Minimally invasive perventricular VSD closure without cardiopulmonary bypass mid-term results from multi-centers

Objective Transesophageal echocardiography (TEE) guided,minimally invasive perventricular device occlusion of ventricular septal defects (VSDs) without cardiopulmonary bypass (CPB) has been applied in multiple centers. We reported experiences and the mid-term results. Methods Four hundred and thirty-two cases from 4 cardiac centers were involved in the study. There were 235 maled and 197 females,aged from 3 months to 15 years,with a body weight varying from 4.0 to 26.0 kg.

Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis:A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.

CLINICAL REPORT ON MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF TREATMENT OF MIGRAINE BY ELECTRO-ACUPUNCTURE AT QI■X■(丘墟GB40)

Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.

Probing the structure of multi-center molecules with odd–even high harmonics

We study high-order harmonic generation(HHG)from multi-center asymmetric linear molecules numerically and analytically.Our simulations show that odd and even HHG spectra of the asymmetric multi-center system respond differently to the change of the molecular structure.Specifically,when the internuclear distances between these nuclei of the molecule have a small change,the odd spectra usually do not change basically,but the even spectra differ remarkably.Based on this phenomenon,a simple procedure is proposed to probe the positions of these nuclei with odd–even HHG.Our results shed light on attosecond probing of the structure of multi-center molecules using HHG.

Minimum MSE Weights of Adjusted Summary Estimator of Risk Difference in Multi-Center Studies

The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a treatment effect in multi-center studies, we propose minimum MSE (mean square error) weights of an adjusted summary estimate of risk difference under the assumption of a constant of common risk difference over all centers. To evaluate the performance of the proposed weights, we compare not only in terms of estimation based on bias, variance, and MSE with two other conventional weights, such as the Cochran-Mantel-Haenszel weights and the inverse variance (weighted least square) weights, but also we compare the potential tests based on the type I error probability and the power of test in a variety of situations. The results illustrate that the proposed weights in terms of point estimation and hypothesis testing perform well and should be recommended to use as an alternative choice. Finally, two applications are illustrated for the practical use.

Effect of a disposable endoscope precleaning kit in the cleaning procedure of gastrointestinal endoscope:A multi-center observational study

BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.

Theoretical study of(e,2e) triple differential cross section of 1b3g orbital of ethylene by vibrational multi-center distorted-wave method

The vibrational motions are usually neglected when calculating(e,2e) triple differential cross sections(TDCSs) of molecules. Here, multi-center distorted-wave method(MCDW) has been modified by including molecular vibrations. This vibrational MCDW method is employed to calculate the TDCSs of 1b3gorbital of ethylene at low(100 eV) and medium(250 eV) incident electron energies in coplanar asymmetric kinematic condition. The results show that molecular vibrations significantly influence the angular distributions of the TDCSs, especially in the binary region along momentum transfer near the Bethe ridge.

Theoretical study of (e,2e) triple differential cross sections of pyrimidine and tetrahydrofurfuryl alcohol molecules using multi-center distorted-wave method

We report theoretical studies of electron impact triple differential cross sections of two bio-molecules,pyrimidine and tetrahydrofurfuryl alcohol,in the coplanar asymmetric kinematic conditions with the impact energy of 250 eV and ejected electron energy of 20 eV at three scattering angles of-5°,-10°,and-15°.Present multi-center distorted-wave method well describes the experimental data,which was obtained by performing(e,2e)experiment.The calculations show that the secondary electron produced by the primary impact electron is strongly influenced by the molecular ionic multi-center potential,which must be considered when the low energy electron interacts with DNA analogues.

Multi-Order and Multi-Center Metallogenic Zoning of Yinshan Cu-Au Polymetallic Ore Deposit,Jiangxi Province,China

Yinshan anticline is the product of tectono-dynamic deformation - metamorphism .Along the axis of the anticline exists a brittle-ductile shearing zone which obviously controls the ore-formation . Mineralization occurs along the axis of the anticline in a width of about 1000m .In the mining area .volcano- subvolcanic rocks of Early Yanshan period are divided into three cycles :Ⅰ intermediate acidic dacite lava and dacite porphyry ;Ⅱ acidic amphibole liparite and quartz porphyry;Ⅲ intermediate andesite porphyrite . Among them activities of ⅠandⅡ cycles are more intensive and are intimately related to the mineralization . Yinshan ore deposit is the result of combinative processes of tectono -dynamic and volcano -magmatic hydrothermal fluids, so that mere are two centers of metallogenic zoning, one being the axial strain zone of Yinshan anticline which is the center of first order, and the other being porphyry stock , 2nd order.

The Volume Effect and Safety of 6% Hydroxyethyl Starch 130/0.4 in Patients Undergoing Major Elective Surgery: An Uncontrolled, Open-Labeled, Multi-Center Study

Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven&#174) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4;for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.

Xi-Feng-Hua-Shi granules for diarrhea-predominant irritable bowel syndrome:protocol for a randomized,double-blind,placebo-controlled multi-center clinical trial

Background:Irritable bowel syndrome(IBS)is a common functional bowel disorder that can severely affect the quality of life of patients.Limited drugs have been reported for modern medical IBS treatment.The advantages of traditional Chinese medicine(TCM)treatment are gradually becoming prominent.Xi-Feng-Hua-Shi granules have been clinically used for diarrhea-predominant IBS(IBS-D)treatment for many years in TCM practice.Thus,this study aimed to further verify the effectiveness and safety of Xi-Feng-Hua-Shi(XFHS)granules in IBS-D treatment through a randomized,double-blind,placebo-controlled multi-center clinical trial and provide high-quality evidence for its effectiveness and safety in treatment,as well as provide a basis for clinical rational drug use and explore new clinical IBS-D treatment plans.Methods:A randomized,double-blind,placebo-controlled multi-center clinical trial will be performed in 23 hospitals.A total of 300 participants will be randomly divided into the experimental group(prescribed with XFHS granules)and the control group(prescribed with the placebo granules),with 150 participants in each group.The appearance,shape,color,and taste of the placebo granules are the same as those of XFHS granules.All participants will receive a 4-week treatment and a 6-month follow-up.The primary outcome is the overall clinical efficacy;the secondary outcomes are the IBS-Symptom Severity Score(IBS-SSS),TCM Syndrome Evaluation,and the IBS-Quality of Life(IBS-QoL)score,mental state assessment,and recurrence rate.Outcome measures(including primary and secondary outcome measures)are collected at baseline,as well as 2,4,16,and 28 weeks post-intervention.Discussion:This randomized,placebo-controlled,multi-center trial may provide high-quality evidence for the clinical XFHS granule efficacy in IBS-D treatment.Additionally,this study will conduct safety evaluations to provide a basis for clinical rational drug use.

Generating attosecond pulses with controllable polarization from cyclic H_(3)^(2+) molecules by bichromatic circular fields

We investigate the polarization properties of harmonics from the cyclic H_(3)^(2+) molecular ions in tailored bichromatic counter-rotating circularly polarized(BCCP)fields by solving the time-dependent Schrödinger equation.The allowed harmonics and their helicities are associated with the symmetry compatibility of the field-target systems,and large intensity difference between adjacent harmonics with opposite helicities appears in a wide spectral range when the BCCP field is at certain rotation angles.We try to explain the intensity difference by using a recombination model based on the quantum-orbit theory and by analyzing the ionization pathways.Moreover,to synthesize attosecond pulse trains with tunable polarization,the intensity difference is manipulated by introducing a seed XUV field,and by changing the relative amplitude ratio as well as the helicity of BCCP fields.

A Study on the Relationship Between Skin Sensitivity and Lifestyle, Skin Conditions

Investigate the self-assessment of the skin sensitivity degree of Chinese cosmetic consumers,and explore the differences in lifestyle and skin conditions among consumers with different degrees of skin sensitivity.The study selected 716 female participants from different cities,and collected relevant data through questionnaire surveys,instrument tests,and other methods.The results found that the participants who self-assessed as having sensitive skin had a lower average age,frequency of skin care,frequency of makeup,and years of makeup.The proportion of choosing medical cosmetology and staying up late was higher,the skin was more elastic,the skin tone was more biased towards red,there were more red areas,and the skin texture was better(p<0.05).The research results can be used to guide the development of cosmetics to meet the needs of consumers with different degrees of skin sensitivity.

China’s Urbanization Process and Outlook~

Starting JPom a low level China＇s rapid urOamzatlon ttas talcen on a targe scale over the past three decades. The urbanization of urban clusters has become a key driver of China＇s economic development. However, China＇s urbanization has been confronted with many issues, such as high resource and environmental costs, low level of citizenship for migrant workers, strong economic polarization and excessive dependence on land encroachment. In the near future, China＇s urbanization will enter a period of strategic transitioning, and the enhancement of the quality of urbanization will become a strategic priority. China＇s urbanization rate is projected to reach 60% by 2020 and 68% by 2030, eventually exceeding 80% by 2050. China＇s future urbanization must proceed from local realities, promote the balanced development of small, medium-sized and large cities and towns, optimize the spatial layout of urbanization, and follow a sensible pattern.

Regular Observation of De-Acclimatization and Randomized Controlled Research of Diagnostic Criteria of High Altitude De-Acclimatization Syndrome among Different Plateau Migrants Crowd after Their Return to the Plain

Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.

Long-term Safety Observations on Side Effects and Com -plications of Non-surgical Sterilization by Chem ical In-stillation of the Fallopian Tubal

The present objective is to observe the side effects and complications of fem ale tubalsterilization by phenol-atabrinepaste (PAP) and phenolm ucilage (PM). 1 705 eligible w om en w ere divided random ly into tw o groups, 871 usinig PAP and 834 w om en using PM. Results: Thefeverratesw ere8.0and 4.4( P< 0.01 ) respec- tively in group PAP and group PM. Infection rates of the appendages w ere 2.3 and 1.2 respectively. The incidence of chem ical peritonitis, w ithin the lim its of pelvic cavity, w ere 1.1and 2.4respectively. Perforation of uterus, pelvic ab- scessand ectopicpregnancy w ere notfound during thisobservation. Slightabdom inal pain after the proceduresw ere 33.6and 30.8respectively. Slightvaginalbleed- ing after the procedure w as 23.2 and 18.0 respectively. Menstruation of the w om en w as not affected by the instillation. This five-year follow -up study neither show ed a positivePap testnor a potentialdeseasecaused by thesterilizing agents. This technique isa safe and efficientm ethod for fem ale sterilization.

Research on Effective Supply Mode of Rural Public Goods

On the basis of definition and classification of rural public goods, this paper analyses the status quo of public goods supply in vast rural areas of China, and it indicates that the electricity and communication facility in rural areas have not yet been popularized; the culture and education facility is critically backward; the medical care and social warfare institutions are short. It points out the rational supply model of public goods as follows: the government plays dominant role in the public goods supply with a large amount of investments, related to the quality of living and production of multitudinous farmers; small wieldy quasi-public goods that can be easily supplied and marginalized public goods can introduce multiplex supply main body under the framework of government guidance. According to this model, corresponding policy suggestions are put forward as follows: increase financial inputs, and perfect local financial system; actively encourage the majority of farmers in rural areas to participate in public goods supply mechanism, so that the supply has pertinence; vigorously develop multiplex supply system of rural public goods, to ensure effective supply.

Measurement and Characteristics of Employment Centers in Shenzhen:A Study Using Enterprise Survey Data in 2017

In the formation process of megacities,urban population is constantly gathering from other cities to large and medium-sized cities,and from the periphery of the city to the center of the city,inducing traffic congestion,overload of main center,reduction of space efficiency,and other major urban diseases.Multi-center urban spatial structure is an effective way to solve the above negative externalities.It is helpful to evaluate the efficiency of the existing industrial distribution structure in the cities and make a reasonable estimate of the future enterprise growth by clarifying the interactive relationship between the development process of a city and the change of the employment center.Based on survey data of Shenzhen "Four Up-scale Enterprises" in 2017,threshold method is used to identify the existing employment centers of Shenzhen,and describe the characteristics of each employment center.Combining calculation of industry location entropy,below conclusions are obtained:①the double main centers (Futian-Luohu center and Nanshan center) in Shenzhen are obvious,and the weak multi-center has initially formed;②the development of the industry is relatively balanced in Futian-Luohu center,and Nanshan center has absolute advantage in information technology industry;③the employment centers outside the original special economic zone are mainly manufacturing industries,showing a highly specialized trend of industries,and cultivation of service industries is insufficient.

New Strategy and Kinetic Energy Regeneration for the Developmen of China’s Urban Agglomeration

The rapid development of modern urban agglomerations has reshaped the territory of China’s economic geography and reconstructed the spatial forms of Chinese cities and regions.Since the reform and opening-up,China’s urban agglomerations have experienced three stages,i.e.spontaneous cultivation,rapid growth,and the super leading role of planning.The gian development area composed of super urban agglomerations is becoming an emerging geographic unit that improves the urban development quality promotes regional integration processes and participates in global industria competition and innovative resource allocations in China.While encountering challenges such as insufficient innovation kinetic energy and implementation difficulties of cross-regional coordination mechanisms,it has also ushered in new opportunities brought about by the shift of the global urban network system focus,the accelerated formation of high-speed rail urban belts,the rise of innovative geographic unit communities,etc.As entering the new era,centering on the high-quality development requirements of urbanization and urban agglomerations,China should establish a new mechanism for more effective coordinated regional development,build an urban pattern of coordinated development of large,medium and small cities and towns with urban agglomerations as the main body,comprehensively enhance the competitiveness of urban agglomerations and regions,and take a steady and innovation-driven road to modernization.

A Study on The Factors Influencing the Facial Apparent Age of Chinese Cosmetic Consumers

To investigate the apparent age of Chinese cosmetic consumers and its influencing factors.The subjects’skin conditions in all dimensions were collected using professional instruments and clinical expert assessment,subjects’lifestyles,skin care and makeup habits were obtained through questionnaire.The apparent age of the subjects was obtained based on the visual perception of photos judged by observers and then averaged.The association between apparent age and skin characteristics,the association between the difference between apparent age and actual age and the subjects'lifestyle and its difference among cities were investigated.The results showed that apparent age had a high correlation with skin tone and severity of skin problems.The model of multiple regression analysis obtained a high resolution(R2=0.704).The use of skin care products may help to delay the apparent aging of the skin.The results of the study have some guiding significance for the development of anti-aging products and the evaluation of anti-aging efficacy and is informative for lifestyle choices to maintain youthfulness.