Single-cell multi-omics in the study of digestive system cancers

Digestive system cancers are prevalent diseases with a high mortality rate, posing a significant threat to public health and economic burden. The diagnosis and treatment of digestive system cancer confront conventional cancer problems, such as tumor heterogeneity and drug resistance. Single-cell sequencing (SCS) emerged at times required and has developed from single-cell RNA-seq (scRNA-seq) to the single-cell multi-omics era represented by single-cell spatial transcriptomics (ST). This article comprehensively reviews the advances of single-cell omics technology in the study of digestive system tumors. While analyzing and summarizing the research cases, vital details on the sequencing platform, sample information, sampling method, and key findings are provided. Meanwhile, we summarize the commonly used SCS platforms and their features, as well as the advantages of multi-omics technologies in combination. Finally, the development trends and prospects of the application of single-cell multi-omics technology in digestive system cancer research are prospected.

Update on aquaporin-4 antibody detection: the early diagnosis of neuromyelitis optica spectrum disorders

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune-mediated primary inflammatory myelinopathy of the central nervous system that primarily affects the optic nerve and spinal cord. The aquaporin 4 antibody (AQP4-Ab) is a specific autoantibody marker for NMOSD. Most patients with NMOSD are seropositive for AQP4-Ab, thus aiding physicians in identifying ways to treat NMOSD. AQP4-Ab has been tested in many clinical and laboratory studies, demonstrating effectiveness in diagnosing NMOSD. Recently, novel assays have been developed for the rapid and accurate detection of AQP4-Ab, providing further guidance for the diagnosis and treatment of NMOSD. This article summarizes the importance of rapid and accurate diagnosis for treating NMOSD based on a review of the latest relevant literature. We discussed current challenges and methods for improvement to offer new ideas for exploring rapid and accurate AQP4-Ab detection methods, aiming for early diagnosis of NMOSD.

Search for a Sub-eV Sterile Neutrino Using Daya Bay's Full Dataset

This Letter presents results of a search for the mixing of a sub-eV sterile neutrino with three active neutrinos based on the full data sample of the Daya Bay Reactor Neutrino Experiment, collected during 3158 days of detector operation, which contains 5.55×10^{6} reactor ν[over ¯]_{e} candidates identified as inverse beta-decay interactions followed by neutron capture on gadolinium. The analysis benefits from a doubling of the statistics of our previous result and from improvements of several important systematic uncertainties. No significant oscillation due to mixing of a sub-eV sterile neutrino with active neutrinos was found. Exclusion limits are set by both Feldman-Cousins and CLs methods. Light sterile neutrino mixing with sin^{2}2θ_{14}≳0.01 can be excluded at 95% confidence level in the region of 0.01  eV^{2}≲|Δm_{41}^{2}|≲0.1  eV^{2}. This result represents the world-leading constraints in the region of 2×10^{-4}  eV^{2}≲|Δm_{41}^{2}|≲0.2  eV^{2}.

[A comparative study of a two-stage surgical approach combining coronectomy with microimplant anchorage traction for extraction of impacted mandibular third molars with different traction angles]

Objective: To establish a two-stage surgical procedure of impacted mandibular third molars (IMTMs) extractions assisted by coronectomy and microimplant anchorage traction and to investigate the influencing factors of root movement and the effects of different traction angles on the clinical outcomes. Methods: Fifty-three IMTM in contact with inferior alveolar nerve (IAN) that underwent tooth extraction in the Peking University School of Stomatology from January 2022 to June 2023 were included, with coronectomy and microimplant anchorage implantation in the first stage of the surgery, root traction was achieved with orthodontic elastic and microimplant anchorages by about 600 g of force, when the IMTM root was detached from IAN, a second surgery was performed to extract the residual root. The basic information of patients and M3M, data on the microimplant anchorage implantation and traction, imaging measurements, and complications were recorded and analyzed. Results: The movement distance of the residual roots was (1.80±0.92) mm, and the duration of traction was (32.9±7.9) d. Multiple linear regression analysis showed that the residual root movement distance was significantly correlated with age, gender, number of roots, traction angle, and depth of the distal bone defect of the second molar (P<0.05). The smaller the traction angle, the more significant the movement of the residual roots (P=0.044). In one case (1.9%, 1/53), the patient experienced abnormal sensation in the lower lip 16 days after traction. Conclusions: The two-stage surgical method of combined coronectomy with rapid traction technique to extract the IMTM allows for rapid movement of the residual root and reduces the risk of IAN injury. The efficiency of root movement can be accelerated by appropriately reducing the traction angle during surgery. The traction effect can be predicted based on indicators such as age, gender, number of roots and depth of distal bone defects of second molar.

PGD: Shared gene linking polycystic ovary syndrome and endometrial cancer, influencing proliferation and migration through glycometabolism

The relationship among polycystic ovary syndrome (PCOS), endometrial cancer (EC), and glycometabolism remains unclear. We explored shared genes between PCOS and EC, using bioinformatics to unveil their pathogenic connection and influence on EC prognosis. Gene Expression Omnibus datasets GSE226146 (PCOS) and GSE196033 (EC) were used. A protein-protein interaction (PPI) network was constructed to identify the central genes. Candidate markers were screened using dataset GSE54250. Differences in marker expression were confirmed in mouse PCOS and human EC tissues using RT-PCR and immunohistochemistry. The effect of PGD on EC proliferation and migration was explored using Ki-67 and Transwell assays. PGD's impact on the glycometabolic pathway within carbon metabolism was assessed by quantifying glucose content and lactic acid production. R software identified 31 common genes in GSE226146 and GSE196033. Gene Ontology functional classification revealed enrichment in the "purine nucleoside triphosphate metabolism process," with key Kyoto Encyclopedia of Genes and Genomes pathways related to "carbon metabolism." The PPI network identified 15 hub genes. HK2, NDUFS8, PHGDH, PGD, and SMAD3 were confirmed as candidate markers. The RT-PCR analysis validated distinct HK2 and PGD expression patterns in mouse PCOS ovarian tissue and human EC tissue, as well as in normal and EC cells. Transfection experiments with Ishikawa cells further confirmed PGD's influence on cell proliferation and migration. Suppression of PGD expression impeded glycometabolism within the carbon metabolism of EC cells, suggesting PGD as a significant PCOS risk factor impacting EC proliferation and migration through modulation of single carbon metabolism. These findings highlight PGD's pivotal role in EC onset and prognosis.

Prediction of Receptor Status in Radiomics: Recent Advances in Breast Cancer Research

Breast cancer is a multifactorial heterogeneous disease and the leading cause of cancer-related deaths in women; its diagnosis and treatment require clinical sensitivity and a comprehensive disciplinary research approach. The expression of different receptors on tumor cells not only provides the basis for molecular typing of breast cancer but also has a decisive role in the diagnosis, treatment, and prognosis of breast cancer. To date, immunohistochemistry (IHC), which uses invasive histological sampling, has been extensively used in clinical practice to analyze the status of receptors and to make an accurate diagnosis of breast cancer. As an invasive assay, IHC can provide important biological information on tumors at a single point in time, but cannot predict future changes (due to treatment or tumor mutations) without additional invasive procedures. These issues highlight the need to develop a non-invasive method for predicting receptor status. The emerging field of radiomics may offer a non-invasive approach to identification of receptor status without requiring biopsy. In this paper, we present a review of the latest research results in radiomics for predicting the status of breast cancer receptors, with potential important clinical applications.

Risk Factors Associated With Quadriceps Tendon Extensor Mechanism Disruption Following Total Knee Arthroplasty

BACKGROUND

Quadriceps tendon extensor mechanism disruption is an infrequent but devastating complication after total knee arthroplasty (TKA). Our knowledge of specific risk factors for this complication is limited by the current literature. Thus, this study aimed to identify potential risk factors for quadriceps tendon extensor mechanism disruption following TKA.

METHODS

A retrospective cohort analysis was performed using the PearlDiver Administrative Claims Database. Patients undergoing TKA without a prior history of quadriceps tendon extensor mechanism disruption were identified. Quadriceps tendon extensor mechanism disruption included rupture of the quadriceps tendon, patellar tendon, or fracture of the patella. Patients who had a minimum of 5 years of follow-up after TKA were included. A total of 126,819 patients were included. Among them, 517 cases of quadriceps tendon extensor mechanism disruption occurred (incidence 0.41%). Hypothesized risk factors were compared between those who had postoperative quadriceps tendon extensor mechanism disruption and those who did not.

RESULTS

On multivariate analysis, increased Charlson Comorbidity Index (odds ratio (OR): 1.10, 95% confidence interval (CI) [1.07 to 1.13]; P < .001), obesity (OR: 1.49, 95% CI [1.24 to 1.79]; P < .001), and fluoroquinolone use any time after TKA (OR: 1.24, 95% CI [1.01 to 1.52]; P = .036) were significantly associated with quadriceps tendon extensor mechanism disruption.

CONCLUSIONS

Our study identified the incidence of quadriceps tendon extensor mechanism disruption following TKA as 0.41%. Identified risk factors for quadriceps tendon extensor mechanism disruption after TKA include an increased Charlson Comorbidity Index, obesity, and use of fluoroquinolones postoperatively.

Single-stage computer-assisted approach for tumour resection and functional restoration of Brown class III maxillary defects-titanium mesh and zygomatic implants combined with vascularized anterolateral thigh flap

The functional restoration of Brown class III maxillary defects is a challenging endeavour in oral and maxillofacial surgery. Conventional reconstruction techniques with osseous free flaps have certain limitations, such as the need for multiple operations and greater patient morbidity. This study introduces a single-stage computer-assisted approach for tumour resection and functional restoration of these defects using titanium mesh, zygomatic implants, and a vascularized anterolateral thigh flap (ALTF). Virtual surgical planning was used to simulate tumour resection, titanium mesh placement, and zygomatic implant insertion. Surgery was performed under the guidance of mixed reality and surgical navigation. The tumour was resected by total hemimaxillectomy, and the reconstruction was performed using a pre-bent patient-specific titanium mesh for the orbital floor and two zygomatic implants placed and exposed through tunnels in an ALTF. The ALTF survived without any perioperative complications. A fixed prosthesis with built-in titanium frame was delivered 4 months postoperatively. At the 1-year follow-up, there was no tumour recurrence, the implants were osseointegrated, and aesthetics and masticatory function were satisfactory. An occlusal force of 155 N was attained on the reconstructed side, compared to 127 N on the non-surgical side.

Correction: Wang et al. Visible Light Motivated the Photocatalytic Degradation of P-Nitrophenol by Ca2+-Doped AgInS2. Molecules 2024, 29, 361

In the original publication [...].

Massive Irreparable Rotator Cuff Tears Treated With a Tuberoplasty Yield Favorable Clinical Outcomes With Variable Rates of Complications: A Systematic Review

PURPOSE

To systematically review the patient-reported outcomes and postoperative complications following tuberoplasty for the treatment of massive irreparable rotator cuff tears.

METHODS

A literature search was conducted using PubMed and EMBASE computerized databases from database inception to June 2023 in accordance with the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Included studies evaluated clinical outcomes, postoperative complications, and reoperation rates following tuberoplasty for the treatment of massive irreparable rotator cuff tears. Exclusion criteria consisted of non-English language, cadaveric studies, case reports, animal studies, studies with overlapping cohorts, letters to editors, and review articles. Study quality was assessed using the Methodological Index for Non-Randomized Studies criteria. Clinical outcome scores included the visual analog scale for pain, University of California Los Angeles score, and Constant score.

RESULTS

Seven studies from 2002 to 2023 consisting of 123 patients with a mean age of 66.5 years (mean range, 63-70.4 years) were included. The mean follow-up time ranged from 18 to 98 months. The mean Methodological Index for Non-Randomized Studies score was 13.5 (range, 13-15). At final follow-up, the mean postoperative visual analog scale pain scores ranged from 2.3 to 2.5, University of California-Los Angeles shoulder score from 27.2 to 27.7, and Constant scores from 59.2 to 90.6. Postoperative active forward flexion and abduction ranged from 131° to 165°, and 123° to 160°, respectively. The change in acromiohumeral distance postoperatively ranged from -1 mm to -0.6 mm. The rate of postoperative complications ranged from 0% to 19% of patients, while 0% to 19% of patients underwent revision surgery to reverse shoulder arthroplasty.

CONCLUSIONS

Tuberoplasty for the treatment of massive irreparable rotator cuff tears results in good clinical outcomes with significant pain relief in select populations. However, the variable reoperation rates should be considered when counseling patients.

LEVEL OF EVIDENCE

Level IV, systematic review of Level IV studies.

Targeting MicroRNA in myopia: Current insights

Myopia, the most prevalent eye condition, has sparked notable interest regarding its origin and prevention. MicroRNAs (miRNAs) are short, non-coding RNA strands typically consisting of 18-24 nucleotides. They play a central role in post-transcriptional gene regulation and are closely associated with both normal and pathological processes in organisms. Recent advances in next-generation sequencing and bioinformatics have provided novel insights into miRNA expression and its regulatory role in myopia. This review discusses the distinct expression patterns, regulatory functions, and potential pathways of miRNAs involved in the onset and progression of myopia. The primary objective of this review was to provide valuable insights into molecular mechanisms underlying myopia and the contribution of miRNAs. These insights are expected to pave the way for further exploration of the molecular mechanisms, diagnosis, treatment, and clinical applications of myopia.

A novel radiomics-based technique for identifying vulnerable coronary plaques: a follow-up study

BACKGROUND

Previous reports have suggested that coronary computed tomography angiography (CCTA)-based radiomics analysis is a potentially helpful tool for assessing vulnerable plaques. We aimed to investigate whether coronary radiomic analysis of CCTA images could identify vulnerable plaques in patients with stable angina pectoris.

METHODS

This retrospective study included patients initially diagnosed with stable angina pectoris. Patients were randomly divided into either the training or test dataset at an 8 : 2 ratio. Radiomics features were extracted from CCTA images. Radiomics models for predicting vulnerable plaques were developed using the support vector machine (SVM) algorithm. The model performance was assessed using the area under the curve (AUC); the accuracy, sensitivity, and specificity were calculated to compare the diagnostic performance using the two cohorts.

RESULTS

A total of 158 patients were included in the analysis. The SVM radiomics model performed well in predicting vulnerable plaques, with AUC values of 0.977 and 0.875 for the training and test cohorts, respectively. With optimal cutoff values, the radiomics model showed accuracies of 0.91 and 0.882 in the training and test cohorts, respectively.

CONCLUSION

Although further larger population studies are necessary, this novel CCTA radiomics model may identify vulnerable plaques in patients with stable angina pectoris.

No Difference in 10-Year Survivorship of Total Shoulder Arthroplasty Versus Hemiarthroplasty for Avascular Necrosis of the Humeral Head

INTRODUCTION

Avascular necrosis of the humeral head (AVN) is characterized by osteonecrosis secondary to disrupted blood flow to the glenohumeral joint. Following collapse of the humeral head, arthroplasty, namely total shoulder arthroplasty (TSA) or humeral head arthroplasty (hemiarthroplasty) is recommended standard of care. The literature is limited to underpowered and small sample sizes in comparing arthroplasty modalities. Therefore, the aims of this study were (1) to compare the 10-year survivorship of TSA and hemiarthroplasty in the treatment of AVN of the humeral head and (2) to identify differences in their revision etiologies.

METHODS

Patients who underwent primary TSA and hemiarthroplasty for AVN were identified using the PearlDiver database. TSA patients were matched by age, gender, and Charlson Comorbidity Index (CCI) to the hemiarthroplasty cohort in a 4:1 ratio since TSA patients were generally older, sicker, and more often female. The 10-year cumulative incidence rate of all-cause revision was determined using Kaplan-Meier survival analysis. Multivariable analysis was conducted using Cox Proportional Hazard modeling. Chi-squared analysis was conducted to compare the indications for revisions between matched cohorts including periprosthetic joint infection (PJI), dislocation, mechanical loosening, broken implants, periprosthetic fracture, and stiffness.

RESULTS

In total, 4,825 patients undergoing TSA and 1,969 patients undergoing hemiarthroplasty for AVN were included in this study. The unmatched 10-year cumulative incidence of revision for patients who underwent TSA and hemiarthroplasty was 7.0% and 7.7%, respectively. The matched 10-year cumulative incidence of revision for patients who underwent TSA and hemiarthroplasty was 6.7% and 8.0%, respectively. When comparing the unmatched cohorts, TSA patients were at significantly higher risk of 10-year all-cause revision (HR: 1.39; P = 0.017) when compared to hemiarthroplasty patients. After matching, there was no significant difference in risk of 10-year all-cause revision (HR: 1.29; P = 0.148) and no difference in the observed etiologies for revision (P > 0.05 for all).

CONCLUSION

After controlling for confounders, only 6.7% of TSA and 8.0% hemiarthroplasties for humeral head AVN were revised within 10-years of index surgery. The demonstrated high and comparable long-term survivorship for both modalities supports the utilization of either for the AVN induced humeral head collapse.

Latest advances and clinical application prospects of resveratrol therapy for neurocognitive disorders

Neurocognitive disorders, such as Alzheimer's disease, vascular dementia, and postoperative cognitive dysfunction, are non-psychiatric brain syndromes in which a significant decline in cognitive function causes great trauma to the mental status of the patient. The lack of effective treatments for neurocognitive disorders imposes a considerable burden on society, including a substantial economic impact. Over the past few decades, the identification of resveratrol, a natural plant compound, has provided researchers with an opportunity to formulate novel strategies for the treatment of neurocognitive disorders. This is because resveratrol effectively protects the brain of those with neurocognitive disorders by targeting some mechanisms such as inflammation and oxidative stress. This article reviews the status of recent research investigating the use of resveratrol for the treatment of different neurocognitive disorders. By examining the possible mechanisms of action of resveratrol and the shared mechanisms of different neurocognitive disorders, treatments for neurocognitive disorders may be further clarified.

Typical brachial plexus: the legacy of a forgotten anatomist, Abram T. Kerr (1873-1938)

The brachial plexus, a complex network of nerves responsible for innervating the upper limb, exhibits remarkable anatomical variations. This editorial explores the composite drawing of a "typical" brachial plexus portrayed by Abram T. Kerr in 1918. This composite drawing of the typical brachial plexus stands as a critical contribution to the field of anatomy and surgery, and encapsulates the most prevalent patterns of formation, branching, and origins within the brachial plexus, offering a statistical map of its common variants. Kerr portrays the typical brachial plexus as a foundational resource for anatomists and medical professionals seeking to navigate the intricate landscape of this neural structure. It serves as a hypothetical model, reflecting the common arrangement of trunks, cords, and branches, shedding light on the typical composition of the plexus observed in most individuals. Beyond being a visual representation, the 'typical' brachial plexus provides a bridge between theoretical knowledge and practical applications, aiding in the identification of variations and deviations in surgical contexts. This composite drawing enhances our comprehension of the intricate and ever-evolving anatomy of the brachial plexus, reinforcing its role as a fundamental reference point for anatomical studies and clinical practice.

Reported Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes Is Greatest in Female Soccer Players and Athletes Participating in Club Sports: A Systematic Review and Meta-analysis

PURPOSE

To identify the risk of anterior cruciate ligament (ACL) injury in adolescent athletes based on sex, sport, and sport affiliation.

METHODS

A literature search was performed using 3 online databases (PubMed, Cochrane Library, and EMBASE) from database inception to November 2023 per the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies consisted of Level I or II studies reporting on ACL injury exposures in time (hours) or injuries per 1,000 athlete-exposures (AEs) (1 game or practice) in adolescent athletes. Exclusion criteria consisted of non-English studies, case reports, animal/cadaveric studies, and review articles. Methodological quality and bias assessment of the included studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. ACL injuries were analyzed and pooled to calculate incidence rates (IRs), per-season risk, and relative risk (RR) based on sex, sport, and sport affiliation (club sport participation vs school sport participation).

RESULTS

A total of 1,389 ACL injuries over 19,134,167 AEs were identified (IR, 0.075; 95% confidence interval [CI], 0.071-0.079). Of these, 670 ACL injuries were reported in female athletes over 7,549,892 AEs (IR, 0.089; 95% CI, 0.087-0.091) with 719 in males over 11,584,275 AEs (IR, 0.062; 95% CI, 0.058-0.067). The greatest RR for ACL injury in females was in soccer (RR, 3.12; 95% CI, 2.58-3.77) for AEs. The greatest per-season risk of ACL injuries reported in female athletes occurred in soccer (1.08%), basketball (1.03%), and gymnastics (1.01%). The greatest per-season risk of ACL injuries reported in male athletes occurred in football (0.82%), lacrosse (0.64%), and soccer (0.35%). Club sport participation, in both AEs (RR, 3.94; 95% CI, 3.19-4.87) and hours of exposure (RR, 1.57; 95% CI, 1.07-2.28), demonstrated an increased risk of ACL injury.

CONCLUSIONS

The risk of ACL injuries was 1.56-fold greater in adolescent female athletes compared with male athletes. The highest-risk sport for females was soccer. Participation in club sports possessed higher rates of injury compared with school sports.

LEVEL OF EVIDENCE

Level II; meta-analysis of Level I and II studies.

Diagnostic performance of contrast-enhanced mammography for suspicious findings in dense breasts: A systematic review and meta-analysis

PURPOSE

Contrast-enhanced spectral imaging (CEM) is a new mammography technique, but its diagnostic value in dense breasts is still inconclusive. We did a systematic review and meta-analysis of studies evaluating the diagnostic performance of CEM for suspicious findings in dense breasts.

MATERIALS AND METHODS

The PubMed, Embase, and Cochrane Library databases were searched systematically until August 6, 2023. Prospective and retrospective studies were included to evaluate the diagnostic performance of CEM for suspicious findings in dense breasts. The QUADAS-2 tool was used to evaluate the quality and risk of bias of the included studies. STATA V.16.0 and Review Manager V.5.3 were used to meta-analyze the included studies.

RESULTS

A total of 10 studies (827 patients, 958 lesions) were included. These 10 studies reported the diagnostic performance of CEM for the workup of suspicious lesions in patients with dense breasts. The summary sensitivity and summary specificity were 0.95 (95% CI, 0.92-0.97) and 0.81 (95% CI, 0.70-0.89), respectively. Enhanced lesions, circumscribed margins, and malignancy were statistically correlated. The relative malignancy OR value of the enhanced lesions was 28.11 (95% CI, 6.84-115.48). The relative malignancy OR value of circumscribed margins was 0.17 (95% CI, 0.07-0.45).

CONCLUSION

CEM has high diagnostic performance in the workup of suspicious findings in dense breasts, and when lesions are enhanced and have irregular margins, they are often malignant.

Analysis of dissolved oxygen influencing factors and concentration prediction using input variable selection technique: A hybrid machine learning approach

Accurate quantification of dissolved oxygen (DO) is critically important for the protection and management of aquatic ecosystems. Successful applications have utilized mechanistic and data-driven models to simulate DO content in aquatic ecosystems. However, mechanistic models present challenges due to their complex and difficult-to-solve conditions, making them less portable. Additionally, data-driven model predictions are hindered by the challenge of numerous input variables, impacting both the running speed and prediction performance of the model. To address these challenges, water quality data and meteorological data of the Tanjiang River were obtained. The maximum information coefficient (MIC) input variable selection technique was employed to identify primary environmental factors influencing DO changes. Furthermore, coupled with support vector regression (SVR), two models (SVR and MIC-SVR) were employed to estimate the DO concentration of the Tanjiang River, and the optimal model was established. The results indicated a shift in the primary pollution factor from ammonia nitrogen to total phosphorus after recent treatment in the Tanjiang River. In comparison with the SVR model, the root mean square error (RMSE) of the MIC-SVR model was reduced by 4.46%, and the Nash-efficiency coefficient (NSE) was improved by 45.85%. In addition, study of kernel function selection revealed that considering as many kernel functions as possible is necessary for improving the performance of the SVR model. Conclusively, the proposed MIC-SVR model serves as an effective tool to analyze the relationship between DO and environmental factors, identifying the primary causes of low DO, and accurately predict the DO concentration in the Tanjiang River (especially in its middle and lower reaches), thus providing a reference for governmental decision-making on water environmental protection and water resource management.

Comprehensive characterization of the chemical constituents of Lianhua Qingwen capsule by ultra high performance liquid chromatography coupled with Fourier transform ion cyclotron resonance mass spectrometry

Lianhua Qingwen capsule is a famous traditional Chinese medicine (TCM) prescription that is widely used for the treatment of respiratory diseases in China. To facilitate in-depth and global characterization of the chemical constituents of Lianhua Qingwen capsule, a profiling method based on ultra-high performance liquid chromatography coupled with Fourier transform ion cyclotron resonance mass spectrometry (UHPLC-FT-ICR-MS) was applied in both positive and negative ion modes for the comprehensive characterization of the chemical profiles of Lianhua Qingwen capsule. A total of 596 compounds were identified or tentatively characterized, including 137 flavonoids, 46 phenylpropanoids, 43 phenylethanoid glycosides, 145 terpenoids, 83 organic acids and their derivatives, 15 quinones, 39 alkaloids, 32 alcohol glycosides and 56 other compounds. Thus, this results widely extended and enriched the chemical constituents of Lianhua Qingwen capsule, which will provide comprehensive and valuable information for its quality control and further pharmacological study, facilitate understanding the effective substance and pharmacodynamic material basis, thereby providing a solid foundation for further development of the Lianhuaqingwen capsule.

What Is the True Impact of Periprosthetic Joint Infection Diagnosis on Mortality?

BACKGROUND

Mortality is a quality indicator that may affect expenditures. Revisions for periprosthetic joint infection (PJI) are, on average, more expensive and exhibit higher morbidity than aseptic revisions, although reimbursement is similar. Therefore, we sought to determine (1) impact on mortality rates of revision total hip and/or knee arthroplasty performed for PJI diagnosis (septic) versus aseptic revisions, at any point in time, and (2) mortality predictors among PJI patients.

METHODS

Retrospective chart review of 978 consecutive patients who underwent revision at a single institution (January 2015 to November 2020). All revisions were evaluated, and it was determined whether patients had a revision for PJI at any point in time or not. Two groups were compared: (1) patients with septic revision(s) (n = 350) and (2) patients who only underwent aseptic revision(s) (n = 628). Demographics and mortality status at latest follow-up (mean 3 years, range: 0 to 18 years, from first revision ever) were assessed. Mortality status was also separately assessed among patients who exclusively had hip revision(s), or solely knee revision(s), or both. Multivariate regression analysis (Cox) was used to determine whether PJI diagnosis was an independent mortality predictor. Among PJI patients, potential mortality predictors were evaluated.

RESULTS

Overall, 65 patients died (6.6%). The septic cohort had significantly more men and American Society of Anesthesiologists (ASA) class-IV patients. Mortality rates were 10.9% and 4.3% (P < .0001) for septic and aseptic revision groups, respectively. After controlling for sex, ASA, and number of revisions, PJI diagnosis was a significant mortality predictor (hazard ratio [HR]: 2.69, 95% confidence interval [CI]: 1.5 to 4.7, P = .001). Among PJI patients, age (HR: 1.05, 95% CI: 1.01 to 1.08, P = .009) and ASA (HR: 4.02, 95% CI: 1.67 to 9.67, P = .002) were independent predictors.

CONCLUSIONS

Having a revision due to PJI diagnosis was associated with 2.5 times increased mortality. Therefore, more accurate coding capturing the complexity and morbidity of revisions for PJI diagnosis is needed.

T2-weighted imaging-based radiomic-clinical machine learning model for predicting the differentiation of colorectal adenocarcinoma

BACKGROUND

The study on predicting the differentiation grade of colorectal cancer (CRC) based on magnetic resonance imaging (MRI) has not been reported yet. Developing a non-invasive model to predict the differentiation grade of CRC is of great value.

AIM

To develop and validate machine learning-based models for predicting the differentiation grade of CRC based on T2-weighted images (T2WI).

METHODS

We retrospectively collected the preoperative imaging and clinical data of 315 patients with CRC who underwent surgery from March 2018 to July 2023. Patients were randomly assigned to a training cohort (n = 220) or a validation cohort (n = 95) at a 7:3 ratio. Lesions were delineated layer by layer on high-resolution T2WI. Least absolute shrinkage and selection operator regression was applied to screen for radiomic features. Radiomics and clinical models were constructed using the multilayer perceptron (MLP) algorithm. These radiomic features and clinically relevant variables (selected based on a significance level of P < 0.05 in the training set) were used to construct radiomics-clinical models. The performance of the three models (clinical, radiomic, and radiomic-clinical model) were evaluated using the area under the curve (AUC), calibration curve and decision curve analysis (DCA).

RESULTS

After feature selection, eight radiomic features were retained from the initial 1781 features to construct the radiomic model. Eight different classifiers, including logistic regression, support vector machine, k-nearest neighbours, random forest, extreme trees, extreme gradient boosting, light gradient boosting machine, and MLP, were used to construct the model, with MLP demonstrating the best diagnostic performance. The AUC of the radiomic-clinical model was 0.862 (95%CI: 0.796-0.927) in the training cohort and 0.761 (95%CI: 0.635-0.887) in the validation cohort. The AUC for the radiomic model was 0.796 (95%CI: 0.723-0.869) in the training cohort and 0.735 (95%CI: 0.604-0.866) in the validation cohort. The clinical model achieved an AUC of 0.751 (95%CI: 0.661-0.842) in the training cohort and 0.676 (95%CI: 0.525-0.827) in the validation cohort. All three models demonstrated good accuracy. In the training cohort, the AUC of the radiomic-clinical model was significantly greater than that of the clinical model (P = 0.005) and the radiomic model (P = 0.016). DCA confirmed the clinical practicality of incorporating radiomic features into the diagnostic process.

CONCLUSION

In this study, we successfully developed and validated a T2WI-based machine learning model as an auxiliary tool for the preoperative differentiation between well/moderately and poorly differentiated CRC. This novel approach may assist clinicians in personalizing treatment strategies for patients and improving treatment efficacy.

[Epidemiological characteristics of diarrheagenic Escherichia coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai, 2014-2021]

Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E. ) coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai and provide evidence for the development of disease control strategies. Methods: Based on multistage systematic sampling, diarrhea surveillance was conducted in 22 sentinel hospitals in Shanghai, the information about cases' demographic, clinical, and epidemiological characteristics were collected. Stool samples were collected for the detection and typing of diarrheagenic E. coli by local centers for disease control and prevention. The positive rate of diarrheagenic E. coli in different populations and seasons from 2014 to 2021 were analyzed. Statistical analysis was conducted by using χ2 test. Results: In 15 185 diarrhea cases, 8.05% (1 222/15 185) were positive for diarrheagenic E. coli. The positive rate was higher in men (8.74%, 684/7 824) than in women (7.31%, 538/7 361). The positive rate was highest in age group 15-29 years (9.14%, 335/3 665) and the annual positive rate was highest in 2021 (10.21%, 83/813), the differences were all significant (P<0.05). In the 1 264 strains of diarrheagenic E. coli analyzed through PCR, enterotoxingenic E. coli was the most frequently identified pathogen (50.24%, 635/1 264), followed by enteroadhesive E. coli (27.93%, 353/1 264), and enteropathogenic E. coli (21.36%, 270/1 264). The positive rate of diarrheagenic E. coli showed obvious seasonality with peak in summer (13.92%, 774/5 562) (χ2=495.73, P<0.001). Conclusions: Diarrheagenic E. coli has become a prominent pathogen in infectious diarrhea cases in Shanghai, the disease can occur all the year round with incidence peak during summer and autumn. Predominant subtypes included enterotoxingenic E. coli, enteroadhesive E. coli and enteropathogenic E. coli. Targeted prevention and control strategies are needed for diarrheagenic E. coli-induced infectious diarrhea in different age groups, seasons and for different types of infections.

Co-occurrence of organophosphate esters and phosphorus fractions in river sediments: Implications for pollution prediction and environment risk assessment

Organophosphate esters (OPEs) and phosphorus (P) are widespread pollutants in aquatic ecosystems, presenting potential ecological risks. However, there is still a lack of comprehensive understanding of their relationships in sediments. In this study, we investigated the co-occurrence and behaviors of the OPEs and P in urban river sediments. The results indicated serious OPE and P pollution in the study area, with substantial spatial variations in the contents and compositions. The OPE congeners and P fractions exhibited different correlations, particularly more significant linear relationships (R = 0.455 - 0.816, p < 0.05) were observed between the aryl-OPEs and P fractions, potentially due to the influence from sources, physicochemical properties, and total organic carbon. About 56 to 71% of variability in predicting the concentrations of aryl-OPE can be explained by the multiple linear regression model using the Fe/Al- and Ca-bound P contents. The study regions exhibited greater aryl-OPEs ecological risks were consistent with the regions with more serious Total P pollution levels. This study represents the first report demonstrating the potential of Fe/Al-P and Ca-P contents in predicting aryl-OPE contents in heavily polluted sediments, providing a useful reference to comprehensively assess the occurrence and environmental behaviors of aryl-OPEs in anthropogenic polluted sediments.

Recent advances on the Role of Gut Microbiota in the Development of Heart Failure by Mediating Immune Metabolism

The association between gut microbiota and the development of heart failure has become a research hotspot in recent years and the impact of gut microbiota on heart failure has attracted growing interest. From 2006 to 2021, the global research on gut microbiota and heart failure has gradually expanded, indicating a developed and promising research field. There were 40 countries, 196 institutions, and 257 authors involved in the publication on the relationship between gut microbiota and heart failure, respectively. In patients with heart failure, inadequate visceral perfusion leads to ischemia and intestinal edema, which compromise the gut barrier. This subsequently results in the translocation of bacteria and bacterial metabolites into the circulatory system and causes local and systemic inflammatory responses. The gastrointestinal tract contains the largest number of immune cells in the human body and gut microbiota play important roles in the immune system by promoting immune tolerance to symbiotic bacteria. Studies have shown that probiotics can act on gut microorganisms, thereby increasing choline metabolism and reducing plasma TMA and TMAO concentrations, thus inhibiting the development of heart failure. Meanwhile, probiotics induce the production of inflammatory suppressors to maintain gut immune stability and inhibit the progression of heart failure by reducing ventricular remodeling. Here, we review the current understanding of gut microbiota-driven immune dysfunction in experimental and clinical heart failure, as well as the therapeutic interventions that could be used to address these issues.

Characteristics and fractionations of sediment oxygen demand in a complex tidal river network area

Tidal river networks are affected by the tide and influenced by complex factors related to sediment oxygen demand (SOD). In this study, we used chemical inhibition to measure the oxygen consumption of different types of SOD to explore the specific oxygen consumption mechanism of sediments. Then, we evaluated the diffusion fluxes of the sediment-water interface and factors affecting SOD using diffusive gradients in thin films. Total SOD in the tidal river network area of the Pearl River basin was ∼0.5928 g/m2/day, which was 8.47% higher than that in the non-tidal river network area but lower than that in black and odorous water reported previously. In the tidal river network area, biological SOD was 15.6% higher in summer than in winter, and the difference in total SOD was greatly influenced by human activity. We observed a significant effect of sediment on SOD in winter, whereas there were no significant correlations between sediment and SOD in summer. Different particle-size distributions lead to different organic matter contents, resulting in different biological SOD ratios between seasons. Our study found that seasonal tidal changes can affect ion exchange at the sediment water interface, leading to changes in SOD.These findings will be of great significance for the study of phenomena associated with low dissolved oxygen in tidal river networks and provide directions for future sediment pollution control.