Effect of Shrinkage Reducing Agent and Steel Fiber on the Fluidity and Cracking Performance of Ultra-High Performance Concrete

Due to the low water-cement ratio of ultra-high-performance concrete(UHPC),fluidity and shrinkage cracking are key aspects determining the performance and durability of this type of concrete.In this study,the effects of different types of cementitious materials,chemical shrinkage-reducing agents(SRA)and steel fiber(SF)were assessed.Compared with M2-UHPC and M3-UHPC,M1-UHPC was found to have better fluidity and shrinkage cracking performance.Moreover,different SRA incorporation methods,dosage and different SF types and aspect ratios were implemented.The incorporation of SRA and SF led to a decrease in the fluidity of UHPC.SRA internal content of 1%(NSRA-1%),SRA external content of 1%(WSRA-1%),STS-0.22 and STE-0.7 decreased the fluidity of UHPC by 3.3%,8.3%,9.2%and 25%,respectively.However,SRA and SF improved the UHPC shrinkage cracking performance.NSRA-1%and STE-0.7 reduced the shrinkage value of UHPC by 40%and 60%,respectively,and increased the crack resistance by 338%and 175%,respectively.In addition,the addition of SF was observed to make the microstructure of UHPC more compact,and the compressive strength and flexural strength of 28 d were increased by 26.9%and 19.9%,respectively.

Fluid-Related Performances and Compressive Strength of Clinker-Free Cementitious Backfill Material Based on Phosphate Tailings

Phosphate tailings are usually used as backfill material in order to recycle tailings resources.This study considers the effect of the mix proportions of clinker-free binders on the fluidity,compressive strength and other key performances of cementitious backfill materials based on phosphate tailings.In particular,three solid wastes,phosphogypsum(PG),semi-aqueous phosphogypsum(HPG)and calcium carbide slag(CS),were selected to activate wet ground granulated blast furnace slag(WGGBS)and three different phosphate tailings backfill materials were prepared.Fluidity,rheology,settling ratio,compressive strength,water resistance and ion leaching behavior of backfill materials were determined.According to the results,when either PG or HPG is used as the sole activator,the fluidity properties of the materials are enhanced.Phosphate tailings backfill material activated with PG present the largest fluidity and the lowest yield stress.Furthermore,the backfill material’s compressive strength is considerably increased to 2.9 MPa at 28 days after WGGBS activation using a mix of HPG and CS,all with a settling ratio of only 1.15 percent.Additionally,all the three ratios of binder have obvious solidification effects on heavy metal ions Cu and Zn,and P in phosphate tailings.

Automated Machine Learning Algorithm Using Recurrent Neural Network to Perform Long-Term Time Series Forecasting

Long-term time series forecasting stands as a crucial research domain within the realm of automated machine learning(AutoML).At present,forecasting,whether rooted in machine learning or statistical learning,typically relies on expert input and necessitates substantial manual involvement.This manual effort spans model development,feature engineering,hyper-parameter tuning,and the intricate construction of time series models.The complexity of these tasks renders complete automation unfeasible,as they inherently demand human intervention at multiple junctures.To surmount these challenges,this article proposes leveraging Long Short-Term Memory,which is the variant of Recurrent Neural Networks,harnessing memory cells and gating mechanisms to facilitate long-term time series prediction.However,forecasting accuracy by particular neural network and traditional models can degrade significantly,when addressing long-term time-series tasks.Therefore,our research demonstrates that this innovative approach outperforms the traditional Autoregressive Integrated Moving Average(ARIMA)method in forecasting long-term univariate time series.ARIMA is a high-quality and competitive model in time series prediction,and yet it requires significant preprocessing efforts.Using multiple accuracy metrics,we have evaluated both ARIMA and proposed method on the simulated time-series data and real data in both short and long term.Furthermore,our findings indicate its superiority over alternative network architectures,including Fully Connected Neural Networks,Convolutional Neural Networks,and Nonpooling Convolutional Neural Networks.Our AutoML approach enables non-professional to attain highly accurate and effective time series forecasting,and can be widely applied to various domains,particularly in business and finance.

Dosimetric risk factors for radiation esophagitis in patients with breast cancer following regional nodal radiation

BACKGROUND Radiation esophagitis(RE)is one of the most common clinical symptoms of regional lymph node radiotherapy for breast cancer.However,there are fewer studies focusing on RE caused by hypofractionated radiotherapy(HFRT).AIM To analyze the clinical and dosimetric factors that contribute to the development of RE in patients with breast cancer treated with HFRT of regional lymph nodes.METHODS Between January and December 2022,we retrospectively analysed 64 patients with breast cancer who met our inclusion criteria underwent regional nodal intensity-modulated radiotherapy at a radiotherapy dose of 43.5 Gy/15F.RESULTS Of the 64 patients in this study,24(37.5%)did not develop RE,29(45.3%)developed grade 1 RE(G1RE),11(17.2%)developed grade 2 RE(G2RE),and none developed grade 3 RE or higher.Our univariable logistic regression analysis found G2RE to be significantly correlated with the maximum dose,mean dose,relative volume 20-40,and absolute volume(AV)20-40.Our stepwise linear regression analyses found AV30 and AV35 to be significantly associated with G2RE(P<0.001).The optimal threshold for AV30 was 2.39 mL[area under the curve(AUC):0.996;sensitivity:90.9%;specificity:91.1%].The optimal threshold for AV35 was 0.71 mL(AUC:0.932;sensitivity:90.9%;specificity:83.9%).CONCLUSION AV30 and AV35 were significantly associated with G2RE.The thresholds for AV30 and AV35 should be limited to 2.39 mL and 0.71 mL,respectively.

Accumulated Clinical Experiences from Successful Treatment of 1377 Severe and Critically Ill COVID-19 Cases

Summary:In late December 2019,COVID-19 was firstly recognized in Wuhan,China and spread rapidly to all of the provinces of China.The West Campus of Wuhan Union Hospital,the designated hospital to admit and treat the severe and critically ill COVID-19 cases,has treated a large number of such patients with great success and obtained lots of valuable experiences based on the Chinese guideline(V7.0).To standardize and share the treatment procedures of severe and critically ill cases,Wuhan Union Hospital has established a working group and formulated an operational recommendation,including the monitoring,early warning indicators,and several treatment principles for severe and critically ill cases.The treatment experiences may provide some constructive suggestions for treating the severe and critically ill COVID-19 cases all over the world.

Biological Effects of Sunflower Seeds Implanted by Carbon Ion

[ Objective ] This study aimed to investigate the effects of carbon ion implantation and implantation times on growth and genetic variation of sunflowers. [ Method] Carbon ions were implanted into Bakui 138, Bakui i36 and Bakui 118 seeds at dose of 5 - 10is C/cm2, before they were planted. Their Fl-generation seeds were irradiated again. Seeds of the both generations were planted and the growth d the seedlings was observed in field tests. Finally, their genetic variation was analyzed through RAPD. [ Result] The germination rate and several agronomic traits like plant height, stem diameter, leaf number and yields of Bakui 138 of once-irradiated group were significantly improved, while that of twice-irradiated group showed opposite trend. The variation of Bakui 136 and Bakui 118 was insig- nificant. At the molecular level, the genetic distance with the control group of once and twice-irradiated groups was 0. 111 1, 0. 108 7 in Bakui 138; 0. 068 O, O. 030 3 in Bakui 136 and 0.062 5,0.043 5 in Bakui 118. [Conclusion] Carbon ion implantation had a significant effect on the growth and development of Bakui 138, and the effect varied with irradiation times. Moreover, it caused genomic variation in the three sunflower cuhivars.

Experimental Synthesis of Polyacrylic-Type Superabsorbent Polymer and Analysis of Its Internal Curing Performances

A solution polymerization method has been used to synthesize a polyacrylic-type superabsorbent polymer(SAP).The influence of various influential factors,such as the temperature,neutralization degree,cross-linking agent,and initiator,on the water absorption capacity of SAP has been investigated.The results show that the absorption can display a non-monotonic behavior depending on the synthesis conditions.The absorption can also change according to the pH,ion types and ion concentration.As the pH value increases,the water absorption capacity decreases significantly.It also decreases if the N^(a+)concentration becomes higher and becomes particularly low in solutions containing Mg^(2+).With the addition of SAP,the compressive strength of cement mortar decreases;the internal relative humidity can be maintained at 96%within 200 hours;and autogenous shrinkage can be reduced by nearly 69%.

Assessment of iris volume in glaucoma patients with type 2 diabetes mellitus by AS-OCT

AIM:To examine the change of iris volume measured by CASIA2 anterior segment optical coherence tomography(ASOCT)in glaucoma patients with or without type 2 diabetes mellitus(T2DM)and explore if there is a correlation between hemoglobin A1c(HbA1c)level and iris volume.METHODS:In a cross-sectional study,72 patients(115 eyes)were divided into two groups:primary open angle glaucoma(POAG)group(55 eyes)and primary angle-closure glaucoma(PACG)group(60 eyes).Patients in each group were separately classified into patients with or without T2DM.Iris volume and glycosylated HbA1c level were measured and analyzed.RESULTS:In the PACG group,diabetic patients'iris volume was significantly lower than those of non-diabetics(P=0.02),and there was a significant correlation between iris volume and HbA1c level in the PACG group(r=-0.26,P=0.04).However,diabetic POAG patients'iris volume was noticeably higher than those of non-diabetics(P=0.01),and there was a significant correlation between HbA1c level and iris volume(r=0.32,P=0.02).CONCLUSION:Diabetes mellitus impact iris volume size,as seen by increased iris volume in the POAG group and decreased iris volume in the PACG group.In addition,iris volume is significantly correlated with HbA1c level in glaucoma patients.These findings imply that T2DM may compromise iris ultrastructure in glaucoma patients.

Preparation of antibacterial non-woven AgNCs@PP-g-PAA via radiation method

With the growing threat of airborne epidemics,there has been an increasing emphasis on personal protection.Masks serve as our primary external defense against bacteria and viruses that might enter the respiratory tract.Hence,it’s crucial to develop a polypropylene(PP)nonwoven fabric with quick antibacterial capabilities as a key component for masks.This study introduces silver nanoclusters(AgNCs)into non-woven PP using radiation technology to infuse antibacterial properties.Initially,a solid ligand(PP-g-PAA)was procured via radiation grafting of the ligand polyacrylic acid(PAA),which was incorporated into the nonwoven PP with the aid of a crosslinking agent at a lower absorbed dosage.Subsequently,AgNCs were synthesized in situ on PP-g-PAA via an interaction between PAA and AgNCs,leading directly to the formation of AgNCs@PP-g-PAA composites.Owing to the hydrophilicity of PAA,AgNCs@PP-g-PAA maintains good moisture permeability even when the voids are heavily saturated with PAA gel,preventing droplet aggregation by diffusing droplets on the surface of the material.This feature enhances the comfort of the masks.Most importantly,due to the incorporation of AgNCs,AgNCs@PP-g-PAA demonstrates outstanding antibacterial effects against Escherichia coli and Staphylococcus aureus,nearly achieving an instant“touch and kill”outcome.In conclusion,we synthesized a modified nonwoven fabric with significant antibacterial activity using a simple synthetic route,offering a promising material that provides improved personal protection.

Intravascular ultrasonography assisted carotid artery stenting for treatment of carotid stenosis: Two case reports

BACKGROUND Digital subtraction angiography(DSA),the gold standard of cerebrovascular disease diagnosis,is limited in its diagnostic ability to evaluate arterial diameter.Intravascular ultrasonography(IVUS)has advantages in assessing stenosis and plaque nature and improves the evaluation and effectiveness of carotid artery sten-ting(CAS).CASE SUMMARY Case 1:A 65-year-old man presented with a five-year history of bilateral lower limb weakness due to stroke.Physical examination showed decreased strength(5-/5)in both lower limbs.Carotid artery ultrasound,magnetic resonance angiography,and computed tomography angiography(CTA)showed a right proximal internal carotid artery(ICA)stenosis(70%-99%),acute cerebral infarction,and severe right ICA stenosis,respectively.We performed IVUS-assisted CAS to measure the stenosis and detected a low-risk plaque at the site of stenosis prior to stent implantation.Post-stent balloon dilatation was performed and postoperative IVUS demonstrated successful expansion and adherence.CTA six months postoperatively showed no significant increase in in-stent stenosis.Case 2:A 36-year-old man was admitted with a right common carotid artery(CCA)dissection detected by ultrasound.Physical examination showed no positive neurological signs.Carotid ultrasound and CTA showed lumen dilation in the proximal CCA with an intima-like structure and bulging in the proximal segment of the right CCA with strip-like low-density shadow(dissection or carotid web).IVUS-assisted DSA confirmed right CCA dissection.CAS was performed and intraoperative IVUS suggested a large residual false lumen.Post-stent balloon dilatation was performed reducing the false lumen.DSA three months postoperatively indicated good stent expansion with mild stenosis.CONCLUSION IVUS aids decision-making during CAS by accurately assessing carotid artery wall lesions and plaque nature preoperatively,dissection and stenosis morphology intraoperatively,and visualizing and confirming CAS postoperatively.

小梁网的干细胞移植治疗原发性开角型青光眼的研究进展

原发性开角型青光眼(primary open angle glaucoma,POAG)是以持续性眼压增高导致视神经损伤为主要临床表现的一种疾病,其发病机制复杂,尚未明确,现阶段临床治疗相对困难。影响眼内压(intraocular pressure,IOP)高低的重要因素是房水引流是否通畅,而房水引流途径中小梁网(trabecular meshwork,TM)起重要调控作用。TM细胞的形态、数量、结构和功能改变均可使房水外流阻力增大,从而导致IOP升高。研究证实诱导多功能干细胞(induced pluripotent stem cells,iPSCs)、骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)和脂肪干细胞(adipose-derived stem cells,ADSCs)已被用于TM细胞的分化和再生,为POAG小梁网的干细胞替代治疗提供可靠的细胞来源。近年研究发现,小梁网干细胞(trabecular meshwork stem cells,TMSCs)在分化为TM细胞方面具有绝对优势,为细胞移植治疗青光眼提供新的靶向,这标志着干细胞治疗POAG进入一个新纪元,为青光眼治疗带来新的曙光。本文将对不同种类干细胞的小梁网移植进行综述,为细胞移植治疗POAG提供新思路。

丙泊酚对小胶质细胞炎症因子的影响及其机制研究

目的探讨丙泊酚对小胶质细胞炎症因子的影响及其机制。方法将小胶质BV-2细胞分为对照组、丙泊酚组、脂多糖(LPS)组、LPS+丙泊酚组,对照组细胞加入PBS液,丙泊酚组细胞加入丙泊酚30μmol/L,LPS组细胞加入LPS 1μg/ml,LPS+丙泊酚组细胞加入丙泊酚30μmol/L+LPS 1μg/ml。采用MTT比色实验测定细胞活性,采用酶联免疫吸附法测定细胞上清液中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,采用逆转录-聚合酶链反应测定细胞p38MAPK和TLR4m RNA的表达,采用Western blot检测细胞p38MAPK和TLR4蛋白表达量。结果 LPS组和LPS+丙泊酚组小胶质细胞活性低于对照组和丙泊酚组(P<0.05),LPS+丙泊酚组小胶质细胞活性高于LPS组(P<0.05);LPS组和LPS+丙泊酚组小胶质细胞上清液中IL-1β、IL-6、TNF-α水平高于对照组和丙泊酚组(P<0.05),LPS+丙泊酚组小胶质细胞上清液中IL-1β、IL-6、TNF-α水平低于LPS组(P<0.05);LPS组和LPS+丙泊酚组小胶质细胞p38MAPK、TLR4 m RNA和蛋白表达量高于对照组和丙泊酚组(P<0.05),LPS+丙泊酚组小胶质细胞p38MAPK、TLR4 m RNA和蛋白表达量低于LPS组(P<0.05);丙泊酚组和对照组小胶质细胞各指标比较,差异无统计学意义(P>0.05)。结论丙泊酚能抑制小胶质细胞过度活化和炎症反应,其机制可能与丙泊酚可下调TLR4-p38MAPK信号通路有关。

Recombinant adenovirus-p53(Gendicine) sensitizes a pancreatic carcinoma cell line to radiation

Objective： In this study, we examine the effects of recombinant adenovirus-p53 （rAd-p53） on the pancreatic carcinoma cell line SW1990. Specifically, we determine if expression of rAd-p53 sensitizes these cells to radiation. Methods： Following transfection of SW1990 cells with rAd-p53, we measured expression of P53, P21 and Bax by immunocytochemistry. Both transfected and control cell lines were irradiated with a range of doses, and the survival fractions （SF） were calculated. Dose survival cttrves were constructed and modeled for comparison. Results： Transfection of SW1990 cells with rAd-p53 resulted in increased expression of P53, P21 and Bax in a time-dependent manner. At 96 h after transfection, 89.92% of cells expressed P53, 56.8% expressed P21, and 76.50% expressed Bax. The SF following radiation was lower in the rAd-p53 transfected cells compared to the control cells, suggesting that rAd-p53 sensitizes SW1990 cells to radiation （Do for the experimental and control groups was 2.199 and 2.462, respectively）. Conclusions： Use of the adenoviral vector is an effective means of transfecting SW1990 cells with wild-type P53, and this sensitizes the cell line to irradiation. This work suggests that combining rAd-p53 with radiation therapy in pancreatic cancer may be therapeutically beneficial.

microRNA-155在原发性开角型青光眼发病机制中的作用

microRNA在眼部组织有特定表达,对眼部组织发挥独特作用。microRNA-155可调控多种信号通路,影响相应蛋白的表达,导致细胞、组织的形态和功能等异常。原发性开角型青光眼的产生机制尚不完全明确,现认为小梁网的形态功能异常是引起眼内压升高的主要原因。研究microRNA-155对原发性开角型青光眼发生发展的影响,可以为原发性开角型青光眼的发病机制和诊治提供新的思路。

Progress in exosomes and their potential use in ocular diseases

Exosomes contain a variety of biological active substances such as proteins,miRNAs,lncRNAs and lipids,and exosomes from different cells play different biological functions.Exosomes,as a carrier,are involved in many pathological processes such as nerve injury and repair,vascular regeneration,immune response,and fibrosis formation.It plays an important role in the treatment of eye diseases such as glaucoma,diabetic retinopathy,and keratitis.This paper reviews the research progress of exosomes in various diseases in vivo,which provides a new way for the treatment of eye diseases.

Multi-cycle reconfigurable THz extraordinary optical transmission using chalcogenide metamaterials

Metamaterials composed of metallic antennae arrays are used as they possess extraordinary optical transmission(EOT)in the terahertz(THz)region,whereby a giant forward light propagation can be created using constructive interference of tunneling surface plasmonic waves.However,numerous applications of THz meta-devices demand an active manipula-tion of the THz beam in free space.Although some studies have been carried out to control the EOT for the THz region,few of these are based upon electrical modulation of the EOT phenomenon,and novel strategies are required for act-ively and dynamically reconfigurable EOT meta-devices.In this work,we experimentally present that the EOT resonance can be coupled to optically reconfigurable chalcogenide metamaterials which offers a reversible all-optical control of the THz light.A modulation efficiency of 88%in transmission at 0.85 THz is experimentally observed using the EOT metama-terials,which is composed of a gold(Au)circular aperture array sitting on a non-volatile chalcogenide phase change ma-terial(Ge2Sb2Te5)film.This comes up with a robust and ultrafast reconfigurable EOT over 20 times of switching,excited by a nanosecond pulsed laser.The measured data have a good agreement with finite-element-method numerical simula-tion.This work promises THz modulators with significant on/off ratios and fast speeds.

Preparation of PSFO and LPSFO nanofibers by electrospinning and their electronic transport and magnetic properties

Pr_(0.5)Sr_(0.5)FeO_(3)(PSFO)and La_(0.25)Pr_(0.25)Sr_(0.5)FeO_(3)(LPSFO)nanofibers are prepared by electrospinning followed by calcination,and their morphologies,microstructures,electronic transports,and magnetic properties are studied systematically.The temperature-dependent resistance curves of PSFO and LPSFO nanofibers are measured in a temperature range from 300 K to 10 K.With the temperature lowering,the resistance increases gradually and then decreases sharply due to the occurrence of ferromagnetic metal phase.The metal-insulator transition temperatures are about 110 K and 180 K for PSFO and LPSFO nanofibers,respectively.The electronic conduction behavior above the transition temperature can be described by one-dimensional Mott’s variable-range hopping(VRH)model.The hysteresis loops and the field-cooled(FC)and zero-field-cooled(ZFC)curves show that both PSFO nanofiber and LPSFO nanofiber exhibit ferromagnetism.Although the doping of La reduces the overall magnetization intensity of the material,it increases the ferromagnetic ratio of the system,which may improve the performance of LPSFO in solid oxide fuel cell.

Effect of purine-rich box1 on proliferation of fibroblasts

Fibroblasts are pleomorphic cells that have a multi­directional effect on organ morphogenesis,tissue homeostasis,and immune response.In fibrotic diseases,fibroblasts synthesize large amounts of extracellular matrix(ECM),leading to scarring and organ failure.Purine-rich boxl(PU.I)is a specific transcription factor of hematopoietic cell and belongs to the E26 transformation specificity(ETS)family.Recently,it was found that the transcription factor PU.I is an important regulatory factor of the profibrotic gene expression program.TGF-J3 had been proved to play an important role in many ocular tissue fibrosis diseases,and up-regulated the expression of PU.I in fibroblasts producing ECM in a Smad-3 dependent manner.We explore the effect of PU.I on fibrosis of different ocular tissues from this perspective.This article reviews the role of PU.l and its effects on fibrosis of ocular tissue and other tissues.

不同年龄段兔结膜淋巴管的分布

目的:探讨新西兰白兔结膜淋巴管的分布及其与年龄的关系。方法:将台盼蓝注射到兔眼四象限(鼻、上、颞、下象限)的结膜下形成含示踪剂囊泡,手术显微镜观察并录像;对含示踪剂囊泡引流的淋巴管数量进行计数,通过单因素方差分析分别检验各组各象限淋巴管数量的差异,并采用配对t检验比较不同年龄组同一象限内兔结膜淋巴管数目的差异。结果:新西兰白兔结膜中间部分分布有粗大环形淋巴管,单个收集淋巴管则主要分布在结膜周边部分。各年龄组内不同象限结膜淋巴管数量差异无统计学意义(均P>0.05),虽然与成年兔相比幼年兔结膜淋巴管分支较少,但两个年龄组之间淋巴管数量差异无统计学意义(均P>0.05)。结论:兔结膜内分布有丰富的淋巴管,不同象限和不同年龄的淋巴管数量差异无统计学意义。

胃癌细胞色素氧化酶CYP3A4基因多态性与含紫杉醇方案化疗敏感相关性的研究(英文)

Objective: The aim of the study was to investigate the relationship between susceptibility of paclitaxel-based regimen and gene polymorphisms of cytochrome oxidase CYP3A4 for advanced gastric cancer. Methods: Peripheral venous blood sample of 53 advanced gastric cancer patients were enrolled to test the mutation of CYP3A4 gene by denaturing high performance liquid chromatography(DHPLC) and DNA sequencing. The relation between the efficacy of paclitaxel-based regimen and CYP3A4 gene polymorphisms was further analyzed. Results: DHPLC indicated that among the 53 patients, 21 cases showed biomodal type(mutation) and 32 cases were of unimodal type(wild-type). Sequencing results showed that the deletion mutation was found at the 27 th basic group of C in exon 10 of CYP3A4 gene. The response rate(RR) and disease control rate(DCR) of wild-type group were 40.6% and 84.4%, while in mutation group they were 33.3% and 85.7%, respectively, with no significances between the two groups(P > 0.05). Of all 53 cases, the median progression-free survival(PFS) was 6.5 months(95% CI: 3.576–9.424 months), and the median overall survival(OS) was 11.0 months(95% CI: 6.955–15.045 months). The median PFS and OS in wild-type group had no differences compared with those in mutation group(7.0 months vs. 7.0 months, P > 0.05; 10.0 months vs. 14.0 months, P > 0.05). Between wild-type and mutation groups, the median PFS of patients applied with oxaliplatin containing regimen and the median OS in patients applied with/without oxaliplatin had no significant differences(P > 0.05), while the median PFS in patients received non-oxaliplatin regime had statistical differences(P = 0.024). The median PFS and OS in patients receiving 3-drug or 2-drug regimes had no correlation with CYP3A4 gene polymorphisms. The adverse effects in the two groups were mild, mainly in grades 1–2. The common adverse effects were anorexia, nausea/vomiting and leucopenia. Conclusion: Deletion mutation was located in the 27 th basic group of C in exon 10 of CYP3A4 gene. Paclitaxel-based regime has a trend to prolong the OS of advanced gastric cancer with mutation type.