Abstract The main goals of this research are to determine the customers’ requirements from hotels based on TripAdvisor and the technical capabilities to fulfill the customers’ requirements. Latent Dirichlet Allocation (LDA), used in this research, is the method to determine customer’s requirements based on reviews from TripAdvisor. An output from the LDA method is used as input to Voice of Customer (VOC) in the quality function deployment (QFD). A hotel is selected to be a case study for implementing the integration of LDA and QFD. Questionnaires are distributed to the respondents for the purposes of filling the QFD. The absolute weight, relative weight, absolute importance and relative importance from the QFD with the highest scores are determined as the major capabilities to fulfill customers’ requirements. Suggestion are given to the hotel based on the output from the QFD. The suggestions for the hotel in this research were unannounced inspections and notes for the list of problems to be solved immediately by the hotel.

Ischemia-reperfusion injury (IRI) has brought attention to flap failure in reconstructive surgery. To improve the prognosis of skin transplantation, we performed experimental IRI by surgical obstruction of blood flow and used sodium ferulate (SF) to prevent IRI in rats. After SF treatment, the morphological and histological changes of the skin flaps were observed by H&E and Masson's trichrome staining. We also detected the expression levels of COX-1, HO-1, and Ki67 by immunohistochemical and western blot analysis. Moreover, enzyme-linked immunosorbent assay was used to identify the content of tumor necrosis factor (TNF)-α, myeloperoxidase (MPO), malondialdehyde (MDA), and nitric oxide (NO) in peripheral blood and skin tissue. Compared with the model group, SF treatment significantly improved the recovered flap area (%) and promoted collagen synthesis. Cyclooxygenase-2 (COX-2) expression was significantly inhibited by heme oxygenase-1 (HO-1) induction after SF treatment. Furthermore, SF significantly inhibited the levels of TNF-α in peripheral blood, MPO and MDA in the skin tissue, and the increased synthesis of NO. Our results showed the protective effects of SF on IRI after flap transplantation and we believe that the protective effects of SF was closely related to the alleviation of the inflammatory response and the inhibition of the oxidative stress injury.

A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE) recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months) that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.

In this study, the effects of slag compositions, slag amount, temperature, and carbon content of steel on the manganese and phosphorus distribution ratios during converter steelmaking were analysed using the classical regular solution theory, and industrial tests were performed using two 80 t top-and-bottom combined blown converters (duplex melting process). The results indicate that the slag amount, temperature, and carbon content in steel are the main factors affecting the manganese yield when converter slag compositions remain constant. The FeO content of the slag has a strong impact on the manganese distribution ratio, while the slag basicity and MgO content have no obvious effect. The calculations and experimental results show that the phosphorus distribution ratio increases sharply with increasing slag basicity R, but then decreases with the increase of MgO and MnO contents in the slag. The final slag in converter steelmaking should have the following characteristics: 3.5 < R < 4.5, 15% < (FeO) < 20%, and 6% < (MgO) < 8%. The slag amount should be controlled appropriately at the same time. The results of this investigation would be useful in deciding on the application of manganese ore in alloying and identifying the slagging regime in converter steelmaking.

BACKGROUND: Recent concerns have been raised about the potential for proton pump inhibitors (PPIs) to blunt the efficacy of clopidogrel. We observed the effect of clopidogrel plus aspirin with or without omeprazole in patients with carotid stenoses after they received placement of carotid stents. METHODS: Sixty-four consecutive patients treated with percutaneous carotid artery stenting (CAS) comprised the sample. All enrolled patients underwent the C13 urea breath test (C13 UBT) before CAS. Patients with Helicobacter pylori infection and a history of peptic ulcer were assigned dual antiplatelet combination with omeprazole. Others received dual antiplatelet without omeprazole. Transcranial Doppler and ultrasonography were performed to assess the middle cerebral artery and carotid artery in follow-up at three months and six months. RESULTS: Eight patients had gastrointestinal bleeding; the event rate was 22.6% without omeprazole and 3.8% with omeprazole. The rate of gastrointestinal bleeding was reduced with omeprazole as compared without omeprazole (p = 0.026, p < 0.05). The two groups did not differ significantly in the rate of instent restenosis and thrombus through transcranial Doppler and ultrasonography. CONCLUSION: Among patients receiving dual antiplatelet therapy, prophylactic use of omeprazole reduced the rate of upper gastrointestinal bleeding. There was no apparent interaction between clopidogrel and omeprazole in patients with carotid artery stenting.

ANTECEDENTES: Recientemente se han expresado preocupaciones acerca de la posibilidad de que los inhibidores de la bomba de protones (IBP) para debilitar la eficacia del clopidogrel. Observamos el efecto del clopidogrel más aspirina con o sin omeprazol en pacientes con estenosis de la arteria carótida después de que recibieran la colocación de stents carotídeos. MÉTODOS: Sesenta y cuatro pacientes consecutivos tratados con stent percutáneo de la arteria carótida (SAC) fueron seleccionados para formar la muestra. A todos los pacientes inscritos se les realizó la prueba de aliento con urea C13 (C13 UBT) antes de CAS. A pacientes con infección por Helicobacter pylori y antecedentes de úlcera péptica les fue asignada una combinación antiplaquetaria dual con omeprazol. Otros recibieron tratamiento antiplaquetario dual sin omeprazol. Se realizaron una prueba Transcranial Doppler y una ultrasonografía a fin de evaluar la arteria cerebral media y la arteria carótida en seguimientos a los tres meses y a los seis meses. RESULTADOS: Ocho pacientes tuvieron hemorragia gastrointerstinal; la tasa de eventos fue 22.6% sin omeprazol y 3.8% con omeprazol. La tasa de hemorragia gastrointerstinal se redujo con omeprazol en comparación con la obtenida sin omeprazol (p = 0,026, p < 0.05). Los dos grupos no difirieron significativamente con respecto a la tasa de restenosis en stent y trombos a través de la prueba Transcranial Doppler y la ultrasonografía. CONCLUSIÓN: Entre los pacientes que reciben terapia antiplaquetaria dual, el uso profiláctico de omeprazol redujo la tasa de hemorragia gastrointestinal superior. No hubo interacción ostensible entre el clopidogrel y el omeprazol en pacientes con stent de la arteria carótida.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumours in the world, especially in Guangxi, China. The causes and mechanism of its tumourigenesis and development have not been completely clarified. Some studies revealed that the hepatic local cellular immune function was one of the factors. In the present study, the local micro-environmental immune status was explored by investigating the number, distribution and function of CD3, CD57,CD20, CD68, and granzyme B (GrB) positive cells in 60 patients with HCC and 62 patients with liver cirrhosis (LC) and its relationship with the prognosis of the patients. The results showed that the number of T and B lymphocytes and natural killer (NK) cells in the liver of HCC patients was significantly higher than that in the LC and normal controls; while the number of macrophages (Mj) was significantly lower. The number of Mj in the tissues decreased successively with the decrease of HCC differentiation; GrB-expressing cells in the liver predominantly consisted of CD57 positive cells. The number of NK cells, B lymphocytes and GrB-expressing cells in the cancerous tissues of stage I and II was significantly higher than that of stages III and IV. The number of T lymphocytes, NK cells, Mj and GrB-expressing lymphocytes in HCC cases without metastasis in 15 months was significantly higher than in the metastatic counterparts. The number of T and B lymphocytes, NK cells, and GrB-expressing cells decreased in patients with the progression of the HCC. These results suggest that the number of T and B lymphocytes, NK cells, Mj and GrB-positive lymphocytes might be important markers in the estimation of hepatic local immune status and be useful factors for predicting the prognosis of HCC patients.

El carcinoma hepatocelular (CHC) es uno de los tumores malignos más comunes en el mundo, especialmente en Guangxi, China. Las causas y el mecanismo de su desarrollo y génesis tumoral no han sido completamente aclarados. Algunos estudios revelaron que la función inmune celular local hepática era uno de los factores. En este estudio se exploró el estatus inmune microambiental local, mediante la investigación del número, distribución y función de CD3, CD57,CD20, CD68, y células positivas para la granzima B (GrB) en 60 pacientes con CHC y 62 pacientes con cirrosis hepática (CH) y su relación con la prognosis de los pacientes. Los resultados mostraron que el número de linfocitos T y B y las células asesinas naturales (NK) en el hígado de los pacientes con HCH, era significativamente mayor que en los controles normales y los pacientes con CH, mientras que el número de macrófagos (Mj) fue significativamente menor. El número de Mj en los tejidos disminuyó sucesivamente a la par con la disminución de la diferenciación de CHC; las células expresoras de GrB en el hígado consistían predominantemente en células positivas CD57. El número de células NK, linfocitos B y células expresoras de GrB en los tejidos cancerosos de etapas I y II, fue significativamente más alto que el de las etapas III y IV. El número de linfocitos T, células NK, Mj y linfocitos expresores de GrB en los casos de CHC sin metástasis en 15 meses, fue significativamente mayor que en las contrapartidas metastáticas. El número de linfocitos T y B, células NK, y células expresoras de GrB, disminuyó en los pacientes a medida que progresaba el CHC. Estos resultados sugieren que el número de linfocitos T y B, células NK, Mj y linfocitos GrB-positivos podrían ser marcadores importantes en la valoración del estatus inmune local hepático y los factores útiles a la hora de predecir la prognosis de los pacientes de CHC.