"Wanda Group is considering the sale of 20 shopping malls in Shanghai, Jiangsu, Zhejiang and other places. Each project is seeking a valuation of about 700 million yuan to 800 million yuan, depending on the location and business. The price of a shopping mall in Shanghai may be as high as 1 billion yuan."
Wanda replied with "false news".
In modern society, the advancement of science and technology has made people pay more and more attention to the convenience and comfort of home life. Among them, smart has been enthusiastically sought after by consumers with its simple and easy operation mode and diverse functions. This article will introduce you three popular smart speakers: Xiaodu Smart Screen X10 2nd Generation, Xiaomi Smart Home Screen Pro 8 and Xiaomi Smart Home Screen 10.
The first small smart screen X10 second generation stands out with its unique design concept and technical advantages. This smart speaker uses a 10-inch high definition large screen with advanced AG paper screen technology, which can effectively reduce the harm of blue light radiation to the eyes and provide users with a healthy visual experience. At the same time, the small smart screen X10 second generation has touch operation function, making your operation simpler and more efficient. What’s more worth mentioning is that the built-in AI assistant allows you to easily complete music playback, weather inquiry and other tasks through voice commands. This product is cost-effective and highly competitive among congeneric products.
The next thing I want to recommend to you is the Xiaomi Smart Home Screen Pro 8. This smart speaker has an excellent display effect. The 8-inch large screen reaches a high resolution of 1920×1080, and the picture is clear and delicate. In terms of design style, the Xiaomi Smart Home Screen Pro 8 is dominated by simplicity and atmosphere. The body is made of high-quality aluminum alloy material, showing high-end quality. In addition, the product is equipped with a powerful quad-core processor inside, which makes it perform well in various applications, whether it is watching high definition movies or playing large-scale games. More importantly, it can be linked with other devices to help you achieve intelligent management of the whole house.
Finally, let me introduce the Xiaomi Smart Home Screen 10 to you. As the last product recommended this time, the Xiaomi Smart Home Screen 10 still continues the fine tradition of the family. It is also equipped with a large 10-inch screen with a resolution of 1920×1080, ensuring that the presented picture is rich in details and vivid. In order to better take care of the family’s work and rest habits, the Xiaomi Smart Home Screen 10 is specially equipped with a physical occlusion button. When you need a quiet environment, you can turn off the screen with just one touch, so as not to affect others’ sleep. What’s more intimate is that this product supports multiple language recognition, such as Mandarin, English and other languages commonly used in many countries and regions around the world, truly realizing global services.
All in all, the above three smart speakers have their own characteristics, focusing on design, hardware configuration and even price. I believe that as long as you make a wise choice according to your actual needs, you will be able to find the most suitable one among many excellent products. Looking forward to the above information to help you make the best decision during the purchasing process!
As the only Chinese film shortlisted for the main competition of this year’s Cannes International Film Festival, the film "The Wild Goose Lake", directed by Diao Yinan and starring Hu Ge, Gui Lunmei, Liao Fan and Wan Qian, held its world premiere on May 18 local time.
"The Wild Goose Lake" is Diao Yinan’s masterpiece that has been polished for many years after the Berlin Golden Bear Award film "Fireworks in the Day". It was started in Wuhan on April 28, 2018 and took nearly half a year to shoot.
In the film, several star actors have contributed ground-breaking performances. Hu Ge tanned himself and lost weight in a short period of time. Gui Lunmei experienced life in Wuhan two months in advance and learned to speak the authentic Wuhan dialect.
The Wild Goose Lake poster
Creative inspiration predates "Daylight Fireworks", and news brings imagination to life
"In the face of framed and wanted fugitives, the story summary given by the crew of" The Wild Goose Lake "is:" In the face of framed and wanted fugitives, the escape for survival becomes a story of seeking death and running back and self-redemption. "Hu Ge plays Zhou Zenong, the leader of the desperate car theft gang, and Gui Lunmei plays a dusty woman who will do anything to exchange for freedom. The two join forces on the road to escape and play a" gamble "of fate. The contradictions of human nature and the emotional tension in an extreme state are full. Suspicion, betrayal, love, loyalty, conscience, complex emotional temptations, and ups and downs in the evolution of actions interweave a strange visual landscape.
The Wild Goose Lake
Diao Yinan’s perspective is set in the urban village of the bustling city, the fading marginal industries and crowds, the crime genre blends the cold atmosphere of the film noir, and the romance of the gangster film, which is more extreme in style than the previous work "Fireworks in the Day".
"The rivers and lakes exist in the infinitely stretched fringes around these cities." Diao Yinan believes that the "almost instinctive" choice of this fringe is also "the choice of romance, and the romance that only exists in the rivers and lakes is a profound romance." In addition, it is also a choice of space, "such a space can lead characters and stories, waiting for them to open up. I put a dark part of myself into it, trying to find comfort."
The Wild Goose Lake is on the cover of the fifth day of the Cannes Film Festival
When it comes to creative inspiration, Diao Yinan said that the idea of filming this story was even before "Fireworks in the Daylight". Many years ago, Diao Yinan heard a foreign song on the sofa one day. "I thought that I was a fugitive who was hunted down and had a bounty, and I wanted to run to the beach, run to find my first love, and let her kill me to receive the bounty." Later, Diao Yinan himself felt that this imagination was too hypocritical, so he gave up. Until a few years later, there was a coverage of a fugitive who escaped from prison and found that he was worth 100,000 when he saw the wanted notice, so he asked someone to report that he left the money to his relatives. "My imagination became news, and I think it might be possible to shoot it without being so hypocritical."
Hu Ge drank alcohol before the red carpet to "crush", Gui Lunmei’s Wuhan words made others "stressed out"
Liao Fan and Gui Lunmei had previously reaped glory in Berlin through their collaboration with Diao Yinan in "Fireworks by Day", and the film’s male lead, Hu Ge, was the first to bring a work to the red carpet at Cannes.
Hu Ge, who has appeared in more TV dramas in the past, was asked this time about his feelings of participating in the Cannes Film Festival. Hu Ge admitted that he had "mixed feelings": "First of all, I was nervous. Before going on the red carpet, I drank a sip of wine from the director’s pocket in the car, and I was shocked." In addition, Hu Ge also expressed the excitement of walking on the Cannes red carpet. "For every actor, this is something to be excited about. I am also very touched. When we walked into the film palace and the entire audience applauded, you felt respected. You felt that you chose this industry and this career, and everything was worth it."
’The Wild Goose Lake ‘crew walks the red carpet at Cannes
The Wuhan dialect performances of the actors in the film became the focus of attention in the post-screening media interviews. Talking about the preparations for the film’s dialect performances, each actor said that they felt "stressed" because they found that Gui Lunmei had spoken the Wuhan dialect very accurately when they entered the group.
The last time Gui Lunmei participated in the performance of "Fireworks in the Daytime", although Diao Yinan set the identity background of a foreigner for her characters, the Mandarin lines with Taiwanese accent still made her characters show a sense of disobedience in the icy Northeast. At this point, Gui Lunmei began to make breakthroughs in dialect performances, learning dialects and experiencing life in Wuhan two months before the start of filming. Gui Lunmei recalls that she was not able to learn Wuhan dialect at first, but walking around the village in the city, chatting with the locals, and thinking about the way they speak and pronounce gave her some knowledge. At the same time, she believes that the dialect does close the distance between the actors and the characters. "Wuhan dialect helps my performance. This language is very powerful, and speaking lines in this language can give the characters some hostility."
Hu Ge, Liao Fan, Wan Qian, Qi Dao and other creators later said that when they entered the group, they found that Gui Lunmei’s Wuhan dialect was very authentic and felt the pressure of "not falling behind", so they worked harder to learn dialects.
The Wild Goose Lake
When Hu Ge first learned to speak Wuhan dialect, he realized that he had learned it "exactly the same", but the teacher was not satisfied, and he was annoyed by it for a while. But one day he had a flash of inspiration and proposed to change his identity and teach the teacher to speak Shanghai dialect. In the process of the teacher imitating Shanghai dialect, Hu Ge "fully realized the feeling of him teaching me", and gradually realized his problem and found a solution.
Liao Fan introduced that everyone experienced life separately before the shooting in Wuhan, and he went to the criminal police team because he played the police. "The feeling of listening to the local criminal police chat every day is very inspiring to me." Wan Qian changed all the conversations in her life to speak Wuhan dialect, and then went to study lines to achieve "the process of quantitative change to qualitative change".
[Smart Car News] On August 17, BYD Tang 2021 was officially launched, with three models: fuel version, DM version and EV version. It is worth noting that the Tang EV version is equipped with BYD’s latest blade battery and will be delivered to customers in the fourth quarter of this year.
BYD Tang 2021 still adopts Dragon Face family-style design and matrix dzi headlights in appearance design, with fine-tuning in details such as front grille, rims and decorative strips. In addition, this car also has popular design elements such as suspended roof and penetrating taillights.
In terms of interior, BYD Tang 2021 is equipped with a 15.6-inch suspended central control display and a 12.3-inch full LCD instrument panel, as well as DiLink 3.0 intelligent networking system. This car is equipped with a 2.0T turbocharged engine, and the DM version is equipped with a powertrain consisting of a 2.0T turbocharged engine and a motor. The comprehensive maximum power of the system is 321kW. The pure electric version is equipped with BYD’s latest blade battery.
The data shows that in April 2022, the retail sales of passenger cars in China reached 1.042 million, down 35.5% year-on-year and 34.0% quarter-on-quarter. Affected by the epidemic, the automobile market in China was hit hard, but even in such a difficult market environment, the Great Wall Gun (parameter picture) still delivered a perfect answer. The Great Wall Gun has reached a new milestone. On May 8, 2022, at Yongchuan Smart Factory in Chongqing, Great Wall Motor held the 300,000 th Great Wall Gun off-line ceremony.
When the Great Wall Cannon was first born, some consumers bought it with the idea of supporting domestic products. But in three years, more and more people recognized and bought it, and it was accidental that the Great Wall Cannon could achieve such outstanding results. Especially in the market segment of pickup truck, which has insufficient market share, Great Wall Gun stands out and occupies the position of domestic pickup truck leader.
The achievement of 300,000 units is a strong proof of Chongqing Smart Factory’s powerful system capability and intellectual strength. As the production base of the Great Wall Gun, Chongqing Factory strictly controls every link from parts screening to four major processes to off-line inspection around the concept of "environmental protection, lean and efficient", so that each product can be delivered with high quality and win the trust of users.
As the pioneer of new pickup truck category, the leader of pickup truck culture and the leader of users’ co-creation, Great Wall Gun has achieved extraordinary report cards, which has helped Great Wall pickup truck rank first in domestic and export sales for 23 consecutive years, with a domestic market share of nearly 50%.
In order to meet the diversified requirements of users, after the launch of the Great Wall Gun series, more subdivided passenger, commercial and off-road pickups appeared, and more personalized modified pickups were launched. Even after the global popular colors of pickups "blue" and "real orange" were launched, some brands also accelerated the frequency of changing body colors. Not only that, but in order to gain a deep insight into user needs, the Firepower Alliance Motorists Association of Great Wall Gun has 31 provincial teams, 800,000 fans of Great Wall Gun App, and.
The success of Great Wall Gun today is the result of the continuous efforts of brands like Great Wall. It shows us that the domestic high-end pickup trucks also have their own unique charm, not only the product strength is high, but also the circle culture is built attentively, and the 300,000-th vehicle of the Great Wall Gun goes off the assembly line, which proves that the market of the Great Wall Gun is infinite, and also contributes to the upward development of China brand pickup trucks.
Cctv newsRecently, the Traffic Management Bureau of the Ministry of Public Security has optimized and improved the traffic safety comprehensive service management platform of the Ministry of Public Security and the self-service handling function of traffic violations of the "Traffic Management 12123" mobile APP, including expanding the scope of non-self-registered motor vehicles and optimizing the filing process, so that it is more convenient to handle traffic violations by itself.
This optimization has expanded the scope of non-motor vehicles that can be filed. Drivers can file small cars under their own names through the "Traffic Management 12123" mobile APP, and are allowed to file any three small cars under their own names at the same time. After filing, the driver can cancel the filing at any time and re-file other small cars that are not his own.
Secondly, the process of "Traffic Management 12123" mobile APP filing non-personal motor vehicles was optimized. The owner of the motor vehicle is a registered user of the Internet platform of the traffic control service of the Ministry of Public Security, and the driver can choose two ways: "scan code for filing" or "SMS verification for filing"; If the owner of a motor vehicle is not a registered user of the Internet platform of the traffic control service of the Ministry of Public Security, the driver can put on record through SMS verification.
The Traffic Management Bureau of the Ministry of Public Security reminds that my motor vehicle traffic violations handled through the Internet platform of the traffic management service of the Ministry of Public Security must meet the following conditions at the same time: First, it is recorded by traffic technology monitoring equipment; Second, the amount of a single fine does not exceed 200 yuan; Third, the sum of the score of the pending illegal act and the driver’s current cumulative score does not reach 12 points. On the basis of meeting the above conditions, drivers can also handle non-scoring traffic violations of their own motor vehicles on the platform. In addition, the driver can also pay the fine through the Internet platform of the traffic control service of the Ministry of Public Security for the summary punishment made by the traffic police on the spot. (CCTV reporter Qi Chenghai)
Answers to some questions about the Internet platform of traffic control service of the Ministry of Public Security
1. Do I need to file a motor vehicle under my name?
A: After the driver is registered as a user of the Internet platform of the traffic control service of the Ministry of Public Security, the motor vehicle under his name will be directly linked to the driver’s name by the platform without filing.
Second, what are the ways to file a motor vehicle that is not under my name?
A: It can be filed through the "Traffic Management 12123" mobile APP and the business window of the public security traffic control department. The "Traffic Management 12123" mobile APP only allows the filing of small cars under non-personal names. If other types of non-personal motor vehicles or non-personal motor vehicles need to be filed, the driver needs to go to the business window of the public security traffic control department for filing.
3. Is there a limit on the number of motor vehicles that are not registered in my name?
A: The driver can record any 3 small cars that are not his own at the same time. A small car is filed at the same time by at most three drivers other than the owner of the motor vehicle. The driver can cancel the filing at any time and re-file other small cars that are not his own, as long as there are no more than 3 cars; The owner of a motor vehicle can also inquire or terminate the filing relationship of other users at any time.
4. Can I file a motor vehicle that is inconsistent with my driver’s license?
A: Yes. In order to facilitate the driver to inquire about traffic violations, the driver can file a motor vehicle that does not conform to his driver’s license. After the registration is successful, the driver can inquire about the traffic violation of the car through the Internet platform of the Traffic Management Service of the Ministry of Public Security, but it cannot be handled by the platform itself.
V. Do I need to go to the business window of the public security traffic control department for face-to-face signing when filing a motor vehicle that is not my own?
A: No. After registering on the Internet platform of the Traffic Management Service of the Ministry of Public Security, the driver can APPly for filing a non-personal motor vehicle through the "Traffic Management 12123" mobile app.
6. Must the owner of the registered motor vehicle be a registered user of the traffic control service Internet platform of the Ministry of Public Security?
A: No. If the owner of the registered motor vehicle is not registered as a user of the Internet platform of the Traffic Management Service of the Ministry of Public Security, the driver can use the SMS verification and filing method through the "Traffic Management 12123" mobile APP.
7. What traffic violations of my motor vehicle can be handled by the Internet platform of the traffic control service of the Ministry of Public Security?
Answer: To deal with my motor vehicle traffic violations through the Internet platform of the Traffic Management Service of the Ministry of Public Security, the following conditions must be met at the same time: ① The amount of a single fine recorded by traffic technology monitoring equipment is not more than that of 200 yuan; ③ The sum of the score of the traffic violations to be dealt with and the driver’s current cumulative score is not 12 points. In addition, the driver can also pay the fine through the Internet platform of the traffic control service of the Ministry of Public Security for the summary punishment made by the traffic police on the spot.
8. After the driver files a motor vehicle that is not his own, which traffic violations of the vehicle can be handled by the platform?
A: Under the conditions listed in "Question 7", the traffic violations without points or those with points after filing can be handled by the service platform.
9. How does the owner of the motor vehicle generate the QR code of the motor vehicle when the driver files by scanning the code?
A: After the owner of a motor vehicle logs in to the "Traffic Management 12123" mobile APP with the registered user of the Internet platform of the Traffic Management Service of the Ministry of Public Security, he shall follow the following steps: click [Motor Vehicle] in the upper left corner of the homepage to select the motor vehicle to be filed and generate [Motor Vehicle QR Code].
X. How can the driver cancel the motor vehicle filing relationship?
A: The driver can cancel the filing relationship of the registered non-personal motor vehicle through the "Traffic Management 12123" mobile APP or go to the business window of the public security traffic control department. After logging in to the "Traffic Management 12123" mobile APP, follow the following steps: Click [Motor Vehicle] &rarr in the upper left corner of the homepage; Click [All Motor Vehicles] → Select the motor vehicle to be deregistered → Click [Unregister this vehicle]. If the same motor vehicle is re-filed after being released from filing, the filing time will be updated to the latest filing time.
XI. How can the owner of a motor vehicle view and cancel the record of his motor vehicle by others?
A: After registering on the Internet platform of the Traffic Management Service of the Ministry of Public Security, the owner of a motor vehicle logs in to the "Traffic Management 12123" mobile APP and follows the following steps: click [Motor Vehicle] &rarr in the upper left corner of the homepage; Click [All Motor Vehicles] → Choose my motor vehicle → Click [View Record of Being Recorded by Others] to see the information of my motor vehicle being recorded by others, and you can cancel the record relationship at any time.
12. What are the consequences of providing false information when filing a non-personal motor vehicle through the platform?
A: For drivers who submit false information, they will not be allowed to record non-personal motor vehicles through the "Traffic Management 12123" mobile APP. The driver must go to the business window of the public security traffic control department to file a non-personal motor vehicle.
Thirteen, in the business window for the record of non-motor vehicles need to carry what materials?
A: Drivers need to bring their original identity certificate, non-self motor vehicle driving license to be filed, original identity certificate of motor vehicle owner and other materials. Motor vehicle owners do not need to go to the business window of the public security traffic control department, but can hand over the materials to the applicant, who will go to the business window of the public security traffic control department to handle them.
Fourteen, in the business window to deal with traffic violations, do you need to file in advance?
A: Handling all traffic violations in the business window does not need to be filed in advance. The police will review the driver’s license, ID card and original motor vehicle license provided by the driver on the spot.
Fifteen, driving unit vehicles, rental vehicles, rental vehicles and other traffic violations how to deal with?
A: The traffic control service Internet platform of the Ministry of Public Security can only handle traffic violations of small cars under personal names. At present, traffic violations that occur when driving a unit vehicle, renting a vehicle, renting a vehicle, etc. can only be handled at the traffic violation handling window of the public security traffic control department. Drivers can file the above vehicles in the business window, and after filing, they can check the illegal situation on the Internet platform of the traffic control service of the Ministry of Public Security.
At the end of August, the Crescent Spring Scenic Area of Mingsha Mountain in Dunhuang presented a spectacular sight of camel teams like dragons. Yang yanmin
At the end of August, the Crescent Spring Scenic Area of Mingsha Mountain in Dunhuang presented a spectacular sight of camel teams like dragons. Yang yanmin
The picture shows that at the end of August, Dunhuang Mingsha Mountain "camel man" walked in the desert. Gao Ying photo
Zhongxin. com Lanzhou, September 4 (Reporter Feng Zhijun, Gao Ying) In the early autumn morning, the "enthusiasm" for tourism in Dunhuang, Gansu, an international tourist city, has not diminished. The local crescent spring scenic spot in Mingsha Mountain presents a spectacular scene of crowds and camel teams. The golden grains of sand became hot under the direct "baking" of the sun, and a large number of camel teams continued to flow, and camel bells were heard endlessly, as if they were in the ancient Silk Road thousands of years ago.
Wang Kerui, 38, is a camel driver in the scenic spot. He told the reporter of Zhongxin.com that camel riding is one of the projects that many tourists must "punch in" when they come to Mingsha Mountain. Each camel team is arranged by number, ranging from 4 to 5 peaks to 6 peaks, all of which are led by special camel drivers, leading tourists to shuttle between the vast sand mountains. At the peak of summer vacation, you should walk at least ten laps in the scorching sun every day, with a distance of nearly 70 kilometers at most.
"Get up at four o’clock every morning and arrive at the scenic spot at five o’clock, and take the camel to the hospitality position … …” Wang Kerui said that the most tiring and hottest time every day is two or three o’clock at noon, which is the highest temperature in Dunhuang every day. Originally, the sand absorbs heat, and people can feel "hot feet" when they walk on the sand. Camels often get "hot" when they walk on it. Sometimes I’m too busy to eat. After a day’s walk, people are exhausted and feel that "my legs and feet are not my own".
"Step on the pedal and hold the saddle steady!" Every time we meet a new group of tourists, camel drivers should constantly repeat the safety instructions when riding camels to tourists. It is thirsty to shout down again and again in the high temperature.
Wang Kerui said that the busiest time is often when a circle has not come back, and the next batch of guests are already waiting. The camel people have almost no rest time, so they can only take a break in the shade and have a drink of tea, and then start the next round of hiking.
In order to ensure the riding safety of tourists, every camel driver has to undergo training for about three months before taking up his post. Wang Kerui said, although this job is very simple, it is still difficult to take the camel away, but it must be taken by a master. The first-hand leaders teach you how to tie the belly belt, saddle up, rein in the reins, and how to walk. These are all technical and seemingly simple, but it is still very difficult to do. First of all, the most basic thing is to ensure the safety of tourists.
It is understood that at present, there are about 1,300 humped camels and more than 400 camel pullers serving tourists in Crescent Spring of Mingsha Mountain in Dunhuang.
Zhao Ziming, a post-90s camel breeder in Mingsha Mountain, Dunhuang, now has his own "small team". He uses all the 30-peak camels in his family for tourism projects and employs seven people to take care of the camels’ "diet and daily life".
Zhao Ziming said that during the tourist season, camels will be fed with feed and other "supplementary nutrition". In the past, camels could be fed by hand, but now the conditions are better than before. In addition, with the continuous considerable income in recent years, the feeding quality of camels is also constantly improving.
In September, the peak of summer tourism in Dunhuang gradually "cooled down", and the work of camel drivers will gradually return to dullness. As the sun sets, the breeze in the evening gently smoothes the footprints left by the previous camel team on the sand dunes, and the camel’s face is wrapped in a shawl to resist the sandstorm and continues to move forward, measuring the vast desert with his feet. (End)
There are many excellent niche games in today’s game market. They may not be advertised by big manufacturers, but they have unique gameplay and deep storylines. The following are some niche games I recommend for you. They all have unique features and charms. I hope you will like them.
1.《Celeste》
Chinese name: azure
Celeste is a platform game released by Canadian game developer Tommo. In the game, the player plays a girl named Madeline, who climbs a mountain and overcomes her inner fear. The game screen is simple and fresh, the music is beautiful, and the game is extremely difficult, which requires players to constantly challenge their limits.
2.《Papers, Please》
Chinese name: Please show me your certificate.
Papers, Please is a simulation game made by American game developer Lucas Pope. The player plays a border inspector to check the documents and information of passengers to prevent illegal entry. The game screen is simple and plain, and the music is dull, but the game plot is exciting and thought-provoking.
3.《Stardew Valley》
Chinese Name: Tale of Star Dew Valley
Stardew Valley is a simulated business game produced by American game developer ConcernedApe. The player plays a city resident, inherits an abandoned farm, and needs to manage the farm, grow crops, breed animals, collect resources, etc., and experience the fun of rural life. The game screen is exquisite, the music is soothing, and the game content is rich. It is a very suitable game to relax.
4.《Undertale》
Chinese name: undertale.
Undertale is a role-playing game created by American game developer Toby Fox. Players play a human trapped in the underground world and need to communicate with various monsters and choose different fighting methods. The cartoon of the game screen is lovely, and the music is cheerful and pleasant, but the game plot is profound and thought-provoking.
The above are some niche games that I recommend for you. They all have unique characteristics and charm, and are worth a try by players.
In the early morning of March 5, Beijing time, the team of Professor Chen Yundai from the Cardiology Center of the General Hospital of the Chinese People’s Liberation Army published a special report on clinical research at the American Heart Association/World Cardiology (ACC/WCC)2023 Conference. Based on the artificial intelligence CT-FFR technology, the clinical research report on the treatment and follow-up of patients with stable coronary heart disease -TARGET trial, the results will be published simultaneously in the top international journals.CirculationJournal (TOP journal in JCR 1 area, impact factor 39.9).
The research was supported by the National Key R&D Program and the Beijing Science and Technology Rising Star Program, and combined with the research teams of cardiology and radiological imaging departments of several top domestic third-class first-class hospitals such as Beijing anzhen hospital affiliated to Capital Medical University, the Second Affiliated Hospital of Zhejiang University Medical College, Qilu Hospital of Shandong University, the First Affiliated Hospital of Xinjiang Medical University, and tongji hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. The correspondent of this research paper is Professor Chen Yundai, Associate Professor Yang Junjie, Deputy Chief Physician Shan Dongkai and Dr. Wang Xi from the Department of Cardiovascular Medicine of PLA General Hospital are the co-first authors of this paper.
Introduction to research
TARGET study is the first multi-center, randomized and controlled clinical study in the world to evaluate the treatment and management of new stable chest pain patients using the field deployment strategy based on machine learning CT-FFR calculation. The research uses the artificial intelligence CT-FFR computing technology independently developed by China (Keya Medical Technology Co., Ltd.), and a total of 1216 patients from six medical centers in China were selected. The pretest probability of obstructive coronary heart disease in the enrolled patients was medium to high, and coronary CT angiography suggested that there was a critical stenosis of 30%-90%. The researchers randomly divided patients into CT-FFR diagnosis and treatment group (experimental group) or standard diagnosis and treatment group (control group). The main end point of the study was the proportion of patients with non-obstructive coronary artery disease or with obstructive coronary artery disease who did not receive revascularization during the follow-up coronary angiography within 90 days. Secondary end points included major adverse cardiovascular events, quality of life outcomes, improvement of angina symptoms and medical costs.
The results showed that compared with the control group, the proportion of patients with non-obstructive coronary disease or obstructive coronary disease who did not receive revascularization in CT-FFR diagnosis and treatment group decreased significantly (28.3% vs. 46.2%, P<0.001). On the whole, there were more patients receiving revascularization in CT-FFR group than in the control group (49.7% vs. 42.8%, P=0.02), but there was no significant difference in the proportion of MACE during the one-year follow-up (hazard ratio, 0.88; 95%CI, 0.59 to 1.30)。 During the follow-up period, the quality of life and symptoms of the two groups were similar, while the medical cost of CT-FFR treatment group tended to decrease. It is concluded that, compared with the standard diagnosis and treatment strategy represented by cardiac stress examination, the on-site deployment of CT-FFR calculation diagnosis and treatment strategy based on machine learning will significantly reduce the proportion of patients who have found non-obstructive coronary artery disease or do not need intervention within 90 days after coronary angiography. In addition, CT-FFR diagnosis and treatment strategy tends to save medical costs and increase the proportion of revascularization in the selected population. At the same time, CT-FFR strategy is consistent with the traditional path in improving patients’ symptoms or quality of life and the incidence of major clinical adverse vascular events.
Research enlightenment
TARGET research results show that "CT-FFR strategy based on machine learning in the field is feasible, safe and effective".
In the past 10 years, the extensive use of coronary CTA has promoted the diagnosis and treatment process of coronary heart disease in China. According to statistics, in 2017, the total number of coronary CTA angiography examinations in China reached 4.6 million. Therefore, the simple diagnostic function of coronary angiography is weakening, but among the patients who have received coronary angiography in China, most cases have not found obstructive coronary stenosis in the catheter room. Part of the reason for this phenomenon is that functional examination is not widely used or advanced cardiac imaging technology is not available enough. TARGET study further emphasizes that coronary angiography should only be applied to those patients who are most likely to have obstructive coronary stenosis or benefit from revascularization, and CT-FFR strategy will significantly optimize the management of stable coronary heart disease population.
This study adopts the CT-FFR simulation calculation technology-deep pulse fraction independently developed by Keya Medical Technology Co., Ltd., uses deep learning technology to evaluate the physiological function of coronary artery, and uses artificial intelligence technology to evaluate the FFR of coronary angiography image, which is a deep learning technology independently developed and optimized based on the latest development in the field of computer vision. It can quickly and accurately analyze the non-invasive blood flow reserve fraction. In January 2020, this technology was approved as the first NMPA artificial intelligence medical device class III certificate in China, and now it has become the only CT-FFR product in the world that has been triple-certified by NMPA in China, CE in the European Union and FDA in the United States.
Pamela Douglas, MD (Duke Clinical Research Institute, Durham, North Carolina), former president of ACC, led the experiment funded by HeartFlow (PLATFORM and PRECISE research). She pointed out that the most outstanding thing about the TARGET experiment is the novelty of its on-site CT-FFR analysis.
It is indeed possible that the field deployment method is cheaper and can return the results faster. In clinical practice, if CCTA is used as a first-line test, Douglas said, then the question becomes: "If you have borderline lesions, what should you do next?" For her, "this is a little obvious, because CT-FFR is only a software analysis. Although the previous products are very complicated, it is not without risk to make an appointment for a load test and ask the patient to come back later."
It is very important to deploy artificial intelligence computing in the field of TARGET research. "The advantage of using artificial intelligence algorithm is that it provides the possibility of field deployment, avoids the need to transfer sensitive medical data, shortens the calculation time and increases the participation of clinicians." They explained that although FFR can also be calculated by field computational fluid dynamics, this strategy is complex and requires a lot of resources. The convenience of machine learning will contribute to the application of CT-FFR in a wider range of scenarios, adding that "on-site CT-FFR strategy is practical and may be more suitable to meet the clinical practice needs in various clinical environments."
Mourinho has a wide range of highlights in his experience of coaching some top clubs in Europe. However, his most famous night happened in the Champions League in 2010/11, when two mysterious red cards seemed to benefit Real Madrid in the following rounds. Real Madrid’s qualification from Group G has been stabilized, and Mourinho tried to take action in the last game of the group stage against Ajax. Mourinho incarnated as a master of shuffling, clearly instructed Ramos and Alonso, and took the initiative to get two yellow cards and was sent off.
After Ramos and Alonso are sent off, they will be suspended for one game, but they will remain innocent in the most important knockout. Sure enough, Alonso completed this task in an efficient way and took the initiative to apply for a red card and was sent off. Ramos then received a second yellow card. As expected, the referee Craig Thompson did what was expected and sent off the two players. Then, Ramos walked up to the referee and shook hands with him, which made it more obvious that he was accepting Mourinho’s instructions.
Although Mourinho’s bold decision achieved the expected results, it also brought some adverse side effects to Real Madrid. UEFA ordered Real Madrid to pay a huge fine, Mourinho was suspended for two games and fined 40,000 euros, and the club was also fined 120,000 euros. This legendary coach who calls himself "a special one" makes UEFA very angry! Despite his cunning tricks, Mourinho felt the pain of facing his arch-rival Barcelona not once, but twice that season. First of all, Barcelona performed better in the two rounds of the Champions League semi-final and eliminated Real Madrid.
Under the leadership of coach Guardiola, Barcelona also easily won the La Liga championship with a 4-point advantage. Mourinho finally left Real Madrid in 2013 and returned to Chelsea, starting his second coaching career. After winning the Premier League title again at Stamford Bridge, the 60-year-old handsome man’s worth and reputation gradually declined. Before he took charge of Rome in 2021, his teaching achievements at Manchester United and Tottenham Hotspur were unsatisfactory and mixed.
Beta thinks: During coaching Real Madrid, Mu Shuai will do whatever it takes to reach another new height! Mourinho is not only a special one, but also a veritable king of cunning. His unique personal charm attracts countless fans! I hope he can go further in Rome!
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