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Abstract Background Pheochromocytoma is rare in pregnant women. It presents as diverse symptoms, including hypertension and sweating. The symptoms of pregnant women with pheochromocytoma and comorbid hypertension often mimic the clinical manifestations of preeclampsia, and these women are often misdiagnosed with preeclampsia. Case presentation In this case, a pregnant woman presented with chest pain as the primary symptom, and a diagnosis of pheochromocytoma was considered after ruling out myocardial ischemia and aortic dissection with the relevant diagnostic tools. This patient then underwent successful surgical resection using a nontraditional management approach, which resulted in a positive clinical outcome. Conclusions It is essential to consider pheochromocytoma as a potential cause of chest pain and myocardial infarction-like electrocardiographic changes in pregnant women, even if they do not have a history of hypertension.

Traditional prices at the distribution level cannot efficiently guide the comprehensive cost recovery. To this end, this paper proposes a novel integrated nodal price by solving a comprehensive investment problem. The proposed integrated nodal price can be inherently decomposed into three price components: i) extended distribution locational marginal price of electricity, ii) distribution locational price of carbon, and iii) distribution locational price of investment. Specifically, the extended distribution locational marginal price enables to recover the power generation cost and on–off cost of generation units via a convexified mixed-integer optimal power flow model; the distribution locational price of carbon enables to recover the carbon emission cost through a carbon footprint tracing method; and the distribution locational price of investment enables to recover the investment cost of distribution network via a reverse power flow tracking method. These three price components work in a complementary manner and are coupled with each other through the shared optimal power flow results. Numerical results demonstrate that the proposed extended distribution locational marginal price can reduce the production cost by 10.41% in contrast to the traditional distribution locational marginal price.

Abstract Background A sudden increase in heart rate (HR) during ablation of the right superior pulmonary venous vestibule (RSPVV) is often detected in patients undergoing circumferential pulmonary vein isolation (CPVI). In our clinical practices, we observed that some patients had few complaints of pain during the procedures under conscious sedation. Aim We aimed to investigate whether there is a correlation between a sudden increase in HR during AF ablation of the RSPVV and pain relief under conscious sedation. Methods We prospectively enrolled 161 consecutive paroxysmal AF patients who underwent the first ablation from July 1, 2018, to November 30, 2021. Patients were assigned to the R group when they had a sudden increase in HR during the ablation of the RSPVV, and the others were assigned to the NR group. Atrial effective refractory period and HR were measured before and after the procedure. Visual Analogue Scale (VAS) scores, vagal response (VR) during ablation, and the amount of fentanyl used were also documented. Results Eighty-one patients were assigned to the R group, and the remaining 80 were assigned to the NR group. The post-ablation HR (86.3 ± 8.8 vs. 70.0 ± 9.4 b/min; p ≤ 0.001) was higher in the R group than in pre-ablation. Ten patients in the R group had VRs during CPVI, as well as 52 patients in the NR group. The VAS score [2.3 (1.3–3.4) vs. 6.0 (4.4–6.9); p ≤ 0.001)] and the amount of fentanyl used (107 ± 12 vs. 172 ± 26 ug; p ≤ 0.001) were significantly lower in the R group. Conclusion A sudden increase in HR during the ablation of the RSPVV was correlated with pain relief in patients undergoing AF ablation under conscious sedation.

The construction of a power system including renewable energy has become the direction of development for the power industry as a result of the “carbon peaking and carbon neutrality” targets. Yet because the electricity market (EM), carbon market (CM), and green certificate market (GCM) have traditionally operated independently, with little interaction among them. To explore the interaction and correlation among the three markets, this paper analyzes the trading patterns and mutual influencing factors of the EM, CM and GCM and proposes the optimal decision-making model of “carbon-electricity-certificate” integration of multiple markets based on the decision-making behavior of power producers in each market. Finally, the golden jackal optimization algorithm (GJO) is used to solve the problem under the condition of network security. The simulation results show that the integration of multiple markets is more conducive to promoting the consumption of renewable energy source (RES), and also verify the feasibility and effectiveness of GJO in solving the optimal decision-making problem of power producers in EM.

Abstract Background Intermediate-risk acute pulmonary embolism (APE) patients are usually defined as hemodynamically stable, comprehending a great therapeutic dilemma. Although anticoagulation therapy is sufficient for most intermediate-risk APE patients, some patients can deteriorate and eventually require a systemic fibrinolytic agent or thrombectomy. Hence, this study aimed to evaluate the predictive value of differences in clinical data for the short-term prognosis of intermediate-risk APE patients. Methods A retrospective cohort of 74 intermediate-risk APE patients confirmed by computed tomography pulmonary angiography was analyzed in the present study. Adverse clinical event outcomes included PE-related in-hospital deaths, critical systolic blood pressure consistently under 90 mmHg, refractory to volume loading and vasopressor infusion requirements, mechanical ventilation, and cardiopulmonary resuscitation. The APE patients were stratified into two groups: adverse outcome (n = 25) and control (n = 49) groups. Then, the clinical data of the two groups were compared. Receiver operating characteristic (ROC) curves were used to explore the predictive value of white blood cell (WBC) counts and the right to left ventricular short-axis (RV/LV) ratio. Model calibration was assessed using the Hosmer–Lemeshow goodness-of-fit statistic. Results The brain natriuretic peptide, WBC count, and the RV/LV ratio were higher in patients with adverse outcomes compared to controls. The APE patients with adverse outcomes presented significantly higher rates of syncope, Negative T waves (NTW) in V1–V3, intermediate-high risk, thrombolytic therapy, and low arterial oxygen saturation (SaO2) compared to controls. In the multivariate logistic regression analysis, the SaO2 1.165 was predictive of adverse outcomes with sensitivity and specificity of 88.00 and 59.20%, respectively. The WBC counts were also able to predict adverse outcomes (AUC = 0.752, p 9.05 was predictive of adverse outcomes with sensitivity and specificity of 68.00 and 73.50%, respectively. Conclusion Overall, a SaO2

Solar energy is one of the main renewable energy sources and has rapidly developed in many countries. However, the photovoltaic (PV) output power will be different under various meteorological and geographical conditions. Therefore, this paper presents an optimization method for the deployment of PV panels in a centralized PV power plant considering multiple factors. Firstly, the whole planning area is divided into a certain amount of sub-areas according to a given area, and fuzzy C-means algorithm is used for terrain clustering according to the geographical characteristics of the sub-areas. Secondly, the correlation analysis between each meteorological factor and PV output power is carried out separately to select the main factors affecting PV output power, and then the expected annual PV output power under the joint action of several main meteorological factors in each terrain is calculated by dual-stage attention mechanism based long short-term memory algorithm. Finally, according to the expected annual PV output of each terrain, considering the constraints including cost, area and so on, the deployment optimization of PV panels is obtained to maximize the annual PV output of the whole PV power plant and minimize the construction cost. The results of case studies show that the proposed methods effectively improve the expected PV output power of the PV power plant and reduce the construction cost.

The operation flexibility of the power system suffers great challenges due to the vigorously developing of renewable energy resources under the promotion of the carbon neutralization goal. To this end, this paper proposes an economical and flexible energy scheduling method for power system integrated with multiple generation resources while considering the operation of low-carbon. Specifically, flexibility evaluation indexes are constructed to describe the characteristics of the flexible generation units. Then they are connected with the flexibility of the power system in an economic and low-carbon flexible energy scheduling model. To coordinate the operation economy, flexibility, and carbon emission reduction, the model incorporates demand response, operational characteristics, and flexibility requirements. Further, the model is fully validated through the simulation on the modified IEEE 30-bus system. Results demonstrate that: the proposed method can reduce the system’s carbon emission and total operating costs and promote photovoltaic consumption.

BackgroundThe musculature of the coronary sinus (CS), especially its distal connection with the post wall of the left atrial (LA), has been associated with the genesis and maintenance of atrial flutter (AFL) and atrial fibrillation (AF). However, the relative contributions of the distal coronary sinus (CSD)-LA connection to PersAF with various degrees of atrial fibrosis remain unknown.ObjectiveThis study aimed to explore the different roles of blocking the CSD-LA connection in the induction of acute AF and middle-term follow-up of recurrence among PersAF patients with various degrees of LA fibrosis.Methods and resultsA retrospective cohort of 71 patients with drug-refractory and symptomatic PersAF underwent ablation for the first time were studied. The population was divided into two groups according to disconnection of the CSD-LA or not. All patients enrolled accepted the unified ablation procedure (circumferential pulmonary vein isolation, non-pulmonary vein trigger ablation and ablation of the CSD-LA connection). Group A (n = 47) successfully blocked the CSD-LA electrical connection and Group B (n = 24) failed. Twenty-five patients could be induced into sustained AF in the Group A compared to 20 in the Group B (53.2 vs. 83.3%, p = 0.013). After a mean follow-up of 185 ± 8 days, 24 (33.8%) patients experienced atrial arrhythmia recurrences. The Group A had significantly fewer recurrences (25.5%) compared to Group B (50%). Meanwhile, in Group A, the ROC curve analysis suggested that in the case of blocking CSD-LA, low voltage area (LVA) of LA can act as a predictive factor for acute AF induction (AUC = 0.943, Cut-off = 0.190, P < 0.001) with sensitivity and specificity of 92.3 and 90.5%, and middle-term recurrence (AUC = 0.889, Cut-off = 0.196, P < 0.001) with sensitivity and specificity of 100 and 65.7%.ConclusionDisconnection of CSD-LA could reduce the inducible rate of acute AF and the recurrences of atrial arrhythmia during middle-term follow-up. The PersAF patients with CSD-LA muscular connection blocked, experienced a higher acute AF inducible rate with larger proportion of LVA of LA (≥19%) and a higher recurrent rate of atrial arrhythmias with a larger proportion of LA fibrosis (≥19.6%).

The goal of tissue-engineered heart valves (TEHV) is to replace normal heart valves and overcome the shortcomings of heart valve replacement commonly used in clinical practice. However, calcification of TEHV is the major bottleneck to break for both clinical workers and researchers. Endothelialization of TEHV plays a crucial role in delaying valve calcification by reducing platelet adhesion and covering the calcified spots. In the present study, we loaded RunX2-siRNA and VEGF into mesoporous silica nanoparticles and investigated the properties of anti-calcification and endothelialization in vitro. Then, the mesoporous silica nanoparticle was immobilized on the decellularized porcine aortic valve (DPAV) by layer self-assembly and investigated the anti-calcification and endothelialization. Our results demonstrated that the mesoporous silica nanoparticles delivery vehicle demonstrated good biocompatibility, and a stable release of RunX2-siRNA and VEGF. The hybrid decellularized valve exhibited a low hemolysis rate and promoted endothelial cell proliferation and adhesion while silencing RunX2 gene expression in valve interstitial cells, and the hybrid decellularized valve showed good mechanical properties. Finally, the in vivo experiment showed that the mesoporous silica nanoparticles delivery vehicle could enhance the endothelialization of the hybrid valve. In summary, we constructed a delivery system based on mesoporous silica to biofunctionalized TEHV scaffold for endothelialization and anti-calcification.

Energy-saving and emission reduction will become the focus of the energy industry in the future. The coordination of the carbon and electricity markets can help achieve the goals of carbon reduction. With the establishment of the carbon market, carbon emitting power generation units (CEPGU) need to consider the trading strategy and comprehensive benefits in the electricity and carbon markets. To further explore the mechanism and interaction process of electricity price and carbon price, the day-ahead electricity market model and carbon market trading model are developed in this study. Based on the deviation between the bid-winning power output in the electricity market and the quota plan in the carbon market, the generation cost model and the carbon quota trading decision model of the units are constructed. Finally, a case study is provided to simulate the coordinated trading process of the carbon and electricity markets. The transaction time scales of the two markets are matched. The results prove that the generation plan of the units can coordinate with the carbon quota level and provide a trading strategy for the power generation enterprises.

Abstract Background Lung tumor embolization leading to acute myocardial infarction (AMI) is rare. Previouscases of lung tumor embolization were reported in the coronary artery. We describe here a case of lung tumor embolization leading to the simultaneous occurrence of AMI and lower extremity arterial embolism. Case presentation A 64-year-old patient was admitted to the emergency department complaining of chest pain and was diagnosed with AMI.An echocardiography showed a mass in the left atrium that was speculated to be a myxoma. An emergency coronary angiography found no evidence of atherosclerosis. On the second day of admission, the patient was diagnosed with lower extremity arterial embolism. Initially, we speculated that the left atrium myxoma caused an embolism resulting in the AMI and lower extremity arterial embolism.However, a lung tumor was the real cause of both conditions. Unfortunately, the patient abandoned treatment when he learned of his disease and died three days later after being discharged from the hospital. Conclusions Lung tumor embolism is an extremely rare cause of AMI. Even rarer is the case presented here, in which a lung tumor embolism caused AMI and lower extremity arterial embolism. Clinicians should recognize lung tumor embolism as a potential cause of AMI.

In order to solve the traffic scheduling problem of the WAN exit part, a traffic scheduling optimization method based on SR Policy/EPE was proposed, which simulated and implemented an Internet egress traffic scheduling scheme on the carrier network. The proposed method that can effectively control the flow of business traffic to achieve end-to-end traffic distribution and flexible scheduling of network-wide traffic. Under the premise of ensuring user experience, it effectively improved the utilization of backbone links, optimized the overall network structure, and greatly improved increased network scalability. Apply SR performance measurement function to various performance indicators, and choose the optimal or suboptimal link to solve the WAN exit congestion problem, which proves the feasibility of this solution.

BackgroundNew-onset atrial fibrillation (NOAF) is associated with worse prognostic outcomes in cases diagnosed with ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, as a credible and convenient marker of insulin resistance, has been shown to be predictive of outcomes for STEMI patients following revascularization. The association between TyG index and NOAF among STEMI patients following PCI, however, has not been established to date.ObjectiveTo assess the utility of the TyG index as a predictor of NOAF incidence in STEMI patients following PCI, and to assess the relationship between NOAF and long-term all-cause mortality.MethodsThis retrospective cohort research enrolled 549 STEMI patients that had undergone PCI, with these patients being clustered into the NOAF group and sinus rhythm (SR) group. The predictive relevance of TyG index was evaluated through logistic regression analyses and the receiver operating characteristic (ROC) curve. Kaplan-Meier curve was employed to explore differences in the long-term all-cause mortality between the NOAF and SR group.ResultsNOAF occurred in 7.7% of the enrolled STEMI patients after PCI. After multivariate logistic regression analysis, the TyG index was found to be an independent predictor of NOAF [odds ratio (OR): 8.884, 95% confidence interval (CI): 1.570–50.265, P = 0.014], with ROC curve analyses further supporting the predictive value of this parameter, which exhibited an area under ROC curve of 0.758 (95% CI: 0.720–0.793, P < 0.001). All-cause mortality rates were greater for patients in the NOAF group in comparison with the SR group over a median 35-month follow-up period (log-rank P = 0.002).ConclusionsThe TyG index exhibits values as an independent predictor of NOAF during hospitalization, which indicated a poorer prognosis after a relatively long-term follow-up.

Background: Myocardial ischemia/reperfusion injury is associated with adverse cardiovascular outcomes after acute myocardial infarction. However, the molecular mechanism of ischemia/reperfusion injury remains unclear. Mitochondria dysfunction is a participant in and regulator of myocardial ischemia-reperfusion injury. However, the molecular mechanisms involved in this process are not yet fully understood. We previously reported that Notch1 can reduce mitochondrial lysis, reduce myocardial infarct size, and inhibit ventricular remodeling. Herein, we explore the role of the downstream target Notch1 in mitochondrial regulation. Methods: This study constructs an ischemic/reperfusion injury rat model and a hypoxia/reoxygenation cell model. The expression of PTEN is detected by real-time PCR, Western blot, and immunofluorescence staining. Cell viability is analyzed with CCK-8. Apoptosis level is detected via the TUNEL assay, and mitochondrial fission/fusion is analyzed with MitoTracker Green staining. Cardiac troponin I (cTnI), lactate dehydrogenase (LDH), superoxide dismutase (SOD), and CK levels of creatine kinase-MB (CK) are measured with ELISA kits. Results: We found that PETN-Pink1-Parkin signaling is inhibited by Notch1 I/R in injured neonatal cardiomyocytes and hearts, i.e., via the inhibition of mitochondrial dysfunction and fragmentation. With the recure of PTEN or Pink1, the protective effect of Notch1 was largely diminished. Conclusion: These results suggest that N1ICD acts protectively against ischemic reperfusion injury by suppressing PTEN-Pink1-mediated mitochondrial dysfunction and fragmentation.

Alveolar adenoma is an isolated, well-defined peripheral lung tumor that originates from type II alveolar cells. The tumor consists of a network of simple, low-cubic, epithelium-coated lacunae with varying amounts of fine and inconspicuous-to-thick spindle cells that sometimes contain mucus sample matrix. Few cases of alveolar adenoma have been reported. These tumors are usually detected by imaging examinations where the alveolar adenoma typically presents as a peripheral, solitary cystic nodule in the lung. The presentation may mimic that of other types of lung tumors, consequently leading to difficulties in the differential diagnosis of this condition. Thus, accurate diagnosis of alveolar adenoma is based on a combination of pathological sections and immunohistochemistry. This study describes an alveolar adenoma in a 59-year-old female patient. Chest X-ray imaging and chest computed tomography identified malignant lesions in the right upper lobe. The patient subsequently underwent a thoracoscopic right upper lobectomy. The diagnosis of alveolar adenoma was confirmed after pathological examination of the excised postoperative tissue. The disease course was stable, and there was no recurrence of pulmonary lesions during 3 years of postoperative patient follow-up. Herein, we report the case of a patient with benign alveolar adenoma with poor imaging and pathological results.

Abstract This paper presents a novel integrated framework for simulating the charging load of an electric vehicle charging station. The framework is built based on the cellular automaton model, including five modules: vehicle generation, charging station, lane change, speed update and boundary clear. The proposed framework can effectively stimulate the system dynamics of the traffic system and charging power process in a charging station. Case studies have verified its feasibility and effectiveness.

The combination of near-infrared (NIR) response and imaging response is a hot research area in which the functions of nanomaterials are maximized. However, the types of such materials reported so far present problems such as requiring complex synthesis. In this study, hydrophilic, porous, and hollow cobalt/manganese oxide (CMO) nanocrystals (NCs) were successfully prepared via a facile and green hydrothermal route. The CMO NCs show strong near-infrared (NIR) absorption, which results from their defect structure due to the coexistence of Co2+ and Co3+ in the as-prepared CMO NCs. Thus, the CMO NCs exhibit excellent photothermal performance, showing photothermal efficiency of up to 43.2%. In addition, the CMO NCs possess good magnetic resonance (MR) imaging performance, with longitudinal relaxivity (r1) of up to 3.48 mM−1 s−1. Finally, for the first time, we prove that the CMO nanocrystals are a promising photothermal agent. Our work provides insights into the application of Mn-based control agents and photothermal agents for photothermal theragnosis therapy.

Background/Aims: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are lethal diseases in humans, and the current treatments have limited therapeutic effects. Cordyceps militaris (CM) is a caterpillar-grown traditional medicinal mushroom, and has been used as a natural invigorant for longevity, endurance, and vitality in China. Recently, purified extracts from CM have been shown to have beneficial effects on various diseases including cancer. Nevertheless, a role of CM in ALI has not been examined previously. Methods: Here, we used a bleomycin-induced ALI model to study the effects of CM on the severity of ALI in mice. The levels of CXCR2, a receptor for Interleukin 8 (IL-8) in pulmonary microvascular endothelial cells, were examined in different experimental groups. The levels of microRNA (miR)-1321 and miR-3188 were also examined in lung samples and in CM. Adeno-associated viruses carrying miR-1321 and miR-3188 were injected into bleomycin-treated mice for evaluation their effects on the severity of ALI. Results: CM treatment significantly alleviated the severity of bleomycin-induced ALI in mice. The increases in lung CXCR2 by bleomycin were significantly reduced by CM at protein level, but not at mRNA level. CM contained high levels of 2 miRNAs (miR-1321 and miR-3188) that target 3'-UTR of CXCR2 mRNA to inhibit its expression. Overexpression of miR-1321 and miR-3188 in mouse lung through AAV-mediated gene therapy mimicked the effects of CM. Conclusion: CM may alleviate severity of murine ALI through miRNAs-mediated CXCR2 inhibition.

Effectively using complementary property of various renewable energy sources by an integrated generation system is a concerned study. Considering the uncertainty of PV, spot price and load, the sizing of integrated generation system with combined market operation is a difficult problem. Based on the above uncertain factors, the sizing method of hydro-PV-pumped storage integrated generation system is proposed in this paper. The output characteristic model is established by utilizing the wide range of hydropower output and flexible schedulability of pumped storage. Then, the volatility ratio of the power exchange curve and load tracking coefficient are the evaluation index of the complementary effect, which ensures the stable and smooth output curve. Further, the uncertainty models of PV, spot price and load are established, considering that, the operation of the power generation system is optimized in the day-ahead market, and the predictive deviation of PV and load is balanced in a real-time market. Based on the above factors, the sizing model of the hydro-PV-pumped storage integrated energy system was proposed based on economics and complementary index. Finally, a case study was undertaken, the sensitivity analysis of the economy and complementarity indices was carried out, as the complementarity index is improved, the economy would be down. Further, the optimal sizing of hydro-PV-pumped storage integrated generation system was obtained, hydropower was a total of 165 MW, PV was 100 MW and pumped storage was 50 MW, that could ensure the economy while meeting the complementary index, the effectiveness of the model proposed was verified.

The cybersecurity of wind farms is an increasing concern in recent years, and its impacts on the power system reliability have not been fully studied. In this paper, the pressing issues of wind farms, including cybersecurity and wind power ramping events (WPRs) are incorporated into a new reliability evaluation approach. Cyber−physical failures like the instantaneous failure and longtime fatigue of wind turbines are considered in the reliability evaluation. The tripping attack is modeled in a bilevel optimal power flow model which aims to maximize the load shedding on the system’s vulnerable moment. The time-varying failure rate of wind turbine is approximated by Weibull distribution which incorporates the service time and remaining life of wind turbine. Various system defense capacities and penetration rates of wind power are simulated on the typical reliability test system. The comparative and sensitive analyses show that power system reliability is challenged by the cybersecurity of wind farms, especially when the installed capacity of wind power continues to rise. The timely patching of network vulnerabilities and the life management of wind turbines are important measures to ensure the cyber−physical security of wind farms.

This paper presents two economic criteria for guiding the energy storage system (ESS) sizing in grid-connected microgrids. The internal power output model and the economic operation model of ESS are firstly established. Then, the combination of heuristic adjustment strategy and hybrid particle swarm optimization algorithm are introduced to solve the optimal operation model of ESS. Then according to the ESS life model and cost-benefit analysis, a static investment economic criterion which is easy and simple to be calculated is proposed to demonstrate the economic feasibility of ESS investment programs in the short term. Considering the time value of currency, a dynamic investment economic criterion is proposed later for long-term investment projects. Furthermore, the ESS sizing boundary of achieving profits could be also obtained according to the criteria which can indicate the economic attractiveness or resistance to ESS investors in the microgrid. A case study has verified its effectiveness. At the same time, sensitivity analysis is given to show the impact on key parameters, such as investment unit price and electricity purchase price on ESS investment.

Areas with hydro power may purchase extra power from the outside power market during dry seasons, which will cause a deviation between the actual and expected power purchase amount due to the inaccurate judgment of the market situation. Because of the uncertainty of price fluctuations, the risk of purchasing power in the real-time market to eliminate this deviation is very high. This paper proposes an innovative trade mode, where the power exchange strategy between multiple areas is adopted through forming an alliance, i.e., one area can use the controllable elements within others, and constructing a monthly and post day-ahead two phase optimization model. The objective function of the monthly stochastic robust optimization considers the power purchase cost to determine the controllable elements dispatch dates for every area in the alliance. Thus, areas can make reasonable dispatch schedules for controllable elements to avoid the resource waste that means more controllable elements are prepared before post day-ahead optimization but less are used after post day-ahead optimization. While the post day-ahead optimization model determines the internal controllable elements dispatch and power exchange amount after the day-ahead market clearing process, users’ satisfaction and dispatch schedule changes for energy storage device are also considered. In order to solve the proposed two phase model, the dual principle and linearization methods are used to convert them into mixed-integer linear programming problems that can be effectively solved by the Cplex solver. The study case verifies the power deviation cost decreases with the power exchange strategy and the important role of energy storage devices.

Due to an imminent fossil energy crisis and environmental pollution, renewable energy, such as photovoltaics, has been vigorously developing. However, the output of photovoltaic energy has strong volatility and intermittency. Thus, the photovoltaic generation system cannot constantly meet the load demand. To address this problem, a virtual power plant with hydro-photovoltaic-thermal generation is proposed in this paper. This virtual power plant utilizes the complementary characteristics of the output of the power sources to ensure a smooth and stable total output curve, and the power supply quality of the virtual power plant is improved. Further, the nonlinear operating cost model of the virtual power plant, with output changing over time, is established on the weighted output of hydro, photovoltaic, and thermal power; then, the corresponding marginal cost model of the virtual power plant is obtained. In the electricity market, three typical mid- to long-term electricity decomposition methods based on average, tracking load and spot price are constructed, and the spot price is predicted by the auto regressive moving average model (ARIMA) model, while the relationship between the spot price and the marginal cost of the virtual power plant is obtained; the marginal cost could also be adjusted based on the ARIMA model. Based on above factors, the sizing model of the virtual power plant is established, considering investment and complementary benefits. Finally, a case study is undertaken, where the sizing scheme for the increasing local load in the typical scenarios of the planning year and the corresponding annual rate of return are obtained. Sensitivity analysis of the influence for the above factors on the sizing of the virtual power plant is carried out. The optimal ratio of mid- to long-term electricity and its decomposition methods, as well as the capacity of the virtual power plant and the sizing ratio of hydropower, photovoltaic, and thermal power are obtained.