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To improve the throughput performance of the autonomous guide vehicle (AGV) unmanned storage system, a two-stage mathematical model was established. The model also considers the equipment configuration of the AGV unmanned storage system and the AGV- picking stations dual resource coordination scheduling problem. In the equipment-task scheduling phase, the model aims at the shortest order completion time, while the equipment configuration and layout model aims at the minimum equipment configuration and operating cost. To solve the two-stage model, a two-layer genetic algorithm was designed. The inner layer algorithm was used to optimize the task scheduling order of AGVs and picking stations. The results of the inner layer algorithm are fed back to the outer model to optimize configuration of the equipment and the picking station’s layout. The inner and outer loops are combined to obtain the optimal equipment configuration scheme. Through the simulation study of an enterprise AGV unmanned storage case, the optimal equipment configuration combination and picking stations layout scheme are obtained. Compared with the equipment configuration scheme based on the principle the task scheduling in operation is another key link that affects the picking efficiency of an unmanned warehouse of random task scheduling and the principle of shortest job time first; The model can improve the efficiency of warehouse retrieval and minimize the number of equipment configurations. Finally, the improved genetic algorithm is used to solve the model, and the performance is compared with that of LINGO to verify the effectiveness of the improved algorithm.

SummaryBackgroundIt has been reported that several cases recovered from COVID-19 tested positive for SARS-CoV-2 after discharge (re-detectable positive, RP), however the clinical characteristics, significance and potential cause of RP patients remained elusive.MethodsA total of 262 COVID-19 patients were discharged from January 23 to February 25, 2020, and were enrolled for analysis of their clinical parameters. The RP and non-RP (NRP) patients were grouped according to the disease severity during their hospitalization period. The clinical characterization at re-admission to the hospital was analyzed. SARS-CoV-2 RNA and plasma antibody levels were detected using high-sensitive detection methods.FindingsUp to March 10, 2020, all of patients were followed up for at least 14 days, and 38/262 of RP patients (14.5%) were present. The RP patients were characterized by being less than 14-years old and having mild and moderate conditions as compared to NRP patients, while no severe patients became RP. Retrospectively, the RP patients displayed fewer symptoms, more sustained remission of CT imaging and earlier RNA negative-conversion but similar plasma antibody levels during their hospitalization period as compared to those NRP patients. When re-admitted to the hospital, these RP patients showed no obvious clinical symptoms or disease progression indicated by normal or improving CT imaging and inflammatory cytokine levels. All 21 close contacts of RP patients were tested negative for SARS-CoV-2 RNA, and no suspicious clinical symptoms were reported. However, 18/24 of RNA-negative samples detected by the commercial kit were tested to be positive for virus RNA using a hyper-sensitive method, suggesting the carrier status of virus possibly existed in patients recovered from COVID-19.InterpretationOur results showed that young and mild COVID-19 patients seem to be RP patients after discharge, who show no obviously clinical symptoms and disease progression upon re-admission. More sensitive RNA detection methods are required to monitor these patients during follow-up. Our findings provide empirical information and evidence for the effective management of COVID-19 patients during their convalescent phase.

Background: This study was designed initially to explore the effect of chemoradiotherapy on patients diagnosed with head and neck cancer (HNC) with respect to the alteration of systematic immunity. Methods: We did a retrospective study enrolling patients received concurrent chemoradiotherapy (CCRT), with or without induction chemotherapy (IC). Blood tests were performed before IC, before and after CCRT. Flow cytometric analysis and turbidimetric inhibition immunoassay were used for detection. Results: A total number of 58 patients were included from April 1, 2018, to March 31, 2019. Levels of immunoglobulins (Ig), including IgA, IgG, and IgM, declined after 2 to 3 cycles of IC and CCRT, respectively. Serum level of total hemolytic complement (CH50) increased ( P < .001) after IC, but kept stably post-CCRT. Natural killer (NK) cells decreased ( P < .01) after IC and enhanced ( P < .001) post-CCRT. The number of CD3+CD4+ T cells got increased ( P < .01) after IC and decreased ( P < .001) post-CCRT. Consistently, both IC and CCRT induced the increase in CD3+CD8+ T cells significantly ( P < .001 vs P < .01). Conclusion: Both radiotherapy (RT) and chemotherapy (CT) induced dual effect of immune response. Concurrent chemoradiotherapy created an active immune response based on the effect induced by IC, suggesting that RT exerted a potential function on mobilizing immune system.

Background: Hepatocellular carcinoma (HCC) patients diagnosed with the same clinic stage by Barcelona Clinic Liver Cancer (BCLC) system show different prognosis due to coexistence of inflammation and tumor heterogeneity. Here, we aimed to seek for inflammation-related molecular biomarkers for accurately predicting diagnosis and prognosis of HCC. Methods: In this multicenter and retrospective analysis, we included 516 patients with HCC from three Chinese hospitals: Nanfang Hospital (Guangzhou, China), Zhujiang Hospital (Guangzhou, China) and Yuebei Hospital (Shaoguan, China). COMMD10 was screened out from inflammation-induced HCC using real-time PCR analysis. Nomogram based on COMMD10 and BCLC stage was established and validated. The predictive accuracy and discriminative ability of the nomogram was determined by concordance index and calibration curve. The primary endpoint was overall survival (OS). In vitro and in vivo assays were performed to investigate the role of COMMD10 in HCC. The potential molecular mechanisms of COMMD10 were determined by luciferase assay, immunofluorescence, immunoprecipitation. Findings: The nomogram based on COMMD10 and BCLC stage yielded more accuracy than BCLC stage alone for predicting OS of HCC patients in multicenter cohorts. COMMD10 can stratify early-stage HCC (BCLC stage 0 and A) patients into two risk groups with significantly different OS. Mechanistically, COMMD10 suppressed proliferation in vitro and in vivo by interacting with Rel homology domain of p65 and potentiating apoptosis by modulating Bcl-2/Bax/caspase-9/3 pathway in HCC. Interpretation: COMMD10 is a powerful prognostic biomarker and values up BCLC staging to predict OS for HCC, especially for identifying early-stage HCC patients who could benefit from individual therapy. Funding Statement: This work was supported by the National Natural Science Foundation of China [NO.81672992,81602685]; the Natural Science Foundation of Guangdong Province [NO. 2017A030313486]. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: This study was approved by the Ethics Committee of Nanfang Hospital of Southern Medical University, and all participants provided written informed consent prior to surgery. It also conforms to the provisions of the Declaration of Helsinki.

Background: The characteristics, significance and potential cause of positive SARS-CoV-2 diagnoses in recovered coronavirus disease 2019 (COVID-19) patients post discharge (re-detectable positive, RP) remained elusive. Methods: A total of 262 COVID-19 patients discharged from January 23 to February 25, 2020 were enrolled into this study. RP and non-RP (NRP) patients were grouped according to disease severity, and the characterization at re-admission was analyzed. SARS-CoV-2 RNA and plasma antibody levels were measured, and all patients were followed up for at least 14 days, with a cutoff date of March 10, 2020. Results: A total of 14.5% of RP patients were detected. These patients were characterized as young and displayed mild and moderate conditions compared to NRP patients while no severe patients were RP. RP patients displayed fewer symptoms but similar plasma antibody levels during their hospitalization compared to NRP patients. Upon hospital readmission, these patients showed no obvious symptoms or disease progression. All 21 close contacts of RP patients were tested negative for viral RNA and showed no suspicious symptoms. Eighteen out of 24 of RNA-negative samples detected by the commercial kit were tested positive for viral RNA using a hyper-sensitive method, suggesting that these patients were potential carriers of the virus after recovery from COVID-19. Conclusions: Our results indicated that young patients, with a mild diagnosis of COVID-19 are more likely to display RP status after discharge. These patients show no obvious symptoms or disease progression upon re-admission. More sensitive RNA detection methods are required to monitor these patients. Our findings provide information and evidence for the management of convalescent COVID-19 patients.