Lateral Heterostructure Formed by Highly Thermally Conductive Fluorinated Graphene for Efficient Device Thermal Management.

The continued miniaturization of chips demands highly thermally conductive materials and effective thermal management strategies. Particularly, the high-field transport of the devices built with 2D materials is limited by self-heating. Here a systematic control of heat flow in single-side fluorinated graphene (FG) with varying degrees of fluorination is reported, revealing a superior room-temperature thermal conductivity as high as 128 W m-1 K-1. Monolayer graphene/FG lateral heterostructures with seamless junctions are approached for device fabrication. Efficient in-plane heat removal paths from graphene channel to side FG are created, contributing significant reduction of the channel peak temperature and improvement in the current-carrying capability and power density. Molecular dynamics simulations indicate that the interfacial thermal conductance of the heterostructure is facilitated by the high degree of overlap in the phonon vibrational spectra. The findings offer novel design insights for efficient heat dissipation in micro- and nanoelectronic devices.

Perforation of the terminal ileum caused by brucellosis: A case report.

Brucellosis, caused by gram-negative coccobacilli of the genus Brucella, is a zoonotic disease with bone and joint complications being common. However, acute abdomen with intestinal perforation is rare. We present a case of a 69-year-old man diagnosed with acute diffuse peritonitis and intestinal perforation due to Brucella infection. Surgical intervention revealed ileocecal perforation with wheel spoke-like necrosis. The patient underwent partial resection, ileum closure, and ileostomy. Positive blood culture and Brucella agglutination confirmed the diagnosis. Targeted tetracycline and aminoglycoside treatment led to recovery.

Thermoresponsive Property of Poly(N,N-bis(2-methoxyethyl)acrylamide) and Its Copolymers with Water-Soluble Poly(N,N-disubstituted acrylamide) Prepared Using Hydrosilylation-Promoted Group Transfer Polymerization.

The group-transfer polymerization (GTP) of N,N-bis(2-methoxyethyl)acrylamide (MOEAm) initiated by Me2EtSiH in the hydrosilylation-promoted method and by silylketene acetal (SKA) in the conventional method proceeded in a controlled/living manner to provide poly(N,N-bis(2-methoxyethyl)acrylamide) (PMOEAm) and PMOEAm with the SKA residue at the α-chain end (MCIP-PMOEAm), respectively. PMOEAm-b-poly(N,N-dimethylacrylamide) (PDMAm) and PMOEAm-s-PDMAm and PMOEAm-b-poly(N,N-bis(2-ethoxyethyl)acrylamide) (PEOEAm) and PMOEAm-s-PEOEAm were synthesized by the block and random group-transfer copolymerization of MOEAm and N,N-dimethylacrylamide or N,N-bis(2-ethoxyethyl)acrylamide. The homo- and copolymer structures affected the thermoresponsive properties; the cloud point temperature (Tcp) increasing by decreasing the degree of polymerization (x). The chain-end group in PMOEAm affected the Tcp with PMOEAmx > MCIP-PMOEAmx. The Tcp of statistical copolymers was higher than that of block copolymers, with PMOEAmx-s-PDMAmy > PMOEAmx-b-PDMAmy and PMOEAmx-s-PEOEAmy > PMOEAmx-b-PEOEAmy.

Nanoparticles exhibiting virus-mimic surface topology for enhanced oral delivery.

The oral delivery of nano-drug delivery systems (Nano-DDS) remains a challenge. Taking inspirations from viruses, here we construct core-shell mesoporous silica nanoparticles (NPs, ~80 nm) with virus-like nanospikes (VSN) to simulate viral morphology, and further modified VSN with L-alanine (CVSN) to enable chiral recognition for functional bionics. By comparing with the solid silica NPs, mesoporous silica NPs and VSN, we demonstrate the delivery advantages of CVSN on overcoming intestinal sequential barriers in both animals and human via multiple biological processes. Subsequently, we encapsulate indomethacin (IMC) into the nanopores of NPs to mimic gene package, wherein the payloads are isolated from bio-environments and exist in an amorphous form to increase their stability and solubility, while the chiral nanospikes multi-sited anchor and chiral recognize on the intestinal mucosa to enhance the penetrability and ultimately improve the oral adsorption of IMC. Encouragingly, we also prove the versatility of CVSN as oral Nano-DDS.

Identification of the High-Affinity Potassium Transporter Gene Family (HKT) in Brassica U-Triangle Species and Its Potential Roles in Abiotic Stress in Brassica napus L.

Members of the high-affinity potassium transporter (HKT) protein family regulate the uptake and homeostasis of sodium and potassium ions, but little research describes their roles in response to abiotic stresses in rapeseed (Brassica napus L.). In this study, we identified and characterized a total of 36 HKT genes from the species comprising the triangle of U model (U-triangle species): B. rapa, B. nigra, B. oleracea, B. juncea, B. napus, and B. carinata. We analyzed the phylogenetic relationships, gene structures, motif compositions, and chromosomal distributions of the HKT family members of rapeseed. Based on their phylogenetic relationships and assemblage of functional domains, we classified the HKT members into four subgroups, HKT1;1 to HKT1;4. Analysis of the nonsynonymous substitutions (Ka), synonymous substitutions (Ks), and the Ka/Ks ratios of HKT gene pairs suggested that these genes have experienced strong purifying selective pressure after duplication, with their evolutionary relationships supporting the U-triangle theory. Furthermore, the expression profiles of BnaHKT genes varies among potassium, phytohormone and heavy-metal treatment. Their repression provides resistance to heavy-metal stress, possibly by limiting uptake. Our results systematically reveal the characteristics of HKT family proteins and their encoding genes in six Brassica species and lay a foundation for further exploration of the role of HKT family genes in heavy-metal tolerance.

Lutein-Based pH and Photo Dual-Responsive Novel Liposomes Coated with Ce6 and PTX for Tumor Therapy.

Liposomes are considered the best nanocarrier for delivering cancer drugs such as chlorin e6 (Ce6) and paclitaxel (PTX). However, the poor stability and non-selectivity release of liposomes may severely limit their further applications. In this study, based on the characteristics of lutein (L) photo-response and orthoester (OE) acid-response, stable and dual-responsive liposomes (Dr-lips) have been prepared. The Dr-lips exhibited a spherical shape with a uniform size of approximately 58.27 nm. Moreover, they displayed a zeta potential ranging from -45.45 to -28.25 mV and showed excellent storage stability, indicating stable colloidal properties. Additionally, they achieved high drug encapsulation rates, with 92.27% for PTX and 90.34% for Ce6, respectively. Meanwhile, under near-infrared (NIR) light at 660 nm, Ce6 plays a key role in accelerating the photodegradation rate of lutein and PEG-OE-L while also enhancing tissue penetration ability. Additionally, Dr-lips loaded with Ce6 and PTX not only displayed excellent pH and photo dual-responsiveness for targeted delivering and releasing but also showed remarkable reactive oxygen species (ROS) generation capacity and impressive anti-tumor activity in vitro. Therefore, it provides a novel strategy for optimizing stability and enhancing their targeted drug delivery of liposome.

Semiparametric estimation of restricted mean survival time as a function of restriction time.

The restricted mean survival time (RMST) is an appealing measurement in clinical or epidemiological studies with censored survival outcome and receives a lot of attention in the past decades. It provides a useful alternative to the Cox model for evaluating the covariate effect on survival time. The covariate effect on RMST usually varies with the restriction time. However, existing methods cannot address this problem properly. In this article, we propose a semiparametric framework that directly models RMST as a function of the restriction time. Our proposed model adopts a widely-used proportional form, enabling the estimation of RMST predictions across an interval using a unified model. Furthermore, the covariate effect for multiple restriction time points can be derived simultaneously. We develop estimators based on estimating equations theories and establish the asymptotic properties of the proposed estimators. The finite sample properties of the estimators are evaluated through extensive simulation studies. We further illustrate the application of our proposed method through the analysis of two real data examples. Supplementary Material are available online.

A Self-Powered UV Photodetector With Ultrahigh Responsivity Based on 2D Perovskite Ferroelectric Films With Mixed Spacer Cations.

Self-powered photodetectors (PDs) have the advantages of no external power requirement, wireless operation, and long life. Spontaneous ferroelectric polarizations can significantly increase built-in electric field intensity, showing great potential in self-powered photodetection. Moreover, ferroelectrics possess pyroelectric and piezoelectric properties, beneficial for enhancing self-powered PDs. 2D metal halide perovskites (MHPs), which have ferroelectric properties, are suitable for fabricating high-performance self-powered PDs. However, the research on 2D metal halide perovskites ferroelectrics focuses on growing bulk crystals. Herein, 2D ferroelectric perovskite films with mixed spacer cations for self-powered PDs are demonstrated by mixing Ruddlesden-Popper (RP)-type and Dion-Jacobson (DJ)-type perovskite. The (BDA0.7 (BA2 )0.3 )(EA)2 Pb3 Br10 film possesses, overall, the best film qualities with the best crystalline quality, lowest trap density, good phase purity, and obvious ferroelectricity. Based on the ferro-pyro-phototronic effect, the PD at 360 nm exhibits excellent photoelectric properties, with an ultrahigh peak responsivity greater than 93 A W-1 and a detectivity of 2.5 × 1015 Jones, together with excellent reproducibility and stability. The maximum responsivities can be modulated by piezo-phototronic effect with an effective enhancement ratio of 480%. This work will open up a new route of designing MHP ferroelectric films for high-performance PDs and offers the opportunity to utilize it for various optoelectronics applications.

Key genes and potential drugs in age-related hearing loss: transcriptome analysis of cochlear hair cells in old mice.

This study aimed to dig new molecular mechanisms and medications for age-related hearing loss (ARHL or presbycusis) by extracting common results of publicly available datasets. Based on five datasets (GSE153882, GSE121856, GSE98070, GSE45026, and GSE98071) in studies of cochlear hair cells, we explored the interrelationships among presbycusis-related genes, including gene interactions, enrichment analysis, miRNA-mRNA matching pairs, and potential new drugs. Together, there were 25 common increased mRNAs. A total of 183 drugs can simultaneously target 11 of these mRNAs. In the interaction network, hub genes included: Cbln1, Prl, Mpp6 and Gh. Meanwhile, there were 74 common decreased mRNAs. The hub genes include Cdkn1a, Egr1, and Ctgf. After de-duplication, the 25 common increased mRNAs had 946 matched miRNAs, with 34 decreased ones; and the 74 decreased mRNAs had 1164 matched miRNAs, with 26 increased ones. Between the inhibitors of increased mRNAs and enhancers of decreased mRNAs, there were 26 common drugs. Besides, we discovered six key genes that may play a crucial role in the onset of presbycusis. In conclusion, by jointly analyzing multiple datasets, we found 25 common increased mRNAs (e.g., Cbln1, Prl, Mpp6 and Gh) and 74 common decreased mRNAs (Cdkn1a, Egr1, and Ctgf), as well as 34 potential therapeutic miRNAs and 26 pathogenic miRNAs, and three candidate drugs (calcitriol, diclofenac, and diethylstilbestrol). They may provide new targets and strategies for mechanistic and therapeutic studies in ARHL.

Gene Expression, Enzyme Activity, Nitrogen Use Efficiency, and Yield of Rice Affected by Controlled-Release Nitrogen.

Controlled- or slow-release urea can improve crop nitrogen use efficiencies and yields in many agricultural production systems. The effect of controlled-release urea on the relationships between levels of gene expression and yields has not been adequately researched. We conducted a 2 year field study with direct-seeded rice, which included treatments of controlled-release urea at four rates (120, 180, 240, and 360 kg N ha-1), a standard urea treatment (360 kg N ha-1), and a control treatment without applied nitrogen. Controlled-release urea improved the inorganic nitrogen concentrations of root-zone soil and water, functional enzyme activities, protein contents, grain yields, and nitrogen use efficiencies. Controlled-release urea also improved the gene expressions of nitrate reductase [NAD(P)H] (EC 1.7.1.2), glutamine synthetase (EC 6.3.1.2), and glutamate synthase (EC 1.4.1.14). With the exception of glutamate synthase activity, there were significant correlations among these indices. The results showed that controlled-release urea improved the content of inorganic nitrogen within the rice root zone. Compared with urea, the average enzyme activity of controlled-release urea increased by 50-200%, and the relative gene expression was increased by 3-4 times on average. The added soil nitrogen increased the level of gene expression, allowing enhanced synthesis of enzymes and proteins for nitrogen absorption and use. Hence, controlled-release urea improved the nitrogen use efficiency and the grain yield of rice. Controlled-release urea is an ideal nitrogen fertilizer showing great potential for improving rice production.

Scalable microfluidic fabrication of vertically aligned two-dimensional nanosheets for superior thermal management.

Two-dimensional (2D) nanosheets have been assembled into various macroscopic structures for wide engineering applications. To fully explore their exceptional thermal, mechanical, and electrical properties, 2D nanosheets must be aligned into highly ordered structures due to their strong structural anisotropy. Structures stacked layer by layer such as films and fibers have been readily assembled from 2D nanosheets due to their planar geometry. However, scalable manufacturing of macroscopic structures with vertically aligned 2D nanosheets remains challenging, given their large lateral size with a thickness of only a few nanometers. Herein, we report a scalable and efficient microfluidics-enabled sheet-aligning process to assemble 2D nanosheets into a large-area film with a highly ordered vertical alignment. By applying microchannels with a high aspect ratio, 2D nanosheets were well aligned vertically under strong channel size confinement and high flow shear stress. A vertically aligned graphene sheet film was obtained and applied to effectively improve the heat transfer of thermal interfacial materials (TIMs). Superior through-plane thermal conductivity of 82.7 W m-1 K-1 at a low graphene content of 11.8 vol% was measured for vertically aligned TIMs. Thus, they demonstrate exceptional thermal management performance for switching power supplies with high reliability.

Vertically Aligned Boron Nitride Nanosheets Films for Superior Electronic Cooling.

Thermally conductive and electrically insulating thermal interface materials (TIMs) are highly desired for electronic cooling. To improve heat transfer efficiency, thermally conductive fillers with a high loading content have been incorporated into the polymer-based TIMs. However, this is usually at the expense of the interfacial thermal resistance reduction and reliability. In this study, vertically aligned boron nitride nanosheet films (VBNFs) have been prepared by a scalable microfluidic spinning process and template-assisted chemical vapor deposition conversion method. A further high-temperature annealing was applied to achieve high crystallinity. VBNFs have been applied as fillers to fabricate TIMs and achieve a superior through-plane thermal conductivity of 6.4 W m-1 K-1 and low modulus of 2.2 MPa at low BN loading of 9.85 vol %, benefitting from the well-aligned vertical sheet structure and high crystallinity. In addition, the fabricated TIMs present high-volume resistivity and breakdown strength, satisfying the electrical insulation demands. The high thermal conductivity and low modulus contribute an outstanding cooling performance to the TIMs in the heat dissipation application for high-power LEDs. This template-assisted conversion technology for the fabrication of orientated BN nanosheets structure and the prepared high-performance TIMs pave the way for efficient thermal management of high-power electronics.

Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects.

BACKGROUND: Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS: We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS: There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS: Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.

Grade 3/4 Adverse Event Costs of Immuno-oncology Combination Therapies for Previously Untreated Advanced Renal Cell Carcinoma.

BACKGROUND: Despite 4 approved combination regimens in the first-line setting for advanced renal cell carcinoma (aRCC), adverse event (AE) costs data are lacking. MATERIALS AND METHODS: A descriptive analysis on 2 AE cost comparisons was conducted using patient-level data for the nivolumab-based therapies and published data for the pembrolizumab-based therapies. First, grade 3/4 AE costs were compared between nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + axitinib using data from the CheckMate 214 (median follow-up [mFU]: 13.1 months), CheckMate 9ER (mFU: 12.8 months), and KEYNOTE-426 (mFU: 12.8 months) trials, respectively. Second, grade 3/4 AE costs were compared between nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + lenvatinib using data from the CheckMate 214 (mFU: 26.7 months), CheckMate 9ER (mFU: 23.5 months), and KEYNOTE-581 (mFU: 26.6 months) trials, respectively. Per-patient costs for all-cause and treatment-related grade 3/4 AEs with corresponding any-grade AE rates ≥ 20% were calculated based on the Healthcare Cost and Utilization Project database and inflated to 2020 US dollars. RESULTS: Per-patient all-cause grade 3/4 AE costs for nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + axitinib were $2703 vs. $4508 vs. $5772, and treatment-related grade 3/4 AE costs were $741 vs. $2722 vs. $4440 over ~12.8 months of FU. For nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + lenvatinib, per-patient all-cause grade 3/4 AE costs were $3120 vs. $5800 vs. $9285, while treatment-related grade 3/4 AE costs were $863 vs. $3162 vs. $5030 over ~26.6 months of FU. CONCLUSION: Patients with aRCC treated with first-line nivolumab-based therapies had lower grade 3/4 all-cause and treatment-related AE costs than pembrolizumab-based therapies, suggesting a more favorable cost-benefit profile.

Molecular Dynamics Simulation of Poly(Ether Ether Ketone) (PEEK) Polymer to Analyze Intermolecular Ordering by Low Wavenumber Raman Spectroscopy and X-ray Diffraction.

Poly(ether ether ketone) (PEEK) is an important engineering plastic and evaluation of its local crystallinity in composites is critical for producing strong and reliable mechanical parts. Low wavenumber Raman spectroscopy and X-ray diffraction are promising techniques for the analysis of crystal ordering but a detailed understanding of the spectra has not been established. Here, we use molecular dynamics combined with a newly developed approximation to simulate local vibrational features to understand the effect of intermolecular ordering in the Raman spectra. We found that intermolecular ordering does affect the low wavenumber Raman spectra and the X-ray diffraction as observed in the experiment. Raman spectroscopy of intermolecular vibration modes is a promising technique to evaluate the local crystallinity of PEEK and other engineering plastics, and the present technique offers an estimation without requiring heavy computational resources.

Associations of Ambient NO2 with Daily Hospitalization, Hospitalization Expenditure and Length of Hospital Stay of Cause-Specific Respiratory Diseases - Shanxi, China, 2017-2019.

What is already known about this topic?: Numerous epidemiological studies have documented the association between ambient nitrogen dioxide (NO2) and mortality and morbidity of respiratory diseases, however, research on the effect of NO2 on the length of hospital stay (LOS) and hospitalization expenditure is limited. What is added by this report?: This study collected the respiratory hospitalization, hospital expenditure, and LOS for respiratory diseases from 2017-2019 in Shanxi, China, and comprehensively evaluated the association between ambient NO2 exposure and respiratory hospitalization, expenditure, and LOS. What are the implications for public health practice?: This study provides evidence on the association between ambient NO2 and respiratory burden, suggesting that continuously reducing the NO2 concentrations could prevent respiratory disease-associated hospital admissions and decrease the relative burden in Shanxi Province and other similar regions.

Biosynthesis of Sesquiterpenes in Basidiomycetes: A Review.

Sesquiterpenes are common small-molecule natural products with a wide range of promising applications and are biosynthesized by sesquiterpene synthase (STS). Basidiomycetes are valuable and important biological resources. To date, hundreds of related sesquiterpenoids have been discovered in basidiomycetes, and the biosynthetic pathways of some of these compounds have been elucidated. This review summarizes 122 STSs and 2 fusion enzymes STSs identified from 26 species of basidiomycetes over the past 20 years. The biological functions of enzymes and compound structures are described, and related research is discussed.

Growth of Pentacene Crystals by Naphthalene Flux Method.

We report the crystal growth of pentacene from a solution of naphthalene. The solubility of pentacene in naphthalene was evaluated by optical absorption at elevated temperature. The crystal growth was performed in an H-shaped sealed glass tube or metal vessels sealed with ultrahigh-vacuum compatible flanges placed in heated two-zone aluminum blocks. The obtained crystals had a single-crystal-like appearance and flat surface. They were made of aligned microtwins of the "bulk type" (interlayer spacing 14.5 Å) polymorph.

Temporal Trends in Grade 3/4 Adverse Events and Associated Costs of Nivolumab Plus Cabozantinib Versus Sunitinib for Previously Untreated Advanced Renal Cell Carcinoma.

BACKGROUND AND OBJECTIVES: Novel immunotherapy-based combination treatments have drastically improved clinical outcomes for previously untreated patients with advanced/metastatic renal cell carcinoma (aRCC). This study aimed to assess the temporal trends in grade 3/4 adverse event (AE) rates and associated costs of nivolumab plus cabozantinib combination therapy versus sunitinib monotherapy in previously untreated patients with aRCC. METHODS: Individual patient data from the CheckMate 9ER trial (nivolumab plus cabozantinib: N = 320; sunitinib: N = 320) were used to calculate the proportion of patients experiencing grade 3/4 AEs. AE unit costs were obtained from the United States (US) 2017 Healthcare Cost and Utilization Project (HCUP) and inflated to 2020 US dollars. Per-patient-per-month (PPPM) all-cause and treatment-related grade 3/4 AE costs over 18-months, temporal trends, and top drivers of AE costs were evaluated in both treatment arms. RESULTS: Overall, the proportion of patients experiencing grade 3/4 AEs decreased over time, with the highest rates observed in the first 3 months for the nivolumab plus cabozantinib and sunitinib arms. Compared with sunitinib, nivolumab plus cabozantinib was associated with consistently lower average all-cause AE costs PPPM [month 3: $2021 vs. $3097 (p < 0.05); month 6: $1653 vs. $2418 (p < 0.05); month 12: $1450 vs. $1935 (p > 0.05); month 18: $1337 vs. $1755 (p > 0.05)]. Over 18 months, metabolism and nutrition disorders ($244), laboratory abnormalities ($182), and general disorders and administration site conditions ($122) were the costliest all-cause PPPM AE categories in the nivolumab plus cabozantinib arm, and laboratory abnormalities ($443), blood and lymphatic system disorders ($254), and metabolism and nutrition disorders ($177) were the costliest in the sunitinib arm. Trends of treatment-related AE costs were consistent with all-cause AE costs. CONCLUSIONS: Nivolumab plus cabozantinib was associated with lower costs of grade 3/4 AE management PPPM than sunitinib, which accumulated over the 18-month study period.

Answering medical questions in Chinese using automatically mined knowledge and deep neural networks: an end-to-end solution.

BACKGROUND: Medical information has rapidly increased on the internet and has become one of the main targets of search engine use. However, medical information on the internet is subject to the problems of quality and accessibility, so ordinary users are unable to obtain answers to their medical questions conveniently. As a solution, researchers build medical question answering (QA) systems. However, research on medical QA in the Chinese language lags behind work on English-based systems. This lag is mainly due to the difficulty of constructing a high-quality knowledge base and the underutilization of medical corpora in the Chinese language. RESULTS: This study developed an end-to-end solution to implement a medical QA system for the Chinese language with low cost and time. First, we created a high-quality medical knowledge graph from hospital data (electronic health/medical records) in a nearly automatic manner that trained a supervised model based on data labeled using bootstrapping techniques. Then, we designed a QA system based on a memory-based neural network and attention mechanism. Finally, we trained the system to generate answers from the knowledge base and a QA corpus on the internet. CONCLUSIONS: Bootstrapping and deep neural network techniques can construct a knowledge graph from electronic health/medical records with satisfactory precision and coverage. Our proposed context bridge mechanisms perform training with a variety of language features. Our QA system can achieve state-of-the-art quality in answering medical questions with constrained topics. As we evaluated, complex Chinese language processing techniques, such as segmentation and parsing, were not necessary for practice and complex architectures were not necessary to build the QA system. Lastly, we created an application using our method for internet QA usage.