[Research progress on AMPK activation in nonalcoholic fatty liver disease]

Nonalcoholic fatty liver disease (NAFLD) occurrence and progression are associated with lipid accumulation, insulin resistance, inflammation, liver damage, fibrosis, and other factors. AMP-dependent protein kinase (AMPK) is a key molecule that regulates bioenergy metabolism and participates in multiple biological processes, including lipid metabolism, autophagy, inflammation, and cell apoptosis. Promoting AMPK activation can reduce hepatic lipid accumulation and insulin resistance, alleviate the development of NAFLD, reduce liver inflammation and fibrosis, and inhibit the progression of NAFLD to nonalcoholic steatohepatitis.

[Study on the comparison of postoperative liver injury caused by hepatic arterial perfusion chemotherapy combined with targeted immunotherapy with hepatic arterial chemoembolization combined with targeted immunotherapy for intermediate-and advanced-stage liver cancer]

Objective: To compare the postoperative liver function injury condition in patients with intermediate-and advanced-stage hepatocellular carcinoma (HCC) treated with hepatic artery infusion chemotherapy (HAIC) and hepatic artery chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and multi-target tyrosine kinase inhibitors (TKIs). Methods: Patients with intermediate-and advanced-stage HCC who were admitted and treated with HAIC/TACE+ICIs+TKIs therapy at Nanfang Hospital of Southern Medical University from January 2019 to November 2021, with follow-up up to July 2023, were retrospectively enrolled. The results of liver function tests within one week before interventional surgery and on the first day after surgery were recorded. The degree of postoperative liver injury was graded according to the common terminology criteria for adverse events 5.0 (CTCAE 5.0). The treatment efficacy was evaluated according to RECIST 1.1 criteria. Measurement data were compared between groups using a t-test or a non-parametric rank sum test. Enumeration data were compared between the groups using the χ(2) test or Fisher's exact probability method. The survival condition differences were analyzed by the log-rank method. Results: This study included 82 and 77 cases in the HAIC and TACE groups. There were no statistically significant differences between the two groups of patients in terms of gender, age, physical condition score, number of tumors, presence or absence of liver cirrhosis, Child-Pugh grade, albumin-bilirubin (ALBI) grade, and combined ICIs and TKIs . The HAIC group had later tumor staging, a greater tumor burden, poorer liver reserve function, and a larger proportion of patients in stage C (81.7% vs. 63.6%), χ(2)=6.573, P = 0.01). There were 53 cases (64.6% vs. 32.5%) with a maximum tumor diameter of ≥ 10cm, χ(2)=16.441, P < 0.001), and more patients had a retention rate of ≥ 10% for indocyanine green (ICG) at 15 minutes (68.3% vs. 51.9%, P = 0.035). The postoperative incidence rate of increased levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin was significantly lower in the HAIC group than that in the TACE group (28.0% vs. 63.6%, χ(2)=20.298, P < 0.001, 54.9% vs. 85.7%, χ(2)=17.917, P < 0.001;40.2% vs. 55.8%, χ(2)=3.873, P = 0.049). The number of patients with postoperative ALBI grade 3 was significantly lower in the HAIC group than that in the TACE group (6.1% vs. 16.9%, χ(2)=4.601, P = 0.032). There was no statistically significant difference in the incidence rate of postoperative hypoalbuminemia, activated partial thromboplastin time, or increased international standardized ratio between the two groups of patients. There was no statistically significant difference in median progression-free survival (7.3 months vs. 8.2 months, P = 0.296) or median overall survival (16.5 months vs. 21.9 months, P = 0.678) between the two groups of patients. Conclusion: The incidence rate of postoperative liver injury is higher in patients with intermediate-and advanced-stage HCC treated with TACE combined with ICIs and TKIs than in patients with HAIC combined with ICIs and TKIs.

Quantitative Time-Course Analysis of Osmotic and Salt Stress in Arabidopsis thaliana Using Short Gradient Multi-CV FAIMSpro BoxCar DIA

A major limitation when undertaking quantitative proteomic time-course experimentation is the tradeoff between depth-of-analysis and speed-of-analysis. In high complexity and high dynamic range sample types, such as plant extracts, balance between resolution and time is especially apparent. To address this, we evaluate multiple compensation voltage (CV) high field asymmetric waveform ion mobility spectrometry (FAIMSpro) settings using the latest label-free single-shot Orbitrap-based DIA acquisition workflows for their ability to deeply quantify the Arabidopsis thaliana seedling proteome. Using a BoxCarDIA acquisition workflow with a -30 -50 -70 CV FAIMSpro setting, we were able to consistently quantify >5000 Arabidopsis seedling proteins over a 21-min gradient, facilitating the analysis of ∼42 samples per day. Utilizing this acquisition approach, we then quantified proteome-level changes occurring in Arabidopsis seedling shoots and roots over 24 h of salt and osmotic stress, to identify early and late stress response proteins and reveal stress response overlaps. Here, we successfully quantify >6400 shoot and >8500 root protein groups, respectively, quantifying nearly ∼9700 unique protein groups in total across the study. Collectively, we pioneer a short gradient, multi-CV FAIMSpro BoxCarDIA acquisition workflow that represents an exciting new analysis approach for undertaking quantitative proteomic time-course experimentation in plants.

Measurement of the top quark mass using a profile likelihood approach with the lepton + jets final states in proton-proton collisions at s=13TeV

The mass of the top quark is measured in 36.3fb - 1 of LHC proton-proton collision data collected with the CMS detector at s = 13 Te V . The measurement uses a sample of top quark pair candidate events containing one isolated electron or muon and at least four jets in the final state. For each event, the mass is reconstructed from a kinematic fit of the decay products to a top quark pair hypothesis. A profile likelihood method is applied using up to four observables per event to extract the top quark mass. The top quark mass is measured to be 171.77 ± 0.37 Ge V . This approach significantly improves the precision over previous measurements.

M, Kveton A, Ayala E, Carrera Jarrin E, Abdelalim AA, Salama E, Abdullah Al-Mashad M, Mahmoud MA, Bhowmik S, Dewanjee RK, Ehataht K, Kadastik M, Lange T, Nandan S, Nielsen C, Pata J, Raidal M, Tani L, Veelken C, Eerola P, Kirschenmann H, Osterberg K, Voutilainen M, Bharthuar S, Brücken E, Garcia F, Havukainen J, Kim MS, Kinnunen R, Lampén T, Lassila-Perini K, Lehti S, Lindén T, Lotti M, Martikainen L, Myllymäki M, Rantanen MM, Siikonen H, Tuominen E, Tuominiemi J, Luukka P, Petrow H, Tuuva T, Amendola C, Besancon M, Couderc F, Dejardin M, Denegri D, Faure JL, Ferri F, Ganjour S, Gras P, Hamel de Monchenault G, Lohezic V, Malcles J, Rander J, Rosowsky A, Sahin M, Savoy-Navarro A, Simkina P, Titov M, Baldenegro Barrera C, Beaudette F, Buchot Perraguin A, Busson P, Cappati A, Charlot C, Damas F, Davignon O, Diab B, Falmagne G, Fontana Santos Alves BA, Ghosh S, Granier de Cassagnac R, Hakimi A, Harikrishnan B, Liu G, Motta J, Nguyen M, Ochando C, Portales L, Salerno R, Sarkar U, Sauvan JB, Sirois Y, Tarabini A, Vernazza E, Zabi A, Zghiche A, Agram JL, Andrea J, Apparu D, Bloch D, Bourgatte G, Brom JM, Chabert EC, Collard C, Darej D, Goerlach U, Grimault C, Le Bihan AC, Van Hove P, Beauceron S, Blancon B, Boudoul G, Carle A, Chanon N, Choi J, Contardo D, Depasse P, Dozen C, El Mamouni H, Fay J, Gascon S, Gouzevitch M, Grenier G, Ille B, Laktineh IB, Lethuillier M, Mirabito L, Perries S, Torterotot L, Vander Donckt M, Verdier P, Viret S, Lomidze D, Lomidze I, Tsamalaidze Z, Botta V, Feld L, Klein K, Lipinski M, Meuser D, Pauls A, Röwert N, Teroerde M, Diekmann S, Dodonova A, Eich N, Eliseev D, Erdmann M, Fackeldey P, Fasanella D, Fischer B, Hebbeker T, Hoepfner K, Ivone F, Lee MY, Mastrolorenzo L, Merschmeyer M, Meyer A, Mondal S, Mukherjee S, Noll D, Novak A, Nowotny F, Pozdnyakov A, Rath Y, Redjeb W, Rehm F, Reithler H, Schmidt A, Schuler SC, Sharma A, Stein A, Torres Da Silva De Araujo F, Vigilante L, Wiedenbeck S, Zaleski S, Dziwok C, Flügge G, Haj Ahmad W, Hlushchenko O, Kress T, Nowack A, Pooth O, Stahl A, Ziemons T, Zotz A, Petersen HA, Martin MA, Alimena J, Asmuss P, Baxter S, Bayatmakou M, Becerril Gonzalez H, Behnke O, Bhattacharya S, Blekman F, Borras K, Brunner D, Campbell A, Cardini A, Cheng C, Colombina F, Consuegra Rodríguez S, Silva GC, De Silva M, Eckerlin G, Eckstein D, Estevez Banos LI, Filatov O, Gallo E, Geiser A, Giraldi A, Greau G, Grohsjean A, Guglielmi V, Guthoff M, Jafari A, Jomhari NZ, Kaech B, Kasemann M, Kaveh H, Kleinwort C, Kogler R, Komm M, Krücker D, Lange W, Leyva Pernia D, Lipka K, Lohmann W, Mankel R, Melzer-Pellmann IA, Mendizabal Morentin M, Metwally J, Meyer AB, Milella G, Mormile M, Mussgiller A, Nürnberg A, Otarid Y, Pérez Adán D, Ranken E, Raspereza A, Ribeiro Lopes B, Rübenach J, Saggio A, Savitskyi M, Scham M, Scheurer V, Schnake S, Schütze P, Schwanenberger C, Shchedrolosiev M, Sosa Ricardo RE, Stafford D, Tonon N, Van De Klundert M, Vazzoler F, Ventura Barroso A, Walsh R, Walter D, Wang Q, Wen Y, Wichmann K, Wiens L, Wissing C, Wuchterl S, Yang Y, Zimermmane Castro Santos A, Albrecht A, Albrecht S, Antonello M, Bein S, Benato L, Bonanomi M, Connor P, De Leo K, Eich M, El Morabit K, Feindt F, Fröhlich A, Garbers C, Garutti E, Hajheidari M, Haller J, Hinzmann A, Jabusch HR, Kasieczka G, Keicher P, Klanner R, Korcari W, Kramer T, Kutzner V, Labe F, Lange J, Lobanov A, Matthies C, Mehta A, Moureaux L, Mrowietz M, Nigamova A, Nissan Y, Paasch A, Pena Rodriguez KJ, Quadfasel T, Rieger M, Savoiu D, Schindler J, Schleper P, Schröder M, Schwandt J, Sommerhalder M, Stadie H, Steinbrück G, Tews A, Wolf M, Brommer S, Burkart M, Butz E, Chwalek T, Dierlamm A, Droll A, Faltermann N, Giffels M, Gosewisch JO, Gottmann A, Hartmann F, Horzela M, Husemann U, Klute M, Koppenhöfer R, Link M, Lintuluoto A, Maier S, Mitra S, Müller T, Neukum M, Oh M, Quast G, Rabbertz K, Shvetsov I, Simonis H, Trevisani N, Ulrich R, van der Linden J, Von Cube RF, Wassmer M, Wieland S, Wolf R, Wozniewski S, Wunsch S, Zuo X, Anagnostou G, Assiouras P, Daskalakis G, Kyriakis A, Loukas D, Stakia A, Diamantopoulou M, Karasavvas D, Kontaxakis P, Manousakis-Katsikakis A, Panagiotou A, Papavergou I, Saoulidou N, Theofilatos K, Tziaferi E, Vellidis K, Zisopoulos I, Bakas G, Chatzistavrou T, Karapostoli G, Kousouris K, Papakrivopoulos I, Tsipolitis G, Zacharopoulou A, Adamidis K, Bestintzanos I, Evangelou I, Foudas C, Gianneios P, Kamtsikis C, Katsoulis P, Kokkas P, Kosmoglou Kioseoglou PG, Manthos N, Papadopoulos I, Strologas J, Csanád M, Farkas K, Gadallah MMA, Major P, Mandal K, Pásztor G, Rádl AJ, Surányi O, Veres GI, Bartók M, Bencze G, Hajdu C, Horvath D, Sikler F, Veszpremi V, Beni N, Czellar S, Karancsi J, Molnar J, Szillasi Z, Teyssier D, Raics P, Ujvari B, Zilizi G, Csorgo T, Nemes F, Novak T, Babbar J, Bansal S, Beri SB, Bhatnagar V, Chaudhary G, Chauhan S, Dhingra N, Gupta R, Kaur A, Kaur A, Kaur H, Kaur M, Kumar S, Kumari P, Meena M, Sandeep K, Sheokand T, Singh JB, Singla A, Ahmed A, Bhardwaj A, Chhetri A, Choudhary BC, Kumar A, Naimuddin M, Ranjan K, Saumya S, Baradia S, Barman S, Bhattacharya S, Bhowmik D, Dutta S, Dutta S, Gomber B, Maity M, Palit P, Saha G, Sahu B, Sarkar S, Behera PK, Behera SC, Chatterjee S, Kalbhor P, Komaragiri JR, Kumar D, Muhammad A, Panwar L, Pradhan R, Pujahari PR, Saha NR, Sharma A, Sikdar AK, Verma S, Naskar K, Aziz T, Das I, Dugad S, Kumar M, Mohanty GB, Suryadevara P, Banerjee S, Guchait M, Karmakar S, Kumar S, Majumder G, Mazumdar K, Mukherjee S, Thachayath A, Bahinipati S, Das AK, Kar C, Mal P, Mishra T, Muraleedharan Nair Bindhu VK, Nayak A, Saha P, Swain SK, Vats D, Alpana A, Dube S, Kansal B, Laha A, Pandey S, Rastogi A, Sharma S, Bakhshiansohi H, Khazaie E, Zeinali M, Chenarani S, Etesami SM, Khakzad M, Mohammadi Najafabadi M, Grunewald M, Abbrescia M, Aly R, Aruta C, Colaleo A, Creanza D, Cristella L, De Filippis N, De Palma M, Di Florio A, Elmetenawee W, Errico F, Fiore L, Iaselli G, Maggi G, Maggi M, Margjeka I, Mastrapasqua V, My S, Nuzzo S, Pellecchia A, Pompili A, Pugliese G, Radogna R, Ramos D, Ranieri A, Selvaggi G, Silvestris L, Simone FM, Sözbilir Ü, Stamerra A, Venditti R, Verwilligen P, Abbiendi G, Battilana C, Bonacorsi D, Borgonovi L, Brigliadori L, Campanini R, Capiluppi P, Castro A, Cavallo FR, Cuffiani M, Dallavalle GM, Diotalevi T, Fabbri F, Fanfani A, Giacomelli P, Giommi L, Grandi C, Guiducci L, Lo Meo S, Lunerti L, Marcellini S, Masetti G, Navarria FL, Perrotta A, Primavera F, Rossi AM, Rovelli T, Siroli GP, Costa S, Di Mattia A, Potenza R, Tricomi A, Tuve C, Barbagli G, Bardelli G, Camaiani B, Cassese A, Ceccarelli R, Ciulli V, Civinini C, D’Alessandro R, Focardi E, Latino G, Lenzi P, Lizzo M, Meschini M, Paoletti S, Sguazzoni G, Viliani L, Benussi L, Bianco S, Meola S, Piccolo D, Bozzo M, Chatagnon P, Ferro F, Robutti E, Tosi S, Benaglia A, Boldrini G, Brivio F, Cetorelli F, De Guio F, Dinardo ME, Dini P, Gennai S, Ghezzi A, Govoni P, Guzzi L, Lucchini MT, Malberti M, Malvezzi S, Massironi A, Menasce D, Moroni L, Paganoni M, Pedrini D, Pinolini BS, Ragazzi S, Redaelli N, Tabarelli de Fatis T, Zuolo D, Buontempo S, Carnevali F, Cavallo N, De Iorio A, Fabozzi F, Iorio AOM, Lista L, Paolucci P, Rossi B, Sciacca C, Azzi P, Bacchetta N, Bortignon P, Bragagnolo A, Carlin R, Checchia P, Dorigo T, Gasparini F, Gasparini U, Grosso G, Layer L, Lusiani E, Margoni M, Maron G, Meneguzzo AT, Pazzini J, Ronchese P, Rossin R, Simonetto F, Strong G, Tosi M, Yarar H, Zanetti M, Zotto P, Zucchetta A, Zumerle G, Zeid SA, Aimè C, Braghieri A, Calzaferri S, Fiorina D, Montagna P, Re V, Riccardi C, Salvini P, Vai I, Vitulo P, Asenov P, Bilei GM, Ciangottini D, Fanò L, Magherini M, Mantovani G, Mariani V, Menichelli M, Moscatelli F, Piccinelli A, Presilla M, Rossi A, Santocchia A, Spiga D, Tedeschi T, Azzurri P, Bagliesi G, Bertacchi V, Bhattacharya R, Bianchini L, Boccali T, Bossini E, Bruschini D, Castaldi R, Ciocci MA, D’Amante V, Dell’Orso R, Donato S, Giassi A, Ligabue F, Matos Figueiredo D, Messineo A, Musich M, Palla F, Parolia S, Ramirez-Sanchez G, Rizzi A, Rolandi G, Roy Chowdhury S, Sarkar T, Scribano A, Spagnolo P, Tenchini R, Tonelli G, Turini N, Venturi A, Verdini PG, Barria P, Campana M, Cavallari F, Del Re D, Di Marco E, Diemoz M, Longo E, Meridiani P, Organtini G, Pandolfi F, Paramatti R, Quaranta C, Rahatlou S, Rovelli C, Santanastasio F, Soffi L, Tramontano R, Amapane N, Arcidiacono R, Argiro S, Arneodo M, Bartosik N, Bellan R, Bellora A, Biino C, Cartiglia N, Costa M, Covarelli R, Demaria N, Grippo M, Kiani B, Legger F, Luongo F, Mariotti C, Maselli S, Mecca A, Migliore E, Monteno M, Mulargia R, Obertino MM, Ortona G, Pacher L, Pastrone N, Pelliccioni M, Ruspa M, Shchelina K, Siviero F, Sola V, Solano A, Soldi D, Staiano A, Tarricone C, Tornago M, Trocino D, Umoret G, Vagnerini A, Vlasov E, Belforte S, Candelise V, Casarsa M, Cossutti F, Della Ricca G, Sorrentino G, Dogra S, Huh C, Kim B, Kim DH, Kim GN, Kim J, Lee J, Lee SW, Moon CS, Oh YD, Pak SI, Ryu MS, Sekmen S, Yang YC, Kim H, Moon DH, Asilar E, Kim TJ, Park J, Choi S, Han S, Hong B, Lee K, Lee KS, Lim J, Park J, Park SK, Yoo J, Goh J, Kim HS, Kim Y, Lee S, Almond J, Bhyun JH, Choi J, Jeon S, Kim J, Kim JS, Ko S, Kwon H, Lee H, Lee S, Oh BH, Oh SB, Seo H, Yang UK, Yoon I, Jang W, Kang DY, Kang Y, Kim D, Kim S, Ko B, Lee JSH, Lee Y, Merlin JA, Park IC, Roh Y, Song D, Watson IJ, Yang S, Ha S, Yoo HD, Choi M, Kim MR, Lee H, Lee Y, Yu I, Beyrouthy T, Maghrbi Y, Dreimanis K, Pikurs G, Potrebko A, Seidel M, Veckalns V, Ambrozas M, Carvalho Antunes De Oliveira A, Juodagalvis A, Rinkevicius A, Tamulaitis G, Norjoharuddeen NB, Hoh SY, Yusuff I, Zolkapli Z, Benitez JF, Castaneda Hernandez A, Encinas Acosta HA, Gallegos Maríñez LG, León Coello M, Murillo Quijada JA, Sehrawat A, Valencia Palomo L, Ayala G, Castilla-Valdez H, Heredia-De La Cruz I, Lopez-Fernandez R, Mondragon Herrera CA, Perez Navarro DA, Sánchez Hernández A, Oropeza Barrera C, Vazquez Valencia F, Pedraza I, Salazar Ibarguen HA, Uribe Estrada C, Bubanja I, Mijuskovic J, Raicevic N, Ahmad A, Asghar MI, Awais A, Awan MIM, Gul M, Hoorani HR, Khan WA, Avati V, Grzanka L, Malawski M, Bialkowska H, Bluj M, Boimska B, Górski M, Kazana M, Szleper M, Zalewski P, Bunkowski K, Doroba K, Kalinowski A, Konecki M, Krolikowski J, Araujo M, Bargassa P, Bastos D, Boletti A, Faccioli P, Gallinaro M, Hollar J, Leonardo N, Niknejad T, Pisano M, Seixas J, Varela J, Adzic P, Dordevic M, Milenovic P, Milosevic J, Aguilar-Benitez M, Alcaraz Maestre J, Barrio Luna M, Bedoya CF, Cepeda M, Cerrada M, Colino N, De La Cruz B, Delgado Peris A, Fernández Del Val D, Fernández Ramos JP, Flix J, Fouz MC, Gonzalez Lopez O, Lopez SG, Hernandez JM, Josa MI, León Holgado J, Moran D, Perez Dengra C, Pérez-Calero Yzquierdo A, Puerta Pelayo J, Redondo I, Redondo Ferrero DD, Romero L, Sánchez Navas S, Sastre J, Urda Gómez L, Vazquez Escobar J, Willmott C, de Trocóniz JF, Alvarez Gonzalez B, Cuevas J, Fernandez Menendez J, Folgueras S, Gonzalez Caballero I, González Fernández JR, Palencia Cortezon E, Ramón Álvarez C, Rodríguez Bouza V, Soto Rodríguez A, Trapote A, Vico Villalba C, Brochero Cifuentes JA, Cabrillo IJ, Calderon A, Duarte Campderros J, Fernandez M, Fernandez Madrazo C, García Alonso A, Gomez G, Lasaosa García C, Martinez Rivero C, Martinez Ruiz del Arbol P, Matorras F, Matorras Cuevas P, Piedra Gomez J, Prieels C, Scodellaro L, Vila I, Vizan Garcia JM, Jayananda MK, Kailasapathy B, Sonnadara DUJ, Wickramarathna DDC, Dharmaratna WGD, Liyanage K, Perera N, Wickramage N, Abbaneo D, Auffray E, Auzinger G, Baechler J, Baillon P, Barney D, Bendavid J, Bermúdez Martínez A, Bianco M, Bilin B, Bin Anuar AA, Bocci A, Brondolin E, Caillol C, Camporesi T, Cerminara G, Chernyavskaya N, Chhibra SS, Choudhury S, Cipriani M, d’Enterria D, Dabrowski A, David A, De Roeck A, Defranchis MM, Deile M, Dobson M, Dünser M, Dupont N, Fallavollita F, Florent A, Forthomme L, Franzoni G, Funk W, Ghosh S, Giani S, Gigi D, Gill K, Glege F, Gouskos L, Govorkova E, Haranko M, Hegeman J, Innocente V, James T, Janot P, Kaspar J, Kieseler J, Kratochwil N, Laurila S, Lecoq P, Leutgeb E, Lourenço C, Maier B, Malgeri L, Mannelli M, Marini AC, Meijers F, Mersi S, Meschi E, Moortgat F, Mulders M, Orfanelli S, Orsini L, Pantaleo F, Perez E, Peruzzi M, Petrilli A, Petrucciani G, Pfeiffer A, Pierini M, Piparo D, Pitt M, Qu H, Quast T, Rabady D, Racz A, Reales Gutiérrez G, Rovere M, Sakulin H, Salfeld-Nebgen J, Scarfi S, Selvaggi M, Sharma A, Silva P, Sphicas P, Stahl Leiton AG, Summers S, Tatar K, Treille D, Tropea P, Tsirou A, Wanczyk J, Wozniak KA, Zeuner WD, Caminada L, Ebrahimi A, Erdmann W, Horisberger R, Ingram Q, Kaestli HC, Kotlinski D, Lange C, Missiroli M, Noehte L, Rohe T, Aarrestad TK, Androsov K, Backhaus M, Calandri A, Datta K, De Cosa A, Dissertori G, Dittmar M, Donegà M, Eble F, Galli M, Gedia K, Glessgen F, Gómez Espinosa TA, Grab C, Hits D, Lustermann W, Lyon AM, Manzoni RA, Marchese L, Martin Perez C, Mascellani A, Nessi-Tedaldi F, Niedziela J, Pauss F, Perovic V, Pigazzini S, Ratti MG, Reichmann M, Reissel C, Reitenspiess T, Ristic B, Riti F, Ruini D, Sanz Becerra DA, Seidita R, Steggemann J, Valsecchi D, Wallny R, Amsler C, Bärtschi P, Botta C, Brzhechko D, Canelli MF, Cormier K, De Wit A, Del Burgo R, Heikkilä JK, Huwiler M, Jin W, Jofrehei A, Kilminster B, Leontsinis S, Liechti SP, Macchiolo A, Meiring P, Mikuni VM, Molinatti U, Neutelings I, Reimers A, Robmann P, Cruz SS, Schweiger K, Senger M, Takahashi Y, Adloff C, Kuo CM, Lin W, Rout PK, Tiwari PC, Yu SS, Ceard L, Chao Y, Chen KF, Chen PS, Cheng H, Hou WS, Khurana R, Kole G, Li YY, Lu RS, Paganis E, Psallidas A, Steen A, Wu HY, Yazgan E, Asawatangtrakuldee C, Srimanobhas N, Wachirapusitanand V, Agyel D, Boran F, Demiroglu ZS, Dolek F, Dumanoglu I, Eskut E, Guler Y, Gurpinar Guler E, Isik C, Kara O, Kayis Topaksu A, Kiminsu U, Onengut G, Ozdemir K, Polatoz A, Simsek AE, Tali B, Tok UG, Turkcapar S, Uslan E, Zorbakir IS, Karapinar G, Ocalan K, Yalvac M, Akgun B, Atakisi IO, Gülmez E, Kaya M, Kaya O, Tekten S, Cakir A, Cankocak K, Komurcu Y, Sen S, Aydilek O, Cerci S, Hacisahinoglu B, Hos I, Isildak B, Kaynak B, Ozkorucuklu S, Simsek C, Sunar Cerci D, Grynyov B, Levchuk L, Anthony D, Brooke JJ, Bundock A, Clement E, Cussans D, Flacher H, Glowacki M, Goldstein J, Heath HF, Kreczko L, Krikler B, Paramesvaran S, Seif El Nasr-Storey S, Smith VJ, Stylianou N, Pass KW, White R, Ball AH, Bell KW, Belyaev A, Brew C, Brown RM, Cockerill DJA, Cooke C, Ellis KV, Harder K, Harper S, Holmberg ML, Jain S, Linacre J, Manolopoulos K, Newbold DM, Olaiya E, Petyt D, Reis T, Salvi G, Schuh T, Shepherd-Themistocleous CH, Tomalin IR, Williams T, Bainbridge R, Bloch P, Bonomally S, Borg J, Brown CE, Buchmuller O, Cacchio V, Montoya CAC, Cepaitis V, Chahal GS, Colling D, Dancu JS, Dauncey P, Davies G, Davies J, Della Negra M, Fayer S, Fedi G, Hall G, Hassanshahi MH, Howard A, Iles G, Langford J, Lyons L, Magnan AM, Malik S, Martelli A, Mieskolainen M, Monk DG, Nash J, Pesaresi M, Radburn-Smith BC, Raymond DM, Richards A, Rose A, Scott E, Seez C, Shukla R, Tapper A, Uchida K, Uttley GP, Vage LH, Virdee T, Vojinovic M, Wardle N, Webb SN, Winterbottom D, Coldham K, Cole JE, Khan A, Kyberd P, Reid ID, Abdullin S, Brinkerhoff A, Caraway B, Dittmann J, Hatakeyama K, Kanuganti AR, McMaster B, Saunders M, Sawant S, Sutantawibul C, Toms M, Wilson J, Bartek R, Dominguez A, Escamilla CH, Uniyal R, Vargas Hernandez AM, Chudasama R, Cooper SI, Croce DD, Gleyzer SV, Perez CU, Rumerio P, Usai E, West C, Akpinar A, Albert A, Arcaro D, Cosby C, Demiragli Z, Erice C, Fontanesi E, Gastler D, May S, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Tsatsos A, Yuan S, Benelli G, Coubez X, Cutts D, Hadley M, Heintz U, Hogan JM, Kwon T, Landsberg G, Lau KT, Li D, Luo J, Narain M, Pervan N, Sagir S, Simpson F, Wong WY, Yan X, Yu D, Zhang W, Abbott S, Bonilla J, Brainerd C, Breedon R, Calderon De La Barca Sanchez M, Chertok M, Conway J, Cox PT, Erbacher R, Haza G, Jensen F, Kukral O, Mocellin G, Mulhearn M, Pellett D, Regnery B, Yao Y, Zhang F, Bachtis M, Cousins R, Datta A, Hauser J, Ignatenko M, Iqbal M, Lam T, Manca E, Nash WA, Saltzberg D, Stone B, Valuev V, Clare R, Gary JW, Gordon M, Hanson G, Long OR, Manganelli N, Si W, Wimpenny S, Branson JG, Cittolin S, Cooperstein S, Diaz D, Duarte J, Gerosa R, Giannini L, Guiang J, Kansal R, Krutelyov V, Lee R, Letts J, Masciovecchio M, Mokhtar F, Pieri M, Quinnan M, Sathia Narayanan BV, Sharma V, Tadel M, Vourliotis E, Würthwein F, Xiang Y, Yagil A, Campagnari C, Citron M, Collura G, Dorsett A, Incandela J, Kilpatrick M, Kim J, Li AJ, Masterson P, Mei H, Oshiro M, Richman J, Sarica U, Schmitz R, Setti F, Sheplock J, Siddireddy P, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Latorre A, Lawhorn JM, Mao J, Newman HB, Nguyen TQ, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhu RY, Alison J, An S, Andrews MB, Bryant P, Dutta V, Ferguson T, Harilal A, Liu C, Mudholkar T, Murthy S, Paulini M, Roberts A, Sanchez A, Terrill W, Cumalat JP, Ford WT, Hassani A, Karathanasis G, MacDonald E, Marini F, Perloff A, Savard C, Schonbeck N, Stenson K, Ulmer KA, Wagner SR, Zipper N, Alexander J, Bright-Thonney S, Chen X, Cranshaw DJ, Fan J, Fan X, Gadkari D, Hogan S, Monroy J, Patterson JR, Reichert J, Reid M, Ryd A, Thom J, Wittich P, Zou R, Albrow M, Alyari M, Apollinari G, Apresyan A, Bauerdick LAT, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Di Petrillo KF, Dickinson J, Elvira VD, Feng Y, Freeman J, Gandrakota A, Gecse Z, Gray L, Green D, Grünendahl S, Guerrero D, Gutsche O, Harris RM, Heller R, Herwig TC, Hirschauer J, Horyn L, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klijnsma T, Klima B, Kwok KHM, Lammel S, Lincoln D, Lipton R, Liu T, Madrid C, Maeshima K, Mantilla C, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, Ngadiuba J, Noonan D, Norberg S, Papadimitriou V, Pastika N, Pedro K, Pena C, Ravera F, Hall AR, Ristori L, Sexton-Kennedy E, Smith N, Soha A, Spiegel L, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Zoi I, Avery P, Bourilkov D, Cadamuro L, Chang P, Cherepanov V, Field RD, Koenig E, Kolosova M, Konigsberg J, Korytov A, Kuznetsova E, Lo KH, Matchev K, Menendez N, Mitselmakher G, Muthirakalayil Madhu A, Rawal N, Rosenzweig D, Rosenzweig S, Shi K, Wang J, Wu Z, Adams T, Askew A, Bower N, Habibullah R, Hagopian V, Kolberg T, Martinez G, Prosper H, Viazlo O, Wulansatiti M, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Kumar Verma R, Rahmani M, Yumiceva F, Adams MR, Cavanaugh R, Dittmer S, Evdokimov O, Gerber CE, Hofman DJ, Lemos DS, Merrit AH, Mills C, Oh G, Roy T, Rudrabhatla S, Tonjes MB, Varelas N, Wang X, Ye Z, Yoo J, Alhusseini M, Dilsiz K, Emediato L, Karaman G, Köseyan OK, Merlo JP, Mestvirishvili A, Nachtman J, Neogi O, Ogul H, Onel Y, Penzo A, Snyder C, Tiras E, Amram O, Blumenfeld B, Corcodilos L, Davis J, Gritsan AV, Kyriacou S, Maksimovic P, Roskes J, Sekhar S, Swartz M, Vámi T, Abreu A, Alcerro Alcerro LF, Anguiano J, Baringer P, Bean A, Flowers Z, King J, Krintiras G, Lazarovits M, Le Mahieu C, Lindsey C, Marquez J, Minafra N, Murray M, Nickel M, Rogan C, Royon C, Salvatico R, Sanders S, Smith C, Wang Q, Wilson G, Allmond B, Duric S, Ivanov A, Kaadze K, Kalogeropoulos A, Kim D, Maravin Y, Mitchell T, Modak A, Nam K, Roy D, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Bethani A, Eno SC, Hadley NJ, Jabeen S, Kellogg RG, Koeth T, Lai Y, Lascio S, Mignerey AC, Nabili S, Palmer C, Papageorgakis C, Wang L, Wong K, Busza W, Cali IA, Chen Y, D’Alfonso M, Eysermans J, Freer C, Gomez-Ceballos G, Goncharov M, Harris P, Kovalskyi D, Krupa J, Lee YJ, Long K, Mironov C, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Wang J, Wang Z, Wyslouch B, Yang TJ, Chatterjee RM, Crossman B, Hiltbrand J, Joshi BM, Kapsiak C, Krohn M, Kubota Y, Mahon D, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Cremaldi LM, Bloom K, Bryson M, Claes DR, Fangmeier C, Finco L, Golf F, Joo C, Kamalieddin R, Kravchenko I, Reed I, Siado JE, Snow GR, Tabb W, Wightman A, Yan F, Zecchinelli AG, Agarwal G, Bandyopadhyay H, Hay L, Iashvili I, Kharchilava A, McLean C, Morris M, Nguyen D, Pekkanen J, Rappoccio S, Williams A, Alverson G, Barberis E, Haddad Y, Han Y, Krishna A, Li J, Lidrych J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Hahn KA, Liu Y, Odell N, Schmitt MH, Velasco M, Band R, Bucci R, Cremonesi M, Das A, Goldouzian R, Hildreth M, Hurtado Anampa K, Jessop C, Lannon K, Lawrence J, Loukas N, Lutton L, Mariano J, Marinelli N, Mcalister I, McCauley T, Mcgrady C, Mohrman K, Moore C, Musienko Y, Ruchti R, Townsend A, Wayne M, Yockey H, Zarucki M, Zygala L, Bylsma B, Carrigan M, Durkin LS, Hill C, Joyce M, Lesauvage A, Nunez Ornelas M, Wei K, Winer BL, Yates BR, Addesa FM, Das P, Dezoort G, Elmer P, Frankenthal A, Greenberg B, Haubrich N, Higginbotham S, Kopp G, Kwan S, Lange D, Loeliger A, Marlow D, Ojalvo I, Olsen J, Stickland D, Tully C, Malik S, Bakshi AS, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Kondratyev D, Koshy AM, Liu M, Negro G, Neumeister N, Paspalaki G, Piperov S, Purohit A, Schulte JF, Stojanovic M, Thieman J, Virdi AK, Wang F, Xiao R, Xie W, Dolen J, Parashar N, Acosta D, Baty A, Carnahan T, Dildick S, Ecklund KM, Fernández Manteca PJ, Freed S, Gardner P, Geurts FJM, Kumar A, Li W, Padley BP, Redjimi R, Rotter J, Yang S, Yigitbasi E, Zhang Y, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Parygin P, Popova E, Taus R, Van Onsem GP, Goulianos K, Chiarito B, Chou JP, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Jaroslawski D, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Routray H, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Fiorendi S, Holmes T, Nibigira E, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Volobouev I, Whitbeck A, Appelt E, Greene S, Gurrola A, Johns W, Melo A, Romeo F, Sheldon P, Tuo S, Velkovska J, Viinikainen J, Cardwell B, Cox B, Cummings G, Hakala J, Hirosky R, Ledovskoy A, Li A, Neu C, Perez Lara CE, Karchin PE, Aravind A, Banerjee S, Black K, Bose T, Dasu S, De Bruyn I, Everaerts P, Galloni C, He H, Herndon M, Herve A, Koraka CK, Lanaro A, Loveless R, Madhusudanan Sreekala J, Mallampalli A, Mohammadi A, Mondal S, Parida G, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Tsoi HF, Vetens W, Warden A, Afanasiev S, Andreev V, Andreev Y, Aushev T, Azarkin M, Babaev A, Belyaev A, Blinov V, Boos E, Borshch V, Budkouski D, Bunichev V, Chadeeva M, Chekhovsky V, Danilov M, Dermenev A, Dimova T, Dremin I, Dubinin M, Dudko L, Epshteyn V, Ershov A, Gavrilov G, Gavrilov V, Gninenko S, Golovtcov V, Golubev N, Golutvin I, Gorbunov I, Ivanov Y, Kachanov V, Kardapoltsev L, Karjavine V, Karneyeu A, Kim V, Kirakosyan M, Kirpichnikov D, Kirsanov M, Klyukhin V, Kodolova O, Konstantinov D, Korenkov V, Kozyrev A, Krasnikov N, Lanev A, Levchenko P, Litomin A, Lychkovskaya N, Makarenko V, Malakhov A, Matveev V, Murzin V, Nikitenko A, Obraztsov S, Oskin A, Ovtin I, Palichik V, Perelygin V, Perfilov M, Petrushanko S, Popov V, Radchenko O, Rusinov V, Savina M, Savrin V, Shalaev V, Shmatov S, Shulha S, Skovpen Y, Slabospitskii S, Smirnov V, Sosnov D, Sulimov V, Tcherniaev E, Terkulov A, Teryaev O, Tlisova I, Toropin A, Uvarov L, Uzunian A, Vorobyev A, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Zhokin A. A search for decays of the Higgs boson to invisible particles in events with a top-antitop quark pair or a vector boson in proton-proton collisions at s=13TeV

A search for decays to invisible particles of Higgs bosons produced in association with a top-antitop quark pair or a vector boson, which both decay to a fully hadronic final state, has been performed using proton-proton collision data collected at s = 13 Te V by the CMS experiment at the LHC, corresponding to an integrated luminosity of 138fb - 1 . The 95% confidence level upper limit set on the branching fraction of the 125Ge V Higgs boson to invisible particles, B ( H → inv ) , is 0.54 (0.39 expected), assuming standard model production cross sections. The results of this analysis are combined with previous B ( H → inv ) searches carried out at s = 7 , 8, and 13Te V in complementary production modes. The combined upper limit at 95% confidence level on B ( H → inv ) is 0.15 (0.08 expected).

Observation of τ Lepton Pair Production in Ultraperipheral Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

We present an observation of photon-photon production of τ lepton pairs in ultraperipheral lead-lead collisions. The measurement is based on a data sample with an integrated luminosity of 404  μb^{-1} collected by the CMS experiment at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02  TeV. The γγ→τ^{+}τ^{-} process is observed for τ^{+}τ^{-} events with a muon and three charged hadrons in the final state. The measured fiducial cross section is σ(γγ→τ^{+}τ^{-})=4.8±0.6(stat)±0.5(syst)  μb, where the second (third) term corresponds to the statistical (systematic) uncertainty in σ(γγ→τ^{+}τ^{-}) in agreement with leading-order QED predictions. Using σ(γγ→τ^{+}τ^{-}), we estimate a model-dependent value of the anomalous magnetic moment of the τ lepton of a_{τ}=0.001_{-0.089}^{+0.055}.

Temporal Structures in Positron Spectra and Charge-Sign Effects in Galactic Cosmic Rays

We present the precision measurements of 11 years of daily cosmic positron fluxes in the rigidity range from 1.00 to 41.9 GV based on 3.4×10^{6} positrons collected with the Alpha Magnetic Spectrometer (AMS) aboard the International Space Station. The positron fluxes show distinctly different time variations from the electron fluxes at short and long timescales. A hysteresis between the electron fluxes and the positron fluxes is observed with a significance greater than 5σ at rigidities below 8.5 GV. On the contrary, the positron fluxes and the proton fluxes show similar time variation. Remarkably, we found that positron fluxes are modulated more than proton fluxes with a significance greater than 5σ for rigidities below 7 GV. These continuous daily positron fluxes, together with AMS daily electron, proton, and helium fluxes over an 11-year solar cycle, provide unique input to the understanding of both the charge-sign and mass dependencies of cosmic rays in the heliosphere.

High Dose Hyperfractionated Thoracic Radiotherapy vs. Standard Dose for Limited Stage Small-Cell Lung Cancer: A Multicenter, Open-Label Randomized, Phase 3 Trial

PURPOSE/OBJECTIVE(S)

Limited stage small-cell lung cancer (LS-SCLC) is associated with poor prognosis. We aimed to assess the efficacy and safety of high-dose, hyperfractionated thoracic radiotherapy of 54 Gy in 30 fractions compared with standard dose (45 Gy in 30 fractions) as a first-line treatment for LS-SCLC.

MATERIALS/METHODS

The study was an open-label, randomized, phase 3 trial, done at 16 public hospitals in China. Key inclusion criteria were patients aged 18-70 years, with previously histologically or cytologically confirmed LS-SCLC, previously untreated or received 1-2 courses of intravenous cisplatin (75 mg/m²of body-surface area, on day 1 or divided into two days of each cycle) or carboplatin (area under the curve of 5 mg/mL per min, day 1 of each cycle)and intravenous etoposide (100 mg/m²of body-surface area, on days 1-3 of each cycle), and an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.Eligible patients were randomly assigned (1:1) to receive volumetric-modulated arc radiotherapy (VMAT) of 45 Gy in 30 fractions or the simultaneous integrated boost VMAT (SIB-VMAT) of 54 Gy in 30 fractions to the primary lung tumor and lymph node metastases starting 0-42 days after the first chemotherapy course. Both groups of patients received thoracic radiotherapy twice per day and 10 fractions per week. Prophylactic cranial radiation (PCI, 25 Gy in 10 fractions) was implemented to patients with responsive disease. The primary endpoint was overall survival. Safety was analyzed in the as-treated population.

RESULTS

Between June 30, 2017, and April 6, 2021, 224 eligible patients were enrolled and randomly assigned to 54 Gy (n = 108) or 45 Gy (n = 116). Median follow-up for the primary analysis was 45 months (IQR 41-48). Median overall survival was significantly improved in the 54 Gy group (62.4 months) compared with the 45 Gy group (43.1 months; p = 0.001). Median progression-free survival was significantly improved in the 54 Gy group (30.5 months) compared with the 45 Gy group (16.7 months; p = 0.044). The most common grade 3-4 adverse events were neutropenia (30 [28%] of 108 patients in the 54 Gy group vs 27 [23%] of 116 patients in the 45 Gy group), neutropenic infections (6 [6%] vs 2 [2%]), thrombocytopenia (13 [12%] vs 12 [10%]), anemia (6 [6%] vs 4 [3%]), and esophagitis (1 [1%] vs 3 [3%]). Treatment-related serious adverse events occurred in 9 [8%] patients in the 54 Gy group and 16 [14%] patients in the 45 Gy group. There were one treatment-related deaths in 54 Gy group (myocardial infarction).

CONCLUSION

Compared with standard thoracic radiotherapy dose of 45 Gy, the high dose of 54 Gy improved overall survival and progression-free survival without increasing toxicities in patients with LS-SCLC, supporting twice-daily hyperfractionated thoracic radiotherapy of 54 Gy with concurrent chemotherapy is an alternative treatment option for LS-SCLC. This study is complete and registered with ClinicalTrials.gov, NCT03214003.

Fibulin-1 Regulates Initiation of Successional Dental Lamina

In humans, teeth are replaced only once, and the successional dental lamina (SDL) of the permanent tooth is maintained in a quiescent state until adolescence. Recently, we showed that biomechanical stress generated by the rapid growth of the deciduous tooth inhibits SDL development via integrin β1-RUNX2 signaling at embryonic day 60 (E60) in miniature pigs. However, the mechanism by which RUNX2 regulates SDL initiation within the SDL stem cell niche remains unclear. In the current study, we transcriptionally profiled single cells from SDL and surrounding mesenchyme at E60 and identified the landscape of cellular heterogeneity. We then identified a specific fibroblast subtype in the dental follicle mesenchyme between the deciduous tooth and the SDL of the permanent tooth (DFDP), which constitutes the inner part of the niche (deciduous tooth side). Compared with traditional dental follicle cells, the specific expression profile of DFDP was identified and found to be related to biomechanical stress. Subsequently, we found that RUNX2 could bind to the enhancer regions of Fbln1 (gene of fibulin-1), one of the marker genes for DFDP. Through gain- and loss-of-function experiments, we proved that the biomechanical stress-mediated RUNX2-fibulin-1 axis inhibits the initiation of SDL by maintaining SDL niche homeostasis.

Genome-wide DNA methylation landscape of four Chinese populations and epigenetic variation linked to Tibetan high-altitude adaptation

DNA methylation (DNAm) is one of the major epigenetic mechanisms in humans and is important in diverse cellular processes. The variation of DNAm in the human population is related to both genetic and environmental factors. However, the DNAm profiles have not been investigated in the Chinese population of diverse ethnicities. Here, we performed double-strand bisulfite sequencing (DSBS) for 32 Chinese individuals representing four major ethnic groups including Han Chinese, Tibetan, Zhuang, and Mongolian. We identified a total of 604,649 SNPs and quantified DNAm at more than 14 million CpGs in the population. We found global DNAm-based epigenetic structure is different from the genetic structure of the population, and ethnic difference only partially explains the variation of DNAm. Surprisingly, non-ethnic-specific DNAm variations showed stronger correlation with the global genetic divergence than these ethnic-specific DNAm. Differentially methylated regions (DMRs) among these ethnic groups were found around genes in diverse biological processes. Especially, these DMR-genes between Tibetan and non-Tibetans were enriched around high-altitude genes including EPAS1 and EGLN1, suggesting DNAm alteration plays an important role in high-altitude adaptation. Our results provide the first batch of epigenetic maps for Chinese populations and the first evidence of the association of epigenetic changes with Tibetans' high-altitude adaptation.

[The technical difficulties and surgical key points of laparoscopic radical resection for perhilar cholangiocarcinoma]

With the continuous accumulation of laparoscopic radical resection for perihilar cholangiocarcinoma(PHC), the safety and feasibility have been confirmed, and some studies have shown that considering the comparable long-term prognosis and short-term outcomes of laparoscopic surgery and open surgery, laparoscopic surgery could be a technically feasible surgical method for PHC patients of all Bismuth-Corlette types. However, laparoscopic radical resection for PHC is still challenging and controversial due to the complex operation process, surgery-related complications and quality control in different centers. How to solve some key points and difficulties in the operation process, reduce surgical complications, improve the survival prognosis of patients, to make the operation widely popularized and applied are urgent problems for hepatobiliary surgeons. In this paper, some technical difficulties and key points of laparoscopic radical resection for PHC are discussed with the author's team surgical experience and related literature.

Efficacy and safety of methylene blue injection for intractable idiopathic pruritus ani: a single-arm metaanalysis and systematic review

PURPOSE

To evaluate how effective methylene blue injection was at treating intractable idiopathic pruritus ani.

METHODS

A comprehensive literature search of the PubMed, Embase, Cochrane library, and Web of Science databases was conducted. All clinical studies (prospective and retrospective) that evaluated the efficacy of methylene blue in treating intractable idiopathic pruritus ani were included. Studies that reported the resolution rate, after a single injection and after a second injection, the recurrence rate, symptom scores, and transient complications of methylene blue injections in treating intractable idiopathic pruritus ani were included.

RESULTS

The seven selected studies included 225 patients with idiopathic pruritus ani. The resolution rates after a single injection and after a second injection was 0.761 (0.649-0.873, P < 0.01, I2 = 69.06%) and 0.854 (0.752-0.955, P < 0.01, I2 = 77.391%), respectively, the remission rates at 1, 3, and 5 years were 0.753 (0.612-0.893, P < 0.001), 0.773 (0.675-0.871, P < 0.001) and 0.240 (0.033-0.447, P < 0.001), respectively, the effect value of the merger was 0.569 (0.367-0.772, P < 0.001, I2 = 79.199%), and the recurrence rates at 1, 2, 3, and < 1 year were 0.202 (0.083-0.322, P < 0.001), 0.533 (0.285-0.781, P < 0.001), 0.437 (-0.044, 0.917, P < 0.001) and 0.067 (0.023-0.111, P < 0.001), respectively. The effect value of the merger was 0.223 (0.126-0.319, P < 0.001, I2 = 75.840).

CONCLUSION

Using methylene blue injections to treat intractable idiopathic pruritus ani is relatively efficacious, resulting in a relatively low recurrence rate and no severe complications. However, the available literature was of poor quality. Therefore, higher quality studies are necessary to confirm that methylene blue injection is efficacious for pruritus ani, such as a randomized prospective multicenter studies.

Resource allocation of rural institutional elderly care in China's new era: spatial-temporal differences and adaptation development

OBJECTIVES

In the new era of China, to ensure that rural residents can get the corresponding institutional elderly services equally, it is necessary to investigate the current situation of resource allocation of rural institutional elderly care and make corresponding adaptation suggestions.

STUDY DESIGN

This research discusses the characteristics and evolution pattern of rural aging, the resource allocation of rural elderly care institutions, and the adaptation degree of rural institutional elderly care resource and aging.

METHODS

The research methodology consists of the following stages: entropy-based Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), kernel density estimation, coupling coordination, spatial autocorrelation, and Theil index decomposition.

RESULTS

The degree of aging in rural areas of China is rising, and the whole population has entered a moderate aging society, showing the spatial characteristics of 'high in the east and low in the west'. The resource allocation of rural institutional elderly care in China is at a low level, and the absolute differences among provinces tend to reduce over time, and the overall resource allocation level tends to decline. The provinces that were in the mismatched adaptation relationship in the early stage have improved; however, the number of provinces with mismatched adaptability has continued to increase. The local spatial autocorrelation of resource adaptation verifies that the middle and lower reaches of the Yangtze River as the core form a hot spot, and during the observation period, the spatial agglomeration effect of the core is strengthened. The Theil index decomposition of resource adaptation indicates that the within-group differences between the eastern and western regions is significantly higher than that between the northeastern and central regions.

CONCLUSIONS

First, special attention should be paid to preventing the resource allocation of rural institutional elderly care in the eastern and western regions from falling again. Second, to avoid more and more low-adapted provinces falling into the 'mismatch dilemma' with the deepening of the aging degree. Third, strengthen cooperation among regions and promote the coordinated development of resource allocation of institutional elderly care in various regions. Fourth, the priority of institutional elderly care balanced development should be given to the eastern region and western region, thus weakening the overall difference.

AI-Derived CT Body Composition in Advanced Non-Small Cell Lung Cancer: A Multicohort Study

PURPOSE/OBJECTIVE(S)

The relationship between body composition (BC) and cancer outcomes is complex and incompletely understood. Previous research in non-small cell lung cancer (NSCLC) has been limited to small single-institution studies, which have yielded inconsistent results.

MATERIALS/METHODS

We conducted a comprehensive multicohort analysis to evaluate the impact of BC on overall survival (OS) in advanced NSCLC treated with systemic therapy. The analysis included data from the phase I/II CP1108 study (NSCLC Durvalumab cohort) and the chemotherapy arm of the phase III MYSTIC trial. We also analyzed data from Dana-Farber Cancer Institute (DFCI) cohorts receiving immunotherapy alone or in combination with chemotherapy. Baseline and follow-up (FU) CT scans were collected and analyzed using deep neural networks for automatic L3 slice selection and body compartment segmentation (skeletal muscle [SM], subcutaneous adipose tissue [SAT], and visceral adipose tissue [VAT]). We compared OS based on baseline BC measures or their change at the first FU scan. The impact of sarcopenia at baseline was evaluated in association with the delta metrics.

RESULTS

A total of 1865 NSCLC patients were analyzed, of which 222 were treated on CP1108, 257 were treated on MYSTIC, 870 received IO monotherapy at DFCI (DFCI-IO), and 516 received chemoimmunotherapy at DFCI (DFCI-CIO). The median ages were 65, 63, 66, and 65, respectively. A loss in SM mass >5%, as indicated by a change in L3 SM area, was significantly associated with poorer OS across all patient groups (median [months]: 5 vs. 19; p<0.001 for CP1108, 11 vs. 14; p = 0.03 for MYSTIC, 11 vs. 17; p<0.001 for DFCI-IO, and 12 vs. 22; p<0.001 for DFCI-CIO). This effect was driven by male patients, with a non-significant association (p>0.5) among female patients in the MYSTIC and DFCI-CIO cohorts. An increase in SAT density >5%, as quantified by the average CT attenuation in HU of the SAT compartment, was significantly linked to poorer OS in three patient groups (median [months]: 4 vs. 19; p<0.001 for CP1108, 10 vs. 17; p<0.001 for DFCI-IO, and 12 vs. 20; p = 0.003 for DFCI-CIO). This was primarily observed among female patients, with a non-significant association (p>0.5) among male patients in the DFCI-CIO cohort. On subgroup analysis, loss in SM mass had an impact on OS in patients with baseline sarcopenia (median [months] 5 vs. 22; p<0.001 for CP1108, 5 vs. 12; p = 0.03 for MYSTIC, 11 vs. 17; p<0.001 for DFCI IO, and 9 vs. 17; p = 0.003 for DFCI-CIO). Conversely, no association was observed between change in SM mass and OS in patients without sarcopenia at baseline in the MYSTIC and DFCI-IO cohorts.

CONCLUSION

Sarcopenia and loss in SM mass during systemic therapy for NSCLC are markers of poor outcome, especially in male patients. SAT density changes are also strongly associated with prognosis, particularly in female patients. Automated CT-derived BC measurements should be considered along with other risk factors in determining lung cancer prognosis and ability to tolerate oncologic treatments.

Prediction Analysis of Dose Verification Based on Plan Complexity Metrics during Radiotherapy

PURPOSE/OBJECTIVE(S)

Plan validation in radiotherapy includes pre-treatment and in-treatment validation. It is feasible to leverage plan complexity to optimize validation processes, because some research reports that the consistency between planning and measurement or execution decreases as plan complexity increases. Therefore, starting from the plan complexity, this study comprehensively and systematically explores these factors affecting whether the plan verification is passed or not and the strength of their correlations, so as to establish a regression model and optimize the verification process.

MATERIALS/METHODS

The IMRT and model-based validation information were retrospectively collected for patients who received tumor radiotherapy at our institution from January 2020 to May 2022. The seventy-eight metrics characterizing the plan complexity were calculated and checked for each plan by an in-house developed computing platform. The comparisons of plan verification results under different tumor species and different verification methods were carried out, and the plan complexity metrics was also compared. Subsequently, Spearman correlation analysis between plan complexity and plan validation under different tumor species, different verification methods and different evaluation indexes was analyzed to provide the basis for regression analysis.

RESULTS

One thousand two hundred twenty-six patients were enrolled in the study. The plans in Eclipse TPS were performed by Varian Edge and iX linear accelerators and their verification were executed by EPID, Delat4, and ArcCheck. The gamma index under evaluation index of 3%/3mm, 3%/2mm, 2%/2mm, 1%/1mm were respectively 97.4% (7.1%), 94.8% (10.9%), 86.1% (20.1%), 50.7% (22.6%). The γ and DD of EPID and Detla4 decreased with the increase of TH, and the change of DD was the most significant, while the DTA of Detla4 did not change significantly with TH, and the passing rate of DTA and γ in thoracic and abdominal was the highest in ArcCheck group. Contrast and Variance were the most different between tumor types. The pelvic MIs and MIa were larger than those planned for the other three sites. Except for head and neck CLS and MD, other metrics did not vary significantly among tumor species. The correlation between the metrics characterizing the static characteristics of leaves was more significant for head and neck tumors; the correlation between metrics characterizing the flux complexity were significantly different in pelvic. There was a correlation between plan complexity and γ indicators, and the overall strength was ArcCheck > EPID > Delta4 for head and neck, Delta4 > EPID and ArcCheck for thorax-abdomen, Delta4 and EPID > ArcCheck for pelvic, Delta4 > ArcCheck > EPID for arms and legs.

CONCLUSION

There was a correlation between different plan complexity metrics. Based on this study, it is feasible to predict the verification results based on these complexity metrics, but the regression models were respectively established according to tumor types and validation methods.

A Comparison of Two Plan Optimization Methods in Three-Dimensional Brachytherapy for Cervical Cancer

PURPOSE/OBJECTIVE(S)

To compare dose distributions created by using two Inverse Planning Simulated Annealing (IPSA) and Hybrid Inverse Planning Optimization (HIPO) in three-dimensional (with CT image guidance) brachytherapy planning for cervical cancer.

MATERIALS/METHODS

Brachytherapy plans for thirty patients with cervical cancer were created using the IPSA and HIPO algorithms (The IPSA algorithm is calculated based on the anatomical structure, and the simulated annealing algorithm is used to optimize the residence time, and the HIPO algorithm is the optimization and replacement for the IPSA). To obtain a HIPO plan, a manually optimized post-loading treatment plan was applied to these 30 patients, and then the treatment plan was reoptimized using the HIPO algorithm based on the original image information. Individual patients will consider interpolation therapy according to the needs of their condition. The types of plans were compared based on a variety of dose volume parameters, including the mean dose covering 90% of high-risk clinical target volume (D90 for HR-CTV), the mean dose to 2 cm3 volume (D2cc) for bladder, rectum, intestine and sigmoid, and average treatment time were compared and analyzed.

RESULTS

Compared with the two groups of plans, mean value of HR-CTV D90 for the HIPO plans was (585 cGy), which was significantly higher than that for the IPSA plans (567 cGy. This difference is statistically significant (P<0.05). The HIPO plans had mean D2cc 422±47 cGy for bladder, 403±38 cGy for rectum, which were lower than those from the SA plans, i.e., 446±42 cGy for bladder and 427±31 cGy for rectum; These differences were statistically significant (t = 5.125, 4.729, P <0.05). There was no statistically significant difference in the sigmoid D2cc doses between the two algorithms. The treatment times for delivering the two types of plans were not significant different.

CONCLUSION

Depending on patient's condition, whether conventional brachytherapy therapy or interpolation therapy is used, the use of the HIPO algorithm to design the treatment regimen without additional treatment time can provide a higher target dose than the manually optimized brachytherapy regimen. Meanwhile, the bladder and rectum doses can be reduced to a certain extent under the premise of ensuring that the target dose met the treatment requirements. There is some increasement for the intestine dose with HIPO planning group, but the dose limits required by the guidelines are still met clinical requirement.

[Discussion on the history of Pinelliae Rhizoma Praeparatum(Fa banxia) Processing]

Before the Song Dynasty, the main processing method of Pinelliae Rhizoma was soup washing. The "new method" in Taiping Huimin Heji JuFang is a processing method that concocted with Ginger,white alum and starter-making.The "Fa Banxia" in the Yuan Dynasty's Yuyuan Yaofang comes from the Taiping Huimin Heji JuFang, and the Fa Wen Banxia, Fa Bai Banxia, and Fa Hong Banxia are the processing methods of patent medicine with a variety of other herbs.Fa Banxia appeared in the Ming Dynasty, and its auxiliary materials were ginger and white alum, and medical formulary began to include formulas containing Fa Banxia. Bencao Gangmu abbreviates the Yuan Dynasty's Fabai Banxia as "Fa Banxia", and is elaborated under the item attached "prescription" item instead of the "treatment". In the literature of Materia Medica, it is recorded that the preparation of auxiliary materials in Fa Banxia increased, including lime, licorice, soap horn, and simple nitro.After Daoguang in the Qing Dynasty, the Fa Banxia in famous medical cases was more used, and at that time, Fa Banxia was Xian Banxia. There are two recipes for Xian Banxia: one is made with seven processes, and the other is soaked in alum licorice water. During the Republican period, Zhang Cigong also pointed out that Fa Banxia was sliced Xian Banxia after rinsing and boiling, while the preparation method of Xian Banxia was Banxia made of ginger and white alum.Ye Juquan pointed out that the so-called "fa" is neither an ancient method nor a new method, questioning the process of repeated immersion in Banxia. After 1949, the questioning of Fa Banxia continued unceasing.Influenced by this, the 1960 edition Beijing Traditional Chinese Medicine Slice Cutting Experience included the method of soaking alum, licorice ,lime water, and was included in the 1963 edition of the Pharmacopoeia of the People's Republic of China.The 1985 version reduced the soaking time and eliminated the soaking process of alum based on the 1963 version, and this method is still used today.

[Microanatomy and functional MRI study of arcuate fasciculus and superior longitudinal fasciculus]

Objectives: To explore the microanatomy and functional MRI(fMRI) of arcuate fasciculus(AF) and superior longitudinal fasciculus(SLF),and to analyze their functions. Methods: Ten normal adult cadaveric head specimens (20 cerebral hemispheres) were fixed with 10% methanal at the Translational Research Institute for Neurological Disorders of the Wannan Medical Collegefrom February to December 2022.The Klingler fiber dissection technique was utilized to perform white matter fiber dissection,with a magnification ranging from 6 to 40.The study focused on the microanatomical structures of the AF and SLF,aiming to explore their relationships with deep brain fibers.Furthermore, six healthy adult volunteers who underwent fMRI of the brain were included.The collected diffusion tensor imaging (DTI) data were processed and integrated with the microanatomical findings for a comprehensive analysis. Results: After removing the gray matter of the cerebral cortex,the superficial U fibers were exposed.The long association fibers that beneath the U fibers were the AF and SLF,which were the main long association fibers in the superficial layers of the brain.The AF could be divided into dorsal and ventral parts,while the SLF could be divided into Ⅰ,Ⅱ,and Ⅲ.SLF Ⅰ lied within the upper bank of the cingulate sulcus,travels medial to the callosal sulcus.The SLF Ⅱ,Ⅲ,and the AF were located on the lateral surface of the brain.By removing the gray matter of the insular cortex and the extreme capsule,exposing the external capsule and claustrum.Subsequently,the AF and SLF Ⅱ,Ⅲ were dissected,revealing the corona radiata and sagittal stratum,along with other deep brain fibers.During the dissection,it was observed that there was a close connection between the AF,SLF Ⅱ,and the deep brain fibers.Furthermore,in the regions above the lateral fissure of the cerebral hemisphere,there was no direct connection of long association fibers between the gray matter cortex and the deep U fibers in the coronal plane.These findings were further supported by DTI studies. Conclusions: The AF and SLF are the major long association fibers that located in the superficial layers of the brain,and closely connect to the gray matter cortex and U fibers,even closely relate with deep brain fibers.In the regions above the lateral fissure of the hemisphere,only the AF and SLF Ⅱ and Ⅲ serve as superficial long association fibers in the anterior-posterior direction.These fibers are likely involved in the transmission of brain functional information between the top and bottom gray matter cortex in the coronal plane above the lateral fissure.

Retraction: Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface

Retraction of 'Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface' by B. L. Wang et al., J. Mater. Chem. B, 2015, 3, 5501-5510, https://doi.org/10.1039/C5TB00597C.

Measurement of the Dependence of the Hadron Production Fraction Ratios f_{s}/f_{u} and f_{d}/f_{u} on B Meson Kinematic Variables in Proton-Proton Collisions at sqrt[s]=13 TeV

The dependence of the ratio between the B_{s}^{0} and B^{+} hadron production fractions, f_{s}/f_{u}, on the transverse momentum (p_{T}) and rapidity of the B mesons is studied using the decay channels B_{s}^{0}→J/ψϕ and B^{+}→J/ψK^{+}. The analysis uses a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 61.6  fb^{-1}. The f_{s}/f_{u} ratio is observed to depend on the B p_{T} and to be consistent with becoming asymptotically constant at large p_{T}. No rapidity dependence is observed. The ratio of the B^{0} to B^{+} meson production fractions, f_{d}/f_{u}, is also measured, for the first time in proton-proton collisions, using the B^{0}→J/ψK^{*0} decay channel. The result is found to be within 1 standard deviation of unity and independent of p_{T} and rapidity, as expected from isospin invariance.

[Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity]

Objective: To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. Methods: A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7th day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, Nemenyi test, and Bonferroni correction. Results: On the 7th day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (P>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (P<0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (P<0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with Z values of 12.91 and 15.69, respectively, P<0.05) and artificial dermis alone group (with Z values of 12.50 and 12.91, respectively, P<0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (P>0.05). In artificial dermis alone group, one patient experienced partial liquefaction and detachment of the double-layer artificial dermis due to local infection of Staphylococcus epidermidis, which received wound dressing change, second artificial dermis transplantation, and subsequent treatment as before. No adverse reactions occurred in the remaining patients during the whole treatment process. Conclusions: Local injection of PRP combined with double-layer artificial dermis is effective in treating wounds with exposed tendon on extremity, which can not only significantly shorten wound healing time and length of hospital stay, but also improve scar pliability after wound healing to some extent in the long term. It is a clinically valuable treatment technique that is worth promoting and applying.

[Humanized anti-CD25 monoclonal antibody as a salvage therapy for steroid-refractory acute graft-versus-host disease after hematopoietic stem cell transplantation]

Objective: To investigate the efficacy of humanized anti-CD25 monoclonal antibody for steroid-refractory acute graft-versus-host disease (SR-aGVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Methods: A total of 64 patients with SR-aGVHD between June 2019 and October 2020 in Suchow Hopes Hematology Hospital were enrolled in this study. Humanized anti-CD25 monoclonal antibodies 1 mg·kg(-1)·d(-1) were administered on days 1, 3, and 8, and then once per week according to the disease progression. Efficacy was assessed at days 7, 14, and 28 after humanized anti-CD 25 treatment. Results: Of the 64 patients with a median age of 31 (15-63) years, 38 (59.4%) were male and 26 (40.6%) were female. The overall response (OR) rate of the humanized CD25 monoclonal antibody in 64 patients with SR-aGVHD on days 7, 14, and 28 were 48.4% (31/64), 53.1% (34/64), and 79.7% (51/64), respectively. Liver involvement is an independent risk factor for poor efficacy of humanized CD25 monoclonal antibody for SR-aGVHD at day 28 (OR=9.588, 95% CI 0.004-0.291, P=0.002). The median follow-up time for all patients was 17.1 (0.2-50.8) months from the start of humanized CD25 monoclonal antibody therapy. The 1- and 2-year OS rates were 63.2% (95% CI 57.1% -69.3%) and 52.6% (95% CI 46.1% -59.1%), respectively. The 1- and 2-year DFS rates were 58.4% (95% CI 52.1% -64.7%) and 49.8% (95% CI 43.4% -56.2%), respectively. The 1- and 2-year NRM rates were 28.8% (95% CI 23.1% -34.5%) and 32.9% (95% CI 26.8% -39.0%), respectively. The results of the multifactorial analysis showed that liver involvement (OR=0.308, 95% CI 0.108-0.876, P=0.027) and GVHD grade Ⅲ/Ⅳ (OR=9.438, 95% CI 1.211-73.577, P=0.032) were independent risk factors for OS. Conclusion: Humanized CD25 monoclonal antibody has good efficacy and safety for SR-aGVHD. This study shows that SR-aGVHD with pretreatment grade Ⅲ/Ⅳ GVHD and GVHD involving the liver has poor efficacy and prognosis and requires early intervention.

DLBCL-associated NOTCH2 mutations escape ubiquitin-dependent degradation and promote chemoresistance

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. Up to 40% of patients with DLBCL display refractory disease or relapse after standard chemotherapy treatment (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone [R-CHOP]), leading to significant morbidity and mortality. The molecular mechanisms of chemoresistance in DLBCL remain incompletely understood. Using a cullin-really interesting new gene (RING) ligase-based CRISPR-Cas9 library, we identify that inactivation of the E3 ubiquitin ligase KLHL6 promotes DLBCL chemoresistance. Furthermore, proteomic approaches helped identify KLHL6 as a novel master regulator of plasma membrane-associated NOTCH2 via proteasome-dependent degradation. In CHOP-resistant DLBCL tumors, mutations of NOTCH2 result in a protein that escapes the mechanism of ubiquitin-dependent proteolysis, leading to protein stabilization and activation of the oncogenic RAS signaling pathway. Targeting CHOP-resistant DLBCL tumors with the phase 3 clinical trial molecules nirogacestat, a selective γ-secretase inhibitor, and ipatasertib, a pan-AKT inhibitor, synergistically promotes DLBCL destruction. These findings establish the rationale for therapeutic strategies aimed at targeting the oncogenic pathway activated in KLHL6- or NOTCH2-mutated DLBCL.

[Effect of fluid viscosity on the biomechanical sequence of oropharyngeal swallowing in healthy males]

Objective: To confirm the effect of fluid with different viscosity on the normal biomechanical sequence of oropharyngeal swallowing in healthy males. Methods: Fifteen healthy male subjects [(27.7±1.8) years old] were recruited from November 2011 to February 2012 and instructed to swallow 15 ml of water (W), nectar-like fluid (N), and honey-like fluid (H) in an upright sitting position. The sensing system was consisted of tongue pressure sensor sheet, bend sensor, surface electrodes and microphone. They were used to monitor tongue pressure, hyoid activity, surface electromyography (EMG) of swallowing-related muscles and swallowing sound, respectively. The swallowing sound was chosen as the reference time. The significance of biomechanical sequence of structural events was determined by repeated-measures analysis of variance (ANOVA). Results: When swallowing liquid of any consistency, hyoid premotor and suprahyoid muscle electromyography (EMG) appeared synchronously (P>0.05), followed by the simultaneous appearances of hyoid rapid movement, peak time of suprahyoid muscle EMG, onset of infrahyoid muscle EMG, and anterior tongue pressure production (P>0.05). The peak time of infrahyoid muscle EMG was very close to the peak time of anterior tongue pressure (P>0.05), and both of them were earlier than the time that the hyoid reaching the highest position (P<0.05). At last, the time that the hyoid departing the highest position was synchronized with the disappearances of suprahyoid muscle EMG, infrahyoid muscle EMG, and tongue pressure (P>0.05). The tongue pressure production and peak time of tongue pressure arose from anterior to posterior along the midline of hard palate during normal swallowing, with the significances for tongue pressure production between the anterior site and the middle site (W: P=0.035, N: P=0.027, H: P=0.013) as well as the anterior site and the posterior site (W: P<0.001, N: P<0.001, H: P<0.001), while the appearance and peak time of the circumferential tongue pressure were very close (P>0.05). The increase of fluid viscosity did not affect the biomechanical sequence of the above structural physiological movements during normal swallowing. There were statistically significant differences between the hyoid premotor and the onset of suprahyoid muscle EMG when swallowing the honey-like liquid [(-1.03±0.47) and (-0.90±0.50) s] and water[(-0.87±0.32) and (-0.74±0.31) s] (P<0.001). Among the delayed structural events, except for the onset of infrahyoid muscle EMG and the tongue pressure production on the anterior site (P>0.05), the occurrences of all the parameters in swallowing honey-like fluid were significantly later than those in swallowing water (onset of hyoid rapid movement, P=0.007; time of hyoid reaching the highest position, P=0.034; time of hyoid departing the highest position, P=0.041; offset of hyoid movement, P=0.035; peak time of suprahyoid muscle EMG: P=0.040; offset of suprahyoid muscle EMG, P=0.014; peak time of infrahyoid muscle EMG: P=0.042; offset of infrahyoid muscle EMG, P=0.028; peak time of Ch.1: P=0.045; offset of Ch.1: P=0.012; onset of Ch.2: P=0.038; peak time of Ch.2: P=0.009; offset of Ch.2: P=0.034; onset of Ch.3: P=0.043; peak time of Ch.3: P=0.011; offset of Ch.3: P=0.026;onset of Ch.4: P=0.040; peak time of Ch.4: P=0.038; offset of Ch.4: P=0.033; onset of Ch.5: P=0.046; peak time of Ch.5:P=0.028; offset of Ch.5: P<0.001), but not for those between nectar-like fluid and honey-like fluid (P>0.05). Conclusions: The alteration of fluid viscosity did not affect healthy male biomechanical sequence of tongue, hyoid and swallowing-related muscles during normal swallowing. The biomechanics of the oropharyngeal structures is physiologically regulated with the alteration of fluid viscosity to ensure swallowing safely and smoothly.