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Supplementary Table S1. Characteristics of Patients Contributing Samples in Figures 1, 2, 4 and 5.

Supplementary Methods. Isolation of Mononuclear Cells from Peripheral Blood and Tissues; Flow Cytometry (FACS); ELISA; Real-Time PCR; Construction of Viral Vectors; Ex Vivo Plasma Cell Induction; Statistical Analysis.

Supplementary Table S2. Clinical Characteristics of the 293 HCC Patients. Supplementary Table S3. Clinical Characteristics of the 16 Gastric Cancer Patients. Supplementary Table S4. Relationships between Peritumoral Stromal IL-21+ Cells and Clinicopathological Characteristics. Supplementary Table S5. Univariate and Multivariate Analyses of Factors Associated with Survival and Recurrence. Supplementary Table S6. Antibodies for Immunoblotting. Supplementary Table S7. Fluorochrome-Conjugated Antibodies Used in Flow Cytometry. Supplementary Table S8. Primers for Real-Time PCR.

Supplementary Figure from PIM2 Expression Induced by Proinflammatory Macrophages Suppresses Immunotherapy Efficacy in Hepatocellular Carcinoma

Cancer immunotherapy restores or enhances the effector function of T cells in the tumor microenvironment, but the efficacy of immunotherapy has been hindered by therapeutic resistance. Here, we identify the proto-oncogene serine/threonine protein kinase PIM2 as a novel negative feedback regulator of IFNγ-elicited tumor inflammation, thus endowing cancer cells with aggressive features. Mechanistically, IL1β derived from IFNγ-polarized tumor macrophages triggered PIM2 expression in cancer cells via the p38 MAPK/Erk and NF-κB signaling pathways. PIM2+ cancer cells generated by proinflammatory macrophages acquired the capability to survive, metastasize, and resist T-cell cytotoxicity and immunotherapy. A therapeutic strategy combining immune checkpoint blockade (ICB) with IL1β blockade or PIM2 kinase inhibition in vivo effectively and successfully elicited tumor regression. These results provide insight into the regulatory and functional features of PIM2+ tumors and suggest that strategies to influence the functional activities of inflammatory cells or PIM2 kinase may improve the efficacy of immunotherapy.Significance:Cross-talk between T cells and macrophages regulates cancer cell PIM2 expression to promote cancer aggressiveness, revealing translational approaches to improve response to ICB in hepatocellular carcinoma.

Supplementary Data from PIM2 Expression Induced by Proinflammatory Macrophages Suppresses Immunotherapy Efficacy in Hepatocellular Carcinoma

Melanocytic nevi (MN) can be classified into three subtypes according to the depth of the nests of nevus cells which is important for management. High-frequency ultrasound (HF-US) can clearly reveal the lesion size, contour, depth, and internal structures. However, the HF-US studies of MN according to subtypes are limited. We aimed to describe the HF-US features of MN and explore its value in accurate classification.This retrospective study was conducted from January 2018 to November 2019. Eighty-five patients with MN were included and examined by 50 and 20 MHz HF-US. The HF-US features were recorded including morphological flatness, depth, shape, boundary, internal echogenicity, hyperechoic spots, lateral acoustic shadow, posterior echoic patterns, mushroom signs, and straw-hat signs. Each image was evaluated by two physicians independently, and the consistency was tested.Eleven lesions could not be detected by HF-US. The rest 74 lesions underwent ultrasonic analysis. MN appeared as strip-shaped or oval, hypoechoic areas localized in the epidermis and dermis under ultrasonography. A strong consistency between HF-US and dermoscopy of determining the lesion depth was achieved (κ = 0.935, p 0.001). The hyperechoic spots were found in 57.6% intradermal nevi. The mushroom signs were seen in 34.8% intradermal nevi, and the straw-hat signs were seen in all the compound nevi.MN can be correctly classified using HF-US, and it had a strong correlation with dermoscopic and clinical classification. HF-US could further reveal the internal morphological features of MN, which may support more precise classification and management.

The reinvigoration of anti-tumor T cells in response to immune checkpoint blockade (ICB) therapy is well established. Whether and how ICB therapy manipulates antibody-mediated immune response in cancer environments, however, remains elusive. Using tandem mass spectrometric analysis of modification of immunoglobulin G (IgG) from hepatoma tissues, we identified a role of ICB therapy in catalyzing IgG sialylation in the Fc region. Effector T cells triggered sialylation of IgG via an interferon (IFN)-γ-ST6Gal-I-dependent pathway. DC-SIGN

Cancer immunotherapy restores or enhances the effector function of T cells in the tumor microenvironment, but the efficacy of immunotherapy has been hindered by therapeutic resistance. Here, we identify the proto-oncogene serine/threonine protein kinase PIM2 as a novel negative feedback regulator of IFNγ-elicited tumor inflammation, thus endowing cancer cells with aggressive features. Mechanistically, IL1β derived from IFNγ-polarized tumor macrophages triggered PIM2 expression in cancer cells via the p38 MAPK/Erk and NF-κB signaling pathways. PIM2+ cancer cells generated by proinflammatory macrophages acquired the capability to survive, metastasize, and resist T-cell cytotoxicity and immunotherapy. A therapeutic strategy combining immune checkpoint blockade (ICB) with IL1β blockade or PIM2 kinase inhibition in vivo effectively and successfully elicited tumor regression. These results provide insight into the regulatory and functional features of PIM2+ tumors and suggest that strategies to influence the functional activities of inflammatory cells or PIM2 kinase may improve the efficacy of immunotherapy. Significance: Cross-talk between T cells and macrophages regulates cancer cell PIM2 expression to promote cancer aggressiveness, revealing translational approaches to improve response to ICB in hepatocellular carcinoma.

Carpesium abrotanoides L. (CA) is widely used as a medicinal plant in Asia. The biological activities of the extract from the roots of Carpesium abrotanoides L. (PCA) and its major components were analyzed in this study. PCA was separated and identified with mass spectrometry. Furthermore, we sought to elucidate the anticancer activity of PCA and its mechanisms. PCA exerted its anti-breast cancer activity through inhibiting the expression of glycolysis-related genes, such as glucose transporter 1, lactate dehydrogenase A, and hexokinase 2. Moreover, PCA downregulated the expression of pyruvate kinase M2 and altered its cellular translocation. We also demonstrated PCA is an inhibitor of the PKM2/hypoxia-inducible factor-1α axis, indicating that PCA is potentially useful as an anti-breast cancer agent. PRACTICAL APPLICATION: In this study, the extract from roots of Carpesium abrotanoides Linn. (PCA) was shown to have a noticeable anticancer effect against breast cancer in vitro, and PCA exerts the anticancer activity by regulating glucose metabolism and PKM2 expression. These findings indicate that PCA is a promising agent with practical applications in the development of functional food containing Carpesium abrotanoides L. root extracts.

Background Patients with hepatocellular carcinoma (HCC) undergoing surgical resection still have a high 5-year recurrence rate (~ 60%). With the development of laparoscopic hepatectomy (LH), few studies have compared the efficacy between LH and traditional surgical approach on HCC. The objective of this study was to establish a nomogram to evaluate the risk of recurrence in HCC patients who underwent LH. Methods The clinical data of 432 patients, pathologically diagnosed with HCC, underwent LH as initial treatment and had surgical margin > 1 cm were collected. The significance of their clinicopathological features to recurrence-free survival (RFS) was assessed, based on which a nomogram was constructed using a training cohort (n = 324) and was internally validated using a temporal validation cohort (n = 108). Results Hepatitis B surface antigen (hazard ratio [HR], 1.838; P = 0.044), tumor number (HR, 1.774; P = 0.003), tumor thrombus (HR, 2.356; P = 0.003), cancer cell differentiation (HR, 0.745; P = 0.080), and microvascular tumor invasion (HR, 1.673; P =0.007) were found to be independent risk factors for RFS in the training cohort, and were used for constructing the nomogram. The C-index for RFS prediction in the training cohort using the nomogram was 0.786, which was higher than that of the 8th edition of the American Joint Committee on Cancer TNM classification (C-index, 0.698) and the Barcelona Clinic Liver Cancer staging system (C-index, 0.632). A high consistency between the nomogram prediction and actual observation was also demonstrated by a calibration curve. An improved predictive benefit in RFS and higher threshold probability of the nomogram were determined by receiver operating characteristic curve analysis, which was also confirmed in the validation cohort compared to other systems. Conclusions We constructed and validated a nomogram able to quantify the risk of recurrence after initial LH for HCC patients, which can be clinically implemented in assisting the planification of individual postoperative surveillance protocols.

A double-loop optimal control strategy combined with a voltage variable charging control scheme is developed to enhance the efficiency of energy recovery and improve control precision for a regenerative hydraulic composite braking system. The proposed voltage variable charging control scheme structure aims to regulate a regenerative braking torque using a charging voltage variation based on an existing battery management system. In addition, an experimental test was conducted to verify the effectiveness of the charging voltage control, and a first loop optimal control was developed to evaluate the ideal ground braking force accurately by transforming several state variables into differential equations. A second optimal control loop was subsequently developed to track an ideal slip ratio using a full-information optimal sliding mode control method under the all-braking conditions. Simulation results corroborate that a composite braking system controlled by the proposed control strategy can implement the regenerative braking behavior precisely with a considerable high-energy recovery efficiency.

The objective of this paper is to propose a modified optimal sliding mode control method for the hydraulic anti-lock braking system of a vehicle to achieve both robustness and optimal control performance. The longitudinal dynamic model of a vehicle, tyre model and hydraulic anti-lock braking system model are established, and the weakness of the common optimal sliding mode control method in designing the anti-lock braking system controller is analysed synthetically. The analyses form the basis for tracking an ideal slip ratio. A new modified optimal sliding mode controller is proposed to regulate the hydraulic anti-lock braking system for a better braking performance and robustness: the optimal sliding mode manifold function includes several virtual damping elements and infinitely small-sized items to meet the working conditions of the current optimal sliding mode control method. The control results of the proposed controller are compared with those of the common sliding mode controller. Simulation results under various road conditions demonstrate that the modified optimal sliding mode controller not only has strong robustness against uncertainties in the road adhesion coefficient but also achieves better control performance of the slip ratio.

To enhance braking force and control convenience of high-speed railway systems, this paper proposes a new electromagnetic track brake, and the corresponding design, optimization, and experimental test are implemented. The proposed track brake is longitudinal-axis magnetic circuits excited by multiple coils electromagnets, and the pole shoes are extending outward. A preliminary design of an electromagnetic track brake is developed, including iron core height, iron core width, iron core gap, excitation ampere-turn, coil arrangement form, coil thickness, and preliminary height of single-layer coil. The electromagnet number and pole shoe gap are optimized through three-dimensional electromagnetic simulation comparisons. The final design of the electromagnetic track brake is determined, including iron core length, copper wire diameter, coil turn, and final height of single-layer coil. Experimental verification of electromagnetic attractive force is performed through prototype tests, and the newly developed electromagnetic track brake can enhance electromagnetic braking deceleration by 39%.

The objective of this study is to present a novel in‐wheel (IW) active vibration system for an IW motor (IWM)‐driven electric vehicle to overcome the negative effects of vertical vibration...

Background/Aims: Herbal materials derived from Juniperus communis (JCo) possess anticancer activity. In this study, we evaluated the efficacy of a JCo berry extract in suppressing glioblastoma growth. Methods: The effects of JCo extract on the viability of normal and glioma cell lines was analyzed using a modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The synergistic therapeutic effect of JCo extract and temozolomide (TMZ) on glioma cells was examined by MTT analysis. Flow cytometry analysis, the terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) test, and western blotting were performed to identify the apoptotic pathway. To determine the in vivo efficacy of the JCo extract, rats were injected with 5 × 104 rat glioma RG2 cells in the back skin and brain hemisphere and then received a subcutaneous injection in the back skin that contained either JCo extract or vehicle. Finally, blood and histologic examinations were performed to evaluate JCo toxicity. Results: The IC50 values of JCo extract were 57–69 µg/mL and 49–67 µg/mL in the glioblastoma cell lines after 24 and 48 h, respectively. However, in non-tumor cell lines, the respective IC50 values of JCo extract were 76–105 µg/mL and 77–108 µg/mL. The JCo extract had a stronger cytotoxicity and a larger range of IC50 values in glioma than in normal cells as compared to those effects caused by temozolomide (TMZ). In addition, the results of flow cytometry analysis, TUNEL test, and western blotting revealed that the JCo extract induced glioma cell cycle arrest through intrinsic and extrinsic apoptotic pathways. In the in vivo studies, a significant reduction of tumor size in JCo-treated rats, as measured by animal MRI, demonstrated that the JCo extract effectively inhibited glioma cell growth and successfully penetrated the blood-brain barrier. The immunohistochemical (IHC) staining detected positive signals of PCNA, VEGFR-1, and VEGFR -2 in 44.49%, 5.88%, and 5.85% of JCo-treated glioma cells, respectively. However, positive signals of PCNA, VEGFR-1, and VEGFR-2 were detected in 73.08%, 9.67%, and 11.70% of vehicle-treated glioma cells, respectively. The IHC examination of PCNA and VEGFR-1 and -2 indicated that JCo extract significantly decreased the degree of neovascularization. However, no significant differences in serum levels of blood cell count and hepatic enzymes, renal function index, and the histologic appearance of vital organs were detected between the JCo and vehicle-treated rats. Conclusion: The JCo extract penetrated the blood-brain barrier and significantly induced glioma cell apoptosis by reducing neovascularization via suppression of the PI3K/AKT/mTOR pathway. Furthermore, JCo extract was less cytotoxic to non-neoplastic vital organs than TMZ.

Background: Tumor-draining lymph nodes (TDLN) played an important role in initiating immune responses. However, the immune status of TDLN in hepatocellular carcinoma (HCC) had not been well studied. Methods: We extracted the immune cells from the TDLN and peripheral blood mononuclear cell (PBMC) of 16 HCC patients. Using flow cytometry, we investigated the phenotype, proliferative capacity, cytotoxic activity and PD-1 expression of the cells in the TDLN and PBMC of HCC patients. Results: The immune status of the TDLN exhibited greater suppression than the PBMC in HCC, exhibiting a higher proportion of Treg cells and lower proportions of NKT, Th17 and Th1 cells. The proportion of Treg cells in TDLN was lower in patients with T1 stage than T2 stage. Moreover, the T cells from TDLN exhibited decreased capacity of proliferation with higher expression of PD-1 compared to PBMC. In addition, the cytotoxic activity of the cells expanded from the TDLN was weaker than the PBMC. Conclusions: The immune cells from the TDLN presented an immunosuppressed status regarding both the phenotypic characteristics and cellular immune function compared to PBMC.

When the operation and maintenance station performs cable maintenance, installation measures, etc., due to the lack of direct and effective tools, and the complicated wiring of the operation and maintenance station equipment, the wiring diagram is inconsistent with the actual situation, which brings risks to the removal of waste cables. As an indispensable safety tool in the power industry, the cable identification device is an important means to ensure the safety of maintenance personnel. In view of the current situation, this paper analyzes the electric field around the cable line of the operation and maintenance station, and simplifies the simulation of the line, and proposes a secondary cable identification device based on the principle of electromagnetic induction, which can quickly identify the target cable, which greatly improves the cable identification performance. Efficiency reduces the time for cable identification and improves safety.

To simultaneously track the ideal slip rate and realize ideal energy recovery efficiency under different complex road conditions, an electro-hydraulic compound anti-lock braking system based on interval type-2 fuzzy logic control strategy and its corresponding braking torque allocation strategy have been developed for electric vehicles. The proposed interval type-2 fuzzy logic controller aims to calculate the ideal total braking torque by four steps, namely, fuzzification, fuzzy inference, type reduction, and defuzzification. The slip rate error and the change rate of slip rate error are utilized as inputs in the fuzzification, and then, the membership degree interval of fuzzy variables determined by the upper and lower membership functions is used to calculate the activation degree interval of different fuzzy rules in the fuzzy inference process, which enhances the anti-interference ability to external uncertainties and internal uncertainties. The braking torque allocation strategy is proposed to maintain the maximum energy recovery efficiency on the premise of safe braking. The software of MATLAB/Simulink is applied to simulate the process of anti-lock braking control under two complex road conditions. Simulation results corroborate the proposed interval type-2 fuzzy logic anti-lock braking control system can not only obtain better slip rate control effect and outstanding robustness but also achieve ideal regenerative braking energy recovery efficiency under both joint-μ and split-μ road surfaces.

In this surgery, we employed intrathecal dissection to reveal right hepatic artery and portal vein for blockage of right hepatic inflow, hepatic vein was shown clearly after “down-top” dissection along inferior vena cava under a left-traction. Cavitron ultrasonic surgical aspirator (CUSA) was involved in parenchyma resection, and right hepatic pedicle and hepatic vein were cut off by Endo GIA.

Background Single port laparoscopic hepatectomy has been applied in some surgeries. We aimed to describe our experience with single port laparoscopic left lateral sectionectomy (SPLS) and to compare the safety and feasibility of this technique with those of conventional multi-port laparoscopic left lateral sectionectomy (MPLS) in the treatment of hepatocellular carcinoma (HCC). Methods A total of 72 consecutive patients who underwent SPLS (n = 33) and MPLS (n = 39) for HCC were enrolled. The peri-operative parameters of safety and feasibility, as well as the short-term oncological outcomes were compared. Results The length of postoperative hospital stay (LOS) was significantly shorter in the SPLS group than in the MPLS group (4.12 vs. 4.59 days, P = 0.043). No significant difference between the two groups was found in the operation time (104.58 vs. 95.69 min in the SPLS group and MPLS group respectively, P = 0.353) or the amount of blood loss (62.73 vs. 68.46 ml, P = 0.595). The 1-year recurrence-free survival rate was 77.9% in the SPLS group and 70.7% in the MPLS group (P = 0.82). Subgroup analysis showed that for patients without cirrhosis, the LOS was shorter in the SPLS group than in the MPLS group (P = 0.033), while for patients with cirrhosis, the LOS was not significantly different between the two groups (P = 0.201), although it was shorter in the SPLS group. Conclusions SPLS was a feasible and safe surgical approach for the treatment of HCC on left lateral section.

Background: Hepatic caudate lobectomy is considered to be a technically difficult surgery because of the unique anatomy and deep location of the hepatic caudate lobe. Here, we assessed the technica...

Morel-Lavallee lesions are rare, closed degloving soft tissue injuries in which the skin and subcutaneous tissues are traumatic separated from the underlying fascia. There is lack of consensus regarding optimal management of these lesions. After failure of conservative management, operative intervention is imperative. The purpose of this manuscript is to describe a minimally invasive endoscopic method for treatment of Morel-Lavallee Lesions, which achieves the goal of an open surgical debridement.

To compare the biomechanical stability of different fixation methods for anterior ring injury of unstable pelvic fractures, and to provide reference for clinical treatment.An unstable pelvic fracture model (Tile C) with one side of the sacroiliac joint dislocation and the pubic rami fracture was constructed via three-dimensional finite element analysis. Five different fixation methods were used in the front, and the rear was fixed with sacroiliac screws. The von Mises stress and strain distributions of different combinations of fixation methods were analyzed under mimicking standing conditions.After being loaded with 500 N vertically, the maximum stress in the anterior fracture was 3.56 MPa in anterior pelvic external fixation (AEF) group, the total displacement and the vertical displacement of the Y axis at the sacroiliac joint and the fracture were not more than 1.5 mm. The maximum stress at fixation, the front of the fracture and sacroiliac joints in the anterior pelvic subcutaneous approach(APA) group and AEF, was significantly higher than anterior modified Stoppa approach(ASA) group, anterior pelvic Ilioinguinal approach (AIA) group, and canulated screw fixation(CSF) group. The total displacement and the vertical displacement of the Y axis at the sacroiliac joint and the fracture in APA group and AEF group were also greater than the other three groups.Anterior ring injury of unstable pelvic fractures can be significantly improved after the fixation of the implants in the five combined methods. However, overall biomechanical properties of ASA, AIA and CSF group are superior to APA and AEF group.

Background Diaphragmatic resection is not common in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). This study aims to evaluate retrospectively the clinical characteristics and surgical results of HCC patients undergoing hepatectomy plus diaphragmatic resection. Methods Between January 2000 and December 2013, 52 HCC patients underwent curative resections combined with diaphragmatic resection, with 11 patients had pathological diaphragmatic invasion (DI), 41 patients had diaphragmatic fibrous adhesion (DFA). The clinicopathological features and results were compared between the two groups. Results 86.5% of the patients had HBV infection. Diameter of tumors was 8.6 ± 3.4 cm, and 34.6% had multiple tumors. In addition, 28.8% had microvascular invasion, 3.8% had macrovascular invasion, but none of the patients had lymph node metastasis or distant metastasis. Moreover, 21.2% had tumor rupture before surgical resection. The DI group exhibited similar clinicopathological features with the DFA group. There were no treatment-related deaths, and major complication was postoperative pleural effusion (46.2%). Other clinical pulmonary issues, such as pneumothorax (5.8%) and pneumonia (3.8%), were also detected. OS at 1, 3 and 5 years was 82.0%, 41.2% and 35.7%, respectively. There was no significant difference in OS and DFS between the DI and DFA groups ( P = 0.499 and P = 0.956, respectively). Conclusions En bloc resection of diaphragm was associated with acceptable morbidity and mortality, and there was no difference in OS and DFS between HCC patients with DI or DFA. Therefore, it would be advisable to perform en bloc diaphragmatic resection when HCC patients present with gross diaphragmatic involvement.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms in the gastrointestinal tract, exhibiting wide variability in their biological behavior. The aim of the present study was to investigate the clinicopathological characteristics and prognostic factors of GISTs in Chinese patients. All GIST cases (n=182) retrieved from the pathology database and the archived files in Shanghai Changzheng Hospital between January 2011 and December 2014 were reviewed. The clinical symptoms, preoperative investigations, treatments, pathological characteristics and follow-up data of these patients were reviewed, and univariate and multivariate survival analyses were performed. A total of 73.1% of the GISTs were located in the stomach, and the most common three symptoms included abdominal pain (30.2%), dyspepsia (23.1%) and gastrointestinal bleeding (21.4%). Univariate analysis revealed that larger tumor size (P

In order to solve detection of multi-user detection in underwater acoustic communication networks, blind adaptive multiuser detection method using LMS algorithm was proposed to solve the MAI problem of multi-user detection in underwater acoustic communication channel when users increase. Two type simulations were executed, including synchronous and asynchronous multi-user simulation analysis, to verify the validity of LMS multi-user detection algorithm and inspection machine. The verification of the effectiveness of the MMSE and MOE algorithm for LMS multi-user detection algorithm was done by simulation.

(1) Background: To investigate the clinical outcomes between radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) for residual hepatocellular carcinoma (RHCC). (2) Methods: 139 patients were diagnosed with the RHCC after post-operative checkup, among whom 39 and 33 patients underwent RFA or SBRT as salvage treatments, respectively. We applied the propensity score matching (PSM) to adjust for imbalances in treatment assignment. Local disease progression, progression-free survival (PFS), overall survival (OS), and treatment-related side effects were the study endpoints. (3) Results: Before PSM, the SBRT group demonstrated significantly lower local disease progression rate (6/33 vs. 23/39; p = 0.002), better PFS (the 1- and 3-year PFS were 63.3% and 49.3% vs. 41.5% and 22.3%, respectively, p = 0.036), and comparable OS (the 1- and 3-year OS were 85.4% and 71.1% vs. 97.3% and 57.6%, respectively, p = 0.680). After PSM of 23 matched cases, the SBRT group demonstrated significantly lower local disease progression rate, better PFS and comparable OS. Centrally located tumor predicted the worse OS. No acute grade 3+ toxicity was observed in both groups. (4) Conclusion: SBRT might be the preferred treatment for RHCC, especially for patients with larger tumors or tumors abutting major vessels, rather than repeated RFA.

To explore clinical effect of vacuum sealing drainage (VSD) combined with discontinuous windowing technique for repairing large area exposed wounds of Achilles tendon.From July 2009 to May 2014, 11 patients with large exposed wounds of Achilles tendon were treated, including 5 males and 6 females with an average age of 43 years old (aged from 7 to 65 years old). Among them, 4 cases were skin necrosis caused by heavy objects abrasion and contusion; 3 cases were caused by distal tibiofibula fractures; 3 cases were caused by bicycle-spoke injuries; 1 case was caused by diabetes. Areas of exposed Achilles tendon were from 6 cmx3 cm to 14 cmx5 cm without tendon rupture or bone exposed. After debridement, discontinuous fenestration on Achilles tendon was made by knife blade parallel with longitudinal axis of Achilles tendon, combined with Vacuum Sealing Drainage (VSD) treatment.After drainage treatment with one VSD cycle (5 to 7 days), abundant fresh granulation tissues were growing on all wounds and survived well after the second phase dermatoplasty. All patients were followed up for 12 to 24 months, the color of skin flap was good, the texture was soft without burst. At 3 to 4 months after operation, subcutaneous fat was appeared under the flap, the skin was sliding, movement of ankle joints was good. No delayed Achilles tendon rupture were occurred.Vacuum sealing drainage (VSD) combined with discontinuous fenestration is a simple, safe and effective method for repairing large area exposed wounds of Achilles tendon,which could minimize the secondary damage caused by wounds of skin flap grafting.

A simple pulsed slow positron beam based on a Penning-trap has been designed and is being constructed in Wuhan University. The cooled positrons from the trap with very low energy dispersion are dumped and chopped to pulses of a few tens of ns in width. Positron pulses are bunched by adjusting the potential of drift tube using an arbitrary wave generator, then accelerated to the target. Influences of the pulse width, the energy dispersion of positrons etc. on the time resolution of bunched positron pulse are simulated. The result shows that lower energy dispersion of positrons leads to much narrower positron pulses, indicating that a trap-based slow positron beam has a great advantage in developing a pulsed slow positron beam.