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Researching the aerodynamic characteristic of projectile at high angle of attack could serve to determine the launching condition and the design method of aerodynamic configuration. The aerodynamic coefficients of a kind of spin-stabilized projectile were calculated and analyzed by CFD. An efficient and precise method of calculating the pitching damping moment was obtained to research the aerodynamic coupling characteristic of spinning motion and pitching motion. The results showed that the aerodynamic coefficients of projectile at high angle of attack was nonlinear, the pitching damping moment was proportional to the pitching angular velocity, magnus force had hysteresis characteristic which was affected by pitching amplitude and frequency.

Critical ultrasonography is widely used in ICU and has become an indispensable tool for clinicians. However, besides operator-dependency of critical ultrasonography, lack of standardized training mainly result in the physicians' heterogenous ultrasonic skill. Therefore, standardized training as well as strict quality control plays the key role in the development of critical ultrasonography. We present this quality control standards to promote better development of critical ultrasonography.重症超声在重症医学相关领域的应用日益广泛，已成为重症专业医生不可或缺的检查、评估与监测手段。但由于超声本身较强的操作者依赖性，且很多医生未能接受规范的重症超声培训，导致认识与应用水平参差不齐。因此，规范重症超声培训及严格质量控制非常关键。为此制定了本标准，以推动重症超声更好地发展。.

Fe25Ni25CoxMoy multi-principal-component alloys (MPCAs) are designed in this study; the ratio of Co and Mo is changed to study the effect on the microstructures and phase selection. Simple solid solution FCC and BCC phases are identified, as well as intermetallic σ, μ, and MoNi phases. With the increment of Mo and the decrement of Co, the phase structure undergoes the following transformation: FCC → FCC + σ → FCC + σ + μ → FCC + BCC + σ + μ → FCC + BCC + MoNi. A great trade-off of mechanical properties is achieved in the Fe25Ni25Co25Mo25 alloy, which consists of FCC + σ + μ multiphases, demonstrating typical dendrite and interdendritic eutectic structures. Furthermore, the pseudo-binary phase diagram of Fe25Ni25CoxMoy MPCAs is obtained using CALPHAD, and the phase formation is discussed in the process. The phase selection in current MPCAs is related to the atomic size differences (δ), valence electron concentration (VEC), the Allen’s electronegativity differences (ΔχAllen), and the enthalpies of mixing (ΔHmix). In this study, the phase selection of Fe25Ni25CoxMoy MPCAs abides by the following criterion: when δ ≤ 3.248 pct, VEC ≥ 9.0, Δχ ≤ 0.09 and ΔH ≤–2.6 kJ/mol, simple FCC phase is preferred; otherwise, multiphase can be obtained. Complex ordered σ and μ phases are stable when 7.65 ≤ VEC ≤ 8.55 and 0.106 ≤ Δχ ≤ 0.147.

This study aimed to explore the significance of renal Doppler ultrasound in evaluating systemic and renal perfusion in sepsis patients before and after fluid resuscitation.Forty sepsis patients admitted to the Department of Intensive Medicine and intensive care unit (ICU) of the Fourth Hospital of Hebei Medical University from June 2014 to December 2014 were enrolled in this study, and 35 patients were included in the final analysis. These patients were divided into positive and negative fluid responsiveness groups. They were also divided into an acute kidney injury (AKI) group and a non-AKI group according to changes in creatinine and urine volume. The correlations of the changes in hemodynamics before and after fluid resuscitation in each group with the changes in renal resistance index (RRI) and renal blood flow (RBF) grades were evaluated.Before and after fluid resuscitation, the heart rate (HR), blood creatinine (Cre), and lactate (Lac) levels of all patients, including the patients in the positive fluid responsiveness group decreased, and the stroke volume (SV) and central venous pressure (CVP) increased. Only HR decreased in the negative fluid responsiveness group. In the AKI group, HR, Cre, and Lac decreased, while in the non-AKI group, HR decreased, but CVP and SV increased. There were differences between HR, Lac, and change rate of Lac (Lac%) after fluid resuscitation for the positive and negative fluid responsiveness groups. There was no statistical difference between the RRI values of each group before and after fluid resuscitation. The RRI values of the AKI group were higher than those of the non-AKI group, while the AKI group's RBF grades were lower than those of the non-AKI group. The change rate of RRI (RRI%) was higher in the AKI group than in the non-AKI group. Except for the negative fluid responsiveness group, the RBF grade of each group increased.The approach of RBF classification based on Doppler ultrasound can be used to evaluate the systemic and renal perfusion of patients with severe sepsis before and after fluid resuscitation, while the RRI value cannot be used for evaluation. However, the RRI value can be used as a dynamic index for the evaluation of renal perfusion in patients with AKI.

Severe patients with coronaviras disease 2019 (COVID-19) are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects: (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancement, stress cardiomyopathy, diffuse cardiac depression and other multiple abnormalities; (3) Critical ultrasonography helps with initiating early treatment in the suspect patient, screening confirmed patients after intensive care unit admission, early assessment of sudden critical events, rapid grading assessment and treatment based on it; (4) Critical ultrasonography helps to quickly screen for the etiology of respiratory failure in patients with COVID-19, make oxygen therapeutic strategy, guide the implementation of lung protective ventilation, graded management and precise off-ventilator; (5) Critical ultrasonography is helpful for assessing the circulatory status of patients with COVID-19, finding chronic cardiopulmonary diseases and guiding extracorporeal membrane oxygenation management; (6) Critical ultrasonography contributes to the management of organs besides based on cardiopulmonary oxygen transport; (7) Critical ultrasonography can help to improve the success of operation; (8) Critical ultrasonography can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19. In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19 patients therapy.重症新型冠状病毒肺炎（COVID-19）患者的特点是病毒侵袭后，肺部损害持续加重，引发呼吸衰竭，并发或继发循环改变与多器官功能障碍。重症超声因其动态、实时、无创、可重复等优点，可广泛用于重症患者的病因诊断、病情评估并指导治疗。现以在湖北省武汉市来自全国参与COVID-19救治的重症专家建议为基础，总结出基于重症超声的重症COVID-19救治的指导建议，皆在为救治COVID-19重症患者提供依据。.

Alveolar echinococcosis is a parasitic zoonosis that severely damages human health. Currently, radical surgical resection is the first choice for hepatic alveolar echinococcosis. For the advanced hepatic echinococcosis patients with refractory radical resection, the palliative surgery combined with chemotherapy, liver transplantation, drug therapy, and radiofrequency microwave ablation may provide comprehensive tools. This article reviews the current situation and progress of comprehensive treatments for hepatic alveolar echinococcosis.

A total of 18 polymorphic microsatellite loci were isolated and characterized from RAPD products in the Xinjiang Arctic Grayling (Thymallus arcticus grubei). The number of alleles (Na) per locus varied from 2 to 10. Observed (Ho) and expected (He) heterozygosities ranged from 0.64 to 0.92, and from 0.63 to 0.88, respectively. Considerable differences were found among HBH, FH and FY populations in the number of alleles, effective number of alleles, number of genotypes at all of these loci. These new RAPD-SSR markers have provided a helpful tool for genetic analyses and resources conservation of T. arcticus grubei. Five additional fish species, Amur grayling (Thymallus grubii), Taimen (Hucho taimen), Sea perch (Lateolabrax japonicus), Lenok (Brachymystax lenok) and Red seam bream (Pagrosomus major) were assessed for cross-species amplification. Three of the five species showed at least one polymorphic locus. In addition, seven loci were found to be polymorphic in at least one species.

Transesophageal echocardiography(TEE) is valuable in intensive care unit (ICU) because its application meets the requirements of diagnosis and treatment of critically ill patients.However, the current application has not fully adapted to the specialty of critical care. TEE could be more valuablein ICU when used with a new way that under the guidance of the theory of critical care and embedded into the treatment workflow. We have expanded and improved the application of traditional TEE and integrated the concept of critical care, established the concept of transesophageal echocardiography for critical care (TEECC). Chinese Critical Ultrasound Study Group (CCUSG) organized experts in the area to form the consensus based the previous studiesand the long term practice of critical care ultrasound and TEE, aiming at clarifying the nature and characteristics of TEECC, promoting the rational and standardized clinical application and the coming researches.The consensus of Chinese experts on clinical application of TEECC (2019) were 33 in total, of whichthe main items were as follows: (1) TEECC is a significant means, which is expanded and improved from the traditional transesophageal echocardiography according to characteristics of critically ill patients and is applied in ICU based on critically clinical scenarios and requirements by the critical care physician, to promote visualized, refined and precisely management of critically ill patients.(2) TEE possesses distinctive superiority in implementation in ICU. It has characteristics of images with good quality, operations with good stability and low-dependent of operators, monitoring with continuity, and visualization with all-dimensional and detail of heart and blood vessels.(3)As a means of refined monitoring that could resulted in precise diagnosis and treatment, TEECC expands the dimension of intensive monitoring and improves the performance of critical care. (4) Indications of TEECC application include clinical etiological searching and invasive procedures guiding when it acted as a traditional role; and also refined hemodynamic monitoring based on critical care rationale and over-all management under specific critical clinical scenarios. (5) TEE and TTE assessments are complementary; they are not alternative. Integrated assessment of TTE and TEE is required under many critical clinical scenarios.(6) TEE should be a necessary configuration in ICU. (7) All-round and significant information regarding to the mechanism of acute circulatory disorders can be provided by TEECC; it is a non-substitutable means of identifying the causes of shock under some special clinical scenarios. (8) Focal extracardiac hematoma can be accurately and rapidly detected by TEE in patients with open-thoracic cardiac surgery or severe chest trauma when highly suspected pericardial tamponade.(9) The priority of pathophysiologic mechanism of septic shock can be rapidly and accurately identified by TEE; even if its pathophysiological changes are complex, including hypovolemia and/or vasospasm and/or left and right heart dysfunction. (10) Causes of hemodynamic disorders can be rapidly and qualitatively evaluated so that the orientation of treatment can be clarified by TEECC. (11) A full range of quantitative indicators for refined hemodynamic management in critically ill patients can be provided by TEECC. (12) TEECC helps to accurately assess volume status and predict fluid responsiveness.(13) TEECC is specially suitable for accurate quantitative assessment of cardiac function.(14) Mini TEE provides long-term continuous hemodynamic monitoring. (15) Standard views are easy to be acquired by TEECC, which is a premise for accurate and repeatable measurements, and a guarantee for assessment of effect and risk of therapy. (16) Compared with invasive hemodynamic monitoring, TEECC is minimally invasive, with low infection risk and high safety.(17) In patients with acute cor pulmonale (ACP) under condition of right ventricular dysfunction and low cardiac output, TEECC is a key tool for assessment. (18) TEECC should be implemented actively when suspicious of left to right shunt in critically ill patients who occurred hypotension that hard to explain the cause. (19) TEECC should be implemented actively when suspicious of right to left shunt in critically ill patients who occurred hypoxemia that hard to explain the cause. (20) TEECC is preferred in hemodynamics monitoring under prone position of ventilated patients.(21) TEECC is an imperative means to achieve over-all management of extracorporeal membrane oxygenation (ECMO) therapy, especially for all-round hemodynamic monitoring. (22) Three basic views is recommended to be used to simplify TEE assessment during cardiac arrest so that reversible causes could be identified, and resuscitation could be guided. (23) The flow related echodynamic evaluation (TEECC-FREE) workflow is preferred in refined hemodynamics monitoring and therapy. (24) Simple workflow of TEECC could be implemented in special critical clinical scenarios. (25) Application of TEECC is highly secure; however, impairments of procedure should also be alert by operators. (26) Pitfalls in application of TEE should be paid attention to by the critical care physician. (27) Timely and rationally application of TEECC is in favor of diagnosis and treatment of critically ill patients and may improve the prognosis.经食管心脏超声（TEE）因其自身的特点和优势，非常适合重症患者诊治的需求而得以在ICU中应用。但由于重症患者诊治的特殊性，目前的应用方式尚未完全适应重症医学的特点，进而限制了其优势的发挥。因此我们结合自己的临床探索实践及国外研究，在重症医学理论指引下，将传统TEE拓展和改进并整合重症医学理念，确立了重症经食管心脏超声（TEECC）的概念，梳理了相关理念与应用规范，制定了《中国重症经食管超声临床应用专家共识（2019）》，旨在阐明TEECC的本质与特点，推动TEECC合理、规范的临床应用，建立规范的TEECC理论体系，引导TEECC实践和临床科研的规范的健康发展，逐步完善TEECC临床应用的理论与实践，提高临床救治水平。.

Stem cell factor (SCF), the ligand of the c-kit receptor, actively participates in the organ reconstruction and fibrosis associated with various diseases, including kidney disease. However, it remains unclear whether SCF plays a role in kidney aging. In the present study, we measured the serum SCF level, estimated glomerular filtration rate (eGFR), and other biological parameters in a Chinese Han group of 892 subjects, and explored the relationship between SCF level and renal function during aging; we sought to define novel biomarkers of kidney aging. Multiple linear regression was used to select potential indicators of decline in renal function. Only age, SCF level, and 25% maximum expiratory flow (25% MEF) were significant predictors after redundancy analysis (|r| > 0.70 and P < 0.05). Multiple linear regression showed that the relationship among eGFR, SCF level, and age could be described as follows: eGFR = 154.486 - (0.846 × age) - (0.011 × SCF level). We found no between-gender difference in the effect of SCF on kidney aging. In conclusion, the SCF level is an ideal biomarker of renal aging and may help to predict changes in eGFR during aging.

Bronchiolitis is a widespread lower respiratory tract infection in infants and young children, and is closely related to the incidence of asthma, and T regulatory cells (Tregs) play a role in its pathogenesis.

To establish the experts consensus on the management of delirium in critically ill patients. A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group. Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 36 experts to reassess all the statements. (1) Delirium is not only a mental change, but also a clinical syndrome with multiple pathophysiological changes. (2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function. (3) Pain is a common cause of delirium in critically ill patients. Analgesia can reduce the occurrence and development of delirium. (4) Anxiety or depression are important factors for delirium in critically ill patients. (5) The correlation between sedative and analgesic drugs and delirium is uncertain. (6) Pay attention to the relationship between delirium and withdrawal reactions. (7) Pay attention to the relationship between delirium and drug dependence/withdrawal reactions. (8) Sleep disruption can induce delirium. (9) We should be vigilant against potential risk factors for persistent or recurrent delirium. (10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases, and can also be alleviated with the improvement of primary diseases. (11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis. (12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium, especially subclinical delirium. (13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium. (14) Daily assessment is helpful for early detection of delirium. (15) Hopoactive delirium and mixed delirium are common and should be emphasized. (16) Delirium may be accompanied by changes in electroencephalogram. Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant. (17) Pay attention to differential diagnosis of delirium and dementia/depression. (18) Pay attention to the role of rapid delirium screening method in delirium management. (19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium. (20) The key to the management of delirium is etiological treatment. (21) Improving environmental factors and making patient comfort can help reduce delirium. (22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium. (23) Communication with patients should be emphasized and strengthened. Family members participation can help reduce the incidence of delirium and promote the recovery of delirium. (24) Pay attention to the role of sleep management in the prevention and treatment of delirium. (25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium. (26) When using antipsychotics to treat delirium, we should be alert to its effect on the heart rhythm. (27) Delirium management should pay attention to brain functional exercise. (28) Compared with non-critically illness related delirium, the relief of critically illness related delirium will not accomplished at one stroke. (29) Multiple management strategies such as ABCDEF, eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients. (30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment. (31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management. Consensus can promote delirium management in critically ill patients, optimize analgesia and sedation therapy, and even affect prognosis.谵妄是ICU中常见的一种急性临床综合征，可导致患者病死率增加，机械通气时间和住院时间延长，引起长期的认知功能障碍，增加医疗费用，严重影响患者的预后。为规范重症患者的谵妄管理，由中国冷静治疗研究组根据国内外最新文献资料和多年来的应用推广经验，组织相关重症医学专家在充分讨论和沟通基础上制定了"重症患者谵妄管理专家共识"。旨在改进重症患者的谵妄管理，优化镇痛镇静治疗，改善患者的预后。.

The genus Tsuga is an ecologically important forest tree genus of Japan with two endemic species, the subalpine Tsuga diversifolia and the temperate Tsuga sieboldii. Despite dominating some of the most important remaining natural forests in Japan, the genetic diversity and structure of these species is unknown with genetic studies hindered by a lack of genetic resources. This study reports the complete chloroplast genome sequences of both T. diversifolia and T. sieboldii and the development of polymorphic chloroplast microsatellite markers. The chloroplast genomes of T. diversifolia and T. sieboldii are 120,802 and 120,797 bp in length, respectively and shared an identical repertoire of 35 tRNA genes, 4 rRNA genes and 72 protein-coding genes. Seven polymorphic chloroplast microsatellite loci were developed and showed an average of 2.24 alleles per locus in T. diversifolia and 3.57 in T. sieboldii. These loci were all successfully genotyped in two other East Asian species (Tsuga chinensis and Tsuga ulleungensis) with an average of 2.28 alleles per locus for both species. The high transferability of these loci, and the fact that all species contained loci with non-overlapping allele size ranges, indicates that these markers will be useful for genetic studies of all East Asian Tsuga species for investigating species boundaries, phylogeography and stand-level processes.

The transcription factor Otx1 is specifically expressed in layer V pyramidal cells (L5PCs) in the cerebral cortex. Otx1 null mutant mice have a defect in the developmental axon pruning of L5PCs and show epileptic seizures. However, the role of Otx1 in electrophysiology, morphology and synaptology of the cortical neurons has not been fully investigated. This study examines the influences of Otx1 on neuronal properties of L5PCs by loss- and gain-of-function approaches. Mice with an Otx1-null mutation had decreased structural measurements of basal dendrites in L5PCs. In contrast, the size of basal dendrites was increased in the Otx1-over-expressed pyramidal cells (PCs) in L2/3 where the gene normally does not express. PCs showed burst and non-burst firing patterns of action potentials. The proportion of burst firing neurons was reduced in the Otx1 mutant but increased in the neurons over-expressing Otx1. Although the burst firing population decreased, the proportion of those bursting neurons with a low threshold increased in the Otx1 mutant mice. Moreover, excitatory facilitating synaptic connections formed between L5PCs were predominant in the Otx1 mutant mice, which greatly contrasted with the predominant depressing synaptic connections in the controls. Taken together, it suggests an enhanced activity of neuronal network in the cortex of Otx1 mutant mice. These data indicate that the Otx1 expression is essential for the normal development of dendritic morphology, intrinsic electrophysiology and synaptic dynamics of L5PCs. This study provides new insights into molecular mechanisms underlying the spatial and temporal regulation of neuronal and synaptic properties of L5PCs, and improves our understanding on the generation of epileptic seizures.

Профили транскриптомов клеточных линий рака молочной железы человека MCF-7 и MDA-MB-435 исследовали с использованием технологии высокопроизводительного секвенирования RNA-Seq. Для скрининга дифференциально экспрессирующихся транскриптов использован пакет программ DESeq. Всего выявлено 229 генов со значимо различающейся экспрессией в клетках MDA-MB-435 по сравнению с клетками MCF-7. Аннотирование биологических функций через Базу данных для аннотации, визуализации и интегрированного обнаружения (DAVID v6.7) позволило выявить, что эти 229 дифференциально экспрессирующихся генов главным образом вовлечены в биологические функции, связанные с клеточной адгезией и движением, процессингом и презентацией антигенов (через MHC класса II), гормональным ответом, организацией внеклеточных структур, ремоделированием тканей и регулированием пролиферации клеток. При анализе индивидуальных генов выявлено, что по сравнению с MCF-7 у клеток MDA-MB-435 выше способность к метастазированию, а также к процессингу и презентации антигенов, и снижена способность к гормональному ответу. Двадцать наиболее представленных транскриптов в клетках MDA-MB-435, такие как VIM, TNC и CD74, ассоциируются с высоким метастатическим потенциалом. Помимо генов, которые, как ранее сообщалось, вовлечены в метастазирование и развитие опухолей, вновь идентифицированные в этом исследовании гены могут послужить основой для выработки нового подхода в вопросах диагностики и прогнозирования агрессивного рака молочной железы.

The technique of thoracoscopic lung surgery has gradually matured. Nowadays, thoracoscope is recommended as the most preferred approach for surgical treatment of early stage non-small cell lung cancer in different guidelines. However, there are still some cases of accidential major bleeding due to vascular injury during thoracoscopic lung surgery. The wall of the hilum vessels is relatively thin. These vessels often involve a great portion of the cardiac output blood flow. Once the injury happened, the emergent condition may be life-threatening due to massive blood loss. Therefore, this became an important factor which hindered the development of thoracoscopic lung surgery. In this review, details of the vascular injury in thoracoscopic lung surgery were summarized, including the incidence of vascular injury, commonly injured sites and reasons of the injuries. Among all the cases of thoracoscopic major pulmonary resection, 2.9% to 9.2% may suffer from vascular injury during the operation. The most commonly injuried sites are pulmonary artery and the branches, and this is also the most critical situation during thoracoscopic lung surgery. Hilum adhesion is the most important risk factor for vascular injury. On the one hand, the suction-compressing angiorrhaphy technique was developed for bleeding control and angioplasty. On the other hand, the strategies like pre-control of the pulmonary, cut the bronchus in advance, and fire the bronchus and pulmonary artery together may decrease the incidence of vascular injury in patients with risk factors.胸腔镜肺外科技术已逐渐成熟，国内外指南均推荐首选胸腔镜进行早期肺癌的外科治疗。尽管如此，胸腔镜肺手术仍偶有大血管损伤出血等意外情况发生。肺门血管壁薄，且紧邻心脏，血流量大，一旦损伤出血，往往较为危急，甚至可能危及患者生命，是阻碍胸腔镜肺外科手术发展的重要因素。本文对胸腔镜肺手术中血管损伤出血的发生情况、易于出现损伤的部位及其原因等进行了总结。国内外文献报道中，胸腔镜肺手术中血管损伤出血发生率为2.9%～9.2%，其中以肺动脉及其分支损伤最为常见，也最为危急，肺门结构粘连是导致血管损伤出血的重要因素。术中可通过胸腔镜吸引－侧压止血技术控制出血，并完成血管修补；对于高危患者，采用肺动脉预阻断、支气管预切断、支气管肺动脉同切等策略可有效预防血管损伤的发生。.

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of critical care-related pulmonary hypertension should be a priority. (11) Attention should be paid to the change of right heart function before and after implementation of mechanical ventilation and adjustment of ventilator parameter. (12) The pulmonary arterial pressure should be monitored timingly when dealing with critical care-related pulmonary hypertension accompanied with circulatory failure.(13) The elevation of pulmonary aterial pressure should be taken into account in critical patients with acute right heart dysfunction. (14) Prone position ventilation is an important measure to reduce pulmonary vascular resistance when treating acute respiratory distress syndrome patients accompanied with acute cor pulmonale. (15) Attention should be paid to right ventricle-pulmonary artery coupling during the management of right heart function. (16) Right ventricular diastolic function is more prone to be affected in critically ill patients, the application of critical ultrasound is more conducive to quantitative assessment of right ventricular diastolic function. (17) As one of the parameters to assess the filling pressure of right heart, central venous pressure can be used to assess right heart diastolic function. (18). The early and prominent manifestation of non-focal cardiac tamponade is right ventricular diastolic involvement, the elevated right atrial pressure should be noticed. (19) The effect of increased intrathoracic pressure on right heart diastolic function should be valued. (20) Ttricuspid annular plane systolic excursion (TAPSE) is an important parameter that reflects right ventricular systolic function, and it is recommended as a general indicator of critically ill patient. (21) Circulation management with right heart protection as the core strategy is the key point of the treatment of acute respiratory distress syndrome. (22) Right heart function involvement after cardiac surgery is very common and should be highly valued. (23) Right ventricular dysfunction should not be considered as a routine excuse for maintaining higher central venous pressure. (24) When left ventricular dilation, attention should be paid to the effect of left ventricle on right ventricular diastolic function. (25) The impact of left ventricular function should be excluded when the contractility of the right ventricle is decreased. (26) When the right heart load increases acutely, the shunt between the left and right heart should be monitored. (27) Attention should be paid to the increase of central venous pressure caused by right ventricular dysfunction and its influence on microcirculation blood flow. (28) When the vasoactive drugs was used to reduce the pressure of pulmonary circulation, different effects on pulmonary and systemic circulation should be evaluated. (29) Right atrial pressure is an important factor affecting venous return. Attention should be paid to the influence of the pressure composition of the right atrium on the venous return. (30) Attention should be paid to the role of the right ventricle in the acute pulmonary edema. (31) Monitoring the difference between the mean systemic filling pressure and the right atrial pressure is helpful to determine whether the infusion increases the venous return. (32) Venous return resistance is often considered to be a insignificant factor that affects venous return, but attention should be paid to the effect of the specific pathophysiological status, such as intrathoracic hypertension, intra-abdominal hypertension and so on. Consensus can promote right heart function management in critically ill patients, optimize hemodynamic therapy, and even affect prognosis.

After WHO Framework Convention on Tobacco Control coming into force for 11 years, the tobacco control has made progress in the world and China. Development and implementation of tobacco control policy are fundamental for tobacco control. This paper introduces the effects of different tobacco control policies in different countries, summarizes the progress and challenges in prohibiting smoking in public place in China. In China, the goal of health for all can be only met by achieving smoke-free.WHO《烟草控制框架公约》生效11年后，在全球和中国都取得了进展，控烟政策的制定和实施是控烟取得进步的保障。本文介绍不同控烟政策在不同国家的效果以及中国公共场所禁烟的进展和面临的挑战。在中国只有全面无烟才能实现全民健康。.

Compare the results of molecular diffusion and mass flow in the interstitial space(ISS) displayed by using optical and magnetic probes and study partitioned drainage of the brain interstitial fluid (ISF).In the study, 36 male SD rats were randomly divided into fluorescent inspection group (18), magnetic tracer group (18). Then they were divided equally into caudate nucleus (Cn), thalamus (T) and substantia nigra (Sn) subgroup, 6 rats in each subgroup. Referencing the brain stereotaxic atlas, the coronal globus pallidus as center level, Cn, T or Sn were acted as puncture positioning target. A 10 μL microsyringe was stereotaxically positioned and the lucifer yellow (LY) solution of 2 μL 10 mmol/L was infused into centric position. The coronary slices undergo cardiac perfusion and fix respectively in time point Cn 3 h, T 2 h and Sn 1 h. The rat brain was placed in rat stainless steel brain matrices and cut backward along visual intersection. The injection point of coronal slice as the center level, take 3 slices in front of the center level and 2 slices behind of it. 1 mm for each slice and 6 slices in total. Then slices were detected by laser scanning confocal microscope (LSCM). Simultaneous, in the same coordinate brain regions of another three groups, a gadolinium-diethylene triamine pentaacetic acidm (Gd-DTPA) solution of 2 μL 10 mmol/L was infused into different injection and detected by MRI tracer-based method. Then the Radiant can be used to measure distribution area of Gd-DTPA.LY and Gd-DTPA have different distribution regions in Cn, T and Sn. After LY and Gd-DTPA were introduced into the Cn subgroup 3 h, compare the 1 to 6 levels distribution area of LY and Gd-DTPA as follows: (10.95±4.27) mmLSCM imaging technology confirmed partitioned drainage of the brain ISF found by MRI tracer-based method and provided technology and method validation for MRI tracer-based method. LSCM imaging technology with higher contrast and resolution, therefore more sophisticated partitioned drainage of the brain interstitial fluid were got.

Inflammation as a significant influence factor plays an important role in the formation and rupture of intracranial aneurysms. However, based on plenty of related studies, it is believed that the hepatocyte growth factor (HGF) is able to prevent vascular inflammation. This paper, therefore, explored the role and mechanism of endogenous HGF in the pathogenesis of intracranial aneurysms.16 blood samples were collected from the intracranial aneurysms and the lumens of the femoral artery of 16 patients. Comparison and quantitative detection of HGF serum concentrations in an aneurysm and femoral artery samples according to the immune assay based on Luminex were followed. The tissue of superficial temporal artery (STA) and ruptured or unruptured intracranial aneurysm from the patients (n=10) who were performed surgical clipping of craniotomy was then collected. The intracranial aneurysm model was induced by surgery on adult c57/B16 mouse and grouping administration of c-Met antagonist PF-04217903 or its solvent DMSO for 3 weeks. Then, the brains of the experimental mouse were dissected and examined whether there were intracranial aneurysms and/or subarachnoid hemorrhage (SAH). The procedures followed by treatment of human endothelial cells cultured in vitro, smooth muscle cells and monocytes with HGF and PF-04217903 lipopolysaccharide (LPS). Through Real-time fluorescence quantitative PCR, with ΔΔCt methods, we used the expressions of β-actin normalized inflammatory factor [intercellular adhesion molecule-1 (ICAM-1)], vascular cell adhesion molecule-1 (VCAM-1), E-selectin, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), monocyte chemoattractant protein-1 (MCP-1), cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2) and transforming growth factor-β (TGF-β).It was found that the concentration of HGF (1076±656) pg/ml from the blood collected from human intracranial aneurysms was significantly higher than that from the femoral artery (196±436) pg/ml (p0.01). Experimental mouse treated with PF-04217903 (c-Met antagonist) and in control group were induced to form intracranial aneurysms. C-Met antagonists did not alter the formation of intracranial aneurysms (p0.05), but significantly increased the occurrence of subarachnoid hemorrhage and reduced the survival rate of mice (p0.05). HGF attenuated the expression of VCAM-1 (p0.05) and E-selectin (p0.05) in human aortic endothelial cells CONCLUSIONS: The plasma HGF levels were elevated in intracranial aneurysms, and the HGF and c-Met were expressed in STA and intracranial aneurysms. In the treatment of intracranial aneurysms, HGF signaling pathway reduced inflammation in endothelial cells and prevented the rupture of intracranial aneurysm through c-Met.

Aims The influence of bacterial species/strains in agitated culture was investigated on the morphology and structure characteristics of bacterial cellulose. Methods and Results Komagataeibacter nataicola Y19 and Gluconacetobacter entanii ACCC10215 were inoculated in Hestrin–Schramm (HS) medium and subjected to agitated cultivation. Different kinds of BCs were obtained including flocky asterisk-like BC by G. entanii ACCC10215 and solid sphere-like BC by K. nataicola Y19. The SEM results showed that the asterisk-like BC had larger pores than the solid sphere-like BC. The FT-IR and X-ray diffraction results showed the asterisk-like BC had lower crystallinity (81·43%), higher cellulose Iα mass fraction (79·74%) and smaller crystallite size. Conclusions The different species/strains can influence the morphology and structure characteristics of BC in agitated culture. Significance and Impact of the Study We examined the influence of different species/strains on the morphology, macro- and microstructure of BCs produced in agitated culture for the first time, which suggest that different BCs with potential applications could be obtained by choosing different species or strains and fermentation method.

Allium species are economically important crops in the world. Viruses are among the most important pathogens affecting their yield, especially those belonging to the genera Potyvirus, Carlavirus, and Allexivirus (Katis et al. 2012). Members of the genus Potyvirus are usually the most abundant and cause most of the damage induced. Onion yellow dwarf virus (OYDV) and Leek yellow stripe virus (LYSV) are often found in almost all Allium-cultivating regions and cause significant yield losses worldwide (Katis et al. 2012; Milosevic et al. 2015). In May 2017, severe leaf twisting, yellowing, and plant stunting were observed on shallot (Allium cepa var. aggregatum) in Jilin and Heilongjiang provinces of China. The disease was found in 77% of fields of shallot (total 12,000 ha) in 2017 and 2018. A total of 29 symptomatic plants were collected and tested using double antibody sandwich (DAS)-ELISA kits (DSMZ, Braunschweig, Germany) for the presence of OYDV and LYSV and a triple antibody sandwich ELISA kit (DSMZ) for shallot latent virus (SLV). OYDV was detected in 24 out of 29 shallot samples, and all were negative for LYSV and SLV. The virus was mechanically transmitted from an ELISA-positive sample to 10 plants of shallot using 0.01 M phosphate buffer (pH 7). All 10 mechanically inoculated plants of shallot developed symptoms identical to those observed on the original host plants 21 days postinoculation. All 10 inoculated plants were DAS-ELISA positive for OYDV. Presence of OYDV in ELISA-positive shallot plants was further confirmed by reverse transcription polymerase chain reaction (RT-PCR). Total RNAs were extracted using the RNeasy Plant Mini Kit (Qiagen, Hilden, Germany); reverse transcription and PCR were carried out with the PrimeScript II first Strand cDNA Synthesis Kit (Takara, Japan) and Premix Taq (Ex Taq version 2.0) (Takara, Japan). OYDV coat protein (CP) specific primer pair (U: GCCGGCCCAGGGGAGGATG; D: CATTCTGACTCCAAGCAGAG) designed to amplify the complete CP gene was used for amplification. All infected shallot plants yielded an amplicon of the expected size (774 bp), whereas no amplification products were obtained from healthy controls. The RT-PCR product derived from the isolate JL1-3 was sequenced after T vector ligation with a pMD18-T Vector Cloning Kit (Takara, Japan) and submitted to GenBank (accession no. KY347900). Pairwise comparison of the JL1-3 isolate CP sequence with other homologous sequences available in GenBank was conducted, and sequence analysis showed that CP gene of this Chinese isolate shared the highest nucleotide identity of 97 and 95% with the CP gene of OYDV isolates OYDV-AT and AC-41 (GenBank accession nos. JX433020 and Y11826) from Germany and Netherlands, respectively. To our knowledge, this is the first report of OYDV on shallot in China. Further investigation is necessary to prevent the spread of this pathogen to new locations and to new hosts (Naderi Saffar et al. 2013) in China.

In this study, we establish a nested atmospheric inversion system with a focus on China using the Bayesian method. The global surface is separated into 43 regions based on the 22 TransCom large regions, with 13 small regions in China. Monthly CO2 concentrations from 130 GlobalView sites and 3 additional China sites are used in this system. The core component of this system is an atmospheric transport matrix, which is created using the TM5 model with a horizontal resolution of 3° × 2°. The net carbon fluxes over the 43 global land and ocean regions are inverted for the period from 2002 to 2008. The inverted global terrestrial carbon sinks mainly occur in boreal Asia, South and Southeast Asia, eastern America and southern South America. Most China areas appear to be carbon sinks, with strongest carbon sinks located in Northeast China. From 2002 to 2008, the global terrestrial carbon sink has an increasing trend, with the lowest carbon sink in 2002. The inter-annual variation (IAV) of the land sinks shows remarkable correlation with the El Niño Southern Oscillation (ENSO). The terrestrial carbon sinks in China also show an increasing trend. However, the IAV in China is not the same as that of the globe. There is relatively stronger land sink in 2002, lowest sink in 2006, and strongest sink in 2007 in China. This IAV could be reasonably explained with the IAVs of temperature and precipitation in China. The mean global and China terrestrial carbon sinks over the period 2002–2008 are −3.20 ± 0.63 and −0.28 ± 0.18 PgC yr−1, respectively. Considering the carbon emissions in the form of reactive biogenic volatile organic compounds (BVOCs) and from the import of wood and food, we further estimate that China's land sink is about −0.31 PgC yr−1.

Piglet diarrhea is one of the primary factors that affects the benefits of the swine industry. Recent studies have shown that exon 2 of the swine leukocyte antigen-DQA gene is associated with piglet resistance to diarrhea; however, the contributions of additional exon coding regions of this gene remain unclear. Here, we detected and sequenced variants in the exon 3 region and examined their associations with diarrhea infection in 425 suckling piglets using the polymerase chain reaction-single-strand conformational polymorphism and sequencing analysis. The results revealed that exon 3 of the swine leukocyte antigen-DQA gene is highly polymorphic and pivotal to both diarrhea susceptibility and resistance in piglets. We identified 14 genotypes (AA, AB, BB, BC, CC, EE, EF, BE, BF, CF, DD, DH, GG, and GF) and eight alleles (A-H) that were generated by 14 nucleotide variants, eight of which were novel, and three nucleotide deletions. Statistical analyses revealed that the genotypes AB and EF were associated with resistance to diarrheal disease (P0.05), and the genotype DD may contribute to diarrhea susceptibility but was unique to Large White pigs (P0.05). These results elucidate the genetic and immunological background to piglet diarrhea, and provide useful information for resistance breeding programs.

Piglet diarrhea is one of the most common factors that affects the benefits of the swine industry. Although recent studies have shown that exon 2 of SLA-DQA is associated with piglet resistance to diarrhea, contributions of genetic variation in the additional exon coding regions of this gene remain unclear. Here, we investigated variation in exons 1, 3 and 4 of the SLA-DQA gene and evaluated their effects on diarrheal infection in 425 suckling piglets. No variation was identified in exon 1. In exon 3, there were eight alleles detected, generated by 14 single nucleotide polymorphisms (SNPs) and three nucleotide deletions, eight SNPs being newly identified. Four allele sequences and three SNPs were identified in exon 4, only one SNP being newly identified. Statistical analysis showed that the genotypes of exon 3 are significantly associated with piglet diarrhea; indeed, genotypes DQA*wb01/wb02 and wb04/wb05 are clearly associated with resistance to piglet diarrhea, as they have the lowest probabilities of infection (P 0.05). However, no significant association was found between the genotypes of exon 4 and diarrhea (P 0.05). These results provide important new information concerning the level of genetic diversity at the SLA-DQA locus and suggest that further genetic association studies of piglet diarrhea resistance should include analyses of both exons 2 and 3 of this locus.

In this paper, a new reliability analysis technique is developed for uncertain structures based on a hybrid uncertain model. Random distributions are used to deal with the uncertainty, while some key parameters in the distribution functions are given variation intervals instead of precise values. Two kinds of hybrid reliability models are constructed based on the reliability index approach (RIA) and the performance measurement approach (PMA), in which the reliability index interval and the target performance interval are employed to evaluate the reliability degree of an uncertain structure, respectively. A monotonicity analysis is conducted for the probability transformation process, which indicates that the extreme values of the limit-state function generally correspond to the bound combinations of the interval parameters. Based on the monotonicity analysis, two efficient algorithms are then formulated to solve the suggested RIA-based and PMA-based hybrid reliability models, in which the outer-layer optimization in terms of random variables and the inner-layer optimization in terms of interval parameters are executed by turns. Three numerical examples are presented to demonstrate the effectiveness of the present method, which include two simple problems with explicit expressions and one complex engineering application.