Clinical efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for large kidney stones:A retrospective comparative study

BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.

A Study on the Association Between Siglec-1 Gene Polymorphism and Susceptibility in Patients with Chronic Obstructive Pulmonary Disease in Luohe Area

Objective:To analyze the association between Siglec-1 gene polymorphism and susceptibility to chronic obstructive pulmonary disease(COPD)in the population of the Luohe area.Methods:A case-control study(150 COPD patients and 150 healthy controls)was conducted to analyze the Siglec-1 allele in two groups of individuals using single nucleotide polymorphism(SNP)high-throughput detection technology,and the frequencies of each allele were compared.Results:The frequency of rs611847 heterozygous A/G genotype in COPD patients was significantly lower in females than in healthy controls(OR=0.282,95%CI=0.085-0.938,P=0.039);among smokers,the frequency of rs3859664 and rs6084444 genotypes in COPD patients was significantly higher than that in the healthy control group(OR=2.028,95%CI=1.111-3.704,P=0.021;OR=1.836,95%CI=1.033-3.262,P=0.038).Conclusion:Among the COPD population in the Luohe area,there is a significant correlation between the genotypes of three SNPs loci,rs3859664,rs6084444,and rs611847 and susceptibility to COPD in different subgroups of the population.The rs3859664 A/G-A/A and rs6084444 A/G-G/G genotypes can increase the risk of COPD in smokers;the rs611847 heterozygous A/G genotype can reduce the risk of COPD in both female and smoking populations.

宁夏胃癌病例流行现状及预后5022例分析

背景宁夏地处我国西北,是我国胃癌(gastric cancer,GC)的高发区,GC位于宁夏地区恶性肿瘤死亡原因首位.但目前关于宁夏地区GC患者流行现状、分布特征及预后的大样本量的流行病学资料非常有限.目的回顾性分析5022例宁夏籍GC住院患者的临床病理资料,了解宁夏地区GC流行现状,明确影响其预后的独立危险因素.方法收集2009年至2017年在宁夏医科大学总医院住院治疗的5022例宁夏籍GC患者的临床病理资料及预后生存信息.以患者确诊日期为观察起点,以因GC死亡日期为观察终点,随访截止日期为2019-01-24,建立数据库.一般人口学资料及临床病理资料描述用率表示.Kaplan-Meier法计算中位生存时间,生存分析组间比较用log-rank法,Cox比例风险模型分析GC患者预后影响因素.通过计算危险比和95%CI计算相对风险.分析GC在该地区的流行现状,明确影响其预后的主要危险因素.结果5022例宁夏籍GC患者中,男性3888例(77.4%),女性1134例(22.6%),男女比为3.43:1,年龄范围为15-93岁,中位年龄为61(15)岁;1734例患者因GC死亡,死亡率为34.5%.GC患者死亡率随年龄增加呈增长的趋势;单因素生存分析显示,年龄、肿瘤(Tumor-Node-Metastasis,TNM)分期、肿瘤位置、大小、分化程度等是宁夏籍GC患者预后的独立危险因素,手术和术后放化疗是其保护因素;Cox生存分析显示,年龄、TNM分期、肿瘤位置、大小、分化程度均是GC患者预后的危险因素,手术和术后放化疗是其保护因素(P<0.01).结论宁夏地区GC患者以男性和老年患者为主;宁夏地区GC患者整体死亡率较高,预后较差;年龄、TNM分期、肿瘤位置等均是该地区GC患者预后的独立危险因素,手术和术后放化疗是其保护因素.

Mapping rapeseed planting areas using an automatic phenology-and pixel-based algorithm(APPA) in Google Earth Engine

The timely and rapid mapping of rapeseed planting areas is desirable for national food security. Most current rapeseed mapping methods depend strongly on images with good observations obtained during the flowering stages. Although vegetation indices have been proposed to identify the rapeseed flowering stage in some areas, automatically mapping rapeseed planting areas in large regions is still challenging.We developed an automatic phenology-and pixel-based algorithm(APPA) by integrating Landsat 8 and Sentinel-1 satellite data. We found that the Normalized Rapeseed Flowering Index shows unique spectral characteristics during the flowering and post-flowering periods, which distinguish rapeseed parcels from other land-use types(urban, water, forest, grass, maize, wheat, barley, and soybean). To verify the robustness of APPA, we applied APPA to seven areas in five rapeseed-producing countries with flowering images unavailable. The rapeseed maps by APPA showed consistently high accuracies with producer accuracies of 0.87–0.93 and F-scores of 0.92–0.95 based on 4503 verification samples. They showed high spatial consistency at the pixel level with the land cover Scientific Expertise Centres(SEC) map in France,Crop Map of England in United Kingdom, national-scale crop-and land-cover map of Germany, and Annual Crop Inventory in Canada at the pixel level. We propose APPA as a highly promising method for automatically and efficiently mapping rapeseed areas.

A case of small intestinal hemorrhage secondary to metastatic lung cancer in the elderly

Gastrointestinal metastasis from primary lung cancer is rare. In the present study, we report the case of a 78-year-old male who was admitted to the emergency department with acute bleeding of the digestive tract. During evaluation, he was found to have lung adenocarcinoma metastasis in the small bowel leading to hemorrhage. A jejunum wedge resection was carried out and bleeding was controlled. However, 2 months after the operation, the patient died from severe pulmonary infection. We also review the published literature of primary lung cancer with gastrointestinal metastasis.

Relationship between sKL, BSP and HD abdominal aortic calcification and prognosis

Objective: To investigate the relationship between the expression levels of sKL and BSP and the calcification and prognosis of abdominal aorta in patients with HD. Methods: 130 patients with HD admitted to our hospital between January 2015 and June 2017 were selected as the research subjects;all patients were treated with Fresenius hemodialysis machine for intervention treatment;the expression levels of sKL and BSP in the patients' blood were monitored, and 30 mmonths were followed up The extent of calcification of the abdominal aorta and the quality of the prognosis of the patients were evaluated and the relationship between the expression levels of sKL and BSP and the calcification and prognosis of the abdominal aorta were analyzed. Results: The levels of sKL and BSP in the blood of patients with different degrees of abdominal aortic calcification were significantly different, and the differences were statistically significant (P <0.05). Among the patients with mild or no calcification, the levels of sKL and BSP were the highest in the blood and those in the death group were the lowest. The sKL level was significantly lower than the survival group, and the BSP level was significantly higher than the survival group, and the differences were statistically significant (P <0.05);the survival rate of patients with high sKL expression was significantly better than that of patients with low sKL expression, and the survival rate of low BSP expression was significantly better High expression in BSP;high sKL and low BSP are independent protective factors affecting abdominal aortic calcification and prognostic quality in HD patients (P <0.05);combined use of sKL and BSP in predicting the prognostic quality of HD patients is sensitive and specific Both are greater than 90%, and AUC> 0.90. Conclusions:High sKL and low BSP in the blood of HD patients are independent protective factors affecting abdominal aortic calcification and prognostic quality. The combined application of sKL and BSP can effectively predict the prognostic quality value of patients.

Factors influencing Medication Literacy in Chinese Children with Nephrotic Syndrome: insights from the MLS-22 scale

Background:The role of the patient’s medication literacy is crucial in ensuring the efficacy of the treatment for nephrotic syndrome(NS).It is imperative to identify and examine instances of inadequate medication literacy in order to effectively manage NS.This study aimed to detect the low medication literacy in Chinese NS children using the 22-item Medication Literacy Scale(MLS-22)and to further analyze its influencing factors.Methods:This study involved consecutive sampling of 157 Chinese children with NS.Interviewer-led questionnaires were used to collect data.Firstly,the MLS-22 was evaluated for reliability and validity.Secondly,the medication literacy level was assessed,and factors related to low scores were examined using a multivariate logistic regression model.Results:MLS-22 proved reliable and valid for detection at a low level in NS children.The tertile was divided into low-level and medium/high-level medication literacy.It was found that the scores of NS children averaged 13.06.Multivariate logistic regression analysis revealed that parents of children with primary NS and congenital NS had lower medication literacy scores,which were related to parents with less than high school education.Conclusions:Healthcare providers should develop tailored strategies to effectively assist Chinese children with limited medication literacy in managing chronic diseases.

A prompt-based approach to adversarial example generation and robustness enhancement

Recent years have seen the wide application of natural language processing(NLP)models in crucial areas such as finance,medical treatment,and news media,raising concerns about the model robustness and vulnerabilities.We find that prompt paradigm can probe special robust defects of pre-trained language models.Malicious prompt texts are first constructed for inputs and a pre-trained language model can generate adversarial examples for victim models via mask-filling.Experimental results show that prompt paradigm can efficiently generate more diverse adversarial examples besides synonym substitution.Then,we propose a novel robust training approach based on prompt paradigm which incorporates prompt texts as the alternatives to adversarial examples and enhances robustness under a lightweight minimax-style optimization framework.Experiments on three real-world tasks and two deep neural models show that our approach can significantly improve the robustness of models to resist adversarial attacks.

Watertight surface reconstruction method for CAD models based on optimal transport

Feature-preserving mesh reconstruction from point clouds is challenging.Implicit methods tend to fit smooth surfaces and cannot be used to reconstruct sharp features.Explicit reconstruction methods are sensitive to noise and only interpolate sharp features when points are distributed on feature lines.We propose a watertight surface reconstruction method based on optimal transport that can accurately reconstruct sharp features often present in CAD models.We formalize the surface reconstruction problem by minimizing the optimal transport cost between the point cloud and the reconstructed surface.The algorithm consists of initialization and refinement steps.In the initialization step,the convex hull of the point cloud is deformed under the guidance of a transport plan to obtain an initial approximate surface.Next,the mesh surface was optimized using operations including vertex relocation and edge collapses/fips to obtain feature-preserving results.Experiments demonstrate that our method can preserve sharp features while being robust to noise and missing data.

Meta-analysis of the effect of low-level occupational benzene exposure on human peripheral blood leukocyte counts in China

To investigate the effect of low-level occupational benzene exposure on human peripheral blood leukocyte counts of the workers,domestic and foreign published research data on the change of human peripheral blood leukocyte counts under low-level occupational benzene exposure from January 1990 to December 2020 were collected and analyzed.According to the literature inclusion and exclusion criteria,18 independent studies from 12 publications were selected for meta-analysis to explore the effect of low-level occupational benzene exposure on human peripheral blood leukocyte counts.The results showed that the peripheral blood leukocyte counts abnormal rates of low-level occupational benzene exposure group were higher than those of the control group,and the difference was statistically significant.Low-level occupational benzene exposure could result in a relatively higher abnormal rate of peripheral blood leukocyte counts in the exposed population,indicating that low-level occupational benzene exposure at workplaces specified by the current benzene occupational exposure limit in China would affect the peripheral blood leukocyte counts of the workers,thus benzene with concentrations under the limit in the ambient air of workplace could be still harmful to the health of the exposed workers.The results of this study could provide a scientific basis for future revision of the benzene occupational exposure limit in China,and could also be a reference for the formulation of environmental standard concerning benzene in China in the future.

Non-uniform B-spline curves with multiple shape parameters

We introduce a kind of shape-adjustable spline curves defined over a non-uniform knot sequence.These curves not only have the many valued properties of the usual non-uniform B-spline curves,but also are shape adjustable under fixed control polygons.Our method is based on the degree elevation of B-spline curves,where maximum degrees of freedom are added to a curve parameterized in terms of a non-uniform B-spline.We also discuss the geometric effect of the adjustment of shape parameters and propose practical shape modification algorithms,which are indispensable from the user's perspective.

Dating recent sediments from the subaqueous Yangtze Delta and adjacent continental shelf,China

In this study we analyzed sediment lithology,fallout of 210Pb and 137Cs,and spheroidal carbonaceous particles(SCPs) for two short cores,YZE and CX38,obtained by gravity corer from the Yangtze River mouth offshore and adjacent continental shelf,to compare geochronological methods on the recent sediments of this area.Lithology and grain size changes in YZE suggested the re-discharging of the North Channel of the Yangtze River mouth by flood events during 1949-1954 and associated accretion in the offshore area.This event was validated by a remarkable zone of declination in both 137Cs and 210Pb activities and the absolute ages derived from the 137Cs and SCPs.In contrast,210Pb results show obvious disturbance of grain size by sediment mixing and cannot be interpreted above 100 cm.In CX38,absolute ages for the early-and mid-1950s were derived by the 137Cs and the SCP profile respectively,which occurred in a reasonable sequence.The excess 210Pb distribution shows exponentially decreasing activities with depth,and the mean sedimentation rate agrees roughly with the one inferred from the SCP profile.We suggest that the limitation of the 210Pb method needs consideration while the SCP profile has the potential to provide a useful and independent dating method for recent Yangtze offshore and adjacent shelf sediments.

Spatiotemporal patterns of winter wheat phenology and its climatic drivers based on an improved pDSSAT model

Acquiring spatiotemporal patterns of phenological information and its drivers is essential for understanding the response of crops to climate change and implementing adaptation measures.However,current approaches to obtain phenology and analyse its drivers have deficiencies such as sparse observations,excessive dependence of remote sensing inversion on sensors,and inevitable difficulties in upscaling site-based crop models into larger regions.Based on the Wang-Engel temperature response function,we improved the Crop Estimation through Resource and Environment Synthesis-Wheat(CERES-Wheat)model.First,we calibrated the model at the regional scale and evaluated its performance.Furthermore,the spatiotemporal changes in winter wheat phenology in China from 2000 to 2015 were analysed.The results showed that the improved model significantly enhanced the simulation accuracy of the anthesis and maturity dates by averages of 13%and 12%in most planting areas,especially in the Yunnan-Guizhou Plateau(YG)with improvements of 26%and 28%.The simulated phenology of winter wheat grown in a colder environment(e.g.,the average temperatures during the vegetative growth period range from 0 to 5℃ and from 15 to 20°C,and the reproductive growth period ranges from 10 to 15°C)also notably improved.These results confirmed that the original temperature response function indeed had limitations.Further analyses revealed that the key phenological dates and growth periods over the past 16 years were dominantly advanced and shortened.Specifically,the anthesis date,vegetative growth period(VGP),and reproductive growth period(RGP)indicated obviously spatial characteristics.For example,the anthesis date and VGP in the North China Plain(NCP)and the Middle-Lower Yangtze Plain(YZ)and the RGP in northwestern China(NW)showed opposite trends of delay and prolongation as comparing with the dominant patterns.Sensitivity analysis indicated that the key phenological dates and growth periods were advanced and shortened as the minimum(T_(min))and maximum temperatures(T_(max))rose,while they were postponed and prolonged with the increased precipitation.However,their responses to solar radiation did not show spatial consistency.Additionally,we found that the sensitivity of phenology to climatic factors differed across subregions.In particular,phenology in southwestern China and YG was more sensitive to T_(min),T_(max),and solar radiation than in the NCP and NW.Moreover,the sensitivity to precipitation in NW was higher than that in YZ.Totally,the improved crop model could provide more refined spatial characteristics of phenology at a large scale and benefit to explore its drivers more objectively.Furthermore,our results highlight that different planting areas should adopt suitable adaptation measures to cope with climate change impacts.Ultimately,the improved model is promising to enhance the accuracy of yield prediction and provide powerful tools for assessing regional climate change impact and adaptability.

Ray-triangular Bezier patch intersection using hybrid clipping algorithm

In this paper, we present a novel geometric method for efficiently and robustly computing intersections between a ray and a triangular Bezier patch defined over a triangular domain, called the hybrid clipping （HC） algorithm. If the ray pierces the patch only once, we locate the parametric value of the intersection to a smaller triangular domain, which is determined by pairs of lines and quadratic curves, by using a multi-degree reduction method. The triangular domain is iteratively clipped into a smaller one by combining a subdivision method, until the domain size reaches a prespecified threshold. When the ray intersects the patch more than once, Descartes＇ rule of signs and a split step are required to isolate the intersection points. The algorithm can be proven to clip the triangular domain with a cubic convergence rate after an appropriate preprocessing procedure. The proposed algorithm has many attractive properties, such as the absence of an initial guess and insensitivity to small changes in coefficients of the original problem. Experiments have been conducted to illustrate the efficacy of our method in solving ray-triangular Bezier patch intersection problems.

Combat data shift in few-shot learning with knowledge graph

Many few-shot learning approaches have been designed under the meta-learning framework, which learns from a variety of learning tasks and generalizes to new tasks. These meta-learning approaches achieve the expected performance in the scenario where all samples are drawn from the same distributions (i.i.d. observations). However, in real-world applications, few-shot learning paradigm often suffers from data shift, i.e., samples in different tasks, even in the same task, could be drawn from various data distributions. Most existing few-shot learning approaches are not designed with the consideration of data shift, and thus show downgraded performance when data distribution shifts. However, it is non-trivial to address the data shift problem in few-shot learning, due to the limited number of labeled samples in each task. Targeting at addressing this problem, we propose a novel metric-based meta-learning framework to extract task-specific representations and task-shared representations with the help of knowledge graph. The data shift within/between tasks can thus be combated by the combination of task-shared and task-specific representations. The proposed model is evaluated on popular benchmarks and two constructed new challenging datasets. The evaluation results demonstrate its remarkable performance.

H4-Boundedness of pullback attractor for a 2D non-Newtonian fluid flow

We prove the H4-boundedness of the pullback attractor for a two- dimensional non-autonomous non-Newtonian fluid in bounded domains.

Polygonal finite element-based content-aware image warping

Mesh-based image warping techniques typically represent image deformation using linear functions on triangular meshes or bilinear functions on rectangular meshes.This enables simple and efficient implementation,but in turn,restricts the representation capability of the deformation,often leading to unsatisfactory warping results.We present a novel,flexible polygonal finite element(poly-FEM)method for content-aware image warping.Image deformation is represented by high-order poly-FEMs on a content-aware polygonal mesh with a cell distribution adapted to saliency information in the source image.This allows highly adaptive meshes and smoother warping with fewer degrees of freedom,thus significantly extending the flexibility and capability of the warping representation.Benefiting from the continuous formulation of image deformation,our polyFEM warping method is able to compute the optimal image deformation by minimizing existing or even newly designed warping energies consisting of penalty terms for specific transformations.We demonstrate the versatility of the proposed poly-FEM warping method in representing different deformations and its superiority by comparing it to other existing state-ofthe-art methods.

戏曲舞台上的动物形

美育在中国文化里是一个很重要的"教化"。最原始的人类可以模仿动物装扮起舞,所以美育源于天性,眼之所及都是艺术。本篇文章梳理了戏曲艺术中的动物与大自然、与人类的和谐关系,以关注戏曲中的图形艺术所蕴含的传统文化精神。