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C1q tumor necrosis factor (TNF)-related protein 9 (CTRP9) is a novel member of the C1q/TNF superfamily. According to our previous review, CTRP9 plays a vital role in the process of cardiovascular diseases, including regulating energy metabolism, modulating vasomotion, protecting endothelial cells, inhibiting platelet activation, inhibiting pathological vascular remodeling, stabilizing atherosclerotic plaques, and protecting the heart. We proposed that CTRP9 could play multiple positive and beneficial roles in vascular lesions in ischemic stroke (IS). Here, we aimed to study the relationship between serum CTRP9 and the etiology, severity, and prognosis of IS patients. A total of 302 patients with IS and 173 non-stroke controls were selected from the same hospital, and all patients with IS were followed up 12 months after stroke onset. Stroke etiology was classified according to the Trial of ORG 10172 in Acute Stroke Treatment classification. Symptomatic severity was determined using the National Institutes of Health Stroke Scale score. The lesion volume of acute cerebral ischemia was measured using magnetic resonance imaging (MRI). The unfavorable functional outcome was a combination of death or major disability 12 months after stroke onset. Receiver operating characteristic (ROC) curves and integrated discrimination improvement (IDI) and net reclassification improvement (NRI) statistics were applied in the statistical analysis. We found that serum CTRP9 levels and the ratios of CTRP9/total cholesterol (TC), CTRP9/triglyceride (TG), CTRP9/low-density lipoprotein cholesterol (LDL-C), and CTRP9/high-density lipoprotein cholesterol (HDL-C) were associated with the presence of IS. Moreover, the serum CTRP9 concentration was positively associated with the severity of IS. Incorporation of CTRP9/LDL-C levels into a fully adjusted model for IS-cardioembolic (CE) improved discrimination and calibration, and significantly improved reclassification. In addition, CTRP9 was a predictor of unfavorable functional outcomes. All the findings indicated that serum CTRP9 could be a promising blood-derived biomarker for the early evaluation and prognosis assessment of IS. Chinese Clinical Trial Registry, ChiCTR1800020330.

Jian Wang,1,&ast; Zhan-Fang Zhu,2,&ast; Fu-Qiang Liu,3 Cun Liu,4 Ai-Mei Ou-Yang,1 Wei-Wei Chen,1 En-Guo Wang,1 Xi-Ming Wang5,6 1Department of Radiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, 250013, People’s Republic of China; 2Department of Internal Medicine, The Hospital of Xi’an Jiaotong University, Xi’an, 710049, People’s Republic of China; 3Department of Cardiovascular, Shaanxi Provincial People’s Hospital, Xi’an, 710068, People’s Republic of China; 4Department of Ultrasound, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, 250013, People’s Republic of China; 5Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, People’s Republic of China; 6Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi-Ming Wang Tel/Fax +86 531-68776846Email wangximing_dr@outlook.comObjective: Earlobe crease (ELC) has been considered as a skin sign of atherosclerosis, and its pathophysiological mechanism is still unclear. Our study aims to test the hypothesis that ELC patients with lower serum levels of the age-suppressing hormone Klotho, which is not only associated with premature aging but also with endothelial dysfunction, may be associated with atherosclerosis.Methods: A total of 135 patients aged 40– 68 years underwent coronary angiography. According to the presence or absence of coronary heart disease (CAD) and ELC, they were divided into three groups: CAD group and ELC group (ELC group, n = 45); no ELC group (non-ELC group, n = 45). There was no ELC or CAD in the control group (control group, n = 45). Serum Klotho concentration was obtained by enzyme-linked immunosorbent assay (ELISA).Results: The Klotho level in the ELC group was 365.6 ± 38.1 pg/mL, while the Klotho level in the non-ELC group was 568.8 ± 44.9 pg/mL. It is worth noting that the Klotho level of the ELC group was significantly lower than that of the non-ELC group (P < 0.001). The serum Klotho level of the control group was higher than that of the non-ELC group (593.3± 45.3 vs 568.8± 44.9 pg/mL, P = 0.702), but the difference was not statistically significant. Multiple logistic regression analysis showed that the Klotho level is a parameter that affects the appearance of ELC.Conclusion: Serum Klotho levels were considerably lower in patients with ELC. We concluded that the perturbations of Klotho in patients might be associated with ELC and with CAD.Keywords: earlobe crease, Klotho, atherosclerosis, premature aging

Marine natural gas hydrate has recently attracted global attention as a potential new clean energy source. Laboratory measurements of various physical properties of gas hydrate-bearing marine sediments can provide valuable information for developing efficient and safe extraction technology of natural gas hydrates. This study presents comprehensive measurement results and analysis of drilled hydrate-bearing sediments samples recovered from Qiongdongnan Basin in the South China Sea. The results show that the gas hydrate in the core samples is mainly methane hydrate with a methane content of approximately 95%, and the other components are ethane and carbon dioxide. The saturation of the samples fluctuates from 2%–60%, the porosity is approximately 38%–43%, and the water content is approximately 30%–50%, which indicate that high water saturation means that timely drainage should be paid attention to during hydrate extraction. In addition, the median diameter of the sediment samples is mainly distributed in the range of 15 to 34 µm, and attention should be paid to the prevention and control of sand production in the mining process. Moreover, the thermal conductivity is distributed in the range of 0.75 to 0.96 W/(m·K) as measured by the flat plate heat source method. The relatively low thermal conductivity of hydrates at this study site indicates that a combined approach is encouraged for natural gas production technologies. It is also found that clay flakes and fine particles are attached to the surface of large particles in large numbers. Such characteristics will lead to insufficient permeability during the production process.

One-dimensional (1D) organic-inorganic hybrid lead halides with unique core-shell quantum wire structures and splendid photoluminescence properties have been considered one of the most promising high-efficiency broadband emitters. However, studies on the broadband emissions in 1D purely face-shared lead iodide hybrids are still rare so far. Herein, we report on a new 1D lead iodide hybrid, (2cepyH)PbI3 (2cepy = 1-(2-chloroethyl)pyrrolidine), characterized with face-sharing PbI6 octahedral chains. Upon UV photoexcitation, this material shows broadband yellow emissions originating from the self-trapped excitons associated with distorted Pb-I lattices on account of the strong exciton-phonon coupling, as proved by variable-temperature emission spectra. Moreover, experimental and calculated results reveal that (2cepyH)PbI3 is an indirect bandgap semiconductor, the band structures of which are governed by inorganic parts. Our work represents the first broadband emitter based on a 1D face-shared lead iodide hybrid and opens a new way to obtain the novel broadband emission materials.

Array antennas with multipolarization function have important research value to improve the stable transmission of communication systems by supporting antenna diversity technology. In this letter, a millimeter-wave (mm-wave) quadri-polarization array antenna based on folded C-type substrate integrated waveguide is proposed. The operating principle is that the proposed differential feeding network can flexibly provide the required amplitude and phase difference, so that four mutually perpendicular single-branch slot array antennas can achieve multiple polarization characteristics. In addition, by removing the metal floor around the array antenna, the distortion of the antenna's main beam is suppressed. Simulation and experimental results show that the proposed quadri-polarization array antenna can provide orthogonal dual-linear polarization and dual-circular polarization radiation patterns. At the same time, it has the advantages of low profile and easy integration.

To explore whether acupuncture can improve sleep disturbance, cognitive impairment and emotional disorders caused by sleep deprivation, and its association with the attenuation of oxidative stress injury in prefrontal cortex. Fifty-two male Sprague-Dawley rats were randomly divided into a control group (n=10), a model group (n=14), a manual acupuncture (MA) group (n=14), and a sham-MA group (n=14). All the groups were established as sleep deprivation models via the modified multiple platform method, except for the control group. Rats in both the MA group and the sham-MA group received corresponding intervention, respectively. After modeling and intervention, the four groups received three behavioral tests, namely sleep monitoring, by comprehensive lab animal monitoring system (CLAMS), Morris water maze (MWM) test and open-field test (OFT), followed by oxygen free radical level test and Western blot (WB) detection for the expression levels of Bax and Bcl-2. The MA group derived more sleep time within 24 h than either the model group or the sham-MA group (both P 0.05), and the escape latency was significantly shorter in these three groups than that in the model group (all P

In this paper, we track the motion of multiple targets in sports videos by a machine learning algorithm and study its tracking technique in depth. In terms of moving target detection, the traditional detection algorithms are analysed theoretically as well as implemented algorithmically, based on which a fusion algorithm of four interframe difference method and background averaging method is proposed for the shortcomings of interframe difference method and background difference method. The fusion algorithm uses the learning rate to update the background in real time and combines morphological processing to correct the foreground, which can effectively cope with the slow change of the background. According to the requirements of real time, accuracy, and occupying less video memory space in intelligent video surveillance systems, this paper improves the streamlined version of the algorithm. The experimental results show that the improved multitarget tracking algorithm effectively improves the Kalman filter-based algorithm to meet the real-time and accuracy requirements in intelligent video surveillance scenarios.

At present, the majority of sports games video adopts MPEG image technology, and MPEG video compression is the current more mainstream approach. After compression, the quality of the video will decline, and other practical problems. However, the existing detection methods of sports video scene conversion, when dealing with MPEG compressed video, are not ideal, often appear the phenomenon of missing detection and wrong detection. In order to solve this problem, this paper proposes a detection method of sports scene conversion on MPEG compressed video based on fuzzy logic. Introducing fuzzy logic into the detection method of video scene conversion is the highlight of this method. Firstly, this paper preprocessed the video image according to the Convention. In this paper, the recognition of image features and specific extraction methods are introduced in detail, and the extraction algorithm of image color features is further optimized. For the design of the detection method, the main innovation is to fully combine the fuzzy logic and macroblock information. In the existing detection methods, different detection schemes are given for the abrupt change of video scene and the gradual change of scene. Finally, in order to verify the actual effect of the detection method in this paper, an experimental analysis based on the keyframe complexity detection method is established. After a number of experiments including the experimental results of scene transition, analysis, and processing time, through the analysis of data, a step-by-step proof of this method has good accuracy and recall.

A wideband, low profile transmitarray antenna (TA) operating in Ku-band (12GHz-18GHz) is proposed. The transmitarray antenna is composed of aperiodic transmitarray units arranged periodically. The TA unit is mainly composed of three layers, which are composed of metals and substrates. Square patches are printed on the substrate of the top and bottom layers, and the middle layer is a Jerusalem slot in the ground. The overall thickness of TA unit is 0.165λ0 (λ0 is the free space wavelength at 15GHz). In Ku-band, the insertion of the TA unit is less than 0.5dB, which reduces the backward radiation of the transmitarray antenna. The 360° phase is achieved by changing the length of the patch and slot, and the proposed transmitarray unit has a flat phase curve and great transmission characteristics. In order to verify the proposed design, a transmitarray antenna with 351 TA units operating at 15GHz is fabricated and measured. The measurement results show that the TA can achieve a 37.3% (14.4GHz-20GHz) 1-dB gain bandwidth, the measurement gain is 23.06dBi with 42.3% aperture efficiency at 15GHz, and the backward radiation level is below -15dB. The designed TA unit has symmetrical structure, so the transmitarray antenna can work in dual linear polarization or dual circular polarization.

Background: Glomerular filtration rate (GFR) is a useful index in many clinical conditions. However, very few studies have assessed the performance of full age spectrum (FAS) equation and the Asian modified Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation in the approximation of GFR in Chinese patients with chronic kidney disease. Objective: This study aimed to compare the diagnostic performance of the above two creatinine-based equations. Methods: A well designed single-center cross-sectional study was performed and the GFR was determined by 3 methods separately in the same day: technetium-99m-diethylene triamine pentaacetic acid (99mTc-DTPA) dual plasma sample clearance method (mGFR); FAS equation method; Asian modified CKD-EPI equation method. The gold standard method was the mGFR. Equations performance criteria considered correlation coefficient, bias, precision, accuracy and the ability to detect the mGFR less than 60 ml/min/1.73 m2. Results: A total of 160 patients were enrolled. The diagnostic performance of FAS showed no significant difference in the correlation coefficient (0.89 vs 0.89), precision (15.9 vs 16.1 ml/min/1.73 m2), accuracy (75.0% vs 76.3%) and the ability to detect the mGFR less than 60 ml/min/1.73 m2 (0.94 vs 0.94) compared with the Asian modified CKD-EPI equation in all participants. The FAS showed a negative bias, while the new CKD-EPI equation showed a positive bias (−1.20 vs 1.30 ml/min/1.73 m2, P 60 ml/min/1.73 m2 subgroup were consistent with that in the whole cohort. The precision and accuracy decreased when GFR > 60 ml/min/1.73 m2 in both equations. Conclusions: The FAS equation and the Asian modified CKD-EPI equation had similar performance in determining the glomerular filtration rate in the Chinese patients with chronic kidney disease. Both the FAS equation and Asian modified CKD-EPI can be a satisfactory method and may be the most suitable creatinine-based equation. Resumen: Antecedentes: La tasa de filtración glomerular (TFG) es un índice útil en muchas condiciones clínicas. Sin embargo, muy pocos estudios han evaluado el rendimiento de la ecuación FAS (full age spectrum) y la ecuación CKD-EPI (Chronic Kidney Disease-Epidemiology Collaboration) modificada para Asia en la aproximación de TFG en pacientes chinos con enfermedad renal crónica. Objetivo: El objetivo de este estudio fue comparar el rendimiento diagnóstico de las dos ecuaciones anteriores basadas en creatinina. Métodos: Se realizó un estudio transversal unicéntrico y bien diseñado, calculándose separadamente la TFG mediante tres métodos en el mismo día: método mGFR (aclaramiento de muestra de plasma dual con 99mTc-DTPA [tecnecio-99m marcado con triamina dietileno de ácido pentaacético]), el método de ecuación FAS y el de ecuación CKD-EPI modificada para Asia. El método de referencia fue mGFR. Los criterios de rendimiento de las ecuaciones consideraron coeficiente de correlación, sesgo, precisión, exactitud y capacidad de detectar un valor de mGFR inferior a 60 mL/min/1,73 m2. Resultados: Se incluyó un total de 160 pacientes. El rendimiento diagnóstico de FAS no reflejó diferencia significativa en cuanto a coeficiente de correlación (0,89 vs. 0,89), precisión (15,9 vs. 16,1 mL/min/1,73 m2), exactitud (75 vs. 76,3%) y capacidad de detectar un valor de mGFR inferior a 60 mL/min/1,73 m2 (0,94 vs. 0,94) en comparación con la ecuación CKD-EPI modificada para Asia, en todos los participantes. La ecuación FAS reflejó un sesgo negativo, mientras que la nueva ecuación CKD-EPI reflejó un sesgo positivo (-1,20 V vs.1,30 mL/min/1,73 m2, p < 0,001). Sin embargo, todos los valores se aproximaron a cero. En el subgrupo mGFR < 60 mL/min/1,73 m2 y el subgrupo mGFR > 60 mL/min/1,73 m2 los valores fueron consistentes con respecto a la cohorte total. La precisión y exactitud se redujeron cuando TFG > 60 mL/min/1,73 m2 en ambas ecuaciones. Conclusiones: La ecuación FAS y la ecuación CKD-EPI modificada para Asia reflejaron un desempeño similar a la hora de determinar la tasa de filtración glomerular en los pacientes chinos con enfermedad renal crónica. Ambos pueden ser métodos satisfactorios y las ecuaciones más idóneas basadas en creatinina.

BACKGROUND Conventional clinical guidelines recommend that at least 12 lymph nodes should be removed during radical rectal cancer surgery to achieve accurate staging. The current application of neoadjuvant therapy has changed the number of lymph node dissection. AIM To investigate factors affecting the number of lymph nodes dissected after neoadjuvant chemoradiotherapy in locally advanced rectal cancer and to evaluate the relationship of the total number of retrieved lymph nodes (TLN) with disease-free survival (DFS) and overall survival (OS). METHODS A total of 231 patients with locally advanced rectal cancer from 2015 to 2017 were included in this study. According to the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) classification system and the NCCN guidelines for rectal cancer, the patients were divided into two groups: group A (TLN ≥ 12, n = 177) and group B (TLN < 12, n = 54). Factors influencing lymph node retrieval were analyzed by univariate and binary logistic regression analysis. DFS and OS were evaluated by Kaplan-Meier curves and Cox regression models. RESULTS The median number of lymph nodes dissected was 18 (range, 12-45) in group A and 8 (range, 2-11) in group B. The lymph node ratio (number of positive lymph nodes/total number of lymph nodes) (P = 0.039) and the interval between neoadjuvant therapy and radical surgery (P = 0.002) were independent factors of the TLN. However,TLN was not associated with sex, age, ASA score, clinical T or N stage, pathological T stage, tumor response grade (Dworak), downstaging, pathological complete response, radiotherapy dose, preoperative concurrent chemotherapy regimen, tumor distance from anal verge, multivisceral resection, preoperative carcinoembryonic antigen level, perineural invasion, intravascular tumor embolus or degree of differentiation. The pathological T stage (P < 0.001) and TLN (P < 0.001) were independent factors of DFS, and pathological T stage (P = 0.011) and perineural invasion (P = 0.002) were independent factors of OS. In addition, the risk of distant recurrence was greater for TLN < 12 (P = 0.009). CONCLUSION A shorter interval to surgery after neoadjuvant chemoradiotherapy for rectal cancer under indications may cause increased number of lymph nodes harvested. Tumor shrinkage and more extensive lymph node retrieval may lead to a more favorable prognosis.

The basic physical properties of marine natural gas hydrate deposits are important to the understanding of seabed growth conditions, occurrence regularity, and occurrence environment of natural gas hydrates. A comprehensive analysis of the core samples of drilling pressure-holding hydrate deposits at a depth of 1310 m in the Shenhu area of the South China Sea was conducted. The experimental results indicate that the particle size in the hydrate sediment samples are mainly distributed in the range from 7.81 µm to 21.72 µm, and the average particle size decreases as the depth of the burial increases. The X-ray CT analytical images and surface characteristics SEM scan images suggest that the sediment is mostly silty clay. There are a large number of bioplastics in the sediment, and the crack inside the core may be areas of hydrate formation.

SIGNIFICANCE This review summarizes the main factors of refractive error after silicone oil removal combined with cataract surgery.The post-operative refractive results of silicone oil removal combined with cataract surgery are closely related to the patient's future vision quality. This report summarizes the factors that influence the difference between the actual post-operative refractive power and the pre-operatively predicted refractive power after silicone oil removal combined with cataract surgery, including axial length, anterior chamber depth, silicone oil, commonly used tools for measuring intraocular lens power, and intraocular lens power calculation formulas, among others. The aim of the report is to assist clinical and scientific research on the elimination of refractive error after silicone oil removal combined with cataract surgery.

BACKGROUND Colorectal cancer is a common digestive cancer worldwide. As a comprehensive treatment for locally advanced rectal cancer (LARC), neoadjuvant therapy (NT) has been increasingly used as the standard treatment for clinical stage II/III rectal cancer. However, few patients achieve a complete pathological response, and most patients require surgical resection and adjuvant therapy. Therefore, identifying risk factors and developing accurate models to predict the prognosis of LARC patients are of great clinical significance. AIM To establish effective prognostic nomograms and risk score prediction models to predict overall survival (OS) and disease-free survival (DFS) for LARC treated with NT. METHODS Nomograms and risk factor score prediction models were based on patients who received NT at the Cancer Hospital from 2015 to 2017. The least absolute shrinkage and selection operator regression model were utilized to screen for prognostic risk factors, which were validated by the Cox regression method. Assessment of the performance of the two prediction models was conducted using receiver operating characteristic curves, and that of the two nomograms was conducted by calculating the concordance index (C-index) and calibration curves. The results were validated in a cohort of 65 patients from 2015 to 2017. RESULTS Seven features were significantly associated with OS and were included in the OS prediction nomogram and prediction model: Vascular_tumors_bolt, cancer nodules, yN, body mass index, matchmouth distance from the edge, nerve aggression and postoperative carcinoembryonic antigen. The nomogram showed good predictive value for OS, with a C-index of 0.91 (95%CI: 0.85, 0.97) and good calibration. In the validation cohort, the C-index was 0.69 (95%CI: 0.53, 0.84). The risk factor prediction model showed good predictive value. The areas under the curve for 3- and 5-year survival were 0.811 and 0.782. The nomogram for predicting DFS included ypTNM and nerve aggression and showed good calibration and a C-index of 0.77 (95%CI: 0.69, 0.85). In the validation cohort, the C-index was 0.71 (95%CI: 0.61, 0.81). The prediction model for DFS also had good predictive value, with an AUC for 3-year survival of 0.784 and an AUC for 5-year survival of 0.754. CONCLUSION We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.

Boundaries play a crucial role in various image-based tasks, but many existing non-learning-based boundary detection methods underperform in recognising authentic boundaries from a complex background. In this study, the authors address this problem using the sparseness-constrained colour-opponent response and the superpixel contrast. First, building on the biologically inspired colour-opponency mechanism, the authors elaborate a method to compute the unbiased sparseness-constrained colour-opponent response. In this procedure, locations showing colour variations are enhanced, while the textural locations are preliminarily suppressed by the cue of local sparseness measure. Second, with the help of superpixel segmentation, the authors present an effective approach to obtain the superpixel contrast map. This approach helps to exploit the object shape information in suppressing textures. Consequently, the authors propose a non-learning-based method to detect boundaries in images, combining the unbiased sparseness-constrained colour-opponent response and the overall superpixel contrast map. Experiment results on widely adopted datasets manifest that the authors method outperforms most of the competing methods. In particular, compared with the state-of-the-art surround-modulation method, the proposed method obtains a comparable performance while consuming much less runtime.

Background Epidemiologically, in China, locally advanced rectal cancer is a more common form of rectal cancer. Preoperative neoadjuvant concurrent chemoradiotherapy can effectively reduce the size of locally invasive tumors and improve disease-free survival (DFS) and pathologic response after surgery. At present, this modality has become the standard protocol for the treatment of locally advanced rectal cancer in many centers, but the optimal time for surgery after neoadjuvant therapy is still controversial. Aim To investigate the impact of time interval between neoadjuvant therapy and surgery on DFS and pathologic response in patients with locally advanced rectal cancer. Methods A total of 231 patients who were classified as having clinical stage II or III advanced rectal cancer and underwent neoadjuvant chemoradiation followed by surgery at the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from November 2014 to August 2017 were involved in this retrospective cohort study. The patients were divided into two groups based on the different time intervals between neoadjuvant therapy and surgery: 139 (60.2%) patients were in group A (≤ 9 wk), and 92 (39.2%) patients were in group B (> 9 wk). DFS and pathologic response were analyzed as the primary endpoints. The secondary endpoints were postoperative complications and sphincter preservation. Results For the 231 patients included, surgery was performed at ≤ 9 wk in 139 (60.2%) patients and at > 9 wk in 92 (39.8%). The patients' clinical characteristics, surgical results, and tumor outcomes were analyzed through univariate analysis combined with multivariate regression analysis. The overall pathologic complete response (pCR) rate was 27.2% (n = 25) in the longer time interval group (> 9 wk) and 10.8% (n = 15) in the shorter time interval group (≤ 9 wk, P = 0.001). The postoperative complications did not differ between the groups (group A, 5% vs group B, 5.4%; P = 0.894). Surgical procedures for sphincter preservation were performed in 113 (48.9%) patients, which were not significantly different between the groups (group A, 52.5% vs group B, 43.5%; P = 0.179). The pCR rate was an independent factor affected by time interval (P = 0.009; odds ratio [OR] = 2.668; 95%CI: 1.276-5.578). Kaplan-Meier analysis and Cox regression analysis showed that the longer time interval (> 9 wk) was a significant independent prognostic factor for DFS (P = 0.032; OR = 2.295; 95%CI: 1.074-4.905), but the time interval was not an independent prognostic factor for overall survival (P > 0.05). Conclusion A longer time interval to surgery after neoadjuvant therapy may improve the pCR rate and DFS but has little impact on postoperative complications and sphincter preservation.

Background For laparoscopic rectal cancer surgery, the inferior mesenteric artery (IMA) can be ligated at its origin from the aorta [high ligation (HL)] or distally to the origin of the left colic artery [low ligation (LL)]. Whether different ligation levels are related to different postoperative complications, operation time, and lymph node yield remains controversial. Therefore, we designed this study to determine the effects of different ligation levels in rectal cancer surgery. Aim To investigate the operative results following HL and LL of the IMA in rectal cancer patients. Methods From January 2017 to July 2019, this retrospective cohort study collected information from 462 consecutive rectal cancer patients. According to the ligation level, 235 patients were assigned to the HL group while 227 patients were assigned to the LL group. Data regarding the clinical characteristics, surgical characteristics and complications, pathological outcomes and postoperative recovery were obtained and compared between the two groups. A multivariate logistic regression analysis was performed to evaluate the possible risk factors for anastomotic leakage (AL). Results Compared to the HL group, the LL group had a significantly lower AL rate, with 6 (2.8%) cases in the LL group and 24 (11.0%) cases in the HL group (P = 0.001). The HL group also had a higher diverting stoma rate (16.5% vs 7.5%, P = 0.003). A multivariate logistic regression analysis was subsequently performed to adjust for the confounding factors and confirmed that HL (OR = 3.599; 95%CI: 1.374-9.425; P = 0.009), tumor located below the peritoneal reflection (OR = 2.751; 95%CI: 0.772-3.985; P = 0.031) and age (≥ 65 years) (OR = 2.494; 95%CI: 1.080-5.760; P = 0.032) were risk factors for AL. There were no differences in terms of patient demographics, pathological outcomes, lymph nodes harvested, blood loss, hospital stay and urinary function (P > 0.05). Conclusion In rectal cancer surgery, LL should be the preferred method, as it has a lower AL and diverting stoma rate.

In industry, it is becoming common to detect and recognize industrial workpieces using deep learning methods. In this field, the lack of datasets is a big problem, and collecting and annotating datasets in this field is very labor intensive. The researchers need to perform dataset annotation if a dataset is generated by themselves. It is also one of the restrictive factors that the current method based on deep learning cannot expand well. At present, there are very few workpiece datasets for industrial fields, and the existing datasets are generated from ideal workpiece computer aided design (CAD) models, for which few actual workpiece images were collected and utilized. We propose an automatic industrial workpiece dataset generation method and an automatic ground truth annotation method. Included in our methods are three algorithms that we proposed: a point cloud based spatial plane segmentation algorithm to segment the workpieces in the real scene and to obtain the annotation information of the workpieces in the images captured in the real scene; a random multiple workpiece generation algorithm to generate abundant composition datasets with random rotation workpiece angles and positions; and a tangent vector based contour tracking and completion algorithm to get improved contour images. With our procedures, annotation information can be obtained using the algorithms proposed in this paper. Upon completion of the annotation process, a json format file is generated. Faster R-CNN (Faster R-convolutional neural network), SSD (single shot multibox detector) and YOLO (you only look once: unified, real-time object detection) are trained using the datasets proposed in this paper. The experimental results show the effectiveness and integrity of this dataset generation and annotation method.

Anti-cluster of differentiation 52 (CD52) monoclonal antibody (mAb) has been employed in the treatment of chronic lymphoblastic leukemia and multiple sclerosis. Previously we developed a perfusion process to produce the biosimilar mAb named “Mab-TH.” A series of quality assessments was conducted in the fields of structural identification, purity analysis, and activity measurement. After these quality researches, this report laid emphasis on preclinical pharmacology and toxicology evaluation. Mab-TH was characterized in biological, pharmacological, and toxicological properties in comparison with the original drug, alemtuzumab. Binding activity and immune-dependent toxicity as in vitro activity were evaluated. Severe immunodeficient mice transplanted with a human leukemia cell line were also used as an in vivo pharmacological model and a 4-week repeated dosing study in cynomolgus monkeys was conducted to evaluate the safety differences. Our results demonstrated that Mab-TH, the anti-CD52 antibody generated by a perfusion process, had high similarity in in vitro and in vivo activities compared with alemtuzumab in relevant preclinical models. The results supported it as a biosimilar candidate for clinical evaluation.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae infection in susceptible individuals. Without proper clinical diagnosis and treatment, leprosy can have a poor prognosis; however, diagnosing leprosy is challenging. We present a case of leprosy with extensive skin infiltration and involvement of the turbinate mucosa and multiple lymph nodes with increased FDG uptake on PET/CT, mimicking malignancy.

Background The efficacy of core decompression plus autologous bone mesenchymal stem cells (BMSCs) for the treatment of osteonecrosis of the femoral head (ONFH) remains controversial. We conducted a systematic review and meta-analysis to explore the efficacy of core decompression combined with BMSCs for OFNH patients. Methods We searched PubMed, Embase, Web of Science, and the Cochrane library databases through October 2018 for randomized controlled trials (RCTs) assessing the effect of core decompression combined with BMSCs for OFNH patients. The primary outcome was the visual analog scale (VAS) score at 6 months, 12 months and 24 months. The pooled data were analyzed using Stata 12.0 software. Results Fourteen studies with 540 patients (core decompression + BMSCs = 275, core decompression alone = 265) were included in our meta-analysis. Compared with the core decompression alone group, the core decompression + BMSCs group showed a significant decrease in the VAS score at 6 months, 12 months and 24 months, and a decrease in the number of hips undergoing total hip arthroplasty (THA), the Western Ontario and McMaster Universities (WOMAC) score and the volume of the postoperative necrotic zone. Core decompression + autologous BMSCs was associated with an increase in HHS postoperatively. No significant difference existed in adverse events. Conclusions Compared with core decompression alone in the treatment of ONFH, the combined utilization of core decompression and autologous BMSCs has better pain relief and clinical outcomes and can delay the collapse of the femoral head more effectively.

Supplemental Digital Content is available in the text, Background: Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed “functional cure,” based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective. Methods: A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively. Results: In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA − PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results. Conclusion: Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL. AIM To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms. METHODS This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis. RESULTS The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (P = 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (P = 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042; P = 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer. CONCLUSION Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carcinoma, but it also increases the risk of AL following the anterior resection of rectal neoplasms.

The rapid development of the information technology (IT) outsourcing industry is making the schedule risk control of IT outsourcing projects an urgent problem which calls for study. This paper proposes a bilevel schedule risk control model using a hierarchical structure for IT outsourcing projects. The decision processes of clients and vendors at the top and base levels are described, respectively. A two-level Tabu-predatory search (TLTPS) with a two-level structure and the capability to find neighborhoods is designed to suit the hierarchical structure and the complexity of the problem. On the other hand, five other algorithms are introduced to compare with TLTPS. Numerical experiments verify the decision support effect of the proposed model and algorithm for the schedule risk control problem in IT outsourcing projects.

In the core process of fractured marine gas hydrate (hereinafter referred to as hydrate) particles being transported up to the surface platform by airtight pipeline in the solid fluidization exploitation of marine gas hydrate reservoirs, influenced by the rising temperature and the dropping pressure, the solid hydrates will decompose and produce a large amount of gas at a certain critical point, causing the liquid–solid two-phase flow in the wellbore to change into complicated gas–liquid–solid multiphase non-equilibrium flow, which further aggravate well control, solid phase transportation and other safety risks. In view of this, the dynamic hydrate decomposition law in the above process was studied in this paper by establishing multiphase wellbore flow mathematical models of wellbore temperature and pressure field, hydrate phase equilibrium, hydrate dynamic decomposition in multiphase riser pipe flow, wellbore multiphase flow coupled hydrate dynamic decomposition, and a numerical calculation method was proposed and verified. The following results were obtained. First, by numerical model analysis, the effects of liquid phase displacement, solid throughput (daily gas production rate) and wellhead back pressure under different construction parameters on multi-phase non-equilibrium pipe flow were obtained. In addition, the field construction guidance measures were put forward based on multiphase non-equilibrium pipe flow characteristics as follows: to properly increase the solid throughput so as to increase the natural gas production, to appropriately increase the liquid-phase displacement and the wellhead back pressure so as to ensure well control safety. This study provides not only a theoretical basis for the prediction of multiphase non-equilibrium pipe flow in the solid fluidization exploitation, but a technical support for the field construction parameter optimization and well control safety. Keywords: Natural gas hydrate, Solid fluidization exploitation, Non-equilibrium multiphase wellbore flow, Decomposition, Well control risks, Construction parameter, Prediction methods

Genes in the S100 family are abnormally expressed in a variety of tumor cells and are associated with clinical pathology, but their prognostic value in melanoma patients has not yet been fully elucidated. In this study, we extracted and profiled S100 family mRNA expression data and corresponding clinical data from the Gene Expression Omnibus database to analyze how expression of these genes correlates with clinical pathology. Compared with normal skin, S100A1, S100A13, and S100B were expressed at significantly higher levels in melanoma samples. S100A2, S100A7, S100A8, S100A9, S100A10, S100A11, and S100P were all highly expressed in primary melanoma samples but were expressed at low levels in metastatic melanoma, and all of these genes were strongly correlated with each other (P

Background/Aims: In heart failure patients with high prevalence of chronic renal disease (CKD), hospitalization and mortality, whether the lipid profile was associated with renal dysfunction remained unknown. The present study intended to clarify the association between the lipid profile and renal dysfunction in the heart failure patients. Methods: 336 hospitalized heart failure patients with left ventricle ejection fraction (LVEF) ≤45% and New York Heart Association (NYHA) class II-IV were enrolled. The estimated glomerular filtration rate (eGFR) < 90 mL/min·1.73 m2 was defined as renal dysfunction. The demographic, clinical data, blood samples and echocardiography were documented. The Pearson simple linear correlation was performed to evaluate the confounding factors correlated with eGFR. The significantly correlated factors were enrolled in Logistic regression as confounding factors to determine the association between the lipid profile and renal dysfunction in the heart failure patients. Results: 182 patients (54.2%) had renal dysfunction and 154 patients (45.8%) did not have renal dysfunction. The waist circumference, platelet counts, platelet distribution width (PDW), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (apoA1), albumin and left ventricular ejection fraction (LVEF) are positively correlated with eGFR (all P< 0.05). Meanwhile, the age, mean platelet volume (MPV), neutrophilic granulocyte percentage (NEUT%), urea nitrogen (BUN), creatinine and total bilirubin (TBIL) are negatively correlated with eGFR (all P< 0.05). The total cholesterol (TC), triglyceride, low density lipoprotein-cholesterol (LDL-C) and apolipoprotein B (apoB) show no correlation with eGFR. After the adjustment of sex, hypertension, diabetes mellitus, age, waist circumference, platelet counts, MPV, PDW, NEUT%, TBIL, albumin and LVEF, HDL-C is the only lipid factor still significantly associated with renal dysfunction in hospitalized heart failure patients (OR=0.119, P=0.003). Conclusion: Among the lipid profile of TC, triglyceride, LDL-C, HDL-C, apo A1 and apo B, the HDL-C is the only lipid factor significantly associated with renal dysfunction in hospitalized heart failure patients.

Accumulated evidence has demonstrated causative links between neuropathic pain (NP) and immune-mediated inflammatory disorders. However, the role of inflammasome-induced pyroptosis in NP remains elusive. Melatonin possesses a well-documented analgesic action in various pain models. The current study aimed to test our hypothesis that melatonin regulated pyroptosis to alleviate NP by inhibiting NF-κB/NLRP3-dependent signaling. A rat model of spinal nerve ligation (SNL) was established to explore the potential association between melatonin and pyroptosis. Behavioral experiments revealed that SNL provoked severe allodynia which was suppressed by the administration of melatonin, a caspase-1 inhibitor (VX-765), or an NF-κB inhibitor (BAY 11-7085). SNL significantly up-regulated the inflammatory cytokines associated with the excessive activation of NLRP3 components and NF-κB signaling, as well as a marked pyroptosis activation. These effects were partially inhibited by melatonin, VX-765 or BAY 11-7085, and when melatonin and inhibitors were added together, the effect was enhanced. In conclusion, melatonin has potent analgesic and anti-inflammatory effects in SNL models through preventing pyroptosis via the NF-κB/NLRP3 inflammasome signaling pathway.

Colorectal cancer (CRC) is a common digestive tract tumor worldwide. In recent years, neoadjuvant chemoradiotherapy (CRT) has been the most comprehensive treatment for locally advanced rectal cancer (LARC). In this study, we explored immune infiltration in rectal cancer (RC) and identified immune-related differentially expressed genes (IRDEGs). Then, we identified response markers in datasets in GEO databases by principal component analysis (PCA). We also utilized three GEO datasets to identify the up- and downregulated response-related genes simultaneously and then identified genes shared between the PCA markers and three GEO datasets. Based on the hub IRDEGs, we identified target mRNAs and constructed a ceRNA network. Based on the ceRNA network, we explored prognostic biomarkers to develop a prognostic model for RC through Cox regression. We utilized the specimen to validate the expression of the two biomarkers. We also utilized LASSO regression to screen hub IRDEGs and built a nomogram to predict the response of LARC patients to CRT. All of the results show that the nomogram and prognostic model offer good prognostic value and that the ceRNA network can effectively highlight the regulatory relationship. hsa-mir-107 and WDFY3-AS2 may be prognostic biomarkers for RC.

Background Locally advanced rectal neuroendocrine neoplasms (NENs) are rare, and the therapeutic effects of surgery in improving the prognosis have been questioned in previous reports. Materials and methods The research included 58 consecutive patients with locally advanced rectal NENs from three Chinese medical centers between 2000 and 2020. All have received radical surgical treatment. The clinicopathological and survival data were collected. Kaplan-Meier methods and a Cox proportional hazards regression model were used to evaluate the prognosis and identify independent prognostic factors. Results All patients were followed up for a median period of 36 (2–125) months. Of the 58 patients, 13 (22.4%) had G1 neuroendocrine tumors (NETs), 15 (25.9%) had G2 NETs, 6 (10.3%) had G3 NETs, and the remaining 24 (41.4%) patients had G3 neuroendocrine carcinomas (NECs). The 1-year and 3-year disease-free survival (DFS) rates were 64.5% and 48.8%, respectively. The 1-year and 3-year overall survival (OS) rates were 90.5% and 75.4%, respectively. Univariate analysis demonstrated that tumor differentiation (p = 0.002), gross morphology (p = 0.009), T stage (p = 0.024), and extramural vascular invasion (p = 0.009) were associated with the OS. The subsequent multivariate analysis confirmed that tumor differentiation [hazard ratio (HR) = 6.002, 95% confidence interval (CI): 1.210–29.767, p = 0.028] and gross morphology (HR = 3.438, 95% CI: 1.038–11.382, p = 0.043) were independent prognostic factors affecting the clinical outcomes. Conclusions Rectal NENs are a heterogeneous group of diseases. The survival benefits obtained from surgery vary widely based on the tumor clinicopathological features. Patients with G3 NECs and ulcerative mass are at high risks of poor prognosis.

Background: About half of the patients with rectal cancer will develop liver metastasis during the course of their illness. Unfortunately, a large proportion of these metastases are unresectable. Surgical resection of the primary tumor vs. palliative treatment in patients with unresectable synchronous liver metastases remains controversial.Methods: Patients with rectal cancer with surgically unresectable liver metastases were identified from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2015. According to different treatment modalities, patients were divided into a primary tumor resection group and a non-resection group. Rates of primary tumor resection and survival were calculated for each year. Kaplan–Meier methods and Cox regression models were used to assess long-term survival. Multivariable logistic regression models were used to evaluate factors potentially associated with primary tumor resection.Results: Among 1,957 patients, 494 (25.2%) had undergone primary tumor resection. Patients with primary tumor resection had significantly better 5-year survival rate (27.2 vs. 5.6%, P < 0.001) compared to the non-resection group. Chemoradiotherapy with primary site resection was associated with the longest mean and 5-year OS (44.7 months, 32.4%). The Cox regression analyses of the subgroup indicated that patients who underwent primary tumor resection had improved survival compared with those who did not undergo resection in all 25 subgroups. Factors associated with primary tumor resection were well or moderately differentiated tumor grade, undergoing radiation, and primary tumor size Conclusions: The majority of patients with rectal cancer with unresectable liver metastases did not undergo primary tumor resection. Our results indicate that resection of the primary tumor appears to offer the greatest chance of survival. Prospective studies are needed to confirm these results.

This study aimed to summarize the effectiveness and safety of acupuncture in the treatment of autism spectrum disorder (ASD) through literature analysis and evaluation. All studies were retrieved from various databases as follows: English databases, such as PubMed, Cochrane Library, Ovid, and Web of Science, and Chinese databases, such as China National Knowledge Infrastructure (CNKI), WanFang Data (WF), and Technology Periodical Database (VIP). The Cochrane Collaboration’s Bias Risk Assessment Scale was used to assess the studies’ risk of bias. The effects of acupuncture treatment for ASD were determined using the following indicators: childhood autism rating scale (CARS), autism behavior check list (ABC), Reynell developmental language scale (RDLS), and functional independence measure of children (WeeFIM). The risk map of bias of these studies’ quality and the meta-analysis results of the indicators was prepared with RevMan 5.2 software. Finally, 16 studies were included, five of which were in English and 11 were in Chinese. The 16 studies included 1332 patients. The CARS results for subgroup analysis were as follows: acupuncture subgroup (MD = −2.65, 95% CI (−3.22, −2.07)) and acupuncture plus massage subgroup (MD = −10.35, 95% CI (−11.34, −9.36)). The ABC results were as follows: (MD = −6.70, 95% CI (−9.10, −4.29)). The analysis results of sensory, relating, language, body and object use, and social/self-help in the subitems of ABC were as follows: sensory (MD = −2.67, 95% CI (−2.90, −2.44)), relating (MD = −3.28, 95% CI (−3.55, −3.02)), language (MD = −2.45, 95% CI (−2.73, −2.16)), body and object use (MD = −1.19, 95% CI (−1.38, −1.00)), and social/self-help (MD = −2.09, 95% CI (−2.30, −1.89)). For the analysis results of comprehension and expression ages in the subitems of RDLS, the comprehension age results were as follows: (MD = 0.08, 95% CI (−0.06, 0.22), P = 0.27). Those of expression age were as follows: (MD = 0.15, 95% CI (0.04, 0.26), P = 0.009 ). The WeeFIM results were as follows: (MD = 3.70, 95% CI (2.38, 5.02)). This study suggested that acupuncture could effectively treat ASD. However, acupuncture methods and prescriptions at this stage remain heterogeneous, and acupuncture treatment operations require standardization. Studies using rigorous and standard research designs are needed to draw stronger conclusions about the advantages of using acupuncture to treat children and adolescents with ASD.

Objectives. To evaluate the efficacy and safety of Ningmitai (NMT) capsules in patients with chronic epididymitis. Methods. This prospective randomized controlled trial included 112 patients diagnosed with chronic epididymitis. The patients were randomized (1 : 1 : 1) to receive levofloxacin (LVX), NMT, or NMT combined with LVX for 4 weeks. The patients were followed up at 2 and 4 weeks after initiation of treatment and were evaluated in terms of Chronic Epididymitis Symptom Index (CESI) scores, epididymal nodules, and safety parameters. The primary endpoints were the CESI scores at the end of 2 and 4 weeks of treatment. The secondary endpoints included the mean epididymal nodule diameter and the clinical efficacy rate. Safety was evaluated by hepatorenal function tests and adverse event reports during the trial. Results. After 2 weeks of treatment, the CESI score of the NMT group was significantly lower than that of the LVX group ( P < 0.05 ). In addition, the clinical efficacy rate of the NMT group was significantly higher than that of the LVX group (55% vs. 8.33%, P < 0.0001 ), indicating that NMT has a rapid effect on chronic epididymitis. After 4 weeks of treatment, there was no significant difference in CESI scores or clinical efficacy rates between the two monotherapy regimens ( P > 0.05 ); however, the mean diameter of epididymal nodules was significantly smaller in the NMT group than in the LVX group ( P < 0.0001 ). Moreover, after 4 weeks of treatment, the patients in the LVX + NMT group, which had a clinical efficacy rate of 97.22%, had lower CESI scores (both P < 0.01 ) and a smaller epididymal nodule diameter (vs. LVX, P < 0.0001 ; vs. NMT, P < 0.05 ) than those in the other two groups. No adverse events or abnormal hepatorenal function were found during the study. Conclusion. NMT significantly improved CESI scores and epididymal nodule diameter in patients with chronic epididymitis. The combination of NMT and LVX provides a much better effect than monotherapy, and this treatment regimen was well tolerated.

The fire safety of offshore booster station has an extremely important impact on the reliable operation of the whole offshore wind farm. The article establishes the corresponding fire protection scheme around the offshore wind turbine group, offshore booster station and the on-land central control center of the offshore wind farm. Among them, each offshore wind turbine, offshore booster station and onshore centralized control center are equipped with independent fire alarm systems. The inspiratory smoke detector and point type composite smoke and temperature detector are mainly used to confirm the secondary alarm. At the same time, the fire extinguishing systems of offshore wind turbines, offshore booster stations and on-land control centers are: high-pressure CO 2 fire extinguishing system, fine water mist fire extinguishing system and water spray fire extinguishing system. Finally, combined with an engineering case, the fire protection scheme of an offshore wind farm is designed.

The two-way counter-rotation technology is mainly applied to the tidal power station. In this paper, the hydrodynamic optimization of the two-way counter-rotating axial-flow pump turbine is carried out. Under the premise of realizing the forward and reverse power generation and the forward and negative pumping basic function, it has important engineering significance and academic value for improving the pump turbine performance of various working conditions. The main contents are as follows: hydraulic design of “S”-shaped blade for the two-way counter-rotating axial-flow pump turbine is conducted, and the influence of the gap between different impeller stages on the performance is calculated and analyzed, and the variation law of head and efficiency of the pump turbine under different inter-stage clearances is obtained. And the influence of the inter-stage gap on the unit is summarized from the vorticity distribution and the axial section pressure cloud diagram analysis, and the range of the best inter-stage gap of the unit performance is determined.

Multi-layer adhesive structural materials are widely used in various industrial fields. The nondestructive testing(NDT) of multi-layer adhesive structure is usually realized by ultrasonic testing method, and the behavior of waveform of ultrasonic waves propagating in multi-layer structure can be predicted by numerical simulation of elastic wave. The numerical simulation includes building medium model and simulating the propagation. In this paper, based on the 2D staggered grid system, the multi-layer adhesive structure model is constructed, and the first-order velocity stress wave equation is solved by the finite difference method, and the propagation of elastic wave in the medium is simulated. Through experiment, the feasibility and accuracy of the numerical simulation method are verified by comparing the ultrasonic longitudinal surface echo of experiment and numerical simulation in both time and frequency domain.

As one of the machines widely used in mining, a semi-autogenous grinding (SAG) mill can significantly improve the roughing efficiency of rock. But the SAG mill still faces the obstacles of significant energy consumption and empirical operation parameters. In order to obtain the optimal operation parameters of a SAG mill, in this paper, the discrete element method (DEM) is used to simulate the breakage process of the particles by controlling three parameters, i.e., the mill speed ratio, the mill fill level ratio, and the steel ball ratio. This method simulates the particles size, mill power, and qualified particles quality of crushed particle, which reveal the grinding strength and energy consumption of the SAG mill. In this paper, the grinding changes of a SAG mill under different parameter conditions are explored. Firstly, an experiment on the influence of a single parameter change on the mill’s operation is set up, and then the influence of three parameter changes on the mill’s operation is analyzed. These changes are characterized by particle size and mill power. Simulation results under the ∅5250 × 500 mm mill model show that the mill operates with the optimal effect when the mill is under the condition of 80% critical speed and 15% fill level; the power of the mill does not increase linearly with an increase in the mill speed ratio, but will decrease after 85% of the critical speed, and finally increase again; the optimal steel ball ratio in the SAG mill depends on the simulation time (mill actual working time) and the limitation of the rated power. The mill speed, fill level ratio, and steel ball ratio can significantly affect mill operation, and our conclusions can provide a reference for an actual situation.

Oxidative stress, which results in the damage of diverse biological molecules, is a ubiquitous cellular process implicated in the etiology of many illnesses. The sulfhydryl-containing tripeptide glutathione (GSH), which is synthesized and maintained at high concentrations in all cells, is one of the mechanisms by which cells protect themselves from oxidative stress. N-acetylcysteine (NAC), a synthetic derivative of the endogenous amino acid L-cysteine and a precursor of GSH, has been used for several decades as a mucolytic and as an antidote to acetaminophen (paracetamol) poisoning. As a mucolytic, NAC breaks the disulfide bonds of heavily cross-linked mucins, thereby reducing mucus viscosity. In vitro, NAC has antifibrotic effects on lung fibroblasts. As an antidote to acetaminophen poisoning, NAC restores the hepatic GSH pool depleted in the drug detoxification process. More recently, improved knowledge of the mechanisms by which NAC acts has expanded its clinical applications. In particular, the discovery that NAC can modulate the homeostasis of glutamate has prompted studies of NAC in neuropsychiatric diseases characterized by impaired glutamate homeostasis. This narrative review provides an overview of the most relevant and recent evidence on the clinical application of NAC, with a focus on respiratory diseases, acetaminophen poisoning, disorders of the central nervous system (chronic neuropathic pain, depression, schizophrenia, bipolar disorder, and addiction), cardiovascular disease, contrast-induced nephropathy, and ophthalmology (retinitis pigmentosa).

Studies have shown that acupuncture is very effective in treating chronic stress depression. However, little is known about the therapeutic mechanism of electro-acupuncture. Metabolomics, on the other hand, is a technology that determines the metabolic changes of organisms caused by various interventions as a whole and is related to the overall effect of electro-acupuncture (EA). 1HNMR, serum sample analysis, and histopathology and molecular biology analysis were used to evaluate the effects of EA. The results show that electro-acupuncture points can regulate the heat pain threshold of chronic stress model rats and change the morphology of adrenal cortex cells Structure, and regulate the contents of corticotropin-releasing hormone, Corticosterone (CORT), glucose, alanine and valine in the samples. These findings help to clarify the therapeutic mechanism of electro-acupuncture on heterologous chronic stress model rats. The effect of electro-acupuncture on improving chronic stress is likely to be achieved by regulating glucose metabolism, which can provide a reference for clinical acupuncture treatment of chronic stress depression.

With the rapid development of the Internet, the scale of the network continues to expand, and the situation of network security is getting more and more severe. Network security requires more reliable information to support, and the prediction of network traffic is an important part of network security. Network traffic prediction data can provide important data reference for network security, especially for reliable data transmission and network monitoring. In fact, network traffic data is affected by a variety of complex and random factors, so network traffic data is a nonlinear data sequence. This paper analyzes the characteristics of network traffic data and proposes an EMD-LSTM model for network traffic data prediction. Firstly, the complex and variable network data traffic is decomposed into several smooth data sequences, and then, the LSTM neural network model, which is suitable for data sequence prediction, is used to predict. The results of the comparison experiments show that the proposed network traffic prediction method reduces the prediction root mean square error in network traffic prediction.

Hydromorphone is an alternative to morphine for intrathecal drug delivery system to treat refractory cancer pain; however, there is not enough clinical evidence to prove it. In our study, 233 patients from 12 different pain management centers across China were enrolled, 121 and 112 in the intrathecal hydromorphone (ITHM) and intrathecal morphine (ITMO) groups, respectively. The primary outcome was the clinical success rate, which was defined as ratio of patients achieving ≥50% pain relief. The noninferiority margin was defined as -0.15. Other outcomes included daily visual analogue scale score, breakthrough pain (BTP) incidence, intrathecal dose change, and patient-controlled analgesia bolus count change, GAD-7/PHQ-9. Clinical success was achieved in 85 and 79 of the 121 ITHM patients (70.2%) and 112 ITMO patients (70.5%), respectively. Compared to the corresponding baseline findings, significantly decreased visual analogue scale scores and BTP incidence were noted in both groups. The dose change rate decreased and increased with time in the ITHM and ITMO groups, respectively (ITHM -3.33% vs ITMO 35.4%, P < 0.01, t test) from the third week. The patient-controlled analgesia bolus change rate was lower in the ITHM group than in the ITMO group (ITHM -19.88% vs ITMO 7.79%, P < 0.01, t test) from first week. Our result shows that ITHM is noninferior to ITMO on pain relief to treat refractory cancer pain, however, at different doses and that the doses of morphine tended to increase, whereas those of hydromorphone decreased over time. Hydromorphone offers advantage over morphine in controlling BTP.

Background/Aims: Nasal continuous positive airway pressure (nCPAP) was recommended as the initial respiratory support for spontaneous breathing in infants with very low birth weight and neonatal respiratory distress syndrome (NRDS). Less invasive surfactant administration (LISA) and minimally invasive surfactant therapy (MIST) have been reported to reduce the incidence of bronchopulmonary dysplasia (BPD). This study aimed to explore the applicability of minimally invasive surfactant administration (MISA) in China. Materials and Methods: MISA was a randomized controlled study conducted at eight level III neonatal intensive care units (NICUs) in China. Spontaneously breathing infants born at 25+0 to 31+6 weeks' gestation who progressively developed respiratory distress during the first 6 h after birth were randomly assigned to receive MISA or endotracheal intubation surfactant administration (EISA). The primary outcome was the difference in the morbidity of BPD between two groups of infants with MISA and EISA at 36 weeks corrected gestational age. Results: Demographic and clinical characteristics of the 151 infants in the MISA group were similar to the 147 infants in the EISA group. The comparison showed no clear benefits in the MISA group in the incidence of BPD, while infants from the EISA group had higher rates of patent ductus arteriosus (PDA) (60.5 vs. 41.1%, p = 0.001). The duration of surfactant infusion and the total time of surfactant administration in the MISA group were significantly longer than in the EISA group. A slightly increased heart rate was noted 1 h post surfactant administration in the EISA group. In subgroup analysis, the comparison of 51 smaller (

Background: The purpose of this study is to evaluate the correlation between spinopelvicalignment and the body weight parameters in healthy Chinese adult volunteers. That has not been systematically studied yet. Methods: 100 Chinese healthy adult volunteers (36 males and 64 females) were included in this study, which grouped according to the gender. The obesity parameters, body mass index (BMI), waist circumference (WC), sagittal abdominal diameter (SAD), transverse abdominal diameter (TAD) and RR (the ratio of SAD to TAD) were measured. The sagittal spinopelvic parameters include pelvic incidence (PI), pelvic tilt (PT), pelvic angulation (PA), sacral slope (SS), sacral inclination (SI), lumbar lordosis (LL) and the disc angle of L5/S1. The coronal spinopelvic parameters include the Cobb angle of the major curve of the spine, lumbar scoliosis (LS) and pelvic obliquity (PO). Pearson's correlation analysis was used to determine correlations between obesity index and spinopelvic alignment parameters. Results: The mean BMI and WC of the males and females was 28.7 ± 3.7 kg/m2 vs 26.8 ± 2.3 kg/m2 and 88.39 ± 9 cm vs 82.6 ± 2.7 cm respectively. In the female group, a strong correlation was found between BMI and PI, WC and PT, WC and PI. However, there was no strong correlation between the obesity and spinopelvic alignment parameters in the male group. None of the coronal spinopelvic parameters showed a correlation with the obesity parameters in two groups. The RR showed a positive linear correlation with PA and PT in both groups. Conclusions: Body weight could influence the spinopelvic alignment,especially for females. People with abdominal obesity, the sagittal spinopelvic alignment is likely to change. But there is little effect on the coronal spinopelvic alignment.