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To investigate the duration of humoral immune response in convalescent coronavirus disease 2019 (COVID-19) patients, we conduct a 12-month longitudinal study through collecting a total of 1,782 plasma samples from 869 convalescent plasma donors in Wuhan, China and test specific antibody responses. The results show that positive rate of IgG antibody against receptor-binding domain of spike protein (RBD-IgG) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the COVID-19 convalescent plasma donors exceeded 70% for 12 months post diagnosis. The level of RBD-IgG decreases with time, with the titer stabilizing at 35.7% of the initial level by the 9th month. Moreover, male plasma donors produce more RBD-IgG than female, and age of the patients positively correlates with the RBD-IgG titer. A strong positive correlation between RBD-IgG and neutralizing antibody titers is also identified. These results facilitate our understanding of SARS-CoV-2-induced immune memory to promote vaccine and therapy development., COVID-19 pandemic is a global health risk, but our understanding on the induced durable immunity remains scarce. Here the authors assess antibody responses in 869 convalescent COVID-19 patients to find that specific antibody titers reduce with time, and the RBD-IgG positive rate exceed 70% at 12 month post diagnosis, with male and older patients showing stronger responses.

To a certain extent, automated fruit sorting systems reflect the degree of automated production in modern food industry, and boast a certain theoretical and application value. The previous studies mostly concentrate on the design of robot structure, and the control of robot motions. There is little report on the feature extraction of fruits in specific applications of fruit sorting. For this reason, this paper explores the target positioning and sorting strategy of fruit sorting robot based on image processing. Firstly, the authors constructed a visual sorting system for fruit sorting robot, and explained the way to recognize objects in three-dimensional (3D) scene and to reconstruct the spatial model based on sorting robot. Next, the maturity of the identified fruits was considered the prerequisite of dynamic sorting of fruit sorting robot. Finally, the program flow of the fruit sorting robot was given. The effectiveness of our strategy was verified through experiments.

This work aimed to improve the early clinical diagnosis rate of atrophic gastritis (AG) and reduce the risk of disease deterioration or cancerization. Three hundred and eight patients with gastric disease were taken as the research object, who were divided into two groups: AG (n = 159) and non-AG (n = 149), according to the diagnosis results. The gastric antrum images of patients were collected, and the DenseNet model for gastric antrum image lesion screening was improved. Then, the differences in serum pepsinogen (PG I and PG II) of patients were detected, and the efficiency of different methods to screen AG was compared. The results revealed that the levels of PG I and PG II in AG patients were substantially reduced, and the sensitivity (70.44%), specificity (66.44%), and accuracy (68.51%) of AG diagnosis by indicator PG I were higher than that of PG II and joint diagnosis. The diagnosis accuracy rate of AG based on the improved DenseNet model was 98.63%. The accuracy of model recognition combined with serological indicators for disease diagnosis was as high as 99.25%, with a sensitivity of 96.17% and a specificity of 94.33%. In summary, the combination of deep learning-based image recognition methods and serological specific indicators could improve the clinical diagnosis rate of AG, which could provide a reference for the subsequent clinical adoption of artificial intelligence recognition technology.

Purpose The application of laparoscopic-assisted total gastrectomy (LATG) for resectable gastric cancer (GC) remains controversial compared with open total gastrectomy (OTG), especially for advanced gastric cancer (AGC) patients according to the inconsistent results demonstrated in the previous studies. The aim of this study was to evaluate the short-term and long-term outcomes between LATG and OTG in a population with more than 80% AGC patients by applying propensity score matching (PSM) method. Methods The data of 365 clinical stage I–III GC cases who underwent total gastrectomy with D2 lymphadenectomy were retrospectively collected from January 2011 to April 2018 in the Department of Gastrointestinal Surgery IV of Peking University Cancer Hospital. Propensity scores were generated through taking all covariates into consideration and 131 pairs of patients receiving either LATG or OTG were matched. Intraoperative, postoperative, and survival parameters were compared in the matched groups accordingly. Risk factors for postoperative complications and overall survival were further analyzed. Results Patient characteristics in the LATG and OTG groups were well balanced after PSM. LATG showed advantages with respect to shorter time to ambulation, first flatus, and first whole liquid diet intake. No significant differences were found between the two groups with regard to postoperative complications as well as overall survival in terms of different pathological stage. Older age was found as an independent risk factor for postoperative complications, and pathological stage for overall survival as well. Conclusion LATG appears to have comparable surgical and oncological safety with OTG by experienced surgeons.

Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 10 9 /L vs. 0.76 × 10 9 /L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.

Context Particulate matter (PM) is an important risk factor for diabetes. However, its underlying mechanisms remain poorly understood. Although liver-derived biological intermediates may play irreplaceable roles in the pathophysiology of diabetes, few studies have explored this in the association between PM and diabetes. Objective We investigated the role of liver enzymes in mediating the relationship between PM exposure and diabetes. Methods We included a total of 7963 participants from the China Multi-Ethnic Cohort. Residential exposure to PM was assessed using a validated spatial-temporal assessment method. Diabetes was diagnosed according to the criteria from American Diabetes Association. Associations between PM, liver enzyme [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase (GGT)], and diabetes were estimated using multivariable regression models. The function of liver enzymes in the relationship between PM and diabetes was assessed using mediation analysis. Results PM exposure was positively associated with the odds of diabetes, with odds ratios of 1.32 (95% CI 0.83, 2.09), 1.33 (95% CI 1.07, 1.65), and 1.18 (95% CI 1.02, 1.36) for every 10-μg/m3 increment in ≤1 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10) PM, respectively. ALT (4.47%) and GGT (4.78%) exhibited statistically significant mediation effects on the association between PM2.5 and diabetes, and the ALT (4.30%) also had a mediating role on PM10. However, none of the liver enzymes had a significant mediating effect on PM1. Conclusion The relationship between PM and diabetes is partially mediated by liver enzymes, suggesting that lipid accumulation, oxidative stress, and chronic inflammation in the liver may be involved in its pathogenesis.

Previous studies have documented consistent findings on the long-term cognitive effects such as postoperative cognitive dysfunction (POCD), delirium and delayed recovery among elderly undergoing cancer surgery. This review was conducted to compare the effect of intravenous and inhalational anesthetic on the postoperative cognitive outcomes among elderly patients undergoing cancer surgery.Systematic review and meta-analysis METHODS: We searched Medline, EMBASE, PubMed Central, ScienceDirect, Google Scholar, and Cochrane library from inception until May 2021. We carried out a meta-analysis with a random-effects model and reported pooled risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI) depending on the type of outcome.In total, we analyzed 10 studies including 2,333 participants. Half of the studies had high risk of bias. For the cognitive score, the pooled SMD was -0.87 [95% CI: -3.97 to 2.24] indicating no statistically significant difference between inhalational and intravenous anesthetic. For POCD, the pooled RR was 1.24 (95% CI: 0.83-1.84); for postoperative delirium, the pooled RR was 2.26 (95% CI: 0.79-6.44); for delayed neurocognitive recovery, the pooled RR was 1.49 (95% CI: 1.09-2.03).Inhalational anesthetics did not show a significant difference in postoperative cognitive outcomes, except delayed neurocognitive recovery, compared to intravenous anesthetic following cancer surgery.

Objective This study aimed to establish a predictive model based on the clinical manifestations and laboratory findings in pleural fluid of patients with pleural effusion for the differential diagnosis of malignant pleural effusion (MPE) and tuberculous pleural effusion (TPE). Methods Clinical data and laboratory indices of pleural fluid were collected from patients with malignant pleural effusion and tuberculous pleural effusion in Zigong First People's Hospital between January 2019 and June 2020，and were compared between the two groups. Independent risk factors or Independent protective factors for malignant pleural effusion were investigated using multivariable logistic regression analysis. Receiver operating characteristic curve (ROC) analysis was performed to assess the diagnostic performance of factors with independent effects, and combined diagnostic models were established based on two or more factors with independence effect. ROC curve was used to evaluate the diagnostic ability of each model, and the fit of the eath model was measured using Hosmer-Lemeshow goodness-of-fit test. Results Patients with MPE were older than those with TPE, the rate of fever of patients with MPE was lower than that of patients with TPE, and these differences were statistically significant (p < 0.05). Carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin-19 fragment antigen (CYFRA21-1), cancer antigen 125 (CA125), and glucose (GLU) levels in the pleural fluid were higher, but total protein (TP), albumin (ALB) and Adenosine deaminase (ADA) levels in the pleural fluid were lower in MPE patients than in TPE patients, and the differences were statistically significant (PConclusion The model established with the combination of CEA and ADA in the pleural fluid has a high differential diagnostic value for malignant pleural effusion and tuberculous pleural effusion, and NSE in the pleural fluid and fever cannot improve the diagnostic efficacy of the diagnostic model.

Mutated KRAS promotes the activation of the MAPK pathway and the progression of colorectal cancer (CRC) cells. Aberrant activation of the PI3K pathway strongly attenuates the efficacy of MAPK suppression in KRAS‐mutated CRC. The development of a novel strategy targeting a dual pathway is therefore highly essential for the therapy of KRAS‐mutated CRC. In this study, a quadruple‐depleting system for the KRAS, MEK1, PIK3CA, and MTOR genes based on CRISPR/SaCas9 was developed. Adenovirus serotype 5 (ADV5) was integrated with two engineered proteins, an adaptor and a protector, to form ADV‐protein complex (APC) for systemic delivery of the CRISPR system. Quadruple‐editing could significantly inhibit the MAPK and PI3K pathways in CRC cells with oncogenic mutations of KRAS and PIK3CA or with KRAS mutation and compensated PI3K activation. Compared with MEK and PI3K/MTOR inhibitors, quadruple‐editing induced more significant survival inhibition on primary CRC cells with oncogenic mutations of KRAS and PIK3CA. The adaptor specifically targeting EpCAM and the hexon‐shielding protector could dramatically enhance ADV5 infection efficiency to CRC cells and significantly reduce off‐targeting tropisms to many organs except the colon. Moreover, quadruple‐editing intravenously delivered by APC significantly blocked the dual pathway and tumor growth of KRAS‐mutated CRC cells, without influencing normal tissues in cell‐ and patient‐derived xenograft models. Therefore, APC‐delivered quadruple‐editing of the MAPK and PI3K pathways shows a promising therapeutic potential for KRAS‐mutated CRC., Aberrant activation of the PI3K pathway interferes with the therapeutic efficacies of MAPK signaling inhibitors in KRAS‐mutated colorectal cancer (CRC). However, overlapping toxicities of small molecule inhibitors limit the treatment effects of combined therapy targeting the MAPK and PI3K pathways. Multiplex genome editing may provide a novel dual‐inhibition strategy for KRAS‐mutated CRC. A quadruple‐depleting system of KRAS, MEK1, PIK3CA, and MTOR based on CRISPR/SaCas9, which were packaged by ADV5 and integrated with two engineered proteins, an adaptor and a protector, to enhance infection efficiency and specificity to CRC cells, could effectively and specifically block tumor progression of KRAS‐mutated CRC models through systemic delivery without vital organ injury, providing a potential option for CRC therapy.

Wide pulse pressure (WPP) is a preclinical indicator for arterial stiffness and cardiovascular diseases. Long-term exposure to ambient particulate matters (PMs) would increase the risk of WPP. Although reducing pollutants emissions and avoiding outdoor activity during a polluted period are effective ways to blunt the adverse effects. Identifying and protecting the susceptible subpopulation is another crucial way to reduce the disease burdens. Therefore, we aimed to identify the susceptible subpopulations of WPP under long-term exposure to PMs. The WPP was defined as pulse pressure over 60 mmHg. Three-year averages of PMs were estimated using random forest approaches. Associations between WPP and PMs exposure were estimated using generalized propensity score weighted logistic regressions. Demographic, socioeconomic characteristics, health-related behaviors, and hematological biomarkers were collected to detect the modification effects on the WPP-PMs associations. Susceptible subpopulations were defined as those with significantly higher risks of WPP under PMs exposures. The PMs-WPP associations were significant with ORs (95%CI) of 1.126 (1.094, 1.159) for PM

Background It has been widely reported that the prognostic nutritional index (PNI) played a pivotal role in nutritional assessment of surgical patients and tumor prognosis. In order to improve the accuracy of evaluation in Western China, we established reference intervals (RIs) of PNI in healthy controls. Methods A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on PNI and to establish RIs. The data came from a healthy routine examination center database and laboratory information system (LIS) of four centers in Western China, and there were 200 persons selected randomly for verification of RIs. Results Five thousand eight hundred and thirty‐nine healthy candidates were enrolled. PNI showed a marked gender dependence, and males had significantly higher PNI than females across all ages (p, A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on prognostic nutritional index (PNI) and to establish reference intervals (RIs). We established reference intervals of PNI in healthy Han Chinese population in Western China, and validated successfully. Further established RIs will lead to better standardizations of PNI for clinical applications.

Background Mutated KRAS promotes the activation of mitogen-activated protein kinase (MAPK) pathway and the progression of colorectal cancer (CRC) cells. Aberrant activation of phosphatidylinositol 3‑kinase (PI3K) pathway strongly attenuates the efficacy of MAPK suppression in KRAS-mutated CRC cells. The development of a novel strategy targeting dual-pathway is therefore highly essential for the therapy of KRAS-mutated CRC cells. Methods In this study, a quadruple-depleting system for KRAS, MEK1, PIK3CA, and mammalian target of rapamycin (MTOR) genes based on Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/SaCas9 was developed. Serotype 5 of adenovirus (ADV5) was used as packaging virus for systemic delivery of the CRISPR system. To enhance infection efficiency and specificity of ADV5 to CRC cells and reduce its non-specific tissue tropism, two engineered proteins, an adaptor and a protector were synthesized and formed an ADV-protein complex (APC) when delivered the quadruple-editing system intravenously in vivo. Results The quadruple-editing significantly inhibited MAPK and PI3K pathways in CRC cells with oncogenic mutations of KRAS and PIK3CA or with KRAS mutation and compensated PI3K activation. Compared with MEK and PI3K/MTOR inhibitors, the quadruple-editing induced more significant survival inhibition on primary CRC cells with oncogenic mutations of KRAS and PIK3CA. The adaptor protein which specifically targeting epithelial cell adhesion molecule (EpCAM) could dramatically enhance infection efficiency of ADV5 to CRC cells. and the protector protein could significantly reduce the off-targeting tropisms in a variety of organs. Moreover, the quadruple-editing intravenously delivered by APC significantly blocked dual-pathway and tumor growth, without influencing normal tissues in cell- and patient-derived xenograft models of KRAS-mutated CRC cells. Conclusions APC-delivered quadruple-editing of MAPK and PI3K pathways effectively and specifically blocked the progression of KRAS-mutated CRC cells.

Background It has been widely reported that the prognostic nutritional index (PNI) played a pivotal role in nutritional assessment of surgical patients and tumor prognosis. In order to improve the accuracy of evaluation in western China, we established reference intervals (RIs) of PNI in healthy controls. Methods A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on PNI and to establish RIs. The data came from a healthy routine examination center database and laboratory information system (LIS) of four centers in western China, and there were 200 persons selected randomly for verification of RIs. Results 5,839 healthy candidates were enrolled. PNI showed a marked gender dependence, and males had significantly higher PNI than females across all ages (P

Background: This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.Methods: 390 consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL.Results: Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age (P = 0.025), alcohol consumption (P = 0.019), pulmonary insufficiency (P = 0.049), and intraoperative blood loss (P = 0.015) as risk factors for EJAL. Of these four risk factors, age (P = 0.043) and alcohol consumption (P = 0.043) were retained as independent risk factors by multivariate analysis.Conclusions: Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.

Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65×109/L vs. 0.76×109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.

Background Relationship between endothelial nitric oxide synthase (eNOS) polymorphisms and predisposition to coronary artery disease (CAD) are still controversial and ambiguous. So we performed this meta-analysis to more precisely estimate relationship between eNOS polymorphisms and CAD by pooling the results of already published studies. Methods We searched Pubmed, Embase, Web of Science and CNKI for eligible studies. We used Review Manager to pool the results of eligible studies. Results One hundred and fifty-five studies were included in this meta-analysis. We found that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms were all significantly associated with CAD in the general population. We also detected similar significant results for eNOS rs1799983, rs2070744 and rs869109213 polymorphisms in both Caucasians and Asians in further subgroup analyses. Conclusions This meta-analysis demonstrated that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms might influence predisposition to CAD in both Caucasians and Asians.

To investigate the duration of humoral immune response in convalescent coronavirus disease 2019 (COVID-19) patients, we conduct a 12-month longitudinal study through collecting a total of 1,782 plasma samples from 869 convalescent plasma donors in Wuhan, China and test specific antibody responses. The results show that positive rate of IgG antibody against receptor-binding domain of spike protein (RBD-IgG) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the COVID-19 convalescent plasma donors exceeded 70% for 12 months post diagnosis. The level of RBD-IgG decreases with time, with the titer stabilizing at 64.3% of the initial level by the 9th month. Moreover, male plasma donors produce more RBD-IgG than female, and age of the patients positively correlates with the RBD-IgG titer. A strong positive correlation between RBD-IgG and neutralizing antibody titers is also identified. These results facilitate our understanding of SARS-CoV-2-induced immune memory to promote vaccine and therapy development.

Acute myeloid leukemia (AML) is a heterogeneous and highly recurrent hematological malignancy. Studies have shown an association between microRNAs and drive genes in AMLs. However, the regulatory roles of miRNAs in AML and how they act on downstream targets and the signaling pathway has been little studied.As to understand the mechanism of mRNA-miRNA interaction in the blood malignancy from a large scale of transcriptomic sequencing studies, we applied a comprehensive miRNA-mRNA association, co-expression gene network and ingenuity pathway analysis using TCGA AML datasets.Our results showed that his-mir-335 was a critical regulatory of homeobox A gene family. PBX3, KAT6A, MEIS1, and COMMD3-BMI1 were predicted as top transcription regulators in the regulatory network of the HOXA family. The most significantly enriched functions were cell growth, proliferation, and survival in the mRNA-miRNA network.Our work revealed that regulation of the HOXA gene family and its regulation played an important role in the development of AML.

BACKGROUND Numerous studies have shown that the hematological components of the systemic inflammatory response, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), and the systemic immune inflammation index (SII) are efficient prognostic indicators in patients with cancers. Most of the studies did not investigate the reference intervals (RIs) of these parameters in healthy controls. METHODS A retrospective cohort study was performed on healthy ethnic Han population aged between 18 and 79 years of age by retrieving the data from a healthy routine examination center database and laboratory infor-mation system of four participating centers in western China. By following the Clinical and Laboratory Standards Institute (CLSI), RIs of each parameter was established and validated. RESULTS The analysis included 5,969 healthy subjects. We found that the individual's gender can significantly influence PLR, LMR, and SII (all p 0.05). Surprisingly, we also found that with an increase in age, the PLR, LMR, and SII tend to decrease, while NLR remained stable. PLR, LMR, and SII values were significantly higher in the young adults (18 - 64 years) than in old adults (65 - 79 years) (p < 0.001). The RIs of NLR, PLR (adults), PLR (old adults), LMR and SII were 0.88 - 4.0, 49 - 198, 42 - 187, 2.63 - 9.9, 142 x 109/L - 804 x 109/L, respectively. CONCLUSIONS Our study addresses possible variations and establishes consensus for the NLR, PLR, LMR, and SII RIs for healthy Han Chinese adults in western China. Further, established RIs can standardize clinical applications and promote the use of these indicators into the routine complete blood count report.

RATIONALE: The indwelling ureteral stents is a common procedure in routine urological practice. The double-J (D-J) stent is the most common type of stents used and is indicated mainly for short-term urinary drainage and prevention of obstruction and infection. However, prolonged indwelling stents may result in disastrous complications, such as hematuria, infection, encrustation, and stone formation. In this context, the persistence of stent in situ might play a key role as a nidus in deposition of urinary sediment, then forming calculus. Although the encrustation may become more serious as time goes on, large bladder stones are relatively rare. However, the serious encrustation and giant stone may complicate or exacerbate the conditions in turn. PATIENT CONCERNS: A 45-year-old female patient who underwent right ureteral stent placement after open ureterolithotomy 6 years ago complained of dysuria, urinary frequency, and urgency over 2 months. DIAGNOSIS: The kidney ureter bladder (KUB) x-ray showed the presence of a giant stone in the bladder and an entire D-J stent. The computed tomography (CT) urography scans revealed normal left kidney, right hydronephrosis, and an encrusted D-J stent with the significant stone, diameter 4.2 cm with a CT value of 1211.0 ±â€Š221.6 HU, on the vesical coil. On the basis of these auxiliary examinations, the case was diagnosed as cystolith and prolonged-indwelling stents. INTERVENTIONS: Pneumatic ballistic lithotripsy was used for crushing the bladder calculi followed by the successful extraction of intact D-J ureteral stent. OUTCOMES: No residual stone was detected on postoperative KUB x-ray and CT urography scans. Patient recovered well and was discharged 10 days after surgery. Semi-annual ultrasound examination was suggested to monitor the effect of therapy. LESSONS: This case reminds us that it is crucial to take various measures to avoid the forgotten ureteral stent and its unfortunate late complication.

A wavelength calibration method is proposed for Fourier domain optical coherence tomography. In the present study, the wavelength remapping procedure is based on the spectral phase function determined by the calibration signal. To accomplish high accuracy feature for wavelength calibration, a common-path interferometer is employed. Two autocorrelation interferograms generated from the common-path interferometer are utilized as the calibration signals. The advantage of the interferometer proposed here is that the accurate optical path difference of the calibration signals could be acquired easily. The wavelength distribution in the spectrometer was deduced with the phase signal. The approach was compared to a wavelength-determined approach using a standard light source with a characterized spectrum. With the result that the mean spectrometer calibration error is 0.1 nm, it demonstrates that the proposed method is more superior in spectrometer calibration. Furthermore, the proposed method allows for higher axial imaging resolution and signal-to-noise ratio (SNR) in the FD-OCT system.

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The synchronization and coordination of material flows is a key element in the supply chain management. To analyze the effects of coordinated replenishment for components, we consider an assembly system with two component-suppliers, one supply-hub and one manufacturer, under stochastic final product demand. We propose three different strategies: (i) the decentralized replenishment, (ii) the coordinated replenishment without coordinated quantity, and (iii) the coordinated replenishment policy with coordinated quantity for infinite planning horizon. We propose optimal decisions for all strategies. Results show that policy (ii) is always better than policy (i). We further identify the conditions under which the third strategy outperforms the other two. Policy (iii) is better on cost saving and service level, only when it satisfies certain conditions. Numerical studies are conducted to validate the model and to derive managerial implications.

The quality and price of suppliers’ products directly influence the potential demand in the market. This paper studies the impact of decision sequence in a two-echelon assembly system with demand uncertainty: suppliers first decide wholesale price and quality investment for their components, and then the manufacturer decides product price after the uncertainty in demand is resolved. We consider three scenarios in the stage of suppliers’ decisions. In case 1, both suppliers simultaneously determine quality investment followed by the simultaneous setting of wholesale prices. In case 2, both suppliers make quality investment and wholesale price decisions simultaneously. In case 3, one supplier acts as a leader and moves first to announce quality investment and wholesale price, and the other supplier moves later. We compare all decision models from each firms’ perspective. Our analysis reveals that the second decision sequence is the best option for the manufacturer and the integrated supply chain and the first decision sequence is the best option for suppliers as a whole, but there is no clear dominating choice for each supplier. The optimal choices of suppliers are mainly determined by the cost structure. We examine and discuss the relation between system parameters and the incentives of suppliers in choosing decision sequence.

Shadow moire fringes have a complex intensity distribution, which makes the existing arcsine function or arccosine function that is used in random phase-shift extraction algorithms unstable in applications. We propose a high-precision algorithm to determine the random phase shift in a robust way. The idea consists of constructing three consecutive fringe patterns by the addition of two background terms suppressed fringe patterns. Then, an iterative self-tuning phase-shifting algorithm is developed to extract the measurement phase in a pointwise manner. Due to the use of an iterative procedure and tangent function, the present method can evaluate the phase shift accurately and robustly and can be implemented easily in many applications. In addition, the proposed method provides a solution for the development of the two-frame random shadow moire technique. We present simulation and optical experiments to demonstrate the correctness of the proposed method. The results show that the proposed method performs better than other methods.

Phase-shifting shadow moire is an efficient technique for three-dimensional (3-D) shape measurement, but the technique is always suffered from the error of phase shifter. A three-frame random phase-shifting algorithm is proposed to relax the requirements of repeatability and accuracy of the phase shifter in a shadow moire system. The proposed method can act as a bridge between the three phase-shifting analysis methods and two-shot phase-shifting methods. The value of introduced arbitrary and unknown phase shift can be calculated by a determinate formula. The algorithm has the advantages of being free from the disturbance of background elimination and less computation. In addition, the proposed method is immune to nonsinusoidal fringe patterns and can be implemented easily in many applications. Both simulation and optical experimental results verify the feasibility of this method.

This study aims to investigate the negative effects of chronic exposure to isoflurane on spermatogenesis and explore the underlying mechanisms. Sixty male rats were randomly allocated to two groups: control group, receiving no treatment, and anesthesia group, administrated exposure to isoflurane (2 ppm) for 25 consecutive days (1 h/day). The negative effects of chronic exposure to isoflurane were evaluated by analyzing the median eminence GnRH content, the relevant hormone levels, some sperm parameters and the mRNA expressions for some reproduction-related genes. Isoflurane significantly decreased the GnRH content and the serum gonadotrophin levels compared with the control group (p