Background:In the overall surgical population,inadvertent perioperative hypothermia has been associated with an increased incidence of surgical site infection(SSI).However,recent clinical trials did not validate this ...Background:In the overall surgical population,inadvertent perioperative hypothermia has been associated with an increased incidence of surgical site infection(SSI).However,recent clinical trials did not validate this notion.This study aimed to investigate the potential correlation between inadvertent perioperative hypothermia and SSIs following liver resection.Methods:This retrospective cohort study included all consecutive patients who underwent liver resection between January 2019 and December 2021 at the First Affiliated Hospital,Zhejiang University School of Medicine.Perioperative temperature managements were implemented for all patients included in the analysis.Estimated propensity score matching(PSM)was performed to reduce the baseline imbalances between the normothermia and hypothermia groups.Before and after PSM,univariate analyses were performed to evaluate the correlation between hypothermia and SSI.Multivariate regression analysis was performed to determine whether hypothermia was an independent risk factor for postoperative transfusion and major complications.Subgroup analyses were performed for diabetes mellitus,age>65 years,and major liver resection.Results:Among 4000 patients,2206 had hypothermia(55.2%),of which 150 developed SSI(6.8%).PSM yielded 1434 individuals in each group.After PSM,the hypothermia and normothermia groups demonstrated similar incidence rates of SSI(7.0%vs.6.3%,P=0.453),postoperative transfusion(13.7%vs.13.3%,P=0.743),and major complications(10.1%vs.9.0%,P=0.309).Univariate regression analysis revealed no significant effects of hypothermia on the incidence of SSI in the group with the highest hypothermia exposure[odds ratio(OR)=1.25,95%confidence interval(CI):0.84-1.87,P=0.266],the group with moderate exposure(OR=1.00,95%CI:0.65-1.53,P=0.999),or the group with the lowest exposure(OR=1.11,95%CI:0.73-1.65,P=0.628).The subgroup analysis revealed similar results.Regarding liver function,patients in the hypothermia group demonstrated lowerγ-glutamyl transpeptidase(37 vs.43 U/L,P<0.001)and alkaline phosphatase(69 vs.72 U/L,P=0.016).However,patients in the hypothermia group exhibited prolonged activated partial thromboplastin time(29.2 vs.28.6 s,P<0.001).Conclusions:In our study of patients undergoing liver resection,we found no significant association between mild perioperative hypothermia and SSI.It might be due to the perioperative temperature managements,especially active warming measures,which limited the impact of perioperative hypothermia on the occurrence of SSI.展开更多
The introduction of third-party evaluation system and the implementation of third-party evaluation system in poverty alleviation is a major innovation in the targeted poverty alleviation work in China.In order to impr...The introduction of third-party evaluation system and the implementation of third-party evaluation system in poverty alleviation is a major innovation in the targeted poverty alleviation work in China.In order to improve the third-party evaluation mechanism,further improve the efficiency of third-party evaluation,and enhance the effectiveness of targeted poverty alleviation,this paper analyzes and summarizes the main problems existing in the current third-party evaluation practice.In view of the related problems,this paper puts forward the corresponding policy recommendations,which are believed to play a positive role in further promoting the development and improvement of the third-party evaluation of getting rid of poverty.展开更多
Poverty alleviation through employment promotion is to promote the poor households to get rid of poverty through promoting employment to increase income. It is the most effective and direct way out of poverty. Dongchu...Poverty alleviation through employment promotion is to promote the poor households to get rid of poverty through promoting employment to increase income. It is the most effective and direct way out of poverty. Dongchuan District, located in the alpine valley area of northeastern Yunnan, is a typical extreme poverty-stricken county in China. Under its jurisdiction, Awang Town is a mountainous township with a wide area of poverty and an extreme poverty. The incidence of poverty in 2015 reached 35.39%. In recent years, through the implementation of various policies to combat poverty, combined with the advantages as a traditional "hometown of migrant labor", focusing on employment- promoting poverty alleviation work, Awang Town has made certain achievements in poverty alleviation work. By the end of 2018, the poverty rate in the town fell to 0.57%, marking a major victory in the town s fight against poverty. Through field investigations, this article summarizes the main practices of Awang Town to carry out employment-promoting targeted poverty alleviation, analyzes the poverty alleviation achievements and successful experience of the town s employment-promoting targeted poverty alleviation work and discusses the promotion and application of this model so as to provide reference Yunnan Province and other poverty-stricken areas to carry out employment-promoting poverty alleviation.展开更多
In this paper,we study an Intelligent Reflecting Surface(IRS)assisted Mobile Edge Computing(MEC)system under eavesdropping threats,where the IRS is used to enhance the energy signal transmission and the offloading per...In this paper,we study an Intelligent Reflecting Surface(IRS)assisted Mobile Edge Computing(MEC)system under eavesdropping threats,where the IRS is used to enhance the energy signal transmission and the offloading performance between Wireless Devices(WDs)and the Access Point(AP).Specifically,in the proposed scheme,the AP first powers all WDs with the wireless power transfer through both direct and IRS-assisted links.Then,powered by the harvested energy,all WDs securely offload their computation tasks through the two links in the time division multiple access mode.To determine the local and offloading computational bits,we formulate an optimization problem to jointly design the IRS's phase shift and allocate the time slots constrained by the security and energy requirements.To cope with this non-convex optimization problem,we adopt semidefinite relaxations,singular value decomposition techniques,and Lagrange dual method.Moreover,we propose a dichotomy particle swarm algorithm based on the bisection method to process the overall optimization problem and improve the convergence speed.The numerical results illustrate that the proposed scheme can boost the performance of MEC and secure computation rates compared with other IRS-assisted MEC benchmark schemes.展开更多
Although most of the 5-axis NC milling machine tool producers declare that their machine poses the function of 5-axis simultaneous machining, and most of the commercialized CAD/CAM software was reported it can support...Although most of the 5-axis NC milling machine tool producers declare that their machine poses the function of 5-axis simultaneous machining, and most of the commercialized CAD/CAM software was reported it can support the 5-axis simultaneous machining, but there are very few analyses about their machining efficiency. I hope that the reader would be interested to know how the new method is?highly effective. The paper did a good job in motivating the problem mentioned here. The model of this paper is extremely efficient ant. This is a highly effective way of surface machining. There are also some areas that need improving. The mathematic presentation is not clear, but much more pages are needed, if the authors like to make it clearer. In the resent paper “The Extreme Efficiency of the New Model in Milling of Complicated Surfaces” we discussed the extreme efficiency of the new model in milling of complicated surfaces in 5-axis machining for 2-dimensional contact. While this time let’s discuss the same problem but much complicated one, 5-axis machining for 3-dimensional contact. As the research activities conducted by Dr. Liu Huran opened a new field and wide horizons in 5-axis machining of sculptured complicated surfaces using mathematical theories, and according to the interesting results presented in paper, Dr. Liu Huran is strongly encouraged if he can submit a similar work but this time with a new title that corresponds to the purpose [1].展开更多
Background:Cancerous ascites is a common and severe complication that occurs in patients with late-stage malignant tumors.The prognosis of cancerous ascites is poor,clinical treatment is difficult and therapeutic outc...Background:Cancerous ascites is a common and severe complication that occurs in patients with late-stage malignant tumors.The prognosis of cancerous ascites is poor,clinical treatment is difficult and therapeutic outcome is disappointing.In the present study,tumor cell-derived vesicles were used as drug delivery vehicles that encapsulated a chemotherapeutic agent and were perfused into a patients’abdominal cavity to effectively kill the cancer cells in cancerous ascites.Pre-clinical data has demonstrated that tumor vesicles that carry low-dose chemotherapeutics can efficiently eliminate metastatic tumor cells in the abdominal cavity with minimal toxic or adverse effects.When combined,tumor cell-derived vesicles can sensitize tumor cells,which facilitates the entry of chemotherapeutics into tumor cells,thereby enhancing killing of tumor cells and limiting the risk of drug resistance.In this study,we designed a clinical trial to evaluate the safety and efficacy of intraperitoneal perfusion with tumor vesicle-encapsulated methotrexate for the treatment of cancerous ascites.Methods:Sixty patients with cancerous ascites were enrolled in this open,randomized and controlled clinical trial.Participants were randomly assigned a visit number and,according to their visiting order for which a random numerical table was used,were assigned to the trial group or the control group in a 1:1 ratio.The change in ascetic volume was used as the study outcome and adverse events were monitored during the entire length of the study.Conclusion:In this clinical trial,randomization and electronic case report forms were implemented.The trial indicated that tumor vesicle-encapsulated methotrexate was proposed to be a safe and effective method for treating malignant ascites.Our study may provide at the first time evidence for the clinical application of tumor vesicles in tumor therapy.展开更多
Land has always been an indispensable element in farmers’ production activities,and it is the root of farmers’ survival. Under the background of rural revitalization,land transfer has become an important means of bo...Land has always been an indispensable element in farmers’ production activities,and it is the root of farmers’ survival. Under the background of rural revitalization,land transfer has become an important means of boosting rural revitalization. In the process of implementing the rural revitalization strategy,how to effectively solve the problems in rural land transfer,such as fragmentation,decentralization,low utilization rate,breach of contracts and difficult financing,is an important aspect of promoting rural modernization. In this paper,the literature on land transfer at home and abroad is sorted out,the current research status and the problems of land transfer under the background of rural revitalization are summarized and consolidated,and corresponding solutions and prospects are put forward. This is of practical significance to further study the land transfer under the background of rural revitalization in China.展开更多
Background and Aims:Great efforts have been made towards increasing our understanding of the pathogenesis involved in hepatocellular carcinoma(HCC),but the rapid growth inherent to such tumor development remains to be...Background and Aims:Great efforts have been made towards increasing our understanding of the pathogenesis involved in hepatocellular carcinoma(HCC),but the rapid growth inherent to such tumor development remains to be explored.Methods:We identified distinct gene coexpression modes upon liver tumor growth using weighted gene coexpression network analysis.Modeling of tumor growth as signaling activity was employed to understand the main cascades responsible for the growth.Hub genes in the modules were determined,examined in vitro,and further assembled into the growth signature.Results:We revealed modules related to the different growth states in HCC,especially the fastest growth module,which is preserved among different HCC cohorts.Moreover,signaling flux in the cell cycle pathway was found to act as a driving force for rapid growth.Twenty hub genes in the module were identified and assembled into the growth signature,and two genes(NCAPH,and RAD54L)were tested for their growth potential in vitro.Genetic alteration of the growth signature affected the global gene expression.The activity of the signature was associated with tumor metabolism and immunity in HCC.Finally,the prognosis effect of the growth signature was reproduced in nine cancers.Conclusions:These results collectively demonstrate the molecule organization of rapid tumor growth in HCC,which is a highly synergistic process,with implications for the future management of patients.展开更多
Locomotion in mollusc Aplysia is implemented by a pedal rolling wave,a type of axial locomotion.Well-studied examples of axial locomotion(pedal waves in Drosophila larvae and body waves in leech,lamprey,and fish)are g...Locomotion in mollusc Aplysia is implemented by a pedal rolling wave,a type of axial locomotion.Well-studied examples of axial locomotion(pedal waves in Drosophila larvae and body waves in leech,lamprey,and fish)are generated in a segmented nervous system via activation of multiple coupled central pattern generators(CPGs).Pedal waves in molluscs,however,are generated by a single pedal ganglion,and it is unknown whether there are single or multiple CPGs that generate rhythmic activity and phase shifts between different body parts.During locomotion in intact Aplysia,bursting activity in the parapedal commissural nerve(PPCN)was found to occur during tail contraction.A cluster of 20 to 30 P1 root neurons(P1Ns)on the ventral surface of the pedal ganglion,active during the pedal wave,were identified.Computational cluster analysis revealed that there are 2 phases to the motor program:phase I(centered around 168°)and phase II(centered around 357°).PPCN activity occurs during phase II.The majority of P1Ns are motoneurons.Coactive P1Ns tend to be electrically coupled.Two classes of pedal interneurons(PIs)were characterized.Class 1(PI1 and PI2)is active during phase I.Their axons make a loop within the pedal ganglion and contribute to locomotor pattern generation.They are electrically coupled to P1Ns that fire during phase I.Class 2(PI3)is active during phase II and innervates the contralateral pedal ganglion.PI3 may contribute to bilateral coordination.Overall,our findings support the idea that Aplysia pedal waves are generated by a single CPG.展开更多
基金supported by grants from the Key R&D Program of Zhejiang(2022C03163)the National Natural Science Foundation of China(82072148).
文摘Background:In the overall surgical population,inadvertent perioperative hypothermia has been associated with an increased incidence of surgical site infection(SSI).However,recent clinical trials did not validate this notion.This study aimed to investigate the potential correlation between inadvertent perioperative hypothermia and SSIs following liver resection.Methods:This retrospective cohort study included all consecutive patients who underwent liver resection between January 2019 and December 2021 at the First Affiliated Hospital,Zhejiang University School of Medicine.Perioperative temperature managements were implemented for all patients included in the analysis.Estimated propensity score matching(PSM)was performed to reduce the baseline imbalances between the normothermia and hypothermia groups.Before and after PSM,univariate analyses were performed to evaluate the correlation between hypothermia and SSI.Multivariate regression analysis was performed to determine whether hypothermia was an independent risk factor for postoperative transfusion and major complications.Subgroup analyses were performed for diabetes mellitus,age>65 years,and major liver resection.Results:Among 4000 patients,2206 had hypothermia(55.2%),of which 150 developed SSI(6.8%).PSM yielded 1434 individuals in each group.After PSM,the hypothermia and normothermia groups demonstrated similar incidence rates of SSI(7.0%vs.6.3%,P=0.453),postoperative transfusion(13.7%vs.13.3%,P=0.743),and major complications(10.1%vs.9.0%,P=0.309).Univariate regression analysis revealed no significant effects of hypothermia on the incidence of SSI in the group with the highest hypothermia exposure[odds ratio(OR)=1.25,95%confidence interval(CI):0.84-1.87,P=0.266],the group with moderate exposure(OR=1.00,95%CI:0.65-1.53,P=0.999),or the group with the lowest exposure(OR=1.11,95%CI:0.73-1.65,P=0.628).The subgroup analysis revealed similar results.Regarding liver function,patients in the hypothermia group demonstrated lowerγ-glutamyl transpeptidase(37 vs.43 U/L,P<0.001)and alkaline phosphatase(69 vs.72 U/L,P=0.016).However,patients in the hypothermia group exhibited prolonged activated partial thromboplastin time(29.2 vs.28.6 s,P<0.001).Conclusions:In our study of patients undergoing liver resection,we found no significant association between mild perioperative hypothermia and SSI.It might be due to the perioperative temperature managements,especially active warming measures,which limited the impact of perioperative hypothermia on the occurrence of SSI.
基金Supported by the Construction Project of Party Branch Secretary’s Studio of "Double Leader" Teachers in Colleges and Universities of the Ministry of Education of ChinaThe Project of Party Construction Research of Yunnan University of Finance and Economics
文摘The introduction of third-party evaluation system and the implementation of third-party evaluation system in poverty alleviation is a major innovation in the targeted poverty alleviation work in China.In order to improve the third-party evaluation mechanism,further improve the efficiency of third-party evaluation,and enhance the effectiveness of targeted poverty alleviation,this paper analyzes and summarizes the main problems existing in the current third-party evaluation practice.In view of the related problems,this paper puts forward the corresponding policy recommendations,which are believed to play a positive role in further promoting the development and improvement of the third-party evaluation of getting rid of poverty.
基金Supported by Construction Project of Party Branch Secretary’s Studio of "Double Leader" Teachers in Colleges and Universities of the Ministry of Education of ChinaProject of Party Construction Research of Yunnan University of Finance and Economics
文摘Poverty alleviation through employment promotion is to promote the poor households to get rid of poverty through promoting employment to increase income. It is the most effective and direct way out of poverty. Dongchuan District, located in the alpine valley area of northeastern Yunnan, is a typical extreme poverty-stricken county in China. Under its jurisdiction, Awang Town is a mountainous township with a wide area of poverty and an extreme poverty. The incidence of poverty in 2015 reached 35.39%. In recent years, through the implementation of various policies to combat poverty, combined with the advantages as a traditional "hometown of migrant labor", focusing on employment- promoting poverty alleviation work, Awang Town has made certain achievements in poverty alleviation work. By the end of 2018, the poverty rate in the town fell to 0.57%, marking a major victory in the town s fight against poverty. Through field investigations, this article summarizes the main practices of Awang Town to carry out employment-promoting targeted poverty alleviation, analyzes the poverty alleviation achievements and successful experience of the town s employment-promoting targeted poverty alleviation work and discusses the promotion and application of this model so as to provide reference Yunnan Province and other poverty-stricken areas to carry out employment-promoting poverty alleviation.
基金supported in part by the National Natural Science Foundation of China under Grant 62271399 and 62206221in part by the Key Research and Development Program of Shaanxi Province under Grant 2022KW-07+1 种基金in part by National Key Research and Development Program of China under Grant 2020YFB1807003in part by the Shanghai Sailing Program under Grant 20YF1416700。
文摘In this paper,we study an Intelligent Reflecting Surface(IRS)assisted Mobile Edge Computing(MEC)system under eavesdropping threats,where the IRS is used to enhance the energy signal transmission and the offloading performance between Wireless Devices(WDs)and the Access Point(AP).Specifically,in the proposed scheme,the AP first powers all WDs with the wireless power transfer through both direct and IRS-assisted links.Then,powered by the harvested energy,all WDs securely offload their computation tasks through the two links in the time division multiple access mode.To determine the local and offloading computational bits,we formulate an optimization problem to jointly design the IRS's phase shift and allocate the time slots constrained by the security and energy requirements.To cope with this non-convex optimization problem,we adopt semidefinite relaxations,singular value decomposition techniques,and Lagrange dual method.Moreover,we propose a dichotomy particle swarm algorithm based on the bisection method to process the overall optimization problem and improve the convergence speed.The numerical results illustrate that the proposed scheme can boost the performance of MEC and secure computation rates compared with other IRS-assisted MEC benchmark schemes.
文摘Although most of the 5-axis NC milling machine tool producers declare that their machine poses the function of 5-axis simultaneous machining, and most of the commercialized CAD/CAM software was reported it can support the 5-axis simultaneous machining, but there are very few analyses about their machining efficiency. I hope that the reader would be interested to know how the new method is?highly effective. The paper did a good job in motivating the problem mentioned here. The model of this paper is extremely efficient ant. This is a highly effective way of surface machining. There are also some areas that need improving. The mathematic presentation is not clear, but much more pages are needed, if the authors like to make it clearer. In the resent paper “The Extreme Efficiency of the New Model in Milling of Complicated Surfaces” we discussed the extreme efficiency of the new model in milling of complicated surfaces in 5-axis machining for 2-dimensional contact. While this time let’s discuss the same problem but much complicated one, 5-axis machining for 3-dimensional contact. As the research activities conducted by Dr. Liu Huran opened a new field and wide horizons in 5-axis machining of sculptured complicated surfaces using mathematical theories, and according to the interesting results presented in paper, Dr. Liu Huran is strongly encouraged if he can submit a similar work but this time with a new title that corresponds to the purpose [1].
文摘Background:Cancerous ascites is a common and severe complication that occurs in patients with late-stage malignant tumors.The prognosis of cancerous ascites is poor,clinical treatment is difficult and therapeutic outcome is disappointing.In the present study,tumor cell-derived vesicles were used as drug delivery vehicles that encapsulated a chemotherapeutic agent and were perfused into a patients’abdominal cavity to effectively kill the cancer cells in cancerous ascites.Pre-clinical data has demonstrated that tumor vesicles that carry low-dose chemotherapeutics can efficiently eliminate metastatic tumor cells in the abdominal cavity with minimal toxic or adverse effects.When combined,tumor cell-derived vesicles can sensitize tumor cells,which facilitates the entry of chemotherapeutics into tumor cells,thereby enhancing killing of tumor cells and limiting the risk of drug resistance.In this study,we designed a clinical trial to evaluate the safety and efficacy of intraperitoneal perfusion with tumor vesicle-encapsulated methotrexate for the treatment of cancerous ascites.Methods:Sixty patients with cancerous ascites were enrolled in this open,randomized and controlled clinical trial.Participants were randomly assigned a visit number and,according to their visiting order for which a random numerical table was used,were assigned to the trial group or the control group in a 1:1 ratio.The change in ascetic volume was used as the study outcome and adverse events were monitored during the entire length of the study.Conclusion:In this clinical trial,randomization and electronic case report forms were implemented.The trial indicated that tumor vesicle-encapsulated methotrexate was proposed to be a safe and effective method for treating malignant ascites.Our study may provide at the first time evidence for the clinical application of tumor vesicles in tumor therapy.
文摘Land has always been an indispensable element in farmers’ production activities,and it is the root of farmers’ survival. Under the background of rural revitalization,land transfer has become an important means of boosting rural revitalization. In the process of implementing the rural revitalization strategy,how to effectively solve the problems in rural land transfer,such as fragmentation,decentralization,low utilization rate,breach of contracts and difficult financing,is an important aspect of promoting rural modernization. In this paper,the literature on land transfer at home and abroad is sorted out,the current research status and the problems of land transfer under the background of rural revitalization are summarized and consolidated,and corresponding solutions and prospects are put forward. This is of practical significance to further study the land transfer under the background of rural revitalization in China.
基金supported by the National Natural Science Foundation of China(No.81772520)Zhejiang Provincial Natural Science Foundation(No.LGF19H030004)+1 种基金Zhejiang Medical and Health Technology Project(No.2018PY039)and Hangzhou Science and Technology Project(No.2017A36,20180533B46).
文摘Background and Aims:Great efforts have been made towards increasing our understanding of the pathogenesis involved in hepatocellular carcinoma(HCC),but the rapid growth inherent to such tumor development remains to be explored.Methods:We identified distinct gene coexpression modes upon liver tumor growth using weighted gene coexpression network analysis.Modeling of tumor growth as signaling activity was employed to understand the main cascades responsible for the growth.Hub genes in the modules were determined,examined in vitro,and further assembled into the growth signature.Results:We revealed modules related to the different growth states in HCC,especially the fastest growth module,which is preserved among different HCC cohorts.Moreover,signaling flux in the cell cycle pathway was found to act as a driving force for rapid growth.Twenty hub genes in the module were identified and assembled into the growth signature,and two genes(NCAPH,and RAD54L)were tested for their growth potential in vitro.Genetic alteration of the growth signature affected the global gene expression.The activity of the signature was associated with tumor metabolism and immunity in HCC.Finally,the prognosis effect of the growth signature was reproduced in nine cancers.Conclusions:These results collectively demonstrate the molecule organization of rapid tumor growth in HCC,which is a highly synergistic process,with implications for the future management of patients.
基金the National Natural Science Foundation of China(grants 32171011,62250004,32100816,62050071,31861143036,31671097,and 31371104)Natural Science Foundation of Jiangsu Province(grant BK20210183)the National Institutes of Health of USA(grants NS066587 and NS118606)。
文摘Locomotion in mollusc Aplysia is implemented by a pedal rolling wave,a type of axial locomotion.Well-studied examples of axial locomotion(pedal waves in Drosophila larvae and body waves in leech,lamprey,and fish)are generated in a segmented nervous system via activation of multiple coupled central pattern generators(CPGs).Pedal waves in molluscs,however,are generated by a single pedal ganglion,and it is unknown whether there are single or multiple CPGs that generate rhythmic activity and phase shifts between different body parts.During locomotion in intact Aplysia,bursting activity in the parapedal commissural nerve(PPCN)was found to occur during tail contraction.A cluster of 20 to 30 P1 root neurons(P1Ns)on the ventral surface of the pedal ganglion,active during the pedal wave,were identified.Computational cluster analysis revealed that there are 2 phases to the motor program:phase I(centered around 168°)and phase II(centered around 357°).PPCN activity occurs during phase II.The majority of P1Ns are motoneurons.Coactive P1Ns tend to be electrically coupled.Two classes of pedal interneurons(PIs)were characterized.Class 1(PI1 and PI2)is active during phase I.Their axons make a loop within the pedal ganglion and contribute to locomotor pattern generation.They are electrically coupled to P1Ns that fire during phase I.Class 2(PI3)is active during phase II and innervates the contralateral pedal ganglion.PI3 may contribute to bilateral coordination.Overall,our findings support the idea that Aplysia pedal waves are generated by a single CPG.
