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Objectives. To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for atherosclerotic carotid plaque neovascularization. Methods. The electronic databases like PubMed, Embase, OVID, and Web of Science were used to search for the relevant studies, which are involved in the evaluation of the diagnostic parameters of QUS for atherosclerotic carotid plaque neovascularization. Review Manager 5.4 and Stata 14.0 were used to estimate the pooled diagnostic value of CEUS. Forest plots, sensitivity analysis, and Deeks’ funnel plots were performed on the included studies. Results. Ten studies eventually met the final inclusion criteria. For diagnostic performance, CUES showed that the pooled values of sensitivity, specificity, positive likelihood odds ratios, negative likelihood odds ratios, and diagnostic odds ratios were 0.83 (95% CI 0.78-0.86), 0.77 (95% CI 0.68-0.84), 3.61 (95% CI 2.59-5.03), 0.23 (95% CI 0.18-0.28), and 16.02 (95% CI 10.02-25.60), respectively. The estimate of the area under curve (AUC) was 0.85 (95% CI 0.82-0.88). Conclusion. Our research supported that CEUS had high sensitivity and specificity in the diagnosis of atherosclerotic carotid plaque neovascularization. More high-quality prospective multicenter studies focusing on the accuracy of CEUS for carotid atherosclerotic plaque should be performed to verify our conclusions.

Transoral endoscopic thyroid surgery via the vestibular approach (TOETVA) has been gradually accepted worldwide due to its scar-free effect on the neck. Even central cervical lymphadenectomy has been performed in some cases of papillary thyroid carcinoma (PTC). However, there are few reports involving lateral neck dissection with TOETVA. In this study, we attempted to perform selective lateral neck dissection (SLND) for PTC via a transoral vestibular approach. This prospective study was conducted from January 2016 to December 2018 in twenty PTC patients with unilateral T1 tumors without capsular invasion and patients with abnormal level III and IV lymph nodes who underwent SLND via a transoral vestibular approach. Endoscopic surgery was successfully accomplished in all 20 PTC patients. The mean age was 29.2 ± 5.5 (20–41) years. The mean operation time was 146.0 ± 18.7 (114–193) min. The average postoperative hospital stay was 6.8 ± 1.3 (5–10) days. The mean number of removed nodes was 7.4 ± 2.5 (4–12) in the central neck and 10.9 ± 2.8 (6–16) in the lateral neck, and the positive yield amounts were 2.0 ± 1.2 (0–4) and 2.7 ± 1.9 (0–6), respectively. No major complications occurred except for 1 case of transient unilateral recurrent laryngeal nerve palsy and two cases of effusion in the operative area. No evidence of persistent or recurrent disease was observed in these patients during a mean follow-up of 24.3 ± 9.1 (6–36) months. The cosmetic results and protection of personal privacy of this procedure were excellent. Endoscopic SLND via the transoral vestibular approach is feasible, safe, and effective for selected PTCs. A multicenter large comparative study is necessary.

In general, maximum power point tracking (MPPT) method is employed to ensure the maximum power extraction from photovoltaic (PV) arrays. The perturbation and observation (P&O) algorithm is widely used in PV system due to its simplicity and ease of implementation. However, this algorithm will introduce perturbation which is the main reason of interharmonics injection in PV system. In this paper, an interharmonics suppression control scheme with modified MPPT algorithm was proposed. In the proposed control scheme, the dc-link voltage reference generated by MPPT was used to deduce whether the PV system was operated near the MPP. When the dc-link reference voltages meet the characteristics of three points oscillation three consecutive times, it was meaning that the PV system was operated at the MPP. Then the constant voltage tracking algorithm was trigged. Otherwise, it was operated under conventional P&O MPPT algorithm. The proposed control scheme can suppress interharmonics emission and improve power quality. Meanwhile, it can maintain the MPPT efficiency. Simulations have been carried out to verify the effectiveness of the proposed control scheme.

With intermittent renewable power generator increasing, it is difficult for microgrid to maintain power generation and demand balance only rely on micro generators control due to power generation randomness. As an important controllable resource, friendly power electronics loads (FPELs), e.g. air conditioners, water heater, can be introduced to improve reliability and stability of microgrid. A friendly load control scheme considering importance degree and intention of loads was proposed to introduce FPELs into power generation and demand balance of microgrid. In microgrid, frequency can indicate power generation and demand balance. When the frequency below and near its minimum value, it means that the power generation is near to rated capacity. Friendly load control scheme can trigger the FPELs to reduce their power consumption according trigger signal preset for every FPEL. The load power was controlled along with frequency deviation, importance degree and intention of loads. This control scheme can automatically introduce the loads in power generation and demand balance control of microgrid. It can save reserve capacity of energy storage and reduce investment of microgrid. Simulation results show the effectiveness of the proposed control scheme.

Background: The majority of differentiated thyroid cancer (DTC) has good prognosis after a careful standardized therapy according to the current guidelines. However, approximately 13% to 15% of DTC shows surprisingly aggressive behavior and invades the surrounding structures, and then a few is very difficult to remove. In that specific context, preoperative neoadjuvant targeted therapy may improve the clinical stage and create an opportunity for operation.Case presentation: We reported a case of 64-year-old woman with locally advanced papillary thyroid cancer (PTC) who presented with dysphagia due to seemingly unresectable tumor, which severely invaded the left esophagus at the junction of neck and thorax, difficult to undergo a safe and complete removal. With an approvement of institution ethics committee, this patient was treated with neoadjuvant therapy (apatinib 500mg orally qd).Six weeks later, the tumor dramatically shrunk from 56*37mm to 29*26mm with well-controlled mild hypertension. After 10 days interval of apatinib withdrawal, complete tumor excision was accomplished without esophagus fistula. Postoperative inhibition and radioiodine 131I ablation were performed. At one-year follow-up evaluation, no tumor recurrence or metastasis was observed.Conclusion: Preoperative short-termed targeted treatment for locally advanced inoperable DTC may become a promising neoadjuvant therapy, which can reduce the tumor size and decrease stage, thus being convenient for complete and safe removal.

Due to the Randomness and fluctuation of the photovoltaic (PV) system, Maximum Power Point Tracking (MPPT) algorithm is employed to ensure the maximum power extraction from PV arrays, when it is connected to the grid. The previous studies have indicated that the MPPT algorithm is one of the main causes of interharmonics emission in PV systems. The MPPT algorithm parameters such as perturbation step size inevitably have a strong impact on the interharmonics in the current injected to the grid. In general, a smaller MPPT perturbation step size will reduce the interharmonics emission level, but it will result in poor tracking performance of the MPPT algorithm. Thus, there is a trade-off between the MPPT efficiency and the interharmonics emission in PV system. In this paper, an interharmonics suppression scheme with variable step size MPPT algorithm was proposed. In the suppression scheme, two voltage values near by the MPPT voltage and two tracking step size are preset. When the dc-link voltage of PV is between the two preset voltage values, it means that the PV power near its MPP and the smaller perturbation step size implemented in the MPPT algorithm. Otherwise, the bigger perturbation step size is employed. It can greatly reduce interharmonics emission level and maintain the MPPT efficiency. Simulations have been carried out to verify the effectiveness of the suppression scheme.

Cervical lymph node metastasis is a prognostic factor of papillary thyroid carcinoma (PTC). This study aimed to investigate clinicopathological features and risk factors of skip lateral lymph node metastasis in PTC patients.We retrospectively reviewed medical records of patients who underwent simultaneous total thyroidectomy with therapeutic central compartment lymph node dissection (LND) and lateral LND for primary PTC from 2014 to 2019. Univariate and multivariate logistic regression analyses were performed to identify clinicopathologic risk factors for skip metastasis. Receiver-operating characteristic (ROC) curves were constructed using the results of the multiple logistic regression analysis to identify data points with the highest sensitivity and lowest false-negative rate.The frequency of skip metastasis was approximately 12.8% (50/390). Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.033; 95% confidence interval [CI], 1.008-1.059; P = 0.010), tumor size (OR 0.251; 95% CI 0.129-0.490; P 0.001) and tumor located in the upper portion (OR 0.378; 95% CI 0.200-0.715; P = 0.003) were independent risk factors of skip metastasis (all P 0.05). The ROC curves showed that the cut-off value of age for predicting skip metastasis was 44.5 years old (sensitivity = 0.620, specificity = 0.618, area under the curve [AUC] = 0.627, P = 0.004); the cut-off value of the tumor diameter for predicting skip metastasis was 1.05 cm (sensitivity = 0.503, specificity = 0.760, AUC = 0.682, P 0.001).Skip metastasis was common in PTC. The PTC patients with age 44.5 years, tumor diameter 1.05 cm and tumor located in the upper portion should be carefully evaluated for skip metastasis.

NIn this study, an mThe expression level of HNRNPC was remarkably upregulated in tumor samples, while WTAP, RBM15, YTHDC2, YTHDC1, FTO, METTL14, METTL3, ALKBH5, KIAA1429, YTHDF1, and ZC3H13 were significantly downregulated in the cancer specimens compared with those in control samples. A three-gene prognostic signature comprising RBM15, KIAA1429, and FTO could predict overall survival in patients with PTC. In addition, the prognostic signature-based risk score was identified as an independent prognostic indicator for PTC.We established a robust m

To investigate the risk factors of lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma. Clinicopathologic feature data of 427 patients with right or double lobes who underwent surgery between January 2014 to August 2019 in the Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, were retrospectively analyzed. The risk factors of LN-prRLN metastasis were analyzed by the Chi-squared test and multivariate logistic regression. LN-prRLN metastasis was detected in 96 patients. Univariate analysis showed that age, right-side tumor diameter, capsular invasion, comorbid adenoma, and VIa compartment LN metastasis were significantly associated with LN-prRLN metastasis (all P

Background N6-Methyladenosine (m6A) is a ubiquitous RNA modification with vital roles in various cancers, but little is known about its role in papillary thyroid carcinoma (PTC), a common endocrine malignancy. Methods In this study, an m6A RNA methylation regulator-based biomarker signature was developed for the effective prediction of prognosis in patients with PTC. The gene expression profiles of m6A RNA methylation regulators and the corresponding clinical information was downloaded from The Cancer Genome Atlas (TCGA). Differentially expressed m6A RNA methylation regulators between tumor and normal control samples, and correlation expression levels, clinical parameters, and outcomes were evaluated. And a prognostic signature was built using a PTC cohort from TCGA. Results The expression level of HNRNPC was remarkably upregulated in tumor samples, while WTAP, RBM15, YTHDC2, YTHDC1, FTO, METTL14, METTL3, ALKBH5, KIAA1429, YTHDF1, and ZC3H13 were significantly downregulated in the cancer specimens compared with those in control samples. A three-gene prognostic signature comprising RBM15, KIAA1429, and FTO could predict overall survival in patients with PTC. In addition, the prognostic signature-based risk score was identified as an independent prognostic indicator for PTC. Conclusions We established a robust m6A RNA methylation regulator-based molecular signature for predicting prognosis in patients with PTC with high accuracy; this signature might provide important guidance for therapeutic strategies.

The VOD (Video-on-Demand) service has come to a reality because of the development of computer network technology and digital technology being more and more mature. But it demands high bandwidth requirement, high quantity data volume and strong real-time, these make the network bandwidth become the bottleneck of the VOD’s development. So, an agent-based distributed VOD model appeared. We present a useful proxy caching scheme based on doubly linked list according to this model, it could settle the problem effectively which server load and network bandwidth base the current network equipment.