Search

In recent years, circular RNA (circRNA) has been found to be involved in a variety of cancer processes. More and more attention has been paid to the research of circRNA in lung cancer. This study aims to investigate whether circ_0000517 affected the physiology of non‐small cell lung cancer (NSCLC) and the underlying mechanism. The results demonstrated that circ_0000517 was highly expressed in lung cancer tissues and cells, and overexpression of circ_0000517 was negatively correlated with the prognosis of NSCLC patients. Silencing of circ_0000517 significantly inhibited the proliferation, glycolysis, and glutamine decomposition of NSCLC cells in vitro and repressed the growth of xenografted tumors in vivo. Moreover, knockdown of circ_0000517 attenuated the expression of PCNA, HK2, LDHA, ASCT2, and GLS1. Further study found that circ_0000517 targeted miR‐330‐5p and miR‐330‐5p targeted YY1. In addition, miR‐330‐5p inhibitor reversed inhibition of cancer cell proliferation, glycolysis, and glutamine decomposition induced by si‐circ_0000517. In conclusion, our study revealed that silencing of circ_0000517 improved the progression of NSCLC through regulating miR‐330‐5p/YY1 axis.

To observe the effects of acupuncture plus spinal manipulations on the physical functioning and levels of alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS). A total of 128 AS cases were allocated into a control group and an observation group using random number table method, with 64 cases in each group. Patients in both groups took sulfasalazine and meloxicam. Patients in the observation group received additional acupuncture plus spinal manipulations. The efficacy, Bath AS functional index (BASFI), Bath AS disease activity index (BASDAI), and the levels of ALP, ESR, CRP and OPG were compared between the two groups after eight weeks of treatment. After treatment, the symptom scores of traditional Chinese medicine in both groups were decreased (all P

Objectives To determine the association of extended-term (>12-month) versus short-term dual antiplatelet therapy (DAPT) with ischemic and hemorrhagic events in high-risk "TWILIGHT-like" patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) in clinical practice. Background Recent emphasis on shorter DAPT regimen after PCI irrespective of indication for PCI may fail to account for the substantial residual risk of recurrent atherothrombotic events in ACS patients. Methods All consecutive patients fulfilling the "TWILIGHT-like" criteria undergoing PCI were identified from the prospective Fuwai PCI Registry. High-risk patients (n = 8,358) were defined by at least one clinical and one angiographic feature based on TWILIGHT trial selection criteria. The primary ischemic endpoint was major adverse cardiac and cerebrovascular events at 30 months, composed of all-cause mortality, myocardial infarction, or stroke while BARC type 2, 3, or 5 bleeding was key secondary outcome. Results Of 4,875 high-risk ACS patients who remained event-free at 12 months after PCI, DAPT>12-month compared with shorter DAPT reduced the primary ischemic endpoint by 63% (1.5 vs. 3.8%; HRadj: 0.374, 95% CI: 0.256-0.548; HRmatched: 0.361, 95% CI: 0.221-0.590). The HR for cardiovascular death was 0.049 (0.007-0.362) and that for MI 0.45 (0.153-1.320) and definite/probable stent thrombosis 0.296 (0.080-1.095) in propensity-matched analyses. Rates of BARC type 2, 3, or 5 bleeding (0.9 vs. 1.3%; HRadj: 0.668 [0.379-1.178]; HRmatched: 0.721 [0.369-1.410]) did not differ significantly between two groups. Conclusions Among high-risk ACS patients undergoing PCI, long-term DAPT, compared with shorter DAPT, reduced ischemic events without a concomitant increase in clinically meaning bleeding events, suggesting that prolonged DAPT can be considered in ACS patients who present with a particularly higher risk for thrombotic complications without excessive risk of bleeding.

Renal tubular cell (RTC) death and inflammation contribute to the progression of obstructive nephropathy, but its underlying mechanisms have not been fully elucidated. Here, we showed that Gasdermin E (GSDME) expression level and GSDME-N domain generation determined the RTC fate response to TNFα under the condition of oxygen-glucose-serum deprivation. Deletion of Caspase-3 (Casp3) or Gsdme alleviated renal tubule damage and inflammation and finally prevented the development of hydronephrosis and kidney fibrosis after ureteral obstruction. Using bone marrow transplantation and cell type-specific Casp3 knockout mice, we demonstrated that Casp3/GSDME-mediated pyroptosis in renal parenchymal cells, but not in hematopoietic cells, played predominant roles in this process. We further showed that HMGB1 released from pyroptotic RTCs amplified inflammatory responses, which critically contributed to renal fibrogenesis. Specific deletion of Hmgb1 in RTCs alleviated caspase11 and IL-1β activation in macrophages. Collectively, our results uncovered that TNFα/Casp3/GSDME-mediated pyroptosis is responsible for the initiation of ureteral obstruction-induced renal tubule injury, which subsequentially contributes to the late-stage progression of hydronephrosis, inflammation, and fibrosis. This novel mechanism will provide valuable therapeutic insights for the treatment of obstructive nephropathy.

Background The efficacy and safety of tigecycline in the treatment of complicated intra-abdominal infections (cIAIs) is potentially controversial. Here we conducted the non-inferiority study to assess the efficacy and safety of tigecycline versus meropenem in the treatment of postoperative cIAIs. Methods Data of abdominal tumor surgery patients with postoperative cIAIs admitted to intensive care unit (ICU) between October 2017 and December 2019 were collected. A prospective, randomized controlled trial was conducted in which 56 eligible patients with cIAIs randomly received intravenous tigecycline or meropenem for 3 to 14 days. Patients and clinicians were not blinded to the group allocation. Results The total of 56 patients were enrolled, which were divided into 2 groups, one group included 30 patients receiving meropenem and another group included 26 receiving tigecycline therapy. The 2 groups were similar at demographic and baseline clinical characteristics. Microorganisms were isolated from 46 of 56 patients (82.14%), with a total of 107 pathogens were cultured in two groups. The two groups had similar distribution of infecting microorganisms. The primary end point was the clinical response at the end-oftherapy (EOT) visit and upon discharge visit and comprehensive efficacy. The clinical success rates were 83.33%, 76.67% for meropenem versus 76.92%, 88.46% for tigecycline at the EOT visit and upon discharge visit (P>0.05), respectively. Comprehensive efficacy did not significantly differ between two groups either. There were no significant differences in 30-day and 60-day all-cause mortality between two groups (P>0.05). The univariable analysis identified that serum albumin at admission ICU, colorectal cancer on oncology type, postoperative abdominal bleeding were the risk factors for 60-day all-cause mortality. The multivariable analysis showed that postoperative abdominal bleeding were independent predictors of 60-day all-cause mortality. Gastrointestinal disorders and antibacterials-induced Fungal Infection were the most frequently reported adverse events (AEs). The incidence of AEs was similar between meropenem and tigecycline groups (P>0.05). Conclusions Taken together, the study demonstrated that tigecycline is as effective and safe as meropenem for postoperative cIAIs in abdominal tumors patients. Tigecycline is non-inferior to meropenem.

At present, most of the methods used in the research of image semantic segmentation ignore the low-level feature information of image, such as space, edge, etc., which leads to the problems that the segmentation of edge and small part is not precise enough and the accuracy of segmentation result is not high. To solve this problem, this paper proposes a multi-source fusion image semantic segmentation model of generative adversarial networks based on FCN: SCAGAN. In VGG19 network, add super-pixel and edge detection algorithm, and introduce the efficient spatial pyramid module to reduce the number of parameters while adding the spatial and edge information of image; Adjust the skipping structure to better integrate the low-level features and high-level features; build a generation model DeepLab-SCFCN combining with the atrous spatial pyramid pooling to better capture the feature information of different scales of the target for segmentation; The FCN with five modules is designed as the discrimination model for GAN. It is verified on the data set PASCAL VOC 2012 that the model achieves IoU of 70.1% with a small number of network layers, and the segmentation effect of edge and small part is better at the same time. This technology can be used in image semantic segmentation.

Background Coronary artery ectasia (CAE) is a rare finding in coronary angiography and associated with worse clinical outcomes. According to the extent of the dilated lesions, CAE is classified into diffuse and focal dilation. The difference in clinical outcomes between these 2 phenotypes remains unknown. Methods A cohort study was conducted comprising CAE patients identified by coronary angiography between January 2009 to December 2013. Follow-up was proceeded annually and the primary outcome was major adverse cardiovascular events (MACE) defined as a component of cardiovascular death and nonfatal myocardial infarction(MI). Kaplan-Meier method and Cox regression models were used to assess the clinical outcomes in diffuse CAE group and focal CAE group. Propensity score matching, propensity score weighting, and subgroup analysis were performed as sensitivity analysis. Results A total of 595 patients were included in this study, including 474 individuals with diffuse CAE and 121 with focal CAE. During a median follow-up of 87 months, Patients in diffuse CAE group showed significantly higher incidences of MACE (13.1% vs. 3.3%;HR 4.28, 95%CI 1.56–11.78, P = .005), as well as cardiovascular death (7.0% vs. 1.7%;HR 4.41, 95%CI 1.06–18.39, P = .041). Higher occurrence rate of MACE was consistent in propensity score matched cohort and propensity score weighted analysis. The same trend towards increased risk of MACE in diffuse CAE group was obtained among subgroup analysis. Conclusions Patients with diffuse CAE was associated with increased risk of MACE compared to those with focal CAE. Diffuse dilation found in coronary angiography should receive more attention by physicians.

Background Advances in oncology led to a substantial increase in the number of patients requiring admission to the intensive care unit (ICU). It remains controversial to start continuous renal replacement therapy (CRRT) for acute kidney injure (AKI) in critically ill patients with cancer because of the poor outcome and high costs. Methods In this retrospective study, we collected data from patients with cancer with postoperative AKI-stage 3 [Kidney Disease: Improving Global Outcomes (KDIGO), 2012] undergoing CRRT in the ICU of Cancer Hospital, Chinese Academy of Medical Sciences from January 2010 to January 2019. Patients were followed up until the time of death or the point of 28-day after ICU admission. Univariate and multivariate analysis was performed to identify risk factors for 28-day survive. Results Of 8,030 cancer patients after surgical operation admitted by ICU, a total of 86 (1.1%) patients developed postoperative AKI: male/female: 62/24, median age 61 [27–82] years. The number of digestive tract/lung/other types of cancer was 59, 10 and 17, respectively. The median Simplified Acute Physiology Score III (SAPS III) was 65 [49–109] and the median Sequential Organ Failure Assessment (SOFA) score was 6 [1–19]. There were 35 deaths eventually and all the deaths occur within 28 days after ICU admission. Twenty-eight-day survive rate was 57.1%±5.8%. In multivariate cox regression analysis, two risk factors independently affected 28-day survive: SAPS III score ≥65 [hazard ratio (HR): 3.451 (1.272–9.365), P=0.015], the presence of shock at the start of CRRT [HR: 10.262 (2.210–47.660), P=0.003]. The cancer status (P=0.076), cancer types (P>0.05 for both) and neoadjuvant therapy associated with cancer (P=0.949) showed no effects on 28-day survive. Conclusions For cancer patients, postoperative AKI-stage 3 is a serious complication with a low 28-day survive rate. Patients with the presence shock at the start of CRRT or SAPS III ≥65 will have a poor 28-day survive. It should be emphasized that the cancer characteristics (status, types or treatment) don’t affect 28-day survive.

As an important extension of fuzzy number, the probabilistic hesitant fuzzy element (PHFE) shows the flexibility of decision makers in expressing hesitant information in multi-criteria decision-making (MCDM) processes. Accordingly, numerous research findings have been obtained since PHFE introduction. However, a few important issues in PHFE utilization remain to be addressed. This study introduces the French organization Rangement Et Synthese De Ronnees Relationnelles’ (ORESTE) approach for MCDM with probabilistic hesitant fuzzy information. First, the limitations of normalized PHFE (NPHFE), Euclidean distance, and several operations in previous studies are discussed. Subsequently, an algorithm is designed to derive the new NPHFE. A new Euclidean distance and several operations are developed on the basis of the proposed NPHFE. Second, the ORESTE approach is extended to probabilistic hesitant fuzzy environments. Lastly, the problem of selecting best research topic is presented to demonstrate that the proposed approach is effective. A comparative study with other approaches is conducted with identical illustrative example.

Background There were conflicting data regarding the effects of neoadjuvant therapy (NT) on the short-term outcomes of critically ill cancer patients. The aim of this study was to investigate whether NT adversely affect the short-term outcomes of critically ill cancer patients who underwent surgery. Methods This was a retrospective study which enrolled all critically ill cancer patients who admitted to intensive care unit (ICU) of Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2017 and September 2018. Patients were divided into two groups: NT group and no NT (nNT) group. The primary outcome was ICU mortality rate. Propensity score analysis and Logistic regression analysis were used to investigate risk factors of ICU death. Results Hundred and twenty-eight patients received NT and 737 patients did not. The ICU mortality was higher in NT group than that in nNT group (3.9% vs. 1.4%, P=0.041) before propensity score matching analysis. After matching, there were no significant difference in ICU mortality between NT group and nNT group. Univariable logistic analysis demonstrated that a history of coronary heart disease (P=0.008), NT (P=0.041), unplanned admission to ICU (P

Current treatments for oral mucosa-related ulcers use drugs to relieve pain and promote healing, but rarely consider drug resistance to bacterial infection in the microenvironment of the oral cavity or the prevention of bleeding from gingival mucosa ulcers. We herein report an injectable, thermogelling chitosan-based system to address these concerns. An aqueous solution of chitosan-based conjugates (chitosan-g-poly(N-isopropylacrylamide) [CS-g-PNIPAAM] including 1a [CS-g-PNIPAAM with less PNIPAAM] and 1b [CS-g-PNIPAAM with more PNIPAAM], and chitosan-g-poly(N-isopropylacrylamide)-g-polyacrylamide [CS-g-PNIPAAM-g-PAM] 3) could reversibly form semi-solid gels at physiological temperatures for easy application to oral cavity ulcer sites by injection. The chitosan-based conjugate thermogels prepared could inhibit both Gram-positive and Gram-negative bacteria and the two with higher chitosan and poly(N-isopropylacrylamide) contents (1a and 1b) promoted proliferation of gingival fibroblasts in vitro. These two thermogels also exhibited improved blood clotting in an in vivo rat study. Thermogels 1a and 1b effectively promoted ulcer healing and shortened ulcer healing times in an oral gingival mucosa ulcer model using Sprague Dawley (SD) rats. These thermogels showed no obvious toxicity to the main organs of SD rats undergoing gingival ulcer treatment. These results suggest that this antibacterial biomaterial could be a promising injectable therapeutic agent for the treatment for oral mucosa ulcers.

The traditional Chinese medicine Poria cum Radix Pini (PRP) is a fungal medicinal material that has been proven to play an important role in the treatment of arrhythmia. However, the mechanism of its effect on arrhythmia is still unclear. In this study, network pharmacology and metabolomics correlation analysis methods were used to determine the key targets, metabolites and potential pathways involved in the effects of PRP on arrhythmia. The results showed that PRP can significantly improve cardiac congestion, shorten the SV-BA interval and reduce the apoptosis of myocardial cells induced by barium chloride in zebrafish. By upregulating the expression of the ADORA1 protein and the levels of adenosine and cGMP metabolites in the cGMP-PKG signalling pathway, PRP can participate in ameliorating arrhythmia. Therefore, we believe that PRP shows great potential for the treatment of arrhythmia.

Objective: The objective of the study is to investigate the effect of critical care transition programs (TPs) on the short-term outcomes in critically ill cancer patients. Methods: Data of critically ill cancer patients admitted to the intensive care unit (ICU) at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between September 2017 and August 2018 were retrospectively reviewed and analyzed. Patients were grouped as TP group or non-TP (nTP) group according to whether patients received post-ICU follow-up. Results: In unmatched groups, compared with nTP group, patients in TP group were more severe with higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher Simplified Acute Physiology Score 3 score, and higher Sequential Organ Failure Assessment score and decreased ICU mortality (0 vs. 3.1%, P = 0.001) and in-hospital mortality (0 vs. 3.2%, P = 0.001). After matching, there were no significant differences in readmission rate, in-hospital mortality, readmission/in-hospital mortality, ICU length of stay (LOS), and hospital LOS between TP and nTP groups (all P > 0.05). Subgroup analysis demonstrated that in severe group (APACHE II >15), compared with nTP group, patients in TP group had increased readmission rate (8.3% vs. 62.5%, P 15. It has no role in less severe critically ill cancer patients with APACHE II ≤15.

Heteronuclear MRI offers broad potential for specific detection and quantification of molecularly targeted agents in diagnosis and therapy planning or monitoring. Here we report a novel method for simultaneous acquisition of dual-nuclei hyper-CEST 129Xe and 19F tumor targeting MRI. 129Xe hyper-CEST MRI, 19F MRI and fluorescent imaging were integrated into PFOB nanoemulsion as a imaging system for sensitive and selective tumor cells detection. As the complement to 1H MRI, 129Xe and 19F signals can also provide efficient and precise anatomical localization of tumors.

We present the calibration strategy for the 20 kton liquid scintillator central detector of the Jiangmen Underground Neutrino Observatory (JUNO). By utilizing a comprehensive multiple-source and multiple-positional calibration program, in combination with a novel dual calorimetry technique exploiting two independent photosensors and readout systems, we demonstrate that the JUNO central detector can achieve a better than 1% energy linearity and a 3% effective energy resolution, required by the neutrino mass ordering determination. [Figure not available: see fulltext.], 0, info:eu-repo/semantics/published

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Chinese College of Cardiovascular Physicians, CS Optimizing Antithrombotic Research Fund (Grant No. BJUHFCSOARF201801-01), the National Key Research and Development Program of China (Grant No. 2018YFC1315602), the Beijing Municipal Health Commission (Grant No. 2020-1-4032), the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (Grant No. 2016-I2M-1-009), and the National Natural Science Foundation of China (Grant No. 81870277). Background Patients with diabetes mellitus (DM) are known to be at high-risk for both ischemic and bleeding complications post-percutaneous coronary intervention (PCI). The ischemic benefit versus bleeding risk associated with extended dual antiplatelet therapy (DAPT) in high-risk "TWILIGHT-like" patients with diabetes mellitus after PCI has not been established. Methods All consecutive high-risk patients fulfilling the "TWILIGHT-like" criteria undergoing PCI from January 2013 through December 2013 were identified from prospective Fuwai PCI Registry. High-risk "TWILIGHT-like" patients were defined by at least 1 clinical and 1 angiographic feature based on TWILIGHT trial selection criteria. The present analysis evaluated 3425 diabetics patients with concomitant high-risk angiographic features who were event-free at 1 year after PCI. Median follow-up was 2.4 years. The primary effectiveness endpoint was a composite of death, myocardial infarction, or stroke (termed major adverse cardiac and cerebrovascular events) and primary safety endpoint was clinically relevant bleeding according to Bleeding Academic Research Consortium type 2, 3, or 5. Results On inverse probability of treatment weighting (IPTW) analysis, prolonged-term (>1-year) DAPT with aspirin and clopidogrel decreased the risk of primary effectiveness endpoint compared with shorter (≤1-year) DAPT (1.8% vs. 4.3%; hazard ratio [HR]IPTW: 0.381; 95% confidence interval [CI]: 0.252-0.576; P Conclusion Among high-risk PCI patients with diabetes mellitus without an adverse event through 1 year, extending DAPT > 1-year significantly reduced the risk of major adverse cardiac and cerebrovascular events without an increase in clinically relevant bleeding, suggesting that such high-risk diabetic patients may be good candidates for long-term DAPT. Abstract Figure.

Background Advances in oncology led to a substantial increase in the number of patients requiring admission to the ICU. It is significant to confirm which cancer critical patients can benefit from the ICU care like noncancer patients. Methods An observational retrospective cohort study using intensive care unit (ICU) admissions of Medical Information Mart for Intensive Care III from the Beth Israel Deaconess Medical Center in Boston, MA, USA between 2001 and 2012 was conducted. Propensity score matching was used to reduce the imbalance between two matched cohorts. ICU patients with cancer were compared with those without cancer in terms of patients’ characteristics and survival. Results There were 38,508 adult patients admitted to ICUs during the period. The median age was 65 years (IQR, 52–77) and 8308 (21.6%) had an underlying malignancy diagnosis. The noncancer group had a significant survive advantage at the point of 28-day, 90-day, 365-day and 1095-day after ICU admission compared with cancer group (P P > 0.05 for all). Conclusions Malignancy is a common diagnosis among ICU patients. Patients without cancer have a survive advantage compared with patients with cancer in the short- and medium-term. However, in selected groups, cancer critical patients can benefit from the ICU care service like noncancer patients in the short-term.

The efficacy and safety of prolonged (>1-year) dual antiplatelet therapy (DAPT) duration in high-risk patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) remain unknown. All patients undergoing PCI at Fuwai hospital between January 2013 and December 2013 were prospectively enrolled into the Fuwai PCI registry. A total of 3,696 high-risk diabetics patients with at least one additional atherothrombotic risk factor were screened for inclusion. The primary efficacy outcome was the composite of all-cause mortality, myocardial infarction, or stroke. The median follow-up duration was 887 days. 69.8% of DM patients were on DAPT at 1 year without discontinuation. Based on multivariate Cox regression model and inverse probability of treatment weighting (IPTW) analysis, long-term (>1-year) DAPT reduced the risk of primary efficacy outcome (1.7% vs 4.1%; adjusted hazard ratio [adjHR]: 0.382, 95% confidence interval [CI]: 0.252 to 0.577; IPTW-HR: 0.362 [0.241 to 0.542]), as well as cardiovascular death and definite/probable stent thrombosis, compared with short-course (≤1-year) DAPT. Risk of the safety end point of clinically relevant bleeding (adjHR: 0.920 [0.467 to 1.816]; IPTW-HR: 0.969 [0.486 to 1.932]) was comparable between longer DAPT and shorter DAPT. A lower number of net clinical benefit adverse outcomes was observed with >1-year DAPT versus ≤1-year DAPT (adjHR: 0.471 [0.331 to 0.671]; IPTW-HR: 0.462 [0.327 to 0.652]), which appeared increasingly favorable in those with multiple atherothrombotic risk characteristics. In high-risk patients with DM receiving PCI who were event free at 1 year, DAPT prolongation resulted in significant reduction in the risk of ischemic events not offset by increase of clinically meaningful bleeding events, thereby achieving a net clinical benefit. Extending DAPT beyond the period mandated by guidelines seems reasonable in high-risk DM patients not deemed at high bleeding risk.

Background: This study aimed to develop a predictive model based on the risk of locoregional recurrence (LRR) in epidermal growth factor receptor (EGFR)-mutant stage III-pN2 lung adenocarcinoma after complete resection. Methods: A total of 11,020 patients with lung surgery were screened to determine completely resected EGFR-mutant stage III-pN2 lung adenocarcinoma. Patients were excluded if they received preoperative therapy or postoperative radiation therapy (PORT). The time from surgery to LRR was recorded. Clinicopathological variables with statistical significance predicting LRR in the multivariate Cox regression were incorporated into the competing risk nomogram. Patients were then sub-grouped based on different recurrence risk as a result of the nomogram. Results: Two hundred and eighty-eight patients were enrolled, including 191 (66.3%) with unforeseen N2 (IIIA1-2), 75 (26.0%) with minimal/single station N2 (IIIA3), and 22 (7.6%) with bulky and/or multilevel N2 (IIIA4). The 2-year overall cumulative incidence of LRR was 27.2% (confidence interval [CI], 16.3%-38.0%). IIIA4 disease (hazard ratio, 2.65; CI, 1.15-6.07; P=0.022) and extranodal extension (hazard ratio, 3.33; CI, 1.76-6.30; P

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare and life-threatening haematological emergency. Although therapeutic plasma exchange together with corticosteroids achieve successful outcomes, a considerable number of patients remain refractory to this treatment and require early initiation of intensive therapy. However, a method for the early identification of refractory iTTP is not available. To develop and validate a model for predicting the probability of refractory iTTP, a cohort of 265 consecutive iTTP patients from 17 large medical centres was retrospectively identified. The derivation cohort included 94 patients from 11 medical centres. For the validation cohort, we included 40 patients from the other six medical centres using geographical validation. An easy-to-use risk score system was generated, and its performance was assessed using internal and external validation cohorts. In the multivariable logistic analysis of the derivation cohort, three candidate predictors were entered into the final prediction model: age, haemoglobin and creatinine. The prediction model had an area under the curve of 0.886 (95% CI: 0.679-0.974) in the internal validation cohort and 0.862 (95% CI: 0.625-0.999) in the external validation cohort. The calibration plots showed a high agreement between the predicted and observed outcomes. In conclusion, we developed and validated a highly accurate prediction model for the early identification of refractory iTTP. It has the potential to guide tailored therapy and is a step towards more personalized medicine.

Radix Paeoniae Rubra (RPR) is a traditional Chinese medicine with anti-inflammatory effects that has been used in chronic pelvic inflammation disease (CPID) therapy. However, research on the mechanism of RPR in CPID therapy is lacking. Here, we used a network pharmacology method to screen targets and found that the PTGS2 target in the arachidonic acid (AA) pathway was significantly related to CPID. Then, regarding the molecular mechanism, it was further confirmed that RPR may reduce the development of CPID by regulating the PTGS2 target. The CPID rat model was established by mixed bacterial infection. We verified the expression of PTGS2 by immunohistochemical analysis, western blotting assays to detect the expression of PTGS2 protein, and polymerase chain reaction detection of PTGS2 mRNA expression. It was observed that the PTGS2 target decreased significantly after RPR administration at different doses. It is suggested that RPR can reverse the abnormal expression of PTGS2 in CPID rats. We believe that RPR is effective in the treatment of CPID, and RPR can reduce the inflammatory symptoms of CPID by regulating the level of PTGS2 in the AA pathway.

Probabilistic hesitant fuzzy sets (PHFSs) are currently attracting the attention of numerous scholars due to their efficiency in representing uncertain and fuzzy information. PHFSs are more convenient than hesitant fuzzy sets for decision makers to provide their preference information. However, several important issues in PHFSs utilization remain to be addressed. The shortcomings of the operations in PHFSs are discussed in this paper. Probabilistic hesitant fuzzy prioritized weighted average (PHFPWA) and probabilistic hesitant fuzzy prioritized weighted geometric (PHFPWG) operators are developed on the basis of idea of prioritized aggregation operators, and their properties are described. The relationship between PHFPWA and PHFPWG operators is investigated. A multi-attribute decision-making method based on the proposed operators is presented. Two practical examples are provided to illustrate the practicality and effectiveness of the proposed method. Comparison analysis and discussion with other aggregation operators based on the same examples are provided.

Objective To noninvasively assess the neurodegenerative changes in the brain of patients with Niemann-Pick type C (NPC) disease by measuring the lesion tissue with the iterative decomposition of water and fat with echo asymmetry and least square estimation-iron quantification (IDEAL-IQ). Materials and Methods Routine brain MRI, IDEAL-IQ and 1H-proton magnetic resonance spectroscopy (1H-MRS, served as control) were performed on 12 patients with type C Niemann-Pick disease (4 males and 8 females; age range, 15-61 years; mean age, 36 years) and 20 healthy subjects (10 males and 10 females; age range, 20-65 years; mean age, 38 years). The regions with lesion and the normal appearing regions (NARs) of patients were measured and analyzed based on the fat/water signal intensity on IDEAL-IQ and the lipid peak on 1H-MRS. Results Niemann-Pick type C patients showed a higher fat/water signal intensity ratio with IDEAL-IQ on T2 hyperintensity lesions and NARs (3.7-4.9%, p < 0.05 and 1.8-3.0%, p < 0.05, respectively), as compared to healthy controls (HCs) (1.2-2.3%). After treatment, the fat/water signal intensity ratio decreased (2.2-3.4%), but remained higher than in the HCs (p < 0.05). The results of the 1H-MRS measurements showed increased lipid peaks in the same lesion regions, and the micro-lipid storage disorder of NARs in NPC patients was detectable by IDEAL-IQ instead of 1H-MRS. Conclusion The findings of this study suggested that IDEAL-IQ may be useful as a noninvasive and objective method in the evaluation of patients with NPC; additionally, IDEAL-IQ can be used to quantitatively measure the brain parenchymal adipose content and monitor patient follow-up after treatment of NPC.

Tracking drugs with 19F MRI would be beneficial for developing theranostics and optimizing drug therapy. To this end, a fluorinated dendritic amphiphile with high 19F MRI sensitivity and biocompatibility has been developed for 19F MRI tracking of doxorubicin (DOX)-loaded liposomes in mice, which may provide an effective platform to in vivo trace various drugs with 19F MRI.

A 63-year-old male who was diagnosed with adenocarcinoma of the right lower lobe presented with 1 week of fever, cough, and progressive dyspnea and admitted to the Intensive Care Unit (ICU). After intubation, physical examination revealed copious, light bloody sputum and diffuse crackles and rales on lung auscultation. The patient was diagnosed as Stage IV adenocarcinoma, septic shock (lung infection), and acute respiratory distress syndrome. His oxygenation failed to improve despite sedation, restrictive fluid therapy, and methylprednisolone, antimicrobials therapy, protective ventilation, plasma supplement, and anticoagulation. Respiratory secretions suctioned from her endotracheal tube averaged 1.0 L daily. On day 2 after admission, octreotide was infused to control sputum volume. The patient's respiratory secretions decreased significantly, and on day 8, the ventilator mode was changed to pressure support ventilation, and the patient was extubated and dismissed from ICU.

Tourism ecological security (TES) is an essential component and basic guarantee of the tourism regional system, and it is of great significance for scientific measurement of the operational status of a regional tourism ecological security system. The study focuses on the “quality” of tourism ecological security that has been neglected in the previous literature. From the perspective of system efficiency, taking the Yangtze River Delta as the case, we build the index system of regional tourism ecological security measurement based on the “DPSIR” model, and identify the quality of the tourism ecological security system using the data envelopment analysis method. On this basis, the study uses spatial autocorrelation to visualize the spatiotemporal patterns of evolution and regional differences, and uses spatial econometric model to study the spatial effects of regional tourism ecological security. The study shows that: the tourism ecological security follows an overall rising trend of “W” fluctuation with regional differences in the Yangtze River Delta (YRD). Tourism ecological security of Jiangsu, Zhejiang and Shanghai is in good condition, that of Anhui Province is poor, and Hangzhou, Zhoushan, Huangshan, Shanghai, Nanjing and other cities perform well. The overall spatial autocorrelation of tourism ecological security is significant and shows a trend of fluctuation intensification. The local correlation indicates that the tourism ecological security space is highly dependent and has a spatial differentiation pattern of “south to north” in Yangtze River Delta. The direct effects of park greenspace per capita, proportion of total tourism revenue in GDP, number of employees in the tertiary industry, and education expenditure on the regional tourism ecological security are significant. And the indirect spatial spillover effect of park greenspace per capita, the proportion of total tourism revenue in GDP, and education expenditure is obvious. Finally, from the perspective of efficiency, quality can effectively clarify the operational process and mutual relationships of regional tourism ecological security systems, and provide a scientific basis and reference for formulating targeted tourism development policies.

With "One Center, One Platform" as the strategic goal, Macau's development has been an essential part of the 12th and the 13th Five-Year Plan. Even though Macau has achieved a great success in development, it encountered bottlenecks, especially urban renewal. This study made a literature review on relevant theories on urban renewal, the development of Macau's urban renewal policy, and collective efficacy to construct the research questions. The study will base on a household survey in an old region of Macau and make use of quantitative research to examine Macanese choice on urban renewal option. From the results, organizational collective efficacy can be divided into two subscales, namely neighbor-to-neighbor mutually assistance collective efficacy and commercial collective efficacy. For Macanese, the latter has a significant impact on their options on urban renewal, which can explain why downtown areas of Hong Kong succeeded at the beginning of Urban Renewal Authority. It is reasonable for Macau SAR government to actively set up Macau Urban Renewal Company Limited. However, urban renewal stresses more on participation of its residents and cities worldwide, all promoting diversified consultation and development patterns in the hope that different public values can coexist upon urban renewal.

Background: Recently, surgical apgar score (SAS) has been reported to be strongly associated with major morbidity after major abdominal surgery. The aim of this study was to assess the value of esophagectomy SAS (eSAS) in predicting the risk of major morbidity after open esophagectomy in a high volume cancer center. Methods: The data of all patients who admitted to intensive care unit (ICU) after open esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College from September 2008 through August 2010 was retrospectively collected and reviewed. Preoperative and perioperative variables were recorded and compared. The eSAS was calculated as the sum of the points of EBL, lowest MAP and lowest HR for each patient. Patients were divided into high-risk (below the cutoff) and low-risk (above the cutoff) eSAS groups according to the cutoff score with optimal accuracy of eSAS for major morbidity. Univariable and multivariable regression analysis were used to define risk factors of the occurrence of major morbidity. Results: Of 189 patients, 110 patients developed major morbidities (58.2%) and 30-day operative mortality was 5.8% (11/189). There were 156 high risk patients (eSAS ≤7) and 33 low risk (eSAS >7) patients. Univariable analysis demonstrated that forced expiratory volume in one second of predicted (FEV1%) ≤78% (44% vs . 61%, P=0.024), McKeown approach (22.7% vs . 7.6%, P=0.011), duration of operation longer than 230 minutes, intraoperative estimated blood loss (347±263 vs . 500±510 mL, P=0.015) and eSAS ≤7 (62.2% vs . 90.0%, P=0.001) were predictive of major morbidity. Multivariable analysis demonstrated that FEV1% ≤78% (OR, 2.493; 95% CI, 1.279–4.858, P=0.007) and eSAS ≤7 (OR, 2.810; 95% CI, 1.105–7.144; P=0.030) were independent predictors of major morbidity after esophagectomy. Compared with patients who had eSAS >7, patients who had eSAS ≤7 had longer hospital length of stay (25.39±14.36 vs . 32.22±22.66 days, P=0.030). However, there were no significant differences in ICU length of stay, duration of mechanical ventilation, ICU death, 30-day death rate and in-hospital death rate between high risk and low risk patients. Conclusions: The eSAS score is predictive of major morbidity, and lower eSAS is associated with longer hospital length of stay in esophageal cancer patients after open esophagectomy.

研究了在实际应用中4 f 传像系统分辨率的影响因素及其作用机制，用于指导系统的设计和装调。首先，在理论上分析了由装调误差引起的像差对系统光学传递函数(MTF)产生的影响，并建立了描述二者关系的数学模型。基于该模型研究了1 μ m分辨率4 f 光学系统的装调误差，仿真计算了系统含有透镜偏心、倾斜、位移误差对MTF的影响，得到了分辨率随误差的变化曲线。实验结果表明，倾斜在15'以内，偏心误差在0.02 mm，位移在0.01 mm范围内，装调误差均会导致分辨率下降，虽然倾斜在极小范围内微调时分辨率会提高，但总的变化趋势不变。绘制的装调误差与分辨率的关系图，可为高分辨率4 f 系统的误差预估提供参考。

This paper proposes a low-complexity spatial-domain error concealment (EC) algorithm for recovering consecutive blocks error in still images or intra-coded (I) frames of video sequences. The proposed algorithm works with the following steps. Firstly the Sobel operator is performed on the top and bottom adjacent pixels to detect the most probable edge direction of current block area. After that one-dimensional (1-D) matching is used on the available block boundaries. Displacement between edge direction candidate and most probable edge direction is taken into consideration as an important factor to improve stability of 1-D boundary matching. Then the corrupted pixels are recovered by linear weighting interpolation along the estimated edge direction. Finally the interpolated values are merged to get last recovered picture. Simulation results demonstrate that the proposed algorithms obtain good subjective quality and higher PSNR than the methods in literatures for most images.

High-refractive-index (HRI) dielectric metasurfaces have attracted a lot of attention recently due to their advantages of low non-radiative losses and high melting temperatures. Silicon is one of feasible HRI materials that has been widely used in solar cells, photonic waveguides, and photon detectors. However, the band-gap ~ 1 eV makes the quantum efficiency of silicon low at near-infrared (NIR) wavelengths. In this work, a high absorptance device is proposed and realized by using amorphous silicon nanoantenna arrays (a-Si NA arrays) that suppress backward and forward scattering with engineered lattice resonance with Kerker effect. The overlap of electric dipole and magnetic dipole resonances is experimentally demonstrated. The absorptance of a-Si NA arrays increases 3-fold in the near-infrared (NIR) range in comparison to unpatterned silicon films. Nonradiating a-Si NA arrays can achieve high absorptance with a small resonance bandwidth (Q = 11.89) at wavelength 785 nm.

BACKGROUND Readmission to intensive care unit (ICU) after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay (LOS). The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer patients. METHODS Data of patients who readmitted to intensive care unit (ICU) at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between January 2013 and November 2016 were retrospectively collected and reviewed. RESULTS A total of 39 patients were included in the final analysis, and the overall readmission rate between 2013 and 2016 was 1.32% (39/2,961). Of 39 patients, 32 (82.1%) patients were judged as unpreventable and 7 (17.9%) patients were preventable. There were no significant differences in duration of mechanical ventilation, ICU LOS, hospital LOS, ICU mortality and in-hospital mortality between patients who were unpreventable and preventable. For 24 early readmission patients, 7 (29.2%) patients were preventable and 17 (70.8%) patients were unpreventable. Patients who were late readmission were all unpreventable. There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable (100% vs. 66.8%, log rank=1.668, P=0.196). CONCLUSION Most readmission patients were unpreventable, and all preventable readmissions occurred in early period after discharge to ward. There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.

Drawing from strategic human resource management and organizational theory, this article develops an integrated typology of employee governance. This typology is based on the dimensions of eliciting employees’ commitment to the organization (commitment-eliciting) and achieving employees’ compliance to rules (compliance-achieving), which yields four approaches to governing employees: disciplined governance, bonded governance, hybrid governance, and unstructured governance. Results from 337 firms show that the hybrid governance approach is linked with significantly higher organizational performance than alternative approaches in the Chinese context. In addition, both commitment-based practices and compliance-based practices are positively related to organizational performance, and their interaction produces additional positive effects.

When using the laser displacement sensor to measure distance, there is a deflection angle which exites between the direction of the laser beam and the direction of axis, this deflection angle has an impact on the final measurement result. This paper presented a calibration method of the laser beam’s direction, designed calibration device and ceramic calibration plate. In the process of calibrating, laser displacement sensor moves along Z-axis and Y-axis of machine, CCD camera takes the image of the spot projected by laser beam on the calibration plate, then calculate the laser beam’s direction based on the movement distance of laser displacement sensor and the spot’s position on calibration plate. Depend on the Mikron five-axis CNC machine tools, this paper describes the whole calibration process in details, the feasibility and accuracy of the method has been verified by experiment. Experimental results show that when the machine tool’s accuracy is within 0.002mm, the calibration error of laser beam’s direction can be controlled within the range of 0.05°.

Graphical User Interfaces (GUI) is becoming increasingly important in the software field as it builds a friendly way between users and software through continuous interactions. A well-developed GUI is therefore an important factor of software quality. In particular, the reliability of GUIs is still on the way of development. Existing software reliability assessment techniques attempt to statistically describe the software testing process and predict the reliability of the system. However, those techniques are not suitable for GUI as quality of GUI is challenged by immense number of event interactions and complex structural profile etc. Furthermore, GUI has a wealth of information about GUI architecture, components, windows and their interactions with each other, which can be adopted to guide the testing process and establish confidence assessment of GUI. In this paper, a Bayesian network model of GUI reliability is introduced to discuss the reliability model topology and its issues encountered in the modeling process. A case is also presented to verify the validity of the model during the GUI reliability assessment process.

As environment problem becomes increasingly prominent and energy supply becomes more and more tension, wind power as a kind of clean and renewable energy is more and more popular. The installation of large scale wind farms has been paid much attention. Collector system consolidates the power generated by turbine units to a substation from where the generated power is transmitted to the power system. Where designing a wind farm collector system, the economics and reliability of operation should be taken consideration. This paper introduces the concept and some typical layouts of the wind farm collector system, then take comparison of those layout around the economics and reliability, this may help to choose an appropriate cable layout when building a new wind farm.

Based on the feature of interval-valued intuitionistic fuzzy multi-attribute decision-making, in this thesis, a mentality parameter is used to reflect the decision makers’ risk attitude in determining of both a membership degree and a non-membership degree. Besides, with the mentality parameter, a new score function and accuracy function are proposed, which integrate the membership degree, the non-membership degree and the hesitancy degree into one index. Furthermore, to compare two interval-valued intuitionistic fuzzy numbers, a new ranking method is generated with the score function and accuracy function. Finally, a multi-attribute decision method under interval-valued intuitionistic fuzzy environment is developed in a linear weighted average operator. And promising numerical results show that this method is available.

This paper introduces the concept of material design, material design, the development status of material design outlook, etc.

According to the sequence of license plate image has low resolution, in order to improve the image resolution, this paper proposes a multiframe super-resolution image reconstruction algorithm based on overcome registration error and Gauss weight interpolation. First, multiframe image sub-pixel image registration, through extracting the SIFT keypoints of the image, rough matching with BBF algorithm, accurate matching with RANSAC algorithm, establishing the homography matrix between matching points. In order to overcome the registration error, this paper proposes a method based on threshold to overcome the registration error. Finally, the multiframe low resolution image is projected into the high resolution image grid by image registration. The value of the high resolution grid is reconstructed with a non-uniform interpolation algorithm based on Gauss weight. The experiments show that both on the subjective evaluation and objective evaluation can obtain satisfactory reconstruction results, and the registration error is robust.