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Background Microsatellite instability, programmed death-ligand 1 and tumor-infiltrating leukocytes are prognostic biomarkers in colorectal cancer but unknown toward familial adenomatous polyposis. Aim To investigate the prognostic and clinicopathological roles of microsatellite instability, programmed death-ligand 1 and tumor-infiltrating leukocytes in familial adenomatous polyposis. Methods Clinical data and paraffin embedded tissues from 45 familial adenomatous polyposis patients were collected. Microsatellite instability was detected by immunohistochemistry and polymerase chain reaction. Programmed death-ligand 1 was detected by immunohistochemistry. Tumor-infiltrating leukocytes comprising CD8+ T cells, M1 and M2 tumor associated macrophages, CD56bright and CD56dim natural killer cells were analyzed using multiple fluorescence immunohistochemistry. Results Microsatellite instability high was noted in 6 samples but not associated with overall survival or progression-free survival. Programmed death-ligand 1 is negative on tumor cells but positive on tumor-infiltrating leukocytes, and positive programmed death-ligand 1 expression on tumor-infiltrating leucocytes is associated with overall survival. Low CD56bright natural killer cell infiltration was associated with longer progression-free survival and was an independent prognostic factor in FAP. Conclusion For familial adenomatous polyposis, microsatellite instability high can be found but has no correlation with prognosis; programmed death-ligand 1 on tumor-infiltrating leukocytes is related with overall survival; CD56bright natural killer cell is an independent prognostic factor associating with longer progression-free survival.

Network Marketing is a practical professional compulsory course. With the advent of big data technology, a hybrid teaching model combining online and offline has emerged. Based on the analysis of the advantages of using a hybrid teaching model in Internet Marketing, this article comprehensively considers a variety of factors and put forward the innovative strategy of blended teaching in Network Marketing in the era of big data. This may provide new paths and methods for enhancing teaching effects, cultivating students’ independent learning, and improving core literacy.

Calibration and validating are very important to DEM models especially for lunar soil. A review of present lunar soil models, evolutions, calibrations and verifications was executed. The result showed that most scholars used trial-and-error method to calibrate the parameters, but did not sum up a calibration law; in terms of validating, most scholars only focused on the internal friction angle and cohesion, but did not care about the elastic–plastic performance and adaptation. In this study, a systematic method was established instead of single-methods specifically for the calibration and validating of lunar soil DEM models. This is a multi-step method based on triaxial compression test. First, the alterable constitutive law previously proposed by the authors was used, and the influence law of each parameter on the peak stress difference and the position of failure point was analyzed and summed up for calibration. Second, the stress–strain curve was adjusted to coincide highly with Scott's test curve using loose real lunar soil. Third, the internal friction angle and cohesion under both loose and dense conditions were compared with the optimal estimated values to verify the shear strength. Fourth, the elastic–plastic behavior under dense condition was compared with Scott’s test result to verify the adaptation of density. Finally, two application simulations were executed to verify the practicability. By referring the systematic method, the purpose of parameter calibration is more explicit, and the validation is more comprehensive.

Background Hepatocellular carcinoma (HCC) is common among adolescents and young adults (AYAs) in areas with endemic hepatitis B virus infection. We sought to characterize clinical features and long-term outcomes among AYAs versus older adults (OAs) who underwent HCC resection. Methods From a Chinese multicenter database, patients were categorized as AYA (aged 13–39 years) versus OA (aged ≥40 years). Patient clinical features, perioperative outcomes, overall survival (OS) and time-to-recurrence (TTR) were compared. Multivariable Cox-regression analyses were performed to identify the impact of age on OS and TTR. Results Among 1952 patients, 354(22.2%) were AYAs. AYAs were less likely to have cirrhosis yet were likely to have advanced tumor pathological characteristics than OAs. Postoperative morbidity and mortality were comparable. Compared with OAs, AYAs had a comparable OS but a decreased TTR. Multivariable analyses identified that young age ( Conclusions Compared with OAs, AYAs had a higher incidence of recurrence following liver resection among patients with HCC, suggesting that enhanced surveillance for postoperative recurrence may be required among AYAs.

Background Pseudomyxoma peritonei (PMP) is a rare mucinous neoplasm with a relatively low incidence of 1 to 2 per million individuals. It is typically characterized by a type of gelatinous ascites named "jelly belly". Most cases of PMP occur in association with ruptured primary mucinous tumors of the appendix (90%). Periodically, PMP can originate from mucinous carcinomas at other sites, including the colorectum, gallbladder, and pancreas. However, unusual origin can occur, as noted in this case report. Case summary A 52-year-old woman had an unusual derivation of PMP from intestinal duplication. The patient complained of abdominal distension and increasing abdominal girth. Abdominal contrast-enhanced computed tomography showed a mass in the greater omentum located on the left side of the abdomen, likely to be a cystic mass of peritoneal origin. A PMP diagnosis was presumed based on the specific signs of the mass with flocculent and stripe-like echoes in ultrasound images. Ultrasound-guided percutaneous aspiration suggested a high likelihood of PMP. Once the PMP diagnosis was recognized, identification of the origin of the primary tumor was indicated. Thus, an exploratory laparoscopy was performed. In the absence of a primary tumor of appendix origin, the diagnosis of a low-grade mucinous neoplasm of intestinal duplication origin was finally confirmed by histopathology. Conclusion PMP is secondary to mucinous carcinomas of the appendix mostly. This case resulted from an unusual derivation from intestinal duplication.

To explore the effect of moxibustion at Shenque (CV 8) on myocardial structure and function in exercise-induced fatigue rats. A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model. Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group, a control group, a model group, a non-meridian non-acupoint group, a Zusanli (ST 36) group and a Shenque (CV 8) group, with 10 rats in each group. Rats in the blank group did not receive treadmill running training or moxibustion. Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque (CV 8). Rats in the model group received treadmill running training but no moxibustion. Rats in the non-meridian non-acupoint group, the Zusanli (ST 36) group and the Shenque (CV 8) group received moxibustion at the non-meridian non-acupoint points, Zusanli (ST 36) or Shenque (CV 8) immediately after each treadmill running training, 15 min each time, once a day for 5 consecutive days a week at a 2-day interval, 60 times of moxibustion in total. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular diastolic volume (LVDv), left ventricular systolic volume (LVSv), ejection fraction (EF), stroke volume (SV), early diastolic peak flow velocity of mitral valve (E) and late diastolic peak flow velocity of mitral valve (A) of each group before and after the last treadmill running training were measured. Blood was collected 6 h after the last treadmill running training, and serum C-reactive protein (CRP), myoglobin (Mb), creatine kinase-myocardial band (CK-MB), cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels were detected. Finally, the heart was separated, the heart mass (HM) was measured, the cTnT level of the myocardial tissue was detected, the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope, the left ventricular fraction shortening (LVFS), E/A and heart mass index (HMI) were calculated. Compared with the same group before treatment, the rat cardiac LVEDd, LVESd, LVDv, LVSv, SV, E and A were significantly increased (all P

Text classification is a fundamental task in content analysis. Nowadays, deep learning has demonstrated promising performance in text classification compared with shallow models. However, almost all the existing models do not take advantage of the wisdom of human beings to help text classification. Human beings are more intelligent and capable than machine learning models in terms of understanding and capturing the implicit semantic information from text. In this article, we try to take guidance from human beings to classify text. We propose Crowd-powered learning for Text Classification (CrowdTC for short). We design and post the questions on a crowdsourcing platform to extract keywords in text. Sampling and clustering techniques are utilized to reduce the cost of crowdsourcing. Also, we present an attention-based neural network and a hybrid neural network to incorporate the extracted keywords as human guidance into deep neural networks. Extensive experiments on public datasets confirm that CrowdTC improves the text classification accuracy of neural networks by using the crowd-powered keyword guidance.

A surface-enhanced infrared absorption spectroscopic chalcogenide waveguide sensor based on the silver island film was proposed for the first time to enhance the sensing performance in both liquid and gas phases. The chalcogenide waveguide sensor was fabricated by the lift-off and oblique angle deposition methods. The surface morphology of the silver island film with different thicknesses was characterized. The absorption of ethanol (liquid) at a wavelength of 1654 nm and that of methane (gas) at 3291 nm were measured using the fabricated chalcogenide waveguide sensor. The chalcogenide waveguide sensor integrated with the 1.8 nm-thick silver island film revealed the best sensing performance. With an acceptable increased waveguide loss resulting from the fabrication of the film, the absorbance enhancement factors for ethanol and methane were experimentally obtained to be >1.5 and >2.3, respectively. The 1σ limit of detection of methane for the sensor integrated with the 1.8 nm-thick silver island film was ∼4.11% for an averaging time of 0.2 s. The mathematic relation between the absorbance enhancement factor and the waveguide loss was derived for sensing performance improvement. Also, the proposed rectangular waveguide sensor provides an idea for the design of a sensor-on-a-chip instead of other waveguide sensors with a high requirement of fabrication accuracy, for example, a slot waveguide or a photonic crystal waveguide.

Surgical resection is the only potentially curative treatment for patients with resectable perihilar cholangiocarcinoma (PHC). There is still no consensus on the value of lymphadenectomy despite evidence indicating lymph node (LN) status is an important prognostic indicator for postoperative long-term survival. We sought to perform a meta-analysis to summarize the current evidence on the value of lymphadenectomy among patients undergoing surgery for PHC. The PubMed (OvidSP), Embase and Cochrane Library were systematically searched for studies published before July 2020 that reported on lymphadenectomy at the time of surgery for PHC after curative surgery. 7748 patients from 28 studies were included in the meta-analysis. No survival benefit was identified with increased number of LN resected (all P > 0.05). Meanwhile, overall LN status was an important prognostic factor. Patients with lymph node metastasis had a pooled estimate hazard ratio of death that was over two-fold higher than patients without lymph node metastasis (HR 2.07, 95% CI 1.65–2.59, P

BACKGROUND Arrhythmogenic right ventricular (RV) cardiomyopathy is a rare and currently underrecognized cardiomyopathy characterized by the replacement of RV myocardium by fibrofatty tissue. It may be asymptomatic or symptomatic (palpitations or syncope) and may induce sudden cardiac death, especially during exercise. To prevent adverse events such as sudden cardiac death and heart failure, early diagnosis and treatment of arrhythmogenic RV cardiomyopathy (ARVC) are crucial. We report a patient with ARVC characterized by recurrent syncope during exercise who was successfully treated with combined endocardial and epicardial catheter ablation. CASE SUMMARY A 43-year-old man was referred for an episode of syncope during exercise. Previously, the patient experienced two episodes of syncope without a firm etiological diagnosis. An electrocardiogram obtained at admission indicated ventricular tachycardia originating from the inferior wall of the right ventricle. The ventricular tachycardia was terminated with intravenous propafenone. A repeat electrocardiogram showed a regular sinus rhythm with negative T waves and a delayed S-wave upstroke from leads V1 to V4. Cardiac magnetic resonance imaging showed RV free wall thinning, regional RV akinesia, RV dilatation and fibrofatty infiltration (RV ejection fraction of 38%). An electrophysiological study showed multiple inducible ventricular tachycardia as of a focal mechanism from the right ventricle. Endocardial and epicardial voltage mapping demonstrated scar tissue in the anterior wall, free wall and posterior wall of the right ventricle. Late potentials were also recorded. The patient was diagnosed with ARVC and treated with combined endocardial and epicardial catheter ablation with a very satisfactory follow-up result. CONCLUSION Clinicians should be aware of ARVC, and further workup, including imaging with multiple modalities, should be pursued. The combination of epicardial and endocardial catheter ablation can lead to a good outcome.

BACKGROUND Pheochromocytoma is a rare endocrine tumor arising from chromaffin cells and having extensive and profound effects on the cardiovascular system by continuously or intermittently releasing catecholamines. The clinical manifestations of pheochromocytoma are diverse, and the typical triad, including episodic headache, palpitations, and sweating, only occurs in 24% of pheochromocytoma patients, which often misleads clinicians into making an incorrect diagnosis. We herein report the case of a patient with intermittent chest pain and elevated myocardial enzymes for 2 years who was diagnosed with pheochromocytoma. CASE SUMMARY A 49-year-old woman presented with intermittent chest pain for 2 years. Two years ago, the patient experienced chest pain and was diagnosed with acute myocardial infarction, with 25% stenosis in the left circumflex. The patient still had intermittent chest pain after discharge. Two hours before admission to our hospital, the patient experienced chest pain with nausea and vomiting, lasting for 20 min. Troponin I and urinary norepinephrine and catecholamine levels were elevated. An electrocardiogram indicated QT prolongation and ST-segment depression in leads II, III, aVF, and V3-V6. A coronary computed tomography angiogram revealed no evidence of coronary artery disease. Echocardiography showed left ventricular enlargement and a decreased posterior inferior wall motion amplitude. Contrast-enhanced computed tomography demonstrated an inhomogeneous right adrenal mass. The patient successfully underwent laparoscopic right adrenalectomy, and histopathology confirmed adrenal pheochromocytoma. During the first-year follow-up visits, the patient was asymptomatic. The abnormal changes on echocardiography and electrocardiogram disappeared. CONCLUSION Clinicians should be aware of pheochromocytoma. A timely and accurate diagnosis of pheochromocytoma is essential for alleviating serious cardiac complications.

Novel non-/minimally-invasive and effective approaches are urgently needed to supplement and improve current strategies for diagnosis and management of hepatocellular carcinoma (HCC). Overwhelming evidence from published studies on HCC has documented that multiple molecular biomarkers detected in body fluids and feces can be utilized in early-diagnosis, predicting responses to specific therapies, evaluating prognosis before or after therapy, as well as serving as novel therapeutic targets. Detection and analysis of proteins, metabolites, circulating nucleic acids, circulating tumor cells, and extracellular vesicles in body fluids (e.g., blood and urine) and gut microbiota (e.g., in feces) have excellent capabilities to improve different aspects of management of HCC. Numerous studies have been devoted in identifying more promising candidate biomarkers and therapeutic targets for diagnosis, treatment, and monitoring responses of HCC to conventional therapies, most of which may improve diagnosis and management of HCC in the future. This review aimed to summarize recent advances in utilizing these biomarkers in HCC and discuss their clinical significance.

A 60-year-old male patient complained of weakness of both legs for one year, intermittent fever for two months, up to 38.0 °C. Physical examination showed bilateral hyperreflexia of knee tendon and positive Hoffman sign on the right side. MR imaging of the cervical spine showed central herniation of the cervical 5-7 disc and compression of the spinal cord. The WBC was normal, C-reactive protein was 24.42mg/l, ESR was 55mm/h, TB antibody, anti acid staining and T-SPOT were negative. Autoantibody was negative and thyroid function was normal. The JOA score was 9 points. During the operation, the herniated disc tissue was taken out for pathological examination and bacterial culture. The posterior longitudinal ligament was removed and no abscess was found. The symptom of asthenia in both legs was relieved and fever disappeared. No growth of aerobe, anaerobe or tubercle bacilli was found in the culture of resected tissue. One year after the operation, the fever did not recur, JOA score increased to 14 points, and MR imaging showed no protrusion in cervical spinal canal. In this case, the fever disappeared after the operation for cervical spondylosis, which may be a special manifestation of sympathetic nerve stimulation or autonomic dysfunction by chronic compression of spinal cord.

We demonstrate a distributed feedback (DFB) semiconductor laser based on i-line lithography and surface periodic current injection technologies with a lasing wavelength of 795 nm, which corresponds to the D1 spectrum of Rb and has many applications with respect to alkali vapor lasers and atomic clocks. The maximum output power, side mode suppression ratio (SMSR), and single-longitudinal-mode tunable range of our device are 50.89 mW (at 20 °C), 34.56 dB, and 12.792 nm, respectively. The rate of change in wavelength with temperature of the laser is 0.401 nm/°C, which is equivalent to that of a Fabry-Perot (FP) laser and much better than that of a general DFB device. This device has a cavity the same as an FP laser without any etching gratings, meanwhile the lasing spectrum behaves a single longitudinal mode characteristic as a DFB laser.

Background Repeat hepatectomy is a feasible treatment modality for intrahepatic recurrence after hepatectomy of hepatocellular carcinoma, yet the survival benefit remains ill-defined. The objective of the current study was to define long-term, oncologic outcomes after repeat hepatectomy among patients with early and late recurrence. Methods Patients undergoing curative-intent repeat hepatectomy for recurrent hepatocellular carcinoma were identified using a multi-intuitional database. Early and late recurrence was defined by setting 1 year after initial hepatectomy as the cutoff value. Patient clinical characteristics, overall survival, and disease-free survival were compared among patients with early and late recurrence before and after propensity score matching. Results Among all the patients, 81 had early recurrence and 129 had late recurrence from which 74 matched pairs were included in the propensity score matching analytic cohort. Before propensity score matching, 5-year overall survival and disease-free survival after resection of an early recurrence were 41.7% and 17.9%, respectively, which were worse compared with patients who had resection of a late recurrence (57.0% and 39.4%, both P Conclusion Repeat hepatectomy for early recurrence was associated with worse overall survival and disease-free survival compared with late recurrence. These data may help inform patients and selection of patients being considered for repeat hepatectomy of recurrent hepatocellular carcinoma.

Background Primitive neuroectodermal tumor (PNET) is a rare kind of sarcoma that is primarily found in the kidney and has a very poor prognosis. Here, we review and summarize the clinical data of patients with renal PNET in our center and follow up the patients for survival status. Although the current literature suggests that chemotherapy may benefit the survival of these patients, the information from our center suggests that this may not be the case. Methods We retrospectively analyzed the clinical data of patients with renal PNET diagnosed pathologically at Peking University First Hospital from January 1, 2007, to January 1, 2018. All of the patients were followed up for survival status. Results Seven patients with renal PNET were found. The ratio of males to females was 6:1. The median age was 29 years (21-72 years) at the time of diagnosis. The preoperative imaging examination showed a large renal mass protruding outwards from the renal contour, with internal necrosis and hemorrhage. Six/7 patients were diagnosed with distant metastasis or retroperitoneal lymph node metastasis. The main clinical manifestations of patients were pain (5/7) and fever (3/7). In immunohistochemistry, all patients' samples were CD99 positive. All patients died in our follow-up, with an average overall survival (OS) of 12.09 months (1.90-26.77 months). Conclusions As a rare renal tumor, renal PNET has a propensity to occur in young males. Most patients have distant metastasis when they are diagnosed, and the prognosis is very poor. Effective treatments are urgently needed.

BACKGROUND Takotsubo cardiomyopathy (TCM) is characterized by reversible left ventricular dysfunction triggered by emotional or physical stress. Only 1%-2% of patients with acute coronary syndrome are diagnosed with TCM. Although obstructive coronary artery disease is frequently considered to be the cause of chest pain, TCM should be considered in some clinical settings. In this case, clinicians did not make a timely and accurate diagnosis for TCM due to a lack of knowledge until the third hospitalization with a left ventriculogram. CASE SUMMARY A 55-year-old postmenopausal woman had intermittent chest pain following emotionally stressful events three times in the past 3 years. Cardiac troponin levels increased after each instance of symptom onset. A transthoracic echocardiogram showed reversible left ventricular dysfunction. The patient underwent three coronary angiograms without evidence of coronary artery disease. A left ventriculogram was first performed at the third hospitalization and revealed apical akinesia with ballooning of the apical region and consistent hypercontractile basal segments. The diagnosis of TCM was confirmed. The patient was treated with an angiotensin-converting-enzyme inhibitor (perindopril) and a β-blocker (metoprolol). No complications occurred during the patient’s hospitalization. The patient was told to avoid stressful events. During the 9-mo follow-up visit, the patient was asymptomatic with an ejection fraction of 55%. CONCLUSION Clinicians should be conscious of the possibility of TCM, especially in postmenopausal women presenting with clinical manifestations similar to acute coronary syndrome without coronary occlusion.

Semiconductor optical amplifiers (SOAs) offer direct electrical injection, power consumption, integration, and anti-radiation advantages over optical fiber amplifiers. However, saturation output power and gain bandwidth have been limited in traditional structure SOAs. We demonstrate a monolithic integrated SOA with broad spectrum, high power, high gain, and small spectral linewidth expansion. The device adopts a two-stage amplified large optical cavity structure, and a lower optical field confinement factor is obtained by adjusting the thickness of the waveguide layer. The lower optical field confinement factor is conducive to improving the coupling efficiency and the maximum output power. Our device, fabricated only by standard i-line lithography with micron-scale precision, obtains excellent and stable performance. When the input power is set to 1 mW, the output power is 419 mW with a gain of 26.23 dB. When the input power is set to 25 mW at 25 °C, the output power increases to 600 mW with a gain of 13.8 dB. The corresponding gain bandwidth of 3 dB measures at least 70 nm. The spectral linewidth after the SOA is 1.15 times wider than that of the seed laser.

Kounis syndrome is a rare type of acute coronary syndrome caused by coronary spasm with or without atherosclerotic plaque erosion or rupture due to inflammatory factors released by allergic reactions. Due to a lack of awareness, Kounis syndrome is often underdiagnosed. Here, we for the first time report a case of Kounis syndrome induced by anisodamine. A 48-year-old woman presented with upper abdominal pain and vomiting after eating. She was diagnosed with gastrointestinal spasm and intramuscularly injected with 10 mg anisodamine. The patient subsequently developed chest pain and hypotension with erythematous rash. A systemic allergic reaction was diagnosed. Saline solution, promethazine and dexamethasone were administered immediately. A 12-lead electrocardiogram indicated ST-segment elevation in II, III and aVF leads. Emergent coronary angiography was recommended. According to a preoperative electrocardiogram, the ST-segment elevation in the II, III and aVF leads had disappeared. Coronary angiograph revealed no significant coronary stenosis. The patient was diagnosed with Kounis syndrome induced by anisodamine, showing acute ST-segment elevation myocardial infarction due to allergic coronary vasospasm. During the 9-month follow-up, the patient did not receive further anisodamine injections and remained free of chest pain. In conclusion, it is essential for clinicians to be aware of Kounis syndrome because of the wide range of triggers and its potentially fatal evolution if not identified in time.

Aging of the population and prolonged life expectancy have significantly increased the number of elderly patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, potential benefits, especially long-term oncologic outcomes of hepatectomy for elderly patients with HCC remain unclear.Patients treated with curative-intent hepatectomy for HCC in 8 Chinese hospitals were enrolled. Patients were divided into the elderly (≥70 years old) and younger (70 years old) groups. Overall survival (OS), cancer-specific survival (CSS), and time-to-recurrence (TTR) were compared. Risk factors of CSS and TTR were evaluated by univariable and multivariable competing-risk regression analyses.Of 2134 patients, 259 (12.1%) and 1875 (87.9%) were elderly and younger aged, respectively. Postoperative 30-day and 90-day mortality was comparable among elderly and younger patients. Compared with younger patients, the elderly had a worse 5-year OS (49.4% vs. 55.3%, P = 0.032), yet a better 5-year CCS (74.5% vs. 61.0%, P = 0.005) and a lower 5-year TTR (33.7% vs. 44.9%, P 0.001), respectively. Multivariable analyses identified that elder age was independently associated with more favorable CSS (HR 0.74, 95%CI 0.58-0.90, P = 0.011) and TTR (0.69, 0.53-0.88, P 0.001) but was not associated with OS (P = 0.136).Age by itself is not a contraindication to surgery, and selected elderly patients with HCC can benefit from hepatectomy. Compared with younger patients, elderly patients have noninferior oncologic outcomes following hepatectomy for HCC.

Pathological cardiac remodeling is an important cause of sudden cardiac death and other cardiovascular diseases in athletes. Unfortunately, people involved in long-term intense endurance exercise (especially professional athletes) do not fully understand the cause and health risks of pathological cardiac remodeling, resulting in pathological cardiac remodeling developing into irreversible damage, which seriously affects sports careers and the postretirement life of athletes. Studies have shown that myocardial inflammation caused by long-term and repeated high-intensity exercise is a prerequisite for inducing pathological remodeling and that effective inhibition of inflammation can block or reverse the pathological process of pathological remodeling. This preliminary study showed that moxibustion at CV 8 inhibited the p38 mitogen-activated protein kinases/nuclear factor-κβ (p38 MAPK/NF-κβ) signaling pathway in myocardium, reduced the expression of cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), and tumor necrosis factor(TNF-α), significantly improved myocardial morphology and function in rats under going long-term and repeated high-intensity exercise, and effectively prevented pathological cardiac remodeling. Moxibustion at CV 8 provides a new physical therapy and experimental basis for the treatment of pathological cardiac remodeling in clinical practice.

Abundant engineering practice shows that coal and rock dynamic disasters often occur in fault zones; hence, the detection of faults in coal mines is important. As an essential branch of seismic tomographic application, research shows that ultrasonic P-wave velocity can detect mine faults and provide technical support for dynamic disaster prewarning systems. Traditional P-wave testing mostly takes rock or raw coal as the research object, which has some shortcomings in controllability, homogeneity and comparability. This paper compares the difference in ultrasonic P-wave propagation velocity in jointless and jointed briquettes through laboratory research, focuses on the effect of macro-joints on P-wave velocity and makes a preliminary theoretical analysis. The results show that: (i) the three-dimensional P-wave velocity throughout a jointless briquette specimen is similar, which reflects the high homogeneity of this medium and avoids the influence of the random distribution of primary bedding, joints and structural planes; (ii) the P-wave velocity in jointless and jointed briquettes is positively correlated with density and forming pressure, and is negatively correlated with the angle between the ultrasonic wave and the joint surface in a sample and (iii) when the P-wave encounters the macroscopic joint surface, it may reflect and refract, changing the propagation direction and inducing wave mode conversion. This study provides the necessary technical support and a theoretical guide to optimise acoustic property analysis of coal and rock as well as a field application for seismic tomography technology.

Background With an increase in life expectancy and improvement of surgical safety, more elderly patients with hepatocellular carcinoma (HCC), even with large tumors, are now considered for hepatectomy. This study aimed to clarify the impact of age on short- and long-term outcomes after major hepatectomy (≥3 segments) for large HCC (≥5 cm). Patients and methods Using a multicenter database, patients who underwent curative-intent major hepatectomy for large HCC between 2006 and 2016 were identified. Postoperative morbidity and mortality, overall survival (OS) and recurrence-free survival (RFS) were compared between the elderly (≥65 years) and younger ( Results Of 830 patients, 92 (11.1%) and 738 (88.9%) were elderly and younger patients, respectively. There were no significant differences in postoperative 30-day mortality and morbidity between the two groups (5.4% vs 2.6% and 43.5% vs 38.3%, both P>0.05). The 5-year OS and RFS rates in elderly patients were also comparable to younger patients (35.0% vs 33.2% and 20.0% vs 20.8%, both P>0.05). In the entire cohort, multivariable Cox-regression analyses identified that old age was not independently associated with OS and RFS. However, in the elderly cohort, preoperative alpha-fetoprotein level >400 μg/L, multiple tumors, macrovascular invasion and microvascular invasion were independently associated with decreased OS and RFS. Conclusion Carefully selected elderly patients benefited from major hepatectomy for large HCC as much as younger patients, and their long-term prognosis was determined by preoperative alpha-fetoprotein level, tumor number and presence of macro- or micro-vascular invasion.

To observe the effects of moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming, and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue. Forty-eight male SPF rats were randomly divided into a blank group, a model group, a non-meridian and non-acupoint group, a Shenshu (BL 23) group, a Zusanli (ST 36) group, and a Shenque (CV 8) group using random number table method, with eight rats in each group. Except for the blank group, rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment. Except for the model group, the other model rats received mild moxibustion immediately after swimming. Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points, those in the Shenshu (BL 23) group received mild moxibustion at bilateral Shenshu (BL 23), those in the Zusanli (ST 36) group received mild moxibustion at bilateral Zusanli (ST 36), and those in the Shenque (CV 8) group received mild moxibustion at Shenque (CV 8) for 15 min. Four hours after the exhaustive swimming, femoral artery blood was collected to detect blood lactate (BLA), lactate dehydrogenase (LDH), creatine kinase (CK), creatinine (CRE), blood urea nitrogen (BUN), cortisol (C) and testosterone (T) levels, and calculate the T/C ratio. Compared with the blank group, rat’s serum levels of BLA, LDH, CK, BUN and C in the model group and the non-meridian and non-acupoint group were increased, and serum levels of CRE and T, and T/C ratios were decreased (P

Background A clear definition of “early recurrence” after hepatocellular carcinoma (HCC) resection is still lacking. This study aimed to determine the optimal cutoff between early and late HCC recurrence, and develop nomograms for pre- and postoperative prediction of early recurrence. Methods Patients undergoing HCC resection were identified from a multi-institutional Chinese database. Minimum P-value approach was adopted to calculate optimal cut-off to define early recurrence. Pre- and postoperative risk factors for early recurrence were identified and further used for nomogram construction. The results were externally validated by a Western cohort. Results Among 1501 patients identified, 539 (35.9%) were recurrence-free. The optimal length to distinguish between early (n = 340, 35.3%) and late recurrence (n = 622, 64.7%) was 8 months. Multivariable logistic regression analyses identified 5 preoperative and 8 postoperative factors for early recurrence, which were further incorporated into preoperative and postoperative nomograms (C-index: 0.785 and 0.834). The calibration plots for the probability of early recurrence fitted well. The nomogram performance was maintained using the validation dataset (C-index: 0.777 for preoperative prediction and 0.842 for postoperative prediction). Conclusions An interval of 8 months was the optimal threshold for defining early HCC recurrence. The two web-based nomograms have been published to allow accurate pre- and postoperative prediction of early recurrence. These may offer useful guidance for individual treatment or follow up for patients with resectable HCC.

Clinical studies and trials have shown that oxytocin can effectively reduce postpartum bleeding, whether by intramuscular (IM) injection or intravenous (IV) injection. These two methods are widely used in the prevention and treatment for the third stage of childbirth. However, it is unclear whether the subtle differences between the mode of these routes have any effect on maternal outcomes. To systematically evaluate the efficacy and safety of oxytocin administered intramuscularly or intravenously for prophylactic management of the third stage of labor after vaginal birth. Computerized retrieval of PubMed, the Cochrane Library, Web of Science, Embase, and ClinicalTrials.gov was conducted to collect randomized controlled trials (RCT) on the effects of IM and IV oxytocin on the third stage of labor. After independent literature screening, data extraction and evaluation of the bias risk of included studies by two evaluators, RevMan 5.3 software was used for a meta-analysis. Six studies with 7734 women were included in this study. Meta-analysis results showed that: the severe postpartum hemorrhage (PPH) rate [risk ratio (RR) 1.54, 95% confidence interval (95% CI) 1.08–2.20, P = 0.02], PPH rate (RR 1.31, 95% CI 1.11–1.55, P = 0.001), incidence of blood transfusion (RR 2.30, 95% CI 1.35–3.93, P = 0.002) and the need of manual removal of placenta (RR 1.44, 95% CI 1.05–1.96, P = 0.02) for IM group were higher than IV group, but there were no significant differences in the use of additional uterotonics (P = 0.31) and the incidence of serious maternal morbidity and adverse effects between two groups. None of the included studies reported maternal death. For clinical practice, intravenous injection oxytocin 10 IU may be a good, safe option in the management of the third stage of labor. Medical conditions, available resources, adverse effects, and women’ s preferences should also be considered. If an IV line is already in place at delivery, IV administration may be preferable to IM injection.

To observe the effects of electroacupuncture (EA) of different frequencies on transmission function, electromyography, nitric oxide synthase (NOS) content and interstitial cells of Cajal (ICC) expression of colon in rat models with slow transit constipation (STC). Of the 50 healthy male Wistar rats, 10 were randomly selected as a normal group and fed with ordinary diet, and the remaining 40 rats were fed with the diet added with the compound diphenoxylate at a dose of 8 mg/(kg·bw) each day for continuous 120 d. The 40 successfully established STC rat models were randomly divided into a model group, a low-frequency EA group (2 Hz), a high-frequency EA group (100 Hz), and a variable-frequency EA group (2 Hz/100 Hz), with 10 rats in each group. Rats in the normal and the model groups were not given any treatment; the low-frequency EA and the high-frequency EA groups were given EA at Tianshu (ST 25), Zusanli (ST 36) and Zhigou (TE 6) with continuous wave at the designated frequency, and the variable-frequency EA group received sparse-dense wave (2 Hz/100 Hz) EA at the same acupoints, once a day for a total of 15 d. After treatment, the colonic transmission function, electromyography, NOS content and ICC expression (calculated by the difference in the area of the C-kit positive cells) of the rats in each group were measured. For the colonic transmission function, compared with the normal group, the first black stool excretion durations of rats in the other groups were significantly prolonged (all P

Background Morbidity remains a common problem following hepatic resection. The aim of this study was to investigate the association between preoperative body mass index (BMI) and morbidity in patients undergoing liver resection for hepatocellular carcinoma (HCC). Methods Patients were divided into three groups according to preoperative BMI: low-BMI (≤18.4 kg/m2), normal-BMI (18.5–24.9 kg/m2) and high-BMI (≥25.0 kg/m2). Baseline characteristics, operative variables, postoperative 30-day mortality and morbidity were compared. Univariable and multivariable analyses were performed to identify independent risk factors associated with postoperative morbidity. Results Among 1324 patients, 108 (8.2%), 733 (55.4%), and 483 (36.5%) were low-BMI, normal-BMI, and high-BMI, respectively. There were no differences in postoperative 30-day mortality among patients based on BMI (P = 0.199). Postoperative 30-day morbidity was, however, higher in low-BMI and high-BMI patients versus patients with a normal-BMI (33.3% and 32.1% vs. 22.9%, P = 0.018 and P Conclusion Compared with normal-BMI patients, low-BMI and high-BMI patients had higher postoperative morbidity, including a higher incidence of SSI after liver resection for HCC.

Image recognition and retrieval is an important application field of digital image and it has a wide range of application scenarios in the computer telecommunications. Convolutional neural networks (CNN) is a kind of feed-forward neural networks which includes convolution calculation and which has a deep structure and it is one of the typical algorithms of deep learning. In recent years, it has become a highly efficient recognition algorithm which has been widely applied in such fields as pattern recognition and image processing. Its characteristics include few training parameters and strong adaptability. On the other hand, Hu invariant moment algorithm-a conventional algorithm, is also extensively used in various image processing fields due to its simple calculation and high efficiency. This paper analyzes the research background and significance of both CNN and Hu invariant moment algorithm, and introduces their research status. Besides, it also analyzes the results of color-, distance- and weight-based Hu invariant moment algorithm, and compares it with CNN to serve as a theoretical support for better achieving image classification, recognition and retrieval technology.

The conversion relationship between power spectral density (PSD) and international roughness index (IRI) was studied based on the filtering white noise method with variable sampling frequency using a quarter vehicle model. Six-degree-of-freedom dynamic equations of the whole aircraft taxiing were obtained considering the lift, upstream and downward bump, roll and pitch motion of the airframe. And then the dynamic load factors of the aircraft wheels under different pavement roughness and various airspeeds were solved by SIMULINK toolbox. The results shown that the mean dynamic load is independent of the pavement roughness, whose values are approximately equal to the load when the aircraft glided on the smooth pavement. The worse the pavement roughness, the greater the maximum dynamic load factor. There are approximately linear relationships between IRI and the maximum dynamic load. When the aircraft glides at low airspeed, the dynamic load increases as the increasing of airspeed. Then the maximum dynamic load factor decreases with the increase of running velocity. Moreover, the formulas for calculating the wheel dynamic load factor under the coupling action of pavement roughness and airspeed were proposed, which could be used to calculated the distribution of the dynamic load in longitudinal direction of the runway and determine the dynamic load values in airport pavement design.

The current runway width design in China was still according to the aircraft size and the accumulated experience in the flight process, and there is no clear calculation method. This paper proposed a new runway width design method based on the wheel traces distribution of the aircraft. A laser test system was developed to measure the aircraft wheel tracks of 17 cross sections along the runway at a feeder airport. The test results indicated that when aircraft takes off or lands, the transverse wheels traces obeyed a normal distribution. The variation curve in landing was selected to fit a numerical formula, which was used to calculate the maximum landing variation within the forward motion range, and the expression of the wheel trace transverse distribution on the section with the maximum discretization was determined. At last, a failure probability of 0.0001% was chosen as the criterion to determine the runway width. It was showed that B737-30 should have at least 45 m width to ensure the 0.0001 % failure probability.

PurposeTo investigate the expression of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), CA19-9, CA724, and CA242 in serum and ascites of pseudomyxoma peritonei (PMP) patients and evaluate the predictive value of these elevated biomarkers in pathological grade, completeness of cytoreduction (CC), and survival.MethodsFrom May 2009 to October 2019, a total of 512 patients diagnosed with PMP through pathology in Aerospace Center Hospital were enrolled. The serum and ascites tumor biomarkers were obtained. The diagnostic values between serum and ascites biomarkers in pathology and CC were compared by the receiver operating characteristic (ROC) curves. The correlation between pathology, cytoreduction, and biomarkers was calculated by univariate and multivariate logistic regression. The associations between different numbers of elevated biomarkers and survival status were examined using univariate and multivariate backward Cox proportional hazard regression models.ResultsThe results showed that the areas under the ROC curves (AUROC) in the diagnosis of CC were 0.798 (95% CI: 0.760–0.836) and 0.632 (95% CI: 0.588–0.676) in serum and ascites biomarkers, respectively. The elevated serum and ascites biomarkers were independent risk factors for both pathology and CC. The 1-year, 3-year, and 5-year survival rates were 89.07%, 73.22%, and 66.94%, respectively. Longer survival was observed in patients who had less than two elevated serum biomarkers compared with those with 2–3 and 4-5 elevated serum biomarkers (p < 0.001).ConclusionCEA, CA125, CA19-9, CA724, and CA242 in serum and ascites can be used to judge the severity and predict the resectability. Furthermore, different numbers of elevated biomarkers can help determine the prognosis of PMP.

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, which lacks effective inhibition of progression and metastasis in the advanced clinical stage. Mesoporous silica nanoparticle (MSN)–based cytotoxic or immunoregulatory drug–loading strategies have attracted widespread attention in the recent years. As a representative of mesoporous biomaterials, MSNs have good biological characteristics and immune activation potential and can cooperate with adjuvants against HCC. This review summarizes the possible future development of the field from the perspective of tumor immunity and aims to stimulate the exploration of the immune mechanism of MSN-based therapy. Through this point of view, we hope to develop new clinical immune drugs that can be applied to HCC clinical management in the future.

Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction calculator for individualized estimating the net survival benefit of adjuvant TACE for patients with resected HCC. Methods From a multicenter database, consecutive patients undergoing curative resection for HCC were enrolled and divided into the developing and validation cohorts. Using the independent survival predictors in the developing cohort, two nomogram models were constructed for patients with and without adjuvant TACE, respectively, which predictive performance was validated internally and externally by measuring concordance index (C-index) and calibration. The difference between two estimates of the prediction models was the expected survival benefit of adjuvant TACE. Results A total of 2514 patients met the inclusion criteria for the study. The nomogram prediction models for patients with and without adjuvant TACE were, respectively, built by incorporating the same eight independent survival predictors, including portal hypertension, Child–Pugh score, alpha-fetoprotein level, tumor size and number, macrovascular and microvascular invasion, and resection margin. These two prediction models demonstrated good calibration and discrimination, with all the C-indexes of greater than 0.75 in the developing and validation cohorts. A browser-based calculator was generated for individualized estimating the net survival benefit of adjuvant TACE. Conclusions Based on large-scale real-world data, an easy-to-use online calculator can be adopted as a decision aid to predict which patients with resected HCC can benefit from adjuvant TACE.

ObjectivesThis study aimed to investigate the value of using ultrasound (US) preoperatively for predicting pathological classification, complete cytoreduction possibility, and survival rate of patients with pseudomyxoma peritonei (PMP).MethodsWe retrospectively studied PMP patients who were scheduled for cytoreductive surgery between May 2009 and October 2019. US examination was performed before surgery. Factors related to high-grade pathology and poor completeness of cytoreduction (CC) score were identified. Associations between ultrasound characteristics and the survival status were also examined to identify independent predictive factors.ResultsPMP patients with clear ascites, abdominal lymph nodes, omental cake, abdominal mass, portal infiltration, and mesenteric involvement visible on US were considered to have high-grade pathology. Various US features were shown to be independent prognostic markers for inadequate cytoreduction in PMP patients. Portal infiltration and mesenteric involvement were significant prognostic factors for lower survival rates (hazard ratio = 3.092, 3.932, respectively). A visual nomogram including these factors was constructed to predict survival rates. The consistency index was 0.777, which reflected relatively high accuracy.ConclusionsPreoperative US has the potential to predict pathological grade and resectability of PMP. Portal infiltration and mesenteric involvement were independent predictors of poor clinical outcomes in PMP patients. Furthermore, a simple-to-use nomogram derived from our study data may be a helpful visual tool in clinical practice to predict 1-, 2-, and 3-year survival rates for PMP patients.

Developing correct, scalable, and fault-tolerant distributed databases is hard and labor-intensive. The increasing complexity of such systems under modern cloud infrastructures, e.g., geo-replicated multi-partitioned datacenters, further limits the number of design alternatives that can be explored in practice. There is therefore a need for the formal analysis of both their qualitative properties, e.g., data consistency, and their quantitative properties, e.g., latency, at an early design stage. In this paper we use formal modeling and both standard and statistical model checking techniques to explore the design space of replicated RAMP (Read Atomic Multi-Partition) transactions for geo-replicated databases. Specifically, we develop in Maude formal, executable specifications of three replicated RAMP designs, two by the RAMP developers and one by us, and analyze their data consistency properties. We further transform the Maude models into probabilistic rewrite theories for statistical model checking w.r.t. performance properties. Our results: (i) are consistent with the conjectures made by the RAMP developers; (ii) uncover our promising new design that not only provides all crucial data consistency guarantees but also outperforms the other design alternatives.

In the field of surface defect detection, the scale difference of product surface defects is often huge. The existing defect detection methods based on Convolutional Neural Networks (CNNs) are more inclined to express macro and abstract features, and the ability to express local and small defects is insufficient, resulting in an imbalance of feature expression capabilities. In this paper, a Multi-Scale Feature Learning Network (MSF-Net) based on Dual Module Feature (DMF) extractor is proposed. DMF extractor is mainly composed of optimized Concatenated Rectified Linear Units (CReLUs) and optimized Inception feature extraction modules, which increases the diversity of feature receptive fields while reducing the amount of calculation, the feature maps of the middle layer with different sizes of receptive fields are merged to increase the richness of the receptive fields of the last layer of feature maps, the residual shortcut connections, batch normalization layer and average pooling layer are used to replace the fully connected layer to improve training efficiency, and make the multi-scale feature learning ability more balanced at the same time. Two representative multi-scale defect data sets are used for experiments, and the experimental results verify the advancement and effectiveness of the proposed MSF-Net in the detection of surface defects with multi-scale features.

BackgroundHepatocellular carcinoma (HCC) is one of the most serious consequences of chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study sought to investigate long-term outcomes after liver resection for HCC among patients with HBV/HCV co-infection (HBV/HCV-HCC) compared with patients with HBV infection (HBV-HCC).MethodsPatients who underwent curative-intent liver resection for HCC were identified from a multicenter Chinese database. Using propensity score matching (PSM), patients with HBV/HCV-HCC were matched one-to-one to patients with HBV-HCC. Overall survival (OS) and recurrence-free survival (RFS) were compared between the two groups before and after PSM.ResultsAmong 2,467 patients identified, 93 (3.8%) and 2,374 (96.2%) patients had HBV/HCV-HCC and HBV-HCC, respectively. Compared with patients with HBV-HCC, patients with HBV/HCV-HCC were older, have poorer liver-related characteristics but better tumor-related characteristics. PSM created 88 pairs of patients with comparable liver- and tumor-related characteristics (all P > 0.2). In the PSM cohort, the 3- and 5-year RFS rates in patients with HBV/HCV-HCC were 48.3% and 38.9%, which were significantly poorer than patients with HBV-HCC (61.8% and 49.2%, P = 0.037). Meanwhile, the 3- and 5-year OS rates in patients with HBV/HCV-HCC were also poorer than patients with HBV-HCC (65.4% and 51.1% vs. 73.7% and 63.0%), with a difference close to be significant between them (P = 0.081).ConclusionComparing to patients with HBV-HCC, liver resection resulted in relatively poorer long-term surgical outcomes in patients with HBV/HCV-HCC.

The rolling path for a radial-axial ring rolling (RARR) process defines the matched motions of all the rolls including the main roll, mandrel, guide rolls and axial rolls. Materials with low thermal conductivity such as titanium alloys show an overheating in the local region of the ring due to the concentration of forming energy. The temperature sensitivity of these materials leads to severe microstructure and forming defects. Therefore, for the RARR process of titanium alloy rings, it is a core industrial technology to plan a rolling path by which the temperature in the whole ring can be maintained within a desired range (a designed control objective of ring temperature) to improve the mechanical properties. In this work, an intelligent real-time temperature-controlled finite element (FE) model for the RARR process of TA15 titanium alloy rings has been developed under ABAQUS/Explicit software. In the intelligent simulation, by establishing a ring growth velocity model relating to the ring temperature, the motions of various rolls could be driven in real time by the control objective of the ring temperature. Without definition of rolling path prior to the simulation, the new intelligent simulation realizes the self-adaptive control of rolling process to maintain the ring temperature within a desired range. By only one calculation, the rolling path satisfying the control objective of temperature can be obtained. This work achieves quick planning of the rolling path for real-time temperature-controlled RARR process.

Preventing and treating opioid dependence and withdrawal is a major clinical challenge, and the underlying mechanisms of opioid dependence and withdrawal remain elusive. We hypothesized that prolonged morphine exposure or chronic inflammation-induced μ-opioid receptor activity serves as a severe stress that elicits neuronal alterations and recapitulates events during development. Here, we report that Wnt signaling, which is important in developmental processes of the nervous system, plays a critical role in withdrawal symptoms from opioid receptor activation in mice. Repeated exposures of morphine or peripheral inflammation produced by intraplantar injection of complete Freund's adjuvant significantly increase the expression of Wnt5b in the primary sensory neurons in dorsal root ganglion (DRG). Accumulated Wnt5b in DRG neurons quickly transmits to the spinal cord dorsal horn (DH) after naloxone treatment. In the DH, Wnt5b, acts through the atypical Wnt-Ryk receptor and alternative Wnt-YAP/TAZ signaling pathways, contributing to the naloxone-precipitated opioid withdrawal-like behavioral symptoms and hyperalgesia. Inhibition of Wnt synthesis and blockage of Wnt signaling pathways greatly suppress the behavioral and neurochemical alterations after naloxone-precipitated withdrawal. These findings reveal a critical mechanism underlying naloxone-precipitated opioid withdrawal, suggesting that targeting Wnt5b synthesis in DRG neurons and Wnt signaling in DH may be an effective approach for prevention and treatment of opioid withdrawal syndromes, as well as the transition from acute to chronic pain.

PurposeThis study aimed to explore the value of preoperative ultrasonography (US) in evaluating the peritoneal cancer index (PCI) of pseudomyxoma peritonei (PMP).MethodsAn ultrasound examination was performed on 59 patients with PMP before surgery, and the ultrasound PCI was evaluated. The accuracy of ultrasound PCI score was evaluated with the surgical PCI score as the gold standard.ResultsThe preoperative ultrasound PCI was compared with the surgical PCI. The Spearman correlation coefficient of the total PCI score was 0.608 (P 20%) was concentrated mainly in areas 2 and 4–8 for 2 points, and underestimation (ConclusionThe ultrasound examination can be used to score the preoperative PCI, judge the severity, and predict the prognosis in patients with PMP.

Bistable electrowetting display (EWD) is a promising low-power electronic paper technology, where power is consumed only during the switching between two stable states; however, it is not required for state maintenance once switched. In this paper, a bistable electrowetting device with non-planar designed controlling electrodes is fabricated by a fully conventional photolithography process. The device has potential for video display applications with a controllable gray scale. The novel electrode design realizes a lower driving voltage and a higher contrast between two stable states than the EWDs with planar electrodes reported previously.

More than two-thirds of patients with hepatocellular carcinoma (HCC) cannot receive curative therapy and have poor survival due to late diagnosis and few prognostic directions. In our study, nontargeted and targeted metabolomics analyses were conducted by liquid chromatography-mass spectrometry to characterize metabolic features of HCC and identify diagnostic and prognostic biomarker candidate incorporating liver tissue and serum metabolites. A total of 552 subjects, including 432 with liver tissue and 120 with serum specimens, were recruited in China. In the discovery cohort, a series of 138 metabolites were identified to discriminate HCC tissues from matched nontumor tissues. Retinol presented with the highest area under the curve (AUC) of 0.991 and associated with Edmondson grade. In the validation cohort, all metabolites in retinol metabolism pathway were examined and the levels of retinol and retinal in tumor tissue and serum decreased in the order of normal to cirrhosis to HCC of Edmondson Grades I to IV. Retinol and retinal levels could also differentiate between HCC and cirrhosis, with AUCs of 0.996 and 0.994, respectively, in tissue and 0.812 and 0.744, respectively, in serum. The AUC of the combined retinol and retinal panel in serum was 0.852. Univariate and multivariate Cox regression identified this panel as an independent predictor for HCC and showed that low expression of retinol and retinal correlated with decreased survival time. In conclusion, the retinol metabolic signature had considerable diagnostic and prognostic value for identifying HCC patients who would benefit from prompt therapy and optimal prognostic direction.

Mild pyrolysis is one of the precombustion mercury control techniques. Mercury removal efficiency through mild pyrolysis has close relation with the weak thermal stability of mercury in coal. The t...

Benzenesulfonamide (BSA) is known as an important chemical material and intermediate in chemical industry. Information concerning solid–liquid equilibrium of BSA in different solvents is essential ...

In this paper, we demonstrate a regrowth-free double-tapered gain-coupled distributed feedback semiconductor laser. It is designed based on periodic surface current injection to reach a high-power and single-longitudinal mode. A continuous-wave output power of over 1.2 W/facet is achieved at 4 A. High single-longitudinal-mode output power reaches up to 0.9 W/facet at 3 A at each uncoated facet. The side mode suppression ratio is nearly 30 dB at 980 nm. The 3 dB spectral width is less than 2.7 pm. The lateral far field divergence angle is only 14.5°, the beam quality factor M2 is 1.7, achieving a near-diffraction-limit emission. Our device, produced by standard i-line lithography, enhances the output power while obtaining the pleasurable spectral and spatial properties. It has great potential in widespread commercial applications such as high efficiency pumping sources for its low-cost, easy fabrication technique and excellent performance.

Background Mesenchymal stem cells (MSCs) can migrate to tissue injury sites where they can induce multipotential differentiation and anti-inflammation effects to treat tissue injury. When traditional therapeutic methods do not work, MSCs are considered to be one of the best candidates for cell therapy. MSCs have been used for treating several injury- and inflammation-associated diseases, including liver cirrhosis. However, the therapeutic effect of MSCs is limited. In some cases, the anti-inflammatory function of naïve MSCs is not enough to rescue tissue injury. Methods Carbon tetrachloride (CCl4) was used to establish a mouse liver cirrhosis model. Enhanced green fluorescence protein (EGFP) and hepatocyte nuclear factor-4α (HNF-4α) overexpression adenoviruses were used to modify MSCs. Three weeks after liver injury induction, mice were injected with bone marrow MSCs via their tail vein. The mice were then sacrificed 3 weeks after MSC injection. Liver injury was evaluated by measuring glutamic-pyruvic transaminase (ALT) and glutamic oxalacetic transaminase (AST) levels. Histological and molecular evaluations were performed to study the mechanisms. Results We found that HNF-4α-overexpressing MSCs had a better treatment effect than unmodified MSCs on liver cirrhosis. In the CCl4-induced mouse liver injury model, we found that HNF-4α-MSCs reduced inflammation in the liver and alleviated liver injury. In addition, we found that HNF-4α promoted the anti-inflammatory effect of MSCs by enhancing nitric oxide synthase (iNOS) expression, which was dependent on the nuclear factor kappa B (NF-κB) signalling pathway. Conclusions MSCs overexpressing HNF-4α exerted good therapeutic effects against mouse liver cirrhosis due to an enhanced anti-inflammatory effect. Gene modification is likely a promising method for improving the effects of cell therapy. Electronic supplementary material The online version of this article (10.1186/s13287-019-1260-7) contains supplementary material, which is available to authorized users.

To investigate the effect of moxibustion at Shenque (CV 8) on the immune system in rats with different levels of exhaustive exercise. Fifty-six male Sprague-Dawley (SD) rats were randomly divided into a blank group (n=8), an exhaustive group (n=24), and a moxibustion group (n=24). The exhaustive group was randomly divided into a 1-time exhaustive group, a 4-time exhaustive group and a 7-time exhaustive group, with 8 rats in each group. According to the treatment time, the moxibustion group was randomly divided into a 1-time moxibustion group, a 4-time moxibustion group and a 7-time moxibustion group, with 8 rats in each group. Rats in the exhaustive groups and the moxibustion groups were subjected to replicating the exhaustive swimming models. Rats in each moxibustion group received mild moxibustion for 15 min immediately after the exhaustive modeling, once every other day. Twenty-four hours after the corresponding exhaustive exercise, the rats in each group were tested for the levels of serum immunoglobulin (Ig) G, IgA, IgM and acid phosphatase (ACP), and the morphological changes of spleen tissues were observed. The level of IgA was detected by immunoturbidimetric assay, and the levels of IgG, IgM and ACP were detected by enzyme-linked immunosorbent assay (ELISA). Compared with the 1-time exhaustive group, swimming time of rats in the 4-time exhaustive group was significantly prolonged (P