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BACKGROUND Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2, is a worldwide pandemic. Some COVID-19 patients develop severe acute respiratory distress syndrome and progress to respiratory failure. In such cases, extracorporeal membrane oxygenation (ECMO) treatment is a necessary life-saving procedure. CASE SUMMARY Two special COVID-19 cases—one full-term pregnant woman and one elderly (72-year-old) man—were treated by veno-venous (VV)-ECMO in the Second People’s Hospital of Zhongshan, Zhongshan City, Guangdong Province, China. Both patients had developed refractory hypoxemia shortly after hospital admission, despite conventional support, and were therefore managed by VV-ECMO. Although both experienced multiple ECMO-related complications on top of the COVID-19 disease, their conditions improved gradually. Both patients were weaned successfully from the ECMO therapy. At the time of writing of this report, the woman has recovered completely and been discharged from hospital to home; the man remains on mechanical ventilation, due to respiratory muscle weakness and suspected lung fibrosis. As ECMO itself is associated with various complications, it is very important to understand and treat these complications to achieve optimal outcome. CONCLUSION VV-ECMO can provide sufficient gas exchange for COVID-19 patients with acute respiratory distress syndrome. However, it is crucial to understand and treat ECMO-related complications.

Background Little is known about the influence of marital status on Chinese prostate cancer (PCa) patients. Marital status may have an impact on overall survival in Chinese men with prostate cancer. Methods We identified 4,208 Chinese patients diagnosed with PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox proportional hazard models were used to determine the impact of marital status on the overall survival (OS) of Chinese PCa patients. Survival analysis was performed using the Kaplan-Meier method. Smoothing function and threshold effect analysis were performed to determine the turning points of variables. Results Univariate analysis demonstrated that marital status, prostate-specific antigen (PSA) category, surgery status, T stage, N stage, and M stage were associated with OS. Multivariate analysis further indicated that marital status, PSA category, surgery status, T stage, and M stage were independent risk factors of OS. Survival analysis demonstrated that the nonwidowed group had a better OS than the widowed group. The risk of poor OS increased rapidly with the PSA level up to the turning point 15.6 and 45.4 ng/mL in the nonwidowed group (HR =1.089; 95% CI: 1.064–1.115; P

Background China is facing challenges of the shifting presentation of tuberculosis (TB) from younger to elderly due to an ageing population, longer life expectancy and reactivation disease. However, the burden of elderly TB and influence factors are not yet clear. To fill the gap, we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China. Methods In this cohort established in 2013 through a prevalence survey conducted in selected sites, a total of 34 076 elderlies without TB were enrolled into two-year follow-up. We used both active and passive case findings to find out all TB patients among them. The person-year (PY) incidence rates for both bacteriologically positive TB and active TB were calculated. Cox proportional regression model was performed to test effect of risk factors, and the population attributable fraction (PAF) of each risk factor contributing to incident TB among elderlies was calculated. Results Over the two-year follow-up period, a total of 215 incident active TB were identified, 62 of which were bacteriologically positive. The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100 000 PY (95% CI: 417.4–546.2 per 100 000 PY) and 138.9 per 100 000 PY (95% CI: 104.4–173.5 per 100 000 PY), respectively. Incident cases detected by active case finding were significantly higher (P Conclusions Ageing population in China had a high TB incidence rate and risk to develop TB disease, implying that National TB Program (NTP) needs to prioritize for elderly. Active case finding should be applied capture more active TB cases among this particular population, especially for male, non-Han nationality, and those with identified risk factors.

Background: To investigate ipsilateral breast tumor recurrence (IBTR) in patients who have undergone breast-conserving surgery (BCS) after neoadjuvant systematic therapy (NST). Method: Three hundred and twenty-one patients undergoing BCS after NST and 2,534 patients undergoing initial BCS from June 2008 to June 2017 at Fudan University Shanghai Cancer Center were retrospectively enrolled, and statistical analyses, including propensity score matching, were applied to compare IBTR-free survival. The main factors related to IBTR in the NST group were estimated utilizing univariate and multivariate analyses. Results: After propensity score matching, the 3-year IBTR-free survival rates were 93.7% (95% CI, 90.6–96.8%) in the NST group and 96.9% (95% CI, 94.9–98.9%) in the matched initial BCS group at a median follow-up period of 58 months. IBTR-free survival did not differ statistically between the two groups (P=0.154). According to multivariate analysis in the NST group, tumor-infiltrating lymphocytes (TILs), epidermal growth factor receptor 2 (HER2) status and pathologic ductal carcinoma in situ (DCIS) constituent were the factors related to IBTR after BCS. Conclusions: BCS after NST and initial BCS have equivalent IBTR-free survival. BCS after NST is a safe and effective therapy in terms of IBTR.

Background Part of tuberculosis (TB) patients were missed if symptomatic screening was based on the main TB likely symptoms. This study conducted to compare the yield and relative costs of different TB screening algorithms in active case-finding in the whole population in China. Methods The study population was screened based on the TB likely symptoms through a face-to-face interview in selected 27 communities from 10 counties of 10 provinces in China. If the individuals had any of the enhanced TB likely symptoms, both chest X-ray and sputum tests were carried out for them furtherly. We used the McNemar test to analyze the difference in TB detection among four algorithms in active case-finding. Of four algorithms, two were from WHO recommendations including 1a/1c, one from China National Tuberculosis Program, and one from this study with the enhanced TB likely symptoms. Furthermore, a two-way ANOVA analysis was performed to analyze the cost difference in the performance of active case-finding adjusted by different demographic and health characteristics among different algorithms. Results Algorithm with the enhanced TB likely symptoms defined in this study could increase the yield of TB detection in active case-finding, compared with algorithms recommended by WHO (p Conclusions Active case-finding based on the enhanced symptom screening is meaningful for TB case-finding and it could identify more active TB cases in time. The findings indicated that this enhanced screening approach cost more compared to algorithms recommend by WHO and China NTP, but the increased yield resulted in comparative costs per patient. And it cost much more that only smear/bacteriological-positive TB cases are screened in active case-finding.

Background: Laparoscopic pancreaticoduodenectomy has developed rapidly in recent years. Postoperative pancreatic fistula is still the most dangerous complication of laparoscopic pancreaticoduodenectomy. Baumgart pancreaticojejunostomy is considered one of the safest anastomosis procedures, with low rates of pancreatic fistula. We modified Blumgart pancreaticojejunostomy and applied the modified procedure during laparoscopic pancreaticoduodenectomy. The modified procedure entailed a longitudinal U-shaped suture through the pancreas for anastomosis of the pancreatic duct and the jejunal mucosa.Methods: We prospectively collected and retrospectively analyzed the data of 120 patients who underwent laparoscopic pancreaticoduodenectomy from January 2016. The total operative time, time for complete pancreaticojejunostomy, postoperative pancreatic fistula rate, postoperative delayed gastric emptying, postoperative bleeding, postoperative length of hospital stays, and mortality within 90 days after surgery were analyzed. An analysis of laparoscopic pancreaticojejunostomy compared with open pancreaticojejunostomy is also reported.Results: In the laparoscopic pancreaticojejunostomy group, the average total operative time, the average time for complete pancreaticojejunostomy, and the average intraoperative blood loss were 271 min, 35.3 min, and 184 ml, respectively. The total postoperative clinically relevant pancreatic fistula rate was 9.2% (Grade B and C fistulas). The incidence rates of postoperative delayed gastric emptying and postoperative biliary fistula were ~2.5 and 1.7%, respectively. The postoperative bleeding rate was 0.83%, and the average postoperative indwelling time of the abdominal drainage tube was 7.3 days. The postoperative length of hospital stay was 10.8 days, and the mortality rate within 90 days after surgery was 0.83%. The rates of clinically relevant postoperative clinically relevant pancreatic fistula are comparable between laparoscopic and open surgery, there were no other severe postoperative complications in either group. The mean postoperative length of hospital stay was significantly shorter in the laparoscopic pancreaticojejunostomy group.Conclusion: The modified laparoscopic-adapted Blumgart anastomosis simplifies and facilitates the creation of the pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. The rates of clinically relevant postoperative pancreatic fistula are comparable with those obtained by open surgery, and length of stay are shoter.

Background: Information about critically ill patients with coronavirus disease 2019 (COVID-19) in China but outside of Wuhan is scarce. We aimed to describe the clinical features, treatment, and outcomes of patients with COVID-19 admitted to the intensive care unit (ICU) in Guangdong Province. Methods: In this multicenter, retrospective, observational study, we enrolled consecutive patients with COVID-19 who were admitted to seven ICUs in Guangdong Province. Demographic data, symptoms, laboratory findings, comorbidities, treatment, and outcomes were collected. Data were compared between patients with and without intubation. Results: A total of 45 COVID-19 patients required ICU admission in the study hospitals [mean age 56.7 ± 15.4 years, 29 males (64.4%)]. The most common symptoms at onset were fever and cough. Most patients presented with lymphopenia and elevated lactate dehydrogenase. Treatment with antiviral drugs was initiated in all patients. Thirty-six patients (80%) developed acute respiratory distress syndrome at ICU admission, and 15 (33.3%) septic shock. Twenty patients (44.4%) were intubated, and 10 (22.2%) received extracorporeal membrane oxygenation. The 60-day mortality was 4.4% (2 of 45). Conclusion: COVID-19 patients admitted to ICU were characterized by fever, lymphopenia, acute respiratory failure, and multiple organ dysfunction. The mortality of ICU patients in Guangdong Province was relatively low with a small sample size.

For breast cancer patients, a false-negative rate lower than 10% can be achieved if targeted axillary dissection (TAD) is performed, which includes the excision of both biopsy-proven positive lymph nodes (BxLNs) and sentinel lymph nodes (SLNs). However, little evidence exists on the accuracy of intraoperative touch imprint cytology (ITPC) applied in TAD after neoadjuvant chemotherapy (NAC) for breast cancer patients with initial axillary metastasis. This study aimed to investigate the accuracy of ITPC in TAD after NAC. Breast cancer patients with biopsy-confirmed nodal metastasis were prospectively enrolled in the study. After completion of NAC, all patients underwent TAD followed by axillary lymph node dissection (ALND). Then ITPC was performed to evaluate BxLNs and SLNs. The accuracy of TAD and ITPC was calculated in comparison with hematoxylin and eosin (H&E) staining of ALNs. The results of ITPC during 6 months at our center in the adjuvant setting were used for comparison . Overall, the false-negative rate of TAD was 10.8%. In a test with 92 patients, ITPC had an accuracy of 92.4%, a sensitivity of 87.9%, and a specificity of 94.9%. In the non-NAC group, ITPC showed similar accuracy (91.2%) and specificity (97.9%) but significantly lower sensitivity (68.9%; P = 0.03). The use of ITPC was feasible for TAD among breast cancer patients with biopsy-confirmed axillary metastasis who were treated with NAC. All the misses in the ITPC involved patients with micrometastases or isolated tumor cells. Use of ITPC can help decrease the number of second operations for patients with residual disease in ALNs after NAC.

Phase-pure cuprous oxide (Cu 2 O) thin films doped with Fluorine (F) have been prepared under thermal diffusion at diffusion temperatures of 1123 K and 1223 K and it is found that higher diffusion temperature leads to larger grain size. F-doping slightly reduces the lattice constant and F-doped Cu 2 O thin films exhibit p-type semiconductor characteristics. The reduction of band gap occurs due to F-doping induced impurity band, because F-doped samples have larger Urbach tails than that of undoped samples. Theoretical calculation demonstrates that substitutional F-doping makes Cu 2 O almost metallic because the energy bands of F atoms enter the forbidden gap, and interstitial F-doping narrows the band gap because F atoms contribute to the valence bands. The doped F atoms are very possibly interstial and play the role of acceptors in Cu 2 O. Phase-pure Cu 2 O doped with F have smaller resistivity and larger hole concentration, implying potential application in solar cells.

In this paper, a self-mode-locked Nd:YVO4 picosecond vortex laser is demonstrated, which can operate on the different Laguerre-Gaussian (LG) modes at 1 064 nm. A π/2 mode converter is utilized to realize the picosecond vortex laser with LG mode transformed from the high-order Hermite-Gaussian (HG) mode. For the proposed laser, the mode-locked pulse repetition rate is 1.81 GHz. The average output powers of LG12 mode and LG02 mode are 1.241 W and 1.27 W, respectively, and their slope efficiencies are 23.2% and 24%, respectively.

In this era of mobile Internet, people can quickly and easily access multimedia services and applications through mobile phones. And multimedia services are ubiquitous in life, such as text, pictures, voice, and video, to convey and receive media that give people all kinds of information. In addition, with the rapid development of the Internet of Things, all the devices around the world have networking functions, so that people not only enjoy application services on mobile phones but also want to further develop with devices of our living environments. IP Multimedia Subsystem (IMS) is a platform that can integrate multimedia services. If people want to enjoy IMS services directly through peripheral devices (i.e., non-IMS devices), they must be authorized by IMS devices to be trusted devices. This paper is based on Gateway as a trusted intermediary role, connecting peripheral devices in the IMS network so that these non-IMS devices can also talk with the IMS device, so IMS users can also use his peripheral devices for IMS talk service.

In the past, in public places, such as schools or public libraries, space borrowing was used by users to visit the counter or to borrow through the Internet. In use, you also need to receive a space access card or a personal identification card (such as a student ID card). In recent years, due to the advancement of information and communication technology, the application of the Internet of Things (IoT) has become more and more. This paper proposes that the IoT space borrowing system integrates all devices and door locks in the space through the IoT technology to provide borrowers' access rights. The borrower can use the smart device to view and borrow the available space and control the IoT devices in the space through the smartphone during the borrowing period. This system not only reduces the manpower requirement of space management but also improves the space borrowing convenience and increases space usage.

A variety of application services have been developed one after another with information and communications technologies coming to the fore over the past years. In this regard, the application services of indoor positioning, for example, indoor positioning navigation, ad push and data analysis, for users mostly staying in indoor environments per day are diversified and promotes economic efficiency significantly. However, indoor positioning is still not accurate enough because an indoor environment is rich in all kinds of noises and more complicated than an outdoor environment. In this research, indoor positioning is embodied through Beacons based on Bluetooth 4.0 and particularly fingerprint indoor positioning with deep learning incorporated is adopted for promotion of accuracy of indoor positioning. Differing from ordinary fingerprint positioning during which a fingerprint map is trained through deep learning in the offline stage only, fingerprint indoor positioning in this research is characterized that signals received in the positioning stage are recognized through deep learning for better validity of signals received and further checked with a trained fingerprint map for estimation of a current location.

Bluetooth Low Energy (BLE) has low power consumption, low cost, faster connection speed, and is extremely easy to deploy. The Beacon function in BLE is the basis for providing indoor positioning. Also, most of today's smart devices have Bluetooth, and all support Bluetooth 4.0 or higher, so BLE is very suitable for indoor positioning of smart devices. In addition to being able to be used for indoor positioning, the Beacon actively broadcasts its Beacon signaling regularly. Such a function can be used for advertising promotion in a designated area. Further, if a Beacon message contains the Uniform Resource Locator (URL) represents an Internet of Things (IoT) device, such a device can be called Web IoT device. It can be seen from the above that BLE's indoor positioning system can not only achieve positioning but also expand the characteristics to provide more diverse application services so that the positioning system has better value. Therefore, this paper takes the shopping mall as an example to implement the application service of integrating the Web IoT and BLE indoor positioning system to provide consumers with more application services, including indoor positioning, advertising push, and Coupon collection and use, Web IoT device display and trial and so on.

In recent years, short video applications have entered our lives and lots of short videos are watched by users every day. ICME and Byte-Dance corporation sponsor the grand challenge for better understanding video content and recommending what users like. The challenge provides an incremental multi-modal video dataset including face features, title features, video content features, audio content features and users' behaviors features consisting of thousands of different users and millions of different videos. This paper reports the implementation details in the grand challenge. We have made different attempts and explorations in feature engineering and model structure, finally we got good results and achievements. The details of feature design, model experiments and ensemble learning are described. In this paper, we provides the implementation details of the whole challenge.

Background The problem of population aging is a critical public health concern in modern China, and more tuberculosis (TB) control efforts are needed to reach elderly people at high priority. In this study, we aim to determine the prevalence and identify the risk factors of TB among elderly people in China. Methods A multistage cluster-sampled cross-sectional survey was conducted in 2013, and 27 clusters were selected from 10 counties of 10 provinces in China. All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray (CXR) and a symptom questionnaire. Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive. Prevalence was calculated, a multiple logistic regression model was performed to confirm the risk factors, and population attributable fraction (PAF) of each risk factor was calculated to indicate the public health significance. Results Of 38 888 eligible people from 27 clusters, 34 269 participants finished both questionnaire and physical examination. There were 193 active pulmonary TB cases, 62 of which were bacteriologically confirmed. The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100 000 (95% CI: 483.73–642.65) and 180.92 per 100 000 (95% CI: 135.89–225.96), respectively. Male sex, older age, living in rural areas, underweight, diabetes, close contact of pulmonary TB (PTB) and previous TB history are all risk factors for TB. The risk of TB increased with increasing age and decreasing body mass index (BMI) after adjusting for other factors, and there is a positive dose–response relationship. Conclusions In China, active case finding (ACF) could be implemented among elderly people aged 65 and above with underweight, diabetes, close contact history and previous TB history as a priority, which will get significant yields and be cost-effective. Electronic supplementary material The online version of this article (10.1186/s40249-019-0515-y) contains supplementary material, which is available to authorized users.

IntroductionAcute kidney injury (AKI) is one of the most common organ dysfunction in sepsis, and increases the risk of unfavourable outcomes. Renal replacement therapy (RRT) is the predominant treatment for sepsis-associated AKI (SAKI). However, to date, no prospective randomised study has adequately addressed whether initiating RRT earlier will attenuate renal injury and improve the outcome of sepsis. The objective of the trial is to compare the early strategy with delayed strategy on the outcomes in patients with SAKI in the intensive care unit (ICU).Methods and analysisThis is a large-scale, multicentre, randomised controlled trial about SAKI. In total, 460 patients with sepsis and evidence of AKI stage 2 of Kidney Disease Improving Global Outcomes (KDIGO) will be recruited and equally randomised into the early group and the delay group in a ratio of 1:1. In the early group, continuous RRT (CRRT) will be started immediately after randomisation. In the delay group, CRRT will initiated if at least one of the following criteria was met: stage 3 of KDIGO, severe hyperkalaemia, pulmonary oedema, blood urea nitrogen level higher than 112 mg/dL after randomisation. The primary outcome is overall survival in a 90-day follow-up period (90-day all-cause mortality). Other end points include 28-day, 60-day and 1-year mortality, recovery rate of renal function by day 28 and day 90, ICU and hospital length of stay, the numbers of CRRT-free days, mechanical ventilation-free days and vasopressor-free days, the rate of complications potentially related to CRRT, CRRT-related cost, and concentrations of inflammatory mediators in serum.Ethics and disseminationThe trial has been approved by the Clinical Research and Application Institutional Review Board of the Second Affiliated Hospital of Guangzhou Medical University (2017–31-ks-01). Participants will be screened and enrolled from patients in the ICU with SAKI by clinicians, with no public advertisement for recruitment. Results will be disseminated in research journals and through conference presentations.Trial registrationNCT03175328.

Objective This study used a prospective cohort study to observe the effect of triple-negative breast cancer on the 2-year disease-free survival rate with or without “TCM formula”. Methods From November 1 st, 2016, the first patient was enrolled in the cohort study. A total of 356 patients were enrolled on January 30, 2019. Among them, 154 cases were followed up for 2 years. During the follow-up, there were 6 cases of shedding, so 6 cases were affected. A total of 148 cases were included in the analysis, including 73 in the exposed group and 75 in the non-exposed group. The exposed group was given “TCM formula” on the basis of standardized treatment, and the non-exposed group was treated with simple triple-negative breast cancer. The two groups visited each of the three months. The interview included safety examination (hematology and imaging). The endpoint was the difference in 2-year invasive disease-free survival between the exposed and non-exposed groups and the safety of the “TCM formula”. Results There were 6 cases of shedding during the experiment and the shedding rate was 3.9 %. The 2-year rate of invasive disease-free survival in the exposed team was 88.7 % and the non-exposed group was 82.5 %. Logistic multivariate regression analysis predicted that “TCM formula” could reduce the disease-related recurrence and metastasis rate by 11 % (OR = 0.89, 95 % CI 0.37−0.956, P＜0.05). Through K–M survival analysis, TNBC patients with age ≤35 years and regional lymph node stage N1 may be the benefit group of “TCM formula”(P＜0.05). During the study, the incidence of total adverse events was 8.2 % in the exposed group, mainly manifested as stomach discomfort, diarrhea, and hepatocyte damage. Conclusion 1. In the exposed group, the two-year rate of invasive disease-free survival increased by 6.2 % compared with the non-exposed group(P＞0.05). 2. According to K–M survival analysis, TNBC patients with age ≤35 years and regional lymph node metastasis to N1 may be potential beneficiaries of “TCM formula”. 3. “TCM Formula” is safe and tolerable to most patients.

The present prospective, randomized, double-blinded, controlled study aimed to investigate the efficacy and safety of dexmedetomidine (DEX) combined with butorphanol for patient-controlled intravenous analgesia (PCIA) following total laparoscopic hysterectomy. A total of 88 patients undergoing total laparoscopic hysterectomy and receiving postoperative PCIA were divided into two groups following surgery. Patients received DEX 0.5 µg/kg intravenously in the DEX group or 0.9% normal saline in the control (CON) group following anesthesia induction. Postoperatively, the PCIA (10 mg butorphanol with 300 µg dexmedetomidine in the DEX group or without DEX in the CON group) was delivered as a 0.5 ml bolus (lockout interval of 15 min) with a continuous background infusion of 2 ml/h. Cardiovascular and respiratory variables, cumulative butorphanol consumption, pain scores, level of sedation, concerning adverse events and the degree of patient satisfaction were recorded for 24 h post-surgery. A total of 81 patients completed the study. Blood pressure and heart rate exhibited no significant difference between the two groups during surgery and for 24 h post-surgery. Compared with the CON group, patients in the DEX group required ~19% less butorphanol (P

IP Multimedia Subsystem (IMS) is the integration platform for multimedia application services and provides a rich feature set of converged services in Next Generation Network (NGN). People can access IMS services anytime anywhere using their self IMS devices which refers to mobile devices equipped with a Universal Subscriber Identity Module (USIM) card. Since the rapid development of Information and Communication Technology (ICT), people own many devices connected to the Internet in the home or office environment. Except for the mobile devices equipped with USIM card, people wish that these devices connected to the Internet also can access IMS services but without USIM card. Therefore, in this paper, we propose an Open Service Gateway Initiative (OSGi)-based IMS service gateway, which can is authorized by the self IMS device and enable these non-IMS devices to access IMS services. Besides, these non-IMS devices may use different network access technologies and network protocols. The proposed IMS service gateway employs the OSGi framework to solve the integration problem.

Purpose: The purpose of this study was to assess the possibility of measuring radiation dose based on primary color chrominance in chemical solutions. Methods: We used an aqueous solution with different concentrations of Alphaurine A and Tracid Brilliant Red B. This was irradiated by 1.5–13.5 kGy 60Co γ radiation. Data were collected by an instrument that can detect information on the three primary colors. Data were analyzed and manipulated for each experiment. Results and conclusions: The result shows that three primary colors chrominance in the aqueous solutions change with different doses of 60Co γ-rays and different concentrations of Alphaurine A and Tracid Brilliant Red B. For Alphaurine A, the red chrominance is gradually reduced as a function of radiation dose. The blue chrominance gradually increases concurrently. The red and green chrominance changes obviously and inversely, but the green chrominance changes little. In Tracid Brilliant Red B solution, the red chrominance gradually decreases as th...

Background: Whether administration of LHRH analog during CT in premenopausal patients with early-stage, hormone receptor-positive disease would reduce CT-induced premature ovarian failure (POF) is still controversial. Moreover, whether LHRH analog would influence the prognosis of patients is unknown yet. This randomized study is to evaluate whether administration of LHRH analog during CT would reduce POF and effect the prognosis of breast cancer. Methods: This is arandomized, controlled phase III clinical trial. Premenopausal patients age Results: Between 2/09 and 5/13, the trial has finished enrollment, 216 patients were enrolled. The median age were 37.5 in combined arm (n=108) and 39 in sequential arm (n=108), respectively. The median follow-up time was 27.4 months and 25.7 months, respectively. 15 patients and 21 patients received neoadjuvant CT, respectively. There were no significant difference in age, tumor stage and CT regimens (p>.05). The median cycles of GN were 25, respectively. 47% had complete primary endpoint data. POF rate were 5/42 (11.9%) in the combined arm and 16/60 (26.7%) in the sequential arm. POF rate (and post-menopausal FSH) rate were 1/42 (2.4%) in the combined arm and 8/60 (13.3%) in the sequential arm. In neoadjuvant CT subgroup, each has 1 patient achieved pathological complete remission, and there was no significant difference in objective clinical response. There were 9 patients in the combined arm and 3 patients in the sequential arm had occured RFS events (including 2 and 0 deaths, respectively, OR=3.18, 95%CI:0.84-12.09, P=.075). Conclusions:LHRH analog administration with CT might be associated with less POF and did not affect the efficacy of neoadjuvant CT, however, had no RFS benefit, it may need longer follow-up. We will conduct an interim analysis in November 2014. Clinicaltrials.gov Registry Number: NCT01712893. Citation Format: Jian-Wei Li, Guang-yu Liu, Ke-Da Yu, Ya-jie Ji, Miao Mo, Li Lei, Jiong Wu, Gen-hong Di, Yi-feng Hou, Zhen Hu, Can-ming Chen, Zhen-Zhou Shen, Zhi-Ming Shao. Effect of using LHRH analog during chemotherapy (CT) on premature ovarian failure and prognosis in premenopausal patients with early-stage, hormone receptor-positive breast cancer: The primary analysis of a randomized controlled phase III trial [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-12-02.

ObjectiveTo observe the effect of low–intensity pulsed ultrasound in the posterolateral lumbar fusion of rabbit.MethodsA total of 48 New Zealand white rabbits were randomly divided into the observation group and control group, including the autogenous iliac observation group, artificial bone observation group, artificial bone control group and autogenous iliac control group according to the different bone grafting. The posterolateral lumbar fusion of rabbits in each group was analyzed and compared.ResultsAfter 4 weeks of treatment using the low–intensity pulsed ultrasound, the fusion in the bone grafting area of observation group was good. There was the relatively dense fusion area between the right transverse process and artificial bone. The left transverse process had been completely fused, with the clear bone trabecula through the fusion area. There was no significant fusion sign in the control group. According to the fusion comparison between two groups, the fusion rate of the observation group was 83.3% and it was significantly higher than the one of the control group (37.5%). Results of the comparison were statistically significant (P

The quality of emergency medical services (EMS) prior to a patient's arrival at a hospital is directly affected by the efficiency to dispatch an ambulance for first aid. In this paper, we created an ambulance dispatching system for first aid, which is integrated with Information and Communication Technology (ICT) and performed on a cloud platform. In virtue of ICT, the system can readily monitor the movements of ambulance with Geographic Information System (GIS) and determine any ambulance dispatching task and saves more time spent in transporting an accident victim to a hospital. Furthermore, the system running on a cloud platform is characteristic of integrated medical resources and terminal equipment with or without powerful hardware that is flexibly added into or removed from the system for supporting dispatch.

To investigate the effects and technical points of laparoscopic splenectomy and esophagogastric devascularization (LS+ED) for portal hypertension (PH) due to liver cirrhosis.In total, 204 PH patients who underwent LS+ED from January 2008 to April 2013 in the Southwest Hospital of the Third Military Medical University were enrolled in this study. We retrospectively analyzed the clinical data and the key technical points and compared the results with other researchers.LS+ED was successfully carried out on 188 patients. The mean duration of surgery was 232±59 minutes, the mean intraoperative blood loss was 189±137 mL, the rate of blood transfusion was 19.6% (40/204), and no deaths occurred during surgery. The mean postoperative interval to passing of flatus was 3.5±0.9 days, and the mean postoperative hospital stay was 8.7±2.2 days. Operative complications occurred in 100 patients, of whom 78 had portal vein system thrombosis (PVST). During a postoperative follow-up period of 2-65 months, 15 cases were lost to follow-up, esophagogastric variceal bleeding re-occurred in 7 patients, encephalopathy occurred in 2 patients, and secondary liver cancer occurred in 3 patients. Five patients died during this period.The technical points of LS+ED include a combined surgical approach, a reasonable surgical procedure, and an appropriate laparoscopic operating plane. LS+ED is a safe and effective treatment for minimal trauma and rapid recovery. PVST is a common and potentially life-threatening complication after LS+ED, and anticoagulation therapy should be given early.

This paper takes the large space air-conditioned buildings air-conditioned buildings as research subjects and sets numerical conditions of large space air-conditioned buildings prototype to conduct a simulation study by means of numerical simulation.Numerical and experimental results show that the standard k-εturbulence model can be used to describe the characteristics of the large space air-conditioned buildings building;the experimental results of a typical location room temperature basically consistent with the numerical results of the prototype and enlarged model.Results of this study will provide a useful reference for the researches of large space air-conditioned buildings air-conditioned building.

The reliability of security system affects the ability of the system to protect people's lives and property safety. Failure risk assessment of security system is an effective method to test the reliability of the system. The fault tree analysis method has been applied to analyze the system failure risk from the angle of each part and considering the human factors. The traditional fault tree analysis method assumes that the probability of bottom events is certain to calculate the top event probability. To obtain accurate bottom events probability is difficult, even impossible because statistical data is not sufficient and the bottom events is fuzzy in fact. Analysis of the fuzzy mathematics theory is introduced into the fault tree. The calculation provides reference for the system design and management.

According to the chatter phenomenon of 3rd stand of a steelworks six-roller tandem cold mill (TCM), vertical vibration of tandem cold mill was simplified to eight degrees of asymmetric freedom mass-spring system. Virtual prototype model on vertical vibration of tandem cold mill was established and natural frequencies and main vibration mode of mill were solved by using automatic dynamic analysis of mechanical systems in software ADAMS. The modal coordinates of main vibration mode of the mill were referred firstly and obtained; the maximal mode of vibration system was found and finally discovered the fifth-octave-mode chatter was the probable vibration of the mill.

The mathematical model of automobile driving was established, the calculation method of standing start acceleration time based on principle of optimal power continuous shift was introduced. The simulation analysis, calculation and verification were conducted by MATLAB. It lays the theoretical foundation for the analysis and calculation of dynamic performance by computer.

The safety and feasibility of laparoscopic splenectomy and esophagogastric devascularization are still uncertain. The aim of this study was to compare our results for laparoscopic splenectomy and esophagogastric devascularization with those for open splenectomy and esophagogastric devascularization. From January 2008 to December 2011, 153 patients were diagnosed with portal hypertension and serious gastroesophageal varices in our institute, among which, 107 patients also had repeated upper gastrointestinal bleeding and 85 had severe hypersplenism. Eighty patients chose laparoscopic splenectomy and esophagogastric devascularization and 73 patients underwent the open procedure. Results and outcomes were compared retrospectively. Nine patients underwent conversion to laparotomy in the laparoscopic group. We compared the laparoscopic group (80 patients) and the open group (73 patients). Operating times and the frequencies of blood transfusions were similar. Blood loss was less (P = 0.044), the passing of flatus was earlier (P = 0.041), and hospital stays were shorter (P = 0.028) in the laparoscopic group. Portal vein system thrombosis after laparoscopy was more frequent (P = 0.012) but the rates of main trunk occlusion were similar between the two groups. Pleural effusion after laparoscopy was less (P = 0.021) and, apart from this, there was no difference in other morbidities between the two groups. During a postoperative follow-up period of 2 to 50 months in 80 patients of the laparoscopic group vs. 73 patients of the open group, the incidence of esophagogastric variceal rebleeding, encephalopathy, and secondary liver cancer showed no significant differences. And the mortality rates for each of the groups were not different. The short-term effects of laparoscopic splenectomy and esophagogastric devascularization were better than those for open surgery, and the medium-term effects were similar between these two surgical approaches. Prospective randomized studies with a greater number of cases are needed to confirm the role of laparoscopy in splenectomy and esophagogastric devascularization.

Segmentation of CT volume data is important and useful in non-destructive testing and evaluating. To eliminate the artifacts influence, we propose a new approach of 3D defect segmentation using two steps. First of all, an initial segmentation using 3D morphological method is performed. The initial segmentation results include false defects. Secondly, resample in polar coordinates method is performed. The experimental results prove that our method is effective to correctly segment 3D defects and eliminate false segmentation. Some experiments on CT volume data with noise are made, the results show that our method is also useful.

Siyu Wu,1,2 Miao Mo,3 Yujie Wang,1,2 Na Zhang,1,2 Jianwei Li,1,2 Genhong Di,1,2 Zhimin Shao,1,2 Jiong Wu,1,2 Guangyu Liu1,2 1Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, 3Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, People’s Republicof China Background: Breast reconstruction (BR), including autologous breast reconstruction (ABR) after mastectomy (MST), has been gaining popularity all around the world, especially in the People’s Republic of China during the past decade. However, there is a small proportion, but a significant number, of patients who develop local recurrence (LR) of breast cancer postoperatively. The purpose of this study is to examine the incidence of LR, discuss risk factors associated with LR, and management of LR following MST and ABR. Methods: A total of 397 patients who underwent MST and ABR after diagnosis of breast cancer were included in this retrospective study. Data were analyzed by the Kaplan–Meier method, the log-rank statistical test, and Cox proportional hazards model. Results: From January 1999 to December 2011, 400 ABRs were performed in 397 patients in Fudan University Shanghai Cancer Center. The median follow-up time in the study was 3.6 years. LR occurred in 11 of 397 patients, with a median time to LR of 2.9 years. In univariate and multivariate analyses, tumor stage, hormonal therapy (yes or no), and tumor type (multifocal or nonmultifocal) were significantly associated with LR after ABR following MST. Conclusion: ABR is an oncologically safe surgical procedure with an acceptable LR rate of 2.8%. Risk factors associated with high rate of LR were higher tumor stage, absence of hormonal therapy, and multifocal tumor type. Keywords: local recurrence, autologous breast reconstruction, incidence, risk factors, management

In order to solve the problem of the photo response non-uniformity (PRNU) for High Dynamic Range (HDR) video system, this paper discusses the causes of the problem and the common solution, and then proposed a new non-uniformity correction approach based on the reference source for HDR video system. This approach use high-pass filter to calibration image in Frequency domain to get the correction matrix of one level light conditions at first. And then performs an inverse Fourier transform to the spatial domain. Finally calculate the difference between the correction matrix and the target image to obtain the corrected results. The experimental result indicates that the approach has good effect on dealing with non-uniformity of the HDR images and the definition has been greatly improved.

With the electric turret work principle, analysis the fault of the CNC lathe turret.Aimed at different fault phenomenon, the fault diagnosis method was proposed. Introducing the specific application of fault diagnosis method through specific cases, provide a theoretical reference for effective control failure and rapid troubleshooting

This paper carries out a series of experimental study on 6 column specimens, analyses and compares with the different parameters on the axial loading tests of RC columns and RC columns strengthened with steel tube. The experimental results show that the RC columns strengthened with steel tube take full advantage of loading properties of both materials, thus greatly improve the bearing capacity of specimens. With the same wall thickness steel tube, the improving degree of bearing capacity of long columns is bigger than the short columns, and the reinforcement effect is more obvious. The experimental results can offer reference for scientific research and engineering staff, and promote this reinforcement method to be widely used in engineering practice.

The article indroduced the system of ore mixing of sintering based on data mining. Appled the method of cluster to the saved history data of the sintering process to classfy the history data into three category. Every new sample should be put into the Corresponding cluster by the distance of Eucliden, at the meantime, find the nearest proportioning ore case, and the quality index of the new sample is same with the nearest case. The method is more useful and easy.

Aim: We conducted the present study to assess health-related quality of life (HRQoL) among bone cancer patients after surgical treatment in one large teaching hospitals in China, and assess the risk factors for improving the physical or mental HRQoL. Methods: 344 eligible adult patients who were admitted to the hospital with malignant bone tumors during the period of Jun. 2008 to Dec. 2011, and a reference group with 361 health cases was recruited in the same hospital during the same period. All 344 patients were followed up for one year. The HRQoL before treatment and after one year was evaluated with the Medical Outcome Short Form 36 (SF-36). Results: All 8 domains of HRQoL had the lowest scores greatly improved over the first year after discharge. However, the patients still had significantly lower scores in every domain than the reference group one year after discharge. Age and type of surgery were associated with HRQoL in the mental domain. Conclusion: The HRQoL of patients with malignant bone tumors greatly improved one year after the treatment. This study also highlighted the utility of HRQoL assessment for prognostic evaluation of patients after surgical treatment for bone cancer.

Currently, research on wetlands is a rapidly developing field. To understand the state of wetland science in China, we used the term “wetland” ,“marsh”, “swamp”, “bog” and “mire” as the keywords to search in the ISI Web of Knowledge and the Chinese Journals Full-Text Database and collect Chinese and English literature on wetland written by Chinese researchers. These publications were analyzed with bibliometric methods by the distribution of the publication year, the author and organization distribution, the journal distribution, the research funds, the research regions and the subjects. The results indicate that core research groups working in the field of wetland science in China have already been formed, although the distribution of research groups was scattered across many institutions and universities. Dispersion and concentration coexisted in the journal distribution of Chinese and English publications—the majority of publications were clumped in a small number of journals, while a minority was scattered in a large number of journals. In China, there are two professional journals publishing papers on wetlands, Wetland Science and Wetland Science & Management. However, it is reasonable to launch an English language wetland journal in the country to enhance communication and cooperation. Research funds for wetland science have a wide array of sources. An important portion of the papers in Chinese was supported by the National Natural Science Foundation of China and provincial foundations, while those in English were supported either by National Natural Science Foundation of China or international funds. Field studies in wetland science were mainly conducted in the regions with great valleys. Wetland hydrology, Wetland Biogeochemical process and Wetland protection and management are the main objects of those studies. With the development of economy, many environmental and resource issues have emerged due to the excessive use and subsequent destruction of wetland areas. Thus, enforcing the protection of wetlands is becoming increasingly popular.

Highlights? The proposed self-adjusting e-course generation process supports personalized learning environments. The process adopts evolutionary algorithms to compose personalized e-courses for individual learners. The feedback information from learners is necessary for adjusting the difficulty of the e-learning material. The experimented results indicate that the past learners' experiences can benefit the next learner. This paper proposes a self-adjusting e-course generation process, which support to provide a truly personalized learning environment. The proposed process is divided into four steps: (1) determining learning concept structure, (2) adjusting the difficulty of the e-learning material, (3) analyzing a learner's ability and learning goals, and (4) composing personalized e-courses. Meanwhile, this paper applies the collaborative voting approach to determine the difficulty of the e-learning material, and the maximum likelihood estimation (MLE) to analyze a learner's ability and her/his learning goals. Since evolutionary algorithms (EAs) have been developed to find close optimal solutions, this paper adopts them to compose personalized e-courses that meet individual learners' demands. Once a learner learns one or more learning concepts covered in a personalized e-course, the feedback information from the learner must be returned to: (I) self-adjust the difficulty of the e-learning material for step 2, and (II) update the learners' ability and learning goals for step 3. Furthermore, to find appropriate EAs for personalized e-course composition, this paper devises some experiments to compare two widely applied EAs, Genetic algorithms (GA) and Particle Swarm Optimization (PSO). When the number of e-learning materials is less than 300, the experimented results indicate that the executing effectiveness of PSO is better than that of GA. Besides, to validate the practicability of the proposed process, an e-course authoring tool based on the proposed process is developed to generate personalized e-courses. The generated personalized e-courses have been provided to 103 actual learners who participate in an "Introduction to Computer" curriculum. The investigation results indicate that the proposed process adapts to learners by utilizing the feedback from many learners. In other words, learning experiences of one organization/class can benefit to another organization/class's learners in the same curriculum.

To understanding future market conditions of agricultural pumps in Henan province, need to predict numbers of agricultural pumps at each year-end. Expatiated the principle of prediction based on BP neural network, and constructed the model of prediction. The BP neural network was trained with normalized statistical data of agricultural pumps in Henan province from 1990 to 2010, and gained parameters of the neural network. Test shows the model has high predictive precision. The average absolute value of predicted relative errors is 1.333%. Numbers of agricultural pumps at each year-end in Henan province of China from 2011 to 2015 were predicted, and the trend was also presented.

It is often needed in engineering that detecting and analyzing vibration signal of some equipment. To meet the requirement, a portable detecting and analytic instrument was designed using virtual instrument concept. In the instrument, notebook computer was used as the platform of hardware. Vibration signal was obtained by integrated piezoelectric acceleration sensor (DTS0104T), and was transferred to a notebook computer through data acquisition card (NI USB-6210) based on USB bus. The software, running on the notebook computer, was developed under LabVIEW. Vibration signal could be displayed on screen, recorded in disk or printed by printer, retrieved, and analyzed. The analysis functions of the instrument include: time-domain analysis, frequency-domain analysis, time-frequency domain analysis, and correlation analysis. The instrument is compact, portable, powerful, and with friendly interfaces, has broad application prospects.

To adjust temperature as the requirement of process curve, an intelligent control system of temperature was designed. In the system, the fuzzy rule was used to adjust parameters of PID controller. Adjusted PID controller was used to control the change of temperature. The system can avoid the disadvantages of common PID, such as, long setting time, wide overshoot, and acquire better control characteristic. It were expatiated that principle and method of control. The hardware structure and the software flow chart were also introduced.

To improve precision of reverse design in cam contour curve, method of using BP neural network was presented. The theory and algorithm of BP neural network were introduced, the principle and process of BP neural network modeling used in the reverse design of cam contour curve were expounded, and the actualize method of reverse design with modeled network was afforded. Experiment indicates that this method is suitable to reverse the contour curve of cam, and has high approach precision. At last, disadvantages of the method were discussed.

In order to improve water quality retrievals of multi-spectral image accurately, this paper puts forward a method for water quality remote retrieva based on support vector regression with parameters optimized by genetic algorithm. The method uses SPOT-5A data and the water quality field data, chose four representative water quality parameters, support vector regression are trained and tested, the parameters of support vector regression are optimized by genetic algorithms. The result of experiment shows that the method has more accuracy than the routine method. It provides a new approach for remote sensing monitoring of environment.

Focused on the facial feature points localization, the enhance ASM algorithm based on modeling texture by the DCT-SVM is proposed. First, the statistical shape model is built. Then, some key feature points are selected and their texture models are built by the DCT-SVM. In the subsequent searching, the feature points are divided into two classes based on their reliability gained by DCT-SVM detector, by combining the reliable feature points to the shape constraint, the original shape can finally match to the target face. Experiments show the algorithm is robust to the expressions change and can better locate the features than the traditional ASM.

We aimed at evaluating the relationship between lean mass and fat mass with age, menopausal age (MA) and years since menopause (YSM) and their effects on bone mineral density (BMD) at segmental regions in postmenopausal elderly women with and without osteoporosis. After using a dual-energy X-ray absorptiometry (DXA) methodology to measure body composition and BMD at posteroanterior spine and hip in 244 postmenopausal elderly non-osteoporotic (Non-OP) women (65.5 ± 4.3 years) and 298 postmenopausal elderly osteoporotic (OP) women (67.1 ± 4.4 years), we found that in postmenopausal elderly Non-OP women, there was no correlation between lean mass with age, MA, and YSM, as well as no correlation between fat mass with age (all, p0.05); leg fat (LF) mass (r = 0.187; p0.01), whole body fat (WF) mass (r = 0.151; p0.05), and trunk fat (TRF) mass (r = 0.141; p0.05) were positively correlated with MA; LF (r = -0.131; p0.05) and WF (r = -0.127; p0.05) were negatively associated with YSM; WF and whole body lean (WL) mass were the most important body composition components influencing BMD at the third lumbar spine (L3), total first to fourth lumbar spine (L1-4) and hip, respectively; TRF was the most significant determinant of BMD at both L2 and L4. In postmenopausal elderly OP women, there was no relationship between body composition with MA (p0.05); Trunk lean (TRL) mass (r = -0.183; p0.05), leg lean (LL) mass (r = -0.136; p0.01), and WL mass (r = -0.162; p0.01) were negatively correlated with age; TRL mass (r = -0.132; p0.05), LL mass (r = -0.152; p0.01), WL mass (r = -0.170; p0.01) were also negative with YSM; WF was the most important factor influencing BMD at lumbar spine and hip. These data suggest in postmenopausal elderly Non-OP women, fat mass (TRF, LF, and WF) was more related with MA; WF and WL mass were the most important body composition components influencing BMD at L1-4 and hip, respectively; in postmenopausal elderly OP women, body composition was not correlated with MA; lean mass (TRL, LL, and WL) was more age-related negatively; WF mass was the most significant factor affecting BMD at lumbar spine and hip.

In order to improve detection efficiency of casting bolster and side frame of railway freight car, the method to automatically detect railway casting porosity and shrinkage cavity using watershed transformation based on X-ray digital radiography is presented. Firstly, while castings of a bolster and a side frame are scanned by 9Mev X-ray digital radiography system, the DR images are obtained. Then one of interested regions is selected in an image. Defects segmentation is implemented by using watershed transformation algorithm in this paper. Lastly, defects area and occupy rate are acquired by analyzing and computing, so that we can judge the casting quality. The experimental results show that defect regions and contours can be accurately acquired. This method has high robustness and practicality. It improves the efficiency of automated inspection of railway castings.

In view of the poor anti-noise performance of traditional methods, the principle of camera calibration is analyzed based on calibration template with planar circles, and a new calibration technique is proposed based on pin-hole perspective model. Firstly, the edges of image ellipses are located in sub-pixel by spatial-moment operator. Then elliptic equations are obtained by the Least Square Fitting method, and common tangents of two arbitrary ellipses are also calculated. Finally, the extrinsic and intrinsic parameters are computed by the Radial Alignment Constraint (RAC) model. Experiments results indicate that proposed method has a goof performance of lower computation complexity and higher precision.