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Upper gastrointestinal endoscopy is critical for esophageal squamous cell carcinoma (ESCC) detection; however, endoscopists require long-term training to avoid missing superficial lesions.To develop a deep learning computer-assisted diagnosis (CAD) system for endoscopic detection of superficial ESCC and investigate its application value.We configured the CAD system for white-light and narrow-band imaging modes based on the YOLO v5 algorithm. A total of 4447 images from 837 patients and 1695 images from 323 patients were included in the training and testing datasets, respectively. Two experts and two non-expert endoscopists reviewed the testing dataset independently and with computer assistance. The diagnostic performance was evaluated in terms of the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity.The area under the receiver operating characteristics curve, accuracy, sensitivity, and specificity of the CAD system were 0.982 [95% confidence interval (CI): 0.969-0.994], 92.9% (95%CI: 89.5%-95.2%), 91.9% (95%CI: 87.4%-94.9%), and 94.7% (95%CI: 89.0%-97.6%), respectively. The accuracy of CAD was significantly higher than that of non-expert endoscopists (78.3%,The diagnostic performance of the CAD system is promising and may assist in improving detectability, particularly for inexperienced endoscopists.

Inefficient electrocatalysts and high-power consumption are two thorny problems for electrochemical hydrogen (H2) production from acidic water electrolysis. Herein we report the one-pot precise synthesis of ultrafine Au core-PtAu alloy shell nanowires (Au@PtxAu UFNWs). Among them, Au@Pt0.077Au UFNWs exhibit the best performance for formic acid oxidation reaction (FAOR) and hydrogen evolution reaction (HER), which only require applied potentials of 0.29 V and −22.6 mV to achieve a current density of 10 mA cm−2, respectively. The corresponding formic acid electrolyzer realizes the electrochemical H2 production at a voltage of only 0.51 V with 10 mA cm−2 current density. Density functional theory (DFT) calculations reveal that the Au-riched PtAu alloy structure can facilitates the direct oxidation pathway of FAOR and consequently elevates the FAOR activity of Au@Pt0.077Au UFNWs. This work provides meaningful insights into the electrochemical H2 production from both the construction of advanced bifunctional electrocatalysts and the replacement of OER.

The catalytic/electrocatalytic performance of platinum (Pt) nanostructures highly relates to their morphology. Herein, we propose a facile self-template pyrolysis strategy at high temperature to synthesize one-dimensionally holey Pt nanotubes (Pt-hNTs) using PtII-dimethylglyoxime complex (PtII-DMG) nanorods as the reaction precursor. The coordination capability of DMG results in the generation of PtII-DMG nanorods, whereas the reducibility of DMG at high temperature leads to the reduction of PtII species in PtII-DMG nanorods. During the reaction process, the inside-out Ostwald ripening phenomenon leads to the hollow morphology of Pt-hNTs. Benefiting from the physical characteristics of hollow and holey structure, Pt-hNTs with clean surface show superior electroactivity and durability for catalyzing ethanol electrooxidation as well as hydrogen evolution reaction in alkaline media. Under optimized experimental conditions, the constructed symmetric Pt-hNTs||Pt-hNTs ethanol electrolyzer only requires an electrolysis voltage of 0.40 V to achieve the electrochemical hydrogen production, demonstrating a highly energy saving strategy relative to traditional water electrolysis.

Spinal fusion is a widely employed treatment of patients with degenerative disc disease, in which a cage is used to replace the disc for spinal fusion. But it often fails for insufficient mechanical strength and poor osseointegration. Here, we designed a polyether-ether-ketone (PEEK)/tantalum (Ta) composite cage with a biomimetic gradient porous micro-structure, simultaneously enhancing mechanical properties and accelerating osseointegration in spinal fusion.In the study, based on the mechanical performances of PEEK and osteogenic potential of Ta, and the three-dimensional (3D) structures of cuttlebone and vertebra, the cages were respectively 3D printed by pure PEEK, PEEK with 5 wt% Ta (PEEK/Ta-5), PEEK with 10 wt% Ta (PEEK/Ta-10) and PEEK with 15 wt% Ta (PEEK/Ta-15), then verifiedVertebral Gyroid structure PEEK/Ta-15 cage exhibited superior mechanical properties than Cuttlebone-like structure PEEK/Ta-15 cage, closer to the cervical vertebra. Furthermore, PEEK/Ta-15 cage with higher Ta microparticles in PEEK provided a biomimetic gradient porous micro-structure with higher surface energy, guiding cell biological behavior, promoting new bone penetration, and accelerating osseointegrationIn conclusion, the study designed a biomimetic gradient porous cage with a micro-structure for enhancing mechanical properties, accelerating osseointegration and forming an anatomical lock in the fusion segment through composites, mechanical efficiency, surface extension, and pores.

EUS has recently gained attraction in mainland China. This study aimed to evaluate the development of EUS from results of two national surveys.EUS-related information, including infrastructure, personnel, volume, and quality indicator, was extracted from the Chinese Digestive Endoscopy Census. Data from 2012 and 2019 were compared, and differences among various hospitals and regions were analyzed. The EUS rates (EUS annual volume per 100,000 inhabitants) between China and developed countries were also compared.The number of hospitals performing EUS in mainland China increased from 531 to 1236 (2.33-fold), and 4025 endoscopists performed EUS in 2019. The volumes of all EUS and interventional EUS increased from 207,166 to 464,182 (2.24-fold) and 10,737 to 15,334 (1.43-fold), respectively. The EUS rate in China was lower than that in developed countries but showed a higher growth rate. EUS rate varied substantially among different provincial regions (in 2019: 4.9-152.0 per 100,000 inhabitants) and showed significant positive association with gross domestic product per capita (in 2019: r = 0.559, P = 0.001). The EUS-FNA-positive rate in 2019 was comparable between hospitals in terms of annual volume (≥50 or50: 79.9% vs. 71.6%, P = 0.704) and practice duration (starting EUS-FNA before or after 2012: 78.7% vs. 72.6%, P = 0.565).EUS has developed considerably in China in recent years but still needs substantial improvement. More resources are in demand for hospitals in less-developed regions and with low EUS volume.

Objective To explore the clinical efficacy of collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture in the treatment of post-herpetic neuralgia (PHN). Methods Seventy-two patients with post-herpetic neuralgia were randomized into observation group and control group. Of the 72 cases, 12 cases fell off, so finally 30 cases in each group. The observation group was treated with collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture, while the control group was treated simply with pregabalin capsules for 20 consecutive days. On the basis of the western medication pregabalin capsules, the same as that of the control group, collateral-pricking and blood-letting cupping combined with electroacupuncture in a surrounding needling technique, was adopted for the observation group, once every two days, ten days as one course of treatment, a total of two courses. The immediate visual analogue scale (VAS) before and after treatment were observed in the two groups, and their clinical effects were compared. Results The VAS scores of PHN patients in the two groups after treatment were lower than those before treatment (both P Conclusion The clinical effect of collateral-pricking and blood-letting cupping combined with electroacupuncture is relatively satisfactory in the treatment of post-herpetic neuralgia.

Water electrolysis is an environmentally friendly and sustainable technique for ultra-pure hydrogen production, while expensive electrode materials and high driving voltage have seriously hindered its commercialization process. Here, Earth-abundant bifunctional porous Ni2P hollow nanotubes on nickel foam (Ni2P-HNTs/NF) electrocatalysts are synthesized through a facile self-template method and a phosphating process, which are perfectly combined with the hydrazine electrooxidation reaction (HzOR) boosted water electrolysis. Benefiting from the unique structural characteristic of open-framework and abundant step atoms, Ni2P-HNTs/NF achieves 10 mA cm-2 at 91 mV (vs. RHE) for the cathodic hydrogen evolution reaction and 18 mV (vs. RHE) for the anodic HzOR in a three electrode system, respectively. The corresponding two-electrode hydrazine electrolyzer produces 10 mA cm-2 with a total voltage of only 152 mV for ultra-pure hydrogen production, highlighting a cost-effective and energy-saving water electrolysis mode.

For the electrochemcial hydrogen production, the oxygen evolution reaction (OER) is a pivotal half-reaction in water splitting. However, OER suffers sluggish kinetics and high overpotential, leading to the increase of overall energy consumption and decrease of the energy efficiency. In this work, high-quality cobalt oxide porous nanotubes (Co3O4-PNTs) are easily obtained by simple self-template approach. One-dimensional (1D) porous structure provides the large specific surface area, enough abundant active atoms and effective mass transfer. In addition, Co3O4-PNTs also own self-stability of 1D architecture, benefitting the their durability for electrocatalytic reaction. Thus, Co3O4-PNTs with optimal annealing temperature and time reveal the attractive alkaline OER performance (Tafel slope of 56 mV dec−1 and 323 mV overpotential at 10 mA cm−2), which outperform the Co3O4 nanoparticles and benchmark commercial RuO2 nanoparticles. Furthermore, Co3O4-PNTs also exhibit excellent OER durability for least 10 h at the 10 mA cm−2. Overall, Co3O4-PNTs with low cost can be serve as a highly reactive and economical catalyst for OER.

BACKGROUND: Tens of millions of gastrointestinal endoscopic procedures are performed every year in China, but the quality varies significantly and related factors are complex. Individual endoscopist- and endoscopy division-related factors may be useful to establish a model to measure and predict the quality of endoscopy. AIM: To establish a model to measure and predict the quality of gastrointestinal endoscopic procedures in mainland China. METHODS: Selected data on endoscopy experience, equipment, facility, qualification of endoscopists, and other relevant variables were collected from the National Database of Digestive Endoscopy of China. The multivariable logistic regression analysis was used to identify the potential predictive variables for occurrence of medical malpractice and patient disturbance. Linear and nonlinear regressions were used to establish models to predict incidence of endoscopic complications. RESULTS: In 2012, gastroscopy/colonoscopy-related complications in mainland China included bleeding in 4,359 cases (0.02%) and perforation in 914 (0.003%). Endoscopic-retrograde-cholangiopancreatography-related complications included severe acute pancreatitis in 593 cases (0.3%), bleeding in 2,151 (1.10%), perforation in 257 (0.13%) and biliary infection in 4,125 (2.11%). Moreover, 1,313 (5.0%) endoscopists encountered with medical malpractice, and 5,243 (20.0%) encountered with the disturbance from patients. The length of endoscopy experience, weekly working hours, weekly night shifts, annual vacation days and job satisfaction were predictors for the occurrence of medical malpractice and patient disturbance. However, the length of endoscopy experience and the ratio of endoscopists to nurses were not adequate to establish an effective predictive model for endoscopy complications. CONCLUSION: The workload and job satisfaction of endoscopists are valuable predictors for medical malpractice or patient disturbance. More comprehensive data are needed to establish quality-predictive models for endoscopic complications.

Developing robust and inexpensive non-noble metal based anode electrocatalysts is highly desirable for alkaline direct methanol fuel cells (ADMFCs). Herein, we successfully develop a facile self-template synthetic strategy for gram-grade porous NiO nanotubes (NTs) by pyrolyzing a nanorod-like Ni-dimethylglyoxime complex. The pyrolysis temperature highly correlates with the morphology and crystallinity of NiO NTs. The optimal NiO NTs exhibit a large electrochemically active surface area, a fast catalytic kinetics, and a small charge transfer resistance, which induce an outstanding electrocatalytic activity for the methanol oxidation reaction (MOR). Compared with conventional NiO nanoparticles, NiO NTs achieve a 11.5-fold increase in mass activity at 1.5 V for the MOR due to nanotubal morphology and abundant non-vacancy defects on the NiO NT surface. Moreover, NiO NTs have a higher electrocatalytic activity for the intermediates of the MOR (such as formaldehyde and formate) than conventional NiO nanoparticles, which also contribute to MOR activity enhancement. Given the facile synthesis and enhanced electrocatalytic performance, NiO NTs may be promising anode electrocatalysts for ADMFCs.

There is huge shortage of ERCP practitioners (ERCPists) in China, and ERCP training is urgently needed. ChangHai Advanced eNdoscopy Courses for ERCP (CHANCE) is a 4-month program for ERCP training since 2004. This study evaluated the efficiency of this short-term training model, and reported on the ERCP careers of the trainees following completion of the CHANCE program.This study was a retrospective investigation included all the CHANCE trainees from Jan 2004 to Dec 2014. Questionnaires were sent to all trainees. The career competence percentage, ERCP careers and predictive factors of career competence were investigated and analyzed.A total of 413 trainees participated in the CHANCE program over 11 years covered by the survey and 258 questionnaires were valid for the study. The mean (SD) age of the trainees was 35.36 (4.17), and the male to female ratio was 4.4:1. The average follow-up time was 7.77 (3.44) years. A total of 173 (67.1%) trainees had achieved career competence. In terms of ERCP careers, the mean annual ERCP volume was 120.60 (96.67), with a complication percentage of 8.2%. Hospital qualification, compliance with follow-up learning guidance, participating academic activity, and practitioner type were identified predictive factors of career competence.As a short-term training program, the CHANCE achieved an acceptable career competence percentage, providing endoscopists more chances to learn ERCP and giving them appropriate training guidance for career competence. This training mode is worth promoting in developing countries with shortage of ERCPists.

The dietary intake of aleurone is beneficial to health, but higher aleurone supplementation is not conducive to wheat flour processing. Transglutaminase has been widely recognized for the positive role in improving the quality of wheat flour products. In the study, protein aggregation behavior and quality of aleurone-riched fine dried noodles were evaluated to explain the effect of transglutaminase on quality and protein characteristics of aleurone-riched fine dried noodles, so as to expand the utilization of wheat by-products and the production of nutrient-riched noodles. The results showed that the aleurone-riched fine dried noodles containing 1.0% TGase had the best texture properties, less cooking loss, and better sensory performance, and noodles had a tighter binding structure. Moreover, transglutaminase could inhibit the extraction of SDS soluble protein in aleurin-riched dried noodles, promoting the transformation of free sulfhydryl group to disulfide bond. Meanwhile, the protein of the aleurin-riched fine dried noodles had a higher proportion of β-sheets, the thermal stability is improved. However, a large amount of TGase can still lead to the poor quality of noodles. Therefore, the addition of 1.0% transglutaminase has a positive effect on the quality of aleurone-riched fine dried noodles through covalent interaction.

Selective hydrogen peroxide (H2O2) electrogeneration by oxygen reduction reaction (ORR) is an efficient and promising synthetic method for H2O2 production. Herein, we build a particular inorganic–organic interface to enhance the electrocatalytic selectivity of reduced graphene oxide (rGO) aerogels for H2O2 electrogeneration by modifying rGO aerogels with polyethyleneimine (PEI). The three-dimensional porous structure of aerogels and the steric hindrance effect of PEI on rGO endow PEI-functionalized rGO (rGO/PEI) aerogels with enhanced selectivity (90.7%), production rate (106.4 mmol gcat–1 h–1), and durability for H2O2 electrogeneration by the two-electron pathway of ORR.

Background Esophageal cancer is a common cancer of the digestive system, with high morbidity and poor prognosis. However, while the prognosis of early esophageal cancer is relatively good, there is no effective model to accurately predict the prognosis of early esophageal cancer. The Aims of this study are to explore risk factors for the prognosis of early esophageal cancer and to establish a prediction nomogram for patients. Methods Surveillance, Epidemiology and End Results (SEER) Stat 8.3.5 was used to collect 2,351 cases of early esophageal cancer from 2004 to 2015 in the SEER database. Early esophageal cancer is defined as a lesion that is confined to the lamina propria and the muscularis mucosa. Prognostic factors were analyzed with the log-rank method and a Cox proportional hazard model by SPSS (v25.0). Independent prognostic factors were used to construct a nomogram with a Cox proportional hazard model. The C-index was used to evaluate the prediction effect of the nomogram. The internal validity of the nomogram was tested by discrimination and calibration using a bootstrap method with 1,000 resamplings. Results The median survival time was 30 months, and the 1-, 3-, and 5-year survival rates were 65.2%, 46.8%, and 41.6%, respectively. The male to female ratio was 3:1, and 85.33% of all patients were white. Univariate analysis showed that risk factors affecting patient prognosis included age (χ2=430.631, P

The construction of maximally entangled bases for the bipartite system $\mathbb {C}^{d}\otimes \mathbb {C}^{d}$ is discussed firstly, and some mutually unbiased bases with maximally entangled bases are given, where 2≤d≤5. Moreover, we study a systematic way of constructing mutually unbiased maximally entangled bases for the bipartite system $\mathbb {C}^{d}\otimes \mathbb {C}^{d^{k}}$ .

Aims To screen and identify safe micro-organisms used during Douchi fermentation, and verify the feasibility of producing high-quality Douchi using these identified micro-organisms. Methods and Results PCR-denaturing gradient gel electrophoresis (DGGE) and automatic amino-acid analyser were used to investigate the microbial diversity and free amino acids (FAAs) content of 10 commercial Douchi samples. The correlations between microbial communities and FAAs were analysed by statistical analysis. Ten strains with significant positive correlation were identified. Then an experiment on Douchi fermentation by identified strains was carried out, and the nutritional composition in Douchi was analysed. Results showed that FAAs and relative content of isoflavone aglycones in verification Douchi samples were generally higher than those in commercial Douchi samples. Conclusions Our study indicated that fungi, yeasts, Bacillus and lactic acid bacteria were the key players in Douchi fermentation, and with identified probiotic micro-organisms participating in fermentation, a higher quality Douchi product was produced. Significance and Impact of the Study This is the first report to analyse and confirm the key micro-organisms during Douchi fermentation by statistical analysis. This work proves fermentation micro-organisms to be the key influencing factor of Douchi quality, and demonstrates the feasibility of fermenting Douchi using identified starter micro-organisms.

Environmentally persistent free radicals (EPFRs) are relatively highly stable and found in the formation of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). Recent studies have concentrated on model dioxin formation reactions and there are few studies on actual waste incineration fly ash. In order to study EPFRs and the correlation with dioxins and heavy metals in waste incineration fly ash, the spins of EPFRs, concentration of PCDD/Fs and metals in samples from 6 different waste incinerators were detected. The medical waste incineration fly ash from Tianjin, municipal solid waste incineration fly ash from Jiangxi Province, black carbon and slag from municipal solid waste incinerator in Lanxi, Zhejiang Province, all contained EPFRs. Above all the signal in Tianjin sample was the strongest. Hydroxyl radicals, carbon-center radicals and semiquinone radicals were detected. Compared with other samples, Jiangxi fly ash had the highest toxic equivalent quantity (TEQ) of dioxins, up to 7.229 4 ng · g⁻¹. However, the dioxin concentration in the Tianjin sample containing the strongest EPFR signals was only 0.092 8 ng · g⁻¹. There was perhaps little direct numeric link between EPFRs and PCDD/Fs. But the spins of EPFRs in samples presented an increasing trend as the metal contents increased, especially with Al, Fe, Zn. The signal strength of radicals was purposed to be related to the metal contents. The concentration of Zn (0.813 7% ) in the Tianjin sample was the highest and this sample contained much more spins of oxygen-center radicals. We could presume the metal Zn had a greater effect on the formation of EPFRs, and was easier to induce the formation of radicals with a longer half-life period.

In the biological aerated filter, the removal efficiency of phosphorus is poor, while the efficiency of organics and nitrogen are very well. In order to solve these problems, the sequence bio-film reactor connects to traditional biological aerated filter, ceramic filler was added to the system, study the effect of bio-film culturing and biological disposal capacity .Control intermittent time of anaerobic and aerobic and aeration volume, the removal effect of COD 、nitrogen and phosphorus are good in the sewage . The results show that anaerobic and aerated time are 3h and 4h in SBBR, the removal efficiency of COD、NH4+-N、TN and TP are 90.07%、85.12%、81.74% and 83.63%, the concentration are 31.37mg/L, 5.15㎎/L, 6.60㎎/L and 1.10㎎/L separately. All of these satisfy theⅠ-B criteria specified in Discharge Standard of Pollutants for Municipal Wastewater Treatment Plant (GB 18918-2002). The system of SBBR-BAF run stably, removal sewage perfectly, avoid return and mud, save energy consumption.

Hydraulic turbine band castings are susceptible to deformation in heat treatment process if their cooling is not well controlled. The coupled analysis of forced air flow and heat transfer in normalizing process of a heavy turbine band runner casting with outer diameter of 8000 mm was carried out by using ANSYS software. The band undergoes significant deformation because of uneven cooling resulted by uneven air flow around it during normalizing. The forced air flow pattern is a key factor which influences the cooling uniformity and efficiency. It is optimized by adjusting the cooling fans’ orientation relative to the casting to form cyclone around it. Consequently, cooling uniformity is improved to avoid deformation.

In order to fabricate the HLA-DQA1 genotyping chip and develop an integrated, parallel technical platform to type HLA system, a pair of primers and a set of probes were designed according to the sequences of HLA-DQA1 exon 2, where the polymorphism is concentrated. The oligonucleotide chip was made with the methods developed in our laboratory. The target DNA was asymmetrically amplified with the labeled sense primer. The signals were scanned and analyzed after the hybridization between microarray and PCR product. The allele types of the samples were identified. The result was verified by the standard DNA and DNA sequencing. The results showed that the genotyping was successfully carried out in 50 standard DNA samples and 50 clinical samples. Among them, results of the 50 standard DNA samples matched their templates. In the other 50 samples, results of the randomly selected 10 matched their sequencing results except that two of them got the incompletely result. In reproducible tests, the signal reappear rate was 95%. It is concluded that HLA-DQA1 genotyping by using our array system is simple and convenient with satisfied accuracy and reproducibility.

To investigate the effects of phenylpropanoid glycoside antioxidant isoverbascoside on cell proliferation and differentiation of human gastric cancer cell line MGC 803.MGC 803 cells were treated with isoverbascoside. Its effects on cell proliferation, tumorigenicity, enzymatic activities, cell cycles, and gene expression were respectively evaluated with cell counting, tumor formation assay, enzymatic assay, flow cytometer analysis, and Western blotting, with Me2SO as positive control.Isoverbascoside could markedly inhibit cell proliferation in dose- and time-dependent manner. Isoverbascoside 20 micromol/L strikingly suppressed cell tumorigenicity, activities of alkaline phosphatase (ALP), and lactate dehydrogenase (LDH), and caused G0/G1 arrest. The expression of G1 S checkpoint related proteins, p53, p21/WAF1, and p16/INK4, were up-regulated after MGC 803 cells were treated with isoverbascoside 20 micromol/L for 4-8 h. Contrarily, the expression of C-myc protein was suppressed after 8 h treatment.Isoverbascoside inhibited cell proliferation, reversed cell malignant phenotypic characteristics, and consequently caused differentiation in MGC 803 cells. These effects might be associated with its activities of causing G0/G1 arrest and regulating the expression of cell cycle related proteins.