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Objectives: Thrombomodulin (TM) is closely related to the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE). However, current evidence on circulating TM levels in SLE patients is contradictory. We conducted this meta-analysis to more accurately assess circulating TM levels in patients with SLE and lupus nephritis (LN) and to analyze related influencing factors. Methods: Systematic search of relevant documents was conducted in PubMed, Embase, and The Cochrane Library databases (up to 28 February 2021). Studies on the comparison of circulating TM between SLE patients and controls were screened and evaluated for inclusion. Random-effects model analysis was applied to calculate the combined standardized mean difference (SMD) with a 95% confidence interval (CI). Heterogeneity was estimated by Q statistics and I2. Results: A total of 353 articles were identified, 14 provided adequate information for this study finally. The results illustrated that SLE patients had higher TM levels than healthy controls (SMD=0.38, 95% CI: 0.02 to 0.74, p=0.04). Circulating TM levels were increased in patients with active SLE compared to inactive SLE patients (SMD=1.12, 95% CI: 0.03 to 2.20, p=0.04). In addition, circulating TM levels of SLE patients with LN were higher than those without LN (SMD=4.55, 95% CI: 1.97 to 7.12, p=0.001). Conclusions: The circulating TM levels in SLE patients are enhanced. In addition, circulating TM levels may be practical in reflecting the disease activity and nephritis involvement of SLE patients.

MicroRNA-199a-5p (miR-199a-5p) and -3p are enriched in the myocardium, but it is unknown whether miR-199a-5p and -3p are co-expressed in cardiac remodeling and what roles they have in cardiac hypertrophy and fibrosis. We show that miR-199a-5p and -3p are co-upregulated in the mouse and human myocardium with cardiac remodeling and in Ang-II-treated neonatal mouse ventricular cardiomyocytes (NMVCs) and cardiac fibroblasts (CFs). miR-199a-5p and -3p could aggravate cardiac hypertrophy and fibrosis in vivo and in vitro. PPAR gamma coactivator 1 alpha (Ppargc1a) and sirtuin 1 (Sirt1) were identified as target genes to mediate miR-199a-5p in promoting both cardiac hypertrophy and fibrosis. However, miR-199a-3p aggravated cardiac hypertrophy and fibrosis through targeting RB transcriptional corepressor 1 (Rb1) and Smad1, respectively. Serum response factor and nuclear factor κB p65 participated in the upregulation of miR-199a-5p and -3p in Ang-II-treated NMVCs and mouse CFs, and could be conversely elevated by miR-199a-5p and -3p. Together, Ppargc1a and Sirt1, Rb1 and Smad1 mediated the pathological effect of miR-199a-5p and -3p by promoting cardiac hypertrophy and fibrosis, respectively. This study suggests a possible new strategy for cardiac remodeling therapy by inhibiting miR-199a-5p and -3p., Graphical abstract, Transcription factor SRF and NF-κB p65 regulate the co-expression of miR-199a-5p and -3p by positive feedback in the pathological cardiac remodeling. Ppargc1a and Sirt1, Rb1 and Smad1 mediate the pathological role of miR-199a-5p and -3p by promoting cardiac hypertrophy and fibrosis, respectively.

In practical applications, particularly in flexible manufacturing systems, there is a high level of uncertainty. A type-2 fuzzy logic system (T2FS) has several parameters and an enhanced ability to handle high levels of uncertainty. This article proposes an improved artificial immune system (IAIS) algorithm to solve a special case of the flexible job shop scheduling problem (FJSP), where the processing time of each job is a nonsymmetric triangular interval T2FS (IT2FS) value. First, a novel affinity calculation method considering the IT2FS values is developed. Then, four problem-specific initialization heuristics are designed to enhance both quality and diversity. To enhance the exploitation abilities, six local search approaches are conducted for the routing and scheduling vectors, respectively. Next, a simulated annealing method is embedded to accept antibodies with low affinity, which can enhance the exploration abilities of the algorithm. Moreover, a novel population diversity heuristic is presented to eliminate antibodies with high crowding values. Five efficient algorithms are selected for a detailed comparison, and the simulation results demonstrate that the proposed IAIS algorithm is effective for IT2FS FJSPs.

Background The aim of the study was to explore the outcomes of computed tomography‐guided microwave ablation (MWA) in non‐small cell lung cancer (NSCLC) patients with adjacent lobe invasion (ALI), and to compare the outcomes of ALI‐NSCLC and non‐ALI NSCLC patients after MWA. Methods A total of 319 NSCLC patients and 366 tumors treated with MWA were included in the study, comprising 34 ALI‐NSCLC patients and 285 non‐ALI NSCLC patients. Complications, local recurrence rates, progression‐free survival (PFS), and overall survival (OS) were compared. Logistic regression analyses were used to investigate the correlation between ALI and the occurrence of pneumothorax after MWA. Results The mean tumor diameter of ablated tumors was 3.6 ± 2.2 cm. There were 95 (29.8%) NSCLC patients in which pneumothorax occurred after MWA, and all patients recovered. Of these, the ALI group had a significantly higher incidence rate of pneumothorax than the non‐ALI group (52.9% vs. 27.0%, p = 0.002). The median PFS and OS for the ALI group were 12.0 ± 10.2 and 15.5 ± 9.5 months, respectively, and that of the non‐ALI group were 13.0 ± 10.6 and 17.0 ± 11.1 months, respectively, and no significant difference was found in PFS (p = 0.329) nor OS (p = 0.394) between the two groups. Local recurrence rates for ALI and non‐ALI groups were 29.4% and 20.7%, respectively, and no significant difference was found (p = 0.244). Logistic regression analyses revealed that ALI can increase the risk of pneumothorax (hazard ratio [HR], 2.867; p = 0.012). Conclusions MWA is an effective and safe approach for ALI‐NSCLC treatment. Although ALI can increase the risk of pneumothorax, ALI‐NSCLC patients reveal a comparable outcome to non‐ALI NSCLC patients after MWA., Microwave ablation is an effective and safe approach for non‐small cell lung cancer patients with adjacent lobe invasion. The presence of adjacent lobe invasion can increase the risk of pneumothorax after microwave ablation.

Purpose To explore the outcomes of computed tomography‒guided microwave (MW) ablation in patients with cavitary non–small cell lung cancer (NSCLC) and to compare the outcomes of cavitary and noncavitary NSCLC treated with MW ablation. Materials and Methods A total of 317 patients with NSCLC (194 men and 123 women) treated with MW ablation were include: 19 patients with cavitary NSCLC and 298 patients with noncavitary NSCLC. Complications, progression-free survival (PFS), and overall survival (OS) were evaluated and compared between the 2 groups. The Kaplan-Meier method was used to investigate the correlation of cavity and OS in patients with NSCLC. Results A total of 364 MW ablation procedures were performed. Adenocarcinoma was the predominant histopathological subtype in patients with cavitary NSCLC (73.7%). Cavitary NSCLC had an incidence rate of 57.9% in overall complications, which was significantly higher than that of 34.6% for noncavitary NSCLC (P = .040). In a mean follow-up of 27.2 months ± 11.9, the median PFS and OS for cavitary NSCLC were 9.0 months ± 8.5 and 14.0 months ± 10.8, respectively, and those for noncavitary NSCLC were 13.0 months ± 10.7 and 17.0 months ± 10.9, respectively. There was no significant difference in PFS (P = .180) or OS (P = .133) between cavitary and noncavitary NSCLC. In addition, the local recurrence rates for cavitary and noncavitary NSCLC were 15.8% and 21.5%, respectively, and no significant difference was found (P = .765). The Kaplan-Meier method revealed no association between the cavity and OS in patients with NSCLC treated with MW ablation. Conclusions MW ablation was an effective and safe approach for cavitary NSCLC treatment. Compared with noncavitary NSCLC, cavitary NSCLC manifested with more complications but a comparable outcome after MW ablation.

Stem cell-based therapy raises hopes for a better approach to promoting tissue repair and functional recovery. However, transplanted stem cells show a high death percentage, creating challenges to successful transplantation and prognosis. Thus, it is necessary to investigate the mechanisms underlying stem cell death, such as apoptotic cascade activation, excessive autophagy, inflammatory response, reactive oxygen species, excitotoxicity, and ischemia/hypoxia. Targeting the molecular pathways involved may be an efficient strategy to enhance stem cell viability and maximize transplantation success. Notably, a more complex network of cell death receives more attention than one crucial pathway in determining stem cell fate, highlighting the challenges in exploring mechanisms and therapeutic targets. In this review, we focus on programmed cell death in transplanted stem cells. We also discuss some promising strategies and challenges in promoting survival for further study.

Background Chronic hepatitis B (CHB) patients have a high virological relapse rate after cessation of nucleos(t)ide analog (NA) treatment, but the clinical outcome remains unclear. This study aimed to investigate the 96-week clinical outcomes and the risk factors for relapse in CHB after cessation of NAs. Methods This study was a prospective trial; 74 eligible patients were enrolled. The patients underwent NA cessation and follow-up according to the 2012 Asian Pacific Association for the Study of the Liver Guideline. Symptoms, biochemical (aspartate aminotransferase [AST], alanine aminotransferase [ALT], total bilirubin, urea nitrogen, creatinine), virological data (hepatitis B surface antigen [HBsAg], hepatitis B e antigen [HBeAg], hepatitis B e antibody [HBeAb], hepatitis B virus [HBV] DNA levels), and color Doppler ultrasound examination results were recorded and analysed. Results After NA cessation, 19 cases were HBsAg-negative without relapse during the 96-week follow-up. Of the 55 cases of HBsAg-positive after cessation, four types of clinical outcomes were observed. Twelve patients had no relapse during the 96-week follow-up (type A, 21.8%), 7 patients underwent virological relapses but spontaneously had a non-virological relapse (type B, 12.7%), 10 patients maintained virological relapse (type C, 18.2%), and 26 patients turned to clinical relapse, received NA retreatment, and achieved ALT normalization and negative conversion of HBV DNA within 12 months (type D, 47.3%). The 2-year overall cumulative rates of virological and clinical relapses were 58.1% and 24.3%, respectively. Independent factors associated with virological relapse were duration of negative HBV DNA, EOT (end of treatment) HBsAg, and original status of HBeAg. The EOT HBsAg was also an independent factor for clinical relapse. Conclusions There are four types of clinical outcomes in patients with CHB after cessation of NA treatment. Further research is needed to explore the mechanism of different clinical outcomes. The EOT HBsAg level is an independent factor associated with both virological and clinical relapse.

Increasing evidence has shown that microRNAs (miRNAs) participate in cardiac fibrosis. We aimed to elucidate the effect of miRNA miR-25-3p on cardiac fibrosis. MiRNA microarray was used to profile miRNAs in the myocardium of angiotensin-II (Ang-II)-infused mice. Effect of miR-25-3p on expression of fibrosis-related genes, including Col1a1, Col3a1, and Acta2, was investigated both in vitro and in vivo. MiR-25-3p was shown increased in the myocardium of Ang-II-infused mice and patients with heart failure. MiR-25-3p enhanced fibrosis-related gene expression in mouse cardiac fibroblasts (mCFs) and in the myocardium of Ang-II-infused mice. Dickkopf 3 (Dkk3) was identified as a target gene of miR-25-3p, and Dkk3 could ameliorate Smad3 activation and fibrosis-related gene expression via enhancing Smad7 expression in mCFs. Additionally, NF-κB signal was proven to mediate upregulation of miR-25-3p in cardiac fibrosis. Our findings suggest that miR-25-3p enhances cardiac fibrosis by suppressing Dkk3 to activate Smad3 and fibrosis-related gene expression.

Background:. Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients. Methods:. In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg−1·min−1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth. Results:. In total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28–0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11–0.44, P

This review aims to compare the different therapeutic strategies for pyogenic liver abscess (PLA) patients, and a protocol for PLA treatment was proposed, which was based on current evidence from the literature. Data cited in this review were obtained primarily from Pubmed up to November, 2020. Articles were selected with the search items “pyogenic liver abscess”, “hepatic abscess”, “bacterial hepatic abscess”, “percutaneous drainage”, “treatment” and “therapy”. After the summary in the current literature, image-guided percutaneous drainage (PD) combined with antibiotics is recommended as first-line therapy despite lacking consensus on the therapeutic strategies. Surgery is generally performed when PLA fails to respond to PD, or the patient has concomitant abdominal diseases. Antibiotics are usually used prior to PD or surgery and the regime could be adjusted according to the blood or/and abscess culture results. When the PLA patients presented with Acute Physiologic and Chronic Health Evaluation II score > 15 points, ICU admission should be considered to reduce the mortality risk. A protocol for PLA treatment was proposed. However, the accuracy of the proposed protocol should be validated in the further studies.

Zhi-Xin Huang, 1– 3 Shumin Yuan, 4 Dongshi Li, 1, 3 Hong Hao, 2 Zhenguo Liu, 2 Jianguo Lin 1, 3 1Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China; 2Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA; 3Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China; 4Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, Guangxi, ChinaCorrespondence: Zhi-Xin HuangDepartment of Neurology, Guangdong Second Provincial General Hospital, 466 Middle Xingang Road, Guangzhou, 510317, Guangdong, ChinaTel/Fax +86 20 89168080Email hzxd6@163.com Zhenguo LiuCenter for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USAEmail liuzheng@health.missouri.eduBackground: Stroke is the leading cause of morbidity and mortality in China. Recurrent stroke (RS) could occur in a significant portion of patients with ischemic stroke with devastating consequence.Methods: To investigate the association between lifestyle and the risk of RS in Chinese patients with acute large-vessel ischemic stroke (ALVIS). A total of 258 patients with ALVIS were recruited in the study (median age 63 years, 30.6% female), and followed for a median of 366 days. The primary outcomes were first RS. Cox Regression and Akaike information criterion were used to establish the best-fit nomograms.Results: During follow-up, 38 of 258 (14.7%) participants had the primary endpoint event. After adjusting for confounding factors in multivariate Cox regression analysis, healthy lifestyles, including bland diet (hazard ratio [HR], 0.365; 95% CI, 0.138– 0.965), daily fruit consumption (HR, 0.474; 95% CI, 0.238– 0.945), good sleep (HR, 0.364; 95% CI, 0.180– 0.739), housework: HR (0.461; 95% CI, 0.200– 1.065), and HDL (HR, 0.329; 95% CI, 0.130– 0.831) were associated with significantly decreased risk for RS after ALVIS, while smoking was associated with a substantial increase in RS risk (HR, 2.590; 95% CI, 1.340– 5.005) and included into the nomogram. A weighted point (from 0 to 100) was given to each risk factor, and the total points could be used to predict the probability of RS for the patient.Conclusion: The nomogram shows that healthy lifestyles (bland diet, daily fruit consumption, good sleep, cigarette cessation, and housework) were important for reducing RS in patients with ALVIS.Keywords: recurrent event, lifestyle, ischemic stroke, stroke, nomogram

Objectives To develop an effective nomogram and artificial neural network (ANN) model for predicting pleural effusion after percutaneous microwave ablation (MWA) in lung malignancy (LM) patients. Methods LM patients treated with MWA were randomly allocated to either the training cohort or the validation cohort (7:3). The predictors of pleural effusion identified by univariable and multivariable analyses in the training cohort were used to develop a nomogram and ANN model. The C-statistic was used to evaluate the predictive accuracy in both the training and validation cohorts. Results A total of 496 patients (training cohort: n = 357; validation cohort: n = 139) were enrolled in this study. The predictors selected into the nomogram for pleural effusion included the maximum power (hazard ratio [HR], 1.060; 95% confidence interval [CI], 1.022–1.100, p = 0.002), the number of pleural punctures (HR, 2.280; 95% CI, 1.103–4.722; p = 0.026) and the minimum distance from needle to pleura (HR, 0.840; 95% CI, 0.775–0.899; p 0.16) on the nomogram should be monitored for pleural effusion.

Purpose This retrospective study aimed to evaluate the safety and efficacy of microwave ablation (MWA) for lung malignancies in patients with severe emphysema. Materials and methods The clinical records of 1075 consecutive patients treated for malignant lung tumors in our department were retrospectively reviewed. Emphysema was assessed based on standard-dose computed tomography (CT) and was considered severe when it occupied ≥25% of the lung. Overall, 26 patients (24 men and 2 women; mean age ± standard deviation [SD]: 71.23 ± 8.18 years, range: 59–88 years) with severe emphysema underwent CT–guided percutaneous MWA for treating 26 tumors (24: non-small cell lung cancer and 2: metastases). The mean tumor size was 3.0 cm (SD: 1.5, range: 1.2–6.5 cm). Follow-up was performed with CT at 1, 3, 6, 12 months after ablation, and every 6 months thereafter. Complications and efficacy were evaluated. Results The median follow-up duration in all patients was 17.5 months (range: 5–37 months, interquartile range: 15.8). The mortality rate was 0% within 30 days after ablation. Major complications including pneumonia, lung abscess and refractory pneumothorax occurred in 19.2% (5/26) patients. The technical success and efficacy rates were 88.5% (23/26) and 87.0% (20/23), respectively, and the local tumor progression rate was 30.0% (6/20). Conclusion MWA appears to be a safe and effective therapeutic option for treating lung malignancies in patients with severe emphysema.

Objectives To develop an effective nomogram model for predicting the local progression after computed tomography-guided microwave ablation (MWA) in non-small cell lung cancer (NSCLC) patients. Methods NSCLC patients treated with MWA were randomly allocated to either the training cohort or the validation cohort (4:1). The predictors of local progression identified by univariable and multivariable analyses in the training cohort were used to develop a nomogram model. The C-statistic was used to evaluate the predictive accuracy in both the training and validation cohorts. Results A total of 304 patients (training cohort: n = 250; validation cohort: n = 54) were included in this study. The predictors selected into the nomogram for local progression included the tumor subtypes (odds ratio [OR], 2.494; 95% confidence interval [CI], 1.415-4.396, p = 0.002), vessels ≥3 mm in direct contact with tumor (OR, 2.750; 95% CI, 1.263-5.988; p = 0.011), tumor diameter (OR, 2.252; 95% CI, 1.034-4.903; p = 0.041) and location (OR, 2.442; 95% CI, 1.201-4.965; p = 0.014). The C-statistic showed good predictive performance in both cohorts, with a C-statistic of 0.777 (95% CI, 0.707-0.848) internally and 0.712 (95% CI, 0.570-0.855) externally (training cohort and validation cohort, respectively). The optimal cutoff value for the risk of local progression was 0.39. Conclusions Tumor subtypes, vessels ≥3 mm in direct contact with the tumor, tumor diameter and location were predictors of local progression after MWA in NSCLC patients. The nomogram model could effectively predict the risk of local progression after MWA. Patients showing a high risk (>0.39) on the nomogram should be monitored for local progression.

Modern detectors in remote-sensing images follow the pipeline that feature maps extracted from ConvNets are shared between classification and regression tasks. However, there exist obvious conflicting demands in multiorientation object detection of remote-sensing images (RSOD) that classification is insensitive to orientations, while regression is quite sensitive. In addition, previous works cannot promise the reliability of rotation-invariant or rotation-equivariant features with only qualitative or intuitive analysis. To address these issues, we propose an encoder–encoder architecture, called rotated feature network (RFN), which produces rotation-sensitive feature maps (RS) for regression and rotation-invariant feature maps (RI) for classification. Specifically, the encoder unit assigns weights for rotated feature maps. The decoder unit extracts RS and RI by performing resuming operators on rotated and reweighed feature maps, respectively. To make the rotation-invariant characteristics more reliable, a metric is adopted to quantitatively evaluate the rotation-invariance by adding a constraint item in the loss, yielding a promising detection performance. Compared with the state-of-the-art methods, our method can achieve a significant improvement in NWPU very high resolution (VHR)-10 and RSOD data sets. The proposed RFN is further evaluated on the scene classification in remote-sensing images, demonstrating its good generalization ability. It can be integrated into an existing framework, leading to better performance with only a slight increase in test time and model complexity.

Objective: We aimed to investigate factors related to in-hospital mortality (IHM) in acute ischemic stroke (AIS) patients. Methods: We prospectively investigated 827,314 patients who were admitted ...

Highlights • T cell-induced immune responses during acute SARS-CoV-2 infection have barely been reported • The importance of CD4+ T cells (but not CD8+ and CD3+ T cells) in SARS-CoV-2-associated pneumonia • CD4+ T cells might be important for the control of SARS-CoV-2. Ideally, this information will contribute to the development of novel treatment methods for SARS-CoV-2, Background The world is facing the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). T cell-induced immune responses during acute SARS-CoV-2 infection have rarely been reported. Methods We use cell counting chips and PCR arrays to offer the first insights into the T cell involved in the course of acute SARS-CoV-2 infection. All consecutive patients with suspected SARS-CoV-2 infection treated at the designated hospital between January 2020 and February 2020 were recruited for the study, and cases were confirmed by real-time RT-PCR. Baseline characteristics for inpatients were prospectively collected and analyzed. Results 96 patients with suspected SARS-CoV-2 infection in our center were screened for inclusion in the study. The median age of the patients was 39.0 years, and 47 (49.0%) were female. Multivariate logistic regression analysis showed that only the CD4+ cell counts were significantly lower in the infection group and slightly higher in the control group. Receiver operating characteristic curve analysis showed good discrimination power between subjects with and subjects without infection. Limitations This is a single-center study of patients with a specific ethnic background and lacks a mechanism. Conclusions These findings imply the importance of CD4+ T cells (but not CD8+ and CD3+ T cells) in SARS-CoV-2 infection associated pneumonia and indicate that CD4+ T cells might be important for the control of SARS-CoV-2.

Background Carotid atherosclerosis (CA) is closely related to stroke, and Framingham Risk Score (FRS) has been used for CA risk evaluation. However, FRS could only be used for subjects of up to 74 years old. The present study was to determine if Essen Stroke Risk Score (ESRS) could be used to estimate CA risk in community populations without age limits. Methods In the present prospective multi-community screening study, we evaluated the prevalence of CA using high-resolution ultrasound in 521 males and 1039 females (35 to 91 years old). Both FRS and ESRS were calculated for the subjects. Multivariate logistic regression analysis was used to determine the predictive values of FRS and ESRS for CA in these subjects. Results Ultrasound data showed that CA was present in 56.2% of the participants (total of 1560). Multivariate logistic regression analysis showed that ESRS was associated with CA with odds ratio (OR): 1.34 (95% confidence interval (CI), 1.12-1.60, p=0.001). Central obesity (OR: 1.40, CI: 1.07-1.83, p=0.015), female (OR: 0.55, CI: 0.39-0.77, p

Control valves are widely used to regulate fluid flux in nuclear power plants, and there are more than 1500 control valves in the primary circuit of one nuclear power plant. With their help, the flux can be regulated to a specific level of water or steam to guarantee the energy efficiency and safety of the nuclear power plant. The flux characteristics of the control valve mainly depend on the valve core shape. In order to analyze the effects of valve core shapes on flux characteristics of control valves, this paper focuses on the valve core shapes. To begin with, numerical models of different valve core shapes are established, and results are compared with the ideal flux characteristics curve for the purpose of validation. Meanwhile, the flow fields corresponding to different valve core shapes are investigated. Moreover, relationships between the valve core opening and the outlet flux under different valve core shapes are carried out. The flux characteristics curve and equation are proposed to predict the outlet flux under different valve core openings. This work can benefit the further research of the flux control and the optimization of the valve core for control valves in nuclear power plants.

Driving cycles provide a basis for vehicle development and calibration and also serves as the foundation for energy consumption and emissions certification of vehicles. This paper presents the China Light-Duty Vehicle Test Cycle (CLTC) developed by the China Automotive Technology & Research Center (CATARC). First, the important steps and technical routes toward the CLTC development process are summarized. Second, the specific CLTC development process is presented in detail, including the data acquisition and data analysis procedures, weighting factor development and driving cycle construction. Then, the main driving characteristics of the New European Driving Cycle (NEDC), the Worldwide Harmonized Light-Duty Vehicles Test Cycle (WLTC), the Federal Test Procedure (FTP-75), the CLTC and the actual collected data are compared. The CLTC has low average speed, a high idle speed ratio and more frequent acceleration and deceleration characteristics. Finally, 70 vehicles are tested based on the NEDC, WLTC, and CLTC according to their legislative procedures in the vehicle emission laboratories of the CATARC and the manufacturers. The results show that the CLTC’s fuel consumption is much higher than that of the NEDC and WLTC, and CLTC can effectively reflect the actual fuel consumption of users.

Mechanical heart valves (MHVs) are widely used to replace diseased heart valves, but it may suffer from cavitation due to the rapid closing velocity of the leaflets, resulting in the damage of red blood cells and platelets. The aim of this study is to apply computational fluid dynamics (CFD) method to investigate the cavitation in bileaflets mechanical heart valves (BMHVs) and discuss the effects of the conduit and leaflet geometries on cavitation intensity. Firstly, CFD method together with moving-grid technology were applied and validated by comparing with experimental results obtained from other literature. Then the leaflets movement and the flow rate of BMHVs with different conduit geometries and leaflet geometries are compared. At last, the duration time of the saturated vapor pressure and the closing velocity of leaflets at the instant of valve closure were used to represent the cavitation intensity. Larger closing velocity of leaflets at the instant of valve closure means higher cavitation intensity. For BMHVs with different conduit geometries, the conduit with Valsalva sinuses has the maximum cavitation intensity and the straight conduit has the minimum cavitation intensity, but the leaflets cannot reach the fully opened state in a straight conduit. For BMHVs with different leaflet geometries, in order to minimize the cavitation intensity, the leaflets are better to have a large thickness and a small rotational radius. CFD method is a promising method to deal with cavitation in BMHVs, and the closing velocity of leaflets has the same trend with the cavitation intensity. By using CFD method, the effects of the conduit geometry and the leaflet geometry on cavitaion in BMHVs are found out.

Multi-criteria decision making (MCDM) methods have become increasingly popular in site selection decision-making of renewable energy power plants because they consider multiple conflicting goals and decision-maker preferences. In this paper, a systematic literature review of MCDM applications for renewable energy site selection is performed, covering a total of 85 papers published from 2001 to 2018 in high-level journals (chosen from the ScienceDirect database). This paper has summarized the exclusion criteria and evaluation criteria of site selection for five energy sources. The five site selection stages, criteria selection, data normalization, criteria weighting, alternative evaluation and result validation, are revealed by content analysis. All papers are further classified by the date, energy source, journal of publication, country of author affiliation, and study area. It is found that different energy sources emphasize different criteria; however, some similarities exist. Literature surveys and expert opinions are most common criteria selection method. Reclassification is most frequently used data normalization method. The analytic hierarchy process is popular for weighting. In alternative evaluation, geographic information systems and weighted linear combination are the most popular tools. Varying the criteria weights is most commonly used result validation method.

Background and aims To investigate the safety and efficacy of direct-acting antiviral (DAA) regimens in a cohort of Chinese patients with chronic hepatitis C virus (HCV) infection. Methods A total of 222 adult Chinese patients were enrolled and treated via DAA regimens in accordance with HCV management guidelines. Treatment responses were evaluated 4 weeks after treatment, at the end of treatment (EOT) and 12 weeks post-treatment. Virological responses, biochemical responses, model for end-stage liver disease (MELD) and Child-Pugh (CP) scores were recorded. Results A total of 218 patients (98.2%) achieved sustained virological response 12 weeks post-treatment and 4 patients relapsed. The combined number of rapid virological responses for all six regimens was 170/222 (76.6%), and 221/222 (99.6%) had achieved virological responses by the end of treatment. In decompensated cirrhosis patients the baseline mean CP score was 6.8 ± 1.3 and the mean MELD score was 10.1 ± 3.3. Compared with the mean CP score at baseline, the mean score is significantly lower at the end of treatment (5.7 ± 1.3) and 12 weeks post-treatment (5.6 ± 1.0). Estimated glomerular filtration rates did not differ significantly from baseline during the treatment or 12 weeks post-treatment. The incidence of adverse events in patients with chronic hepatitis C and compensated cirrhosis was 42/172 (24.4%), and in patients with decompensated cirrhosis it was 8/22 (36.4%). The most frequently reported adverse events were elevated indirect bilirubin, fatigue and rash. There were no cases of serious adverse events, death or treatment discontinuation because of adverse events. Conclusion DAA regimens were highly effective and well tolerated irrespective of HCV genotype, cirrhosis, liver or kidney transplantation, hepatocellular carcinoma, HCV/hepatitis B virus co-infection, or renal failure.

Primary aldosteronism (PA) is a common form of endocrine hypertension. The diagnostic process of PA includes a screening test, confirmatory test, and subtype classification. In this review, we have summarized the latest advances in the diagnosis of PA with regard to screening and confirmatory tests and provided some recommendations to improve clinical practice. Keywords: Primary aldosteronism, Screening test, Confirmatory test

Two-dimensional (2D) semiconductors have attracted tremendous interest as natural passivation and atomically thin channels could facilitate continued transistor scaling. However, air-stable 2D semiconductors with high performance are quite elusive. Recently, an extremely-air-stable ${\mathrm{Mo}\mathrm{Si}}_{2}{\mathrm{N}}_{4}$ monolayer was successfully fabricated [Hong et al., Science 369, 670 (2020)]. To further reveal its potential application in sub-5-nm metal-oxide-semiconductor field-effect transistors (MOSFETs), there is an urgent need to develop integrated circuits. Here, we report first-principles quantum-transport simulations on the performance limits of n- and p-type sub-5-nm monolayer (ML) ${\mathrm{Mo}\mathrm{Si}}_{2}{\mathrm{N}}_{4}$ MOSFETs. We find that the on-state current in the ${\mathrm{Mo}\mathrm{Si}}_{2}{\mathrm{N}}_{4}$ MOSFETs can be effectively manipulated by the length of gate and underlap, as well as the doping concentration. Very strikingly, we also find that for the n-type devices the optimized on-state currents can reach up to 1390 and 1025 \textmu{}A/\textmu{}m for high-performance and low-power (LP) applications, respectively, both of which satisfy the International Technology Roadmap for Semiconductors (ITRS) requirements. The optimized on-state current can meet the LP application (348 \textmu{}A/\textmu{}m) for p-type devices. Finally, we find that the ${\mathrm{Mo}\mathrm{Si}}_{2}{\mathrm{N}}_{4}$ MOSFETs have an ultralow subthreshold swing and power-delay product, which have the potential to realize high-speed and low-power consumption devices. Our results show that ${\mathrm{Mo}\mathrm{Si}}_{2}{\mathrm{N}}_{4}$ is an ideal 2D channel material for future competitive ultrascaled devices.

A single-pixel neural network object classification scenario in the sub-Nyquist ghost imaging system is proposed. Based on the neural network, objects are classified directly by bucket measurements without reconstructing images. Classification accuracy can still be maintained at 94.23% even with only 16 measurements (less than the Nyquist limit of 1.56%). A parallel computing scheme is applied in data processing to reduce the object acquisition time significantly. Random patterns are used as illumination patterns to illuminate objects. The proposed method performs much better than existing methods for both binary and grayscale images in the sub-Nyquist condition, which is also robust to environment noise turbulence. Benefiting from advantages of ghost imaging, it may find applications for target recognition in the fields of remote sensing, military defense, and so on.

We studied whether myo-inositol supplementation throughout lactation, alone and combined with leptin, may reverse detrimental effects on hypothalamic structure and function caused by gestational calorie gestation (CR) in rats. Candidate early transcript-based biomarkers of metabolic health in peripheral blood mononuclear cells (PBMC) were also studied. Offspring of dams exposed to 25% gestational CR and supplemented during lactation with physiological doses of leptin (CR-L), myo-inositol (CR-M), the combination (CR-LM), or the vehicle (CR-V) as well as control rats (CON-V) were followed and sacrificed at postnatal day 25. Myo-inositol and the combination increased the number of neurons in arcuate nucleus (ARC) (only in females) and paraventricular nucleus, and myo-inositol (alone) restored the number of αMSH+ neurons in ARC. Hypothalamic mRNA levels of Lepr in CR-M and Insr in CR-M and CR-LM males were higher than in CR-V and CON-V, respectively. In PBMC, increased expression levels of Lrp11 and Gls in CR-V were partially normalized in all supplemented groups (but only in males for Gls). Therefore, myo-inositol supplementation throughout lactation, alone and combined with leptin, reverts programmed alterations by fetal undernutrition on hypothalamic structure and gene expression of potential early biomarkers of metabolic health in PBMC, which might be attributed, in part, to increased leptin sensitivity.

Oil is an important industrial raw material used as both a fuel and energy source and is the pillar of national economies. With the development of the petroleum industry, oil pollution is becoming ...

This paper investigates the fuzzy position/force hybrid control for a class of 5-degree-of-freedom (DOF) redundantly actuated parallel robots. The position control law is designed based on the proportional-integral-differential (PID) for the 5-DOF redundantly actuated parallel robot. The fuzzy proportional-integral (PI) redundant actuation force control law is designed based on the position/force hybrid control structure for the 5-DOF redundantly actuated parallel robot. The optimum driving force is obtained in the presence of interference, and the force tracking performance of the fuzzy PI controller is better than the conventional PI controller under the interference condition. Based on the fuzzy position/force hybrid controller, the tracking performance of the closed-loop system for the 5-DOF redundantly actuated parallel robot is improved by using the fuzzy position/force hybrid controller and the interference is eliminated effectively in the control system design. Finally, the co-simulation results of ADAMS and MATLAB/SIMULINK are given to show the effectiveness and advantages of the proposed methods compared with the conventional PI controller.

The well-studied star compound, CH3NH3PbI3, has attracted plenty of attention because of its remarkable optical and electrical properties. Consequently, new switching multifunctional hybrid compounds can be widely used in many fields such as solar cells, light-emitting diodes, optical data storage and so on. Therefore, switching multifunctional hybrid compounds with dielectric and semiconducting properties simultaneously will also find roles in the next generation of optoelectronic coupling materials. In fact, discovering an effective method to synthesize (multi)functional hybrid materials remains a pressing challenge. Thanks to the "quasi-spherical theory" proposed by Xiong et al., we used 7-azabicyclo[2.2.1]heptane as the quasi-spherical cation to construct molecule-based crystalline materials that exhibit responsive properties. Then, we tried to exploit the knowledge of crystal engineering and coordination chemistry to explain (multi)functional molecular materials. A layered organic-inorganic hybrid compound, (C6H12N)2Pb(NO3)4 (1), was grown and its dielectric switching property and semiconducting behaviour were investigated. Insights from differential scanning calorimetry measurements, variable-temperature X-ray structural studies, and dielectric spectroscopy revealed the origin of the phase transition, which is related to the motion of the organic ammonium and inorganic framework in solid-state crystals. Furthermore, 1 is also a wide bandgap semiconductor with an optical bandgap of 3.53 eV. The realization of switching and semiconducting properties simultaneously in layered Pb-based perovskites has a great significance toward research into hybrid compounds and the development of dielectric-optoelectronic integrated materials.

In recent years, deep learning has greatly improved the ability of wheatear detection. However, there are still three main problems in wheatear detection based on unmanned aerial vehicle (UAV) platforms. First, dense wheat plants often overlap, and the wind direction will blur the pictures, which obviously interferes with the detection of wheatears; second, due to the different maturity, color, genotype, and head orientation, the appearance will also be different; third, UAV needs to take images in the field and conduct real-time detection, which requires the embedded module to detect wheatears quickly and accurately. Given the above problems, we studied and improved YoloV4, and proposed a robust method for wheatear detection using UAV in natural scenes. For the first problem, we modified the network structure, deleted the feature map with a size of $19\times 19$ , and used k-means algorithm to re-cluster the anchors, and we proposed a method of prediction box fusion. For the second problem, we used the pseudo-labeling method and data augmentation methods to improve the generalization ability of the model. For the third problem, we simplified the network structure, replaced the original network convolution with the improved depthwise separable convolution, and proposed an adaptive ReLU activation function to reduce the amount of calculation and speed up the calculation. The experimental results showed that our method can effectively mark the bounding of wheatears. In test sets, our method achieves 96.71% in f1-score, which is 9.61% higher than the state of the art method, and the detection speed is 23% faster than the original method. It can be concluded that our method can effectively solve the problems of wheatear detection based on the UAV platform in natural scenes.

This paper develops and applies a procedure for detecting damage in a composite slab-on-girder bridge structure comprising of a reinforced concrete slab and three steel I beams, using vibration cha...

Objectives Lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC). No clinical trials have been performed, and no course of treatment for LELC has been established because of it's rarity. This study presents a patient with primary pulmonary LELC, who was treated with nivolumab, and responded favorably. Materials and methods A patient with primary pulmonary LELC was treated using nivolumab. Result The patient responded well to immunotherapy with nivolumab. After five cycles of the nivolumab, the size of the tumor and the lesions of the liver became smaller. A blood test showed that CYFRA21-1 and NSE had dramatically decreased from before, especially the CYFRA21-1. Conclusion EBV-positive pulmonary LELC with high expression of PD-L1 may derive a benefit from PD-1/PD-L1 blockade.

Background Drug‐eluting beads bronchial arterial chemoembolization (DEB‐BACE) can embolize the tumor‐feeding artery and also be loaded with antitumor drugs, which can be released slowly into the local tumor environment. The effect of DEB‐BACE in patients with lung cancer remains unclear. We evaluated the efficacy and safety of DEB‐BACE with gemcitabine‐loaded CalliSpheres beads in patients with non‐small cell lung cancer (NSCLC). Methods From May 2017 to December 2018, six patients with NSCLC who were ineligible or refused to receive standard treatment underwent DEB‐BACE with gemcitabine‐loaded CalliSpheres beads. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression‐free survival (PFS), overall survival (OS), and quality of life. Safety was evaluated by the occurrences of adverse events and serious adverse events. Results All patients were treated with DEB‐BACE loaded with gemcitabine (800 mg) using CalliSpheres beads. Five patients also received transarterial infusion with nedaplatin (80–100 mg). Of the six patients, five underwent a second session of DEB‐BACE, with intervals of one month between the first and second session. The median follow‐up time was 16.5 months (7.0–23.0 months). ORR and disease control rate were 50.0% and 100.0%, 50.0% and 83.3%, 50.0% and 66.7% respectively at 2, 4, and 6 months after DEB‐BACE. One patient maintained a partial response and the other five had progressive disease, of whom two patients died and the other three remained alive receiving targeted therapy, radiotherapy, transarterial infusion or thermal ablation. The median PFS was 8.0 months (4–23 months), and the 6‐ and 12 month PFS rates were 66.7% and 16.7%, respectively. The median OS was 16.5 months (7–23 months), and the six and 12 month OS rates were 100.0% and 66.7%, respectively. Hemoptysis, cough and dyspnea disappeared after DEB‐BACE in four patients. Global quality of life, physical and emotional functioning were all significantly improved at two months (P

Obesity may impact surgical outcomes of gastrectomy. Whether visceral fat area (VFA) is a better obesity parameter than body mass index (BMI) is still controversial. The aim of this study is to compare the accuracy and effectiveness of VFA and BMI in predicting the short-term surgical outcomes of gastrectomy. Patients who were diagnosed with gastric cancer were measured for BMI and VFA preoperatively and then divided into a VFA-H (VFA-high) group and VFA-L (VFA-low) group, at the cutoff point of 100 cm2, and a BMI-H (BMI-high) group and BMI-L (BMI-low) group, at the cutoff point of 25 kg/m2. The short-term surgical outcomes were compared between the different groups. In total, 276 patients were enrolled in this study; 55 (19.9%) patients were classified into the BMI-H group, and 122 (44.2%) patients were classified into the VFA-H group. There was a significant correlation between BMI and VFA (r = 0.652, p

In this paper, the modified performance limitation of multi‐input multi‐output (MIMO) wireless networked time‐delay systems over fading channels is investigated, where the characteristic o...

目前大中型控制阀大多存在结构复杂、驱动能耗 大、反应时间慢、振动噪声大、稳定性差和使用 寿命短等缺点。基于此, 浙江大学相关研究人员 组建了特种控制阀研究室, 致力于提升控制阀的 整体性能和设计水平。 本研究室的主要方向为: 1. 控制阀内部流动特性 分析和新结构设计开发; 2. 流体目标流量、温度、 压力和振动噪声等的智能控制研究; 3. 适应纳米 流体、压缩氢气和高温高压过热蒸汽等新流体介 质的智慧控制阀研究。 特种控制阀作为超超临界火电机组、核电、石化 高压反应和百万吨级乙烯工程等国家重大重点 工程的关键零部件之一, 将会在内流动机理、新 结构开发、新流体介质和智能控制等研究领域得 到广泛关注和长足发展

Background There is still a lack of data on deep vein thrombosis (DVT) following surgically treated femoral shaft fracture (FSF). The goal of this study was to investigate the characteristics of postoperative DVT and the association between the occurrence of DVT and risk factors in patients undergoing surgical treatment for FSF. Methods This observational retrospective case-control study reviewed 308 patients who received surgical treatment of FSF between January 2016 and October 2020 at a university hospital. Univariate analyses were performed on the data of demographics, comorbidities, laboratory biomarkers, and operation-related indexes. The receiver operating characteristic (ROC) curve analysis, univariate analyses, and multivariate logistic regression analysis were employed to identify the independent risk factors associated with DVT. Results In total, 308 patients with surgically treated FSF were included, among whom 48 (15.6%) patients had postoperative DVTs. The univariate analyses showing significant differences regarding DVT were American Society of Anesthesiologists (ASA) classification, diabetes mellitus, current smoking, aspartate transaminase (AST), and very-low-density lipoprotein (VLDL) level among the 34 factors. According to the ROC results, the optimal cutoff values for intraoperative blood loss, d-dimer, and age were 350 ml, 1.08 μg/ml, and 35 years, respectively. The multivariable model demonstrated 4 significantly independent associations with postoperative DVT, including current smoking, intraoperative blood loss (> 550 ml), age (> 35 years), and d-dimer > 1.09 μg/ml. Conclusion These risk factors as screening tools contribute to risk stratification of the occurrence of thromboembolic events. In addition, our findings would help orthopedic surgeons make a cross-specialty decision and implement targeted precaution measures for patients with FSF.

Background Hepatocellular carcinoma (HCC), with Hepatitis B viurs X protein (HBx) as one of the main etiology, harbors various metabolic phenotypes for distinct nutrient availability inside solid tumors. Trichostatin A is a histone inhibitor, supposed to inhibit cancer development. However, the role of TSA in tumor cells with metabolic stress has received little investigation. Methods We built a HBx-overexpression hepatoma cell model with HBx plasmids transfection, and EBSS was applied in nutrient-deprived cell model. Through western blot, Q-PCR and immunoprecipitation, we further explored the molecular mechanism of TSA-related anti-cancer function. Results In our study here, we found that TSA inhibited HBx-enhanced metastasis in metabolic stress, and demonstrated that Sirtuin 3 (SIRT3), one of tumor suppressors in HCC, played a role in TSA-related anti-cancer function in metabolic stress, and TSA promoted SIRT3 transcription. Conclusions We suggest that TSA alleviated specific subset of HCC, the HBx-induced HCC in metabolic stress, through promoting SIRT3 transcription, suggesting that TSA is a potential drug for HCC treatment.

Background:There is controversy about the characteristics and prognostic implications of signet ring cell gastric cancers and non-signet ring cell gastric cancers.Objective:This study aims to evaluate clinicopathological characteristics and prognoses of signet ring cell carcinoma (SRCC) and non-signet ring cell carcinoma (NSRCC) of stomach.Methods:Studies compared between SRCC and NSRCC of the stomach after gastrectomy and published before September 1st, 2020, in the PubMed, Cochrane, and Embase databases, were identified systematically.Results:A total of 2,865 studies were screened, and 36 studies were included, with 19,174 patients in the SRCC group and 55,942 patients in the NSRCC group. SRCC patients were younger in age (P< 0.001), less likely to be male patients (P< 0.001), more afflicted with upper third lesions (P< 0.001), and presenting with more Borrmann type IV tumors (P= 0.005) than NSRCC patients. Lymph nodes metastasis was similar between SRCC and NSRCC patients with advanced tumor stage (OR: 0.86, 95% CI: 0.67–1.10,P= 0.23), but lower in the SRCC than NSRCC patients with early tumor stage (OR: 0.73; 95% CI: 0.56–0.98,P= 0.02). SRCC patients had comparable survival outcomes with NSRCC patients for early gastric cancers (HR: 1.05, 95% CI: 0.65–1.68,P< 0.001) but had significantly poor prognosis for patients with advanced tumor stage (HR: 1.50, 95% CI: 1.28–1.76,P< 0.001).Conclusions:Signet ring cell carcinomas of the stomach are an increasingly common histopathological subtype of gastric cancers. These kinds of patients tend to be younger in age and more often female. Although, signet ring cell gastric cancer is a negative prognostic factor for patients with advanced stage. The difference is that for early stage of signet ring cell gastric cancers, it has low lymph nodes metastasis rate and comparable prognosis with non-signet ring cell cancers.

Purpose To evaluate the short-term efficacy and safety of immunotherapy with sintilimab combined with bronchial arterial infusion (BAI) chemotherapy/drug-eluting embolic (DEE) bronchial arterial chemoembolization (BACE) for advanced non–small cell lung cancer (NSCLC). Materials and Methods Ten patients with advanced NSCLC were treated with sintilimab plus BAI/DEE-BACE between December 2019 and November 2020 and retrospectively evaluated. The Response Evaluation Criteria in Solid Tumors version 1.1 was applied to evaluate the treatment response. The local tumor control duration, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier analysis. Results At 30 days after the last multimodal treatment, complete response, partial response, and stable disease were recorded in 1 (10%), 7 (70%), and 2 (20%) patients, respectively, for an objective response rate of 80% and a disease control rate of 100%. No patient experienced progressive disease. The median duration of local tumor control was 8.0 months (95% CI, 6.2–9.7 months). The median PFS and OS were 11.0 months (95% CI, 6.9–15.1 months) and 8.0 months (95% CI, 5.5–10.5 months), respectively. Two cases of Grade III adverse events related to medications were reported. Conclusions Sintilimab combined with BAI/DEE-BACE for patients with advanced NSCLC appears to be safe and feasible. Compared with previous studies on BAI/DEE-BACE, the addition of immunotherapy may improve survival.

Objectives To develop effective nomograms for predicting pneumothorax and delayed pneumothorax after microwave ablation (MWA) in lung malignancy (LM) patients. Methods LM patients treated with MWA were randomly allocated to a training or validation cohort at a ratio of 7:3. The predictors of pneumothorax identified by univariate and multivariate analyses in the training cohort were used to develop a predictive nomogram. The C-statistic was used to evaluate predictive accuracy in both cohorts. A second nomogram for predicting delayed pneumothorax was developed and validated using identical methods. Results A total of 552 patients (training cohort: n = 402; validation cohort: n = 150) were included; of these patients, 27.9% (154/552) developed pneumothorax, with immediate and delayed pneumothorax occurring in 18.8% (104/552) and 9.1% (50/552), respectively. The predictors selected for the nomogram of pneumothorax were emphysema (hazard ratio [HR], 6.543; p

To effectively predict the life of high voltage dc power relay, the authors design the structure of the relay to extending its life. The contact failure mechanism of relay products is analyzed by observing the appearance of several contact failures. The electromagnetic-thermal field coupling model is established and the state of heat flow and distribution of temperature increase between electrical and thermal coupling contacts are analyzed through simulations and experiments. An adaptive neural network control system is established to conduct sample training, obtain the best stiffness coefficient of the main spring, and optimize the design of the main spring structure composed of composite springs. The action voltage, release voltage, contact resistance, contact pressure, action time, and release time as characteristic parameters, and the relative error, correlation degree, variance ratio, and small error probability of each characteristic parameter, are calculated. The precision grade index of contact resistance and action time is defined as level 1. The two characteristic parameters are selected as the prediction variables to establish the life-prediction model based on gray theory. The relative error between the predicted and test life is 5.31%–5.6%, indicating that the life-prediction model has high accuracy. The test results show that the combined main spring structure can extend the life of a relay by 18.15%.

BackgroundMicrovascular insufficiency plays an important role in the development of diabetic cardiomyopathy (DCM), therapeutic angiogenesis has been mainly used for the treatment of ischemic diseases. This study sought to verify the preclinical performance of SonoVue microbubbles (MB) combined ultrasound (US) treatment on myocardial angiogenesis in the rat model of DCM and investigate the optimal ultrasonic parameters.MethodsThe male Sprague–Dawley (SD) rats were induced DCM by streptozotocin through intraperitoneal injecting and fed with high-fat diet. After the DCM model was established, the rats were divided into the normal group, DCM model group, and US + MB group, while the US + MB group was divided into four subsets according to different pulse lengths (PL) (8 cycles;18 cycle;26 cycle; 36 cycle). After all interventions, all rats underwent conventional echocardiography to examine the cardiac function. The rats were sacrificed and myocardial tissue was examined by histology and morphometry evaluations to detect the myocardial protective effect of SonoVue MBs using US techniques.ResultsFrom morphologic observation and echocardiography, the DCM rats had a series of structural abnormalities of cardiac myocardium compared to the normal rats. The US-MB groups exerted cardioprotective effect in DCM rats, improved reparative neovascularization and increased cardiac perfusion, while the 26 cycle group showed significant therapeutic effects on the cardiac functions in DCM rats.ConclusionThis strategy using SonoVue MB and US can improve the efficacy of angiogenesis, even reverse the progress of cardiac dysfunction and pathological abnormalities, especially using the 26 cycle parameters. Under further study, this combined strategy might provide a novel approach for early intervention of DCM in diabetic patients.

With the development policies and plans for vocational education appearing, modular curriculum in improving the vocational education and training system is more important to improve the education quality. The concept of module was introduced in the paper. The modular curriculum was explained by the analogy with the system which is composed of modules with different functions and characteristics. The characteristics of modular curriculum including functionality, interchangeability, flexibility and applicability were introduced and discussed. Taking automobile major as an example, the modules of the curriculums were studied and divided. The background and the career analysis of the students were investigated and researched on automobile engineering. Especially, the professional course modules were studied according to professional background and career analysis of the students. Curriculums in the professional modules were divided into four parts including Basic technology courses for specialty group, Vocational and technical skills courses, Professional comprehensive modular courses, and Innovative practical modular courses. Among the course modules, the professional comprehensive modular courses and the innovative practical modular courses are designed and divided into specific courses, and the specific courses were firstly designed with the type of micro lectures.

Chronic posttraumatic headache (PTH) is among the most common and disabling sequelae of traumatic brain injury (TBI). Current PTH treatments are often only partially effective and have problematic side effects. We previously showed in a small randomized trial of patients with chronic nontraumatic headaches that manipulation of dietary fatty acids decreased headache frequency, severity, and pain medication use. Pain reduction was associated with alterations in oxylipins derived from n-3 and n-6 fatty acids, suggesting that oxylipins could potentially mediate clinical pain reduction. The objective of this study was to investigate whether circulating oxylipins measured in the acute setting after TBI could serve as prognostic biomarkers for developing chronic PTH. Participants enrolled in the Traumatic Head Injury Neuroimaging Classification Protocol provided serum within 3 days of TBI and were followed up at 90 days postinjury with a neurobehavioral symptom inventory (NSI) and satisfaction with life survey. Liquid chromatography-tandem mass spectrometry methods profiled 39 oxylipins derived from n-3 docosahexaenoic acid (DHA), and n-6 arachidonic acid and linoleic acid. Statistical analyses assessed the association of oxylipins with headache severity (primary outcome, measured by headache question on NSI) as well as associations between oxylipins and total NSI or satisfaction with life survey scores. Among oxylipins, 4-hydroxy-DHA and 19,20-epoxy-docosapentaenoate (DHA derivatives) were inversely associated with headache severity, and 11-hydroxy-9-epoxy-octadecenoate (a linoleic acid derivative) was positively associated with headache severity. These findings support a potential for DHA-derived oxylipins as prognostic biomarkers for development of chronic PTH.

Introduction: Patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive amyopathic dermatomyositis (ADM) often develop rapidly progressive interstitial lung diseases (RP-ILD), with poor treatment success. Many studies have shown that this is the main cause of death in patients with anti-MDA5 antibody-positive ADM.Case Presentation: A 37-years-old woman developed a cough, shortness of breath, and a rash on both hands, which resembled Gottron's signs. Upon laboratory examination, the results were as follows: antinuclear antibody (ANA) positive; anti-Ro52 antibody positive; and anti-MDA5 antibody positive. Pulmonary high-resolution CT (HRCT) scan showed pulmonary interstitial inflammatory changes, and mediastinal and subcutaneous emphysema. She was finally diagnosed with anti-MDA5 antibody-positive ADM accompanied by RP-ILD. She was first given high-dose-steroid pulse therapy with methylprednisolone (500 mg per day for 3 days) followed by methylprednisolone (40 mg, daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day). Since her discharge from our hospital in March of 2018, she has maintained the methylprednisolone therapy (tapered to 10 mg daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day).Outcomes: Pulmonary HRCT scans taken on 4, 9, and 26 months after her discharge from our hospital showed that the interstitial pneumonitis had significantly improved and that mediastinal and subcutaneous emphysema had been gradually absorbed. The patient can now participate in regular work and activities of daily living.Conclusion: The treatment of methylprednisolone pulse therapy combined with cyclosporine A and hydroxychloroquine may be an option for the RP-ILD accompanied by anti-MDA-positive ADM. After the acute phase, this combination therapy strategy is helpful to the disease control of patients.