In this paper, a dynamic update algorithm of double scrambling-DNA row and column closed loop based on chaotic system is proposed. The classical scrambling and diffusion structure are used in the whole process. In the scrambling stage, a new pixel reconstruction method is proposed by combining the Hilbert curve with Knuth-Durstenfeld shuffle algorithm to overcome the shortcoming of nearby storage of Hilbert curve. This method reconstructs the pixel matrix of one-dimensional vector according to the Hilbert curve coding method, and achieves good scrambling effect, while reducing its time complexity and space complexity. In the diffusion stage, combining the plaintext row, the ciphertext row and the key row, and taking advantage of the parallel computing power and high storage density of the DNA encoding, the existing block diffusion operation is improved, and the two-round diffusion of the DNA encoding is proposed. When the last line of ciphertext is generated, the first line of ciphertext is updated and the closed-loop dynamic update of the encryption system is realized. Finally, SHA-256 is used to give the secret key and calculate the initial value of the chaotic system. The simulation results show that the “double scrambling-DNA row and column closed loop dynamic” update algorithm proposed in this paper can effectively improve the efficiency of information transmission and have high security.
Importance Prior trials of extracranial-intracranial (EC-IC) bypass surgery showed no benefit for stroke prevention in patients with atherosclerotic occlusion of the internal carotid artery (ICA) or middle cerebral artery (MCA), but there have been subsequent improvements in surgical techniques and patient selection. Objective To evaluate EC-IC bypass surgery in symptomatic patients with atherosclerotic occlusion of the ICA or MCA, using refined patient and operator selection. Design, Setting, and Participants This was a randomized, open-label, outcome assessor–blinded trial conducted at 13 centers in China. A total of 324 patients with ICA or MCA occlusion with transient ischemic attack or nondisabling ischemic stroke attributed to hemodynamic insufficiency based on computed tomography perfusion imaging were recruited between June 2013 and March 2018 (final follow-up: March 18, 2020). Interventions EC-IC bypass surgery plus medical therapy (surgical group; n = 161) or medical therapy alone (medical group; n = 163). Medical therapy included antiplatelet therapy and stroke risk factor control. Main Outcomes and Measures The primary outcome was a composite of stroke or death within 30 days or ipsilateral ischemic stroke beyond 30 days through 2 years after randomization. There were 9 secondary outcomes, including any stroke or death within 2 years and fatal stroke within 2 years. Results Among 330 patients who were enrolled, 324 patients were confirmed eligible (median age, 52.7 years; 257 men [79.3%]) and 309 (95.4%) completed the trial. For the surgical group vs medical group, no significant difference was found for the composite primary outcome (8.6% [13/151] vs 12.3% [19/155]; incidence difference, −3.6% [95% CI, −10.1% to 2.9%]; hazard ratio [HR], 0.71 [95% CI, 0.33-1.54]; P = .39). The 30-day risk of stroke or death was 6.2% (10/161) in the surgical group and 1.8% (3/163) in the medical group, and the risk of ipsilateral ischemic stroke beyond 30 days through 2 years was 2.0% (3/151) and 10.3% (16/155), respectively. Of the 9 prespecified secondary end points, none showed a significant difference including any stroke or death within 2 years (9.9% [15/152] vs 15.3% [24/157]; incidence difference, −5.4% [95% CI, −12.5% to 1.7%]; HR, 0.69 [95% CI, 0.34-1.39]; P = .30) and fatal stroke within 2 years (2.0% [3/150] vs 0% [0/153]; incidence difference, 1.9% [95% CI, −0.2% to 4.0%]; P = .08). Conclusions and Relevance Among patients with symptomatic ICA or MCA occlusion and hemodynamic insufficiency, the addition of bypass surgery to medical therapy did not significantly change the risk of the composite outcome of stroke or death within 30 days or ipsilateral ischemic stroke beyond 30 days through 2 years. Trial Registration ClinicalTrials.gov Identifier: NCT01758614
Kombucha is a customary tea-based beverage that is produced through the process of fermenting a mixture of tea and sugar water with symbiotic culture of bacteria and yeast (SCOBY). Traditional kombucha has various beneficial effects and can improve immunity. The significant market share of Kombucha can be attributed to the growing consumer inclination towards healthy foods within the functional beverage industry. The research focus has recently expanded from the probiotics of traditional black tea kombucha to encompass other teas, Chinese herbs, plant materials, and alternative substrates. There is a lack of comprehensive literature reviews focusing on substance transformation, functional, active substances, and efficacy mechanisms of alternative kombucha substrates. This article aimed to bridge this gap by providing an in-depth review of the biological transformation pathways of kombucha metabolites and alternative substrates. The review offers valuable insights into kombucha research, including substance metabolism and transformation, efficacy, pharmacological mechanism, and the purification of active components, offering direction and focus for further studies in this field.
Sepsis is associated with high rates of mortality in the intensive care unit and accompanied by systemic inflammatory reactions, secondary infections, and multiple organ failure. Biological macromolecules are drugs produced using modern biotechnology to prevent or treat diseases. Indeed, antithrombin, antimicrobial peptides, interleukins, antibodies, nucleic acids, and lentinan have been used to prevent and treat sepsis. In vitro, biological macromolecules can significantly ameliorate the inflammatory response, apoptosis, and multiple organ failure caused by sepsis. Several biological macromolecules have entered clinical trials. This review summarizes the sources, efficacy, mechanism of action, and research progress of macromolecular drugs used in the prevention and treatment of sepsis.
Introduction There are two approaches for the treatment of intracranial aneurysm (IA): interventional therapy and craniotomy, both of which have their advantages and disadvantages in terms of treatment efficacy. To avoid overtreatment of unruptured aneurysms (UIA), to save valuable medical resources and to reduce patient mortality and disability rate, it is vital that neurosurgeons select the most appropriate type of treatment to provide the best levels of care. In this study, we propose a refined, prospective, multicentre study for the Chinese population with strictly defined patient inclusion criteria, along with the selection of representative clinical participating centres. Methods and analysis This report describes a multicentre, prospective cohort study. As IA is extremely harmful if it ruptures, ethical issues need to be taken into account with regard to this study. Researchers are therefore not able to use randomised controlled trials. The study will be conducted by 12 clinical centres located in different regions of China. The trial recruitment programme begins in 2016 and is scheduled to be completed in 2020. We expect 1500 participants with UIA to be included. Clinical information relating to the participants will be recorded objectively. The primary endpoints are an evaluation of the safety and efficiency of interventional treatment and craniotomy for 6 months after surgery, with each participant completing at least 1 year of follow-up. The secondary endpoint is the evaluation of safety and efficacy of interventional therapy and craniotomy clipping when participants are treated for 12 months. We also address the success of treatment and the incidence of adverse events. Ethics and dissemination The research protocol and the informed consent form for participants in this study were approved by the Ethics Committee of Zhujiang Hospital of Southern Medical University (2017-SJWK-001). The results of this study are expected to be disseminated in peer-reviewed journals in 2021. Trial registration number NCT03133598 .
Intelligent identification method of indicator number of substation instrument based on deformable convolutional neural network there are many equipment in substation, and the value and scale of oil thermometer, oil level gauge, pressure gauge and other instrument equipment reflect the operation state of most instruments and meters, which is particularly important. Therefore, the research on value reading of instrument equipment in substation is particularly key. At present, for the instrument recognition of substation, most studies use traditional image processing and machine learning methods. However, in the recognition process, due to the influence of uneven illumination, complex background, rotation angle, image blur, shooting angle, proportion change and other factors, the recognition accuracy of pointer instrument is low and its usability is poor. In order to solve the above problems, this paper combines the traditional image processing technology with the deep learning method, and proposes an automatic recognition method of substation pointer instrument based on deformable convolutional neural network. The idea of deformable volume is introduced to enhance the modeling ability of convolutional neural network, so as to improve the accuracy of instrument recognition. The main idea is that firstly, the deformable convolution neural network method is used to detect the instrument image in the image, then the residual neural network is used to extract the key points of the instrument dial and pointer, then the detected key points are used to fit the dial circle and pointer, and finally the readout value is calculated according to the deflection angle of the pointer relative to the scale. The experimental results show that this method is very effective for the identification of pointer instruments, and has high accuracy and practicability, which is conducive to promoting the realization of intelligent operation and maintenance of substation.
The authors aimed to elucidate the relationship between latest ischemic event and the incidence of subsequent ischemic stroke in patients with symptomatic artery occlusion.
Objective To investigate the mechanism of intracranial paeudoaneurysm forming, to enhance cure rate and decrease mortality and morbidity. Method Data from 17 patients underwent surgical treatment after 2004 were collected. Clinical characteristics and surgical results of patients with intracranial paeudoaneurysm were assessed. Results 17 cases were dignosised by CT,3D-CTA, DSA and others clinical manifestations. All of the patients were treated by clipping/sticking the neck of aneurysm. 1 cases died, 1 cases was severe disability,4 cases were mild disability. Conclusions Intracranial pseudoaneurysm is a special category in intracranial aneurysm. Bleeding rate was higher than other types in preoperation and interoperation. Early diagnosis is important in preventing secondly hemorrhage, early operation is necessary in decrease morbidity and mortality.
Key words:
Intracranial aneurysm; Pseudoaneurysm; Surgical procedures,operative
OBJECTIVE To study the application value of emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage, and to evaluated by the economic analysis whether the emergency endoscopy was safe and effective,or shorten the hospitalization days and reduced the medical costs. METHODS Ninety-one patients with massive upper gastrointestinal hemorrhage were randomly divided into emergency endoscopy group (group A) and non-emergency endoscopy group (group B). The patients in group A underwent endoscopy as soon as the blood pressures were normal and the patients of group B underwent endoscopy at 24-48 hours after hospitalization. They would be treated depending on the conditions by endoscopy. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the endoscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evaluated and the cost-effect ratio (C/E) was calculated. RESULTS The correct diagnosis rates and the endoscopy costs of group A were higher than the group B (100.0 percent vs.90.2 percent, P<0.05; (714.78+/-263.54) yuan vs. (383.57+/-251.72) yuan, P<0.01), and the rebleeding rates, the mean hospitalizations days, the blood transfusion costs and the drugs costs and the total hospitalization costs were all lower compared to the group B (6.1 percent vs. 26.8 percent, P<0.05; (5.42+/-1.70) days vs. (8.51+/-2.30) days, P<0.01; (791.80+/-258.35) yuan vs. (1270.29+/-569.21) yuan, P<0.01; (945.22+/-125.82) yuan vs. (1223.81+/-254.44) yuan, P<0.01; (2785.76+/-353.26) yuan vs. (3 527.76+/-555.62)yuan, P<0.01. The C/E of group A was lower than the group B (2785.76 yuan per patient vs. 3527.76 yuan per patient, P<0.01). CONCLUSION Emergency endoscopy is not only safe and effective but also economical in the diagnosis and treatment of massive upper gastrointestinal hemorrhage.
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