in three groups. Conclusion: The presented study proved that CCTA showed good correlations in the estimation of LV filling pressures compared with echocardiography in T2DM patients. Accordingly, retrospectively ECG-gated CCTA may provide valuable information on the evaluation of LVDD in T2DM patients.

The dynamic characteristics of gas flow are often not considered in the simulation test for coal and gas outburst, making coal-like materials hard to meet the required similarity. To solve this issue, based on previous studies on the physical and mechanical properties of coal-like materials and the characteristics of gas adsorption and emission, we investigated the deformation and gas flow characteristics of coal-like materials under triaxial stress conditions using a triaxial servo-controlled seepage equipment for thermo-fluid-solid coupling of coal containing methane. Analysis of the experimental data revealed the relationship of their stress to strain as well as the relationship of their permeability to principal stress difference and strain. In addition, a coal-like material with best seepage dynamic flow characteristics was chosen and its corresponding preparation Scheme 1 was used as the preferable scheme for preparation of class V dangerous seam. The results provide a new idea and research method for further refining preparation of materials similar to coal and gas outburst seam.

Effective chemotherapy remains an important issue in the treatment of drug resistant cancer. The aim of the present study was to establish novel polymeric nanoparticles composed of the antitumor drug, doxorubicin (DOX), and an inhibitor of the drug efflux pump‑associated protein, P‑glycoprotein (P‑gp), in order to overcome drug resistance in tumor cells. Poly(D,L‑lactide‑co-glycolide) (PLGA), DOX‑loaded PLGA (PLGA‑DOX), P‑gp inhibitor (cyclosporin A; CsA)‑coated PLGA (PLGA‑CsA) and DOX and CsA co‑loaded PLGA (PLGA‑DOX‑CsA) nanoparticles were prepared using solvent evaporation. The size distribution, ζ potential and electron microscopy observations of the nanoparticles were character- ized. Accumulation and efflux assays were performed using confocal and fluorescence‑activated cell sorting (FACS), and the pump activity of P‑gp was detected through FACS. The uptake of the nanoparticles and the viability of Taxol-resistant A549 cells treated with various nanoparticles were analyzed via FACS in vitro. Furthermore, the tumor growth and survival rates of A549‑Taxol‑bearing mice were monitored in vivo. Prepared particles were nanosized and the efflux rates of PLGA‑DOX and PLGA‑DOX‑CsA were signifi- cantly decreased compared with the free DOX. Drug efflux pump activity was effectively inhibited by the PLGA‑CsA and PLGA‑DOX‑CsA groups compared with the PLGA, PLGA‑DOX and free DOX groups. Cell viability results demonstrated that PLGA‑DOX and PLGA‑DOX‑CsA induced the increased death of A549‑Taxol cells. In vivo tumor models demonstrated that PLGA‑DOX and PLGA‑DOX‑CsA mark- edly inhibited the tumor growth and improved the survival rate of A549‑Taxol‑bearing mice. Antitumor drug and drug efflux pump inhibitor co‑loaded nanoparticles offer advan - tages to overcome the drug resistance of tumors and highlight new therapeutic strategies to control drug resistant tumors.