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Objective In the present study, we evaluated the feasibility of a self-expanding venous stent for treating iliofemoral venous obstruction. Methods The present retrospective study reviewed the data from 49 patients who had undergone Zilver Vena (Cook Medical, Bloomington, Ind) stent placement for treatment of iliofemoral venous obstruction from September 2017 to March 2019. All patients had undergone received follow-up duplex ultrasound examinations to assess for stent patency. The Villalta scores and Venous Clinical Severity Scores (VCSSs) were also calculated to stratify the postoperative improvement in disease. Results Of the 49 patients, 19 had had acute deep vein thrombosis, 7, nonthrombotic iliac venous lesions, and 23, post-thrombotic syndrome. At 1 year after Zilver Vena stent placement, the primary, assisted primary, and secondary patency rates were 93.8%, 95.9%, and 97.9%, respectively. The baseline median Villalta score before treatment for those with post-thrombotic syndrome was 19 (range, 11-30), and the median VCSS for the patients with post-thrombotic syndrome and nonthrombotic iliac venous lesions was 11 (range, 6-25). At 1 year after stent placement, the median Villalta score for the post-thrombotic syndrome patients was 4.0 (range, 2-18), and the median VCSS for the post-thrombotic syndrome and nonthrombotic iliac venous lesions patients was 3.0 (range, 2-12). Conclusions Venous placement of self-expanding stents offers excellent 1-year patency rates and improved the outcomes of patients with iliofemoral venous obstruction caused by acute deep vein thrombosis, nonthrombotic iliac venous lesions, and post-thrombotic syndrome.

Objective:The aim of this study was to present the clinical characteristics and dynamic changes in laboratory parameters of the coronavirus disease 2019 (COVID-19) in Guangzhou, and explore the probable early warning indicators of disease progression.Method:We enrolled all the patients diagnosed with COVID-19 in the Guangzhou No. 8 People’s Hospital. The patients’ demographic and epidemiologic data were collected, including chief complaints, lab results, and imaging examination findings.Results:The characteristics of the patients in Guangzhou are different from those in Wuhan. The patients were younger in age, predominately female, and their condition was not commonly combined with other diseases. A total of 75% of patients suffered fever on admission, followed by cough occurring in 62% patients. Comparing the mild/normal and severe/critical patients, being male, of older age, combined with hypertension, abnormal blood routine test results, raised creatine kinase, glutamic oxaloacetic transaminase, lactate dehydrogenase, C-reactive protein, procalcitonin, D-dimer, fibrinogen, activated partial thromboplastin time, and positive proteinuria were early warning indicators of severe disease.Conclusion:The patients outside epidemic areas showed different characteristics from those in Wuhan. The abnormal laboratory parameters were markedly changed 4 weeks after admission, and also were different between the mild and severe patients. More evidence is needed to confirm highly specific and sensitive potential early warning indicators of severe disease.

This study sought to validate the performance of simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) imaging in characterizing carotid IPH by histology. Thirty-five patients with carotid atherosclerotic disease (symptomatic 50–70% stenosis or > 70% stenosis) scheduled for carotid endarterectomy underwent 3.0-T carotid MR imaging by acquiring SNAP and magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) sequences. Presence and area of IPH were separately evaluated on SNAP and MP-RAGE images. Presence and area of IPH were also assessed on histology. Agreement between SNAP/MP-RAGE and histology was determined in identify and quantify IPH using Cohen kappa, Spearman correlation, and Bland-Altman analyses. Of all 35 patients (mean age: 63.1 ± 8.8 years; 27 males), 128 slices with successful registration were eligible for analysis. The accuracy, sensitivity, specificity, and positive and negative predictive values were 86.7%, 85%, 89.6%, 93.2%, and 78.2% for SNAP, and 76.6%, 75%, 79.2%, 85.7%, and 65.5% for MP-RAGE in identification of IPH, respectively. In identification of IPH, the kappa value between SNAP and histology and between MP-RAGE and histology was 0.725 and 0.520, respectively. The correlation between SNAP and histology (r = 0.805, p < 0.001) was stronger than that between MP-RAGE and histology (r = 0.637, p < 0.001) in measuring IPH area. Bland-Altman analysis showed that, in measuring IPH area, the bias of SNAP (1.4 mm2, 95% CI: − 0.016 to 2.883) was smaller than that of MP-RAGE (1.7 mm2, 95% CI: − 0.039 to 3.430) compared with histology. This validation study by histology demonstrates that SNAP sequence better identifies and quantifies carotid intraplaque hemorrhage compared with traditional MP-RAGE sequence. • SNAP imaging showed better agreement with histology compared with MP-RAGE imaging, especially for the IPHs with small size. • SNAP sequence is a more effective tool to identify and quantify carotid IPH than traditional sequence of MP-RAGE that can help clinicians to optimizing the treatment strategy. • The plaque components of rich lipid pools or loose matrix and chronic/old IPH (cholesterol crystals) can lead to false positive and false negative results in SNAP and MP-RAGE imaging for identifying IPH.

Background MicroRNAs (miRNAs) play important roles in the development and progression of sepsis. This study investigated the clinical value of miR-19b-3p in sepsis patients, and explored its role in regulating inflammatory responses in HUVECs cells. Methods 103 patients with sepsis and 98 healthy individuals were recruited. qRT-PCR was used for the measurement of miR-19b-3p level. Cell viability was evaluated using CCK-8. The protein levels of TNF-α and IL-6 were measured using ELISA. Receiver operating characteristic (ROC) curve and logistic regression analysis were constructed to evaluate the diagnostic and prognostic values of miR-19b-3p in sepsis patients. Results MiR-19b-3p level was significantly reduced in the serum from patients with sepsis compared with healthy controls (P P P = 0.037). MiR-19b-3p level was negatively associated with serum levels of IL-6 (r = − 0.852, P r = − 0.761, P P Conclusion MiR-19b-3p might be a potential biomarker for the early diagnosis and prognosis of sepsis patients. Overexpression of miR-19b-3p alleviated sepsis-induced inflammatory responses.

Lovastatin is a statin produced by Monascus purpureous-fermented pu-erh tea, which is used in the treatment of cardiovascular diseases and prostate cancer. Bacteria-mediated cancer immunotherapy (BCI), which is an effective antitumor strategy compared with conventional immunotherapies, targets neutrophil infiltration associated with tumor recurrence and metastasis. In mouse colon cancer models, combination treatment with lovastatin and BCI suppressed tumor progression by extending the survival of tumor-colonizing bacteria. We used zebrafish live imaging to show that lovastatin decreases the recruitment of neutrophils to the inflammatory site by inducing neutrophil apoptosis via phosphorylation of ERK and AKT. The present findings suggest that the combination of BCI with lovastatin or fermented pu-erh tea is an effective approach compared with conventional cancer immunotherapy.

ObjectivesIt is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate trends in drug use, prescribing patterns and spending for antineoplastic drug therapies for CRC in major cities of China.MethodsInformation from 128 811 antineoplastic drug prescriptions in CRC was retrospectively collected from the Hospital Prescription Analysis Cooperative Project. The prescriptions extracted included demographic information of patients, the generic name and the price of antineoplastic drugs. The Mann-Kendall and Cochran-Armitage trend test was used to estimate the trends of antineoplastic agent usage.ResultsThe number of antineoplastic prescriptions ranged from 18 966 in 2015 to 34 219 in 2019. Among the prescriptions collected in this study, the annual cost of antineoplastic drugs increased by 117.2%, and average prescription cost increased by 20%. Throughout the study period, the most prescribed antineoplastic drugs were capecitabine, oxaliplatin, fluorouracil and irinotecan, representing 49%, 27%, 21% and 9% of (per cent of visits (PV)). The PV of bevacizumab and cetuximab increased by 494% and 338% (from 1.8% and 1.3% in 2015 to 10.7% and 5.7% in 2019). In prescribing patterns of antineoplastic agents, monotherapy gradually decreased, while combination therapy, especially three-drug combination, increased significantly from 1.35% to 7.31%.ConclusionThis study estimated recent trends of antineoplastic drug use and expenditure for Chinese patients with CRC. These results would inform CRC treatment decisions, including health insurance negotiation, precision therapy access, allocation of research funding and evaluation of the financial burden of CRC drug treatment.

Purpose This paper aims to examine a type of interorganizational learning called Industry Peer Networks (IPNs), in which a network of non-competing small businesses cooperates to improve their skills and to stay abreast of the industry trends, so that the firms remain competitive in the local and regional markets. The key characteristic of an IPN is the regular gathering of peers in small groups (typically 20 or fewer carefully selected members) in an atmosphere of significant trust, guided by a facilitator, to participate in a series of formal and informal activities through established guidelines, to share knowledge about management and marketing, exchange information about industry trends beyond their core markets, discuss issues related to company performance and provide constructive criticism about peer companies. Design/methodology/approach The qualitative research on the context included visits to 13 peer meetings, three workshops for peer members, seven semi-structured interviews with members and many communications with the founder, chairman, committee chairpersons and several facilitators of peer meetings that spanned across five years. Data collection and analysis followed grounded theory building techniques. Findings The authors identified both cooperative and competitive learning practices that a small business could carry out to grow from a novice to an expert IPN peer member. The cooperative elements such as peer discussions, disclosure of financial data and exposure to various business models allow member firms to learn vicariously through the successes and/or failure of their peers. At the same time, the competitive elements such as service delivery critiques, business performance benchmarking and firm ranking also prompt the members to focus on execution, to emphasize accountability and to strive for status in the network. The IPN in this research has also built network legitimacy over time, and it has sustained a viable administrative entity that has a recognizable form and structure, whose functions are to strategically manage network activities and network growth to attract like-minded new members. Research limitations/implications First, because this research focused on fleshing out the transformative practices engaged by IPN peers, it necessarily neglected other types of network relationships that affect the small businesses, including local competitors, vendors and customers. Second, the small employment size of these firms and the personal nature of network ties in the IPN may provide an especially fertile ground for network learning that might not exist for larger firms. Third, the technology-intensive and quality-sensitive nature of IT firms may make technological trend sensitization and operating efficiency more competitive advantages in this industry than in others. Finally, although participation in IPN is associated with higher level of perceived learning, the relationship between learning and business performance is not yet articulated empirically. Practical implications The study contributes to the understanding of cooperative/competitive transformative practices in the IPN by highlighting the defining features at each transformation stage, from firms being isolated entities which react to market forces to connected peers which proactively drive the markets. IPNs are most effective for business owners who are at their early growth stage, in which they are positioned to grow further. Nevertheless, the authors also present the paradoxical capacity of IPNs to propel firms along trajectories of empowerment or disengagement. Social implications As 78.5 per cent of the US firms are small businesses having fewer than 10 employees, the knowledge of firm and IPN transformation is important for both researchers and advocates of small businesses to understand the roots of success or failure of firms and the IPNs in which they are embedded. Originality/value Earlier research has not explored the network-level effects as part of a full array of outcomes. Instead, research involving IPNs has focused primarily on the motivation and immediate firm-level outcomes of IPNs. Research to this point has also failed to examine IPNs from a developmental perspective, how the firms and the IPN as a network transform over time.

Objectiveg : A systematic review and meta-analysis were performed to evaluate the necessity for compression therapy with elastic stockings following endovenous thermal ablation (EVTA) for chronic venous insufficiency. Methods : MedLine, ScienceDirect and the Cochrane Library were searched for the relevant literature according to the inclusion and exclusion criteria. Two researchers independently extracted data and assessed the quality of the literature. Randomized controlled trials comparing the use of elastic stockings for compression therapy versus no compression therapy following RFA or EVLA for varicose veins were included in this study. The primary outcome of postoperative pain was assessed using the visual analogue pain scale (VAS). Secondary outcomes included the bruising score, quality of life, venous clinical severity score, time to return to normal activities, complications, and the rate of saphenous vein occlusion. The mixed effect model or random effect model was used to calculate relative risk (RR), mean difference (MD) or standardized mean difference (SMD) following the heterogeneity test. Sensitivity analysis was performed for outcomes with high heterogeneity (I2>50%). Outcomes were described qualitatively for studies that could not be pooled. Results : Six RCTs with 1,045 subjects were included. Overall, postoperative compression therapy significantly reduced the mean pain in the first 10 days post-EVTA (MD= - 4.98,95% CI: -8.71 to -1.24), and the time to return to normal activities (MD=-1.01, 95% CI: -1.97 to -0.06). In terms of the bruising score, the venous clinical severity score, complications (RR=1.05,95% CI: 0.55-2.00), quality of life at 2 weeks (MD= -0.71,95% CI: -2.09 to 0.67) and 6 months (MD=0.26,95% CI: -1.22 to 1.74), and the saphenous vein occlusion rate (RR=1.00,95% CI: 0.95-1.04), there were no significant differences between the compression and control groups. Conclusion : Our study recommends the routine use of compression therapy with elastic stockings following EVTA of varicose veins to reduce postoperative pain and the time to return to normal activities. However, further multi-center and high-quality randomized clinical trials (RCT) are needed for the unified treatment for varicose veins, the target population as well as the duration of compression therapy on whether elastic stockings is beneficial following EVTA.

Although aquaculture provides a stable and high-quality source of food, the environmental effects related to large-scale industrial aquacultural activities have raised concern. To identify the influence of aquacultural activities on sedimentary bacterial communities, we collected surface and deeper sediments from a series of sites subjected to varying intensities of aquacultural activities within Eastern Lake Taihu, China. The associated physicochemical properties were measured, and 16S rRNA gene sequencing was applied to determine the related bacterial communities in sediment. The diversity and composition of bacterial communities within the surface sediments differed significantly from those of the deeper sediment samples. Marked differences were also found between the surface sediments of the aquaculture-influenced and non-aquaculturally influenced sites. More importantly, phylogenetic structure analysis indicated that stochastic processes dominated the assembly of the bacterial communities; yet, the relative contribution of deterministic processes to bacterial community assembly was greater in the aquacultural zones than in the non-aquacultural zones. Furthermore, we identified total phosphorus (TP) as the most important factor driving the assembly of bacterial communities influenced by aquaculture in sediment. These findings provide useful information for ecological assessments and remediation strategies for aquaculture-influenced ecosystems.

WAP four-disulfide core domain 2 (WFDC2) is a small secretory protein that has been widely studied in ovarian cancer. It has been proven that WFDC2 promotes proliferation and metastasis in ovarian cancer, and serves as a diagnostic biomarker. However, the specific function of WFDC2 in prostate cancer has not been reported. Here, we first screened the diagnostic marker and favorable prognostic factor WFDC2 in prostate cancer by bioinformatics. WFDC2 expression was negatively correlated with Gleason score and metastasis in prostate cancer. Then, we revealed that overexpression of WFDC2, and addition of recombinant protein HE4 can significantly inhibit prostate cancer metastasis in vivo and in vitro. By co-immunoprecipitation and co-localization assays, we proved that WFDC2 binds to the extracellular domain of epidermal growth factor receptor (EGFR). Immunoblot showed that WFDC2 overexpression and recombinant protein HE4 addition inactivated the EGFR/AKT/GSK3B/Snail signaling pathway, and then restrained the progression of epithelial–mesenchymal transition. In conclusion, our study identified that the tumor suppressor WFDC2 can suppress prostate cancer metastasis by inactivating EGFR signaling.

Background: Depression is pervasive in the military context and is likely to elicit lasting negative effects on health. Based on interpersonal models, social-interpersonal stressors are significantly associated with the development and maintenance of depression. However, little is known about the mechanisms by which these stressors increase the risk of depression in terms of social relationships. Rejection sensitivity, which refers to people who are sensitive to social rejection and tend to anxiously expect, readily perceive, and overreact to it, may play an underlying role in this process, as it is formed through social-interpersonal stressors and then aggravates further symptoms of depression. Objectives: The current study aimed to examine the mediating effects on the relationship between social-interpersonal stressors and depressive symptoms in the military context. Methods: This study recruited 600 soldiers aged from 17-36 (M = 21.80; SD = 2.99; 100% males) with a cluster sampling method who completed Social-Interpersonal Stressors subscale, Rejection Sensitivity Questionnaire (RSQ) and Self-Rating Depression Scale (SDS). Mediation analyses examined the underlying mechanism between social-interpersonal stressors and depressive symptoms. Results: The results support the hypothesis and indicate that rejection sensitivity mediates the association between social-interpersonal stressors and depressive symptoms (B indirect = 0.02, p < 0.001, 95% CI= 0.005 to 0.044). Conclusions: The findings suggest that interventions designed to desensitize individuals’ high levels of rejection sensitivity may help to decrease their risk of depressive symptoms in the military environment. Rejection sensitivity is an important mechanism underpinning the development of depressive symptoms. Other theoretical and applied implications for prevention of depressive symptoms in the military context are discussed.

BACKGROUND The relationship between plaque characteristics and their predictive value for perioperative cerebral blood flow (CBF) are unknown. PURPOSE To investigate the relationship between carotid plaque characteristics and perioperative CBF utilizing MRI. STUDY TYPE Prospective. POPULATION In all, 131 patients with carotid moderate-to-severe stenosis referred for carotid endarterectomy (CEA). FIELD STRENGTH/SEQUENCE 3T, black-blood T1 - and T2 -weighted, 3D time-of-flight, and simultaneous noncontrast angiography intraplaque hemorrhage. ASSESSMENT The relative CBF (rCBF = CBFindex-hemisphere /CBFcontralateral-hemisphere ) and the CBF difference ratio (DRCBF = [CBFpost-CEA - CBFpre-CEA ]/CBFpre-CEA ) in the middle cerebral artery territory were measured. The pre- and post-CEA CTP data were used as the assessment standard for CBF change. Carotid lipid-rich necrotic core (LRNC), intraplaque hemorrhage, calcification, fibrous cap rupture, maximum wall thickness, normalized wall index (NWI), and stenosis were determined. STATISTICAL TESTS Pearson or Spearman correlation, Mann-Whitney U-test, and linear regression. RESULTS Patients with LRNC had higher rCBFpre-CEA than those without (1.0 ± 0.1 vs. 0.9 ± 0.1, P

Background It has been proved that multi-contrast cardiovascular magnetic resonance (CMR) vessel wall imaging could be used to characterize carotid vulnerable plaque components according to the signal intensity on different contrast images. The signal intensity of plaque components is mainly dependent on the values of T1 and T2 relaxation. T1 mapping recently showed a potential in identifying plaque components but it is not well validated by histology. This study aimed to validate the usefulness of in vivo T1 mapping in assessing carotid vulnerable plaque components by histology. Methods Thirty-four subjects (mean age, 64.0 ± 8.9 years; 26 males) with carotid plaques referred to carotid endarterectomy were prospectively enrolled and underwent 3 T CMR imaging from May 2017 to October 2017. The T1 values of intraplaque hemorrhage (IPH), necrotic core (NC) and loose matrix (LM) which were identified on multi-contrast vessel wall images or histology were measured on in-vivo T1 mapping. The IPHs were divided into two types based on the proportion of the area of fresh hemorrhage on histology. The T1 values of different plaque components were compared using Mann-Whitney U test and the agreement between T1 mapping and histology in identifying and quantifying IPH was analyzed with Cohen’s Kappa and intraclass correlation coefficient (ICC). Results Of 34 subjects, 19 had histological specimens matched with CMR imaging. The mean T1 values of IPH (651 ± 253 ms), NC (1161 ± 182 ms) and LM (1447 ± 310 ms) identified by histology were significantly different. The T1 values of Type 1 IPH were significantly shorter than that of Type 2 IPH (456 ± 193 ms vs. 775 ± 205 ms, p p p = 0.028) and segmentation (ICC = 0.816, 95% CI 0.679–0.894) of IPHs between T1 mapping and histology. Conclusions The T1 values of carotid plaque components, particularly for intraplaque hemorrhage, are differentiable, and the stage of intraplaque hemorrhage can be classified according to T1 values, suggesting the potential capability of assessment of vulnerable plaque components by T1 mapping.

BACKGROUND Intravenous thrombolysis is the only approved pharmacological treatment for acute ischemic stroke (AIS) patients, but the immediate response to thrombolysis varies by patient. OBJECTIVE To investigate the factors associated with early neurological improvement (ENI) after the administration of intravenous recombinant tissue plasminogen activator (rt-PA) treatment to AIS patients within 4.5 hours of onset. METHODS Demographics, onset to treatment time, risk factors, and clinical and laboratory data of 209 AIS patients undergoing intravenous rt-PA therapy at a Chinese hospital between January 2013 and August 2016 were retrospectively analyzed. The National Institutes of Health Stroke Scale (NIHSS) score was recorded before thrombolytic therapy, 24 hours after the treatment, and 7 days after the treatment to evaluate the recovery of neurological function. ENI was defined as a ≥4-point decrease in NIHSS score compared with baseline or a score of 0 or 1 at 24 hours and 7 days. A multivariate logistic regression analysis was performed to assess the outcomes. RESULTS Of the 209 AIS patients treated by intravenous thrombolysis with rt-PA, low-density lipoprotein (LDL) levels were significantly lower (P

Background: Identifying risk factors of cardiovascular events is crucial for stroke prevention and they can be used as predictive factors of stroke outcomes.In this study, it is to evaluate the risk factors that predict outcomes of acute non-cardioembolic ischemic stroke in patients stratified by Essen Stroke Risk Score (ESRS). Methods: A retrospective study was carried out in acute non-cardioembolic ischemic stroke patients in a Chinese tertiary-care teaching hospital. ESRS stratification and factors that might influence the outcomes of stroke, as indicated by fatal or non-fatal combined vascular events of recurrent stroke, myocardial infarction, or primary intracranial hemorrhage, were documented. Univariate analysis and multivariable regression analysis was used to identify independent predictors of stroke outcomes. Results: A total of 878 patients with acute non-cardioembolic ischemic stroke who completed a mean follow-up of 5.2 years were enrolled, and 163 patients experienced at least one component of the combined vascular event. In patients with an ESRS ≤ 3, age ≥ 65 years (OR , 2.935; 95% CI 1.625-5.301, P < 0.001) and clopidogrel treatment (OR , 1.685 ; 95% CI , 1.026-2.768; P = 0.041) were significantly associated with stroke outcomes. In patients with an ESRS > 3, age ≥ 65 years (OR , 2.107, 95% CI , 1.208-3.673 ; P = 0.008) and history of diabetes (OR , 1.465 ; 95% CI , 1.041–2.062 ; P = 0.027) were risk factors for stroke outcomes , whereas clopidogrel treatment (OR , 0.542; 95% CI , 0.356–0.824; P = 0.003) was a protective factor for stroke outcomes. Conclusions: According to this study, clopidogrel treatment, blood pressure control, and glycemic control are protective factors for stroke outcomes in high-risk patients (ESRS>3).

This study aimed to investigate the spatial distribution and patterns of multimorbidity among the elderly in China. Data on the occurrence of 14 chronic diseases were collected for 9710 elderly participants in the 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Web graph, Apriori algorithm, age-adjusted Charlson comorbidity index (AAC), and Spatial autocorrelation were used to perform the multimorbidity analysis. The multimorbidity prevalence rate was estimated as 49.64% in the elderly in China. Three major multimorbidity patterns were identified: [Asthma/Chronic lungs diseases]: (Support (S) = 6.17%, Confidence (C) = 63.77%, Lift (L) = 5.15); [Asthma, Arthritis, or rheumatism/ Chronic lungs diseases]: (S = 3.12%, C = 64.03%, L = 5.17); [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack]: (S = 3.96%, C = 51.56, L = 2.69). Results of the AAC analysis showed that the more chronic diseases an elderly has, the lower is the 10-year survival rate (P < 0.001). Global spatial autocorrelation showed a positive spatial correlation distribution for the prevalence of the third multimorbidity pattern in China (P = 0.032). The status of chronic diseases and multimorbidity among the elderly with a spatial correlation is a significant health issue in China.

Aspirin and clopidogrel are both acceptable antiplatelet options for the secondary prevention of noncardioembolic ischemic stroke. Associations between Essen Stroke Risk Score (ESRS) and antiplatelet treatment in Chinese patients with noncardioembolic ischemic stroke were assessed. This retrospective study was taken in a tertiary care hospital located in eastern China. Patients with noncardioembolic ischemic stroke hospitalized during January 1, 2009, to December 31, 2011, were classified according to ESRS during index stroke hospitalization. Antiplatelet strategy at the time of discharge was categorized as aspirin (100 mg/day) vs. clopidogrel (75 mg/day). Patients received follow-up from July 1, 2014, to December 31, 2015, and the efficacy of clopidogrel and aspirin in different ESRS subgroups was assessed with respect to reducing the risk of a combined vascular event of recurrent stroke, myocardial infarction, or primary intracranial hemorrhage. Totally, 1175 non-cardiac stroke patients were included, among which 878 patients completed follow-up surveys. Of the patients who completed the follow-up, 458 (52.2%) had an ESRS 3, and 621 (70.7%) received aspirin. Patients who received clopidogrel tended to be older, and more patients had hypertension, diabetes, and an ESRS 3 than patients who received aspirin. Over a mean follow-up of 5.2 years, the rate of combined vascular events was 19.3% in the aspirin group and 16.7% in the clopidogrel group. Compared with clopidogrel-treated patients, a significant (P = 0.044) reduction in combined vascular events in aspirin-treated patients was observed in patients with an ESRS ≤ 3 (OR, odds ratio 0.5; 95% CI 0.3 to 0.9). However, a significant (P = 0.002) increase in combined vascular events was observed in patients with an ESRS 3 (OR 2.2; 95% CI 1.3 to 3.8). More clopidogrel-treated patients with ESRS 3 and ESRS = 3 discontinued treatment than their counterparts who took aspirin (P 0.05). Adverse drug events, such as digestive discomfort and bleeding, were similar. In conclusion, clopidogrel is suggested for patients with an ESRS 3 and aspirin for patients with an ESRS ≤ 3 for the secondary prevention of noncardioembolic ischemic stroke in Chinese patients.

Coronary heart disease (CHD) is one of the leading causes of morbidity and mortality worldwide, and more efforts should be made to reduce the risk of cardiovascular events. This study aimed to investigate the impact of clinical pharmacist intervention on the prognosis of acute coronary syndrome (ACS) in Chinese patients with CHD. Two hundred and forty patients who had ACS were recruited. Participants were randomly assigned to the intervention group (n = 120) or the control group (n = 120). The intervention group received a medication assessment and education by the clinical pharmacist at discharge and telephone follow-ups at 1 week and 1 and 3 months after discharge. The control group received usual care. The primary outcomes of this study were the proportion of patients who had major adverse cardiovascular events (MACEs), including mortality, nonfatal myocardial infarction (MI), stroke, and unplanned cardiac-related rehospitalizations within 6 and 12 months after hospital discharge. Secondary outcome was self-reported medication adherence to evidence-based medications for CHD (antiplatelets, statins, β-blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). Of 240 enrolled patients, 238 (98.3%) completed 6-month follow-up, and 235 (97.9%) completed 12-month follow-up. There were no significant differences between intervention and control groups in the percentages of patients who incurred MACEs within the 6-month follow-up (3.3% vs 7.6%, respectively, P = 0.145) or 12-month follow-up (10.9% vs 12.1%, respectively, P = 0.783). Significant improvements were found in the prescribing rates of β-blockers and all four classes of medications at discharge in the intervention group compared with the control group (P = 0.001 and P = 0.009, respectively). There was no significant difference between the intervention and control groups in the use of all four classes of medications at the 6-month follow-up (48.3% vs 45.8%, respectively, P = 0.691) and 12-month follow-up (47.9% vs 46.6%, respectively, P = 0.836). The use of β-blockers was nonsignificantly higher in the intervention group than in the control group at the 6-month follow-up (74.2% vs. 64.4%, P = 0.103) and 12-month follow-up (74.8% vs 63.8%, P = 0.068). Clinical pharmacist intervention had no significant effects on reduction in cardiovascular events among patients with CHD. Further studies with larger sample sizes and longer time frames for both intervention and follow-up are needed to validate the role of the clinical pharmacist in the morbidity and mortality of CHD. Clinical Trial Registration: chictr.org.cn, identifier ChiCTR-IOR-16007716.

To develop and verify a risk predictive model/scoring system for pulmonary embolism (PE) among hospitalized patients with deep venous thrombosis of the lower extremities (LDVT).776 patients with LDVT were enrolled in a case-control study between January 2016 and June 2017 from the Vascular Surgery Department of Shanxi Dayi Hospital, China. They were randomly divided into development (543 patients, 70%) and validation (233 patients, 30%) databases. Based on the results of pulmonary computed tomography arteriography, patients were divided into 2 categories; those with PE were designated as the case group, whereas those without comprised the controls. A logistic regression model and scoring system for PE in patients with LDVT was established in the development database and verified in the validation database. Scoring system (Shanxi Dayi Hospital score [SDH score]) was tabulated as follows: right lower extremity or bilateral lower extremities, 1; surgery or immobilization, 1; malignant tumor, 1; history of venous thromboembolism (VTE), 2; D-dimer1,000 ng/mL, 2; and unprovoked, 2. Calibration and discrimination of the model were assessed by the Hosmer-Lemeshow goodness of fit test and the area under the receiver operating characteristic curve (AUC). Wells score, the Revised Geneva score, and the SDH score for predictive value of PE by AUC in the validation database were compared.776 patients with LDVT were divided into 2 risk categories based on the scores from the risk model as follows: PE unlikely (score3) and PE likely (score ≥3). Sensitivity, specificity, and crude agreement of the SDH score in the development database were 76.39%, 55.89%, and 61.33%, respectively. In the validation database, the logistic regression model showed good calibration and discriminative power. The Hosmer-Lemeshow goodness of fit test P value was0.05, and the AUC was 0.705 (95% CI: 0.634-0.776, P 0.001). The SDH score also showed good discriminative power, and the AUC was 0.702 (95% CI: 0.631-0.774, P 0.001). Sensitivity, specificity, and crude agreement of the SDH score in the validation database were 67.61%, 61.73%, and 63.52%, respectively. AUC for the Wells score and the Revised Geneva score was 0.611 (95% CI: 0.533-0.688, P = 0.007) and 0.585 (95% CI: 0.503-0.666, P = 0.040), respectively. Difference of the AUC was not statistically significant between the Wells score and the SDH score (0.611 vs. 0.702, P = 0.059) but was so between the Revised Geneva score and the SDH score (0.585 vs. 0.702, P = 0.016). Sensitivity of the Wells score, Revised Geneva score, and the SDH score (64.79%, 67.61% vs. 67.61%) was not statistically significant. However, the specificity of the Wells score and Revised Geneva score was significantly lower than that of the SDH score (48.77%, 39.51% vs. 61.73%).Our logistic regression model and the SDH score based on 7 risk factors as right lower extremity, bilateral lower extremities, unprovoked, surgery or immobilization, malignant tumor, history of VTE, and D-dimer1,000 ng/mL showed good calibration and discriminative power for the assessment of PE risk in patients with LDVT. The SDH score is more specific for PE prediction in the Chinese population, compared with the Wells score and the Revised Geneva score.

Aquaculture accounts for an extremely valuable and rapidly expanding sector of global food production, yet its environmental impacts on aquatic ecosystems have attracted much concern. In this study, we collected water samples from eastern Lake Taihu, China. We targeted sites varying in their intensity of aquacultural activities and sampled them over multiple seasons. For each sample, we measured physicochemical variables, and we sequenced the 16S rRNA gene of the respective bacterial communities using an Illumina second-generation sequencing platform. Marked differences in diversity and bacterial community composition were observed between seasons, whereas we observed relatively weak differences between sites. Remarkable differences in the abundance of the bacterial community were observed at the phylum and genus levels across the different seasons. Stochastic processes dominated the assembly of bacterial communities in the aquaculture-influenced systems, and the assembly processes of bacterial community differed between seasons. Our observations highlight the effect of seasonality on bacterial communities and provide a more complete knowledge base for the proper assessment of the effects of aquacultural activities on freshwater ecosystems.

This paper focuses on two novel enhancement schemes for thin-walled square concrete filled steel tubular (CFST) columns, i.e., diagonal rib stiffener and circular liner stiffener, with the advantages of sufficient confinement, easy fabrication, and flat outer surface. Seven thin-walled square CFST columns were tested under pseudo-static loading, considering the parameters of stiffener type, the width-to-thickness ratio of steel tube, and axial load ratio. The test results indicated that all the stiffened specimens showed excellent seismic performance with higher lateral resistance, better ductility, and greater energy dissipation than the unstiffened counterpart. The specimens with diagonal rib stiffeners effectively restricted the local buckling of the square steel tube but suffered a weld fracture between the tube plate and the diagonal rib at a large drift ratio. The circular liner stiffener could provide sufficient confinement to the core concrete. Even in the case of a high axial load ratio of 0.6, the circular liner stiffened specimen still showed a ductile behavior with the ultimate drift ratio (DR0.85) of 1/35 and the ductility coefficient (μ) of 4.3. The hysteretic behavior of the thin-walled square CFST columns with diagonal rib/circular liner stiffeners was predicted by both the FE model and the simplified theoretical model, in which the post-buckling strength of the thin-walled square steel tube and the confinement effect of the stiffeners are considered.

An increase in the use of iodinated contrast media, such as iohexol, iodixanol, iopamidol and iopromide, occasionally causes contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). The present study aimed to assess the effects of low levels of hemoglobin on the development of CIN in patients with normal renal function following CAG/PCI. A total of 841 consecutive patients undergoing CAG/PCI were divided into two groups: Patients with low levels of hemoglobin (male

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients. Methodology: This was a matched case-control study of a 67-bed ICU in a tertiary care teaching hospital from 1 January 2011 through 30 June 2013. The control cases were selected among the patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) and were matched with CRKP cases for year of ICU admission and site of infection. The clinical outcomes and antibiotic treatments were analyzed. Results: One hundred and thirty patients were included in the study (65 cases and 65 controls). Bivariable analysis showed that age of patients (p = 0.044), number of antibiotic groups (p = 0.001), and exposure to carbapenems (p < 0.001) were associated with CRKP infection. Using multivariate analysis adjusted for age, prior hospitalization, number of antibiotic groups, and previous exposure to carbapenems, previous carbapenem exposure (p < 0.001) was identified as an independent risk factor for CRKP infection. Conclusions: These data suggest that exposure to carbapenems is an independent risk factor for CRKP infection. Patients with this clinical factor should be targeted for interventions to reduce the subsequent risk of infection.

Background Several studies have indicated that high albuminuria is associated with renal function decline. However, the relationship between the urinary albumin-to-creatinine ratio (ACR) and risk of developing tubular injury remains unclear. Our aim was to investigate the association of ACR with the risk of developing tubular impairment in patients with type 2 diabetes. Methods This longitudinal observational study compared baseline with follow-up data in 183 patients with type 2 diabetes. ACR, urinary alpha-1-microglobulin-to-creatinine ratio (A1MCR) and estimated glomerular filtration rate (eGFR) were used to evaluate albuminuira, tubular injury and glomerular filtration function, respectively. Results Levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and A1MCR were significantly different at the two-year follow-up compared with baseline levels. Among patients both with baseline ACR above and below 30 mg/g, the percentage with A1MCR > 15 mg/g clearly increased after follow-up (P 15 mg/g over the follow-up increased with increasing baseline ACR values lower baseline eGFR. Among the patients with baseline ACR > 63.10 mg/g, all showed increased A1MCR values at follow-up compared with baseline. In the multivariate regression analysis, the patients with baseline ACR > 63.10 mg/g had a strong risk of A1MCR rising from normal to >15 mg/g (odds ratio (OR) = 11.12, P = 0.001) over the follow-up, while the males had a 2.89-fold risk of A1MCR increasing from normal to >15 mg/g compared with females. Conclusion Baseline ACR level is related to increased risk of developing renal tubular injury; in particular, this association is much stronger in patients with type 2 diabetes and baseline ACR > 63.10 mg/g.

Background:Some studies have shown that Human Papillomavirus (HPV) is strongly associated with cervical cancer. As we all know, cervical cancer still remains the fourth most common cancer, affecting women worldwide. Thus, it is both challenging and essential to detect risk types of human papillomaviruses.Methods:In order to discriminate whether HPV type is highly risky or not, many epidemiological and experimental methods have been proposed recently. For HPV risk type prediction, there also have been a few computational studies which are all based on Machine Learning (ML) techniques, but adopt different feature extraction methods. Therefore, we conclude and discuss several classical approaches which have got a better result for the risk type prediction of HPV.Results:This review summarizes the common methods to detect human papillomavirus. The main methods are sequence- derived features, text-based classification, gap-kernel method, ensemble SVM, Word statistical model, position- specific statistical model and mismatch kernel method (SVM). Among these methods, position-specific statistical model get a relatively high accuracy rate (accuracy=97.18%). Word statistical model is also a novel approach, which extracted the information of HPV from the protein “sequence space” with word statistical model to predict high-risk types of HPVs (accuracy=95.59%). These methods could potentially be used to improve prediction of highrisk types of HPVs.Conclusion:From the prediction accuracy, we get that the classification results are more accurate by establishing mathematical models. Thus, adopting mathematical methods to predict risk type of HPV will be the main goal of research in the future.

This paper describes our submissions to SemEval 2018 task 1. The task is affect intensity prediction in tweets, including five subtasks. We participated in all subtasks of English tweets. We extracted several traditional NLP, sentiment lexicon, emotion lexicon and domain specific features from tweets, adopted supervised machine learning algorithms to perform emotion intensity prediction.

This study used the Night Light Development Index (NLDI) to measure the regional inequality of public services in Mainland China at multiple scales. The NLDI was extracted based on a Gini Coefficient approach to measure the spatial differences of population distribution and night light distribution. Population data were derived from the dataset of China’s population density grid, and night light data were acquired from satellite imagery. In the multi-scale analysis, we calculated the NLDI for China as a whole, eight economic regions, 31 provincial regions, and 354 prefectural cities for the two years of 2005 and 2010. The results indicate that Southwest China and Northwest China are the regions with the most unequal public services, with NLDI values of 0.7116 and 0.7251 for 2005, respectively, and 0.6678 and 0.6304 for 2010, respectively. In contrast, Northern Coastal China had the lowest NLDI values of 0.4775 and 0.4312 for 2005 and 2010, respectively, indicating that this region had the most equal public services. Also, the regional inequality of Mainland China in terms of NLDI has been reduced from 0.6161 to 0.5743 during 2005–2010. The same pattern was observed from the provincial and prefectural analysis, suggesting that public services in Mainland China became more equal within the five-year period. A regression analysis indicated that provincial and prefectural regions with more public services per capita and higher population density had more equal public services.

Purpose – The study aims to examine whether and how second-hand clothing shoppers differ from non-shoppers on various psychographic variables, including environmentalism, perception of contamination, price sensitivity and perception of vintage clothing. Additionally, this study hopes to uncover whether and how the aforementioned psychographic variables help predict second-hand clothing shopping behaviour, specifically shopping frequency at second-hand clothing stores. Design/methodology/approach – Data were collected through a survey method from 152 college students. Findings – Results showed that college students who shopped at second-hand clothing stores were more likely to be environmentally conscious, more sensitive to higher prices and more likely to wear used clothing to express a vintage look and to be “green”, and to perceive used clothing to be less contaminated, as compared to those who did not shop at second-hand clothing stores. This study concluded that, among college students, second-hand clothing shoppers may do so not only for economic reasons but also for creation of style and feeling special about themselves. Research limitations/implications – This study suggests that college students who shop at second-hand clothing stores are different from those who do not shop at second-hand stores in terms of their environmental attitudes, perceptions of contamination from used clothing, sensitivity to prices and how they feel about vintage clothing. Further, financial concern (i.e. price sensitivity) is no longer the only reason for second-hand clothing shopping. Originality/value – Little research has been conducted to understand second-hand clothing shopping behaviour among college students. This study examined multiple psychographic variables and provided insights into college students’ second-hand shopping behaviour.

It remains a challenging task for automatic image annotation problem due to the semantic gap between visual features and semantic concepts. To reduce the gap, this paper puts forward a kernel-based multiview joint sparse coding (KMVJSC) framework for image annotation. In KMVJSC, different visual features as well as label information are considered as distinct views and are mapped to an implicit kernel space, in which the original nonlinear separable data become linearly separable. Then, all the views are integrated into a multiview joint sparse coding framework aiming to find a set of optimal sparse representations and discriminative dictionaries adaptively, which can effectively employ the complementary information of different views. An optimization algorithm is presented by extending K-singular value decomposition (KSVD) and accelerated proximal gradient (APG) algorithms to the kernel multiview framework. In addition, a label propagation scheme using the sparse reconstruction and weighted greedy label transfer algorithm is also proposed. Comparative experiments on three datasets have demonstrated the competitiveness of proposed approach compared with other related methods.

Node degree is regarded as an important and convenient metric to measure the connectivity of wireless ad hoc networks. Existing studies are mainly based on the assumption that nodes are static and do not provide closed-form expressions for node degree. In this paper, we investigate three fundamental characteristics of a wireless ad hoc network: Its node degree distribution, its average node degree and its maximum node degree experienced by the nodes during their movement. We introduce a novel mathematical model to derive analytical expressions in the presence of radio channel fading. Furthermore, our results reveal that the node degree distribution follows a binomial distribution regardless of the initial distribution of nodes’ location. The results of this paper are useful to study node connectivity and to improve the algorithmic complexity of incentive protocols.

Purpose To examine prescription trends and patterns in five antihypertensive drug classes during 2007 - 2012 in China. Methods A retrospective time series data was investigated from 2007 to 2012. Prescription data of five classes of antihypertensive drugs (calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, and diuretics) were accessed from the Hospital Prescription Analysis Program Database, including 59 hospitals in four cities in China. The drugs were coded using the Anatomic Chemical Therapeutic (ATC) classification. Quantities were standardized using the defined daily dose (DDD) measurement methodology. Results The total number of DDDs of the five classes of antihypertensive drugs prescribed in the sample hospitals increased by 83.3% and the total cost of antihypertensive drugs increased by 92.4% from 2007 to 2012. During the whole study period, CCBs, ARBs, ACEIs, β-blockers, and diuretics represented in DDDs 42.8%, 28.3%, 13.3%, 10.8%, and 4.8%, respectively, of the total five classes of anti-hypertensive drugs. The average annual increase rate of ARBs, β-blockers, CCBs, ACEIs, and diuretics, in DDDs, was 23.4%, 13.3%, 13.2%, 1.4%, and -4.2%, respectively Conclusions The consumption of the five classes of antihypertensive drugs in China nearly doubled from 2007 to 2012. The top-prescribed antihypertensive drug classes were CCBs and ARBs, and the latter increased most rapidly.

In traditional data fusion algorithms based on context awareness, time-varying application situations and context acquisition cost are not considered, which leads to inaccurate situation prediction and low applicability of data fusion. In this paper, a space-based context model is introduced, in which the sensors' history from three aspects, the context attribute, the context state and the situation space are described. Then optional attributes with the maximum overall utility are chosen by Dynamic Bayesian Networks. After that, the related situation prediction is obtained through data fusion. A data fusion algorithm CFACA (Context Fusion Algorithm based on Context Awareness) proposed in this paper gives a dynamic data fusion method. In the end, the simulation of this algorithm is discussed and the results show the effectiveness of the CFACA.

Data grid is the fundamental work of graphics drafting, scientific computing and the realization of spatial analysis. The paper uses dynamic grid system and assigning technology of spatial data to implement interoperability of multiple-sources data. Assign grid system has multi-attributes, which applies geographic information system (GIS) and the external program to implement overlay analysis and other complicated spatial analysis functions. The merits of dynamic grid system are a complete vector format, the data quantity being small, implementing multiple sources data merging and spatial analysis of massive data. Keywords-Dynamic Grid System; Spatial Overlay Analysis; Assigning Technology; Interoperability

Lifetime prolonging is one significant research issue in underwater acoustic sensor networks (UASNs). First this paper analyzes the relationship between the receiving energy consumption and the transmission energy consumption in the acoustic communication of UASNs. The routing tree is built up on the factor of optimal transmission range. Then a hybrid data transmission mechanism based on energy level is proposed to balance energy consumption. The mechanism combines one-hop and multi-hop data transmission to underwater sink considering the current energy level of adjacent nodes. An optimal classification number of energy level has been evaluated through theoretical analysis. Our design will help prolong the lifetime of whole UASN. The simulation results of UASN's lifetime and the energy consumption of sensor nodes have proved the efficiency of the Energy-Level-based hybrid Transmission (ELT) mechanism.

The choice of antibiotic monotherapy or combination therapy to treat Pseudomonas aeruginosa bacteraemia is controversial. The aim of this review was to compare both types of therapy to determine which delivers the best outcome for P. aeruginosa bacteraemia. We systematically searched electronic bibliographic databases, including PubMed, Ovid EMBASE and The Cochrane Library, for clinical studies that compared combination therapy with monotherapy in the treatment of P. aeruginosa bacteraemia. Eligible articles were analysed using Stata(®)/SE software v.12.0. Stratification analysis was conducted by study design and treatment type. Publication bias was assessed using Begg's funnel plot and Egger's test. Ten studies (eight retrospective and two prospective) involving 1239 patients were analysed. We found no difference between combination therapy and monotherapy when the data were combined (odds ratio = 0.89, 95% confidence interval 0.57-1.40; P = 0.614) or when data were analysed in subgroups. Neither combination therapy nor monotherapy treatment appears to have a significant effect on mortality rates in patients with P. aeruginosa bacteraemia. Further studies evaluating the effects of combination therapy or monotherapy in more specialised cases, such as when encountering a multidrug-resistant organism, are necessary.

Background Low-molecular-weight heparins (LMWHs) are safe and effective anticoagulant options for cardiovascular patients when applied as body weight-adjusted doses. However, there are some barriers that make it difficult to implement weight-adjusted doses in clinical practice. Therefore, it is vital to learn the dosing practices of LMWH and its efficacy and safety in clinical practice. Methods A retrospective study was conducted in cardiovascular inpatients who had received at least one dose of LMWH during a 6-month period. Appropriateness of LMWH dosing was determined and major clinical outcomes (major adverse vascular events and major bleeding) during hospitalization were evaluated. Results A total of 376 admissions representing 364 patients received LMWH treatment. Of these, 17.0% (64/376) of admissions did not have body weight records. Of the 312 admissions included for the outcome study, only 34 cases (10.9%) received the recommended doses of LMWH, while 51 cases (16.3%) received mild underdoses, 223 cases (71.5%) received major underdoses and 4 (1.3%) received excess doses. There were 10 major adverse vascular events, which occurred more often in patients receiving excess doses of LMWH than in patients receiving recommended, mild or major underdoses (50%, 2.9%, 2.0% and 2.7%, respectively, P < 0.001). After multivariable analysis, severe renal insufficiency was an independent risk factor for major adverse vascular events [odds ratio (OR), 31.93; 95% confidence interval (CI), 5.99-170.30; P < 0.001]. No major bleeding was recorded. Conclusions Underdose of LMWH is commonly used in cardiovascular inpatients, which was suboptimal according to guidelines. Using LMWH at a fixed, low dose for treatment purposes in patients without severe renal insufficiency was not associated with a higher risk of adverse vascular events in the current study, though larger studies with extended follow-ups are required to fully assess the long-term consequences of LMWH underdosing.

The epidemiology, clinical presentation, and treatment of infective endocarditis (IE) has significantly changed over the past few years in developed countries. However, relevant data from developing countries are different and remain scarce. The objective of this study was to evaluate the clinical presentations, treatment and outcomes of IE patients in a tertiary hospital in East China over an 8-year period. This was a retrospective observational study of consecutive cases of definite or possible IE as per the modified Duke criteria between January 2008 and December 2015. A total of 135 definite and 39 probable IE cases were identified. The mean age was 47.8 ± 15.7 years, with a male preponderance (1.9: 1). Degenerative valve disease accounted for 30.5% cases of IE, followed by congenital heart disease (29.9%) and rheumatic heart disease (14.9%). Native cardiac valves were present in 93.7% of the IE patients. Echocardiography and blood culture were performed in all patients, of whom 55.2% were found to have large vegetations (≥10 mm) and the positive rate of blood culture was 60.3%. Streptococcus remained the chief causative agent that was identified in 61.9% of culture-positive patients. Glycopeptide antibacterials and cephalosporins were the most frequently used antimicrobial drugs for IE therapy. Seventy-six (43.7%) of the IE patients were surgically treated. The mortality rate during hospital stay was 10.9%. Our data reflected clinical and microbiological profile, and treatment of IE in a tertiary hospital located in the East China.

Background:The effectiveness of restoring the sinus rhythm by catheter ablation relative to that of medical rate control for persistent atrial fibrillation (AF) patients with heart failure (HF) remains to be defined.Methods:We systematically searched Embase, Pubmed, the Cochrane Library, and

To determine differences in adherence to secondary prevention guidelines (pharmacological interventions) among coronary heart disease (CHD) patients between a Chinese medicine (CM) hospital and a general hospital in a Chinese city.Medical records of 200 patients consecutively discharged from the CM hospital and the general hospital for CHD were reviewed to determine the proportions of eligible patients who received antiplatelet agents, β-blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) and statins at discharge. The effects of patient characteristics and hospital type on the use of these medicines were estimated using logistic regression models.Patients discharged from the CM hospitals were older; more likely females; had greater history of hyperlipidemia, cerebrovascular diseases and less smoker (P0.01 or P0.05). They were less likely to receive coronary angiography and percutaneous coronary intervention, and had a longer length of stay than those discharged from the general hospital (P0.01 or P0.05). There were no significant differences in antiplatelet agents (96% vs. 100%, P=0.121) or statins (97.9% vs. 100%, P=0.149) use between the CM hospital and the general hospital. In multivariable analyses that adjusted for patient characteristics and hospital type, there was no significant difference in use of β-blockers between the CM hospital and the general hospital. In contrast, patients discharged from the CM hospital were less likely to receive ACE inhibitors/ARBs compared with those discharged from the general hospital (odds ratio: 0.3, 95% confidence interval: 0.105-0.854).In this study, the CM hospital provides the same quality of care in CHD for prescribing evidence-based medications at discharge compared with another general hospital except for ACE inhibitors/ARBs use.

A novel algorithm for the computation of Lucas sequences is proposed to improve the efficiency of cryptosystems based on it. By the introduction of pre-computation, the original Characteristic polynomial algorithm is modified to reduce the number of multiplication operations. The influence of window size on efficiency of the algorithm is also analyzed, and a optimization scheme is presented. In circumstances that more than one values of Lucas sequence need to be calculated, the new algorithm is more efficient than the existing Yen-Laih algorithm.

The complex network property discovering is important for network modeling, performance evaluation and robustness assessment. WAP network, a kind of complex networks for mobile users, is developing rapidly and attracting a lot of research in recent years, but the research for its topology is rare. In this paper, WAP network topology is focused on. It is compared with WWW on three aspects: degree distribution, clustering and spectrum. Especially a new method on clustering is proposed to examine the asymmetry property of topology. The distinctions of topology between two networks are shown.

A recently proposed public key cryptosystem based on Chebyshev polynomials suggests a new approach to data encryption. But the security of the cryptosystem has not been investigated in depth, for lack of an appropriate analysis method. In this paper, a new representation of Chebyshev polynomial is introduced to study security issues of the cryptosystem. The properties of Chebyshev polynomial sequence are presented, and their impact on the cryptosystem are discussed. Finally some principles for parameter selection for the cryptosystem are proposed. The methodology used in this paper is supposed to offer a useful means for future researches on this topic.

Node degree has been regarded as one of the important and convenient metrics to measure the connectivity of the wireless ad hoc networks. Many studies concerning node degree are based on the assumption of static connectivity graph on the number of nodes, which can not reflect the mobility characteristics in ad hoc networks. In this paper we investigate three fundamental characteristics of a wireless ad hoc network: its node degree distribution, its average node degree and its maximum node degree experienced by all the nodes during theirs movement. We employ a novel mathematical modeling to derive their analytical expressions in presence of radio channel fading. The results of this paper are useful in the study of connectivity and improving algorithm complexity of incentive protocols. Also, these results are of practical value for researchers in this area, e.g., if they set the parameters in a network-level simulation of a mobile ad hoc network or if they design a wireless sensor network.

Objective To observe the effects of inhaled Chuankezhi injection (CKZ) on airway inflammation in a mouse model of asthma and dilation of isolated guinea-pig airway smooth muscle in vitro, which can provide pharmacodynamic evidence for CKZ treating acute attack of asthma. Method BALB/c mice were sensitized with ovalbumin (OVA) on Days 1, 15, and then were inhaled with OVA aerosol on Days 22-28. The sensitized mice were administered with inhalation of aerosolized CKZ injection (0.2, 0.4, 0.8 mL x kg(-1), bid), or intraperitoneal injection of CKZ (0.4 mL x kg(-1), bid), dexamethsone (0.5 mg x kg(-1) x d(-1)) and saline (control) on Days 22-28. Airway inflammation was evaluated by counting cells in bronchoalveolar lavage fluid (BALF) and by lung histology. The influences of CKZ on the dilation of tracheal smooth muscle in guinea-pig and the contraction induced by carbamylcholine (CCH)/histamine in vitro were also observed. Result In vivo, OVA-sensitized mice developed a significant airway inflammatory response that was significant inhibited by inhalation of CKZ (0.8 mL x kg(-1), bid), and intraperitoneal injection of CKZ (0.4 mL x kg(-1), bid) and dexamethasone (0.5 mg x kg(-1) x d(-1)). in vitro, CKZ did not dilate tracheal smooth muscles in guinea-pigs, and did not attenuate the contraction induced by carbamylcholine (CCH)/histamine. Conclusion CKZ can modulate airway inflammation in asthma, but has no dilation effect on the tracheal smooth muscle in guinea-pig in vitro. These results demonstrate that inhaled CKZ is not a preferred administration.

This paper derives analytical expressions for the probability of link availability and the node degree distribution in mobile ad hoc networks. The expressions (1) account for system parameters such as the node density, node transmission range, and the radio channel fading; and (2) hold for an arbitrary mobility model with initially uniformly distributed spatial nodes that are allowed to move only within a certain bounded area. We validate the efficacy of our expressions through simulations of the SMS mobility model. Our results reveal that the node degree distribution follows a binomial distribution regardless of the initial distribution of nodes’ location. The results presented in this paper are useful in studying the connectivity of mobile nodes, in estimating the capacity of mobile ad hoc networks, and provide a good understanding of the impact of fundamental network parameters in the presence of mobility.

For packet-based wireless WiMAX network, layer-based design is a simple but effective structure, while to obtain high system performance on unstable and dynamic changes of wireless channel condition, loosely-coupled cross-layer is a more effective method. In this paper, through analyzing and constructing the practical channel model, channel-aware adaptive packet size algorithm for maximized resource utility (APS_MRU) based on cross-layer design-- combining adaptive modulation at physical with automatic repeat request (ARQ) protocol at MAC layer is proposed. And the closed-form solution is expressed. Numerical results show that dynamic packet size according to timevarying channel and MCS improve the data rate and resource utility in each round.

The performance of mobile ad hoc networks (MANETs) is influenced by many factors including node mobility, node density, and wireless transmission range. The dynamics induced by these factors along the paths between MANET nodes affect node connectivity. Research efforts aiming at quantifying such path dynamics are limited (1) considering only the impact of a small number of factors, mostly node mobility; (2) quantifying only some path metrics, mainly the distribution of path lifetime and the expected path lifetime; and (3) relying mainly on simulation rather than analysis. In this paper, we provide closed form equations relating node mobility, node density, and wireless transmission range to path dynamics in MANETs as expressed by the path lifetime, the path churn rate and the path frequency. The closed form equations reveal interesting aspects of MANET performance and can be used in optimizing MANET routing protocols and applications.

The characteristics of node-pair paths are a primary consideration in the design of routing protocols in mobile ad-hoc networks (MANETs). Existing research studies on MANET paths focus on their dynamics in the presence of node mobility and ignore the impact of network configuration such as node density and node transmission range. In this paper, we study MANET paths using a smooth mobility model, which complies with the physical law of smooth motion and is sensitive to the change of node velocity over small timescales. Our Study reveals that for paths connecting nodes with slow mobility through a small number of hops, path stability and availability are dominated by network configuration; whereas, for paths connecting nodes with moderate/fast mobility through a large number of hops, they are dominated by node mobility.