Value of long non-coding RNA HAS2-AS1 as a diagnostic and prognostic marker of glioma

BACKGROUND

Glioma presents high incidence and poor prognosis, and therefore more effective treatments are needed. Studies have confirmed that long non-coding RNAs (lncRNAs) basically regulate various human diseases including glioma. It has been theorized that HAS2-AS1 serves as an lncRNA to exert an oncogenic role in varying cancers. This study aimed to assess the value of lncRNA HAS2-AS1 as a diagnostic and prognostic marker for glioma.

METHODS

The miRNA expression data and clinical data of glioma were downloaded from the TCGA database for differential analysis and survival analysis. In addition, pathological specimens and specimens of adjacent normal tissue from 80 patients with glioma were used to observe the expression of HAS2-AS1. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic ability and prognostic value of HAS2-AS1 in glioma. Meanwhile, a Kaplan-Meier survival curve was plotted to evaluate the survival of glioma patients with different HAS2-AS1 expression levels.

RESULTS

HAS2-AS1 was significantly upregulated in glioma tissues compared with normal tissue. The survival curves showed that overexpression of HAS2-AS1 was associated with poor overall survival (OS) and progression-free survival (PFS). Several clinicopathological factors of glioma patients, including tumor size and WHO grade, were significantly correlated with HAS2-AS1 expression in tissues. The ROC curve showed an area under the curve (AUC) value of 0.863, indicating that HAS2-AS1 had good diagnostic value. The ROC curve for the predicted OS showed an AUC of 0.906, while the ROC curve for predicted PFS showed an AUC of 0.88. Both suggested that overexpression of HAS2-AS1 was associated with poor prognosis.

CONCLUSIONS

Normal tissues could be clearly distinguished from glioma tissues based on HAS2-AS1 expression. Moreover, overexpression of HAS2-AS1 indicated poor prognosis in glioma patients. Therefore, HAS2-AS1 could be used as a diagnostic and prognostic marker for glioma.

Posterior perforator tibial artery flaps for soft tissue defects of limbs: a retrospective cohort study

PURPOSE

To investigate the clinical effect of posterior perforator tibial artery flaps on repairing soft tissue defects of limbs.

METHODS

From June 2012 to June 2021, 14 cases of soft tissue defects of limbs were repaired with pedicled or free flaps of posterior perforator tibial artery. Among them, there were 9 cases of pedicled flaps and 5 cases of free flaps. The donor sites were closed directly or covered with skin grafting. The defects area varied from 3 × 5 cm to 7 × 16 cm. All cases were followed up for 1 year to 2 years.

RESULTS

All flaps survived completely except 3 cases with distal end necrosis and the 3 cases healed after dressing change. There were not any other complications at both donor and recipient sites. Appearance of the recipient sites was close to the surrounding skin. All patients were satisfied with the results.

CONCLUSION

Posterior perforator tibial artery flaps have the advantages of relatively simple technique, few damage, few complications and satisfying appearance. It is a good choice for soft tissue defects of limbs.

Kurarinone, a flavonoid from Radix Sophorae Flavescentis, inhibits RANKL-induced osteoclastogenesis in mouse bone marrow-derived monocyte/macrophages

Inflammation-induced osteoclast proliferation is a crucial contributor to impaired bone metabolism. Kurarinone (KR), a flavonoid extracted from the Radix Sophorae Flavescentis, exhibits notable anti-inflammatory properties. Nevertheless, the precise influence of KR on osteoclast formation remains unclear. This study's objective was to assess the impact of KR on osteoclast activity in vitro and unravel its underlying mechanism. Initially, a target network for KR-osteoclastogenesis-osteoporosis was constructed using network pharmacology. Subsequently, the intersecting targets were identified through the Venny platform and a PPI network was created using Cytoscape 3.9.1. Key targets within the network were identified employing topological algorithms. GO enrichment and KEGG pathway analysis were then performed on these targets to explore their specific functions and pathways. Additionally, molecular docking of potential core targets of KR was conducted, and the results were validated through cell experiments. A total of 83 target genes overlapped between KR and osteoclastogenesis-osteoporosis targets. Enrichment analysis revealed their role in inflammatory response, protein tyrosine kinase activity, osteoclast differentiation, and MAPK and NF-κB signaling pathways. PPI analysis and molecular docking demonstrate that key targets MAPK14 and MAPK8 exhibit more stable binding with KR compared to other proteins. In vitro experiments demonstrate that KR effectively inhibits osteoclast differentiation and bone resorption without cellular toxicity. It suppresses key osteoclast genes (NFATc1, c-Fos, TRAP, MMP9, Ctsk, Atp6v2), hinders IκB-α degradation, and inhibits ERK and JNK phosphorylation, while not affecting p38 phosphorylation. The results indicate that KR may inhibit osteoclast maturation and bone resorption by blocking NF-κB and MAPK signaling pathways, suggesting its potential as a natural therapeutic agent for osteoporosis.

New Structures in the J/ψJ/ψ Mass Spectrum in Proton-Proton Collisions at sqrt[s]=13 TeV

A search is reported for near-threshold structures in the J/ψJ/ψ invariant mass spectrum produced in proton-proton collisions at sqrt[s]=13  TeV from data collected by the CMS experiment, corresponding to an integrated luminosity of 135  fb^{-1}. Three structures are found, and a model with quantum interference among these structures provides a good description of the data. A new structure is observed with a local significance above 5 standard deviations at a mass of 6638_{-38}^{+43}(stat)_{-31}^{+16}(syst)  MeV. Another structure with even higher significance is found at a mass of 6847_{-28}^{+44}(stat)_{-20}^{+48}(syst)  MeV, which is consistent with the X(6900) resonance reported by the LHCb experiment and confirmed by the ATLAS experiment. Evidence for another new structure, with a local significance of 4.7 standard deviations, is found at a mass of 7134_{-25}^{+48}(stat)_{-15}^{+41}(syst)  MeV. Results are also reported for a model without interference, which does not fit the data as well and shows mass shifts up to 150 MeV relative to the model with interference.

Improved small vessel visibility in diabetic foot arteriography using dual-energy CT

AIM

To test the feasibility and performance of dual-energy computed tomography (DECT) in foot arteriography of diabetic patients, where contrast medium is largely reduced within the small vessels.

MATERIALS AND METHODS

A total of 50 diabetic patients were enrolled prospectively, where DECT was acquired immediately after the CT angiography (CTA, group A) of the lower extremity. Two images were derived from the DECT data, one optimal virtual monochromatic image (VMI, group B) and one fusion image (group C), both of which were compared against the CTA image for visualising the foot arteries. The contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were evaluated. The arterial course and contrast were graded each using a five-point scale. The clarity of small vessel depiction was quantified by comparing the number of plantar metatarsal arteries found in the maximum intensity projection image.

RESULTS

The median CNRs and SNRs obtained in group B were approximately 45% and 20% higher than those in groups A and C, respectively (p<0.05). Group B also received higher subjective scores on the posterior tibial artery and the foot arteries (all >3) than groups A and C. The number of visible branches of the plantar metatarsal arteries was found to be substantially higher (p<0.05) in group B (median=6) than in groups A (median=2) and C (median=4).

CONCLUSION

DECT was found to be superior to conventional CTA in foot arteriography, and beyond the lower extremity, it might be a general favourable solution for imaging regions with small vessels and reduced contrast medium.

[Research progress on the effect of common metabolism-related comorbidities on health outcomes and management strategies in patients with chronic hepatitis B]

With the increasing life expectancy and lifestyle changes of patients with chronic hepatitis B (CHB), the significance of comorbidities of chronic non-communicable diseases (NCDs) in disease progression and health prognosis of CHB patients is gaining prominence. This study aims to explore the association between CHB and NCDs comorbidities, focusing on the impact of common metabolism-related diseases, such as metabolic syndrome and diabetes, on the health outcomes of CHB patients. We also summarize studies on integrating the management of comorbidities in CHB patients and provide relevant recommendations for effective management. The findings of this study serve as a foundation for understanding the clinical characteristics and prevalence trends, reducing the disease burden of comorbidities among CHB patients, and establishing a comprehensive and coordinated management system for comorbidities.

The impact of air pollutants on spontaneous abortion: a case-control study in Tongchuan City

OBJECTIVES

Studies related to air pollutants and spontaneous abortion in urban northwestern China are scarce, and the main exposure windows of pollutants acting on pregnant women are unclear.

STUDY DESIGN

Case-control study.

METHODS

Data were collected from pregnant women in Tongchuan City from 2018 to 2019. A total of 289 cases of spontaneous abortion and 1156 cases of full-term labor were included and analyzed using a case-control study. Logistic regression models were developed to explore the relationship between air pollutants and spontaneous abortion after Chi square analysis and Air pollutant description.

RESULTS

O3 (odds ratio [OR] = 1.028) is a risk factor for spontaneous abortion throughout pregnancy. PM2.5 (OR = 1.015), PM10 (OR = 1.010), SO2 (OR = 1.026), and NO2 (OR = 1.028) are risk factors for spontaneous abortion in the 30 days before the last menstrual period. PM2.5 (OR = 1.015), PM10 (OR = 1.013), SO2 (OR = 1.036), and NO2 (OR = 1.033) are risk factors for spontaneous abortion in the 30-60 days before the last menstrual period. PM2.5 (OR = 1.028), PM10 (OR = 1.013), SO2 (OR = 1.035), and NO2 (OR = 1.059) are risk factors for spontaneous abortion in the 60-90 days before the last menstrual period.

CONCLUSION

Exposure to high levels of air pollutants may be a cause of increased risk of spontaneous abortion, especially in the first trimester of the last menstrual period.

Network Pharmacology and Experimental Validation to Elucidate the Pharmacological Mechanisms of Luteolin Against Chondrocyte Senescence

BACKGROUND

Luteolin, a flavonoid found in various medicinal plants, has shown promising antioxidant, anti-inflammatory, and anti-aging properties. The cartilaginous endplate (CEP) represents a crucial constituent of the intervertebral disc (IVD), assuming a pivotal responsibility in upholding both the structural and functional stability of the IVD.

OBJECTIVE

Exploring the precise mechanism underlying the protective effects of luteolin against senescence and degeneration of endplate chondrocytes (EPCs).

METHODS

Relevant targets associated with luteolin and aging were obtained from publicly available databases. To ascertain cellular functions and signaling pathways, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were employed. Core genes were identified through the construction of a protein-protein interaction (PPI) network. Molecular docking (MD) was utilized to assess the binding affinity of luteolin to these core genes. Finally, the impact of luteolin on the senescence and degeneration of EPCs was evaluated in an in vitro cellular senescence model induced by tert-butyl hydroperoxide (TBHP).

RESULTS

There are 145 overlapping targets between luteolin and senescence. Analysis using GO revealed that these targets primarily participate in cellular response to oxidative stress and reactive oxygen species. KEGG analysis demonstrated that these markers mainly associate with signaling pathways such as p53 and PI3K-Akt. MD simulations exhibited luteolin's binding affinity to P53, Cyclin-dependent kinase (CDK)2, and CDK4. Cell cycle, cell proliferation, and β- galactosidase assays confirmed that luteolin mitigated senescence in SW1353 cells. Western blot assays exhibited that luteolin significantly suppressed the expression of Matrix Metallopeptidase (MMP) 13, P53, and P21, while concurrently promoting CDK2, CDK4, and Collagen Type II Alpha 1 (COL2A1) expression.

CONCLUSION

In summary, luteolin demonstrated beneficial properties against aging and degeneration in EPCs, offering novel insights to mitigate the progression of intervertebral disc degeneration (IVDD).

Anatomical Study of Cross-Transfer of the Contralateral C7 Nerve Through the Posterior Epidural Pathway of the Cervical Spine for the Treatment of Spastic Paralysis of the Upper Limbs

BACKGROUND

This study explored the safety and feasibility of surgical treatment of spastic paralysis of the central upper extremity by contralateral cervical 7 nerve transfer via the posterior epidural pathway of the cervical spine.

METHODS

Five fresh head and neck anatomical specimens were employed to simulate contralateral cervical 7 nerve transfer through the posterior epidural pathway of the cervical spine. The relevant anatomical landmarks and surrounding anatomical relationships were observed under a microscope, and the relevant anatomical data were measured and analysed.

RESULTS

The posterior cervical incision revealed the cervical 6 and 7 laminae, and lateral exploration revealed the cervical 7 nerve. The length of the cervical 7 nerve outside the intervertebral foramen was measured to be 6.4 ± 0.5 cm. The cervical 6 and cervical 7 laminae were opened with a milling cutter. The cervical 7 nerve was extracted from the inner mouth of the intervertebral foramen, and its length was 7.8 ± 0.3 cm. The shortest distance of the cervical 7 nerve transfer via the posterior epidural pathway of the cervical spine was 3.3 ± 0.3 cm.

CONCLUSIONS

Cross-transfer surgery of the contralateral cervical 7 nerve via the posterior epidural pathway of the cervical spine can effectively avoid the risk of nerve and blood vessel damage in anterior cervical nerve 7 transfer surgery; the nerve transfer distance is short, and nerve transplantation is not required. This approach may become a safe and effective procedure for the treatment of central upper limb spastic paralysis.

Efficacy and safety of bicyclol for treating patients with antituberculosis drug-induced liver injury

BACKGROUND: Bicyclol was used for treating idiosyncratic acute drug-induced liver injury (DILI) in a phase II trial. This study was aimed at evaluating the efficacy and safety of bicyclol 25 and 50 mg thrice a day (TID) for treating acute DILI caused by anti-TB drugs in the light of the trial results.METHODS: We analysed clinical data of patients with TB drug-induced DILI in the trial database. The primary endpoint was reduction in serum alanine aminotransferase (ALT) levels after 4 weeks of treatment compared to baseline.RESULTS: Overall, 148 patients were included, with respectively 48, 52 and 48 patients included in the control (456 mg polyene phosphatidylcholine TID), high-dose (50 mg bicyclol TID) and low-dose (25 mg bicyclol TID) groups. ALT levels decreased by respectively â-"149.0 (IQR â-"299.3 to â-"98.3 (), â-"225.5 (IQR â-"309.3 to â-"181.8 ) and â-"242.5 (IQR â-"364.8 to â-"153.8) U/L in the control, high-dose and low-dose groups (P < 0.001). The ALT normalisation rates at weeks 1, 2, 4, 6 and 8 were higher in the high- and low-dose groups, while adverse events and serious adverse events were similar across groups.CONCLUSIONS: Bicyclol (25 and 50 mg TID) is effective and safe in treating anti-TB DILI, and bicyclol 50 mg TID showed higher efficacy.

Methods of Immobilization after Achilles Tendon Rupture Repair: A Comparative Study in Rat Model

OBJECTIVE

The Achilles tendon (AT) is the most frequently ruptured in the human body. Literature describing different immobilization methods' impact on tendon healing after AT repair is lacking. We compare plaster cast, splint, and K-wire to determine which is the most stable and has the fewest complications.

METHODS

Sixty rats aged 5-6 months were selected to establish Achilles tendon injury in two hind legs model. After suturing the ends of the AT together with a modified "Kessler" method (Prolene 5-0). The skin incision was interrupted and sutured with 1-0 thread. Rats were divided into three immobilization methods (plaster cast group, splint group, and K-wire group). In plaster cast group, the hind leg was cast with plaster in the extended position of the hip and knee joints, and the ankle joint was at 150°. Splint and K-wire group used splints and 0.8-mm K-wires, separately. The fixed period was 4 weeks. The incidence of stability and complications (death, necrosis of the legs, necrosis of the skin, and incisional infection) were recorded. Differences were detected using the chi-square test.

RESULTS

Within 4 weeks observation, K-wires showed better stability (90%) compared with the other two ways (40% in plaster cast group, 65% in splint group; p < 0.05). Rats immobilized with K-wires (10%) suffered significantly lower complications compared with plaster cast and splint group (15%; p < 0.05).

CONCLUSION

K-wire has better stability, lower complication rate than other methods. Immobilization with K-wire may be a promising tool in future clinical Achilles tendon rupture applications.

Collision in double-image encryption scheme based on spatial encoding and phase-truncation Fourier transforms

In this paper, the security strength of a double-image cryptosystem using spatial encoding and phase-truncation Fourier transforms (PTFTs) is evaluated. Unlike the conventional PTFT-based cryptosystem, where two random phase masks (RPMs) are used as public keys to provide enough phase constrains in the estimation, in the improved cryptosystem, the RPM generated by a random amplitude mask (RAM) is treated as an unknown parameter. Due to this fixed RAM, the number of constraints in the estimation decreases to achieve high robustness against potential iterative attacks. Moreover, instead of two phase-only masks (POMs), here the two POMs and the RAM are utilized as the private keys in the improved cryptosystem; thus, the key space of the double-image cryptosystem has been enlarged. However, we noticed that the RAM used to encode plaintexts spatially and to generate the phase encryption key is independent of the plaintexts. This could be recovered by a known pair of plaintexts and the ciphertext. Once the information of the RAM is retrieved, the phase key RPM can also be produced making the cryptosystem vulnerable. Based on this finding, new hybrid algorithms, including a known-plaintext attack and a known key attack are proposed to crack the enhanced PTFT-based cryptosystem. The information of the plaintexts can be retrieved from one POM using the proposed algorithms without any knowledge of another POM and the corresponding ciphertext. Numerical simulations have been carried out to validate the information disclosure problem still exists in the double-image cryptosystem based on spatial encoding and PTFTs.

[Evaluation of effects of comprehensive intervention based on key persons on AIDS-related high-risk behaviors in male sex workers in entertainment venues]

Objective: To evaluate the effect of comprehensive intervention model based on key persons in entertainment venues on the incidence of AIDS-related high-risk behaviors in male sex workers (MSW). Data from this study thus can be used to provide compelling evidence for the wider implementation of the intervention model. Methods: In this randomized controlled trial, MSW were recruited and followed-up from May to December, 2021 in entertainment venues in Wuxi, Jiangsu Province, with an estimated sample size of 320. The MSW in the intervention group were provided with comprehensive interventions via key persons in entertainment venues compared with the control group receiving routine interventions. The effect of the intervention model was assessed by comparing the behavioral differences between these two groups and in the intervention group before and after intervention. Results: A total of 330 MSW were recruited at baseline survey, in which 168 were divided into intervention group and 162 into control group. There was no significant difference in socio-demographic characteristics between two groups (all P>0.05). After intervention for 6 months, the rate of consistent condom use in commercial homosexual activities in the intervention group was 79.5% (101/127), higher than 63.2% (74/117) in the control group, and in the intervention group, 90.1% (73/81) of MSW used condom consistently in heterosexual activities, higher than in the control group (59.6%, 59/99) . Compared with 30.8% (36/117) of MSW with drug abuse history in the control group, a lower proportion of 9.4% (12/127) was observed in the intervention group. Differences in all of aforementioned variables were significant (all P<0.05). After intervention, the incidence of group sex was 3.9% (5/127) in the intervention group and 9.4% (11/117) in the control group, the incidence of anal sex post-alcohol consumption was 40.2% (51/127) in the intervention group and 32.5% (38/117) in control group, the differences were not significant (all P>0.05). Conclusions: The intervention model based on key persons in entertainment venues could promote consistent condom use in MSW in both commercial homosexual and heterosexual activities and help them reduce drug abuse, but had no significant effect on decreasing group sex and anal sex after alcohol consumption. It is crucial to improve the intervention model according to the specific characteristics of MSW in order to enhance the effects of comprehensive intervention.

[Research progress on the comorbidity between hepatitis B virus infection and noncommunicable diseases]

With the decline in hepatitis B virus (HBV) incidence and the increase in the life expectancy of infected individuals, the population infected with HBV is experiencing rapid aging, leading to an escalating risk of co-morbid chronic noncommunicable diseases (NCDs). This study summarizes research related to the comorbidity between HBV and NCDs, discussing the aging of the HBV-infected population, the mechanisms, prevalence, and management of this comorbidity. This study provides insights into potential directions for future research on the comorbidity between HBV and NCDs and aims to provide a basis for further research and the development of prevention and treatment strategies for the comorbidity of NCDs among HBV-infected individuals in China.

[Qualitative and quantitative PET/MRI in the evaluation of axillary lymph node metastasis in patients with breast cancer]

Objective: To investigate the value of qualitative and quantitative PET/MRI in the evaluation of axillary lymph node metastasis in patients with breast cancer. Methods: A total of 33 patients with breast cancer underwent preoperative PET/MRI examinations in Jingling Hospital from February to August in 2022 were retrospectively collected. All these patients were female, aged from 34 to 73 (51.4±11.3) years. Histopathological results and follow-up data were deemed as the referent standard, and the images were independently evaluated by two experienced breast imaging radiologists. The qualitative PET/MRI evaluation procedures were designed to evaluated the MRI alone to classify the axillary lymph nodes firstly, and then, the axillary lymph nodes status was reclassified by combining MRI and PET images. The net reclassification improvement index (NRI) was calculated using the R Programming Language (RStudio). The quantitative PET/MRI evaluation of the maximum standard uptake value (SUVmax) of axillary lymph nodes were measured by two radiologists, respectively, and the average value was compared with the referent standard to conduct a receiver operating characteristic (ROC) curve to select the optimal cutoff value of SUVmax. Based on the cutoff value and MRI classification results, axillary lymph nodes status was divided into quantitative PET/MRI positive or negative. The sensitivity, specificity and accuracy of MRI and quantitative PET/MRI in evaluating axillary lymph node metastasis were compared, and the area under the ROC curve (AUC) was compared. Results: There was no significant difference in sensitivity, specificity and accuracy between MRI and quantitative PET/MRI in evaluating lymph node metastasis of breast cancer (81.82% vs 95.46%; 81.82% vs 100%; 81.82% vs 96.97%) (all P>0.05). The AUC had a statistically significant difference [0.82 (0.65 to 0.93) vs 0.98 (0.85 to 1.00), P=0.026)]. According to the referent standard, in the 11 cases without ipsilateral axillary lymph node metastasis, the SUVmax was 0.83±0.18, while in the 22 cases with ipsilateral axillary lymph node metastasis, the SUVmax was [4.36 (1.77, 5.85)]. Compared with MRI alone, the NRI of qualitative PET/MRI in evaluating lymph node metastasis was 36.36% (P=0.021). Conclusion: Compared with MRI alone, quantitative PET/MRI has a higher AUC for evaluating axillary lymph node metastasis in patients with breast cancer, and qualitative PET/MRI had a better reclassification power in the evaluation of axillary lymph node metastasis.

[Risk predictive models of healthcare-seeking delay among imported malaria patients in Jiangsu Province based on the machine learning]

OBJECTIVE

To create risk predictive models of healthcare-seeking delay among imported malaria patients in Jiangsu Province based on machine learning algorithms, so as to provide insights into early identification of imported malaria cases in Jiangsu Province.

METHODS

Case investigation, first symptoms and time of initial diagnosis of imported malaria patients in Jiangsu Province in 2019 were captured from Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System of Chinese Center for Disease Control and Prevention. The risk predictive models of healthcare-seeking delay among imported malaria patients were created with the back propagation (BP) neural network model, logistic regression model, random forest model and Bayesian model using thirteen factors as independent variables, including occupation, species of malaria parasite, main clinical manifestations, presence of complications, severity of disease, age, duration of residing abroad, frequency of malaria parasite infections abroad, incubation period, level of institution at initial diagnosis, country of origin, number of individuals travelling with patients and way to go abroad, and time of healthcare-seeking delay as a dependent variable. Logistic regression model was visualized using a nomogram, and the nomogram was evaluated using calibration curves. In addition, the efficiency of the four models for prediction of risk of healthcare-seeking delay among imported malaria patients was evaluated using the area under curve (AUC) of receiver operating characteristic curve (ROC). The importance of each characteristic was quantified and attributed by using SHAP to examine the positive and negative effects of the value of each characteristic on the predictive efficiency.

RESULTS

A total of 244 imported malaria patients were enrolled, including 100 cases (40.98%) with the duration from onset of first symptoms to time of initial diagnosis that exceeded 24 hours. Logistic regression analysis identified a history of malaria parasite infection [odds ratio (OR) = 3.075, 95% confidential interval (CI): (1.597, 5.923)], long incubation period [OR = 1.010, 95% CI: (1.001, 1.018)] and seeking healthcare in provincial or municipal medical facilities [OR = 12.550, 95% CI: (1.158, 135.963)] as risk factors for delay in seeking healthcare among imported malaria cases. BP neural network modeling showed that duration of residing abroad, incubation period and age posed great impacts on delay in healthcare-seek among imported malaria patients. Random forest modeling showed that the top five factors with the greatest impact on healthcare-seeking delay included main clinical manifestations, the way to go abroad, incubation period, duration of residing abroad and age among imported malaria patients, and Bayesian modeling revealed that the top five factors affecting healthcare-seeking delay among imported malaria patients included level of institutions at initial diagnosis, age, country of origin, history of malaria parasite infection and individuals travelling with imported malaria patients. ROC curve analysis showed higher overall performance of the BP neural network model and the logistic regression model for prediction of the risk of healthcare-seeking delay among imported malaria patients (Z = 2.700 to 4.641, all P values < 0.01), with no statistically significant difference in the AUC among four models (Z = 1.209, P > 0.05). The sensitivity (71.00%) and Youden index (43.92%) of the logistic regression model was higher than those of the BP neural network (63.00% and 36.61%, respectively), and the specificity of the BP neural network model (73.61%) was higher than that of the logistic regression model (72.92%).

CONCLUSIONS

Imported malaria cases with long duration of residing abroad, a history of malaria parasite infection, long incubation period, advanced age and seeking healthcare in provincial or municipal medical institutions have a high likelihood of delay in healthcare-seeking in Jiangsu Province. The models created based on the logistic regression and BP neural network show a high efficiency for prediction of the risk of healthcare-seeking among imported malaria patients in Jiangsu Province, which may provide insights into health management of imported malaria patients.

Hybrid plaintext attack for a cryptosystem based on interference and the phase-retrieval technique

In this paper, the security strength of an enhanced cryptosystem based on interference and the phase-retrieval technique is evaluated. The security strength of the optical cryptosystem was improved through the phase-retrieval technique used to generate a phase-only mask (POM) as the ciphertext. Due to the complex mathematical model of the phase-retrieval technique, it seems that a silhouette problem existing in the conventional interference-based scheme was removed. However, we noted that the random phase mask (RPM) regarded as the only private key was fixed in the encryption path, which is not related to the plaintext and makes it possible to be recovered using a known-plaintext attack (KPA). Moreover, we also found that the RPM has high key sensitivity, and it should be recovered precisely to retrieve information of plaintexts during the attack. Thus, a hybrid KPA where three pairs of known plaintexts and their ciphertexts are regarded as the amplitude and phase constraints to obtain the precise estimation of the RPM is proposed. Then, with the help of the estimated private key, information of the original plaintexts encoded using the cryptosystem under study could be retrieved from an arbitrarily given ciphertext without any knowledge of the private key. Our cryptoanalysis shows that the cryptosystem based on interference and the phase-retrieval technique is vulnerable to the proposed attack, and there is a security leak in it. Numerical simulations have been carried out to demonstrate the performance of our proposed attack.

Repair of Finger Pulp Defect and Sensory Reconstruction Using Reverse Homodigital Artery Island Flap With Palmar Cutaneous Branches of the Proper Digital Nerve

OBJECTIVE

To illustrate the clinical outcomes of the reverse digital proper artery island flap with anastomosing the palmar cutaneous branches of the proper digital nerve for the reconstruction of finger pulp defects.

METHODS

From December 2007 to December 2017, a total of 20 patients with finger pulp defects were treated with reverse digital proper artery island flap for innervated construction. Functional outcomes, aesthetic appearance, and complications were evaluated. Functional outcomes were assessed according to range of motion, sensory grade (S0-S4), static 2-point discrimination, Semmes-Weinstein monofilament test, and Cold Intolerance Severity Score. Aesthetic appearance was evaluated according to the Michigan Hand Outcomes Questionnaire.

RESULTS

All flaps survived completely without any complications, and all patients were followed up for at least 12 months. The average static 2-point discrimination, Semmes-Weinstein monofilament, and Cold Intolerance Severity Score results of the injured fingers were 6.35 mm (range, 5-8 mm), 3.64 (range, 2.83-4.17), and 19 (range, 8-24), respectively. All patients achieved recovery in sensation from S3+ to S4. The active ranges of motion of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the affected fingers were satisfactory. Based on the Michigan Hand Outcomes Questionnaire, 11 patients were strongly satisfied, and 9 were satisfied with the appearance of the injured finger.

CONCLUSIONS

The reverse digital proper artery island flap with anastomosing the palmar cutaneous branches of the proper digital nerve is an effective and reliable alternative for the reconstruction of finger pulp defect. In the recovery of sensation, this flap leads to satisfactory effects.

Projection to extract the perpendicular component (PEPC) method for extracting kinetics from time-resolved data

Time-resolved x-ray liquidography (TRXL) is a potent method for investigating the structural dynamics of chemical and biological reactions in the liquid phase. It has enabled the extraction of detailed structural aspects of various dynamic processes, the molecular structures of intermediates, and kinetics of reactions across a wide range of systems, from small molecules to proteins and nanoparticles. Proper data analysis is key to extracting the information of the kinetics and structural dynamics of the studied system encrypted in the TRXL data. In typical TRXL data, the signals from solute scattering, solvent scattering, and solute-solvent cross scattering are mixed in the q-space, and the solute kinetics and solvent hydrodynamics are mixed in the time domain, thus complicating the data analysis. Various methods developed so far generally require prior knowledge of the molecular structures of candidate species involved in the reaction. Because such information is often unavailable, a typical data analysis often involves tedious trial and error. To remedy this situation, we have developed a method named projection to extract the perpendicular component (PEPC), capable of removing the contribution of solvent kinetics from TRXL data. The resulting data then contain only the solute kinetics, and, thus, the solute kinetics can be easily determined. Once the solute kinetics is determined, the subsequent data analysis to extract the structural information can be performed with drastically improved convenience. The application of the PEPC method is demonstrated with TRXL data from the photochemistry of two molecular systems: [Au(CN)₂^-]₃ in water and CHI₃ in cyclohexane.

[Lysosomal membrane protein Sidt2 knockout induces apoptosis of human hepatocytes in vitro independent of the autophagy-lysosomal pathway]

OBJECTIVE

To explore the regulatory mechanism of human hepatocyte apoptosis induced by lysosomal membrane protein Sidt2 knockout.

METHODS

The Sidt2 knockout (Sidt2^-/-) cell model was constructed in human hepatocyte HL7702 cells using Crispr-Cas9 technology.The protein levels of Sidt2 and key autophagy proteins LC3-II/I and P62 in the cell model were detected using Western blotting, and the formation of autophagosomes was observed with MDC staining.EdU incorporation assay and flow cytometry were performed to observe the effect of Sidt2 knockout on cell proliferation and apoptosis.The effect of chloroquine at the saturating concentration on autophagic flux, proliferation and apoptosis of Sidt2 knockout cells were observed.

RESULTS

Sidt2^-/- HL7702 cells were successfully constructed.Sidt2 knockout significantly inhibited the proliferation and increased apoptosis of the cells, causing also increased protein expressions of LC3-II/I and P62(P < 0.05) and increased number of autophagosomes.Autophagy of the cells reached a saturated state following treatment with 50 μmol/L chloroquine, and at this concentration, chloroquine significantly increased the expressions of LC3B and P62 in Sidt2^-/- HL7702 cells.

CONCLUSION

Sidt2 gene knockout causes dysregulation of the autophagy pathway and induces apoptosis of HL7702 cells, and the latter effect is not mediated by inhibiting the autophagy-lysosomal pathway.

[Progress in research on HIV cluster detection and response]

HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.

[Difficulties and challenges of pelvic exenteration in locally advanced rectal cancer]

In recent years, with advances in pelvic oncology and surgical techniques, surgeons have redefined the boundaries of pelvic surgery. Combined pelvic exenteration is now considered the treatment of choice for some patients with locally advanced and locally recurrent rectal cancer, but it is only performed in a few hospitals in China due to the complexity of the procedure and the large extent of resection, complications, and high perioperative mortality. Although there have been great advances in oncologic drugs and surgical techniques and equipment in recent years, there are still many controversies and challenges in the preoperative assessment of combined pelvic organ resection, neoadjuvant treatment selection and perioperative treatment strategies. Adequate understanding of the anatomical features of the pelvic organs, close collaboration of the clinical multidisciplinary team, objective assessment and standardized preoperative combination therapy creates the conditions for radical surgical resection of recurrent and complex locally advanced rectal cancer, while the need for rational and standardized R0 resection still has the potential to bring new hope to patients with locally advanced and recurrent rectal cancer.

[Association between physical exercise and non-alcoholic fatty liver disease in people infected with hepatitis B virus]

Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m² (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.

[Fibroblasts overpressing WNT2b cause impairment of intestinal mucosal barrier]

OBJECTIVE

To investigate the mechanism by which fibroblasts with high WNT2b expression causes intestinal mucosa barrier disruption and promote the progression of inflammatory bowel disease (IBD).

METHODS

Caco-2 cells were treated with 20% fibroblast conditioned medium or co-cultured with fibroblasts highly expressing WNT2b, with the cells without treatment with the conditioned medium and cells co-cultured with wild-type fibroblasts as the control groups. The changes in barrier permeability of Caco-2 cells were assessed by measuring transmembrane resistance and Lucifer Yellow permeability. In Caco-2 cells co-cultured with WNT2b-overexpressing or control intestinal fibroblasts, nuclear entry of β-catenin was detected with immunofluorescence assay, and the expressions of tight junction proteins ZO-1 and E-cadherin were detected with Western blotting. In a C57 mouse model of dextran sulfate sodium (DSS)-induced IBD-like enteritis, the therapeutic effect of intraperitoneal injection of salinomycin (5 mg/kg, an inhibitor of WNT/β-catenin signaling pathway) was evaluated by observing the changes in intestinal inflammation and detecting the expressions of tight junction proteins.

RESULTS

In the coculture system, WNT2b overexpression in the fibroblasts significantly promoted nuclear entry of β-catenin (P < 0.01) and decreased the expressions of tight junction proteins in Caco-2 cells; knockdown of FZD4 expression in Caco-2 cells obviously reversed this effect. In DSS-treated mice, salinomycin treatment significantly reduced intestinal inflammation and increased the expressions of tight junction proteins in the intestinal mucosa.

CONCLUSION

Intestinal fibroblasts overexpressing WNT2b causes impairment of intestinal mucosal barrier function and can be a potential target for treatment of IBD.

Comparison of Treatment Methods of Thumb-Tip Defects With Phalangeal Bone Exposure: Modified Heterodigital Neurovascular Island Flap Versus Free Lateral Great Toe Flap

PURPOSE

Modified heterodigital neurovascular island flaps and free lateral great toe flaps are dependable methods for treating thumb-tip defects with phalangeal bone exposure. We retrospectively analyzed and compared the details and results of the two methods.

METHODS

This retrospective study included 25 patients with thumb injuries with phalangeal bone exposure treated between 2018 and 2021. Patients were categorized as per the following surgical methods: (1) modified heterodigital neurovascular island flap (12 patients, finger flap group) and (2) free lateral great toe flap (13 patients, toe flap group). The Michigan Hand Outcome Questionnaire, aesthetic appearance, Vancouver Scar Scale, Cold Intolerance Severity Score, static 2-point discrimination, Semmes-Weinstein monofilament, and range of motion of the metacarpophalangeal joint of the injured thumb were evaluated and compared. In addition, operation time, hospital stay, return-to-work time, and complications were recorded and compared.

RESULTS

In both groups, the defect was successfully repaired, with no cases of complete necrosis. The 2 groups had similar mean scores in static 2-point discrimination, Semmes-Weinstein monofilament, range of motion, and Michigan Hand Outcome Questionnaire scores. The aesthetic appearance, scarring, and cold tolerance of the toe flap group were better than the finger flap group. The operation time, hospital stay, and return-to-work time in the finger flap group were shorter than the toe flap group. The finger flap group had 2 complications-a superficial infection and 1 case of partial flap necrosis. The toe flap group had 3 complications-a superficial infection, 1 case each of partial flap necrosis, and partial skin graft loss.

CONCLUSION

Both treatments can achieve satisfactory results; however, they each have advantages and disadvantages.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

[Pelvic autonomic nerve preservation in rectal cancer: anatomical concept and clinical significance]

Colorectal cancer is one of the most common cancers in the world, and surgery is the mainstage treatment. Urogenital and sexual dysfunction after radical resection of rectal cancer has become an important problem for patients, which seriously affects the quality of life. Some patients give up radical surgery for rectal cancer because of the concerns about sexual and urinary dysfunction. The cause of this problem is intraoperative of injury pelvic autonomic nerve. The preservation of the hypogastric nerve during the surgery is important for the male ejaculation. Pelvic splanchnic nerves are mainly responsible for the male erection. The anatomical origin, distribution, and urogenital function of these two nerves are detailed described in this article. At the same time, this article introduces the classification, key points of the operation and the evaluation of autonomic nerve preservation surgery. With the rapid development of minimally invasive surgery, performing radical surgery for rectal cancer is important, we also need to fully understand the anatomical concept of pelvic autonomic nerves, and apply modern minimally invasive surgical techniques to preserve the patient's pelvic autonomic nerves as well. It is an compulsory course and an important manifestation for the standardization of rectal cancer surgery.

Carpal tunnel syndrome caused by tophi deposited under the epineurium of the median nerve: A case report

Introduction

Usually caused by compression of the wrist's median nerve, carpal tunnel syndrome (CTS) is one of the most common types of peripheral neuropathy. Tophi deposited under the epineurium of the median nerve compress the median nerve, leading to CTS, which is very rare.

Case presentation

We report a 64-year-old man with a history of tophaceous gout who presented with typical CTS symptoms and was admitted to our hospital. A physical examination revealed swelling over the right volar aspect of the carpal region, and he was unable to flex due to subcutaneous rigidity. Tinel's sign and Phalen's maneuver were positive. Electrophysiological studies confirmed the diagnosis of CTS. A carpal tunnel release and surgery to remove the gouty tophus of the right wrist were performed when serum uric acid levels were within normal limits (5.8 mg/dl). During the operation, tophi deposited under the epineurium of the median nerve were found, and the tophi were completely removed. Operative findings confirmed the diagnosis of CTS due to gout. The patient recovered uneventfully without signs of recurrence of gout and CTS symptoms during a 1-year follow-up period.

Conclusion

A gouty tophus is an uncommon cause of CTS, and CTS may be caused by gouty tophi if there is evidence of extrinsic compression of the median nerve or symptoms emanating from the carpal tunnel.

Reconstruction of the central slip insertion of the extensor tendon with the partial slip of the flexor digitorum superficialis tendon

INTRODUCTION

To introduce the surgical approach and clinical effect of transferring the partial slips of the flexor digitorum superficialis (FDS) tendon to reconstruct the insertion of the central slip of the extensor tendon (CSET) through an established bone tunnel (BT).

MATERIALS AND METHODS

From April 2019 to March 2021, nine patients (six males and three females) with the CSET insertion rupture or defect were admitted to the institution and the CSET insertion was reconstructed with partial tendon slips on both sides of the FDS. The active range of motion of the interphalangeal joint of the affected finger was measured by a goniometer, the degree of pain was evaluated by visual analogue scale (VAS), and the grip strength of the affected limb was measured by an electronic hand dynamometer.

RESULTS

The average postoperative follow-up was 12 months. No complications occurred. At the last follow-up, six of the patients were very satisfied and three were satisfied with their recovery.

CONCLUSION

The reconstruction of the CSET insertion by transferring the partial tendon slips of the FDS seem to be safe and feasible with minimal invasion to the donor tendon.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

Reverse digital artery island flap with versus without sensory nerve coaptation for finger pulp reconstruction

PURPOSE

Whether an innervated reverse digital artery island flap is superior to a non-innervated reverse digital artery island flap still remains controversial. We aimed to compare the clinical outcomes of the two flaps in repairing finger pulp soft tissue defects.

METHODS

Medical records of patients who underwent finger pulp reconstruction between January 2007 and December 2017 were evaluated retrospectively. A total of 45 patients were included. Twenty underwent sensory nerve reconstruction with cutaneous branches of the proper digital nerve, and 25 underwent the surgery without sensory nerve reconstruction. Surgical results, complications and sensory function were collected for analysis. Sensory function was assessed by static two-point discrimination and the modified sensory evaluation standard of British Medical Research Council.

RESULTS

The average operation time of innervated flaps was 23 min longer than non-innervated flaps. All 45 flaps survived completely. There was no significant difference in complications between groups. The average follow-up was 22 months. At the final follow-up, five non-innervated flaps had no recovery of static two-point discrimination. The average static two-point discrimination of the remaining 20 non-innervated flaps was larger than that of innervated flaps. Innervated flaps consistently achieved higher sensory function grades according to the modified sensory evaluation standard of British Medical Research Council.

CONCLUSION

An innervated reverse digital artery island flap can achieve better sensory function recovery in a shorter time. This procedure did not increase the incidence of complications, although it extended the operation time. It has proven to be a good technique for finger pulp reconstruction.

Programmed Death of Microglia in Alzheimer's Disease: Autophagy, Ferroptosis, and Pyroptosis

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, amyloid-β (Aβ) plaques and the formation of neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau. Increasing evidence has demonstrated that the damage of cell plays an important role in AD. Cell death is a critical phenomenon for physiological functions, which promotes AD pathogenesis. Programmed cell death, including necroptosis, pyroptosis, autophagy, and ferroptosis, have been discovered that have unique biological functions and pathophysiological characteristics. Here, we review the available evidence detailing the mechanisms of programmed microglial death, including pyroptosis, autophagy, and ferroptosis. We also highlight the role of programmed death of microglia during the process of AD and focus on the connection between the disease and cell death.

[Prevention and management of stoma-related complications after surgery for low rectal cancer]

The related technology of enterostomy is a professional skill that colorectal surgeons need to master, and it is clinically important to prevent the occurrence of enterostomy-related complications of low rectal cancer. The early complications of enterostomy include stoma retraction, stoma ischemic necrosis, stoma edema and peripheral dermatitis, and the long-term complications include parastomal hernia, stenosis and stoma prolapse. In addition, the rare or easily neglected stoma cancer, difficulty of stoma closure and following social psychological disorders should also be paid attention to by surgeons. Effective reduction of enterostomy complications can lead to better quality of life for patients, which is the best interpretation of the concept of "patient-centered ness" by colorectal surgeons.

High-affinity chromodomains engineered for improved detection of histone methylation and enhanced CRISPR-based gene repression

Histone methylation is an important post-translational modification that plays a crucial role in regulating cellular functions, and its dysregulation is implicated in cancer and developmental defects. Therefore, systematic characterization of histone methylation is necessary to elucidate complex biological processes, identify biomarkers, and ultimately, enable drug discovery. Studying histone methylation relies on the use of antibodies, but these suffer from lot-to-lot variation, are costly, and cannot be used in live cells. Chromatin-modification reader domains are potential affinity reagents for methylated histones, but their application is limited by their modest affinities. We used phage display to identify key residues that greatly enhance the affinities of Cbx chromodomains for methylated histone marks and develop a general strategy for enhancing the affinity of chromodomains of the human Cbx protein family. Our strategy allows us to develop powerful probes for genome-wide binding analysis and live-cell imaging. Furthermore, we use optimized chromodomains to develop extremely potent CRISPR-based repressors for tailored gene silencing. Our results highlight the power of engineered chromodomains for analyzing protein interaction networks involving chromatin and represent a modular platform for efficient gene silencing.

[The incidence and time distribution of early transient intraocular pressure elevation after penetrating canaloplasty]

Objective: To report the incidence and time distribution of early transient intraocular pressure (IOP) elevation after penetrating canaloplasty. Methods: Retrospective case series study. Data of patients treated by penetrating canaloplasty for glaucoma in the Eye Hospital of Wenzhou Medical University from June 2015 to March 2020 were collected. Early transient IOP elevation was defined as an increase of IOP to over 21 mmHg on the first week to the third month after surgery followed by a decrease to 21 mmHg or less within 3 months. Main outcome measures included IOP, quantity of medication use, the occurrence time and duration of IOP elevation. Generalized estimating equations were used for statistical analysis, and measurement data with non-normal distribution was represented as M (Q₁, Q₃). Results: A total of 277 patients (315 eyes) achieved 360-degree catheterization of the canal successfully, and 299 eyes (94.9%) completed the postoperative 6-month follow-up. Thirty-four eyes (10.8%) had persistently high IOP, so the surgical treatment failed in them. Consequently, 234 patients (265 eyes) were enrolled in the analyses, including 161 males (184 eyes) and 73 females (81 eyes). The median age was 42 (26, 54) years, the mean preoperative IOP was (37.7±11.1) mmHg, and the mean number of drugs used was 3 (2, 4). The incidence of early transient IOP elevation was 43.0% (114/265) in all enrolled eyes, 42.7% (35/82) in eyes with primary open angle glaucoma, 37.8% (17/45) in eyes with primary angle closure glaucoma, 27.7% (13/47) in eyes with congenital glaucoma and 53.8% (49/91) in eyes with secondary glaucoma. The IOP began to increase on the first to fourth week in 91.2% (104/114) of eyes with early transient IOP elevation and reached the peak [21.3 mmHg to 54.8 mmHg; mean, (32.4±8.2) mmHg] in 88.6% (101/114) on the first to fifth week after surgery. The IOP elevation lasted for no more than 4 weeks in 69.3% (79/114) of eyes. Conclusions: Over 40.0% of patients with penetrating canaloplasty may experience postoperative transient IOP elevation. The incidence is relatively high in secondary glaucoma but low in congenital glaucoma. Most of the elevations and peak IOP occur within 1-4 weeks after surgery.

Security analysis on an interference-based optical image encryption scheme

In this paper, the security strength of the improved optical cryptosystem based on interference has been evaluated. Compared to the previous interference-based cryptosystems in which the plaintext is encoded into two phase-only masks (POMs), here the plaintext is encoded into a POM and an amplitude mask (AM). Since the information of the plaintext cannot be recovered directly when one of the masks is released in the decryption process of the improved cryptosystem, it seems that it is free from the silhouette problem. However, we found that the random phase mask (RPM) serving as the encryption key is not related to the plaintext. Thus, it is possible to recover the RPM first by using the known-plaintext attack (KPA). Moreover, the POM and the AM generated in the encryption path only contains the phase and amplitude information, respectively. Thus, these can be utilized as additional constraints in the proposed iterative process. Based on these findings, two kinds of hybrid attacks, including a KPA and the iterative processes with different constraints, are proposed to crack the improved cryptosystem. In the designed KPA with a pair of the known plaintext and its corresponding masks, the RPM is recovered first. With the aid of the recovered RPM, two iterative processes with different released masks are proposed to recover the information of the plaintext without any knowledge of another mask. To the best of our knowledge, this is the first time that the existence of the silhouette problem in the cryptosystem under study has been reported. Numerical simulation has been carried out to validate the feasibility and effectiveness of the proposed hybrid attacks.

[Willingness to use the three types of pre-exposure prophylaxis and associated factors among men who have sex with men in Chengdu]

Objective: To investigate the willingness to use three types of pre-exposure prophylaxis (PrEP) and its associated factors among MSM in Chengdu. Methods: A total of 793 MSM were recruited through Chengdu Tongle Health Consultation Service Centre between November 2021 to January 2022. Data were collected, including demographic characteristics, sexual behaviors in the last six months, PrEP-related stigma, HIV anticipated stigma, MSM internalized stigma, and willingness to use three types of PrEP. Univariate and multivariate logistic regression models were conducted to investigate the associated factors of willingness in using the three types of PrEP. Results: Among 793 participants, willingness to take on-demand PrEP was higher (68.3%). Higher education and multiple sexual partners increased the willingness to use oral PrEP, higher education [compared with junior high school or below, high school or technical secondary school (aOR=2.43, 95%CI: 1.13-5.21), junior college (aOR=2.67, 95%CI: 1.27-5.61), bachelor degree (aOR=3.21, 95%CI: 1.52-6.74), master degree or above (aOR=3.77, 95%CI: 1.54-9.26)], multiple sexual partners (aOR=1.54, 95%CI: 1.12-2.11) were positively associated with daily oral PrEP. HIV anticipated stigma was positively associated with the willingness in using all three types of PrEP: daily oral PrEP (aOR=1.07, 95%CI: 1.02-1.12), on-demand PrEP (aOR=1.09, 95%CI: 1.03-1.15), and injectable PrEP every 8 week (aOR=1.06, 95%CI: 1.01-1.11). Conclusions: The overall willingness in using PrEP in MSM in Chengdu is relatively high, and the promotion of PrEP is highly feasible. In the future, we should continue to promote publicity and education on HIV and PrEP-related knowledge in this population, improve the cognitive level, and guide MSM to establish the correct motivation for PrEP use.

[Concept of lateral lymph nodes in rectal cancer and controversy over lateral lymph node dissection]

Lateral lymph node (LLN) metastasis in locally advanced rectal cancer (LARC) is associated with patient prognosis. However, the role of lateral lymph node dissection (LLND) remains controversial. The concept of LLN and the exact definition of LLND have been inconsistently reported in the literatures. The treatment strategy for LARC has differed between the East and the West. The Japanese doctors advocates total mesorectal excision (TME) with LLND for LARC, but less neoadjuvant radiochemotherapy (NARC). European and Americans prefer NARC plus TME, and do not recommend LLND. So far, only the Japanese Statute of Colorectal Cancer has a clear definition of the concept of LLN and LLND. The use of TME plus LLND for LARC is not supported by high level evidences. In today's high-speed development of minimally invasive surgery, the proper selection of standardized surgical methods for LARC requires the joint efforts of scholars from the East and the West to conduct multicenter high-grade clinical trials to select the best treatment option for patients with LARC.

Histopathologic features predictive of metastasis and survival in 230 patients with cutaneous squamous cell carcinoma of the head and neck and non-head and neck locations: a single-center retrospective study

BACKGROUND

Staging systems for cutaneous squamous cell carcinoma (cSCC) produce inconsistent risk stratification.

OBJECTIVE

The aim of this study was to identify further prognostic parameters for better stratification.

METHODS

We retrospectively analysed the prognostic significance of clinicopathologic parameters of 230 patients who underwent primary excision of invasive cSCC of the head and neck (n = 115) and non-head and non-neck (n = 115) locations. In addition to known high-risk features, we analysed tumour nest shape, invasion pattern, lymphoid response pattern and tumour budding.

RESULTS

On multivariable analysis, lymphovascular invasion (LVI) and high tumour budding predicted worse disease-specific survival, and ulceration, LVI and high tumour budding predicted worse overall survival. Only ulceration was independently associated with risk of nodal metastasis.

CONCLUSION

High tumour budding, LVI and ulceration are independently associated with poor outcome in cSCC and may be used to refine cSCC prognostic stratification, which is crucial to optimize clinical decision and to identify patients who are more likely to benefit from more aggressive interventions or clinical trials.

AB1043 IDENTIFICATION OF UNUSUAL TOPHI ANTERIOR TO THE THYROID CARTILAGE USING DIFFERENT IMAGING METHODS

Background

Inadequately treated gout patients could develop tophi. However, tophi could appear as atypical mass, leading to difficulty in differential diagnosis.

Objectives

The objectives of the study were to describe an unusual case with tophi anterior to the Thyroid Cartilage using different imaging methods.

Methods

Clinical information of the case was presented. Ultrasound, dual energy Computed Tomography (DECT) and CT scan were compared to describe the tophi.

Results

A 66-year-old man with a 30-year history of gout was admitted. He had received urate-lowering drugs intermittently over the past few years. Physical examination revealed multiple tophi on the hands, feet, and other auricular surfaces. Moreover, there was a subcutaneous mass above the thyroid cartilage (Figure 1A). Ultrasound revealed hyperechoic nodule anterior to the thyroid cartilage, 11*7cm in size, with uneven internal echo, no blood flow signal inside, and a close relationship between the barrier of the nodule and the thyroid cartilage (Figure 1B). DECT of the neck confirmed that the mass anterior to the thyroid cartilage were tophi (Figure 1C-D). A plain radiographic evaluation demonstrated soft-tissue swellings and para-articular erosions involving hands (Figure 1E-F). The serum creatinine and uric acid levels were elevated as follows, creatinine, 562 μmol per liter (normal range, 31.8 to 116); and uric acid, 621 μmol per liter (normal range, 90 to 420).

Figure 1.

Tophi detected by different imaging methods. A.A picture of the mass anterior to the thyroid cartilage; B. A mass anterior to the thyroid cartilage detected by ultrasound; C. The mass anterior to the thyroid cartilage detected by dual energy CT; D. The mass anterior to the thyroid cartilage detected by CT scan; E. a picture of tophi in the hands; F. a plain radiograph of tophi in the hands.

Conclusion

DECT has more advantages over ultrasound and CT for detection of atypical tophi in gout patients.

Disclosure of Interests

Yutong Jiang Grant/research support from: Scientific and Technological Planning Project of Guangzhou City [grant number 202102020150], Xinyu Wu: None declared, Zetao Liao: None declared, Jun Qi: None declared, Jieruo Gu: None declared