Vessel traffic safety in busy waterways: A case study of accidents in western shenzhen port

Throughout the world, busy waterways near large ports witness heavy vessel traffic in recent decades. The waterways are characterized by high risk in terms of loss of life, property, and pollution to environment. To facilitate maritime safety management with satisfactory efficiency and efficacy, the authors propose a framework of safety indexes to evaluate the risk level in busy waterways according to the accident severity, fatality rate and special indicators of maritime transportation. The safety indexes consist of Safety Evaluation Index (SEI) and Safety Warning Index (SWI), and are derived from the proposed risk criteria of Chinese vessel traffic. As a case study, data on vessel traffic accidents reported in the Western Shenzhen Port, South China from 1995 to 2015 are analyzed. The actual risk level of this area during the period is calculated under the framework. The implementation of the safety indexes indicate that the risk criteria and safety indexes are practicable and effective for the vessel traffic management. The methodology based on long-term accident data can significantly support the risk analysis in the macroscopic perspective for busy ports and waterways, such that SWI can act as threshold to trigger actions, while SEI can act as an indicator to measure safety status.

A 4-gene prognostic signature predicting survival in hepatocellular carcinoma

OBJECTIVE

To develop an independent prognostic signature for patients with hepatocellular carcinoma (HCC).

METHODS

HCC gene expression profile the cancer genome atlas-liver hepatocellular carcinoma and GSE14520 were used as discovery and test set, respectively. Differentially expressed genes (DEGs) were identified between HCC tissues and adjacent normal liver tissues. Univariate Cox proportional hazards regression analysis was performed to identify DEGs correlated with survival of HCC patients. A 4-gene-based signature was constructed based on a least absolute shrinkage and selection operator Cox penalized regression model. The predictive value of the signature was analyzed and validated.

RESULTS

Two hundred sixty-three DEGs were identified between HCC and adjacent liver tissues. After univariate survival analysis, 90 DEGs were found to be significantly correlated with the overall survival (OS) of HCC patients, of which 4 genes (KPNA2, CDC20, SPP1, and TOP2A) with non-zero coefficient were used to construct a prognostic signature. The 4-gene signature was significantly associated with the age (P = 0.046), grade ( P = 0.022), and T stage ( P = 0.023) of HCC patients in the discovery set and it also significantly associated with TNM stage ( P = 0.033), and serum alpha-fetoprotein lever ( P = 0.034). Patients in the 4-gene low-risk group were associated with better OS and recurrence-free survival (RFS) than those in the high-risk group in the discovery and test set. Meanwhile, the 4-gene signature is an independent prognostic factor regarding OS and RFS in the discovery and test set.

CONCLUSION

We developed a 4-gene-based signature, which could be a candidate prognostic factor for patients with HCC.

Effects of early intravenous low-dose of metoprolol on cardiac sympathetic activities and electrophysiological properties in myocardial infarction heart

This study observed the effects of early intravenous low-doses of metoprolol on cardiac sympathetic activities and electrophysiological properties in myocardial infarction (MI) dogs. Thirty two mongrel dogs with the first diagonal branch of the left anterior descending coronary artery ligated were randomly divided into three groups: The low-dose group was given metoprolol 0.6 mg/kg immediately by intravenous injection (n=12); the target-dose group was given metoprolol 1.6 mg/kg (n=12), and the control group was injected with normal saline at the same dose of the target-dose group (n=8). Norepinephrine (NE) and epinephrine (E) levels in the coronary sinus (CS) blood as well as the ventricular effective refractory period (ERP) were all measured during the experiments. We found that NE and E concentrations in the three groups were all increased compared with the previous measurement before ligation. ERP values after MI were significantly decreased in all three groups compared with the first measurements. The three groups all exhibited uneven shortness of ERP among different regions, with significant shortness in infarcted area. Furthermore, there was no difference between the low and target-dose of metoprolol in the reduction of regional ERP, and the same effect was also observed in induced arrhythmias. In conclusion, a lower dose of metoprolol performed similarly as target-dose in reducing the catecholamine concentrations in dogs with MI. Our study demonstrated that a lower dose of metoprolol may be reasonable compared with the target-dose in β-blocker therapy due to similar effect and lower toxicity.

A novel gene-pair signature for relapse-free survival prediction in colon cancer

Background

Colon cancer (CC) patients with early relapse usually have a poor prognosis. In this study, we aimed to identify a novel signature to improve the prediction of relapse-free survival (RFS) in CC.

Methods

Four microarray datasets were merged into a training set (n=1,045), and one RNA-sequencing dataset was used as a validation set (n=384). In the training set, microarray meta-analysis screened out 596 common RFS-related genes across datasets, which were used to construct 177,310 gene pairs. Then, the LASSO penalized generalized linear model identified 16 RFS-related gene pairs, and a risk score was calculated for each sample according to the model coefficients.

Results

The risk score demonstrated a good ability in predicting RFS (area under the curve [AUC] at 5 years: 0.724; concordance index [C-index]: 0.642, 95% CI: 0.615–0.669). High-risk patients showed a poorer prognosis than low-risk patients (HR: 3.519, 95% CI: 2.870–4.314). Subgroup analysis reached consistent results when considering multiple confounders. In the validation set, the risk score had a similar performance (AUC at 5 years: 0.697; C-index: 0.696, 95% CI: 0.627–0.766; HR: 2.926, 95% CI: 1.892–4.527). When compared with a 13-gene signature, a 15-gene signature, and TNM stage, the score showed a better performance (P<0.0001; P=0.0004; P=0.0125), especially for the patients with a longer follow-up (R2=0.988, P<0.0001). When the follow-up was >5 years (n=314), the score demonstrated an excellent performance (C-index: 0.869, 95% CI: 0.816–0.922; HR: 13.55, 95% CI: 7.409–24.78).

Conclusion

Our study identified a novel gene-pair signature for prediction of RFS in CC.

Co-expression network analysis identified CDH11 in association with progression and prognosis in gastric cancer

Background and aims

Gastric cancer (GC) is one of the most common cancers worldwide, and its pathogenesis is related to a complex network of gene interactions. The aims of our study were to find hub genes associated with the progression and prognosis of GC and illustrate the underlying mechanisms.

Methods

Weighted gene co-expression network analysis (WGCNA) was conducted using the microarray dataset and clinical data of GC patients from Gene Expression Omnibus (GEO) database to identify significant gene modules and hub genes associated with TNM stage in GC. Functional enrichment analysis and protein-protein interaction network analysis were performed using the significant module genes. We regarded the common hub genes in the co-expression network and protein-protein interaction (PPI) network as "real" hub genes for further analysis. Hub gene was validated in another independent dataset and The Cancer Genome Atlas (TCGA) dataset.

Results

In the significant purple module (R ²=0.35), a total of 12 network hub genes were identified, among which six were also hub nodes in the PPI network of the module genes. Functional annotation revealed that the genes in the purple module focused on the biological processes of system development, biological adhesion, extracellular structure organization and metabolic process. In terms of validation, CDH11 had a higher correlation with the TNM stage than other hub genes and was strongly correlated with biological adhesion based on GO functional enrichment analysis. Data obtained from the Gene Expression Profiling Interactive Analysis (GEPIA) showed that CDH11 expression had a strong positive correlation with GC stages (P<0.0001). In the testing set and Oncomine dataset, CDH11 was highly expressed in GC tissues (P<0.0001). Survival analysis indicated that samples with a high CDH11 expression showed a poor prognosis. Cox regression analysis demonstrated an independent predictor of CDH11 expression in GC prognosis (HR=1.482, 95% CI: 1.015-2.164). Furthermore, gene set enrichment analysis (GSEA) demonstrated that multiple tumor-related pathways, especially focal adhesion, were enriched in CDH11 highly expressed samples.

Conclusion

CDH11 was identified and validated in association with progression and prognosis in GC, probably by regulating biological adhesion and focal adhesion-related pathways.

The emergence of a highly pathogenic porcine reproductive and respiratory syndrome virus with additional 120aa deletion in Nsp2 region in Jiangxi, China

Highly pathogenic porcine reproductive and respiratory syndrome (HP-PRRS), which emerged in China in 2006, was characterized by high fever, high morbidity and high mortality. The causative agent of the disease was a highly pathogenic variant of porcine reproductive and respiratory syndrome virus (also called HP-PRRSV), which has a discontinuous deletion of 1 + 29 amino acids (aa) in the Nsp2 coding region, compared to classical PRRSV. In 2014, fattened pigs on a pig farm in Jiangxi Province suffered from clinical symptoms of high fever, dyspnoea and death. A PRRSV, termed JX2014T2, was isolated from samples of the dead pigs. Genomic analysis of the isolated PRRSV indicated that the genome of the virus was 14,960 bp in length and belonged to the North American genotype. In the Nsp2-coding region, there was a discontinuous deletion of 1 + 29 aa, similar to HP-PRRSV; however, an additional continuous deletion of 120 amino acids between aa 628 and 747 was found. Further analysis of the pathogenicity of PRRSV JX2014T2 was performed in piglets, and the results indicated that all infected piglets suffered from typical clinical symptoms of PRRS, such as high fever, cough, mental depression, anorexia, dyspnoea and palpebral swelling and died within 15 days postinfection (dpi). This demonstrated that the newly isolated PRRSV JX2014T2 strain containing an additional deletion of 120 aa is highly pathogenic to piglets, suggesting that a highly pathogenic variant with new genetic features is circulating in China.

Sucrose is involved in the regulation of iron deficiency responses in rice (Oryza sativa L.)

Sucrose signaling pathways were rapidly induced in response to early iron deficiency in rice plants, and the change of sucrose contents in plants was essential for the activation of iron deficiency responses. Sucrose is the main product of photosynthesis in plants, and it functions not only as an energy metabolite but also a signal molecule. However, a few studies have examined the involvement of sucrose in mediating iron deficiency responses in rice. In this study, we found that the decrease in photosynthesis and total chlorophyll concentration (SPAD values) in leaves occurred at a very early stage under iron deficiency. In addition, the sucrose was increased in leaves but decreased in roots of rice plants under iron deficiency, and also the sucrose transporter (SUT) encoded genes' expression levels in leaves were all inhibited, including OsSUT1, OsSUT2, OsSUT3, OsSUT4, and OsSUT5. The carbohydrate distribution was changed under iron deficiency and sucrose might be involved in the iron deficiency responses of rice plants. Furthermore, exogenous application of sucrose or dark treatment experiments were used to test the hypothesis; we found that the increased endogenous sucrose would cause the repression of iron acquisition-related genes in roots, while further stimulated iron transport-related genes in leaves. Compared to the exogenous application of sucrose, the dark treatment had the opposite effects. All the above results highlighted the important role of sucrose in regulating the responses of rice plants to iron deficiency.

A circular white-light flare with impulsive and gradual white-light kernels

White-light flares are the flares with emissions visible in the optical continuum. They are thought to be rare and pose the most stringent requirements in energy transport and heating in the lower atmosphere. Here we present a nearly circular white-light flare on 10 March 2015 that was well observed by the Optical and Near-infrared Solar Eruption Tracer and Solar Dynamics Observatory. In this flare, there appear simultaneously both impulsive and gradual white-light kernels. The generally accepted thick-target model would be responsible for the impulsive kernels but not sufficient to interpret the gradual kernels. Some other mechanisms including soft X-ray backwarming or downward-propagating Alfvén waves, acting jointly with electron beam bombardment, provide a possible interpretation. However, the origin of this kind of white-light kernel is still an open question that induces more observations and researches in the future to decipher it.

Profiles of differentially expressed genes and overexpression of NEBL indicates a positive prognosis in patients with colorectal cancer

The present study aimed to identify differentially expressed genes (DEGs) in colorectal cancer (CRC) and provide novel prognostic biomarkers for CRC. The microarray dataset GSE41258 was used to screen DEGs of CRC. Subsequently, a protein-protein interaction network of DEGs and Gene Ontology analysis were performed to identify hub genes and associated biological processes. Nebulette (NEBL) and complement C1q like 1 (C1QL1) were validated using reverse transcription-quantitative polymerase chain reaction in patients with CRC. Survival analysis was performed for the two hub genes. GSE41258 dataset included 182 CRC samples and 54 normal tissues. A total of 759 DEGs, including 279 upregulated and 480 downregulated were screened between both groups. NEBL and C1QL1 were identified as the two hub genes and upregulated genes involved in various biological processes, including ‘regulation of biological quality’ and ‘response to stimulus’, respectively. Additionally, the overexpression of NEBL and C1QL1 in experimental validation was consistent with the aforementioned bioinformatics analysis results. Survival analysis suggested that overexpressed NEBL in patients with CRC was associated with a positive prognosis for overall survival. In conclusion, CRC was associated with a large group of DEGs. From the upregulated genes, overexpressed NEBL in patients CRC indicated a positive prognosis for overall survival and may be used as a prognostic biomarker for patients with CRC.

Diagnostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Crohn's Disease

The aim of this study is to investigate the diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with Crohn's disease (CD) and non-CD controls. These ratios were all derived from complete blood counts. Two hundred and six participants including CD inpatients and non-CD controls were retrospectively enrolled. We found statistically higher NLR and PLR and lower LMR in CD patients than in non-CD controls (all P < 0.01). However, NMR was not different between the two groups (P = 0.18). In addition, NLR, PLR, and LMR were associated with CRP and ESR. Optimal cutoffs for NLR and PLR were 2.72 (sensitivity: 68.3%, specificity: 75.9%, and overall accuracy: 70.1%) and 132.88 (sensitivity: 76.7%, specificity: 84.8%, and overall accuracy: 80.8%), respectively. In conclusion, the NLR and PLR might be effective, readily available, and low-cost biomarkers for differentiating CD patients from non-CD controls.

Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis

AIM

The aim of this study was to identify the best probiotic supplementation in triple therapy for pediatric population with Helicobacter pylori infection.

METHODS

Eligible trials were identified by comprehensive searches. Relative risks with 95% confidence intervals and relative ranks with P scores were assessed.

RESULTS

Twenty-nine trials (3122 participants) involving 17 probiotic regimens were identified. Compared with placebo, probiotic-supplemented triple therapy significantly increased H. pylori eradication rates (relative ratio (RR) 1.19, 95% CI 1.13-1.25) and reduced the incidence of total side effects (RR 0.49, 95% CI 0.38-0.65). Furthermore, to supplemented triple therapy, Lactobacillus casei was identified the best for H. pylori eradication rates (P score = 0.84), and multi-strain of Lactobacillus acidophilus and Lactobacillus rhamnosus for total side effects (P score = 0.93). As for the subtypes of side effects, multi-strain of Bifidobacterium infantis, Bifidobacterium longum, L. acidophilus, L. casei, Lactobacillus plantarum, Lactobacillus reuteri, L. rhamnosus, Lactobacillus salivarius, Lactobacillus sporogenes, and Streptococcus thermophilus was the best to reduce the incidence of diarrhea; multi-strain of Bacillus mesentericus, Clostridium butyricum, and Streptococcus faecalis for loss of appetite; multi-strain of B. longum, Lactobacillus bulgaricus, and S. thermophilus for constipation; multi-strain of Bifidobacterium bifidum, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. reuteri, and Streptococcus for taste disturbance; Saccharomyces boulardii for bloating; and multi-strain of Bifidobacterium breve, B. infantis, L. acidophilus, L. bulgaricus, L. casei, L. rhamnosus, and S. thermophilus for nausea/vomiting.

CONCLUSIONS

Probiotics are recommended to supplement triple therapy in pediatrics, and the effectiveness of triple therapy is associated with specific probiotic supplementation.

[Road-side observational survey on 4 unlawful acts among electric bicycle riders in Zhejiang]

OBJECTIVE

To investigate the prevalence of key unlawful acts among electric bicycle riders and provide evidence for the development of specific interventions.

METHODS

A 4-day road-side survey was conducted in Jinhua, Zhejiang province, in 2013. The speed of electric bicycle was measured by speed measuring instrument and the unlawful acts of riders, such as reverse riding, running the red-light and carrying passengers, were observed with non-participatory way.

RESULTS

A total of 3 448 running electric bicycles were observed and the average speed was 26 km/h, the proportion of electric bicycle at the speed of ≥15 km/h was 87.06%. The average speed was highest during 10 am-11 am(30 km/h). the number of observed electric bicycle riders with unlawful acts of ' running the red-light','reverse riding' and ' carrying passengers' were 1 315, 656 and 1 877 respectively, and the estimated rate was 10.01%, 4.99% and 15.22%, respectively. More ' running the red-light','reverse riding' and ' carrying passengers' occurred during 7 am-8 am(14.59%)and 13 pm-14 pm(15.25%), 13 pm-14 pm(7.33%)and 17 pm-18 pm(7.63%), 6 am-7 am(32.44%)and 12 pm-13 pm(27.90%), respectively.

CONCLUSION

Overspeeding, carrying passengers, running the red-light, reverse riding were the key unlawful acts among electric bicycle riders. Targeted intervention should be carried out to reduce the prevalence of unlawful riding acts and the incidence of electric bicycle related injuries and deaths.

Fabrication of magnetically responsive HKUST-1/Fe3O4 composites by dry gel conversion for deep desulfurization and denitrogenation

Selective adsorption by use of metal-organic frameworks (MOFs) is an effective method for purification of hydrocarbon fuels. In consideration that the adsorption processes proceed in liquid phases, separation and recycling of adsorbents should be greatly facilitated if MOFs were endowed with magnetism. In the present study, we reported for the first time a dry gel conversion (DGC) strategy to fabricate magnetically responsive MOFs as adsorbents for deep desulfurization and denitrogenation. The solvent is separated from the solid materials in the DGC strategy, and vapor is generated at elevated temperatures to induce the growth of MOFs around magnetic Fe₃O₄ nanoparticles. This strategy can greatly simplify the complicated procedures of the well-known layer-by-layer method and avoid the blockage of pores confronted by introducing magnetic Fe₃O₄ nanoparticles to the pores of MOFs. Our results show that the adsorbents are capable of efficiently removing aromatic sulfur and nitrogen compounds from model fuels, for example removing 0.62mmolg^-1S and 0.89mmolg^-1N of thiophene and indole, respectively. In addition, the adsorbents are facile to separate from liquid phases by use of an external field. After 6 cycles, the adsorbents still show a good adsorption capacity that is comparable to the fresh one.

Urgent transcatheter arterial embolization for the treatment of ruptured renal angiomyolipoma with spontaneous hemorrhage

Background The rich neovascularization of renal angiomyolipoma (AML) has a tendency for spontaneous rupture with subsequent hemorrhage. Nephrectomy or nephron-sparing surgery has rarely been used as a primary treatment in urgent situations. Purpose To evaluate the safety and long-term outcomes for patients treated by urgent transcatheter arterial embolization (TAE) for spontaneous ruptured renal AML with severe hemorrhage. Material and Methods A retrospective evaluation was performed of 25 renal AML cases with spontaneous hemorrhage confirmed by imaging. Polyvinyl alcohol (PVA) particles and coils of multiple sizes were used to embolize the spontaneous renal AML ruptures. Results The technical success rate of TAE was 96% (24/25). One week post-TAE, 1 patient with recurrent hemorrhage underwent emergency nephrectomy. Minor complications affected 16 patients with post-embolization syndrome; 15 patients resolved using conservative measures and one patient received nephrectomy post TAE 1 week later. All patients were followed up for 24-72 months (median, 50.2 months). Surgical treatment was avoided for 92% (23/25) of patients, and the re-embolization rate was 0% at 2 years post TAE. In the 23 patients without surgical treatment, the mean maximum diameter of renal AML was reduced from 12.4 ± 5.5 cm to 6.3 ± 2.5 cm and no hemorrhage occurred during follow-up. Conclusion Urgent TAE is a technically feasible and minimally invasive procedure for controlling severe hemorrhage and preservation of renal function following spontaneous ruptured renal AML.

Substitution disorder and photoluminescent property of a new rare-earth borate: K3TbB6O12

A new rare-earth borate K3TbB6O12 has been prepared using the high temperature molten salt method and was structurally determined by single crystal X-ray diffraction analyses. The structure features a three-dimensional (3D) framework which is composed of isolated B5O10, KO6, KO8 and TbO6 groups. An atom site in the 32 screw axis is shared by K and Tb atoms with the molar ratio of 1:1. The self-activated photoluminescence (PL) property of K3TbB6O12 was studied. Under the excitation of 378 nm, the emission spectrum exhibits an intense green emission centered at 543–548 nm with the chromaticity coordinates (0.342, 0.590), which can be assigned to the 5D4→7F5 transition of Tb3+. The excitation spectra cover a wide range from 330 to 385 nm, which suggests that the K3TbB6O12 phosphors can be effectively excited by a near-UV light source. One may expect that compound K3TbB6O12 can be used as a green phosphor pumped by near-UV LED chips.

Clinical efficacy of agitation thrombolysis via transjugular access for treatment of acute portal vein thrombosis

AIM: To evaluate the clinical efficacy of agitation thrombolysis via transjugular access for the treatment of acute portal vein thrombosis.

METHODS: Thirteen patients with acute portal vein thrombosis treated from October 2012 to March 2015 at our hospital were analyzed retrospectively. The portal vein was approached via the transjugular intrahepatic portosystemic route, followed by agitation thrombolysis to resolve the thrombi. The need for transjugular intrahepatic portosystemic shunt (TIPS) was based on the presence of portal hypertension, and then a catheter was indwelled into the thrombi. The success rate, thrombolytic therapeutic time and effect, and complications were observed. Computed tomography and Doppler ultrasound were performed to follow the patency of the portal vein and TIPS stent.

RESULTS: Agitation thrombolysis were successfully created in 12 patients. Of 8 patients who underwent TIPS, 1 underwent wide resection due to confirmed extensive intestinal necrosis on postoperative day 2; however, the patient died 9 d later. In the remaining 11 patients, the portal vein was recanalized > 90% as revealed by CT findings. There was a significant difference in lumen occupancy between pre- and post-operation (P < 0.01). The clinical symptoms such as abdominal pain, ascites, and gastrointestinal bleeding were all relieved or disappeared. The complications were mainly as follows: intraoperative subcapsular bleeding in one patient; death due to intestinal necrosis in one patient; hepatic encephalopathy at 3 mo in one patient with TIPS; and hematuria during thrombolysis in one patient. During follow-up, TIPS stent stenosis was noted in one patient at 7 mo and treated by balloon angioplasty.

CONCLUSION: Agitation thrombolysis via transjugular access for the treatment of acute portal vein thrombosis is safe and effective.

Transcatheter arterial embolization combined with radiofrequency ablation activates CD8(+) T-cell infiltration surrounding residual tumors in the rabbit VX2 liver tumors

Purpose

To evaluate the effect of transcatheter arterial embolization (TAE) combined with radiofrequency ablation (RFA) treatment (TAE + RFA) on the expression of heat shock protein 70 (HSP70) in residual tumors and explore the relationship between the HSP70 and CD8⁺ T-cell infiltrate surrounding residual tumors in the rabbit VX2 liver tumor model.

Materials and methods

Animals with VX2 liver tumors were randomized into four groups (control, TAE, RFA, and TAE + RFA) with 15 rabbits in each group. Five rabbits in each group were sacrificed on days 1, 3, and 7 after treatment. HSP70 expression and infiltration of CD8⁺ T-cells in the liver and residual tumors surrounding the necrosis zone were detected by immunohistochemistry staining. The maximal diameters of tumor necrosis, numbers of metastases, and tumor growth rate were compared on day 7 after treatment.

Results

TAE + RFA achieved larger maximal diameter of tumor necrosis, lower tumor growth rate, and fewer metastatic lesions, compared with other treatments on day 7. The number of CD8⁺ T-cells in the TAE + RFA group was significantly higher than in other groups on days 1, 3, and 7. There was a positive correlation between HSP70 expression level and infiltration of CD8⁺ T-cells surrounding the residual tumor on day 1 (r=0.9782, P=0.012), day 3 (r=0.93, P=0.021), and day 7 (r=0.8934, P=0.034).

Conclusion

In the rabbit VX2 liver tumor model, TAE + RFA activated the highest number of CD8⁺ T-cells surrounding residual tumors. TAE + RFA appears to be a beneficial therapeutic modality for tumor control and antitumor immune response in this model.

Endovascular treatment of visceral artery pseudoaneurysms: Analysis of 42 cases

AIM: To determine the clinical features and endovascular treatment of visceral artery pseudoaneurysms (VAPA).

METHODS: Clinical data and our experience with interventional treatment of 42 patients with VAPA were retrospectively analyzed. Follow-up was carried out via assessment of contrast-enhanced computed tomography or computed tomography angiography images.

RESULTS: Endovascular treatment was technically successful in 38 (90.4%) patients, of whom one died of multisystem organ failure 28 d after intervention. The 30 d mortality rate was 2.4% (1/42). Four patients required secondary interventions because of rebleeding and were successfully treated by reintervention. In the follow-up period, 17 patients suffering from cancer died from 1 to 12 mo after embolization because of disease progression (n = 8), multisystem organ failure (n = 7), myocardial infarction (n = 1), and septic shock (n = 1). Four patients suffered partial splenic infarction and post-embolization syndrome. During follow-up, no patient had hepatic insufficiency or bowel ischemia; no VAPA occurred in all patients.

CONCLUSION: Endovascular management is minimally invasive and highly successful in treating VAPA and particularly useful in poor surgical candidates.

Intraductal Radiofrequency Ablation Followed by Locoregional Tumor Treatments for Treating Occluded Biliary Stents in Non-Resectable Malignant Biliary Obstruction: A Single-Institution Experience

Objectives

To determine the safety and feasibility of intraductal radiofrequency ablation (RFA) followed by locoregional tumor treatments in patients with non-resectable malignant biliary obstruction and stent re-occlusion.

Methods

Fourteen patients with malignant biliary obstruction and blocked metal stents were studied retrospectively. All had intraductal RFA followed by locoregional tumor treatments and were monitored clinically and radiologically. The practicality, safety, postoperative complications, jaundice remission, stent patency and survival time were analyzed.

Results

Combination treatment was successful for all patients. There were no severe complications during RFA or local treatments. All patients had stent patency restored, with a decline in serum bilirubin. Three patients had recurrent jaundice by 195, 237 and 357 days; two patients underwent repeat intraductal RFA; and one required an internal-external biliary drain. The average stent patency time was 234 days (range 187-544 days). With a median follow-up of 384 days (range 187-544 days), six patients were alive, while eight had died. There was no mortality at 30 days. The 3, 6, 12 and 18 month survival rates were 100%, 100%, 64.3% and 42.9%, respectively.

Conclusion

Intraductal RFA followed by locoregional tumor treatments for occluded metal stents is safe and practically feasible and potential increase stent patency and survival times.

Extreme ultraviolet imaging of three-dimensional magnetic reconnection in a solar eruption

Magnetic reconnection, a change of magnetic field connectivity, is a fundamental physical process in which magnetic energy is released explosively, and it is responsible for various eruptive phenomena in the universe. However, this process is difficult to observe directly. Here, the magnetic topology associated with a solar reconnection event is studied in three dimensions using the combined perspectives of two spacecraft. The sequence of extreme ultraviolet images clearly shows that two groups of oppositely directed and non-coplanar magnetic loops gradually approach each other, forming a separator or quasi-separator and then reconnecting. The plasma near the reconnection site is subsequently heated from ∼1 to ≥5 MK. Shortly afterwards, warm flare loops (∼3 MK) appear underneath the hot plasma. Other observational signatures of reconnection, including plasma inflows and downflows, are unambiguously revealed and quantitatively measured. These observations provide direct evidence of magnetic reconnection in a three-dimensional configuration and reveal its origin.

Magnetic reconnection is a fundamental energy release process taking place in various astrophysical environments, but it is difficult to observe it directly. Here, the authors provide evidence of three-dimensional magnetic reconnection in a solar eruption using combined perspectives of two spacecraft.

Lower gastrointestinal bleeding: Role of 64-row computed tomographic angiography in diagnosis and therapeutic planning

AIM: To determine the value of computed tomographic angiography (CTA) for diagnosis and therapeutic planning in lower gastrointestinal (GI) bleeding.

METHODS: Sixty-three consecutive patients with acute lower GI bleeding underwent CTA before endovascular or surgical treatment. CTA was used to determine whether the lower GI bleeding was suitable for endovascular treatment, surgical resection, or conservative treatment in each patient. Treatment planning with CTA was compared with actual treatment decisions or endovascular or surgical treatment that had been carried out in each patient based on CTA findings.

RESULTS: 64-row CTA detected active extravasation of contrast material in 57 patients and six patients had no demonstrable active bleeding, resulting in an accuracy of 90.5% in the detection of acute GI bleeding (57 of 63). In three of the six patients with no demonstrable active bleeding, active lower GI bleeding recurred within one week after CTA, and angiography revealed acute bleeding. The overall location-based accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of GI bleeding by 64-row CTA were 98.8% (249 of 252), 95.0% (57 of 60), 100% (192 of 192), 100% (57 of 57), and 98.5% (192 of 195), respectively. Treatment planning was correctly established on the basis of 64-row CTA with an accuracy, sensitivity, specificity, PPV and NPV of 98.4% (248 of 252), 93.3% (56 of 60), 100% (192 of 192), 100% (56 of 56), and 97.5% (192 of 196), respectively, in a location-based evaluation.

CONCLUSION: 64-row CTA is safe and effective in making decisions regarding treatment, without performing digital subtraction angiography or surgery, in the majority of patients with lower GI bleeding.

[An automatic peak detection method for LIBS spectrum based on continuous wavelet transform]

Spectrum peak detection in the laser-induced breakdown spectroscopy (LIBS) is an essential step, but the presence of background and noise seriously disturb the accuracy of peak position. The present paper proposed a method applied to automatic peak detection for LIBS spectrum in order to enhance the ability of overlapping peaks searching and adaptivity. We introduced the ridge peak detection method based on continuous wavelet transform to LIBS, and discussed the choice of the mother wavelet and optimized the scale factor and the shift factor. This method also improved the ridge peak detection method with a correcting ridge method. The experimental results show that compared with other peak detection methods (the direct comparison method, derivative method and ridge peak search method), our method had a significant advantage on the ability to distinguish overlapping peaks and the precision of peak detection, and could be be applied to data processing in LIBS.