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Objectives To establish the three-dimensional facial soft tissue morphology of adolescent and adult females in the Guangdong population and to study the morphological characteristics of hyperdivergent skeletal class II females in Guangdong compared with that of normodivergent class I groups. Materials and methods The 3dMDface system was used to capture face scans of 160 patients, including 45 normal and 35 hyperdivergent skeletal class II adolescents (aged 11–14 years old) and 45 normal and 35 hyperdivergent skeletal class II adults (aged 18–30 years old). Thirty-two soft tissue landmarks were mapped, and 21 linear, 10 angular and 17 ratio measurements were obtained by 3dMDvultus analysis software. Data were assessed with a t-test of two independent samples between the normal adolescent and adult groups and between the normal and hyperdivergent skeletal class II groups. Results The linear measurements of the Guangdong adult females were larger than those of the adolescents in both Class I and Class II groups. However, the angular and ratio measurements had no significant difference. The vertical linear measurements were higher and the sagittal and transverse linear measurements were smaller in the hyperdivergent class II group (p p p Conclusions The three-dimensional facial morphology of Guangdong adolescent and adult females was acquired. The facial soft tissue measurements of the adults were higher in the three dimensions except for the facial convexity and proportional relationships which were similar, suggesting that the growth pattern remained the same. The three-dimensional facial soft tissue features of hyperdivergent skeletal class II were characterized by the terms “long, convex, and narrow”. Three-dimensional facial measurements can reflect intrinsic hard tissue characteristics.

e20510 Background: Studies revealed the pathogenesis and exploring the treatment of lung adenocarcinoma (LUAD), but overall survival (OS) of LUAD patients still remains low in the recent years. Methods: This study analyzed the relationship between gene expression and histone modifications, and discussed the prognostic value of these findings in patients with LUAD. Four types of histone modifications including H3K9me3, H3K27me3, H3K27ac and H3K4me3 were included. Promoters and enhancers in protein coding genes (PCGs) were selected as targeted analyzing regions. Unsupervised consensus clustering was performed to identify molecular subtypes. Cox regression analysis and stepwise Akaike information criterion (stepAIC) were applied to construct a prognostic model. Results: A large number of epigenetic abnormal genes in lung adenocarcinoma were found by comparing the histone modifications and methylation regions on the elements including. We identified 699 epigenetic dysregulated genes specific to LUAD. Finally, based on these epi-PCGs, we constructed three molecular types of LUAD and identified 5 epi-PCGs as prognostic markers for LUAD patients. Conclusions: Our research provided a better understanding that the abnormal epigenetic regulation of PCG expression contributes a lot for the progress of gene regulation in LUAD. These novel molecular subtypes and the prognostic model could serve as guiders to assist decision-makings for LUAD treatment.

BackgroundDue to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for orthodontists. The abnormal orofacial myofunctional status (OMS) may be a major risk factor contributing to the development and relapse of SAOB. This study is aimed at evaluating the OMS and the efficacy of orofacial myofunctional therapy (OMT) alone for SAOB subjects.MethodsEighteen adolescents with SAOB (4 males, 14 females; age: 12–18 years) and eighteen adolescents with normal occlusion (2 males, 16 females; age: 12–18 years) were selected. The electromyographic activity (EMGA) associated with mastication and closed mouth state was measured. Lateral cephalography was used to evaluate craniofacial morphology. Wilcoxon signed rank tests and t-tests were performed to evaluate myofunctional and morphological differences. Pearson or Spearman correlation analysis was used to investigate the correlations between EMGA and morphological characteristics. SAOB subjects were given OMT for 3 months, and the EMGA was compared between before and after OMT.ResultsDuring rest, anterior temporalis activity (TAA) and mentalis muscle activity (MEA) increased in SAOB subjects, but TAA and masseter muscle activity (MMA) decreased in the intercuspal position (ICP); and upper orbicularis activity (UOA) and MEA significantly increased during lip sealing and swallowing (P P P ConclusionSAOB subjects showed abnormal OMS features including aberrant swallowing patterns and weak masticatory muscles, which were interrelated with the craniofacial dysmorphology features including a greater anterior facial height and incisor protrusion. Furthermore, OMT contributes to OMS harmonization, indicating its therapeutic prospect in SAOB.

Utility tunnel is increasingly applied for underground space development, and its health monitoring becomes attractively important. The acoustic emission (AE) technology is often used for damage monitoring of small-scale specimens made of concrete or rock in the laboratory. In this study, the AE technology is adopted to instrument a novel prefabricated utility tunnel to provide insights into the leakage behavior of the structure during the sealing test. Filtering is conducted on AE data to eliminate the influence of noise interference, especially for data in the pressurization stage. The traditional ring-down count and AE energy are determined from eigenvalue analysis of AE events. It is found that these conventional calculations can be well related to the pattern of internal water pressure, and the Felicity effect is found in the loading process. Furthermore, time series analysis is carried out for each specific pressurization or pressure-holding stage during the sealing test, in which the b-value (an important mean to study the characteristics of AE signal) is evaluated. Results show that the b-value can also be used as a prediction basis for pre-alarming monitoring before the occurrence of seepage failure for utility tunnel.

Objective To conduct a meta-analytic review of studies investigating the effect of the anesthesia modality on perioperative mortality in endovascular repair of ruptured abdominal aortic aneurysms (REVAR). Methods The present meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were comprehensively searched from database inception to January 2020. Eligible studies included cohort studies that reported the 30-day/in-hospital mortality rate or the multivariate adjusted odds ratio (OR) or hazard ratio of the mortality risk for patients who underwent emergency REVAR under locoregional anesthesia (LA) versus general anesthesia (GA). The random-effects model was used to estimate the ORs by pooling the related data from individual studies. Results A total of eight studies were finally included in this study. The first meta-analysis of seven studies that reported the 30-day/in-hospital mortality with a total of 3,116 patients (867 in the LA group and 2,249 in the GA group) revealed that LA was associated with a lower 30-day/in-hospital mortality than GA (16.4% vs. 25.4%, unadjusted OR 0.47, 95% confidence interval [CI] 0.32–0.68). The second meta-analysis of three of these seven studies (including 586 patients in the LA group and 1,945 in the GA group) that reported the perioperative variables revealed comparable baseline characteristics but a lower 30-day/in-hospital mortality in the LA group (unadjusted OR 0.55, 95% CI 0.42–0.71). The third meta-analysis of the adjusted ORs or hazard ratios that were reported from four studies (including 501 patients in the LA group and 1,136 in the GA group) showed a similar trend (adjusted OR 0.37, 95% CI 0.19–0.75). Conclusion REVAR under LA is associated with a lower 30-day/in-hospital mortality than REVAR under GA. However, as the included studies may have had some observation bias, further randomized controlled trials are warranted to validate the present results.

BACKGROUND Recent studies of the association between cystatin C and peripheral artery disease (PAD) have produced inconsistent results, and few studies have been conducted to investigate this association in the Chinese Han population. Therefore, we evaluated the relationship between cystatin C and PAD using Chinese data. METHODS We performed a secondary analysis of the data from a previously published case-control study about PAD in our center. We examined the relationship between cystatin C and PAD by logistic regression models and subgroup and interaction analyses. We also constructed a propensity score-matched population by matching the conventional risk factors to further validate this association. In addition, we explored the relationship between cystatin C level and ankle-brachial index (ABI) strata (

Objective. To shed light on the association between hyperhomocysteinemia (HHcy) and thoracoabdominal aortic aneurysms (TAAAs). Methods. From July 2013 to March 2017, we conducted a matched case–control study involving individuals who presented to the Chinese People’s Liberation Army General Hospital and underwent thoracoabdominal magnetic resonance angiography or computed tomography angiography. A total of 73 patients with TAAAs were enrolled in the case group, and 219 sex-matched subjects without TAAAs were included in the control group. We then examined the relationship between HHcy and TAAAs by logistic regression models and subgroup as well as interaction analyses. Results. Serum total homocysteine (tHcy) concentrations and the proportion of HHcy were significantly higher in the patients with TAAAs than in those without TAAAs (P<0.001). Furthermore, the multivariate logistic regression models indicated that participants with HHcy had a 2.14-fold higher risk of TAAAs than those with a normal serum tHcy level (adjusted odds ratio (OR), 2.14; 95% confidence interval, 1.00–4.56). Similarly, each 1 μmol/L increase in the serum tHcy concentration was associated with a 4% higher risk of TAAAs (adjusted OR, 1.04; 95% confidence interval, 1.00–1.07). Subgroup analyses indicated that HHcy tended to be associated with a greater risk of TAAAs in all stratified subgroups (adjusted ORs>1). Furthermore, the interaction analyses revealed no interactive role in the association between HHcy and TAAAs. Conclusions. The present case–control study suggests that HHcy is an independent risk factor for TAAAs. Larger prospective cohort studies are warranted to validate these findings.

Purpose Minimally invasive esophagectomy is increasingly performed for esophageal or gastroesophageal junctional cancer, with advantages of improved perioperative outcomes in comparison with open esophagectomy. McKeown and Ivor Lewis are widely used procedures of minimally invasive esophagectomy, and there have been controversies on which one is preferred for patients with resectable esophageal or junctional cancer. Patients and methods This review was registered at the International Prospective Register of Systematic Reviews (number CRD42017075989). Studies in PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov were thoroughly investigated. Eligible studies included prospective and retrospective studies evaluating short-term outcomes of minimally invasive McKeown esophagectomy (MIME) vs minimally invasive Ivor Lewis esophagectomy (MILE) in patients with resectable esophageal or junctional tumors. Main parameters included anastomotic leak and 30-day/in-hospital mortality. Overall incidence rates (ORs)/weighted mean difference (WMD) with 95% confidence intervals (CIs) were calculated by employing random-effects models. Results Fourteen studies containing 3,468 cases were included in this meta-analysis. Age, male sex, and American Joint Committee on Cancer (AJCC) stage between the 2 groups were not statistically different. MIME led to more blood loss, longer operating time, and longer hospital stay than MILE. MIME was associated with higher incidence of pulmonary complications (OR =1.96, 95% CI =1.28-3.00) as well as total anastomotic leak (OR =2.55, 95% CI =1.40-4.63), stricture (OR =2.07, 95% CI =1.05-4.07), and vocal cord injury/palsy (OR =5.62, 95% CI =3.46-9.14). In addition, the differences of R0 resection rate, number of lymph modes retrieved, blood transfusion rate, length of intensive care unit stay, incidence of cardiac arrhythmia, and Chyle leak between MIME and MILE were not statistically significant. Notably, incidence of severe anastomotic leak (OR =1.28, 95% CI =0.73-2.24) and 30-day/in-hospital mortality (OR =1.76, 95% CI =0.92-3.36) as well as 90-day mortality (OR =2.22, 95% CI =0.71-6.98) between the 2 procedures were also not significantly different. Conclusion This study suggests that MIME and MILE are comparable with respect to clinical safety. MILE may be a better option when oncologically and clinically suitable. MIME is still a safe alternative procedure when clinically indicated. However, this evidence is at risk for bias; randomized controlled trials are needed to validate or correct our results.

With the development of the era of big data and the continuous updating of computer technology, the traditional teaching is not satisfied with the current diversified educational development concept, especially for the computer operation class, computer operation has become the mainstream of the current computer experiment class.With the increasing number of computer experiments and the extensive use of computers in open laboratories, how to manage computer experiments reasonably has become an urgent problem. The function of the computer is powerful, and students have different habits of using the computer, and the entertainment function of the computer is also loved by many students. Therefore, in the process of experiment, students often play games and watch movies, which is not easy to manage. In order to solve these problems, this paper studies the computer experiment management system under the virtual environment to help teachers manage the experiment process. This paper studies the function modules of the computer experiment management system, explains the key elements of the analysis of the implementation of the experiment management system, and explains the construction scheme of the virtual experiment teaching environment, and expounds the ant colony algorithm used in the design and management of the course scheduling system. This paper also analyzes the operation and load of computer experiment management through simulation experiment research, and tests and analyzes to prove the rationality of the management system. The experimental research shows that in the daily computer experiment management system, the most commonly used is the experimental teaching, and the conventional office, accounting for 27.35 and 26.33 respectively. The highest utilization rate of the computer experiment system is the daily teaching, accounting for 53.6%.

Supplemental Digital Content is available in the text, To shed light on the interaction between the American Joint Committee on Cancer (AJCC) T stage and M stage in the determination of the overall survival (OS) and cancer-specific survival (CSS) of esophageal carcinoma patients. Moreover, to confirm our hypothesis that tumors that metastasize to distant sites in the early T stage may reflect a more biologically aggressive disease compared with those that metastasize in more advanced T stages. We performed a retrospective cohort study with patients who were pathologically diagnosed with esophageal cancer between 2004 and 2014 in the surveillance epidemiology and end results (SEER) database. The primary study variables were the T and M stage, as well as their interaction terms. We performed a survival analysis of the interaction terms using unadjusted Kaplan–Meier methods and adjusted Cox proportional hazards models. Furthermore, we performed an exploratory analysis with stratification by histological type, esophageal adenocarcinoma (EAC), and esophageal squamous cell carcinoma (ESCC). Data of 19,078 patients were retrieved from the SEER database. Unadjusted Kaplan–Meier curve indicated that patients with T2 and T3 stage had longer median OS and CSS (3 months and 4 months, respectively) than with T1 stage in distantly metastatic esophageal cancer (M1 stage). Multivariate analysis revealed a significant interaction between the T stage and M stage when determining the OS and CSS of esophageal cancer (P

Jianqing Deng, Zhipeng Ren, Jiaxin Wen, Bo Wang, Xiaobin Hou, Zhiqiang Xue, Xiangyang Chu Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China Purpose: This study aimed to establish a nomogram to predict the overall survival (OS) of the general non-small-cell lung cancer (NSCLC) patients with distant metastasis. Patients and methods: We investigated Surveillance, Epidemiology, and End Results database for NSCLC patients with distant metastasis diagnosed between 2010 and 2014. Statistically significant prognostic factors were identified using uni- and multivariable Cox regression analyses. A nomogram incorporating these prognostic factors was developed and evaluated by the Harrell’s concordance index (C-index), calibration plots, and risk group stratifications. Results: We finally included 18,209 patients for analysis. These patients were divided into two groups, 14,567 cases for the training cohort and 3,642 for the validation cohort. Marital status, sex, race, age, histology, T stage, N stage, histological differentiation, bone metastasis, brain metastasis, liver metastasis, with M1a disease, surgery of primary cancer, and chemotherapy were identified as the prognostic factors of the OS and integrated to construct the nomogram. The nomogram had a C-index of 0.704 (95% CI: 0.699–0.709) in the training set and 0.699 (95% CI: 0.689–0.709) in the validation set. The calibration curves for 1- and 2-year OS in the training and validation sets showed acceptable agreement between the predicted and observed survival. Also, the nomogram was capable of stratifying patients into different risk groups within the patients who presented with bone, liver, or brain metastasis, as well as in each T, N stage, respectively. Conclusion: A nomogram was established and validated to predict individual prognosis for the general patients with distantly metastatic NSCLC. Global prospective data with the latest TNM classification and more comprehensive prognostic factors are needed to improve this model. Keywords: nomogram, metastatic lung cancer, SEER, prognosis, overall survival, prediction

At present, a large number of people in the world are suffering from type 2 diabetes (T2DM), so it is urgent to develop effective treatment measures of T2DM. In China, many clinical studies have shown that Jinqi Jiangtang Tablet (JQJTT), a traditional Chinese patent medicine (TCPM), has a good effect in the treatment of T2DM. This systematic review and meta-analysis is intended to assess the efficacy and safety of JQJTT plus conventional therapy in the treatment of T2DM.Seven electronic databases were searched to include in eligible studies published from inception to May 24, 2018. Randomized controlled trials (RCTs) of JQJTT in combination with the conventional therapy versus conventional therapy alone or combined with placebo were included. The two reviewers independently conducted data extraction and quality assessment. For different variable types, the outcome measures were expressed as risk ratios (RRs) or mean differences (MDs). According to the value of ISeventeen studies conducted in China were identified in this systematic review, which included 1,425 participants. The meta-analysis on the effective rate of the comparison groups showed a significant difference in favor of the JQJTT group (RR 1.34; 95%CI [1.02, 1.75]; p = 0.04). In addition, the results showed a statistically significant reduction in FBG (MD -0.85; 95%CI [-1.03, -0.68]; p 0.00001), 2hPG (MD -1.95; 95%CI [-2.33, -1.56]; p 0.00001), HbA1c (MD -0.76; 95%CI [-1.03, -0.49]; p 0.00001), FINS (MD -3.05; 95%CI [-3.69, -2.42]; p 0.00001), PINS (MD -10.22; 95%CI [-13.93, -6.50]; p 0.00001), HOMA-IR (MD -1.11; 95%CI [-1.55, -0.68]; p 0.00001), LDL-C (MD -0.37; 95%CI [-0.63, -0.11]; p = 0.006), TC (MD -0.46; 95%CI [-0.85, -0.08]; p = 0.02), TG (MD -0.34; 95%CI [-0.47, -0.20]; p 0.00001) with JQJTT plus conventional therapy versus conventional therapy alone. There was no statistical difference between the two comparison groups in HDL-C, total incidence of adverse events and incidence of hypoglycemia.The available evidence indicates that JQJTT combined with conventional therapy for treating T2DM has a good performance in regulating glycolipid metabolism and improving insulin resistance. However, due to the limitations of this systematic review, the results should be interpreted with caution.

Multilayer core–shell poly (styrene-butyl acrylate) latex particles were synthesized via semi-continuous emulsion polymerization, and the process was monitored by a dynamic laser scattering (DLS). The layers of the latex particles were designed to have progressively decreasing glass transition temperatures (Tg) from the core (layer 1) to the outmost shell (layer 4), which was achieved by varying the mass ratio of butyl acrylate (BA) to styrene (St) in the synthesis of each layer. Divinylbenzene (DVB) was added as the crosslinking agent in each layer except for the outmost layer in order to ensure that a continuous film can be formed at room temperature. The damping properties of the formed films as well as the influences of synthesis variables, including the content of DVB added in the internal layers (i.e., layers 1, 2, and 3), the total mass ratio and sequence between layers 3 and 4, and the Tg of each layer were studied by dynamic mechanical analysis (DMA). The results showed that four-layer core–shell latex particles with proper DVB content in each layer exhibited the best damping properties, with a broad effective damping range (tan δ > 0.3) ranging from −12.0 °C to 97.2 °C. The widening of the damping peak can be explained by the formation of a gradient IPN structure in latex particles. Furthermore, the morphology of the formed films was studied by AFM in tapping mode.