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Regression testing is required in each iteration of microservice systems. Regression testing selection, which reduces testing costs by selecting a subset from the original test cases, is one of the main techniques to optimize regression testing. Existing techniques mainly rely on the information retrieved from artifacts such as code files and system models. For microservice systems with service autonomy, development method diversity and a large amount of services, such artifacts are too difficultly obtained and costly processed to apply those approaches. This paper presents a regression testing selection approach called MRTS-BP, which needs the API gateway layer logs instead of code files and system models as inputs. By parsing the API gateway layer logs, our approach establishes the service dependency matrix, which in further is transformed into a directed graph with the services as nodes. Then, to find out which test cases are affected by service changes, an algorithm based on belief propagation is presented to compute the quantitative results of service-change propagation from the directed graph. Finally, the relationships between original test cases and service-change propagation results are established to select test cases with three strategies. To evaluate the efficiency of MRTS-BP, the empirical study based on four microservice systems is presented. A typical technique RTS-CFG is compared with MRTS-CFG and four experiments are setup to investigate four research questions. The results show that MRTS-BP can not only reduce the number of test cases by half compared with the retest-all strategy while ensuring the safety, but also save at least 20% testing time costs more than that of RTS-CFG. MRTS-BP is more practical than the techniques relying on the artifacts when the latter cannot be implemented due to the artifacts are difficult to obtain and process.

Carbon dots are zero‐dimensional carbon nanomaterials with quantum confinement effects and edge effects, which have aroused great interests in many disciplines such as energy, chemistry, materials, and environmental applications. They can be prepared by chemical oxidation, electrochemical synthesis, hydrothermal preparation, arc discharge, microwave synthesis, template method, and many other methods. However, the raw materials' high cost, the complexity and environmental‐unfriendly fabrication process limit their large‐scale production and commercialization. Herein, we review the latest developments of coal‐based carbon dots about selecting coal‐derived energy resources (bituminous coal, anthracite, lignite, coal tar, coke, etc.) the developments of synthesis processes, surface modification, and doping of carbon dots. The coal‐based carbon dots exhibit the advantages of unique fluorescence, efficient catalysis, excellent water solubility, low toxicity, inexpensive, good biocompatibility, and other advantages, which hold the potentiality for a wide range of applications such as environmental pollutants sensing, catalyst preparation, chemical analysis, energy storage, and medical imaging technology. This review aims to provide a guidance of finding abundant and cost‐effective precursors, green, simple and sustainable production processes to prepare coal‐based carbon dots, and make further efforts to exploit the application of carbon dots in broader fields.

In order to improve the efficiency of the company's selection and configuration of automobile constant velocity universal joint, and to reduce the enterprise’s internal production costs, a method for the development and design of automobile constant velocity universal joint was proposed based on mass customization in this study. By constructing the master model of constant velocity universal joint components, modular development of products of the same family with similar functional structures was carried out, and the configuration design and variant design of universal joint components are completed. Use CATIA to design a digital platform for automotive constant velocity joint that quickly responds to customer needs, and perform fatigue life experiments on the designed constant velocity joint. The results show that the digital platform of constant velocity universal joint can more efficiently mass-produce customized products.

sRecent evidence suggests that CD147 serves as a novel receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Blocking CD147 via anti-CD147 antibody could suppress the in vitro SARS-CoV-2 replication. Meplazumab is a humanized anti-CD147 IgG2 monoclonal antibody, which may effectively prevent SARS-CoV-2 infection in coronavirus disease 2019 (COVID-19) patients. Here, we conducted a randomized, double-blinded, placebo-controlled phase 1 trial to evaluate the safety, tolerability, and pharmacokinetics of meplazumab in healthy subjects, and an open-labeled, concurrent controlled add-on exploratory phase 2 study to determine the efficacy in COVID-19 patients. In phase 1 study, 59 subjects were enrolled and assigned to eight cohorts, and no serious treatment-emergent adverse event (TEAE) or TEAE grade ≥3 was observed. The serum and peripheral blood Cmax and area under the curve showed non-linear pharmacokinetic characteristics. No obvious relation between the incidence or titer of positive anti-drug antibody and dosage was observed in each cohort. The biodistribution study indicated that meplazumab reached lung tissue and maintained >14 days stable with the lung tissue/cardiac blood–pool ratio ranging from 0.41 to 0.32. In the exploratory phase 2 study, 17 COVID-19 patients were enrolled, and 11 hospitalized patients were involved as concurrent control. The meplazumab treatment significantly improved the discharged (P = 0.005) and case severity (P = 0.021), and reduced the time to virus negative (P = 0.045) in comparison to the control group. These results show a sound safety and tolerance of meplazumab in healthy volunteers and suggest that meplazumab could accelerate the recovery of patients from COVID-19 pneumonia with a favorable safety profile.

Background Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China. Methods After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test. Results The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71-4.92 mIU/L, 12.2-20.1 pmol/L, 3.9-6.0 pmol/L, 65.6-135.1 nmol/L, and 1.2-2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens. Conclusions Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.

In this paper, the generation of relativistic electron mirrors (REMs) and the reflection of an ultra-short laser off this mirrors are discussed, applying two-dimensional particle-in-cell (2D-PIC) simulations. REMs with ultra-high acceleration and expanding velocity can be produced from a solid nanofoil illuminated normally by an ultra-intense femtosecond laser pulse with a sharp rising edge. Chirped attosecond pulse can be produced through the reflection of a counter-propagating probe laser off the accelerating REM. In the electron moving frame, the plasma frequency of the REM keeps decreasing due to its rapidly expanding. The laser frequency, on the contrary, keeps increasing due to the acceleration of REM and the relativistic Doppler shift from the lab frame to the electron moving frame. Within an ultra-short time interval, the two frequencies will be equal in the electron moving frame, which leads the resonance between laser and REM. The reflected radiation near this interval and the corresponding spectra will be amplified due to the resonance. Through adjusting the arriving time of the probe laser, certain part of the reflected field could be selectively amplified or depressed, leading to the selectively adjusting of the corresponding spectra.

Ischemic postconditioning (PostC) conventionally refers to a series of brief blood vessel occlusions and reperfusions, which can induce an endogenous neuroprotective effect and reduce cerebral ischemia/reperfusion (I/R) injury. Depending on the site of adaptive ischemic intervention, PostC can be classified as in situ ischemic postconditioning (ISPostC) and remote ischemic postconditioning (RIPostC). Many studies have shown that ISPostC and RIPostC can reduce cerebral IS injury through protective mechanisms that increase cerebral blood flow after reperfusion, decrease antioxidant stress and anti-neuronal apoptosis, reduce brain edema, and regulate autophagy as well as Akt, MAPK, PKC, and KATP channel cell signaling pathways. However, few studies have compared the intervention methods, protective mechanisms, and cell signaling pathways of ISPostC and RIPostC interventions. Thus, in this article, we compare the history, common intervention methods, neuroprotective mechanisms, and cell signaling pathways of ISPostC and RIPostC.

Fluorescent carbon dots (CDs) are admirable nanomaterials due to their superior optical properties and low cost. However, regulation of the emission colors in CDs for lighting device still remains a challenge. In this work, we developed a green hydrothermal method to obtain three emission colors of CDs using l -tyrosine (for blue CDs), o-phenylendiamine (for green CDs) and l -tyrosine/o-phenylendiamine mixture (for orange-red CDs). These CDs possess good water dispersibility, strong emission with high quantum yields, and excellent photostability. Furthermore, the resulting CDs were dispersed in polyvinyl alcohol (PVA) matrix to yield solid state films, where the self-quenching effect in solid state was effectively avoided. A full-color light-emitting diode was fabricated by packing the CDs-PVA composites on the top of a UV-chip, which have superior potential applications in CDs-based solid-state lighting system.

Lane detection is essential for many aspects of autonomous driving, such as lane-based navigation and high-definition (HD) map modeling. Although lane detection is challenging especially with complex road conditions, considerable progress has been witnessed in this area in the past several years. In this survey, we review recent visual-based lane detection datasets and methods. For datasets, we categorize them by annotations, provide detailed descriptions for each category, and show comparisons among them. For methods, we focus on methods based on deep learning and organize them in terms of their detection targets. Moreover, we introduce a new dataset with more detailed annotations for HD map modeling, a new direction for lane detection that is applicable to autonomous driving in complex road conditions, a deep neural network LineNet for lane detection, and show its application to HD map modeling.

The aim of this study was to develop population-specific regression equations for age estimation by investigating the correlation between chronological age and pulp–tooth volume ratios in three typ...

Background. Numerous studies have highlighted that long noncoding RNA (lncRNA) can indirectly regulate the expression of mRNAs by binding to microRNA (miRNA). LncRNA-associated ceRNA networks play a vital role in the initiation and progression of several pathological mechanisms. However, the lncRNA-miRNA-mRNA ceRNA network in endothelial cells under cyclic stretch is seldom studied. Methods. The miRNA, mRNA, and lncRNA expression profiles of 6 human umbilical vein endothelial cells (HUVECs) under circumferential stress were obtained by next-generation sequencing (NGS). We identified the differential expression of miRNAs, mRNAs, and lncRNAs using the R software package GDCRNATools. Cytoscape was adopted to construct a lncRNA-miRNA-mRNA ceRNA network. In addition, through GO and KEGG pathway annotations, we analyzed gene functions and their related pathways. We also adopted ELISA and TUNEL to investigate the effect of si-NEAT1 on endothelial inflammation and apoptosis. Results. We recognized a total of 32978 lncRNAs, 1046 miRNAs, and 31958 mRNAs in 6 samples; among them, 155 different expressed lncRNAs, 74 different expressed miRNAs, and 960 different mRNAs were adopted. Based on the established theory, the ceRNA network was composed of 13 lncRNAs, 44 miRNAs, and 115 mRNAs. We constructed and visualized a lncRNA-miRNA-mRNA network, and the top 20 nodes are identified after calculating their degrees. The nodes with most degrees in three kinds of RNAs are hsa-miR-4739, NEAT1, and MAP3K2. Functional analysis showed that different biological processes enriched in biological regulation, response to stimulus and cell communication. Pathway analysis was mainly enriched in longevity regulating, cell cycle, mTOR, and FoxO signaling pathway. Circumferential stress can significantly downregulate NEAT1, and after transducing si-NEAT1 for 24 h, inflammatory cytokine IL-6 and MCP-1 were significantly increased; furthermore, fewer TUNEL-positive cells were found in the si-NEAT1 treated group. Conclusions. The establishing of a ceRNA network can help further understand the mechanism of vein graft failure. Our data demonstrated that NEAT1 may be a core factor among the mechanical stress factors and that cyclic stress can significantly reduce expression of NEAT1, give rise to inflammation in the early stage of endothelial dysfunction, and promote EC apoptosis, which may play an essential role in vein graft failure.

Well integrity technology can effectively ensure the safety of the entire life cycle of oil and gas wells. With the exploration and development of more and more high-temperature, high-pressure, high-yield and deep wells, and the constantly increasing requirements for safety and environmental protection in various countries, well integrity technology has become a research hot spot in the oil industry. Based on the analysis of the four basic concepts of well integrity: full life cycle, well integrity management system, well barrier, and risk assessment, this article conducts a comparative analysis of the development history of well integrity technologies at home and abroad, and systematically summarizes foreign wells. The current status of integrity technology, based on the above investigation and analysis, puts forward suggestions for the next development direction of well integrity technology, which has certain guiding significance for the development of the integrity of the next step.

Context Heart failure is one of the most serious diseases worldwide. Astragaloside IV (ASI) is widely used in the treatment of cardiovascular diseases. Objective To elucidate the antioxidative mechanism of ASI in a rat model of left coronary artery ligation. Materials and methods Left coronary artery of Sprague–Dawley rats was ligated to establish the model of heart failure, and then vehicle (saline) or ASI (1 mg/kg/day) was orally administered to the rats (n = 15) for 6 weeks. Echocardiography was used to evaluate the cardiac function. Myocardial infarct size was measured by triphenyltetrazolium chloride staining. Oxidative stress in the ventricular myocardium was determined. Molecular mechanisms were investigated by Western blot and chromatin immunoprecipitation. Results ASI improved the cardiac function, especially ejection fraction (75.27 ± 5.75% vs. 36.26 ± 4.14%) and fractional shortening (45.39 ± 3.66% vs. 17.88 ± 1.32%), and reduced the infarct size of left ventricle (20.69 ± 2.98% vs. 39.11 ± 3.97%). ASI maintained the levels of glutathione, catalase and superoxide dismutase and prevented the leakage of creatine kinase. In addition, ASI induced the protein expression of Nrf2 (1.97-fold) and HO-1 (2.79-fold), while reduced that of Keap-1 (0.77-fold) in the ventricular myocardium. In H9c2 cells, a rat cardiomyocyte cell line, ASI induced the translocation of Nrf2 from cytoplasm to nucleus, followed by transcriptional activation of NQO-1 (8.27-fold), SOD-2 (3.27-fold) and Txn-1 (9.83-fold) genes. Discussion and conclusions ASI prevented heart failure by counteracting oxidative stress through the Nrf2/HO-1 pathway. Application in clinical practice warrants further investigation.

Weight loss after bariatric surgery yields important health benefits. A multitude of observational studies have investigated the association of bariatric surgery for severe obesity with the risk of cancer. However, the results were debatable. The aim of the present study was to estimate the effect of bariatric surgery on overall cancer risk. A systematic literature search was performed to identify studies evaluating the association of bariatric surgery for severe obesity with the risk of cancer. Meta-analysis was performed to calculate combined prevalence. Twenty-one cohort studies with 304,516 patients with obesity having under gone bariatric surgery and 8,492,408 patients with obesity as controls were included. Meta-analysis found decreased cancer risk to be associated with bariatric surgery (OR = 0.56, 95% CI = 0.48–0.66), both for the incidence of cancer (OR = 0.56, 95% CI = 0.46–0.68) and mortality of cancer (OR = 0.56, 95% CI = 0.41–0.75). In subgroup analysis, bariatric surgery was significantly associated with decreased breast cancer risk and endometrial cancer risk, but not associated with other cancer risk. Our meta-analysis indicated that bariatric surgery for severe obesity was associated with decreased cancer risk, both for cancer incidence and mortality. Moreover, further studies estimating the functional effect and side effects may eventually provide a better, comprehensive understanding.

Objective. To determine the subcellular localization of epithelial cell adhesion molecule (EpCAM) in labial salivary gland (LSG) and evaluate the diagnostic use of the extracellular domain of EpCAM (EpEX) and intracellular domain (EpICD) for primary Sjögren’s syndrome (pSS). Methods. Immunohistochemical (IHC) analysis was conducted using EpEX and EpICD domain-specific antibodies on labial salivary gland biopsy (LSGB) from participants. Chi-square or Fisher’s exact analysis, Mann–Whitney U-test, and Kruskal-Wallis test compared differences among groups. Independent risk factors of pSS were determined by multiple logistic regression analysis. Receiver-operator characteristic curves (ROC) were carried out to estimate the diagnostic value. Results. Compared to non-SS controls, loss of membranous EpEX and EpICD expression was observed in LSGB of pSS patients, which occurred in parallel with increased accumulation of cytoplastic and nuclear EpICD. The subcellular EpEX/EpICD expressions were associated with various features of pSS patients, especially histopathological grade of LSGB. Furthermore, high IHC scores of membranous EpEX were independent risk factors for pSS, even for the pSS patients at early stage. The IHC scores of subcellular EpEX/EpICD were of great diagnostic value for pSS with high sensitivity (70-80%) and specificity (85-95%). Conclusion. This study first found the aberrant expression pattern of EpCAM in LSG of pSS patients. The IHC scores of subcellular EpEX/EpICD were demonstrated to have the potential to act as diagnostic biomarkers for pSS.

Evidence of active tuberculosis (ATB) in patients with rheumatic diseases are research priorities but limited data from China have been reported. Research targeting patients not taking anti-TNF biologics are especially insufficient. We aimed to investigate the prevalence and risk factors of ATB in this at-risk population. We conducted a tertiary hospital-based, multi-center, cross-sectional study by using stratified multi-stage cluster sampling strategy to screen ATB in patients with rheumatic diseases. We estimated the prevalence of ATB in patients with rheumatic diseases and identified risk factors among those who were not taking anti-TNF biologic. A total of 13,550 patients with rheumatic diseases were enrolled, and the result showed the standardized prevalence of ATB according to the composition ratio of various types of rheumatic disease was 882/100000 (95% confidence interval (CI): 706-1057). Multivariable logistic regression analysis in patients not taking anti-TNF biologics showed that the independent risk factors of ATB were having systemic lupus erythematosus (SLE) (OR=2.722, 95% CI: 1.437-5.159, p=0.002), having Behcet's disease (BD) (OR= 5.261, 95% CI: 2.071-13.365, p

Currently, herbal and dietary supplements have been widely applied to prevent and treat various diseases. However, the potential toxicities and adverse reactions of herbal and dietary supplements have been increasingly reported, and have gradually attracted widespread attention from clinical pharmacists and physicians. Metabolic activation of specific natural products from herbal and dietary supplements is mediated by hepatic cytochrome P450 or intestinal bacteria, and generates chemical reactive/toxic metabolites that bind to cellular reduced glutathione or macromolecules, and form reactive metabolites-glutathione/protein/DNA adducts, and these protein/DNA adducts can result in toxicities. The present review focuses on the relation between metabolic activation and toxicities of natural products, and provides updated, comprehensive and critical comment on the toxic mechanisms of reactive metabolites. The key inductive role of metabolic activation in toxicity is highlighted, and frequently toxic functional groups of toxic natural products were summarized. The biotransformation of drug cytochrome P450 or intestinal bacteria involved in metabolic activation were clarified, the reactive metabolites-protein adducts were selected as biomarkers for predicting toxicity. And finally, further perspectives between metabolic activation and toxicities of natural products from herbal and dietary supplements are discussed, to provide a reference for the reasonable and safe usage of herbal and dietary supplements.

ObjectivesHip involvement is an important cause of disability and poor prognosis in patients with spondyloarthritis (SpA). Tumor necrosis factor (TNF)-α inhibitor treatment has been demonstrated to be effective in SpA patients with hip arthritis; however, quantitative assessment using MRI in long-term follow-up needs further application and observation.MethodsA total of 239 patients were involved in this study. Methotrexate and sulfasalazine were given as basic treatment. In total, 165 patients received TNF-α inhibitors plus basic treatment, and 74 received basic treatment only, as controls. Clinical symptoms were assessed at baseline and at weeks 12, 24, and 52. MRI performances of hip arthritis, including bone marrow edema (BME) and synovitis, were quantitatively assessed using the Hip Inflammation MRI Scoring System (HIMRISS).ResultsThe clinical values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Harris hip score, and Ankylosing Spondylitis Disease Activity Score (ASDAS)-ESR in both groups showed significant clinical remission at week 52 (p < 0.001). However, the change in disease activity levels at week 52 in the control group was significantly worse than in the TNF-α inhibitor group. At week 52, MRI showed a significant remission trend in the TNF-α inhibitor group versus baseline, and total HIMRISS scores were significantly decreased (26.49 ± 10.37 vs. 20.59 ± 9.41, p < 0.001); the control group only had slight improvement (p < 0.05).ConclusionsTNF-α inhibitors could significantly improve clinical and MRI manifestations of hip involvement in patients with SpA. Quantitative MRI assessment combined with clinical assessment can be used to accurately evaluate the treatment effect of TNF-α in SpA patients with hip involvement to help guide targeted treatment.

Background: Multimodal postoperative analgesia with intravenous ibuprofen can reduce the consumption of opioids and reduce the postoperative pain intensity. Recommended dose in the USA and Europe is 800 mg every 6 hours for the management of moderate to severe postoperative pain. The purpose of this study was to investigate whether 800 mg is needed in the Chinese population.Methods: This is a multicenter, randomized, controlled multi-center trial. Adult patients (18-65 years of age) scheduled for abdominal or orthopedic surgery under general anesthesia with endotracheal intubation were eligible. Subjects were randomized at a ratio of 1:1:1 to receive ibuprofen at 400 or 800 mg or saline every 6 hours for 48 hours after the operation. All subjects received morphine access through patient-controlled intravenous analgesia (PCIA) device, which was set as background infusion rate 0.5 mg/h, bolus 1 mg, 5-minute lock interval and 20-mg 4-hour limit. The primary endpoint was morphine consumption within the first 24 hours after surgery. Results: A total of 396 patients were enrolled (180 men, 216 women; 46±12.4 years of age; 106 patients receiving abdominal surgery, and 290 patients receiving orthopedic surgery). The number of patients was 131 in the placebo group, 132 in the 400-mg group, and 133 in the 800-mg group. The 3 groups did not differ in age, sex, BMI and the type of surgery. Median 24-hour morphine consumption was 39.1 mg (IQR: 29.7, 61.7) mg in the placebo control, 29.8 mg (IQR: 24.3, 43.7) mg in the 400-mg group, and 28.0 mg (IQR: 24.1, 35.9) in the 800-mg group (PConclusions: Intravenous ibuprofen at either 400 or 800 mg every 6 hours could reduce postoperative morphine consumption, with apparently equal efficacy in Chinese population.

This study was aimed to explore the magnetic resonance imaging (MRI) image features based on the fuzzy local information C-means clustering (FLICM) image segmentation method to analyze the risk factors of restroke in patients with lacunar infarction. In this study, based on the FLICM algorithm, the Canny edge detection algorithm and the Fourier shape descriptor were introduced to optimize the algorithm. The difference of Jaccard coefficient, Dice coefficient, peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), running time, and segmentation accuracy of the optimized FLICM algorithm and other algorithms when the brain tissue MRI images were segmented was studied. 36 patients with lacunar infarction were selected as the research objects, and they were divided into a control group (no restroke, 20 cases) and a stroke group (restroke, 16 cases) according to whether the patients had restroke. The differences in MRI imaging characteristics of the two groups of patients were compared, and the risk factors for restroke in lacunar infarction were analyzed by logistic multivariate regression. The results showed that the Jaccard coefficient, Dice coefficient, PSNR value, and SSIM value of the optimized FLICM algorithm for segmenting brain tissue were all higher than those of other algorithms. The shortest running time was 26 s, and the highest accuracy rate was 97.86%. The proportion of patients with a history of hypertension, the proportion of patients with paraventricular white matter lesion (WML) score greater than 2 in the stroke group, the proportion of patients with a deep WML score of 2, and the average age of patients in the stroke group were much higher than those in the control group ( P < 0.05 ). Logistic multivariate regression showed that age and history of hypertension were risk factors for restroke after lacunar infarction ( P < 0.05 ). It showed that the optimized FLICM algorithm can effectively segment brain MRI images, and the risk factors for restroke in patients with lacunar infarction were age and hypertension history. This study could provide a reference for the diagnosis and prognosis of lacunar infarction.

Background and Aims: Patients with heart failure with reduced ejection fraction (HFrEF) are among the most challenging patients undergoing coronary artery bypass grafting surgery (CABG). Several surgical risk scores are commonly used to predict the risk in patients undergoing CABG. However, these risk scores do not specifically target HFrEF patients. We aim to develop and validate a new nomogram score to predict the risk of in-hospital mortality among HFrEF patients after CABG.Methods: The study retrospectively enrolled 489 patients who had HFrEF and underwent CABG. The outcome was postoperative in-hospital death. About 70% (n = 342) of the patients were randomly constituted a training cohort and the rest (n = 147) made a validation cohort. A multivariable logistic regression model was derived from the training cohort and presented as a nomogram to predict postoperative mortality in patients with HFrEF. The model performance was assessed in terms of discrimination and calibration. Besides, we compared the model with EuroSCORE-2 in terms of discrimination and calibration.Results: Postoperative death occurred in 26 (7.6%) out of 342 patients in the training cohort, and in 10 (6.8%) out of 147 patients in the validation cohort. Eight preoperative factors were associated with postoperative death, including age, critical state, recent myocardial infarction, stroke, left ventricular ejection fraction (LVEF) ≤35%, LV dilatation, increased serum creatinine, and combined surgery. The nomogram achieved good discrimination with C-indexes of 0.889 (95%CI, 0.839–0.938) and 0.899 (95%CI, 0.835–0.963) in predicting the risk of mortality after CABG in the training and validation cohorts, respectively, and showed well-fitted calibration curves in the patients whose predicted mortality probabilities were below 40%. Compared with EuroSCORE-2, the nomogram had significantly higher C-indexes in the training cohort (0.889 vs. 0.762, p = 0.005) as well as the validation cohort (0.899 vs. 0.816, p = 0.039). Besides, the nomogram had better calibration and reclassification than EuroSCORE-2 both in the training and validation cohort. The EuroSCORE-2 underestimated postoperative mortality risk, especially in high-risk patients.Conclusions: The nomogram provides an optimal preoperative estimation of mortality risk after CABG in patients with HFrEF and has the potential to facilitate identifying HFrEF patients at high risk of in-hospital mortality.

Sepsis, with its high morbidity and mortality, is a difficult problem in critical care medicine. The purpose of this study is to investigate the involvement of GRB2-associated binding protein 1 (GAB1) in septic lung injury. Lipopolysaccharide (LPS)-induced mouse model and A549 cell model were used to simulate septic lung injury. Haematoxylin and eosin (H&E) staining was used to observe the pathological changes. The terminal-deoxynucleotidyl transferase/(TdT)-mediated dUTP-biotin nick end labelling (TUNEL) staining and flow cytometry were used to detect apoptosis. The levels of inflammatory factors in the bronchoalveolar lavage fluid (BALF) were determined by enzyme-linked immunosorbent assay (ELISA). In LPS-induced sepsis mice, GAB1 expression was markedly reduced, and GAB1 overexpression significantly attenuated cell apoptosis and decreased levels of macrophages, neutrophils, and inflammatory factors in the BALF. Our results also demonstrated that GAB1 overexpression significantly reduced LPS-induced apoptosis and inflammation of A549 cells. More importantly, GAB1 overexpression significantly inhibited the Toll-like receptor/ NFkappaB (TLR4/NF-κB) pathway, while silencing GAB1 significantly activated the TLR4/NF-κB pathway and induced apoptosis and increased expression of inflammatory factors. However, the TLR4 inhibitor TAK-242 eliminated the effect of GAB1 silencing on A549. In conclusion, GAB1 is a key regulator of sepsis by inhibiting TLR4/NF-κB mediated apoptosis and inflammation.

Currently, polymyxin B has been widely used in the treatment of multidrug-resistant Gram-negative pathogen infections. Due to the limited pharmacokinetic/pharmacodynamic data, the optimal dosage regimen for the recently proposed therapeutic target of the area under the concentration-time curve over 24 h in steady state divided by the minimum inhibitory concentration 50–100 mg⋅h/L has not yet been established. Moreover, most studies have focused on critically ill patients, yet there have been no studies in the field of renal transplantation. To optimize the dosage strategy and reduce the risk of toxicity, a population pharmacokinetics model of polymyxin B with the Phoenix NLME program was developed in our study. A total of 151 plasma samples from 50 patients were collected in the present study. Polymyxin B plasma concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry. A one-compartment model adequately described the data, and the clearance and volume of distribution were 1.18 L/h and 12.09 L, respectively. A larger creatinine clearance was associated with increased clearance of polymyxin B (p < 0.01). Monte Carlo simulation showed that a regimen of a 75 mg loading dose with a 50 mg maintenance dose was a better option to achieve an optimal therapeutic effect (minimum inhibitory concentration ≤1 mg/L) and to reduce the incidence of side effects for patients with renal impairments. The developed model suggested that dosing adjustment should be based on renal function in renal transplant patients.

Sentiment analysis data on Chinese shopping comments has gained much attention in recent years. Many previous studies focus on the relationship between words in a single sentence but ignore the context relationship between sentences. To better serve this problem, we propose a method based on Bidirectional Encoder Representations from Transformers (BERT) pre-training language model, Hierarchical Bi-directional Long Short-Term Memory (Hierarchical Bi-LSTM) and attention mechanism for Chinese sentiment analysis. We first use BERT pretraining language model to obtained word vector, then applies Hierarchical Bi-LSTM model to extract contextual feature from sentences and words. Finally, we inj ect attention mechanism to highlight key information. Base on the experimental results, our method achieves more idealistic performance.

Ni based nano/micro structures are wildly applied in fabrication of nano/micro imprint template, meta-surface, diffractive elements, etc. In this work, the fabrication of Ni structures by electroplating method on a AIST resist is studied. AIST is first deposited on glass substrate to form a layer of thin film. Then, the film is exposed to arbitrary pattern structure by laser direct writing system. And the exposed region changes from amorphous state to crystalline state due to photo-thermal physical reaction. Owing to the different development rates of the exposed region and the non-exposed region, the micro/nano structures can be obtained. Subsequently, continuous Ni structures were formed by electroplating method on the former AIST structure which confirmed by the images of optical microscope(OM) and scanning electron microscope(SEM). This work greatly broadens the application scope and prospect of direct laser writing in heat- mode lithography technology.

ObjectiveInjections of proteoglycan aggrecan (PGA) have been reported to induce axial spondyloarthritis (ax-SpA) in BALB/c mice. It is considered to be a model for radiographic ax-SpA. However, evaluation of the extent of axial disease by histopathological assessment of every intervertebral space is labor-intensive. The objective of our paper is to test the feasibility of Micro Computed Tomography (Micro-CT) in rapidly enumerating the number of intervertebral spaces affected in each mouse.MethodsArthritis was induced in BALB/c mice by intraperitoneal injections of PGA. Involvement of several spinal segments, and selected sacroiliac and hip joints were evaluated by histopathology. The involvement of all intervertebral spaces, sacroiliac and hip joints was evaluated by Micro-CT.ResultsBALB/c mice injected with PGA developed histopathology of SpA-like axial lesions, including spondylitis, sacroiliac joint arthritis and hip joint arthritis. Micro-CT allowed us to clearly enumerate the number of lesions in each mouse.ConclusionMicro-CT allows quantitative assessment of the extent of axial involvement in PGA-induced mouse spondylitis. This can be a useful tool in assessing therapeutic interventions.

Background: Voriconazole is a triazole antifungal agent and a commonly used first-line treatment for invasive aspergillosis (IA). The study was performed to explore the factors affecting voriconazole trough concentration and maintenance dose to optimize voriconazole dosage in pediatric patients. Method: The demographic information, concentration data, CYP2C19 genotypes, and clinical outcomes of eligible pediatric patients from January 1th, 2016 to December 31th, 2018 were collected retrospective . Result: The study finally included 145 voriconazole trough concentrations from 94 pediatric patients. Steady trough concentration ranged from 0.04 to 16.11 μg/mL. Morerover, the distinction between the maximum and the minimum corrected concentration of per kilogram maintenance dosage is as high as 907 folds and children ≤2 years old showed the minimum variation compared to other individuals (P-1kg/12h, respectively had been required in order to achieve therapeutic level (PConclusion: Pediatric patients especially those ≤12 years old might need a higher dosage regime to achieve therapeutic trough concentration. Importantly, early and repeat monitoring of voriconazole is essential to ensure the effectiveness and safety of voriconazole in children.

The available information which is sharply increased requires a long time-period and high-capacity preservation method. In this paper, we proposed a method to preserve miniature image in stack structure. A large number of information images with a minimum pixel size of 200 nm were transferred to an AIST thin film using a laser directly writing system. After clearness, the information region was retained and the non-information region was removed. The single-layer information region samples with a thickness of 0.15 mm have high contrast and high transmittance. After being stacked and packaged into a 52-layer structure, each layer information image can be read out directly by an optical microscopy. The tolerance of the material to acid, alkali, and temperature is tested, and the results show that this method has excellent information preservation performance. This work provides a promising solution for future information preservation.

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Prostate cancer (PCa) remains the secondary highest cause of cancer‐related death in the United States in men. It has been reported that microRNAs can serve as key regulators in tumor development and progression in various cancers including PCa. In this study, we examined the effect of miR‐498 on proliferation, radiosensitivity, invasion, and migration of PCa cells. The proliferation of LNCaP and DU‐145 PCa cells with altered expression of miR‐498 was evaluated by MTT assay. The invasion and migration of LNCaP and DU‐145 PCa cells were assess by matrigel invasion assay and transwell migration assay. The protein expression level in PCa cells was examined by western blot. The function of miR‐498 on radiation‐induced apoptosis in LNCaP and DU‐145 PCa cells was detected by Caspase‐Glo3/7 assay. Forced expression of miR‐498 improved the proliferation, invasion and migration in PCa cells. Furthermore, miR‐498 decreased the sensitivity of PCa cells after ionizing radiation treatment. MiR‐498 reduced the radiation‐induced apoptosis in PCa cells by regulation of BAX and Bcl‐2 expression. Meanwhile, miR‐498 altered the expression of E‐cadherin, N‐cadherin, snail, and Vimentin in both LNCaP and DU‐145 PCa cells and regulated epithelial to mesenchymal transition (EMT). Further study showed that aberrant expression of miR‐498 changed the expression levels of phosphatase and tensin homolog and p‐AKT in LNCaP and DU‐145 PCa cells. In a summary, miR‐498 displayed important roles in tumor development and progression in PCa cells, and might act as a potential prognostic biomarker and predict radiotherapy response in PCa.

The speckle tracking technique has demonstrated its great potential in glacier velocity field (GVF) mapping applications. It analyzes the cross correlation between two synthetic aperture radar (SAR) images, which is capable of providing 2-D glacier motion measurements with acceptable accuracy. Since the coherence between a SAR image pair illuminating glacier areas cannot be preserved everywhere in nearly all cases, inevitable no data areas will be presented in SAR speckle tracking products. In this letter, a relatively convenient method is proposed to recover a GVF generated by the speckle tracking technique. This method considers a GVF recovery problem to be a unitary supervised training problem and resolve it via an artificial neural network. A targeted architecture of the network for recovering a GVF is presented. Moreover, the parameters correlative with glacier motion mechanism are proposed to be introduced into the network, which is able to effectively improve the performance of GVF recovery. For the purpose of validation, the proposed method is compared with the well-known Kriging interpolation method based on real speckle tracking products. The experimental results demonstrate that the proposed method can effectively recover a GVF derived from the speckle tracking technique.

Linear guides are widely used in automation, aerospace production, and medical care. It is currently one of the most concerning issues how to monitor its surface quality in the manufacturing proces...

Color-tunable semiconductor quantum dots (QDs) are highly attractive for a wide range of applications including imaging, sensing, and lighting. Herein, we reported a facile synthesis of copper-doped zinc sulfide quantum dots (ZnS:Cu QDs) with tunable emission colors, using a microwave-assisted one-pot reaction. 3-mercaptopropionic acid (MPA) was used as a stabilizer agent and sulfide source for the formation of ZnS:Cu QDs. The photoluminescence of ZnS:Cu QDs showed a clear red-shift as increasing Cu concentration, which can be controlled by microwave irradiation time. As increasing the irradiation time, the emission color (peak) of ZnS:Cu QDs changed from blue (500 nm) to green (540 nm), yellow (580 nm), and to orange-red (595 nm). The obtained ZnS:Cu QDs were highly luminescent, as evidenced by their high quantum yields. The potential utility of ZnS:Cu QDs as a novel lighting source was demonstrated in a near-UV chip-based white light-emitting diode.

A multilayer film with high reflection wavebands and specific visible appearance has been designed based on principles of photonic crystals and optical interference. The angle and thickness sensitivities of this film, which is fabricated with germanium and zinc selenide, were studied and discussed. This multilayer film possesses a high average reflectance between 3 and 5 μm (92.1%) and 8–14 μm (84.2%) wavebands, thereby contributing to a low emissivity in those wavebands according to Kirchhoff's law of thermodynamics. As a result, IR energy from a hot object covered with this film would be suppressed, and low IR signature is expected to be realized. Chromaticity diagram shows that the chromaticity coordinates of this film is close to those of real green plants, which will make it more difficult to distinguish this film from green plant background. Combining the above features, this photonic crystal based film is promising to realize low IR and visible signatures under appropriate conditions.

Anti-nuclear antibodies to speckled 100 kDa (sp100) and glycoprotein 210 (gp210) are specific serologic markers of primary biliary cholangitis (PBC) of uncertain/controversial clinical or prognostic significance. To study the genetic determinants associated with sp100 and gp210 autoantibody subphenotypes, we performed a genome-wide association analysis of 930 PBC cases based on their autoantibody status, followed by a replication study in 1,252 PBC cases. We confirmed single-nucleotide polymorphisms rs492899 (P = 3.27 × 10-22 ; odds ratio [OR], 2.90; 95% confidence interval [CI], 2.34-3.66) and rs1794280 (P = 5.78 × 10-28 ; OR, 3.89; 95% CI, 3.05-4.96) in the human major histocompatibility complex (MHC) region associated with the sp100 autoantibody. However, no genetic variant was identified as being associated with the gp210 autoantibody. To further define specific classical human leukocyte antigen (HLA) alleles or amino acids associated with the sp100 autoantibody, we imputed 922 PBC cases (211 anti-sp100-positive versus 711 negative cases) using a Han Chinese MHC reference database. Conditional analysis identified that HLA-DRβ1-Asn77/Arg74, DRβ1-Ser37, and DPβ1-Lys65 were major determinants for sp100 production. For the classical HLA alleles, the strongest association was with DRB1*03:01 (P = 1.51 × 10-9 ; OR, 2.97; 95% CI, 2.06-4.29). Regression analysis with classical HLA alleles identified DRB1*03:01, DRB1*15:01, DRB1*01, and DPB1*03:01 alleles can explain most of the HLA association with sp100 autoantibody. Conclusion: This study indicated significant genetic predisposition to the sp100 autoantibody, but not the gp210 autoantibody, subphenotype in PBC patients. Additional studies will be necessary to determine if these findings have clinical significance to PBC pathogenesis and/or therapeutics.

The objective of the present study was to generate multiple regression models for stature estimation on the basis the combination of the clavicle, scapula and sternum derived from 3D-VRT images in Chinese population. The study sample comprised 363 individuals from China, including 159 females and 204 males, with documented ages between 19 and 82 years. Separate multiple linear regression equations for estimating stature on the basis of the measurements from the clavicle, scapula and sternum were then devised for males and females. For assessing the correlation between the stature and measurements of the clavicle, scapula and sternum, the Pearson's correlation coefficient was calculated and its significance was tested by Students t test. Finally, the multiple regression equations calculated from the measurements of the clavicle, scapula and sternum in relation to stature for each sex were established in the present study. The accuracy of stature prediction ranged from 4.777 to 5.313 cm for male and from 4.388 to 4.658 cm for female. In conclusion, the present results provide indications that the combination of the clavicle, scapula and sternum should be used as alternatives for stature estimation, and the multiple equations presented for stature estimation seem to be a more accurate than the equations from single bone.

Since the associations of fermented dairy foods intake with risk of cardiovascular diseases (CVD) remained inconsistent, we carried out this meta-analysis on all published cohort studies to estimate the overall effect. We searched the PubMed and CNKI (China National Knowledge Infrastructure) databases for all articles within a range of published years from 1980 to 2018 on the association between fermented dairy foods intake and CVD risk. Finally, 10 studies met the inclusion criteria for this study, with 385,122 participants, 1,392 Myocardial infarction, 4,490 coronary heart disease (CHD), 7,078 stroke, and 51,707 uncategorized CVD cases. Overall, statistical evidence of significantly decreased CVD risk was found to be associated with fermented dairy foods intake (OR = 0.83, 95% CI = 0.76-0.91). In subgroup analysis, cheese and yogurt consumptions were associated with decreased CVD risk (OR = 0.87, 95% CI = 0.80-0.94 for cheese and OR = 0. 78, 95% CI = 0.67-0.89 for yogurt). Our meta-analysis indicated that fermented dairy foods intake was associated with decreased CVD risk.

Numerous factors have an impact on the temporal correction of integrated modular avionics application. As early as in the design phase, verification should be conducted to guarantee the rigorous temporal requirements for safety consideration which are fulfilled. This paper proposes a model for underlining verification in the design phase. The model captures the temporally related design in an industrial standard for software application and operation system (ARINC653). The finite-state machine mechanism is employed to formulate the behavior model of the application and application execution interface. Furthermore, temporal requirements are measured under the simulation of the state machine model. A case study is conducted on a real-world auto-pilot application that conformed with ARINC653.

Cleaning product gas from biomass gasification is one of the major challenges for the application of biomass as a renewable energy source for power generation and value-added chemical synthesis. Non-thermal plasmas are a novel alternative technology for decomposing such tar compounds. In this research, the use of a dielectric barrier discharge (DBD) reactor was investigated for the decomposition of toluene (a tar surrogate) in a synthetic product gas containing H2, CO and CO2. The effect of residence time (0.95–2.82 s), plasma power (5–40 W), concentration (20–82 g/N m3), and temperature (ambient −400 °C) were investigated. It was demonstrated that the percentage removal of tar increased with increasing plasma power and residence time. 99%+ removal of toluene was observed at a plasma power of 40 W (the highest power used) and a residence time of 2.82 s (the highest residence time used). At ambient temperature, the toluene decomposition products include CO, lighter hydrocarbons, and solid residue. Unfortunately, at low temperatures, there was substantial solid residue formation. The synergetic effect of temperature and plasma was investigated to determine whether it could decrease residue formation. It was found that the solid residue completely disappeared at 400 °C. Furthermore, the selectivity and the yield of lower hydrocarbons increased with operating temperature. However, the yield of CO decreased due to the termination of radicals through the combination of CO and O at higher temperatures. Overall, this work demonstrates that toluene can be almost completely converted to smaller molecules by a DBD non-thermal plasma, and that a degree of control can be established by varying power, residence time and temperature, including eliminating the problem of solid residue formation.

Background: Meropenem is a carbapenem antibiotic that has demonstrated excellent in vitro activity against gram-negative clinical isolates and is commonly used in critically ill patients. This study aimed to find the pharmacokinetic/ pharmacodynamic of meropenem in critically ill patients and whether prolonged injection duration is really beneficial to meropenem therapy. Method: We included 209 samples in 64 patients in this prospective study. PPK analysis and Monte Carlo dosing simulations were developed using Phoenix.Results: A two-compartment model described the data adequately. Clearance (CL), volume (V), clearance of peripheral compartment (CL2), volume of peripheral compartment (V2) were 6.15 L/h, 2.83 L/h, 17.40L, and 17.48L, respectively. Creatinine clearance and uric acid were significant covariates. Patients with creatinine clearance of 60 ml/min or less and uric acid greater than 400 μmol/l could achieve the target > 90% under the minimum inhibitory concentration (MIC) of 8 mg/L, even with the administration dose of 500 mg/8 h with a 2-h infusion. Prolonging the infusion time significantly improved the therapeutic effect when MIC＜4. However, for the pharmacodynamic (PD) effects of 100% fT > MIC and 100% fT > 4MIC, no significant statistical difference was observed in critically ill patients.Conclusions: Critically ill patients with lower creatinine clearance and higher uric acid levels were likely to need a lower dosage of meropenem. Prolonged infusion time were not always beneficial for those who need a higher therapeutic target (100% fT > MIC,100% fT > 4 MIC) or with MIC 4mg/L. Increasing dose or alternative therapeutic strategies may be required for critically ill patients with drug-resistant or severe infections. The study is of great significance to guide the rational use of meropenem in critically ill patients.Trial registration: The trial was registered in the China Clinical Trial (ChiCTR1900020672). Registered on 12 January 2019.

Background Hepatocellular carcinoma (HCC) is the sixth most common cancer globally, and a major unresolved medical issue. According to guideline recommendations of European Association for the Study of the Liver in 2018 and American Society for Clinical Oncology (ASCO) Guideline, nivolumab are reasonable options for appropriate advanced stage HCC. Methods We searched the PubMed, Embase and CNKI (China National Knowledge Infrastructure) databases for all articles within a range of published years from 2010 to 2020 of nivolumab in advanced hepatocellular carcinoma, and carried out this meta-analysis on all published studies to estimate prognostic factors of nivolumab in advanced hepatocellular carcinoma. Results Finally, 6 studies with 627 advanced hepatocellular carcinoma patients treated with nivolumab met the inclusion criteria for this study. Our results indicated that α -fetoprotein (AFP), eastern Cooperative Oncology Group (ECOG) performance status, Child-Pugh class, portal vein invasion, protein induced by vitamin K absence-II (PIVKA-II), and albumin-bilirubin (ALBI) score were prognostic factor of nivolumab in advanced hepatocellular carcinoma, but hepatitis C virus (HBV) infection, barcelona Clinic Liver Cancer (BCLC) stage, and extrahepatic metastasis were not significant prognostic factors. Conclusions Our meta-analysis indicated the potential prognostic factor of nivolumab in advanced hepatocellular carcinoma. However, ongoing clinical and translational research may provide us a better understanding of the prognostic factor and mechanisms.

Background and Aim of the Study Many studies support that the no‐touch (NT) procedure can improve the patency rate of vein grafts. However, it is not clear that the sequential vein graft early expansion in the NT technique during off‐pump coronary artery bypass grafting (CABG). This study will explore this issue. Methods This was a prospective single‐center randomized controlled clinical trial. A total of 100 patients undergoing off‐pump CABG with the sequential saphenous graft were randomly assigned to two groups: the NT and conventional (CON) groups. Perioperative and postoperative data were collected during the hospital stay. The mean diameter of sequential grafts was measured using cardiac computed tomography angiography 3 months after the operation. Results There was a significant difference in the average diameter of sequential grafts between the two groups (NT: [2.98 ± 0.42], CON: [3.26 ± 0.51], p = .005). There was no difference in occlusion of sequential venous grafts between the two groups (NT: 4/48 [8.3%], CON: 5/49 [10.2%], p = 1.000). There were differences in surgery time between the two groups (NT: 220 [188,240], CON: 190 [175,230], p = .009). Conclusions The sequential graft early expansion in the NT technique is not as pronounced as that in the conventional technique, which may have a long‐term protective effect on the grafts.

Purpose To investigate risk factors of bone cement leakage in percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture (OVCF). Methods A total of 236 patients (344 vertebrae) who underwent PVP between November 2016 and June 2020 were enrolled in the study. Clinical and radiological characteristics, including age, gender, course of disease, trauma, type of vertebral fracture, cortical continuity of vertebral body, intervertebral vacuum cleft (IVC), fracture severity, fracture level, basivertebral foramen, bone cement dispersion types, the cement injection volume, the type of cement leakage, puncture approach, and intrusion of the posterior wall, were considered as potential risk factors. Three types of leakage (type-B, type-C, and type-S) were defined and risk factors for each type were analyzed. Logistic analysis was used to study the relationship between each factor and the type of cement leakage. Results The incidences of the three types of leakage were 28.5%, 24.4%, and 34.3%. The multinomial logistic analysis revealed that the factors of type-B leakage were the shape of cement and basivertebral foramen. One significant factor related to type-C leakage was cortical disruption, and the factors of type-S leakage were bone cement dispersion types, basivertebral foramen, cleft, fracture severity, an intrusion of the posterior wall, and gender. Conclusion Different types of cement leakage have their own risk factors, and the analysis of risk factors of these might be helpful in reducing the rate of cement leakage.

Background Voriconazole (VRC) is a triazole anti-fungal agent and a first-line treatment for invasive fungal infection (IFI) generally. The purpose of our study was performed to explore the factors affecting voriconazole trough concentration (Ctrough) and to show VRC dose adjustment experience in children. Methods The demographic information, concentration data, CYP2C19 genotypes and clinical outcomes of eligible children from January 1th, 2016 to December 31th, 2018 were collected. Factors affecting the voriconazole trough concentration were statistically analyzed. Results A total of 145 trough concentrations in 94 patients were included in this study, 54.5% of which achieved the target concentrations; however, 35.9% and 9.6% of which were sub-therapeutic and super-therapeutic post-multiple dosing. For children ≤ 2, 2–6, 6–12, and 12–18 years, the median VRC maintenance doses of 5.7, 6.7, 5.0 and 3.3 mg/kg twice daily respectively had been required in order to achieve therapeutic level (P

Background: Over/under-estimating renal function may increase inappropriate dosing strategy associated adverse outcomes; however, previously reported equations to estimate renal function have limited accuracy in chronic kidney disease (CKD) patients. Consequently, we intended to develop a novel equation to precisely estimate renal function and subsequently guide clinical treatment for CKD patients.Methods: A novel approach, Xiangya-s equation, to estimate renal function for CKD patients was derived by linear regression analysis and validated in 1885 patients with measured glomerular filtration rate (mGFR) < 60 ml/min/1.73 m2 by renal dynamic imaging at three representative hospitals in China, with the performance evaluated by accuracy, bias and precision. In the meanwhile, 2,165 atrial fibrillation (AF) patients who initiated direct oral anticoagulants (DOACs) between December 2015 and December 2018 were identified and renal function was assessed by estimated creatinine clearance (eCrCl). Events per 100 patient-years was calculated. Cox proportional hazards regression was applied to compare the incidence of outcomes of each group.Results: Xiangya-s equation demonstrated higher accuracy, lower bias and improved precision when compared with 12 creatinine-based and 2 CysC-based reported equations to estimate GFR in multi-ethnic Chinese CKD patients. When we applied Xiangya-s equation to patients with AF and CKD prescribed DOACs, wide variability was discovered in eCrCl calculated by the Cockcroft-Gault (CG), Modification of Diet in Renal Disease Study (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Xiangya equation which we had developed for generally patients and Xiangya-s equations, which persisted after grouping by different renal function stages. Equation choice affected drug-dosing adjustments, with the formulas agreeing for only 1.19%, 5.52%, 33.22%, 26.32%, and 36.61% of potentially impacted patients for eCrCl cutoffs of Conclusion: Xiangya-s equation provides more accurate GFR estimates in Chinese CKD patients who need consecutive monitoring of renal function, which may assist clinicians in choosing appropriate drug dosages.

Objective Diabetes mellitus (DM) is one of the largest epidemics the world has faced. Given the morbidity and mortality burden of DM, it is important to identify modifiable factors that affect the natural course of the disease. To estimate the overall DM risk of fermented dairy foods intake, the present meta-analysis was carried out on published studies. Methods The PubMed , Embase and CNKI (China National Knowledge Infrastructure) databases were searched for all articles available from 1980 to 2020 on the association between fermented dairy foods intake and DM risk. All studies met the inclusion criteria were collected for analysis. The odds ratio (OR) corresponding to the 95% confidence interval (95% CI) was used to assess the association between fermented dairy foods intake and DM risk. Results Finally, 15 studies met the inclusion criteria for this study, with 485,992 participants, and 20,207 incidence of diabetes. Overall, decreased DM was found to be significantly associated with higher fermented dairy foods intake (OR = 0.925, 95% CI = 0.856 – 0.999). In subgroup analysis, higher yogurt consumptions were significantly associated with decreased DM risk (OR = 0.828, 95% CI = 0.729 – 0.941). Conclusion Our meta-analysis indicated that fermented dairy foods intake were associated with decreased DM risk, especially with higher fermented dairy foods intake.

Ankylosing spondylitis (AS) is most common in adolescents and the ultimate result is disability, which places a huge burden on patients and society. Therefore, the key to improve the prognosis of AS is the early diagnosis of hip injury. To examine if AS patients whose hip pain is either absent or minimal might already have observable MRI and X-ray hip changes. Clinical and imaging hip data were systematically analyzed in 200 healthy controls (HC) and 300 AS with varying degrees of hip pain. Forty-four patients with early hip osteoarthritis (OA) served as positive imaging controls. In MRI images, BME lesions in the STIR sequence were much more frequent in AS (62%) compared to HC (2%) (p < 0.0001). Most importantly, 42% of AS with no or minimal hip pain had one or more MRI lesions. This was much more frequent compared to the 2% in HC (p < 0.05). These lesions in AS were observed singly or in combination in the trochanters (8%), femoral heads (12%), and acetabula (13%). Parallel finding that X-ray changes were present in patients with minimal or no hip pain was also observed with X-ray. Based on the normal hip width of HC, joint space narrowing was observed in 94.3% of the entire AS cohort, and importantly 56.7% of AS patients with no or mild hip pain. In these latter patients, functional activities of the hips such as walking were normal. At least 40% of AS patients with minimal or no hip pain might already show MRI and X-ray changes.

BackgroundIn the mid-1990s, the Swedish expert team proposed saphenous vein graft (SVG) harvesting with pedicle tissue. The short-term and long-term patency rates of the great saphenous vein obtained by the no-touch (NT) were higher than those obtained by the conventional (CON). In the past, NT harvesting was mainly used in on-pump coronary artery bypass grafting (CABG), and vein grafts were mostly single vein grafts. In this study, we retrospectively analyzed the safety and effectiveness of sequential vein grafts using NT harvesting in off-pump CABG.MethodsFrom 2017 to 2019, a total of 505 patients were included in the study. There were 150 patients in the NT group and 355 patients in the CON group. After applying propensity score matching (1:1 matching), 148 patients were included in each group. Baseline data, graft patency, post-operative complications, leg wound complications and 1-year major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups.ResultsThere was no significant difference in the patency rate of sequential venous grafts between the two groups 1 year after the operation either before [NT: 7.1% (10/141) vs. CON: 11.5% (38/331), p = 0.149) or after matching (NT: 7.1% (10/140) vs. CON: 7.3% (9/124), p = 0.971]. There was no significant difference in the composite clinical endpoint between the two groups either before [NT: 3 (2.3%) vs. CON: 9 (2.8%), p = 1.000] or after matching [NT: 3 (2.3%) vs. CON: 3 (2.5%), p = 1.000]. There were differences in leg wound complications between the two groups both before [NT: 9 (6.9%) vs. CON: 6 (1.9%), p = 0.007] and after matching [NT: 9 (6.9%) vs. CON: 2 (1.7%), p = 0.043].ConclusionsThe application of the NT harvesting in off-pump CABG with sequential vein grafts is safe and effective. NT method has disadvantages in leg wound.

Background: The main graft material for coronary artery bypass grafting (CABG) is the combination of the internal mammary artery and great saphenous vein. The patency rate of vein grafts is considered not ideal; more studies support that the no-touch (NT) procedure can improve the patency rate of vein grafts. However, it is not clear that the NT technology is used in the sequential saphenous vein grafting during off-pump coronary artery bypass surgery. This study explored whether the NT technique is as safe and effective as the conventional technique in off-pump coronary artery bypass surgery using sequential vein grafts.Methods: This was a prospective single-centre randomized controlled clinical trial. A total of 200 patients undergoing off-pump coronary artery bypass grafting in the sequential saphenous graft were randomly assigned to two groups: the no-touch (NT) and conventional (CON) groups. Perioperative and postoperative data were collected during the hospital stay. The occlusion of sequential grafts was measured by cardiac computed tomography angiography (CCTA) 3 months post CABG. Leg wound complications were followed up. The mean diameter of sequential grafts for the first 100 patients was measured using CCTA 3 months after the operation.Results: The primary endpoint was that there was no difference in occlusion of sequential venous grafts between the two groups (NT: 9/180 (4.4%), CON: 5/194 (1.5%), p=0.22). Similarly, there were no differences in composite clinical events (NT: 2/91 (2.2%), CON: 1/96 (1.0%), p=0.96). There was no difference in leg wound complications between the two groups (NT: 8/91 (8.8%), CON: 4/96 (4.2%), p=0.20). However, there was a significant difference in the average diameter of sequential grafts between the two groups (NT: (2.98±0.42), CON: (3.26±0.51), p=0.005).Conclusions: The early clinical results suggest that the NT technique is as safe and effective as the conventional technique in sequential grafting in off-pump coronary artery bypass surgery. The sequential graft early expansion in the NT technique is not as pronounced as that in the conventional technique, which may have a long-term protective effect on the grafts.Trial Registration: Registered 1 November 2018, ClinicalTrials.gov NCT03729531, http://www.clinicaltrials.gov