Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.

A Study of Hie and LBP: The First Step to Improve Subjective Well-Being

Backgrounds: Health does not only physical health, therefore, we need to study it from various viewpoints. Many Japanese female complain of a Hie or a low back pain (LBP), which they reduce their subjective well-being. We analyze. Those patients often have acupuncture therapy. In this study, we analyze the characteristics of Hie and LBP, the satisfaction level of alternative therapy and we pursue a tip to improve subjective well-being. Methods: Of 1000 women, Hie (+)/Hie (−) or LBP (+)/LBP (−), we compared their body temperature (BT) (axilla) and body mass index (BMI). Furthermore, the Chi test identified ten factors of “body” and seven “mind” information. Results: In the result of BT (axilla) while LBP indicated a significant difference. Both Hie and LBP showed difference in the opposite direction. Hie did now show such clear differences in “body” information. However, interestingly, all seven questions in the “mind” information showed statistical difference. Discussion and conclusion: One reason why those patients have acupuncture therapy may acupuncture therapy traditionally has not separate “mind” and “body” and it has the concept of “mind-body unity”. To improve subjective well-being, first we need to focus on “Mind” as well as “mind-body unity”. Mental-health support is important for patients with Hie or LBP to reduce physiological stress.

The Optimal Design of TMD for Offshore Structures

This paper presents the optimal design procedure of Tuned Mass Damper (TMD) for reducing vibration of an actual steel jacket offshore platform excited by random wave loading. In this study, a frequency domain is taken. The force on the structure is determined by use of the linearized Morison equation for an input Power Spectral Density (PSD) of wave elevation. The sensitivity of optimum values of TMD to characteristic parameters of random wave spectrum is analyzed. An optimized TMD design for the modeled platform is given based on design conditions and the findings of the study.

Optimal Design of TMD Under Long-Term Nonstationary Wave Loading

Traditionally, the use of a tuned mass damper (TMD) is to improve the surviability of the primary structure under extraordinary loading environment while the design loading condition is described by either a harmonic function or a stationary random process that can be fully characterized by a power spectral density (PSD) function. Aiming at prolonging the fatigue life of an offshore platform, this study considers an optimal design of TMD for the platform under long-term nonstationary loading due to long-term random sea waves characterized by a probabilistic power spectral density (PPSD) function In principle, a PPSD could be derived based on numerous ordinary PSD functions; and each of them is treated as realization of the corresponding PPSD. This study provides a theoretical development for the optimal TMD design by minimizing the cost function to be the mean square value of the expected long term response. A numerical example is presented to illustrate the developed design procedure.

Bottom water temperature measurements in the South China Sea,eastern Indian Ocean and western Pacific Ocean

文章报道了一批新的海底底水温度(BWT)数据,其中南海(SCS)158个站位、东印度洋(EIO)30个站位及西太平洋(WPO)37个站位。基于这批新的BWT数据,获得南海和西太平洋海域底水温度与水深经验关系,可为地球物理和物理海洋提供准确、可靠的海底温度边界。这将有助于海底油气资源调查与评估。同时,这批实测数据表明:1)水深超过3500m的海域,其底水温度在南海约为2.47℃,比东印度洋(～1.34℃)和西太平洋(～1.60℃)稍微偏高。这与大洋传送带模式所预测的情况比较吻合。该模式认为:低温高盐的海水,从北大西洋格陵兰岛和冰岛附近海域下沉到深层,然后向南流动,再与南极洲周围海域的低温高盐海水一同向北进入印度洋和太平洋。而南海是一个相对比较封闭的热带边缘海,其内部海水与印度洋和菲律宾海交换有限,导致海水温度整体高于印度洋和太平洋。2)台西南盆地水深在2700～3000m的部分站位,其底水温高达约3.00℃,明显高于其周边同水深海域底水温度(平均值约为2.33℃)。这可能是台西南盆地海底水热活动导致的结果。3)在东印度洋和西太平洋水深超过4800m海域,底水温度随着水压增大稍有升高,其升高率分别为10.6mK·MPa^(-1)和12.0mK·MPa^(-1)。这与理论估算的深层底水绝热压力温度梯度范围较为吻合。这也意味着东印度洋和西太平洋深层底水,主要由绝热自压作用导致其温度随着深度的增大而升高。

Influence of contamination on banded iron formations in the Isua supracrustal belt, West Greenland: Reevaluation of the Eoarchean seawater compositions

Banded Iron Formations（BIFs） are chemical sediments, ubiquitously distributed in the Precambrian supracrustal belts; thus their trace element compositions are helpful for deciphering geochemical evolution on the Earth through time. However, it is necessary to elucidate factors controlling the whole-rock compositions in order to decode the ancient seawater compositions because their compositions are highly variable. We analyzed major and trace element contents of the BIFs in the 3.8-3.7 Ga Isua supracrustal belt（ISB）, southern West Greenland. The BIFs are petrographically classified into four types：Black-,Gray-, Green-and White-types, respectively. The Green-type BIFs contain more amphiboles, and are significantly enriched in Co, Ni, Cu, Zn, Y, heavy rare earth element（HREE） and U contents. However,their bulk compositions are not suitable for estimate of seawater composition because the enrichment was caused by secondary mobility of metamorphic Mg, Ca and Si-rich fluid, involvement of carbonate minerals and silicate minerals of olivine and pyroxene and/or later silicification or contamination of volcanic and clastic materials. The White-type BIFs are predominant in quartz, and have lower transition element and REE contents. The Gray-type BIFs contain both quartz and magnetite. The Black-type BIFs are dominated by magnetite, and contain moderate to high transition element and REE contents. But,positive correlations of V, Ni, Zn and U contents with Zr contents suggest that involvement of detrital,volcanic and exhalative materials influences on their contents. The evidence for significant influence of the materials on the transition element contents such as Ni in the BIFs indicates the transition element contents in the Archean ocean were much lower than previously estimated. We reconstructed secular variations of V,Co, Zn and U contents of BIFs through time, which show Ni and Co contents decreased whereas V, Zn and U contents increased through time. Especially, the Ni and Co contents drastically decreased in the Mesoarchean rather than around the Great Oxidation Event. On the other hand, the V,Zn and U contents progressively increased from the Mesoarchean to the Proterozoic. Stratigraphical trends of the BIFs show increase in Y/Ho ratios and decrease in positive Eu anomaly upwards, respectively. The stratigraphic changes indicate that a ratio of hydrothermal fluid to seawater component gradually decrease through the deposition, and support the Eoarchean plate tectonics, analogous to the their stratigraphic variations of seafloor metalliferous sediments at present and in the Mesoarchean.

Percutaneous injection of hemostatic agents for active liver hemorrhage

BACKGROUND: Active hemorrhage arising from hepatic injury can be life-threatening and require immediate attention. At present, nonoperative management of abdominal solid organ injuries has become the usual method of care. The purpose of this study was to determine whether, hemocoagulase injection alone guided by contrast-enhanced ultrasonography (CEUS) could control active bleeding in rabbit liver. METHODS: The livers of 30 rabbits were punctured with an 18-gauge semiautomatic biopsy needle to create an active bleeding liver model, which was confirmed with CEUS. The animals were randomly divided into two groups: a treatment group (n=15) and a control group (n=15). In the treatment group, hemocoagulase was injected into the bleeding site under CEUS guidance. In the control group, the active bleeding site was treated with normal saline. When these treatment procedures had been performed, lactated Ringer's solution was given to both groups to maintain the mean arterial pressure at 70 mmHg for 1 hour. The intraperitoneal blood loss, hematocrit, mean heart rate, and macroscopic and microscopic examinations were analyzed at the end of the study. RESULTS: CEUS showed hypoechoic and anechoic perfusion defects in active bleeding liver models. Macroscopic and microscopic examinations also supported the results. After the hemocoagulase injection, the former bleeding site appeared on CEUS as an area devoid of contrast. The blood loss was lower in the treatment group than in the control group (38.0+/-16.6 ml versus 107.9+/-20.8 ml; t=10.172, P<0.05). The mean hematocrit value and the heart rate were higher in the treatment group than in the control group (hematocrit: 23.9+/-3.8% versus 18.8+/-4.1%; t=3.541, P<0.05; heart rate: 250+/-18 versus 223+/-15; t=4.551, P<0.01). CONCLUSION: Hemocoagulase injection alone under the guidance of CEUS is a simple and quick method to control blood loss in active liver bleeding.

Chiral Synthesis of the Key Intermediate of Diterpenoids

(-)-Methyl(4R, 5S, 10R)-14-methoxypodocarpa-8, 11, 13-triene-19-oate(1), which is the key intermediate for synthesis of diterpenoids, was synthesized from (R)-(+)-2-methyl-2-(2`-nitrovinyl)-delta-valerolactone(2).

Recent Progress in Plasma Control Studies on the Improvement of Plasma Performance in Heliotron J

Recent progress in plasma control studies on the improvement of plasma performance in Heliotron J is reviewed. The supersonic molecular beam injection （SMBI） fueling is successfully applied to Heliotron J plasma. A supersonic H2-beam is effectively injected to increase fueling efficiency and generate a peaked density profile. Local fueling with a short-pulsed SMBI can increase the core plasma density and avoid the degradation arising from edge cooling. Second harmonic electron cyclotron current drive （ECCD） experiments were conducted by launching a focused Gaussian beam with a parallel refractive index of -0.05 ≤ Nil 〈 0.6. Results show that the electron cyclotron （EC） driven current is determined not only by Nil but also by local magnetic field （B） structure where the EC power is deposited. Detailed analysis of the observed NI and B dependences is in progress with a ray-tracing simulation using the TRAVIS code. Fast ion velocity distribution was investigated using fast protons generated by ion cyclotron resonant frequency （ICRF） minority heating. For the standard configuration in Heliotron J, charge ex- change neutral particle analysis （CX-NPA） measurements show higher effective temperature of fast minority protons in the on-axis resonance case compared to that in the HFS （high field side） off-axis resonance case. However, the increase in bulk ion temperature in the HFS resonance case is larger than that in the on-axis resonance.

Evaluation of activated area in the electrostatic accelerator facilities

In order to clear the activated area in electrostatic accelerator facilities,four accelerator facilities were selected and typical neutron emission experiments were performed.Neutron flux during operation and induced activity caused by charged particles on the accelerator and its surrounding area after irradiation were measured.Also the monitored neutron flux and calculated value by Monte Carlo calculation using PHITS code were compared.It was confirmed that the results between calculated data and measured data showed the good agreement with each other.Finally,it was concluded that we have to take care the activation of beam line and target.But,it is not necessary to treat accelerator tank,surrounding materials,and building concrete as radioactive materials in case of decommissioning.

中脑梗死后出现阵发性失语和共济失调

The authors describe a patient who showed paroxysmal dysarthria and right limb ataxia after midbrain infarction. SPECT imaging showed marked hypoperfusion in the left parietal lobe while the patient was having frequent paro xysmal attacks. After treatment with phenytoin, the symptoms and hypoperfusion in SPECT imaging improved. The authors conclude that dysfunction of the cerebellothalamocortical pathway aftermidbrain infarction may cause paro xysmal dysarthria and ataxia.

Irritable bowel syndrome in Chinese nursing and medical school students—Related lifestyle and psychological factors

Background: Previous studies have shown that the prevalence of irritable bowel syndrome (IBS) is 10% - 15% in the general population. IBS is a functional gastrointestinal disorder characterized by abdominal pain, abdominal discomfort and disordered defecation associated with a stressful lifestyle. However, the cause of IBS has not been clarified yet. Based on a similar, previous study in Japan, this study investigated the prevalence of IBS and the relationship between IBS and stress, lifestyle and dietary habits among nursing and medical school students in China. Methods: Designed to investigate IBS symptoms, life- style, dietary intake, life events, anxiety and depresssion, a blank self-administrated questionnaire was used to survey 2500 nursing or medical students in China. Questionnaires were collected from 2141 stu- dents (85.6%) and responses obtained from 1934 students (90.3%) were analyzed. Results: On the whole, the prevalence of IBS was 32.1% in this study, 26.6% in males and 33.6% in females. In females, the IBS group showed a bedtime later than that in the non-IBS group, and the length of time asleep in the IBS group was shorter than that in the non-IBS group (p p = 0.005). In females, the IBS group showed a frequency for the intake of vegetables and potatoes that was lower than that of the non-IBS group (p = 0.007, p = 0.023). The prevalence of IBS among nursing and medical school students in China (32.1%) was significantly lower than that in Japan (35.5%). Especially, the number of females in the constipation dominant IBS subgroup in China (11.8%) was less than that found in Japan (20.4%). Conclusions: The prevalence of IBS was high among nursing and medical students in China, but lower than that shown in Japan.

Ki-67标记指数作为眼表新生物的一个恶性标记

Purpose: To evaluate the relationships among histopathological type, clinical malignant grade, and Ki-67 labeling index (LI) in sebaceous gland carcinoma (SGC), conjunctival squamous cell carcinoma (SCC), and conjunctival intraepithelial neoplasia (CIN), with pterygium and normal conjunctiva as controls. Methods: This retrospective study was conducted at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. We used tissue specimens obtained from 20 patients (four SGC, four SCC, four CIN, four pterygium, and four normal conjunctiva). Ki-67 immunohistochemical analysis was performed in all 20 cases. Results: The Ki-67 labeling index (LI) was 46.1± 3.0% (average± SD) in SGC, 28.4± 4.5% in SCC, 20.0± 7.2% in CIN, 9.0± 2.2% in pterygium, and 6.8± 2.3% in normal conjunctiva. Ki-67 LI was significantly (Mann-Whitney U test, P < 0.05) higher in SGC than in SCC, and higher, but not significantly, in SCC than in CIN. Ki-67 LI was significantly (P < 0.05) higher in SCC and CIN than in pterygium. Conclusions: These results suggest that Ki-67 LI may be a sensitive marker for ocular malignant tumor grading.

日本雄胜干热岩区二氧化碳-水注入实验室和现场试验

本文介绍了日本雄胜干热岩区（HDR；温度为200℃）实验室和野外二氧化碳储存试验结果。在试验过程中，部分二氧化碳预期与岩石发生交互作用并以碳酸盐沉淀（地质反应器；从岩石和碳酸盐沉淀物提取钙）。2007年，把二氧化碳溶解水（含有固态二氧化碳的河水）直接注入OGC-2井（从9月2日至9日）和Run#2（从9月11日至16日））。同时，也向水井中注入多种示踪剂。利用取样器（容量500m1）在深度约800m的位置收集水样，并对其化学和同位素成分进行监测。在Run#2开展试验期间，在把二氧化碳-水注入OGC-2井2天后，向OGC-1井注入河水。在开展野外试验期间，利用“现场分析”技术测定方解石的分解或沉淀速率。把由钛棒或金薄膜覆盖的方解石晶体置于晶胞中，并嵌入晶体探测器内。随后把这种晶体探测器下入OGC-2井内，并在特定深度把水样导入探测器。l小时后取出探测器，并利用最新开发的相位移干涉仪观测方解石晶体，以分析储层流体中方解石的溶解或沉淀速率。“现场分析”结果表明，在注入后2天内观测到方解石沉淀。该结果支持大多数注入的二氧化碳可能以碳酸盐沉淀的观点。

利用小活检样本进行角膜缘上皮原代培养和自体移植成功治疗严重单侧眼表疾病

Background: Patients with severe unilateral ocular surface disease require rec onstruction of the damaged ocular surface. We succeeded in culturing primary cor neal limbal epithelial cells taken from minimal biopsy and,once grown, transplan ting them on denuded amniotic membrane (AM). Methods: Autologous corneal limbal epithelial cells from a 3 mm2 biopsy of the uninjured eye were grown for 3weeks on a denuded AM carrier. The resultant sheet was then transplanted onto the unil ateral severely chemically injured eye. Results: Minimal biopsy showed the autol ogous cultivated corneal epithelial cells to have 4-5 layers of sufficient stra tification and to be well differentiated. At 19 months post-transplantation, th e ocular surface epithelium was stable and there were no epithelial defects. Con clusion: We document that it is possible to produce sufficiently stratified, wel l differentiated, autologous cultivated corneal limbal epithelium on AM from a m inimal biopsy of the donor eye and to transplant it onto the injured eye.

双气囊内镜可检测到表现为多个溃疡瘢痕的回肠黏膜相关淋巴组织淋巴瘤

A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice previously. However, numerous investigations, including hematological and biochemical studies, gastroscopy, colonoscopy, computed tomography, scintigraphy, and angiography had failed to detect the source of bleeding in the gastrointestinal tract. On this a dmission,double-balloon enteroscopy was performed and revealed several ulcer scars with localized dilation of the ileum. Histopathological examination of the biopsy specimens reveled no abnormal finding. Partial resection of the ileum was performed to prevent further gastrointestinal bleeding, and histopathological examination of the resected specimen revealed aggregation of atypical lymphocytes, predominantly in the muscularis propria layer. Immunohistochemical examination demonstrated that the tumor cells were positive for CD20 and BCL2, but negative for UCHL1. Based on these findings, the lesion was diagnosed as a marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue. Eighteen months after surgery, the patient was still in complete remission.

A randomized controlled trial of lifestyle self-monitoring for irritable bowel syndrome in female nursing school students

Background: The aim of this study was to verify the efficacy of lifestyle self-monitoring for the improvement of the IBS and reveal what has been changed due to the intervention. Methods: A total of 111 nursing school students were randomized into three groups, two intervention groups (a two-month intervention group, n = 34, and a four-month intervention group, n = 35) and a control group (n = 34). The intervention groups conducted lifestyle self-monitoring in conjunction with a 15-minutes group work for either two or four months. The primary outcome measure was Rome II criteria for IBS. Other outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Gastrointestinal Symptom Rating Scale (GSRS). They were assessed at the baseline and the end of both of the intervention periods. Analysis was conducted as intention-to-treat. Results: The prevalence of IBS did not change significantly after the intervention in any of the groups. The HAD-A score, a subscale of the HADS score for anxiety, decreased 1.4 points in the two-month intervention group (p = 0.02) and 2.3 points in the four-month intervention group of (p = 0.01) after intervention. The average GSRS decreased 0.2 points in the control group (p = 0.05) and 0.3 points in the four-month intervention group (p < 0.01). Conclusions: Lifestyle self-monitoring for two or four months did not reduce the prevalence of the IBS significantly, but it did decrease anxiety and improved the QOL related to gastrointestinal symptoms in female nursing school students.

Numerical investigation on arching effect surrounding deep cylindrical shaft during excavation process

Predicting the inner displacements of deep vertical shafts during the excavation process has been a difficult task considering the geological,structural,and constructional influences.In fact,the two-dimensional(2D)analytical solution based on the retaining wall model remains insufficient for understanding the actual behavior during an excavation.This is because the deformation of vertical shafts becomes complicated due to the unexpected arching effect brought about by the three-dimensional(3D)flexible displacements occurring in the excavation process.Previous analytical solutions only considered the limit equilibrium.Therefore,the present study deals with a 3D soil-structure simulation by considering the displacements of a cylindrical shaft and the mechanical behavior of the surrounding soil as well as the geometry of the cylindrical structure.Moreover,this mechanical behaviors of the surrounding soil and shaft are controlled by the shaft stiffness;hence,the relationships among the shaft stiffness,mechanical behavior of the surrounding soil(in terms of earth pressure coefficient),and shaft displacement were investigated.A cylindrical model,120 m in depth and 20 m in diameter,was positioned at the center of a sand domain,and each excavation step was performed at an interval depth of 20 m.A 3D finite difference method analysis was applied using the modified Cam-Clay(MCC)model to represent the soil behavior.As a result,the present study provides a new normalized lateral earth pressure theory for excavated shafts by considering the 3D arching effect obtained from parametric studies using various levels of shaft stiffness.From a comparison with the analytical solutions of previous studies(Terzaghi,1943a;Prater,1977;Cheng&Hu,2005),it is found that the previous studies underestimated the earth pressure acting on the cylindrical shaft because they did not consider the accurate arching effect.

Volatolomics in healthcare and its advanced detection technology

Various diseases increasingly challenge the health status and life quality of human beings.Volatolome emitted from patients has been considered as a potential family of markers,volatolomics,for diagnosis/screening.There are two fundamental issues of volatolomics in healthcare.On one hand,the solid relationship between the volatolome and specific diseases needs to be clarified and verified.On the other hand,effective methods should be explored for the precise detection of volatolome.Several comprehensive review articles had been published in this field.However,a timely and systematical summary and elaboration is still desired.In this review article,the research methodology of volatolomics in healthcare is critically considered and given out,at first.Then,the sets of volatolome according to specific diseases through different body sources and the analytical instruments for their identifications are systematically summarized.Thirdly,the advanced electronic nose and photonic nose technologies for volatile organic compounds(VOCs)detection are well introduced.The existed obstacles and future perspectives are deeply thought and discussed.This article could give a good guidance to researchers in this interdisciplinary field,not only understanding the cutting-edge detection technologies for doctors(medicinal background),but also making reference to clarify the choice of aimed VOCs during the sensor research for chemists,materials scientists,electronics engineers,etc.

Inhibition of aryl hydrocarbon receptor signaling promotes the terminal differentiation of human erythroblasts

The aryl hydrocarbon receptor(AHR)plays an important role during mammalian embryo development.Inhibition of AHR signaling promotes the development of hematopoietic stem/progenitor cells.AHR also regulates the functional maturation of blood cells,such as T cells and megakaryocytes.However,little is known about the role of AHR modulation during the development of erythroid cells.In this study,we used the AHR antagonist StemRegenin 1(SR1)and the AHR agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin during different stages of human erythropoiesis to elucidate the function of AHR.We found that antagonizing AHR signaling improved the production of human embryonic stem cell derived erythrocytes and enhanced erythroid terminal differentiation.RNA sequencing showed that SR1 treatment of proerythroblasts upregulated the expression of erythrocyte differentiation-related genes and downregulated actin organization-associated genes.We found that SR1 accelerated F-actin remodeling in terminally differentiated erythrocytes,favoring their maturation of the cytoskeleton and enucleation.We demonstrated that the effects of AHR inhibition on erythroid maturation were associated with F-actin remodeling.Our findings help uncover the mechanism for AHRmediated human erythroid cell differentiation.We also provide a new approach toward the large-scale production of functionally mature human pluripotent stem cell-derived erythrocytes for use in translational applications.