Maximal diameters and mean computed tomography (CT) value of synchronous multiple pure ground-glass opacities in lung adenocarcinoma are smaller

AIMS

Synchronous multiple pure ground-glass opacities (SMpGGOs) are observed more commonly. Nevertheless whether characteristics of SMpGGOs are similar to those of solitary pure ground-glass opacities (SpGGOs), remains unknown. This retrospective study aimed to compare radiographic characteristics between SMpGGOs and SpGGOs.

MATERIALS AND METHODS

We retrospectively included patients along with SpGGOs or SMpGGOs at XXX between August 2018 and June 2020. They were enrolled in two groups (SpGGOs and SMpGGOs). The clinical records, pathologic features, and radiographic manifestations of two groups were collected and compared with SPSS 21.0.

RESULTS

138 patients (58 patients with 58 SpGGOs, 80 patients with 187 SMpGGOs) were evaluated. The threshold values of maximal diameters and mean computed tomography value for adenocarcinoma were 5.5 mm (sensitivity 86.4%, specificity 55.6%, AUC 0.777) and -615.0 Hu in SMpGGOs (sensitivity 61.4%, specificity 66.7%, AUC 0.651) for SMpGGOs, whereas 12.5 mm (sensitivity 54.5%, specificity 100%, AUC 0.851) and -531.9 Hu (sensitivity 43.2%, specificity 100%, AUC 0.724) in SpGGOs.

CONCLUSION

The threshold values of maximal diameters and mean computed tomography value for adenocarcinoma in SMpGGOs may be smaller than those in SpGGOs (5.5 mm vs. 12.5mm, -615.0 Hu vs. -531.9 Hu).

A coordinated attack by a bacterial secretion system and a small molecule drives prey specificity

Vibrio species are recognized for their role in food- and water-borne diseases in humans, fish, and aquatic invertebrates. We screened bacterial strains isolated from raw food shrimp for those that are bactericidal to Vibrio strains. Here we identify and characterize Aeromonas dhakensis strain A603 which shows robust bactericidal activity specifically towards Vibrio and related taxa but less potency toward other Gram-negative species. Using the A603 genome and genetic analysis, we show that two antibacterial mechanisms account for its vibriocidal activity -- a highly potent Type Six Secretion System (T6SS) and biosynthesis of a vibriocidal phenazine-like small molecule, named here as Ad-Phen. Further analysis indicates coregulation between Ad-Phen and a pore-forming T6SS effector TseC, which potentiates V. cholerae to killing by Ad-Phen.

Quercetin ameliorates lipid deposition in primary hepatocytes of the chicken embryo

1. The accumulation of excessive fat plays a role in the development of non-alcoholic fatty liver disease (NAFLD) and phytogenic feed additives have the potential to ameliorate this. This study involved the isolation and culture of primary hepatocytes from chicken embryos to establish a model of hepatic steatosis induced by oleic acid/dexamethasone (OA/DEX). Lipid accumulation and cell viability were assessed using Nile Red staining, Oil Red O staining and cell count Kit -8 (CCK8) following treatment with varying concentrations of quercetin (Que). The potential mechanism by which Que exerts its effects was preliminarily investigated.2. The results indicated that OA effectively treated lipid accumulation in hepatocytes. There was no notable variance in cell proliferation between the normal and OA/DEX groups when subjected to Que treatment at concentrations of 1000 ng/ml and 10 000 ng/ml. Triglycerides and cholesterol (low and high density) decreased with Que treatment, with the most substantial reduction observed at 10 000 ng/ml.3. Gene expression levels decreased to levels similar to those in the control groups. Western blot data demonstrated that sterol regulatory element-binding protein 1 (SREBP-1) protein expression correlated with its mRNA expression level. Que mitigated lipid accumulation through the alpha serine/threonine protein kinase (AKT) and extracellular signal-regulated kinase (ERK) pathways. Expression levels of lipid-related genes (APOB, PPARα, CYP3A5 and SREBP-1) decreased to levels similar to the control groups. Western blot data demonstrated that the SREBP-1 protein expression correlated with its mRNA expression level.4. Supplementation with Que ameliorated lipid accumulation through AKT and ERK signalling pathway in OA/DEX-induced high-fat hepatocytes.

Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade

PURPOSE

This study aimed to develop nomograms that combine clinical factors and MRI tumour regression grade to predict the pathological response of mid-low locally advanced rectal cancer to neoadjuvant chemoradiotherapy.

METHODS

The retrospective study included 204 patients who underwent neoadjuvant chemoradiotherapy and surgery between January 2013 and December 2021. Based on pathological tumour regression grade, patients were categorized into four groups: complete pathological response (pCR, n=45), non-complete pathological response (non-pCR; n=159), good pathological response (pGR, n=119), and non-good pathological response (non-pGR, n=85). The patients were divided into a training set and a validation set in a 7:3 ratio. Based on the results of univariate and multivariate analyses in the training set, two nomograms were respectively constructed to predict complete and good pathological responses. Subsequently, these predictive models underwent validation in the independent validation set. The prognostic performances of the models were evaluated using the area under the curve (AUC).

RESULTS

The nomogram predicting complete pathological response incorporates tumour length, post-treatment mesorectal fascia involvement, white blood cell count, and MRI tumour regression grade. It yielded an AUC of 0.787 in the training set and 0.716 in the validation set, surpassing the performance of the model relying solely on MRI tumour regression grade (AUCs of 0.649 and 0.530, respectively). Similarly, the nomogram predicting good pathological response includes the distance of the tumour's lower border from the anal verge, post-treatment mesorectal fascia involvement, platelet/lymphocyte ratio, and MRI tumour regression grade. It achieved an AUC of 0.754 in the training set and 0.719 in the validation set, outperforming the model using MRI tumour regression grade alone (AUCs of 0.629 and 0.638, respectively).

CONCLUSIONS

Nomograms combining MRI tumour regression grade with clinical factors may be useful for predicting pathological response of mid-low locally advanced rectal cancer to neoadjuvant chemoradiotherapy. The proposed models could be applied in clinical practice after validation in large samples.

[Advances in thoracic consolidation radiotherapy after first-line immunotherapy combined with chemotherapy for extensive stage small cell lung cancer]

Small cell lung cancer (SCLC) accounts for about 13%~17% of primary bronchial lung cancer. Due to its rapid growth rate, aggressive behavior, early metastasis and poor prognosis, about 70% of patients were diagnosed with extensive-stage (ES) disease. Although most ES-SCLC patients are sensitive to initial chemotherapy, local recurrence and distant metastasis develop in the short term. Immunotherapy has brought the dawn to overcome it. At present, immune checkpoint inhibitor combined with chemotherapy has become an important strategy as first-line therapy for ES-SCLC. Nevertheless, patients are still at a high risk of chest lesion recurrence after initial systemic therapy. Whether the addition of thoracic consolidation radiotherapy (TRT) can reduce chest lesion recurrence rate remains to be determined. In this review, we summarized the latest research progress in the mode of first-line chemotherapy combined with immunotherapy followed by TRT in ES-SCLC, aiming to provide reference for clinical practice.

Blocking Interfacial Proton Transport via Self-Assembled Monolayer for Hydrogen Evolution-Free Zinc Batteries

Aqueous Zn-ion batteries (ZIBs) are promising next-generation energy storage devices, yet suffer from the issues of hydrogen evolution reaction (HER) and intricate side reactions on the Zn anode surface. The hydrogen (H)-bond networks play a critical role in interfacial proton transport that may closely relate to HER but are rarely investigated. Herein, we report a self-assembled monolayer (SAM) strategy which is constructed by anchoring ionic liquid cations on Ti3C2Tx substrate for HER-free Zn anode. Molecule dynamics simulations reveal that the rationally designed SAM with a high coordination number of water molecules (25-27, 4-6 for Zn2+) largely reduces the interfacial densities of H2O molecules, therefore breaking the connectivity of H-bond networks and blocking proton transport on the interface, by which the HER is suppressed. Then, a series of in situ characterizations demonstrate that negligible amounts of H2 gas are collected from the Zn@SAM-MXene anode. Consequently, the symmetric cell enables a long-cycling life of 3000 h at 1 mA cm-2 and 1000 h at 5 mA cm-2. More significantly, the stable Zn@SAM-MXene films are successfully used for coin full cells showing high-capacity retention of over 94 % after 1000 cycles and large-area (10×5 cm2) pouch cells with desired performance.

Dynamic contrast-enhanced magnetic resonance imaging in cervical cancer: correlation between quantitative parameters and molecular markers hypoxia-inducible factors-1-alpha, vascular endothelial growth factor, and Ki-67

AIM

To investigate whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to non-invasively detect microenvironmental condition by quantitatively measuring blood perfusion, vessel wall permeability, and vascularity, and to elucidate the possible correlations between DCE-MRI quantitative parameters and the expression level of hypoxia, vascularity, and cell proliferation related molecular biomarkers.

MATERIALS AND METHODS

In this prospective single center clinical study, 58 patients diagnosed with cervical cancer underwent DCE-MRI before anticancer treatment were enrolled. Ktrans, Kep, Ve, and Vp were generated from Extended Toft's model. Then patients conducted colposcopy biopsy within 1 week after DCE-MRI. Pretreatment expression levels of HIF-1α, VEGF and Ki-67 were assessed and scored by immunohistochemistry on colposcopy obtained tumor specimens.

RESULTS

In HIF-1α low-expression group, Ktrans (p=0.031) and Kep (p=0.012) values were significantly higher than the high-expression group. In VEGF high-expression group, Ktrans (p=0.044) and Ve values (p=0.021) were significantly higher than the low-expression group. In Ki-67 high-expression group, Ktrans (p=0.026) and Kep (p=0.033) were significantly higher than the low-expression group. Multiple linear regression analyses and Pearson correlation revealed that Ktrans independently negatively correlated with HIF-1α expression, Ve independently positively correlated with VEGF, and Kep independently positively correlated with Ki-67. The area under the ROC curves of Ktrans for HIF-1α, Ve for VEGF, and Kep for Ki-67 were 0.728, 0.743, 0.730, respectively.

CONCLUSION

Our results suggest that DCE-MRI quantitative parameters could be potentially used as imaging markers for non-invasively detecting microenvironmental hypoxia, vascularity and proliferation in cervical cancer patients.

Correlation analysis between HLA-DQA1*0102/DQB1*0602 genotypes and narcolepsy patients in China

Background and objective

At present, the etiology of narcolepsy is not fully understood, and it is generally believed to be an autoimmune reaction caused by interactions between environmental and genetic factors. Human leukocyte antigen (HLA) class II genes are strongly associated with this gene, especially HLA-DQB1*0602/DQA1*0102. In this study, we mainly analyzed the correlation between different genotypes of HLA-DQB1*0602/DQA1*0102 and clinical manifestations in Chinese patients with narcolepsy.

Experimental method

Narcolepsy patients who were treated at the Department of Neurology, The First Affiliated Hospital of Shandong First Medical University from January 2021 to September 2023 were selected. General information, sleep monitoring data, cerebrospinal fluid (CSF) orexin levels, and human leukocyte antigen gene typing data were collected. The statistical analysis was performed using SPSS 26.0, and the graphs were drawn using GraphPad Prism 9.5.

Main results

A total of 78 patients were included in this study. The DQA1 and DQB1 gene loci were detected in 54 patients, and only the DQB1 gene locus was detected in 24 narcoleptic patients. The most common allele at the HLA-DQB1 locus was *0602 (89.7%), and the most common genotype at this locus was *0602*0301 (19.2%), followed by *0602*0602 (17.9%). The most common phenotype of the HLA-DQA1 locus is *0102 (92.6%), and the most common genotype of this locus is *0102*0102 (27.8%), followed by *0102*0505 (14.8%). There were significant differences (p < 0.05) between HLA-DQB1*0602-positive and HLA-DQB1*0602-negative patients in terms of orexin-A levels, presence or absence of cataplexy, UNS, PSG sleep latency, REM sleep latency, N1 sleep percentage, oxygen depletion index, and average REM latency on the MSLT. The HLA-DQA1*0102-positive and HLA-DQA1*0102-negative patients showed significant differences (p < 0.05) in disease course, presence or absence of sudden onset, PSG REM sleep latency, N1 sleep percentage, and average REM latency on the MSLT. There were significant differences in the average REM latency of the MSLT between HLA-DQB1*0602/DQA1*0102 homozygous and heterozygous patients p < 0.05, and no differences were found in the baseline data, orexin-A levels, scale scores, or other sleep parameters.

Conclusion

Different genotypes of HLA-DQA1*0102/DQB1*0602 are associated with symptoms of cataplexy in Chinese narcoleptic patients. Homozygous individuals have a shorter mean REM latency in the MSLT, greater genetic susceptibility, and relatively more severe sleepiness.

Changing Cinnamaldehyde Skeleton Achieves Antibacterial Nanoswitch

Changeable substituent groups of organic molecules can provide an opportunity to clarify the antibacterial mechanism of organic molecules by tuning the electron cloud density of their skeleton. However, understanding the antibacterial mechanism of organic molecules is challenging. Herein, we reported a molecular view strategy for clarifying the antibacterial switch mechanism by tuning electron cloud density of cinnamaldehyde molecule skeleton. The cinnamaldehyde and its derivatives were self-assembled into nanosheets with excellent water solubility, respectively. The experimental results show that α-bromocinnamaldehyde (BCA) nanosheets exhibits unprecedented antibacterial activity, but there is no antibacterial activity for α-methylcinnamaldehyde nanosheets. Therefore, the BCA nanosheets and α-methylcinnamaldehyde nanosheets achieve an antibacterial switch. Theoretical calculations further confirmed that the electron-withdrawing substituent of the bromine atom leads to a lower electron cloud density of the aldehyde group than that of the electron-donor substituent of the methyl group at the α-position of the cinnamaldehyde skeleton, which is a key point in elucidating the antimicrobial switch mechanism. The excellent biocompatibility of BCA nanosheets was confirmed by CCK-8. The mouse wound infection model, H&E staining, and the crawling ability of drosophila larvae show that as-prepared BCA nanosheets are safe and promising for wound healing. This study provides a new strategy for the synthesis of low-cost organic nanomaterials with good biocompatibility. It is expected to expand the application of natural organic small molecule materials in antimicrobial agents.

Association study of FLT4 and HYDIN single nucleotide polymorphisms with atrial septal defect susceptibility in the Han Chinese population of Southwest China

BACKGROUND

Atrial septal defect (ASD) is a common form of congenital heart disease. Although several genes related to ASD have been found, the genetic factors of ASD remain unclear. This study aimed to evaluate the correlation between 10 candidate single nucleotide polymorphisms (SNPs) and sporadic atrial septal defects.

METHODS

Based on the results of 34 individual whole exome sequences, 10 candidate SNPs were selected. In total, 489 ASD samples and 420 normal samples were collected. The 10 SNPs in the case group and the control group were identified through Snapshot genotyping technology. The χ2-test and unconditional regression model were used to evaluate the relationship between ASD and each candidate SNP. Haploview software was used to perform linkage disequilibrium and haplotype analysis.

RESULTS

The χ2 results showed that the FLT4 rs383985 (P = 0.003, OR = 1.115-1.773), HYDIN rs7198975 (P = 0.04621, OR = 1.003-1.461), and HYDIN rs1774266 (P = 0.04621, OR = 1.003-1.461) alleles were significantly different between the control group and the case group (P < 0.05). Only the association with the FLT4 polymorphism was statistically significant after adjustment for multiple comparisons.

CONCLUSION

These findings suggest that a possible molecular pathogenesis associated with sporadic ASD is worth exploring in future studies.

A sandwich electrochemiluminescence immunoassay based on 1T-MoS2@dual MOFs for detecting CA153

A "signal-on" electrochemiluminescence (ECL) immunosensor has been proposed for detecting carbohydrate antigen 153 (CA153) based on the dual MOFs sandwich strategy. The conductive and porous substrate consisting of 1T-MoS2 and two-dimensional conductive metal-organic framework (MOF, Ni-HAB) was anchored onto the glassy carbon electrode (GCE) to label the capture antibody (Ab1), and the luminescence-functionalized MOF (Ru(bpy)32+@UiO-66-NH2) was utilized to immobilize the detection second antibody (Ab2) to construct a "signal-on" responsive sandwich-type electrochemiluminescence immunoassay. Meanwhile, tripropylamine (TPA) acts as the co-reactant and provides a luminescence system for Ru(bpy)32+@UiO-66-NH2. The luminescence-functionalized MOFs showed excellent ECL activity owing to the tunable structure of MOFs. The remarkable enhancement in ECL intensity was obtained by the immunoreaction of antigen and antibody. Under the optimized conditions, the biosensor exhibited a detection limit of 0.0001 U mL-1 (S/N = 3) with a wide range from 0.001 to 50 U mL-1. The proposed ECL immunosensor was applicable for detecting human serum samples with a recovery of 99.83 ∼ 101 % (RSD < 5 %). This work demonstrates that the advantage of multifunctional MOFs could be applied to construct highly selective ECL immunosensor, and it may facilitate the diagnosis of breast cancer in clinics.

Effect of quercetin on granulosa cells development from hierarchical follicles in chicken

1. The bioflavonoid quercetin is a biologically active component, but its functional regulation of granulosa cells (GCs) during chicken follicular development is little studied. To investigate the effect of quercetin on follicular development in laying hens, an in vitro study was conducted on granulosa cells from hierarchical follicles treated with quercetin.2. The effect of quercetin on cell activity, proliferation and apoptosis of granulosa cells was detected by CCK-8, EdU and apoptosis assays. The effect on progesterone secretion from granulosa cells was investigated by enzyme-linked immunosorbent assay (ELISA). Expression of proliferating cell nuclear antigen (PCNA) mRNA and oestrogen receptors (ERs), as well as the expression of steroid acute regulatory protein (StAR), cytochrome P450 cholesterol side chain cleavage enzyme (P450scc) and 3β-hydroxysteroid dehydrogenase (3β-HSD) mRNA during progesterone synthesis, were measured by real-time quantitative polymerase chain reaction (RT-qPCR). PCNA, StAR and CYP11A1 protein expression levels were detected using Western blotting (WB).3. The results showed that treatment with quercetin in granulosa cells significantly enhanced cell vitality and proliferation, reduced apoptosis and promoted the expression of gene and protein levels of PCNA. The levels of progesterone secretion increased significantly following quercetin treatment, as did the expression levels of StAR and CYP11A1 using the Western Blot (WB) method.4. The mRNA expression levels of ERα were significantly upregulated in the 100 ng/ml and 1000 ng/ml quercetin-treated groups, while there was no significant difference in expression levels of ERβ mRNA.

Role of interleukin-6 and endothelin-1 receptors in enhanced melanocyte dendricity of facial spots and suppression of their ligands by niacinamide and tranexamic acid

BACKGROUND

Hyperpigmented spots are common issues in all ethnicities with a hallmark characteristic of increased melanocyte dendricity.

OBJECTIVES

To determine (1) potential receptors and/or cytokines that are involved in increased melanocyte dendricity in multiple facial spot types; (2) treatment effects of skin-lightening compounds on identified cytokine release from keratinocytes and on dendricity in melanocytes.

METHODS

Facial spots (melasma, solar lentigo, acne-induced post-inflammatory hyperpigmentation) and adjacent non-spot skin biopsies were collected from Chinese women (age 20-70). The epidermal supra and basal layers were laser dissected to enrich keratinocyte or melanocyte biology respectively for transcriptome analysis. Melanocyte dendricity was assessed histologically by immunofluorescent staining. Effect of interleukin-6 (IL-6) and endothelin-1 (ET-1) on melanocyte dendricity and melanosome transfer were assessed in human melanocytes or melanocyte-keratinocyte co-culture models. Treatment effects of skin-lightening compounds (niacinamide, tranexamic acid [TxA], sucrose laurate/dilaurate mixture [SDL]) were assessed on IL-6 or ET-1 release from keratinocytes and on dendricity in melanocytes.

RESULTS

Transcriptome analysis revealed IL-6 receptor and ET-1 receptor were significantly upregulated compared to the adjacent normal skin, visually confirmed at the protein level through immunostaining. Melanocytes in spot areas are more dendritic than melanocytes in adjacent non-spot skin. The addition of IL-6 and ET-1 to cell culture models increased melanocyte dendricity and melanosome transfer. IL-6 release was significantly suppressed by niacinamide and its combination, while ET-1 release was significantly reduced by both niacinamide and TxA. In contrast, SDL acted directly upon melanocytes to reduce dendricity.

CONCLUSION

Interleukin-6 and ET-1 receptors are significantly upregulated in multiple facial spot types. The in vitro testing demonstrated their respective ligands increased melanocyte dendricity. Tested skin-lightening compounds showed reduction in release of IL-6/ET-1 from epidermal keratinocytes and/or inhibition of melanocyte dendricity. This work sheds light on pathophysiological mechanism of facial spots and potential new mechanisms of these skin-lightening compounds which warrant further human clinical validation.

Role of Cisplatin in Inducing Acute Kidney Injury and Pyroptosis in Mice via the Exosome miR-122/ELAVL1 Regulatory Axis

Although cisplatin is an effective chemotherapy drug for the treatment of various cancers, its clinical use is limited due to its side effects, especially nephrotoxicity. Unfortunately, acute kidney injury (AKI) caused by cisplatin remains one of the main challenges in effective cancer treatment. Evidence increasingly suggests that renal inflammation and pyroptotic inflammatory cell death of renal tubular epithelial cells (RTECs) mainly determine the progression and outcome of cisplatin-induced AKI. However, it is not clear how cisplatin regulates the pyroptosis of RTECs cells in AKI. The current study aimed to determine the regulation mechanism of AKI induced by cisplatin. We used cisplatin to induce AKI in vivo. We performed H&E staining of mouse kidney tissue sections and evaluated serological indicators of kidney injury (including blood urea nitrogen (BUN), serum creatinine, and tumor necrosis factor-alpha (TNF-alpha)). We used immunohistochemistry and western blot to detect the important substrate protein gasdermin D (GSDMD) and key target caspase-1 of pyroptosis, respectively. Cisplatin induced mouse AKI and RTECs pyroptosis. HK2 cell-derived exosomes treated with cisplatin influenced pyroptosis of the surrounding HK2 cells. Cisplatin-treated HK2 cells exosome-derived miR-122 regulated pyroptosis in the surrounding cells. Exosome-derived miR-122 affected cisplatin-induced AKI and HK2 cells pyroptosis by regulating the expression of embryonic lethal abnormal vision (ELAVL1). These results suggest that exosome miR-122 inhibited pyroptosis and AKI by targeting ELAVL1 under cisplatin treatment, and this offers a potential target for the treatment of AKI.

Cardiac function evaluated by two-dimensional speckle tracking imaging in fetuses with congenital heart disease of ventricular afterload increase

AIMS

To study myocardial deformation in fetuses with ventricular afterload increase compared with gestational age-matched controls using speckle tracking echocardiography.

METHODS AND RESULTS

Eighty-nine fetuses were retrospectively selected from the pregnancy screen by echocardiography. There are 41 fetuses with gestational age-matched normal heart served as the control group, 25 fetuses with congenital heart disease (CHD) leading to left ventricular (LV) afterload increase as group LVA and 23 fetuses with CHD leading to right ventricular(RV) afterload increases as group RVA. LV and RV fractional shortening (FS) were measured by conventional methods. The longitudinal strain (LS) and strain rate (LSr) were analyzed by EchoPac software. Group LVA and RVA compared with control group, the LV FS was no significant difference, but LS and LSr values of LV were lower in fetuses with LVA compared to the control group (LS:-15.97(-12.50,-22.52)vs -27.53(-24.33,-29.16) %, p < .01; systolic strain rate (SRs):-1.34(-1.12,-2.16) vs -2.55(-2.28,-2.92) 1/sec, p < .01; early diastolic strain rate (SRe):1.70 ± 0.57 vs 2.46 ± 0.61 1/sec, p < 0.01; late diastolic strain rate (SRa):1.62 ± 0.82 vs 2.39 ± 0.81 1/sec, p < .01). LS and LSr values of LV or RV were lower in fetuses with RVA compared to the control group (LV: LS:-21.52 ± 6.68 vs -26.79 ± 3.22%, p < .01; SRs:-2.11 ± 0.78 vs -2.56 ± 0.43 1/sec; p = .02; RV: LS:-17.64 ± 7.58 vs -26.38 ± 3.97%, p < .01; SRs:-1.62 ± 0.67 vs -2.37 ± 0.44 1/sec; p < .01).

CONCLUSION

The results of this study showed that the ventricular LS, LSr, SRs, SRe, SRa values were lower in fetuses with LV or RV afterload increasing CHD estimated by speckle tracking imaging but LV and RV FS were normal,which indicated the strain imaging is feasible in evaluating cardiac function of fetus, and may be more sensitive.

Solvation Sheath Engineering by Multivalent Cations Enabling Multifunctional SEI for Fast-Charging Lithium-Metal Batteries

With the pursuit of high energy and power density, the fast-charging capability of lithium-metal batteries has progressively been the primary focus of attention. To prevent the formation of lithium dendrites during fast charging, the ideal solid electrolyte interphase should be capable of concurrent fast Li+ transport and uniform nucleation sites; however, its construction in a facile manner remains a challenge. Here, as Al3+ has a higher charge and Al metal is lithiophilic, we tuned the Li+ solvation structure by introducing LiNO3 and aluminum ethoxide together, resulting in the dissolution of LiNO3 and the simultaneous generation of fast ionic conductor and lithiophilic sites. Consequently, our approach facilitated the deposition of lithium metal in a uniform and chunky way, even at a high current density. As a result, the Coulombic efficiency of the Li||Cu cell increased to over 99%. Moreover, the Li||LiFePO4 full cell demonstrated significantly enhanced cycling performance with a remarkable capacity retention of 94.5% at 4 C, far superior to the 46.1% capacity retention observed with the base electrolyte.

Identifying the key factors affecting the trimethylamine N-oxide content of teleost fishes collected from the marginal seas of China and the epipelagic zone of the northwest Pacific Ocean

To identify the key factors influencing the trimethylamine N-oxide (TMAO) content of teleost fishes living in shallow seas and the epipelagic zone of the deep ocean, the muscle TMAO content was measured in 152 teleost fishes (21 species) collected from the marginal seas of China and the epipelagic zone of the northwest Pacific Ocean (NWPO) during May-July 2021. The results showed that the TMAO content in all fishes varied from 4.99 to 82.97 mmol kg-1, and it varied notably among different species, e.g., the highest average content (72.71 ± 8.22 mmol kg-1 in Argyrosomus argentatus) was 1 order of magnitude higher than the lowest one (Scomber japonicus), but the ratios of the highest content to the lowest content in each species varied from 1.29 to 3.28, suggesting that the interspecific variations in TMAO content were obviously greater than the intraspecific variations. Moreover, no correlation was observed between the TMAO content of the 152 fishes and the corresponding environmental factors of seawater depth, salinity and temperature, indicating that species played a more important role than environmental factors in driving TMAO accumulation. To exclude the influence of species, intraspecies correlations between TMAO content and environmental factors were analyzed. In the marginal seas of China, only ∼8 % of the TMAO content of teleost fishes (1 species) showed a positive correlation with salinity and depth, but ∼50 % of the TMAO content (5 species) was negatively correlated with temperature. Moreover, the TMAO content of the fish increased by 4.66 ± 1.38 % compared with their corresponding intraspecific average values for every 1 °C of temperature decrease. A similar phenomenon was also found in the TMAO content of pelagic teleost fishes in the NWPO, suggesting that temperature was a key environmental factor affecting the TMAO content of teleost fishes in shallow seas and the epipelagic zone of the deep ocean.

Magnetic properties and critical behaviors of the nodal-line semimetal candidate ErIn3

The AuCu3-type intermetallic compoundsReIn3(Re= a rare earth ion) with type-IV magnetic space groups are predicted to show topologically nontrivial electronic states. Here, we grow ErIn3single crystals, and study their magnetic properties and critical behaviors by means of the magnetic susceptibility, and magnetization isotherm measurements. Combining a detailed analysis of the magnetic susceptibility and isothermal magnetization, we find that this compound harbors a complicated magnetic phase diagram, and its magnetic moment arrangement appears not to simply follow the fashion as observed in the isostructural counterpart GdIn3(it adopts a conventional type-Cmagnetic structure that belongs to type-IV magnetic space groups). A careful study of the magnetic properties around the antiferromagnetic (AFM)-paramagnetic transition yields the critical exponentsβ= 0.309 (0.297),γ= 1.117 (1.038), andδ= 4.617 (4.454), indicating that the tricritical mean field model or the three-dimensional Ising model works for ErIn3's magnetic behaviors and the presence of a long-range AFM interaction therein. Besides, the exchange interaction distanceJ(r) ∼r-4.665as well confirms a long-range magnetic coupling in ErIn3. Our results offer the clues that the magnetic structure varies from one member ofReIn3family to another, and to confirm their electronic features in the AFM phases further experimental and theoretical studies are still desired.

A Comparison of Clinicopathologic Outcomes and Patterns of Lymphatic Spread across Neoadjuvant Chemotherapy, Neoadjuvant Chemoradiotherapy and Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma

PURPOSE/OBJECTIVE(S)

To evaluate the differences in pathologic complete response (pCR) rates, TRG score, pathologic T stage and the pattern of lymphatic spread among patients receiving neoadjuvant chemotherapy (NCT) or neoadjuvant chemoradiotherapy (NCRT) or neoadjuvant immunochemotherapy (NICT) prior to esophagectomy for locally advanced esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

A total of 702 patients with ESCC who completed transthoracic esophagectomy followed neoadjuvant therapy at three cancer centers from January 2017 to December 2022 were enrolled. Among the included patients, 382 patients were treated with NCR, 172 with NCRT, and 148 with NICT. Inverse probability of treatment weighting (IPTW) was performed to control potential confounding factors. Pathological response of primary tumor was evaluated using the Chirieac modified tumor regression grade (TRG) system. The complete regression of primary lesion and nodal metastases were considered pCR. Lymph node classification system used the 8th edition of AJCC. Specimens were assessed for pattern of lymphatic spread.

RESULTS

After adjusting for baseline characteristics, the R0 resection rate did not significantly differ between the patients receiving NCT or NCRT or NICT (99.48% vs.100% vs.98.65%, P = 0.273). Compared with the NCT group, the NCRT group and NICT group had an advantage in pathological response (P<0.05). The pCR rate was 7.07% in the NCT group, 30.23% in the NCRT group, and 22.30% in the NICT group. Compared to the other two groups, the TRG score (P<0.05) and pathologic T stage (P<0.05) in the NCT group were significantly higher. In the NCT group, 9.97% had ypT0 disease, compared with 35.76% in the NCRT group and 25.68% in the NICT group. And in the NCT group, 9.71% had TRG1 disease, compared with 32.76% in the NCRT group and 25% in the NICT group. Compared with NICT, NCRT can significantly reduce the rate of LNM in station 1R (0 vs 3.38%, P<0.05) and 2R (1.15% vs 6.76%, P<0.05). Subgroup analysis according to the tumor location distribution showed that in upper thoracic cases, there was no statistical difference in LNM rates among stations no matter whether patients received NCT or NCRT or NICT. NICT group had higher LNM rates in station 2R (9.1%) in middle thoracic cases (P<0.05) and in station 18 (7.5%) (P<0.05) in lower thoracic cases, compared with the NCRT group and NCT group.

CONCLUSION

NCRT or NICT followed by surgery may result in a promising pCR rate and show a better performance in therapeutic response of primary lesion. No matter whether patients received NCT or NCRT or NICT, multiple level and skip node metastases are common, and adequate lymphadenectomy should be achieved to ensure the complete removal of metastatic lymph nodes.

Safety and Efficacy Analysis of Patients with Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Treated with SHR-1316 Plus Chemotherapy and Sequential Chest Radiotherapy as First-Line Therapy from a Phase II Trial

PURPOSE/OBJECTIVE(S)

CAPSTONE-1, a phase 3 trial, showed that SHR-1316 (PD-L1 antibody) combined with standard first-line chemotherapy could prolong overall survival (OS) in patients (pts) with ES-SCLC. The CREST trial reported consolidative thoracic radiotherapy (TRT) of 30 Gy in 10 fractions provided a 10% 2-year OS benefit and more intensive TRT should be investigated in ES-SCLC. In the era of immunotherapy, the role of TRT also needs further exploration. Therefore, we designed this clinical trial to investigate the efficacy and safety of SHR-1316 plus first-line chemotherapy followed by TRT combined with SHR-1316.

MATERIALS/METHODS

Key inclusion criteria were pts aged 18-75 years, with previously untreated histologically or cytologically confirmed ES-SCLC, and an ECOG performance status of 0-1. Eligible pts would receive 4∼6 cycles of SHR-1316 (20mg/kg, D1, q3w) combined with EP/EC (etoposide, 100mg/m2, D1-5, q3w and cisplatin, 75mg/m², D1-3, q3w or carboplatin, AUC = 5, D1, q3w), followed by SHR-1316 combined with TRT (≥3 Gy*10 f or ≥2 Gy*25 f, involved-field irradiation), and then the maintenance therapy with SHR-1316 until disease progression or intolerable adverse events (AEs). The main endpoints included ORR, PFS and safety.

RESULTS

From October 2020 to January 2023, 33 pts received SHR-1316 and sequential consolidative TRT. Among them, 19 pts received high-dose TRT (>3 Gy*10 f or ≥2 Gy*25 f) and 14 pts received low-dose TRT (≤3 Gy*10 f or<2 Gy*25 f). The median age was 62 (range: 38-73). Most pts were male (28, 84.8%), former smokers (22, 66.7%) with an ECOG performance status 1 (32, 97%). Ten (30.3%) pts were diagnosed with brain metastasis and 10 (30.3%) pts had liver metastasis at baseline. At the data cutoff date, 9 pts remained on treatment, the average number of treatment cycles was 9.2. 33 pts had at least one 1 post-treatment tumor assessment. The confirmed ORR and DCR were 90.9% (30/33) and 100% (33/33) in all pts, were 89.5% (17/19) and 100% (19/19) in high-dose TRT group, and were 92.9% (13/14) and 100% (14/14) in low-dose TRT group. The median PFS was 10.2(CI: 5.8∼14.7) months in all pts, was 7 (CI: 3.8∼10.2) months in high-dose TRT group and 10.4 (CI: 8.4∼12.3) months in low-dose TRT group. AEs occurred in 27 (81.8%) pts and grade 3 or 4 AEs occurred in 20 (60.6%) pts. The most common grade 3 or 4 AEs included neutropenia (15, 45.5%), leukopenia (8, 24.2%), lymphocytopenia (5, 15.2%), pneumonia (3, 9.1%), anemia (3, 9.1%) and thrombocytopenia (2, 6.1%).

CONCLUSION

SHR-1316 plus chemotherapy and sequential TRT as first-line therapy for ES-SCLC showed promising efficacy and acceptable safety. There is no significant difference between high-dose and low-dose TRT groups in terms of safety and efficacy according to current data.

An Efficient Transformer Model for Synthesizing Dual Energy CT from Single Energy Scanner

PURPOSE/OBJECTIVE(S)

Dual-energy CT can be used to optimize radiation treatment. Recently, deep learning has been demonstrated to synthesize high-energy CT images from low-energy ones for dose reduction and lower CT system burden. As the state-of-the-art deep learning architecture, the computation burden of Transformer increases quadratically with the feature size, making the model training resource-demanding or even infeasible. Here, we introduce an efficient transformer for the balance between CT image synthesis quality and computational burden.

MATERIALS/METHODS

The model is a U-shape deep neural network with encoders and decoders built by Transformer blocks. The model input is low-energy 100kVp CT image and the output is high-energy 140kVp one. Each block has a Self Channel Correlation Unit (SCCU) and a Self Spatial Attention Unit (SSAU). Local shortcuts are applied for both units. Under-sampling operation achieved by pixel shuffling is used to obtain multi-scale feature maps, and the transformer block is applied on each feature scale. Symmetric skip connection sending features from shallow layers to deep layers, thus an additional 1 × 1 convolution is used for feature fusion in each decoder. In a SCCU, the feature is first mapped to one Query, one Key, and one Value. Then the Query and the Key tensors perform matrix multiplication to compute cross covariance of feature channels. The channel correlation score can be obtained by normalization of the covariance, and it is used to weight the Value tensor. As a result, the model complexity only increases linearly with the feature size. Besides the channel weighting, we enhance spatial information using SSAU, where the feature is mapped to two tensors. One tensor after activation is used to point-wisely calibrate another tensor. Additional Transformer blocks are cascaded to the last decoder for feature refinement. Because of the structure similarity of low- and high-energy CT images, a global shortcut is used to ease model training. Clinical iodine contrast-enhanced dual energy CT image datasets of 19 patients are used in this study. The dual-energy scanning is performed by a SOMATOM Definition Flash DECT scanner. We split the datasets into training dataset of 15 patients, validation dataset of 1 patient, and testing dataset of 3 patients. The image size is 512 × 512 with pixel size 0.5 × 0.5 mm2.

RESULTS

The U-Net model with 1.95M parameters and 44.87G FLOPS achieved the averaged PSNR value of 44.55 dB (s.t.d. 1.34) and averaged RMSE value of 0.0060 (s.t.d. 0.001). In comparison, our efficient Transformer with 1.408M parameters and 31.375G FLOPS achieved the averaged PSNR value of 44.78 dB (s.t.d. 1.37) and RMSE value of 0.0059 (s.t.d. 0.001), demonstrating our model has better performance with small model size and less computation.

CONCLUSION

The efficient Transformer model allows high-resolution CT image synthesis with small model scale and computation burden from low-energy CT image.

A Feasibility Study of Dose Band Prediction in Radiotherapy: Predicting a Dose Spectrum

PURPOSE/OBJECTIVE(S)

Current deep learning-based dose prediction methods can only predict a specific dose distribution. If the predicted dose is inaccurate, no more options can be selected. We proposed a novel dose prediction method named dose band prediction, which outcomes a spectrum of predicted dose distribution for planning and quality assurance (QA).

MATERIALS/METHODS

Upper-Band and Lower-Band losses were involved in 3D convolution neural networks to establish the Upper-Band Network (UBN) and Lower-Band Network (LBN). Each voxel's ideal dose spectrum (dose band) was defined by the maximum/minimum rational dose predicted by UBN/LBN. 130 NPC cases with Tomotherapy (dataset 1), 49 cervix cases with IMRT (dataset 2) and 43 cervix cases with VMAT (dataset 3) were enrolled to establish and evaluate our dose band prediction method.

RESULTS

The dose band prediction method can successfully predict a spectrum of doses. Upper-Band/Lower-Band presents maximum/minimum rational dose; Middle-Line presents the average of Upper-Band and Lower-Band. The clinical implement dose was used as the reference dose. We evaluated the maximum interval between the reference and Upper-Band/Middle-Line/Lower-Band doses, and the percentage dose difference was used as the evaluation method. The differences in PTV for Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 2.47%, 0.54%, and 2.8%; in dataset 2, they were within 0.37%, 1.15%, and 2.69%; in dataset 3, they were within 0.96%, 0.35%, and 1.66%. The mean difference of OARs for the Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 8.13%, 4.97%, and 8.19%; in dataset 2, they were within 8.8%, 4.48%, and 5.52%; in dataset 3, they were within 4.01%, 3.13%, and 5.79% (shown in Table 1).

CONCLUSION

Dose Band prediction achieved high-accuracy dose prediction by the Middle-Line. More importantly, the Upper-Band/Lower-Band provided a spectrum of possible rational doses. Our Dose Band prediction method is based on a specific loss function, so it can easily be applied in various network and patient cases. Dose Band prediction towards a more robust plan QA and planning assistance. Table 1. The maximum interval of doses (percentage dose difference, %).