As in the building of deep buried long tunnels, there are complicated conditions such as great deformation, high stress, multi-variables, high non-linearity and so on, the algorithm for structure optimization and its application in tunnel engineering are still in the starting stage. Along with the rapid development of highways across the country, It has become a very urgent task to be tackled to carry out the optimization design of the structure of the section of the tunnel to lessen excavation workload and to reinforce the support. Artificial intelligence demonstrates an extremely strong capability of identifying, expressing and disposing such kind of multiple variables and complicated non- linear relations. In this paper, a comprehensive consideration of the strategy of the selection and updating of the concentration and adaptability of the immune algorithm is made to replace the selection mode in the original genetic algorithm which depends simply on the adaptability value. Such an algorithm has the advantages of both the immune algorithm and the genetic algorithm, thus serving the purpose of not only enhancing the individual adaptability but maintaining the individual diversity as well. By use of the identifying function of the antigen memory, the global search capability of the immune genetic algorithm is raised, thereby avoiding the occurrence of the premature phenomenon. By optimizing the structure of the section of the Huayuan tunnel, the current excavation area and support design are adjusted. A conclusion with applicable value is arrived at. At a higher computational speed and a higher efficiency, the current method is verified to have advantages in the optimization computation of the tunnel project. This also suggests that the application of the immune genetic algorithm has a practical significance to the stability assessment and informationlzation design of the wall rock of the tunnel.

Objective To observe the clinical effect of Yangyin Tongluo Pills combined with acupuncture for the treatment of cerebral infarction sequela. Methods One hundred patients with cerebral infarction sequela were evenly randomized into treatment group and control group. The control group was given acupuncture therapy combined with oral use of clopidogrel, and the treatment group was given acupuncture therapy combined with oral use of Yangyin Tongluo Pills (mainly composed of Fructus Lycii, Flos Chrysanthemi, Radix Rehmanniae, Cortex Moutan, Radix Salviae Miltiorrhizae, Flos Carthami, Semen Persicae, Pheretima, Rhizoma Gastrodiae, Ramulus Uncariae cum Uncis, Spica Prunellae, Radix Glehniae, Radix Ophiopogonis, Fructus Schisandrae Chinensis, Radix Pseudostellariae) . One month constituted a treatment course, and the treatment covered 2 courses. After treatment, the therapeutic effect of the two groups was evaluated, and the changes of National Institute of Health Stroke Scale ( NIHSS) scores and Barthel Index Scale for activities of daily living ( ADL) , and hemorrheology indexes were observed before and after treatment. Results (1) After treatment for 2 courses, NIHSS scores were decreased, ADL scores were increased in the two groups (P<0.01 compared with those before treatment) , and the improvement of the treatment group was superior to that of the control group ( P<0.01) . ( 2) After treatment, hemorrheology indexes were much improved in the treatment group ( P<0 . 05 or P<0 . 01 ) , but remained unchanged in the control group ( P>0.05) . The treatment group had better effect on improving hemorrheology indexes than the control group (P<0.05) . (3) The total effective rate of the treatment group was 90.00% and that of the control group was 64.00%, the overall therapeutic effect of the treatment group being superior to that of the control group (P<0.05) . Conclusion Yangyin Tongluo Pills combined with acupuncture are effective for the treatment of cerebral infarction sequela, and the effect is superior to that of acupuncture combined with clopidogrel.

Objective Analyse the causes,diagnosis and treatment for delayed hemorrhage after distal radical gastrectomy.Methods Retrospective study on 45 patients combined with intro-abdominal hemorrhage after distal radical gastrectomy from January 2008 to June 2013.Results Thirteen patients combined with delayed hemorrhage in these 45 patients,all of 13 patients had intro-abdominal hemorrhage in 1week to 4 weeks after operation.And 5 of the 13 patiens were intermittent intro-abdominal hemorrhage 1 week after operation,these patients were demonstrated the blood come from gastroduodenal artery pseudoaneurysm fracture by CT and DSA examine,and they were cured by interventional embolization.Other 8 patients were marginal ulcer hemorrhage diagnosed by gastroscope,and they stoped bleeding with the help of gastroscope.Conclusions The causes of delayed hemorrhage after distal radical gastrectomy were complicated,and CT,DSA and endoscope can use for diagnosis.What was more,interventional embolization and endoscope were helpful for curing the intro-abdominal hemorrhage,avoiding re-operation.

Objective To assess the ability of pixel-based quantitative evaluation of CT values in differentiating benign and malignant cystic-solid ovarian tumors.Methods CT images of 41 cystic-solid ovarian lesions from 39 patients were reviewed,with 27 benign and 14 malignant confirmed by post-operation pathology or follow-up.Regions of interest (ROIs) were drawn along edges of tumors on all slices of contrast-enhanced images with ImageJ software.CT values of each pixel were extracted.CT values of 20,25,30,35 and 40 HU were used respectively as the threshold to divide cystic and solid components.Solid proportion,the mean and median CT values of solid component were calculated and compared between benign and malignant groups.Results Mean CT values of solid components were all higher in malignant than in benign ovarian masses under all the threshold values (P<0.05).For median CT values, the same trend existed under the threshold of 20,25,35 and 40 HU (P<0.05).For the solid proportion,difference was found only under the 40 HU threshold, with lower value in malignant group (0.67±0.25) than in benign group (0.47±0.31).ROC curves were drawn to differentiate benign and malignant lesions.The highest AUC was obtained by using the mean CT value of solid components defined by 40 HU threshold (AUC=0.735).Conclusion Pixel-based quantitative evaluation on CT images could help to define cystic and solid components of ovarian masses, with 40 HU to be an optimal threshold.Cystic-to-solid proportion and CT value of solid components derived from whole lesion can help to differentiate benign or malignant lesions.

Objective To observe the possible relationship of cardiac troponin T (cTnT) with cardiac disease and death events in hemodialysis patients Methods The cTnT was measured with dry chemical method in 57 hemodialysis patients The patients were followed up for one year Results The concentration of cTnT was more than 0 10 ?g/L in 12 of the 57 unselected hemodialysis patients 8 in the 12 patients were diagnosed as diabetes mellitus 7 of 12 patients died and the death reason was acute left ventricular failure(33 3%) in 4 patients In other 45 patients with normal cTnT, 3 died and only 1 died of heart failure(2 22%) The cTnT concentrations of pre-and post-hemodialysis were measured in 24 patients The concentration was more than 0 1 ?g/L in 6 patients before dialysis Post-dialysis concentration was increased in 5 patients', the value was decreased in the other one Conclusions In hemodialysis patients without acute myocardial infarction, mortality and cardiovascular events are closely correlated with the increase of cTnT concentration. Patients with diabetes mellitus have higher incidence in the abnormality of cTnT concentration.The process of hemodialysis does not affect the concentration of cTnT.

Objective: To investigate the expression of caspase1 mRNA in hippocampus of(developing) rats following recurrent seizures and the effects of tetramethylpyrazine on it.Methods: One(hundred) and(sixty)two postnatal SpragueDawley rats of 20day old were randomly divided into three groups: the control group,the seizure group and the tetramethylpyrazine treated group.Seizure model of rats were induced by(inhalant) flurothyl daily in 6 consecutive days.Brain tissue was sampled at 6 hours,1 day,(3 days) and 7 days in each group after last seizure,and the expression of caspase1 mRNA in the hippocampus was(detected) by(reverse) transcriptionpolymerase chain reaction(RTPCR).At the same time,the water content was(detected) and the pathological changes in the hippocampus of rats were observed after recurrent seizures and the brain injury was evaluated by using a semiquantitative neuropathological scoring system.Results: In(tetramethylpyrazine) treated group,the levels of caspase1 mRNA in the hippocampus,water content of brain tissues and neuropathological score at different time points were obviously lower than those in seizure group(except water content of brain tissues at 7 days,all P

OBJECTIVE To analyze the caloric test findings of the unilateral primary horizontal and posterior semicircular canal benign paroxysmal positional vertigo(HSC-BPPV and PSC-BPPV).METHODS Caloric test were tested in 152 PSC-BPPV patients and 25 HSC-BPPV patients after Dix-Hallpike test and Roll test.RESULTS Of 152 PSC-BPPV patients 64 canal paresis(CP)were found in the abnormal side and 44 in the normal side;Of 25 HSC-BPPV patients 16 canal paresis were found in the abnormal side and 9 in the normal side.The incidence of CP in PSC-BPPV is 30.3% and the incidence of CP in HSC-BPPV is 52%.13 Patients with PSC-BPPV were found abnormal Directional Preponderance(DP)and 10 Patients with PSC-BPPV were found abnormal Directional Preponderance.CONCLUSION The incidence of CP in the abnormal side of HSC-BPPV and PSC-BPPV is more than that of the normal side.The incidence of CP in abnormal side of the HSC-BPPV is more than that of PSC-BPPV.The incidence of abnormal DP in HSC-BPPV is more than that of PSC-BPPV.

BACKGROUND:Navigation assisted minimal y invasive posterior lumbar interbody fusion and pedicle screw fixation can precisely real-time guide a variety of operation under minimal y invasive sleeve, and implant the pedicle screws and interbody fusion cage and other implants safely and accurately, thus can determine the decompression parts. Minimal y invasive transforaminal lumbar interbody fusion is the typical approach in recent years for the successful application of minimal y invasive spine surgery techniques with the advantages of smal incision, less bleeding, slight tissue damage and faster recovery. OBJECTIVE:To evaluate the short-term effect of minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system and open posterior transforaminal lumbar interbody fusion. METHODS:Forty cases with single-level lumbar disc herniation were retrospectively analyzed. The patients were treated with minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system (20 cases) and open posterior transforaminal lumbar interbody fusion (20 cases) respectively for the comparative analysis. The fusion duration, intraoperative blood loss, postoperative drainage volume, the length of postoperative hospital stay and the length of hospital stay were compared between two groups. The wound pain and function were evaluated after treatment with visual analogue scale score and Japanese Orthopaedic Association score. RESULTS AND CONCLUSION:Al patients were fol owed-up for 7.7 months. The operative duration in the minimal y invasive transforaminal lumbar interbody fusion group was longer than that in the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P<0.01);the length of hospital stay and length of postoperative hospital stay of the minimal y invasive transforaminal lumbar interbody fusion group were shorter than the open posterior transforaminal lumbar interbody fusion group, and the differences were significant (P<0.01);the intraoperative blood loss of the minimal y invasive transforaminal lumbar interbody fusion group was less than the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P<0.05);the postoperative drainage volume of the minimal y invasive transforaminal lumbar interbody fusion group was less than the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P<0.01). The visual analogue scale score was significantly decreased and the Japanese Orthopaedic Association score was significantly increased in the minimal y invasive transforaminal lumbar interbody fusion group at 3 days after internal fixation compared with open posterior transforaminal lumbar interbody fusion group (P<0.01), but there were no significant differences in the visual analogue scale score and Japanese Orthopaedic Association score between the two groups before operation and 6 months after operation (P>0.05).The results indicate that minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system is an effective method for lumbar disc herniation with the advantages of less intraoperative blood loss, less postoperative drainage volume, smal trauma, short hospital stay and short-term efficacy.

Objective To analyze the advantages and disadvantages of minimally invasive video -assisted thyroidectomy(MIVAT)and totally endoscopic thyroidectomy (TET).Methods The study included 70 patients undergoing MIVAT and TET at Qilu Hospital of Shandong University and Yantai Yuhuangding Hospital from Jan . 2012 to Dec.2012.46 patients undergoing MIVAT(MIVAT group)and 24 patients undergoing TET(TET group) were analyzed retrospectively .Data of gender,age,operative data,intraoperative and postoperative complications , length of stay , feelings of patients and cosmetic effect were collected and analyzed .MIVAT and TET were com-pared in terms of safety ,trauma and cosmetic effect .Results ①About safety:no permanent recurrent laryngeal nerve(RLN)palsy and parathyroid injury occurred in either group .One case in MIVAT group and no case in TET group was converted to open surgery (2.2%vs 0%,P>0.05) .②About trauma:the intraoperative blood loss and postoperative drainage amount in the MIVAT group were significantly less than those in the TET group ( P <0.05).Postoperative VAS score at 6 hours was similar,but MIVAT group showed lower postoperative VAS score than TET group at 12 hours and 24 hours ( P<0.05 ) .No significant difference was observed between the 2 groups about C reactive protein (CRP)on the 1st day before operation,the 1st and 3rd day after operation(P>0.05).③About cosmetic effect:the 2 groups had similar patient satisfaction index .Conclusions The study shows similar results in safety and trauma .The 2 approaches are both safe and valid .Patients using the two ap-proaches are equally satisfied with the cosmetic effect .

Objective To investigate the safety and efficacy of intravenous thrombolysis (IVT) in elderly patients (aged≥80 years) with acute ischemic stroke.Methods From July 2014 to February 2016,157 consecutive patients with acute cerebral infarction treated with alteplase for intravenous thrombolysis within 4.5 h after onset at the Department of Neurology,the Third People's Hospital of Chengdu were collected retrospectively.They were confirmed by head CT or MRI.They were divided into a ≥80-year old group (n=47) and a <80-year old group (n=110) according to the age of onset.The baseline data were documented,including the risk factors for cardiocerebrovascular diseases,National Institute of Health stroke scale (NIHSS) score,onset to thrombolytic time (3.0-4.5 h),and application of anticoagulant drugs,etc.The adverse reactions of the patients were observed and the safety and efficacy of thrombolysis were evaluated,that is 7 d and 3 months mortality,symptomatic intracranial hemorrhage rate,and good recovery rates of intravenous thrombolysis at 24 h,1 week,and 3 months.Results (1) Compared with the <80-year old group,the ratio of atrial fibrillation and median age in the ≥80-year old group were higher.There were significant differences between the two groups (59.6% [n=28] vs.32.7% [n=36],83 [81,85] vs.67 [59,75] years old,all P<0.01).There were no significant differences in the remaining baseline data between the two groups (all P>0.05).(2) In the subtypes of cerebral infarction etiology,the proportion of cardiogenic embolism in the ≥80-year old group was higher than that in the <80-year old group.There was significant difference between the two groups (59.6% [n=28] vs.32.7% [n=36],P<0.01).There was no significant difference in the other etiological types between the two groups (all P>0.05).(3) There were no significant differences at one week (6.4% [n=3] vs.6.4% [n=7] respectively) and 3 months (12.8% [n=6] vs.9.1% [n=10]) in the mortality rates between the ≥80-year old group and the <80-year old group (all P>0.05).There were no significant differences in the proportions of intracranial hemorrhage (10.6% [n=5] vs.8.2% [n=9]) and symptomatic intracranial hemorrhage (4.3% [n=2] vs.6.4% [n=7]) between the two groups (all P>0.05).There was no significant difference between the good recovery rate at 24 h (38.3% [n=18] vs.45.5% [n=50]) and that at one week (53.2% [n=25] vs.62.7% [n=69];all P>0.05).The long-term (3 months) favorable prognosis rate in the ≥80-year old group was lower than that in the <80-year old group.There was significant difference between the two groups (51.1% [n=24] vs.71.8% [n=79], P<0.05).Conclusion For the onset within 4.5 h (aged≥80 years) in elderly patients with acute ischemic stroke,selecting the appropriate cases for intravenous thrombolysis is help to increase safety and early benefit.