Epidemiology and early screening strategies for colorectal cancer in China

China ranks the first worldwide in the number of new colorectal cancer(CRC) cases and CRC-related deaths. The increasing incidence of early-onset CRC in recent years highlights the challenges related to CRC screening and prevention. High-quality colonoscopy is the universally used gold standard for CRC screening. Risk assessment combined with a two-step screening strategy based on colonoscopy and non-invasive examinations was proven to be highly effective. However, systematic use of well-established risk factors associated with CRC, beyond age, could better identify those who might harbor advanced colorectal neoplasia, improve the diagnostic yield of current screening modalities, and optimize the selection of individuals who might benefit most from preventive strategies.“Personalization” and “Standardization” are the future development directions of CRC screening, from the initiation of screening in those at high risk for CRC to follow-up after treatment, which are the key to ensure the screening efficiency.

Clinical efficacy of combined skin acupuncture and external washing therapy of Zhuang nationality medicine in the treatment of chronic eczema

To evaluate the clinical efficacy of combined skin acupuncture and external washing therapy of Zhuang nationality medicine in the treatment of chronic eczema.Methods:One hundred and twenty patients with chronic eczema were randomly divided into an experimental group(60 cases)and a control group(60 cases).The experimental group was treated with skin acupuncture combined with external washing therapy,and the control group was treated with externally applied mometasone furoate cream.The patients’symptoms and total severity were scored and analyzed before and after the 4-week treatment.The symptoms scored included:erythema,papule/hard swelling,epidermal exfoliation,mossy lesion,exudation/scab,and pruritus.Clinical efficacy and adverse reactions were compared before and after the 4-week treatment.Results:Scores for the different kinds of skin derogation,pruritus symptoms,the eczema area,and severity index(EASI)were all reduced after the treatments.Pruritus symptoms and EASI scores in the experimental group were lower than those of the control group(P<0.05).The total effective rate in the experimental group was 81.03%,which was much higher than the 61.11%in the control group(Z=-2.391,P=0.017).Conclusion:The clinical efficacy of combined skin acupuncture and external washing therapy of Zhuang nationality medicine in the treatment of chronic eczema was better than that of mometasone furoate cream.

An Analysis on the Teaching Reform of the Basic Course of Zhuangyi Undergraduate Major

The basic course of Zhuangyi is a part of the undergraduate course which teaching content covers the basic theory of Zhuangyi,diagnosis of Zhuangyi,basic theory of traditional Chinese medicine,diagnostics of traditional Chinese medicine,anatomy of Western medicine and pathology.Whether we can lay a solid foundation for the professional knowledge of Zhuangyi is related to the ability of students to enter clinical posts.This paper explores the teaching method reform of basic courses of Zhuangyi,in order to cultivate high-level talents more suitable for the current social requirements.

Epidemiology and risk factors of colorectal cancer in China

In China, colorectal cancer(CRC) ranked fourth and fifth in the highest incidence and mortality rates of all malignancies in 2018, respectively. Although these rates are below the world average, China placed first worldwide in the number of new CRC cases and CRC-related deaths because of its comparatively large population. This disease represents a threat to the health of population and incurs a heavy economic burden on the society and individuals. CRC has various risk factors, including age, sex, lifestyle, genetic factors, obesity, diabetes, gut microbiota status, and precancerous lesions. Furthermore, incidence and mortality rates of CRC are closely related to socioeconomic development levels, varying according to regional and population characteristics. Prevention is the main strategy to reduce incidence and mortality rates of CRC. This can be achieved through strategies stimulating lifestyle changes, healthy diet habits, and early screening for high-risk individuals. To reduce the burden of CRC, public health officials should promote prevention and management of modifiable risk factors through national policies. The rising incidence and mortality rates of CRC in China may be timely curbed by clarifying specific epidemiological characteristics, optimizing early screening strategies, and strictly implementing diagnosis and treatment guidelines. Thus, this study aimed to collect and report the current research status on epidemiology and risk factors of CRC in China.

Experimental and clinical study of influence of high-frequency electric surgical knives on healing of abdominal incision

AIM： To study the influence of high-frequency electric surgical knives on healing of abdominal incision. METHODS： Two hundred and forty white rats were divided into 10^0, 10^2, 10^5, and 10^8 groups and rat models of abdominal operation were induced by using electric surgical knives and common lancets respectively. Then they were respectively given hypodermic injections of normal saline and 0.2 mL quantitative mixture of Escherichia coil, Staphylococcus aureus and Pseudornonas aeruginosa at a concentration of 10^2, 10^5 and 10^8. On the basis of the animal experiment, 220 patients undergoing abdominal operations （above type Ⅱ） were randomly allocated into one of following three groups： electric knife （EK, 93 cases）, electro-coagulation （EC, 55 cases） and control （72 cases）. High-frequency electric surgical knives were used to dissect abdominal tissues and electro-coagulation for hemostasis in EK group. Common lancets and electro-coagulation were applied in EC group. Common lancets and tieing silk suture were used in the controls. RESULTS： In all the groups except group 10^0, infection rate of incisional wounds made by electric surgical knives were remarkably higher than that with common lancets. Furthermore, there were significant differences in groups 10^2, 10^5, and 10^8 （P 〈 0.05）, but not in group 10^0 （P 〉 0.05） between EK and EC groups. Clinical studies showed a delayed wound healing in 16 cases （17.20%） in EK, 11 cases （16.36%） in EC and 2 cases （2.86%）in the control groups. A significant difference between EK and the control groups （χ^2= 8.57, P 〈 0.01）, and between EC and the control groups （χ^2 = 5.66, P 〈 0.05） was observed, but not between EK and EC （χ^2= 0.017, P 〉 0.05）. CONCLUSION： High-frequency electric knives may remarkably delay abdominal incision healing. Its application should be minimized so as to reduce the possibility of postoperative complications.

Mucinous adenocarcinoma:A unique clinicopathological subtype in colorectal cancer

Mucinous adenocarcinoma(MAC)is a unique clinicopathological subtype of colorectal cancer,which is characterized by extracellular mucinous components that comprise at least 50%of the tumor tissue.The clinical characteristics,molecular features,response to chemo-/radiotherapy,and prognosis of MAC are different from that of non-MAC(NMAC).MAC is more common in the proximal colon,with larger volume,higher T-stage,a higher proportion of positive lymph nodes,poorer tumor differentiation,and a higher proportion of peritoneal implants compared to NMAC.Although biopsy is the main diagnostic method for MAC,magnetic resonance imaging is superior in accuracy,especially for rectal carcinoma.The aberrant expression of mucins,including MUC1,MUC2 and MUC5AC,is a notable feature of MAC,which may be related to tumor invasion,metastasis,inhibition of apoptosis,and chemo-/radiotherapy resistance.The genetic origin of MAC is mainly related to BRAF mutation,microsatellite instability,and the CpG island methylator phenotype pathway.In addition,the poor prognosis of rectal MAC has been confirmed by various studies,and that of colonic MAC is still controversial.In this review,we summarize the epidemiology,clinicopathological characteristics,molecular features,methods of diagnosis,and treatments of MAC in order to provide references for further fundamental and clinical research.

Underwater wireless optical NOMA communication experiment system exploiting GaN-based micro-LED array grouping

This paper has proposed an experimental system for non-orthogonal multiple access(NOMA)wireless optical communication in challenging underwater turbulent environments,employing the gallium nitride(GaN)-based micro-LED array.This design of the GaN-based micro-LED array enables the independent transmission of signals from distinct data streams within the NOMA framework,facilitating direct optical power-domain superposition of NOMA signals.The experimental setup involves emulating oceanic turbulence channels,characterized by varying the level of scintillation intensity,to thoroughly investigate the bit error rate(BER)performance.The outcomes unequivocally demonstrate the superiority of our proposed NOMA scheme,as compared to conventional circuit-driven optical NOMA systems utilizing fixed LED array grouping,particularly in the presence of turbulent underwater channels.The proposed NOMA scheme exhibits consistently superior BER performance and maintains excellent linearity at the lower frequencies while effectively mitigating signal distortion at the higher frequencies.

Real-time UWOC miniaturized system based on FPGA and LED arrays and its application in MIMO

In order to alleviate the impact of turbulence on the performance of underwater wireless optical communication(UWOC)in real time,and achieve high-speed real-time transmission and low cost and miniaturization of equipment,a 2×2 real-time multiple-input and multiple-output(MIMO)high-speed miniaturized UWOC system based on a field-programmable gate array(FPGA)and a high-power light-emitting diode(LED)array is designed in this Letter.In terms of multiplexing gain,the imaging MIMO spatial multiplexing and high-order modulation for the first time are combined and the real-time high-speed transmission of PAM-4 signal based on the LED array light source in 12 m underwater channel at 100 Mbps rate is implemented,which effectively improves the throughput of the UWOC system with a high-power commercial LED light source.In light of diversity gain,the system employs the diversity of repeated coding scheme to receive two identical non-return-to-zero on-off keying(NRZ-OOK)signals,which can compensate the fading or flickering sublinks in real time under the bubble-like simulated turbulence condition,and has high robustness.To our knowledge,this is the first instance of a high rate and long-distance implementation of a turbulence-resistant real-time MIMO miniaturized UWOC system based on FPGA and high-power LED arrays.With spatial diversity or spatial multiplexing capabilities,its low cost,integrity,and high robustness provide the system with important practical prospects.

转子故障数据集降维的CKLPMDP算法研究

针对传统的数据降维方法难以兼顾局部流形结构和多流形判别结构学习的问题,提出一种相关熵测度核局部保持多流形判别投影算法(correntropy kernel locality preserving multi-manifold discriminant projection,CKLPMDP)的转子故障数据集降维方法。该方法的显著特点是采用相关熵测度监督近邻图的构建,首先将数据集映射到高维核空间,然后在核空间中综合考虑数据集的局部流形结构和多流形判别结构信息,提取出最优表征故障数据集的低维敏感特征矢量,采用三维图直观地显示出低维分类效果,并以低维敏感特征矢量输入K近邻分类器(K-nearest neighbor,KNN)中的辨识率和聚类分析中类间距S_(b)、类内距S_(w)作为衡量降维效果的指标。通过双跨转子实验台的振动信号数据集进行验证,与其他几种典型特征提取方法对比,该方法能更有效地提取出局部流形和多流形判别信息,在转子故障辨识中表现出更好的分类性能。

Metagenomic and targeted metabolomic analyses reveal distinct phenotypes of the gut microbiota in patients with colorectal cancer and type 2 diabetes mellitus

Background:Type 2 diabetes mellitus(T2DM)is an independent risk factor for colorectal cancer(CRC),and the patients with CRC and T2DM have worse survival.The human gut microbiota(GM)is linked to the development of CRC and T2DM,respectively.However,the GM characteristics in patients with CRC and T2DM remain unclear.Methods:We performed fecal metagenomic and targeted metabolomics studies on 36 samples from CRC patients with T2DM(DCRC group,n=12),CRC patients without diabetes(CRC group,n=12),and healthy controls(Health group,n=12).We analyzed the fecal microbiomes,characterized the composition and function based on the metagenomics of DCRC patients,and detected the short-chain fatty acids(SCFAs)and bile acids(BAs)levels in all fecal samples.Finally,we performed a correlation analysis of the differential bacteria and metabolites between different groups.Results:Compared with the CRC group,LefSe analysis showed that there is a specific GM community in DCRC group,including an increased abundance of Eggerthella,Hungatella,Peptostreptococcus,and Parvimonas,and decreased Butyricicoccus,Lactobacillus,and Paraprevotella.The metabolomics analysis results revealed that the butyric acid level was lower but the deoxycholic acid and 12-keto-lithocholic acid levels were higher in the DCRC group than other groups(P<0.05).The correlation analysis showed that the dominant bacterial abundance in the DCRC group(Parvimonas,Desulfurispora,Sebaldella,and Veillonellales,among others)was negatively correlated with butyric acid,hyodeoxycholic acid,ursodeoxycholic acid,glycochenodeoxycholic acid,chenodeoxycholic acid,cholic acid and glycocholate.However,the abundance of mostly inferior bacteria was positively correlated with these metabolic acid levels,including Faecalibacterium,Thermococci,and Cellulophaga.Conclusions:Unique fecal microbiome signatures exist in CRC patients with T2DM compared to those with non-diabetic CRC.Alterations in GM composition and SCFAs and secondary BAs levels may promote CRC development.

Systematic assessment of cyber-physical security of lane keeping control system for autonomous vehicles

In this article,a systematic assessment of cyber-physical security is developed for the lane-keeping control(LKC)system of autonomous vehicles(AVs),which has not been attempted before.A novel impact analysis methodology for typical cyber-attacks is proposed with new evaluation metrics from the viewpoint of safety and performance and innovative index-based resilience and security criteria.Specifically,a security criterion is investigated by tracking performance,comfort and vehicle stability to evaluate the safety and security of the vehicle LKC system.Hardware-in-the-Loop(HiL)experimental results show that the proposed evaluation metrics are effective in analyzing the impact of cyberattacks on the commercial LKC system of Dongfeng Motor comprehensively.Finally,the conclusion provides guidelines for attack detection,diagnosis,and countermeasures for AVs.

“Watch and wait”strategy after neoadjuvant chemoradiotherapy in rectal cancer:opportunities and challenges

The"watch and wait"(W&W)strategy has been widely used in rectal cancer patients who have achieved clinical complete response(cCR)after neoadjuvant chemoradiotherapy(nCRT),which can save them from surgery and improve their quality of life.However,this strategy also has many unsolved practical problems,including the improvement of cCR/pCR rate,the search for efficient predictors,the standard follow-up and the methods of rescue surgery,etc.Larger sample size and more standardized clinical trials are still needed to obtain credible evidence.Therefore,we must rationally view the cCR after nCRT for middle and low rectal cancer,understand the risk of W&W strategy,and make a reasonable choice.It is particularly important to emphasize that we should actively carry out prospective multi-center clinical trials to produce high-level evidence suitable for Chinese characteristics,so that more rectal cancer patients can benefit from nCRT.