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International audience; Full text linksfull-text provider logoActionsFavoritesSharePage navigation Title & authors Abstract Similar articles Publication types MeSH terms Substances Related information LinkOut - more resourcesComparative StudyAm Heart J. 2020 Sep;227:19-30.doi: 10.1016/j.ahj.2020.06.005. Epub 2020 Jun 20.Rationale and design of the RIGHT trial: A multicenter, randomized, double-blind, placebo-controlled trial of anticoagulation prolongation versus no anticoagulation after primary percutaneous coronary intervention for ST-segment elevation myocardial infarctionYan Yan 1 , Xiao Wang 2 , Jincheng Guo 3 , Yongjun Li 4 , Hui Ai 5 , Wei Gong 6 , Bin Que 7 , Lei Zhen 8 , Jiapeng Lu 9 , Changsheng Ma 10 , Gilles Montalescot 11 , Shaoping Nie 12Affiliations PMID: 32663660 DOI: 10.1016/j.ahj.2020.06.005 AbstractBackground: Current guidelines recommend anticoagulation therapy during primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI). However, whether anticoagulation should be continued after pPCI has not been well investigated.Methods/design: The RIGHT trial is a prospective, multicenter, randomized, double-blind, placebo-controlled trial in STEMI patients treated with pPCI evaluating the prolongation of anticoagulation after the procedure. Patients are randomized in a 1:1 fashion to receive either prolonged anticoagulant or matching placebo (no anticoagulation) for at least 48 hours after the procedure. When randomized to anticoagulation prolongation, the patient is assigned to intravenous unfractionated heparin (UFH) or subcutaneous enoxaparin or intravenous bivalirudin (same drug and same regimen at each center). The primary efficacy endpoint is the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, stent thrombosis (definite) or urgent revascularization (any vessel) at 30 days. The primary safety endpoint is major bleeding (BARC 3-5) at 30 days. Based on a superiority design and assuming a 35% relative risk reduction (from 7% to 4.5%), 2856 patients will be enrolled, accounting for a 5% drop-out rate (α = 0.05 and power = 80%).Conclusion: The RIGHT trial tests the hypothesis that post-procedural anticoagulation is superior to no anticoagulation in reducing ischemic events in STEMI patients undergoing pPCI.

BackgroundThe aim of this study was to evaluate the value of copeptin in predicting mortality including both short-term and long-term mortality in patients with acute coronary syndrome (ACS).MethodsPotential studies were searched and selected through PubMed, Embase and Cochrane databases up to December 2019. The predictive performance was evaluated by the pooled sensitivity and specificity, and summary receiver operating characteristic curves. Cochran's Q test and I2 index were used to assess between-study heterogeneity, and Deek's test and funnel plots were used to assess publication bias.ResultsTotal six studies comprising 2269 patients were included in this meta-analysis. The area under the receiver operating characteristic curve of copeptin in predicting mortality in patients with ACS was 0.73 (95% CI: 0.69-0.77). The pooled sensitivity and specificity of copeptin were 0.77 (95% CI: 0.59-0.89) and 0.60 (95% CI: 0.47-0.71), respectively. Significant between-study heterogeneity was identified in both sensitivity (P = 0.01; I2 = 69.76%) and specificity (PConclusionsCopeptin has acceptable prognostic value for mortality in patients with ACS. Further studies based on multimarker strategy are needed to evaluate the prognostic value of copeptin for ACS in conjunction with other well-established biomarkers.

Subtle ligand modifications on Ru

Background: Although increased age is associated with higher systolic blood pressure (SBP) in general, there may be variation across individuals in how SBP changes over time. The goal of this paper is to identify heterogeneity in SBP trajectories among young adults with similar initial values and identify personal characteristics associated with different trajectory patterns. This may have important implications for prevention and prognosis. Methods: A cohort of 12,468 individuals aged 18–35 years in the Qingdao Port Cardiovascular Health Study in China was followed yearly during 2000–2011. Individuals were categorized into three strata according to their baseline SBP: ≤110 mmHg, 111–130 mmHg, and >130 mmHg. Within each stratum, group-based trajectory analyses were conducted to identify distinct SBP trajectory patterns, and their association with sociodemographic and baseline health characteristics was assessed by ordinal logistic regression. Results: Five distinct groups of individuals exhibiting divergent patterns of increasing, stable or decreasing SBP trends were identified within each stratum. This is a first report to identify a subgroup with decreasing trend in SBP. Individuals with more advanced age, having less than high school education, family history of cardiovascular diseases, greater body mass index, greater waist circumference, and hyperlipidemia at baseline were more likely to experience trajectories of higher SBP within each stratum. Conclusions: The diverging trajectories among young adults with similar initial SBP highlight the need for prevention and feasibility of effective blood pressure control, while the identified risk factors may inform targeted interventions.

Summary China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary health-care physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies.

The development of aggregation-induced-emission (AIE)-active and reversible mechanochromic fluorescent organic materials has been of great interest in recent years because of their potential and practical application in many fields. Five vinamidinium salts that bear different aryl substitutes (Ar = phenyl (N1), p-methylphenyl (N2), p-bromophenyl (N3), p-nitrophenyl (N4) and naphthyl (N5)) were designed and synthesized. Their photophysical properties were investigated via a series of spectroscopic and theoretical methods. All compounds exhibit intense 1π-π*/intramolecular charge-transfer (1ICT) absorption bands in the region from ca. 300 nm–450 nm. All compounds except N5 display aggregation induced enhanced emission behavior in DMSO-CH2Cl2 mixtures, and relatively high quantum efficiency in solid-states (ΦF = 0.06–0.22). Compounds N1 and N3 with yellow and orange solid fluorescence, respectively, show mechanochromic and vapochromic response. Upon grinding, the emission of N1 and N3 could be transformed to green–yellow and yellow, respectively, and restored when the ground powders were fumed with MeOH vapor. Powder X-ray diffraction spectroscopy indicates that the reversible mechanochromism is ascribed to the transformation of a crystalline state into an amorphous state. Compound N1 is used in data-security protection and is of assistance in the rational design of smart luminescent materials.

A series of Pt(II) complexes bearing difluoro-boron-dipyrromethene (Bodipy) acetylide ligands and different alkyl/aryl substituted 2,2′-bipyridyl ligands (Pt-1 – Pt-3) were synthesized and characterized. Their photophysics, aggregation included emission (AIE) and optical power limiting properties were systematically investigated via UV−Vis absorption, emission, transient absorption, and nonlinear transmission spectroscopy/technique. These complexes exhibit 1π-π* transitions/metal-to-ligand charge transfer (1MLCT) absorption bands in UV-Vis spectral region and green fluorescence assigned to 1π-π* state mixed with 1MLCT character. All complexes exhibit obvious AIE in CH3CN-water solution system. When water fraction increased, nanoparticles of Pt(II) complexes were formed owing to the aggregation, and the emission intensity and triplet excited state lifetime both increased. In addition, complexes Pt-1 – Pt-3 all exhibit triplet transient absorption (TA) in visible region, where reverse saturable absorption (RSA) could occur. The strength of RSA at 532 nm follows the trend: Pt-2 > Pt-3 > Pt-1. The significant AIE, TA and OPL properties of these complexes would be useful for rational design of transition-metal complexes with high emission quantum yield, broadband excited-state absorption, long excited-state lifetime, and strong nonlinear absorption for multi-functional applications.

China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes). As China deepens its health-care reform, it has the opportunity to build an integrated, cooperative primary health-care system, generating knowledge from practice that can support improvements, and bolstered by evidence-based performance indicators and incentives.

ω-transaminase can mediate the asymmetric synthesis of chiral amines from aldehydes and ketones, which has important value in the synthesis of pharmaceutical intermediates. A novel ω-transaminase derived from Paracoccus pantotrophus (PpTA) was obtained and cloned in E. coli BL21(DE3) for expression. The enzyme has high activity for 2-ketobutyric acid and benzylamine, as well as for aromatic compounds with side chains longer than ethyl aliphatic hydrocarbons. Molecular simulation showed that the S-pocket in the active center is larger than those of other ω-transaminases. Thereafter, a whole-cell catalytic system was designed to prepare l -2-aminobutyric acid by cascading PpTA and other enzymes. By using several strategies (regulation of RBS intensity, by-product decomposition and cofactor self-sufficiency), whole-cell cascade biocatalysis showed a high ee value (> 99%) and high yield (71%) in one pot reaction. This study therefore proposes an efficient biocatalyst for the synthesis of unnatural amino acids with the participation of ω-transaminase.

Key Points Question What is the prevalence of dyslipidemia in Chinese adults and what are the treatment and control rates of elevated low-density lipoprotein cholesterol in both primary and secondary prevention populations? Findings In this cross-sectional study of 2 314 538 community residents, 33.8% had dyslipidemia, 3.2% had established atherosclerotic cardiovascular disease (ASCVD), and 10.2% had high risk of ASCVD; 26.6% of those with ASCVD and 42.9% of those at high risk of ASCVD achieved low-density lipoprotein cholesterol control targets. Statins were available in 49.7% of the primary care institutions surveyed, with the lowest availability in rural village clinics. Meaning These findings suggest that dyslipidemia has become a major public health problem in China and is often inadequately treated and uncontrolled., This cross-sectional study assesses the prevalence, treatment, and control of dyslipidemia in community residents and the availability of lipid-lowering medications in primary care institutions in China., Importance Dyslipidemia, the prevalence of which historically has been low in China, is emerging as the second leading yet often unaddressed factor associated with the risk of cardiovascular diseases. However, recent national data on the prevalence, treatment, and control of dyslipidemia are lacking. Objective To assess the prevalence, treatment, and control of dyslipidemia in community residents and the availability of lipid-lowering medications in primary care institutions in China. Design, Setting, and Participants This cross-sectional study used data from the China-PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project, which enrolled 2 660 666 community residents aged 35 to 75 years from all 31 provinces in China between December 2014 and May 2019, and the China-PEACE primary health care survey of 3041 primary care institutions. Data analysis was performed from June 2019 to March 2021. Exposures Study period. Main Outcomes and Measures The main outcome was the prevalence of dyslipidemia, which was defined as total cholesterol greater than or equal to 240 mg/dL, low-density lipoprotein cholesterol (LDL-C) greater than or equal to 160 mg/dL, high-density lipoprotein cholesterol (HDL-C) less than 40 mg/dL, triglycerides greater than or equal to 200 mg/dL, or self-reported use of lipid-lowering medications, in accordance with the 2016 Chinese Adult Dyslipidemia Prevention Guideline. Results This study included 2 314 538 participants with lipid measurements (1 389 322 women [60.0%]; mean [SD] age, 55.8 [9.8] years). Among them, 781 865 participants (33.8%) had dyslipidemia. Of 71 785 participants (3.2%) who had established atherosclerotic cardiovascular disease (ASCVD) and were recommended by guidelines for lipid-lowering medications regardless of LDL-C levels, 10 120 (14.1%) were treated. The overall control rate of LDL-C (≤70 mg/dL) among adults with established ASCVD was 26.6% (19 087 participants), with the control rate being 44.8% (4535 participants) among those who were treated and 23.6% (14 552 participants) among those not treated. Of 236 579 participants (10.2%) with high risk of ASCVD, 101 474 (42.9%) achieved LDL-C less than or equal to 100 mg/dL. Among participants with established ASCVD, advanced age (age 65-75 years, odds ratio [OR], 0.63; 95% CI, 0.56-0.70), female sex (OR, 0.56; 95% CI, 0.53-0.58), lower income (reference category), smoking (OR, 0.89; 95% CI, 0.85-0.94), alcohol consumption (OR, 0.87; 95% CI, 0.83-0.92), and not having diabetes (reference category) were associated with lower control of LDL-C. Among participants with high risk of ASCVD, younger age (reference category) and female sex (OR, 0.58; 95% CI, 0.56-0.59) were associated with lower control of LDL-C. Of 3041 primary care institutions surveyed, 1512 (49.7%) stocked statin and 584 (19.2%) stocked nonstatin lipid-lowering drugs. Village clinics in rural areas had the lowest statin availability. Conclusions and Relevance These findings suggest that dyslipidemia has become a major public health problem in China and is often inadequately treated and uncontrolled. Statins were available in less than one-half of the primary care institutions. Strategies aimed at detection, prevention, and treatment are needed.

Background Cardiovascular diseases (CVD) is the leading cause of death in China. Secondary prevention medications can improve the prognosis of CVD, yet little is known about the current use, variation and associated factors of these therapies in China. Purpose The aim of this study was to describe the current use of secondary prevention medications among patients with established CVD in the community setting in China, assess variations across population subgroups, and identify the individual characteristics associated with these therapies. Methods We studied 2.6 million participants aged 35–75 years from all 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project, a government-funded public health program conducted from 2014 to 2018. Participants self-reported their history of ischemic heart disease (IHD) or ischemic stroke (IS) and medication use in an interview. Among participants with IHD and/or IS, we assessed the reported use of secondary prevention medications (anti-platelet drugs and statins) in the overall population and in 1,530,408 population subgroups, defined by all possible combinations of 16 factors (age, sex, urbanity, geographic region, ethnicity, occupation, annual household income, education, marital status, medical insurance, current smoker, current drinker, history of hypertension, history of diabetes, body mass index and years since diagnosis). Multivariable mixed models with a logit link function and community-specific random intercepts were fitted to assess the associations of demographic, socioeconomic and health behavior factors with the reported use of secondary prevention mediations. Results Among 2,613,035 screened participants, 2.9% (74,830) had history of IHD and/or IS (1.2% for IHD, 2.4% for IS). Overall, the reported use rate either anti-platelet drugs or statins was 21.9% (18.3% anti-platelet drugs, 11.0% statins, and 7.4% both). Among the 1,530,408 population subgroups, the use of secondary prevention medications varied substantially (3.4% to 52.0%). Multivariable analyses found that that younger people, women, those living in rural areas, current smokers, current drinkers, people without hypertension or diabetes, and those with established CVD for more than 2 years were less likely to take anti-platelet drugs or statins (Figure). Forest plot of multivariable mixed model Conclusions The current use of secondary prevention drugs is suboptimal and varies substantially across population subgroups in China. Our study identifies target populations for interventions to improve secondary prevention of CVD. Acknowledgement/Funding This study was supported by the Ministry of Finance of China and National Health Commission of China

INTRODUCTION AND OBJECTIVES:The incidence of kidney stones in China has increased dramatically in recent decades. However, there is limited information on factors associated with kidney stones, par...

Background: Dyslipidemia, historically rare in China, may be common but has not been well studied. Methods: We used data from the China-PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project, a national cardiovascular disease screening project that enrolled 2·6 million community residents aged 35-75 in all 31 provinces from September 2014 through November 2018, and the China-PEACE primary health care survey of 3 529 primary care institutions. We assessed the prevalence, treatment, and control of dyslipidemia in community residents and the availability of lipid-lowering medications in primary care institutions. Findings: Among 2 314 858 participants with lipid measurements, one third (782 184; 33·8%) had dyslipidemia. Of 71 793 participants who had established atherosclerotic cardiovascular disease (ASCVD) and were recommended by guidelines for lipid-lowering medications regardless of low-density lipoprotein cholesterol (LDL-C) levels, 10 121 (14 ·1%) were treated and of those treated, 4 535 (44·8%) achieved LDL-C ≤70 mg/dL. Of 236 666 participants who had high risk of ASCVD, 101 511 (42·9%) achieved LDL-C ≤ 100 mg/dL. Advanced age, female sex, non-Han ethnicity, lower income, smoking, alcohol consumption, non-diabetes in participants with established ASCVD and younger age, female sex, non-Han ethnicity in participants with high risk of ASCVD were associated with lower control of LDL-C (all p

Background : Qingfei Paidu Tang (QPT), a formula of traditional Chinese medicine, which was suggested to be able to ease symptoms in patients with Coronavirus Disease 2019 (COVID-19), has been recommended by clinical guidelines and widely used to treat COVID-19 in China. However, whether it decreases mortality remains unknown. Purpose : We aimed to explore the association between QPT use and in-hospital mortality among patients hospitalized for COVID-19. Study design : A retrospective study based on a real-world database was conducted. Methods : We identified patients consecutively hospitalized with COVID-19 in 15 hospitals from a national retrospective registry in China, from January through May 2020. Data on patients’ characteristics, treatments, and outcomes were extracted from the electronic medical records. The association of QPT use with COVID-19 related mortality was evaluated using Cox proportional hazards models based on propensity score analysis. Results : Of the 8939 patients included, 28.7% received QPT. The COVID-19 related mortality was 1.2% (95% confidence interval [CI] 0.8% to 1.7%) among the patients receiving QPT and 4.8% (95% CI 4.3% to 5.3%) among those not receiving QPT. After adjustment for patient characteristics and concomitant treatments, QPT use was associated with a relative reduction of 50% in in-hospital COVID-19 related mortality (hazard ratio, 0.50; 95% CI, 0.37 to 0.66 P, Graphical abstract Image, graphical abstract

In metal machining, due to the material around the cutting edge subjected to high pressure, the subsurface generates a plastic deformation layer. And near the edge of finished surface the plastic deformation layer acts as a Poisson burr. This paper proposes an analytical model to predict the sizes of Poisson burr based on Flamant and Boussinseq equations in the plastic deformation problem. Besides the mechanical loading, the thermal effects are also taken into account in this model and assumed as moving heat sources during the cutting. The finite element simulation of aluminum 6061 alloy is utilized to verify the results of theoretical analysis. The results show that the sizes of Poisson burr has a great sensitivity to material properties and processing parameters. In addition, due to the serrated chips and brittle fracture of high strain rate, the Poisson burrs are not continuous along the longitudinal cutting direction. Through comparative study it is found that the theoretical model describes burr sizes with considerable accuracy. As a result, this paper may provide a better understanding the mechanism of Poisson burr formation and the theoretical basis of processing parameters optimization.

Key Points Question What are the risk factors associated with major cardiovascular events within 1 year among patients who survive an acute myocardial infarction? Findings In this cohort study of 4227 patients with acute myocardial infarction, 19 risk factors associated with major cardiovascular events 1 year after acute myocardial infarction, comprising 15 unique variables, were identified. A risk model to predict 1-year cardiovascular events after an acute myocardial infarction was developed and evaluated based on these risk factors. Meaning Identification of individuals at the highest risk of long-term cardiovascular events after acute myocardial infarction may aid in the provision of targeted, intensive, and higher-quality longitudinal care following discharge., This cohort study identifies risk factors associated with major cardiovascular events within 1 year of acute myocardial infarction in Chinese patients and describes the development and evaluation of a risk model to predict such events., Importance Patients who survive acute myocardial infarction (AMI) have a high risk of subsequent major cardiovascular events. Efforts to identify risk factors for recurrence have primarily focused on the period immediately following AMI admission. Objectives To identify risk factors and develop and evaluate a risk model that predicts 1-year cardiovascular events after AMI. Design, Setting, and Participants Prospective cohort study. Patients with AMI (n = 4227), aged 18 years or older, discharged alive from 53 acute-care hospitals across China from January 1, 2013, to July 17, 2014. Patients were randomly divided into samples: training (50% [2113 patients]), test (25% [1057 patients]), and validation (25% [1057 patients]). Risk factors were identified by a Cox model with Markov chain Monte Carlo simulation and further evaluated by latent class analysis. Analyses were conducted from May 1, 2017, to January 21, 2018. Main Outcomes and Measures Major cardiovascular events, including recurrent AMI, stroke, heart failure, and death, within 1 year after discharge for the index AMI hospitalization. Results The mean (SD) age of the cohort was 60.8 (11.8) years and 994 of 4227 patients (23.5%) were female. Common comorbidities included hypertension (2358 patients [55.8%]), coronary heart disease (1798 patients [42.5%]), and dyslipidemia (1290 patients [30.5%]). One-year event rates were 8.1% (95% CI, 6.91%-9.24%), 9.0% (95% CI, 7.22%-10.70%), and 6.4% (95% CI, 4.89%-7.85%) for the training, test, and validation samples, respectively. Nineteen risk factors comprising 15 unique variables (age, education, prior AMI, prior ventricular tachycardia or fibrillation, hypertension, angina, prearrival medical assistance, >4 hours from onset of symptoms to admission, ejection fraction, renal dysfunction, heart rate, systolic blood pressure, white blood cell count, blood glucose, and in-hospital complications) were identified. In the training, test, and validation samples, respectively, the risk model had C statistics of 0.79 (95% CI, 0.75-0.83), 0.73 (95% CI, 0.68-0.78), and 0.77 (95% CI, 0.70-0.83) and a predictive range of 1.2% to 33.9%, 1.2% to 37.9%, and 1.3% to 34.3%. The C statistic was 0.69 (95% CI, 0.65-0.74) for the latent class model in the training data. The risk model stratified 11.3%, 81.0%, and 7.7% of patients to high-, average-, and low-risk groups, with respective probabilities of 0.32, 0.06, and 0.01 for 1-year events. Conclusions and Relevance Nineteen risk factors were identified, and a model was developed and evaluated to predict risk of 1-year cardiovascular events after AMI. This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction.

Background The reasons for China's high stroke prevalence are not well understood. The cardiovascular risk factor profiles of China and the United States have not been directly compared in nationally representative population samples. Methods and Results Using data from the CHARLS (China Health and Retirement Longitudinal Study) and the NHANES ( US National Health and Nutrition Examination Survey), we compared cardiovascular risk factors from 2011 to 2012 among people aged 45 to 75 years between the 2 countries (China, 12 654 people; United States, 2607 people): blood pressure, cholesterol, body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, and high‐sensitivity C‐reactive protein. Compared with the United States, China had a lower prevalence of hypertension but a higher mean blood pressure and a higher proportion of patients with severe hypertension (≥160/100 mm Hg) (10.5% versus 4.5%). China had substantially lower rates of hypertension treatment (46.8% versus 77.9%) and control (20.3% versus 54.7%). Dyslipidemia was less common in China, but lipid levels were not significantly different because dyslipidemia awareness and control rates in China were 3‐ and 7‐fold lower than US rates, respectively. High‐sensitivity C‐reactive protein, body mass index, and waist circumference were significantly lower in China than in the United States. Clustering of hypertension with other cardiovascular risk factors was more common in China. Conclusions Hypertension is more common in the United States, but blood pressure levels are higher in China, which may be responsible for China's high stroke prevalence. The low rates of awareness, treatment, and control of hypertension provide an exceptional opportunity for China to reduce risk in its population.

Ti-6Al-4V alloy is known as a typical difficult-to-machine hard material due to its inherent properties such as low thermal conductivity, low elastic modulus, and high reactivity with cutting tool materials. This paper proposes a two-dimensional coupled thermo-mechanical model of plane strain orthogonal cutting for Ti-6Al-4V alloy deformation near the exit edge. Johnson–Cook material constitutive model and Cockroft–Latham damage criterion are utilized in the model for better understanding the plastic behavior and chips formation during the cutting process. The machining parameters such as cutting speed, tool edge radius, rake angle, and cutting depth are taken into account in the simulation. The results show that an edge defect generates at the exit edge after machining. The edge defect consists of two fracture surfaces, namely, the first fracture surface of opening-mode crack and the second fracture surface of sliding-mode crack. Besides, the edge defect sizes are greatly sensitive to machining parameters. This study provides a better understanding of burr/breakout formation mechanism near the exit surface and optimization of machining parameters in cutting Ti-6Al-4V alloy.

Recently, graphene-based materials have become well-known nonlinear optical materials for the potential application of laser protection. Two new graphene oxide-platinum complex (GO-Pt) hybrid materials (GO-Pt-1, GO-Pt-2) have been fabricated through covalent modification and electrostatic adsorption of different Pt complexes with GO. The structural and photophysical properties of the resultant hybrid materials were studied. The nonlinear optical properties and optical power limiting (OPL) performance of Pt complexes, GO, and GO-Pt hybrid materials were investigated by using Z-scan measurements at 532 nm. At the same transmittance, the results illustrate that functionalization of GO makes GO-Pt hybrid materials possess better nonlinear optical properties and OPL performance than individual Pt complexes and GO due to a combination of nonlinear scattering, nonlinear absorption, and photoinduced electron and energy transfer between GO and Pt complex moieties. Furthermore, the nonlinear optics and OPL performance of GO-Pt-2 are better than those of GO-Pt-1, due to not only the excellent optical limiting of Pt-2 and more molecules per area of GO but also the way of combination of Pt-2 and GO.

IntroductionChina has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC.Methods and analysisThis paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers.Ethics and disseminationThe central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China.Trial registration numberNCT02953926

Background: \ud Around 200 million adults in China have hypertension, but few are treated or achieve adequate control of their blood pressure. Available and affordable medications are important for successfully controlling hypertension, but little is known about current patterns of access to, and use of, antihypertensive medications in Chinese primary health care.\ud \ud Methods: \ud We used data from a nationwide cross-sectional survey (the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project primary health care survey), which was undertaken between November, 2016 and May, 2017, to assess the availability, cost, and prescription patterns of 62 antihypertensive medications at primary health-care sites across 31 Chinese provinces. We surveyed 203 community health centres, 401 community health stations, 284 township health centres, and 2474 village clinics to assess variation in availability, cost, and prescription by economic region and type of site. We also assessed the use of high-value medications, defined as guideline-recommended and low-cost. We also examined the association of medication cost with availability and prescription patterns.\ud \ud Findings: \ud Our study sample included 3362 primary health-care sites and around 1 million people (613 638 people at 2758 rural sites and 478 393 people at 604 urban sites). Of the 3362 sites, 8·1% (95% CI 7·2–9·1) stocked no antihypertensive medications and 33·8% (32·2–35·4) stocked all four classes that were routinely used. Village clinics and sites in the western region of China had the lowest availability. Only 32·7% (32·2–33·3) of all sites stocked high-value medications, and few high-value medications were prescribed (11·2% [10·9–11·6] of all prescription records). High-cost medications were more likely to be prescribed than low-cost alternatives.\ud \ud Interpretation: \ud China has marked deficiencies in the availability, cost, and prescription of antihypertensive medications. High-value medications are not preferentially used. Future efforts to reduce the burden of hypertension, particularly through the work of primary health-care providers, will need to improve access to, and use of, antihypertensive medications, paying particular attention to those with high value.\ud \ud Funding: \ud CAMS Innovation Fund for Medical Science, the Entrusted Project from the China National Development and Reform Commission, and the Major Public Health Service Project from the Ministry of Finance of China and National Health and Family Planning Commission of China.

Hypertension is common in China and its prevalence is rising, yet it remains inadequately controlled. Few studies have the capacity to characterise the epidemiology and management of hypertension across many heterogeneous subgroups. We did a study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations.We made use of data generated in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project from Sept 15, 2014, to June 20, 2017, a population-based screening project that enrolled around 1·7 million community-dwelling adults aged 35-75 years from all 31 provinces in mainland China. In this population, we defined hypertension as systolic blood pressure of at least 140 mm Hg, or diastolic blood pressure of at least 90 mm Hg, or self-reported antihypertensive medication use in the previous 2 weeks. Hypertension awareness, treatment, and control were defined, respectively, among hypertensive adults as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure of less than 140/90 mm Hg. We assessed awareness, treatment, and control in 264 475 population subgroups-defined a priori by all possible combinations of 11 demographic and clinical factors (age [35-44, 45-54, 55-64, and 65-75 years], sex [men and women], geographical region [western, central, and eastern China], urbanity [urban vs rural], ethnic origin [Han and non-Han], occupation [farmer and non-farmer], annual household income [¥10 000, ¥10 000-50 000, and ≥¥50 000], education [primary school and below, middle school, high school, and college and above], previous cardiovascular events [yes or no], current smoker [yes or no], and diabetes [yes or no]), and their associations with individual and primary health-care site characteristics, using mixed models.The sample contained 1 738 886 participants with a mean age of 55·6 years (SD 9·7), 59·5% of whom were women. 44·7% (95% CI 44·6-44·8) of the sample had hypertension, of whom 44·7% (44·6-44·8) were aware of their diagnosis, 30·1% (30·0-30·2) were taking prescribed antihypertensive medications, and 7·2% (7·1-7·2) had achieved control. The age-standardised and sex-standardised rates of hypertension prevalence, awareness, treatment, and control were 37·2% (37·1-37·3), 36·0% (35·8-36·2), 22·9% (22·7-23·0), and 5·7% (5·6-5·7), respectively. The most commonly used medication class was calcium-channel blockers (55·2%, 55·0-55·4). Among individuals whose hypertension was treated but not controlled, 81·5% (81·3-81·6) were using only one medication. The proportion of participants who were aware of their hypertension and were receiving treatment varied significantly across subpopulations; lower likelihoods of awareness and treatment were associated with male sex, younger age, lower income, and an absence of previous cardiovascular events, diabetes, obesity, or alcohol use (all p0·01). By contrast, control rate was universally low across all subgroups (30·0%).Among Chinese adults aged 35-75 years, nearly half have hypertension, fewer than a third are being treated, and fewer than one in twelve are in control of their blood pressure. The low number of people in control is ubiquitous in all subgroups of the Chinese population and warrants broad-based, global strategy, such as greater efforts in prevention, as well as better screening and more effective and affordable treatment.Ministry of Finance and National Health and Family Planning Commission, China.

With the rapid development in the Internet-of-Things field, it's important to develop an economical, efficient, robust kind of network as an infrastructure. Server-centric Networks based on random topologies promises such features with its high performance in reducing cost of network establishment and in its flexibility of unscheduled incremental growth of devices. However, network failures in such an enormous incorporate system are catastrophic and will predictably bring a significant loss. The artificial maintenance in rerouting will be onerous. In this work, we put out a new method to help networks with random topologies to automatically explore and build a local optimal route in the situation which unpredictable failures lead to the invalid of previous route. When the failures have been repaired, the temporally rerouting will be abandoned so this procedure will not affect the normal working performance. This method brings progress in random topologies' fault tolerance, and eventually count for system's high availability.

Background Patients admitted to hospital with acute myocardial infarction (AMI) have considerable variability in in-hospital risks, resulting in higher demands on health-care resources. Simple risk-assessment tools are important for the identification of patients with higher risk to inform clinical decisions. However, few risk assessment tools have been built that are suitable for populations with AMI in China. We aim to develop a practical prediction model to assess the risk of major adverse cardiovascular events (MACE) in patients with AMI in a retrospective study and externally validate the model in two studies. Methods 8010 patients from 161 hospitals randomly selected throughout mainland China were enrolled as samples to develop the prediction model (derived sample) in this retrospective study, which was a nationally representative sample of patients with AMI 2011. 4485 patients from a prospective study enrolled from 2012 to 2014, and 11 476 patients from a nationally representative retrospective study in 2015, were used for external validation. Patients' characteristics, medical history, risk factors at admission, and in-hospital events were abstracted from medical records. The primary outcome was in-hospital MACE, including death, recurrent AMI, or ischemic stroke. Predictors were selected using step-wise logistic regression and Markov chain Monte Carlo simulation. Findings The proportions of in-hospital MACE were 935 (11·7%) of 8010 patients, 1299 (11·3%) of 11 476 patients, and 395 (8·8%) of 4485 patients among the derived sample and the two external-validation samples, respectively. Nine predictors (ie, age, sex, left ventricular ejection fraction, Killip class, systolic blood pressure, creatinine, white blood cell count, heart rate, and blood glucose) were independently associated with in-hospital MACE. The model did well in both discrimination and calibration capability, with C statistics of 0·85, 0·74, and 0·80, and calibration slopes of 0·98, 0·84, and 0·97 (p Interpretation We developed and validated a prognostic model to predict in-hospital MACE among Chinese patients with AMI. This model might assist in the identification of high-risk patients who might occur adverse events during hospitalisation because of AMI, and thereby better inform clinical decision-making to support quality improvement. Funding National Key Research and Development Program, Ministry of Science and Technology of China; and Research Special Fund for Public Welfare Industry of Health, National Health and Family Planning Commission of China.

Background As cardiovascular risk increases in China, interest in strategies to mitigate it is growing. However, national information about the prevalence and treatment of high cardiovascular disease (CVD) risk is limited. Objective To assess the prevalence and treatment of high CVD risk as well as variations in risk across population subgroups. Design National project of CVD screening and management. Setting 141 county-level regions in all 31 provinces of China. Participants Local residents aged 35 to 75 years. Measurements Rates of high CVD risk were assessed both in the overall study population and by age, sex, body mass index, geographic region, and socioeconomic status. Multivariable mixed models were fitted to assess the associations between individual characteristics and high CVD risk. Statin and aspirin use was evaluated among persons at high risk for CVD. Results Among 1 680 126 participants, 9.5% (95% CI, 9.5% to 9.6%) had high risk for CVD. Mixed models identified persons who were of Han ethnicity, had medical insurance, were currently using alcohol, or were obese as more likely to be at high risk for CVD. Of those with high CVD risk, only 0.6% (CI, 0.5% to 0.6%) and 2.4% (CI, 2.3% to 2.5%) reported using statins and aspirin, respectively. Among persons with high CVD risk and hypertension, 31.8% were receiving antihypertensive medications. Limitation Samples were not nationally representative. Conclusion Of the 1.7 million participants, 1 in 10 had a high risk for CVD; among those at high risk, fewer than 3% were receiving statins or aspirin. An immense opportunity exists for risk mitigation in this substantial population. Primary Funding Source Ministry of Finance and National Health Commission, China.

We assessed the effect of increased serum uric acid (SUA) concentration and hyperuricemia on subclinical organ damage. A cross-sectional examination of 1243 asymptomatic patients aged 55 to 84 years was conducted from September to October 2012. All participants underwent the measurements of SUA and other established cardiovascular (CV) risk factors. A morning spot urine sample was collected to detect microalbuminuria, and carotid plaque was scanned by B-mode ultrasound; the cardioankle vascular index and ankle-brachial index were obtained to evaluate arterial stiffness and peripheral artery disease (PAD), respectively. After adjustment for established CV risk factors, multiple logistic regression analyses showed that the highest quartile of SUA concentration and hyperuricemia had an independent association with PAD (respective odds ratios: 3.86 [1.26-11.83] and 2.33 [1.14-4.77]); this association maintained significantly in males but disappeared in females. Serum uric acid concentration and hyperuricemia are significantly associated with PAD in males.

The outcome of human immunodeficiency virus (HIV)-1 infection and course to AIDS are variable among individuals. Both chemokine receptor 5 (CCR5) and CCR2 gene polymorphisms play essential roles in the susceptibility of HIV-1 infection. To investigate the main and epistatic effects of the CCR5 promoter and CCR2-V64I polymorphisms on HIV-1 infection in the Northern Han Chinese, subjects of 91 HIV-1-infected patients and 91 health controls were recruited. Single-nucleotide polymorphisms (SNPs) in the CCR5 promoter region and CCR2-V64I variants were genotyped. In the single-locus analysis, CCR5 58755-G and CCR5 59653-T alleles were significantly associated with HIV-1 infection (odds ratio [OR]=0.529, 95% confidence interval [CI]: 0.295-0.948; OR=1.710, 95% CI: 1.039-2.814). After adjustment with age and gender, subjects with the CCR5 59653-CT genotype showed the increased risk of HIV-1 infection compared with those with the wild-type CC genotype (adjusted OR=2.502; 95% CI: 1.332-4.698). No positive association was observed in other SNPs. Haplotype-based association analysis revealed that the haplotype TATGC was associated with the susceptibility to HIV-1 infection (p=0.003). Besides, we found the significant epistatic effects between the CCR5 58755-A/G and CCR5 59029-A/G polymorphisms associated with the lower risk of HIV-1 infection. In addition, we also identified the best three-factor interaction model, including the CCR5 58755-A/G, 59029-A/G, and CCR2-V64I polymorphisms, indicating that there were also strong gene-gene interactions between the CCR5 promoter and CCR2 polymorphisms on the susceptibility of HIV-1 infection. These findings contribute to understanding the genetic mechanism for the susceptibility of HIV-1 infection in Northern Han Chinese.

Angiotensinogen (AGT) M235T and angiotensin-converting enzyme (ACE) Insertion/Deletion polymorphisms have been reported to be significantly associated with ischemic stroke. However, the results have been inconsistent. Therefore, we performed a comprehensive meta-analysis to evaluate the role of the AGT M235T and ACE I/D polymorphisms as risk factors for ischemic stroke in Han Chinese population.We performed a comprehensive search in MEDLINE (PubMed), the China National Knowledge Infrastructure (CNKI) platforms and WANFANG databases, to identify the studies evaluating the association between the AGT M235T or ACE I/D polymorphisms and ischemic stroke, up to August 2011, in Chinese and English languages. The combined effects were estimated by fixed effects model or random effects model depending on the between-study heterogeneity, which was analyzed using the heterogeneity Q statistic test. Publication bias was evaluated using Begg's test, Egger's test and funnel plot.A total of 58 studies were selected for the final meta-analysis, including 7168 ischemic stroke cases and 5944 controls. Among them, 11 studies evaluated the effect of AGT M235T as a risk factor for ischemic stroke, while the remaining evaluated the ACE I/D polymorphism. Overall, a significant association was identified for both the AGT M235T and ACE I/D polymorphisms, under pair wise comparisons, dominant, recessive and additive models, however, there was significant heterogeneity among the ACE I/D polymorphism studies (P0.10). On meta-regression analyses, geographic region was identified as a significant source of between-study heterogeneity for both the polymorphisms. The stratified analysis by geographic distribution indicated that the AGT T allele could increase the risk of ischemic stroke in northern Chinese (OR=2.029, 95% CI: 1.714-2.401, P0.001) as compared to southern Chinese individuals (OR=1.821, 95% CI: 1.586-2.090, P=0.002). In contrast, the ACE D allele could increase the susceptibility of ischemic stroke in southern Chinese (OR=1.692, 95% CI: 1.455-1.966, P0.001) as compared to northern Chinese individuals (OR=1.297, 95% CI: 1.089-1.545, P=0.004). There was a possibility of publication bias for ACE I/D (P0.001), but not for AGT M235T (P0.05).Our meta-analysis strongly suggested that the AGT M235T and ACE I/D polymorphisms significantly contribute to the risk of ischemic stroke in Han Chinese population. Also, the stratified analysis showed that the effects of these two polymorphisms differ by the geographic region. Further studies with more specific common information and large sample size are needed to understand the genetic mechanism of ischemic stroke.

Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will inform population-based strategies to improve cardiovascular health in China. Trial registration number NCT02329886.

Importance Body mass index (BMI) is positively associated with blood pressure (BP); this association has critical implications for countries like China, where hypertension is highly prevalent and obesity is increasing. A greater understanding of the association between BMI and BP is required to determine its effect and develop strategies to mitigate it. Objective To assess the heterogeneity in the association between BMI and BP across a wide variety of subgroups of the Chinese population. Design, Setting, and Participants In this cross-sectional study, data were collected at 1 time point from 1.7 million adults (aged 35-80 years) from 141 primary health care sites (53 urban districts and 88 rural counties) from all 31 provinces in mainland China who were enrolled in the China PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project, conducted between September 15, 2014, and June 20, 2017. A comprehensive subgroup analysis was performed by defining more than 22 000 subgroups of individuals based on covariates, and within each subgroup, linearly regressing BMI to BP. Main Outcomes and Measures Systolic BP was measured twice with the participant in a seated position, using an electronic BP monitor. Results The study included 1 727 411 participants (1 027 711 women and 699 700 men; mean [SD] age, 55.7 [9.8] years). Among the study sample, the mean (SD) BMI was 24.7 (3.5), the mean (SD) systolic BP was 136.5 (20.4) mm Hg, and the mean (SD) diastolic BP was 81.1 (11.2) mm Hg. The increase of BP per unit BMI ranged from 0.8 to 1.7 mm Hg/(kg/m2) for 95% of the subgroups not taking antihypertensive medication. The association between BMI and BP was substantially weaker in subgroups of patients taking antihypertensive medication compared with those who were untreated. In untreated subgroups, 95% of the coefficients varied by less than 1 mm Hg/(kg/m2). Conclusions and Relevance The association between BMI and BP is positive across tens of thousands of individuals in population subgroups, and, if causal, given its magnitude, would have significant implications for public health., This population-based cross-sectional study of 1.7 million Chinese adults assesses the association between body mass index (BMI), blood pressure, and hypertension across subgroups of age, sex, income, race, smoking, stroke, and more., Key Points Question How does increasing body mass index affect the prevalence of hypertension and cardiovascular health in different groups of people in China? Findings In this population-based cross-sectional study, the association between body mass index and blood pressure was consistent and positive across more than 20 000 subgroups of 1.7 million Chinese adults and was only substantially affected by treatment with antihypertensive medication. Meaning Trends in increasing body mass index may lead to increases in blood pressure and cardiovascular events, suggesting the need for measures of better prevention of this increase, as well as mitigation of hypertension with treatment and lifestyle measures.

Objective To examine the effect of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guidelines on the prevalence of hypertension and eligibility for initiation and intensification of treatment in nationally representative populations from the United States and China. Design Observational assessment of nationally representative data. Setting US National Health and Nutrition Examination Survey (NHANES) for the most recent two cycles (2013-14, 2015-16) and China Health and Retirement Longitudinal Study (CHARLS) (2011-12). Participants All 45-75 year old adults who would have a diagnosis of hypertension and be candidates for treatment on the basis of the ACC/AHA guidelines, compared with current guidelines. Main outcome measures Diagnosis of hypertension and candidacy for initiation and intensification of antihypertensive treatment. Results Adoption of the 2017 ACC/AHA hypertension guidelines in the US would label 70.1 (95% confidence interval 64.9 to 75.3) million people in the 45-75 year age group as having hypertension, representing 63% (60.6% to 65.4%) of the population in this age group. Their adoption in China would lead to labeling of 266.9 (252.9 to 280.8) million people or 55% (53.4% to 56.7%) of the same age group as having hypertension. This would represent an increase in prevalence of 26.8% (23.2% to 30.9%) in the US and 45.1% (41.3% to 48.9%) in China. Furthermore, on the basis of treatment patterns and current guidelines, 8.1 (6.5 to 9.7) million Americans with hypertension are untreated, which would be expected to increase to 15.6 (13.6 to 17.7) million after the implementation of the ACC/AHA guidelines. In China, on the basis of current treatment patterns, 74.5 (64.1 to 84.8) million patients with hypertension are untreated, estimated to increase to 129.8 (118.7 to 140.9 million. In addition, the ACC/AHA guidelines would label 8.7 (6.0 to 11.5) million adults in the US and 51 (40.3 to 61.6) million in China as having hypertension that would not require antihypertensive treatment, compared with 1.5 (1.2 to 2.1) million and 23.4 (12.1 to 35.1) million with the current guidelines. Finally, even among people receiving treatment, the proportion that are candidates for intensification of treatment is estimated to increase by 13.9 (12.2 to 15.6) million (from 24.0% to 54.4% of treated patients) in the US, and 30 (24.3 to 35.7) million (41.4% to 76.2% of treated patients) in China, if the ACC/AHA treatment targets are adopted. Conclusions If adopted, the 2017 ACC/AHA hypertension guidelines will markedly increase the number of people labeled as having hypertension and treated with drugs in both the US and China, leading to more than half of those aged 45-75 years in both countries being considered hypertensive.

Mannose-binding lectin (MBL) is a key molecule of the innate immune system and a competent to bind carbohydrates of a variety of microorganisms, resulting in complement activation and opsonophagocytosis against various pathogens. However, there is no systemic investigation on the MBL's role in innate immune responses against HIV-1 infection among northern Han Chinese. This study investigated the association between MBL and HIV-1 infection susceptibility among northern Han Chinese. A total of 91 HIV-1 infected patients and 91 HIV-1 seronegative healthy individuals were recruited. Six polymorphisms of MBL2 gene were genotyped by pyrosequencing. The quantitative measurement of serum MBL concentration and MBL complex activity were performed by ELISA. The CD4+ T-cell counts were determined by flow cytometry. The plasma viral loads of 91 HIV-1 infected patients were determined by bDNA method. The results show that there is an association between MBL and HIV-1 infection susceptibility among northern Han Chinese. The individuals with B variant, low serum MBL concentration and low MBL complex activity are more susceptible to HIV-1 infection.

by developing a start-stop system of a BSG motor, this paper systematically presents the vehicle control principle, strategy and verification and assessment indicators of the start-stop system, and applies it successfully in a motor. Exhaust emissions and fuel-consumption tests of a vehicle were performed in the rotating hub, and the results show a 5% reduction in fuel consumption for the motor, and a 12% decline in fuel consumption when the experiments were carried out in urban areas. The control technology and vehicle examination and evaluation indicators have important guiding significance to the subsequent research of the start-stop system. Introduction A BSG start-stop system belongs to a micro-hybrid technology. In other words, at the engine’s idle speed, if the external environment and the vehicle status satisfy the start-stop system requirement, the engine automatically turns off when the driver releases the clutch pedal, and the engine automatically starts when the driver depresses the clutch pedal or the brake pedal[1,2]. The technology makes small changes to conventional vehicles and can significantly reduce fuel consumption, so it has become an important technology for vehicle energy conservation and emission reduction. The vehicle control unit receives the sensor signal and the signal coming from the CAN bus, and judges whether the BSG system is working and determines whether to start or stop the engine according to the internal control strategy[3], and controls engine starting and flameout. The vehicle control unit can control the starting and shutdown relay, thereby controlling the original vehicle ECU as well as controlling engine starting and flameout. When the vehicle control unit’s shutdown relay controls the high level output, the shutdown relay switches off, the ECU power cord is disconnected, and the engine stalls. The starting gear of the original vehicle ECU ignition switch is connected to the signal line[4,5,6]. When the vehicle control unit starts, the relay control terminal has low level output, and the starting relay is closed. The starting gear of the ECU ignition switch is joined, and ECU controls the engine starting. Therefore, the vehicle control unit controls engine starting and flameout by using the relay simulation key. Vehicle Control Strategy The vehicle control strategy consists of three parts: the vehicle and driver safety, driving operation habits, and the environment and road adaptability. According to the abovementioned strategiese, the vehicle formulates a start-stop system control strategy, the automatic engine stopping control strategy and the automatic engine starting control strategy. Factors taken into account for developing the vehicle control strategy Factors regarding the vehicle and driver safety: whether the seat belt is fastened, whether the engine hood is closed, whether the BSG system is faulty, engine coolant temperature, brake system pressure after the engine is switched off, automatic vehicle sliding speed after the engine is switched off, the state of charge of a battery, and catalyst temperature, etc. 4th International Conference on Mechatronics, Materials, Chemistry and Computer Engineering (ICMMCCE 2015) © 2015. The authors Published by Atlantis Press 286 Factors regarding driving operation habits: whether the seat belt is fastened, whether the transmission is in neutral, whether the clutch is disconnected, and whether the transmission is in reverse gear and so on. Factors regarding the environment and road adaptability: the ambient temperature, the air conditioner application signal and automatic engine flameout when the vehicle speed is smaller than a specific value, etc. Fig. 1 The principle diagram of the vehicle control strategy The Main Content of the Vehicle Control Strategy The Start-stop System Closing Control Strategy The start-stop system closing control strategy can be divided into subjective and objective levels: when the driver wants to close the start-stop system subjectively, he/she can close the start-stop system only by pressing the system closing button. If one of these conditions is met: the driver is not wearing a seatbelt, or engine hood is not closed, or the BSG system is faulty, the start-stop system automatically stops working, and the vehicle condition is the same as that without a start-stop system. The start-stop system closing control strategy is shown in Figure 2. Fig. 2 The block diagram of start-stop system shutdown control The Automatic Engine Stopping Control Strategy When the driver encounters traffic lights or needs long-stay parking, the start-stop system can play a role and achieve automatic engine shutdown only when all of the following conditions are met. The automatic engine stoping control strategy is shown in Figure 3. engine cutout/idling engine start engine flamout start-top system working

The photocatalytic degradation of methylene blue solution by 8 photocatalytic diphenylanthrazoline compounds was investigated. All diphenylanthrazoline compounds exhibited a good photocatalytic activity towards the methylene blue solution. The removal rate for chemical oxygen demand (CODCr) in the methylene blue solution at 12 hours was ~54.1% to 96.3%. 2,8-Bis(4-triphenylamino)-4,6-diphenyl-1,9-anthrazoline (TM-2-d) was selected for further investigation because of its better photocatalytic activity. To study the optimal reaction conditions for the photocatalytic degradation of dye wastewater, photocatalyst was applied to degrade methylene blue solution. The decolorization rate for simulated dye solutions can exceed 99% in 10 hours, and the CODCr removal rate exceeded 91%. These organic semiconductor materials, diphenylanthrazoline compounds, displayed comparative photocatalytic properties to the inorganic semiconductor materials, which can be used in the photocatalytic degradation of organic pollutants.

Objectives To comprehensively evaluate the association of ERCC1 C8092A and ERCC2 Lys751Gln polymorphisms with the risk of glioma. Methods Potential studies were searched and selected through the Pubmed/MEDLINE, EMBASE, the China National Knowledge Infrastructure (CNKI) platforms, WanFang and VIP database up to June 2013. Two investigators independently reviewed full text and included studies met inclusion criteria. Combined odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated in a fixed-effects model or a random-effects model according to results of heterogeneity test. All analyses were performed by Revman 5.2 and Stata 10.0 software. Results A total of 10 studies were included in our meta-analysis, including 3,580 glioma patients and 4,728 controls. Overall, ERCC1 C8092A polymorphism was associated with the risk of glioma (AA vs. CC: OR = 1.29, 95%CI: 1.07–1.55, P = 0.01; recessive model: OR = 1.29; 95% CI: 1.07–1.55, P = 0.01). When stratified by ethnicity, significant association was only observed in the Chinese population (AA vs. CC: OR = 1.37, 95%CI: 1.03–1.81, P = 0.03; recessive model: OR = 1.34; 95% CI: 1.02–1.75, P = 0.04). For ERCC2 Lys751Gln polymorphism, no significant association was found between ERCC2 Lys751Gln polymorphism and the risk of glioma in different genetic models. A significant association of ERCC2 Lys751Gln polymorphism with the risk of glioma was identified in the Caucasian population under recessive model (OR = 0.87; 95% CI: 0.78–0.98, P = 0.02), but not in the Chinese population. Conclusion This meta-analysis suggested that the AA genotype of ERCC1 C8092A polymorphism might increase the susceptibility of glioma in the Chinese population. And the TT genotype of ERCC2 Lys751Gln polymorphism may decrease the risk of glioma in the Caucasian population. But the small number of studies and moderate methodological quality require cautious interpretation of the study results.

Background: PRKG1 plays an important role in regulating vascular smooth muscle contraction. And this gene is regarded as one of the candidate genes on salt-sensitive hypertension. The aim of this study was to investigate the effects of environmental risk factors and two SNPs and haplotypes structures of PRKG1 gene with blood salt-sensitive patients among essential hypertension. Method: Three hundred and forty-two essential hypertensive were recruited in a case-case study, a modified Sullivan’s acute salt load method was conducted to identify the salt-sensitivity and salt-resistant. Medical history and lifestyle risk factors were obtained by questionnaire, and blood and urine specimens were collected to test the biochemical indicators. We used the Sequenom Mass ARRAY Platform for genotyping of PRKG1 gene single nucleotide polymorphisms (SNPs) (rs7897633/SNP1, rs1904694/SNP2). We applied statistical software SPSS17.0, multifactor dimensionality reduction method 1.1.0 and haploview 4.0 to do the analyses. Results: There were 63 salt sensitivity subjects in 342 essential hypertension individuals, accounting for 18.4% of the total. Age and 24-hour urinary sodium concentration were the risk factors associated with salt-sensitive hypertension. The results of the logistic regression model showed that subjects carrying SNP1-AA genotype and SNP2-GG genotypes had 2.83-fold (95% CI: 1.21-6.63) and 3.50-fold (95% CI: 1.54-7.93) risks to have salt-sensitive hypertension, respectively. Haplotype analysis showed that haplotype CA had 0.56-fold (95% CI: 0.38-0.84) decreased risk for salt-sensitive hypertension, whereas, haplotype AG had 1.78-fold (95% CI: 1.20-2.65) increased risk for saltsensitive hypertension. Conclusion: Age and 24-hour urinary sodium concentration are the environmental risk factors associated with salt-sensitive hypertension. Genotypes of SNP1-AA, SNP2-GG and haplotype AG of PRKG1 gene were risk factors for salt-sensitivity in essential hypertension.

Introduction Collection of high-quality data from large populations is considered essential to generate knowledge that is critical to an era of precision medicine. Cardiovascular disease (CVD) is a leading cause of mortality in China and is a suitable focus of an initiative to discover factors that would improve our ability to assess and modify individual risk. Methods and analysis The pilot phase of China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project is being conducted during 2014–2015 in four provinces across China to demonstrate the feasibility of a population-based assessment. It is designed to screen 0.4 million community-dwelling residents aged 40–75 years with measurements of blood pressure, height and weight, a lipid blood test, and a questionnaire on cardiovascular-related health status. Participants identified at high risk of CVD receive further health assessments, including ECG, ultrasound scan, blood and urine analysis, and a questionnaire on lifestyle and medical history. Collection of blood and urine samples is used to establish a biobank. High-risk subjects are also counselled with suggestions regarding potential lifestyle changes. In addition, high-risk subjects are followed-up either in a return clinic visit or by telephone interview, with measurement of blood pressure, weight, ECG, and a questionnaire on survival status, hospitalisations and lifestyle. The first 0.1 million participants screened were used to conduct a preliminary analysis, with information on baseline characteristics, health-related behaviours, anthropometric variables, medical history, and prevalence of high-risk subjects. Ethics and dissemination The central ethics committee at the China National Center for Cardiovascular Disease (NCCD) approved the pilot. Written informed consent is obtained from all participants on entry into the project. Findings will be disseminated in future peer-reviewed papers and will inform strategies aimed at developing precise methods of assessing and modifying risk. Trial registration number NCT02536456.

N-glycans play an essential role in biological process and are associated with age, gender, and body mass parameters in Caucasian populations, whereas no study has been reported in Chinese populations. To investigate the correlation between N-glycan structures and metabolic syndrome (MetS) components, we conducted a population-based study in 212 Chinese Han individuals. The replication study was performed on 520 unrelated individuals from a Croatian island Korčula. The most prominent observation was the consistent positive correlations between different forms of triantennary glycans and negative correlations between glycans containing core-fucose with MetS components including BMI, SBP, DBP, and fasting plasma glucose (FPG) simultaneously. Significant differences in a number of N-glycan traits were also detected between normal and abnormal groups of BMI, BP, and FPG, respectively. In the multivariate analysis, the level of monosialylated glycans (structure loadings = -0.776) was the most correlated with the MetS related risk factors, especially with SBP (structure loadings = 0.907). Results presented here are showing that variations in the composition of the N-glycome in human plasma could represent the alternations of human metabolism and could be potential biomarkers of MetS.