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Planetary reducer box undertakes the vibration transmitted from gear transmission system to bearing, and further transmits the vibration to the base. Research on the transmission path contribution of reducer box has an important guiding role in reducing vibration. This paper first analyzed the contribution of each vibration path of the gearbox based on the velocity intervention loss, so as to identify the main transmission path of the gearbox vibration; then the vibration test of the gearbox is carried out to verify the correctness of the transmission path model. The results show that the vibration transmission path of the right bearing of the gearbox is the main transmission path, and the established vibration transmission path dynamics model of the gearbox can well reveal the contribution law of the vibration transmission path of the gearbox.

To study the incidence and risk factors of osteonecrosis of the femoral head (ONFH) after internal fixation in adult patients with femoral neck fracture (FNF) after 2000, and identify high-risk population of ONFH.PubMed, Medline, The Cochrane Library, CNKI, Wanfang and VIP Database were searched to collect all the literatures on ONFH and related risk factors after internal fixation of FNF from January 1th 2000 to July 1th 2020. Study extraction was performed according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literatures extraction, management and data entry, and R Studio 3.6.5 software was used for Meta-analysis. Subgroup analysis, sensitivity analysis and publication bias detection were used to explore the sources of heterogeneity and the reliability of the evaluation results.A total of 16 studies with 5521 patients were included. Meta-analysis showed that the incidence of ONFH after internal fixation for adult FNF was 14.5% [95%After 2000, the total incidence of ONFH after internal fixation of adult FNF has decreased, while the necrosis rates of patients with displaced fracture and poor reduction are still at a high level. The interval between injury and surgery was not analyzed in this study because of the inconstant division in the original literature.

The correlations between hydroxytryptamine receptor 2A (HTR2A) gene polymorphisms (1438A/G, 102T/C, and rs7997012G/A) and the safety and efficacy of antidepressants in depression patients were constantly reported, but conclusions are debatable. This meta-analysis ascertained forty-two studies on the efficacy (including response and remission) and side-effect issued before February 2020. Pooled analyses indicated significant associations of 1438A/G polymorphism (16 studies, 1931 subjects) and higher response within dominant model (OR: 1.40, 95% CI: 1.12-1.76); rs7997012G/A polymorphism (nine studies, 1434 subjects) and higher remission in overall models (dominant model: OR: 1.30, 95% CI: 1.01-1.66; recessive model: OR: 2.20, 95% CI: 1.53-3.16; homozygote model: OR: 2.73, 95% CI: 1.78-4.17); 102T/C polymorphism (eight studies, 804 subjects) and reduced risk of side-effect within recessive (OR: 0.57, 95% CI: 0.4-0.83) and homozygote models (OR: 0.54, 95% CI: 0.29-0.99). For depression patients, genotyping of HTR2A polymorphisms is a promising tool for estimating the outcome and side-effect of antidepressants.

Purpose Diseases relapse and severe infection caused by delayed immune reconstitution are still challenges in the haplo-identical hematopoietic stem cell transplantation (haplo-HSCT). Non-myeloablative transplant regimens also only alleviated these complications and did not solve the above problems. Among them, the thymus damage caused by preconditioning including irradiation and chemotherapy and graft-versus-host disease (GVHD) is the primary issue. Accelerating the recovery of thymus-derived T cells after transplantation is a key to solving above problem. Methods Therefore, we established a cell culture system using Notch ligand Delta4 and IL-7 that could induce and amplify hematopoietic stem cells differentiation and proliferation into precursor T (preT) cells in vitro. Non-myeloablative HSCT protocol was modified by using induced preT and G-CSF mobilized donor splenic mononuclear cells (MNC) co-infusion. Thymic GVHD, thymic repair, thymus-derived T cell development were compared in thymus-irradiated mice treated with MNC+preT and only MNC by polychromatic immunofluorescence tracking and T cell receptor Vβ detection. Results The data showed that pre T cells highly expressed CC9 and RANKL markers restored thymic architecture, weakened GVHD effects, enhanced immuno-tolerance and accelerated immune reconstitution by activating the RANK/RANKL pathway.Conclusion The modified non-myeloablative regimen containing preT cells will be more conducive to the widespread use of haplo-HSCT in clinical work.

Micro-transplantation (MST) by chemotherapy, combined with granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (GPBSC) infusion, from an HLA partial matched related donor has shown some encouraging effective therapy for acute myeloid leukemia (AML). However, the outcome of human leukocyte antigen (HLA) fully mismatched unrelated donor-derived MST in such patients is still unknown. In the present study, we compared the efficacy of HLA fully mismatched unrelated donor-derived MST, and partly matched related donor-derived MST, in AML of 126 patients from two centers in China, These patients, aged 16 to 65 years, were given three or four courses of MST, which consisted of a high dosage cytarabine followed by GPBSC from unrelated donor or related donor. There was a statistically significant difference in 3-year leukemia-free survival (LFS) and 3-year overall survival (OS) between the unrelated and the related group. The non-treatment-related mortality (NRM) rates of patients, and other adverse complications, were no different in the two groups. In conclusion, unrelated donor-derived MST is believed to be a safe treatment, with efficacy similar to or higher than related donor-derived MST. This result provides support for the potential of MST for expanding the donor selection. However, the specific mechanism of action needs further study.

Background. Hip fracture is one of the major risk factors of global mortality and disability. The aim of this study was to map the pattern of intertrochanteric femoral fractures in China, providing a pilot national dataset and basis for medical policy proposals. Methods. A multistage probability sampling strategy was applied in the national baseline survey. Thirty provinces in mainland China were included in this survey. A standardized questionnaire survey was conducted to collect information about basic characteristics such as age, working seniority, hospital level, and residence, with two other parts including perioperative and postoperative treatment parameters. Odds ratios and 95% confidence interval were used to determine essential statistical differences. The proportion of the options in each region was compared using the chi-square (χ2) test. The histogram and choropleth map of the monthly number of admissions were created using Excel 2016 to show the distribution characteristics. Results. In total, 1065 valid responses were included, representing a 96.7% survey capture rate. Perioperative treatment and postoperative care distinctly varied across regions and hospital levels. The monthly number of admissions was relatively lower in the Northern region, with higher proportion of hospitalizations to secondary hospitals compared with the Eastern region. The patients in the Eastern region or tertiary hospitals had shorter preoperative waiting time and hospitalization period. Conclusions. We found apparent geographic variations in intertrochanteric femoral fractures in this study, and the data can be used for drafting national healthcare plans and medical policies.

BackgroundThe treatment outcomes of elderly patients aged over 70 with acute myeloid leukemia (AML) have been very disappointing. In comparison, our designed HLA-mismatched hematopoietic stem cell micro-transplantation (MST) has achieved such encouraging treatment results in AML patients as might warrant further investigations of the outcomes of MST for the above mentioned patients. MethodsOne hundred and eleven patients aged 70-88 years were enrolled. Eighty patients were assigned to the high-risk MST or standard MST group according to high-risk prognostic factors. The other thirty-one patients were assigned to either the chemotherapy group or support group. After receiving induction chemotherapy with cytarabine and anthracycline, patients who achieved complete remission (CR) were given another 2 cycles of post-remission therapy with cytarabine. Each chemotherapy regimen was followed by donor stem cell infusion in the MST groups. ResultMST achieved an encouragingly high CR rate in patients (63.8%), even in high-risk patients (54%). It was significantly higher than that in the chemotherapy alone group. The 1-year overall survival (OS) of MST patients was 57.7% and was 68.6% in the high-risk and standard group, respectively, whereas the OS was only 37.3% in the chemotherapy group. The severe infection rate was 36% and 54% in MST and chemotherapy group. No GVHD was observed in MST patients. A larger updated T cell clones was observed in MST patients by T cell receptor repertoire analysis with a Next Generation Sequencing methodology. ConclusionsThese results suggested that MST is a safe and practical treatment regimen conducive to a longer-term survival for AML patients at a highly advanced age.

Bone defects in femoral neck fractures are strongly associated with the prognosis after internal fixation. However, qualitative analysis of bone defects in femoral neck fractures has already been performed, quantitative studies have not been reported. In this study, we aimed to systematically analyse the morphological characteristics of bone defects in patients with femoral neck fractures using computed tomography (CT) images combined with computer image analysis techniques.Four hundred and sixty-nine patients with femoral neck fractures from January 2014 to December 2018 at two grade A tertiary hospitals were included. Models were created in Mimics software based on CT images collected within 1 week after injury and then imported into 3-matic software for virtual reduction. The volume of the bone defect (VBD), maximum defect thickness (MDT), extent of the bone defect region (EBDR) , main defect quadrant (MDQ), collapse type and fracture classification were calculated and recorded.The EBDR, collapse type and MDT all had a significant positive effect on the VBD (P0.05), with a more significant effect at higher quantiles. Age also had a significant positive effect on the VBD (P 0.05), but its effect was more pronounced at lower quantiles. Compared to non-subcapital fractures, subcapital fractures had a positive effect on the VBD only at the 50 and 75% quantiles (P 0.01). The female sex had a significant negative effect on the VBD compared to the male sex (P 0.05).This study established a reliable computer image processing method for quantitative analysis of the VBD in femoral neck fractures and revealed that all patients with femoral neck fractures had bone defects, which can occur at any part of the femoral neck. The EBDR, MDT, collapse type, and patient age and sex were all important risk factors for the extent of the defect and should be taken into account in surgical planning.

The different open-circuit fault causes (i.e. terminal block damage, bonding wire fracture, driver circuit failure, et al.) lead to both one-way open-circuit and two-way open-circuit in neutral-point-clamped (NPC) inverters, namely the mixed-type open-circuit fault. In order to achieve a high diagnosis accuracy, the two types of open-circuit manifestations are simulated with two simulation ways to acquire mixed monitoring signal samples, on this basis, a diagnosis method using a dual-input convolutional neural network (CNN) is proposed. The method uses the three-phase currents as the main monitoring signals, and the six midpoint voltages of the upper and down half bridge arms as the auxiliary monitoring signals for the open-circuit fault diagnosis. The effectiveness of the method is validated by simulation, and the effects of different sample durations and training sample numbers on the network training and diagnosis results are analyzed quantitatively.

Severely immunosuppressed AIDS patients with recurrent opportunistic infections (OIs) represent an unmet medical need even in the era of antiretroviral therapy (ART). Here we report the development of a human leukocyte antigen (HLA)-mismatched allogeneic adaptive immune therapy (AAIT) for severely immunosuppressed AIDS patients. Twelve severely immunosuppressed AIDS patients with severe OIs were enrolled in this single-arm study. Qualified donors received subcutaneous recombinant granulocyte-colony-stimulating factor twice daily for 4–5 days to stimulate hematopoiesis. Peripheral blood mononuclear cells were collected from these donors via leukapheresis and transfused into the coupled patients. Clinical, immunological, and virological parameters were monitored during a 12-month follow-up period. We found AAIT combined with ART was safe and well-tolerated at the examined doses and transfusion regimen in all 12 patients. Improvements in clinical symptoms were evident throughout the study period. All patients exhibited a steady increase of peripheral CD4+ T cells from a median 10.5 to 207.5 cells/μl. Rapid increase in peripheral CD8+ T-cell count from a median 416.5 to 1206.5 cells/μl was found in the first 90 days since initiation of AAIT. In addition, their inflammatory cytokine levels and HIV RNA viral load decreased. A short-term microchimerism with donor cells was found. There were no adverse events associated with graft-versus-host disease throughout the study period. Overall, AAIT treatment was safe, and might help severely immunosuppressed AIDS patients to achieve a better immune restoration. A further clinical trial with control is necessary to confirm the efficacy of AAIT medication.

Objectives Alcohol consumption is one of the leading factors contributing to premature osteopenia. MicroRNA (miRNA) coordinates a cascade of anabolic and catabolic processes in bone homeostasis and dynamic vascularization. The aim was to investigate the protective role of miR‐4286 in alcohol‐induced bone loss and its mechanism. Materials and Methods The effect of miR‐4286 and alcohol on bone mesenchymal stem cells (BMSCs) and human umbilical vein endothelial cells (HUVECs) was explored via multiple in vitro assays, including cell proliferation, QPCR, Western blot, osteogenesis, angiogenesis etc miR‐4286 directly regulated HDAC3 was investigated by luciferase reporter assay, and the function of HDAC3 was also explored in vitro. Moreover, alcohol‐induced bone loss in mice was established to reveal the preventive effect of miR‐4286 by radiographical and histopathological assays. Results In vitro, ethanol dramatically inhibited the proliferation and osteogenesis of BMSCs, and substantially impaired the proliferation and vasculogenesis of HUVECs. However, a forced overexpression of miR‐4286 within BMSCs and HUVECs could largely abolish inhibitory effects by alcohol. Furthermore, alcohol‐induced inhibition on osteogenic and vasculogenic functions was mediated by histone deacetylase 3 (HDAC3), and dual‐luciferase reporter assay showed that HDAC3 was the direct binding target of miR‐4286. In vivo, micro‐CT scanning and histology assessment revealed that miR‐4286 could prevent alcohol‐induced bone loss. Conclusions We firstly demonstrated that miR‐4286 might function via intimate osteogenesis‐angiogenesis pathway to alleviate alcohol‐induced osteopenia via targeting HDAC3., miR‐4286 might function via intimate osteogenesis‐angiogenesis pathway to alleviate alcohol‐induced osteopenia via targeting HDAC3. miR‐4286 may be a potential diagnostic and therapeutic target for alcohol‐induced bone loss.

In incremental sheet forming (ISF), including single point incremental forming (SPIF) and double side incremental forming (DSIF), the material formability can be significantly enhanced when compared with conventional sheet forming processes. The material deformation in ISF is far more complicated because of the combined material deformation under stretching, bending, shearing, and cyclic loading, with an additional effect of compression in DSIF. Despite extensive investigation on material deformation during ISF, no theory has yet been widely agreed to explain different types of the material fracture behavior observed in ISF experiments. This paper presents a comprehensive review on the formability enhancement in ISF and proposes possible fracture mechanisms explaining the different types of fracture behavior observed in the experimental investigations. Discussions are presented to outline the current research progress and possible solutions to overcome the current ISF process limitations because of the material processing failure due to fracture.

A new test method for sheet metal deformation, Tension under Cyclic Bending and Compression (TCBC), is developed in this study. The TCBC method is capable of testing material deformation under tension, bending, and compression with cyclic loading. The effect of each deformation mode can be independently controlled by adjusting corresponding parameters. Using the TCBC test rig developed, aluminium alloy AA5251-H22 is tested under four different testing conditions: simple tension, tension under cyclic compression, tension under cyclic bending, and tension under cyclic bending and compression. The maximum elongation of the tested specimen at fracture and the tensile force required for material plastic deformation are evaluated. The results show that the maximum elongation increases significantly under the TCBC condition due to localised plastic deformation under compression that delays the fracture. Finite element modelling of the TCBC test is developed to obtain stress distributions to explain the enhanced formability. The new TCBC method may be used for testing material formability that resembles double-side incremental forming.

Power converters based on power semiconductor switches (e.g. IGBTs) are widely used in power grids, ships, unmanned vehicles, etc. Open-circuit faults of the switches, which are featured with concealment, must be diagnosed in time to prevent serious losses. In this paper, a step-GA-BP algorithm for the open-circuit fault diagnosis is proposed, and then validated using a typical three-phase two-level inverter. A Simulink model of the inverter is built, by which the output phase voltages are simulated and collected as signal samples to train a neural network diagnosis model. The conventional BP neural network is combined with the genetic algorithm (i.e. the step-GA-BP algorithm) to optimize the training process. The proposed algorithm achieves high diagnosis accuracy and shows advantages over the compared algorithms, in addition, the effects of duration and number of the signal samples are analyzed.

Introduction This study aimed to analyze the diversity of intestinal flora in patients with chronic hepatitis B (CHB) and investigate the effect of entecavir on the intestinal flora in these patients. Methods Thirty patients with CHB and 30 healthy controls were recruited from the Department of Infectious Diseases and Department of Gastroenterology of Shanghai Tongji Hospital between January 2017 and December 2018. Stool samples were collected for the detection of intestinal flora by high-throughput sequencing. Patients with CHB received antivirus therapy with entecavir for 8 weeks. The biochemical and virological responses were assessed and the intestinal flora were compared. Results After entecavir treatment, the blood levels of alanine aminotransferase (ALT), interleukin-6 (IL-6), IL-8, tumor necrosis factor (TNF), and hepatitis B virus (HBV) DNA reduced significantly in patients with CHB and the species abundance of intestinal flora increased markedly. In patients with CHB, the unique genera included Butyrivibrio, Phaseolus acutifolius, and Prevotellaceae NK3B31 group before treatment and Howardella, Candidatus Stoquefichus, Citrobacter, Dysgonomonas, Faecalicoccus, Methanobrevibacter, Mitsuokella, Mobilitalea, Succinivibrio, Gluconobacter, and Plesiomonas after treatment. The abundance of the following genera increased significantly after entecavir treatment in patients with CHB: Clostridium sensu stricto 1, Erysipelotrichaceae UCG-007, and Intestinibacter. The abundance of Streptococcus, Atopobium, and Murdochiella reduced markedly after entecavir treatment in patients with CHB. Conclusion After 8-week entecavir treatment, the blood biochemical, immunological, and virological responses improved significantly, the species abundance of intestinal flora increased markedly, and there were unique genera in patients with CHB before and after treatment. Electronic supplementary material The online version of this article (10.1007/s40121-020-00355-w) contains supplementary material, which is available to authorized users.

Background: Delayed hematopoietic recovery was one of the factors that limited the clinic application of umbilical cord blood (UCB) transplantation. Two different methods of overcoming the limitation were evaluated by this systematic review and meta-analysis. One strategy was to expand UCB unit ex vivo for increasing cell dose and another strategy was to incubate UCB unit with small molecules in vitro for enhancing bone marrow (BM) homing ability. Methods: Relevant literatures were collected from 2000 to 2020 by searching the databases of PubMed, Medline, and EMBASE. A total of 15 studies that met the inclusion criteria were included in the meta-analysis. Results: Similar clinical effects including neutrophil recovery (P=0.308), platelet recovery (P=0.4754), and 100-day survival (P=0.4216) between two methods were observed. Faster neutrophil recovery was associated with higher infused total nucleated cells (TNCs) (R2=0.4526 P2=0.9777 P=0.095) in patients of expansion group and incubation group, respectively. Conclusion: Although the treatment outcomes by using expanded stem cells were getting better all these years with fast development of cell culture techniques according to our cumulative meta-analysis. It seems the application of incubation procedure was safer and more convenient than expansion regarding to their similar clinic effects. This study was registered at RROSPERO (Registration no. CRD42020149750).

To remedy the lack of human leukocyte antigen (HLA)-matched donors and address the problems bedeviling traditional allogeneic hematopoietic stem cell transplantation which induces the resultant graft-versus-host disease, we designed a scheme called HLA-mismatched hematopoietic stem cell microtransplantation (MST) for patients with acute myeloid leukemia (AML), where encouraging results were achieved. In providing answers to such questions as how to select the donors of MST and which factors were involved in the outcome of MST. One hundred thirty-one AML patients from four centers with lower or standard risk of prognosis after complete remission were given three courses of MST: high dose of cytarabine plus infusion of granulocyte colony-stimulating factor mobilized peripheral blood stem cells from HLA-mismatched donors. Leukemia-free survival (LFS) and overall survival were compared, with respect to gender difference, number of HLA-matched loci, killer cell immunoglobulin-like receptor (KIR), and ligand mismatch between donors and recipients. Median LFS of recipients with different KIR ligands from those of donors was found to be significantly higher than that of recipients having identical ligands with donors (

Incremental sheet forming (ISF), including single point incremental forming (SPIF) and double side incremental forming (DSIF), has demonstrated significantly enhanced material formability compared to traditional sheet metal forming processes. However, the material deformation mechanisms that lead to the enhanced formability in DSIF are not fully understood. In this study, a new test method, named as Tension under Cyclic Bending and Compression (TCBC), has been developed to investigate four deformation modes observed in DSIF, including tension, compression, bending and cyclic loading, on the material formability enhancement. An analytical model based on the elementary plasticity theory has been developed to characterize the effect of tension, compression, bending and cyclic loading on the initiation of material plastic deformation. A TCBC rig has been manufactured and experimental tests of two aluminium alloys have been conducted by applying the Design of the Experiments to investigate the significant effects of different deformation modes on the material formability. Finite element modelling of TCBC test as well as DSIF process has also been developed to compare their plastic strain evolution and strain paths during the cyclic deformation process. The material formability has been found to be improved significantly under TCBC condition and the existence of compression loading leads to strengthened localized material plastic deformation, which contributes to the enhanced material formability and delayed fracture. The new TCBC test method developed in this study has demonstrated its potential to replace the current testing method using the DSIF process itself for material formability studies.

The LSGM-carbonate composite electrolyte is a new type of medium and low temperature SOFC electrolyte material, which has great application potential. In this paper, the molten salt infiltration method was used to prepare the LSGM-carbonate composite electrolyte. The results of SEM test proved that the molten salt infiltration method was more appropriate in preparing the LSGM-carbonate composite electrolyte comparing with direct mixing method. The influence of the type and content of pore forming agent was investigated. The result showed that the polymethyl methacrylate (PMMA) had an excellent pore forming performance and could create interconnected pore structures successfully in LSGM matrix. The XRD result indicated that the LSGM-carbonate composite electrolyte showed almost a single LSGM phase and the carbonate remained glass state. Four terminal method was used to measure the conductivity. The result showed that the conductivity of the LSGM-carbonate composite electrolytes was increased by one order of magnitude compared with pure LSGM. The conductivity of LSGM-carbonate composite electrolytes increased firstly and then decreased with the increasing of PMMA. The LSGM-carbonate composite electrolyte prepared by 25 wt.% PMMA addition has the highest conductivity during the whole range of test temperature and reached 0.3 S.cm-1 at 600°C.