Two Cases of Multi-antibiotic Resistant Cronobacter spp. Infections of Infants in China＊

Infections by Cronobacter spp. are hazardous to infants since they can lead to neonatal meningitis, bacteremia, and necrotizing enterocolitis. Cronobacter spp. are frequently resistant to 13-1actam derivatives, macrolides, and aminoglycosides. In addition, multi-resistant strains have also been detected. In China, the isolation rate of Cronobacter spp. from commercial powdered infant formula （PIF） or follow-up formula （FUF） is relatively high. Nevertheless, clinical cases of Cronobacter infection have been ignored to date. Here we describe two cases of Cronobacter infection detected at the Wuhan Women and Children Medical Care Center Hospital （Wuhan City, China）. We provide the genomic analysis of the isolates and the antibiotic-resistance profiles of the two strains. The Cronobacter strains identified in this study were not susceptible to third-generation cephalosporins, aminoglycoside, and/or trimethoprim-sulfamethoxazole. Whole genome sequencing revealed various genes known to encode antibiotic resistance. Future studies are needed to determine whether the genes predicted in this study are functional. As with Enterobocter spp., the antibiotic resistance of Cronobocter is a serious issue that requires more attention.

Fatal complications in a patient with severe multi-space infections in the oral and maxillofacial head and neck regions: A case report

BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.

Case Retrieval Method of Multi-parameter for Customized Product

The CBR (Case-Based Reasoning) usually is been used to accomplish customized products by variant design or reusable design.In the CBR,retrieve is very important.A simple case retrieval method is been brought forward to retrieve a opti- mal prototype based on using inputted multi-parameters,it can be programmed easily.An example has been proved this method can find optimal prototype for new design task efficiently.

Towards Multi-Faceted Test Cases Optimization

The target of software engineering is to produce high quality software product at low cost. Software testing is labour-intensive, ambiguous and error prone activity of software development. How to provide cost-effective strategies for software test cases optimization problem such as classification, minimization, selection, and prioritization has been one of the research focuses in software testing for a long time. Many researchers and academicians have addressed the effectiveness/fitness and optimization of test cases, and obtained many interesting results. However, one issue of paramount importance in software testing i.e. the intrinsic imprecise and uncertainty of test cases fitness, fitness parameters, multi-objective optimization, is left unaddressed. Test cases fitness depends on several parameters. Vagueness of fitness of test cases and their fitness parameters have created the uncertainty in test cases optimization. Cost and adequacy values are incorporated into multi-faceted optimization of test cases. This paper argues test cases optimization requires multi-faceted optimization in order to adequately cater realistic software testing. In this paper, authors have identified several parameters for test cases fitness and multiple objectives for test cases optimization. In addition above, authors have formulated the test cases optimization problem in three different ways using multi-faceted concept. These formulations can be used in future by authors and researchers.

Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report

BACKGROUND Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the reobstruction. CONCLUSION A MHSEMS is a new choice of stent for biliary tract diseases.

CBR技术在Multi-Agent故障诊断中的应用

随着现代工业的发展,为故障诊断系统提出了更高的要求,单一的诊断算法已经很难甚至不能完成诊断任务,因此多算法诊断系统的研究开发成为了当前的热点,多Agent结构的诊断系统就是代表之一。但这种结构导致多个A-gent之间结果冲突和诊断资源浪费的问题。该文提出使用CBR(Case-BasedReasoning)技术实现Agent之间的协调,并实现了一个多Agent的故障诊断原型系统,为解决以上问题提供了一条途径。

基于CBR的Multi-agent旋转机械故障诊断系统

近年来,基于Multi-agent的分布式智能系统已成功地应用于众多领域.将Multi-agent技术应用于旋转机械故障诊断系统,结合CBR技术,分析了系统的基本框架和实现途径,较好地实现了Multi-agent之间的协调,克服了单一故障诊断方法的局限性,解决了诊断软件的通用性和适应性之间的矛盾,为旋转机械多算法诊断系统的研究与开发提供了一定的借鉴.应用表明,该系统能快速、准确地进行故障诊断.

基于案例推理与Multi-agent的TBT预警系统研究

我国出口产品频繁遭受技术性贸易壁垒(TechnicalBarrierstoTrade,简称TBT)限制,给国民经济带来一定影响,迫切需要建立TBT预警系统。论文将基于案例推理的方法引入TBT预警领域,给出了实现的关键技术,提出了基于案例推理与Multi-agent的预警系统功能结构框架,初步实现预警功能,为TBT预测预警问题提供了一种新的思路和方法。

Multi-features Based Approach for Moving Shadow Detection

In the video-based surveillance application, moving shadows can affect the correct localization and detection of moving objects. This paper aims to present a method for shadow detection and suppression used for moving visual object detection. The major novelty of the shadow suppression is the integration of several features including photometric invariant color feature, motion edge feature, and spatial feature etc. By modifying process for false shadow detected, the averaging detection rate of moving object reaches above 90% in the test of Hall-Monitor sequence.

The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST)

The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.

Giant simple hepatic cyst with multiple elevated serum tumormarkers: A case report

BACKGROUND Simple hepatic cysts are relatively common in adults, and mostly appear asasymptomatic incidental radiologic findings. Occasionally, a large cyst will causesymptoms. Elevations in the serum biomarkers protein induced by vitamin Kabsence (PIVKA)-II, cancer antigen (CA) 12-5, and CA19-9 are often associatedwith malignant tumors in the liver or bile ducts. This is the first report to describea case of hepatic cyst with elevated levels of PIVKA-II and CA12-5.CASE SUMMARY An 84-year-old Chinese woman was admitted with gradual abdominal distension.Her symptoms started 1 year ago, and she had poor appetite and a weight loss of5 kg within the past 2 wk. She denied any symptoms associated with abdominalpain, fever and chills, nausea and vomiting, etc. The abdomen was enlarged, morein the right upper quadrant, without tenderness. Laboratory examination showedsignificantly increased serum levels of PIVKA-II, CA12-5, and CA19-9. Acomputed tomography scan revealed multiple round cysts in the liver with clearboundaries. The largest cyst was 20.1 cm × 12.2 cm × 19.6 cm in size, located in theright lobe of the liver with mild dilatation of the intrahepatic bile duct, but therewas no contrast enhancement. Percutaneous drainage on the largest hepatic cystand polycinnamol sclerosing agent injection into the cyst cavity were performed.After treatment, the patient’s symptoms relieved and the elevated serum tumormakers reduced to the normal levels dramatically.CONCLUSION The present report identifies an unusual case of a giant hepatic cyst with markedelevation of serum tumor marker levels of PIVKA-II, CA12-5, and CA19-9. Aftertreatment, these three serum markers dramatically decreased to normal levels.The mechanisms for the elevation of these tumor markers may be as follows: (1) Agiant hepatic cyst compresses the liver, causing injury to the hepatocytes, whichmay lead to secretion of a large amount of PIVKA-II;and (2) Some tumorassociatedantigens, such as carcinoembryonic antigen, CA19-9, CA12-5, andCA15-3, are expressed on inflammatory cells.

17α-hydroxylase/17,20 carbon chain lyase deficiency caused by p.Tyr329fs homozygous mutation:Three case reports

p.Tyr329fs is a cytochrome P450c17 mutation among Chinese individuals.However,data on 17-α-hydroxylase deficiency caused by cytochrome P450c17 p.Tyr329fs homozygous mutation are lacking.This paper is a case report of three patients homozygous for p.Tyr329fs who were diagnosed with 17-α-hydroxylase deficiency between 2005 and 2019.CASE SUMMARY Case 1 presented with hypertension,hypokalemia,sexual infantilism and delayed bone age.The patient had a 46,XY karyotype,was homozygous for p.Tyr329fs and was recently treated with dexamethasone 0.375 mg qn.Case 2 presented with hypokalemia,sexual infantilism,osteoporosis and delayed bone age.The patient had a 46,XY karyotype,was homozygous for p.Tyr329fs and was treated with dexamethasone 0.75 mg qn at the last follow-up.Serum potassium and blood pressure could be maintained within normal range for cases 1 and 2.Case 3 presented with amenorrhea,sexual infantilism,osteopenia and delayed bone age.The patient had a 46,XX karyotype,was homozygous for p.Tyr329fs and was treated with dexamethasone 0.75 mg qn and progynova 1 mg qd.Outpatient follow-up revealed an adrenocorticotropic hormone(8 AM)of<5.00 pg/mL.CONCLUSION The homozygous p.Tyr329fs mutation usually manifests as a combined deficiency,and definitive diagnosis depends primarily on genetic testing.

A Comparative Study of Acute Hemodynamic Effects of Multi -site Cardiac Pacing in patients with cardiac function NYHA class ⅠtoⅡ without bundle branch block

Objective To compare the acute hemodynamic effects of five different pacing modes in patients with cardiac function NYHA class Ⅰ to Ⅱ without bundle branch block (BBB). Methods This study included 12 patients (SSS 7, Ⅲ°AVB 5) undergoing pacemaker implantation. Right ventricular apex (RVA), right ventricular outflow tract (RVOT), right ventricular bifocal (RV-Bi), left ventricular base (LVB) and bi -ventricular (Bi-Ⅴ) pacing at 60 -80 ppm were done in VVI mode prior to implantation of DDD pacemaker. The cardiac index (CI), mean pulmonary artery pressure (mPAP) and pulmonary capillary wedge pressure (PCWP) were measured with Swan - Ganz thermodilution catheter after 5 minutes of each pacing mode. Results (1) Comparing to pacing at RVA (CI: 2. 41± 0. 38 L/min per m2, PCWP: 16. 7 ±3.3 mmHg), the CI increased and the PCWP decreased significantly in pacing at RVOT(CI: 2. 63 ± 0.46, PCWP: 13. 8±2. 3), LVB(CI: 2. 78±0.52, PCWP: 14. 4±3.1), RV-Bi(CI: 2. 83±0.57, PCWP: 12. 8± 2. 5) and Bi -Ⅴ pacing (CI: 2. 94± 0.60, PCWP: 12. 7±2. 5), P < 0. 01, respectively. (2) The CI of RV-Bi and Bi-Ⅴ pacing was higher than that of RVOT and LVB pacing, the PCWP was lower, P < 0. 05, respectively. (3) There was no significant difference between RV - Bi pacing and Bi-Ⅴ pacing in CI and PCWP. Conclusion There is no significant difference between RV - Bi pacing and Bi -V pacing in the acute hemodynamic effects; however,dual - site pacing is much better than single site pacing in that aspect for patients with cardiac function NYHA class Ⅰ to Ⅱ without BBB. Among single site pacing, the RVOT and LVB pacing is better than RVA pacing in cardiac function.

Research on A Master - slave Multi - microcomputers Control System for Hollow Spindle Fancy Yarn Spinning Machine

In this paper, a successfully studied and developed master - slave muld - microcomputers control system based on PC - BUS for hollow spindle fancy yarn spinning machine, mainly Its overall scheme, software and hardware construction, is introduced. Spinning experiments show that the system achieves satisfactory result. This system can solve the diftkultles of mechatronical fusion between domestic hollow splndk fancy yarn spuming muchine and its microcomputer control technology.

On the Representation of Multi-layer Woven Structure

A quantitative method is developed to identify the structures of multi-layer woven fabric in this study. Six structural parameters are selected to represent the fabric structure. With some design criteria for the reinforcement of textile composites, the relationships among the structural parameters are derived for different binding patterns of the fabric structure. The conditions, which meet the requirements of structural cell stability,are also discussed.

Computer-aided Pattern Design of Multi-bar Warp Knitted Fabrics

To meet the development trend of multi-bar warp knit-ting machine towards high-speed,advanced technologyand computer control and the requirements of variousproducts with small quantity,there are many researcheson the computer-aided pattern design of multi-barwarp knitted fabrics.In terms of the special propertiesof the computer-aided pattern design of multi-barwarp knitted fabrics,the Object Oriented Program(OOP)programming-Object Windows class Library(OWL)programming is selected.According to thecharacters of the OWL programming,various functionsare defined.Pattern design and technical parameters canbe output,which offers a great convenience for the fac-tory.

MODS： A Novel Metaheuristic of Deterministic Swapping for the Multi-Objective Optimization of Combinatorials Problems

This paper states a new metaheuristic based on Deterministic Finite Automata （DFA） for the multi - objective optimization of combinatorial problems. First, a new DFA named Multi - Objective Deterministic Finite Automata （MDFA） is defined. MDFA allows the representation of the feasible solutions space of combinatorial problems. Second, it is defined and implemented a metaheuritic based on MDFA theory. It is named Metaheuristic of Deterministic Swapping （MODS）. MODS is a local search strategy that works using a MDFA. Due to this, MODS never take into account unfeasible solutions. Hence, it is not necessary to verify the problem constraints for a new solution found. Lastly, MODS is tested using well know instances of the Bi-Objective Traveling Salesman Problem （TSP） from TSPLIB. Its results were compared with eight Ant Colony inspired algorithms and two Genetic algorithms taken from the specialized literature. The comparison was made using metrics such as Spacing, Generational Distance, Inverse Generational Distance and No-Dominated Generation Vectors. In every case, the MODS results on the metrics were always better and in some of those cases, the superiority was 100%.

Erxian decoction potentially prevents postmenopausal osteoporosis by modulating miR-335: a study based on bioinformatics analysis and preliminary clinical case validation

Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predict the miRNA targets of Erxian decoction for the treatment of postmenopausal osteoporosis,and the results were validated by clinical trials.Methods:In this study,we identified possible targets of Erxian decoction in osteoporosis by means of network pharmacological analysis and bioinformatic prediction.Fifteen cases of postmenopausal osteoporosis with kidney Yin and Yang deficiency(In traditional Chinese medicine,kidney Yin nourishes and moistens the tissues of the internal organs of the body,while kidney Yang promotes and warms the tissues of the internal organs of the body.)were treated with Erxian decoction for four weeks,and serum bone metabolism indices(P1NP,osteocalcin,andβ-CTX)and miRNA-335-5p expression were measured before and after treatment.Results:The constructed miRNA postmenopausal osteoporosis related gene network of the effective compound of the Erxian decoction has 296 points and 981 edges.The 39 postmenopausal osteoporosis related genes regulated by miRNA-335-5p were enriched in ossification,while the signaling pathways were enriched in rheumatoid arthritis,the Toll signaling pathway,the HIF-1 signaling pathway,and the MAPK signaling pathway.After taking Erxian decoction,the expression of the serum bone formation index(P1NP,osteocalcin)and miRNA-335-5p gene expression levels increased significantly.The alterations in P1NP and osteocalcin were correlated with the changes in miRNA-335-5p.Conclusion:Circulating miRNA-335-5p may serve as an important target of Erxian decoction in the treatment of postmenopausal women.The effect of Erxian decoction on bone formation is significant,but the underlying mechanism requires further investigation.

Creutzfeldt-Jakob disease presenting as Korsakoff syndrome caused by E196A mutation in PRNP gene:A case report

BACKGROUND Prion diseases are a group of degenerative nerve diseases that are caused by infectious prion proteins or gene mutations.In humans,prion diseases result from mutations in the prion protein gene(PRNP).Only a limited number of cases involving a specific PRNP mutation at codon 196(E196A)have been reported.The coexistence of Korsakoff syndrome in patients with Creutzfeldt-Jakob disease(CJD)caused by E196A mutation has not been documented in the existing literature.CASE SUMMARY A 61-year-old Chinese man initially presented with Korsakoff syndrome,followed by rapid-onset dementia,visual hallucinations,akinetic mutism,myoclonus,and hyperthermia.The patient had no significant personal or familial medical history.Magnetic resonance imaging of the brain revealed extensive hyperintense signals in the cortex,while positron emission tomography/computed tomography showed a diffuse reduction in cerebral cortex metabolism.Routine biochemical and microorganism testing of the cerebrospinal fluid(CSF)yielded normal results.Tests for thyroid function,human immunodeficiency virus,syphilis,vitamin B1 and B12 levels,and autoimmune rheumatic disorders were normal.Blood and CSF tests for autoimmune encephalitis and autoantibody-associated paraneoplastic syndrome yielded negative results.A test for 14-3-3 protein in the CSF yielded negative results.Whole-genome sequencing revealed a diseasecausing mutation in PRNP.The patient succumbed to the illness 11 months after the initial symptom onset.CONCLUSION Korsakoff syndrome,typically associated with alcohol intoxication,also manifests in CJD patients.Individuals with CJD along with PRNP E196A mutation may present with Korsakoff syndrome.

An E-Negotiation Agent Using Rule Based and Case Based Approaches: A Comparative Study with Bilateral E-Negotiation with Prediction

The research in the area of automated negotiation systems is going on in many universities. This research is mainly focused on making a practically feasible, faster and reliable E-negotiation system. The ongoing work in this area is happening in the laboratories of the universities mainly for training and research purpose. There are number of negotiation systems such as Henry, Kasbaah, Bazaar, Auction Bot, Inspire, and Magnet. Our research is based on making an agent software for E-negotiation which will give faster results and also is secure and flexible. The negotiation partners and contents between the service providers change frequently. The negotiation process can be transformed into rules and cases. Using these features, a new automated negotiation model for agent integrating rule based and case based reasoning can be derived. We propose an E-negotiation system, in which all product information and multiple agent details are stored on the cloud. An E-negotiation agent acts as a negotiator. Agent has user’s details and their requirements for a particular product. It will check rules based data whether any rule is matching with the user requirement. An agent will see case based data to check any similar negotiation case matching to the user requirement. If a case matches with user requirement, then agent will start the negotiation process using case based data. If any rule related requirement is found in the rule base data, then agent will start the negotiation process using rule based data. If both rules based data and cases based data are not matching with the user requirement, then agent will start the negotiation process using Bilateral Negotiation model. After completing negotiation process, agent gives feedback to the user about whether negotiation is successful or not. The product details, rule based data, and case based data will be stored on the cloud. So that system automatically becomes flexible. We also compare E-negotiation agent automated negotiation and behavior prediction system to prove that using rule based and case based approaches system should become fast.