To evaluate the Efficacy and safety of phosphodiesterase type 5 inhibitors as a medical therapy for distal ureteral calculi by means of a systematic review and network meta‐analysis (NMA). We searched the Embase, Medline, and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCTs) published before May, 2017. Stone passage rate as the primary outcome. We used random effects model for pairwise meta‐analyses and Bayesian random effects model for NMA. We evaluated the quality of evidence by the GRADE framework for each network estimate. Five RCTs (861 patients) comparing four different interventions. The results of NMA showed that compared with tamsulosin alone, tamsulosin combined with tadalafil group was associated with significantly higher stone passage rate (odds radio [OR] 2.55, 95% credible intervals [Crl] 1.11 to 5.89). When considering stone expulsion rate, compared with tamsulosin, silodosin was ranked best (OR 3.58, 95% Crl 1.13 to 11.91), followed by tamsulosin combined with tadalafil (OR 2.55, 95% Crl 1.11 to 5.89) and tadalafil alone (OR 1.86, 95% Crl 0.95 to 4.25). No significant difference was found considering safety profiles between any interventions. This meta‐analysis indicates that tamsulosin combined with tadalafil is an effective treatment option for ureteral stones with a low occurrence of side effects. Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy. Since sample size of included studies, further RCTs are strongly encouraged to address the clinical question.
BackgroundSeptic myocardial depression has been associated with increased morbidity and mortality. miR-885-5p has been shown to regulate cell growth, senescence, and/or apoptosis. Published studies demonstrated that Homeobox-containing protein 1 (HMBOX1) inhibits inflammatory response, regulates cell autophagy, and apoptosis. However, the role of miR-885-5p/HMBOX1 in sepsis and septic myocardial depression and the underlying mechanism is not fully understood.Materials and MethodsExosomes (exos) derived from sepsis patients (sepsis-exos) were isolated using ultracentrifugation. Rats were subjected to cecal ligation and puncture surgery and treated with sepsis-exos. HMBOX1 was knocked down or overexpressed in AC16 cells using lentiviral plasmids carrying short interfering RNAs targeting human HMBOX1 or carrying HMBOX1 cDNA. Cell pyroptosis was measured by flow cytometry. The secretion of IL-1β and IL-18 was examined by ELISA kits. Quantitative polymerase chain reaction (PCR) or western blot was used for gene expression.ResultsSepsis-exos increased the level of miR-885-5p, decreased HMBOX1, elevated IL-1β and IL-18, and promoted pyroptosis in AC16 cells. Septic rats treated with sepsis-exos increased the serum inflammatory cytokines is associated with increased pyroptosis-related proteins of hearts. MiR-885-5p bound to the three prime untranslated regions of HMBOX1 to negatively regulate its expression. Overexpressing HMBOX1 reversed miR-885-5p-induced elevation of inflammatory cytokines and upregulation of NLRP3, caspase-1, and GSDMD-N in AC16 cells. The mechanistic study indicated that the effect of HMBOX1 was NF-κB dependent.ConclusionSepsis-exos promoted the pyroptosis of AC16 cells through miR-885-5p via HMBOX1. The results show the significance of the miR-885-5p/HMBOX1 axis in myocardial cell pyroptosis and provide new directions for the treatment of septic myocardial depression.
This study aimed to assess the role of prostate-specific antigen density (PSAD) and negative multiparametric magnetic resonance imaging (mpMRI) in predicting prostate cancer for biopsy-naïve men based on a large cohort of the Chinese population. From a prostate biopsy database between March 2017 and July 2021, we retrospectively identified 240 biopsy-naïve patients with negative prebiopsy mpMRI (Prostate Imaging Reporting and Data System version 2 [PI-RADS v2] score <3). Logistic regression analysis was performed to select the potential predictors for clinically significant prostate cancer (csPCa). Receiver operating characteristic (ROC) curve analysis and area under the ROC curve (AUC) were performed to assess the diagnostic accuracy. The negative predictive values of mpMRI in excluding any cancer and csPCa were 83.8% (201/240) and 90.8% (218/240), respectively. ROC curve analysis indicated that PSAD was the most promising predictor, with an AUC value of 0.786 (95% confidence interval [CI]: 0.699–0.874), and multiparametric logistic regression analysis confirmed that higher PSAD remained a significant marker for predicting csPCa (odds ratio [OR]: 10.99, 95% CI: 2.75–44.02, P < 0.001). Combining negative mpMRI and PSAD below 0.20 ng ml −2 obviously increased the predictive value in excluding PCa (91.0%, 101/111) or csPCa (100.0%, 111/111). If a PSAD below 0.20 ng ml −2 was set as the criterion to omit biopsy, nearly 46.3% of patients (463 per 1000) with negative mpMRI could safely avoid unnecessary biopsy, with approximately 4.2% of patients (42 per 1000) at risk of missed diagnosis of PCa and no patients with csPCa missed. A PI-RADS v2 score <3 and a PSAD <0.20 ng ml −2 could be potential criteria for the Chinese population to omit prompt biopsy safely.
High-performance Elliptic Curve Cryptography (ECC) implementation in encryption authentication severs has become a challenge due to the explosive growth of e-commerce's demand for speed and security. Point multiplication (PM) is the most common and complex operation in ECC which directly determines the performance of the whole system. This article proposes a 6CC-6CC (clock cycle) dual-field PM architecture and a 6CC-4CC dual-field PM architecture based on maximizing utilization of Karatsuba multipliers and re-ordering schedule strategy in PM. The Montgomery Ladder algorithm used in PM is modified to a 4CC algorithm for better resource utilization and parallel computation. To solve the frequency drop problem while working on large finite field, the PM architectures for high and low field are carefully studied to have universal critical path length and balanced performance. Both of the architectures are implemented over GF(2 571 ) and GF(2 283 ) on Xilinx Virtex-5 and Virtex-7 FPGAs (Field-Programmable Gate Array) for comparison. The 6CC-6CC architecture is shown to have the best performance on GF(2 571 ), which achieves one PM operation in 17.44 µs using 81549 LUTs (Look-Up-Table ) with the frequency of 197.2 MHz on Virtex-5, and 12.55 µs using 80970 LUTs with the frequency of 274.1 MHz on Virtex-7. The 6CC-4CC architecture performs better on GF(2 283 ) with the shortest computation time. It takes only 3.21 µs to finish one PM operation on Virtex-5 and 2.22 µs on Virtex-7, which are faster than all the previous designs. The implementation results prove that the proposed architectures have state-of-the-art performance as well as higher versatility for ECC designs.INDEX TERMS Elliptic curve cryptography (ECC), dual-field point multiplication, montgomery ladder, field-programmable gate array (FPGA) implementation.
Objectives This study assessed the impact of early postoperative organ dysfunction (EPOD) on in-hospital mortality of patients with type A aortic dissection (TAAD) after surgery. Methods Patients with TAAD who underwent surgical repair requiring deep hypothermic circulatory arrest from January 2020 to December 2021 were included. The Sequential Organ Failure Assessment (SOFA) score was calculated for three days postoperatively to stratify the severity of organ dysfunction. Patients with SOFA of 0–4, 5–8 or > 8 were defined as mild, moderate or severe EPOD. The primary outcome was in-hospital mortality, and a composite secondary outcome was defined as in-hospital death or any major complications. Kaplan–Meier curves were used to compare survival probability. The area under the receiver operating characteristic curve (AUROC) and calibration plots were used to evaluate the predictive power and overall performance of SOFA. Results Of the 368 patients, 5 patients (3%) with moderate EPOD and 33 patients (23%) with severe EPOD died. No patient died with mild EPOD. The AUROCs of SOFA for predicting mortality and the composite outcome were 0.85(0.81–0.88) and 0.81(0.77–0.85) on postoperative day 1. Each point of postoperative day 1 SOFA score corresponded to an odds ratio of 1.65 (1.42–1.92) for mortality. Of the six components of the SOFA system, only coagulation (2.34[1.32–4.13]), cardiovascular (1.47[1.04–2.08]), central nervous system (1.96[1.36–2.82]) and renal (1.67[1.04–2.70]) functions were associated with higher risk of mortality. Conclusions EPOD stratified by the SOFA score was associated with higher risk of death and predicted the clinical outcomes of patients with TAAD with good accuracy.
The leakage of toxic or hazardous gases not only pollutes the environment, but also threatens people's lives and property safety. Many countries attach great importance to the rapid and effective gas leak detection technology and instrument development. However, the gas leak imaging detection systems currently existing are generally limited to a narrow-band in Medium Wavelength Infrared (MWIR) or Long Wavelength Infrared (LWIR) cooled focal plane imaging, which is difficult to detect the common kinds of the leaking gases. Besides the costly cooled focal plane array is utilized, the application promotion is severely limited. To address this issue, a wide-band gas leak IR imaging detection system using Uncooled Focal Plane Array (UFPA) detector is proposed, which is composed of wide-band IR optical lens, sub-band filters and switching device, wide-band UFPA detector, video processing and system control circuit. A wide-band (3µm~12µm) UFPA detector is obtained by replacing the protection window and optimizing the structural parameters of the detector. A large relative aperture (F # =0.75) wide-band (3µm~12µm) multispectral IR lens is developed by using the focus compensation method, which combining the thickness of the narrow-band filters. The gas leak IR image quality and the detection sensitivity are improved by using the IR image Non-Uniformity Correction (NUC) technology and Digital Detail Enhancement (DDE) technology. The wide-band gas leak IR imaging detection system using UFPA detector takes full advantage of the wide-band (MWIR&LWIR) response characteristic of the UFPA detector and the digital image processing technology to provide the resulting gas leak video easy to be observed for the human eyes.Many kinds of gases, which are not visible to the naked eyes, can be sensitively detected and visualized. The designed system has many commendable advantages, such as scanning a wide range simultaneously, locating the leaking source quickly, visualizing the gas plume intuitively and so on. The simulation experiment shows that the gas IR imaging detection has great advantages and widely promotion space compared with the traditional techniques, such as point-contact or line-contactless detection.
Since entering the era of big data, the degree of information sharing is getting higher and higher; the information exchange is becoming more and more convenient, but at the same time, personal information is also easy to be exposed to the network environment, if it is used by criminals to lead to information leakage, and then bring certain risks. Therefore, it is in the information age and do a good job of network information security and confidentiality. At present, the security and secrecy of network information are mainly realized by cryptography. Public key cryptography can encrypt information and ensure the security of information transmission, so it is widely used in the contemporary society. At present, elliptic curve encryption is highly respected in the research field of public key cryptosystem. Elliptic curve encryption is divided into two main points, multiplication and inversion, respectively. Through the comparison of these two algorithms, it can be found that there are several choices if the main research objective is to save time, and the Euclidean extension method is mainly discussed in this paper. In other words, more efficient algorithms are used in the hardware implementation process, and a variety of algorithms can be used instead of a single curve algorithm. In this process, we can find the special features of upper level operation and bottom level finite operation. The upper level operation is KP operation, while the bottom level operation is fast calculation of four kinds of K in finite field operation, and finally realize FPGA algorithm. With the help of Quartus ii developed by predecessors, the upper and lower operations of elliptic curve are carried out using VHDL language. Combined ANXIX9.62 in the elliptic curve of each module to test, so as to ensure the accuracy of the data, reduces the error. According to the test results, the designed chip can efficiently complete the elliptic curve encryption system in the whole process. And the average KP operation time can reach 15.15 ms at 20 MHz frequency. At the same time, the chip can complete the operation on ECC public key with any variable curve in F domain less than 256. Therefore, this chip is a high-speed elliptic curve cryptographic chip with optional system parameters. Based on this, this article on the elliptic curve encryption algorithm based on FPGA hardware implementation of system design, from the view of mathematical study analysis, was carried out on the elliptic curve cryptosystem, according to the above two big difficulty, namely, the polynomial of GF(2), the finite field multiplication, and inversion; there will be a detailed studies of discussion, through software comparison to find the differences between different software, especially the software implementation performance level. In addition, it will also focus on the design of elliptic curve algorithm PGA, so as to explore the solution of the algorithm hardware.
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