High incidence combination of multiple primary malignant tumors of the digestive system

BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.

A Highly Sensitive Femtosecond Time-Resolved Sum Frequency Generation Vibrational Spectroscopy System with Simultaneous Measurement of Multiple Polarization Combinations

Characterization of real-time and ultrafast motions of the complex molecules at surface and interface is critical to understand how interracial molecules function. It requires to develop surface-sensitive, fast-identification, and time-resolved techniques. In this study, we employ several key technical procedures and successfully develop a highly sensitive femtosecond time-resolved sum frequency generation vibrational spectroscopy （SFG-VS） system. This system is able to measure the spectra with two polarization combinations （ssp and ppp, or psp and ssp） simultaneously. It takes less than several seconds to collect one spectrum. To the best of our knowledge, it is the fastest speed of collecting SFG spectra reported by now. Using the time-resolved measurement, ultrafast vibrational dynamics of the N-H mode of α-helical peptide at water interface is determined. It is found that the membrane environment does not affect the N-H vibrational relaxation dynamics. It is expected that the time-resolved SFG system will play a vital role in the deep understanding of the dynamics and interaction of the complex molecules at surface and interface. Our method may also provide an important technical proposal for the people who plan to develop time-resolved SFG systems with simultaneous measurement of multiple polarization combinations.

Heterogeneous information phase space reconstruction and stability prediction of filling body–surrounding rock combination

Traditional research believes that the filling body can effectively control stress concentration while ignoring the problems of unknown stability and the complex and changeable stress distribution of the filling body–surrounding rock combination under high-stress conditions.Current monitoring data processing methods cannot fully consider the complexity of monitoring objects,the diversity of monitoring methods,and the dynamics of monitoring data.To solve this problem,this paper proposes a phase space reconstruction and stability prediction method to process heterogeneous information of backfill–surrounding rock combinations.The three-dimensional monitoring system of a large-area filling body–surrounding rock combination in Longshou Mine was constructed by using drilling stress,multipoint displacement meter,and inclinometer.Varied information,such as the stress and displacement of the filling body–surrounding rock combination,was continuously obtained.Combined with the average mutual information method and the false nearest neighbor point method,the phase space of the heterogeneous information of the filling body–surrounding rock combination was then constructed.In this paper,the distance between the phase point and its nearest point was used as the index evaluation distance to evaluate the stability of the filling body–surrounding rock combination.The evaluated distances(ED)revealed a high sensitivity to the stability of the filling body–surrounding rock combination.The new method was then applied to calculate the time series of historically ED for 12 measuring points located at Longshou Mine.The moments of mutation in these time series were at least 3 months ahead of the roadway return dates.In the ED prediction experiments,the autoregressive integrated moving average model showed a higher prediction accuracy than the deep learning models(long short-term memory and Transformer).Furthermore,the root-mean-square error distribution of the prediction results peaked at 0.26,thus outperforming the no-prediction method in 70%of the cases.

Efficacy of Bortezomib in Combination with Dexamethasone in the Treatment of Primary Multiple Myeloma

Objective:To study the clinical efficacy of bortezomib combined with dexamethasone in the treatment of primary multiple myeloma.Methods:Seventy patients with primary multiple myeloma treated in Shaanxi Provincial People’s Hospital between January 2020 and January 2021 were divided into two groups,a control group and a study group,using the random number table method;35 patients in the control group were treated with conventional treatment,and the other 35 patients in the study group were treated with bortezomib combined with dexamethasone.The patients’clinical outcomes,clinical indices,satisfaction,and adverse reactions were compared between the two groups.Results:There were significant differences(p<0.05)in the indices between the two groups of patients treated with different treatment modalities for primary multiple myeloma.Conclusion:The use of bortezomib combined with dexamethasone for patients with primary multiple myeloma can effectively improve the treatment outcomes,clinical indices,patient satisfaction,and adverse reactions;hence,it is worthy to be widely promoted in clinical practice.

Combined model based on optimized multi-variable grey model and multiple linear regression

The construction method of background value is improved in the original multi-variable grey model （MGM（1,m）） from its source of construction errors. The MGM（1,m） with optimized background value is used to eliminate the random fluctuations or errors of the observational data of all variables, and the combined prediction model together with the multiple linear regression is established in order to improve the simulation and prediction accuracy of the combined model. Finally, a combined model of the MGM（1,2） with optimized background value and the binary linear regression is constructed by an example. The results show that the model has good effects for simulation and prediction.

Performance gain bounds of coherently combining multiple radars in a target-based calibration manner

To achieve a high signal-to-noise ratio(SNR) while maintaining moderate radar antenna, a target-based calibration manner is available to coherently combine multiple radars. The key to this calibration manner is to estimate coherence parameters(CPs), i.e., time and phase calibration values in transmission and reception estimation, by separating the target returns into monostatic and bistatic echoes. However, CPs estimations exist uncertainties, which will affect the performance gain after multiradar coherent combination. The principle of coherently combining multiple radars is elaborated and the signal probability model for CPs estimation is established. On this basis, CPs Cramer-Rao bound(CRB) is derived in the closed-form, according to which the non-tight and tight upper bounds for multiple radars coherent combination performance gain are derived in the closed-form and via Monte Carlo(MC) simulations, respectively. Simulations validate the correctness of the derived CRB and gain bounds.

Novel mechanism of drug resistance to proteasome inhibitors in multiple myeloma

Multiple myeloma(MM) is a cancer caused by uncontrolled proliferation of antibody-secreting plasma cells in bone marrow, which represents the second most common hematological malignancy. MM is a highly heterogeneous disease and can be classified into a spectrum of subgroups based on their molecular and cytogenetic abnormalities. In the past decade, novel therapies, especially, the first-in-class proteasome inhibitor bortezomib, have been revolutionary for the treatment of MM patients. Despite these remarkable achievements, myeloma remains incurable with a high frequency of patients suffering from a relapse, due to drug resistance. Mutation in the proteasome β5-subunit(PSMB5) was found in a bortezomib-resistant cell line generated via long-term coculture with increasing concentrations of bortezomib in 2008, but their actual implication in drug resistance in the clinic has not been reported until recently. A recent study discovered four resistance-inducing PSMB5 mutations from a relapsed MM patient receiving prolonged bortezomib treatment. Analysis of the dynamic clonal evolution revealed that two subclones existed at the onset of disease, while the other two subclones were induced. Protein structural modeling and functional assays demonstrated that all four mutations impaired the binding of bortezomib to the 20 S proteasome, conferring different degrees of resistance. The authors further demonstrated two potential approaches to overcome drug resistance by using combination therapy for targeting proteolysis machinery independent of the 20 S proteasome.

Magneto-elastic combination resonances analysis of current-conducting thin plate

Based on the Maxwell equations, the nonlinear magneto-elastic vibration equations of a thin plate and the electrodynamic equations and expressions of electromagnetic forces are derived. In addition, the magneto-elastic combination resonances and stabilities of the thin beam-plate subjected to mechanical loadings in a constant transverse magnetic filed are studied. Using the Galerkin method, the corresponding nonlinear vibration differential equations are derived. The amplitude frequency response equation of the system in steady motion is obtained with the multiple scales method. The excitation condition of combination resonances is analyzed. Based on the Lyapunov stability theory, stabilities of steady solutions are analyzed, and critical conditions of stability are also obtained. By numerical calculation, curves of resonance-amplitudes changes with detuning parameters, excitation amplitudes and magnetic intensity in the first and the second order modality are obtained. Time history response plots, phase charts, the Poincare mapping charts and spectrum plots of vibrations are obtained. The effect of electro-magnetic and mechanical parameters for the stabilities of solutions and the bifurcation are further analyzed, Some complex dynamic performances such as perioddoubling motion and quasi-period motion are discussed.

Novel ensemble learning based on multiple section distribution in distributed environment

Because most ensemble learning algorithms use the centralized model, and the training instances must be centralized on a single station, it is difficult to centralize the training data on a station. A distributed ensemble learning algorithm is proposed which has two kinds of weight genes of instances that denote the global distribution and the local distribution. Instead of the repeated sampling method in the standard ensemble learning, non-balance sampling from each station is used to train the base classifier set of each station. The concept of the effective nearby region for local integration classifier is proposed, and is used for the dynamic integration method of multiple classifiers in distributed environment. The experiments show that the ensemble learning algorithm in distributed environment proposed could reduce the time of training the base classifiers effectively, and ensure the classify performance is as same as the centralized learning method.

A COMPARATIVE STUDY ON THERAPEUTIC RESPONSE AND SURVIVAL TIME OF PATIENTS WITH MULTIPLE MYELOMA TREATED WITH MODIFIED VMCP REGIMEN

Therapeutic response and survival time or 43 patients with multiple myeloma treated with modified VMCP(Vincristine,Melphalan, Cyelophosphamide and perdnisone;mVMCP)multidrug regimen are analyzed,and compared with those of 41 patients treated with VACP, M2, MP and other regimens.Therapeutic response to mVMCP regimen was better than that to other combination regimens(83. 5% VS 60.9%;P< 0.01).The median remission duration in patients responding to mVMCP was longer than that to other regimens(18.7 vs 12.2 mouths;P<0.001).But the survival time of two groups of responders was not signifficautly different(32. 5 vs 34.1 mouths; P>0.5).The prognostic significance of various pretreatment characteristics was evaluated in term of therapeutic response.The bone status and renal function had a significant inverse correlation with the survival time of patients responding to chemotherapy.Our data indicate that the patients with MM treated by mean or mVMCP regimen can obtain a better response in early treatment and maintain a longer remission duration as well as a better performance status. although the regimen can not prolong the patients survival time.

MicroPath-A pathway-based pipeline for the comparison of multiple gene expression profiles to identify common biological signatures

High throughput gene expression analysis is swiftly becoming the focal point for deciphering molecular mechanisms underlying various dif-ferent biological questions. Testament to this is the fact that vast volumes of expression profiles are being generated rapidly by scientists worldwide and subsequently stored in publicly available data repositories such as ArrayEx-press and the Gene Expression Omnibus (GEO). Such wealth of biological data has motivated biologists to compare expression profiles gen-erated from biologically-related microarray ex-periments in order to unravel biological mecha-nisms underlying various states of diseases. However, without the availability of appropriate software and tools, they are compelled to use manual or labour-intensive methods of com-parisons. A scrutiny of current literature makes it apparent that there is a soaring need for such bioinformatics tools that cater for the multiple analyses of expression profiles. In order to contribute towards this need, we have developed an efficient software pipeline for the analysis of multiple gene expression data-sets, called Micropath, which implements three principal functions;1) it searches for common genes amongst n number of datasets using a number crunching method of comparison as well as applying the principle of permutations and combinations in the form of a search strat-egy, 2) it extracts gene expression patterns both graphically and statistically, and 3) it streams co-expressed genes to all molecular pathways belonging to KEGG in a live fashion. We sub-jected MicroPath to several expression datasets generated from our tolerance-related in-house microarray experiments as well as published data and identified a set of 31 candidate genes that were found to be co-expressed across all interesting datasets. Pathway analysis revealed their putative roles in regulating immune toler-ance. MicroPath is freely available to download from: www.1066technologies.co.uk/micropath.

A new combined therapy to 15 patients with multiple organ failure in abdominal surgery

AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF)treated successfully by a new combined therapy four high doses in volume and one support“FHDOS”short period high doses in large volume anJsodaminum;short period high doses in large volume dexamethasonum;high doses in large volume of dis- infectant antibiotics;high doses in large volume of abdominal cav- ity washing liquor and support of nutrition metabolism.The mortal- ity rate and cost of MOF were decreased.It is simple,practical and effective. METHODS The study group consisted of 15 patients(10 wom- en,5 men;average age,42.7)who were hospitalized in our hospital.All patients were given“FHDOS”:short period high in large volume Anisodaminum:intravenous injection 40 mg once; another 40rag may be added 30 minutes later according to condition.The total amount may reach 120-240 mg a day,or,in- travenous injection 40 mg every 15 minutes until condition being under control.Short period high doses in large volume Dexamethasonum:intravenous injection 100-200 mg once;this remedy may be continued for 1-3 days;the amount also may de- crease according to condition.High doses in large volume of dis- infectant Antibiotics:select and use antibiotics according to clini- cal condition,inference of Gram's stain;it is necessary to re- peatedly culture bacteria in many parts,and then,to make ad- justment according to culture result and drug-resistance,and to prevent carefully the dual infections from occurring.High doses in large volume of abdominal cavity washing liquor:generally adopt- ing physiological saline 6000o8000ml in washing abdominal cavity. “One support”means full support of nutrition metabolism. RESULTS All the patients in this group survive well after the rescue without any complication. CONCLUSIONS MOF should be prevented,if possible,by stopping or controlling the injury,removing as much necrotic tis- sue as possible,improving blood flow and oxygen consumption, supporting metabolism,and preventing infection or treating it ear- ly and adequately.“FHDOS”is a combined therapy and plays a key role in treating MOF.

Simple, Rapid and Sensitive Detection of Pseudomonas aeruginesa by Colorimetric Multiple Cross Displacement Amplification

Pseudomonas aeruginosa(P:aeruginosa)is a major opportunistic pathogen in hospital-acquired infections.Thus,carly diagnosis is the best strategy for fighting against these infections.In this report,we incorporated multiple crOsS displacement amplification(MCDA)combined with the malachite green(MG)for rapid,sensitive,specific and visual detection of P.aeruginosa by targeting the oprl gene.The MCDA-MG assay was conducted at 67°C for only 40 min during the amplification stage,and then products were directly detected by using colorimetric indicators(MG),eliminating the use of an electrophoresis instrument or amplicon analysis equipment.The entire process,including specimen processing(35 min),amplification(40 min)and detection(5 min),can be finished within 80 min.All 30 non-P.aeruginosa strains tested negative,indicating the high specificity of the MCDA primers.The analytical sensitivity of the MCDA-MG assay was 100 fg of genomic templates per reaction in pure culture,which was in complete accordance with MCDA by gel clectrophoresis and real-time turbidity.The assay was also successfully applied to detecting P.aeruginosa in stool samples.Therefore,the rapidity,simplicity,and nearly equipment free platform of the MCDA-MG technique make it possible for clinical diagnosis,and more.

Clinical features of multiple trauma patients combined with spine and spinal cord injuries

Objective To analyze the clinical features of the multiple trauma patients combined with spine and spinal cord injuries.Methods A retrospective study was performed in143multiple trauma patients combined with spine and spinal

Diagnostic Method and Adaptability Analysis of Multiple Water Breakthroughs in Horizontal Well in Combined Well Pattern

The combined well pattern has been widely used in reservoir development, with a common pattern being a horizontal well in the center for oil production and multiple vertical wells around for water injection. For this type of well pattern, determining the horizontal well is affected by which injection wells, especially when the injecting water breaks through, accurately determining the direction of water inflow will provide an important basis for targeted water well measures. Based on the production performance data of horizontal wells, the semi logarithmic relationship curves of water-oil ratio, derivative water-oil ratio, and cumulative production were used for the first time to determine the breakthrough problem of water injection in the surrounding water injection wells of horizontal wells based on their response characteristics. The adaptability of this method under different influencing factors was analyzed. Introducing the parameter of cumulative production not only preserves the variation trend of the derivative of water-oil ratio with time, but also facilitates the processing of actual production data.

Recognition of Characters by Adaptive Combination of Classifiers

In this paper, the visual feature space based on the long Horizontals, the long Verticals, and the radicals are given. An adaptive combination of classifiers, whose coefficients vary with the input pattern, is also proposed. Experiments show that the approach is promising for character recognition in video sequences.

Clinical Efficacy of Lenalidomide Combined with Cyclophosphamide and Dexamethasone in the Treatment of Multiple Myeloma

Objective:Multiple myeloma has a great impact on patients;the use of implant denture restorative treatment is ideal,and it is vital to carry out scientific treatment methods.Methods:The research subjects were inclusive of 60 patients with mxiltiple myeloma,who were randomly selected from January 2019 to December 2019.The patients were divided into a study group and a control group,with 30 patients in each group.The patients in the control group were treated with conventional treatment,while the patients in the study group were treated with lenalidomide combined with cyclophosphamide and dexamethasone.The effectiveness of treatment,adverse effects,and clinical indices of the two groups were compared.Results:Comparing different treatment methods,the differences in the indices between the two groups were statistically significant(p<0.05).Conclusion:The use of lenalidomide combined with cyclophosphamide and dexamethasone in the treatment of patients with multiple myeloma increases the effectiveness of treatment and improves patientsJ clinical indices;thus,it is worthy of promotion.

道阻且长,“行”者将“治”:公共事务的行为治理之道

行为治理是将行为科学洞见应用于公共治理场域而发展出的治理新模式。行为治理关注政府、组织和公民三类核心治理主体在互动过程中的心理、认知及行为规律,并分析治理主体互动关系的元素特征如何影响主体行为,同时更全面地考虑环境因素对微观行为的影响,以及个体行为汇聚为集体行动并产生更广泛治理结果的机制。行为治理呼吁治理工具的组合运用,强调“助推”和“助力”两大行为工具的内部融通,重视行为工具与传统工具的外部联动。行为治理脱胎于行为公共管理和行为公共政策,更强调各主体间的互动性,更重视环境的复杂性,更主张治理工具在内外部及各层次上的融会贯通。行为治理紧扣治理主体的行为要素,自下而上、从微观到宏观,丰富国家治理现代化的思想库和工具箱。

水利工程施工的IT2FS-MARCOS风险评价

为解决专家决策的主观性造成的风险评价不确定性和不同风险参数权重下考虑多种风险因子评价问题,这里提出一种基于IT2FS-MARCOS法的水利工程施工风险评价方法。首先确定水利工程施工风险指标评估体系,运用最优最劣法(BWM)融合基于层间相关性的客观赋权法(CRITIC)的组合赋权法对各风险参数的权重进行分析;然后引入区间2型模糊集(IT2FS)改进多准则决策中的基于折衷方案的备选方案排序法(MARCOS)计算各风险因素的效用函数值,基于效用函数值进行风险因素分析和评价。结合工程实例应用,表明:地质、天气条件和作业计划安排等风险因素危险程度较高,其中地质条件对该施工项目安全威胁最大,为水利工程施工需重点管理的风险因子。该模型的特点是不仅考虑了专家评价的模糊性,而且采用多准则决策方法避免对风险参数简单加权,与优劣解距离法(TOPSIS)相比,本方法与工程实际符合得更好,有望为处理水利工程不确定信息下的风险评价提供一种新的思路。

基于SELECT理念腹腔镜下保留脾脏的胰体尾切除

腹腔镜下胰体尾切除术目前已经成为治疗胰腺体尾部肿瘤的标准术式。而腹腔镜下保留脾脏的胰体尾切除术由于可保留脾脏功能,减少脾切除术后并发症,越来越受到重视。然而,胰腺肿瘤发病隐匿、解剖位置复杂,这些对其诊断和保留脾脏的胰体尾切除术带来了挑战。近年来,我们团队积累了丰富的胰腺肿瘤诊疗经验,创新提出“SELECT”(S-Single-Operator Cholangiopancreatoscopy,E-ERCP,L-Laparoscopy,E-Endoscopic ultrasound,C-Choledochoscopy/Confocal laser endomicroscopy,T-Traditional Chinese medicine)多镜组合中西医微创诊治理念。根据胰腺肿瘤的类型及特点,应用多种内镜和腹腔镜技术,多种不同微创诊疗方法的优选组合,围手术期采用中医药,进行中西医结合加速康复。将SELECT理念充分应用于腹腔镜下保留脾脏的胰体尾切除术,有利于术前精准诊断、术中精准切除、术后并发症预判和治疗,一站式诊治胰腺肿瘤,使病人利益最大化。