MCC950 alleviates seizure severity and angiogenesis by inhibiting NLRP3/ IL-1β signaling pathway-mediated pyroptosis in mouse model of epilepsy

Epilepsy is one of the most common serious chronic brain disorders, affecting up to 70 million people worldwide. Vascular disruption, including blood-brain barrier impairment and pathological angiogenesis, exacerbates its occurrence. However, its underlying mechanisms remain elusive. MCC950 is a specific small-molecule inhibitor that selectively blocks NLRP3 inflammatory vesicle activation across the blood-brain barrier, limits downstream IL-1β maturation and release, and exerts therapeutic effects across multiple diseases. In the present study, an epilepsy model was established by intraperitoneal administration of Kainic acid to adult male C57BL/6J wild-type mice. The results revealed that the epilepsy susceptibility of MCC950-treated mice was decreased, and neural damage following seizure episodes was reduced. In addition, immunofluorescence staining, RT-qPCR, and Western blot demonstrated that MCC950 inhibited the expression of the NLRP3 inflammasome and its related proteins in microglia, whereas microangiogenesis was found to be increased in the cerebral cortex and hippocampus of epileptic mice, and these effects could be reversed by MCC950. Furthermore, neurobehavioral impairment was observed in the epileptic mouse model, and MCC950 similarly alleviated the aforementioned pathological process. To the best of our knowledge, this is the first study to establish that pathological microangiogenesis is associated with NLRP3/IL-1β signaling pathway activation in a Kainic acid-induced epilepsy mouse model and that MCC950 administration attenuates the above-mentioned pathological changes and exerts neuroprotective effects. Therefore, MCC950 is a promising therapeutic agent for the treatment of epilepsy.

Multi-metal contaminant mobilizations by natural colloids and nanoparticles in paddy soils during reduction and reoxidation

Naturally-occurring colloids and nanoparticles are crucial in transporting heavy metal contaminants in soil-water systems. However, information on particle-bound metals' size distribution and elemental composition in paddy soils under redox-fluctuation is scarce. Here, we investigated the mobilization of Cu, Cd, and Pb-containing nanoparticles and colloids in four contaminated soils with distinctive geochemical properties during reduction and subsequent re-oxidation. Using AF4-UV-ICP-MS and STEM-EDS, we observed that particle-bound metals were primarily associated with two sizes ranges: 0.3-40 kDa (F1) and 130 kDa-450 nm (F2), which mainly consisted of organic matter (OM), iron hydroxide and clay minerals. Cu and Pb were more likely bound to colloid than Cd. Colloidal Cu, Pb and Cd accounted for averages of 83.2%, 72.4% and 19.8% of their total concentration in solution (<0.45 µm) during soil reduction, and decreased during soil re-oxidation. This proportion was also positively correlated with aqueous pH and DOC but negatively correlated with Eh. Further quantitative analysis demonstrated that Cu/Cd positively correlated with OM at nanometric scale (F1). This study provides quantitative insights into the size, composition and abundance of polymetallic pollutant-carrying particles in paddy soils during redox fluctuation, and highlights the importance of nanometric interactions between OM and toxic cationic metals for their release.

Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients

OBJECTIVES

To assess the safety and efficacy of radiofrequency ablation (RFA) for capsular-located papillary thyroid microcarcinoma (PTMC) in a large cohort and to compare its outcomes with those of noncapsular-located PTMC.

METHODS

We retrospectively reviewed patients who underwent RFA for solitary capsular-located and noncapsular-located low-risk PTMC (n = 1095) from June 2014 to October 2020. To balance confounding variables between capsular and noncapsular groups, we employed the 1:1 propensity score matching approach. We evaluated and compared tumor changes, disease progression, and complications in both groups. Furthermore, we analyzed the association between capsular location and disease progression using multivariable Cox regression.

RESULTS

During a mean follow-up time of 29.86 ± 16.14 months and 29.73 ± 15.69 months, no substantial difference was observed between capsular and noncapsular groups in the latest volume (0.83 ± 3.66 mm3 vs. 0.85 ± 3.67 mm3, p = 0.44) and volume reduction ratio (99.29 ± 4.04% vs. 99.43 ± 3.03%, p = 0.43), and cumulative disappearance rate (87.87% vs. 86.07%, p = 0.31). In addition, no significant differences were observed in complication incidence (1.35% vs. 1.12%, p = 0.76) and progression-free survival (p = 0.53). Based on adjusted multivariate Cox proportional hazard analysis, the association between capsular location and disease progression was nonsignificant (all p > 0.05).

CONCLUSION

This study demonstrates that the short-term outcomes of RFA for capsular-located PTMCs are comparable to those of noncapsular-located PTMCs. These findings indicate that RFA may be a viable and effective alternative for eligible patients with solitary capsular-located PTMC.

CLINICAL RELEVANCE STATEMENT

Radiofrequency ablation may serve as a safe and effective alternative treatment method for eligible patients with capsular-located and noncapsular-located papillary thyroid microcarcinoma.

KEY POINTS

• The safety and efficacy of radiofrequency ablation for capsular-located and noncapsular-located papillary thyroid microcarcinomas were comparable. • Disease progression did not differ significantly between capsular-located and noncapsular-located papillary thyroid microcarcinomas. • The incidence of complications for capsular-located papillary thyroid microcarcinoma was low.

The influence of tide-brought nutrients on microbial carbon metabolic profiles of mangrove sediments

Mangrove ecosystems in the intertidal zone are continually affected by tidal inundation, but the impact of tidal-driven nutrient inputs upon bacterial communities and carbon metabolic features in mangrove surface sediments remains underexplored, and the differences in such impacts across backgrounds are not known. Here, two mangrove habitats with contrasting nutrient backgrounds in Shenzhen Bay and Daya Bay in Shenzhen City, China, respectively, were studied to investigate the effects of varying tidal nutrient inputs (especially dissolved inorganic nitrogen and PO43--P) on bacterial community composition and functioning in sediment via field sampling, 16S rDNA amplicon sequencing, and the quantitative potential of microbial element cycling. Results showed that tidal input increased Shenzhen Bay mangrove's eutrophication level whereas it maintained the Daya Bay mangrove's relatively oligotrophic status. Dissolved inorganic nitrogen and PO43--P levels in Shenzhen Bay were respectively 12.6-39.6 and 7.3-29.1 times higher than those in Daya Bay (p < 0.05). In terms of microbial features, Desulfobacteraceae was the dominant family in Shenzhen Bay, while the Anaerolineaceae family dominated in Daya Bay. Co-occurrence network analysis revealed more interconnected and complex microbial networks in Shenzhen Bay. The quantitative gene-chip analysis uncovered more carbon-related functional genes (including carbon degradation and fixation) enriched in Shenzhen Bay's sediment microbial communities than Daya Bay's. Partial least squares path modeling indicated that tidal behavior directly affected mangrove sediments' physicochemical characteristics, with cascading effects shaping microbial diversity and C-cycling function. Altogether, these findings demonstrate that how tides influence the microbial carbon cycle in mangrove sediments is co-correlated with the concentration of nutrient inputs and background status of sediment. This work offers an insightful lens for better understanding bacterial community structure and carbon metabolic features in mangrove sediments under their tidal influences. It provides a theoretical basis to better evaluate and protect mangroves in the context of global change.

Research on the effect of environmental regulation to the green water resource efficiency in China-based on the perspectives of high pressure and low suction

Environmental regulation with spatial spillover effect is an important way to accelerate the transformation and upgrading of modern water resources structure, and then achieve sustainable development of China's water resources. How does environmental regulation affect the GWRE to alleviate or solve China's water shortage? In this paper, the GWRE is measured based on panel data from 31 provinces in China from 2000-2020, and the impact of high pressure (low suction) and heterogeneity on GWRE by environmental regulations is explored. The results revealed that the high pressure of environmental regulation significantly promoted the improvement of GWRE, but the improvement effect of low suction power was not significant. Similar conclusions are drawn under the tests of population size-economic distance and population size-technology distance. The high pressure of market-type and autonomous-type environmental regulation has a significant effect on GWRE, while the improvement effect of command-type environmental regulation is weak. The high pressure of environmental regulation in the eastern, central, western, and northeastern regions has a decreasing effect on GWRE. It is recommended to break the principle of GDP performance appraisal, establish and improve the "green performance" evaluation system, adopt regional differentiated environmental regulation policies, and establish a modern green water resources industrial structure system.

Bionic Structural Coloration of Textiles Using the Synthetically Prepared Liquid Photonic Crystals

The structural coloration of textiles with bionic photonic crystals (PCs) is expected to become a critical approach to the ecological coloration of textiles. Rapid and large-area preparation of PC structurally colored textiles can be achieved via self-assembly of high mass fractions of liquid photonic crystals (LPCs). However, the rapid and large-scale manufacturing of LPCs remains a challenge. In this work, the pH regulator is added in the process of emulsion polymerization to solve the problem of phase transformation caused by the thermal decomposition of the initiator to produce H+ , directly achieving 40 wt.% PS nanospheres in the dispersion. Then oligomers and small-molecule salts are removed from the system via dialysis, and the pre-crystallized LPC system is efficiently prepared. Adjusting the particle size and the mass fraction of nanospheres is shown to be an efficient way to control the optical properties of LPCs. The rapid and large-area preparation of PC structural color fabric and the patterned PC structural color fabric with an iridescent effect is implemented by using LPCs as the assembly intermediate. By constructing the encapsulation layer on the surface of the PC structural color fabric, the consistency of high structural stability and high color saturation of the PC is realized.

Effects of Skeleton Structure of Mesoporous Silica Nanoadjuvants on Cancer Immunotherapy

Mesoporous silica nanoparticles (MSNs) have been widely praised as nanoadjuvants in vaccine/tumor immunotherapy thanks to their excellent biocompatibility, easy-to-modify surface, adjustable particle size, and remarkable immuno-enhancing activity. However, the application of MSNs is still greatly limited by some severe challenges including the unclear and complicated relationships of structure and immune effect. Herein, three commonly used MSNs with different skeletons including MSN with tetrasulfide bonds (TMSN), MSN containing ethoxy framework (EMSN), and pure -Si-O-Si- framework of MSN (MSN) are comprehensively compared to study the impact of chemical construction on immune effect. The results fully demonstrate that the three MSNs have great promise in improving cellular immunity for tumor immunotherapy. Moreover, the TMSN performs better than the other two MSNs in antigen loading, cellular uptake, reactive oxygen species (ROS) generation, lymph node targeting, immune activation, and therapeutic efficiency. The findings provide a new paradigm for revealing the structure-function relationship of mesoporous silica nanoadjuvants, paving the way for their future clinical application.

Long-Term Outcomes and Risk Factors of Radiofrequency Ablation for T1N0M0 Papillary Thyroid Carcinoma

Importance

Radiofrequency ablation (RFA) has gained increasing interest as a minimally invasive procedure to treat low-risk papillary thyroid carcinoma (PTC). Considering the indolent nature of this disease, studies in large populations with long follow-up would be invaluable to further substantiate the effectiveness of RFA.

Objective

To evaluate the long-term (58.5 months) outcomes of patients with T1N0M0 PTC who underwent RFA and investigate risk factors for local tumor progression (LTP).

Design, Setting, and Participants

This cohort study included 1613 patients aged 18 years or older with T1N0M0 PTC who underwent ultrasonography-guided RFA between January 2014 and December 2020 at the Chinese People's Liberation Army General Hospital in Beijing, China. Included in the analysis were patients with PTC (confirmed by biopsy) with a maximum diameter of 20 mm or less; no evidence of extrathyroidal extension (capsular disruption or involvement of perithyroidal tissue), lymph node metastasis, or distant metastasis on ultrasonography or computed tomography; and no evidence of an aggressive subtype of PTC on biopsy. Patients with PTC larger than 2 cm, less than 12 months of follow-up, or inadequate follow-up information were excluded. Data were analyzed in April 2023.

Main Outcomes and Measures

Long-term progression rate, disease-free survival, and complete tumor disappearance and their associations with patient and tumor characteristics. Disease-free survival was calculated using Kaplan-Meier analysis. Cox proportional hazards regression analyses were performed to assess risk factors for LTP and complete tumor disappearance.

Results

The study comprised 1613 patients (mean [SD] age, 43.3 [10.2] years; 1256 women [77.9%]) with 1834 T1N0M0 PTC tumors. During a mean follow-up of 58.5 months (range, 27 to 111 months), LTP was observed in 69 patients (4.3%), including 42 (2.6%) with tumor recurrence and 27 (1.7%) with tumor persistence. Cumulative disease-free survival rates at 1, 3, 5, and 8 years were 98.0%, 96.7%, 96.0%, and 95.7%, respectively. The overall complication rate was 2.0% (32 patients), with 6 (0.4%) major complications. Independent risk factors for LTP included subcapsular tumor location 2 mm or less from the capsule or trachea (hazard ratio [HR], 3.36; 95% CI, 2.02-5.59; P < .001) and multifocal tumors (HR, 2.27; 95% CI, 1.30-3.96; P = .004). Furthermore, 1376 patients (85.3%) showed complete tumor disappearance at follow-up ultrasonographic examination. Factors associated with complete tumor disappearance included age 40 years or less (HR, 0.78; 95% CI, 0.70-0.87; P < .001), stage T1a tumors (HR, 0.37; 95% CI, 0.31-0.45; P < .001), and unifocal tumors (HR, 0.50; 95% CI, 0.42-0.60; P < .001).

Conclusions and Relevance

In this cohort study, ultrasonography-guided RFA for T1N0M0 PTC had excellent long-term outcomes. Patients with unifocal T1N0M0 PTC and subcapsular tumor location more than 2 mm from the capsule or trachea may be the best candidates for RFA.

Machine learning-derived cycle length variability metrics predict spontaneously terminating ventricular tachycardia in implantable cardioverter defibrillator recipients

Aims

Implantable cardioverter defibrillator (ICD) therapies have been associated with increased mortality and should be minimized when safe to do so. We hypothesized that machine learning-derived ventricular tachycardia (VT) cycle length (CL) variability metrics could be used to discriminate between sustained and spontaneously terminating VT.

Methods and results

In this single-centre retrospective study, we analysed data from 69 VT episodes stored on ICDs from 27 patients (36 spontaneously terminating VT, 33 sustained VT). Several VT CL parameters including heart rate variability metrics were calculated. Additionally, a first order auto-regression model was fitted using the first 10 CLs. Using features derived from the first 10 CLs, a random forest classifier was used to predict VT termination. Sustained VT episodes had more stable CLs. Using data from the first 10 CLs only, there was greater CL variability in the spontaneously terminating episodes (mean of standard deviation of first 10 CLs: 20.1 ± 8.9 vs. 11.5 ± 7.8 ms, P < 0.0001). The auto-regression coefficient was significantly greater in spontaneously terminating episodes (mean auto-regression coefficient 0.39 ± 0.32 vs. 0.14 ± 0.39, P < 0.005). A random forest classifier with six features yielded an accuracy of 0.77 (95% confidence interval 0.67 to 0.87) for prediction of VT termination.

Conclusion

Ventricular tachycardia CL variability and instability are associated with spontaneously terminating VT and can be used to predict spontaneous VT termination. Given the harmful effects of unnecessary ICD shocks, this machine learning model could be incorporated into ICD algorithms to defer therapies for episodes of VT that are likely to self-terminate.

Sonographic Evolution and Pathologic Findings of Papillary Thyroid Cancer After Radiofrequency Ablation: A Five-Year Retrospective Cohort Study

Background: The criteria for determining technical efficacy of thermal ablation for papillary thyroid carcinoma (PTC) are not clearly defined. We analyzed the involution process of the ablation zone with clear pathologic results on core-needle biopsy (CNB) to clarify the relationship between sonographic changes and pathologic findings. Methods: This retrospective cohort study included 382 patients with unifocal T1N0M0 PTC who underwent radiofrequency ablation (RFA) between May 2014 and August 2021. Patients with a single ablation zone biopsy (recommended at 3 or 6 months for T1a and 6 or 12 months for T1b) and regular neck ultrasound (US)/contrast-enhanced ultrasound imaging follow-up at 1, 3, 6, and 12 months and every 6-12 months thereafter after RFA were included. Patients also underwent yearly chest computed tomography. CNB was performed in the target lesion ablation zone's central, peripheral, and surrounding thyroid parenchyma to detect the presence of tumor cells. If the thyrotropin (TSH) was >2 mU/L, levothyroxine was prescribed with the intention of keeping the TSH 0.5-2 mU/L. Technical efficacy was defined as tumor disappearance by imaging follow-up together with the pathologically confirmed absence of tumor cells in the ablation zone. Results: During the mean follow-up period of 67.8 ± 18.2 months (22-110 months), the overall incidence of persistent disease and the technical efficacy rate were 3.9% (15/382; 2.9% of T1a, and 12.2% of T1b) and 96.1%, respectively. Tumor size (p = 0.03) and subcapsular location (p = 0.04) were risk factors associated with persistent disease. The technical success rate was 100%. Of the 367 ablation zones with benign CNB results, 336 (91.6%) showed tumor disappearance on US and no re-emergence of imaging-visible tumors during follow-up. Male sex (p = 0.006), age <40 years (p = 0.003), T1a tumor (p < 0.01), and energy per milliliter (p < 0.03) were significantly associated with tumor disappearance. Conclusions: US-guided RFA is an effective treatment for small low-risk PTC. Tumor disappearance on US after RFA may suggest an excellent prognosis and confirm complete ablation of the macroscopic tumor, but this sonographic finding is generally late and requires histological confirmation.

[Efficacy and short-term outcomes of myocardial protection using single-dose histidine-tryptophan-ketoglutarate cardioplegia during aortic root surgery with different duration of myocardial ischemia]

Objective: To explore the efficacy of myocardial protection with single-dose histidine-tryptophan-ketoglutarate (HTK) cardioplegia during aortic root operation, and the correlation between short-term clinical outcomes and duration of myocardial ischemia. Methods: The data of clinical cases undergoing myocardial protection with single-dose HTK cardioplegia during aortic root operation from January 2018 to December 2022 were retrospectively reviewed. Patients were divided into conventional HTK cardioplegia group (<3 h) and prolonged HTK cardioplegia group (≥3 h) according to duration of intraoperative myocardial ischemia. A 1∶1 propensity score matching was performed and the correlations between duration of myocardial ischemia and postoperative short-term outcomes (30-day mortality, readmission, mechanical circulation support and renal insufficiency) were analyzed. Results: A total of 282 patients were included in the final analysis, with 210 cases in the conventional HTK cardioplegia group and 72 cases inthe prolonged HTK cardioplegia group before matching. After matching, there were 64 cases (53 males and 11 females) in the conventional HTK cardioplegia group, with a mean age of (49.4±14.2) years. The prolonged HTK cardioplegia group had 64 cases (55 males and 9 females), with a mean age of (50.5±12.3) years. Higher sensitivity troponin [12 h: 10.1 (4.6, 18.7) μg/Lvs 4.1(2.2, 8.6) μg/L, P=0.002; 24 h: 7.7 (4.5, 19.0) μg/L vs 4.8 (2.2, 11.9) μg/L, P=0.025] and creatine kinase isoenzyme[12 h: 46.3 (28.1, 62.4) μg/L vs 20.7(14.1, 32.9) μg/L, P<0.001; 24 h: 26.3(13.4, 49.2) μg/L vs 14.5 (10.1, 33.5)μg/L, P=0.011] after surgery was detected in prolonged HTK cardioplegia group. Comparisons of other primary and secondary endpoint events showed no significant differences between the two groups (all P>0.05). Multivariate binary logistic regression showed that duration of myocardial ischemia had no significant effect on postoperative 30-day mortality (OR=1.255, 95%CI: 0.500-3.148, P=0.629), 30-day readmission (OR=0.378, 95%CI: 0.069-2.065, P=0.261) and mechanical circulation support (OR=0.991, 95%CI: 0.331-2.970, P=0.998). Conclusion: During aortic root surgery, single-dose HTK cardioplegia may provide satisfactory myocardial protection, and there was no significant correlation between duration of myocardial ischemia and short-term clinical outcomes.

The diagnosis and treatment for primary cardiac angiosarcoma with N-ras gene mutation and MSI-L: A case report and review of the literature

RATIONALE

Primary cardiac angiosarcomas (PCA) is a rare malignancy with a poor prognosis. Currently, there is no standard treatment protocol for the PCA. We report a case of PCA in a 51-year-old woman.

PATIENT CONCERNS

A 51-year-old woman initially presented with unexplained palpitations and chest tightness accompanied by nausea and vomiting, which worsened after activity and improved after rest. After symptomatic treatment, the symptoms improved, and the above symptoms recurred 8 months later.

DIAGNOSES

Positron emission tomography-computed tomography revealed multiple lung nodules of varying sizes, some of which exhibited increased glucose metabolism. Furthermore, a soft tissue mass protruding into the pericardial cavity and involving the adjacent right atrium was observed in the right pericardium. The mass exhibited increased glucose metabolism, suggestive of a pericardial tumor with multiple lung metastases. Finally, histopathologic diagnosis of metastatic angiosarcoma was done by computed tomography-guided percutaneous lung and mediastinal biopsy.

INTERVENTIONS

The patient was treated with palliative chemotherapy for the primary cardiac angiosarcomas and hematogenous lung metastasis. One cycle later, the result of Next-Generation Sequencing showed that the microsatellite instability status was determined to be low-level. Based on this result, tislelizumab was added to the original chemotherapy regimen.

OUTCOMES

Unfortunately, the patient with PCA passed away after only 2 cycles of chemotherapy, and the cause of death remained unknown.

LESSONS

This case report well demonstrates typical imaging findings of a rare cardiac angiosarcomas and emphasizes importance of early investigation for accurate diagnosis and proper management of the cardiac angiosarcomas.

Integrated metagenomic and metaproteomic analyses reveal bacterial micro-ecological mechanisms in coral bleaching

IMPORTANCE

Coral reefs worldwide are facing rapid decline due to coral bleaching. However, knowledge of the physiological characteristics and molecular mechanisms of coral symbionts respond to stress is scarce. Here, metagenomic and metaproteomic approaches were utilized to shed light on the changes in the composition and functions of coral symbiotic bacteria during coral bleaching. The results demonstrated that coral bleaching significantly affected the composition of symbionts, with bacterial communities dominating in bleached corals. Through differential analyses of gene and protein expression, it becomes evident that symbionts experience functional disturbances in response to heat stress. These disturbances result in abnormal energy metabolism, which could potentially compromise the health and resilience of the symbionts. Furthermore, our findings highlighted the highly diverse microbial communities of coral symbionts, with beneficial bacteria providing critical services to corals in stress responses and pathogenic bacteria driving coral bleaching. This study provides comprehensive insights into the complex response mechanisms of coral symbionts under heat stress from the micro-ecological perspective and offers fundamental data for future monitoring of coral health.

[Establishment of a topographic map assessment system for facial and cervical wounds and scars of burn patients based on the Delphi method]

Objective: To construct a targeted and accurate evaluation system for facial and cervical wounds and scars of burn patients. Methods: The method combining literature analysis and survey research was adopted, and the basic principles of item system construction were followed. From June to August 2020, based on the aesthetic standards of facial and cervical plastic surgery, the topographic map assessment system for facial and cervical wounds and scars of burn patients was preliminarily formed, focusing on the assessment of wounds and scars in the necks and faces of patients after burns. In September 2020, 38 experts in the relevant fields were consulted in advance and the questionnaire was revised according to the experts' opinions. From December 2020 to March 2021, the Delphi method was applied to conduct inquiry by correspondence with 35 experts in relevant fields from Guangzhou, Shenzhen, Shanghai, Beijing, and other cities, who met the inclusion criteria, and the items were screened and established. The effective recovery rate of inquiry questionnaire was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all items was calculated to determine the level of expert authority, the average importance expert score, the average coefficient of variation, and the average full score rate of all the third-level items were calculated to determine the concentration of expert opinions, the average coefficients of variation and Kendall's harmony coefficients of the importance, sensitivity, and operability expert scores of all the third-level items were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically analyzed with chi-square test. Results: Among the 35 experts consulted by Delphi method, mainly were male, aged (48±10) years, with 8-38 years of working experience, mainly with associate senior titles and above, all with a bachelor's degree or above education background, and of whom 11 were burn experts, 7 were wound repair experts, 4 were plastic surgery experts, and 13 were rehabilitation medicine experts. Finally, a topographic map assessment system for facial and cervical wounds and scars of burn patients was formed, including 4 first-level items, 21 second-level items, 40 third-level items, and 1 mask. The effective recovery rate of inquiry questionnaire was 100% (35/35). The average authority coefficient of all items was 0.89. The average importance expert score was 4.67, the average coefficient of variation of importance expert score was 0.01, and the average full score rate of all the third-level items was 86.3%. The average coefficients of variation of the importance, sensitivity, and operability expert scores of all the third-level items were 0.01, 0.01, and 0.02, respectively. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically significant (with χ2 values of 1 201.53, 745.67, and 707.07, respectively, P<0.05). Conclusions: The established topographic map assessment system for facial and cervical wounds and scars of burn patients has high scientificity and reliability, which can be used for the evaluation of facial and neck wounds or scars in burn patients.

[Hsp90 participates in the necroptosis of mouse neural cells induced by aluminum through the RIP1/RIP3/MLKL pathway]

Objective: To investigate whether heat shock protein 90 (HSP90) participates in the necroptosis of C57BL/6 mouse neurons and spatial memory impairment induced by Aluminum maltol [Al (mal) (3)] through RIP1/RIP3/MLKL pathway. Methods: In March 2022, Thirty-two C57 mice were randomly divided into control group, Low dose group, a medium dose group, and a high-dose group, with 8 mice in each group, and injected intraperitoneally with physiological saline, 20, 40, and 80, respectivelyμmol/kgAl (mal) (3) was administered, it was injected 5 days a week and discontinued 2 days for 60 days. Morris water maze test was used to test the spatial learning and memory ability of mice. Nissl staining was used to observe the pathological changes of brain tissue. The protein expression levels of RIP1, RIP3, MLKL and HSP90 in hippocampus were determined by Western blotting. Results: In the water maze experiment, compared with the control group, the number of mice crossing the platform decreased in each dose group, the difference was statistically significant (H=9.50, P=0.023), and the number of mice crossing the platform was statistically significant among each dose group (P <0.05). Compared with the control group, the number of hippocampal nerve cells in each dose group decreased, the arrangement was disordered, and the Nissellite bodies decreased. Western blotting results showed that compared with the control group, the expression level of RIP1 protein in the hippocampus of mice in high-dose group was higher, and the difference was statistically significant (P <0.05). The expression levels of RIP3, MLKL and HSP90 in hippocampal tissue of mice in medium and high dose groups were increased, and the differences were statistically significant (P<0.05). After siRNA intervention decreased the expression of HSP90 protein, the expressions of HSP90, RIP1, RIP3 and MLKL in Al (mal) (3) groups were increased, and the differences were statistically significant (P<0.05) . Conclusion: Through RIP1/RIP3/MLKL pathway, HSP90 is involved in neuronal programmed necrosis and spatial memory impairment induced by maltol aluminum in C57 mice.

[Attitude toward sexual health education and its correlates among community-based older adults in Shanghai]

Objective: To understand the attitudes toward sexual health education and its correlates among community-based older adults in Shanghai, China. Methods: From June 2020 to December 2022, a cross-sectional survey was conducted among community residents aged ≥50 in Shanghai through multi-stage sampling. The estimated sample size was 735. The questionnaire included sociodemographic characteristics, health characteristics, and history of sexual health education. The multivariable logistic regression model was used to assess the correlates of attitudes toward sexual health education among community-based older adults. Results: A total of 824 participants (489 males and 335 females) with age of (65.1±8.1) years were included, whose main age distribution was 60-69 years (45.3%). The prevalence of supporting sexual health education among older adults was 49.4% (45.2% of men and 55.5% of women). Males (aOR=0.61, 95%CI: 0.44-0.83), aged 70 years and older (aOR=0.62, 95%CI: 0.40-0.94), urban residents (aOR= 2.54, 95%CI: 1.81-3.58), self-reported very good or excellent health status (aOR=1.64,95%CI: 1.04-2.58), having depressive symptoms (aOR=0.37,95%CI: 0.15-0.85), and having a history of sexual health education (aOR=8.64,95%CI: 4.62-17.70) were associated with their attitude toward sexual health education. Conclusions: The proportion of community-based older adults in Shanghai who support sexual health education was not high. Their attitudes toward sexual health education were associated with their self-reported health status, depressive symptoms, and history of sex education. Health professionals and institutions should focus on community-based older adults with key characteristics and tailor interventions to promote the willingness to receive sexual health education among older adults in China and to promote the popularity of sexual health education in this population.

[Sexually active status and its correlates among community-based older adults in Tianjin]

Objective: To understand the sexually active status among community-based older adults aged ≥50 years in Tianjin, China, and to explore the potential correlates. Methods: A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 was conducted between June 2020 and December 2022. The estimated sample size was 735. The survey collected questionnaire information through face-to-face interviews with investigators, including sociodemographic, health, and sexual lifestyle characteristics. The multivariable logistic regression model was used to assess correlates of sexually active status. Results: A total of 776 study participants (510 males and 266 females) were included, whose major age distribution was 50-59 years (45.9%). The overall sexual activity prevalence of the participants was 45.6%. Older age (60-69: aOR=0.67, 95%CI: 0.45-0.99; ≥70: aOR=0.12, 95%CI: 0.07-0.21), being male (aOR=1.93, 95%CI: 1.32-2.82), living in urban area (aOR=0.18, 95%CI: 0.12-0.28), living with spouse/married (aOR=2.80, 95%CI: 1.41-5.58), living alone (aOR=0.51, 95%CI: 0.27-0.96), having difficulty climbing stairs or walking (aOR=0.55, 95%CI: 0.31-0.97), having chronic diseases (one chronic disease: aOR=0.55, 95%CI: 0.36-0.85; two or more chronic diseases: aOR=0.53, 95%CI: 0.33-0.84) were associated with sexually active status among older adults. Conclusions: Many community-based older adults remained sexually active. There was an association between physical health and sexually active status among community-based older adults. Incorporating sexual health services into healthcare services for community-based older adults could be advocated, with a concurrent emphasis on enhancing the awareness and competence of providing sexual health services among community-based healthcare workers.

[Utilization of sexual and reproductive health services and its correlates among community- based older adults in Chongqing]

Objective: To investigate the utilization of sexual health services among community-based older adults in Chongqing and explore its potential correlates. Methods: A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 years was conducted in Chongqing between June 2020 and December 2022. A questionnaire including information on demographic characteristics, general health, sexual health status, and sexual health services utilization was collected. Sexual health and reproductive services utilization was defined as having ever been tested for human immunodeficiency virus (HIV), or having had a male/gynecological reproductive health examination in the past year. Logistic regression was used to examine the correlates of the utilization of sexual health services. Results: A total of 794 community-based older adults participated in the study (482 were male, and 312 were female). The mean age was (62.8±8.2) years. The proportion of HIV testing was 18.0%, and the proportion of reproductive health examination was 10.1% among community-based older adults. The results of multivariate logistic regression analysis showed that the age group of 60-69 years (aOR=0.37, 95%CI: 0.18-0.76), female (aOR=11.34, 95%CI: 5.71-22.52), monthly income ≥5 000 yuan (aOR=3.05, 95%CI: 1.01-9.27), being sexual activity (aOR=4.99, 95%CI: 2.23-11.15) was significantly associated with had a reproductive health examination in the past year. Conclusions: The proportion of sexual health services utilization among older adults was low. Older sexual health education should be further strengthened, the close relationship between older adults should be correctly guided and dealt with, and the sexual health services suitable for the older population should be formulated.

[Condom use and its correlates among community-based older adults in Chongqing]

Objective: To understand the current status of condom use and its correlates among community-based older adults in Chongqing, China. Methods: Cross-sectional study based on a multistage sampling method was conducted in Chongqing from June 2020 to December 2022. The estimated sample size was 735. Through face-to-face interviews, the investigators collected the sociodemographic characteristics, sexual behavior characteristics, awareness of AIDS prevention knowledge, etc. A multivariable logistic regression model was used to explore the correlates of condom use during the last sexual behavior among the participants. Results: A total of 761 participants were included in this study, with 476 males and 285 females, whose average age was (63.8±8.2) years old, mainly in the age group of 60-69 years (44.5%). Among the participants, the rate of condom use during the last sexual behavior was 9.7%. The multivariable logistic regression analysis indicated that correlates of condom use during the last sexual behavior included urban household registration (aOR=2.34, 95%CI: 1.12-4.89), monthly income of 1 000-4 999 Yuan, and 5 000 Yuan and above (aOR=4.49, 95%CI: 1.31-15.41; aOR=16.33, 95%CI: 4.30-62.00), self-assessed sexual behavior risk as very risky/relatively risky (aOR=3.97, 95%CI: 1.40-11.31), awareness of AIDS prevention knowledge (aOR=0.36, 95%CI: 0.21-0.62). Conclusions: The rate of condom use among community-based older adults in Chongqing is low. Comprehensive intervention measures should be taken in combination with the characteristics and needs of community-based older adults to improve awareness of AIDS prevention knowledge and perception of AIDS risk and promote condom use among this population.

Traumatic Aortic Dissection as a Unique Clinical Entity: A Single-Center Retrospective Study

BACKGROUND

This study aimed to compare the clinical characteristics, treatment approaches, and outcomes of the Stanford Type B traumatic aortic dissection (TAD) with non-traumatic aortic dissection (NTAD), and assess better management for TAD.

METHODS

We retrospectively analyzed patients who underwent thoracic endovascular aortic repair for Stanford type B aortic dissection at The First Hospital of China Medical University between 2014 and 2022. The patients were divided into TAD and NTAD groups based on whether they had a history of acute trauma. This study ultimately included 65 patients with TAD and 288 with NTAD. We assessed and compared the baseline characteristics, laboratory indicators, imaging features, surgical procedures, and follow-up results between the groups.

RESULTS

The TAD group was younger compared to the NTAD group (50.00 [IQR40.00-59.00] vs. 55.00 [IQR 47.00-61.00] years, p = 0.020). A lower percentage of the TAD group had a history of hypertension (20% vs. 71.18%, p < 0.001). The length of aortic dissection was shorter in the TAD group compared to the NTAD group (30.00 [IQR 22.00-40.00] vs. 344.00 [IQR 237.25-400.00] mm, p < 0.001). All patients with TAD underwent TEVAR following the same strategy as NTAD. The mean preoperative duration was 7.00 (IQR 2.00-14.00) days in the TAD group and 11.00 (IQR 8.00-15.00) days in the NTAD group (p < 0.001). TAD showed fewer complications after TEVAR in mid-to-long-term follow-up.

CONCLUSIONS

TAD is distinct from NTAD. TAD typically presents with more localized lesions than NTAD, and the patients experience a shorter preoperative duration and a better mid-to-long-term outcome.

[Periodic dynamic observation and analysis of cellular and humoral immunity indexes of adults infected with Omicron BA.1]

Objective: To analyze the immunological characteristics and antibody changes of patients infected with the Omicron BA.1 and evaluate the possibility of secondary infection. Methods: A total of 104 patients infected with Omicron BA.1 in the Jinnan District of Tianjin from January 8 to February 2, 2022, were included in the study. The control group and case group were matched 1∶1 based on age, sex and vaccination status. Serum was collected from the case group and control group at 3, 6 and 9 months after infection. The serum levels of interleukin4 (IL-4), IL-5 and interferon-gamma (IFN-γ), as well as the positive rates of IgG, IgG1 and IgG2, were detected by ELISA. Results: The highest concentration of IFN-γ in the case group at 6 months after infection was 145.4 pg/ml, followed by a decrease in concentration. The concentrations of IL-4 and IL-5 began to decrease at 6 months after infection (all P<0.001). There was no significant difference in the IgG2 positive rate between the case group and the control group at 6 months after BA.1 infection. However, at 9 months, there was a significant decrease compared to the control group (P=0.003). The ratio of IFN-γ/IL4 at 3 months after infection in the case group was lower than that in the control group (P<0.001). There was no significant difference in the ratio between the case group and the control group at 9 months after infection. Conclusion: The cellular immune function has been impaired at 3 months after infection with BA.1, and the specific cellular immune and humoral immune functions decrease significantly after 6 months, and the risk of secondary infection increases.

[Emerging and comparative genomic analysis of a novel plasmid carrying blaKPC-2 in Citrobacter freundii]

Objective: To explore the drug resistance mechanism and gene structure characteristics of a carbapenemase-producing novel incompatibility group plasmid pNY2385-KPC from Citrobacter freundii. Methods: A multi-drug resistant strain was obtained from urine samples of patients with fever in the emergency ward of Li Huili Hospital, Ningbo Medical Center. Bacterial species was preliminary identified and finally confirmed by 16S rRNA gene amplification and the average nucleotide identity alignment, respectively. The minimum inhibitory concentrations of the antimicrobial agents were determined by VITEK 2 Compact System. The complete genome sequence was obtained by "third-generation" sequencing methods, and then detailed annotation of gene function and comparative genomic analysis of plasmid structure were carried out by BLASTP/BLASTN, RefSeq, ConservedDomains, ResFinder, Isfinder, etc. Results: The pNY2385-KPC carried by citrobacter freundii NY2385 belonged a novel incompatibility group, and contained blaKPC-2 and conjugative transfer (type Ⅳ secretory system, T4SS) genes, which could induce conjugative transfer. A total of 15 plasmids of the same type as pNY2385-KPC were retrieved by NCBI, which were from Citrobacter freundii, and the rest were from Serratia marcescens, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Raoultella planticola and other bacteria, and were broad-host-range plasmids. The sequence comparative analysis of all 6 of the novel plasmid from Citrobacter freundii showed that the structure of the novel plasmid had certain conserved property, with Tn6296 variant structure carrying blaKPC-2, and plasmid pCF1807-3 had both repApNY2385-KPC and repAIncX8. Conclusion: The pNY2385-KPC type plasmids in Citrobacter freundii carried blaKPC-2 resistance gene, which were divided into two subtypes: repApNY2385-KPC single replicator and repApNY2385-KPC/repAIncX8 complex replicator, belonging to broad-host-range plasmids. And as a mobile genetic element, the plasmids promote the spread of blaKPC-2.

Bio-friendly long-term subcellular dynamic recording by self-supervised image enhancement microscopy

Fluorescence microscopy has become an indispensable tool for revealing the dynamic regulation of cells and organelles. However, stochastic noise inherently restricts optical interrogation quality and exacerbates observation fidelity when balancing the joint demands of high frame rate, long-term recording and low phototoxicity. Here we propose DeepSeMi, a self-supervised-learning-based denoising framework capable of increasing signal-to-noise ratio by over 12 dB across various conditions. With the introduction of newly designed eccentric blind-spot convolution filters, DeepSeMi effectively denoises images with no loss of spatiotemporal resolution. In combination with confocal microscopy, DeepSeMi allows for recording organelle interactions in four colors at high frame rates across tens of thousands of frames, monitoring migrasomes and retractosomes over a half day, and imaging ultra-phototoxicity-sensitive Dictyostelium cells over thousands of frames. Through comprehensive validations across various samples and instruments, we prove DeepSeMi to be a versatile and biocompatible tool for breaking the shot-noise limit.

Spatial redundancy transformer for self-supervised fluorescence image denoising

Fluorescence imaging with high signal-to-noise ratios has become the foundation of accurate visualization and analysis of biological phenomena. However, the inevitable noise poses a formidable challenge to imaging sensitivity. Here we provide the spatial redundancy denoising transformer (SRDTrans) to remove noise from fluorescence images in a self-supervised manner. First, a sampling strategy based on spatial redundancy is proposed to extract adjacent orthogonal training pairs, which eliminates the dependence on high imaging speed. Second, we designed a lightweight spatiotemporal transformer architecture to capture long-range dependencies and high-resolution features at low computational cost. SRDTrans can restore high-frequency information without producing oversmoothed structures and distorted fluorescence traces. Finally, we demonstrate the state-of-the-art denoising performance of SRDTrans on single-molecule localization microscopy and two-photon volumetric calcium imaging. SRDTrans does not contain any assumptions about the imaging process and the sample, thus can be easily extended to various imaging modalities and biological applications.

The development and application of a novel reagent for fixing red blood cells with glutaraldehyde and paraformaldehyde

OBJECTIVE

The currently employed red blood cell reagents have a short shelf life. Some hospitals with a small number of specimens will be unable to utilize them within the validity period, resulting in a substantial increase in the purchase price. Therefore, the method of developing long-term red blood cell reagents is a problem worthy of further study.

METHODS

In this experiment, the type and concentration of the red blood cell reagent treatment solution were evaluated based on the red blood cell antigen concentration 24 h after treatment. In addition, the qualified glutaraldehyde/paraformaldehyde reagent was stored for six months, and five red blood cell indices were measured every month. At the same time, the detection indices of treated red blood cell reagents and untreated red blood cell reagents were compared.

RESULTS

It was discovered that treated red blood cells containing 0.005% GA and 0.05% PFA were more suitable for the preservation of red blood cells than other treated concentrations, and the preservation time could reach six months. The test tube method (n = 24) and microcolumn gel card (n = 35) were used to determine the accuracy of the treated blood cells containing 0.005% glutaraldehyde +0.05% paraformaldehyde, with an accuracy of 100%.

CONCLUSION

This experiment resulted in the development of a novel reagent for treating red blood cells with glutaraldehyde/paraformaldehyde fixed solution that can effectively prolong its storage time by two to three times that of red blood cell reagents currently on the market.

Cryptanshinone extract of Salvia miltiorrhiza stimulates pediatric acute myeloid leukemia stem cell apoptosis and the anti-inflammatory mechanism via accelerating microRNA-211-5p to supress Janus kinase 2/signal transducer and activator of transcription 3 signaling pathway activation

This study was designed to explore cryptanshinone (CPT) extract of Salvia miltiorrhiza stimulating pediatric acute myeloid leukemia (AML) stem cell (LSC) apoptosis and anti-inflammatory mechanism via accelerating microRNA (miR)-211-5p to restrain Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway activation. Obtaining blood samples from pediatric acute myeloid leukemia patients and healthy volunteers and detecting miR-211-5p and JAK2 were performed. Purchase of the human AML cell line KG1a was conducted, and sorting of KG1a cells was to gain LSC. Test of miR-211-5p and JAK2, the phosphorylation of JAK2/STAT3 was implemented. Pretreatment of LSCs was with CPT. Variation of miR-211-5p and JAK2 in LSCs was via plasmid transfection to explore their actions in cell advancement with apoptosis and inflammation. Identification of the targeting of miR-211-5p with JAK2 was implemented. In results: MiR-211-5p was declined in endometrial cancer, while JAK2 was elevated; CPT was available to boost LSC apoptosis and restrain the inflammation; elevated miR-211-5p or repressive JAK2 was available to strengthen the acceleration of CPT on LSCs apoptosis and the repression of inflammation; MiR-211-5p targeted JAK2; augmented JAK2 was available to turn around the action of elevated miR-211-5p. We conclude that CPT extract of Salvia miltiorrhiza stimulated pediatric LSC apoptosis and restrained the inflammation via accelerating microRNA (miR)-211-5p to suppress JAK2/STAT3 pathway activation.

Theory and modeling of light-matter interactions in chemistry: current and future

Light-matter interaction not only plays an instrumental role in characterizing materials' properties via various spectroscopic techniques but also provides a general strategy to manipulate material properties via the design of novel nanostructures. This perspective summarizes recent theoretical advances in modeling light-matter interactions in chemistry, mainly focusing on plasmon and polariton chemistry. The former utilizes the highly localized photon, plasmonic hot electrons, and local heat to drive chemical reactions. In contrast, polariton chemistry modifies the potential energy curvatures of bare electronic systems, and hence their chemistry, via forming light-matter hybrid states, so-called polaritons. The perspective starts with the basic background of light-matter interactions, molecular quantum electrodynamics theory, and the challenges of modeling light-matter interactions in chemistry. Then, the recent advances in modeling plasmon and polariton chemistry are described, and future directions toward multiscale simulations of light-matter interaction-mediated chemistry are discussed.

[Clinical study of modified Shirodkar transvaginal cervical cerclage during pregnancy in the treatment of cervical insufficiency]

Objective: To investigate the clinical efficacy of modified Shirodkar transvaginal cervical cerclage (TVCC) in the treatment of cervical insufficiency (CI) and its impact on maternal and fetal outcomes. Methods: The clinical data of 218 pregnant women with CI admitted to Fu Xing Hospital, Capital Medical University from January 1, 2015 to August 31, 2021 was retrospectively analyzed. According to different surgical approaches, they were divided into modified Shirodkar TVCC treatment during pregnancy (TVCC group, 108 cases) and non-pregnant women underwent laparoscopic cervical cerclage (LACC) treatment (LACC group, 110 cases). The clinical data and pregnancy outcomes of the two groups were compared. Furthermore, the two groups of pregnant women were stratified according to cervical length (CL) to explore the effects of the two surgical methods on the pregnancy outcomes of CI women with different CL. Results: (1) Related indicators before and during cerclage: there were no complications such as massive hemorrhage, bladder injury and anesthesia accident in the two groups of pregnant women during cerclage. Compared with the LACC group, TVCC group had longer preoperative CL [(2.3±0.6) vs (2.7±0.6) cm], more intraoperative blood loss [(7.5±0.5) vs (14.4±1.4) ml] and longer hospital stay [(6.0±0.1) vs (7.3±0.4) day]. However, the operation time was shorter [(42.9±1.6) vs (25.9±1.4) minute] and the hospitalization cost was less [(9 912±120) vs (5 598±140) yuan], and the differences were statistically significant (all P<0.05). (2) Pregnancy outcomes: live birth rates were 95.4% (103/108) in the TVCC group and 96.4% (106/110) in the LACC group, showing no significant difference between the two groups (χ2=2.211, P=0.232). The preterm birth rate (12.0%, 13/108) in the TVCC group was higher than that in the LACC group (7.3%, 8/110), the neonatal birth weight was lower than that in the LACC group [(3 006±96) vs (3 225±42) g], and the proportion of low birth weight infants was higher than that in the LACC group [15.5% (16/103) vs 1.9% (2/106)], and the differences were statistically significant (all P<0.05). (3) Stratified analysis of CL: for pregnant women with CL<2.0 cm, the miscarriage rate of the TVCC group was higher than that of the LACC group (2/9 vs 3.0%), and the live birth rate was lower than that of the LACC group (7/9 vs 97.0%), and the differences were statistically significant (all P<0.05). For CL 2.0-<2.5 cm, 2.5-<3.0 cm, CL≥3.0 cm, there were no statistically significant differences in preterm birth rate and live birth rate between the two groups (all P>0.05). Conclusions: Modified Shirodkar TVCC is simple and easy to operate, which significantly reduces the cesarean section rate and medical cost compared with LACC, and there is no significant difference in the live birth rate. When there is inevitable late abortion, laparoscopic cerclage removal does not need to be performed again, which could reduce the second operation and is worthy of clinical application.

[Establishment of a nomogram prediction model using common preoperative indicators for early weight loss after laparoscopic sleeve gastrectomy]

Objectives: To construct a nomogram prediction model using common preoperative indicators for early weight loss (EWL) 1 year after laparoscopic sleeve gastrectomy (LSG). Methods: Relevant data of obese patients who had undergone LSG from January 2015 to May 2022 in Fujian Medical University Union Hospital and Quanzhou First Hospital Affiliated Fujian Medical University were analyzed. Patients with a history of major abdominal surgery, severe gastroesophageal reflux disease, pregnancy within 1 year after surgery, or who were lost to follow-up were excluded, resulting in a total of 200 patients in the study (190 from Fujian Medical University Union Hospital and 10 from Quanzhou First Hospital Affiliated Fujian Medical University). The participants were 51 men and 149 women of a mean age 29.9±8.2 years and a body mass index (BMI) 38.7±6.5 kg/m2. All patients in this group underwent standardized LSG procedure. Achieving ideal weight (BMI≤25 kg/m2) 1 year after LSG was defined as goal of EWL. Logistic regression analyses were performed to identify factors that independently influenced EWL. These factors were incorporated into the nomogram model. Receiver operating characteristic (ROC) curves (the larger the area under the curve [AUC], the better the predictive ability and accuracy of the model), likelihood ratio test (higher likelihood ratio indicates greater model homogeneity), decision curve analysis (higher net benefit indicates a better model), Akaike information criterion (AIC; smaller AIC indicates a better model), and Bayesian information criterion (BIC; smaller BIC indicates a better model) were used to validate the predictive ability of the column line diagram model. Results: In this study of 200 obese patients who underwent LSG surgery, 136 achieved EWL goal, whereas the remaining 64 did not. The rate of EWL goal achievement of the entire group was 68.0%. Compared with patients who did not achieve EWL goal, those who did had lower BMI, alanine transaminase, aspartate transaminase, triglycerides, and higher cholesterol. Additionally, the proportion of female was higher and the proportions of patients with fatty liver and hypertension lower in those who achieved EWL goal (all P<0.05). Univariate and multivariate logistic regression analysis revealed that preoperative BMI (OR=0.852, 95%CI: 0.796-0.912, P<0.001), alanine transaminase (OR=0.992, 95%CI: 0.985-0.999, P=0.024), presence of fatty liver (OR=0.185, 95%CI: 0.038-0.887, P=0.035) and hypertension (OR=0.374, 95%CI: 0.144-0.969, P=0.043) were independently associated with failure to achieve EWL goal. Cholesterol (OR=1.428, 95%CI: 1.052-1.939, P=0.022) was independently associated with achieving EWL goal. We used the above variables to establish an EWL nomogram model. ROC analysis, the likelihood ratio test, decision curve analysis, and AIC all revealed that the predictive value of the model was better than that of BMI alone (nomogram model vs. BMI: area under the curve 0.840 vs. 0.798, P=0.047; likelihood ratio: 58.785 vs. 36.565, AIC: 193.066 vs. 207.063, BIC: 212.856 vs. 213.660). Conclusion: Our predictive model is more accurate in predicting EWL after LSG compared with using BMI.

[Clinical phenotype and genetic analysis of patients with left ventricular noncompaction caused by the biallelic mutation of MYBPC3 and MYH7]

Objective: To explore the relationship between pathogenic gene, mutation and phenotype of left ventricular noncompaction (LVNC) patients and their family members. Methods: The subjects were the proband with LVNC and her family members. The medical history including electrocardiogram, echocardiography and cardiac magnetic resonance examination of the proband and family members were collected. Whole exome sequencing of the proband was performed, bioinformatics analysis focused on the genes related to hereditary cardiomyopathy. Candidate pathogenic sites were validated by Sanger sequencing. The clinical interpretation of sequence variants were classified according to American College of Medical Genetics and Genomics (ACMG) guidelines. Results: The proband carried a heterozygous variation of the MYBPC3 gene c.C2827T and the MYH7 gene c.G2221C. The proband's sister carried heterozygous variation of MYBPC3 gene c.C2827T. According to the ACMG guidelines, the variant was determined to be pathogenic. Conclusion: The missense variant of MYBPC3 gene c.C2827T and MYH7 gene c.G2221C are identified from the proband with LVNC and her family member, which provides a genetic basis for clinical diagnosis and genetic counseling of the patients and the family members with LVNC.

High-Quality Ultrathin Gd2O2S Nanosheets with Oxygen Vacancy-Decorated rGO for Enhanced Electromagnetic Wave Absorption

The development of extreme performance and multifunctional electromagnetic (EM) wave absorption materials is essential to eliminating undesirable frequency EM pollution. As a promising rare-earth compound, gadolinium oxysulfide (Gd2O2S) has become a significant field of study among nanomaterials with multidisciplinary applications. Herein, the ultrathin Gd2O2S nanosheets with 1 nm thickness were fabricated via a facile hot injection method and then mixed with reduced graphene oxide (rGO) through coassemble and carbonization methods to form Gd2O2S/rGO composites. As a new kind of multifunction EM-wave absorption materials, Gd2O2S/rGO composites exhibited excellent EM-wave absorption performance with an absorption capacity of -65 dB (2.1 mm) and an adequate absorption bandwidth of 5.6 GHz at 1.9 mm. Additionally, their EM-wave absorption mechanisms have been unveiled for the first time. The outstanding EM-wave absorption performance of Gd2O2S/rGO composites could be attributed to the ultrathin Gd2O2S nanosheets with oxygen vacancy and rGO layers with high conductivity and large specific surface area, which will also facilitate the polarization loss, conductivity loss, and multiple reflection and scattering of EM waves between the rGO layer and Gd2O2S nanosheets. Overall, compared to previously reported rGO-based EM-wave absorption materials, this work provides a promising approach for the exploitation and synthesis of Gd2O2S/rGO composites with lightweight and high-performance microwave attenuation.

Five-year Outcome Between Radiofrequency Ablation vs Surgery for Unilateral Multifocal Papillary Thyroid Microcarcinoma

CONTEXT

Ultrasound (US)-guided radiofrequency ablation (RFA) has been considered as an alternative to surgery or active surveillance for papillary thyroid microcarcinoma (PTMC). However, little is known about the long-term outcomes of RFA in comparison with surgery for unilateral multifocal PTMC.

OBJECTIVE

This work aims to report the comparison between RFA vs surgery for unilateral multifocal PTMC over a more than 5-year follow-up period.

METHODS

This was a retrospective study at a primary care center with a median follow-up period of 72.9 months. A total of 97 patients with unilateral multifocal PTMC were treated with RFA (RFA group, n = 44) or surgery (surgery group, n = 53). In the RFA group, patients were treated by a bipolar RFA generator and an 18-gauge bipolar RF electrode with a 0.9-cm active tip. In the surgery group, patients underwent thyroid lobectomy with prophylactic central neck dissection.

RESULTS

During the follow-up, no statistically significant differences were found in disease progression (4.5% vs 3.8%; P = ≥.999), lymph node metastasis (2.3% vs 3.8%; P = ≥.999), persistent lesion (2.3% vs 0%; P = .272), and RFS rates (97.7% vs 96.2%; P = .673) in the RFA and surgery groups. Patients undergoing RFA had a shorter hospitalization (0 vs 8.0 [3.0] d; P < .001), shorter procedure time (3.5 [2.4] vs 80.0 [35.0] min; P < .001), lower estimated blood loss (0 vs 20.0 [15.0] mL; P < .001), and lower costs ($1768.3 [0.1] vs $2084.4 [1173.8]; P = .001) than those in the surgery group. The complication rate in the surgery group was 7.5%, whereas none of the RFA-treated patients experienced any complications (P = .111).

CONCLUSION

This study revealed 6-year comparable outcomes between RFA and surgery for unilateral multifocal PTMC. RFA may be a safe and effective alternative to surgery in selected patients with unilateral multifocal PTMC.

Aquatic environment impacts of floating photovoltaic and implications for climate change challenges

With the aggravation of global warming and the increasing demand for energy, the development of renewable energy is imminent. Floating photovoltaic (FPV) is a new form of renewable energy generation. However, the impact of FPV on the aquatic environment is still unclear. By long-term empirical monitoring and data analysis, this paper reveals the shading effect of large-scale FPV power station on aquatic environment for the first time. The results show that: (1) Compared with the non-photovoltaic (NP) zone, FPV only significantly reduces the concentration of dissolved oxygen in the photovoltaic (P) zone. (2) The concentration of chlorophyll a, nitrate nitrogen and total phosphorus increase, while pH and ammonia nitrogen decrease. FPV only causes an effect of the same order of magnitude as the initial concentration, and has no significant adverse effects on the nutritional status of the water body at a coverage ratio less than 50%. (3) FPV has a cooling effect on the water body during the daytime and a thermal insulation effect at night, with the most pronounced impact on peak water temperature (Tw). The heating and cooling process of Tw in P zone usually lags behind the NP zone by 1-3 h. The diurnal fluctuation and vertical difference of Tw as well as the stability of water body are reduced under the shading of FPV, alleviating the influence of climate change on Tw and water body stratification. (4) If 10% of the water area larger than 1 km2 in China are used to develop FPV, more than 900 million tons of CO2 emissions can be reduced, and about 5 billion m3 water can be saved, which is significant in the context of climate change. In general, this paper provides a reference for the future aquatic environmental impact assessment of FPV and the formulation of related policies.

[Clinical characteristics analysis of patients with severe immune checkpoint inhibitors related myocarditis]

Objective: To analyze the clinical characteristics of patients with severe immune checkpoint inhibitors (ICIs) related myocarditis. Methods: A retrospective study was conducted on the 50 patients with ICIs-related myocarditis in the multidisciplinary cardio-oncology clinic of Zhongshan Hospital affiliated to Fudan University from April 2020 to April 2022. The age of patients was (63.7±10.8) years old, including 37 males and 13 females. The patients were divided into the mild group (n=37) and the severe group (n=13) according to severity. The differences of basic characteristics, clinical manifestations, laboratory tests, auxiliary examination, combined irAEs, treatment and outcomes between the two groups of patients were analyzed. Results: The immunotherapy time [M(Q1,Q3)] of patients in the mild group and severe group were 81 (49, 134) and 24 (20, 116) days, respectively (P<0.05). In the severe group, the levels of cTnT [0.605 (0.317, 1.072) μg/L], NT-proBNP [1 126 (386, 1 744) ng/L], CK-MB [78 (48, 238) U/L], and CK-MM [240 (45, 6 543) U/L] were higher than those in the mild group [0.104 (0.045, 0.189) μg/L, 237 (39, 785) ng/L, 24 (20, 33) U/L, 108 (72, 168) U/L, respectively] (all P<0.05). The left ventricular ejection fraction of the severe group [64% (57%, 65%)] was lower than that of the mild group [66% (63%, 69%)] (P<0.05), and the incidence of conduction block (n=4, 4/13) and abnormal ventricular wall motion (n=4, 4/13), the incidence of ICIs-related myositis (n=10, 10/13), ICIs-related hepatitis (n=4, 4/13) and ICIs-related neurotoxicity (n=4, 4/13) were higher than those in the mild group (n=1, 2.7%; n=2, 5.4%; n=16, 43.2%; n=2, 5.4%; n=1, 2.7%, respectively) (all P<0.05). The proportion of patients receiving intensified immunosuppressive therapy and mortality rate in the severe group were 12/13 (n=12) and 4/13 (n=4), which were both higher than those in the mild group [10.8% (n=4) and 0] (both P<0.05). Conclusions: The incidence of ICIs-related myocarditis is not high, but the severe rate and mortality are high. The differential diagnosis of severe ICIs related myocarditis should be combined with myocardial markers, electrocardiogram and echocardiogram, and early diagnosis and treatment can improve the prognosis of patients.

Radiofrequency ablation for papillary thyroid cancer located in isthmus: comparison with that originated in thyroid lobe

PURPOSE

To analyze the outcomes of radiofrequency ablation (RFA) for isthmus papillary thyroid cancer (PTC) versus PTC originating from the lobes.

METHODS

Patients with solitary low-risk PTC treated with RFA between July 2014 and December 2019 were retrospectively reviewed. This study was approved by our institutional review board. Of the 562 patients, 104 and 458 had PTCs located in the thyroid isthmus and thyroid lobes, respectively. Local tumor progression (LTP), LTP-free survival (LTPFS), changes in tumor volume, and complications were compared between the two groups using propensity-score matching (PSM).

RESULTS

The isthmic and lobar groups showed no significant differences in LTP (2.9% vs. 3.8%), new PTC (2.9% vs. 2.9%), persistent lesions (0.0% vs. 0.2%), or LTPFS after PSM. Before PSM, the two groups showed significant differences in the volume reduction ratio (VRR) of the ablated tumors at 1, 3, 24, 30, and 48 months after RFA, but no differences between the two groups were observed in tumor volume, VRR, or disappearance rate after PSM (p > .05). One patient in the isthmic group presented with coughing, while another complained of hoarseness. Complications did not differ significantly between the two groups (p > .05).

CONCLUSIONS

The outcomes of RFA for patients with low-risk PTC in the thyroid isthmus and thyroid lobes were similar. Therefore, RFA may serve as an alternative treatment option for patients with low-risk isthmic PTC.

Sodium Citrate Nanoparticles Induce Dual-Path Pyroptosis for Enhanced Antitumor Immunotherapy through Synergistic Ion Overload and Metabolic Disturbance

Metabolic reprogramming, as one of the characteristics of cancer, is associated with tumorigenesis, growth, or migration, and the modulation of metabolic pathways has emerged as a novel approach for cancer therapy. However, the conventional metabolism-mediated apoptosis process in tumor cells exhibits limited immunogenicity and inadequate activation of antitumor immunity. Herein, phospholipid-coated sodium citrate nanoparticles (PSCT NPs) are successfully prepared, which dissolve in tumor cells and then release significant amounts of citrate ions and Na+ ions. Massive quantities of ions lead to increased intracellular osmotic pressure, which activates the caspase-1/gasdermin D (GSDMD) mediated pyroptosis pathway. Simultaneously, citrate induces activation of the caspase-8/gasdermin C (GSDMC) pathway. The combined action of these two pathways synergistically causes intense pyroptosis, exhibiting remarkable antitumor immune responses and tumor growth inhibition. This discovery provides new insight into the potential of nanomaterials in modulating metabolism and altering cell death patterns to enhance antitumor immunotherapy.

[A preliminary prediction model of depression based on whole blood cell count by machine learning method]

This study used machine learning techniques combined with routine blood cell analysis parameters to build preliminary prediction models, helping differentiate patients with depression from healthy controls, or patients with anxiety. A multicenter study was performed by collecting blood cell analysis data of Beijing Chaoyang Hospital and the First Hospital of Hebei Medical University from 2020 to 2021. Machine learning techniques, including support vector machine, decision tree, naïve Bayes, random forest and multi-layer perceptron were explored to establish a prediction model of depression. The results showed that based on the blood cell analysis results of healthy controls and depression group, the accuracy of prediction model reached as high as 0.99, F1 was 0.975. Receiver operating characteristic curve area and average accuracy were 0.985 and 0.967, respectively. Platelet parameters contributed mostly to depression prediction model. While, to random forest differential diagnosis model based on the data from depression and anxiety groups, prediction accuracy reached 0.68 and AUC 0.622. Age, platelet parameters, and average volume of red blood cells contributed the most to the model. In conclusion, the study researched on the prediction model of depression by exploring blood cell analysis parameters, revealing that machine learning models were more objective in the evaluation of mental illness.

AI-assisted compressed sensing and parallel imaging sequences for MRI of patients with nasopharyngeal carcinoma: comparison of their capabilities in terms of examination time and image quality

OBJECTIVE

To compare examination time and image quality between artificial intelligence (AI)-assisted compressed sensing (ACS) technique and parallel imaging (PI) technique in MRI of patients with nasopharyngeal carcinoma (NPC).

METHODS

Sixty-six patients with pathologically confirmed NPC underwent nasopharynx and neck examination using a 3.0-T MRI system. Transverse T2-weighted fast spin-echo (FSE) sequence, transverse T1-weighted FSE sequence, post-contrast transverse T1-weighted FSE sequence, and post-contrast coronal T1-weighted FSE were obtained by both ACS and PI techniques, respectively. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and duration of scanning of both sets of images analyzed by ACS and PI techniques were compared. The images from the ACS and PI techniques were scored for lesion detection, margin sharpness of lesions, artifacts, and overall image quality using the 5-point Likert scale.

RESULTS

The examination time with ACS technique was significantly shorter than that with PI technique (p < 0.0001). The comparison of SNR and CNR showed that ACS technique was significantly superior with PI technique (p < 0.005). Qualitative image analysis showed that the scores of lesion detection, margin sharpness of lesions, artifacts, and overall image quality were higher in the ACS sequences than those in the PI sequences (p < 0.0001). Inter-observer agreement was evaluated for all qualitative indicators for each method, in which the results showed satisfactory-to-excellent agreement (p < 0.0001).

CONCLUSION

Compared with the PI technique, the ACS technique for MR examination of NPC can not only shorten scanning time but also improve image quality.

CLINICAL RELEVANCE STATEMENT

The artificial intelligence (AI)-assisted compressed sensing (ACS) technique shortens examination time for patients with nasopharyngeal carcinoma, while improving the image quality and examination success rate, which will benefit more patients.

KEY POINTS

• Compared with the parallel imaging (PI) technique, the artificial intelligence (AI)-assisted compressed sensing (ACS) technique not only reduced examination time, but also improved image quality. • Artificial intelligence (AI)-assisted compressed sensing (ACS) pulls the state-of-the-art deep learning technique into the reconstruction procedure and helps find an optimal balance of imaging speed and image quality.

Vitamin E Treatment Improves the Antioxidant Capacity of Patients Receiving Dialysis: A Systematic Review and Meta-Analysis

SCOPE

To summarize the effect of vitamin E-coated dialyzer membranes (VEMs) treatment or oral vitamin E intake on antioxidant molecules, such as superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT), and total antioxidant level in patients receiving dialysis.

METHODS AND RESULTS

A literature search of PubMed, Embase, CNKI, and the Cochrane Library databases is performed from inception to July 1, 2023, with no language nor country restrictions. Twenty-four experimental studies involving 512 patients undergoing dialysis are selected for meta-analysis. The levels of antioxidant markers in the blood of patients receiving hemodialysis (HD) improve with long-term VEMs treatment (p = 0.016). According to the findings of each antioxidant index, there is a significant increase in the levels of erythrocyte-derived SOD (p = 0.047), CAT (p = 0.029), and plasma-derived total antioxidant level (p < 0.001). The antioxidant marker levels in patients receiving HD are significantly increased by oral vitamin E intake (p < 0.001). Erythrocyte-derived SOD (p = 0.003), GPX (p < 0.001), and CAT (p = 0.001) substantially improves after 2-6 months of intervention with oral vitamin E preparation. The antioxidant index of patients receiving peritoneal dialysis (PD) is unaffected by oral vitamin E treatment (p = 0.945).

CONCLUSION

Vitamin E therapy has a favorable effect on the retention of antioxidant compounds in patients undergoing dialysis.

[A single-center study on the oncological outcomes of active surveillance of thyroid nodules measuring≤1 cm with highly suspicious ultrasound features]

Objective: To investigate the oncological outcomes of active surveillance (AS) in patients showing thyroid nodules measuring≤1 cm with highly suspicious ultrasound features. Methods: A prospective single-center cohort study. A total of 534 patients with highly suspicious thyroid nodules (2015 American Thyroid Association Nodule Sonographic Patterns and Risk of Malignancy: High Suspicion) were enrolled in this study, the patients received AS at Peking Union Medical College Hospital between January 2017 and November 2022 to assess oncological outcomes (disease progression, recurrence/metastasis rate, etc). The patients were followed up every 6 months for physical examination and neck ultrasound examination. And the value of tumor volume changes in evaluating tumor enlargement was explored too. Results: There were 413 females and 121 males in this cohort, with a mean age of (42.6±11.8) years. During a median follow-up period of 45.6 months (ranged from 3.5 to 176.0 months), disease progression occurred in 26 patients (4.9%) with highly suspicious thyroid nodules, characterized by a minimum 3-mm increase in tumor diameter in 19 patients (3.6%) and lymph node metastases in 7 patients (1.3%). Forty-seven (8.8%) patients opted for delayed surgery, with 29 patients due to a change in preference. There was no significant differences in pathologic and follow-up outcomes between patients with disease progression and preference change. Patients aged≤40 years had a higher cumulative incidence of 5-year disease progression than those aged>40 years (4.9% vs 1.9%, P=0.060). No patients experienced distant metastases or deaths. Among the 595 high-risk thyroid nodules with continuous volume assessment results and an increase in nodule diameter of less than 3 mm (including all high-risk nodules in patients with single or multiple nodules), 184 (30.9%) and 79 (13.3%) nodules exhibited volume increases of more than 50% and 100%, respectively, in multiple measurements. Among the nodules with volume changes exceeding 50% and 100%, the proportion of nodules with a baseline tumor diameter of≤0.5 cm was significantly higher than those with a diameter of>0.5 cm, at 69.0% vs 31.0% (P<0.001) and 77.2% vs 22.8% (P<0.001), respectively. Conclusions: Active surveillance in patients with highly suspicious subcentimeter thyroid nodules has good short-term oncological outcomes and can be considered a safe alternative to surgery. Due to the large variability in the measurement results of tumor volume, it is not suitable as an indicator for evaluating tumor enlargement.

Activation of AIM2 by hepatitis B virus results in antiviral immunity that suppresses hepatitis C virus during coinfection

IMPORTANCE

Clinical data suggest that Hepatitis C virus (HCV) levels are generally lower in Hepatitis B virus (HBV) co-infected patients, but the mechanism is unknown. Here, we show that HBV, but not HCV, activated absent in melanoma-2. This in turn results in inflammasome-mediated cleavage of pro-IL-18, leading to an innate immune activation cascade that results in increased interferon-γ, suppressing both viruses.

Identification of urinary volatile organic compounds as a potential non-invasive biomarker for esophageal cancer

Early diagnosis of esophageal cancer (EC) is extremely challenging. The study presented herein aimed to assess whether urinary volatile organic compounds (VOCs) may be emerging diagnostic biomarkers for EC. Urine samples were collected from EC patients and healthy controls (HCs). Gas chromatography-ion mobility spectrometry (GC-IMS) was next utilised for volatile organic compound detection and predictive models were constructed using machine learning algorithms. ROC curve analysis indicated that an 8-VOCs based machine learning model could aid the diagnosis of EC, with the Random Forests having a maximum AUC of 0.874 and sensitivities and specificities of 84.2% and 90.6%, respectively. Urine VOC analysis aids in the diagnosis of EC.

Indole-3-acetic acid as a cross-talking molecule in algal-bacterial interactions and a potential driving force in algal bloom formation

Most signaling molecules are involved in inter-or intra-species communication, and signaling involving cross-kingdom cell-to-cell communication is limited. Howerver, algae and bacteria exchange nutrients and information in a range of interactions in marine environments. Multiple signaling molecules exist between algae and bacteria, including quorum-sensing molecules, nitric oxide, and volatile organic compounds. Recently, indole-3-acetic acid (IAA), an auxin hormone that is a well-studied signaling molecule in terrestrial ecosystems, was found to act as a cue in cross-kingdom communication between algae and bacteria in aquatic environments. To increase understanding of the roles of IAA in the phycosphere, the latest evidence regarding the ecological functions of IAA in cross-kingdom communication between algae and bacteria has been compiled in this review. The pathways of IAA biosynthesis, effects of IAA on algal growth & reproduction, and potential mechanisms at phenotypic and molecular levels are summarized. It is proposed that IAA is an important molecule regulating algal-bacterial interactions and acts as an invisible driving force in the formation of algal blooms.

Enhanced strategies for phosphate recovery from urine by magnesium galvanic process

Magnesium galvanic process (MGP) can be applied to recover phosphate from source-separated urine. However, information on how the urine matrix affects MGP performance is limited. Therefore, this study investigated the mechanism of phosphate recovery by MGP in synthetic and real urine matrixes. Our results showed that the major components in urine (i.e., NH4+, Cl-, and HCO3-) all exhibited acceleration effects on corrosion of Mg plate. However, the underlying action mechanism of each component was distinct. Ammonium facilitated the conversion from MgO to Mg(OH)2, chloride complexed with Mg2+ ions, and bicarbonate led to complexation as well as formation of MgCO3. Furthermore, our results revealed an interesting aspect where although bicarbonate alone accelerated the corrosion of Mg plate, its coexistence with other ions inhibited overall performance due to the blocking effect of formed MgCO3 on chloride penetration and reduction in free magnesium ion concentration. After elucidating the interaction of NH4+, Cl-, and HCO3- on the passive layer of the Mg plate, we proposed to pretreat urine with HCl, which resulted in a significant enhancement in current production and phosphate recovery. This improved MGP was further tested in a continuous flow reactor, which recovered over 95% of phosphate in real urine for more than 1 h. The phosphate precipitates were confirmed as high purity struvite. Generally, the improved MGP, which simultaneously produced Mg2+, dihydrogen, and electricity with no energy input, is a promising sustainable and green alternative for phosphate recovery from source-separated urine.

[Efficacy, prognosis and influencing factors of transcatheter arterial embolization in the treatment of neuroendocrine neoplasm liver metastases]

Objective: To evaluate the efficacy of transcatheter arterial embolization (TAE) in the treatment of neuroendocrine neoplasm liver metastases (NENLM), analyze the prognosis and related factors. Methods: Clinical data of NENLM patients treated with TAE in the First Affiliated Hospital of Nanjing Medical University from January 2018 to March 2022 were retrospectively analyzed. Objective response rate (ORR), disease control rate (DCR), and adverse event rate after TAE were evaluated according to the Response Evaluation Criteria In Solid Tumors and the Common Terminology Criteria for Adverse Events. The prognosis was evaluated by median overall survival (mOS) and median progression-free survival (mPFS). The survival curve was plotted by Kaplan-Meier method. Multivariate Cox regression was used to analyze prognostic factors. Results: A total of 39 NENLM patients were included in this study, aged (53.3±10.3) (23-74) years old, including 23 males and 16 females. Among them, 9 cases had functional neuroendocrine neoplasms. There were 31 cases with primary sites locating in the digestive system, 32 cases with WHO G1 and G2 primary sites, 27 cases with abundant blood supply for liver metastases and 13 cases with liver tumor load >50%. Thirty patients received treatment of long-acting somatostatin analogue(SSA). A total of 123 TAE were performed in 39 cases, with an ORR of 38.5% (15/39) and a DCR of 76.9% (30/39). There were no serious adverse events of level 4-5 during the perioperative period. The median follow-up was 38.7 (95%CI: 31.3-46.1) months, with mOS of 37.3(95%CI: 27.0-47.5) months and mPFS of 12.6 (95%CI: 7.1-18.1) months. Multivariate Cox regression analysis found that the combination of long-term SSA treatment was an influencing factor for overall survival of patients (HR=0.207, 95%CI: 0.076-0.567, P=0.002). Conclusions: TAE can effectively reduce the load of liver metastases in patients with NENLM, and the combination of long-term SSA treatment can improve the ovreall survival of patients.

Directing (110) Oriented Lithium Deposition through High-flux Solid Electrolyte Interphase for Dendrite-free Lithium Metal Batteries

Controlling lithium (Li) electrocrystallization with preferred orientation is a promising strategy to realize highly reversible Li metal batteries (LMBs) but lack of facile regulation methods. Herein, we report a high-flux solid electrolyte interphase (SEI) strategy to direct (110) preferred Li deposition even on (200)-orientated Li substrate. Bravais rule and Curie-Wulff principle are expanded in Li electrocrystallization process to decouple the relationship between SEI engineering and preferred crystal orientation. Multi-spectroscopic techniques combined with dynamics analysis reveal that the high-flux CF3 Si(CH3 )3 (F3 ) induced SEI (F3 -SEI) with high LiF and -Si(CH3 )3 contents can ingeniously accelerate Li+ transport dynamics and ensure the sufficient Li+ concentration below SEI to direct Li (110) orientation. The induced Li (110) can in turn further promote the surface migration of Li atoms to avoid tip aggregation, resulting in a planar, dendrite-free morphology of Li. As a result, our F3 -SEI enables ultra-long stability of Li||Li symmetrical cells for more than 336 days. Furthermore, F3 -SEI modified Li can significantly enhance the cycle life of Li||LiFePO4 and Li||NCM811 coin and pouch full cells in practical conditions. Our crystallographic strategy for Li dendrite suppression paves a path to achieve reliable LMBs and may provide guidance for the preferred orientation of other metal crystals.

[The association of renalase single-nucleotide polymorphisms rs2576178 and rs10887800 with hypertension in patients with obstructive sleep apnea]

Objective: To evaluate the associations between the renalase single-nucleotide polymorphisms rs2576178 and rs10887800 and the risk of hypertension in OSA patients. Methods: A total of 3, 570 male OSA subjects diagnosed via standard polysomnography were included in this retrospective study. We recorded anthropometric, genomic, and polysomnographic parameters and blood pressure levels. All subjects were divided into four groups based on quartiles of the apnea-hypopnea index (AHI). The relationships between rs2576178 and rs10887800 and the risk of hypertension were evaluated using the binary logistic regression, and haplotype analysis. Results: In the bottom AHI quartile, rs10887800 was significantly associated with the risk of hypertension according to the dominant model [odds ratio(OR)=0.691, 95% confidence interval (CI)=0.483-0.990, P=0.044] even after adjustment for age, sex, and the body mass index. The G-A haplotype was associated with a co-effect of the two SNPs, namely, the risk of hypertension decreased (OR=0.879, 95%CI=0.784-0.986, P=0.028). Conclusions: We find no association between single rs2576178 or rs10887800 variants with the risk of hypertension in our OSA population. But, the synergistic effect of the two polymorphisms is associated with the risk of hypertension in OSA patients.

Pressure-modulated lattice structural evolution in TiS2

Titanium disulfide (TiS2) has drawn considerable attention in materials, physics, and chemistry thanks to its potential applications in batteries, supercapatteries and thermoelectric devices. However, the simplified and controlled synthesis of high-quality TiS2 remains a great challenge. In this study, a straightforward widely accessible approach to the one-step chemical vapor transport (CVT) process is presented. Meanwhile, combining high-pressure (HP) Raman spectroscopy measurements and first-principles calculations, the pressure-induced phase transition of TiS2 from P3̄m1 phase (phase I) to C2/m phase (phase II) at 16.0 GPa and then to P6̄2m phase (phase III) at 32.4 GPa was disclosed. The discovery of HP being within the Weyl semi-metallic phase represents a significant advancement towards understanding the electronic topological states, discovering new physical phenomena, developing new electronic devices, and gaining insight into the properties of elementary particles.

Sodium Bicarbonate Nanoparticles for Amplified Cancer Immunotherapy by Inducing Pyroptosis and Regulating Lactic Acid Metabolism

Although immunotherapy has a broad clinical application prospect, it is still hindered by low immune responses and immunosuppressive tumor microenvironment. Herein, a simple and drug-free inorganic nanomaterial, alkalescent sodium bicarbonate nanoparticles (NaHCO3 NPs), is prepared via a fast microemulsion method for amplified cancer immunotherapy. The obtained alkalescent NaHCO3 regulates lactic acid metabolism through acid-base neutralization so as to reverse the mildly acidic immunosuppressive tumor environment. Additionally, it can further release high amounts of Na+ ions inside tumor cells and induce a surge in intracellular osmolarity, and thus activate the pyroptosis pathway and immunogenic cell death (ICD), release damage-associated molecular patterns (DAMPs) and inflammatory factors, and improve immune responses. Collectively, NaHCO3 NPs observably inhibit primary/distal tumor growth and tumor metastasis through acid neutralization remitted immunosuppression and pyroptosis induced immune activation, showing an enhanced antitumor immunity efficiency. This work provides a new paradigm for lactic acid metabolism and pyroptosis mediated tumor treatment, which has a potential for application in clinical tumor immunotherapy.