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Hong Kong has a long history of applying masonry retaining walls to provide horizontal platforms and stabilize man-made slopes. Due to the sub-tropical climate, some masonry retaining walls are colonized by trees. Extreme weather, such as typhoons and heavy rains, may cause rupture or root failure of those trees, thus resulting in instability of the retaining walls. A monitoring and warning system for the movement of masonry retaining walls and sway of trees has been designed with the application of fiber Bragg grating (FBG) sensing technology. The monitoring system is also equipped with a solar power system and 4G data transmission devices. The key functions of the proposed monitoring system include remote sensing and data access, early warning, and real-time data visualization. The setups and working principles of the monitoring systems and related transducers are introduced. The feasibility, accuracy, serviceability and reliability of this monitoring system have been checked by in-site calibration tests and four-month monitoring. Besides, a two-level interface has been developed for data visualization. The monitoring results show that the monitored masonry retaining wall had a reversible movement up to 2.5 mm during the monitoring period. Besides, it is found that the locations of the maximum strain on trees depend on the crown spread of trees.

Airspace complexity is a critical metric in current Air Traffic Management systems for indicating the security degree of airspace operations. Airspace complexity can be affected by many coupling factors in a complicated and nonlinear way, making it extremely difficult to be evaluated. In recent years, machine learning has been proved as a promising approach and achieved significant results in evaluating airspace complexity. However, existing machine learning based approaches require a large number of airspace operational data labeled by experts. Due to the high cost in labeling the operational data and the dynamical nature of the airspace operating environment, such data are often limited and may not be suitable for the changing airspace situation. In light of these, we propose a novel unsupervised learning approach for airspace complexity evaluation based on a deep neural network trained by unlabeled samples. We introduce a new loss function to better address the characteristics pertaining to airspace complexity data, including dimension coupling, category imbalance, and overlapped boundaries. Due to these characteristics, the generalization ability of existing unsupervised models is adversely impacted. The proposed approach is validated through extensive experiments based on the real-world data of six sectors in Southwestern China airspace. Experimental results show that our deep unsupervised model outperforms the state-of-the-art methods in terms of airspace complexity evaluation accuracy.

Spiking neural network (SNN) is one of the most successful methods to imitate biological brain behavior and learning potential. The information processing mechanism of SNN combines the concepts of time and space. To address the performance dropping problem during the conversion process from the artificial neural network (ANN) to SNN, this paper proposes a proportional attenuation leaky integrate-and-fire (RA-LIF) neuron model to solve the problem of membrane potential loss caused by leaky integrate-and-fire (LIF) neurons. The accuracy of the SNN network based on RA-LIF neurons on MNIST is 98.76%. This paper also proposes a weight normalization method to help adjust the network spiking rate to reduce the loss. We evaluate and analyze the performance of SNN networks based on LIF, RA-LIF, and AD-LIF. By analyzing the spike firing rate and convergence rate, the effects of spike frequency and neuron threshold on the performance of the network are discussed. So far, the SNN transformed by ANN can only achieve worse or similar performance compared with the original network. For the first time, the performance of the SNN transformed by the proposed RA-LIF neuron model and weight normalization method is better than the original network, which shows the test accuracy of 98.88% on MNIST. The SNN obtained by converting the LeNet network using the above method achieves a test accuracy of 98.91% on MNIST. In conclusion, the RA-LIF neuron model and normalization method proposed in this paper have promising applicability. Moreover, this method has the characteristics of high precision and fast calculation speed, which can provide a reference for the research of the SNN framework.

PURPOSE High mobility group box 1 (HMGB1) and homocysteine (Hcy) play important roles in contrast-induced acute kidney injury (CI-AKI). We compared HMGB1 to Hcy as preprocedural predictors for CI-AKI in coronary artery disease (CAD) patients after percutaneous coronary artery intervention (PCI). METHODS We included 257 eligible patients who were categorized into CI-AKI ( +) and CI-AKI ( -) group. The differences in clinical characteristics and biochemical indexes between two groups were analyzed. RESULTS We observed that thirty-eight (14.8%) of 257 eligible CAD patients developed CI-AKI. HMGB1 (14.65 [11.13-24.89] vs 10.88 [7.94-13.23], p

There are limited studies in the development of testing apparatus on unsaturated soils due to the complex structure, tedious calibration process, and large demands on test time and skills. In this study, a novel multifunctional apparatus (MFA) has been designed and manufactured for testing the unsaturated soils. This state-of-the-art testing apparatus is based on modular design and can be configured to conduct a variety of tests such as pressure plate test, oedometer test, direct shear test, and triaxial creep test under suction-controlled conditions. This apparatus has a high-grade stainless-steel chamber which is used to measure the total volume changes of an unsaturated soil specimen in triaxial creep tests. Based on the calibration results, the creep coefficient for MFA is about half of the coefficient for a typical double-cell system. Additionally, the MFA is designed in a manner to enable testing specimens with different dimensions and to control soil suction based on different techniques. Typical calibration results, test procedures, and experimental results obtained from this apparatus are presented and discussed in detail. Finally, the performance of this apparatus is well verified by the experimental results. It is found that the MFA is capable of and reliable for performing above-mentioned tests and accurately investigating engineering behaviour of both saturated and unsaturated geomaterials.

Objective To first report the application of percutaneous full-endoscopic anterior transcorporeal cervical discectomy (PEATCD) with channel repair for a patient with adjacent segment disease (ASD) after anterior cervical discectomy and fusion. Methods PEATCD with channel repair was performed for a patient with ASD at the cranial level adjacent to previous fusion at the C5–C6 level. The pre- and postoperative clinical symptoms were evaluated with Japanese Orthopedic Association and visual analog scale (VAS). The radiological examinations included magnetic resonance imaging, computed tomography, and plain radiographs, which were used to evaluate the cervical alignment, stability, intraoperative decompression, and bony channel. Results The procedure was successfully completed within 70 minutes. The drainage tube was unnecessary. No surgery-related complications were recorded. The postoperative neck pain immediately improved to VAS 3 from preoperative VAS 6. The Japanese Orthopedic Association scores also took a turn for the better gradually from preoperative 10 to final 16 (improvement rate 85.7%). The muscle power recovered completely, and the Hoffman sign turned to negative during follow-up periods. Magnetic resonance imaging 1 week postoperatively showed a total removal of the herniation. The bony channel was almost disappeared on computed tomography images 3 months postoperatively. During postoperative periods, no relapse, channel collapse, bone plug migration, or instability was observed. Conclusion As a novel and supplemental procedure for ASD after anterior cervical discectomy and fusion, PEATCD combines the advantages of transcorporeal approach and endoscopy together, which decreases iatrogenic damage to disc, preserves the cervical motion segment, and reduces surgical trauma. As the limitations of 1 case show, the effectiveness and reliability of PEATCD for patients with ASD should be verified in further studies.

Objective Little is known about the disease progression of Parkinson's disease patients with subjective cognitive complaint (PD‐SCC). This longitudinal cohort study aims to compare the progression of clinical features and quality of life (QoL) in PD patients with normal cognition (NC), SCC, and mild cognitive impairment (MCI). Methods A total of 383 PD patients were enrolled, including 189 PD‐NC patients, 59 PD‐SCC patients, and 135 PD‐MCI patients, with 1–7 years of follow‐up. Linear mixed models were applied to evaluate longitudinal changes in motor symptoms, nonmotor features (cognitive impairment, depression, and excessive daytime sleepiness), and QoL in PD. Results At baseline, PD‐SCC patients had lower Beck Depression Inventory (BDI) scores and Parkinson's Disease Questionnaire‐39 (PDQ‐39) scores than PD‐NC patients (all p

Electrocardiogram (ECG) is widely used in Myocardial infarction (MI) diagnosis. The automatic diagnosis of MI based on the 12-lead ECG needs to consider not only the waveform change features in multi-resolution time series, but also the spatial correlation information between the leads. To this end, this work proposed multiscale spatiotemporal feature extraction method based on Convolutional neural network (CNN) for MI automatic diagnosis. First, the 12-lead ECG is first transformed into an ECG image through wavelet decomposition and 3-dimensional space reconstruction. The MI-CNN model is then constructed to identify MI using 41368 ECG images. Finally, we develop the LL-CNN model, which is utilized only after the ECG signal is identified as an MI event by the MI-CNN model, to localize MI by employing transfer learning to overcome the limited data problem. The proposed method has achieved an accuracy of 99.51% on MI detection, and a macro-F1 of 99.14% on MI localization. Moreover, the features visualization shows that U-wave has significant diagnostic value for MI. The proposed method significantly improves the performance of MI detection and localization compared with other methods. It is promising to be used for MI monitoring and diagnosis.

Background Fat embolism syndrome (FES) is a rare complication caused by the presence of fat particles in the microcirculation, which usually occurs within 12-72 h after trauma. At present, there have been few cases of fat embolism presenting within 3 h after trauma. Here, we report a case of femoral fracture complicated with an acute fat embolism caused by a car accident. Case summary A 29-year-old woman with pain, swelling and limited movement of her left lower limb after a car accident was taken by ambulance to our hospital. X-ray examination showed fracture of the middle and lower part of the left femur and fracture of the base of the left fifth metatarsal bone. She was hospitalized and admitted to the orthopedic ward. After the attending doctor performed tibial tubercle bone traction, the patient became confused, followed by respiratory distress. Finally, she was transferred to the intensive care unit. After nearly a month of treatment in the intensive care unit, the patient's cognitive function gradually recovered over 6 mo. Conclusion For patients with early traumatic fractures, young emergency physicians and orthopedics should be aware of the possibility of FES.

BACKGROUND Patients with ankylosing spondylitis (AS) combined with severe cervical fusion deformity have difficult airways. Awake fiberoptic intubation is the standard treatment for such patients. Alleviating anxiety and discomfort during intubation while maintaining airway patency and adequate ventilation is a major challenge for anesthesiologists. Bronchial blockers (BBs) have significant advantages over double-lumen tubes in these patients requiring one-lung ventilation. AIM To evaluate effective drugs and their optimal dosage for awake fiberoptic nasotracheal intubation in patients with AS and to assess the pulmonary isolation effect of one-lung ventilation with a BB. METHODS We studied 12 AS patients (11 men and one woman) with lung or esophageal cancer who underwent thoracotomy with a BB. Preoperative airway evaluation found that all patients had a difficult airway. All patients received an intramuscular injection of penehyclidine hydrochloride (0.01 mg/kg) before anesthesia. In the operating room, dexmedetomidine(0.5 μg/kg) was infused intravenously for 10 min, with 2% lidocaine for airway surface anesthesia, and a 3% ephedrine cotton swab was used to contract the nasal mucosa vessels. Before tracheal intubation, fentanyl (1 μg/kg) and midazolam (0.02 mg/kg) were administered intravenously. Awake fiberoptic nasotracheal intubation was performed in the semi-reclining position. Intravenous anesthesia was administered immediately after successful intubation, and a BB was inserted laterally. The pre-intubation preparation time, intubation time, facial grimace score, airway responsiveness score during the fiberoptic introduction, time of end tracheal catheter entry into the nostril, and lung collapse and surgical field score were measured. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded while entering the operation room (T1), before intubation (T2), immediately after intubation (T3), 2 min after intubation (T4), and 10 min after intubation (T5). After surgery, all patients were followed for adverse reactions such as epistaxis, sore throat, hoarseness, and dysphagia. RESULTS All patients had a history of AS (20.4 ± 9.6 years). They had a Willson's score of 5 or above, grade III or IV Mallampati tests, an inter-incisor distance of 2.9 ± 0.3 cm, and a thyromental (T-M) distance of 4.8 ± 0.7 cm. The average pre-intubation preparation time was 20.4 ± 3.4 min, intubation time was 2.6 ± 0.4 min, facial grimace score was 1.7 ± 0.7, airway responsiveness score was 1.1 ± 0.7, and pulmonary collapse and surgical exposure score was 1.2 ± 0.4. The SBP, DBP, and HR at T5 were significantly lower than those at T1-T4 (P < 0.05). While the values at T1 were not significantly different from those at T2-T4 (P > 0.05), they were significantly different from those at T5 (P < 0.05). Seven patients had minor epistaxis during endotracheal intubation, two were followed 24 h after surgery with a mild sore throat, and two had hoarseness without dysphagia. CONCLUSION Patients with AS combined with severe cervical and thoracic kyphosis should be intubated using fiberoptic bronchoscopy under conscious sedation and topical anesthesia. Proper doses of penehyclidine hydrochloride, dexmedetomidine, fentanyl, and midazolam, combined with 2% lidocaine, administered prior to intubation, can provide satisfactory conditions for tracheal intubation while maintaining the comfort and safety of patients. BBs are safe and effective for one-lung ventilation in such patients during thoracotomy.

The aim of this paper is to develop 10-year cardiovascular disease (CVD) risk prediction models for the contemporary Chinese populations based on the Guangzhou Biobank Cohort Study (GBCS) and to compare its performance with models based on Framingham’s general cardiovascular risk profile and the Prediction for Atherosclerotic CVD Risk in China (China-PAR) project. Subjects were randomly classified into the training (n = 15,000) and validation (n = 12,721) sets. During an average of 12.0 years’ follow-up, 3,732 CVD events occurred. A 10-year sex-specific CVD risk prediction model including age, systolic blood pressure, use of antihypertensive medication, smoking, and diabetes was developed. Compared with the Framingham and China-PAR models, the GBCS model had a better discrimination in both women (c-statistic 0.72, 95% CI 0.71–0.73) and men (c-statistic 0.68, 95% CI 0.67–0.70), and the risk predicted was closer to the actual risk. This prediction model would be useful for identifying individuals at higher risks of CVD in contemporary Chinese populations.

To the best of our knowledge, this is the largest clinical retrospective study in AN‐SAH patients, and is the first time to establish accurate predictive models paired with bleeding pattern. Background Angiogram‐negative subarachnoid hemorrhage (AN‐SAH) has a definite incidence of delayed cerebral ischemia (DCI) and poor clinical outcomes. The purpose is to screen independent factors and establish a nomogram to guide the clinical therapy and assess post‐discharge prognosis. Methods We identified 273 consecutive patients referred to our institute from 2013 to 2018 for AN‐SAH. A nomogram to predict poor outcomes was formulated based on the multivariable models of independent risk factors. The accuracy and discrimination of nomograms were determined in training and internal validation cohorts. Results The overall poor outcome rates of AN‐SAH were 14.3% and 8.7% at 3 months and 12 months, respectively. In addition, perimesencephalic AN‐SAH (PAN‐SAH) presented with a more unfavorable prognosis compared with non‐perimesencephalic AN‐SAH (NPAN‐SAH). The clinical prognosis was associated with the World Federation of Neurosurgical Societies scale (WFNS) (odds ratio, 3.82 [95% CI, 1.15‐12.67] for 3‐month outcome; and odds ratio, 31.69 [95% CI, 3.65‐275.43] for 12‐month outcome), Subarachnoid hemorrhage Early Brain Edema Score (SEBES) (odds ratio, 10.39 [95% CI, 1.98‐54.64] for 3‐month outcome; odds ratio, 10.01 [95% CI, 1.87‐53.73] for 12‐month outcome), and symptomatic vasospasm (odds ratio, 3.16 [95% CI, 1.03‐9.70] for 3‐month outcome; odds ratio, 5.15 [95% CI, 1.34‐19.85] for 12‐month outcome). The nomogram was constructed based on the above features, which represented great predictive value in clinical outcomes. Conclusions Symptomatic vasospasm, high WFNS, cerebral edema, and NPAN‐SAH after hemorrhage were associated with poor outcome of AN‐SAH. The nomogram with WFNS (3‐5), SEBES (3‐4), vasospasm, and NPAN‐SAH represented a practical approach to provide individualized risk assessment for AN‐SAH patients., To the best of our knowledge, this is the largest clinical retrospective study in AN‐SAH, and is the first time to establish accurate predictive models paired with bleeding pattern.

Reconstruction of complete bilateral maxillary defects (CBMDs) can be challenging due to the extensive loss of bone and soft tissues. This is a retrospective case series of 46 consecutive patients with CBMDs that were reconstructed with different microvascular free flaps. The authors aimed to evaluate the surgical outcomes and discuss the different reconstruction options in this case series. Thirty-six patients underwent reconstruction following ablation surgery for malignant tumors, 6 for benign tumors, 3 patients were treated for osteomyelitis, and 1 patient underwent free flap reconstruction for posttraumatic defects. Free fibula flap (n = 26) is the most commonly used reconstruction method in this case series, which was used in all defect types. This is followed by anterolateral thigh flap (n = 10), 5 rectus abdominis myocutaneous free flap, 3 radial forearm free flaps, and 2 composite free flaps. In this series, 44 free flaps survived, whereas only 2 flaps were lost. All patients could resume a soft diet postoperatively. Reconstruction of CBMDs with vascularized free flaps is a safe and reliable procedure.

The burden of non-communicable diseases (NCDs) has increased in China. However, the contribution of dietary risks to the NCD burden has not been evaluated. This study aimed to estimate the burden of ischemic heart disease (IHD) and colorectal cancer (CRC) attributable to a diet low in fiber in China from 1990 to 2017. China data from the Global Burden of Disease Study (GBD) 2017 were used to assess the age-, sex-, and province-specific mortality and disability-adjusted life-years (DALYs) of IHD and CRC related to a diet low in fiber. In 2017, a diet low in fiber contributed 170,143 [95% uncertainty interval (UI): 99,623–256,806] IHD deaths and 25,561 (95% UI: 13,726–39,215) CRC deaths, with the population attributable fractions (PAFs) were 9.7 and 13.7%, respectively. Males had higher risk-attributable mortality and DALY rates for IHD and CRC than females. An upward trend with age in rates of mortality and DALY was observed. All-age risk-attributable mortality and DALY rates increased significantly by 111.4 and 53.2% for IHD, and 94.4 and 59.6% for CRC from 1990 to 2017, respectively; however, the corresponding age-standardized rates for IHD and CRC showed relatively stable trends. Heilongjiang, Xinjiang, and Inner Mongolia were ranked as the top three provinces in terms of total risk-attributable NCD burden in 2017. China has a large and growing NCD burden attributable to a diet low in fiber. Greater priority in disease prevention and control should be given to male and older adults throughout China, particularly in some western provinces.

Objective The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure. Material and methods The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Titanium mesh exposure was recorded and the risk factors were identified. Results Mean follow-up was for 24.8 months (range, 6-92 months). Ophthalmic function was successfully restored in 63/66 patients. Aesthetic restoration was not considered satisfactory by 10 patients. Titanium mesh exposure occurred in six patients (exposure rate, 9.1%). Preoperative radiotherapy was identified as an independent risk factor for mesh exposure (OR = 28.8, P = 0.006). Previous surgery, postoperative radiotherapy, pathological type of the primary lesion, the type of tissue flap applied, and the use of intraoperative navigation were not significant risk factors. Six patients with titanium mesh exposure underwent second surgery, but mesh exposure recurred in two patients due to insufficient soft tissue coverage. Conclusion Individualized titanium mesh with free flap can effectively restore maxilla-orbital defects. Preoperative radiotherapy is an independent predictor of postoperative titanium mesh exposure. Adequate soft tissue coverage of the mesh may reduce the risk of mesh exposure. Level of evidence Level 4 (case-control study) Laryngoscope, 2021.

In air traffic and airport management, experience gained from past operations is crucial in designing appropriate strategies when facing a new scenario. Therefore, this paper uses massive spatiotemporal flight data to identify similar traffic and delay patterns, which become critical for gaining a better understanding of the aviation system and relevant decision-making. However, as the datasets imply complex dependence and higher-order interactions between space and time, retrieving significant features and patterns can be very challenging. In this paper, we propose a probabilistic framework for high-dimensional historical flight data. We apply a latent class model and demonstrate the effectiveness of this framework using air traffic data from 224 airports in China during 2014–2017. We find that profiles of each dimension can be clearly divided into various patterns representing different regular operations. To prove the effectiveness of these patterns, we then create an estimation model that provides preliminary judgment on the airport delay level. The outcomes of this study can help airport operators and air traffic managers better understand air traffic and delay patterns according to the experience gained from historical scenarios.

Background To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). Methods A total of 230 patients participated in the study: TFESI (Group T, n = 110), TFESI combined with RF (Group TR, n = 120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, treatment time, complications, and recurrence were compared between the two groups. Results The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P P P = 0.002). There was no significant difference in hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05). Conclusion These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

Glucagon-like peptide-1 (GLP-1) receptor stimulation ameliorates parkinsonian motor and non-motor deficits in both experimental animals and patients; however, the disease-modifying mechanisms of GLP-1 receptor activation have remained unknown. The present study investigated whether exendin-4 (a GLP-1 analogue) can rescue motor deficits and exert disease-modifying effects in a parkinsonian rat model of α-synucleinopathy. This model was established by unilaterally injecting AAV-9-A53T-α-synuclein into the right substantia nigra pars compacta, followed by 4 or 8 weeks of twice-daily intraperitoneal injections of exendin-4 (5 μg/kg/day) starting at 2 weeks after AAV-9-A53T-α-synuclein injections. Positron emission tomography/computed tomography (PET/CT) scanning and immunostaining established that treatment with exendin-4 attenuated tyrosine-hydroxylase-positive neuronal loss and terminal denervation and mitigated the decrease in expression of vesicular monoamine transporter 2 within the nigrostriatal dopaminergic systems of rats injected with AAV-9-A53T-α-synuclein. It also mitigated the parkinsonian motor deficits assessed in behavioral tests. Furthermore, through both in vivo and in vitro models of Parkinson’s disease, we showed that exendin-4 promoted autophagy and mediated degradation of pathological α-synuclein, the effects of which were counteracted by 3-methyladenine or chloroquine, the autophagic inhibitors. Additionally, exendin-4 attenuated dysregulation of the PI3K/Akt/mTOR pathway in rats injected with AAV-9-A53T-α-synuclein. Taken together, our results demonstrate that exendin-4 treatment relieved behavioral deficits, dopaminergic degeneration, and pathological α-synuclein aggregation in a parkinsonian rat model of α-synucleinopathy and that these effects were mediated by enhanced autophagy via inhibiting the PI3K/Akt/mTOR pathway. In light of the safety and tolerance of exendin-4 administration, our results suggest that exendin-4 may represent a promising disease-modifying treatment for Parkinson’s disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13311-021-01018-5.

BACKGROUND A previous study showed that irrigation with 100 mL saline reduced residual common bile duct (CBD) stones, which potentially cause recurrent stones after endoscopic retrograde cholangiopancreatography. AIM To determine whether saline irrigation can improve CBD clearance after lithotripsy. METHODS This prospective self-controlled study enrolled patients receiving mechanical lithotripsy for large (> 1.2 cm) CBD stones. After occlusion cholangiography confirmed CBD stone clearance, peroral cholangioscopy (POC) was performed to determine clearance scores based on the number of residual stones. The amounts of residual stones spotted via POC were graded on a 5-point scale (score 1, worst; score 5, best). Scores were documented after only stone removal (control) and after irrigation with 50 mL and 100 mL saline, respectively. The stone composition was analyzed using infrared spectroscopy. RESULTS Between October 2018 and January 2020, 47 patients had CBD clearance scores of 2.4 ± 1.1 without saline irrigation, 3.5 ± 0.7 with 50 mL irrigation, and 4.6 ± 0.6 with 100 mL irrigation (P < 0.001). Multivariate analysis showed that CBD diameter > 15 mm [odds ratio (OR) = 0.08, 95% confidence interval (CI): 0.01-0.49; P = 0.007] and periampullary diverticula (PAD) (OR = 6.51, 95%CI: 1.08-39.21; P = 0.041) were independent risk factors for residual stones. Bilirubin pigment stones constituted the main residual stones found in patients with PAD (P = 0.004). CONCLUSION Irrigation with 100 mL of saline may not clear all residual CBD stones after lithotripsy, especially in patients with PAD and/or a dilated (> 15 mm) CBD. Pigment residual stones are soft and commonly found in patients with PAD. Additional saline irrigation may be required to remove retained stones.

Background The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex OKC) and comprehensively improve the understanding of this disease. Material and Methods We retrospectively investigated five cases of PIOSCC ex OKC at Peking University School and Hospital of Stomatology. We also conducted a systematic review of studies on PIOSCC ex OKC by using online databases from their inception until February 2020. Results In our series of five cases, all lesions were located in the mandible. Three cases (60%) showed recurrent OKCs and two cases (40%) showed primary OKCs. During the follow-up period, one patient died of local relapse. No patients developed metastasis. On the basis of our literature survey, we selected 22 articles reporting 29 patients with PIOSCC ex OKC. Seven of these patients (24.1%) showed local recurrence, three patients (10.3%) developed cervical metastasis, three patients (10.3%) developed distant metastasis (in the pleura in one case and in the lung in two cases), and seven patients died from the disease during the follow-up period. The disease-specific 5-year survival rate in the study group was 53.2%. Through univariate and multivariate analysis, local recurrence was identified as the only significant independent prognostic factor for survival (P < 0.05). Conclusions The results suggest that PIOSCC ex OKC is a rare intermediate-grade malignancy. Although elective neck dissection is typically unnecessary, adequate therapy should be applied to achieve the lowest local recurrence rate possible to ensure a favorable survival rate. Key words:Primary intraosseous squamous cell carcinoma, odontogenic keratocyst, prognosis.

Jing Xiao,1,2 Wenbo Wan,2 Ying Zhang,1,2 Jun Ma,2 Lin Yan,2 Yukun Luo,1,2 Jie Tang1,2 1School of Medicine, Nankai University, Tianjin, People’s Republic of China; 2Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Jie TangDepartment of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Fuxing Road 28#, Beijing 100853, People’s Republic of ChinaTel +86-10-5549-9056Fax +86-10-5549-9255Email txiner@sina.vip.comBackground: After surgical correction of testicular torsion, up to 68% of ipsilateral testes undergo atrophy due to ischemia-reperfusion injury (IRI). Recent studies have shown that dexmedetomidine (Dex) alleviates IRI in various vital organs. However, those studies evaluated its protective effect on short-term reperfusion.Purpose: We aimed to investigate whether Dex has a long-term protective effect against testicular injury after IRI.Materials and Methods: A total of 24 New Zealand white rabbits were randomly divided into three groups (n = 8/group): the control group (saline-infused rabbits without IRI), the IRI group (saline-injected rabbits with IRI), and the Dex group (Dex-injected rabbits with IRI). The spermatic cord of rabbits in IRI and Dex groups was ligated for 4 h, and 1 h before reperfusion, Dex was administered intraperitoneally at a dose of 50 μg/kg body weight in group Dex, whereas saline was administered at the same dose to the IRI and control groups. Rabbits were kept alive for 4 weeks post reperfusion, then the testes were harvested, and the rabbits were euthanized.Results: Four weeks post reperfusion, testicular volumes of the affected side decreased considerably in the IRI and Dex groups compared to the control group, with no significant difference between the IRI and Dex groups. Compared to the control group, the Johnson score and the mean seminiferous tubular diameters were significantly decreased in the IRI and Dex groups, but no significant differences were observed after administration of Dex. There were no significant differences in malondialdehyde and superoxide dismutase levels between the groups treated with and without Dex.Conclusion: Dex administration 3 h after ischemia and 1 h before reperfusion did not demonstrate a significant protective effect against testicular injury 4 weeks after IRI in rabbits. Further research is needed to confirm the potential therapeutic effects of Dex by varying the experimental conditions.Keywords: dexmedetomidine, testis, reperfusion injury, testicular atrophy, testicular torsion

Idiopathic rapid eye movement sleep behaviour disorder (RBD) is now recognized as an early manifestation of α-synucleinopathies. Increasing experimental studies demonstrate that manipulative lesion or inactivation of the neurons within the sublaterodorsal tegmental nucleus (also known as the subcoeruleus nucleus in humans) can induce RBD-like behaviours in animals. As current RBD animal models are not established on the basis of α-synucleinopathy, they do not represent the pathological substrate of idiopathic RBD and thus cannot model the phenoconversion to Parkinson’s disease. The purpose of this study was therefore to establish an α-synucleinopathy-based RBD animal model with the potential to convert to parkinsonian disorder. To this end, we first determined the functional neuroanatomical location of the sublaterodorsal tegmental nucleus in wild-type C57BL/6J mice and then validated its function by recapitulating RBD-like behaviours based on this determined nucleus. Next, we injected preformed α-synuclein fibrils into the sublaterodorsal tegmental nucleus and performed regular polysomnographic recordings and parkinsonian behavioural and histopathological studies in these mice. As a result, we recapitulated RBD-like behaviours in the mice and further showed that the α-synucleinopathy and neuron degeneration identified within the sublaterodorsal tegmental nucleus acted as the neuropathological substrates. Subsequent parkinsonian behavioural studies indicated that the α-synucleinopathy-based RBD mouse model were not stationary, but could further progress to display parkinsonian locomotor dysfunction, depression-like disorder, olfactory dysfunction and gastrointestinal dysmotility. Corresponding to that, we determined α-synuclein pathology in the substantia nigra pars compacta, olfactory bulb, enteral neuroplexus and dorsal motor nucleus of vagus nerve, which could underlie the parkinsonian manifestations in mice. In conclusion, we established a novel α-synucleinopathy-based RBD mouse model and further demonstrated the phenoconversion of RBD to Parkinson’s disease in this animal model.

Background There was a paucity of follow-up studies in the disease progression of early-onset PD patients with Parkin mutations (Parkin-EOPD). Here we conducted a longitudinal study to investigate the progression of motor and cognitive features of Parkin-EOPD patients. Methods Genetic analysis was performed via target sequencing and multiplex ligation-dependent probe amplification. Thirty patients carrying homozygous or compound heterozygous Parkin mutations with at least 2 follow-up revisions were investigated as the Parkin-EOPD group. Fifty-two patients with at least 2 follow-up revisions, who did not have any known causative PD mutations, GBA or LRRK2 risk variants, a heterozygous Parkin mutation or 2 Parkin mutations without a segregation test, were defined as the genetically undefined EOPD (GU-EOPD) group. A linear mixed-effect model was implemented to evaluate longitudinal changes in motor symptoms and cognition. Results At baseline, the Parkin-EOPD group had a lower Unified Parkinson's Disease Rating Scale score (UPDRS-III) (off-medication) than the GU-EOPD group, without significant differences in cognition. A longitudinal study showed the estimated progression rate per year (standard error) of the UPDRS-III score (off-medication) was lower in the Parkin-EOPD group (0.203 [0.3162] points per year) than in the GU-EOPD group (1.056 [0.3001] points per year). The difference in the UPDRS-III score rate between the 2 groups was 0.853 (0.4183) (P = 0.042). The Parkin-EOPD group showed better maintenance of spatial processing ability compared with the GU-EOPD group (P = 0.027). Conclusion Parkin-EOPD patients showed a slower deterioration of motor symptoms and a better spatial processing ability than GU-EOPD patients, which suggests that subtyping according to genetic features can help predict PD progression. © 2020 International Parkinson and Movement Disorder Society.

In triaxial tests, it is of great importance to accurately measure the radial strain of a specimen. However, devices for radial strain measurement are relatively fewer than the ones for vertical strain measurement. In this study, a new measurement device based on the fiber Bragg grating (FBG) was developed to determine the small and large radial strains of a soil specimen. The new device includes two yokes and two compass-type mechanisms, which are mounted on diametrically opposite sides of the specimen. Metal strips bonded with FBG sensors were chosen as sensing elements and installed at two ends of two legs of a compass-type mechanism so that the small deformation of the specimen could be amplified by a constant ratio to a more detectable value with a higher signal–noise ratio. Considering the temperature sensitivity of FBG and the real working environment, the new device was carefully calibrated underwater. Validation tests on an intact triaxial specimen demonstrated that the new device can work reliably and accurately under both static and cyclic loadings.

The 55-km-long Hong Kong–Zhuhai–Macao Bridge (HZMB) is the world’s longest sea-crossing bridge, connecting Hong Kong with Zhuhai and Macao at the mouth of the Pearl River Estuary in China, comprising 22.9-km-long steel bridges. HZMB is the leading steel bridge in China, with top-level manufacturing and installation technology. This paper outlines the steel bridge construction experiences of HZMB to provide comparisons for the construction of other long sea-crossing steel bridges at home or abroad. The main considerations of construction constraints, scheme selection, structural and aesthetic design of HZMB are presented, and the following points related to new strategies in the steel bridge construction of HZMB are elaborated: (1) construction quality assurance, (2) automatic manufacturing technology, (3) large segment offshore installation, (4) eco-friendly paint (content limitation of volatile organic compounds) and new multifunctional inspection gantry, and (5) Guss Mastic Asphalt steel deck pavement system. The successful implementation of those strategies shows that the steel bridge construction of HZMB promotes improvement in the overall construction and management level of the Chinese bridge industry. The advanced experience of HZMB has opened up broad prospects for the design and construction of offshore bridge engineering in China.

The prediction of the mechanical properties of hot-rolled strips is a very complex, highly dimensional and nonlinear problem, and the published models might lack reliability, practicability and generalization. Thus, a new model was proposed for predicting the mechanical properties of hot-rolled strips by deep learning. First, the one-dimensional numerical data were transformed into two-dimensional data for expressing the complex interaction between the influencing factors. Subsequently, a new convolutional network was proposed to establish the prediction model of tensile strength of hot-rolled strips, and an improved inception module was introduced into this network to abstract features from different scales. Many comparative experiments were carried out to find the optimal network structure and its hyperparameters. Finally, the prediction experiments were carried out on different models to evaluate the performance of the new convolutional network, which includes the stepwise regression, ridge regression, support vector machine, random forest, shallow neural network, Bayesian neural network, deep feed-forward network and improved LeNet-5 convolutional neural network. The results show that the proposed convolutional network has better prediction accuracy of the mechanical properties of hot-rolled strips compared with other models.

Breast cancer was the most frequent and the second most deadly cancer in women in 2018 in China; thus, early diagnosis of breast cancer is important. Studies have reported that tissue stiffness promotes cancer progression through increased collagen or fibrosis. Shear wave elastography (SWE) is a technique for measuring tissue stiffness. However, the mechanisms underlying cancer tissue stiffness or fibrosis are not entirely clear. Hypoxia‐inducible factor 1 (HIF‐1α) is expressed in response to hypoxia and contributes to tumor progression and metastasis. Kindlin‐2 is an important co‐activator of integrin. We have reported that Kindlin‐2 influences breast cancer stiffness and metastasis. In this study, SWE was used to determine the maximum elasticity (Emax) of patients before operation or core needle biopsy. The specimens were used for staining. Knockdown, overexpression, co‐immunoprecipitation, and immunofluorescence assays were used to explore the relationship between HIF‐1α and Kindlin‐2. We found that HIF‐1α and Kindlin‐2 were highly expressed in invasive breast cancer and that the expression levels of HIF‐1α and Kindlin‐2 were correlated with Emax. HIF‐1α interacts with Kindlin‐2. Besides, HIF‐1α and Kindlin‐2 influence the expression of P4HA1, an important protein in collagen biogenesis through the integrin/FAK pathway. Our study first identified a new mechanism of invasive breast cancer stiffness by linking HIF‐1α and Kindlin‐2 to collagen biogenesis. Therefore, based on SWE, Emax could be a physical biomarker of invasive breast cancer for early, noninvasive diagnosis, and HIF‐1α and Kindlin‐2 could be pathological markers for early diagnosis and targeted therapy., The expression levels of HIF‐1α and Kindlin‐2 and Emax were correlated with each other. HIF‐1α and Kindlin‐2 influence the progress of collagen biogenesis through integrin/FAK pathway. Emax could be a physical biomarker for early, noninvasive diagnosis, and HIF‐1α and Kindlin‐2 could be pathological markers for early diagnosis and targeted therapy.

The recognition of partial discharge mode is an important indicator of the insulation condition in transformers, based on which maintenance can be arranged. Discharge feature extraction is the key to recognize discharge mode. To solve the problem of poor stability and low recognition rate of partial discharge mode, this paper proposes a feature extraction method based on synchrosqueezed windowed Fourier transform and multi-scale dispersion entropy. First, the four partial discharge signals collected under laboratory conditions are decomposed by synchrosqueezed windowed Fourier transform, then a number of band-limited intrinsic mode type functions are obtained, and the original feature quantities of partial discharge signals are obtained by calculating the multi-scale dispersion entropies of each intrinsic mode type function. Based on that, original feature quantity is optimized by using the maximum relevance and minimum redundancy criteria. Finally, the classification is implemented by the support vector machine. Experimental results show that in the case of noise interference, the proposed synchrosqueezed windowed Fourier transform–multi-scale dispersion entropy method can still accurately describe the feature of different discharge signals and has a higher recognition rate than both the empirical mode decomposition–multi-scale dispersion entropy method and the direct multi-scale dispersion entropy method.

Recently, the Riemannian manifold has received special attention in unsupervised clustering since the real-world visual data usually resides on a special manifold where Euclidean geometry fails to capture. Although many clustering algorithms have been proposed, most of them use only a single geometric model to describe the data. In this paper, a multi-geometric subspace clustering model is proposed, and the subspace representation is learned together by constructing a shared affinity matrix of multi-order data. Experimental results on several different types of datasets show that the clustering performance of our proposed algorithm is better than most of subspaces algorithms.

Objective: To explore the relationship between cerebrospinal fluid-contacting neurons (CSF-cNs) and endogenous neural progenitor cells (ENPCs) and whether CSF-cNs are involved in nerve repair after spinal cord injury (SCI).Methods: Cholera toxin B-horseradish peroxidase complex (CB-HRP) and cholera toxin B conjugated with saporin (CB-SAP) were injected into the lateral ventricles of spinal cord injured rats to mark and destroy the CSF-cNs. Then the rats in the experimental group were injured by SCI. Observe the content and co-expression of CSF-cNs and ENPCs in rats of each group, and observe the recovery of motor function after SCI in each group.Results: After the destruction of CSF-cNs, the number of ENPCs decreased significantly in the long term after the surgery, and the recovery of motor function also deteriorated as compared to the group with intact CSF-cNs. Meanwhile some cells in the spinal cord express both the biological marker of CSF-cNs and ENPCs.Conclusion: This study shows that the population of ENPCs and motor function recovery in SCI rats declined after the destruction of CSF-cNs, suggesting that CSF-cNs affect the ENPCs population and may be involved in the recovery of neural function after SCI.

To determine whether diabetes mellitus (DM) contributes to the drug resistance of carbamazepine (CBZ), we investigated the correlation between the blood glucose status and the CBZ resistance condition in patients with trigeminal neuralgia (TN). A total of 155 TN patients treated with the CBZ monotherapy were selected at Shanghai General Hospital and Shanghai Xinhua Hospital from September 2018 to January 2020. Among them, 15 were diagnosed with DM. Patients’ CBZ resistance levels were evaluated according to progression-free survival. We utilized ordered multiple classification logistic regression to determine the dominant factors leading to CBZ resistance. We analyzed the correlation between hemoglobin A1c (HbA1c) and progression-free survival using the Pearson correlation analysis. The regression analysis showed that DM was the only factor affecting CBZ resistance (p = 0.035; OR = 0.327; 95% CI, 0.115–0.926). Progression-free survival was 28.5 ± 21.2 months in the DM group and 66.0 ± 33.2 months in the non-DM group. The concentration of HbA1c in the blood was negatively correlated with progression-free survival (r = − 0.197; p = 0.014). This study shows that blood glucose status is a significant factor contributing to the CBZ resistance in the treatment of TN. The progression-free survival of patients is affected by the status of DM and blood HbAlc levels.

This paper studies reachable set estimation for systems with parameter uncertainties and known input. A new method is proposed for estimating real-time reachable sets of systems with parameter uncertainties, known input and non-zero initial condition. In order to reduce the effect of known inputs on the reachable set estimation, we propose a method by separating the uncertain systems into two subsystems: the subsystem with known input and the subsystem with parameter uncertainties. By solving the optimization problem in terms of linear matrix inequalities, real-time reachable sets are obtained. The effectiveness of the proposed method is illustrated by the simulation result of the lateral dynamic system of a vehicle.

Background Simultaneous dislocation of the radial head and distal radio-ulnar joint without fracture (Criss-Cross Injury) in an adult patient is rarely reported in previous studies. The pathological changes and injury patterns have not been clearly demonstrated. Case presentation A 26-year-old woman presented with acute pain of the right wrist and elbow after a fall from cycling. Physical examination revealed an unstable elbow and wrist joint. Plain radiographs showed volar dislocation of the radial head and dorsal dislocation of the distal radius without associated fracture, forming a criss-cross appearance of the ulna and radius on the lateral radiograph. MRI images confirmed partial rupture of the proximal interosseous membrane from its dorsal attachment on the radius, as well as partial rupture of the medial collateral ligament. Conservative treatment failed because the radiocapitellar joint and distal radio-ulnar joint could not be simultaneously reduced. Surgical exploration revealed a highly unstable radial head, but the annular ligament was found to be intact. Manual force was applied to reduce the radial head and a percutaneous K-wire was used to stabilize the proximal radioulnar joint with the forearm in full supination. After surgery, the elbow was immobilized in 90° flexion by a long arm cast for 4 weeks. The K-wire was removed at 6 weeks postoperatively. At 18 months postoperatively, the patient had regained a full range of flexion and extension, with normal supination and a slight limitation in pronation. Conclusions The proximal IOM, especially the dorsal band, was injured in Criss-Cross injuries, while the central part of the IOM remained intact. This injury pattern distinguished itself from Essex-Lopresti injury, which mainly involves rupture of the central band of the IOM.

Genomics-based neoantigen discovery can be enhanced by proteomic evidence, but there remains a lack of consensus on the performance of different quality control methods for variant peptide identification in proteogenomics. We propose to use the difference between accurately predicted and observed retention times for each peptide as a metric to evaluate different quality control methods. To this end, we develop AutoRT, a deep learning algorithm with high accuracy in retention time prediction. Analysis of three cancer data sets with a total of 287 tumor samples using different quality control strategies results in substantially different numbers of identified variant peptides and putative neoantigens. Our systematic evaluation, using the proposed retention time metric, provides insights and practical guidance on the selection of quality control strategies. We implement the recommended strategy in a computational workflow named NeoFlow to support proteogenomics-based neoantigen prioritization, enabling more sensitive discovery of putative neoantigens., Identifying mutation-derived neoantigens by proteogenomics requires robust strategies for quality control. Here, the authors propose peptide retention time as an evaluation metric for proteogenomics quality control methods, and develop a deep learning algorithm for accurate retention time prediction.

Angiopoietin-2 (Ang-2) is a proangiogenic factor that mediates inflammation and atherosclerosis. We evaluated the predictive value of circulating Ang-2 levels for periprocedural myocardial injury (PMI) in 145 patients undergoing elective percutaneous coronary intervention (PCI), and investigated whether post-PCI Ang-2 levels are influenced by PMI. PMI was defined as a post-procedural troponin elevation above the 5×99th percentile upper reference limit. Blood samples for Ang-2 analysis were collected at admission and on postoperative days 1 and 3. PMI occurred in 40 patients (28%). At baseline, there was no difference in Ang-2 levels between PMI and non-PMI patients (P=0.554). However, a significant interaction effect between PMI occurrence and time on Ang-2 levels was observed (interaction P=0.036). Although serum Ang-2 levels in non-PMI patients gradually decreased, Ang-2 levels in PMI patients did not change between different time-points. Multiple logistic regression analysis revealed that age, total stent length, and serum levels of N-terminal pro-brain natriuretic peptide were independent PMI predictors. These findings indicate that pre-procedural Ang-2 levels do not impact PMI occurrence after elective PCI. However, changes in Ang-2 levels after the procedure are closely related to PMI.

Chronic fatigue syndrome is an agnogenic disease worldwide. Nurses are at a high risk of chronic fatigue syndrome. However, no research has been done to examine the associations of workplace violence, organizational support, and occupational stress with chronic fatigue syndrome among Chinese nurses. This study aimed to examine effects of these factors on chronic fatigue syndrome in this occupational group.Cross-sectional. All participants voluntarily completed a questionnaire survey.The study was conducted in Liaoning province from December 2017-January 2018. Self-administered questionnaires were distributed to 1,200 nurses, including Effort-Reward-Imbalance, Workplace Violence Scale, Survey of Perceived Organizational Support, together with age, gender, marital status, education levels, physical activities, job rank, monthly income, and weekly working hours. Complete responses were obtained from 1,080 (90%) participants. Chronic fatigue syndrome was diagnosed by doctors according to the Centers for Disease Control and Prevention criteria. Multivariable logistic regression was performed to examine these independent risk factors.The prevalence of chronic fatigue syndrome was 6.76%. The results of logistic regression analysis showed that nurses who experienced serious higher levels of overcommitment, workplace violence and less organizational support were more likely to be classified as chronic fatigue syndrome.There was a high prevalence of chronic fatigue syndrome. Lower workplace violence, more organizational support and lower overcommitment could be effective resources for reducing chronic fatigue syndrome.Workplace violence, organizational support, and occupational stress were related to chronic fatigue syndrome, which helped to explain why Chinese nurses suffered higher prevalence of chronic fatigue syndrome. Overcommitment explained chronic fatigue syndrome better than Effort/Reward Ratio, so intrinsic stress played a more critical role than extrinsic stress in chronic fatigue syndrome. Chinese nurses suffered serious sleep disorders and impairment of concentration and memory. These symptoms might also attribute to serious occupational stress, unsafe and unsupportive working environment. Creating a safe and supportive working environment, relieving intrinsic occupational stress should be considered as an institutional strategy to early prevent chronic fatigue syndrome.目的: 慢性疲劳综合征是一种病因不明的世界性疾病。护士患慢性疲劳综合征的风险很高。然而,目前尚无针对中国护士工作场所暴力、组织支持和职业压力与慢性疲劳综合征之间的关系的研究。本研究旨在探讨这些因素对该职业人群慢性疲劳综合征的影响。 设计: 横断面。所有参与者自愿完成问卷调查。 方法: 本研究于2017年12月至2018年1月在辽宁省进行。共向1,200 名护士发放自填问卷,包括付出收获不平衡、工作场所暴力量表、组织支持感问卷,以及年龄、性别、婚姻状况、教育程度、体育锻炼、职级、月收入、每周工作时间调查。共有1,080名(90%)参与者给出了完整答复。慢性疲劳综合征由医生根据疾病预防控制中心标准进行诊断。同时采用多变量逻辑回归对此类独立风险因素进行分析。 结果: 慢性疲劳综合征患病率为6.76%。逻辑回归分析结果表明,护士如果经历重大的、较高水平的过度承诺,工作场所暴力和较少的组织支持,更容易患有慢性疲劳综合征。 结论: 慢性疲劳综合征患病率较高。减少工作场所暴力、提供更多的组织支持以及减少过度承诺可有助于降低慢性疲劳综合症的患病概率。 影响: 工作场所暴力、组织支持、职业压力与慢性疲劳综合征相关,这有助于解释中国护士慢性疲劳综合征患病率较高的原因。相对于付出/获得比,过度承诺更适合用于解释慢性疲劳综合征的患病原因,因此内在压力比外在压力对慢性疲劳综合征中的影响更为严重。中国护士普遍存在严重的睡眠障碍,注意力和记忆力减退情况。这些症状也可归因于较高的职业压力以及工作环境缺乏安全性和支持性。创造安全且具支持性的工作环境、缓解内在的职业压力应被视为一种早期预防慢性疲劳综合征的制度策略。.

This study aimed to establish an effective prognostic nomogram for microvascular decompression (MVD)–treated trigeminal neuralgia (TN). The nomogram was based on a retrospective cohort study of 1054 patients with TN. During the period 2005–2014, 845 patients at our department treated TN with MVD and served as a development cohort. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The model was externally validated by 209 TN patients during 2014–2016. Multivariate cox analysis suggested that the patient’s age, atypical pain, vascular type, number of offending vessels, and second MVD were significant factors influencing the prognosis of MVD-treated TN. The C index of nomogram in the development cohort was 0.767 (95% CI, 0.739–0.794), and 0.749 (95% CI, 0.688–0.810) in the validation cohort. We developed and validated a nomogram to predict 3-year overall remission rate after MVD treatment of TN. The nomogram can be used in clinical trials to determine the likelihood of pain recurrence in TN patients treated with MVD for 3 years to aid in the comprehensive treatment of TN.

Increasing evidence suggests that inflammation is associated with the development of acute ischemic stroke (AIS). The neutrophil-to-lymphocyte ratio (N/L) is an important marker of inflammation and is highly correlated with mortality in stroke patients in recent studies. The N/L of patients who experience hemorrhagic transformation (HT) after AIS is know, but any relationship between N/L and large artery atherosclerosis (LAA) remains unclear, this is our present topic. We enrolled 185 patients with LAA-type HT in the development cohort from a prospective, consecutive, hospital-based stroke registry to this end. We matched these patients to 213 LAA patients who did not develop HT as controls. The incidence of HT after LAA was significantly greater (P

Objective: Few studies have investigated the association of apolipoprotein B (ApoB) with the progression of diabetic kidney disease (DKD) and the risk of renal replacement therapy (RRT). Method: In this retrospective cohort study, a group of 258 DKD patients with stage 3–5chronic kidney disease(CKD)were divided into low ApoB (

Purpose This study aimed to evaluate the clinical efficacy and imaging results of percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) through comparing it with minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF). Materials and methods We performed a retrospective analysis on patients with lumbar degenerative disease treated by PETLIF or MISTLIF from September 2017 to January 2019, and the patients were divided into two groups: the PETLIF group and the MISTLIF group. The clinical and imaging parameters of the two groups were evaluated. Results There was no significant difference between the two groups in complication rate. The operative time in the PETLIF group was significantly less than that in the MISTLIF group. Compared with those before operation, the postoperative VAS-L and VAS-B scores were significantly improved after operation in the both groups. In addition, the postoperative VAS-B score of the PETLIF group was significantly lower than that of the MISTLIF group. At the last follow-up, there was no significant difference between the two groups in the VAS-L score, VAS-B score, ODI score, and bony fusion rate. Conclusions Both PETLIF and MISTLIF could achieve satisfactory clinical outcomes in the treatment of lumbar degenerative disease, but our study suggested that PETLIF had less damage, rapid recovery after operation, and short discharge time.

Discrete-modulated continuous-variable quantum key distribution with homodyne detection is widely recognized for its ease of implementation, efficiency with respect to error correction, and its compatibility with modern optical communication devices. However, recent studies report that the application of homodyne detection obtains poor tolerance to excess noise and insufficient transmission distance, hence seriously restricting the large-scale deployment of quantum secure communication networks. In this paper, we propose a homodyne detection protocol using the quadrature phase shift keying technique. By limiting information leakage, our proposed protocol enhances excess noise tolerance to a high level. Furthermore, we demonstrate that homodyne detection performs better than heterodyne detection in quaternary-modulated continuous-variable quantum key distribution under the untrusted detector noise scenario. The security is analyzed using the tight numerical method against collective attacks in the asymptotic regime. Our results imply that the current protocol is able to distribute keys in nearly intercity area and thus paves the way for constructing low-cost quantum secure communication networks., 14 pages, 10 figures. Accepted by PRX Quantum

One of the major clinical manifestations of peripheral neuropathy, either resulting from trauma or diseases, is chronic pain. While it significantly impacts patients’ quality of life, the underlying mechanisms remain elusive, and treatment is not satisfactory. Systemic chronic inflammation (SCI) that we are referring to in this perspective is a state of low-grade, persistent, non-infective inflammation, being found in many physiological and pathological conditions. Distinct from acute inflammation, which is a protective process fighting against intruders, SCI might have harmful effects. It has been associated with many chronic non-communicable diseases. We hypothesize that SCI could be a predisposing and/or precipitating factor in the development of chronic pain, as well as associated comorbidities. We reviewed evidence from human clinical studies indicating the coexistence of SCI with various types of chronic pain. We also collated existing data about the sources of SCI and who could have it, showing that those individuals or patients having SCI usually have higher prevalence of chronic pain and psychological comorbidities. We thus elaborate on the need for further research in the connection between SCI and chronic pain. Several hypotheses have been proposed to explain these complex interactions.

Background: Neurofilaments in cerebrospinal fluid (CSF) and in blood are considered promising biomarkers of amyotrophic lateral sclerosis (ALS) because their levels can be significantly increased in patients with ALS. However, the roles of neurofilaments, especially blood neurofilaments, in the prognosis of ALS are inconsistent. We performed a meta-analysis to explore the prognostic roles of blood neurofilaments in ALS patients.Methods: We searched all relevant studies on the relationship between blood neurofilament levels and the prognosis of ALS patients in PubMed, Embase, Scopus, and Web of Science before February 2, 2021. The quality of the included articles was assessed using the Quality in Prognosis Studies (QUIPS) scale, and R (version 4.02) was used for statistical analysis.Results: Fourteen articles were selected, covering 1,619 ALS patients. The results showed that higher blood neurofilament light chain (NfL) levels in ALS patients were associated with a higher risk of death [medium vs. low NfL level: HR = 2.43, 95% CI (1.34–4.39), p < 0.01; high vs. low NfL level: HR = 4.51, 95% CI (2.45–8.32), p < 0.01]. There was a positive correlation between blood phosphorylated neurofilament heavy chain (pNfH) levels and risk of death in ALS patients [HR = 1.87, 95% CI (1.35–2.59), p < 0.01]. The levels of NfL and pNfH in blood positively correlated with disease progression rate (DPR) of ALS patients [NfL: summary r = 0.53, 95% CI (0.45–0.60), p < 0.01; pNfH: summary r = 0.51, 95% CI (0.24–0.71), p < 0.01].Conclusion: The blood neurofilament levels can predict the prognosis of ALS patients; specifically, higher levels of blood neurofilaments are associated with a greater risk of death.