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Central Asia (including five countries: Kazakhstan, Kyrgyzstan, Turkmenistan, Uzbekistan, and Tajikistan) is rich in oil reserves and has become one of the most important target regions for global oil investment. The construction of the Silk Road Economic Belt has prompted Central Asia to look outwards for more collaborations in the oil industry. China's need for oil investment in Central Asia has also increased significantly. This research established a comprehensive index system for assessing the risks of transnational oil investment in Central Asia. The system incorporated political, regulatory, economic, social, and infrastructural indices. Based on the Delphi method and fuzzy comprehension evaluation method, we qualitatively and quantitatively assessed and analyzed the risks of transnational oil investment in Central Asia. The results indicate that the risk score for regulatory risk was highest with the value of 6.1670, indicating a high risk level in transnational oil investment, followed by economic, social, political, and infrastructural risk indices. Of the 18 secondary risk indices calculated, there were seven indices with the probability of high risk occurrence exceeded 30.0% and the descending order was as follows: establishment of mining rights; host country intervention in operations; taxing system; stability of regulations; war and turmoil; labor capital; and ethnic, cultural, and religious differences. These seven critical risks should be watched closely and avoided during transnational oil investment in Central Asia. This study provides a comprehensive understanding of the potential risks of investing oil in Central Asia. The findings demonstrate the causes of these risks and provide a scientific basis for reasonably avoiding oil investment risk and improving investment benefits for both host and investing countries.

G protein-coupled receptor 174 (GPR174) is mainly expressed in thymus, spleen, lymph nodes, and leukocytes, and genetic variation in GPR174 is associated with susceptibility to autoimmune diseases, indicating that GPR174 is involved in the immune response. However, the function of GPR174 in regulating inflammatory responses against bacterial infection in sepsis remains unclear. In this study, we investigated the role of GPR174 in regulating suppressive function of regulatory T cells (Treg cells) and the underlying mechanism of Gpr174-deficient Treg cells in controlling cytokine storm of sepsis. We showed that Gpr174-dedicient mice were resistant to inflammatory shock induced by lipopolysaccharide (LPS) and cecal ligation and puncture (CLP). Moreover, Gpr174 was highly expressed in Treg cells, and its deficiency in mice promoted the expression of cytotoxic T lymphocyte associated antigen 4 (CTLA-4) and interleukin (IL)−10 in Treg cells. By using the LPS-induced sepsis model, we demonstrated that anti-inflammatory macrophages (M2 macrophages) induction was Treg cell-dependent and Gpr174-deficient Treg cells protected mice against sepsis-induced lung damage through prompting M2 macrophages polarization. In vitro, Gpr174-deficient Treg cells also promoted the polarization of macrophages toward M2 cells and dampened the secretions of pro-inflammatory cytokines (IL-6 and tumor necrosis factor-α (TNF-α)) in macrophages. In conclusion, these findings suggested that GPR174 plays an important role in the initial period of sepsis through the regulation of macrophage polarization and pro- and anti-inflammatory cytokine secretions. Therefore, GPR174 may be a promising target for therapeutic agents to regulate inflammatory disorders.

Background Cavity effusion is common in patients with infectious diseases. However, the incidence rate and characteristics of serous cavity effusions (SCE) in septic patients are not clear to date. The objective of this study was to investigate the incidence and characteristics of SCE in septic patients and to explore the correlations between the bloody effusions and the illness severity/prognosis in septic patients. Methods From January 2010 to January 2015, a total of 214 patients with severe sepsis and septic shock were enrolled in this retrospective observational study. Thoracentesis or abdominal paracentesis was performed in 45 septic patients because of massive pleural effusions or ascites. The serum concentrations of VEGF, VEGFR, Ang, sICAM-1, sVCAM-1, E-selectin, Serpine1 and VE-cadherin in 45 septic patients underwent paracentesis were measured by enzyme-linked immunosorbent assay (ELISA). Results Of the 214 septic patients, 155 (72.4%) had SCE according to imaging or ultrasound manifestations. 45 subjects with SCE underwent therapeutic thoracentesis or abdominal paracentesis. Effusion laboratory analysis showed that exudates were predominant when compared with transudates (95.6% vs. 4.4%), and 16 (35.6%) patients suffered bloody effusions. Compared with patients with non-bloody effusions, those with bloody effusions showed higher critical illness scores (13 vs. 17 for APACHE II; 7 vs. 9 for SOFA), and higher mortality (6.9% vs. 62.5%). Moreover, patients with bloody effusions had delayed TT and APTT, increased D-dimer concentration, and higher serum levels of CRP and PCT (P

The battery size is measured by the proposed machine vision method. The morphological method is used to locate the edge at the pixel level quickly, and then the Zernike moment method is used to extract the sub-pixel edge. An in-situ comparison method is proposed to calculate the size deviation between the battery and the standard board, by which the measurement error caused by the distortion when the image has residual distortion can be effectively reduce.

Objective. The aim was to study the therapeutic effects and mechanisms of QWRG on adjuvant-induced RA in rats.Methods. The RA rat models were manipulated and subsequently divided into five experimental groups: AIA, DEX, and QWRG groups. The paw volume, body weight, arthritic score, and mechanical nociceptive threshold were assessed. The serum levels of the RF, MDA, ALP, AST, ALT, IL-1β, IL-2, IL-16, and TNF-αwere measured. The proliferative capacity of lymphocytes was evaluated, and the synovial tissue was histopathologically examined.Results. The paw swelling and arthritic scores were relieved, and the variation of relative body weight and mechanical nociceptive threshold had improved in the AIA rats. The serum levels of RF, MDA, ALP, AST, and ALT were alleviated, and the inflammation and cartilage damage were effectively attenuated in the AIA rats. Simultaneously, the inflammation of the synovial cavity was alleviated, and the grading of synovitis reduced by inhibiting the expressions of IL-1β, TNF-α, and IL-16 in the serum and synovium tissue.Conclusion. Our results suggested that the antiarthritic properties of QWRG may be due to immunodepression and downregulation of inflammatory cytokines, which may be a potential candidate for the treatment of RA.

Doxorubicin (DOX) is one of the most effective chemotherapeutic drugs. However, its clinical use has been hampered due to the development of cardiotoxicity. Vitexin, which is the active ingredient of hawthorn leaf extract, has various biological activities, including antioxidant and anti-inflammatory actions. The present study aimed to investigate whether vitexin was able to protect against DOX-induced acute cardiotoxicity in model rats and the mechanisms of this protective effect were assessed. Adult Sprague-Dawley rats were randomly assigned into the control (saline only), model (DOX only) and vitexin-treated (DOX plus vitexin) groups. Rats in the model and vitexin-treated groups were injected with DOX (2 mg/kg; i.p.) once a week for 4 weeks. Rats in the vitexin-treated group were administered 30 mg/kg oral vitexin once daily at doses for 4 weeks. The levels of lactate dehydrogenase, creatine kinase isoenzyme-MB, malondialdehyde, superoxide dismutase, catalase and myeloperoxidase were assessed using assay kits. The levels of inflammatory mediators, including tumor necrosis factor-α, interleukin (IL)-1β, IL-6, nuclear factor (NF)-κB, and caspase-3, were assayed by the enzyme-linked immunosorbent assay method. Western blot analysis was performed to assess the protein expression levels of p-FOXO3a. Vitexin pretreatment significantly protected against DOX-induced myocardial damage, which was characterized by increased serum creatine kinase isoenzyme-MB and lactate dehydrogenase. Vitexin significantly ameliorated oxidative stress injury evoked by DOX, demonstrated by the inhibition of lipid peroxidation and the elevation of antioxidant enzyme activities. Furthermore, DOX provoked inflammatory responses by increasing the expression levels of IL-1β, IL-6, NF-κB and tumor necrosis factor-α, whereas vitexin pretreatment significantly inhibited these inflammatory responses. Notably, DOX induced apoptotic tissue damage by increasing caspase-3 activity, whereas vitexin administration was able to decrease caspase-3 activity. In addition, vitexin induced elevated FOXO3a protein expression levels in the vitexin-treated group. In conclusion, the findings of the present study suggested that vitexin possesses cardioprotective action against DOX-induced cardiotoxicity by suppressing oxidative stress, inflammation and apoptotic signals.

To satisfy the lightweight requirements of large pipe weapons, a novel electrohydraulic servo (EHS) system where the hydraulic cylinder possesses three cavities is developed and investigated in the present study. In the EHS system, the balancing cavity of the EHS is especially designed for active compensation for the unbalancing force of the system, whereas the two driving cavities are employed for positioning and disturbance rejection of the large pipe. Aiming at simultaneously balancing and positioning of the EHS system, a novel neural network based active disturbance rejection control (NNADRC) strategy is developed. In the NNADRC, the radial basis function (RBF) neural network is employed for online updating of parameters of the extended state observer (ESO). Thereby, the nonlinear behavior and external disturbance of the system can be accurately estimated and compensated in real time. The efficiency and superiority of the system are critically investigated by conducting numerical simulations, showing that much higher steady accuracy as well as system robustness is achieved when comparing with conventional ADRC control system. It indicates that the NNADRC is a very promising technique for achieving fast, stable, smooth, and accurate control of the novel EHS system.

BACKGROUND: Community-acquired pneumonia (CAP) in autoimmune diseases (AID)-induced immunocompromised host (ICH) had a high incidence and poor prognosis. However, only a few studies had determined the clinical characteristics of these patients. Our study was to explore the characteristics and predictors of mortality in CAP patients accompanied with AID-induced ICH. METHODS: From 2013 to 2018, a total of 94 CAP patients accompanied with AID-induced ICH, admitted to Emergency Department of Zhongshan Hospital, Fudan University, were enrolled in this study. Clinical data and the risk regression estimates of repeated predictors were evaluated by generalized estimating equations (GEEs) analysis. An open-cohort approach was used to classify patient’s outcomes into the survival or non-survival group. RESULTS: The hospital mortality of patients with CAP occurring in AID-induced ICH was 60.64%. No significant differences were found with respect to clinical symptoms and lung images between survival and non-survival groups, while renal insufficiency and dysfunction of coagulation had higher proportions in non-survival patients (P

The Uygur herb, Hyssopus officinalis L., has been demonstrated to affect the levels of a number of cytokines in asthmatic mice, including interleukin-4, -6 and -17 and interferon-γ. In the present study, the effect of Hyssopus officinalis L. on airway immune regulation and airway inflammation was investigated in a mouse model of chronic asthma. A total of 32 BALB/c mice were randomly divided into four groups, which included the normal, chronic asthmatic, dexamethasone treatment and Hyssopus officinalis L.treatment groups. Mice were sensitized and challenged with ovalbumin to establish an asthma model and the ratio of eosinophils (EOS) in the bronchoalveolar lavage fluid (BALF) was determined. In addition, the levels of immunoglobulin (Ig)E and IgG were detected using an enzyme-linked immunosorbent assay. The degree of airway mucus secretion was observed using the periodic acid-Schiff stain method. The results demonstrated that the ratio of EOS in the BALF and the level of serum IgE in the chronic asthmatic and dexamethasone treatment groups increased, while the level of serum IgG decreased, when compared with the normal group. In addition, excessive secretion of airway mucus was observed in these two groups. However, the EOS ratio in the BALF and the levels of serum IgE and IgG in the Hyssopus officinalis L. treatment group were similar to the results observed in the normal group. In conclusion, Hyssopus officinalis L. not only plays an anti-inflammatory role by inhibiting the invasion of EOS and decreasing the levels of IgE, but also affects immune regulation.

Objective To evaluate minimally invasive treatment of clavicular fractures with cannulated screw. Methods Data of 65 patients who had undergone minimally invasive treatment with cannulated screws for clavicular fractures from April 2009 to October 2010 were retrospectively analyzed and compared with those of 65 patients with clavicular fractures who had been treated by the same surgeons with plates. In the study group, there were 41 males and 24 females, aged from 19–67 years (mean, 35.8 years). According to Craig's classification, there were 29 group 1 and 36 of group 2-II. Neer scores were used to evaluate shoulder function and radiographs to assess fracture union. Results The incision length was 4–5 cm in the cannulated screw group (CSG) and 10–11 cm in the reconstructive plate group (RPG). Radiographs showed bone union was achieved in both groups, the bone healing time being 13.2 ± 6.9 weeks in the CSG and 16.3 ± 8.7 weeks in the RPG. All patients were followed up for 6 to 20 months (average, 10.6 months). The average Neer score was 96.6 ± 3.4 in the CSG and 94.2 ± 5.8 in the RPG. In the CSG, screw loosening occurred in five, and fracture displacement in three. There was a significant difference in fracture healing time between two groups but not in Neer score. Conclusion Minimally invasive treatment of clavicular fractures with cannulated screws has the advantages of minimal invasion, short bone healing time, good clinical outcomes, and being relatively inexpensive.

Rationale: The peak of blood glucose was during 9 pm to 3 am. There is a stable, spontaneous and short-term abnormal increase of blood glucose. The pathophysiological mechanism is unknown. It is speculated that the cause might be the imbalance of the glucose-regulating hormone that is caused by the disorder of the biological clock system. Patient concerns: The case was a 73-year old man with bilateral glaucoma (only mild light perception) and was hospitalized to establish a viable hypoglycemic plan. He received 4 shots of insulin enhancement, oral meditation, pre-mixed insulin treatment during the 22 days. However, his blood glucose had been spontaneously increased from 9 pm to 3 am which was the highest of the day, and then resumed by itself. Insulin intervention was effective. Diagnosis: Glaucomatous blindness and diabetes, spontaneous and transient hyperglycemia before sleep. Interventions: We used insulin aspart 3u when we found hyperglycemia three times at 9 pm and it was effective. Without intervention, blood sugar will automatically improve in the morning. Outcomes: During the late night and early morning, there is a stable, spontaneous and short-term transit abnormal increase in blood glucose, which suggests the complexity of blood glucose adjustment. Lessons: Due to the case specialty, we could not do the systematic review of the study. However, it improves the awareness of the abnormal periodically increase of blood glucose during the special periods, and provides with a reference for clinical research of dawn and dusk phenomenon. Multi-point blood glucose monitoring or dynamic blood glucose monitoring throughout the day is of great significance for the detection of special types of hyperglycemia.

To compensate for the nonlinearity and to achieve finely-tuned tracking accuracy of a gun control system driven by an AC machine, an improved active disturbance rejection control (IADRC) strategy with neural network embedding (NN-IADRC) is developed in this paper. The proposed IADRC, which has amnestic memory effects, can be regarded as an extension of the conventional ADRC (CADRC), making it a special case of the IADRC. To further attenuate the dependence on system models and enhance the disturbance rejection capacities of the IADRC strategy, an on-line NN-based optimum updating approach is also developed in this paper. Finally, a series of experiments are conducted on the semi-physical simulation platform to estimate the performance of the control system and the effects of the memory factor on the system. The experimental results confirm that the proposed NN-IADRC is highly robust. The results also confirm that it performs more excellently than the CADRC and that its fine tuning has attained tracking accuracy.

Supplemental Digital Content is available in the text, The diabetes dusk phenomenon (spontaneous and transient pre-dinner hyperglycemia) anecdotally exists but has not been investigated. A total of 80 diabetic patients that received continuous subcutaneous insulin infusions were retrospectively studied. They were grouped into a routine group (R) (consecutive δDG [dusk blood glucose difference]

Background Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) play a central role in the endothelial permeability regulation and dysfunction, which is associated with the development of sepsis and acute lung injury/acute respiratory distress syndrome (ALI/ARDS). The aim of this study is to assess the diagnostic and prognostic values of TF and TFPI in patients with sepsis and sepsis-induced ARDS. Methods A total of 62 patients with sepsis, 167 patients with severe sepsis and 32 healthy volunteers were enrolled in this prospective observational study. TF and TFPI levels were measured by enzyme-linked immunosorbent assay (ELISA). Results Patients with sepsis-induced ARDS showed significantly higher median levels of TF compared with patients without ARDS (1425.5 (1019.9 to 2595.2) pg/ml vs 916.2 (724.1 to 1618.2) pg/ml, P 0.05). The AUC of TF for the diagnosis of sepsis-induced ARDS was 0.749 (95% confidence interval (CI) 0.675-0.822). Plasma TF levels in the non-survivors of severe sepsis were significantly higher than those of survivors (1618.6 (1017.1 to 2900.8) pg/ml vs. 979.9 (757.2 to 1645.5) pg/ml, P 0.05). Conclusions Our data showed that tissue factor is a valuable diagnostic biomarker for the diagnosis of sepsis-induced ARDS. Moreover, tissue factor is a strong prognostic marker for short-term mortality in severe sepsis and sepsis-induced ARDS patients.

Introduction Activation of inflammation and coagulation was closely related and mutually interdependent in sepsis. Tissue factor (TF) and its endogenous inhibitor, tissue factor pathway inhibitor (TFPI) was the main regulators of the initiation of coagulation process. Altered plasma levels of TF and TFPI have been related to worse outcome in sepsis. The objective of this study was to investigate whether single nucleotide polymorphisms (SNPs) in the TF and TFPI genes were associated with risk and outcome for patients with severe sepsis. Methods Seventeen SNPs in TF and TFPI were genotyped in samples of sepsis (n =577) and severe sepsis patients (n =476), and tested for association in this case–control collection. We then investigated correlation between the associated SNPs and the mRNA expression, and protein level of the corresponding gene. The mRNA levels of TF were determined using real-time quantitative reverse transcription-polymerase chain reaction and the soluble plasma levels of TF were measured using enzyme linked immunosorbent assay (ELISA) method. Results Association analysis revealed that three TF SNPs in perfect linkage disequilibrium, rs1361600, rs3917615 and rs958587, were significantly associated with outcome of severe sepsis. G allele frequency of rs1361600 in survivor patients was significantly higher than that in nonsurvivor severe sepsis patients (P =4.91 × 10-5, odds ratio (OR) =0.48, 95% confidence interval (CI) 0.33 to 0.69). The association remained significant after adjustment for covariates in multiple logistic regression analysis and for multiple comparisons. Lipopolysaccharide-induced TF-mRNA expression levels in peripheral blood mononuclear cells from subjects carrying rs1361600 AG and GG genotypes, were significantly lower than those subjects carrying AA genotype (P =0.0012). Moreover, severe sepsis patients of GG and GA genotypes showed lower serum levels of TF than patients with AA genotype (Padj =0.02). The plasma levels of TF were also associated with outcome of severe sepsis patients (Padj =0.01). However, genotype and allele analyses did not show any significant difference between sepsis and severe sepsis patients. Conclusions Our findings indicate that common genetic variation in TF was significantly associated with outcome of severe sepsis in Chinese Han population. Electronic supplementary material The online version of this article (doi:10.1186/s13054-014-0631-9) contains supplementary material, which is available to authorized users.

In this manuscript, acoustic wave propagation in a novel three-dimensional porous phononic crystal-Kagome lattice, is studied by using finite element method. Firstly, a Kagome-sphere structure is established based on Kagome truss. For lattice with fixed rods (sphere radius varied) or fixed spheres (rod radius varied), the band structures are calculated in order to clarify the influence of geometrical parameters (sphere and rod sizes) on the bandgap characteristics in Kagome-sphere lattice. The vibration modes at the band edges of the lowest bandgaps are investigated with the aim to understand the mechanism of the bandgap generation. It is found that the emergence of the bandgap is due to the local resonant vibration of the unit cell at the adjacent bands. The width and position of this bandgap can be tuned by adjusting the geometrical parameters. An equivalent mass-spring model is proposed and the equivalent system resonance frequency can be evaluated which predicts well the upper and lower edges of the complete bandgaps. Moreover, the critical geometrical parameter is formulated which gives the critical geometrical condition for the opening of the complete bandgaps. The results in this paper are relevant to the bandgap structure design of three-dimensional porous phononic crystals (PPCs).

It has been proved that Uygur herbHyssopus offcinalisL. could affect the levels of some cytokines (such as IL-4, IL-6, IL-17, and IFN-γ) in asthmatic mice. By detection of the expressions of MMP-9 and TIMP-1 and the morphological changes, the aim of this research is to reveal the mechanism of Uygur herbHyssopus offcinalisL. in the process of airway remodeling. It was observed that the expressions of MMP-9 and TIMP-1 increased, but the ratio of MMP-9/TIMP-1 decreased in airway remodeling group. However, the expression of both MMP-9 and TIMP-1 decreased after being treated with dexamethasone andHyssopus offcinalisL., accompanied by the relieved pathological changes, including collagen deposition, mucus secretion, and smooth muscle proliferation. It is suggested that Uygur herbHyssopus offcinalisL. could inhibit airway remodeling by correcting imbalance of MMP-9/TIMP-1 ratio.

Blood glucose fluctuations have higher risk than absolute blood glucose level in diabetic chronic complications. At present, “dawn phenomenon” is well known by clinicians, but “dusk phenomenon” has not been recognized. This study explored the objective existence of “dusk phenomenon” (spontaneous and transient predinner hyperglycemia) and its clinical significance. The data of 54 patients with diabetes, who received routine insulin pump therapy between December 2010 and October 2012 in our hospital, were retrospectively analyzed. These patients included 4 patients with type 1 diabetes mellitus (DM) (T1DM) and 50 patients with type 2 DM (T2DM). According to the difference between predinner and postlunch blood glucose levels, the 50 patients with T2DM were divided into dusk phenomenon group (4 patients, all the differences ≥0 mmol/L during insulin pump therapy), nondusk phenomenon group (12 patients, all the differences 0.05). In T2DM patients, the predinner blood glucose level was significantly higher in dusk phenomenon group than in suspicious group and nondusk phenomenon group (all P

Several lines of in vivo evidence demonstrated that activation of δ-opioid receptors (ORs) with agonists mimics the cardioprotective effect of ischemic preconditioning. However, the subtypes of ORs involved and the molecular and cellular mechanisms are not entirely clear. To investigate the significance of the contribution by δ ORs to cardiomyocyte survival, we used an in vitro model of hypoxia/reoxygenation (H/R) in primary cultures of neonatal rat cardiomyocytes to study the role of different δ ORs in cardiomyocyte apoptosis and the relevant downstream signaling pathway. The results showed that apoptosis in neonatal cardiomyocytes induced by H/R was reversed by δ2 OR agonist, deltorphin E but not by δ1 OR agonist DPDPE; the deltorphin E-induced cytoprotection was totally abrogated by the MEK inhibitor PD98059 and overexpression of dominant interfering form of MEK1; in contrast, overexpression of constitutive active form of MEK1 exerted a similar protective effect as deltorphin E. These results suggest that δ2 OR, but not δ1 OR, plays a key role in preventing cardiomyocytes from apoptosis during H/R injury, which is mainly mediated by the MEK/ERK1/2 pathway.