l. yang

We aimed to develop a mould for the over-flexion and over-extension positions to solve the technical problem of patients who find it difficult to form the over-flexion and over-extension positions of the cervical spine by lowering their heads forwards and raising their heads backwards.

We calculated the average physiological bending radian of normal people and measured the depth of the cervical physiological curve using Borden's method. Finally, we designed a mould that conformed to the characteristics of the human cervical spine to conduct nasal bone examinations in the over-flexion and over-extension positions in combination with the patient's examination position.

When the neck is equipped with an over-flexion and over-extension mould when performing coronal nasal bone examinations, the nasal bone structure is more fully displayed than in routine examinations; furthermore, the clinical diagnosis efficiency greatly improves, and the rate of misdiagnosis significantly reduces.

This model increases the comfort of patients and solves the technical problem of patients who cannot maintain the over-flexion and over-extension positions for an extended period.

The issue of pedestrian-level wind environments around high-rise buildings is closely related to the comfort and safety of human settlements. In this paper, we study the effects of different wind direction angles and spacing ratios on the wind environment at pedestrian heights around buildings arranged in an equilateral triangle configuration. Three-dimensional steady-state numerical simulation was employed, with the standard k-ε model selected as the turbulence model. Wind speed ratios and different area ratio parameters are used to quantitatively express the degree and range of influence of wind speed by buildings. The results show that the maximum wind speed ratio at the corner of a building is greatly affected by the wind direction angle, with 45°, 135°, and 157.5° being the unfavorable wind direction angles. Conversely, the area ratio of different areas is greatly affected by the spacing ratio. As the spacing ratio increases, the mutual interference effect between buildings weakens, resulting in a better pedestrian wind environment. Owing to the unique layout of the building group, different degrees of ventilation corridors are formed among the three buildings. The wind speed amplification effect in the corridors is more significant, and the areas with poor wind environments are concentrated in these corridors.

To assess the efficacy of various acupuncture therapies for treating radiotherapy-induced radiation enteritis (RE). Relevant studies on RE treatment through acupuncture and moxibustion were collected from medical databases. These studies were meticulously screened based on stringent inclusion and exclusion criteria. Their methodological quality was evaluated, and data were meta-analysed using Revman 5.3 software. Six studies were included in this analysis. The fixed effect (FE) model revealed a statistically significant difference in the distribution of apparent efficacy between the experimental and control groups [OR = -0.18, 95% CI (-0.25, -0.11), P < 0.00001], as well as in the distribution of cure rates [OR = 0.35, 95% CI (0.20, 0.62), P = 0.0003]. The FE model also showed a significant difference in Karnofsky Performance Scale (KPS) scores [OR = -6.94, 95% CI (-10.39, -3.48), P < 0.0001]. Subgroup analysis for age and gender revealed no significant differences. This research model's robustness suggests that acupuncture and moxibustion, when used in combination, are more effective in treating patients with RE than control treatments. This effectiveness is evident in terms of significant effect proportion, cure rates, and KPS scores. These conclusions are consistent across different genders and ages.

The To measure regulatory T cells (Tregs) expression in driver-gene-negative advanced non-small cell lung cancer (NSCLC) as well as its effect on the therapeutic efficacy and prognosis of immune checkpoint inhibitors (ICIs).

Fifty patients with advanced non-small cell lung cancer without driving genes who were receiving treatment with a monoclonal antibody targeting the programmed death receptor-1 (PD-1) made up the study group. 30 healthy subjects in the same period were chosen into the control group. Flow cytometry was used to identify CD4highCD25+Foxp3+Treg cells in peripheral blood of all participants. Relation between CD4highCD25+Foxp3+Treg cells and tumor markers were explored, and efficacy and prognosis in patients before and after therapy was analyzed.

The fraction of CD4highCD25+Foxp3+Treg cells in the study group was higher (P<0.05). Following three rounds of PD-1 monoclonal antibody treatment, patients' CD4highCD25+Foxp3+Treg cells proportion was lower than before treatment (P<0.01), and showed a positive correlation with tumor markers (P<0.05). The fraction of CD4highCD25+Foxp3+Treg cells in the CR+PR group decreased in both the second and third cycles after treatment compared to the SD+PD group (P<0.01), but no change was found before or during the first cycle (P>0.05). CD4highCD25+Foxp3+Treg cells proportion in the death group presented higher relative to the survival group (P<0.05). CD4highCD25+Foxp3+Treg cells predicted the area under the ROC curve was 0.8134, with significant difference (P<0.05).

CD4highCD25+Foxp3+Treg cells proportion in peripheral blood of NSCLC patients shows increased, and has predictive value for therapeutic efficacy of ICIs and prognosis of driver-gene-negative advanced NSCLC patients.

Radiograph of hand and wrist has been widely used in children's bone age assessment (BAA). However, ionizing radiation may be harmful for children in the future. Therefore, alternative methods have been attempted for the evaluation of children's bone age. Here, we reported an automated volume scanner (AVS) in assessing the biological age of children in comparison with X-ray radiograph as the gold standard.

Total 22 children (13 male and 9 female) with short stature or precocious puberty were enrolled into this study. Their chronological age ranged from 4 to 14 years old. The children's left hand-wrist was scanned with the AVS by putting them into a water sink containing tape water. Coronal images of the left hand-wrist were reconstructed and compared with X-ray images.

The number of patients whose hand-wrist bones (except for the first metacarpal sesamoid bone and the secondary ossification center of the first metacarpal bone) identified by AVS image was not significantly different from that by X-ray image. In addition, the total number of observed bones in each patient were not significantly different between the two methods. The concordance rate (percentage of patients whose hand-wrist bone presented in both AVS image and X-ray image) was high and the inter-observer variance of BA was small.

The AVS method was highly correlated with the standard radiograph for children's bone age assessment with small inter-observer variability. This novel AVS method could be an alternative method in clinical practice for bone age assessment with higher safety and reliability.

To investigate the difference between CT-guided three‑dimensional brachytherapy using insertion needles and Fletcher applicator brachytherapy.

Ninety-three patients with cervical squamous cell carcinoma were included. Insertion needle or Fletcher applicators were used depending on tumor conditions. The target volume, target and organs at risk (OAR) dose, and treatment-related complications, in patients receiving the different brachytherapy techniques were compared.

The mean volume of the high-risk clinical target volume (HR-CTV) and intermediate-risk clinical target volume (IR-CTV) in the Fletcher applicator group were smaller compared with the insertion needle group (P<0.05). The mean values of D90 per fraction of the HR-CTV and IR-CTV in the Fletcher applicator group were 101 cGy and 60 cGy lower, respectively, compared with the insertion needle group (P<0.05). The mean bladder and rectum D0.1cm3 per fraction, the mean sigmoid and small intestine D2cm3 per fraction were statistically different between two groups( all P<0.05), the remaining dosimetric parameters were no significant differences (P>0.05). Following dose normalization, with the exception of the mean normalized sigmoid D0.1cm3 per fraction for the received by the OAR in the Fletcher applicator group and the insertion needle group were significantly different (P<0.05). There was no serious complication in the brachytherapy of two types applicators.

Brachytherapy using insertion needles enables the treatment of larger target volumes with higher target doses when compared with conventional Fletcher applicator brachytherapy. In addition, the doses received by the OAR are lower, indicating that it is a safe and effective technique that warrants wide adoption.

The cooling efficiency of blade is growing demand with increasing turbine inlet temperature in gas turbine development. Ribs used in cooling channels is a common cooling structure, therefore, many configurations were studied by previous literatures, including angle, spacing, shape etc. However, there are less research about the dislocation ribs structure. In this paper, the 45-deg parallel ribs, crossed ribs and dislocation ribs were investigated by numerical simulation, in order to reveal the heat transfer performance and flow mechanism. Refer to the experiment, SST k-ω model was applied in steady simulation, at Re from 20000 to 50000. Due to the angled ribs can induce the secondary flow and generate small helical vortices at front corner, heat transfer performance was elevated. The large rotating vortices influenced by the ribs arrangement occupy the center channel, thence the dislocation caused different flow and heat transfer results. The results shown that parallel rib has higher heat transfer enhancement than crossed ribs, but pressure loss possess considerable level. At Re=21587, the averaged turbulent kinetic energy of Case2.2 with dislocation ribs is 22.4% lower than parallel ribs. The all 45-deg crossed ribs present higher level of overall thermal performance, and Case2.2 is optimal for the range of Re investigated

Previous studies show inconsistent effect estimates for the efficacy of Endostar in patients with advanced non-small cell lung cancer (NSCLC) undergoing chemoradiotherapy. Therefore, this meta-analysis aimed to determine the effectiveness and safety on the basis of data obtained from available randomized controlled trials (RTCs). We find relevant articles reporting the use of Endostar combined with chemoradiotherapy regimens in the treatment of advanced NSCLC. The retrieval period was from June 2008 to June 2018. A total of 11 RTCs that recruited a total of 735 patients were included. Overall, the results indicated that patients who received Endostar plus chemoradiotherapy showed a significantly increased incidence of objective response rate (ORR) (relative risk [RR] = 1.48; 95% confidence interval [CI] = 1.31–1.67; P < 0.00001) and disease control rate (DCR) (RR = 1.17; 95% CI = 1.09–1.25; P < 0.00001) compared with those who received chemoradiotherapy alone. However, no significant difference was noted between groups for 1-year survival rate (RR = 1.06; 95% CI = 0.91–1.23; P = 0.48). Furthermore, combined Endostar with chemoradiotherapy did not yield a high incidence of stable and elevated Karnofsky performance score (RR = 1.06; 95% CI = 0.91–1.23; P = 0.48). Moreover, no significant difference was noted in the incidence of total toxicity between the two groups. The findings of our study indicated that treatment with Endostar plus chemoradiotherapy yielded a high incidence of ORR or DCR, but did not trigger excess adverse events in patients with NSCLC.