The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most se...The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.展开更多
基于内点半定规划(semi-definite programming,SDP),提出一种求解最优潮流(optimal power flow,OPF)的新方法——SDP-OPF法。该方法将非凸OPF问题等价转换为半定规划问题,然后应用原始–对偶内点法求解。根据OPF半定规划模型的特点,采...基于内点半定规划(semi-definite programming,SDP),提出一种求解最优潮流(optimal power flow,OPF)的新方法——SDP-OPF法。该方法将非凸OPF问题等价转换为半定规划问题,然后应用原始–对偶内点法求解。根据OPF半定规划模型的特点,采用基于半定规划的稀疏技术,使存储效率和计算性能得以大幅度提高。以4节点的简单电力系统为例,展示模型等价转换的过程及如何获取原OPF问题的解。IEEE-300节点等6个标准系统的仿真计算表明:所提算法具有超线性收敛性,其计算结果与内点非线性规划的结果一致,且能保证解的全局最优性,可在多项式时间内完成,是一种应用前景广阔的方法。展开更多
Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is ge...Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis(PEP). However, as the efficacy of endoscopic papillary largeballoon dilatation(EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy(EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP.展开更多
Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemot...Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemotherapy(HAIC) is one of the most recommended treatments in Japan. Although there have been no randomized controlled trials comparing sorafenib with HAIC,several retrospective analyses have shown no significant differences in survival between the two therapies. Outcomes are favorable for HCC patients exhibiting macroscopic vascular invasion when treated with HAIC rather than sorafenib,whereas in HCC patients exhibiting extrahepatic spread or resistance to transcatheter arterial chemoembolization,good outcomes are achieved by treatment with sorafenib rather than HAIC. Additionally,sorafenib is generally used to treat patients with Child-Pugh A,while HAIC is indicated for those with either Child-Pugh A or B. Based on these findings,we reviewed treatment strategies for advanced HCC. We propose that sorafenib might be used as a first-line treatment for advanced HCC patients without macroscopic vascular invasion or Child-Pugh A,while HAIC is recommended for those with macroscopic vascular invasion or Child-Pugh A or B. Additional research is required to determine the best second-line treatment for HAIC non-responders with Child-Pugh B through future clinical trials.展开更多
The characteristics of a rotating stall of an impeller and diffuser and the evolution of a vortex generated at the diffuser leading-edge(i.e., the leading-edge vortex(LEV)) in a centrifugal compressor were investigate...The characteristics of a rotating stall of an impeller and diffuser and the evolution of a vortex generated at the diffuser leading-edge(i.e., the leading-edge vortex(LEV)) in a centrifugal compressor were investigated by experiments and numerical analysis. The results of the experiments revealed that both the impeller and diffuser rotating stalls occurred at 55 and 25 Hz during off-design flow operation. For both, stall cells existed only on the shroud side of the flow passages, which is very close to the source location of the LEV. According to the CFD results, the LEV is made up of multiple vortices. The LEV is a combination of a separated vortex near the leading-edge and a longitudinal vortex generated by the extended tip-leakage flow from the impeller. Therefore, the LEV is generated by the accumulation of vorticity caused by the velocity gradient of the impeller discharge flow. In partial-flow operation, the spanwise extent and the position of the LEV origin are temporarily transmuted. The LEV develops with a drop in the velocity in the diffuser passage and forms a significant blockage within the diffuser passage. Therefore, the LEV may be regarded as being one of the causes of a diffuser stall in a centrifugal compressor.展开更多
Perilla frutescens seed (PFS) oil is reported to inhibit skin photoaging;however, its effect on melanogenesis has not yet been investigated. Herein, we tested the anti-melanogenesis activity of an oil-based extract fr...Perilla frutescens seed (PFS) oil is reported to inhibit skin photoaging;however, its effect on melanogenesis has not yet been investigated. Herein, we tested the anti-melanogenesis activity of an oil-based extract from PFS with supercritical carbon dioxide (scCO<sub>2</sub>). In a cell culture system, B16 mouse melanoma cells were treated with the PFS scCO<sub>2</sub> extract and other samples. The PFS scCO<sub>2</sub> extract decreased melanin production by approximately 90% in B16 mouse melanoma cells without cytotoxicity at 100 μg/mL. This effect was greater than that of the well-known melanogenesis inhibitor, kojic acid. Although a hexane-extracted PFS oil and a squeezed PFS oil also decreased melanin production in the B16 cells, the inhibitory effect of the PFS scCO<sub>2</sub> extract was higher than both of these. Chemical analysis of the PFS scCO<sub>2</sub> extract and squeezed PFS oil showed that almost 90% of the components of both oils were α-linolenic acid, linoleic acid, and oleic acid. Furthermore, the ratio of those three fatty acids across both samples was almost the same. When the three fatty acids were mixed in the same ratio as in the PFS scCO<sub>2</sub> extract, the IC<sub>50</sub> of the mixture for melanin production in B16 melanoma cells was identical to that of the PFS scCO<sub>2</sub> extract. However, the IC<sub>50</sub> of the squeezed PFS oil was approximately 6.6 times higher than that of the mixture. Although those fatty acids are the main inhibitory ingredients against melanin production in all of the extracts, some factor(s) in the squeezed PFS reduce their affinity with the cells. These results indicated that the PFS scCO<sub>2</sub> extract could be a superior melanogenesis inhibitor. Although its main ingredients are probably the same as those of the squeezed PFS oil, it is necessary to extract with scCO<sub>2</sub> for stronger anti-melanogenesis activity.展开更多
AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were ...AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.展开更多
Enhancements of edge zonal flows,radial electric fields,and turbulence are observed in electron cyclotron resonance heating-heated plasmas(Zhao et al 2013 Nucl.Fusion 53083011).In this paper,the effects of sawtooth he...Enhancements of edge zonal flows,radial electric fields,and turbulence are observed in electron cyclotron resonance heating-heated plasmas(Zhao et al 2013 Nucl.Fusion 53083011).In this paper,the effects of sawtooth heat pulses on flows and turbulence are presented.These experiments are performed using multiple Langmuir probe arrays in the edge plasmas of the HL-2A tokamak.The edge zonal flows,radial electric fields,and turbulence are all enhanced by sawteeth.Propagation of the zonal flow and turbulence intensities is also observed.The delay time of the maximal intensity of the electric fields,zonal flows,and turbulence with respect to the sawtooth crashes is estimated as~1 ms and comparable to that of the sawtooth-triggered intermediate phases.Not only the zonal flows but also the radial electric fields lag behind the turbulence.Furthermore,the intensities of both the zonal flows and electric fields nearly linearly increase/decrease with the increase/decrease of the turbulence intensity.A double-source predator-prey model analysis suggests that a relatively strong turbulence source may contribute to the dominant zonal flow formation during sawtooth cycles.展开更多
BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event analysis.AIM To examine GC incidence in an endoscopic surve...BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event analysis.AIM To examine GC incidence in an endoscopic surveillance cohort.METHODS This study was retrospectively conducted at the Toyoshima Endoscopy Clinic.Patients who underwent two or more esophagogastroduodenoscopies were enrolled.GC incidence was based on Kyoto classification scores,such as atrophy,intestinal metaplasia(IM),enlarged folds(EFs),nodularity,diffuse redness(DR),and total Kyoto scores.Hazard ratios(HRs)adjusted for age and sex were calculated using a Cox hazard model.RESULTS A total of 6718 patients were enrolled(median age 54.0 years;men 44.2%).During the follow-up period(max 5.02 years;median 2.56 years),GC developed in 34 patients.The average frequency of GCs per year was 0.19%.Kyoto atrophy scores 1[HR with score 0 as reference:3.66,95%confidence interval(CI):1.06 to 12.61],2(11.60,3.82-35.27),IM score 2(9.92,4.37-22.54),EF score 1(4.03,1.63-9.96),DR scores 1(6.22,2.65-14.56),and 2(10.01,3.73-26.86)were associated with GC incidence,whereas nodularity scores were not.The total Kyoto scores of 4(HR with total Kyoto scores 0-1 as reference:6.23,95%CI:1.93 to 20.13,P=0.002)and 5-8(16.45,6.29-43.03,P<0.001)were more likely to develop GC,whereas the total Kyoto scores 2-3 were not.The HR of the total Kyoto score for developing GC per 1 rank was 1.75(95%CI:1.46 to 2.09,P<0.001).CONCLUSION A high total Kyoto score(≥4)was associated with GC incidence.The endoscopy-based diagnosis of gastritis can stratify GC risk.展开更多
Two examples of the use of vortex control to reduce noise and enhance the stable operating range of a centrifugal compressor are presented in this paper.In the case of high-flow operation of a centrifugal compressor w...Two examples of the use of vortex control to reduce noise and enhance the stable operating range of a centrifugal compressor are presented in this paper.In the case of high-flow operation of a centrifugal compressor with a vaned diffuser,a discrete frequency noise induced by interaction between the impeller-discharge flow and the diffuser vane,which appears most notably in the power spectra of the radiated noise,can be reduced using a tapered diffuser vane(TDV) without affecting the performance of the compressor.Twin longitudinal vortices produced by leakage flow passing through the tapered portion of the diffuser vane induce secondary flow in the direction of the blade surface and prevent flow separation from the leading edge of the diffuser.The use of a TDV can effectively reduce both the discrete frequency noise generated by the interaction between the impeller-discharge flow and the diffuser surface and the broadband turbulent noise component.In the case of low-flow operation,a leading-edge vortex(LEV) that forms on the shroud side of the suction surface near the leading edge of the diffuser increases significantly in size and blocks flow in the diffuser passage.The formation of an LEV may adversely affect the performance of the compressor and may cause the diffuser to stall.Using a one-side tapered diffuser vane to suppress the evolution of an LEV,the stable operating range of the compressor can be increased by more than 12 percent,and the pressure-rise characteristics of the compressor can be improved.The results of a supplementary examination of the structure and unsteady behavior of LEVs,conducted by means of detailed numerical simulations,are also presented.展开更多
The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with t...The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Ultrasonography (US) demonstrated a heterogeneous echogenic cyst measuring 11 cm × 8 cm in size in S2 of the liver, indicated intracystic hemorrhage of simple liver cyst or cystadenocarcinoma, but the differential diagnosis was considerably difficult. Levovist (Schering, Berlin, Germany) US revealed no enhancement of the intracystic structures, suggesting a clot in the case of intracystic hemorrhage. An operation was performed and the resected lesion showed a solitary benign liver cyst, measuring 5.5 cm × 4.7 cm × 8.5 cm containing a large blood clot. The patient had an uneventful recovery after the surgery. Levovist US may play an important role in discrimination between intracystic hemorrhage of simple hepatic cysts and cystadenocarcinoma of the liver.展开更多
Background: This study evaluated the effectiveness of hand therapy for elderly people with dementia and the change in effectiveness depending on sex differences between the patients and operators. Methods: The Abe’s ...Background: This study evaluated the effectiveness of hand therapy for elderly people with dementia and the change in effectiveness depending on sex differences between the patients and operators. Methods: The Abe’s behavioral and psychological symptoms of dementia score (ABS), index of resistance to care, and inner balance scanner scores were evaluated. Results: The mean ABS was 18.4 (before therapy), 16.0 (operator of the same sex), and 17.1 (operator of the opposite sex). The mean index scores for resistance to care were 15.3 (before therapy), 15.2 (operator of the same sex), and 13.2 (operator of the opposite sex). When the operator and patient were of the same sex, the mean value of comparison of total power (TP) decreased from 28,060.4 (before therapy) to 5974.3 (after therapy), and the mean low frequency (LF)/high frequency (HF) ratio decreased from 1.7 (before therapy) to 1.2 (after therapy). When the operator was of the opposite sex of that of the patient, the mean TP value decreased from 25,760.4 (before therapy) to 7669.5 (after therapy), and the mean LF/HF ratio increased from 1.2 (before therapy) to 1.5 (after therapy). Conclusions: Hand therapy was the most effective when the patient and operator were of the same sex.展开更多
Aim： To investigate the effects of rat Erythropoietin （Epo） on spermatogenesis by transferring rat Epo gene into cryptorchid testes by means of in vivo electroporation. Methods： Sprague-Dawley rats with surgically...Aim： To investigate the effects of rat Erythropoietin （Epo） on spermatogenesis by transferring rat Epo gene into cryptorchid testes by means of in vivo electroporation. Methods： Sprague-Dawley rats with surgically-induced unilateral cryptorchidism were divided into three groups： the first group was given intratesticular injections of pCAGGS-Epo （pCAGGS-Epo group）, the second group was given intratesticular injections of pCAGGS （pCAGGS group）, and the third group were given intratesticular injections of phosphate-buffered saline （PBS group）. At the same time, square electric pulses of 30 V were applied six times with a time constant of 100 ms. One or two weeks after injection, each testis was weighed and the ratio of the total number of germ cells to that of Sertoli cells （G/S ratio） was calculated to evaluate the impairment of spermatogenesis. Ten testes taken from each of the three groups were examined at each time point. Results： The testicular weight after the injection of pCAGGS-Epo or pCAGGS control plasmid was （0.85 ± 0.08） g and （0.83 ± 0.03） g, respectively, at week 1 （P = 0.788） and （0.62 ± 0.06） g and （0.52 ± 0.02） g, respectively, at week 2 （P = 0.047）. At week 1, spermatids and sperm were more abundant in testes with pCAGGS-Epo than those in the control testes. At week 2, spermatids and sperm were hardly detected in either group. The G/S ratio was 23.27 ± 6.80 vs. 18.63 ± 5.30 at week 1 （P = 0.0078） and 7.16 ± 3.06 vs. 6.05 ± 1.58 at week 2 （P = 0.1471）, respectively. Conclusion： The transfer of Epo to rat testes by in vivo electroporation may reduce the risk of the germ cell loss caused by cryptorchidism.展开更多
Numerical study is performed to investigate the swirling flow around a rotating disk in a cylindrical casing. The disk is supported by a thin driving shaft and it is settled at the center of the casing. The flow devel...Numerical study is performed to investigate the swirling flow around a rotating disk in a cylindrical casing. The disk is supported by a thin driving shaft and it is settled at the center of the casing. The flow develops in the radial clearance between the disk tip and the side wall of the casing as well as in the axial clearance between the disk surfaces and the stationary circular end walls of the casing. Keeping the geometry of the casing and the size of the radial clearance constant, we compared the flows developing in the fields with small, medium and large axial clearances at the Reynolds number from 6000 to 30,000. When the rotation rate of the disk is small, steady Taylor vortices appear in the radial clearance. As the flow is accelerated, several tens of small vortices emerge around the disk tip. The axial position of these small vortices is near the end wall or the axial midplane of the casing. When the small vortices appear on one side of the end walls, the flow is not permanent but transitory, and a polygonal flow with larger several vortices appears. With further increase of the rotation rate, spiral structures emerge. The Reynolds number for the onset of the spiral structures is much smaller than that for the onset of the spiral rolls in rotor-stator disk flows with no radial clearance. The spiral structures in the present study are formed by the disturbances that are driven by a centrifugal instability in the radial clearance and they are penetrated radially inward along the circular end walls of the casing.展开更多
Aeolian tone from a semi-circular cylinder in a uniform flow is studied experimentally for various angles of attack. It is found that the peak sound spectrum of the Aeolian tone from the semi-circular cylinder is smal...Aeolian tone from a semi-circular cylinder in a uniform flow is studied experimentally for various angles of attack. It is found that the peak sound spectrum of the Aeolian tone from the semi-circular cylinder is smaller than that from the circular cylinder and the lowest sound is observed around the zero angle of attack. This is due to the reduction in the fluctuating lift force on the semi-circular cylinder compared to that of the circular cylinder. This result suggests the validity of the analogy between the sound pressure level and the fluctuating lift force on a semi-circular cylinder in a stream. The flow visualization study also supports these results.展开更多
A novel technique for reducing reverberation artifact in acoustic shadow imaging using nonlinear ultrasound interaction, called nonlinear acoustic shadow method, has been developed and experimentally studied. In this ...A novel technique for reducing reverberation artifact in acoustic shadow imaging using nonlinear ultrasound interaction, called nonlinear acoustic shadow method, has been developed and experimentally studied. In this technique, the conventional acoustic shadow method is modified by using the secondary wave generated by nonlinear interaction of two primary sound waves emitted from parametric array. Either conventional or nonlinear acoustic shadow imaging is carried out for aluminum square cylinder and the size of the shadow is compared. The result shows that the nonlinear acoustic shadow method reduces reverberation artifact inside the square cylinder and has better accuracy in the size measurement than conventional acoustic shadow method.展开更多
In this paper, the measurement of an aerodynamic sound source for a semi-circular cylinder in a uniform flow is described using Particle Image Velocimetry (PIV). This experimental technique is based on vortex sound th...In this paper, the measurement of an aerodynamic sound source for a semi-circular cylinder in a uniform flow is described using Particle Image Velocimetry (PIV). This experimental technique is based on vortex sound theory, where the time derivative of vorticity is evaluated with the aid of two sets of standard PIV systems. The experimental results indicate that the sound source for the semi-circular cylinder is located around the shear layer near the edge of the semi-circular cylinder. The sound source intensity and the area are reduced in the semi-circular cylinder compared with those of a circular cylinder. This result indicates that the aerodynamic sound of the semi- circular cylinder is smaller than that of the circular cylinder, which supports the microphone measurement result.展开更多
The secondary flow downstream of a triple elbow layout was studied experimentally and numerically to visualize the flow behavior under swirling inlet flow conditions. The inlet swirling condition was generated by a sw...The secondary flow downstream of a triple elbow layout was studied experimentally and numerically to visualize the flow behavior under swirling inlet flow conditions. The inlet swirling condition was generated by a swirl generator, consisting of a rotary pipe and honeycomb assembly. The experiments were carried out in turbulent water flow condition at Reynolds number Re = 1 × 104 and inlet swirl intensity S = 1. Ultrasonic measurements were taken at four locations downstream of the third elbow. The two-dimensional velocity field of the flow field was measured using the phased array ultrasonic velocity profiler technique to evaluate the flow field with separation. Furthermore, a numerical simulation was performed and its results were compared with the experimental data. The numerical result was obtained by solving three-dimensional, Reynolds-averaged Navier-Stokes equations with the renormalization group k-ε turbulence model. The experimental results confirmed that the swirling flow condition modified the size of the separation region downstream of the third elbow. A qualitative comparison between the experimental and CFD simulation results of the averaged velocity field downstream of the third elbow showed similar tendency on reverse flow.展开更多
This paper deals with the statistical properties of unsteady structure of cavitating water-jet issuing into a stagnant fluid of water using the shadowgraph imaging combined with the proper orthogonal decomposition (PO...This paper deals with the statistical properties of unsteady structure of cavitating water-jet issuing into a stagnant fluid of water using the shadowgraph imaging combined with the proper orthogonal decomposition (POD) analysis. The experimental result indicates that the cavitating jet is composed of axisymmetric mode, while the periodic axial oscillation is found along the jet centerline. The reconstructed cavitation images show the presence of growing, shrinking and shedding motion in the cavitation cloud, which sustains a periodic behavior of the cavitating jet.展开更多
Background and Aims: The liver is the first organ affected by toxic copper in the classical and severe hepatic forms of Wilson's disease(WD).Because their associated chronic liver damage is mostly asymptomatic,an ...Background and Aims: The liver is the first organ affected by toxic copper in the classical and severe hepatic forms of Wilson's disease(WD).Because their associated chronic liver damage is mostly asymptomatic,an intervention using a special test including serum alanine aminotransferase(ALT)activity is needed for detecting WD.Methods: Using the modified international criteria for the diagnosis of WD,45 patients were selected from the collective databases of our institutions,and 7 infants were reviewed from the literature.Two patients had the severe hepatic form,with nor-moceruloplasminemia and no mutations in ATP7B.The rapid ALT change during hemolytic anemia was adjusted for a baseline.The diagnostic potential of the ALT test was assessed from the age-dependent natural course of the liver damage of WD.Results: The natural course had three stages.ALTs were still low in some infants younger than 4 years-old.They were high in all children between the ages of 4 and 8 years-old;then,they reduced to low levels in some patients over 9 years of age.The high ALT stage represents chronic active hepatitis,and the sub-sequent low ALT stage is due to silent cirrhosis.The hepatic cop-per content is a reliable but invasive test,while urinary copper secretion is an alternative,non-invasive test for copper toxicosis of WD.The serum ceruloplasmin and ATP7B analyses are sub-type tests of WD.The response to anti-copper regimens is the final test result.Conclusions: ALTcould be the first parameter to test to detect WD in children between the ages of 4 and 8 years.展开更多
文摘The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.
文摘基于内点半定规划(semi-definite programming,SDP),提出一种求解最优潮流(optimal power flow,OPF)的新方法——SDP-OPF法。该方法将非凸OPF问题等价转换为半定规划问题,然后应用原始–对偶内点法求解。根据OPF半定规划模型的特点,采用基于半定规划的稀疏技术,使存储效率和计算性能得以大幅度提高。以4节点的简单电力系统为例,展示模型等价转换的过程及如何获取原OPF问题的解。IEEE-300节点等6个标准系统的仿真计算表明:所提算法具有超线性收敛性,其计算结果与内点非线性规划的结果一致,且能保证解的全局最优性,可在多项式时间内完成,是一种应用前景广阔的方法。
文摘Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis(PEP). However, as the efficacy of endoscopic papillary largeballoon dilatation(EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy(EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP.
基金Supported by the Japan Society for the Promotion of Science,KIBAN-B,No.16H05287
文摘Sorafenib is used worldwide as a first-line standardsystemic agent for advanced hepatocellular carcinoma(HCC) on the basis of the results of two large-scale Phase Ⅲ trials. Conversely,hepatic arterial infusion chemotherapy(HAIC) is one of the most recommended treatments in Japan. Although there have been no randomized controlled trials comparing sorafenib with HAIC,several retrospective analyses have shown no significant differences in survival between the two therapies. Outcomes are favorable for HCC patients exhibiting macroscopic vascular invasion when treated with HAIC rather than sorafenib,whereas in HCC patients exhibiting extrahepatic spread or resistance to transcatheter arterial chemoembolization,good outcomes are achieved by treatment with sorafenib rather than HAIC. Additionally,sorafenib is generally used to treat patients with Child-Pugh A,while HAIC is indicated for those with either Child-Pugh A or B. Based on these findings,we reviewed treatment strategies for advanced HCC. We propose that sorafenib might be used as a first-line treatment for advanced HCC patients without macroscopic vascular invasion or Child-Pugh A,while HAIC is recommended for those with macroscopic vascular invasion or Child-Pugh A or B. Additional research is required to determine the best second-line treatment for HAIC non-responders with Child-Pugh B through future clinical trials.
文摘The characteristics of a rotating stall of an impeller and diffuser and the evolution of a vortex generated at the diffuser leading-edge(i.e., the leading-edge vortex(LEV)) in a centrifugal compressor were investigated by experiments and numerical analysis. The results of the experiments revealed that both the impeller and diffuser rotating stalls occurred at 55 and 25 Hz during off-design flow operation. For both, stall cells existed only on the shroud side of the flow passages, which is very close to the source location of the LEV. According to the CFD results, the LEV is made up of multiple vortices. The LEV is a combination of a separated vortex near the leading-edge and a longitudinal vortex generated by the extended tip-leakage flow from the impeller. Therefore, the LEV is generated by the accumulation of vorticity caused by the velocity gradient of the impeller discharge flow. In partial-flow operation, the spanwise extent and the position of the LEV origin are temporarily transmuted. The LEV develops with a drop in the velocity in the diffuser passage and forms a significant blockage within the diffuser passage. Therefore, the LEV may be regarded as being one of the causes of a diffuser stall in a centrifugal compressor.
文摘Perilla frutescens seed (PFS) oil is reported to inhibit skin photoaging;however, its effect on melanogenesis has not yet been investigated. Herein, we tested the anti-melanogenesis activity of an oil-based extract from PFS with supercritical carbon dioxide (scCO<sub>2</sub>). In a cell culture system, B16 mouse melanoma cells were treated with the PFS scCO<sub>2</sub> extract and other samples. The PFS scCO<sub>2</sub> extract decreased melanin production by approximately 90% in B16 mouse melanoma cells without cytotoxicity at 100 μg/mL. This effect was greater than that of the well-known melanogenesis inhibitor, kojic acid. Although a hexane-extracted PFS oil and a squeezed PFS oil also decreased melanin production in the B16 cells, the inhibitory effect of the PFS scCO<sub>2</sub> extract was higher than both of these. Chemical analysis of the PFS scCO<sub>2</sub> extract and squeezed PFS oil showed that almost 90% of the components of both oils were α-linolenic acid, linoleic acid, and oleic acid. Furthermore, the ratio of those three fatty acids across both samples was almost the same. When the three fatty acids were mixed in the same ratio as in the PFS scCO<sub>2</sub> extract, the IC<sub>50</sub> of the mixture for melanin production in B16 melanoma cells was identical to that of the PFS scCO<sub>2</sub> extract. However, the IC<sub>50</sub> of the squeezed PFS oil was approximately 6.6 times higher than that of the mixture. Although those fatty acids are the main inhibitory ingredients against melanin production in all of the extracts, some factor(s) in the squeezed PFS reduce their affinity with the cells. These results indicated that the PFS scCO<sub>2</sub> extract could be a superior melanogenesis inhibitor. Although its main ingredients are probably the same as those of the squeezed PFS oil, it is necessary to extract with scCO<sub>2</sub> for stronger anti-melanogenesis activity.
文摘AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.
基金National Natural Science Foundation of China(Nos.12075057,11775069,11320101005,and 11875020)National Magnetic Confinement Fusion Science Program of China(No.2017YFE0301201)+3 种基金East China University of Technology,Doctoral Foundation(Nos.DHBK 2017134 and DHBK 2018059)Grant-in-Aid for Scientific Research of the Japan Society for the Promotion of Science(Nos.15H02155,15H02335,21K03513)Landmark Achievements in Nuclear Science and Technology(No.xxkjs2018011)Natural Science Foundation of Jiangxi Province(Nos.20202ACBL201002 and 0192ACB80006)。
文摘Enhancements of edge zonal flows,radial electric fields,and turbulence are observed in electron cyclotron resonance heating-heated plasmas(Zhao et al 2013 Nucl.Fusion 53083011).In this paper,the effects of sawtooth heat pulses on flows and turbulence are presented.These experiments are performed using multiple Langmuir probe arrays in the edge plasmas of the HL-2A tokamak.The edge zonal flows,radial electric fields,and turbulence are all enhanced by sawteeth.Propagation of the zonal flow and turbulence intensities is also observed.The delay time of the maximal intensity of the electric fields,zonal flows,and turbulence with respect to the sawtooth crashes is estimated as~1 ms and comparable to that of the sawtooth-triggered intermediate phases.Not only the zonal flows but also the radial electric fields lag behind the turbulence.Furthermore,the intensities of both the zonal flows and electric fields nearly linearly increase/decrease with the increase/decrease of the turbulence intensity.A double-source predator-prey model analysis suggests that a relatively strong turbulence source may contribute to the dominant zonal flow formation during sawtooth cycles.
文摘BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event analysis.AIM To examine GC incidence in an endoscopic surveillance cohort.METHODS This study was retrospectively conducted at the Toyoshima Endoscopy Clinic.Patients who underwent two or more esophagogastroduodenoscopies were enrolled.GC incidence was based on Kyoto classification scores,such as atrophy,intestinal metaplasia(IM),enlarged folds(EFs),nodularity,diffuse redness(DR),and total Kyoto scores.Hazard ratios(HRs)adjusted for age and sex were calculated using a Cox hazard model.RESULTS A total of 6718 patients were enrolled(median age 54.0 years;men 44.2%).During the follow-up period(max 5.02 years;median 2.56 years),GC developed in 34 patients.The average frequency of GCs per year was 0.19%.Kyoto atrophy scores 1[HR with score 0 as reference:3.66,95%confidence interval(CI):1.06 to 12.61],2(11.60,3.82-35.27),IM score 2(9.92,4.37-22.54),EF score 1(4.03,1.63-9.96),DR scores 1(6.22,2.65-14.56),and 2(10.01,3.73-26.86)were associated with GC incidence,whereas nodularity scores were not.The total Kyoto scores of 4(HR with total Kyoto scores 0-1 as reference:6.23,95%CI:1.93 to 20.13,P=0.002)and 5-8(16.45,6.29-43.03,P<0.001)were more likely to develop GC,whereas the total Kyoto scores 2-3 were not.The HR of the total Kyoto score for developing GC per 1 rank was 1.75(95%CI:1.46 to 2.09,P<0.001).CONCLUSION A high total Kyoto score(≥4)was associated with GC incidence.The endoscopy-based diagnosis of gastritis can stratify GC risk.
文摘Two examples of the use of vortex control to reduce noise and enhance the stable operating range of a centrifugal compressor are presented in this paper.In the case of high-flow operation of a centrifugal compressor with a vaned diffuser,a discrete frequency noise induced by interaction between the impeller-discharge flow and the diffuser vane,which appears most notably in the power spectra of the radiated noise,can be reduced using a tapered diffuser vane(TDV) without affecting the performance of the compressor.Twin longitudinal vortices produced by leakage flow passing through the tapered portion of the diffuser vane induce secondary flow in the direction of the blade surface and prevent flow separation from the leading edge of the diffuser.The use of a TDV can effectively reduce both the discrete frequency noise generated by the interaction between the impeller-discharge flow and the diffuser surface and the broadband turbulent noise component.In the case of low-flow operation,a leading-edge vortex(LEV) that forms on the shroud side of the suction surface near the leading edge of the diffuser increases significantly in size and blocks flow in the diffuser passage.The formation of an LEV may adversely affect the performance of the compressor and may cause the diffuser to stall.Using a one-side tapered diffuser vane to suppress the evolution of an LEV,the stable operating range of the compressor can be increased by more than 12 percent,and the pressure-rise characteristics of the compressor can be improved.The results of a supplementary examination of the structure and unsteady behavior of LEVs,conducted by means of detailed numerical simulations,are also presented.
文摘The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Ultrasonography (US) demonstrated a heterogeneous echogenic cyst measuring 11 cm × 8 cm in size in S2 of the liver, indicated intracystic hemorrhage of simple liver cyst or cystadenocarcinoma, but the differential diagnosis was considerably difficult. Levovist (Schering, Berlin, Germany) US revealed no enhancement of the intracystic structures, suggesting a clot in the case of intracystic hemorrhage. An operation was performed and the resected lesion showed a solitary benign liver cyst, measuring 5.5 cm × 4.7 cm × 8.5 cm containing a large blood clot. The patient had an uneventful recovery after the surgery. Levovist US may play an important role in discrimination between intracystic hemorrhage of simple hepatic cysts and cystadenocarcinoma of the liver.
文摘Background: This study evaluated the effectiveness of hand therapy for elderly people with dementia and the change in effectiveness depending on sex differences between the patients and operators. Methods: The Abe’s behavioral and psychological symptoms of dementia score (ABS), index of resistance to care, and inner balance scanner scores were evaluated. Results: The mean ABS was 18.4 (before therapy), 16.0 (operator of the same sex), and 17.1 (operator of the opposite sex). The mean index scores for resistance to care were 15.3 (before therapy), 15.2 (operator of the same sex), and 13.2 (operator of the opposite sex). When the operator and patient were of the same sex, the mean value of comparison of total power (TP) decreased from 28,060.4 (before therapy) to 5974.3 (after therapy), and the mean low frequency (LF)/high frequency (HF) ratio decreased from 1.7 (before therapy) to 1.2 (after therapy). When the operator was of the opposite sex of that of the patient, the mean TP value decreased from 25,760.4 (before therapy) to 7669.5 (after therapy), and the mean LF/HF ratio increased from 1.2 (before therapy) to 1.5 (after therapy). Conclusions: Hand therapy was the most effective when the patient and operator were of the same sex.
文摘Aim： To investigate the effects of rat Erythropoietin （Epo） on spermatogenesis by transferring rat Epo gene into cryptorchid testes by means of in vivo electroporation. Methods： Sprague-Dawley rats with surgically-induced unilateral cryptorchidism were divided into three groups： the first group was given intratesticular injections of pCAGGS-Epo （pCAGGS-Epo group）, the second group was given intratesticular injections of pCAGGS （pCAGGS group）, and the third group were given intratesticular injections of phosphate-buffered saline （PBS group）. At the same time, square electric pulses of 30 V were applied six times with a time constant of 100 ms. One or two weeks after injection, each testis was weighed and the ratio of the total number of germ cells to that of Sertoli cells （G/S ratio） was calculated to evaluate the impairment of spermatogenesis. Ten testes taken from each of the three groups were examined at each time point. Results： The testicular weight after the injection of pCAGGS-Epo or pCAGGS control plasmid was （0.85 ± 0.08） g and （0.83 ± 0.03） g, respectively, at week 1 （P = 0.788） and （0.62 ± 0.06） g and （0.52 ± 0.02） g, respectively, at week 2 （P = 0.047）. At week 1, spermatids and sperm were more abundant in testes with pCAGGS-Epo than those in the control testes. At week 2, spermatids and sperm were hardly detected in either group. The G/S ratio was 23.27 ± 6.80 vs. 18.63 ± 5.30 at week 1 （P = 0.0078） and 7.16 ± 3.06 vs. 6.05 ± 1.58 at week 2 （P = 0.1471）, respectively. Conclusion： The transfer of Epo to rat testes by in vivo electroporation may reduce the risk of the germ cell loss caused by cryptorchidism.
文摘Numerical study is performed to investigate the swirling flow around a rotating disk in a cylindrical casing. The disk is supported by a thin driving shaft and it is settled at the center of the casing. The flow develops in the radial clearance between the disk tip and the side wall of the casing as well as in the axial clearance between the disk surfaces and the stationary circular end walls of the casing. Keeping the geometry of the casing and the size of the radial clearance constant, we compared the flows developing in the fields with small, medium and large axial clearances at the Reynolds number from 6000 to 30,000. When the rotation rate of the disk is small, steady Taylor vortices appear in the radial clearance. As the flow is accelerated, several tens of small vortices emerge around the disk tip. The axial position of these small vortices is near the end wall or the axial midplane of the casing. When the small vortices appear on one side of the end walls, the flow is not permanent but transitory, and a polygonal flow with larger several vortices appears. With further increase of the rotation rate, spiral structures emerge. The Reynolds number for the onset of the spiral structures is much smaller than that for the onset of the spiral rolls in rotor-stator disk flows with no radial clearance. The spiral structures in the present study are formed by the disturbances that are driven by a centrifugal instability in the radial clearance and they are penetrated radially inward along the circular end walls of the casing.
文摘Aeolian tone from a semi-circular cylinder in a uniform flow is studied experimentally for various angles of attack. It is found that the peak sound spectrum of the Aeolian tone from the semi-circular cylinder is smaller than that from the circular cylinder and the lowest sound is observed around the zero angle of attack. This is due to the reduction in the fluctuating lift force on the semi-circular cylinder compared to that of the circular cylinder. This result suggests the validity of the analogy between the sound pressure level and the fluctuating lift force on a semi-circular cylinder in a stream. The flow visualization study also supports these results.
文摘A novel technique for reducing reverberation artifact in acoustic shadow imaging using nonlinear ultrasound interaction, called nonlinear acoustic shadow method, has been developed and experimentally studied. In this technique, the conventional acoustic shadow method is modified by using the secondary wave generated by nonlinear interaction of two primary sound waves emitted from parametric array. Either conventional or nonlinear acoustic shadow imaging is carried out for aluminum square cylinder and the size of the shadow is compared. The result shows that the nonlinear acoustic shadow method reduces reverberation artifact inside the square cylinder and has better accuracy in the size measurement than conventional acoustic shadow method.
文摘In this paper, the measurement of an aerodynamic sound source for a semi-circular cylinder in a uniform flow is described using Particle Image Velocimetry (PIV). This experimental technique is based on vortex sound theory, where the time derivative of vorticity is evaluated with the aid of two sets of standard PIV systems. The experimental results indicate that the sound source for the semi-circular cylinder is located around the shear layer near the edge of the semi-circular cylinder. The sound source intensity and the area are reduced in the semi-circular cylinder compared with those of a circular cylinder. This result indicates that the aerodynamic sound of the semi- circular cylinder is smaller than that of the circular cylinder, which supports the microphone measurement result.
文摘The secondary flow downstream of a triple elbow layout was studied experimentally and numerically to visualize the flow behavior under swirling inlet flow conditions. The inlet swirling condition was generated by a swirl generator, consisting of a rotary pipe and honeycomb assembly. The experiments were carried out in turbulent water flow condition at Reynolds number Re = 1 × 104 and inlet swirl intensity S = 1. Ultrasonic measurements were taken at four locations downstream of the third elbow. The two-dimensional velocity field of the flow field was measured using the phased array ultrasonic velocity profiler technique to evaluate the flow field with separation. Furthermore, a numerical simulation was performed and its results were compared with the experimental data. The numerical result was obtained by solving three-dimensional, Reynolds-averaged Navier-Stokes equations with the renormalization group k-ε turbulence model. The experimental results confirmed that the swirling flow condition modified the size of the separation region downstream of the third elbow. A qualitative comparison between the experimental and CFD simulation results of the averaged velocity field downstream of the third elbow showed similar tendency on reverse flow.
文摘This paper deals with the statistical properties of unsteady structure of cavitating water-jet issuing into a stagnant fluid of water using the shadowgraph imaging combined with the proper orthogonal decomposition (POD) analysis. The experimental result indicates that the cavitating jet is composed of axisymmetric mode, while the periodic axial oscillation is found along the jet centerline. The reconstructed cavitation images show the presence of growing, shrinking and shedding motion in the cavitation cloud, which sustains a periodic behavior of the cavitating jet.
文摘Background and Aims: The liver is the first organ affected by toxic copper in the classical and severe hepatic forms of Wilson's disease(WD).Because their associated chronic liver damage is mostly asymptomatic,an intervention using a special test including serum alanine aminotransferase(ALT)activity is needed for detecting WD.Methods: Using the modified international criteria for the diagnosis of WD,45 patients were selected from the collective databases of our institutions,and 7 infants were reviewed from the literature.Two patients had the severe hepatic form,with nor-moceruloplasminemia and no mutations in ATP7B.The rapid ALT change during hemolytic anemia was adjusted for a baseline.The diagnostic potential of the ALT test was assessed from the age-dependent natural course of the liver damage of WD.Results: The natural course had three stages.ALTs were still low in some infants younger than 4 years-old.They were high in all children between the ages of 4 and 8 years-old;then,they reduced to low levels in some patients over 9 years of age.The high ALT stage represents chronic active hepatitis,and the sub-sequent low ALT stage is due to silent cirrhosis.The hepatic cop-per content is a reliable but invasive test,while urinary copper secretion is an alternative,non-invasive test for copper toxicosis of WD.The serum ceruloplasmin and ATP7B analyses are sub-type tests of WD.The response to anti-copper regimens is the final test result.Conclusions: ALTcould be the first parameter to test to detect WD in children between the ages of 4 and 8 years.
