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Myocardial infarction (MI) results in cardiomyocyte death and ultimately leads to heart failure. Pyroptosis is a type of the inflammatory programmed cell death that has been found in various diseased tissues. However, the role of pyroptosis in MI heart remains unknown. Here, we showed that CXADR‐like membrane protein (CLMP) was involved in pyroptosis in the mouse MI heart. Our data showed that CLMP was strongly expressed in fibroblasts of the infarcted mouse hearts. The Clmp +/− mice showed more serious myocardial fibrosis and ventricular dysfunction post‐MI than wild‐type (Clmp +/+) mice, indicating a protective effect of the fibroblast‐expressed CLMP against MI‐induced heart damage. Transcriptome analyses by RNA sequencing indicated that Il‐1β mRNA was significantly increased in the MI heart of Clmp +/− mouse, which indicated a more serious inflammatory response. Meanwhile, cleaved caspase‐1 and Gasdermin D were significantly increased in the Clmp +/− MI heart, which demonstrated enhanced pyroptosis in the Clmp knockdown heart. Further analysis revealed that the pyroptosis mainly occurred in cardiac fibroblasts (CFs). Compared to wild‐type fibroblasts, Clmp +/− CFs showed more serious pyroptosis and inflammatory after LPS plus nigericin treatment. Collectively, our results indicate that CLMP participates in the pyroptotic and inflammatory response of CFs in MI heart. We have provided a novel pyroptotic insight into the ischaemic heart, which might hold substantial potential for the treatment of MI.

To evaluate calyceal irrigation fluid temperature changes during flexible ureteroscopic Ho:YAG laser lithotripsy. Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature–time curve was drawn and time needed to reach 43 °C without irrigation was documented. Thirty-two patients were enrolled in our study. The temperature–time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s). Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.

ObjectiveTo evaluate the clinical performance and utility for risk stratification of DH3 HPV assay in women (≥30 years) with NILM cytology.MethodsA prospective cohort was established in Central China between November 8 to December 14, 2016 which consisted of 2180 women aging 30-64 years with NILM cytology. At baseline, all women were screened using DH3 HPV assay. HPV 16/18 positive women would be assigned to colposcopy and biopsied if necessary. Then, hr-HPV positive women without CIN2+ lesions would be followed up by cytology every 12 months for two years. In the 3rd year of follow up, all women that were not biopsy proven CIN2+ would be called back and screened by cytology again. In follow-up period, women with ASC-US and above were referred to colposcopy and biopsied if clinically indicated. CIN2+ was the primary endpoint in analysis. The clinical performance and utility for risk stratification of DH3 HPV assay were assessed by SPSS 22.0 and SAS 9.4.ResultsOf 2180 qualified women, the prevalence of hr-HPV was 8.5% (185/2180), 45(2.1%) were HPV 16/18 positive. The clinical performance for HPV16/18 was 91.7% for sensitivity, 98.4% for specificity, respectively against CIN2+ detection at baseline. In four years of study, the corresponding rates of HPV 16/18 were 51.5% and 98.7%, respectively. The cumulative absolute risk for the development of CIN2+ was as high as 37.8% for HPV 16/18 positive women, followed by hr-HPV positive (14.6%), other hr-HPV positive (11.0%) and HPV negative (0.3%) in three years. The relative risk was 125.6 and 3.4 for HPV 16/18 positive group when compared with HPV negative and other hr-HPV positive group, respectively.ConclusionsDH3 HPV assay demonstrated excellent clinical performance against CIN2+ detection in cervical cancer screening and utility of risk stratification by genotyping to promote scientific management of women with NILM cytology.

BackgroundUrachal cancer is a rare neoplasm in the urological system. To our knowledge, no published study has explored to establish a model for predicting the prognosis of urachal cancer. The present study aims to develop and validate nomograms for predicting the prognosis of urachal cancer based on clinicopathological parameters.MethodsBased on the data from the Surveillance, Epidemiology, and End Results database, 445 patients diagnosed with urachal cancer between 1975 and 2018 were identified as training and internal validation cohort; 84 patients diagnosed as urachal cancer from 2001 to 2020 in two medical centers were collected as external validation cohort. Nomograms were developed using a multivariate Cox proportional hazards regression analysis in the training cohort, and their performance was evaluated in terms of its discriminative ability, calibration, and clinical usefulness by statistical analysis.ResultsThree nomograms based on tumor–node–metastasis (TNM), Sheldon and Mayo staging system were developed for predicting cancer-specific survival (CSS) of urachal cancer; these nomograms all showed similar calibration and discrimination ability. Further internal (c-index 0.78) and external (c-index 0.81) validation suggested that Sheldon model had superior discrimination and calibration ability in predicting CSS than the other two models. Moreover, we found that the Sheldon model was able to successfully classify patients into different risk of mortality both in internal and external validation cohorts. Decision curve analysis proved that the nomogram was clinically useful and applicable.ConclusionsThe nomogram model with Sheldon staging system was recommended for predicting the prognosis of urachal cancer. The proposed nomograms have promising clinical applicability to help clinicians on individualized patient counseling, decision-making, and clinical trial designing.

Rationale: As a hallmark of various heart diseases, cardiac fibrosis ultimately leads to end-stage heart failure. Anti-fibrosis is a potential therapeutic strategy for heart failure. Long noncoding RNAs (lncRNAs) have emerged as critical regulators of heart diseases that promise to serve as therapeutic targets. However, few lncRNAs have been directly implicated in cardiac fibrosis. Methods: The lncRNA expression profiles were assessed by microarray in cardiac fibrotic and remote ventricular tissues in mice with myocardial infarction. The mechanisms and functional significance of lncRNA-AK137033 in cardiac fibrosis were further investigated with both in vitro and in vivo models. Results: We identified 389 differentially expressed lncRNAs in cardiac fibrotic and remote ventricular tissues in mice with myocardial infarction. Among them, a lncRNA (AK137033) we named Safe was enriched in the nuclei of fibroblasts, and elevated in both myocardial infarction and TGF-β-induced cardiac fibrosis. Knockdown of Safe prevented TGF-β-induced fibroblast-myofibroblast transition, aberrant cell proliferation and secretion of extracellular matrix proteins in vitro, and mended the impaired cardiac function in mice suffering myocardial infarction. In vitro studies indicated that knockdown of Safe significantly inhibited the expression of its neighboring gene Sfrp2, and vice versa. The Sfrp2 overexpression obviously disturbed the regulatory effects of Safe shRNAs in both the in vitro cultured cardiac fibroblasts and myocardial infarction-induced fibrosis. Dual-Luciferase assay demonstrated that Safe and Sfrp2 mRNA stabilized each other via their complementary binding at the 3'-end. RNA electrophoretic mobility shift assay and RNA immunoprecipitation assay indicated that RNA binding protein HuR could bind to Safe-Sfrp2 RNA duplex, whereas the knockdown of HuR dramatically reduced the stabilization of Safe and Sfrp2 mRNAs, down-regulated their expression in cardiac fibroblasts, and thus inhibited TGF-β-induced fibrosis. The Safe overexpression partially restrained the phenotype change of cardiac fibroblasts induced by Sfrp2 shRNAs, but not that induced by HuR shRNAs. Conclusions: Our study identifies Safe as a critical regulator of cardiac fibrosis, and demonstrates Safe-Sfrp2-HuR complex-mediated Sfrp2 mRNA stability is the underlying mechanism of Safe-regulated cardiac fibrosis. Fibroblast-enriched Safe could represent a novel target for anti-fibrotic therapy in heart diseases.

BackgroundConventional clinical detection methods such as CT, urine cytology, and ureteroscopy display low sensitivity and/or are invasive in the diagnosis of upper tract urinary carcinoma (UTUC), a factor precluding their use. Previous studies on urine biopsy have not shown satisfactory sensitivity and specificity in the application of both gene mutation or gene methylation panels. Therefore, these unfavorable factors call for an urgent need for a sensitive and non-invasive method for the diagnosis of UTUC.MethodsIn this study, a total of 161 hematuria patients were enrolled with (n = 69) or without (n = 92) UTUC. High-throughput sequencing of 17 genes and methylation analysis for ONECUT2 CpG sites were combined as a liquid biopsy test panel. Further, a logistic regression prediction model that contained several significant features was used to evaluate the risk of UTUC in these patients.ResultsIn total, 86 UTUC− and 64 UTUC+ case samples were enrolled for the analysis. A logistic regression analysis of significant features including age, the mutation status of TERT promoter, and ONECUT2 methylation level resulted in an optimal model with a sensitivity of 94.0%, a specificity of 93.1%, the positive predictive value of 92.2% and a negative predictive value of 94.7%. Notably, the area under the curve (AUC) was 0.957 in the training dataset while internal validation produced an AUC of 0.962. It is worth noting that during follow-up, a patient diagnosed with ureteral inflammation at the time of diagnosis exhibiting both positive mutation and methylation test results was diagnosed with ureteral carcinoma 17 months after his enrollment.ConclusionThis work utilized the epigenetic biomarker ONECUT2 for the first time in the detection of UTUC and discovered its superior performance. To improve its sensitivity, we combined the biomarker with high-throughput sequencing of 17 genes test. It was found that the selected logistic regression model diagnosed with ureteral cancer can evaluate upper tract urinary carcinoma risk of patients with hematuria and outperform other existing panels in providing clinical recommendations for the diagnosis of UTUC. Moreover, its high negative predictive value is conducive to rule to exclude patients without UTUC.

We reported our initial experience of robotic-assisted laparoscopic artery-sparing varicocelectomy using indocyanine green (ICG) fluorescence angiography in treatment of varicocele. A total of 45 varicocelectomies in 27 patients were performed. The mean operation time was 49.1 ± 8.5 min for unilateral and 65.6 ± 8.3 min for bilateral repair. 47.2 s after ICG injection, testicular artery (TA) was visualised. After an interval of 31.3 s, fluorescent veins were identified. Of all the 45 spermatic cords, 68.9% had a solitary artery, while 31.1% had 2 arteries. The mean hospital stay was 1.6 ± 0.9 days. Semen concentration and motility were significantly improved 6 months after surgery, no recurrence, hydrocele or testicular atrophy was observed. Our study demonstrated that robotic-assisted laparoscopic artery-sparing varicocelectomy using ICG fluorescence angiography is a safe, effective and promising technique in treatment of varicocele.

FDA approved the Da Vinci Surgical System in 2000 for clinical usage, and robotic assisted radical prostatectomy was performed in the same year. With the prevailing of robot-assisted laparoscopic radical prostatectomy, urologist realized the advantages of performing complicated pelvic surgeries with robotic surgical system, and thus ventured into robotic assisted radical cystectomy. Wolfram et al. first reported robot-assisted laparoscopic radical cystectomy and intracorporeal neobladder in 2003.Menon was the first person who standardized the procedure of robotic assisted radical cystectomy (RARC). First, a transverse incision was made near the bottom of rectovesical pounch, vas deferens and seminal vesicle gland was mobilized A transverse incision was made to open Denonvilliers Fascia, seminal vesicle gland and vas deferens ampulla were retracted with the bladder. Anterior wall of rectum was separated from prostate until apex. Subsequently, peritoneum was incised and dissected at the avascular plane to identify bilateral ureters at iliac arteries bifurcation. Both ureters were dissected down to trigone. Bilateral superior vesical arteries were divided, Peritoneum was incised next to lateral lateral umbilical ligament, Prevesical space was separated, puboprotatic ligament was divided, bladder and prostate were mobilized.

Background The prevalence of adverse food reactions in patients with chronic inhalant diseases has seldom been studied in China. This study is to investigate the prevalence of adverse food reactions and the symptoms caused in respiratory patients. Methods Respiratory patients in allergy clinics were asked to complete a questionnaire. Patients’ information such as age, gender, family history of allergy, and adverse reactions to a list of 48 foods and the symptoms caused, was recorded. Multivariate analyses were performed to determine the prevalence of adverse food reactions and their associated symptoms. Results 459 subjects, with an average age of 32 years old, completed the questionnaire; 45.3% were male. Among the 459 subjects, 38.1% (175/459) had an adverse reaction to food: 13.6% had an adverse food reaction to crab, 12.4% had an adverse food reaction to shrimp; and 9.9% had an adverse reaction to shellfish. Peach and nectarine were also shown to be common causative foods with 6.8% of the study group showing an adverse reaction to peach and 5.2% to nectarine. Seafood mainly caused skin symptoms and fruits gave rise to more throat, oral, and gastrointestinal problems. Conclusion The prevalence of adverse food reactions is high for patients with respiratory diseases. This indicates that adverse food reactions should be considered in the treatment and management of patients with chronic inhalant diseases. Electronic supplementary material The online version of this article (10.1186/s13223-017-0228-3) contains supplementary material, which is available to authorized users.

This paper reports on the design and implementation of an innovative fiber optic sensor based on extrinsic Fabry-Perot interferometer (EFPI) to accurately measure the tensile strain of the Inconel 718 specimen. The measurement results were compared with the strain measured simultaneously by the electronic extensometer. The fast Fourier transform (FFT) method was used to obtain the cavity length from the real-time spectrum. The proposed EFPI sensor revealed a sensitivity of 26.59 nm/μe and a strain measurement range of 166,000 μe. By matching strain with the stress measured by tensile testing machine, the full stress-strain curves of the Inconel 718 specimen were obtained at different strain rates from 0.00001/s to 0.001/s. The finite element method (FEM) was used to verify the accuracy of the proposed EFPI sensor.

The milling stability of thin-walled components is an important issue in the aviation manufacturing industry, which greatly limits the removal rate of a workpiece. However, for a thin-walled workpiece, the dynamic characteristics vary at different positions. In addition, the removed part also has influence on determining the modal parameters of the workpiece. Thus, the milling stability is also time-variant. In this work, in order to investigate the time variation of a workpiece’s dynamic characteristics, a new computational model is firstly derived by dividing the workpiece into a removed part and a remaining part with the Ritz method. Then, an updated frequency response function is obtained by Lagrange’s equation and the corresponding modal parameters are extracted. Finally, multi-mode stability lobes are plotted by the different quadrature method and its accuracy is verified by experiments. The proposed method improves the computational efficiency to predict the time-varying characteristics of a thin-walled workpiece.

To provide guidance for the tool materials selection in the machining of high-strength steels, this article outlines the application of fuzzy comprehensive evaluation method for the cutting performance evaluation of cemented carbide tools, ceramic tools, and cermet tools. The results indicate that cermets with the best comprehensive cutting performance are chosen as the optimum tool materials for the machining of high-strength steels. Moreover, the severe adhesion wear characteristics of cemented carbide tools are detrimental to the surface quality of workpieces. The obvious crater wear and furrow-like scratches caused mainly by abrasive wear, as well as adhesive wear can shorten the life of ceramic tools. The sharp cutting edge and good wear resistance of cermet tools are not only beneficial to the machined surface quality of workpieces, but also prolong the tool life. The analysis of tool wear proves the reliability and accuracy of fuzzy comprehensive evaluation method.

The material removal rate and required workpiece surface quality of thin-walled structure milling are greatly limited due to its severe vibration, which is directly associated with the dynamic characteristics of the system. Therefore, the suppression of vibration is an unavoidable problem during milling. A novel partial surface damping method is proposed to modify the mode of the thin walled cantilever plate and to suppress vibration during milling. Based on classical plate theory, the design criterion is analyzed and configuration of the partial surface damper is introduced, in which viscoelastic plate and constraining plate are attached to the surface of the plate to increase the system’s natural frequency and loss factor. In order to obtain the energy expression of the cutting system, the Ritz method is used to describe the unknown displacements. Then, with Lagrange’s equation, the natural frequency and loss factor are calculated. In addition, the plate is divided into a finite number of square elements, and the regulation of treated position is studied based on theoretic and experimental analysis. The milling tests are conducted to verify its damping performance and the experimental results show that with treatment of partial surface damper, the deformation of the bare plate is reduced from 0.27 mm to 0.1 mm, while the vibration amplitude of the bare plate is reduced from 0.08 mm to 0.01 mm. The proposed research provides the instruction to design partial surface damper.

Background: Two kinds of regimens (2-1-1 and 1-1-1-1-1) can be selected after Zagreb regimen(2-1-1)of PVRV was officially approved in Beijing in January 2015. Up to now, the subjects for most studies about the comparison between Zagreb and Essen regimen are under 50 y old, rarely at and above. Aging of the immune system may result in decreasing efficacy of vaccination, especially for adults aged above 65–70 y. This study compared the safety and immunogenicity of the Zagreb and Essen regimen in Chinese adults aged 50 and above with the goal to provide a supplemental data for this age group. Methods: A total of 114 cases were divided into 2 groups randomly, received PVRV under the Zagreb and Essen regimens respectively. Serum samples were collected at D0, D7, D14, D42, D180 and D365 to determine the rabies serum neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT). Safety analyses were made by comparing the AEs in day-3, day-7, and day-(7 + 21) in Zagreb or day-(7 + 28) in Essen by gender and age cohorts. Results: 617 blood samples were obtained. Two groups showed similar immunogenicity, the neutralizing antibody titer of all subjects at D14 and D42 showed >0.5 IU/ml. Under the same regimen, Subjects ≥65 y had lower GMC than those who

Background Ischemic heart diseases are still a threat to human health. Human pluripotent stem cell-based transplantation exhibits great promise in cardiovascular disease therapy, including heart ischemia. The purpose of this study was to compare the efficacy of human embryonic stem cell-derived cardiomyocyte (ESC-CM) therapy in two heart ischemia models, namely, permanent ischemia (PI) and myocardial ischemia reperfusion (IR). Methods Human embryonic stem cell-derived cardiomyocytes were differentiated from engineered human embryonic stem cells (ESC-Rep) carrying green fluorescent protein (GFP), herpes simplex virus-1 thymidine kinase (HSVtk), and firefly luciferase (Fluc). Two different heart ischemia models were generated by the ligation of the left anterior descending artery (LAD), and ESC-Rep-derived cardiomyocytes (ESC-Rep-CMs) were transplanted into the mouse hearts. Cardiac function was analyzed to evaluate the outcomes of ESC-Rep-CM transplantation. Bioluminescence signal analysis was performed to assess the cell engraftment. Finally, the inflammation response was analyzed by real-time PCR and ELISA. Results Cardiac function was significantly improved in the PI group with ESC-Rep-CM injection compared to the PBS-injected control, as indicated by increased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS), as well as reduced fibrotic area. However, minimal improvement by ESC-Rep-CM injection was detected in the IR mouse model. We observed similar engraftment efficiency between PI and IR groups after ESC-Rep-CM injection. However, the restricted inflammation was observed after the injection of ESC-Rep-CMs in the PI group, but not in the IR group. Transplantation of ESC-Rep-CMs can partially preserve the heart function via regulating the inflammation response in the PI model, while little improvement of cardiac function in the IR model may be due to the less dynamic inflammation response by the mild heart damage. Conclusions Our findings identified the anti-inflammatory effect of ESC-CMs as a possible therapeutic mechanism to improve cardiac function in the ischemic heart. Electronic supplementary material The online version of this article (10.1186/s13287-019-1271-4) contains supplementary material, which is available to authorized users.

Background: In the large amount of hematuria patients, a considerable part of them originate in upper tract urinary carcinoma(UTUC). The most important in the evaluation of hematuria is to find accurate and economical method to discriminate between non-malignant and malignant causes. Liquid biopsy for urine samples can be helpful for UTUC diagnosis in patients with hematuria and rule out individuals with low-risk. Methods: In this study, we combined high-throughput sequencing of 17 genes and methylation analysis for ONECUT2 CpG sites as a liquid biopsy panel. We developed a prediction model which contained several significant features to evaluate the risk of UTUC in hematuria patients. Findings: 94 healthy, 70 UTUC- and 70 UTUC+ cases’ samples are qualified for this study, our liquid biopsy panel resulting in a sensitivity of 94% (66/70), and a specificity of 96% (158/164), the positive predication value of 92% and a negative predication value of 98% in this study. With age as additional factor, our model was able to stratify patients into a low or high-risk group with an accuracy score at 94%. Further validation in a large prospective cohort will answer whether this early screening tool can also be used in monitoring postoperative patients who need serials of follow-ups. Interpretation: Urine based liquid biopsy can assist evaluating upper tract urinary carcinoma risk of patients with hematuria and outperformed FISH for accurately ruling out patients who do not have UTUC. Funding Statement: In this research, no funding or other financial supports was received. Declaration of Interests: The authors declared that they have no conflicts of interest to this study. Ethics Approval Statement: Informed written consent was obtained from patients at PLA General Hospital and the study was approved by the Committees on Clinical Research Ethics of the Chinese PLA General Hospital.

Background: Upper tract urinary carcinoma (UTUC) includes renal pelvic cancer and ureteral cancer. For its diagnosis, ureteroscopy is the only method to obtain pathological result before surgery. However, there are also some problems with ureteroscopy. In addition to the trauma and infection risks, the possibility of exudation and adhesion of surrounding tissues after ureteroscopy is significantly increased, hypertension in the cavity may cause tumor spread, and the use of ureteroscopy and biopsy may cause recurrence of bladder tumors after surgery. These unfavorable factors make clinically urgent need for a sensitive and non-invasive method for the diagnosis of UTUC. Materials and Methods: In this study, 150 hematuria patients with upper tract urinary disease and 100 healthy people were enrolled. Among the patients, 75 were pathologically confirmed with upper tract urinary carcinoma while 75 with benign urinary diseases. A Genetron Urinary Assay was designed to maximize the number of unique driver gene variants of UTUC by a limited number of amplicons. Next-generation sequencing libraries were constructed using multiplex PCR methods. We also detected CpG-sites on ONECUT2 gene by performing bisulfite-specific real-time PCR for bisulfite converted DNA. Furthermore, we developed a prediction model based on several significant features to evaluate the risk of UTUC. Results: 234 samples were available for analysis. Our liquid biopsy assay demonstrated a sensitivity of 94%, a specificity of 96%, a positive predication value (PPV) of 92% and a negative predication value(NPV) of 98% in this study. By using a decision tree model, we found age, gene mutations of HRAS, TERT and TP53 and methylation of ONECUT2 did place at some key nodes to classify the risk of patients of UTUC, and age around 48.5, the frequencies of mutated genes above certain value and ΔCt value of ONECUT2 about 7.6 would be good cutoffs. This model was able to stratify patients into a low or high-risk group with an accuracy score at 94%. After further analysis, we found that ONECUT2 methylation and TP53 mutations were more common in high grade UTUC (p Conclusion: In this study, Genetron Urinary Assay has a good performance in the diagnostic of UTUC. Its high sensitivity, high specificity, and non-invasiveness make it a potential clinical alternative to ureteroscopy. Further validation in a large prospective cohort of wide population is necessary to prove the true clinical value of this newly developed method. Citation Format: Xin Ma, Yansheng Xu, Hongzhao Li, Xing Ai, Jiangping Gao, Yiming Liang, Qiaosong Zheng, Kaisheng Mao, Tonghui Ma, Xu Zhang. A urine-based liquid biopsy method for detection of upper tract urinary carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2293.

Background: Ureteral stenting is a technique-demanding procedure performed during robot-assisted laparoscopic ureteral reimplantation (RALUR). Many stenting techniques have been reported; however, none of them could be accepted as an ideal way. Objectives: The aim of the study was to report our initial results of a modified stenting technique for RALUR. Methods: Consecutive 4 patients undergoing RALUR were prospectively enrolled into our study. Our ureteral stenting technique included the following steps: catheterize a head-cut Foley catheter at the beginning of the operation, drag out the Foley catheter from the ureterovesical stoma after finishing posterior anatomosis, insert a guide wire through the catheter to the ureter lumen, and place the double-J (DJ) stent over the guide wire with a pusher. Results: All surgeries were successfully performed without severe complications. The mean stenting time was 1.6 min. No submucosa pseudocanal was found during stenting. DJ stent was removed 4 weeks after surgery. During the 3-month follow-up, it was observed that no vesicoureteral reflux or ureter stricture was found. Conclusions: Our ureteral stenting technique is an effective, simple, and safe procedure in RALUR, and could also be performed in laparoscopic ureteral reimplantation.

Rationale: Aging is one of the most significant risk factors for cardiovascular diseases, and the incidence of myocardial ischemia increases dramatically with age. Some studies have reported that cardiosphere-derived cells (CDCs) could benefit the injured heart. Nevertheless, the convincing evidence on CDC-induced improvement of aging heart is still limited. Objective: In this study, we tested whether the CDCs isolated from neonatal mice could benefit cardiac function in aging mice. Methods and Results: We evaluated cardiac function of PBS- (n=15) and CDC-injected (n=19) aging mice. Echocardiography indicated that left ventricular (LV) ejection fraction (57.46%±3.57% versus 57.86%±2.44%) and LV fraction shortening (30.67%±2.41% versus 30.51%±1.78%) showed similar values in PBS- and CDC-injected mice. The diastolic wall thickness of LV was significantly increased after CDC injection, resulting in reduced diastolic LV volume. The pulse-wave Doppler and tissue Doppler imaging indicated that aging mice receiving PBS or CDC injection presented similar values of the peak early transmitral flow velocity, the peak late transmitral flow velocity, the ratio of the peak early transmitral flow velocity to the peak late transmitral flow velocity, and the ratio of the peak early transmitral flow velocity to the peak early diastolic mitral annular velocity, respectively. Pressure-volume loop experiment indicated that the LV end-diastolic pressure-volume relationship and end-systolic pressure-volume relationship were comparable in both PBS- and CDC-injected mice. Postmortem analysis of aging mouse hearts showed similar fibrotic degree in the 2 groups. In addition, the aging markers showed comparable expression levels in both PBS- and CDC-injected mice. The systemic aging performance measures, including exercise capacity, hair regrowth capacity, and inflammation, showed no significant improvement in CDC-injected mice. Finally, the telomere length was comparable between PBS- and CDC-injected mice. Conclusions: Together, these results indicate that CDCs do not improve heart function and systemic performances in aging mice.

Background: Accurate assessing donor renal function is crucial to the success of living kidney transplants. We studied the roles of donor kidney glomerular filtration rate (GFR) and donor/recipient body surface area (BSA) ratio in kidney selection for living transplantation from family members. Methods: We included 204 recipients who were subjected to living kidney transplantation from family members in our hospital from February 2011 to February 2015 and followed up for over 2 years. Recipients were divided into six groups according to donor GFR and donor/recipient BSA ratio. The effects of donor GFR or donor/recipient BSA ratio on the recovery of renal graft functions were evaluated. Results: The post-operative serum creatinine (SCr) reduction rate, steady-state SCr level, and estimated GFR (eGFR) of the group with donor GFR ≥ 40 ml/min were slightly higher to those of the group with donor GFR 0.05). The renal function recovery of the group with donor/ recipient BSA ratio ≤ 0.8 was significantly lower than that of the group with donor/recipient BSA ratio ≥ 1.2 (p < 0.05). The post-operative SCr reduction rate, steady-state SCr level, and eGFR of the group with GFR < 40 ml/min and donor/recipient BSA ratio ≤ 0.8 were all significantly lower than those of the other five groups (P < 0.05). Such values of the two groups with donor/recipient BSA ratio >1.2 were significantly higher than those of the other four groups (p < 0.05). Conclusions: The selection of donor kidneys from relatives for living kidney transplantation should also consider donor/recipient BSA ratio in addition to donor GFR. (REV INVES CLIN. 2018;70:169-76)

Based on the concept of cleaner production, the feasibility of application of the flue gas in mine mouth power to fire prevention and extinguishing in goaf was numerically studied by taking the mechanized caving mining face 11-214 of Caocun coal mine as the example. The heterogeneity porosity and multi-component gas transport equations were introduced into the mathematical model. The calculated results showed that the area of “spontaneous combustion zone” turn small obviously in goaf and the maximum width of “spontaneous combustion zone” in goaf decreased from 78m to 9.5m after injecting the flue gas. At the same time, the sink terms of oxygen consumption was formed in the port of gas injection. The migration law of flue gas showed that the numerical calculation of goaf should select the different computation model based on the judgment basis of Reynolds number. Through the continuous monitoring of the migration of flue gas at different locations in goaf, the reasonable parameters of flue gas injection was obtained for high efficient fire prevention .

Considering the self-excited and forced vibrations in peripheral milling processes, a novel optimization method of cutting parameters is presented. The optimization method proposed, which is based on the vibration frequency analysis during milling processes, can achieve the most stable cutting process in relative stable region (or conditional stable region). First, relationships between vibration frequencies and phase angle of tooth of cutter in milling processes are investigated. Four kinds of spindle speeds associated with several bifurcations and vibrations are defined. Second, chatter-free regions are subdivided according to these spindle speeds. It is shown that in the so-called subregion C, cutting parameters can be simultaneously optimized for higher material removal rate (MRR) and higher surface accuracy. Third, optimal control theory is employed to determine the optimal cutting parameters, which can achieve the most stable cutting process in relative stable region. Optimizations of spindle speeds and depth of cut are conducted by using the stability charts and performance contours diagrams. The results show that the optimal cutting parameters can also be obtained in the so-called subregion C. Finally, the numerical results are verified and analyzed through milling experiments.

Aerodynamic noise spectrum of rotary face milling cutters consists of a broad range of high frequencies and discrete tones. This paper aims to develop a method to calculate the aerodynamic noise generation and propagation by rotary face milling cutters. The effects of milling cutter geometry on the generation of aerodynamic noise are analyzed. Based on the computational fluid dynamics (CFD) method, the Ffowcs Williams–Hawkings (FW–H) equation is used to predict the sound pressure level (SPL) of aerodynamic noise in face milling cutters. The accurate calculation of time-varying flow variables along with the rotation of cutter is very important for the prediction of aerodynamic noise. In this case, the Navier–Stokes (N–S) equation is employed to evaluate the pressure and velocity fields around the milling cutters, first in a steady mode with the Multiple Reference Frames (MRF) model, and then in an unsteady mode with sliding mesh technique (SMT) by introducing the steady flow variables as its initial fields. It is found that both the overall aerodynamic noise due to the entire cutter and the aerodynamic noise only due to the cutter gullet regions are significantly affected by the number of cutter teeth/gullet regions. Moreover, six representative milling cutters with different tooth numbers and geometries of gullet regions are chosen to study the effects of gullet configuration on aerodynamic noise generation, and the characteristics of noise spectra generated by the cutters are analyzed. The aerodynamic noise generated only by the cutter gullet regions is found to be strongly dependent on the gullet design-volume and shape. The results also reveal that the gullet design advantage of Cutter C in reducing noise generation among the eight-tooth designs, and the gullet design advantage of Cutter A in reducing noise generation among the five and seven-tooth designs in this investigation.

A generalized cutting mechanics model is proposed for milling processes with solid end mills and inserted cutters. The unified mathematical model is employed for the description of the solid milling flute and insert on a reference tool body. The friction and normal forces acting on the rake face are transformed into milling coordinates using a general transformation matrix by simply assigning operation specific parameters. The generalized model can be used to predict and optimize the machining operations including solid end mills and inserted cutters.

To determine the anatomic differences in patients of atresia by using high-resolution computed tomography (HRCT) and 3D volume rendered (VR) CT.High-resolution computed tomography (HRCT) was performed in 43 atresia patients including 34 unilateral atresia patients (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 9 bilateral atresia patients (6 males, 3 females, mean age 13.2 years, range 9-19 years). HRCT and 3D VR findings were compared with those in 43 normal ears of the unilateral atresia patients with normal PTA results (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 11 patients with sensorineural hearing loss but with no associated aplasia of the middle and inner ear (n=22, 7 males and 4 females, range 8-20.8 years, median age of 13.4 years) by using the independent one sample T test.On the HRCT images, the angle between the basic line and the tympanic segment of the facial nerve is more acute. And the area of the malleus-incus-joint or the malleus-incus-complex in the diseased ears is smaller than that in the control subjects (P0.05). The tympanic segment is shorter and the area of the tympanic cavity is smaller in the atresia group, while the diameter of the oval window is also smaller in atresia group than that in the control group (P0.05). The morphologic differences of the small ossicles and the entire length of the tympanic and mastoid segments can be depicted on a single 3D VR CT image.The facial nerve demonstrates abnormal lateral and anterior displacement in the CAA patients and the area of the Malleus-incus-joint and the tympanic cavity are significantly smaller, and the oval window is much narrower in the control group. HRCT and 3D VR CT provide valuable information about preoperative planning of patients with CAA. Measurements of all the angles and length serve as useful adjunct measurements in determining surgical candidacy.

The polyurethane rigid foam/expanded perlite thermal insulation composites (PPC) have been prepared by mixing the two-component polyurethane and expanded perlite. The effects of proportioning of constituents on the fireproofing performance of PPC were investigated according to maximum flame height using a small scale burner test. The results showed the expanded perlite has a great effect on the flame retardant properties of PPC.

The efficiency of the high-speed milling process is often limited by the occurrence of chatter. In order to predict the occurrence of chatter, accurate models are necessary. With the speed increasing, gyroscopic effect plays an important pole on the system behavior, including dynamic characteristic and rotating behavior. Considering the influence of gyroscopic effect on rotating behavior, an updated model for the milling process is presented which features as model of the equivalent profile of tool. In combination with this model, a nonlinear instantaneous cutting force model is proposed. The use of this updated equivalent profile of tool results in significant differences in the static uncut thickness compared to the traditional model.

The strong demand for increasing productivity and workpiece quality in milling process makes the machine-tool system operate close to the limit of its dynamic stability. Milling cutters with variable pitch angles can be very effective in improving stability against chatter for certain speed ranges, which will be predicted by the model presented here. The present paper deals with the design of structural geometry of variable pitch end mills in detail. Based on the analysis of tooth engagement factor, which is expressed and extended in the paper, an approach is proposed to design variable pitch end mill with high milling stability. The certain speed ranges with high milling stability are given.

Vibration frequencies during high-speed milling processes are investigated. Based on the resonant theory and three critical stats of phase position of successive two cutter teeth, six kinds of spindle speeds are shown, which divide the stable region in stability limit diagram into four parts. Furthermore, using optimal control theory, a novel stable region is proposed, which divides the region into three parts (unconditional stable, optimal stable, and conditional stable region).

This paper studies the application of CBR (case-based reasoning) in stone equipments variant design. As the actual design process and CBR process have collateral corresponding relation, CBR accords with the actual design process of deviser. The basic resolution model of variant design is established, and the instance of products variant design is presented. With the application of variant design principle, the design intensity will be lightened, and the design time will be shortened. Therefore the variant design accommodates the requirement of products diversification and client orientation.

The strong demand for increasing productivity and workpiece quality in milling process makes the machine–tool system operate close to the limit of its dynamic stability. Besides predicting accurately chatter stability, it is required that some optimizations should be conducted, e.g., cutter structure, for improving the dynamic stability limits. Milling cutters with variable pitch angles can be very effective in improving stability against chatter for certain speed ranges, which will be predicted by the model presented here. The present paper deals with the design of structural geometry of variable pitch end mills in detail. Based on the analysis of tooth engagement factor, which is expressed and extended in the paper, an approach is proposed to design variable pitch end mill with high milling stability. The certain speed ranges with high milling stability are given. An example of the design of variable pitch end mills is illustrated to demonstrate the validity of this method.

A method for predicting simultaneous dynamic stability limit of thin-walled workpiece high-speed milling process is described. The proposed approach takes into account the variations of dynamic characteristics of workpiece with the tool position. A dedicated thin-walled workpiece representative of a typical industrial application is designed and modeled by finite element method. The curvilinear equation of modal characteristics changing with tool position is regressed. A specific dynamic stability lobe diagram is then elaborated by scanning the dynamic properties of workpiece along the machined direction throughout the machining process. The results show that, during thin-walled workpiece milling process, material removing plays an important part on the change of dynamic characteristics of system, and the stability limit curves are dynamic curves with time–variable. In practical machining, some suggestion is interpreted in order to avoid the vibrations and increase the chatter free material removal rate and surface finish. Then investigations are compared and verified by high-speed milling experiments with thin-walled workpiece.

Powder metallurgy (PM) nickel-based superalloy is regarded as one of the most important aerospace industry materials. A series of turning tests in a wide range of speeds with different inserts were carried out to select the proper tool material. Then, the effect of cutting parameters on the cutting force, cutting temperature and tool wear was investigated for the selected insert. The effect of cutting parameters on the tool wear was examined through SEM and TEM micrographs. The experiential functions of tool life, cutting force and cutting temperature were developed. Finally, the cutting parameters in PM nickel-based superalloy dry turning were optimized based on tool life-efficiency contour analysis. The present approach and results will be helpful for understanding the machinability of PM nickel-based superalloy during dry turning for the manufacturing engineers.

In the present paper, a dynamic modeling approach is presented to determine the contact stiffness and structural damping between the spindle and the toolholder; and then, the spindle and the toolholder are coupled by some springs and dampers. Finally, the dynamic performances of the HSK-A63 spindle/toolholder interface are analyzed by means of finite element method (FEM). From the simulated results, it can be seen that the natural frequencies of the first two modes increase with the increase of the rotational speed, which make the HSK spindle/toolholder interface appear good dynamic performances and be suitable for high-speed machining.

During the high-speed milling operations of 7050-T7451 aluminum alloy using solid carbide end mills, helical angle, axial and radial depth-of-cut have significant effects on the milling uniformity. A surface roughness predictive model of work-piece was developed by using a full-factorial experimental design and multi-linear regression technology. Genetic algorithm was utilized to optimize the helical angle and cutting parameters by means of a series of operations of selection, crossover and mutation based on genetics. The result shows that it is possible to select optimum axial depth-of-cut, radial depth-of-cut and helical angle for obtaining minimum cutting force and reasonably good metal removal rate.

The granite cutting processing using diamond circular saw blades is the most extensive application processing methods. The cutting force is measured at different cutting depth ap, sawing feed rate vf and linear velocity v when the granite is cut by diamond circular saw blade by orthogonal experimental method. And the sawing force empirical formulas relative to these three variables are educed. We can obtain the experimental results as follows. The radial force Fn is greater than the tangent force Ft when ap is smaller than the circular saw blade diameter. The corresponding Fn and Ft are all smaller as the feed rate is greater at the same circular saw blade diameter. The cutting forces increase obviously as the cutting depth increases at the same circular saw blade diameter and feed rate.

The polyurethane rigid foam/expanded perlite thermal insulation composites (PPC) have been prepared by mixing the two-component polyurethane and expanded perlite. The effects of proportioning of constituents on the mechanical and thermal properties of PPC were investigated. The results showed the compressive strength of PPC was improved and good heat-insulating was achieved, which would promote the application of polyurethane rigid foam and expanded perlite in buildings.

To develop a new porcine model with horn of the uterus to mimic an enlarged ureter for training for laparoscopic ureteral reimplantation (LUR) and to evaluate its feasibility.Ten female pigs were used in the training. The pig was placed to a dorsal position after an anesthetic was administered. The horn of the uterus near the bladder was dissected, then spatulated and trimmed to replace the enlarged ureter. LUR was performed according to standard operation steps. Four trainees completed the LUR procedure based on a mentor-trainee model to guarantee the success of the procedure and the quality of the anastomoses. The learning curve of operative time was analyzed. The anastomotic stoma was cut off postoperatively and checked extracorporeally. After the course, questionnaire surveys were sent to the trainees to investigate satisfaction of the training and assess the impact of the training on their learning of "real" LUR in future practice.This model reproduced the key technique steps of LUR. Four LUR procedures were performed on each pig. The operative time declined from 170.0 +/- 10.3 minutes to 90.3 +/- 3.7 minutes (P0.01) after the trainees had performed 10 LURs. There was proper stitching in each "ureterovesical" anastomosis. At the end of training, all trainees could accomplish a LUR procedure skillfully on the model; they were satisfied after the course and thought the training was helpful to future practice of LUR.The new model was feasible and cost-effective for training in the basic skills of laparoscopic ureteral reconstruction procedures.

A method for predicting the stability of thin-walled workpiece milling process is described. The proposed approach takes into account the dynamic characteristics of workpiece changing with tool positions. A dedicated thin-walled workpiece representative of a typical industrial application is designed and modeled by finite element method (FEM). The workpiece frequency response function (FRF) depending on tool positions is obtained. A specific 3D stability chart (SC) for different spindle speeds and different tool positions is then elaborated by scanning the dynamic properties of workpiece along the machined direction throughout the machining process. The dynamic optimization of cutting parameters for increasing the chatter free material removal rate and surface finish is presented through considering the chatter vibration and forced vibration. The investigations are compared and verified by high speed milling experiments with flexible workpiece.

The strong demand for increasing productivity and workpiece quality in high-speed milling make the machine-tool system has to operate close to the limit of its dynamic stability. This requires that the chatter stability is predicted accurately to determine the optimal milling parameters. An analytical stability prediction method was proposed with multi-degree-of-freedom (MDOF) system modal analysis. This paper describes the development of this new method which allows considering the effects of multi-mode dynamics of system, higher excited frequency (i.e. tooth passing frequency) and wider spindle speed range on stability limits in high-speed milling, and these to help in selection of milling parameters for a maximum material removal rates (MRR) in real operations without chatter. Some tests were carried out to demonstrate the quality of this method used in real machining. Final, the main influencing factors of stability limits in high-speed milling were analyzed.

By analyzing the reasoning of a high-speed cutting database system, a case modifying method is put forward. According to the variables’ difference of the solution part in a case, a constraint satisfaction problem (CSP) and similarity calculation are used to modify a case. The constraint relationship of discrete variables is described by establishing a rule knowledge base. The algorithm of CSP is used to solve the discrete variable constraint problem. On the basis of the high-speed cutting theory, a similarity calculation formula is deduced to calculate the consecutive variables. The CSP and similarity calculation are applied to case modifying, which is possible to automatically modify cases in the high-speed cutting database system.

In this paper, the components of a high-speed cutting system are analyzed firstly. The component variables of the high-speed cutting system are classified into four types: uncontrolled variables, process variables, control variables, and output variables. The relationships and interactions of these variables are discussed. Then, by analyzing and comparing intelligent reasoning methods frequently used, the hybrid reasoning is employed to build the high-speed cutting database system. Then, the data structures of high-speed cutting case base and databases are determined. Finally, the component parts and working process of the high-speed cutting database system on the basis of hybrid reasoning are presented.

The present work puts forward a generalized simulation model to evaluate the topography of ball-end milled surfaces by considering both the tool deflection and the tool runout. Firstly, a solid ball-end mill with S-shaped cutting edges is modeled as the basis. Then the tool tip trajectory is derived from the tool runout as well as the cutting forces induced tool deflection. And consequently the topography and scallop height of the machined surface are estimated by the numerical calculations of the matrix equations. With good expandibility, the proposed model can incorporate more machining information such as the movements of rotatory axes and tool wear, and hence, can be used to optimize the cutting conditions and parameters in 5-axis ball-end milling process.

A new dynamics model for multi-degree of freedom high-speed milling system is proposed, which takes account of regenerative effects and the effects of the relative vibration of spindle axis in milling process. Based on the mode synthesis theory and the zeroth-order approximation of the Fourier series, an integrated stability analytical method for multiple frequencies is presented, which involves multiple orders modal characteristics and higher order excitations in high-speed milling process. The chatter stability lobes are predicted in the frequency domain using the proposed stability analytical method, and verified by milling experiments. It is shown that stability regions involving multiple natural modes are reduced contrary to the case of single natural mode.

To report our experience with the treatment of pelvi-ureteric junction obstruction (PUJO) using the retroperitoneal laparoscopic Hellstrom (RLH) technique to relocate the crossing vessel. We used the RLH technique selectively in eight patients with PUJO from an aberrant crossing vessel, according to observations during surgery. The crossing vessel was mobilized and embedded in the generous pelvic wall with 4-0 polyglactin sutures to relieve the PUJO. Follow-up studies included intravenous urography, ultrasonography and renal functional scintigraphy at 1 month after surgery and every 3 months thereafter. The mean (range) operative duration was 45 (40-60) min; the blood loss was negligible. Crossing vessels were identified to be anterior to the renal pelvis in two patients and posterior in six. The hospital stay after surgery was 5 (4-7) days. No paregoric was required after surgery. The collecting systems were intact and no JJ stent was required in any patient. The mean (range) follow-up was 13.6 (12-15) months. In all patients the obstruction was resolved or significantly improved, and there were no complications, e.g. urine leakage and infection.Along-term follow-up is mandatory. The RLH technique is a minimally invasive alternative for patients with PUJO caused by a crossing vessel. Embedding the crossing vessels in the pelvic wall is feasible and safe for such patients; empirical judgement during surgery is prudent for success. laparoscopic, pelvic-ureteric junction obstruction, retroperitoneal space.