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With the development of economy and the progress of medical science and technology, artificial prosthesis replacement has become an important means to improve the dysfunction caused by human bone diseases. However, there are still some loose phenomena caused by stress shielding. To solve the complications of aseptic loosening after calcaneal prosthesis replacement, an optimal design method for the prosthesis was proposed. The prosthesis was designed and optimized according to the real bone shape and the replacement requirements by the combination of computed tomography (CT) technology, computer-aided design, finite element analysis, and power flow theory. CT data were imported into MIMICS and Geomagic Studios. UG was used to obtain the geometric model of the human skeleton. Then, the 3D finite element model of the prosthesis was established by combining the finite element software Abaqus, and a series of finite element analysis was carried out. The prosthesis was topologically optimized and filled with a porous structure. The prosthesis was implanted by computer simulation. Finally, the power flow method was used to compare the dynamic performance and energy transfer before and after the prosthesis replacement to verify the rationality of the prosthesis design. In this paper, this method was used to optimize the design of the calcaneal prosthesis, and the research shows that this method can reduce the stress shielding effect of the calcaneal prosthesis. From the case of calcaneal prosthesis optimization, this method is not only a supplement to the contemporary biomechanical theory but also can guide the design of bone prosthesis in bone prosthesis replacement surgery.

To investigate the action mechanisms of electroacupuncture (EA) on postoperative immunosuppression. Male C57BL/6 mice (5`-7 weeks old) were randomly divided into: the sham injury group, the surgical trauma stressed group, the EA group [surgery + 2/100 Hz EA at Neiguan (PC 6)], and the EA+ Nal (surgery + EA + intraperitoneal injection of naloxone). Abdominal surgical trauma stress mice model was established. EA was performed on bilateral PC 6 acupoints by an EA apparatus (2/100 Hz) for 20 min once a day for 3 days. The mRNA expressions of MOR, DOR, and KOR in thymus and L3`-L5 dorsal root ganglions (DRG) were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and the protein expressions of MOR, DOR, and KOR in thymus were measured by Western blot. Flow cytometry assay was used to detect the levels of T lymphocyte subtypes in the peripheral blood. Surgical trauma induced decreased the mRNA expression level of MOR in both thymus (P 0.05). Furthermore, T lymphocyte population of CD3+ and CD4+ was decreased in the peripheral blood after surgical trauma (both P

Background:. High-frequency irreversible electroporation (H-FIRE) is a novel, next-generation nanoknife technology with the advantage of relieving irreversible electroporation (IRE)-induced muscle contractions. However, the difference between IRE and H-FIRE with distinct ablation parameters was not clearly defined. This study aimed to compare the efficacy of the two treatments in vivo. Methods:. Ten Bama miniature swine were divided into two group: five in the 1-day group and five in the 7-day group. The efficacy of IRE and H-FIRE ablation was compared by volume transfer constant (Krans), rate constant (Kep) and extravascular extracellular volume fraction (Ve) value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), size of the ablation zone, and histologic analysis. Each animal underwent the IRE and H-FIRE. Temperatures of the electrodes were measured during ablation. DCE-MRI images were obtained 1, 4, and 7 days after ablation in the 7-day group. All animals in the two groups were euthanized 1 day or 7 days after ablation, and subsequently, IRE and H-FIRE treated liver tissues were collected for histological examination. Student's t test or Mann-Whitney U test was applied for comparing any two groups. One-way analysis of variance (ANOVA) test and Welch's ANOVA test followed by Holm-Sidak's multiple comparisons test, one-way ANOVA with repeated measures followed by Bonferroni test, or Kruskal-Wallis H test followed by Dunn's multiple comparison test was used for multiple group comparisons and post hoc analyses. Pearson correlation coefficient test was conducted to analyze the relationship between two variables. Results:. Higher Ve was seen in IRE zone than in H-FIRE zone (0.14 ± 0.02 vs. 0.08 ± 0.05, t = 2.408, P = 0.043) on day 4, but no significant difference was seen in Ktrans or Kep between IRE and H-FIRE zones at all time points (all P > 0.05). For IRE zone, the greatest Ktrans was seen on day 7, which was significantly higher than that on day 1 (P = 0.033). The ablation zone size of H-FIRE was significantly larger than IRE 1 day (4.74 ± 0.88 cm2vs. 3.20 ± 0.77 cm2, t = 3.241, P = 0.009) and 4 days (2.22 ± 0.83 cm2vs. 1.30 ± 0.50 cm2, t = 2.343, P = 0.041) after treatment. Apoptotic index (0.05 ± 0.02 vs. 0.73 ± 0.06 vs. 0.68 ± 0.07, F = 241.300, P 0.05). Electrode temperature variations were not significantly different between the two zones (18.00 ± 3.77°C vs. 16.20 ± 7.45°C, t = 0.682, P = 0.504). The Ktrans value (r = 0.940, P = 0.017) and the Kep value (r = 0.895, P = 0.040) of the H-FIRE zone were positively correlated with the number of hepatocytes in the ablation zone. Conclusions:. H-FIRE showed a comparable ablation effect to IRE. DCE-MRI has the potential to monitor the changes of H-FIRE ablation zone.

Objective Sepsis is a major challenge in intensive care unit (ICU) worldwide and the septic survivors are left with long-term cognitive deficits. This work aims to explore the effects of electroacupuncture (EA) on long-term cognitive function and its underlying mechanism in sepsis-survivor mice. Methods Sepsis was induced by cecal ligation and puncture in C57BL/6 male mice. Seven days post-surgery, sepsis-survivor mice were treated with EA or nonacupoint EA for 17 days twice daily. Then, cognitive function was evaluated by Morris water maze task. The hippocampus tissue were collected from the mice at 30 days post-surgery. The level of nitric oxide and the expression of endothelial nitric oxide (eNOS), phospho-eNOS (p-eNOS), and amyloid β–peptide (Aβ) were measured. Results Compared with the sham-operated control, sepsis-survivors had significant cognitive deficits evidenced by the increased time of escape latency and reduced crossing number in Morris water maze task, as well as lower NO and p-eNOS level and higher Aβ level. EA treatment at GV20 and ST36 acupoints but not at a nonacupoint improved the cognitive function, increased the NO and p-eNOS level, and decreased Aβ generation; while eNOS inhibitor (L-NAME) undermined the efficacy of EA treatment. Conclusion In conclusion, repeated EA treatment could ameliorate the long-term cognitive impairment via manipulating the expression of p-eNOS and related Aβ in sepsis-survivor mice.

Neuropathic pain (NeuP) is an important clinical problem accompanying negative mood symptoms. Neuroinflammation in the amygdala is critically involved in NeuP, and the dopamine (DA) system acts as an important endogenous anti-inflammatory pathway. Electroacupuncture (EA) can improve the clinical outcomes in NeuP, but the underlying mechanisms have not been fully elucidated. This study was designed to assess the effectiveness of EA on pain and pain-related depressive-like and anxiety-like behaviors and explore the role of the DA system in the effects of EA. Male Sprague-Dawley rats were subjected to the chronic constrictive injury (CCI) model to induce NeuP. EA treatment was carried out for 30 min once every other day for 3 weeks. The results showed that CCI caused mechanical hyperalgesia and depressive and anxiety-like behaviors in rats and neuroinflammation in the amygdala, such as an increased protein level of TNFα and IL-1β and activation of astrocytes. EA treatment significantly improved mechanical allodynia and the emotional dysfunction induced by CCI. The effects of EA were accompanied by markedly decreased expression of TNFα, IL-1β, and glial fibrillary acid protein (GFAP) in the amygdala. Moreover, EA treatment reversed CCI-induced down-regulation of DA concentration, tyrosine hydroxylase (TH) expression, and DRD1 and DRD2 receptors. These results suggest that EA-ameliorated NeuP may possibly be associated with the DA system to inhibit the neuroinflammation in the amygdala.

BACKGROUND: The foot is an important part of the human body. Its functions are mainly walking and load-bearing. It also keeps the human body stable and absorbs ground vibrations to protect important human organs. OBJECTIVE: Many researchers use finite element methods to study the biomechanics of the foot. However, current studies on the finite element of the foot are based on the stress and displacement response analysis of the foot under static or quasi-static conditions, ignoring the movement process of the foot and the impact of vibration. Moreover, the joint application of energy method and finite element analysis in foot biomechanics is rarely reported. METHODS: In this paper, to obtain the foot energy transfer process, the transient response of the foot under neutral position is analyzed based on the energy method. RESULTS: The results show that: (1) In this model, the energy analysis follows the conservation of energy, which indicates that the transient response analysis has obtained a reasonable response. (2) When the foot touches the ground, the strain energy of the calcaneus, second metatarsal and third metatarsal is relatively large, which is consistent with the main stress concentration area of the plantar. (3) The gravity of the human body is mainly transmitted through the talus to the calcaneus, while the effect of transmittal through the scaphoid to the cuneiform bone and metatarsal is weak. CONCLUSION: This study can not only more clearly and intuitively reflect the energy transfer and source of various skeletal foreheads in the foot, but also provide a new research idea for the study of foot biomechanics.

As one of the media of the ground and feet, the design of footwear products has lately received great attention, and the cushioning performance of the sole has become a key factor for the comfort and sportiness of the foot. In this paper, a new type of middle sole sports shoes with an alternating gradient lattice structure was proposed. The dynamic response of the structure was analyzed by ABAQUS software, and the model was validated by modal analysis. The effects of different kinds of alternating lattice and uniform lattice sole models on vibration isolation were analyzed by using the vibration level difference as the evaluation index of vibration characteristics. The analysis results are as follows: (a) We found that the mean of the vibration level difference of the alternating gradient structure is higher than that of the uniform lattice structure, which confirms the feasibility of the alternating gradient arrangement and its excellent buffering performance. (b) Two kinds of vibration stage drop values of the 24-series alternating lattice structure model are analyzed, and “C-G-X″ structure has the highest vibration stage drop value. In addition, the comprehensive analysis of the alternating gradient lattice structure of the soles shows that the four types of structures have good cushioning performance, and the C-series structure in the frequency range of 0–140 Hz vibration level difference value is higher than other series. The results show that the evaluation index of vibration level difference based on mechanical vibration characteristics can accurately analyze the response of different structure soles to vibration, which also provides a method for the future design of vibration reduction and exploration of the biomechanics of footwear.

Vibration is a common phenomenon in people’s daily life. As the main bearing part of the human body, the foot can cushion the impact and shock of external force, and alleviate the influence of external vibration on the human body. Footwear with different structures and materials could cause kinematic, kinetic and biomechanical changes in the foot and leg. It is necessary to evaluate the effects of various footwear on the foot. In this paper, a method based on the vibration cushion characteristics of shoes is proposed to discuss the effect of shoes on feet. First of all, the modal test of the common sole was carried out in this paper, and the acceleration vibration level difference of the sole was obtained. Then, based on the finite element method, the power flow method was used to analyze the soles under different gait patterns. Finally, the vibration analysis of the soles filled with different porous structures was carried out by power flow method. The results show that the vibration level difference and power flow method can be used to study the vibration behavior of vibrating body from the aspects of structure and energy accurately and effectively, and the soles filled with triangular and quadrilateral porous structure have better damping performance. This method can be used to further study the biomechanical effect of the sole on foot and as a reference for shoe design.

IntroductionPostoperative ileus (POI), a common complication after surgery, severely affects postoperative recovery. It is unclear whether pretreatment with transcutaneous electrical acupoint stimulation (TEAS) can improve recovery from POI. This trial will evaluate the effects of pretreatment with TEAS on POI.Methods and analysisThis will be a prospective, randomised controlled trial. American Society of Anesthesiologists (ASA) physical status classification I–III level patients, aged 18–75 years and scheduled for laparoscopic colon surgery, will be included in the study. It is planned that 146 subjects will be randomised to the TEAS and sham TEAS (STEAS) groups. The groups will undergo two sessions of TEAS/STEAS daily for 3 days before surgery, with a final TEAS/STEAS treatment 30 min before anaesthesia. The primary endpoint of the study will be time to first defaecation. Secondary endpoints will include time to first flatus, time to tolerance of oral diet, GI-2 (composite outcome of time to first defaecation and time to tolerance of oral diet), time to independent walking, length of hospital stay, postoperative pain Visual Analogue Scale score on the first 3 days after surgery, analgesic requirements, complications and plasma concentrations of interferon-β (IFN-β), IFN-γ, interleukin-6 (IL-6) and IL-1β. Multiple linear regression will be used to identify independent predictors of outcome measures.Ethics and disseminationThis study has been approved by the Chinese Registered Clinical Trial Ethics Review Committee (No. ChiECRCT-20170084). The results of the trial will be published in an international peer-reviewed journal.Trial registration numberThis study has been registered with the Chinese Clinical Trial Registry (No. ChiCTR-INR-17013184).Trial statusThe study was in the recruitment phase at the time of manuscript submission.

Background: Though Cardiac surgery under cardiopulmonary bypass (CPB) under epidural anesthesia in conscious patients is associated with increased risk of epidural hematoma. We developed a monitored anesthesia care (MAC) platform for cardiac surgery under CPB. In the current prospective study, we investigated the safety and effectiveness of the MAC platform versus intubated general anesthesia (IGA) in patients receiving elective open-heart surgery. Methods: The study included adult patients who were scheduled to undergo open-heart surgery under CPB at our hospital between April 2012 and February 2017. MAC consisted of local anesthesia at the site of sternotomy, sedation with dexmedetomidine, analgesia with remifentanil/sufentanil, and electroacupuncture. MAC versus IGA was chosen by the patients. Findings: Eleven patients received MAC and 13 patients received IGA. The two groups were comparable in the demographic, baseline and operative variables. No conversion occurred from MAC to IGA. No major complications occurred during the surgery in both groups. No confirmed awareness events after surgery were reported in both groups. There was no statistical difference in the incidence of postoperative complications between the two groups (P >0.05). The intraoperative consumption of sufentanil and remifentanil was significantly lower in the MAC group than the IGA group (P < 0.001). The time to drinking was significantly shorter in the MAC group (2.14±0.90 h) than the IGA group (22.31±3.33 h) (P

Background Cardiac surgery involving cardiopulmonary bypass (CPB) is known to be associated with a transient postoperative immunosuppression. When severe and persistent, this immune dysfunction predisposes patients to infectious complications, which contributes to a prolonged stay in the intensive care unit (ICU), and even mortality. Effective prevention and treatment methods are still lacking. Recent studies revealed that acupuncture-related techniques, such as electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS), are able to produce effective cardioprotection and immunomodulation in adult and pediatric patients undergoing cardiac surgery with CPB, which leads to enhanced recovery. However, whether perioperative application of TEAS, a non-invasive technique, is able to improve immunosuppression of the patients with post-cardiosurgical conditions is unknown. Thus, as a preliminary study, the main objective is to evaluate the effects of TEAS on the postoperative expression of monocytic human leukocyte antigen (-D related) (mHLA-DR), a standardized “global” biomarker of injury or sepsis-associated immunosuppression, in patients receiving on-pump coronary artery bypass grafting (CABG). Methods This study is a single-center clinical trial. The 88 patients scheduled to receive CABG under CPB will be randomized into two groups: the group receiving TEAS, and the group receiving transcutaneous acupoint pseudo-electric stimulation (Sham TEAS). Expression of mHLA-DR serves as a primary endpoint, and other laboratory parameters (e.g., interleukin [IL]-6, IL-10) and clinical outcomes (e.g., postoperative infectious complications, ICU stay time, and mortality) as the secondary endpoints. In addition, immune indicators, such as high mobility group box 1 protein and regulatory T cells will also be measured. Discussion The current study is a preliminary monocentric clinical trial with a non-clinical primary endpoint, expression of mHLA-DR, aiming at determining whether perioperative application of TEAS has a potential to reverse CABG-associated immunosuppression. Although the immediate clinical impact of this study is limited, its results would inform further large-sample clinical trials using relevant patient-centered clinical outcomes as primary endpoints. Trial registration ClinicalTrials.gov, NCT02933996. Registered on 13 October 2016.

Background Electroacupuncture (EA) is widely applied for pain management, but the analgesic effects of EA have not been fully elucidated. In this study, we investigated the effect of EA on inflammatory pain caused by intraplantar injection of complete Freund's adjuvant (CFA) and apelin/APJ expression in the spinal cord of rats. Methods The study was conducted in 3 parts. In part 1, Sprague-Dawley rats were divided into 4 groups (n = 10): sham, CFA, EA (CFA + 2 Hz EA at acupoints), and NA-EA (CFA + acupuncture without electrical stimulation). The time courses of mechanical and thermal sensitivity were determined. The protein and messenger RNA (mRNA) levels of apelin and APJ in the spinal cord were assayed by Western blotting and real-time polymerase chain reaction, respectively. In part 2, the rats were divided into 5 groups (n = 7-8): sham, CFA, EA, F13A (CFA + intrathecal injection of F13A), and EA-F13A (CFA + EA + intrathecal injection of F13A). In part 3, the rats were divided into 5 groups (n = 8): sham, CFA, EA, apelin-13 (CFA + intrathecal injection of apelin-13), and EA + apelin-13 (CFA + EA + intrathecal injection of apelin-13). Results EA treatment exhibited significant antinociceptive effects (mechanical sensitivity: mean difference [99% confidence interval {CI}]: 5.86 [4.96-6.77]; thermal sensitivity: mean difference [99% CI]: 2.45 [0.91-4.00]; EA versus CFA) and mitigated the CFA-induced reduction of apelin and APJ protein and mRNA expression in the spinal cord. Furthermore, intrathecal injection of the apelin/APJ system antagonist F13A blocked the analgesic effect of EA (mechanical sensitivity: mean difference [99% CI]: 8.99 [5.81-12.17]; thermal sensitivity: mean difference [99% CI]: 4.22 [1.33-7.12]; EA versus EA-F13A). When EA was combined with apelin-13 through intrathecal administration, it was more potent in reducing mechanical allodynia (mean difference [99% CI]: 5.98 [2.38-9.57], EA + apelin-13 versus apelin-13; mean difference [99% CI]: 4.29 [0.72-7.87], EA + apelin-13 versus EA) and thermal hyperalgesia (mean difference [99% CI]: 5.23 [2.19-8.28], EA + apelin-13 versus apelin-13; mean difference [99% CI]: 6.43 [3.38-9.48], EA + apelin-13 versus EA). Conclusions EA stimulation could alleviate inflammatory pain, at least in part, by restoring apelin and APJ mRNA and protein expression levels, which are downregulated in the CFA pain model.

Aims This study aims to examine the effects of electroacupuncture (EA) pretreatment on brain injury after cardiac arrest and cardiopulmonary resuscitation (CA/CPR) and its underlying mechanisms. Materials and methods Adult male C57BL/6 mice were subjected to 6 min of cardiac arrest induced with a potassium chloride infusion and resuscitated by chest compressions and an epinephrine infusion. During the 3 days prior to CA/CRP, mice received EA pretreatment (1 mA, 2 Hz; daily session of 30 min) at the Baihui acupoint (GV20) once daily. Stimulation at a nonacupoint served as a control. In mechanistic studies, mice received the AKT inhibitor LY294002 or endothelial nitric oxide synthase (eNOS) inhibitor L-NIO 30 min before EA pretreatment. A neurological assessment was conducted 24 h after CA/CRP, followed by animal sacrifice and evaluation of physiological brain damage. Key findings CA/CPR resulted in severe brain injury as evidenced by neurological deficits and increased neuronal apoptosis, oxidative stress and the proinflammatory cytokines TNF-α and IL-6. EA pretreatment at the GV20 acupoint but not at a nonacupoint attenuated the neurological deficits and the pathological changes induced by CA/CPR. LY294002 or L-NIO eliminated the neuroprotective effects of the EA pretreatment. Significance This study showed that EA pretreatment at the GV20 acupoint can protect the brain from damage associated with globalized ischemia followed by reperfusion and that these protective effects occur via the AKT/eNOS signaling pathway.

Splenic artery aneurysm, without obvious symptoms, is a direct threat to the patient's life, once it ruptures as hemorrhagic shock. Imaging examinations have been the main diagnostic methods of splenic artery aneurysm, including ultrasound, computed tomography (CT), magnetic resonance imaging, and digital subtraction angiography (DSA). Although various inspective methods have their own advantages and disadvantages, abdominal CT examination is the most comprehensively applied method in clinical settings. The representative images of splenic artery aneurysm from a relatively large number of patients examined by CT are presented in this study. A total of 327 cases with splenic artery aneurysm were enrolled from 1998 to 2014, including 142 males and 185 females, with the age ranging from 37 to 78 years and an average age of 51.8 years old. The diagnosis of splenic artery aneurysm was confirmed by ultrasonography and CT examination. There were 20 cases accompanied with cirrhosis, 13 with hypertension, 12 with systemic multiple sclerosis, 10 with diabetes, 6 with gastrointestinal tumor, and 10 with cerebral infarction. Diagnostic criteria of CT imaging were as follows.[1] The diagnostic criteria for true aneurysm were limited expansion of splenic artery with intact wall and clear boundaries from the normal splenic artery, with the maximum width of the neck more than 1.5 times greater than that of the normal vascular. The diagnostic criteria for pseudoaneurysm were one discontinuous side of damaged splenic arterial wall and aneurysm body being on one side of the artery with a high density of contrast agent in angiography at the center, but no imaging in the aneurysm wall. The diagnostic criteria of dissecting aneurysm were eccentric expanded blood vessels with a double vascular wall of different density at cross-section in vascular reconstruction. All of the 327 cases were diagnosed with splenic artery aneurysm, including 306 cases with single tumor and 21 with multiple 2–5 tumors. The aneurysm diameter ranged from 2 to 15 cm with an average of 4.97 ± 2.28 cm. The shuttle aneurysms were found in 196 cases, approximately round in 56 cases, oval in 19 cases, hemisphere in 13 cases, and irregular in 22 cases. Aneurysm wall calcification was found in 249 cases. True aneurysms were confirmed in 288 cases, including multiple aneurysms in 21 cases, pseudoaneurysm in 31 cases, and dissecting aneurysm in 8 cases. There were 276 aneurysms in the middle and distal segment of the splenic artery, 40 adjacent to the splenic porta, and 11 adjacent to the splenic artery origin. A total of 314 aneurysms arose from the initial segment of splenic artery and in normal celiac trunk, 4 from abdominal aorta, 3 from the superior mesenteric artery, and 6 with abnormal combination of hepatic artery, splenic artery, and mesenteric artery. The representative images of splenic artery aneurysm are shown in Figure 1. Figure 1 Representative computed tomography images of splenic artery aneurysm. (a) Splenic artery aneurysm with calcified wall and mural thrombus located in the rear of the pancreas. (b) Branching artery aneurysm of the splenic artery. (c) Aneurysm at the initial ... A total of 285 cases underwent endovascular intervention treatment, 21 cases were pseudoaneurysms, and 264 were true aneurysms located in the middle and distal segment of the splenic artery. Moreover, 41 cases underwent traditional surgery, 11 cases were at the initial segment of the splenic artery, 6 were giant aneurysms, 5 were aneurysms adjacent to splenic portal, 5 were combined with wide and irregular aneurysm neck, 5 were abnormally combined with celiac trunk and superior mesenteric artery, 4 were multiple aneurysms, and 5 were general aneurysms in the middle and distal segment of splenic porta. There was 1 case of true aneurysm in the middle segment of the splenic artery underwent laparoscopic splenic artery aneurysm resection. No life-threatening complications were observed. There were 11 of 285 cases treated with intervention, which showed mild to moderate partial splenic infarction with abdominal pain and low fever and improved after conservative treatment. Moreover, 2 of 41 cases treated with traditional operations showed mild stenosis of anastomosis. All cases satisfied the clinical cure standard and without perioperative death when they were discharged without recurrence in the 6 months to 12 years’ follow-up using the CT angiography examination. Abdominal ultrasound is widely used in clinical settings due to economical, convenient, and noninvasive character; however, obesity, gastrointestinal gas, and serious arteriosclerosis impaired its positive rate and accurate rate. Enhanced magnetic resonance angiography is often used for the diagnosis of aneurysm, but often accompanied with certain restrictions due to in vivo metal implants such as pacemaker or aneurysm clip and claustrophobic fear of long time examination. DSA has been considered the “gold standard” for the diagnosis of vascular diseases. However, its gold standard status was challenged by the development of noninvasive imaging technologies, especially the development of multi slice CT angiography imaging technology. The data of abdominal CT examination in arterial phase were directly used for vascular reconstruction in the background through various reconstruction techniques to obtain aneurysm information from different angles, especially the structural characteristics of giant complex aneurysm and combined malformation of visceral artery.[2,3] From this study, CT angiography helped to determine the size, number, shape, location, and internal structure of splenic artery aneurysm, display the anatomic relationship between aneurysm and its surrounding organs, and clarify the relationship between the origin of the aneurysm and visceral artery. In recent years, vast majority of splenic aneurysm have received therapy through the vascular intervention.[4] Meanwhile, traditional surgical operation is still a reliable method for patients with complex splenic artery aneurysm who are unable to choose interventional therapy, such as splenic artery aneurysm adjacent to splenic artery or celiac artery, with proximal broad aneurysm distorted neck, with complicated arteriovenous fistula, with huge aneurysm body, and have close relationship with spleen and pancreas.[5] Therefore, multi-slice spiral CT angiography is a relatively accurate and efficient inspective method to clearly show the structural features of splenic artery aneurysm and provide anatomical and pathological information for the clinicians, and it may be helpful in making different treatment regimens according to the clinical characteristics of the aneurysm. Financial support and sponsorship This study was supported by a grant from the Hainan Provincial Research Program (No. YJJC20130009). Conflicts of interest There are no conflicts of interest.

Celestial navigation is an important type of autonomous navigation technology which could be used as an alternative to Global Navigation Satellite Systems (GNSS) when a vessel is at sea. After several centuries of development, a variety of astronomical vessel position (AVP) determination methods have been invented, but the basic concepts of these methods are all based on angular observations with a device such as a sextant, which has disadvantages including low accuracy, manual operation, and a limited period of observation. This paper proposes a new method that utilises a fisheye camera to image the celestial bodies and horizon simultaneously. Then, we calculate the obliquity of the fisheye camera's principal optical axis according to the image coordinates of the horizon. Next, we calculate the altitude of the celestial bodies according to the image coordinates of the celestial bodies and the obliquity. Finally, the AVP is determined by the altitudes according to the robust estimation method. Experimental results indicate that this method not only could realize automation and miniaturization of the AVP determination system, but could also greatly improve the efficiency of celestial navigation.

Objective Multiple biliary hamartomas (MBHs) are rare benign malformations of the intrahepatic bile ducts. There are only a handful of clinical studies based on large populations on the incidence of MBHs. Materials and methods A series of 1697 consecutive liver needle biopsies was examined for the occurrence of MBHs. Results A total of six patients (0.35%, four men and two women, a 2 : 1 ratio) were confirmed by histology to have MBHs. Of the total of 1697 patients, 59 (3.5%) patients were younger than 18 years of age, 828 patients (48.8%) were between 18 and 38 years of age, and 810 patients (47.7%) were older than 38 years of age. Of the six MBHs patients, one was 17 years of age and the other five patients were older than 39 years of age. The median (range) age of the patients was 42 (17-63) years. Although nearly half (48.8%) of the biopsied patients were between 18 and 38 years of age, no MBH was found in this group. All MBHs patients were diagnosed with fibrosis/cirrhosis by initial ultrasound scanning; however, only two patients were confirmed to have cirrhosis by histological examination. Of those two patients with cirrhosis, one had concomitant congenital hepatic fibrosis and the other had concomitant cirrhotic hepatitis B. The latter patient developed hepatocellular carcinoma 1 year after biopsy. No kidney cysts were found in any of the six MBHs patients. MRI scanning was performed in four patients and the results were consistent with the histological diagnosis. Conclusion MBHs are not common in patients who undergo liver biopsy and, in this study, the occurrence was higher in the older age group.

A high-rise residential building is the frame-supported shear wall structure. Testing found that concrete strength 6 pieces of shear wall of the tenth floor can not meet the original design requirements of C50 when the nineteenth floor was constructing. A way of replacing concealed column and corner column only by comparison an analysis.The safety of the structure was ensured and good strengthening effect was achieved by reasonable design of temporary support and construction, concrete selection and the whole deformation monitoring.

Objective To observe the effect of decoction for reinforcing lung Qi on T-lymphocytic function, interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in peripheral blood of patients with non-small cell lung cancer after operation with argon helium lancet in order to explore its mechanism. Methods A total of 76 patients suffering from non-small cell lung cancer without surgical indication were randomly divided into a treatment group treated with decoction for reinforcing lung Qi and argon helium lancet and a control group treated with argon helium lancet only to observe lymphocytic proliferation, detect the percentage of positive cells in the T-lymphocyte CD 28 with flow cytometry and detect the expression of IL-2 and TNF-α in peripheral blood with enzyme linked immunosorbent assay. Results Proliferation of T-lymphocytes and expression of CD 28 , IL-2 and TNF-α in peripheral blood after treatment in the treatment group were more obviously strengthened than those before treatment and those in the control group (all P Conclusion The mechanism of using decoction for reinforcing lung Qi and argon helium lancet to treat lung cancer may be realized through promoting T-lymphocytic proliferation, up-regulating expression of CD 28 , IL-2 and TNF-α, and activating T-cells.

Objective: To summarize our experience in the anesthetic management of conjoined twins undergoing one-stage surgical separation. Methodology: Medical records of conjoined twins admitted to our hospital for treatment and considered for surgical separation from 1996 to present were retrospectively reviewed. Four cases of conjoined twins underwent one-stage surgical separation under general anesthesia. Preoperative evaluation was performed to determine the extent of anatomical conjunction and associated anomalies. Anesthesia was simultaneously induced in all conjoined twins. The intubation procedure was successfully performed with the head slightly rotated to each baby’s side, followed by the administration of vecuronium. Anesthetic agents were administered according to the estimated weight of each baby. One case of conjoined twins underwent surgical separation with cardiopulmonary bypass due to shared hearts. Results: All conjoined twins were successfully separated. No significant respiratory or cardiac events occurred during surgery except for one twin, which died after separation because of complicated congenital heart disease. Conclusions : Accurate preoperative evaluation, respiratory and circulatory management, and close cooperation of the multidisciplinary team are important aspects of anesthetic management of conjoined twins surgery.

In this paper, we present a method of using machine vision technology to detect the nozzle of plant protection equipment through two spray variables (spray angle and spray volume distribution area), which provides a good experimental direction to improve the performance of the nozzle of plant protection equipment. Firstly, we get the images information with different backgrounds and shooting angles. Secondly, we process the images by edge detection, mathematical morphology and other related digital image processing techniques. Thirdly, we obtain the target area of spray angle and fog quantity distribution using the Hough transform line detection algorithm and pixel method. Finally, we compare the area and angle with the reference values to judge the rationality of the method and establish the error range. Experimental results show that the feature variable values are ideal for plant protection equipment nozzle spray angle and spray volume distribution area. It is proved that the feasibility of our method.

Supplemental Digital Content is available in the text, To investigate changes in the HBV replication level along with the natural course of chronic HBV infection and to examine the accuracy of the immune tolerant phase defined by the serological profile. A total of 390 chronic HBV-infected patients were retrospectively recruited for this study. They were classified into immune-tolerance (IT), immune-clearance (IC), low-replicative (LR), and HBeAg-negative hepatitis (ENH) phases according to serological profiles (single-standard, SS) or dual-standard (DS) with the inclusion of liver histology. Serum HBV DNA and HBsAg were quantitatively measured, and liver histology was quantitatively analyzed. The accuracy of the SS-defined IT phase was low, and active pathological changes were detected in 56 of 112 SS-defined IT patients. DS-defined IT patients had higher HBsAg levels (P = 0.0002) than the SS-defined patients. The quantitative HBsAg level can help identify SS-defined IT patients with potential liver injury. The area under the received operating characteristic curve for predicting the DS-defined IT phase was 0.831 (HBsAg 4.398 log IU/mL; sensitivity 87.5%; specificity 73.2%). HBV DNA was reduced by 4 logs, whereas HBsAg was only decreased by 2 logs with HBeAg positive to negative phase conversion. Approximately half of IT patients defined by SS may have medium or severe liver injury. Quantitative measurement of the HBsAg level can help identify SS-defined IT patients with potential liver injury.

Whole body (3D) and respiratory gated (4D) FDG-PET/CT scans performed pre-radiotherapy (pre-RT) and post-radiotherapy (post-RT) were analyzed to investigate the impact of 4D PET in evaluating 18F-fluorodeoxyglucose (FDG) uptake changes due to therapy, relative to traditional 3D PET.3D and 4D sequential FDG-PET/CT scans were acquired pre-RT and approximately one month post-RT for patients with non-small cell lung cancer (NSCLC). The lesions of high uptake targeted with radiotherapy were identified on the pre-RT scan of each patient. Each lesion on the 3D and each of the five phases of the 4D scan were analyzed using a region of interest (ROI). For each patient the ROIs of the pre-RT scans were used to locate the areas of initial FDG uptake on the post-RT scans following rigid registration. Post-RT ROIs were drawn and the FDG uptake was compared with that of the pre-RT scans.Sixteen distinct lesions from 12 patients were identified and analyzed. Standardized uptake value (SUV) maxima were significantly higher (p-value0.005) for the lesions as measured on the 4D compared to 3D PET. Comparison of serial pre and post-RT scans showed a mean 62% decrease in SUV with the 3D PET scan (range 36-89%), and a 67% decrease with the 4D PET scan (range 30-89%). The mean absolute difference in SUV change on 3D versus 4D scans was 4.9%, with a range 0-15% (p-value = 0.07).Signal recovery with 4D PET results in higher SUVs when compared to standard 3D PET. Consequently, differences in the evaluation of SUV changes between pre and post-RT plans were observed. Such difference can have a significant impact in PET-based response assessment.

High hardness and abrasiveness, low ROP and seriously deviation are the features of Shanle block Xishanyao formation in Turpan-Hami Oilfield, whose lithology was conglomerate, glutenite, interbedded sandstone, large angle of bedding and many fractures. To enhance ROP at this high hardness and abrasive region, designing of PDC bit is introduced based on crown shape, blade, teeth, bit hydraulics and so on. The designed bit had a good performance in the test of Well He-3 at Shanle block.

The content and species of 11 heavy metals in surface sediments from 8 typical lakes located in Wuhan,China,were investigated,and the accumulation,contamination,potential ecological risks and possible sources of metals were discussed in this paper.According to the metal geoaccumulation indexes,the results showed that the lake sediments had heavily polluted by Cd and evidently by Zn and Hg.On the whole,heavy pollutions of metals were observed in Lake Longyang and medium pollution in Lake Nantaizi and Lake Moshui,whereas the slight pollution in other lakes.Distribution of metals in sediments was observed to be not significant correlation with physicochcmical properties of sediments,whereas distinctly influenced by urban industries.11 metals distributed differently in lake sediments.The largest percentage of the form of available speciation was Cd in the lake sediments,with much higher potential ecological hazards,followed by Mn,Zn,Co,Cu and Pb.In contrary,As,Sb and Hg were dominantly associated with the residual fraction,indicating rare adverse biological effects.Correlation analysis and principal component analysis indicated that the heavy meal accumulation in the lake sediments were mainly attributed to the combustion of fossil fuel accompanied with metal refining,and followed with the effects of the biogeochemical processes of earth weathering.

Excessive release of high mobility group box-1 (HMGB1) protein from ischemic cardiomyocytes activates inflammatory cascades and enhances myocardial injury after reperfusion. Here we report evidence that electroacupuncture of mice at Neiguan acupoints can inhibit the up-regulation of cardiac HMGB1 following myocardial ischemia and attenuate the associated inflammatory responses and myocardial injury during reperfusion. These benefits of electroacupuncture were partially reversed by administering recombinant HMGB1 to the mice and further potentiated by administering anti-HMGB1 antibody. Electroacupuncture-induced inhibition of HMGB1 release was markedly reduced by unilateral vagotomy or administration of nicotinic receptor antagonist, but not by chemical sympathectomy. The cholinesterase inhibitor neostigmine mimicked the effects of electroacupuncture on HMGB1 release and myocardial ischemia reperfusion injury. Culture experiments with isolated neonatal cardiomyocytes showed that acetylcholine, but not noradrenaline, inhibited hypoxia-induced release of HMGB1 via a α7nAchR-dependent pathway. These results suggest that electroacupuncture acts via the vagal nerve and its nicotinic receptor-mediated signaling to inhibit HMGB1 release from ischemic cardiomyocytes. This helps attenuate pro-inflammatory responses and myocardial injury during reperfusion.

Objective: We evaluated 3-D computed tomography angiography (3-D CTA) in the diagnosis of the nutcracker phenomenon, and its significance in postoperative follow up. Patients and Methods: Three-dimensional CTA was used to compare the anatomical relations of the left renal vein with the aorta and the superior mesenteric artery in patients with the nutcracker phenomenon and in a control group. Four patients with the nutcracker phenomenon received a surgical procedure of the transposition of the left renal vein. The 3-D CTA was used for all patients during postoperation follow-up testing. Results: The 3-D CTA showed a compression of the left renal vein between the aorta and the superior mesenteric artery (SMA) and the abnormal acute angle between them. The angles and distances between the SMA and the aorta were 39.3 ± 4.3° and 3.1 ± 0.2 mm in the patient groups and 90 ± 10° and 12 ± 1.8 mm in the control groups, respectively. Differences in angles and distances were statistically significant between the two groups (P

We investigate mosaic structure evolution of GaN films annealed for a long time at 800°C grown on sapphire substrates by metalorganic chemical vapour deposition by high-resolution x-ray diffraction. The result show that residual stress in GaN films is relaxed by generating edge-type threading dislocations (TDs) instead of screw-type TDs. Compared to as-grown GaN films, the annealed ones have larger mean twist angles corresponding to higher density of edge-type TDs but smaller mean tilt angles corresponding to lower density of screw-type TDs films. Due to the increased edge-type TD density, the lateral coherence lengths of the annealed GaN films also decrease. The results obtained from chemical etching experiment and grazing-incidence x-ray diffraction (GIXRD) also support the proposed structure evolution.

A high yielding rice variety mutant (Oryza sativa L., Zhenhui 249) with low chlorophyll b (Chl b) has been discovered in natural fields. It has a quality character controlled by a pair of recessive genes (nuclear gene). The partial loss of Chl b in content affects the efficiency of light harvest in a light harvest complex (LHC), thus producing the difference of the exciting energy transfer and the efficiency of photochemistry conversion between the mutant and wild-type rice in photosynthetic unit. The efficiency of utilizing light energy is higher in the mutant than that in the wild-type rice relatively. For further discussion of the above-mentioned difference and learning about the mechanism of the increase in the photochemical efficiency of the mutant, the pico-second resolution fluorescence spectrum measurement with delay-frame-scanning single photon counting technique is adopted. Thylakoid membranes of the mutant and the wild-type rice are excited by an Ar+ laser with a pulse width of 120 ps, repetition rate of 4 MHz and wavelength of 514 nm. Compared with the time and spectrum property of exciting fluorescence, conclusions of those ultrafast dynamic experiments are: 1) The speeds of the exciting energy transferred in photo-system I are faster than that in photo-system II in both samples. 2) The speeds of the exciting energy transfer of mutant sample are faster than those of the wild-type. This might be one of the major reasons why the efficiency of photosynthesis is higher in mutant than that in the wild-type rice.

Spinal cord ischemia significantly threatens patient health. Cervical spinal cord ischemia is mainly caused by anterior spinal artery (ASA) or anterior radicular artery (ARA) injury. Because of the complex hemodynamics in cervical spinal cord arteries, conventional CT angiography (CTA) does not satisfactorily show the ASA and ARA. In this study, cervical cord CTA was done to 20 patients suspected of cervical spinal cord ischemia with an increased dose of contrast medium and an extra 6-s delay from the peak time determined on the test bolus. The visualization quality of ASA and ARA in the cervical cord CTA was compared with conventional craniocervical CTA using a four-grade visual analogue scale, and injuries to ASA and ARA were evaluated. Our initial experience indicated that cervical cord CTA can efficiently display the anatomical features and comprehensively evaluate injury of the ASA and ARA.

The association between hepatitis B surface antigen (HBsAg) and hepatitis B 'e' antigen (HBeAg) levels and liver inflammation and fibrosis in patients with chronic hepatitis B (CHB) in the immune clearance (IC) remains elusive. The aim of the present study was to investigate whether HBsAg and HBeAg levels were associated with liver inflammation and fibrosis in CHB patients during the IC phase. Kendall's rank correlation analysis and receiver operating characteristic curves were used to determine the correlation between HBsAg, HBeAg and liver pathological stages. Multivariate analysis by forward logistic regression was used to analyze significant predictors of cirrhosis. A liver pathology‑predicting model (IC model), which used routinely assessed markers in combination with HBsAg and HBeAg levels, was constructed. There were significantly positive correlations between the HBsAg and HBeAg levels (γ=0.317, P

Background The diagnostic accuracy of interleukin-6 (IL-6) in predicting bacterial infection in cirrhotic patients remains unclear. The aim of this meta-analysis is to explore the potential diagnostic value of IL-6 in cirrhotic patients. Methods We systematically searched PubMed, Embase (via OvidSP), Web of Science, the Cochrane Library, and Scopus for studies published from inception to October 2015. Studies were enrolled if they included assessment of the accuracy of IL-6 in the diagnosis of bacterial infection in cirrhotic patients and provided sufficient data to construct a 2 × 2 contingency table. Results Totally, 535 studies were searched in the initial database and finally 6 studies involving 741 patients were included for the final analysis. The pooled sensitivity, specificity and diagnostic odds ratio were 0.85 (95% confidence interval [CI], 0.64-0.94), 0.91 (95% CI, 0.80-0.96) and 52.89 (95% CI, 15.21-183.86), respectively. The pooled positive likelihood ratio was 8.99 (95% CI, 4.13-19.55) and the pooled negative likelihood ratio was 0.17 (95% CI, 0.07-0.43). The area under the receiver operating characteristic curve was 0.94 (95% CI, 0.92-0.96). Conclusion This meta-analysis suggests IL-6 has a high diagnostic value for the differentiation of bacterial infection in patients with cirrhosis.

To solve the vagueness and randomness of knowledge representation in the process of decision-making analysis of equipment support system assessment, the paper applies cloud theory to build valuation model. According the analysis about the equipment support system, the input and output parameter of valuation is defined, and the concept subsets are also designed. Based on the research on the cloud theory, the paper designs the multi-condition and multi-rule generator, and introduces the detailed process of calculating. Finally, using the application example is to demonstrate the method.

To investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive I-125 seeds interstitial implantation (ISI) synchronized chemotherapy and Chinese medicine (CM) for the treatment of advanced stage of non-small cell lung cancer (NSCLC). Ninety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups: the synchronized therapy group (A), the chemotherapy plus CM-treated group (B), and the chemotherapy-treated group (C); a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers (carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment), clinical symptoms, and quality of life (QOL) in patients. The total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing signifificant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more signifificant in Group A than those in Group C (all P

The purpose of this study was to evaluate the safety and efficacy of CT-guided percutaneous cryoablation for osteoid osteoma in children.This study was approved by the institutional ethics committee. From January 2007 to July 2008, six children (four boys, two girls, mean age 12.6 years old) with osteoid osteoma were treated with CT-guided percutaneous cryoablation. The procedures were carried out under conscious sedation and local anesthesia. CT guidance was used for procedural planning, instrument guidance, and monitoring. An argon-based cryoablation system was used. Each cryoablation included two freezing-thawing cycles. Follow-up was performed to assess technical and clinical outcome for a minimum of 12 months. A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure, and mean VAS for the group was compared pre- and post-procedure with a t-test. The mean clinical follow-up period was 28.7 months (ranging from 18 to 36 months).Cryoablation was technically and clinically successful for all patients. No major immediate or delayed complications were observed. Significant pain relief (P0.05) was observed in all patients after operation. Mean VAS were 6.57 ± 0.55 pre-procedure and 0.57 ± 0.10 1 month post-procedure. Patients were allowed to fully bear their weight and function without limitation within 3 days after the procedure. Pain recurrence was not observed in any patient.Percutaneous cryoablation is safe and effective for the treatment of osteoid osteomas in children. Notably, this procedure can be accomplished without general anesthesia.

AbstarctPatients with acute on chronic liver failure (ACLF) usually present with severe coagulopathy. Abdominal paracentesis is often performed in these patients. The aim of this study was to analyze the prevalence of hemorrhagic events after paracentesis and the predictive factors of this condition