In view of the lack of systemic analysis for stepless transmission using noncircular gears, two basic noncircular gear units, an addition unit adopting differential mechanism and a multiplication unit applying a fixed gear train, are proposed. Then, the design methods of the noncircular gear pair of each unit, transmission ratio relationship, rotation angle relationship and key parameters with specific physical meanings are studied. The adjusting properties, composing strategy and varying range of transmission ratio etc. are investigated in detail for each unit. Following this, several examples of using a noncircular gear pair in the units and their manipulation technique are introduced.

Objective To explore the effect of amifostine combined with low-dose cyclosporine in treatment of refractory immune thrombocytopenia effect and related mechanisms.Methods 60 cases of refractory immune thrombocytopenia patients using parallel randomized controlled groups, divided into three groups, 20 cases in each group, amifostine group were treated with amifostine, cyclosporine group were treated with cyclosporine, amifostine+CSA group received amifostine+cyclosporine A treatment.The platelet count, platelet membrane glycoprotein antibody, lymphocyte subsets and bone marrow megakaryocyte count were observed and compared.Results After different treatment of three, six months, the level of platelet count of patients in three groups were compared with the group before treatment were significantly increased, and the treatment of platelet count level of amifostine group and cyclosporine group were significantly lower than that of amifostine +CSA group, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.The total efficacy of amifostine+CSA group was significantly higher than the other two groups, the difference was statistically significant ( P<0.05 ) , there was no significant difference between amifostine group and cyclosporine group.After the treatment, the platelet membrane glycoprotein GPIIb/IIIa antibody levels in three groups were significantly increased, and ring the detection level of amifostine+CSA group after treatment was significantly higher than the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the three groups of CD4 +, CD4 +/CD25 +and CD4 +/CD8 +levels were significantly increased, CD8 +decreased significantly, the difference was statistically significant (P<0.05).And the level of change after treatment with amifostine +cyclosporine group was significantly higher than that of the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the number of bone marrow megakaryocytes in the three groups was significantly lower than that before treatment , the level of count after treatment with amifostine +cyclosporine was significantly lower than that of the other two groups, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and cyclosporine group.The adverse reactions of amifostine group and amifostine+CSA group were significantly lower than that in cyclosporine group, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and amifostine+CSA group.Conclusion Amifostine combined with low dose of cyclosporine in treatment of refractory immune thrombocytopenia can play a synergistic effect, improve the therapeutic effect, and effectively reduce the dosage and adverse reactions.

Objective To evaluate the proportion and clinical significance of CD4+CD25+ regulatory T cells in childhood acute lymphocyte leukemia(AEL)during different therapeutic stages.Methods 55 peripheral blood samples from 40 children patients with ALL were detected by muhiparameter flow cytometry with fluoresce-hbeled monoclonal antibody.Results Treg cells phenotypically express not only CD62L but also FoxP3 protein.In patients with ALL standard-risk the proportion of CD4+CD25Hi was(1.04±0.33)% in the first course of induction treatment, (1.60±0.44)% in maintenance treatment groups, and(1.29±0.30)% in complete remission groups respectively,while in patients with ALL the intermediate and high risk during maintenance therapy was(2.24±0.75)%.Conclusion Compared with healthy children,the proportion of Treg ceHs in ALL is significantly higher,and may be related to the effect of chemical treatment and severity of ALL.The elevated proportion of Treg may contribute to disease relapse.

Objective To investigate the correlation between Toll-like receptor2 (TLR2) gene promoter region -597T/C polymorphism and primary ANCA associated small vasculitis (AAV) in Guangxi Han people. Methods A case contrastive control study was adopted in the study. Patients with AAV (patients group, n=110) and healthy people (control group, n = 200) were recruited. Associated serum indexes were detected and polymorphisms of TLR2 gene promoter 597T/C were analyzed by polymerase chain restricted fragment length polymorphisms (PCR-RFLP). Results (1)Three TLR2-597T/C genotypes were discovered in 110 AAV patients, namely, TT, TC and CC, with the frequency of 54.55%,40.00% and 5.45% respectively. And the frequencies of allele T and C were 74.55% and 25.45%. In control group, the genotype frequencies of TT, TC and CC were 56.00%,40.50% and 3.50%, with 76.25% of allele T and 23.75% of allele C. No significant differences were found in neither genotype distribution nor allele frequencies between the patients group and control group ( P > 0 . 05 ) . ( 2 ) Significant differences were found in the incidence of proteinuria rate and the hemoglobin (P< 0.05)in AAV patients. (3)There was no significant difference between AI and CI in TT, TC and CC genotype in AAV patients. Conclusions Polymorphism of TLR2-597T/C may be correlated with the incidence of proteinuria and the level of hemoglobin, while no obvious correlation with the genetic susceptibility of ANCA in vasculitis patients of Guangxi Han people.

Objective:To explore the characteristics of type 3 secretion system and biofilm of Pseudomonas aeruginosa in diabetic foot wound, and to analyze the relationship between these factors, as well as to the antibiotic sensitivity.Methods:Thirty-three strains of Pseudomonas aeruginosa were collected from the foot wounds of diabetic foot inpatients in Tianjin Medical University Chu Hsien-I Memorial Hospital from February 1, 2018 to December 31, 2018. Thirteen strains of Pseudomonas aeruginosa were collected from non-diabetic wounds. All strains were tested for antibiotic sensitivity. The virulence genes exoS or exoU of Pseudomonas aeruginosa and the ability of biofilm formation were tested. The characteristics of exoS or exoU and biofilm of Pseudomonas aeruginosa were analyzed. Patients′ clinical outcomes were also analyzed.Results:Pseudomonas aeruginosa with exoS gene was the major pathogen, 90.9% found in diabetic foot group and 84.6% in control group, with no significant difference( χ2=0.54, P=0.46). The drug-resistant strains of Pseudomonas aeruginosa with exoS accounted for 16.7% in diabetic foot group and 18.2% in control group, also with no significant difference( χ2=0.18, P=0.83). There were 5 strains of Pseudomonas aeruginosa carrying exoU, 3 strains in diabetic foot group, of which 1 was resistant, 2 in control group, no resistant strain. Pseudomonas aeruginosa increased the ability of biofilm formation in diabetic foot group, accounting for 57.6%, and for resistant strains, 83.3% of them increased the biofilm formation ability. Two kinds of Pseudomonas aeruginosa produced different biofilms, but they were effectiveless for carbapenem antibiotics. The times of debridement ( P<0.01), time of antibiotic use ( P<0.01) were more in biofilm wound, but the healing rate reached 75%-90%. Conclusion:Pseudomonas aeruginosa secreting ExoS is the main one in the diabetic foot wound. The ability of Pseudomonas aeruginosa to produce biofilm in DF wound is increased. Biofilm is one reason for its antibiotic resistance. Multiple debridement combined with sensitive antibiotics is an effective method to remove biofilm.

Abstract The smoking prevalence among population in Macau has been steadily declined in the past 10 years and Macau boasts one of the lower smoking prevalences in the world. However, the prevalence of adolescent smoking is relatively high. This article described the MPOWER anti smoking package for adolescents in Macau. It also offered suggestions for future improvements in controlling smoking of the young people, including monitoring illicit tobacco trade and smuggling, raising the age limit to buy tobacco products, innovating the methods of health education on harms of tobacco smoke, and enhancing scrutiny on smoking behavior around school campuses. The smoking prevalence among adolescents can be reduced with comprehensive and inclusive anti smoking programs which are tailored to behavioral and psychological characteristics of young people, in line with the local social economic contexts, and take on advantages of scientific and technological developments.

Objective:To investigate the correlation between neutrophil to lymphocyte ratio (NLR) and 30-day clinical outcomes in patients with spontaneous cerebral hemorrhage and whether adding NLR to ICH score improve the accuracy of predicting poor outcomes.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurology, the Second People's Hospital of Hefei from March 2018 to April 2019 were enrolled retrospectively. The demographic and baseline clinical and imaging data were documented. The absolute neutrophil counts and absolute lymphocyte counts within 24 h of onset were obtained and NLR was calculated. At 30 d after the onset of cerebral hemorrhage, the modified Rankin Scale was used to evaluate the outcomes. Good outcome was defined as ≤2, and poor outcome was defined as >2. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline NLR, ICH score and NLR+ ICH score for poor outcomes in patients with spontaneous cerebral hemorrhage. Results:A total of 159 patients with spontaneous cerebral hemorrhage were enrolled, including 106 males (66.67%), age 62.29±15.10 years. Neutrophil count was (7.30±3.95)×10 9/L, lymphocyte count was (1.41±0.67)×10 9/L, and NLR was 6.94±7.66. Baseline hematoma volume was 17.93±25.87 ml, median ICH score 0 (interquartile range 0-1). The outcomes of 60 patients (37.7%) were poor at 30 d. Univariate analysis showed that coronary heart disease, systolic blood pressure, diastolic blood pressure, high-sensitivity C-reactive protein, fasting blood glucose, white blood cell count, neutrophil count, NLR, hematoma broken into the ventricle, hematoma volume, NIHSS and ICH scores in the poor outcome group were significantly higher than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage (odds ratio 1.135, 95% confidence interval 1.092-2.321; P=0.038). The ROC curve analysis showed that the best cut-off value of NLR was 6.679, and the sensitivity and specificity of predicting poor outcomes were 51.67% and 76.77% respectively; the best cut-off value of ICH score was 1.0, and the sensitivity and specificity of predicting poor outcomes were 69.71% and 89.80% respectively; the sensitivity and specificity of the combined application of NLR + ICH score to predict poor outcomes were 74.58% and 82.65% respectively. Conclusions:NLR was independently associated with poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage. Adding it to the ICH score could improve the accuracy of predicting poor outcome.

Objective The psychometric hepatic encephalopathy scale (PHES),including five psychometric tests,is a standard for the diagnosis of minimal hepatic encephalopathy (MHE) and enjoys predictive value of overt hepatic encephalopathy (OHE).We investigate whether a simplified PHES is as useful as the whole PHES.Methods Seventy consecutive hepatitis B cirrhotic patients without OHE,admitted to our hospital from October 2012 to June 2013,and other 72 healthy volunteers were chosen in our study.PHES was performed in both groups.Expected normal reference value formula were established based on the 5 psychometric tests in healthy controls,and backward logistic regression was performed by eliminating stepwise variables of PHES to get a simplified PHES (SPHES).Then,SPHES was performed on the 70 patients and followed up for a year to detect the prevalence rate of MHE and OHE.Results PHES was easily influenced by age and educational level.In patients with liver cirrhosis,44.29％ patients (31/70) had MHE based on PHES and 41.43％ (9/70) had MHE based on SPHES,without significant differences (P＞0.05).According to the follow-up study,21 patients developed OHE; the number of developing OHE showed no significant difference between MHE patients dignosed by PHES and SPHES (P＞0.05).Conclusion SPHES is as good as PHES in diagnosing MHE and predicting the occurrence of OHE,which consumes less time and is more suitable for clinical screening.

Depression is a common emotional disorder, which has high incidence rate and mortality worldwide. Ascorbic acid (AA) is also known as vitamin C. As a kind of reducing vitamin, AA participates in anti-oxidation, enzyme assistance and neuro-modulation in the central nervous system. Clinical evidence and animal studies show that AA has anti-depressant effect. This article reviews the function of AA in the nervous system, the current researches on relation between AA and depression, and possible mechanism, and analyzes its therapeutic significance in this disease, hoping to provide new ideas for the clinical treatment of depression.

Objective To evaluate the effect of doxofylline on pulmonary inflammatory response induced by mechanical ventilation in rats with chronic obstructive pulmonary disease (COPD).Methods Thirty adult male Sprague-Dawley rats,aged 8 weeks,weighing 200-250 g,were divided into 3 groups (n=10 each) using a random number table method:control group (C group),COPD group and doxofylline group (Dox group).Rats were fed in normoxia for 2 months,and normal saline 0.2 ml was injected into the trachea on 1st and 30th days in C group.Rats were exposed to cigarette smoke for 30 min every day,lasting for 2 months,and lipopolysaccharide 200 μg (0.2 ml) was injected into the trachea on 1st and 30th days in COPD and Dox groups.Two months later,rats in each group were anesthetized,tracheally intubated,and then mechanically ventilated.Doxofylline 50 mg/kg was intravenously injected immediately after intubation in Dox group,and the equal volume of normal saline was given instead in C and COPD groups.Pulmonary specimens were taken after 120 min of mechanical ventilation for examination of pathological changes and for determination of wet/dry weight ratio (W/D ratio) and tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) contents (by enzyme-linked immunosorbent assay).Results No significant pathological change of lung tissues was found in C group,and COPD pathological changes were observed in COPD and Dox groups.Compared with C group,the W/D ratio and TNF-α level were significantly increased,and the IL-10 level was decreased in COPD and Dox groups (P＜0.05).Compared with COPD group,the W/D ratio and TNF-α level were significantly decreased,and the IL-10 level was increased in Dox group (P＜0.05).Conclusion Doxofylline can reduce the pulmonary inflammatory response induced by mechanical ventilation in rats with COPD.