Smart transition pathways and development incentive mechanism of China's smart community elderly care industry under market dominance: Considering a multi-subjective behavior game.

Against the backdrop of an aging population, China is actively experimenting with an innovative elderly care model, so smart community elderly care has recently received widespread attention. However, the results of the implementation of the model have not yet met the expectation due to the variety of interests among the relevant participants. In this study, we identified the most core stakeholders in smart community elderly care, developed a four-party evolutionary game model including local governments, communities, service supply enterprises and households with elderly members. By applying the system dynamics method, we simulate the evolutionary paths and explore the complex interactions at the multiparticipant level in order to facilitate the transition of community elderly care services from traditional to smart, and then propose managerial insights for accelerating the construction of smart community elderly care. The results suggest that: (1) the four players in the game influence each other and are intimately related, and the benign interaction between them will further stimulate the vitality of the smart community elderly care industry; (2) appropriate improvement in policy support will strongly promote smart community elderly care, and the incentive effect on the demand side (households with elderly members) is more significant; (3) when households' preference for smart services increases, and the perceived value to communities and enterprises reaches a certain threshold, communities and enterprises will actively adopt smart solution and technology as well as develop stable portfolio strategy; (4) measures such as simultaneously increasing the level of smart and resource synergy will promote the system evolution toward smart services, and the system is more sensitive to the internal behavior of the enterprise than the external behavior between community and enterprise.

Risk assessment of deep-sea floating offshore wind power projects based on hesitant fuzzy linguistic term set considering trust relationship among experts.

The development of deep-sea floating offshore wind power (FOWP) is the key to fully utilizing water resources to enhance wind resources in the years ahead, and then the project is still in its initial stage, and identifying risks is a crucial step before promoting a significant undertaking. This paper proposes a framework for identifying risks in deep-sea FOWP projects. First, this paper identifies 16 risk criteria and divides them into 5 groups to establish a criteria system. Second, hesitant fuzzy linguistic term set (HFLTS) and triangular fuzzy number (TFN) are utilized to gather and describe the criterion data to ensure the robustness and completeness of the criterion data. Third, extending the method for removal effects of criteria (MEREC) to the HFLTS environment through the conversion of TFNs, under the influence of subjective preference and objective fairness, a weighting method combining analytic network process (ANP) and MEREC is utilized to calculate criteria weights, and the trust relationship and consistency between experts are used to calculate the expert weights to avoid the subjective weighting given by experts arbitrariness. Fourth, the study's findings indicated that the overall risk level of the deep-sea FOWP projects is "medium." Fifth, sensitivity and comparative analyses were conducted to test the reliability of the assessment outcomes. lastly, this research proposes risk management measures for the deep-sea FOWP project's establishment from economic, policy, technology, environment, and management aspects.

Deep learning algorithms for classification and detection of recurrent aphthous ulcerations using oral clinical photographic images.

Background/purpose: The application of artificial intelligence diagnosis based on deep learning in the medical field has been widely accepted. We aimed to evaluate convolutional neural networks (CNNs) for automated classification and detection of recurrent aphthous ulcerations (RAU), normal oral mucosa, and other common oral mucosal diseases in clinical oral photographs. Materials and methods: The study included 785 clinical oral photographs, which was divided into 251 images of RAU, 271 images of the normal oral mucosa, and 263 images of other common oral mucosal diseases. Four and three CNN models were used for the classification and detection tasks, respectively. 628 images were randomly selected as training data. In addition, 78 and 79 images were assigned as validating and testing data. Main outcome measures included precision, recall, F1, specificity, sensitivity and area under the receiver operating characteristics curve (AUC). Results: In the classification task, the Pretrained ResNet50 model had the best performance with a precision of 92.86%, a recall of 91.84%, an F1 score of 92.24%, a specificity of 96.41%, a sensitivity of 91.84% and an AUC of 98.95%. In the detection task, the Pretrained YOLOV5 model had the best performance with a precision of 98.70%, a recall of 79.51%, an F1 score of 88.07% and an AUC of Precision-Recall curve 90.89%. Conclusion: The Pretrained ResNet50 and the Pretrained YOLOV5 algorithms were shown to have superior performance and acceptable potential in the classification and detection of RAU lesions based on non-invasive oral images, which may prove useful in clinical practice.

A hybrid DEMATEL-COPRAS method using interval-valued probabilistic linguistic term set for sustainable hydrogen fuel cell supplier of new energy vehicles.

With the continuous development of the global economy, global environmental pollution, climate degradation and global warming are becoming increasingly serious. In order to deal with the increasingly serious environmental problems, the government is vigorously supporting and promoting the development of new energy vehicles (NEVs). As the core unit of NEVs, one of the main challenges faced by hydrogen fuel cell (HFC) supplier is to select the best supplier for their business among all possible suppliers. Selecting the optimal supplier is a key decision in green supplier management. Therefore, it is extremely important and meaningful to select an optimal HFC supplier to provide power for NEVs. This paper proposes a new decision-making framework based on Decision-Making Trial and Evaluation Laboratory (DEMATEL) method and Complex proportional assessment (COPRAS) method under interval-valued probabilistic linguistic environment to select the appropriate HFC supplier of NEVs. Firstly, this paper establishes the evaluation criteria system of HFC supplier assessment which is the synthesis of economical, environmental, social, technical, organisation and service aspects. Then, in order to express the uncertainty of expert decision-making, this paper uses interval-valued probabilistic linguistic term set (IVPLTS) to describe the evaluation information. Next, the interval-valued probabilistic linguistic term set decision-making trial and evaluation laboratory (IVPLTS-DEMATEL) method is applied to calculate the criteria weights. Moreover, this paper constructs the interval-valued probabilistic linguistic term set Complex Proportional Assessment (IVPLTS-COPRAS) model for the selection of HFC supplier of NEVs. Finally, a case in China with sensitivity analysis and comparison analysis are executed to illustrate the feasibility and validity of the proposed approach. This paper provides valuable references for investors and companies to select the most appropriate HFC supplier of NEVs under uncertain environment.

Evolutionary game of stakeholders' behavioral strategies in wetland ecosystems from the vulnerability perspective.

Wetland ecosystems have been seriously degraded by human activities and natural factors, and its restoration and coordinated development depend on long-term effective cooperation between the government and investors and providers. From the perspective of vulnerability of wetland ecosystem construction, this paper takes the government and investors, providers as the research object and propose a wetland ecosystem cooperation network, the article considers the "Matthew effect" of network connection and relationship cost, and uses the method of the evolutionary game on complex networks to construct the cooperative game model of wetland ecosystems. This research finds that (1) the vulnerability of wetland ecosystem varies greatly in different development stages, especially when the government subsidy coefficient for providers is reduced to 0.3, the vulnerability index is instead smaller.(2) The cooperative strategy adopted by investors can produce synergistic effect, which plays a major role in the healthy function of wetland ecosystem. (3) When the government subsidy coefficient for investors reaches 0.8, wetland ecosystem vulnerability shows a significant downward trend; when the provider loss coefficient reaches 0.8, wetland ecosystem vulnerability is significantly reduced and system stability is significantly enhanced. Thus, when the government actively promotes cooperation by adopting appropriate subsidies and regulation for investors and providers, the willingness of investors and providers to cooperate rapidly converges to 1, wetland ecosystem in vulnerability is at the lowest level. Finally, the findings combined with the numerical simulation analysis indicates that the importance of investors cooperating with the government in taking cooperative strategies actively, showing that stakeholder behavioral strategies can improve wetland ecosystem vulnerability. This paper provides a theoretical basis for the cooperation of wetland ecosystem stakeholders and a new direction for effectively reducing the vulnerability of wetland ecosystems and building efficient and benign wetland ecosystems in practice, which is of far-reaching significance for promoting wetland conservation management and an important reference value for wetland conservation planning, governance and improving the level of wetland conservation management.

Selection of plastic solid waste treatment technology based on cumulative prospect theory and fuzzy DEMATEL.

Under the global implementation of a low-carbon economy, the treatment of municipal plastic solid waste (PSW) has become an important task to be solved urgently. In the actual decision-making process of PSW treatment, the evaluation information is usually fuzzy, and the decision-makers (DMs) are bounded rational. For selecting the most appropriate PSW treatment technology, we propose a multi-criteria decision-making (MCDM) method based on cumulative prospect theory and fuzzy decision-making trail and evaluation laboratory (DEMATEL). Firstly, we construct the criteria system of PSW treatment that consists of 9 sub-criteria from the perspectives of environment, economy, society, and technology. Then, considering the interdependences and interactions between these evaluation criteria and allowing multiple stakeholders to participate in decision-making, we propose a fuzzy DEMATEL method to deal with the fuzziness of evaluation in the decision-making process and determine the weights of the evaluation criteria. Subsequently, taking into account the different opinions of different stakeholders and psychological factors such as risk preference and loss aversion of stakeholders, we aggregate the evaluation information of different stakeholders and develop the PSW treatment alternatives to rank the orders by using the proposed multi-actor cumulative prospect theory (CPT) method. We study seven alternative processes for PSW treatment by the developed model, including landfill, recycling, pyrolysis, incineration, and the combination of landfilling and recycling, landfill and incineration, and recycling and pyrolysis. According to the ranking results, we find the combination of recycling and incineration is the best treatment alternative. We take the seven PSW treatment technologies in Shanghai as the case study to verify the effectiveness and feasibility of the proposed method. Through the sensitivity analysis and comparison analysis with fuzzy similarity to ideal solution (FTOPSIS) method and an acronym in Portuguese of the interactive and multi-criteria decision-making (TODIM) method, we illustrate the effectiveness and superiority of the proposed method. This research provides significant references for the PSW treatment technology selection problems under uncertain environments and extends the methods in the decision-making field.

A multi-criteria group decision-making framework for investment assessment of offshore floating wind-solar-aquaculture project under probabilistic linguistic environment.

The offshore floating wind-solar-aquaculture (WSA) system with its advantages such as strong seakeeping ability, considerable power generation, and full utilization of ocean space and water resources will have a bright prospect in the future. In order to accelerate the sustainable development of the energy industry, it is very important to build a reasonable investment decision-making framework. Therefore, this paper aims to build a multi-criteria group decision-making (MCGDM) framework for investment decision-making of this project. Firstly, a comprehensive criteria system has been established. Secondly, probabilistic language term sets (PLTSs) are introduced to describe the uncertainty and fuzziness of decision information. Thirdly, the expert weight determination model is established based on the correlation measure and correlation coefficient of PLTSs, and the PL-fuzzy decision-making trial and evaluation laboratory (DEMATEL) method and the information entropy method are introduced to determine the subjective and objective weights of the criteria. In addition, considering the decision maker's psychological behavior, we choose probabilistic language the interactive and multiple attribute decision-making (TODIM) method to determine the optimal investment alternative. Finally, we apply the proposed framework to a case study. The results illustrate that the alternative A3 possesses the optimal comprehensive performance with the overall value is 1. Then, we conduct sensitivity analysis and comparative analysis to verify its robustness and feasibility. Scenario analysis in TODIM method showed that it is reasonable to express decision preference by setting different recession coefficients in the actual decision-making environment. This study can provide some reference for decision-makers, and also extend the method of decision-making field.

Overexpression of lncRNA A2M-AS1 inhibits cell growth and aggressiveness via regulating the miR-587/bone morphogenetic protein 3 axis in lung adenocarcinoma.

Lung adenocarcinoma (LUAD) is a malignant tumor that occurs in the lungs. Numerous reports have substantiated the participation of long non-coding RNAs (lncRNAs) in the tumorigenesis of LUAD. Previously, lncRNA alpha-2-macroglobulin antisense RNA 1 (A2M-AS1) was confirmed to be an important regulator in the biological processes of LUAD and dysregulation of A2M-AS1 was associated with non-small cell lung cancer (NSCLC) progression. However, the precise mechanism of A2M-AS1 in LUAD has not been elucidated. Therefore, our study was designed to investigate the detailed molecular mechanism of A2M-AS1 in LUAD. Herein, the expression of lncRNA A2M-AS1, microRNA (miRNA) miR-587, and bone morphogenetic protein 3 (BMP3) in LUAD cell lines and tissues were detected by real-time quantitative polymerase chain reaction (RT-qPCR) and western blotting. The viability, proliferation, migration and invasion of LUAD cells were tested by cell counting kit-8 (CCK-8), colony formation and Transwell assays. In vivo tumor growth was investigated by xenograft animal experiment. Interactions among A2M-AS1, miR-587 and BMP3 were measured by RNA pulldown and luciferase reporter assays. In this study, A2M-AS1 was downregulated in LUAD tissues and cells and related to poor prognosis in LUAD patients. A2M-AS1 overexpression suppressed LUAD cell proliferation, migration and invasion in vitro and inhibited tumor growth in vivo. Mechanistically, A2M-AS1 directly bound with miR-587 to promote BMP3 expression in LUAD cells. Low expression of BMP3 was found in LUAD tissues and cells and was closely correlated with poor prognosis in LUAD patients. BMP3 deficiency reserved the inhibitory influence of A2M-AS1 overexpression on LUAD cell behaviors. Overall, A2M-AS1 inhibits cell growth and aggressiveness via regulating the miR-587/BMP3 axis in LUAD.

Knockdown of Long Noncoding RNA LINC00240 Inhibits Esophageal Cancer Progression by Regulating miR-26a-5p.

Background: Esophageal cancer is the most prevalent digestive system tumor. Due to a lack of characteristic symptoms and early diagnosis, a confirmed esophageal cancer is typically detected at a progressively harmful stage. Therefore, it is critical to investigate the molecular mechanisms governing the formation and progression of esophageal cancer in order to identify new treatment targets for esophageal cancer early detection. Methods: We first screened the differentially expressed gene LINC00240 in the TCGA database. Multivariate analysis and Cox regression were performed, and a nomogram was constructed for internal validation. The correlation between LINC00240 and immune cells was analyzed using the TIMER database. The possible mechanism of action was explored through GSEA enrichment analysis. Then, in 43 esophageal cancer tissues, paracancour tissues, and cell lines, the LINC00240 expression was found. Transwell assays, CCK-8, and clone formation assays were utilized to assess the impact of LINC00240 on the metastasis of esophageal cancer cells. The binding activity of LINC00240 to downstream miRNAs was assessed using the luciferase reporter gene. Results: TCGA database showed that LINC00240 expression was increased in cancer tissues compared to adjacent tissues. The C-index of the nomogram is 0.712 (0.666-0.758), and the prediction model has good accuracy. According to the TIMER database, the LINC00240 expression is linked to immune infiltration and may be crucial in encouraging the immune escape of tumor cells. Gene enrichment analysis depicts that LINC00240 could influence the biological events of esophageal cancer by taking part in pathways such as affecting the cell cycle. LINC00240 expression was substantially greater in the plasma of esophageal cancer patients (3.94 ± 1.55) than in the normal control group (2.13 ± 0.89). Plasma expression of LINC00240 was linked to the degree of differentiation (P=0.0345) and TNM stage (P=0.0409). Knocked down LINC00240 inhibited esophageal cancer cells proliferation, lone formation, and invasion. LINC00240 might bind itself to miR-26a-5p and influence its expression. MiR-26a-5p inhibitor can dramatically limit the ability of LINC00240 knockdown on plate colony formation and relocation of esophageal cancerous cells was demonstrated in colony formation and migration experiments. Conclusion: LINC00240 expression is elevated in esophageal cancerous tissues, and knocking down LINC00240 decreases esophageal cancer cell proliferation, clone formation, invasion, and migration via miR-26a-5p. As a result, LINC00240 could be a novel target for esophageal cancer patients' early diagnosis and treatment.

Circ_0037078 promotes trophoblast cell proliferation, migration, invasion and angiogenesis by miR-576-5p/IL1RAP axis.

BACKGROUND: Preeclampsia (PE) is a common hypertensive disorder of pregnancy. Recent studies have suggested that circular RNAs (circRNAs) play a pathological role in PE. Herein, this study aimed to investigate the action and mechanism of circ_0037078 in PE process. METHODS: The quantitative real-time PCR (qRT-PCR) and Western blot were used to determine the expression levels of RNAs and genes. Cell proliferation, migration, invasion and angiogenesis were evaluated by using cell counting kit-8 (CCK-8), colony formation, transwell, and tube formation assays, respectively. The target relation between miR-576-5p and IL1RAP (Interleukin-1 receptor accessory protein) and circ_0037078 was predicted by bioinformatics analysis and verified by dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. RESULTS: Circ_0037078 expression was higher in placental tissues of patients with PE than that of normal control. Knockdown of circ_0037078 led to an enhancement of the proliferation, migration, invasion, and angiogenesis in trophoblast cells. Mechanistically, circ_0037078 acted as a sponge for miR-576-5p, thus elevating the expression of IL1RAP, which was targeted by IL1RAP. Further rescue experiments suggested that miR-576-5p inhibition reversed the effects of circ_0037078 knockdown on above behaviors of trophoblast cells. Moreover, miR-576-5p overexpression enhanced the proliferative, migratory, invasive, angiogenic phenotypes of trophoblast cells, which were attenuated by IL1RAP up-regulation. CONCLUSION: Circ_0037078 knockdown promotes trophoblast cell proliferation, migration, invasion, and angiogenesis in vitro by miR-576-5p/IL1RAP axis, providing a novel insight into the etiology of PE.

Circular RNA circ_0032962 promotes trophoblast cell progression as ceRNA to target PBX3 via sponging miR-326 in preeclampsia.

Preeclampsia (PE) is the leading cause of maternal deaths in primipara. It is mainly characterized by defect migration and invasion of trophoblast cells. Circular RNAs (circRNAs) have been widely reported to be associated with PE progression. This study is designed to explore the role and mechanism of circ_0032962 on trophoblast cell behavior. Circ_0032962, microRNA-326 (miR-326), and Pre-B-cell leukemia homeobox 3 (PBX3) levels were measured by real-time quantitative polymerase chain reaction (RT-qPCR). Cell proliferation ability, migration, and invasion were measured by Cell Counting Kit-8 (CCK-8), 5-ethynyl-2'-deoxyuridine (EdU), Colony formation, wound healing, and transwell assays. Protein levels of E-cadherin, Vimentin, N-cadherin, and PBX3 were examined by western blot assay. The binding relationship between miR-326 and circ_0032962 or PBX3 was predicted by circular RNA Interactome or Starbase and then verified by a dual-luciferase reporter assay. Circ_0032962 and PBX3 levels were declined in placenta tissues from preeclampsia patients, and miR-326 was elevated. Apart from that, circ_0032962 knockdown could suppress cell proliferation ability, migration, invasion, and epithelial-mesenchymal transition (EMT) in trophoblast cells. Mechanically, circ_0032962 could affect PBX3 expression through sponging miR-326. Circ_0032962 could contribute to trophoblast cell growth ability and metastasis partly by regulating the miR-326/PBX3 axis, providing a novel insight into the pathogenesis and treatment of PE.

Oral reactive capillary hemangiomas induced by SHR-1210 in the treatment of non-small cell lung cancer: a case report and literature review.

BACKGROUND: Antibodies to PD-1 and PD-L1 have remarkably improved the overall survival of many patients with advanced solid tumors. SHR-1210 is an anti-PD-1 monoclonal antibody. Dermatologic reactive capillary hemangiomas (RCH) were the most common and unique drug-related AEs of SHR-1210, but rare on oral mucosa and gastrointestinal mucosa. Herein we report a case of RCH occurred in oral mucosa during the clinical trials of SHR-1210 in the treatment of non-small cell lung cancer. CASE PRESENTATION: A male in his 60 s with a history of non-small cell lung cancer received injection of anti-PD-1 monoclonal antibodies SHR-1210. The patient developed drug-related RCH on skin after the first injection and began to have gingival hyperplasia one year after the first injection which gradually increased in size and affect eating and speaking. Anti-PD-1 treatments were continued. After periodontal treatment, two oral lesions and one skin lesion were surgically removed. Similar histological manifestation was found in all three lesions as reactive capillary hemangiomas. All lesions had a good prognosis without recurrence on oral mucosa within one year after surgery. CONCLUSIONS: Oral reactive capillary hemangiomas could be induced by SHR-1210 in the treatment of non-small cell lung cancer. Surgical resection is an effective treatment with a good prognosis.

The effects of family follow-up nursing on elderly cognitive impairment patients' Barthel index scores and mental statuses.

OBJECTIVE: To explore the effects of family follow-up nursing on the Barthel Index scores and emotional statuses of elderly cognitive impairment patients. METHODS: A total of 90 dementia patients with cognitive impairments were randomized into group A, which underwent routine family nursing, or group B, which underwent family follow-up nursing for 6 months. The patients' cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Their disability levels were determined using the Barthel Index and the WHO rating scale (the WHODAS II scale), and the caregiver's burden levels were evaluated using the Zarit Caregiver Burden Interview (ZBI). The negative emotions were assessed using the Negative Mood Regulation Expectancies Scale (the NMRE-C). The two groups' quality of life and living abilities were assessed using the World Health Organization Quality of Life-BREF Scale (the WHOQOL BREF scale) and the Activities of Daily Living Scale (the ADL scale). RESULTS: After the intervention, the MMSE and MoCA scores increased in group B compared with the scores in group A (P<0.01). The Barthel Index scores increased, but the WHODAS II scores decreased in group B compared with the scores in group A (all P<0.001). The ZBI score was (34.30±4.19) in group A and (31.64±3.69) in group B (t=3.196, P=0.002). The NMRE-C score was (122.38±10.20) in group A and (144.39±11.30) in group B (t=9.699, P<0.001), and the quality of life and living abilities of the patients in group B improved significantly compared with the quality of life and living abilities of the patients in group A (all P<0.01). CONCLUSION: Family follow-up nursing can alleviate cognitive impairment in elderly dementia patients reduce their negative emotions, increase their independent living abilities, and decrease the caregiver's burden. It should be widely applied in clinical settings.

miR-125b prevent the progression of esophageal squamous cell carcinoma through the p38-MAPK signaling pathway.

BACKGROUND: To examine the clinical significance of miR-125b in esophageal squamous cell carcinoma (ESCC) and to research the effect of miR-125b on the biological function of ESCC cells and the relevant underlying mechanism. METHODS: The expression of miR-125b in ESCC tissues and cell lines were discovered by RT-PCR assay. The interrelation between miR-125b expression and clinicopathological parameters and the forecasting of ESCC patients were analyzed. CCK-8 method and Transwell methods were used to detect the increased growth, shifting, and irruption of ESCC cells. Bioinformatics analysis was applied to forecast the possible target genes of miR-125b and verified through dual-luciferase reporter gene assay. After that, the expression of p38-MAPK mRNA and protein were found out by RT-PCR and Western blot. RESULTS: The expression of miR-125b was down-regulated in ESCC tissues and cell lines (P<0.05). And the expression of miR-125b was closely about tumor differentiation, TNM level, and lymph node metastasis in ESCC patients. The low miR-125b formulation was closely related to rough forecasting in ESCC patients. Large scale expression of miR-125b can effectively decrease the acceleration, shifting, and irrupting strengths of ESCC cells. Bioinformatics analysis showed p38-MAPK was forecasted to be a potential mark of miR-125b, which was confirmed by dual luciferase assay, and extreme expression of miR-125b can stop the expression of p38-MAPK mRNA and protein. CONCLUSIONS: miR-125b is down-regulated in ESCC. Moreover, its expression level is significant concerning tumor progression and prognosis in patients with ESCC. MiR-125b can stop the high growth and shifting of ESCC cells having p38-MAPK at target.

Effects of Streptococcus salivarius K12 with nystatin on oral candidiasis-RCT.

OBJECTIVE: To evaluate the efficacy and safety of Streptococcus salivarius K12 as an adjuvant in treating oral candidiasis. METHODS: A total of 56 patients were participated in the randomized, double-blinded, placebo-controlled clinical trial. The S. salivarius K12 or placebo lozenges plus nystatin tablets were given for up to 4 weeks at 1-week interval and then followed up for 1 week thereafter. We collected and analyzed the mycological and clinical data, treatment course, and safety data. RESULTS: At the end of the treatment, significant differences were found in the mycological cure rates between K12 group and control group (90.48% and 55.56%, respectively, p = 0.008). Survival analysis demonstrated no statistical difference in overall cure rates comprehensively considering mycological cure, clinical improvement, and recurrence (p = 0.078), while statistical difference was found in mycological cure (p = 0.013) between the two groups. The median treatment courses of K12 group and control group were 3 weeks and 4 weeks, respectively. No severe events were reported during the study. CONCLUSION: Streptococcus salivarius K12 exhibited potential efficacy and safety as an adjuvant in treating oral candidiasis by enhancing mycological cure and shortening the treatment course of conventional antifungal therapy in this randomized, double-blinded, placebo-controlled clinical trial. Further large-scale clinical studies are desired to accumulate more evidence for its clinical applications.

Effects of Liraglutide Combined with Insulin on Oxidative Stress and Serum MCP-1 and NF-kB Levels in Type 2 Diabetes.

OBJECTIVE: To investigate the effects of liraglutide combined with insulin on oxidative stress and expression levels of serum monocyte chemoattractant protein-1 (MCP-1) and nuclear factor-kB (NF-kB) in patients with type 2 diabetes. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: Department of Endocrinology, the Second Hospital Affiliated to Lanzhou University, China, from September 2016 to January 2018. METHODOLOGY: Ninety-two patients with type 2 diabetes were selected as objects of study. They were randomly divided into observation group and control group, with 46 cases in each group. The control group was treated with insulin alone, and the observation group was treated with liraglutide in combination with insulin. The changes of levels of blood glucose, serum MDA, SOD, MCP-1 and NF-kB were compared between the two groups before and after treatment, and the blood glucose target rate after treatment was compared between the two groups. RESULTS: Before treatment, there were no significant differences in fasting blood glucose, 2h postprandial blood glucose, serum MDA, serum SOD, serum MCP-1 and serum NF-kB between the two groups (p=0.885, 0.961, 0.919, 0.990, 0.954 and 0.837, respectively). After treatment, levels of the fasting blood glucose, 2h postprandial blood glucose, serum MDA, serum MCP-1, and serum NF-kB in the observation group were lower than those in the control group (all p<0.001). The serum SOD level and blood glucose target rate were higher in the observation group than those in the control group (p<0.001 and p=0.010, respectively). CONCLUSION: Liraglutide combined with insulin therapy can effectively improve blood glucose levels in type 2 diabetic, reduce oxidative stress status, decrease the expression of serum MCP-1 and NF-kB, and inhibit the internal inflammatory response.

An Arc-shaped Piezoelectric Bistable Vibration Energy Harvester: Modeling and Experiments.

In order to improve vibration energy harvesting, this paper designs an arc-shaped piezoelectric bistable vibration energy harvester (ABEH). The bistable configuration is achieved by using magnetic coupling, and the nonlinear magnetic force is calculated. Based on Lagrangian equation, piezoelectric theory, Kirchhoff's law, etc., a complete theoretical model of the presented ABEH is built. The influence of the nonlinear stiffness terms, the electromechanical coupling coefficient, the damping, the distance between magnets, and the load resistance on the dynamic response and the energy harvesting performance of the ABEH is numerically explored. More importantly, experiments are designed to verify the energy harvesting enhancement of the ABEH. Compared with the non-magnet energy harvester, the ABEH has much better energy harvesting performance.

Double Right Testicular Arteries Passing Through the Hiatus in the Trifurcated Testicular Vein.

Variations of the testicular artery have been commonly described by many authors, although reports for accessory or double testicular arteries were scarce. The testicular vein displays a great variability as regards their numbers, courses, and sites of termination. We present here a single right testicular vein dividing into three trunks at the terminal drainage, and the bifurcated right testicular artery passed through the hiatus of the testicular vein.

Efficacy and safety of Chinese patent medicines in the treatment of recurrent aphthous stomatitis: A systematic review.

BACKGROUND: Recurrent aphthous stomatitis (RAS) is the most common chronic oral mucosal condition of the oral cavity. Investigators in clinical trials have evaluated the effectiveness of Chinese patent medicines in the treatment of RAS. However, the results are conflicting rather than conclusive. To evaluate the efficacy and safety of Chinese patent medicines for the treatment of RAS, the authors conducted a systematic review. TYPES OF STUDIES REVIEWED: The authors searched 9 electronic databases to identify randomized controlled trials (RCTs) or potential clinical controlled trials (CCTs), published in any language, in which the investigators compared Chinese patent medicines with vitamin tablets or placebos for the treatment of RAS. RESULTS: The authors included 11 RCTs and 1 CCT in the review. Results showed that Chinese patent medicines were beneficial for patients with RAS in relieving ulcer pain and reducing the duration and frequency of attacks. The reported adverse effects of Chinese patent medicines included stomachache, abdominal distention, diarrhea, mild nausea, and gastrointestinal discomfort, which were either self-limiting or could be relieved by treatment cessation. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Chinese patent medicines may be effective for treatment of RAS by means of relieving pain and reducing ulcer size and episode duration and frequency.