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Background Breast malignancy is the most frequently diagnosed malignancy in women worldwide, and the diagnosis relies on invasive examinations. However, most clinical breast changes in women are benign, and invasive diagnostic approaches cause unnecessary suffering for the patients. Thus, a novel noninvasive approach for discriminating malignant breast lesions from benign lesions is needed. Methods We performed cell-free DNA (cfDNA) sequencing on plasma samples from 173 malignant breast lesion patients, 158 benign breast lesion patients, and 102 healthy women. We then analyzed the cfDNA-based nucleosome profiles, which reflect the various tissues of origin and transcription factor activities. Moreover, by using machine learning classifiers along with the cfDNA sequencing data, we built classifiers for discriminating benign from malignant breast lesions. Receiver operating characteristic curve analyses were used to evaluate the performance of the classifiers. Results cfDNA-based nucleosome profiles reflected the various tissues of origin and transcription factor activities in benign and malignant breast lesions. The cfDNA-based transcription factor activities and breast malignancy-specific transcription factor-binding site accessibility profiles could accurately distinguish benign and malignant breast lesions, with area under the curve values of 0.777 and 0.824, respectively. Conclusions Our proof-of-principle study established a methodology for noninvasively discriminating benign from malignant breast lesions.

Nowadays, telecommunications have become an indispensable part of our life, 5G technology brings better network speeds, helps the AR and VR industry, and connects everything. It will deeply change our society. Transmission is the vessel of telecommunications. While the vessel is not so healthy, some of them are overloaded, meanwhile, others still have lots of capacity. It not only affects the customer experience, but also affects the development of communication services because of a resources problem. A transmission network is composed of transmission nodes and links. So that the possible topology numbers equal to node number multiplied by number of links means it is impossible for humans to optimize. We use Al instead of humans for topology optimization. The AI optimization solution uses an ITU Machine Learning (ML) standard, Breadth-First Search (BFS) greedy algorithm and other mainstream algorithms to solve the problem. It saves a lot of money and human resources, and also hugely improves traffic absorption capacity. The author comes from the team named "No Boundaries". The team attend ITU AI/ML in 5G Challenge and won the Gold champions (1st place).

Hong-Wu Wang,1,* Yi-Jin Hu,1,* Guo-Lin Wang2 1Department of Anesthesiology, TEDA International Cardiovascular Hospital of Tianjin Medical University, Tianjin, 300052, People’s Republic of China; 2Department of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, 300074, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guo-Lin WangDepartment of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, 300074, People’s Republic of ChinaTel/Fax +86 15822855566Email wanggl698521@163.comBackground: Protamine is a polycationic, and a strong basic peptide isolated from Clupeidae or Salmonidae fishes’ sperm, which is rich in arginine and highly alkaline.Objective: To explore the effect of lidocaine pre-treatment on protamine-induced pulmonary vascular reaction during the repair of congenital heart disease.Methods: Eighty patients undergoing repair of congenital heart disease were randomly divided into four groups: A1 (non-pulmonary hypertension + lidocaine pre-treatment) group, A2 (non-pulmonary hypertension + normal saline) group, B1 (pulmonary hypertension + lidocaine pre-treatment) group, and B2 (pulmonary hypertension + normal saline) group. Hemodynamic parameters, pulmonary inflammation, and pulmonary function were assessed at six intraoperative time points, two intraoperative time points and three intraoperative time points, respectively. P-value < 0.05 was considered statistically significant.Results: A2 group exhibited increased PAP, Paw, RI and A-aDO2. B2 group exhibited increased Paw, RI and A-aDO2 and decreased Cydn and OI after protamine administration. These changes were not observed in A1 and B1 group. Compared with A1 and B1 groups, plasma TXB2 level in A2 and B2 group was higher, but 6-keto-PGF1a in A2 and B2 groups was lower. Incidence of protamine adverse reactions in A1 and B1 group was lower than that in A2 and B2 group.Conclusion: Precondition of lidocaine before neutralization of heparin may be effective for protamine-induced pulmonary vascular reaction during CHD repair.Keywords: congenital heart disease, protamine, adverse reactions, extracorporeal circulation, pulmonary hypertension

BACKGROUND: According to the global cancer burden data released in 2020, breast cancer (BC) has become the most common cancer in the world. Similar to those of other cancers, the present methods used in clinic for diagnosing early BC are invasive, inaccurate, and insensitive. Hence, new non-invasive methods capable of early diagnosis are needed. METHODS: We applied next-generation sequencing and analyzed the messenger RNA (mRNA) profiles of plasma extracellular vesicles (EVs) derived from 14 BC patients and 6 patients with benign breast lesions. We used 3 regression models, namely support vector machine (SVM), linear discriminate analysis (LDA), and logistic regression (LR), to develop classifiers for use in making predictive BC diagnoses; and used 259 plasma samples, including those obtained from 144 patients with BC, 72 patients with benign breast lesions, and 43 healthy women, which were divided into training groups and validation groups to verify their performances as classifiers by quantitative reverse transcription polymerase chain reaction (RT-qPCR). The area under the curve (AUC) and accuracy, sensitivity, and specificity of the classifiers were cross-validated with the leave-1-out cross-validation (LOOCV) method. RESULTS: Among all combinations assessed with the 3 different regression models, an 8-mRNA combination, named EXOB(mRNA), exhibited high performance [accuracy =71.9% and AUC =0.718, 95% confidence interval (CI): 0.652 to 0.784] in the training cohort after LOOCV was performed, showing the largest AUC in the SVM model. The mRNAs in EXOB(mRNA) were HLA-DRB1, HAVCR1, ENPEP, TIMP1, CD36, MARCKS, DAB2, and CXCL14. In the validation cohort, the AUC of EXOB(mRNA) was 0.737 (95% CI: 0.636 to 0.837). In addition, gene function and pathway analyses revealed that different levels of gene expression were associated with cancer. CONCLUSIONS: We developed a high-performing predictive classifiers including 8 mRNAs from plasma extracellular vesicles for diagnosing breast cancer.

The effects of local factors on activation of immune cells infiltrating the central nervous system (CNS) in a rat model of traumatic brain injury (TBI) remain elusive. The cytokine, interleukin (IL)-15, is crucial for development and activation of CD8 T lymphocytes, a prominent lymphocytic population present in TBI lesions. We investigated whether IL-15 originates from astrocytes and whether IL-15 can evoke the CD8 T-lymphocyte response in TBI. We observed that astrocytes were activated in a rat model of TBI and that IL-15 was overexpressed on the surface of astrocytes. Further, CD8 T lymphocytes infiltrating TBI lesions colocalized with IL-15-expressing astrocytes. Activated CD8 T lymphocytes released granzyme B (Gra-b), which, in turn, activated caspase-3-induced poly(ADP-ribose) polymerase cleavage and, ultimately, neuronal apoptosis. Conversely, inhibition of astrocyte activation by pre-treatment with the specific inhibitor, fluorocitrate (FC), that reduces carbon flux through the Krebs cycle in astrocytes resulted in improved neurological function and memory. FC pre-treatment was also associated with downregulated IL-15 expression and CD8 T-cell activation as well as decreased levels of neuronal apoptosis, suggesting that IL-15 initiated a domino effect toward apoptosis. In contrast, rats pre-treated with recombinant rat IL-15 showed upregulated CD8 T-cell numbers and Gra-b levels, in addition to induction of neuronal apoptosis. Together, our results indicated that IL-15 could induce neuronal apoptosis by enhancing CD8 T-cell function in a rat model of TBI.

Background The duration of humoral and T and B cell response after the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. Methods We performed a cross-sectional study to assess the virus-specific antibody and memory T and B cell responses in coronavirus disease 2019 (COVID-19) patients up to 343 days after infection. Neutralizing antibodies and antibodies against the receptor-binding domain, spike, and nucleoprotein of SARS-CoV-2 were measured. Virus-specific memory T and B cell responses were analyzed. Results We enrolled 59 patients with COVID-19, including 38 moderate, 16 mild, and 5 asymptomatic patients; 31 (52.5%) were men and 28 (47.5%) were women. The median age was 41 years (interquartile range, 30–55). The median day from symptom onset to enrollment was 317 days (range 257 to 343 days). We found that approximately 90% of patients still have detectable immunoglobulin (Ig)G antibodies against spike and nucleocapsid proteins and neutralizing antibodies against pseudovirus, whereas ~60% of patients had detectable IgG antibodies against receptor-binding domain and surrogate virus-neutralizing antibodies. The SARS-CoV-2-specific IgG+ memory B cell and interferon-γ-secreting T cell responses were detectable in more than 70% of patients. Conclusions Severe acute respiratory syndrome coronavirus 2-specific immune memory response persists in most patients approximately 1 year after infection, which provides a promising sign for prevention from reinfection and vaccination strategy.

Background: Long-term morphine use is associated with serious side effects, such as morphine-induced hyperalgesia and analgesic tolerance. Previous investigations have documented the association between dopamine (DA) neurons in the ventral tegmental area (VTA) and pain. However, whether VTA DA neurons are implicated in morphine-induced hyperalgesia and analgesic tolerance remains elusive. Methods: Initially, we observed behavioural effects of lidocaine administration into VTA or ablation of VTA DA neurons on morphine-induced hyperalgesia and anti-nociceptive tolerance. Subsequently, c-Fos expression in nucleus accumbens (NAc) shell-projecting and medial prefrontal cortex (mPFC)-projecting VTA DA neurons after chronic morphine treatment was respectively investigated. Afterwards, the effects of chemogenetic manipulation of NAc shell-projecting or mPFC-projecting DA neurons on morphine-induced hyperalgesia and anti-nociceptive tolerance were observed. Additionally, effects of chemogenetic manipulation of VTA GABA neurons on c-Fos expression in VTA DA neurons were investigated. Results: Lidocaine injection into VTA relieved established hyperalgesia and anti-nociceptive tolerance whereas ablation of VTA DA neurons prevented the development of morphine-induced hyperalgesia and anti-nociceptive tolerance. Chronic morphine treatment increased c-Fos expression in NAc shell-projecting DA neurons, rather than in mPFC-projecting DA neurons. Chemogenetic manipulation of NAc shell-projecting DA neurons had influence on morphine-induced hyperalgesia and tolerance. However, chemogenetic manipulation of mPFC-projecting DA neurons had no significant effects on morphine-induced hyperalgesia and anti-nociceptive tolerance. Chemogenetic manipulation of VTA GABA neurons affected the c-Fos expression in VTA DA neurons. Conclusions: These findings revealed the involvement of NAc shell-projecting VTA DA neurons in morphine-induced hyperalgesia and anti-nociceptive tolerance, and may shed new light on the clinical management of morphine-induced hyperalgesia and analgesic tolerance. Perspective: This study demonstrated that NAc shell-projecting DA neurons rather than mPFC-projecting DA neurons in the VTA were implicated in morphine-induced hyperalgesia and anti-nociceptive tolerance. Our findings may pave the way for the discovery of novel therapies for morphine-induced hyperalgesia and analgesic tolerance.

Objective To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication. Methods A total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hedĭng (EX-LE2鹤顶), Neixīyan (内膝眼EX-LE4), Dubi (犊鼻ST35), Xuehai (血海SP10), Liangqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment. Results (1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P Conclusion The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.

Neutralization of SARS-CoV-2 Variants by Convalescent and Vaccinee Serum Analysis of serum samples from patients convalescing after SARS-CoV-2 infection and after vaccination with BBIBP-CorV or Cor...

Objectives Beginning in June 2017, numerous dengue virus (DENV) infections occurred in the Jining City of Shandong Province, formerly a dengue-free region in East China. We sought to describe the clinical and epidemiological features of this outbreak. Methods We reviewed the clinical records and epidemiological data regarding a case series of patients diagnosed with DENV in Jining City, from June 30 to September 14, 2017. Diagnosis was confirmed by molecular method, culture, or rapid diagnostic tests. Sequencing of the DENV envelope gene or the whole viral genome was performed for 11 patients. Additionally, neutralizing antibodies against DENV was measured among patients and residents from their same villages. Results Data from 150 patients were evaluated in this outbreak. None were diagnosed with dengue hemorrhagic fever or dengue shock syndrome. The patients’ ages ranged between 2–88 years (median 51 years, [IQR=37.5–64.3]), and 100 (66.7%) were female. Epidemiological analyses implicated a man who had visited Saudi Arabia as the likely source of the outbreak. Phylogenetic studies identified DENV serotype 1. Most of the patients demonstrated increases of neutralizing antibody titers one year after infection compared with titers three months after infection. The residents living in dengue-affected villages had a significant higher seroprevalence of 21.2% (95%CI 16.9-25.5) than residents (3.2%, 95%CI-0.36-6.7) living in a non-dengue-affected village. Conclusions This report documents the first dengue outbreak in Shandong Province, China, in more than 60 years. It underscores the need for medical providers to record patients’ travel histories and to consider dengue in their differential diagnoses.

Background This Bayesian network meta-analysis (NMA) was conducted to compare efficacy and safety of programmed death 1/ligand 1 (PD-1/L1) inhibitors in previous untreated advanced non-small cell lung cancer (NSCLC) patients. Methods Eligible studies evaluating first-line anti-PD-1/L1 based regimens in advanced NSCLC patients were included. Overall survival (OS), progression free survival (PFS), objective response rate (ORR), as well as treatment-related severe adverse events (tr-SAE) were synthesized within the Bayesian framework. Subgroup analysis was conducted according to PD-L1 expression. Results Twelve studies including 7,490 patients and 9 treatment strategies were enrolled in this study. For the PD-L1 expression non-selective patients, all chemo-immunotherapies were significantly better than chemotherapy for prolonging OS and PFS, except for caremlizumab plus chemotherapy (HR =0.72) failed to show advantages for OS. In addition, pembrolizumab plus chemotherapy showed better PFS than nivolumab plus ipilimumab (HR =0.66). In PD-L1 ≥50% patients, all immunotherapy was better than chemotherapy for OS, except for nivolumab (HR =0.83) and nivolumab plus ipilimumab (HR =0.70). For PFS, pembrolizumab plus chemotherapy (HR =0.39), atezolizumab plus chemotherapy (HR =0.47) and pembrolizumab (HR =0.67) were significantly better than chemotherapy. In PD-L1 1-49% patients, pembrolizumab plus chemotherapy (HR =0.52) and atezolizumab plus chemotherapy (HR =0.70) were better than chemotherapy for PFS. In the PD-L1 positive or negative group, all included corresponding regimens were equivalence according to OS and PFS. Conclusions We conducted a systematic comparison of first line immunotherapy for advanced NSCLC. Chemo-immunotherapies were better than chemotherapy and mono-immunotherapies in most patients. Pembrolizumab might have better efficacy than other PD-1/L1 inhibitors.

Objective To explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease. Methods Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yīfēng (翳风 TE17) and Qiānzheng (牵正 EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House–Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side. Results After 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56±4.25, 34.13±4.28, and 7.46±1.53 respectively, significantly increased in comparing with 11.69±2.45, 12.98±3.34, and 2.62±1.41 respectively before treatment (all P Conclusion Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.

Background. Many epidemiological studies have investigated the risk factors for clonorchiasis, but endoscopic findings of this disease in endoscopic retrograde cholangiopancreatography (ERCP) have not been well characterized. In this study, we evaluated clonorchiasis in ERCP in patients with biliary and pancreatic diseases. Methods. This was a retrospective two-center study in hospitalized patients who received ERCP between January 2012 and October 2018. All patients were divided into clonorchiasis and nonclonorchiasis groups. Data were analyzed using univariate analysis and multivariate analyses. Results. A total of 1119 patients were included, and clonorchiasis was diagnosed in 19.2% patients. Detection of Clonorchis sinensis eggs in bile samples was higher than that in fecal samples (85.9% vs. 58.7%; P=0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P=0.0001), age≤60 years old (95% CI: 1.212–2.474, P=0.003), patients with papilla fistula (95% CI: 0.081–0.900, P=0.033), and patients with a common bile duct (CBD) diameter<12 mm (95% CI: 1.093–2.130, P=0.013) were associated with clonorchiasis incidence. Nonclonorchiasis endoscopic diagnosis did not significantly correlate with clonorchiasis incidence (P>0.05). Conclusions. The detection of C. sinensis eggs was significantly higher in bile than in fecal samples; thus, bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. We found that male, age≤60 years old, and CBD diameter<12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor.

Objectives Despite the importance of immunological memory for protective immunity against viral infection, whether H7N9-specific antibodies and memory T-cell responses remain detectable years after the original infection is unknown. Methods A cross-sectional study was conducted to investigate the immune memory responses of H7N9 patients who contracted the disease and survived during the 2013–2016 epidemics in China. Sustainability of antibodies and T-cell memory to H7N9 virus were examined. Healthy individuals receiving routine medical examinations in a physical examination centre were recruited as control. Results A total of 75 survivors were enrolled and classified into four groups based on the time elapsed from illness onset to specimen collection: 3 months (n = 14), 14 months (n = 14), 26 months (n = 28) and 36 months (n = 19). Approximately 36 months after infection, the geometric mean titres of virus-specific antibodies were significantly lower than titres in patients 3 months after infection, but 16 of 19 (84.2%) survivors in the 36-month interval had microneutralization (MN) titres ≥40. Despite the overall declining trend, the percentages of virus-specific cytokine-secreting memory CD4+ and CD8+ T cells remained higher in survivors at nearly all time-points in comparison with control individuals. Linear regression analysis showed that severe disease (mean titre ratio 2.77, 95% CI 1.17–6.49) was associated with higher haemagglutination inhibition (HI) titre and female sex for both HI (1.92, 1.02–3.57) and MN (3.33, 1.26–9.09) antibody, whereas female sex (mean percentage ratio 1.69, 95% CI 1.08–2.63), underlying medical conditions (1.94, 95% CI 1.09–3.46) and lack of antiviral therapy (2.08, 95% CI 1.04–4.17) were predictors for higher T-cell responses. Conclusions Survivors of H7N9 virus infection produced long-term antibodies and memory T-cell responses. Our findings warrant further serological investigation in general and high-risk populations and have important implications for vaccine design and development.

Background and Aims: The prognosis of intrahepatic cholangiocarcinoma (ICC) after radical resection is far from satisfactory, but the effect of postoperative transarterial chemoembolization (p-TACE) remains controversial. This multi-center retrospective study was to evaluate the clinical value of p-TACE and identify the selected patients who would benefit from p-TACE. Methods: Data of ICC patients who underwent radical resection with/without p-TACE therapy was obtained from 12 hepatobiliary centers in China between Jan 2014 and Jan 2017. Overall survival (OS) was set as the primary endpoint, which was analyzed by the Kaplan-Meier method before and after propensity score matching (PSM). Subgroup analysis was conducted based on the established staging system and survival risk stratification. Results: A total of 335 patients were enrolled in this study, including 39 patients in the p-TACE group and 296 patients in the non-TACE group. Median OS in the p-TACE group was longer than that in the non-TACE group (63.0 months vs. 18.0 months, P=0.041), which was confirmed after 1:1 PSM (P=0.009). According to the 8th TNM staging system, patients with stage II and stage III stage would be benefited from p-TACE (P=0.021). Subgroup analysis stratified by risk factors showed that p-TACE could only benefit patients with risk factors

Instrumentation and control (I&C) systems act as the central nervous system of the Nuclear Power Plant as the erroneous functioning of them can become a reason for an inevitable casualty. The information from these instruments is crucial for plant operators to assess and continuously monitor the plant status. This fact highlights the significance of instrument availability during all possible environmental conditions in a Nuclear Power Plant (NPP). Along with several instruments used in an NPP, transmitters have gained momentous significance in the instrumentation loop as they provide critical information about the plant status. Therefore, the CN0289 pressure transmitter, which has been used extensively in industrial applications, is taken as an object of study for this paper. The instrumentation availability analysis depends on its evaluation under the faulted environment that may be caused by severe accidents. So, the aberrations in the output of the transmitter circuit under harsh environmental conditions have been observed in a well privileged simulating environment MULTISIM. The effect of accidental conditions like elevated temperature, humidity and high pressure have been analyzed on electronic components of the circuit and components most critical for the instrument availability have been identified. Later, a discriminant classifier has been implemented to analyze the instrument condition under different environmental scenarios for its availability. For this purpose, faulty signals are generated in MATLAB by using the statistical formulas of the faults observed in the output of the transmitter circuit. A set of timedomain distinguishing features have been selected to evaluate the instrument usability by the discriminant classifier. Based on these distinguishing features, a quadratic curve separates the faulty signals from the healthy ones indicating the availability of the instrument in a particular scenario. So, this analysis aids in assessing the instrument performance and later a guideline to ameliorate its design for operation under harsh environmental conditions.

Cloud service-based applications are subject to reliability critical problem, as the reliability of the application relies on both the failed states and the probabilities of the failures. Classically, reliability analysis approaches are lack of estimating unknown failure rate and non-exponentially distributed failure times. We propose a new framework for analyzing the reliability. The method is mainly decomposed in four successive steps: a non-Makovian stochastic Petri net (NMSPN) model which describes the failure behavior of underlying applications, a software reliability growth model (SRGM) which estimates the failure data of each basic service, a reachability graph which discoveries all the failure sequences, and a computation procedure which computes the occurrences of non-exponential failures. We assess and validate our method by conducting experiment on an actual application. The results demonstrate that the method is competitive compared to the existing approaches for reliability analysis, while providing a better reliability. This result is helpful to the managers in optimizing the overall quality of the cloud service-based application.

Breast cancer is the second cause of cancer-associated death among women and seriously endangers women’s health. Therefore, early identification of breast cancer would be beneficial to women’s health. At present, circular RNA (circRNA) not only exists in the extracellular vesicles (EVs) in plasma, but also presents distinct patterns under different physiological and pathological conditions. Therefore, we assume that circRNA could be used for early diagnosis of breast cancer. Here, we developed classifiers for breast cancer diagnosis that relied on 259 samples, including 144 breast cancer patients and 115 controls. In the discovery stage, we compared the genome-wide long RNA profiles of EVs in patients with breast cancer (n=14) and benign breast (n=6). To further verify its potential in early diagnosis of breast cancer, we prospectively collected plasma samples from 259 individuals before treatment, including 144 breast cancer patients and 115 controls. Finally, we developed and verified the predictive classifies based on their circRNA expression profiles of plasma EVs by using multiple machine learning models. By comparing their circRNA profiles, we found 439 circRNAs with significantly different levels between cancer patients and controls. Considering the cost and practicability of the test, we selected 20 candidate circRNAs with elevated levels and detected their levels by quantitative real-time polymerase chain reaction. In the training cohort, we found that BCExoC, a nine-circRNA combined classifier with SVM model, achieved the largest AUC of 0.83 [95% CI 0.77-0.88]. In the validation cohort, the predictive efficacy of the classifier achieved 0.80 [0.71-0.89]. Our work reveals the application prospect of circRNAs in plasma EVs as non-invasive liquid biopsies in the diagnosis and management of breast cancer.

Polarization dependency is an intrinsic property of liquid crystals (LC) devices but major problem is optical efficiency. We demonstrated a polarization independent liquid crystal phase modulation based on the orthogonal nematic LC (OLC) mode wherein the optics axes of nematic liquid crystal molecules are set orthogonally to adjacent sub-domains for the first time. Such an OLC mode includes sub-domain with anisotropic orientations but collectively presents a capability of a polarizer-free optical phase modulation. An OLC mode cell provides a tunable optical phase of ∼3.35π radians for unpolarized light and different linearly polarized light. Among the polarizer-free LC mode, the proposed OLC mode is single-layered with large tunable optical phase. We also demonstrated a polarizer-free LC micro-lens. We expect this novel LC mode provide alternatives technology roadmap for upcoming optical applications, such as electrically tunable ophthalmic lenses and optical systems for augmented reality.

Purpose The purpose of this paper is to study the seismic performance of the energy-saving block and invisible multi-ribbed frame composite walls (EBIMFCW), changing the shear-span ratio as the test parameter, the low-cycle reciprocating loading tests of six 1/2 scale wall models were carried out. Design/methodology/approach The test design method and analysis are used for the seismic performance of the EBIMFCW. Findings With the increase of shear-span ratio: the walls tend to occur bending failure even more, the initial stiffness of the wall decreases, the overall ductility of the wall is improved and the walls tend to occur bending failure. Originality/value The previous studies do not involve the seismic performance of EBIMFCW under different shear-span ratios. Therefore, the paper studies the hysteresis behavior, ductility, stiffness degradation and energy dissipation performance of EBIMFCW under different shear-span ratios.

BACKGROUND The de Winter electrocardiography (ECG) pattern is a sign that implies proximal left anterior descending coronary artery occlusion in patients with chest pain. The previous view was that the de Winter ECG pattern is static. CASE SUMMARY A 65-year-old man presented with sudden chest pain at rest associated with diaphoresis for 55 min. The first ECG showed only T-wave inversion in III and aVF leads. Another ECG was performed at the 100th minute, showing upsloping ST segments depressed with tall and symmetrical T waves in the precordial leads; the J point was raised by 0.1 mV at the aVR lead. The patient was referred to our catheterization laboratory. A third ECG showed ST segment elevation by 0.2 mV in the I and aVL leads. The patient underwent emergency coronary angiography, which revealed complete proximal left anterior descending coronary (LAD) occlusion. The second patient presented with a 1-h history of sudden-onset, severe, substernal crushing chest pain. The first ECG showed ST-segment elevation (0.1–1.7 mV) in I, aVL, and precordial leads. The patient was referred to the catheterization laboratory. On arrival, his symptoms alleviated, and ECG showed that the ST-segments had significantly fallen back. The third ECG showed a typical de Winter pattern. Coronary angiography revealed 99% stenosis of the middle LAD. CONCLUSION The de Winter ECG pattern is transient and dynamic, and it reflects proximal or mid-LAD subtotal occlusion rather than total occlusion.

Objectives To observe the clinical effect on the sequela of peripheral facial paralysis treated with the penetrating-sticking-pulling technique of acupuncture. Methods A total of 53 patients with the sequela of peripheral facial paralysis were diagnosed and divided into an observation group (26 cases) and a control group (27 cases) according to the visiting sequence. In the observation group, the penetrating-sticking-pulling technique of acupuncture was adopted. The Sibai (四白 ST 2), Quanliao (颧髎 SI 18) and Jiachē (颊车 ST 6) et al. were needling toward Dicāng (地仓 ST 4) separately. The combined acupoints were selected according to clinical symptoms of individual patient. In the control group, the routine acupuncture was used, in which, ST 2, EX-HN 5, ST 7, ST 6, and ST 4 as well as Hegŭ (合谷 LI 4) on the healthy side were selected. The treatment was given once every two days and a 7-treatment made one course. There were 3 days at interval between the courses. After 2 courses of treatment, the facial nerve function, e.g., Hourse–Brackmann (H–B) grading, Sunnybrook score and clinical effect were observed. Results ① After treatment, H-B grading and Sunnybrook score were better than those before treatment in either of the observation group or the control group (P Conclusion The penetrating-sticking-pulling technique of acupuncture achieves the definite effect on the sequela of peripheral facial paralysis and this therapy deserves to be promoted in clinical practice.

Objective To explore the change of intestinal microecology in patients with primary Sjogren's syndrome (pSS) and correlation with disease activity, and also discuss the therapy effect of Yangyin Yiqi Huoxue Recipe (, YYHD). Methods Sixteen pSS patients were enrolled in the present study, who received 3-month treatment of YYHR, 200 mL orally twice daily. Their pre-and post-test ESSDAI scores, erythrocyte sedimentation rate (ESR) and serum immunoglobulin G (IgG) levels were measured respectively. The 16SrDNA metagenomic sequencing was used to detect and analyze the abundance and diversity of intestinal bacteria flora and the proportion of bacteria at the levels of phylum, family, and genus, in comparision with those of 6 healthy subjects in the control group. Results The abundance and diversity of intestinal bacteria flora in pSS patients were lower than those of healthy subjects (P 0.05). Conclusions There exists an imbalance of intestinal microecology in pSS patients, which can be improved through the treatment with YYHD. Besides, such treatment can also improve the disease activity and adjust the diversity of intestinal bacteria flora, the composition and the abundance of intestinal flora.

Background. The bile infection may already exist before the administration of an interventional procedure, despite no clinical manifestations of cholangitis detected. Blood cultures remained negative even in more than half of the febrile cases with cholangitis. Risk factors associated with bacterial growth in bile before the intervention are not well defined. To establish the bacterial profiles isolated from the bile samples and to identify risk factors for bacterial colonization in the bile system. Methods. Individuals who underwent endoscopic retrograde cholangiopancreatography (ERCP) interventions were enrolled. Bile samples were aspirated and were immediately transferred into a sterile tube for storage. Results. Positive bile cultures were detected in 363 (38.0%) of 956 patients, including 322 benign diseases and 41 malignances. Of 363 positive cases, 351 (96.7%) were monoinfection and 12 (3.3%) multi-infection. Escherichia coli were the most common Gram-negative bacteria (210, 56.0%), followed by Klebsiella pneumoniae (45, 12.0%). Enterococcus faecalis represented the most common Gram-positive microorganism (19, 5.07%), while Candida albicans (11, 2.93%) were the dominant fungi. Klebsiella pneumoniae were more frequently detected in malignant diseases (P=0.046). Age, previous ERCP history or OLT history, and CBD diameter were independent risk factors for positive cultures (P<0.05) while preoperative jaundice drug therapy was the protective factor for bile infection (P<0.05). Conclusion. Monomicrobial infection was dominant among all infections, and Klebsiella pneumoniae strains were more frequently isolated from patients with malignant diseases. To effectively manage patients who are at a high risk for bile infection, a detailed diagnosis and treatment plan for each case should be prepared.

In this letter, we explore a limited feedback scheme for meeting the requirements that different users demand different communication rates. The main idea of this letter is to prioritize users by assigning different priority weights to the residual interference of each user. Then, by minimizing the weighted sum of residual interference, the optimal scheme for the allocation of feedback bits to support service differentiation is designed. Simulation results show that the proposed scheme can support service differentiation regarding communication rates and the degree of difference in communication rate between users can be flexibly adjusted by changing the weights.

Source rocks are the material basis of oil and gas generation and determine the potential resources of exploration blocks and have important research value. This paper studies the lithology, thickness, and geochemistry of Mesozoic source rocks in the southeastern East China Sea continental shelf. The results show that the Mesozoic source rocks are mainly dark mudstone and coal-bearing strata. The total thickness of Lower–Middle Jurassic source rocks ranges from 100 m to 700 m, and that of Lower Cretaceous source rocks ranges from 50 m to 350 m. The overall thickness of Mesozoic source rocks is distributed in the NE direction and their thickness center is located in the Jilong Depression. The Lower–Middle Jurassic source rocks are mainly developed shallow marine dark mudstone and transitional coal measure strata. Those of the Lower Cretaceous are mainly mudstone of a fan delta front. Lower–Middle Jurassic and Lower Cretaceous hydrocarbon source rocks are dominated by type III kerogen, with Lower–Middle Jurassic hydrocarbon source rocks having high organic matter abundance and being medium–good hydrocarbon source rocks, while Lower Cretaceous hydrocarbon source rocks have relatively poor quality. From northwest to southeast, the vitrinite reflectance Ro of Mesozoic source rocks increases gradually. Source rocks in the study area are divided into three types. The first hydrocarbon-generating area is mainly located in the southeastern region of the study area, and the Jilong Depression is the hydrocarbon-generating center. The results of this study can provide a basis for exploration of Mesozoic oil and gas resources in the southeastern East China Sea continental shelf. © 2019 China Geology Editorial Office.

Objective Over the past decade, several studies have highlighted that axillary lymph node ratio (ratio of involved over excised axillary lymph nodes) was a superior predictor for survival outcomes compared with ypN staging. Thus, this study aimed to integrate the prognostic value of axillary lymph node ratio to improve individualized prediction of survival in node-positive breast cancer patients after neoadjuvant chemotherapy. Methods A clinical data of 339 node-positive breast cancer patients after neoadjuvant chemotherapy from two independent centers were retrospectively reviewed. A nomogram incorporating axillary lymph node ratio was constructed to predict disease-free survival based on Cox proportional hazards model. The discrimination, calibration ability, and clinical usefulness of the axillary lymph node ratio-based model were evaluated using C-index, calibration curve, risk group stratification and decision curve analysis and were compared with the TNM staging system. Results Independent prognostic factors for disease-free survival were age, pathological T stage, axillary lymph node ratio, histological grade, estrogen receptor status, Ki67 and lymphovascular invasion, which were entered into the nomogram. The C-index of the axillary lymph node ratio-based nomogram was higher than that of the TNM staging system (0.773 vs 0.610). The calibration plot indicated close agreement between model predictions and actual observations. Based on the risk group stratification of the nomogram, Kaplan-Meier curves demonstrated significant differences between the low-risk and high-risk groups (P < 0.0001). Conclusions The axillary lymph node ratio-based nomogram provided more accurate individualized risk prediction of disease-free survival in node-positive breast cancer patients after neoadjuvant chemotherapy. This practical tool may assist oncologists in selecting the high-risk patients who are in need of a specific treatment strategy.

Background: Metastatic non-small cell lung cancer (NSCLC) has many comorbidities, such as chronic obstructive pulmonary disease, coronary heart disease, and older age-related comorbidities. A survival benefit was observed in such patients who underwent surgery for selected oligometastatic disease. However, to the best of our knowledge, there is no evidence to support whether lobectomy (compared with sub-lobar resection) would further prolong these patients' lives. Methods: Patients with metastatic NSCLC who underwent primary tumor resection were identified from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into lobectomy and sub-lobar resection groups. Propensity score matching (PSM, 1:1) was performed to match the baseline characteristics of the two groups. Cancer-specific survival (CSS) was estimated. Results: In total, 24,268 patients with metastatic NSCLC were identified; 4,114 (16.95%) underwent primary tumor surgery, and of these, 2,045 (49.71%) underwent lobectomy and 1,766 (42.93%) underwent sub-lobar resection. After PSM, 644 patients in each group were included. Lobectomy was independently correlated with longer median CSS time [hazards ratio (HR): 0.70, 95% confidence interval (CI): 0.61-0.80, P

Gene expression signatures have been used to predict the outcome of chemotherapy for breast cancer. The nucleosome footprint of cell-free DNA (cfDNA) carries gene expression information of the original tissues and thus may be used to predict the response to chemotherapy. Here we carried out the nucleosome positioning on cfDNA from 85 breast cancer patients and 85 healthy individuals and two cancer cell lines T-47D and MDA-MB-231 using low-coverage whole-genome sequencing (LCWGS) method. The patients showed distinct nucleosome footprints at Transcription Start Sites (TSSs) compared with normal donors. In order to identify the footprints of cfDNA corresponding with the responses to neoadjuvant chemotherapy in patients, we mapped on nucleosome positions on cfDNA of patients with different responses: responders (pretreatment, n = 28; post-1 cycle, post-3/4 cycles, and post-8 cycles of treatment, n = 12) and nonresponders (pretreatment, n = 10; post-1 cycle, post-3/4 cycles, and post-8 cycles of treatment, n = 10). The coverage depth near TSSs in plasma cfDNA differed significantly between responders and nonresponders at pretreatment, and also after neoadjuvant chemotherapy treatment cycles. We identified 232 TSSs with differential footprints at pretreatment and 321 after treatment and found enrichment in Gene Ontology terms such as cell growth inhibition, tumor suppressor, necrotic cell death, acute inflammatory response, T cell receptor signaling pathway, and positive regulation of vascular endothelial growth factor production. These results suggest that cfDNA nucleosome footprints may be used to predict the efficacy of neoadjuvant chemotherapy for breast cancer patients and thus may provide help in decision making for individual patients.

With the widespread occurrence of aquaculture diseases and the broad application of antibiotics, drug-resistant pathogens have increasingly affected aquatic animals’ health. Marine probiotics, which live under high pressure in a saltwater environment, show high potential as a substitute for antibiotics in the field of aquatic disease control. In this study, twenty strains of non-hemolytic bacteria were isolated from the intestine of wild oysters and perch, and a model of Caenorhabditis elegans infected by Vibrio anguillarum was established. Based on the model, ML1206, which showed a 99% similarity of 16S rRNA sequence to Planococcus maritimus, was selected as a potential marine probiotic, with strong antibacterial capabilities and great acid and bile salt tolerance, to protect Caenorhabditis elegans from being damaged by Vibrio anguillarum. Combined with plate counting and transmission electron microscopy, it was found that strain ML1206 could significantly inhibit Vibrio anguillarum colonization in the intestinal tract of Caenorhabditis elegans. Acute oral toxicity tests in mice showed that ML1206 was safe and non-toxic. The real-time qPCR results showed a higher expression level of genes related to the antibacterial peptide (ilys-3) and detoxification (ugt-22, cyp-35A3, and cyp-14A3) in the group of Caenorhabditis elegans protected by ML1206 compared to the control group. It is speculated that ML1206, as a potential probiotic, may inhibit the infection caused by Vibrio anguillarum through stimulating Caenorhabditis elegans to secrete antibacterial effectors and detoxification proteins. This paper provides a new direction for screening marine probiotics and an experimental basis to support the potential application of ML1206 as a marine probiotic in aquaculture.

As Internet Technology (IT) rapidly grows, it is necessary to protect private and confidential information of collected data from both smart and Internet of Things (IoT) devices. It becomes a necessity to protect and hide confidential or private information for data sharing or publishing between collaborators and partners. The concept of Privacy-Preserving Data Mining, known as PPDM, is created to clean the database for hiding sensitive information. However, it applies only to binary databases. To handle Privacy-Preserving Utility Mining, known as PPUM, we present a Maximum Sensitive Utility-Maximum Sensitive conflIct algorithm, known as MSU-MSI, to find conflicting items within sensitive high-utility itemsets for sanitization of data. Transactions with sensitive high-utility itemsets are first projected for the sanitization process. Next, the number of conflicting items within the itemsets is calculated, and the designed progress is used to reduce the quantity value of processed items for sanitization. In our experimental results, the designed algorithm is compared with the standard algorithms like HHUIF, MSICF, and the state-of-the-art MSU-MAX and MSU-MIN approaches. Finally, the proposed MSU-MSI is shown to achieve better performance in terms of missing cost, especially in extreme datasets (very dense or very sparse), a true testament to the process. Furthermore, the designed MSU-MSI achieved an excellent performance in terms of database structure similarity and database utility similarity with a very slight difference compared to the previously achieved top results.

While some individuals infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present mild-to-severe disease, many SARS-CoV-2-infected individuals are asymptomatic. We sought to identify the distinction of immune response between asymptomatic and moderate patients. We performed single-cell transcriptome and T-cell/B-cell receptor (TCR/BCR) sequencing in 37 longitudinal collected peripheral blood mononuclear cell samples from asymptomatic, moderate, and severe patients with healthy controls. Asymptomatic patients displayed increased CD56briCD16− natural killer (NK) cells and upregulation of interferon-gamma in effector CD4+ and CD8+ T cells and NK cells. They showed more robust TCR clonal expansion, especially in effector CD4+ T cells, but lack strong BCR clonal expansion compared to moderate patients. Moreover, asymptomatic patients have lower interferon-stimulated genes (ISGs) expression in general but large interpatient variability, whereas moderate patients showed various magnitude and temporal dynamics of the ISGs expression across multiple cell populations but lower than a patient with severe disease. Our data provide evidence of different immune signatures to SARS-CoV-2 in asymptomatic infections.

The dynamics, duration, and nature of immunity produced during SARS-CoV-2 infection are still unclear. Here, we longitudinally measured virus-neutralising antibody, specific antibodies against the spike (S) protein, receptor-binding domain (RBD), and the nucleoprotein (N) of SARS-CoV-2, as well as T cell responses, in 25 SARS-CoV-2-infected patients up to 121 days post-symptom onset (PSO). All patients seroconvert for IgG against N, S, or RBD, as well as IgM against RBD, and produce neutralising antibodies (NAb) by 14 days PSO, with the peak levels attained by 15–30 days PSO. Anti-SARS-CoV-2 IgG and NAb remain detectable and relatively stable 3–4 months PSO, whereas IgM antibody rapidly decay. Approximately 65% of patients have detectable SARS-CoV-2-specific CD4+ or CD8+ T cell responses 3–4 months PSO. Our results thus provide critical evidence that IgG, NAb, and T cell responses persist in the majority of patients for at least 3–4 months after infection., Understanding if lasting immune responses can be induced by SARS-CoV-2 infection is important for controlling the COVID-19 pandemic. Here, the authors show, in a cohort of 25 patients, that IgG and T cell responses, as well as neutralising antibody, are still detectable against various SARS-CoV-2 proteins 3 months post-symptom onset, while IgM levels largely wane at this time.

BACKGROUND: Whether non-intubated spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) is a safe procedure remains controversial for mediastinal tumor patients with impaired lung function. Herein, we assessed feasibility of SV-VATS in lung function deficiency patients underwent mediastinal tumor resection. METHODS: From December 2015 to February 2020, 32 mediastinal tumor patients with impaired lung function (preoperative forced expiratory volume in 1 second

Background The prognositc factors in patient with invasive cribriform carcinoma (ICC) of breast is still remain controversal. The study aims to establish a nomogram to predict the survival outcomes in patients with ICC based on the Surveillance, Epidemiology and End Results (SEER) database. Methods We retrieved SEER database for clinical data about patients including ICC and infiltrating ductal carcinoma (IDC) from 2004 to 2015. Kaplan-Meier survival was used to compare the difference survival outcomes between ICC and IDC. ICC patients were randomly allocated to training cohort and validation cohort. A nomogram was built to predict individual patient’s 3-year and 5-year survival status for ICC. The established TMN model and the newly established nomogram was further evaluated by the concordance index (C-index) and the decision curve analysis (DCA). Results Comparing the baseline clinical data between IDC and ICC, a significant of smaller tumor mass, less infiltrated lymph nodes, lower metastases rate, better tumor differentiation degree, higher proportion of estrogen receptor (ER) and progesterone receptor (PR) positive and lower rate of chemotherapy and radiotherapy was found in ICC. Age at diagnosis, marriage status, tumor location, T stage, M stage, ER status, surgery were independent significant prognostic factors for the overall survival (OS). A significantly higher C-index was found in nomogram compared with established TNM model in validation cohort. Conclusions The prognosis of ICC patients is better than that of IDC patients. The nomogram is recommended for future patient with ICC to survival analysis.

In this paper, a wideband dual circular polarization septum antenna working in X-band is presented. The antenna can realize dual circular polarization by inserting a stepped metal septum in the rectangular waveguide. The bandwidth of the antenna is widened by loading the dielectric in the rectangular waveguide and using a stepped feeding at the bottom of the antenna, which makes the antenna element convenient for array application. The simulation results show that the proposed antenna can obtain a 15% bandwidth for the VSWR less than 2, the isolation between the input ports less than -10 dB, and the axial ratio less than 3 dB.

Purpose: During surgical procedure on lumbar spondylolisthesis, the role of reducing slip remains controversial. The purpose of the present study was to compare fusion in situ with reduction in clinical and radiographic outcomes. Methods: A literature research was performed at PubMed, Embase, Web of Science, and Cochrane Library. After screening by two authors, ten articles were brought into this meta-analysis finally, and the quality was evaluated by the modified Newcastle–Ottawa Scale (NOS). Isthmic, moderate, and serious spondylolisthesis were all analyzed separately. Sensitivity analyses were performed for high-quality studies, and the publication bias was evaluated by the funnel plot. Results: Most criteria did not have statistical differences between reduction and fusion in situ groups. However, in reduction group, the union rate was significantly higher (P=0.008), the slippage was much improved (P Conclusions: Both reduction and fusion in situ for lumbar spondylolisthesis were related with good clinical results. Reduction led to higher rate of fusion, better radiographic slippage, and shorter hospital stay. After sufficient decompression, reduction did not incur additional risk of neurologic impairment compared with fusion in situ.

Most of the charging piles run in harsh environments such as outdoor for a long time, and are prone to reliability problems, which has become one of the bottlenecks affecting the development of new energy automobile industry. Taking the classic DC charging pile as an example, the reliability index of the DC charging pile is proposed. In-depth analysis of the reliability impact of the internal structural function modules of the DC charging pile, and the minimum cut set method was used to calculate the failure index of the DC charging pile. The calculation example calculates the reliability indicators such as the failure rate of the charging pile through specific parameters to verify the effectiveness of the method in this paper.

Data concerning the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic and paucisymptomatic patients are lacking. We report a 3-family cluster of infections involving asymptomatic and paucisymptomatic transmission. Eight of 15 (53%) members from 3 families were confirmed with SARS-CoV-2 infection. Of 8 patients, 3 were asymptomatic and 1 was paucisymptomatic. An asymptomatic mother transmitted the virus to her son, and a paucisymptomatic father transmitted the virus to his 3-month-old daughter. SARS-CoV-2 was detected in the environment of 1 household. The complete genomes of SARS-CoV-2 from the patients were > 99.9% identical and were clustered with other SARS-CoV-2 sequences reported from China and other countries.

Primary Sjogren's syndrome (pSS) is a chronic autoimmune disease with a long duration of illness, for which there is no cure. Patients often suffer from anxiety and depression due to various reasons, exhibiting a decline in their quality of life. Chinese medicine (CM) has certain advantages in the treatment of pSS, which not only helps relieve clinical symptoms and improve treatment outcomes, but also reduces anxiety and depression and improves the quality of life. Therefore, CM should be considered as early as possible given its effectiveness and synergistic effects in treating pSS.

Background: Previous studies reported that stress-induced phosphoprotein 1 (STIP1) can be secreted by hepatocellular carcinoma (HCC) cells and is increased in the serum of HCC patients. However, the therapy-monitoring and prognostic value of serum STIP1 in HCC remains unclear. Here, we aimed to systemically explore the prognostic significance of serum STIP1 in HCC. Methods: A total of 340 HCC patients were recruited to this study; 161 underwent curative resection and 179 underwent transcatheter arterial chemoembolization (TACE). Serum STIP1 was detected by enzyme-linked immunosorbent assay (ELISA). Optimal cutoff values for serum STIP1 in resection and TACE groups were determined by receiver operating characteristic (ROC) analysis. Prognostic value was assessed by Kaplan-Meier, log-rank, and Cox regression analyses. Predictive values of STIP1 for objective response (OR) to TACE and MVI were evaluated by ROC curves and logistic regression. Results: Serum STIP1 was significantly increased in HCC patients when compared with chronic hepatitis B patients or health donors (both P < 0.05). Optimal cutoff values for STIP1 in resection and TACE groups were 83.43 and 112.06 ng/ml, respectively. High pretreatment STIP1 was identified as an independent prognosticator. Dynamic changes in high STIP1 status were significantly associated with long-term prognosis, regardless of treatment approaches. Moreover, post-TACE STIP1 was identified as an independent predictor for OR, with a higher area under ROC curve (AUC-ROC) than other clinicopathological features. Specifically, pretreatment STIP1 was significantly increased in patients with microvascular invasion (MVI), and was confirmed as a novel, powerful predictor for MVI. Conclusions: Serum STIP1 is a promising biomarker for outcome evaluation, therapeutic response assessment, and MVI prediction in HCC. Integration serum STIP1 detection into HCC management might facilitate early clinical decision making to improve the prognosis of HCC.

Purpose Recombinant human thrombopoietin (rhTPO) has been evaluated as a therapeutic intervention for radiation-induced myelosuppression. However, the immunogenicity induced by a repeated-dosing strategy raises concerns about the therapeutic use of rhTPO. In this study, single-dose administration of rhTPO was evaluated for efficacy in the hematopoietic response and survival effect on mice and nonhuman primates exposed to total body irradiation (TBI). Methods and Materials Survival of lethally (9.0 Gy) irradiated C57BL/6J male mice was observed for 30 days after irradiation. Hematologic evaluations were performed on C57BL/6J male mice given a sublethal dose of radiation (6.5 Gy). Furthermore, in sublethally irradiated mice, we performed bone marrow (BM) histologic evaluation and evaluated BM-derived clonogenic activity. Next, the proportion and number of hematopoietic stem cells (HSCs) were analyzed. Competitive repopulation experiments were conducted to assess the multilineage engraftment of irradiated HSCs after BM transplantation. Flow cytometry was used to evaluate DNA damage, cell apoptosis, and cell cycle stage in HSCs after irradiation. Finally, we evaluated the efficacy of a single dose of rhTPO administered after 7 Gy TBI in male and female rhesus monkeys. Results A single administration of rhTPO 2 hours after irradiation significantly mitigated TBI-induced death in mice. rhTPO promoted multilineage hematopoietic recovery, increasing peripheral blood cell counts, BM cellularity, and BM colony-forming ability. rhTPO administration led to an accelerated recovery of BM HSC frequency and multilineage engraftment after transplantation. rhTPO treatment reduced radiation-induced DNA damage and apoptosis and promoted HSC proliferation after TBI. Notably, a single administration of rhTPO significantly promoted multilineage hematopoietic recovery and improved survival in nonhuman primates after TBI. Conclusions These findings indicate that early intervention with a single administration of rhTPO may represent a promising and effective radiomitigative strategy for victims of radiation disasters.

The lattice anchoring structure is a widely used single-form retaining structure to enhance the stability of soil slope. Meanwhile, the lattice anchoring beam is commonly combined with a gravity wall, namely a combined retaining structure, to support the high slope in engineering practice. In this study, the numerical models for both a single-form lattice anchoring structure and a combined retaining structure were established using FLAC3D code. The Wenchuan ground motions with different amplitudes were applied to investigate and compare the seismic response of the single-form lattice anchoring structure and the combined retaining structure regarding the earth pressure response, the deformation response, the mechanical characteristic of anchor and the element state of structure during earthquake. The numerical results were verified by shaking table test in terms of the dynamic earth pressure response and the axial stress of anchor. Although an intense earth pressure response was observed behind the combined retaining wall, the combined retaining structure was recommended to support the high slope in high seismic intensity region instead of the single-form lattice anchoring structure in view of the deformation of structure, the axial stress of anchor and the failure state of element.

Due to the diversity and complexity of distribution networks, the classical modular software development method may face the difficulty in modular division, data sharing and collaboration of different specialties. Inspired by the idea of separating the control plane from the data forwarding plane in software-defined networking (SDN), a method of power data virtual plane is proposed in this paper to improve software development efficiency. Layered processing of power data virtual plane is designed to meet the diversity characteristics of intelligent distribution network and the multi-source and heterogeneous characteristics of information. This paper introduces the design idea and implementation process of virtual plane in detail. The main component of the power data virtual plane, power data warehouse and application scheduling are presented. Finally, the performance of the proposed virtual plane method is verified by practical distribution network examples with different communication networks and information.

Determining the longevity of natural immunity after SARS-CoV-2 infection is critical for understanding immune protection and optimizing vaccine design. Over six months have been passed since the emergence of COVID-19 in China. We evaluated humoral and cellular responses in 418 patients six months after infection. 95.9% and 98.1% of the patients maintained SARS-CoV-2-specific IgG and neutralizing antibodies. All severe patients were positive for IgG and neutralizing antibodies and had significantly higher titers than mild and moderate patients as well as asymptomatic individuals. The patients had a more robust SARS-CoV-2-specific CD4+ T cell response than CD8+ T cells six months after infection. Unexpectedly, sustained immune activation was observed, which displayed as the evaluated proinflammatory monocytes, non-classical NK cells, CD4+ Treg cells, and activated CD4+ T cells. Our findings indicate that SARS-CoV-2 gives rise to persisting and robust protective immunity, which provides a promising sign for prevention from reinfection and vaccination strategy. Funding: This work was supported by grants from the Natural Science Foundation of China (81773494 to M.J.M.), the National Major Project for Control and Prevention of Infectious Disease of China (2017ZX10303401-006 to M.J.M.), the Special National Project on Investigation of Basic Resources of China (2019FY101502 to M.J.M.). Conflict of Interest: The authors declare no competing interests. Ethical Approval: All patients provided written informed consent. The study was conducted following the Declaration of Helsinki, and the Institutional Review Board of the Academy of Military Medical Sciences approved the study protocol (IRB number: AF/SC-08/02.46).

As important means of marine surveys, resource development and military purpose, underwater vehicles are widely used in civilian and military applications. High precision navigation is a necessary condition for underwater vehicles to obtain effective information. It is also a key factor in determining the safe operation and smooth return of underwater vehicles. Inertial navigation system is the core equipment for navigation of underwater vehicles, but its positioning accuracy error increases with time, which is unable to meet the requirements of long-time and long-range underwater vehicles. Aiming at this problem, combining the advantages of high accuracy in short term of the inertial navigation system and the error of LBL acoustic navigation system that does not accumulate with time, this paper designs the inertial/acoustic integrated navigation system of underwater vehicles. The system can calibrate and correct the inertial navigation system of underwater vehicles in the situation where GPS and BeiDou satellite positioning cannot be used, which can satisfy the needs of deep sea high precision, long-range navigation and autonomous navigation of underwater vehicles.

Aiming at the rapid identification of rural buildings in complex environments from high-spatialresolution images, an improved Mahalanobis distance colour segmentation method (IMDCSM) is proposed and realised in Red, Green and Blue (RGB) space. Vector sets of a lower discrete degree are obtained by filtering the colour vector sets of the building samples, and a standard ellipsoid equation can be constructed based on these vector sets. The threshold of interested colour range can be flexibly and intuitively selected by changing the shape and size of this ellipsoid. Then, according to the relationship between the location of the image pixel colour vector and the ellipsoid, all building information can be extracted quickly. To verify the effectiveness of the proposed method, unmanned aerial vehicle (UAV) images of two areas in the suburbs of Chengdu city and Deyang city were utilised as experimental data for image segmentation, and the existing colour segmentation method based on the Mahalanobis distance was selected as an indicator to assess the effectiveness of this method. The experimental results demonstrate that the completeness and correctness of this method reached 95% and 83.0%, respectively, values that are higher than those of the Mahalanobis distance colour segmentation method (MDCSM). In general, this method is suitable for the rapid extraction of rural building information, and provides a new threshold selection method for classification.

The accurate prediction of overall survival (OS) is important in clinical decision-making for breast cancer treatment. We developed a model to predict the OS of non-metastatic breast cancer patients in China. This multicenter study included 1844 non-metastatic breast cancer patients who underwent breast cancer surgery between January 2009 and December 2011 in 3 tertiary teaching hospitals in China. Data were collected retrospectively from the database of each hospital. We used univariate and multivariate Cox proportional hazard regression analyses to screen for predictors. A nomogram was developed in the training cohort (from Sun Yat-sen Memorial Hospital [SYSMH]), externally validated in 2 validation cohorts (from the First People’s Hospital of Foshan [FPHF] and Sun Yat-sen University Cancer Center (SYUCC)), and compared with CancerMath, a mathematical-based model. We used Receiver Operating Characteristic curves and calibration plots to assess the models. At median follow-ups of 65.9, 68.6, and 66.2 months, the 5-year OS rates were 93.0%, 86.7%, and 91.0% in the SYSMH, FPHF, and SYUCC cohorts, respectively. We identified age, T stage, lymph node status, estrogen receptor, and human epidermal growth factor receptor 2 statuses as significant prognostic factors. A nomogram was developed and externally validated in the FPHF (area under the curve= 0.74) and SYUCC (area under the curve= 0.77) cohorts. Calibration plots showed that the predicted OS was consistent with the actual OS. The nomogram outperformed CancerMath in our study population. In summary, we developed a nomogram to predict survival among non-metastatic breast cancer patientsin China. This nomogram is superior to the CancerMath model in Chinese populations. Key words: breast cancer; nomogram; overall survival; prediction