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A water-permeable membrane reactor is proposed to promote CO2 methanation with in situ removal of H2O. A two-dimensional CFD simulation model is built up and the effects of GHSV, H2O permeance and CO2/H2 permeation selectivity are investigated.

Background The optimal treatment for elderly patients with esophageal cancer (EC) remains controversial. In the present study, we aimed to investigate whether elderly patients with stage II–III EC could benefit from trimodal therapy. Methods The selected elderly patients with stage II–III EC between 2004 and 2015 were included in a retrospective cohort study from the Surveillance, Epidemiology, and End Results database. The patients were divided into two groups based on whether or not they underwent surgery. The inverse probability of treatment weighting (IPTW) analysis was used to balance the confounding factors between the two groups. The Cox regression analysis, the log‐rank test, and the Kaplan–Meier curves were conducted to identify the survival benefits of different treatment regimes. Results A total of 1596 patients were included in this cohort study, in which 278 patients underwent surgery. In the combination of chemoradiotherapy and surgery group, there were more male patients, more patients aged between 75 and 79 years, and more married patients in the surgery group. Moreover, there were more patients with adenomatous carcinoma, more patients with a tumor size of less than 5 cm, and more patients with a T3 stage in the combination group. In the survival analysis, patients in the combination group had a longer overall survival (OS) and EC‐specific survival (ECSS). After IPTW analysis, the survival analysis generated similar results. The competitive risk model found that our results were stable. There was still a significant difference in OS and ECSS between the combination group and chemoradiotherapy alone group for esophageal adenocarcinoma (p, The old patients were not off limits to radical and comprehensive treatment. Elderly patients with stage II–III EC, especially those with adenocarcinoma, could benefit from the combination of surgery and chemoradiotherapy.

Circular RNAs contribute to the progression of glioma. However, the biological role and underlying mechanism of circ_0082375 in glioma remain unclear. Quantitative real-time PCR and Western blot assay were used to evaluate the expression levels of circ_0082375, microRNA-485-5p, and Wnt family member 7B (Wnt7B). The overall survival of glioma patients was estimated by the Kaplan–Meier curve. Cell proliferation, apoptosis, invasion, and migration were detected by cell counting kit-8, 5-ethynyl-2 -deoxyuridine (EdU) staining, flow cytometry, and transwell assays, respectively. Glucose level and lactate production were determined using glucose and lactate assay kits. In vitro angiogenesis assay was used to evaluate the angiogenesis of glioma cells. The interaction between microRNA (miR)-485-5p and circ_0082375 or Wnt family member 7B (Wnt7B) was verified by dual-luciferase reporter and RNA immunoprecipitation assays. A xenograft model was used to verify the function of circ_0082375 in vivo. circ_0082375 was upregulated in glioma tissues, and it was closely related to the prognosis of glioma patients. circ_0082375 knockdown suppressed cell proliferation, migration, invasion, angiogenesis, glycolysis, and epithelial-mesenchymal transition (EMT), and promoted cell apoptosis in glioma cells. irc_0082375 was a sponge of miR-485-5p, which directly targeted Wnt7B. Knockdown of circ_0082375 inhibited the malignancy, angiogenesis, and glycolysis of glioma cells in vitro by sponging miR-485-5p. Besides, circ_0082375 knockdown hampered the growth of glioma growth by regulating the miR-485-5p/Wnt7B axis in vivo. Altogether, circ_0082375 regulated miR-485-5p/Wnt7B axis to promote the malignancy, angiogenesis, and glycolysis of glioma cells, thereby contributing to the progression of glioma.

Ischemia/reperfusion (I/R) injury is an inevitable process during heart transplant and suppressing I/R injury could greatly improve the survival rate of recipients. Mesenchymal stem cells (MSCs) have positive effects on I/R. We aimed to investigate the mechanisms underlying the protective roles of MSCs in I/R. Both cell model and rat model of myocardial I/R were used. MTT assay and flow cytometry were used to measure cell viability and apoptosis, respectively. QRT-PCR and western blotting were employed to measure levels of lncRNA HCP5 (HLA complex P5), miR-497, apoptosis-related proteins, and insulin-like growth factor (IGF1)/PI3K/AKT pathway. Dual luciferase assay was used to validate interactions of HCP5 and miR-497, miR-497 and IGF1. Echocardiography was performed to evaluate cardiac function of rats. Serum levels of CK-MB and LDH were measured. H&E and Masson staining were used to examine morphology of myocardial tissues. hBMSC-derived exosomes (hBMSC-Exos) increased the viability of cardiomyocytes following hypoxia/reperfusion (H/R) and decreased apoptosis. H/R diminished HCP5 expression in cardiomyocytes while hBMSC-Exos recovered the level. Overexpression of HCP5 in hBMSC-Exos further enhanced the protective effects in H/R while HCP5 knockdown suppressed. HCP5 directly bound miR-497 and miR-497 targeted IGF1. miR-497 mimics or si-IGF1 blocked the effects of HCP5 overexpression. Further, hBMSC-Exos alleviated I/R injury in vivo and knockdown of HCP5 in hBMSC-Exos decreased the beneficial effects. AntagomiR-497 blocked the effects of HCP5 knockdown. HCP5 from hBMSC-Exos protects cardiomyocytes against I/R injury via sponging miR-497 to disinhibit IGF1/PI3K/AKT pathway. These results shed light on mechanisms underlying the protective role of hBMSC-Exos in I/R.

A novel ensemble Yu’s norm-based deep metric learning (DMLYu) is proposed to diagnose the fault of rolling bearing in this paper, which can diagnose the fault classes through the information fusion method that combines the different diagnosis results produced by several Yu’s norm-based deep metric learning models with different scale signals. The suggested method is composed of three steps: firstly the vibration signal is decomposed into multiple IMF components by the EEMD method, then these IMF components are input into the DMLYu models which is called the modified deep metric learning model based on Yu’s norm-based similarity measure, respectively, to extract the feature parameters to diagnose the fault of rolling bearings from the different scales, and finally the final diagnosis decision is made by fusion strategy based on Bayesian belief method (BBM). At last, through a multifaceted diagnosis test of rolling bearing on different datasets, the effectiveness of the proposed ensemble DMLYu based on BBM is verified, and the superiority of the proposed diagnosis method is validated by comparing its diagnosis accuracy and generalization with DMLYu based on voting method and the individual DMLYu model.

BACKGROUND: Hepatic dysfunction (HD) is a common complication that can occur after surgical repair of acute type A aortic dissection (ATAAD) and is associated with poor prognosis. However, the incidence of early preoperative HD and the associated risk factors in patients with ATAAD have not been fully elucidated. METHODS: A total of 984 ATAAD patients who received surgical repair within 48 hours of symptom onset at our department from January 2014 to December 2019 were retrospectively analyzed. Patients were divided into the non-HD group and the HD groups according to the Model of End-Stage Liver Disease (MELD) score before surgery. The clinical parameters and clinical outcomes of the 2 groups were collected and compared. RESULTS: Preoperative HD was detected in 268 patients (27.2%). The incidence of in-hospital complications, including the need for dialysis (34.0% vs. 9.2%; P

The El Niño-Southern Oscillation (ENSO) is one of the main drivers of the interannual climate variability of Earth and can cause a wide range of climate anomalies, so multi year ENSO forecasts are a paramount scientific issue. However, most existing works rely on the conventional iterative mechanism and, thus, fail to provide reliable long-term predictions due to error accumulation. Although methods based on deep learning (DL) apply the parallel modeling scheme for different lead times instead of a single iteration model, they leverage the same DL model for prediction, which can not fully mine the variability of different lead times, resulting in a decrease of prediction accuracy. To solve this problem, we propose a novel parallel deep convolutional neural network (CNN) with a heterogeneous architecture. In this study, by adaptively selecting network architectures for different lead times, we realize variability modeling of different tasks (lead times) and thereby improve the reliability of long-term predictions. Furthermore, we propose a relationship between different prediction lead times and neural network architecture from a unique perspective, namely, the receptive field originally proposed in computer vision. According to the spatio-temporal correlated area and sampling scale of lead times, the size of the convolution kernel and the mesh size of sampling are adjusted as the lead time increases. The Coupled Model Intercomparison Project phase 5 (CMIP5) from 1861 to 2004 and the Simple Ocean Data Assimilation (SODA) from 1871 to 1973 were used for model training, and the GODAS from 1982 to 2017 were used for testing the forecast skill of the model. Experimental results demonstrate that the proposed method outperforms the other well-known methods, especially for long-term predictions.

The upgrade of the BESIII end cap time-of-flight (TOF) detector needs to achieve a ~40-ps time resolution level to provide high-performance reference time for beam testing. Fast silicon photomultiplier tubes (SiPMs) have excellent time characteristics and the transition time spread (TTS) can reach tens of picoseconds. Therefore, SiPMs are selected to replace the PMTs in T0 detectors. In this article, we describe that the time characteristics of a fast SiPM and T0 system were studied using a high-speed real-time oscilloscope. In order to obtain the optimal time resolution, coupling techniques of the plastic scintillators and SiPMs were studied. Single-ended coupling between a SiPM and a plastic scintillator can obtain the best time resolution.

The photomultiplier tube (PMT) and silicon photomultiplier (SiPM) of small areas have the characteristics of fast time response, suitable for the detection of fast and extremely weak light signals, and the transit time spread (TTS) can be on the picosecond scale. The test system is generally divided into two types: one is the direct acquisition of the waveform (DAW), (DAW such as the high-sampling oscilloscope), and the other is an indirect acquisition of the waveform (IDAW). In this article, both DAW and IDAW will be used to carry out the comparative test of ultra-fast photodetectors to complete the calibration of the performance of ultra-fast detectors and the study on time test systems. This will be helpful for beam experiments to be carried out in the laboratory and provide effective support for the development of domestic fast PMT.

Purpose The aim of this study was to identify risk factors for ankle valgus in children with hereditary multiple exostoses (HME). Methods We retrospectively reviewed the medical records of patients with HME who were examined at our hospital between 2010 and 2020. Patients’ age and sex were recorded along with radiographic variables including mechanical axis deviation (MAD), mechanical lateral distal tibia angle (LDTA), fibula/tibia length ratio (F/T); distal fibula station according to Malhotra's classification, location of exostoses at the ankle joint and fibular neck/physis width (N/P) ratio, which were measured from radiographs. Binary logistic regression analysis was performed to identify significant independent risk factors for ankle valgus. Results There were 61 children (20 girls and 41 boys; 122 ankles) who met the inclusion criteria. The mean age was 10.4 years (sd 3.4) and mean LDTA was 83° (sd 7°). Ankle valgus was found in 64 ankles (52%). In addition to younger age, exostoses involving the lateral aspects of the distal tibial and the medial aspect of the distal fibula (odds ratio (OR) = 4.091; 95% confidence interval (CI) 1.065 to 15.712; p = 0.040), F/T ratio < 0.96 (OR = 4.457; 95% CI 1.498 to 13.261; p = 0.007) and N/P ratio > 1.6 (OR = 2.855; 95% CI 1.031 to 7.907; p = 0.043) were associated with an increased risk of developing ankle valgus, while sex and MAD were unrelated to its occurrence. Conclusion Young age, exostoses involving both the distal tibia and fibula, the F/T ratio < 0.96 and fibular N/P width ratio > 1.6 seemed to be risk factors of developing ankle valgus. Levels of evidence Prognostic studies, IV

Objective To investigate the outcomes of C‐shaped release around the greater trochanter in gluteal muscle contracture under arthroscopy. Methods From December 2016 to January 2018, 185 patients with gluteal muscle contracture who treated under arthroscopy were reviewed, including 69 males and 116 females. All patients had a history of repeated intramuscular injection into the buttocks. The follow signs were positive in all the patients before surgery: squatting and crouching disability, difficulty in crossing the leg, Ober's sign positive, clicking sound during rotation of the hip. The C‐shaped release around the greater trochanter under arthroscopy was performed in 96 cases (C‐shaped release group) with an average age of 24.6 ± 4.9 years old, and conventional gluteal muscle contracture release under arthroscopy was performed in 89 cases (conventional release group) with an average age of 25.1 ± 5.0 years. The released tissues in the C‐shaped release group: iliotibial band (ITB) about 5 cm distal to the proximal end of the greater trochanter, the contracture tissue near the posterior and superior of the greater trochanter, which depended on both intraoperative physical examination and arthroscopic observation. The released tissues in conventional release group: the contracture tissues in gluteal muscles according to observation under arthroscopy. The gluteal muscle contracture disability scale (GDS) and Visual analogue scale (VAS) were evaluated before surgery and at the last follow‐up. Results The average release time after making arthroscopic operation space for each lower limb were 12.2 ± 3.2 min in the C‐shaped release group, and 21.4 ± 6.1 min in the conventional release group (P = 0.000). All the patients were followed for at least of 2 years after operation. There was one case of wound hematoma in the C‐shaped release group and five cases in the conventional release group(P = 0.079), abductor weakness (IV level)occurred in two patients in the C‐shaped release group and five cases in the conventional release group (P = 0.208). GDS was 49.3 ± 17.3 (22 to 70) in theC‐shaped release group and 48.1 ± 15.6 (23 to 69) in the conventional release group before surgery (P = 0.622), 91.7 ± 5.2 (83 to 100) in the C‐shaped release group and 90.2 ± 6.1 (83 to 98) in the conventional release group (P = 0.073) with difference nearly significant at last follow‐up. Conclusion Arthroscopic C‐shaped release around the greater trochanter had less operation time, acceptable complication occurrence, and it has an optimistic outcome for gluteal muscle contracture under arthroscope., The target area of arthroscopic C‐shaped release was formed by the iliotibial band tissue 5 cm distal to the proximal end of the greater trochanter (A), the contracture tissue nearly posterior (B) and superior (C) of the greater trochanter.

Objective Postoperative cognitive dysfunction (POCD) after anesthesia and surgery (AS) is a common complication in the elderly population. A cholinergic-dependent signal, the alpha7-nicotinic acetylcholine receptor (α7-nAChR), has been suggested to regulate cognitive processes in a variety of neurologic diseases. In the current study, we determined whether electroacupuncture (EA) pretreatment ameliorates AS-induced POCD in aged rats, as well as the underlying mechanism. Methods Male Sprague-Dawley rats (20 months old) were randomly assigned to the following 5 groups (n=12): vehicle; POCD (tibial fracture surgery); EA plus POCD; EA plus POCD and alpha-bungarotoxin (α-BGT); and POCD plus α-BGT groups. Alpha-bungarotoxin (1 μg/kg), a selective antagonist of α7-nAChR, was administrated via intraperitoneal injection before EA. Thirty days post-AS, the Morris water maze and a novel objective recognition test were used to evaluate cognitive function. Neuronal amount, apoptosis, microglial activation, percentage of high mobility group box 1 (HMGB1)- and nuclear factor-κB (NF-κB)-positive microglia, and levels of HMGB-1 downstream factors, including NF-κB, interleukin-6 (IL-6), and IL-1β, were detected by Nissl staining, immunofluorescence, and Western blot assays. Results EA pretreatment significantly increased crossing platform times and elevated the time with a novel object, restored the quantity of neurons, decreased TUNEL-positive neurons, alleviated activation of microglia, downregulated expression of HMGB1 and NF-κB in the microglia, and reduced levels of phosphor-NF-κB, IL-6, and IL-1β 35 days after AS, while α-BGT partially reversed these changes. Conclusion EA pretreatment improved AS-induced POCD in aged rats, and the underlying mechanism may be associated with inhibition of HMGB1–NF-κB via an α7-nAChR signal in the microglia., Graphical Abstract

Objective To determine the effectiveness of hip arthroscopy combined with endoscopic iliotibial band (ITB) release in patients with both femoroacetabular impingement (FAI) syndrome and external snapping hip (ESH). Methods Retrospectively review the preoperative and minimum of 2‐year follow‐up data of patients with both FAI syndrome and ESH who underwent endoscopic ITB release during hip arthroscopy (FAI + ESH group) from January 2014 to December 2018. The same number of age‐ and gender‐matched FAI syndrome patients without ESH undergoing hip arthroscopy were enrolled in the control group (FAI group). Patient‐reported outcomes (PROs) including international Hip Outcome Tool (iHOT‐33), modified Harris Hip Score (mHHS), visual analog scale for pain (VAS‐pain), and abductive force of affected hip at 3 month and 2 years postoperatively were comparatively analyzed. The VAS‐satisfaction score of two groups at 2 years postoperatively were also analyzed. Results The prevalence of ESH in FAI syndrome patients undergoing hip arthroscopy in our institution was 5.5% (39 of 715 hips), including nine males (10 hips) and 29 females (29 hips). The mean age at the time of surgery was 32.1 ± 6.9 years (range, 22–48 years). According to inclusion and exclusion criteria, 23 patients were enrolled in FAI + ITB group. Twenty‐three age‐ and sex‐matched FAI syndrome patients were enrolled in FAI group. At 24 months postoperatively, no patient still suffered ESH symptoms and painful palpation at lateral region in FAI + ITB group. The iHOT‐33, mHHS, and VAS‐pain score of patients in FAI + ESH group were significantly severer than patients in FAI group preoperatively (41.6 ± 7.5 vs 48.8 ± 7.2, 54.8 ± 7.2 vs 59.2 ± 6.9, 5.5 ± 0.9 vs 4.7 ± 1.0; P 0.05). At 3 months after surgery, the abductive force of operated hip was significantly smaller than that in FAI group (82.4 ± 12.4 N vs 91.9 ± 16.1 N, P 0.05). The VAS‐satisfaction scores of patients in the two groups were at a similarly high level (90.5 ± 6.8 vs 88.8 ± 7.3, P > 0.05). There was no complication and no arthroscopic revision in either group until 2‐year follow‐up. Conclusion Although abductive force recovery of the hip was delayed, hip arthroscopy combined with endoscopic ITB release addressed hip snapping in patients with both FAI syndrome and ESH, and could get similar functional improvement, pain relief, recovery speed, as well as patient satisfaction compared with the pure hip arthroscopy in FAI syndrome patients without ESH., This article confirmed that hip arthroscopy combined with endoscopic iliotibial band (ITB) release would address hip snapping in patients with both femoroacetabular impingement (FAI) syndrome and external snapping hip (ESH), and would get similar functional improvement, pain relief, recovery speed, as well as patient satisfaction, compared with the pure hip arthroscopy in FAI syndrome patients without ESH.

In order to better explore the spontaneous combustion characteristics of lignite, a low-temperature heating experimental device was used to study the changes in the physical and chemical structure ...

Xenogeneic porcine fibrin sealant (PFS), derived from porcine blood, was used as a scaffold for cartilage tissue engineering. PFS has a porous microstructure, biocompatibility and degradation, and it provides a perfect extracellular matrix environment for the adhesion and proliferation of chondrocytes. Recently, PFS in combination with autologous chondrocytes (ACs) were used to study the microstructure of PFS scaffolds and promotion effect on the proliferation and migration of ACs. In this study, we investigated the effects of PFS in combination with ACs on the healing of cartilage defects in rabbits. A full‐thickness cartilage defect was made in the femoral trochlear in rabbits, subsequently, three surgical procedures were used to repair the defect, namely: the defect was treated with microfracture (MF group); the defect was filled with PFS alone (PFS group) or in combination with ACs (PFS + ACs group); the unrepaired cartilage defects served as the control group (CD group). Three and 6 months after the operation, the reparative effect was evaluated using medical imaging, gross scoring, pathological staining, biomechanical testing and biochemical examination. The PFS group showed a limited effect on defect repair, this result was significantly worse than the MF group. The best reparative effect was observed in the PFS + ACs group. These results hinted that PFS in combination with autologous chondrocytes has broad prospects for clinical applications in cartilage tissue engineering.

Thin filament pyrometry is used to measure the time-varying temperature field in a 1-m methanol pool fire. A digital camera with optical filters and zoom lens recorded the emission intensity of an array of 12-µm silicon–carbide filaments oriented horizontally at various heights across the steadily burning pool fire. A 50-µm-diameter thermocouple measured the temperature at locations corresponding to the filament positions. A correlation was developed between the local probability density functions of the thermocouple time-series measurements corrected for radiation and thermal inertia effects and the camera grayscale pixel intensity of the filaments. A regression analysis yields the local mean temperature and its variance. The time series of the temperature field is transformed into average values during consecutive phases of the fire’s puffing cycle, providing quantitative insight into the complex and dynamic structure of a turbulent fire.

Liandi Huang,1,2 Huanhuan Gao,3 Zhigang Wang,2,4 Yixin Zhong,5 Lan Hao,4 Zhiyu Du1 1Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 2State Key Laboratory of Ultrasound in Medicine and Engineering, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 3Department of Ophthalmology, Third Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 4Chongqing Key Laboratory of Ultrasound Molecular Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 5Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of ChinaCorrespondence: Zhiyu DuDepartment of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaEmail duzhiyu@hospital.cqmu.edu.cnPurpose: Anti-inflammation is essential for dry eye disease. Traditional anti-inflammation agent corticosteroids applied in dry eye disease (DED) treatment could result in high intraocular pressure, especially in long-term treatment. Thus, we have prepared a liposome loading 1-bromoheptadecafluorooctane and tetrandrine (PFOB@LIP-Tet) to treat DED via anti-inflammation that hardly affects intraocular pressure in this study, which provided another therapy strategy for dry eye disease.Methods: We firstly detected the physicochemical properties of PFOB@LIP-Tet. Next, we tested the biosafety of synthesized liposomes for corneal epithelium. Then, we explored the accumulations and distribution of PFOB@LIP-Tet both in cellular and animal models. And then, we assessed the therapeutic effects of PFOB@LIP-Tet formulations by laboratory and clinical examinations. Last, we examined the changes in eye pressure before and after treatment.Results: PFOB@LIP-Tet and Tet showed a characteristic absorption peak at 282 nm while PFOB@LIP did not. Large amounts of PFOB@LIP-Tet remained on the ocular surface and accumulated in the corneal epithelial cells in DED rabbits. Corneal staining scores of DED rabbits respectively treated by ATS, PFOB@LIP-ATS, Tet-ATS and PFOB@LIP-Tet-ATS for seven days were 3.7± 0.5, 3.2± 0.4, 1.5± 0.5 and 0.5± 0.5. The expressions of related cytokines were correspondingly downregulated significantly, indicating that the inflammation of DED was successfully suppressed. The intraocular pressure changes of DED rabbits before and after treatment by PFOB@LIP-Tet showed no statistical significance.Conclusion: We successfully synthesized PFOB@LIP-Tet, and it could effectively treat dry eye disease via anti-inflammation but hardly affected the intraocular pressure.Keywords: tetrandrine, inflammation, liposomes, dry eye disease

Wind pressures at two points on the cladding of a building are not completely correlated. The fully correlated probabilities of the wind pressure on cladding decrease as the scale of the cladding increases. Therefore, a reduction in the area extreme pressure (AEP) is required. In this study, a comparative analysis of the AEP reduction stipulations of the building codes from several countries was initially conducted; the results showed that the applicability of current codes is limited. Subsequently, we determined the effects of AEP reduction on large-scale claddings using the area- and moving-average methods, based on wind tunnel test data. The results indicated that the AEP reduction for large-scale cladding differs at different positions on the roof surface as the reduction at the corners and edges is more significant compared with that at the interior of the roof. The results of the moving-average method exhibited substantial dispersion and uncertainty when the correlation between adjacent measuring points was weak; thus, it is unsuitable for application toward large-scale cladding. Therefore, employing the area-average method, this study proposed different reduction equations for different positions on a roof surface. These equations can be used as a reference for future research and for revising specifications regarding large-scale cladding.

Objectives Identifying drugs with time-varying efficacy or toxicity, and understanding the underlying mechanisms would help to improve treatment efficacy and reduce adverse effects. In this study, we uncovered that the therapeutic effect of Fuzi (the lateral root of Aconitum carmichaelii Debeaux) depended on the dosing time in mice with adenine-induced chronic kidney disease (CKD). Methods The Fuzi efficacy was determined by biomarker measurements [i.e. plasma creatinine (CRE), blood urea nitrogen (BUN) and urinary N-acetyl-β-D-glucosaminidase (NAG)], as well as inflammation, fibrosis and histological analyses. Circadian regulation of Fuzi pharmacokinetics and efficacy was evaluated using brain and muscle Arnt-like protein-1 (Bmal1)-deficient (Bmal1−/−) mice. Key findings The Fuzi efficacy was higher when the drug was dosed at ZT10 and was lower when the drug was dosed at other times (ZT2, ZT6, ZT14, ZT18 and ZT22) according to measurements of plasma CRE, BUN and urinary NAG. Consistently, ZT10 (5 PM) dosing showed a stronger protective effect on the kidney (i.e. less extensive tubular injury) as compared to ZT22 (5 AM) dosing. This was supported by lower levels of inflammatory and fibrotic factors (IL-1β, IL-6, Tnf-α, Ccl2, Tgfb1 and Col1a1) at ZT10 than at ZT22. Pharmacokinetic analyses showed that the area under the curve (AUC) values (reflective of systemic exposure) and renal distribution of aconitine, hypaconitine and mesaconitine (three putative active constituents) for Fuzi dosing at ZT10 were significantly higher than those for herb dosing at ZT22, suggesting a role of circadian pharmacokinetics in Fuzi chronoefficacy. Drug efficacy studies confirmed that aconitine, hypaconitine and mesaconitine possessed a kidney-protecting effect. In addition, genetic knockout of Bmal1 in mice abolished the time-dependency of Fuzi pharmacokinetics and efficacy. This reinforced the existence of chronoefficacy for Fuzi and supported the role of circadian pharmacokinetics in Fuzi chronoefficacy. Conclusions The efficacy of Fuzi against CKD depends on the dosing time in mice, which is associated with circadian pharmacokinetics of the three main active constituents (i.e. aconitine, hypaconitine and mesaconitine). These findings highlight the relevance of dosing time in the therapeutic outcomes of herbal medicines.

Some impediments, including insufficient drug release, poor tumor penetration, and lack of real-time imaging guidance, still limited the therapeutic efficiency of nanotechnology-based drug delivery systems. Here, light-responsive perfluoropentane (PFP) based nanodroplets as doxorubicin (DOX) nanocarriers that could achieve deep tumor delivery under multimodal imaging guidance were developed. Triggered by laser irradiation, the liquid PFP with low boiling point could go through small-to-big size change and liquid-to-gas phase transformation. At the same time, the accompanied cavitation effect led to not only the disruption of dense extracellular matrix for deep penetration but also the disruption of endo-/lysosome for nucleus delivery of released DOX. Furthermore, different from many imaging approaches which were always "on", only upon laser stimulation could the nanodroplets act as ultrasound/fluorescence probes due to the echogenic PFP bubbles and the recovered fluorescence of DOX itself after released from nanodroplets, which was highly desirable to indicate the DOX state in real time. Therefore, such PFP nanodroplets with phase/size tunable properties enable site-specific drug delivery efficiently and exhibit their potent in cancer theranostics.

Deep learning is increasingly popular in remote sensing communities and already successful in land cover classification and semantic segmentation. However, most studies are limited to the utilization of optical datasets. Despite few attempts applied to synthetic aperture radar (SAR) using deep learning, the huge potential, especially for the very high resolution (VHR) SAR, are still underexploited. Taking building segmentation as an example, the VHR SAR datasets are still missing to the best of our knowledge. A comparable baseline for SAR building segmentation does not exist, and which segmentation method is more suitable for SAR image is poorly understood. This article first provides a benchmark high-resolution (1 m) GaoFen-3 SAR datasets, which cover nine cities from seven countries, review the state-of-the-art semantic segmentation methods applied to SAR, and then summarize the potential operations to improve the performance. With these comprehensive assessments, we hope to provide the recommendation and roadmap for future SAR semantic segmentation.

Qiang Yang,1 Yanghao Zhou,1 Jin Chen,1 Ning Huang,1 Zhigang Wang,2 Yuan Cheng1 1Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People’s Republic of China; 2Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People’s Republic of ChinaCorrespondence: Yuan ChengDepartment of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People’s Republic of ChinaTel +86 023 63693540Email chengyuan@hospital.cqmu.edu.cnBackground: Therapy for glioblastoma (GBM) has always been very challenging, not only because of the presence of the blood-brain barrier (BBB) but also due to susceptibility to drug resistance. Recently, the clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 9 (CRISPR/Cas9) has revolutionized gene editing technology and is capable of treating a variety of genetic diseases, including human tumors, but there is a lack of safe and effective targeting delivery systems in vivo, especially in the central nervous system (CNS).Methods: Lipid-polymer hybrid nanoparticles (LPHNs-cRGD) were constructed for efficient and targeting delivery of CRISPR/Cas9 plasmids targeting O6-methylguanine-DNA methyltransferase (MGMT), a drug-resistance gene to temozolomide (TMZ). Focused ultrasound (FUS)-microbubbles (MBs) were used to non-invasively and locally open the BBB to further facilitate gene delivery into glioblastoma in vivo. The gene editing efficiency and drug sensitivity changes were evaluated both in vitro and in vivo.Results: The gene-loaded LPHNs-cRGD were successfully synthesized and could protect pCas9/MGMT from enzyme degradation. LPHNs-cRGD could target GBM cells and mediate the transfection of pCas9/MGMT to downregulate the expression of MGMT, resulting in an increased sensitivity of GBM cells to TMZ. MBs-LPHNs-cRGD complexes could safely and locally increase the permeability of the BBB with FUS irradiation in vivo and facilitated the accumulation of nanoparticles at the tumor region in orthotopic tumor-bearing mice. Furthermore, the FUS-assisted MBs-LPHNspCas9/MGMT-cRGD enhanced the therapeutic effects of TMZ in glioblastoma, inhibited tumor growth, and prolonged survival of tumor-bearing mice, with a high level of biosafety.Conclusion: In this work, we constructed LPHNs-cRGD for targeting delivery of the CRISPR/Cas9 system, in combination with FUS-MBs to open the BBB. The MBs-LPHNs-cRGD delivery system could be a potential alternative for efficient targeting gene delivery for the treatment of glioblastoma.Keywords: CRISPR/Cas9, LPHNs, FUS, microbubbles, glioblastoma

Deformation behaviour during loading and unloading is studied in compression of an aluminium plate with a high ratio between the diameter and the thickness by a DLC coated die. A compressed plate becomes thinner during unloading after the plate is compressed to a larger reduction in thickness in loading. The plastic deformation of a compressed plate during unloading is confirmed by measuring the increase of the plate diameter during unloading. The optimum profile of a die crown approaches to the reverse shape of the elastic deflection of a flat die at the loading stroke end with increasing reduction in thickness.

The purinergic P2X3 receptor in the carotid body (CB) is considered a new target for treating hypertension, although approaches for targeted regulating P2X3 receptor expression are lacking. Here, we explored the feasibility of targeted P2X3 receptor down-regulation in CBs by localized low-intensity focused ultrasound (LIFU)-mediated gene delivery to reduce the blood pressure. Thirty-two Kunming canines were randomly assigned to the treatment group (n = 14), negative control group (n = 10), LIFU + cationic microbubbles group (n = 4), and LIFU-only group (n = 4). Plasmid-loaded cationic microbubbles were injected and bilateral CBs were irradiated with a LIFU-based transducer. Flow cytometry showed that 33.15% of transfected cells expressed the green fluorescent protein reporter gene. T7 endonuclease I assays showed an insertion-deletion rate of 8.30%. The P2X3 receptor mRNA- and protein-expression levels in CBs decreased by 56.31% and 45.10%, respectively, in the treatment group. Mean systolic (152.5 ± 3.0 vs 138.0 ± 2.9 mm Hg, P = 0.003) and diastolic (97.8 ± 1.5 vs 87.2 ± 2.3 mm Hg, P= 0.002) blood pressures reduced on day 14 in the treatment group, compared with the baseline values, whereas no effects were observed with LIFU treatment or cationic microbubbles injection alone. Canines treated with this strategy exhibited no local or systemic adverse events. Thus, LIFU-mediated gene delivery to CBs successfully modulated CB function and reduced blood pressure in a canine model, suggesting a new possibility for treating hypertension and further clinical translation.

BackgroundPatients with stage I-III gastric cancer (GC) undergoing R0 radical resection display extremely different prognoses. How to discriminate high-risk patients with poor survival conveniently is a clinical conundrum to be solved urgently.MethodsPatients with stage I-III GC from 2010 to 2016 were included in our study. The associations of clinicopathological features with disease-free survival (DFS) and overall survival (OS) were examined via Cox proportional hazard model. Nomograms were developed which systematically integrated prognosis-related features. Kaplan–Meier survival analysis was performed to compare DFS and OS among groups. The results were then externally validated by The Sixth Affiliated Hospital, Sun Yat-sen University.ResultsA total of 585 and 410 patients were included in the discovery cohort and the validation cohort, respectively. T stage, N stage, lymphatic/vascular/nerve infiltration, preoperative CEA, and CA19-9 were independent prognostic factors (P < 0.05). Two prognostic signatures with a concordance index (C-index) of 0.7502 for DFS and 0.7341 for OS were developed based on the nomograms. The 3-year and 5-year calibration curves showed a perfect correlation between predicted and observed outcomes. Patients were divided into three risk groups (low, intermediate, high), and distinct differences were noticed (p < 0.001). Similar results were achieved in the validation cohort. Notably, a free website was constructed based on our signatures to predict the recurrence risk and survival time of patients with stage I-III GC.ConclusionsThe signatures demonstrate the powerful ability to conveniently identify distinct subpopulations, which may provide significant suggestions for individual follow-up and adjuvant therapy.

Background: Delta triphalangeal thumbs (DTPT) and irregular epiphysis thumbs (IET) had different anatomic deformities. Our primary purpose was to evaluate the clinical and radiographic outcomes of surgical treatment in DTPT and IET. Methods: In total, 43 ulnar-deviated thumbs were included and categorized into 2 types according to x-ray and exploration during surgery, DTPT and IET. Surgical excision of the delta phalanx in DTPT and intraepiphysis osteotomy in IET was conducted. Results: In total, 23 ulnar-deviated thumbs were classified as DTPT and 20 as IET. Ten thumbs that could not be classified initially were followed-up until they could be categorized at the mean age of 24 months. The preoperative mean degrees of ulnar deviation at the interphalangeal joints were 40 and 33 degrees, in DTPT and IET, respectively. The mean degrees were 2 and 5 degrees in final follow-up, showing significant improvement (DTPT, P

To investigate the changes of organic and inorganic substances produced by coal heat pyrolysis in the dry distillation channel in coal underground gasification, lignite coal was used as the object of this study. The pyrolysis reaction in the range of room temperature to 600 °C was carried out using coal pyrolysis reactor of high-temperature tubular heating furnace. SEM, FTIR and x-ray diffractometer analyzed the sample. The results show: The increase in pyrolysis temperature leads to a decrease in tar yield and an increase in gas and char coke yield. The surface of the coal sample shows molten state and gradually harden. The expansion of porosity accelerates the transportation of gas in coal seams. Coal pyrolysis is prone to hydrogen bond breakage at 400 °C. In addition, the content of unsaturated halogenated hydrocarbons increases under pyrolysis.

In an entrained-flow coal gasifier, gasification slag derived from the melting of mineral matter in coal flows along the refractory wall and is tapped out. The refractory of spallation and dissolut...

A symmetric 2D CFD model of catalytic membrane reactor for dry reforming of methane (DRM) was built up. Nondimensionalization method was employed and the governing equations were simplified. Crucia...

OBJECTIVETransinfundibular craniopharyngioma (TC) is one of the 4 subtypes of suprasellar craniopharyngioma. In this study, the authors analyzed the clinical features of and operative technique for TC.METHODSA total of 95 consecutive cases of suprasellar craniopharyngioma that had been resected via the endoscopic expanded endonasal approach were retrospectively reviewed. Patients were divided into 2 groups: 34 in the TC group and 61 in the nontransinfundibular craniopharyngioma (NC) group. Clinical and radiographic features, intraoperative findings, histopathological and genetic findings, and surgical outcomes were analyzed and compared between groups.RESULTSCompared with NC, TC was mostly seen in adult patients (97.1%); it was rare in children (2.9%). Clinical presentations tended toward headache, hydrocephalus, and diabetes insipidus. The relatively smaller volume, midline location (consistent with the stalk position), unidentifiable stalk, no shift of the third ventricle, and greater likelihood to involve the third ventricle and cause hydrocephalus were the characteristic features of TC in the preoperative MRI study. According to the degree of vertical extension of the tumor, the 34 TCs could be classified into 3 subtypes: type 1, entity was limited to stalk (n = 2, 5.9%); type 2, tumor extended up to the third ventricle (type 2a) or down to the subdiaphragmatic cavity (type 2b) (n = 23, 67.6%); and type 3, tumor extended in both directions (n = 9, 26.5%). For TC resection, the chiasm–pituitary corridor, lamina terminalis corridor, and pituitary corridor could be used separately or jointly. Most of the TCs originated from the infundibulum–tuber cinereum, grew within and along the long axis of the infundibulum, and the pituitary stalk was not usually preserved in TCs (20.6%), whereas the rate of preservation was higher (80.3%) in NCs. Bilateral hypothalamic injury was found in nearly all TCs if radical resection was performed, whereas the relationship between NCs and hypothalamus was either compression (32.8%) or unilateral invasion (67.2%). Meanwhile, the postoperative endocrine and neuropsychological function outcomes in patients with TC were worse than in patients with NC. The genetic analysis with whole-exome sequencing studies showed no differential mutations of CTNNB1 (β-catenin) and BRAF (V600E) between TC and NC subtypes, but there was a difference between adamantinomatous craniopharyngioma and papillary craniopharyngioma.CONCLUSIONSTC is a special subtype of suprasellar craniopharyngioma, which is remarkably different from NC. Identification of this type of tumor preoperatively is essential for the planning of appropriate surgical approach and degree of excision.

During the underground coal gasification process, due to the particularity of the gasification channel, a large amount of coal pyrolysis will occur in the coal seam. By studying the characteristics...

Accurate prediction of rolling force is an effective method to improve strip quality in rolling process. To achieve this goal, a novel arc tangent velocity field model based on the upper bound method is proposed to evaluate the rolling force. The mathematical expression of rolling force is derived from the virtual work principle and maximum plastic work principle. Comparing the experimental results with the proposed analytical model prediction, it has been found that this model is good for estimation of rolling force. Meanwhile, the finite element method is also used to simulate the rolling process to verify the validity of the analytical model. It is shown that this model can be used for prediction of rolling force in practice.

This study examined the hip morphology of paediatric patients with mucopolysaccharidosis (MPS) type IVA (MPS IVA). This was a retrospective chart review of 42 hips in 21 children with MPS IVA. Pelvic radiographs and magnetic resonance imaging (MRI) scans of 42 hips and arthrograms of 13 hips were analysed. The bony, cartilaginous and labral coverage of the acetabulum was determined by acetabular index (AI), centre edge angle (CEA) and femoral head coverage (FHC). The mean age at the time of radiography was 66.3 ± 21.7 months. The bony, cartilaginous and labral AI in the MRI assessment were 36.3 ± 5.3, 18.3 ± 4.7 and 12.1 ± 4.6 degrees, respectively. The inter-class correlation coefficients (ICCs) for the bony AI, CEA and FHC measurements on radiographs and MRI were 0.936, 0.879 and 0.810, respectively. In the MRI assessment, labrum in 12 of 42 hips appeared as a regular triangle, and it was flat on 30/42 hips. The average arthrographic AI (AAI) was 11.1 ± 2.7 degrees. The ICCs value of AAI versus cartilaginous and labral AI on MRI indicates good agreement but higher in labral AI. Hips in MPS IVA exhibited obvious cartilage and labrum compensation in response to abnormal ossification of bony acetabulum. Cartilage in MPS IVA hip increases the thickness in the longitudinal direction, while the labrum becomes flatten in the horizontal direction. The AAI may represent intraoperative labrum coverage. The femora-acetabular harmony is difficult to determine using radiography only, and pre-operative MRI and an intraoperative arthrogram are very important in a hip assessment in MPS IVA.

Ultrasound can promote the drug release from drug-loaded substances and alter the tumor local microenvironment to facilitate the transport of drug carriers into the tumor tissues. Based on the altered tumor microenvironment, nanobubbles (NBs) as drug carriers with surfaces functionalized with targeting ligands can reach the tumor sites, thereby increasing the efficacy of chemotherapy. Herein, paclitaxel (PTX)-loaded poly(lactide-co-glycolide) (PLGA) NBs are prepared as drug carriers with covalently conjugated herceptin (anti-HER2 monoclonal antibody) on the surface to guide the target. The effect of ultrasound on the drug release and targeting of the herceptin-conjugated drug-loaded nanobubbles (PTX-NBs-HER) on the cancerous cells is determined. The use of ultrasound significantly improves the cell targeting capability in vitro, and efficiency of enhanced permeability and retention in vivo. The combination of PTX-NBs-HER and ultrasound facilitates the release of PTX, as well as the uptake and cell apoptosis in vitro. The in vivo application of both PTX-NBs-HER and ultrasound enhances the PTX targeting and accumulation in breast cancers while reducing the transmission and distribution of PTX in healthy organs. The combination of ultrasound with PTX-NBs-HER as contrast agents and drug carriers affords an image-guided drug delivery system for the precise targeted therapy of tumors.

The flow stress of wire material, the friction coefficient and the sticking capability of the lubrication coating on the wire surface are evaluated with a single test. In this test, the specimen cut off from the end of a wire coil is set on a V-groove die and then is compressed into the V-groove by a punch. Friction coefficient is determined by the ratio of the punch load and the die load. The flow stress curve is calculated using the punch load-punch stroke curve. The proposed method is suitable for the use in the wire manufacturing shops for cold forging.

Although nanotechnology has shown great promise for treating multiple vascular diseases in recent years, simultaneous noninvasive detection and efficient dissolution of deep venous thrombosis (DVT) still remains challenging. In particular, long blockage areas and large thrombus thicknesses in DVT cause enormous difficulties for site-specific deep-seated thrombus theranostics. Therefore, based on the unique components of DVT, the novel concept of a thrombin-responsive full-thickness infiltration nonpharmaceutical nanoplatform for DVT theranostics is proposed here. The penetration depth is innovatively enhanced with efficient targeting and accumulation in the whole thrombi. Herein, we report a thrombin-responsive phase-transition liposome incorporating a liquid perfluoropentane (PFP) core and modified with two binding peptides, activatable cell-penetrating peptide (ACPP) and fibrin-binding ligand (FTP), which contribute to efficient liposome targeting and accumulation within the thrombi. This targeted nanoplatform is constructed to dig out the thrombus with the assistance of low-intensity focused ultrasound (LIFU), performing the destructive function of an excavator via an acoustic droplet vaporization effect (acting as a "nanoexcavator" system), which can activate and vaporize into microbubbles to enhance LIFU efficacy. The resulting microbubbles enable real-time monitoring of the therapeutic process with ultrasound imaging and high performance photoacoustic imaging after loading DIR. This non-invasive nonpharmaceutical thrombolytic strategy is an improvement over existing clinical methods without systemic side effects.

Liver cancer (LC) is the third largest contributor to mortality related to malignancies worldwide. The study was directed toward exploring the effects of miR-223 on LC proliferation and apoptosis. ...

Objective To investigate the way that miR-136 regulated spleen tyrosine kinase (SYK) and transforming growth factor-β1 (TGF-β1)/Smad3 signaling pathways on renal fibrosis. Methods 100 male SD (Sprague-Dawley) rats were randomly divided into diabetic nephropathy (DN) group, normal control (NC) group, miR-136 mimics group, and control group. The renal fibrosis model of diabetic rats was established by streptozotocin (STZ) method. NRK-52E cells were transfected into six groups: HG group, HG + miR-136 group, HG + miR-NC group, miR-136 + SYK group, miR-136 + NC group, and control group. Histopathological examination, the expressions of miR-136 and SYK mRNA, the expression of mTOR, blood glucose, urine protein, body weight, creatinine level, blood urea nitrogen (BUN), and KW/BW were detected in each group. Transfection efficiency, the targeted binding, and regulation between miR-136 and SYK, as well as the expression level of related inflammatory factors, the expression levels of SYK, E-Cad (E-cadherin), Vimentin, Collagen I, α-smooth muscle actin (α-SMA), and vascular endothelial growth factor A (VEGFA) were detected. Results It was shown that the expression level of miR-136 in DN group significantly decreased. The blood glucose and urine protein concentrations in the DN group and miR-136 mimics group significantly increased and the body weight was decreased, but the blood glucose concentration in the miR-136 mimics group increased with time. The prolongation of the decline significantly decreased, and the growth rate of urinary protein reduced. Creatinine, BUN, and the kidney weight to body weight ratio (KW/BW) in DN group increased significantly. Cell culture results showed that SYK was a target gene of miR-136 and miR-136/SYK-mediated renal fibrosis by activating TGF-β1/Smad3 signal. Conclusion SYK activates TGF-β1/Smad3 signaling, while miR-136 inhibits TGF-β1/Smad3 signaling mediating tubular epithelial cell fibrosis by down-regulating SYK.

Background Carbapenem-resistant Enterobacteriaceae (CRE) meningitis are associated with poor outcomes and high mortality. Here, we report the first successful treatment case of serious meningitis caused by extremely carbapenem-resistant Enterobacter cloacae (minimum inhibitory concentration (MIC) of imipenem ≥16mg/L) with high-dose prolonged infusion of meropenem and i.v. amikacin plus intraventricular (IVT) amikacin. Case presentation A 17-year-old girl developed meningitis from an extremely carbapenem-resistant Enterobacter cloacae (MIC of imipenem ≥16mg/L) as a complication of the removal of a giant central neurocytoma located in bilateral and third ventricles. The patient received four surgeries (one tumor excision and three external ventricular drainages) and was treated with a 70 days course of antibiotics therapy during 100 days hospitalization. Finally, she was safely and successfully treated with the high-dose prolonged infusion of meropenem and i.v. amikacin plus IVT amikacin. Conclusion This case report shows the possibility of the antibiotic regimen of high-dose prolonged infusion of meropenem and i.v. amikacin plus IVT amikacin in the successful treatment of CRE meningitis (MIC of imipenem ≥16mg/L) especially when other antibiotics are unavailable or restricted.

Backgrounds Sonodynamic therapy (SDT) as an emerging reactive oxygen species (ROS)-mediated antitumor strategy is challenged by the rapid depletion of oxygen, as well as the hypoxic tumor microenvironment. Instead of the presently available coping strategies that amplify the endogenous O2 level, we have proposed a biodegradable O2 economizer to reduce expenditure for augmenting SDT efficacy in the present study. Results We successfully fabricated the O2 economizer (HMME@HMONs-3BP-PEG, HHBP) via conjugation of respiration inhibitor 3-bromopyruvate (3BP) with hollow mesoporous organosilica nanoparticles (HMONs), followed by the loading of organic sonosensitizers (hematoporphyrin monomethyl ether; HMME) and further surface modification of poly(ethylene glycol) (PEG). The engineered HHBP features controllable pH/GSH/US-sensitive drug release. The exposed 3BP could effectively inhibit cell respiration for restraining the oxygen consumption, which could alleviate the tumor hypoxia conditions. More interestingly, it could exorbitantly elevate the autophagy level, which in turn induced excessive activation of autophagy for promoting the therapeutic efficacy. As a result, when accompanied with suppressing O2-consumption and triggering pro-death autophagy strategy, the HHBP could achieve the remarkable antitumor activity, which was systematically validated both in vivo and in vitro assays. Conclusions This work not only provides a reduce expenditure means for enduring SDT, but also represents an inquisitive strategy for tumor treatments by inducing pro-death autophagy. Graphical Abstract

The mechanical response law of underground utility tunnels passing through active faults is complicated, and the structures suffer severe damage. An experimental model test with a scaling ratio of 1:30 has been designed to simulate thrust fault dislocation with the 45° dip angle. Through the monitoring and analysis of the lining structure vertical displacement, strains, contact pressure, and failure patterns, the mechanical behavior of the utility tunnel structure with flexible joints passing through the active thrust fault with the 45° dip angle is investigated. The results show that the compression failure occurs mainly in the joint area of the segmental lining. The surrounding rock forms a triangular shear zone as a result of thrust fault displacement. After the fault dislocation is completed, the longitudinal direction of the tunnel is bent into a Z-shape, forming a compression zone and void zone near the fault trace to accommodate the displacement of the thrust fault. The cracks, fragments of concrete peeling off and dislocations are mainly concentrated in the vicinity of the fault trace; especially, the segments B–D are the most damaged. The three segments B, C, and D appear to have an obvious dislocation at the flexible joint, and the average displacement is 6.9 mm (actually 0.207 m) and 4.3 mm (actually 0.129 m). The maximum tensile and compressive strains are distributed in 3# with values of1716.5 μe and − 1182.6 μe, respectively. Compression and tensile failure occur. The segments with flexible joints improve the overall anti-disconnection performance. When the thrust fault displacement exceeds 50 mm (actually 1.5 m), the damage length of the lining structure within the hanging wall and the footwall is 3.5S (S is the maximum span of the tunnel) and 2.4S, respectively.

Recently, the concept of spatial and direction modulation (SDM) has been developed to reap the advantages of both spatial modulation (SM) and directional modulation (DM). On the one hand, DM ensures the transmission security at the expected direction. On the other hand, the structure of SM-aided distributed receivers can enhance the security even if the eavesdropper is located in the same direction as the legitimate receiver. However, the above advantages are achieved based on the assumption that the eavesdropper is not equipped with distributed receivers. On the other hand, the information security can no longer be guaranteed when the eavesdropper is also equipped with distributed receivers. To alleviate this problem, we considered a joint design of SDM and covert information mapping (CIM) in order to conceive of a more robust structure of CIM-SDM. Furthermore, both the detection performances at the eavesdropper and the legitimate user were quantified through theoretical derivation. In general, both the analysis and simulation results supported that the proposed CIM-SDM structure provides more robust secure performance compared to the original SDM, even if the extreme condition of distributed receivers at the eavesdropper is considered, at the cost of moderate performance loss at the legitimate user.

Objective This study aimed to identify risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection (AD) repair surgery. Methods A total of 830 consecutive patients who received acute DeBakey type I AD surgery between 2014 and 2019 were included in the study. The associations between 30-day mortality and perioperative parameters were examined in order to identify risk factors. Results Our data suggested that the overall 30-day mortality rate of all enrolled patients was 11.7%. Unsurprisingly, non-survivors were older and more frequently accompanied with histories of cardiovascular diseases. For intraoperative parameters, the prevalence of coronary artery bypass grafting and cardiopulmonary bypass times were increased in non-survivors. In addition, acute kidney injury (AKI), dialysis, stroke, and deep sternal wound infection were more commonly seen among non-survivors. The multivariate logistic regression analysis suggested that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery, and postoperative AKI were independent risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery. Conclusions Our study demonstrated that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery as well as postoperative AKI were risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery.

Background Hepatic dysfunction (HD) increases the morbidity and mortality rates after cardiac surgery. However, few studies have investigated the association between HD and acute DeBakey type I aortic dissection (ADIAD) surgery. This retrospective study aimed to identify risk factors for developing HD in patients who received acute type I aortic dissection repair and its consequences. Methods A total of 830 consecutive patients who received ADIAD surgery from January 2014 to December 2019 at our center were screened for this study. The End-Stage Liver Disease (MELD) score more than 14 was applied to identify postoperative HD. Logistic regression model was applied to identify risk factors for postoperative HD, Kaplan–Meier survival analysis and Cox proportional hazards regression assay were conducted to analyze the association between HD and postoperative long-term survival. Results Among 634 patients who eventually enrolled in this study, 401 (63.2%) experienced postoperative HD with a 30-Day mortality of 15.5%. Preoperative plasma fibrinogen level (PFL) [odds ratio (OR): 0.581, 95% confidence interval (CI): 0.362–0.933, P = 0.025], serum creatinine (sCr) on admission (OR: 1.050, 95% CI 1.022–1.079, P P = 0.039), and postoperative mechanical ventilation (MV) duration (OR: 1.019, 95% CI 1.003–1.035, P = 0.020) were identified as independent risk factors for developing postoperative HD by multivariate analyses. In addition, the Kaplan–Meier analysis indicated that the long-term survival rate was significantly different between patients with or without postoperative HD. However, the hazard ratios of long-term survival for these two groups were not significantly different. Conclusions HD was a common complication after ADIAD surgery and associated with an increasing 30-Day mortality rate. Decreased PFL, elevated sCr, prolonged CPB duration, and longer postoperative MV time were independent risk factors for postoperative HD.

BackgroundRecently, a few researches focus on the correlation between postoperative carcinoembryonic antigen (post-CEA) and the outcome of colorectal cancer (CRC), but none investigates the predictive value of post-CEA in a prognostic model. Besides, current recommendations on the frequency of post-CEA surveillance are not individualized and well followed. There is an absence of identification of patients who are more likely to have abnormal post-CEA levels and need more frequent CEA measurements.MethodsConsecutive CRC patients who underwent curative surgery were enrolled and randomly divided into the discovery (n=352) and testing cohort (n=233). Impacts of preoperative CEA (pre-CEA) and post-CEA on prognosis were assessed. Cox regression model was applied to develop prognostic nomograms, which were validated by the concordance index (C-index), calibration curve, and receiver operating characteristic curve (ROC) analysis. And prediction improvement of the nomograms was assessed with net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Logistic regression was used to identify predictive risk factors and construct the prediction model for post-CEA elevation.ResultsPost-CEA independently predicted overall survival (OS) and disease-free survival (DFS), while pre-CEA did not. Post-CEA elevation represented higher risks in patients with normal pre-CEA, compared to those with persistent elevated CEA. The nomograms for OS and DFS were established with body mass index, tumor differentiation, N stage, lymphocyte-to-monocyte ratio, and post-CEA. The nomograms showed good calibration and superior discrimination than pTNM stage, with the C-index of 0.783 and 0.759 in the discovery set and 0.712 and 0.774 in the testing set for OS and DFS, respectively. Comparisons between models using IDI and NRI implied that the nomograms performed better than pTNM stage and the predictive power could be improved with the addition of post-CEA. The prediction model for post-CEA elevation was established with age, platelet-to-lymphocyte ratio, preoperative CA19-9, and pre-CEA. The AUC of the model in the two cohorts was 0.802 and 0.764, respectively.ConclusionsElevated post-CEA was a strong indicator of poor prognosis. The addition of post-CEA significantly enhanced the performance of prognostic nomograms. And the prediction model for post-CEA elevation may help identify patients who ought to reasonably receive more intensive postoperative surveillance of CEA levels.

Huipu Li,1,&ast; Shasha Shi,1,&ast; Meng Wu,2,&ast; Wei Shen,1 Jianli Ren,3 Zhechuan Mei,1 Haitao Ran,3 Zhigang Wang,3 Yi Tian,4 Jian Gao,1 Hongyun Zhao1,3 1Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 3Chongqing Key Laboratory of Ultrasound Molecular Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Department of Plastic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongyun Zhao; Jian Gao Email zhychina@cqmu.edu.cn; 982213482@qq.comPurpose: Prepare a multifunctional ultrasound molecular probe, cell-penetrating peptide-modified 10-hydroxycamptothecin-loaded phase-transformation lipid nanoparticles (iRGD-ICG-10-HCPT-PFP-NPs), and to combine iRGD-ICG-10-HCPT-PFP -NPs with low-intensity focused ultrasound (LIFU) for precision theranostics against hepatocellular carcinoma (HCC).Materials and Methods: The morphology of nanoparticles (NPs) and iRGD-ICG-10-HCPT-PFP-NPs was detected. In vitro, we examined targeting ability by flow cytometry and confocal laser scanning microscopy (CLSM), assessed penetration ability into hepatoma cells, and assessed killing ability. In vivo, we examined the targeting ability of the NPs with a photoacoustic (PA) imager and fluorometer (FL), while LIFU irradiation was used to trigger the release of chemotherapeutic drugs, which had a therapeutic effect on tumors.Results: The particle size of iRGD-ICG-10-HCPT-PFP-NPs was 298.4 ± 10.42 nm. In vitro, iRGD-ICG-10-HCPT-PFP-NPs bound more to SK-Hep1 cells than ICG-10-HCPT-PFP-NPs. iRGD-ICG-10-HCPT-PFP-NPs could achieve PA/ultrasound imaging. The percentage of antiproliferative and apoptotic cells in the iRGD-ICG-10-HCPT-PFP-NPs+LIFU group was significantly higher. In vivo, iRGD-ICG-10-HCPT-PFP-NPs can target tumor sites and achieve PA/ultrasound imaging. The tumor volume in the iRGD-ICG-10-HCPT-PFP-NPs+LIFU group was significantly smaller, and the antiproliferative and proapoptotic effects were higher.Conclusion: We successfully prepared a novel molecular probe that has good targeting, can perform ultrasound/PA dual-modality imaging, and can penetrate deep into tumors to achieve better therapeutic tumor effects, providing a new idea and method for theranostics of HCC.Keywords: molecular probe, homing membrane peptide, precision diagnosis and treatment, dual-modality imaging

Background:To explore long-non-coding RNA (lncRNAs),messenger RNAs (mRNAs) expression profiles and biological functions in the urine samples in lupus nephritis (LN) patients.Methods:Three LN patients and three healthy controls(con) were recruited,whose midstream morning urine was collected.A microarray of mRNA and lncRNA was applied to explore total RNA expression variation.Then venn analysis was applied to screen out specific gene expression in the LN group compared to the con group.Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed to reveal the gene functions of the dysregulated lncRNA-associated with LN;STRING online website and Cytoscape software network analysis were applied to construct protein interaction network (PPI) and screen out the Hub Gene.Drug online websites were conducted as drug prediction websites.Results:A total of 273 mRNAs and 549 lncRNAs were differentially expressed in LN patients' urine compared with the con group.GO analysis of LN revealed that mRNAs from the lncRNA-mRNA network were enriched in terms of antigen-negative regulation of immune response.KEGG analysis of hub genes related to the LN lncRNA-mRNA network highlights their critical role in protein processing in the endoplasmic reticulum,P53 signaling pathway.Co-expression and PPI network analysis suggested that high-degree nodes are clustered in apoptosis,autophagy, reactive oxygen species pathway.Drug prediction indicated that the targeted drugs mainly included antioxidant activity,phosphorylative mechanism.Conclusion:Our findings indicated that the differential expressed urinary lncRNAs(DELs) possessed considerable clinical value in the diagnosis and potential therapeutic applications of drugs in LN patients.

Background Although overt hepatic encephalopathy (OHE) patients were shown to have bilaterally symmetrical structural and functional abnormalities in the whole brain, few studies have focused on the bilateral cerebral hemisphere commissural fibers and measured functional coordination between bilateral hemispheres. This study aimed to investigate the structural changes of the corpus callosum (CC) and interhemispheric functional coordination in patients with OHE and to test the hypothesis that abnormal CC induced by OHE impairs interhemispheric functional coordination in cirrhosis patients. Methods The microstructural integrity and the volumes of each subregion of the CC were analyzed by diffusion tensor imaging (DTI) and three-dimensional T1-weighted imaging. Voxel-mirrored homotopic connectivity (VMHC) was derived from resting-state functional magnetic resonance imaging (MRI). Results Compared with the healthy controls (HCs) and patients without hepatic encephalopathy (noHE), the OHE group showed decreased volumes in all subregions of the CC. In OHE patients, the decreased fractional anisotropy (FA) of CC-5 correlated with decreased VMHC in the middle occipital gyrus (MOG) and precuneus. The value of FA in CC-5 and the volumes of CC-3, CC-4, and CC-5 showed correlations with neuropsychological performance in patients with OHE. Conclusions These findings suggest that impairment of interhemispheric white matter pathways may disturb the functional connectivity associated with coordination and neurocognitive performance.

Benggang is a typical erosional landform in southern and southeastern China. Since benggang poses significant risks to local ecological environments and economic infrastructure, it is vital to accurately detect benggang-eroded areas. Relying only on remote sensing imagery for benggang detection cannot produce satisfactory results. In this study, we propose integrating high-resolution Digital Orthophoto Map (DOM) and Digital Surface Model (DSM) data for efficient and automatic benggang discovery. The fusion of complementary rich information hidden in both DOM and DSM data is realized by a two-stream convolutional neural network (CNN), which integrates aggregated terrain and activation image features that are both extracted by supervised deep learning. We aggregate local low-level geomorphic features via a supervised diffusion-convolutional embedding branch for expressive representations of benggang terrain variations. Activation image features are obtained from an image-oriented convolutional neural network branch. The two sources of information (DOM and DSM) are fused via a gated neural network, which learns the most discriminative features for the detection of benggang. The evaluation of a challenging benggang dataset demonstrates that our method exceeds several baselines, even with limited training examples. The results show that the fusion of DOM and DSM data is beneficial for benggang detection via supervised convolutional and deep fusion networks.