MicroRNA-150-5P regulates Th1/Th2 cytokines expression levels by targeting EGR2 in allergic rhinitis

BACKGROUND

MiR-150-5p is one of the miRNAs in the expression profile of miRNAs, and in many previous studies, it has been shown that miR-150-5p may play an important role in peripheral blood dendritic cells (DCs) of allergic rhinitis (AR) patients. We sought to investigate the role and mechanism of miR-150-5p in regulating DC function by modulating EGR2 and influencing T cell derivation to promote AR development.

METHODS

The expression of miR-150-5p and EGR2 in AR patients was examined by real-time quantitative polymerase chain reaction (qRT-PCR), the expression of IL-4 cytokines in the supernatant of AR patients was tested by enzyme-linked immunosorbent assay (ELISA), and the expression of eosinophils in the supernatant of AR patients was measured by HE staining. The expression of EGR2 was detected by immunohistochemistry and fluorescent m-immunohistochemistry.

RESULTS

MiR-150-5p expression was up-regulated and EGR2 expression was down-regulated in peripheral blood DCs from AR patients. miR-150-5p upregulated DCs, which promoted T-cell differentiation. miR-150-5p further regulated EGR2, which suppressed DCs and caused alteration of T-cell differentiation, in turn triggering the occurrence of AR.

CONCLUSION

MiR-150-5p and its target gene EGR2 are involved in the development of AR, and DCs foster T-cell differentiation in peripheral blood of AR patients.

Evaluation of brain iron deposition in different cerebral arteries of acute ischaemic stroke patients using quantitative susceptibility mapping

AIM

To investigate differences in iron deposition between infarct and normal cerebral arterial regions in acute ischaemic stroke (AIS) patients using quantitative susceptibility mapping (QSM).

MATERIALS AND METHODS

Forty healthy controls and 40 AIS patients were recruited, and their QSM images were obtained. There were seven regions of interest (ROIs) in AIS patients, including the infarct regions of responsible arteries (R1), the non-infarct regions of responsible arteries (R2), the contralateral symmetrical sites of lesions (R3), and the non-responsible cerebral arterial regions (R4, R5, R6, R7). For the healthy controls, the cerebral arterial regions corresponding to the AIS patient group were selected as ROIs. The differences in corresponding ROI susceptibilities between AIS patients and healthy controls and the differences in susceptibilities between infarcted and non-infarct regions in AIS patients were compared.

RESULTS

The susceptibilities of infarct regions in AIS patients were significantly higher than those in healthy controls (p<0.0001). There was no significant difference in non-infarct regions between the two groups (p>0.05). The susceptibility of the infarct regions in AIS patients was significantly higher than those of the non-infarct region of responsible artery and non-responsible cerebral arterial regions (p<0.01).

CONCLUSIONS

Abnormal iron deposition detected by QSM in the infarct regions of AIS patients may not affect iron levels in the non-infarct regions of responsible arteries and normal cerebral arteries, which may open the door for potential new diagnostic and treatment strategies.

The value of quantitative contrast-enhanced ultrasonography analysis in evaluating central retinal artery microcirculation in patients with diabetes mellitus: comparison with colour Doppler imaging

AIM

To compare the efficacy of quantitative contrast-enhanced ultrasonography (CEUS) analysis and colour Doppler ultrasound (CDU) in evaluating central retinal artery (CRA) microcirculation in patients with diabetes mellitus (DM).

MATERIALS AND METHODS

In this prospective study, a total of 55 patients (98 eyes) with DM were enrolled as the study group. They were compared to 46 age-matched healthy volunteers (92 eyes) who were selected as the control group. Each patient underwent CDU and subsequent CEUS examination. CDU and quantitative CEUS parameters were evaluated. The diagnostic efficiency of the diagnostic performance of CEUS and CDU was evaluated and compared, and the scale thresholds of predictive indicators for the diagnosis of proliferative diabetic retinopathy (PDR) were evaluated using receiver operating characteristics (ROC) curve analyses.

RESULTS

Group pairwise comparisons showed that the end diastolic velocity (EDV) and arrival time (AT) of CRA were significant predictors for PDR by CDU and by quantitative CEUS analysis, respectively (all p<0.05). The ROC curve analysis showed that the area under the curve value of AT was significantly higher than that of EDV (0.875 versus 0.634, p=0.0002). Accordingly, an AT cut-off value of 1.07 seconds resulted a sensitivity of 90.62 % and a specificity of 79.31 %.

CONCLUSION

Quantitative CEUS analysis can improve the accuracy of clinical staging of diabetic retinopathy for the patients with DM, and the AT showed the best diagnostic efficiency.

Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

[Research progress in clinical diagnosis and treatment of osteosarcoma of the jaw]

Osteosarcoma of the jaw (JOS), is a relatively rare type of osteosarcoma, with a unique pathogenesis and pathological manifestations. The clinical manifestation of JOS is not characteristic, and it often needs to be diagnosed by combining radiological and pathological examination. At present, the conventional treatment of JOS is a comprehensive treatment based on surgery and supplemented by radiotherapy and chemotherapy. Recently, the emergence of new therapies such as immunotherapy, gene therapy, phototherapy and traditional Chinese medicine has provided more choices for treatment and brought new hope to patients with JOS. Therefore, this article summarized the current understanding of diagnosis and the latest treatment development of JOS.

[Nomogram prediction model of cervical anastomotic leakage after esophageal cancer surgery]

Objective: To retrospectively analyze the risk factors of anastomotic leakage in the neck after esophageal cancer and establish a nomogram prediction model that can accurately predict the occurrence of anastomotic leakage in the neck of the patient. Methods: The study retrospectively analyzed 702 patients who underwent radical esophageal cancer surgery between January 2010 and May 2015 at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. A multivariate logistic regression model was used to determine the risk factors for neck anastomotic leak, and a nomogram model was constructed, internal validation methods were used to evaluate and verify the predictive effectiveness of the nomogram. Results: There were 702 patients in the whole group, 492 in the training group and 210 in the validation group. The incidence of postoperative cervical anastomotic leak was 16.1% (79/492) in 492 patients with esophageal cancer in the training group. Multifactorial analysis revealed calcification of the descending aorta (OR=2.12, 95% CI: 1.14, 3.94, P=0.018), calcification of the celiac artery (OR=2.29, 95% CI: 1.13, 4.64, P=0.022), peripheral vascular disease (OR=5.50, 95% CI: 1.64, 18.40, P=0.006), postoperative ventilator-assisted breathing (OR=5.33, 95% CI: 1.83, 15.56, P=0.002), pleural effusion or septic chest (OR=3.08, 95% CI: 1.11, 8.55, P=0.031), incisional fat liquefaction and infection (OR=3.49, 95% CI: 1.68, 7.27, P=0.001) were independent risk factors for the development of cervical anastomotic leak after esophageal cancer surgery. The results of the nomogram prediction model showed that the consistency indices of the training and external validation groups were 0.73 and 0.74, respectively (P<0.001), suggesting that the prediction model has good predictive efficacy. Conclusion: The nomogram prediction model can intuitively predict the incidence of postoperative cervical anastomotic leakage in patients with high prediction accuracy, which can help provide a clinical basis for preventing cervical anastomotic leak and individualized treatment of patients.

[Establishment and validation of nomogram prediction model for complicated acute appendicitis]

Objective: To establish and internally validate a nomogram model for predicting complicated acute appendicitis (CA). Methods: The clinical data from 663 acute appendicitis patients from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from October 2015 to October 2022 were retrospectively analyzed. There were 411 males and 252 females, aged (M (IQR)) 41 (22) years (range: 18 to 84 years). There were 516 cases of CA and 147 cases of uncomplicated acute appendicitis. The minimum absolute contraction and selection operator regression model was used to screen the potential relative factors of CA, and the screened factors were included in the Logistic regression model for multivariate analysis. Software R was used to establish a preoperative CA nomogram prediction model, the receiver operating characteristic curve of the model was drawn, and the value of area under the curve (AUC) was compared to evaluate its identification ability, and the Bootstrap method was used for internal verification. Results: The elderly (age≥60 years) (OR=2.428, 95%CI: 1.295 to 4.549), abdominal pain time (every rise of 1 hour) (OR=1.089, 95%CI: 1.072 to 1.107), high fever (body temperature≥39 ℃) (OR=1.122, 95%CI: 1.078 to 1.168), total bilirubin (every rise of 1 μmol/L) (OR=2.629, 95%CI: 1.227 to 5.635) were independent relative factors of CA (all P<0.05). The AUC of this model was 0.935 (95%CI: 0.915 to 0.956). After internal verification using the Bootstrap method, the model still had a high discrimination ability (AUC=0.933), and the predicted CA curve was still in good agreement with the actual clinical CA curve. Conclusion: The clinical prediction model based on the elderly (age≥60 years), prolonged abdominal pain time, high fever (body temperature≥39 ℃), and increased total bilirubin can help clinicians effectively identify CA.

PD-L1 Inhibitors Combined with Thoracic Radiotherapy in First-Line Treatment of Extensive Stage Small Cell Lung Cancer: A Propensity Score-Matched, Real-World Study

PURPOSE/OBJECTIVE(S)

The CREST study showed that the addition of thoracic radiotherapy (TRT) could improve the survival of extensive stage small cell lung cancer (ES-SCLC), but whether TRT can bring survival benefit in the era of immunotherapy is controversial. This study aims to explore the efficacy and safety of adding TRT to the combination of PD-L1 inhibitors and chemotherapy.

MATERIALS/METHODS

Thepatients who received PD-L1 inhibitors combined with platinum-based chemotherapy as the first-line treatment of ES-SCLC from January 2019 to December 2021 were retrospectively collected. According to whether they received TRT, they were divided into two groups, and the follow-up analysis was performed. Propensity score matching (PSM) in with a 1:1 ratio was performed to balance the baseline characteristics of the two cohorts. The endpoints were progression-free survival (PFS) and OS.

RESULTS

A total of 211 patients with ES-SCLC were enrolled, of whom 70 (33.2%) patients received standard therapy plus TRT as first-line treatment, and 141 (66.8%) patients in the control group received PD-L1 inhibitors plus chemotherapy. After PSM, a total of 65 pairs of patients were enrolled in the analysis. There were no significant differences in baseline characteristics between the two groups of patients who received TRT and those who did not. In all patients, the median PFS (mPFS) in the TRT group and the non-TRT groupwere 9.5 months and 7.2 months, respectively, with HR = 0.60 (95% CI 0.41-0.87, p = 0.007). The median OS (mOS) in the TRT group was also significantly longer than that in the non-TRT group (24.1 months vs. 18.5 months, HR = 0.53, 95% CI 0.32-0.85, p = 0.009). Multivariable analysis showed that baseline liver metastasis and bone metastasis were independent prognostic factors for OS. In terms of safety, immunotherapy combined with thoracic radiotherapy increased the incidence of treatment-related pneumonia (p<0.001), most of which were grade 1-2.

CONCLUSION

This real-world study shows that adding TRT to durvalumab or atezolizumab plus chemotherapy significantly improves survival in ES-SCLC. It leads to more treatment-related pneumonia, but most of them can be relieved after symptomatic treatment. This treatment model deserves to be explored in prospective clinical trials.

Application of Metal-Free Dearomatization Reaction as a Sustainable Strategy to Direct Access Complex Cyclic Compounds

The highly efficient construction of complicated heterocyclic frameworks in an atom- and step-economic manner is still one of the cores of synthetic chemistry. Dearomatization reactions show the unique advantage for the construction of functionalized heterocycles and have attracted widespread attention over the past two decades. The metal-free approach has proved to be a green and sustainable paradigm for the synthesis of spirocyclic, polycyclic and heterocyclic scaffolds, which are widely present in natural products and bioactive molecules. In this review, the advances in the recent six years (2017-2023) in metal-free dearomatization reactions are highlighted. Emphasis is placed on developments in the field of organo-catalyzed dearomatization reactions, oxidative dearomatization reactions, Brønsted acid- or base-promoted dearomatization reactions, photoredox-catalyzed dearomatization reactions, and electrochemical oxidation dearomatization reactions.

Breast cancer diagnosis and prognosis using a high b-value non-Gaussian continuous-time random-walk model

AIM

To compare the diagnostic performance of mono-exponential model-derived apparent diffusion coefficient (ADC), continuous-time random-walk (CTRW) model-derived D_m, α, β and their combinations in discriminating malignancy of breast lesions, and investigate the association between model-derived parameters and prognosis-related immunohistochemical indices.

MATERIALS AND METHODS

A total of 85 patients with breast lesions (51 malignant, 34 benign) were analysed in this retrospective study. Clinical characteristics include oestrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER2), and Ki-67. The ADC was fitted using a mono-exponential model (b-values = 0, 800 s/mm²), while D_m, α, and β were fitted using a CTRW model. Independent Student's t-test and the Mann-Whitney U-test were used for the comparison of parameters. Discrimination performance was accomplished by receiver operating characteristic (ROC) analysis, and Spearman's correlation analysis was used to explore the association between immunohistochemical indices and diffusion parameters, the statistical significance level was p<0.05.

RESULTS

D_m and ADC demonstrated similar performance in differentiating malignant and benign lesions (AUC = 0.928 versus 0.930), while the combination of D_m, α, and β could improve the AUC to 0.969. The combined parameter generated by ADC, D_m, α, and β was effective in identifying the ER+/ER- and PR+/PR- patients. Temporal heterogeneity parameter α correlated significantly with the expression of PR.

CONCLUSION

Diffusion parameters derived from the CTRW model could effectively discriminate the malignancy of breast lesions. Meanwhile, the hormone receptor expression could be distinguished by combined diffusion parameters, and have the potential to reflect the prognosis.

[A case report of the first and second branchial arch syndrome with torticollis]

A 54-month-old female patient presented to the department of ophthalmology with abnormal head posture and facial asymmetry for two years. The patient's facial development was asymmetrical, with the middle 1/3 of the left side shorter than the right side. The left ear is less malformed than the right. There was no obvious abnormality in corneal light reflex and eye movement. Head tilt test ( -). So, paralysis of the superior oblique muscle was excluded. In consultation with the department of maxillofacial surgery, the patient was confirmed as the first and second branchial arch syndrome and torticollis.

Regio- and Chemoselective Copper-Catalyzed Formal [2+2+2] Cycloaddition of Primary Amines with Arylacetylenes to 2,4,5-Trisubstituted Pyridines

Disclosed herein is an efficient strategy for the synthesis of 2,4,5-trisubstituted pyridines via CuI/NBS-catalyzed formal intermolecular [2+2+2] cycloaddition of easily available primary amines and nonactivated terminal alkynes. Moreover, this given reaction features a new mode of cycloaddition with high regio- and chemoselectivity, good atom- and step-economy, broad substrate scope, and wide functional group compatibility. Further mechanism studies indicate that this transformation starts with oxidative alkynylation of the amine to form a propargylamine intermediate, followed by radical addition to the alkyne and intramolecular cycloaddition, delivering the pharmacologically interesting multisubstituted pyridines.

Selectivity Controlled Hydroamination of Alkynes to Sulfonyl Fluoride Hubs: Development and Application

A hydroamination of unactivated alkynes and lithium bis(fluorosulfonyl)imide (LiN(SO₂F)₂) is described under mild conditions, affording a single regioisomer of the sulfonyl fluorides. This method features broad functional group compatibility and delivers the target vinyl fluorosulfonimides in good to excellent yields. Moreover, gram-scale hydroamination of terminal and internal alkynes is achieved. Further transformations exploiting the reactivity of the vinyl fluorosulfonimide are subsequently developed for the synthesis of fluorosulfates and diphenyl sulfate.

[Impact of neoadjuvant immunotherapy on pulmonary function and perioperative outcomes in patients with resectable non-small cell lung cancer]

Objective: To explore the effect of neoadjuvant immunotherapy on pulmonary function and the efficacy in patients with resectable non-small cell lung cancer. Methods: Data of 30 patients with non-small cell lung cancer (NSCLC) who received neoadjuvant immunotherapy before surgery in the Chest Hospital of Shanghai Jiaotong University from March 2018 to September 2021 were retrospectively collect. The efficacy and safety of neoadjuvant immunotherapy in the perioperative period and changes in pulmonary function of patients before and after neoadjuvant treatment were valuated. Results: The patients were all-male with age of (61±8)years old, The major pathological response (MPR) rate of patients receiving neoadjuvant immunotherapy was 43%(13 cases), the pathologic complete response (pCR) rate was 37% (11 cases), disease control rate (DCR) was 97% (29 cases), objective response rate (ORR) was 67% (20 cases). The forced expiratory volume in one second (FEV1) after treatment was (2.59±0.63) L, and the ratio of FEV1 to the predicted value (FEV1%pred) was 85.27%±15.86%, which were significantly higher than those before treatment [(2.48±0.59)L, 81.73%±15.94%, respectively] (P=0.013, 0.022, respectively). Forced vital capacity (FVC) after treatment was (3.59±0.77) L, which was also significantly higher than before [(3.47±0.76) L,P=0.036]; while there were no statistical difference in FEV1/FVC and FVC accounted for the proportion of predicted values (FVC%pred) between before and after treatment (P=0.084, 0.344, respectively). The ratio of carbon monoxide dispersion (DLCO) to the predicted value (DLCO%pred) decreased from 83.61%±13.10% to 78.69%±13.85% after treatment (P=0.023). There was no significant difference in the incidence of postoperative complications between the DLCO%pred decreased group and the non-decreased group (3/18 vs 0/6; P=0.546). Conclusions: Neoadjuvant immunotherapy can increase the rate of MPR and PCR, significantly increase FEV1 and FEV1%pred, but also lead to a decrease in DLCO%pred; neoadjuvant immunotherapy does not increase the incidence of postoperative complications.

[Risk factors of perinatal complications in patients with pulmonary hypertension underwent cesarean section in 4 Chinese centers]

Objective: To identify the risk factors related to perinatal complications in patients with pulmonary hypertension underwent cesarean section. Methods: We retrospectively analyzed the medical records of all pregnant women with pulmonary hypertension hospitalized in 4 different hospitals in Shandong province and underwent cesarean section between May 2010 and May 2020. Patients were divided into perinatal complication group and control group according to the presence or absence of perinatal complications. Perinatal complications included aggravated heart function, new onset arrythmias, sudden cardiac arrest, all-cause death within 42 days post cesarean section, postpartum bleeding and thrombotic events. Risk factors of perinatal complications were analyzed. Results: A total of 167 patients (47 cases in the perinatal complication group and 120 cases in the control group) were included in this study. The average age of this cohort was 28(24, 32) years, and 75(44.9%) patients suffered newly diagnosed pulmonary hypertension during pregnancy. The main cause of pulmonary hypertension was congenital heart disease (137(82.0%)). Age, pregnant weeks, percent of primipara, intra-cardiac shunt, and receiving targeted medication therapy, cardiac dimensions were similar between the two groups. A total of 62 complications were recorded in the complication group including 28 cases of aggravated heart function, 4 cases of new onset arrythmias, 2 cases of cardiac arrest, 11 cases of bleeding or thrombotic events and 17 patients were dead. Prevalence of idiopathic pulmonary hypertension and general anesthesia was significantly higher, functional capacity was significantly lower in perinatal complication group than in control group (all P<0.05). The estimated systolic pulmonary artery pressure, serum N-terminal pro-B type natriuretic peptide and total bilirubin (TBIL) levels were significantly higher in perinatal complication group than in control group (all P<0.05). Logistic analysis demonstrated WHO Function Class(FC) Ⅲ/Ⅳ (OR=2.416,95%CI 1.016-5.743, P=0.046) and TBIL level (OR=6.874,95%CI 1.643-28.757, P=0.008) were the independent risk factors of perinatal complications. Conclusion: TBIL and WHO FC are independent risk factors of perinatal complications in pregnant women with pulmonary hypertension underwent cesarean section.

Synthesis of N-alkenylisoquinolinones via palladium-catalyzed cyclization/C4–O bond cleavage of oxazolidines

A palladium-catalyzed cascade ring-opening reaction to synthesize N-alkenylisoquinolinones via cyclization and C–O bond cleavage is reported.

Microwave-assisted decarboxylative reactions: advanced strategies for sustainable organic synthesis

Recent advances in the microwave-assisted decarboxylative reactions of carboxylic acids and their derivatives, including transition-metal-catalyzed and metal-free approaches, are summarized.

Synthesis of nitrogen-tethered 1,6-enynes through CuI/TFA catalysis

A new cascade process of the TFA-promoted Pictet–Spengler reaction and Cu-catalyzed intermolecular hydride transfer/alkynylation of an amine, formaldehyde solution, and an alkyne has been developed.

Chemodivergent Synthesis of Oxazolidin-2-ones via Cu-Catalyzed Carboxyl Transfer Annulation of Propiolic Acids with Amines

Carboxylic acids are widely found in natural products and bioactive molecules and have served as raw material compounds in industry. We now report the first example of copper(I)-catalyzed carboxyl transfer annulation of propiolic acids with amines, thereby chemodivergently constructing the oxazolidine-2-ones. In this reaction, two kinds of key propargyamine intermediates were formed through sequential CuI/NBS-catalyzed oxidative deamination/decarboxylative alkynylation or CuI-catalyzed decarboxylative hydroamination/alkynylation. The advantages of this decarboxylative coupling/carboxylative cyclization are showcased in the atom economy, chemical specificity, and functional group tolerance.

Microwave-Assisted Cu(I)-Catalyzed Synthesis of Unsymmetrical 1,4-Diamino-2-butynes via Cross-A3-Coupling/Decarboxylative A3-Coupling

1,4-Diamino-2-butynes display both chemical and physiological properties. Here a highly efficient synthesis avenue to generate unsymmetric 1,4-diamino-2-butynes has been developed by microwave-assisted Cu(I)-catalyzed cross-A³-coupling/decarboxylative coupling of two different amines, formaldehyde, and propiolic acid through a domino process. This multicomponent reaction provides a series of target products in moderate to good yields with high chemoselectivity.

Microwave-Assisted Palladium-Catalyzed Reductive Cyclization/Ring-Opening/Aromatization Cascade of Oxazolidines to Isoquinolines

An efficient palladium-catalyzed reaction of N-propargyl oxazolidines for the construction of 4-substituted isoquinolines under microwave irradiation is developed. This transformation proceeds through a sequential palladium-catalyzed reductive cyclization/ring-opening/aromatization cascade via C-O and C-N bond cleavages of the oxazolidine ring. The practical value of this method has also been explored by conducting a millimole-scale reaction, as well as by transforming the isoquinoline into a key intermediate for the synthesis of a lamellarin analogue.

Application of Maxillary Sinus Effusion Detection in Diagnosis of Drowning

Abstract

Objective To study the imaging characteristics of maxillary sinus effusion in drowned bodies, to explore its morphological characteristics and value in the diagnosis of the cause of death, and to provide objective evidence to support the study of virtual anatomy of drowning. Methods The 154 postmortem CT examination cases （31 cases of drowning, 123 cases of non-drowning） of Beijing Public Security Bureau Forensic Center in 2019 were collected. The bodies of all cases were scanned by multi-layer spiral CT before double-blind reading by clinical imaging experts. Maxillary sinus of corpses with maxillary sinus effusion in imaging findings was punctured. The detection rate of maxillary sinus effusion was calculated. The CT value and volume of maxillary sinus effusion were measured on 3D DICOM workstation. Results The detection rate of maxillary sinus effusion in the drowning was 100%, the shape was horizontal liquid level, the volume was 1.2-11.2 mL, the CT value was 6.08-19.02 Hu, with an average value of 12.85 Hu. The detection rate of maxillary sinus effusion in non-drowning was 19.51% （24/123）, the shape was wavy or irregular, and there were bubbles inside, the volume was 0.4-13.4 mL, the CT value was 23.68-77.75 Hu, with an average value of 42.08 Hu. The differences in CT value between the two groups had statistical significance. Conclusion The postmortem CT examination method can be used to observe the shape and measure the CT value of the maxillary sinus effusion in the bodies in water, which can be an auxiliary examination method for identification of drowning.

[Multicenter cross-sectional investigation on the cleaning status and influencing factors of skin cleaning outside the wound in adult trauma patients]

Objective: To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients. Methods: A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients. Results: A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups (χ²=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions: Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.

CF3SO3H-enabled cascade ring-opening/dearomatization of indole derivatives to polycyclic heterocycles

A novel dearomatization process to produce fused polycyclic indolines via a CF3SO3H-mediated cascade ring-opening of a β-lactam and hydroaminative cyclization is demonstrated. It provides a new strategy for the synthesis of important polycyclic indoline-2-amine derivatives in moderate to excellent yields, as well as with good functional group tolerance. Moreover, transformation of the product was performed to deliver the corresponding acid, alcohol and amide smoothly.

Invasive and in situ squamous cell carcinoma of the skin: a nationwide study in Iceland

BACKGROUND

The worldwide incidence of cutaneous squamous cell carcinoma (cSCC) is increasing.

OBJECTIVES

To evaluate the tumour burden of in situ and invasive cSCC in Iceland, where the population is exposed to limited ultraviolet radiation.

METHODS

This whole-population study used the Icelandic Cancer Registry, which contains records of all in situ and invasive cSCC cases from 1981 to 2017. Incidence of cSCC was evaluated according to age, anatomical location, residence and multiplicity, and trends were assessed using joinpoint analysis. Age-standardized rates (WSR) and age-specific incidence rates per 100 000 person-years were calculated, along with cumulative and lifetime risks.

RESULTS

Between 1981 and 2017, in situ cSCC WSR increased from 1·2 to 19·1 for men and from 2·0 to 22·3 for women. Invasive cSCC WSR rose from 4·6 to 14 for men and from 0·3 to 13·2 for women. The average number of in situ cSCC lesions was 1·71 per woman and 1·39 per man. Women developed more in situ cSCCs than invasive cSCCs in almost all anatomical locations, whereas men developed more invasive cSCCs, mostly on the head and neck. The rates of in situ cSCC were higher in Reykjavik compared with rural areas. Furthermore, women more commonly developed multiple in situ lesions. For lip cSCCs, invasive lesions occurred more frequently than in situ lesions among both sexes. Joinpoint analysis showed that in situ cSCC in women exhibited the most rapid incidence increase.

CONCLUSIONS

cSCC has become an increasingly significant public health problem in Iceland. Tanning bed use and travelling abroad may contribute to skin cancer development. Public health efforts are needed to stem the behaviours leading to this rapid rise in cSCC.

Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults

Both sarcopenia and low bone mineral density (BMD) have become public health concerns. We found that presarcopenic and/or sarcopenic individuals were more likely to have lower BMD. And this relationship has race and sex-specific discrepancy.

PURPOSE

The purpose of the study was to investigate the racial and gender differences in the relationship between sarcopenia and BMD among older adults.

METHODS

Totally, 5476 subjects (mean age = 65.7 ± 6.4) of non-Hispanic White (n = 3297), non-Hispanic Black (n = 1265), and non-Hispanic Asian (n = 914) were analyzed. Sarcopenia was defined according to the revised European consensus on definition and diagnosis of sarcopenia (EWGSOP2). General linear model and multivariable linear regression model were used to examine the relationship between sarcopenia and regional/whole body BMD stratified by race and sex. Adjustments were conducted for physiological, behavioral, and disease factors.

RESULTS

Comparing with normal older participants, presarcopenic and sarcopenic elderly were more likely to have lower BMD. Although the difference was not statistically significant in a few sub-groups, among the three racial groups, the strongest association between sarcopenia and BMD was found in non-Hispanic Black people, followed by non-Hispanic White people and non-Hispanic Asian people. In addition, significant differences of BMD across sarcopenia stages were found in more sub-groups in women than in men after adjusting for covariates.

CONCLUSIONS

In this older cohort, sarcopenia is significantly related to low regional/whole-body BMD, and these associations vary by race and sex. Consideration in race and sex is warranted when developing strategies to maintain or minimize BMD loss.

Forensic Progress on Death Following Carotid Sinus Inhibition

Abstract

Death after carotid sinus trauma is usually attributed to death from inhibition, a type of sudden death. Currently, the number of incidents is scarce, and related studies are few. Therefore, how to determine the involvement of carotid sinus and determine the role of diseases in the cause of death has always been a difficult point in forensic investigation. This article sorts out the research literature on carotid sinus related death at home and abroad in recent years, systematically reviews the anatomic structure of the carotid sinus nerve, the clinical epidemiology of carotid sinus syndrome, and the research on the death mechanism of carotid sinus injury at home and abroad in recent years, in order to provide references for forensic pathology research and prosecution.

ORAOV1-B Promotes OSCC Metastasis via the NF-κB-TNFα Loop

Metastasis, a powerful prognostic indicator of oral squamous cell carcinoma (OSCC), is chiefly responsible for poor cancer outcomes. Despite an increasing number of studies examining the mechanisms underlying poor outcomes, the development of potent strategies is hindered by insufficient characterization of the crucial regulators. Long noncoding RNAs (lncRNAs) have recently been gaining interest as significant modulators of OSCC metastasis; however, the detailed mechanisms underlying lncRNA-mediated OSCC metastasis remain relatively uncharacterized. Here, we identified a novel alternative splice variant of oral cancer overexpressed 1 (ORAOV1), named as ORAOV1-B, which was subsequently validated as an lncRNA and correlated with OSCC lymph node metastasis; significantly increased invasion and migration were observed in ORAOV1-B-overexpressing OSCC cells. RNA pulldown and mass spectrometry identified Hsp90 as a direct target of ORAOV1-B, and cDNA microarrays suggested TNFα as a potential downstream target of ORAOV1-B. ORAOV1-B was shown to directly bind to and stabilize Hsp90, which maintains the function of client proteins, receptor-interaction protein, and IκB kinase beta, thus activating the NF-κB pathway and inducing TNFα. Additionally, TNFα reciprocally enhanced p-NF-κB-p65 and the downstream epithelial-mesenchymal transition. ORAOV1-B effects were reversed by a TNFα inhibitor, demonstrating that TNFα is essential for ORAOV1-B-regulated metastatic ability. Consistent epithelial-mesenchymal transition in the ORAOV1-B group was demonstrated via an orthotopic model. In the metastatic model, ORAOV1-B significantly contributed to OSCC-related lung metastasis. In summary, the novel splice variant ORAOV1-B is an lncRNA, which significantly potentiates OSCC invasion and metastasis by binding to Hsp90 and activating the NF-κB-TNFα loop. These findings demonstrate the versatile role of ORAOV1 family members and the significance of genes located within 11q13 in promoting OSCC. ORAOV1-B might serve as an attractive OSCC metastasis intervention target.