Considering the fact that C language integrated production system(CLIPS) does not support backward chaining rules which are the base reasoning in fault diagnosis,a solution based on OOP method's message-handling mechanism was proposed to deal with this problem;moreover,an expert system knowledge acquisition shell that can accept rules about fault processing of chemical production in structured Chinese natural language was established to automatically convert the rules to codes which can be executed in CLIPS environment.A fault diagnosis expert system designed for the shift section in ammonia plant proves the practicability of this method.
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Complete staghorn calculi present one of the most challenging conditions in managing upper urinary tract stones. The complexity of treatment increases significantly when combined with severe scoliosis, particularly in patients with a Cobb angle exceeding 90°. This case report describes the treatment of a patient with severe scoliosis, characterized by a Cobb angle greater than 90°, who also presented with complete staghorn calculi. The patient successfully underwent single-stage, totally ultrasound-guided, tubeless mini-percutaneous nephrolithotomy, achieving excellent stone clearance without complications. This report aims to enhance the understanding of diagnosing and managing severe scoliosis in patients with complete staghorn calculi and to highlight the efficacy and safety of totally ultrasound-guided mini-percutaneous nephrolithotomy as a surgical approach.
Patients with chronic kidney disease have an increased risk for progression to ESRD. The purpose of this study was to examine factors that predict increased risk for adverse renal outcomes. Cox regression was performed to assess the potential of 38 baseline risk factors to predict the clinical renal composite outcome of 50% or 25-ml/min per 1.73 m2 GFR decline or ESRD among 1094 black patients with hypertensive nephrosclerosis (GFR 20 to 65 ml/min per 1.73 m2). Patients were trial participants who had been randomly assigned to one of two BP goals and to one of three antihypertensive regimens and followed for a range of 3 to 6.4 yr. In unadjusted and adjusted analyses, baseline proteinuria was consistently associated with an increased risk for adverse renal outcomes, even at low levels of proteinuria. The relationship of proteinuria with adverse renal outcomes also was evident in analyses that were stratified by level of GFR, which itself was associated with adverse renal outcomes but only at levels <40 ml/min. Other factors that were significantly associated with increased renal events after adjustment for baseline GFR, age, and gender, both with and without adjustment for baseline proteinuria, included serum creatinine, urea nitrogen, and phosphorus. In black patients with hypertensive nephrosclerosis, increased proteinuria, reduced GFR, and elevated levels of serum creatinine, urea nitrogen and phosphorus were directly associated with adverse clinical renal events. These findings identify a subset of this high-risk population that might benefit from even more aggressive treatment.
Allogeneic umbilical cord blood haematopoietic stem cells (UCB-HSCs) can be transplanted into a host with the intact innate immunity with limited immuno-reaction, although the mechanisms remain unclear. The present studies aimed at investigating potential mechanisms of allogeneic UCB-HSCs escape from the cytolysis of natural killer (NK) cells. We compared UCB-HSCs ability to protect from NK-mediated cytotoxicity with peripheral blood or bone marrow haematopoietic stem cells (PB-HSCs and BM-HSCs). HSCs expressed lower levels of natural cytotoxicity receptor ligands including NKp30L, NKp44L and NKp46L than monocytes. Blocking these ligands respectively or in combination could increase the resistance of HSCs against NK cell mediated cytotoxicity. High expression of HLA-G was noticed on UCB-HSCs, rather than PB-HSCs or BM-HSCs, whereas blockade of HLA-G significantly elevated NK cell mediated cytolysis to UCB-HSCs. Thus, we conclude that natural cytotoxicity receptors and HLA-G on HSCs may contribute to the escape from NK cells, and activate and inhibitory NK cell receptors and their ligands can be novel therapeutic targets in cell transplantation.
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