This paper puts forward a constructive heuristic algorithm called the method of inserting the minimum neighbor edge from outside to the center (IMNEFOTC) that can be applied to solve large-scale and ultra-large-scale travelling salesman problems. Through it and the randomized greedy heuristic algorithm (RGH) which greedy heuristic algorithm is modified, a general meta-heuristic search algorithm framework is built. The general search algorithm (GSA) is based on a set of initial solutions, and continuous 2-opt operations are performed, so as to search for solutions in better quality. The data from the experiment reveals that the performance of IMNEFOTC is better than the traditional greedy algorithm, and the GSA can obtain a pretty satisfactory solution in a reasonable range of time.
Abstract This study was conducted to compare the differences of the whole blood zinc concentration in patients with chronic kidney disease (CKD) as compared to healthy controls, and to explore the correlations of the whole blood zinc level with coronary artery calcification (CAC) and cardiovascular event (CVE) in CKD patients. 170 CKD patients and 62 healthy controls were recruited . The whole blood zinc concentration were determined in using atomic absorption spectroscopy (AAS) method. The degrees of CAC were evaluated by Agatston score based on computed tomography (CT). Regular follow-up visits were performed to record the incidence of CVE, and risk factors were analyzed by COX proportional hazard model and Kaplan-Meier survival curve. There were statistically significant lower zinc in CKD patients than in healthy population. The prevalence of CAC was 58.82% in CKD patients. Our study found that dialysis duration, iPTH, ALP, 25(OH)D3, neutrophil-lymphocyte ratio (NLR), total cholesterol and Hs-CRP were positively correlated with CAC, while albumin, Hb and zinc were negatively correlated with CAC. A COX proportional hazard model demonstrated that moderate to severe CAC, NLR, phosphate, 25(OH)D 3 , iPTH and HLDL were associated with an increased risk for CVE, while zinc, Hb and albumin was inversely associated with a reduced risk for CVEs. Kaplan-Meier curve showed that low zinc (zinc <86.62μmol/L) patients and moderate to severe CAC patients had lower survival respectively. Our study found the lower levels of zinc and higher prevalence of CAC in CKD patients, the low zinc is involved in the high incidence rate of moderate to severe CAC and CVE in CKD patients.
Background Obesity is a recognized risk factor for chronic kidney disease (CKD), but whether weight change is associated with CKD remains unclear. This research aimed to investigate the relationship between weight change patterns across adulthood and the risk of CKD.
State-tree structure (STS) is a powerful tool for the modeling and control of large-scale discrete-event systems (DES) whose structure is organized in a top-down hierarchy. The notorious state-explosion problem can be managed effectively in the framework of STS. Priority is an important concept and exists in a wide range of DES, such as manufacturing systems, traffic systems, and logistic (service) systems. In this article, a conditional-preemption matrix is used to describe the preemption relations among events, which can represent the priority intuitively. In order to augment STS with priority, we propose a novel STS framework: STS with conditional-preemption matrices (STSM), which aims to solve different kinds of issues related to priority. The optimal nonblocking supervisory control is deployed in the framework of STSM. Symbolic synthesis algorithms are implemented and integrated in a software tool, STSLib, which exploits binary decision diagrams as a basis for efficient computation. The developed approach is demonstrated by (a) manufacturing systems using automatic guided vehicles and (b) real-time systems.
The present study aimed to investigate the levels of IL‑36α and its association with disease activity in patients with systemic lupus erythematosus (SLE). A total of 60 patients with SLE and 29 healthy controls were enrolled in the present study. Disease activity was evaluated using the SLE disease activity index (SLEDAI). The serum levels of IL‑36α, IL‑36 receptor antagonist (IL‑36Ra) and IL‑17 were assessed using ELISA. The levels of IL‑36α in patients with SLE were significantly higher compared with those of healthy controls. There was a significant increase in IL‑36α in the active SLE group (SLEDAI score ≥5) compared with that of the healthy controls (P<0.001). The serum IL‑36α levels were higher in patients with active SLE than in patients with quiescent disease (P=0.012). IL‑36Ra was downregulated in patients with SLE (P=0.007). The serum IL‑17 levels were elevated in patients with SLE (P=0.036), and a positive correlation was observed between the IL‑36α and IL‑17 levels (r=0.453, P=0.003). The serum IL‑36α levels were associated with SLEDAI (r=0.374, P=0.003), proteinuria (r=0.329, P=0.010) and complement 3 (r=‑0.336, P=0.009). Patients who were receiving glucocorticoid treatment had lower IL‑36α levels than those who were not receiving glucocorticoid treatment (P=0.003). Patients with lupus nephritis had higher serum IL‑36α levels compared with those found in patients without lupus nephritis (P=0.037). The serum IL‑36α concentration was elevated in patients with SLE, and was correlated with disease activity and IL‑17 levels. The aberrant serum IL‑36α levels observed in the present study and its clinical association with SLE suggest the important role of IL‑36α in onset and progression of SLE. In addition, the association of IL‑36α with IL‑17 level indicates its involvement in the regulation of T helper 17 cytokines.
The incidence of diabetic nephropathy (DN) increases year by year. However, clinical characteristics of DN patients on maintenance hemodialysis (MHD) were rarely reported in China. The purpose of this study was to examine the clinical characteristics of the DN patients on MHD in Anhui Province, Eastern China.The clinical data of MHD patients in the hemodialysis centers of 26 hospitals in Anhui Province from January 1, 2014, to March 31, 2014, were examined. The differences between DN patients and non-DN patients were compared regarding vascular access, nutritional status, mineral and bone disorder, and other indexes.Among the selected 2768 adult MHD patients, 427 had DN. The incidence of hypertension, coronary heart disease, and cerebral thrombus in DN patients was 94.1%, 21.5%, and 15.0%, respectively, which were higher than those in non-DN patients (P < 0.001). Category of vascular access for hemodialysis in DN patients was arteriovenous fistula (AVF) (87.4% [373/427]) and tunneled cuffed catheter (TCC) (11.2% [48/427]). The percentage of AVF was significantly lower than that of non-DN patients (P < 0.001), and percentage of TCC was significantly higher than that of non-DN patients (P < 0.001). Hemoglobin achievement rate in DN patients was 32.0%. The incidence of hypoalbuminemia was 24.7%, significantly higher than that in non-DN patients (P < 0.001). The achievement rate of the target range in mineral values was 55.9% in corrected serum calcium level, 30.1% in serum phosphorus level, and 49.3% in intact parathyroid hormone (iPTH) level in DN patients. Compared with non-DN patients, the achievement rate of serum phosphorus was significantly higher in DN patients.DN patients on MHD in Anhui province exhibited different clinical characteristics compared to non-DN hemodialysis patients. They presented higher percentage in TCC use and cardiovascular complication, lower serum albumin and iPTH levels than those in non-DN patients.
Objectives To compare the effectiveness and safety of the Braidin® slender 7 Fr sheath with a standard 6 Fr sheath for treating left main bifurcation disease. Methods From January 2017 to March 2019, 277 patients with left main bifurcation disease who underwent the transradial approach for percutaneous coronary intervention were divided into the slender 7 Fr sheath group (Braidin® slender 7 Fr sheath, n = 154) and standard 6 Fr sheath group (n = 123). Pathological features, surgical effect, and complications were evaluated. Results The rate of using the classic crush technique was significantly higher in the slender 7 Fr sheath group than in the standard 6 Fr sheath group. The slender 7 Fr sheath group had a significantly shorter operation time than the standard 6 Fr sheath group. There were no significant differences in the radial artery occlusion rate after surgery and at 1 month of follow-up between the groups. Multivariate logistic regression analysis showed that 6 Fr and Braidin slender 7 Fr sheaths did not predict radial artery occlusion. Conclusion The Braidin slender 7 Fr sheath has a superior operative process and similar safety for the radial artery as that of the standard 6 Fr sheath for treating left main bifurcation disease.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)