Eulerian Algorithms for Computing the Forward Finite Time Lyapunov Exponent Without Finite Difference upon the Flow Map

In this paper, effective Eulerian algorithms are introduced for the computation of the forward finite time Lyapunov exponent (FTLE) of smooth flow fields. The advantages of the proposed algorithms mainly manifest in two aspects. First, previous Eulerian approaches for computing the FTLE field are improved so that the Jacobian of the flow map can be obtained by directly solving a corresponding system of partial differential equations, rather than by implementing certain finite difference upon the flow map, which can significantly improve the accuracy of the numerical solution especially near the FTLE ridges. Second, in the proposed algorithms, all computations are done on the fly, that is, all required partial differential equations are solved forward in time, which is practically more natural. The new algorithms still maintain the optimal computational complexity as well as the second order accuracy. Numerical examples demonstrate the effectiveness of the proposed algorithms.     

飞秒激光辅助超声乳化联合Ahmed青光眼引流阀植入术治疗合并难治性青光眼的白内障

目的：评估飞秒激光辅助超声乳化联合Ahmed青光眼引流阀植入术治疗合并难治性青光眼的白内障的有效性和安全性。

方法：回顾性病例对照研究。2019-10/2021-10入院合并难治性青光眼的白内障患者53例53眼，依据自愿选择分为飞秒激光辅助白内障超声乳化(FLACS)组26例26眼和常规白内障超声乳化(CPCS)组27例27眼。两组分别行FLACS和CPCS联合Ahmed青光眼引流阀植入术。比较两组患者术中超声乳化能量释放量(CDE)、有效超声时间(EPT)的差异和术前与术后抗青光眼药物数量的变化，以及术后观察不同时期(1d，1wk，1、3mo)在提高最佳矫正视力(BCVA)，降低眼压、角膜内皮细胞损伤程度和手术并发症及成功率状况。

结果：FLACS组术中CDE和EPT明显低于CPCS组(t=8.50、5.16； P<0.01、=0.001)。两组术后抗青光眼药物较术前均明显减少(t=9.12、7.76； P=0.011、0.016)，但两组间无差异(t=1.79，P=0.082)。两组术后BCVA均较术前改善，眼压均较术前降低(P<0.05)。FLACS组在术后早期(1d，1wk)BCVA的改善较CPCS组更显著(t=9.74、8.49； P=0.008、0.012)，但在术后1、3mo的BCVA改善程度并无不同(t=0.62、0.44； P=1.415、2.021)。CPCS组在术后随访不同时期的角膜内皮细胞损伤较FLACS组更明显(P<0.05)。术后随访的不同时期FLACS组和CPCS组在控制眼压方面无差异(F_组间=0.64，P_组间=0.421)。FLACS组的手术并发症发生率27%(7/26)较CPCS组89%(24/27)低(χ²=20.95，P<0.01)，其中角膜水肿(8% vs 41%)、前囊撕裂(0 vs 11%)在FLACS组中明显低于CPCS组，后囊破裂(0 vs 7%)、玻璃体脱出(0 vs 4%)及人工晶状体偏位(0 vs 7%)也均发生在CPCS组。但两组的治疗总成功率相近(P=28.718)。

结论：飞秒激光辅助超声乳化联合Ahmed青光眼引流阀植入术可充分发挥联合手术的精准微创可控优势，帮助合并难治性青光眼的白内障患者有效降低眼压及更早获得视力恢复。     

Analysis on internal mechanism of zedoary turmeric in treatment of liver cancer based on pharmacodynamic substances and pharmacodynamic groups

Zedoary tumeric (Curcumae Rhizoma, Ezhu in Chinese) has a long history of application and has great potential in the treatment of liver cancer. The anti liver cancer effect of zedoary tumeric depends on the combined action of multiple pharmacodynamic substances. In order to clarify the specific mechanism of zedoary tumeric against liver cancer, this paper first analyzes the mechanism of its single pharmacodynamic substance against liver cancer, and then verifies the joint anti liver cancer mechanism of its "pharmacodynamic group". By searching the research on the anti hepatoma effect of active components of zedoary tumeric in recent years, we found that pharmacodynamic substances, including curcumol, zedoarondiol, curcumenol, curzerenone, curdione, curcumin, germacrone, β-elemene, can act on multi-target and multi-channel to play an anti hepatoma role. For example, curcumin can regulate miR, GLO1, CD133, VEGF, YAP, LIN28B, GPR81, HCAR-1, P53 and PI3K/Akt/mTOR, HSP70/TLR4 and NF-κB. Wnt/TGF/EMT, Nrf2/Keap1, JAK/STAT and other pathways play an anti hepatoma role. Network pharmacological analysis showed that the core targets of the "pharmacodynamic group" for anti-life cancer are AKT1, EGFR, MAPK8, etc, and the core pathways are neuroactive live receiver interaction, nitrogen metabolism, HIF-1 signaling pathway, etc. At the same time, by comparing and analyzing the relationship between the specific mechanisms of pharmacodynamic substance and "pharmacodynamic group", it is found that they have great reference significance in target, pathway, biological function, determination of core pharmacodynamic components, formation of core target protein interaction, in-depth research of single pharmacodynamic substance, increasing curative effect and so on. By analyzing the internal mechanism of zedoary tumeric pharmacodynamic substance and "pharmacodynamic group" in the treatment of liver cancer, this paper intends to provide some ideas and references for the deeper pharmacological research of zedoary tumeric and the relationship between pharmacodynamic substance and "pharmacodynamic group".     

Endostar,an Antiangiogenesis Inhibitor,Combined With Chemoradiotherapy for Locally Advanced Cervical Cancer

This phase II randomized clinical trial aimed to assess the efficacy and toxicity of Endostar, an antiangiogenesis inhibitor, combined with concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Patients with LACC were randomly assigned to either CCRT plus Endostar (CCRT+E arm) or CCRT alone (CCRT arm). All patients received pelvic intensity-modulated radiation therapy (IMRT) and brachytherapy. Weekly cisplatin was administered concurrently with IMRT. Patients in the CCRT+E arm also received concurrent Endostar every 3 weeks for two cycles. The primary endpoint was progression-free survival (PFS) and acute toxicities. The exploratory endpoint was the impact of vascular endothelial growth factor receptor-2 (VEGFR2) expression on long-term survival. A total of 116 patients were enrolled. Patients in the CCRT+E arm and in the CCRT arm had similar acute and late toxicity profile. The 1- and 2-year PFS were 91.4% versus 82.1% and 80.8% versus 63.5% (p=0.091), respectively. The 1- and 2-year distance metastasis-free survival (DMFS) were 92.7% versus 81.1% and 86.0% versus 65.1% (p=0.031), respectively. Patients with positive VEGFR2 expression had significant longer PFS and overall survival (OS) compared with those with negative VEGFR2 expression. Patients in the CCRT+E arm had significantly longer PFS, OS, and DMFS than those in the CCRT arm when VEGFR2 expression was positive. In conclusion, CCRT plus Endostar significantly improved DMFS but not PFS over CCRT alone. The addition of Endostar could significantly improve survival for patients with positive VEGFR2 expression.     

腹腔镜与开腹手术治疗子宫内膜癌的疗效比较

目的:探讨腹腔镜与传统开腹手术治疗子宫内膜癌的临床效果差异。方法:回顾性分析陕西省人民医院2013年10月至2018年3月114例确诊为子宫内膜癌并以腹腔镜治疗的患者为研究对象（腹腔镜组），以同期62例开腹手术治疗的子宫内膜癌病例为对照组，两组在手术时间、术中出血量、淋巴结清扫个数、术后膀胱功能恢复时间、排气时间、体温恢复时间、住院时间及并发症等各方面指标进行比较。结果:腹腔镜组术中失血量、输血率、术后体温恢复时间、肠道功能恢复时间、膀胱功能恢复时间、术后住院天数及手术并发症发生率显著低于开腹组(P<0.05)。腹腔镜组与开腹组在手术时间、术中清扫淋巴结数目、复发率及总生存率差异无统计学意义。结论:与传统方法相比，腹腔镜手术短期效果良好，生存率相当，在具备丰富的腹腔镜手术经验、完善的腹腔镜设备的条件下，可以广泛应用于子宫内膜癌患者的治疗。     

SLC12A5 interacts and enhances SOX18 activity to promote bladder urothelial carcinoma progression via upregulating MMP7

Solute carrier family 12 member 5 (SLC12A5) has an oncogenic role in bladder urothelial carcinoma. The present study aimed to characterize the molecular mechanisms of SLC12A5 in bladder urothelial carcinoma pathogenesis. Functional assays identified that in bladder urothelial carcinoma SLC12A5 interacts with and stabilizes SOX18, and then upregulates matrix metalloproteinase 7 (MMP7). In vivo and in vitro assays were performed to confirm the effect of SLC12A5’s interaction with SOX18 on MMP7‐mediated bladder urothelial carcinoma progression. SLC12A5 was upregulated in human bladder tumors, and correlated with the poor survival of patients with bladder urothelial carcinoma tumor invasion and metastasis, promoted by SLC12A5 overexpression. We demonstrated that SLC12A5 interacted with SOX18, and then upregulated MMP7, thus enhancing tumor progression. Importantly, SLC12A5 expression correlated positively with SOX18 and MMP7 expression in bladder urothelial carcinoma. Furthermore, SLC12A5 expression was suppressed by miR‐133a‐3p. Ectopic expression of SLC12A5 partly abolished miR‐133a‐3p‐mediated suppression of cell migration. SLC12A5‐SOX18 complex‐mediated upregulation on MMP7 was important in bladder urothelial carcinoma progression. The miR‐133a‐3p/SLC12A5/SOX18/MMP7 signaling axis was critical for progression, and provided an effective therapeutic approach against bladder urothelial carcinoma.     

基于Andersen行为模型的消化道肿瘤患者支持性照顾需求现状及影响因素分析

目的调查消化道肿瘤患者的支持性照顾需求现状并分析其影响因素。方法于2019年1—10月间,采用便利抽样的方法,抽取重庆市三峡中心医院内消化道肿瘤患者共370例,采用一般资料调查表、癌症病人支持性照顾需求简明问卷(SCNS-SF34)、医院焦虑和抑郁量表(HADS)、社会网络支持量表(LSNS)进行问卷调查。以Andersen行为模型为基础,将调查内容中关于消化道肿瘤患者支持性照顾需求的影响因素分别纳入倾向性因素、使能因素和需求性因素中,构建4个线性回归模型进行分析,并检验各模型的拟合优度,采用多元线性回归分析消化道肿瘤患者支持性照顾需求的影响因素。结果共发放问卷370份,回收有效问卷365份,有效回收率为98.6%。365例消化道肿瘤患者支持性照顾需求总均分为(3.42±0.54)分,其中生理与日常生活需求>健康信息需求>照顾与支持需求>心理需求>性需求。多元线性回归分析结果显示:倾向性因素中年龄、婚姻状况,使能因素中的家庭平均月收入、疾病负担能力、社会网络支持,需求性因素中的病程、疾病分期、疼痛情况、焦虑程度、抑郁程度是消化道肿瘤患者支持性照顾需求的主要影响因素(P<0.05)。结论消化道肿瘤患者有较高的支持性照顾需求,其需求受多种因素的影响,建议临床医护人员针对不同需求患者进行针对性满足,并对不同影响因素进行综合考量并加以分类分析。