简介：Alinear4-nodequadrilateralquasi-conformingplaneelementwithinternalparametersisproposed.Theelementpreservesadvantagesofthequasi-conformingtechnique,includinganexplicitstiffnessmatrix,whichcanbeappliedtononlinearproblems.Theweakpatchtestguaranteestheconvergenceoftheelement.ThenthelinearelementisextendedtothegeometricallynonlinearanalysisintheframeworkofTotalLagrangian(TL)formulation.Thenumericaltestsindicatethatthepresentelementisaccurateandinsensitivetomeshdistortion.

简介：Forapairofnodess,tinanundirectedgraphG=(V,A)andagivenlevelUofallowabledelay,wewouldliketomodifythenetworkbynode-basedoredge-basedupgradingstrategiestomakethedelaybetweensandtnotgreaterthanU.Inthispaper,wepresentsomeNP-hardresultsforthedelayimprovementproblems.

简介：Objective:ThepurposesofthisstudyweretoidentifyriskfactorsforcervicallymphnodemetastasisandtoexaminetheassociationbetweenBRAFV600Estatusandclinicalfeaturesinpapillarythyroidmicrocarcinoma(PTMC).Methods:Atotalof1,587patientswithPTMC,treatedinTianjinMedicalUniversityCancerInstituteandHospitalfromJanuary2011toMarch2013,underwentretrospectiveanalysis.Wereviewedandanalyzedfactorsincludingclinicalresults,pathologyrecords,ultrasoundresults,andBRAFV600Estatus.Results:Multivariatelogisticregressionanalysesdemonstratedthatgender(male)[oddsratio(OR)=1.845,P=0.000],age(<45years)(OR=1.606,P=0.000),tumorsize(>6mm)(OR=2.137,P=0.000),bilateralism(OR=2.011,P=0.000)andextrathyroidalextension(OR=1.555,P=0.001)servedasindependentpredictorsofcentrallymphnodemetastasis(CLNM).Moreover,CLNM(OR=29.354,P=0.000)servedasanindependentpredictoroflaterallymphnodemetastasis(LLNM).Amongpatientswithasolitaryprimarytumor,thosewithtumorlocationinthelowerthirdofthethyroidlobeortheisthmusweremorelikelytoexperienceCLNM(P<0.05).UnivariateanalysesindicatedthatCLNM,LLNM,extrathyroidalextension,andmultifocalitywerenotsignificantlyassociatedwithBRAFV600Emutation.Conclusions:ThepresentstudysuggestedthatprophylacticneckdissectionofthecentralcompartmentshouldbeconsideredinpatientswithPTMC,particularlyinmenwithtumorsizegreaterthan6mm,agelessthan45years,extrathyroidalextension,andtumorbilaterality.AmongpatientswithPTMC,BRAFV600Emutationisnotsignificantlyassociatedwithprognosticfactors.ForabetterunderstandingofsurgicalmanagementofPTMCandtheriskfactors,werecommendmulticenterresearchandlong-termfollow-up.

简介：AbstractBackground:Previous studies have revealed that diabetes mellitus (DM) promotes disease progress of gastric cancer (GC). This study aimed to further investigating whether DM advanced lymph nodes (LNs) metastasis in GC.Methods:The clinicopathologic data of GC patients with >15 examined LN (ELN) between October 2004 and December 2019 from a prospectively maintained database were included. The observational outcomes included the number (N3b status) and anatomical distribution (N3 stations) of metastatic LN (MLN).Results:A total of 2142 eligible patients were included in the study between October 2004 and December 2019. N3 stations metastasis (26.8% in DM vs. 19.3% in non-DM, P = 0.026) and N3b status (18.8% in DM vs. 12.8% in non-DM, P = 0.039) were more advanced in the DM group, and multivariate logistic regression analyses confirmed that DM was an independent factor of developing N3 stations metastasis (odds ratio [OR] = 1.771, P= 0.011) and N3b status (OR= 1.752, P= 0.028). Also, multivariate analyses determined DM was independently associated with more MLN (β = 1.424, P = 0.047). The preponderance of N3 stations metastasis (DM vs. non-DM, T1-2: 2.2% vs. 4.9%, T3: 29.0% vs. 20.3%, T4a: 38.9% vs. 25.8%, T4b: 50.0% vs. 36.6%; ELN16-29: 8.6% vs. 10.4%, ELN30-44: 27.9% vs. 20.5%, ELN ≥ 45: 37.7% vs. 25.3%), N3b status (DM vs. non-DM, T1-2: 0% vs. 1.7%, T3: 16.1% vs. 5.1%, T4a: 27.8% vs. 19.1%, T4b: 44.0% vs. 28.0%; ELN16-29: 8.6% vs. 7.9%, ELN30-44: 18.0% vs. 11.8%, ELN ≥ 45: 26.4% vs. 17.3%), and the number of MLN (DM vs. non-DM, T1-2: 0.4 vs. 1.1, T3: 8.6 vs. 5.2, T4a: 9.7 vs. 8.6, T4b: 17.0 vs. 12.8; ELN16-29: 3.6 vs. 4.6, ELN30-44: 5.8 vs. 5.5, ELN ≥ 45: 12.0 vs. 7.7) of DM group increased with the advancement of primary tumor depth stage and raising of ELN.Conclusions:DM was an independent risk factor for promoting LN metastasis. The preponderance of LN involvement in the DM group was aggravated with the advancement of tumor depth.

简介：Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.

简介：Objective:TheUnionforInternationalCancerControl(UICC)Node(N)classificationisthemostcommonusedstagingmethodfortheprognosisofgastriccancer.Itdemandsadequate,atleast16lymphnodes(LNs)tobedissected;thereforedifferentstagingsystemswereinvented.Methods:BetweenMarch2005andMarch2010,164patientswereevaluatedattheDepartmentofGeneralSurgeryintheKenézyGyulaHospitalandattheDepartmentofGeneral,ThoracicandVascularSurgeryintheKaposiMórHospital.The6th,7thand8thUICCN-stagingsystems,thenumberofexaminedLNs,thenumberofharvestednegativeLNs,themetastaticlymphnoderatio(MLR)andthelogoddsofpositiveLNs(LODDS)weredeterminedtomeasuretheir5-yearsurvivalratesandtocomparethemtoeachother.Results:Theoverall5-yearsurvivalrateforallpatientswas55.5%withamedianoverallsurvivaltimeof102months.Thetumorstage,gender,UICCN-stages,MLRandtheLODDSweresignificantprognosticfactorsforthe5-yearsurvivalwithunivariateanalysis.The6thUICCN-stagedidnotfollowtheadequateriskincomparingN2vs.N0andN3vs.N0withmultivariateinvestigation.ComparisonofperformancesoftheresidualNclassificationsprovedthattheLODDSsystemwasfirstinthepredictionofprognosisduringtheevaluationofallpatientsandincaseswithlessthan16harvestedLNs.TheMLRgavethebestprognosticpredictionwhenadequate(morethanorequalto16)lymphadenectomywasperformed.Conclusions:WesuggesttheapplicationofLODDSsystemroutinelyinwesternpatientsandtheusageofMLRclassificationincaseswithextendedlymphadenectomy.

简介：有在一个减少的蚂蟥神经原模型的混乱的增加时期的串联的机制与人诊所轨道作为一个僵绳节点限制周期的分叉被建议令人满意“小脑叶条件”，而不是不可靠的大祸。在每刺增加，新尖铁出现在爆炸ers的刺的阶段的结束。

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简介：为排干肿瘤的淋巴的刺激发现一个可行方法为在诊所的使用作准备的节点(TDLN)房间，TDLN房间的CTL活动由不同刺激导致了(IL-2独自一个，IL-2+自体同源的肿瘤抗原(atAg)，IL-2+GM-CSF+IL-4+atAg)被最大的LDH测量酶版本。机制被形态学和CD83+TDLN房间的察觉的观察探索。由IL-2+GM-CSF+IL-4+atAg的TDLN房间的扩大由独自一个的IL-2或IL-2+atAg比那显著地高(p<0.01)。IL-2+GM-CSF+IL-4+atAg导致的TDLN房间的AntitumorCTL活动比另外的组的那些显著地高。在与IL-2+GM-CSF+IL-4+atAg对待的TDLN人口以内的CD83+房间的数字显著地被提高。由IL-2+GM-CSF+IL-4+atAg刺激TDLN房间的方法比有IL-2或IL-2+atAg的刺激好。IL-2+GM-CSF+IL-4+atAg导致的TDLN房间生产了更树枝状的房间(DC)。在我们的学习，我们建立了T房间和DC一起被刺激的一个系统前vivo，它是容易的进行并且生产有希望的结果。它为改进可能在临床的癌症治疗被使用的TDLN房间antitumor活动提供了一个新方法。

简介：Objective:Thisrandomizedstudyaimedtocomparetheclinicalefficacybetweenthenoveldualtracercomposedofindocyaninegreen(ICG)andbluedye(BD)andtheconventionaldualtracercomposedofradioisotopeandBDforsentinellymphnode(SLN)mappinginpatientswithbreastcancer.Methods:Thisstudyenrolled471clinicallylymphnode-negativepatientswithprimarybreastcancer.Allpatientsunderwentmastectomy,andthoseundergoingsentinellymphnodebiopsy(SLNB)wererandomizedtoreceivebluedyeplusradioisotope(RBgroup)orBDplusICG(IBgroup).ThedetectionperformancesonSLNidentificationrate,positiveSLNcounts,detectionsensitivity,andfalse-negativeratewerecomparedbetweenthetwogroups.Results:IntheIBgroup,97%(194/200)ofthepatientswhounderwenttheICGandBDdualtracerinjectionshowedfluorescentpositivelymphaticvesselswithin2–5min.TheidentificationrateofSLNswascomparablebetweentheIBgroup(99.0%,198/200)andtheRBgroup(99.6%,270/271)(P=0.79).NosignificantdifferenceswereobservedintheidentificationrateofmetastaticSLNs(22.5%vs.22.9%,P>0.05,RBgroupvs.IBgroup,thesamebelow),positiveSLNcounts(3.72±2.28vs.3.91±2.13,P>0.05),positivemetastaticSLNcounts(0.38±0.84vs.0.34±0.78,P>0.05),SLNBdetectionsensitivity(94.4%vs.92.5%,P>0.05),orfalse-negativerate(5.6%vs.7.5%,P>0.05)betweenthetwogroups.Conclusions:ICGcanbeusedasapromisingalternativetracerforradioisotopeinSLNmapping,andwhenitiscombinedwithBDinlymphangiography,itofferscomparabledetectionsensitivitycomparedtotheconventionallymphaticmappingstrategiesthatarewidelyusedinclinicalpractice.

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简介：合作中继作为一种有效技术新兴在下一代的细胞的网络在高数据率范围上完成要求，象长期的进化进展(LTE进展)一样。在这份报纸，我们在向LTE进展中继细胞的网络的multihop上建议一种分布式的联合继电器节点(RN)选择和力量分配计划，两个都考虑无线隧道状态和RN的剩余精力。我们提出作为一个不安的土匪系统中继细胞的网络的multihop。一阶的有限状态的Markov链被用来描绘变化时间的隧道和剩余精力状态转变。与这随机的优化明确的表达，最佳的政策有戏剧性地减少计算复杂性的indexability性质。模拟结果证明建议计划罐头高效地提高期望的系统报酬，与另外的存在算法相比。

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简介：摘要 ：传统中药材购药流程复杂且效率低，即使在发达医院，药材被封装成包，也需人工抓药。故论文围绕如何有效提高中药材购药效率问题，提出一款基于Node-RED的分布式中药材一体化取药系统。该系统通过设计上位机、药柜改装、搭建Node-RED物联网技术等，完成对设计系统的联网、中药方的准确录入、药材实时查看及状态检测、语音及显示屏提示等功能。论文从数据流向的角度，依次介绍了从录入数据到数据分析过程中的软硬件设计方案。

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