Amorphous FeSnOx Nanosheets with Hierarchical Vacancies for Room-Temperature Sodium-Sulfur Batteries

Room-temperature sodium-sulfur (RT Na-S) batteries, noted for their low material costs and high energy density, are emerging as a promising alternative to LIBs in various applications including power grids and standalone renewable energy systems. These batteries are commonly assembled with glass fiber membranes, which face significant challenges like the dissolution of polysulfides, sluggish sulfur conversion kinetics, and the dendrites growth. Here, we develop an amorphous FeSnOx nanosheet with hierarchical vacancies, including abundant oxygen vacancies (Ovs) and nano-sized perforations, that can be assembled into a multifunctional layer overlaying commercial separators for RT Na-S batteries. The Ovs offer strong adsorption and abundant catalytic sites for polysulfides, while the defect concentration is finely tuned to elucidate the polysulfides conversion mechanisms. The nano-sized perforations aid in regulating Na ions transport, resulting in uniform Na deposition. Moreover, the strategic addition of trace amounts of Ti3C2 forms an amorphous/crystalline interface that significantly improves the mechanical properties of the separator and suppresses dendrite growth. As a result, the task-specific layer achieves ultra-light (~0.1mg cm-2), ultra-thin (~200nm), and ultra-robust (modulus = 4.9GPa) characteristics. Consequently, the RT Na-S battery maintained a high capacity of 610.3mAh g-1 and an average Coulombic efficiency of 99.9% after 400 cycles at 0.5C.

[Analysis of compliance with lung protective mechanical ventilation strategy in patients with acute respiratory distress syndrome]

Objective: To assess the compliance with a lung protective ventilation strategy and to evaluate the relationship with prognosis in patients with acute respiratory distress syndrome (ARDS). Methods: In the prospective multicenter cohort study (CHARDS), patients with ARDS undergoing invasive mechanical ventilation were enrolled to collect essential information, mechanical ventilation data, and prognostic data. Compliance was operationally defined as tidal volume ≤7 ml/kg predicted body weight (PBW) or plateau pressure ≤30 cmH2O or driving pressure≤15 cmH2O. Tidal volume data collected 7 days prior to ventilation after ARDS diagnosis were categorized into four groups: standard group (Group A, 100% compliance), non-standard group (Group B, 50%-99% compliance, Group C,1%-49% compliance,and Group D,totally non-compliant). Plateau pressure and drive pressure measurements were recorded on the first day. Stepwise regression, specifically Logistics regression, was used to identify the factors influencing ICU survival. Results: A total of 449 ARDS patients with invasive mechanical ventilation were included; the proportion of mild, moderate, and severe patients was 71 (15.8%), 198 (44.1%) and 180 (40.1%), respectively. During the first 7 days, a total of 2880 tidal volume measurements were recorded with an average tidal volume of (6.89±1.93) ml/kg PBW. Of these measurements, 53.2% were found to be≤7 ml/kg PBW. The rates of compliance with lung protective mechanical ventilation were 29.8% (134/449), 24.5% (110/449), 23.6% (106/449), and 22% (99/449) in groups A, B, C, and D, respectively. In the standard group, the tidal volume for mild ARDS patients was 18.3%(13/71), while it was 81.7%(58/71)in the non-standard group. Similarly, in patients with moderate ARDS, the tidal volume was 25.8% (51/198) in the standard group, while it was 74.2% (147/198) in the non-standard group. Finally, in patients with severe ARDS, the tidal volume was 38.9% (70/180) in the standard group, while it was 61.1% (110/180) in the non-standard group. Notably, the compliance rate was higher in patients with moderate and severe ARDS in group A compared to patients with mild and moderate ARDS (18.3% vs. 25.8% vs. 38.9%, χ2=13.124, P=0.001). Plateau pressure was recorded in 221 patients, 95.9% (212/221) patients with plateau pressure≤30 cmH2O, and driving pressure was recorded in 207 patients, 77.8% (161/207) patients with a driving pressure ≤15 cmH2O.During the first 7 days, the mortality rate in the intensive care unit (ICU) was lower in the tidal volume standard group compared to the non-standard group (34.6% vs. 51.3%, χ2=10.464, P=0.001). In addition, the in-hospital mortality rate was lower in the standard group compared to the non-standard group (39.8% vs. 57%, χ2=11.016, P=0.001).The results of the subgroup analysis showed that the mortality rates of moderate and severe ARDS patients in the standard group were significantly lower than those in the non-standard group, both in the ICU and in the hospital (all P<0.05). However, there was no statistically significant difference in mortality among mild ARDS patients (all P>0.05). Conclusions: There was high compliance with recommended lung protective mechanical ventilation strategies in ARDS patients, with slightly lower compliance in patients with mild ARDS, and high compliance rates for plateau and drive pressures. The tidal volume full compliance group had a lower mortality than the non-compliance group, and showed a similar trend in the moderate-to-severe ARDS subgroup, but there was no significant correlation between compliance and prognosis in patients with mild ARDS subgroup.

[Role of neoadjuvant rectal score in prognosis and adjuvant chemotherapy decision-making in locally advanced rectal cancer following neoadjuvant short-course radiotherapy and consolidation chemotherapy]

Objectives: To assess the prognostic impact of the neoadjuvant rectal (NAR) score following neoadjuvant short-course radiotherapy and consolidation chemotherapy in locally advanced rectal cancer (LARC), as well as its value in guiding decisions for adjuvant chemotherapy. Methods: Between August 2015 and August 2018, patients were eligible from the STELLAR phase III trial (NCT02533271) who received short-course radiotherapy plus consolidation chemotherapy and for whom the NAR score could be calculated. Based on the NAR score, patients were categorized into low (＜8), intermediate (8-16), and high (＞16) groups. The Kaplan-Meier method, log rank tests, and multivariate Cox proportional hazard regression models were used to evaluate the impact of the NAR score on disease-free survival (DFS). Results: Out of the 232 patients, 24.1%, 48.7%, and 27.2% had low (56 cases), intermediate (113 cases), and high NAR scores (63 cases), respectively. The median follow-up period was 37 months, with 3-year DFS rates of 87.3%, 68.3%, and 53.4% (P＜0.001) for the low, intermediate, and high NAR score groups. Multivariate analysis demonstrated that the NAR score (intermediate NAR score: HR, 3.10, 95% CI, 1.30-7.37, P=0.011; high NAR scores: HR=5.44, 95% CI, 2.26-13.09, P＜0.001), resection status (HR, 3.00, 95% CI, 1.64-5.52, P＜0.001), and adjuvant chemotherapy (HR, 3.25, 95% CI, 2.01-5.27, P＜0.001) were independent prognostic factors for DFS. In patients with R0 resection, the 3-year DFS rates were 97.8% and 78.0% for those with low and intermediate NAR scores who received adjuvant chemotherapy, significantly higher than the 43.2% and 50.6% for those who did not (P＜0.001, P=0.002). There was no significant difference in the 3-year DFS rate (54.2% vs 53.3%, P=0.214) among high NAR score patients, regardless of adjuvant chemotherapy. Conclusions: The NAR score is a robust prognostic indicator in LARC following neoadjuvant short-course radiotherapy and consolidation chemotherapy, with potential implications for subsequent decisions regarding adjuvant chemotherapy. These findings warrant further validation in studies with larger sample sizes.

DPSCs regulate epithelial-T cell interactions in oral submucous fibrosis

BACKGROUND

Oral submucous fibrosis (OSF) is a precancerous lesion characterized by fibrous tissue deposition, the incidence of which correlates positively with the frequency of betel nut chewing. Prolonged betel nut chewing can damage the integrity of the oral mucosal epithelium, leading to chronic inflammation and local immunological derangement. However, currently, the underlying cellular events driving fibrogenesis and dysfunction are incompletely understood, such that OSF has few treatment options with limited therapeutic effectiveness. Dental pulp stem cells (DPSCs) have been recognized for their anti-inflammatory and anti-fibrosis capabilities, making them promising candidates to treat a range of immune, inflammatory, and fibrotic diseases. However, the application of DPSCs in OSF is inconclusive. Therefore, this study aimed to explore the pathogenic mechanism of OSF and, based on this, to explore new treatment options.

METHODS

A human cell atlas of oral mucosal tissues was compiled using single-cell RNA sequencing to delve into the underlying mechanisms. Epithelial cells were reclustered to observe the heterogeneity of OSF epithelial cells and their communication with immune cells. The results were validated in vitro, in clinicopathological sections, and in animal models. In vivo, the therapeutic effect and mechanism of DPSCs were characterized by histological staining, immunohistochemical staining, scanning electron microscopy, and atomic force microscopy.

RESULTS

A unique epithelial cell population, Epi1.2, with proinflammatory and profibrotic functions, was predominantly found in OSF. Epi1.2 cells also induced the fibrotic process in fibroblasts by interacting with T cells through receptor-ligand crosstalk between macrophage migration inhibitory factor (MIF)-CD74 and C-X-C motif chemokine receptor 4 (CXCR4). Furthermore, we developed OSF animal models and simulated the clinical local injection process in the rat buccal mucosa using DPSCs to assess their therapeutic impact and mechanism. In the OSF rat model, DPSCs demonstrated superior therapeutic effects compared with the positive control (glucocorticoids), including reducing collagen deposition and promoting blood vessel regeneration. DPSCs mediated immune homeostasis primarily by regulating the numbers of KRT19 + MIF + epithelial cells and via epithelial-stromal crosstalk.

CONCLUSIONS

Given the current ambiguity surrounding the cause of OSF and the limited treatment options available, our study reveals that epithelial cells and their crosstalk with T cells play an important role in the mechanism of OSF and suggests the therapeutic promise of DPSCs.

Oral mirtazapine decreases the gastrointestinal adverse effects in cats on doxorubicin chemotherapy

Anorexia, depression, and vomiting are the common adverse effects of chemotherapy in humans and animals. Mirtazapine is primarily used as an appetite stimulant and antiemetic in dogs and cats. Therefore, we evaluated the efficacy of mirtazapine in reducing the gastrointestinal adverse effects in cats receiving doxorubicin chemotherapy. This single-masked, placebo-controlled crossover study enrolled 11 cats with malignant mammary gland tumors. The cats were randomly assigned to receive either mirtazapine (1.88 mg/cat) or placebo every 48 h for 2 weeks from the first initiation of doxorubicin chemotherapy. Each cat was then crossed over to the alternate group on the subsequent chemotherapy with a 1-week wash-out period. The owners were asked to record appetite score, activity score, episodes of vomiting and diarrhea for 2 weeks after each doxorubicin administration. Cats treated with mirtazapine showed significantly increased bodyweight compared with those on placebo (P = 0.010). The appetite and activity scores during mirtazapine treatment was significantly higher than those during placebo treatment (P = 0.005 and 0.018, respectively). Furthermore, the prevalence of episodes of vomiting during mirtazapine treatment was significantly lower than that during placebo treatment (P = 0.026). Our results demonstrate that mirtazapine can significantly increase bodyweight, appetite, and activity and reduce vomiting in cats after doxorubicin chemotherapy.

Continuous Ultrathin Zwitterionic Covalent Organic Framework Membrane Via Surface-Initiated Polymerization Toward Superior Water Retention

Efficient construction of proton transport channels in proton exchange membranes maintaining conductivity under varied humidity is critical for the development of fuel cells. Covalent organic frameworks (COFs) hold great potential in providing precise and fast ion transport channels. However, the preparation of continuous free-standing COF membranes retaining their inherent structural advantages to realize excellent proton conduction performance is a major challenge. Herein, a zwitterionic COF material bearing positive ammonium ions and negative sulphonic acid ions is developed. Free-standing COF membrane with adjustable thickness is constructed via surface-initiated polymerization of COF monomers. The porosity, continuity, and stability of the membranes are demonstrated via the transmission electron microscopy (TEM), atomic force microscopy (AFM), and scanning electron microscopy (SEM) characterization. The rigidity of the COF structure avoids swelling in aqueous solution, which improves the chemical stability of the proton exchange membranes and improves the performance stability. In the higher humidity range (50-90%), the prepared zwitterionic COF membrane exhibits superior capability in retaining the conductivity compared to COF membrane merely bearing sulphonic acid group. The established strategy shows the potential for the application of zwitterionic COF in the proton exchange membrane fuel cells.

[Development and application of homeostatic medicine in stomatology]

Homeostatic medicine is the science of studying the balance of molecules, cells, tissues, organs as well as the whole of the organism, and it is a comprehensive discipline based on the maintenance of balance for the promotion of health, prevention and treatment of diseases. The introduction of homeostatic medicine is of great significance for the development of dentistry. Through the study of oral homeostasis, it helps to elucidate the intrinsic mechanism of disease occurrence fundamentally based on a unique perspective, which is expected to provide effective solutions for clinical diseases and impetus for continuous progress in the development of medicine, and to point out the direction for the developments of science and technology in the future.

Flexible Metasurfaces for Multifunctional Interfaces

Optical metasurfaces, capable of manipulating the properties of light with a thickness at the subwavelength scale, have been the subject of extensive investigation in recent decades. This research has been mainly driven by their potential to overcome the limitations of traditional, bulky optical devices. However, most existing optical metasurfaces are confined to planar and rigid designs, functions, and technologies, which greatly impede their evolution toward practical applications that often involve complex surfaces. The disconnect between two-dimensional (2D) planar structures and three-dimensional (3D) curved surfaces is becoming increasingly pronounced. In the past two decades, the emergence of flexible electronics has ushered in an emerging era for metasurfaces. This review delves into this cutting-edge field, with a focus on both flexible and conformal design and fabrication techniques. Initially, we reflect on the milestones and trajectories in modern research of optical metasurfaces, complemented by a brief overview of their theoretical underpinnings and primary classifications. We then showcase four advanced applications of optical metasurfaces, emphasizing their promising prospects and relevance in areas such as imaging, biosensing, cloaking, and multifunctionality. Subsequently, we explore three key trends in optical metasurfaces, including mechanically reconfigurable metasurfaces, digitally controlled metasurfaces, and conformal metasurfaces. Finally, we summarize our insights on the ongoing challenges and opportunities in this field.

Stretchable and Smart Wettable Sensing Patch with Guided Liquid Flow for Multiplexed in Situ Perspiration Analysis

Stretchable sweat sensors have become a personalized wearable platform for continuous, noninvasive health monitoring through conformal integration with the human body. Typically, these devices are coupled with soft microfluidic systems to control sweat flow during advanced analysis processes. However, the implementation of these soft microfluidic devices is limited by their high fabrication costs and the need for skin adhesives to block natural perspiration. To overcome these limitations, a stretchable and smart wettable patch has been proposed for multiplexed in situ perspiration analysis. The patch includes a porous membrane in the form of a patterned microfoam and a nanofiber layer laminate, which extracts sweat selectively from the skin and directs its continuous flow across the device. The integrated electrochemical sensor array measures multiple biomarkers simultaneously such as pH, K+, and Na+. The soft sensing patch comprises compliant materials and structures that allow deformability of up to 50% strain, which enables a stable and seamless interface with the curvilinear human body. During continuous physical exercise, the device has demonstrated a special operating mode by actively accumulating sweat from the skin for multiplex electrochemical analysis of biomarker profiles. The smart wettable membrane provides an affordable solution to address the sampling challenges of in situ perspiration analysis.

[Prevalence of frailty and related factors in middle-aged and elderly people in island and mountainous areas of Taizhou, Zhejiang Province]

Objective: To compare the prevalence of frailty and related factors in middle-aged and elderly people aged ≥45 years in island and mountainous areas of Taizhou, Zhejiang Province. Methods: Based on cross-sectional design, stratified cluster sampling and quota sampling methods were adopted. One administrative district was randomly selected from each of six coastal and three inland administrative districts in Taizhou during July to August, representing two different geographical terrains. In the island area (Jiaojiang District), all residents aged ≥45 years were included by cluster sampling. In the mountainous area (Xianju County), participants were selected through quota sampling, with same gender and age distributions. Data about their demographic characteristics, lifestyle and health-related factors were collected through questionnaire surveys and laboratory examinations. The prevalence of frailty was assessed using the Fried frailty phenotype scale. Hierarchical analysis and multivariate logistic regression analysis were used to compare the influencing factors of frailty. Results: A total of 1 011 local residents were studied, in whom island and mountainous residents accounted for 48.1% (486/1 011) and 51.9% (525/1 011) respectively; men and women accounted for 45.9% (464/1 011) and 54.1% (547/1 011) respectively. Middle-aged (45-49 years), younger elderly (60-74 years), and older elderly (≥75 years) residents accounted for 38.6% (390/1 011), 44.6% (451/1 011), and 16.8% (170/1 011) respectively. The overall prevalence rate of frailty was 3.6% (36/1 011), the prevalence rate was 3.7% (17/464) in men and 3.5% (19/547) in women. The prevalence rates in age groups 45-59,60-74 years and ≥75 years were 0.3% (1/390), 2.2% (10/451), and 14.7% (25/170), respectively. The prevalence rates of frailty and pre-frailty in island area were 6.0% (29/486) and 39.1% (190/486), respectively, which was higher than those in mountainous area (1.3%, 7/525) and (30.9%, 162/525). After adjusting for potential confounding factors, the risk for frailty in island residents was significantly higher than that in mountainous residents (aOR=1.55,95%CI: 1.07-2.25,P=0.019). In island area, older age (60-74 years:aOR=2.52,95%CI: 1.56-4.13; ≥75 years:aOR=11.65,95%CI:5.38-26.70), being women (aOR=1.94,95%CI: 1.20-3.17), suffering from depression (aOR=1.09,95%CI:1.02-1.17) were associated with frailty symptoms. In mountainous area, older age was also associated with an increased risk of frailty symptoms, but the OR value was lower than those in island area (60-74 years: aOR=1.74,95%CI:1.04-2.94;≥75 years: aOR=4.78,95%CI:2.45-9.50). Polydrug use (aOR=2.08,95%CI: 1.14-3.80) and suffering from depression (aOR=1.10,95%CI: 1.02-1.18) had significant positive association with frailty symptoms. Higher education level had significant negative association with frailty symptoms (junior high school: aOR=0.40,95%CI: 0.21-0.75; senior high school and technical secondary school: aOR=0.29,95%CI: 0.15-0.53; college or above:aOR=0.22,95%CI: 0.11-0.42). Conclusions: The prevalence of frailty in middle-aged and elderly community residents was significantly higher in island area than in mountainous area in Taizhou. The frailty-related factors varied with area. The elderly people (≥75 years) and women in island area had higher risk for frailty. Older age and suffering from depression were the independent risk factors for frailty. It is necessary to pay attention to the health risk factors and special environment in island area, and take comprehensive intervention measures to delay the process of debilitation and improve the quality of life of middle-aged and elderly people.

Mussel-inspired antibacterial sponge for highly efficient water purification and sterilization

With the current expansion of urban areas and industrial development, the increasing discharge of wastewater containing bacteria poses a threat to human health. Although substantial advancements have been made in antibacterial materials, there is still a need for an efficient method that can thoroughly remove bacteria through sterilization and adsorption during wastewater treatment. Here, we report a mussel-inspired antibacterial sponge with outstanding antibacterial efficiency exceeding 95% and a high removal ratio of the bacterial corpses for water purification after contacting for 30 min. The high-efficient antibacterial performance is attributed to the stable releasing property of Ag+ and the charge interaction with quaternary amine salts. Combining the key features, including high-efficient, synergistic mechanism, and corpse capture, the antibacterial sponge shows excellent disinfection effects. This study provides a new method for water purification without bacterial residue.

Machine learning-directed electrical impedance tomography to predict metabolically vulnerable plaques

The characterization of atherosclerotic plaques to predict their vulnerability to rupture remains a diagnostic challenge. Despite existing imaging modalities, none have proven their abilities to identify metabolically active oxidized low-density lipoprotein (oxLDL), a marker of plaque vulnerability. To this end, we developed a machine learning-directed electrochemical impedance spectroscopy (EIS) platform to analyze oxLDL-rich plaques, with immunohistology serving as the ground truth. We fabricated the EIS sensor by affixing a six-point microelectrode configuration onto a silicone balloon catheter and electroplating the surface with platinum black (PtB) to improve the charge transfer efficiency at the electrochemical interface. To demonstrate clinical translation, we deployed the EIS sensor to the coronary arteries of an explanted human heart from a patient undergoing heart transplant and interrogated the atherosclerotic lesions to reconstruct the 3D EIS profiles of oxLDL-rich atherosclerotic plaques in both right coronary and left descending coronary arteries. To establish effective generalization of our methods, we repeated the reconstruction and training process on the common carotid arteries of an unembalmed human cadaver specimen. Our findings indicated that our DenseNet model achieves the most reliable predictions for metabolically vulnerable plaque, yielding an accuracy of 92.59% after 100 epochs of training.

Unleashing the Potential of MXene-Based Flexible Materials for High-Performance Energy Storage Devices

Since the initial discovery of Ti3 C2 a decade ago, there has been a significant surge of interest in 2D MXenes and MXene-based composites. This can be attributed to the remarkable intrinsic properties exhibited by MXenes, including metallic conductivity, abundant functional groups, unique layered microstructure, and the ability to control interlayer spacing. These properties contribute to the exceptional electrical and mechanical performance of MXenes, rendering them highly suitable for implementation as candidate materials in flexible and wearable energy storage devices. Recently, a substantial number of novel research has been dedicated to exploring MXene-based flexible materials with diverse functionalities and specifically designed structures, aiming to enhance the efficiency of energy storage systems. In this review, a comprehensive overview of the synthesis and fabrication strategies employed in the development of these diverse MXene-based materials is provided. Furthermore, an in-depth analysis of the energy storage applications exhibited by these innovative flexible materials, encompassing supercapacitors, Li-ion batteries, Li-S batteries, and other potential avenues, is conducted. In addition to presenting the current state of the field, the challenges encountered in the implementation of MXene-based flexible materials are also highlighted and insights are provided into future research directions and prospects.

[Clinicopathological features and prognosis of 47 adults with Hirschsprung's disease and Hirschsprung's disease allied disorders]

Objective: To improve understanding and treatment of adult Hirschsprung's disease (HD) and Hirschsprung's disease allied disorders (HAD) by investigating the clinicopatho- logical features, diagnostic and treatment methods, and prognosis. Methods: This was a retrospective observational study. The study cohort comprised patients aged 18-65 years admitted to the Sixth Hospital of Sun Yat-sen University between January 2007 and December 2022 who were diagnosed with adult HD or HAD by postoperative pathological examination. Those with severe cardiovascular disease, diabetes mellitus, or cirrhosis of the liver were excluded, leaving 47 patients in the study cohort. Emergency open surgery was performed on patients with life-threatening manifestations, whereas those whose condition was stable received conservative treatment to stabilize them, following which they underwent a standard surgical procedure. Surgical procedures performed included the Duhamel procedure, Soave procedure, subtotal colonic resection, total colonic resection, and creation of a palliative stoma. Variables studied included clinicopathological characteristics, treatment modalities, postoperative complications, and long-term anal function. Complications were evaluated in accordance with the Clavien-Dindo criteria, and long-term anal function according to the 2005 Krickenbeck International Classification Criteria. Results: Of the 47 patients, 33 were men and 14 women, with a median age of 29 (18-51) years. HD was diagnosed in 41 (87.2%) patients and HAD in six (12.8%). The commonest initial symptom was dyspareunia (70.2%,33/47), followed by abdominal distension (57.4%, 27/47) and abdominal pain (44.7%,21/47). The detection rates of HD/HAD by barium enema + defecography, anorectal manometry, and preoperative rectal biopsy were 86.8% (33/38), 16/19, and 7/7, respectively. Three (6.4%) patients had discrepant preoperative clinical and postoperative pathological diagnoses. None of the three misdiagnosed patients had undergone preoperative rectal biopsy. Of the 47 study patients, three chose non-surgical treatment and 44 surgical treatment. All surgeries were successfully completed. Postoperative complications occurred in 19 patients (43.2%), including one death case who had undergone emergency surgery. The median duration of follow-up after surgery was 65 (12-180) months. Three patients in the surgical treatment group were lost to follow-up. Of the remaining 41 patients, 36, three, and two had excellent, good, and poor long-term anal function, respectively. The differences in outcomes between the surgical and non-surgical treatment groups (no patients, one, and two with excellent, good, and poor long-term anal function, respectively) (Z=-3.883, P=0.001) were statistically significant. Of the 44 patients who underwent surgical treatment, 41 underwent standard surgeries and three emergency surgeries because their conditions were life-threatening. The difference in complication rate between standard surgery and emergency surgery groups (39.0% [16/41] vs. 3/3, χ2=2.115, P=0.146) was not statistically significant. However, the rate of postoperative Grade III-V complications was lower in the standard surgery group (4.9% [2/41] vs. 2/3, Z=-2.668, P=0.008). Long-term anal function was significantly better in the standard surgery than emergency surgery group (94.7% [36/38] vs. 0/3, Z=-4.935, P=0.001). The 41 standard surgeries included 11 Duhamel's procedures, six Soave's procedures, 19 subtotal colonic resections, three total colonic resections, and two palliative colostomies. The incidence of postoperative complications was significantly superior in the Duhanmels procedures and palliative colostomies group(1/11 and 0/2, P=0.041). Of the 41 patients who underwent standard surgery, 23 underwent open surgery and 18 minimally invasive laparoscopic surgery. The incidence of postoperative Grade III-V complications and long-term anal function were significantly superior in the laparoscopic group than in the open group (all P<0.05). Conclusion: It is easy to misdiagnose adult HD and HAD, surgical treatment is safe and feasible, and its long-term efficacy is good.

Audio-Visual Fusion Based on Interactive Attention for Person Verification

With the rapid development of multimedia technology, personnel verification systems have become increasingly important in the security field and identity verification. However, unimodal verification systems have performance bottlenecks in complex scenarios, thus triggering the need for multimodal feature fusion methods. The main problem with audio-visual multimodal feature fusion is how to effectively integrate information from different modalities to improve the accuracy and robustness of the system for individual identity. In this paper, we focus on how to improve multimodal person verification systems and how to combine audio and visual features. In this study, we use pretrained models to extract the embeddings from each modality and then perform fusion model experiments based on these embeddings. The baseline approach in this paper involves taking the fusion feature and passing it through a fully connected (FC) layer. Building upon this baseline, we propose three fusion models based on attentional mechanisms: attention, gated, and inter-attention. These fusion models are trained on the VoxCeleb1 development set and tested on the evaluation sets of the VoxCeleb1, NIST SRE19, and CNC-AV datasets. On the VoxCeleb1 dataset, the best system performance achieved in this study was an equal error rate (EER) of 0.23% and a detection cost function (minDCF) of 0.011. On the evaluation set of NIST SRE19, the EER was 2.60% and the minDCF was 0.283. On the evaluation set of the CNC-AV set, the EER was 11.30% and the minDCF was 0.443. These experimental results strongly demonstrate that the proposed fusion method can significantly improve the performance of multimodal character verification systems.

[Prospective cohort study of the association of cardiovascular disease with triglyceride glucose index and triglyceride glucose-related indicators]

Objective: To investigate the association of cardiovascular diseases (CVD) with triglyceride glucose index (TyG) and TyG-related indicators in Uyghur populations of The Xinjiang Production and Construction Corps. Methods: Based on the cohort of the Uygur population of The Xinjiang Production and Construction Corps, 11 833 study subjects were included. The Kaplan-Meier method was used to estimate the cumulative incidence of CVD in each quartile of TyG and TyG-related indicators. Cox proportional hazards regression model was used to evaluate the relationship between TyG and CVD, TyG-related indicators and CVD. Framingham CVD risk score model (Framingham model) was used to evaluate whether the addition of TyG and TyG-related indicators could improve the predictive ability of the model. The potential mediating role of the TyG in the association between obesity and CVD was examined through mediation effect analysis. Results: The average age of the subjects was (37.00±13.67) years-old, and 51.0% were male. The median follow-up time was 5.67 years, with 1 288 CVD events. The cumulative incidence of CVD increased with the increase of TyG and TyG-related indicators quartiles, and compared with the Q1 group, the risk of CVD in the Q4 group of TyG, TyG-BMI, and TyG-WHtR increased by 20% (HR=1.20, 95%CI: 1.01-1.42), 77% (HR=1.77, 95%CI: 1.46-2.16) and 68% (HR=1.68, 95%CI: 1.36-2.09), respectively. After adding TyG, TyG-BMI, and TyG-WHtR to the Framingham model, respectively, the model's area under the curve, net reclassification improvement, and integrated discrimination improvement were improved. In the association between BMI, WHtR, and CVD, the proportion of mediating effects mediated by the TyG index was 10.55% and 11.50%. Conclusions: Elevated levels of TyG and TyG-related indicators were strongly associated with the risk of CVD in the Uyghur population of The Xinjiang Production and Construction Corps, with TyG-BMI being the most closely correlated with CVD. Early monitoring of TyG-BMI helps identify high-risk groups of CVD.

Multifunctional Microneedle Patches via Direct Ink Drawing of Nanocomposite Inks for Personalized Transdermal Drug Delivery

Additive manufacturing, commonly known as 3D printing, allows decentralized drug fabrication of orally administered tablets. Microneedles are comparatively favorable for self-administered transdermal drug delivery with improved absorption and bioavailability. Due to the cross-scale geometric characteristics, 3D-printed microneedles face a significant trade-off between the feature resolution and production speed in conventional layer-wise deposition sequences. In this study, we introduce an economical and scalable direct ink drawing strategy to create drug-loaded microneedles. A freestanding microneedle is efficiently generated upon each pneumatic extrusion and controlled drawing process. Sharp tips of ∼5 μm are formed with submillimeter nozzles, representing 2 orders of magnitude improved resolution. As the key enabler of this fabrication strategy, the yield-stress fluid inks are formulated by simply filling silica nanoparticles into regular polymer solutions. The approach is compatible with various microneedles based on dissolvable, biodegradable, and nondegradable polymers. Various matrices are readily adopted to adjust the release behaviors of the drug-loaded microneedles. Successful fabrication of multifunctional patches with heterogeneously integrated microneedles allows the treatment of melanoma via synergistic photothermal therapy and combination chemotherapy. The personalized patches are designed for cancer severity to achieve high therapeutic efficacy with minimal side effects. The direct ink drawing reported here provides a facile and low-cost fabrication strategy for multifunctional microneedle patches for self-administering transdermal drug delivery.

A self-assembled implantable microtubular pacemaker for wireless cardiac electrotherapy

The current cardiac pacemakers are battery dependent, and the pacing leads are prone to introduce valve damage and infection, plus a complete pacemaker retrieval is needed for battery replacement. Despite the reported wireless bioelectronics to pace the epicardium, open-chest surgery (thoracotomy) is required to implant the device, and the procedure is invasive, requiring prolonged wound healing and health care burden. We hereby demonstrate a fully biocompatible wireless microelectronics with a self-assembled design that can be rolled into a lightweight microtubular pacemaker for intravascular implantation and pacing. The radio frequency was used to transfer energy to the microtubular pacemaker for electrical stimulation. We show that this pacemaker provides effective pacing to restore cardiac contraction from a nonbeating heart and have the capacity to perform overdrive pacing to augment blood circulation in an anesthetized pig model. Thus, this microtubular pacemaker paves the way for the minimally invasive implantation of leadless and battery-free microelectronics.

Stretchable Thermoelectric Fibers with Three-Dimensional Interconnected Porous Network for Low-Grade Body Heat Energy Harvesting

Electricity generation from body heat has garnered significant interest as a sustainable power source for wearable bioelectronics. In this work, we report stretchable n-type thermoelectric fibers based on the hybrid of Ti3C2Tx MXene nanoflakes and polyurethane (MP) through a wet-spinning process. The proposed fibers are designed with a 3D interconnected porous network to achieve satisfactory electrical conductivity (σ), thermal conductivity (κ), and stretchability simultaneously. We systematically optimize the thermoelectric and mechanical traits of the MP fibers and the MP-60 (with 60 wt % MXene content) exhibits a high σ of 1.25 × 103 S m-1, an n-type Seebeck coefficient of -8.3 μV K-1, and a notably low κ of 0.19 W m-1 K-1. Additionally, the MP-60 fibers possess great stretchability and mechanical strength with a tensile strain of 434% and a breaking stress of 11.8 MPa. Toward practical application, a textile thermoelectric generator is constructed based on the MP-60 fibers and achieves a voltage of 3.6 mV with a temperature gradient between the body skin and ambient environment, highlighting the enormous potential of low-grade body heat energy harvesting.

Methodological and Reporting Quality of Non-Inferiority or Equivalence Designs: A Systematic Review of Trial Characteristics, Design Consideration and Interpretation in Breast Cancer Radiotherapy Trials

PURPOSE/OBJECTIVE(S)

To investigate the methodological and reporting quality of non-inferiority (NI)/equivalence trials of breast cancer radiotherapy and to provide suggestions for future NI/equivalence trials.

MATERIALS/METHODS

Prospective phase III randomized controlled trials (RCTs) comparing different radiation modalities in patients with breast cancer and designed or interpreted as NI/equivalence were identified in PubMed, EMBASE and Cochrane library. Two reviewers independently extracted data on trial characteristics, statistical design assumptions and analysis considerations, primary end point results and conclusions. The relationship between the number of published trials and the year of publication was assessed by simple linear regression. Trials with pre-specified NI margins as absolute risk differences were reevaluated using margins as relative risk differences.

RESULTS

A total of 1490 records were screened and 41 articles published between January 1, 2001 and May 9, 2022 were selected for full text review. A total of 21 trials were included (18 designed as NI and 3 as equivalence). Publication of these trials increased over time (p = 0.023). Trial interventions included dose fractionation (n = 10), partial/whole breast irradiation (n = 8) and tumor bed boost (n = 3). Eleven (52.4%) trials clearly described the non-efficacy benefits. The primary endpoints included 5-year local recurrence (LR) (n = 11), 5-year locoregional recurrence (n = 3), acute/late toxicities (n = 5), 2-year LR and cosmetic outcome (n = 1), and 10-year LR (n = 1). Only seven (33.3%) trials provided justification of the margins. The absolute and relative risk margins were both mentioned in nine (42.9%) trials' methods and reported in six (28.6%) trials' results. The analyzed populations were intention-to-treat (ITT) in 10, both ITT and per-protocol in 9 trials. Seventeen (81%) trials reported confidence interval (CI), with twelve reporting CI that agreed with the type I error used in sample size calculation, but only eight (38.1%) reported p value for NI/equivalence test. Fifteen (71.4%) trials concluded NI/equivalence. Five (23.8%) trials had misleading conclusions (four for not mentioning small sample size insufficient to confirm NI/equivalence and one for inconsistent with the published results). Thirteen (61.9%) trials reported that the protocol's initial accrual target was not met, with ten (47.6%) owing to overestimation of event rates. For trials that met NI only based on absolute margin, three of eight (37.5%) trials were classified as inconclusive with the assumed relative margins.

CONCLUSION

The use of NI/equivalence trials of breast cancer radiotherapy has dramatically increased recently, but there is substantial room for improvement in the methodological and reporting quality of NI/equivalence trials.

Early Cardiotoxicity in Patients Receiving Hypofractionated Radiotherapy after Breast Conserving Surgery: Analysis of a Prospective Study

PURPOSE/OBJECTIVE(S)

To evaluate the early cardiotoxicity of hypofractionated radiotherapy (HFRT) in patients with left-sided breast cancer after breast-conserving surgery, and to investigate the correlation between cardiotoxicity and cardiac dose.

MATERIALS/METHODS

A total of 103 women from 2017 to 2018 who received left-sided whole-breast with or without regional nodal irradiation either using deep inspiration breath-hold (DIBH) or free-breathing (FB) technique were prospectively enrolled. N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram, and radionuclide myocardial perfusion imaging were conducted before and after HFRT. Logistic regression analyses were performed to determine the association of cancer treatment, cardiac dose, and cardiovascular risk factors with cardiotoxic effects.

RESULTS

The mean dose (Dmean) of the heart, left anterior descending coronary artery (LAD), left ventricular (LV), and right ventricular (RV) in all patients was 403 cGy, 1685 cGy, 627 cGy, and 444 cGy, respectively. In comparison to FB, DIBH significantly reduced cardiac dose (heart Dmean 250 cGy vs. 570 cGy, LAD Dmean 1250 cGy vs. 2170 cGy, LV Dmean 420 cGy vs. 850 cGy, RV Dmean 260 cGy vs. 650 cGy; all p<0.001). With a median follow-up of 49 months (range, 2-65 months), no patients had clinical cardiac abnormalities or cardiac-related symptoms, but 42 (41%) patients had subclinical cardiac events. Among them, 41 were electrocardiogram changes, and one had LV ejection fraction decreased by 10% compared with the baseline level. Twenty-five (60%) recovered during follow-up, of which 17 (40%) experienced subclinical changes only once. The mean value of NT-proBNP did not change significantly before and after HFRT. In univariate analyses, DIBH technique significantly decreased the risk of subclinical cardiac events compared with FB (OR 0.31, 95% CI 0.14-0.71; p = 0.006); however, higher mean doses of heart and LV, anthracycline-based chemotherapy, obesity, and hypertension were associated with increased risk of subclinical cardiac events (all p<0.05).

CONCLUSION

Early subclinical cardiac damage after HFRT in left-sided breast cancer is dose-related, and mostly manageable and reversible without medical intervention.

[Analysis on death causes of HIV/AIDS patients in Taizhou, Zhejiang Province, 1998-2022]

Objective: To understand the incidence and causes of HIV/AIDS death patients in Taizhou from 1998 to 2022. Methods: The data were collected from the AIDS Integrated Prevention and Control Information System of China Information System for Diseases Control and Prevention and Taizhou Chronic Disease Information Management System. By the end of 2022, a total of 5 126 HIV/AIDS patients living in Taizhou for a long time were included, SAS 9.4 was used for Kruskal-Wallis test, χ2 test and trend analysis. Results: From 1998 to 2022, a total of 796 HIV/AIDS patients died, with a fatality rate of 15.53% (796/5 126), in whom 52.26% (416/796) died within one year after confirmation. The proportion of HIV/AIDS patients who died within one year decreased (trend χ2=5.60, P<0.001). For the constituent of death causes, there were 140 (17.59%) deaths of AIDS, 237 (29.77%) deaths of malignant tumors, 99 (12.44%) deaths of cardiovascular disease, 58 (7.29%) deaths caused by injuries, 160 (20.10%) deaths due to other causes, and 102 (12.81%) deaths due to unknown causes. The constituent ratio of deaths of malignant tumor, cardiovascular disease and other causes increased over time (trend χ2=1.92, P=0.028; trend χ2=2.81, P=0.003; trend χ2=2.07, P=0.020). There were differences in the distribution of death causes in HIV/AIDS cases in terms of age, occupation, marital status, ethnic group, educational level and mode of transmission (all P<0.05). The average age of the death cases due to cardiovascular disease was higher than other death cases, the cases who died from AIDS had shorter survival time and the lower initial CD4+T cells after confirmation compared with all other death cases, and the time interval from confirmation to treatment in HIV/AIDS patients with unknown death causes was longer than those of all other death cases (all P<0.05). Conclusions: The constituent ratio of non-AIDS related deaths in HIV/AIDS patients in Taizhou was relatively high and showed an upward trend during 1998-2022. It is necessary to further strengthen the early screening, prevention and treatment of chronic non infectious diseases.

Polymeric Phthalocyanine-Based Nanosensitizers for Enhanced Photodynamic and Sonodynamic Therapies

Photodynamic therapy and sonodynamic therapy are two highly promising modalities for cancer treatment. The latter holds an additional advantage in deep-tumor therapy owing to the deep penetration of the ultrasonic radiation. The therapeutic efficacy depends highly on the photo/ultrasound-responsive properties of the sensitizers as well as their tumor-localization property and pharmacokinetics. A novel nanosensitizer system based on a polymeric phthalocyanine (pPC-TK) is reported herein in which the phthalocyanine units are connected with cleavable thioketal linkers. Such polymer could self-assemble in water forming nanoparticles with a hydrodynamic diameter of 48 nm. The degradable and flexible thioketal linkers could effectively inhibit the π-π stacking of the phthalocyanine units, rendering the resulting nanoparticles an efficient generator of reactive oxygen species upon light or ultrasonic irradiation. The nanosensitizer could be internalized into cancer cells readily, inducing cell death by efficient photodynamic and sonodynamic effects. The potency is significantly higher than that of the monomeric phthalocyanine (PC-4COOH). The nanosensitizer could also effectively inhibit the growth of tumor in liver tumor-bearing mice by these two therapies without causing noticeable side effects. More importantly, it could also retard the growth of a deep-located orthotopic liver tumor in vivo by sonodynamic therapy.

Secondary Structure in Overcoming Photosensitizers' Aggregation: α-Helical Polypeptides for Enhanced Photodynamic Therapy

Aggregation caused quenching (ACQ) effect can severely inhibit the application of hydrophobic photosensitizers (PSs) bearing planar and rigid structures. Most of the reported cases utilized random-coiled polymers for the in vivo delivery of PSs, which would inevitably aggravate ACQ effect due to the flexible chains. In this work, the role of polymers' secondary structures (especially α-helical conformation) in overcoming the PSs' aggregation is systemically investigated based on the design of α-helical polypeptides bearing tetraphenylporphyrin (TPP) side chains. Atomistic molecular dynamics simulation, fluorescence quantum yield, and reactive oxygen species (ROS) generation yield are evaluated to demonstrate that α-helical polypeptide backbones can significantly boost both fluorescence quantum yield and ROS by suppressing the π-π stacking interaction between TPP units. The enhanced in vitro and in vivo phototoxicity for helical polypeptides also reveal functions of secondary structures in inhibiting ACQ and improving the membrane activity. Successful in vivo photodynamic therapy (PDT) results in mice bearing H22 tumors showed great potentials for further clinical applications.

[Curative effects of bi-pedicled deep inferior epigastric perforator flap in repairing large soft tissue defects in the lower limbs]

Objective: To investigate the curative effects of bi-pedicled deep inferior epigastric perforator (DIEP) flap in repairing large soft tissue defects in the lower limbs. Methods: A retrospective observational study was conducted. From February 2016 to June 2020, 16 patients with large soft tissue defects in the lower limbs caused by trauma or after tumor/scar resection were admitted to the Department of Hand Surgery of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, including 9 males and 7 females, aged 25-58 years, with the area of soft tissue defects ranging from 14.0 cm×8.0 cm to 32.0 cm×18.0 cm. Using the abdomen as the donor site, the conjoined abdominal wall flap, i.e., the bi-pedicled DIEP flap (with an area ranging from 15.0 cm×9.0 cm to 32.0 cm×20.0 cm) carrying two sets of the trunk of the deep inferior epigastric artery was designed and resected to repair the wound. The donor site wound was sutured directly. The flap survival and wound healing in the donor and recipient areas were observed after operation. The curative effect was evaluated during the follow-up. At the last follow-up, the American Knee Society score and lower extremity functional scale were used to assess the functions of knee joint and lower limb, respectively. Results: The flaps of 15 patients survived after operation; the flap of one patient had partial infection at the edge after operation but healed after debridement and dressing change. The wounds in the donor and recipient areas of 16 patients all healed well. Follow-up of 16-28 months showed that the recipient area had a good shape and pliable texture, and there was no obvious swollen appearance, hyperpigmentation, or abnormal hair growth; the donor site had linear scar only, with no complications such as abdominal hernia or hyperplastic scar; the functions of knee joint and lower limb were well reconstructed, with no recurrence of tumor. At the last follow-up, among the 4 patients with knee joint injury, 3 cases were excellent and 1 case was good in the evaluation of knee joint function; among the 12 patients with lower limb injury, 9 cases were excellent and 3 cases were good in the evaluation of lower limb function. Conclusions: The donor site of bi-pedicled DIEP flap is concealed with abundant tissue and large area for resection, with which can be used to repair large soft tissue defects in the lower limbs, achieving good short-term results of appearance and function restoration.

[Pulmonary crystal-storing histiocytosis: a case report]

A 45-year-old female patient was found to have a nodule in the right lower lobe on physical examination. Chest CT showed the nodule was lobulated measuring 24 mm×23 mm, with obvious enhancement and adjacent pleural traction. As the PET-CT showed increased ¹⁸F-FDG uptake suggesting malignancy, the wedge resection of the right lower lobe was performed. Grossly, the mass was adjacent to the pleural area with indistinct boundary. On cut sections, the lesion was solid and tough, with a greyish-pink colour. Microscopically, the lesion had an ill-defined margin, and was composed of spindle and polygonoid histiocytes with rich eosinophilic cytoplasm similar to rhabdoid muscle cells. The cytoplasm of histiocytes was filled with diamond-shaped or club-shaped crystals. Immunohistochemistry (IHC) showed the histiocytes were positive for CD68, κ, λ, IgG, IgM and IgA. The patient had been followed up for 41 months and had shown neither recurrences nor new diseases. CSH is a rare non-neoplastic histiocytic proliferative disease. Pulmonary CSH should be differentiated from multiple diseases. Accurate pathological diagnosis depends on its morphology and immunophenotype. This disease is often related to potential lymphoproliferative or plasma cell disorder. After diagnosis, a systemic examination is required and long-term follow-up is recommended.

Ultrasensitive and ultrastretchable electrically self-healing conductors

Self-healing is a bioinspired strategy to repair damaged conductors under repetitive wear and tear, thereby largely extending the life span of electronic devices. The self-healing process often demands external triggering conditions as the practical challenges for the widespread applications. Here, a compliant conductor with electrically self-healing capability is introduced by combining ultrahigh sensitivity to minor damages and reliable recovery from ultrahigh tensile deformations. Conductive features are created in a scalable and low-cost fabrication process comprising a copper layer on top of liquid metal microcapsules. The efficient rupture of microcapsules is triggered by structural damages in the copper layer under stress conditions as a result of the strong interfacial interactions. The liquid metal is selectively filled into the damaged site for the instantaneous restoration of the metallic conductivity. The unique healing mechanism is responsive to various structural degradations including microcracks under bending conditions and severe fractures upon large stretching. The compliant conductor demonstrates high conductivity of ∼12,000 S/cm, ultrahigh stretchability of up to 1,200% strain, an ultralow threshold to activate the healing actions, instantaneous electrical recovery in microseconds, and exceptional electromechanical durability. Successful implementations in a light emitting diode (LED) matrix display and a multifunctional electronic patch demonstrate the practical suitability of the electrically self-healing conductor in flexible and stretchable electronics. The developments provide a promising approach to improving the self-healing capability of compliant conductors.

Maskless Fabrication of Highly Conductive and Ultrastretchable Liquid Metal Features through Selective Laser Activation

In the rising field of stretchable electronics, liquid metals are ideal candidate conductors with metallic conductivity and intrinsic deformability. The complex patterning methods of liquid metal features have limited their widespread applications. In this study, we report a maskless fabrication approach for the facile and scalable patterning of liquid metal conductors on an elastomer substrate. Laser-activated patterns are employed as versatile templates to define arbitrary liquid metal patterns. The as-prepared liquid metal features show an excellent conductivity of 3.72 × 10⁴ S/cm, a high resolution of 70 μm, ultrahigh stretchability of up to 1000% strain, and electromechanical durability. The practical suitability of liquid metal conductors is demonstrated by fabricating a stretchable light-emitting diode (LED) matrix and a smart sensing glove. The maskless fabrication technique introduced here allows versatile patterning of liquid metal conductors with affordable costs, which may stimulate a broad range of applications in stretchable electronic devices and systems.

Microfluidic Organ-Chips and Stem Cell Models in the Fight Against COVID-19

SARS-CoV-2, the virus underlying COVID-19, has now been recognized to cause multiorgan disease with a systemic effect on the host. To effectively combat SARS-CoV-2 and the subsequent development of COVID-19, it is critical to detect, monitor, and model viral pathogenesis. In this review, we discuss recent advancements in microfluidics, organ-on-a-chip, and human stem cell-derived models to study SARS-CoV-2 infection in the physiological organ microenvironment, together with their limitations. Microfluidic-based detection methods have greatly enhanced the rapidity, accessibility, and sensitivity of viral detection from patient samples. Engineered organ-on-a-chip models that recapitulate in vivo physiology have been developed for many organ systems to study viral pathology. Human stem cell-derived models have been utilized not only to model viral tropism and pathogenesis in a physiologically relevant context but also to screen for effective therapeutic compounds. The combination of all these platforms, along with future advancements, may aid to identify potential targets and develop novel strategies to counteract COVID-19 pathogenesis.

Ultrastretchable MXene Microsupercapacitors

Stretchable microsupercapacitors represent emerging miniaturized energy-storage devices for next-generation deformable electronics. Two-dimensional (2D) transition metal carbides (MXenes) are considered attractive electrode materials due to their metallic conductivity, hydrophilic surfaces, and excellent processability. Here, an ultrastretchable microsupercapacitor of interdigitated MXene microelectrodes with crumpled surface textures is created. The microsupercapacitor shows a series of attractive properties including a high specific capacitance of ≈185 mF cm^-2 , ultrahigh stretchability up to 800% area strain, and ≈89.7% retention of the initial capacitance after 1000 stretch-relaxation cycles. In addition to static strains, the microsupercapacitor demonstrates robust mechanical properties to retain stable charging-discharging capability under dynamic stretching at different strain rates. A self-powering circuit system utilizes four microsupercapacitor packs to power a light-emitting diode (LED) array, which exhibits stable operations under large tensile strain and skin-attached wearable settings. The developments offer a generic design strategy to enhance the deformability of microsupercapacitors based on 2D nanomaterials.

Lipidomics insight on differences between human MFGM and dietary-derived lipids

Milk fat globule membrane (MFGM) contains lipids, which are essential for promoting infant brain development and improving cognition. In this study, the lipid differences between human MFGM and four dietary lipid sources (cow MFGM, soybean, krill, and yolk) were compared using the UHPLC-Q-Exactive MS-based lipidomics techniques. A total of 45 lipid classes and 5048 lipid species were detected. The analysis of phospholipid classes revealed that the lipid composition of human MFGM and cow MFGM was more similar than the other dietary-derived lipids. Additionally, the human MFGM lipid species were compared with cow MFGM, soybean, krill, and yolk, and 401, 416, 494, and 444 significantly different lipids were identified, respectively. Through lipid metabolic pathway analysis, differential lipids were mainly involved in the glycerophospholipid metabolic pathway. Overall, these results will provide a rationale for the future addition of lipids to infant formula to more closely approximate human MFGM lipid profiles.

Ultrathin Hollow Co/N/C Spheres from Hyper-Crosslinked Polymers by a New Universal Strategy with Boosted ORR Efficiency

Porous carbon materials with hollow structure, on account of the extraordinary morphology, reveal fascinating prospects in lithium-ion batteries, electrocatalysis, etc. However, collapse in ultrathin carbon spheres due to insufficient rigidity in such thin materials obstructs further enhanced capability. Based on hyper-crosslinked polymers (HCPs) with sufficient pore structure and rigid framework, a new bottom-up strategy is proposed to construct SiO₂ @HCPs directly from aromatic monomers. Heteroatom and function groups can be facilely introduced to the skeleton. The thickness of HCPs' wall can be tuned from 9 to 20 nm, which is much thinner than that of hollow sphere synthesized by the traditional method, and the sample with a thickness of 20 nm shows the highest surface area of 1633 m² g^-1 . The oxygen reduction reaction is conducted and the CoNHCS electrocatalysts with an ultrathin thickness of 5 nm display higher half-wave potential than those of bulk samples, even better than commercial Pt/C electrode. On account of the hollow structure, the relative current density loss of electrocatalysts is only 4.1% in comparison with 27.7% in Pt/C electrode during the 15 000 s test, indicating an obvious higher long-term stability. The new strategy to construct hollow HCPs may shed light on efficient chemical catalysis, drug delivery, and electrocatalysis.

[The efficacy of radiotherapy based combined therapy for unresectable locally invasive bladder cancer and its associated factors analysis]

Objective: Retrospective analysis of the efficacy and influencing factors of bladder preservation integrated therapy for unresectable invasive bladder cancer confined to the pelvis was done, also including the bladder function preservation and adverse effects analysis. Methods: Sixty-nine patients with unresectable locally invasive bladder cancer who received radiotherapy-based combination therapy from March 1999 to December 2021 at our hospital were selected. Among them, 42 patients received concurrent chemoradiotherapy, 32 underwent neoadjuvant chemotherapyand 43 with transurethral resection of bladder tumors (TURBT) prior to radiotherapy. The late adverse effect of radiotherapy, preservation of bladder function, replase and metastasis and survival were followed-up. Cox proportional hazards models were applied for the multifactorial analysis. Results: The median age was 69 years. There were 63 cases (91.3%) of uroepithelial carcinoma, 64 of stage Ⅲ and 4 of stage Ⅳ. The median duration of follow-up was 76 months. There were 7 grade 2 late genito urinary toxicities, 2 grade 2 gastrointestinal toxicities, no grade 3 or higher adverse events occurred. All patients maintained normal bladder function, except for 8 cases who lost bladder function due to uncontrolled tumor in the bladder. Seventeen cases recurred locally. There were 11 cases in the concurrent chemoradiotherapy group with a local recurrence rate of 26.2% (11/42) and 6 cases in the non-concurrent chemoradiotherapy group with a local recurrence rate of 22.2% (6/27), and the difference in local recurrence rate between the two groups was not statistically significant (P=0.709). There were 23 cases of distant metastasis (including 2 cases of local recurrence with distant metastasis), including 10 cases in the concurrent chemoradiotherapy group with a distant metastasis rate of 23.8% (10/42) and 13 cases in the non-concurrent chemoradiotherapy group with a distant metastasis rate of 48.1% (13/27), and the distant metastasis rate in the non-concurrent chemoradiotherapy group was higher than that in the concurrent chemoradiotherapy group (P=0.036). The median 5-year overall survival (OS) time was 59 months and the OS rate was 47.8%. The 5-year progression-free survival (PFS) time was 20 months and the PFS rate was 34.4%. The 5-year OS rates of concurrent and non-concurrent chemoradiotherapy group were 62.9% and 27.6% (P<0.001), and 5-year PFS rates were 45.4% and 20.0%, respectively (P=0.022). The 5-year OS rates of with or without neoadjuvant chemotherapy were 78.4% and 30.1% (P=0.002), and the 5-year PFS rates were 49.1% and 25.1% (P=0.087), respectively. The 5-year OS rates with or without TURBT before radiotherapy were 45.5% and 51.9% (P=0.233) and the 5-year PFS rates were 30.8% and 39.9% (P=0.198), respectively. Multivariate Cox regression analysis results showed that the clinical stage (HR=0.422, 95% CI: 0.205-0.869) was independent prognostic factor for PFS of invasive bladder cancer. The multivariate analysis showed that clinical stages (HR=0.278, 95% CI: 0.114-0.678), concurrent chemoradiotherapy (HR=0.391, 95% CI: 0.165-0.930), neoadjuvant chemotherapy (HR=0.188, 95% CI: 0.058-0.611), and recurrences (HR=10.855, 95% CI: 3.655-32.638) were independent prognostic factors for OS of invasive bladder cancer. Conclusion: Unresectable localized invasive bladder cancer can achieve satisfactory long-term outcomes with bladder-preserving combination therapy based on radiotherapy, most patients can retain normal bladder function with acceptable late adverse effects and improved survival particularly evident in patients with early, concurrent chemoradiotherapy and neoadjuvant chemotherapy.

A facile and scalable patterning approach for ultrastretchable liquid metal features

Liquid metals represent an attractive class of compliant conductors featuring metallic conductivity and inherent deformability. The widespread implementation of liquid metal conductors in stretchable electronics is currently hindered by the lack of a facile patterning approach. In this study, we introduce a facile and scalable patterning approach to create liquid metal features on an elastomer substrate. A screen-printed Ag nanoflake pattern is employed as a template for the subsequent selective coating of a liquid metal layer. The as-prepared liquid metal conductors show a bulk-level conductivity of ∼2.7 × 10⁴ S cm^-1, an ultrahigh stretchability of up to 700% tensile strain, and excellent electromechanical durability. The practical suitability is demonstrated by the successful fabrication of an ultradeformable ribbon cable and a smart sensing glove. The efficient and economical access to ultrastretchable liquid metal features may open up a broad range of emerging applications in soft electronic devices and systems.

Precise oral delivery systems for probiotics: A review

Probiotics have several health benefits to the host. However, low pH in the stomach, various digestive enzymes and bile salts in the intestine threaten their viability and function. Thus, probiotics need to be protected during gastric transit to address challenges associated with low viability and impaired function. At present, probiotic delivery systems with different trigger mechanisms have been constructed to successfully introduce numerous high-viability probiotics to the intestine. On this basis, the application of non-targeted/targeted probiotic delivery systems in different gut microenvironment and the adjuvant therapeutic effect of probiotic delivery systems on other disease were discussed in detail. It is important to also note that most of the current studies in this area focused on non-targeted probiotic delivery systems. Moreover, changes in intestinal microenvironment under disease state and discontinuous distribution of disease site limit their development. Thus, emphasis were made on the optimization of non-targeted probiotic delivery systems and the necessity of designing more precisely targeted ones.

[Neurocognitive impairment and characteristics of neurocognitive performance among people with HIV on antiretroviral treatment]

Objective: Using two measuring tools to examine the prevalence and correlates of neurocognitive impairment (NCI) as well as characteristics of neurocognitive performance among people with HIV (PWH) on antiretroviral treatment (ART). Methods: A total of 2 250 treated PWH from the Comparative HIV and Aging Research in Taizhou (CHART) were recruited in Taizhou, Zhejiang province. The Chinese version of the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS) were used to evaluate their neurocognitive performance. Cluster analysis was conducted on the seven cognitive domains in the scale. Results: Among 2 250 treated PWH, 48.0% (1 080/2 250) were aged 45 to 89, 79.2% (1 782/2 250) were male, and 37.8% (852/2 250) had primary school education or below. The prevalence of neurocognitive impairment judged by MMSE and IHDS among HIV-infected people was 14.3% (321/2 250) and 31.8% (716/2 250), respectively. Aged 60 to 89 (aOR=2.63, 95%CI:1.52-4.56), depressive symptoms (aOR=5.58, 95%CI:4.20-7.40) and treatment with EFV (aOR=2.86, 95%CI:1.89-4.34) were main risk factors of NCI diagnosed by MMSE. Male (aOR=0.71, 95%CI:0.51-1.00), overweight (aOR=0.63, 95%CI:0.44-0.89), and high education level (aOR=0.11, 95%CI:0.05-0.25) were protective factors of NCI diagnosed by MMSE. Aged 60 to 89 (aOR=3.10, 95%CI:2.09-4.59), depressive symptoms (aOR=1.78, 95%CI:1.44-2.20) and treatment with EFV (aOR=1.79, 95%CI:1.41-2.29) were risk factors of NCI diagnosed by IHDS. Male (aOR=0.75, 95%CI:0.58-0.97), underweight (aOR=0.67, 95%CI:0.47-0.96), baseline CD4⁺ T lymphocyte (CD4) counts ≥350 cells/μl (aOR=0.69, 95%CI:0.53-0.91) and high education level (aOR=0.23, 95%CI:0.14-0.39) were protective factors of NCI diagnosed by IHDS. The neurocognitive performance of HIV-infected people can be divided into four main types. Among four types, age, gender, education level, alcohol drinking, depressive symptoms, waist-to-hip ratio, hypertension, diabetes, baseline CD4 counts and treatment with EFV were different statistically (all P<0.05). Conclusions: There are four main types of neurocognitive performance in treated PWH. The prevalence of NCI is high among this population, underscoring the need for tailored prevention and intervention.

[Efficacy comparison of minimally invasive atlantoaxial mass fusion and open atlantoaxial fusion in the treatment of atlantoaxial dislocation]

Objective: To compare the clinical effects of minimally invasive intermuscular atlantoaxial lateral mass fusion (Mis-PALF) and open atlantoaxial fusion in patients with atlantoaxial dislocation. Methods: The clinical data of patients with atlantoaxial dislocation who received Mis-PALF operation (17 cases) or open atlantoaxial fusion (88 cases, as control) in the Third Hospital of Peking University from September 2015 to September 2021 were analyzed retrospectively. In Mis-PALF group, there were 9 males and 8 females, aged (45.8±19.8) years; and there were 48 males and 40 females in the control group, aged (50.0±13.9) years. The operation time, perioperative blood loss, postoperative body temperature, postoperative pain [assessed with visual analogue scale (VAS)], postoperative additional analgesic drugs, postoperative hospitalization time, the improvement rate of Japanese Orthopedic Association (JOA) scores of spinal cord function in three-months follow-up and complications were compared between the two groups. Results: Mis-PALF group had less perioperative blood loss than control group [(111.8±35.9)ml vs (362.9±18.6)ml, P<0.01], shorter hospitalization time [(3.06±0.63) days vs (4.24±0.14) days, P<0.01] and fewer additional analgesic drugs (3/17 vs 56/88, P<0.01). There was no significant difference between the Mis-PALF and control group in operation time [(125±7)min vs (113±8)min, P=0.525], patients with fever(11/17 vs 37/88, P=0.086) or postoperative pain (1/17 vs 13/88, P=0.357), the improvement rate of JOA score (66.9%±28.8% vs 74.2%±28.6%, P=0.409) and complications rate (1/17 vs 3/88, P=1.000). Conclusion: Mis-PALF can significantly reduce the perioperative blood loss, shorten the postoperative hospitalization time and the additionally use of analgesic drugs without increasing complications.

Prenatal exposure to nickel and atopic dermatitis at age 3 years: a birth cohort study with cytokine profiles

BACKGROUND

Nickel, the fifth most common element on Earth, is the leading inducer of contact allergies in humans, with potent immunological effects. Nickel-induced contact allergies predominantly affect females. Maternal exposure to nickel has been associated with several developmental abnormalities. However, how a maternal nickel exposure affects the development of atopic diathesis and immune abnormalities in children has never been addressed.

OBJECTIVES

We aimed to determine whether maternal Ni exposure affects the development of atopic dermatitis and immune abnormalities in their children.

METHODS

Using a birth cohort study, we analysed 140 mother-child pairs recruited in 2012-2015 from central Taiwan. Maternal exposure to nickel was estimated using urinary nickel levels measured by inductively coupled plasma mass spectrometry (ICP-MS). The serum levels of 65 analytes and IgE in 3-year-old children were profiled with a multiplex ELISA. The correlation between the maternal urinary nickel concentration and serum analyte levels was assessed using Spearmen's correlation. Multivariant regression analysis was performed to evaluate the association between maternal urinary nickel levels and serum analyte concentrations in their children.

RESULTS

The geometric means of the maternal urinary nickel and the children's serum IgE levels were 2.27 μg/L and 69.71 IU/ml, respectively. The maternal nickel exposure was associated with increased serum levels of IL-1β, IL-2, TNF-α, and leukaemia inhibitory factor (LIF) but with decreased serum levels of matrix metalloproteinase-1 (MMP-1), IL-2R, and eotaxin-1 in the children. In addition, the development of childhood atopic dermatitis at 3 years old was significantly associated with the child's serum levels of IgE and IL-2R, but it was negatively associated with the maternal nickel exposure.

CONCLUSIONS

This is the first study showing the potential immunological effects of maternal nickel exposure in their children at an early developmental stage.

Effects of dietary inclusion of cassava starch-extraction-residue meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks

This study was designed to evaluate the effects of different dietary levels of cassava starch extraction residue meal (CReM) on egg production, egg quality, oxidative status, egg yolk fatty acid profile, and hepatic expression of fatty acid metabolism-related genes. In total, 288 Longyan laying ducks aged 21 wk with similar BW were randomly assigned to 4 dietary treatments, each consisting of 6 replicates of 12 birds. The birds were fed a typical corn-soybean meal diet, which contained 0% (control), 5%, 10%, and 15% CReM, mainly replacing wheat bran, and the experiment lasted for 16 wk. The tested CReM levels did not show significant effects on the egg production, nonmarketable egg percentage, egg weight, daily egg mass, and FCR (g feed: g egg), but daily feed intake was reduced with increased CReM level (linear P < 0.001, quadratic P < 0.05). Yolk color increased (linear and quadratic, P < 0.01) with the increase in CReM level, but the Haugh unit, yolk proportion, albumen proportion, shell proportion, eggshell thickness, and eggshell strength were unaffected. Yolk contents of C11:0 and C12:0 (linear, quadratic, P < 0.01) and total saturated fatty acids increased, and the C22:1 level decreased (linear P < 0.01, quadratic P < 0.05) with the increase in CReM level, but the total monounsaturated fatty acids, the individual and total polyunsaturated fatty acids and n−6 and n−3 fatty acids, triglycerides, and total cholesterol in egg yolk were not affected. Hepatic gene expression revealed a significant increase in peroxisome proliferators-activated receptors γ (linear, quadratic, P < 0.001), but the expression of fatty acid synthase, sterol regulatory element binding protein 1 and apolipoprotein A1 genes were unaffected by CReM level. In conclusion, the results of the current study indicated that the CReM could be included up to 15% in laying duck diets without negative effects on the egg-laying rate, egg quality, and oxidative status. Dietary inclusion of CReM increased the yolk content of total saturated fatty acids and SOD activity in the liver.

Combining Self-supervised Learning and Active Learning for Disfluency Detection

Spoken language is fundamentally different from the written language in that it contains frequent disfluencies or parts of an utterance that are corrected by the speaker. Disfluency detection (removing these disfluencies) is desirable to clean the input for use in downstream NLP tasks. Most existing approaches to disfluency detection heavily rely on human-annotated data, which is scarce and expensive to obtain in practice. To tackle the training data bottleneck, in this work, we investigate methods for combining self-supervised learning and active learning for disfluency detection. First, we construct large-scale pseudo training data by randomly adding or deleting words from unlabeled data and propose two self-supervised pre-training tasks: (i) a tagging task to detect the added noisy words and (ii) sentence classification to distinguish original sentences from grammatically incorrect sentences. We then combine these two tasks to jointly pre-train a neural network. The pre-trained neural network is then fine-tuned using human-annotated disfluency detection training data. The self-supervised learning method can capture task-special knowledge for disfluency detection and achieve better performance when fine-tuning on a small annotated dataset compared to other supervised methods. However, limited in that the pseudo training data are generated based on simple heuristics and cannot fully cover all the disfluency patterns, there is still a performance gap compared to the supervised models trained on the full training dataset. We further explore how to bridge the performance gap by integrating active learning during the fine-tuning process. Active learning strives to reduce annotation costs by choosing the most critical examples to label and can address the weakness of self-supervised learning with a small annotated dataset. We show that by combining self-supervised learning with active learning, our model is able to match state-of-the-art performance with just about 10% of the original training data on both the commonly used English Switchboard test set and a set of in-house annotated Chinese data.

Screening and Probiotic Potential Evaluation of Bacteriocin-Producing Lactiplantibacillus plantarum In Vitro

Probiotics are gaining attention due to their functions of regulating the intestinal barrier and promoting human health. The production of bacteriocins is one of the important factors for probiotics to exert beneficial properties. This study aimed to screen bacteriocin-producing Lactiplantibacillus plantarum and evaluate the probiotic potential in vitro. It was found that L. plantarum Q7, L. plantarum F3-2 and L. plantarum YRL45 could produce bacteriocins and inhibit common intestinal pathogens. These three strains had probiotic potential with tolerance to the gastrointestinal environmental and colonization in the gut, and exhibited various degrees of anti-inflammatory activity and tight junction function in the intestinal barrier. Particularly, L. plantarum YRL45 could significantly (p < 0.05) reduce the increase in nitric oxide (NO), prostaglandin E2 (PGE2), necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) induced by lipopolysaccharide (LPS), thereby easing inflammatory response. L. plantarum F3-2 could remarkably (p < 0.05) up-regulate the expression levels of ZO-1, Occludin and Claudin-1 in intestinal epithelial injured cells, which was conducive to protecting the intestinal barrier. These findings provided fundamental information about the probiotic properties of bacteriocin-producing L. plantarum, which suggested that L. plantarum Q7, L. plantarum F3-2 and L. plantarum YRL45 had the potential to be used as novel probiotic strains.

[Overview on diagnosis and treatment of oral diseases in the Qing Royal Court]

The remained documents and archives show that the history of diagnosis and treatment of oral diseases in royal court of the Qing Dynasty was over 200 years. The departmental system of medical care in the Qing Royal Court was inherited from former Ming Dynasty. Although the departments in the system changed over reigns, the Department of Dentistry exist all the time. In a set of historical records of 38 medical cases opened to the public, the documented symptoms and diseases, in the sense of modern medical science, included periodontitis, oral mucosal diseases, dental caries, parotiditis, etc., and the patients involved various ranks in the court, showing that oral diseases were common in the Qing Royal Court. The royal doctors ranked variedly and the medication they used was diverse. Medical fuming or steaming and medical heating were some distinctive methods among the treatments. In 1600s, the western modern medical science started to be introduced into China. In the reign of Kangxi Emperor (1700s), many western doctors were employed by the royal court and they engaged in the treatment of oral diseases. The late Qing Dynasty appeared the second peak that western doctors came into China. In 1898, Dr. Jingrong Chen, a dentist who possessed knowledge of modern dentistry in Beijing city, set up a dental clinic in the royal court and gave treatment to patients in the royal members and high-ranking officials.

Intrinsically stretchable electronics with ultrahigh deformability to monitor dynamically moving organs

Intrinsically stretchable electronics represent an attractive platform for next-generation implantable devices by reducing the mechanical mismatch and the immune responses with biological tissues. Despite extensive efforts, soft implantable electronic devices often exhibit an obvious trade-off between electronic performances and mechanical deformability because of limitations of commonly used compliant electronic materials. Here, we introduce a scalable approach to create intrinsically stretchable and implantable electronic devices featuring the deployment of liquid metal components for ultrahigh stretchability up to 400% tensile strain and excellent durability against repetitive deformations. The device architecture further shows long-term stability under physiological conditions, conformal attachments to internal organs, and low interfacial impedance. Successful electrophysiological mapping on rapidly beating hearts demonstrates the potential of intrinsically stretchable electronics for widespread applications in health monitoring, disease diagnosis, and medical therapies.

[Expression comparison and clinical significance of PD-L1 (22C3) and PD-L1 (SP142) in triple negative breast cancer]

Objective: To investigate the expression of programmed death ligand-1 (PD-L1, SP142) and PD-L1 (22C3) in triple-negative breast cancer (TNBC), and analyze their correlation with the clinicopathological factors and prognosis. Methods: The clinicopathologic data of 259 patients with TNBC treated in Cancer Hospital from August 2010 to December 2013 were collected. Whole section of surgical tissue samples were collected to conduct PD-L1 (SP142) and PD-L1 (22C3) immunohistochemical (IHC) staining. The PD-L1 expression in tumor cells and tumor infiltrating immune cells were visually assessed respectively, the relationship between PD-L1 expression and clinicopathologic characterizes were analyzed. Univariable and multivariable Cox proportional hazards regression models were used to test the correlations between PD-L1 expression and disease-free survival (DFS) and overall survival (OS). Results: The positive rates of SP142 (immune cell score, ICs≥1%) and 22C3 (combined positive score, CPS≥1) were 42.1%(109/259) and 41.3%(107/259) in TNBC tissues, respectively, with a total coincidence rate of 82.3%. The Kappa value of positive expression cases was 0.571 and the distribution difference of SP142 and 22C3 positive expression cases was statistically significant (P<0.001). The PD-L1 positive patients were less likely to have vascular invasion (P<0.05), but with higher histological grade and Ki-67 proliferation index (P<0.05). The recurrence/metastasis cases(8) of the patients with positive PD-L1 (SP142) was significantly lower than that of patients with negative PD-L1(SP142, 27, P=0.016). The positive expression of PD-L1 (SP142) patients were longer DFS (P=0.019). The OS of patients with positive PD-L1 (SP142) were longer than those with negative PD-L1 (SP142), but without significance (P=0.116). The positive expression of PD-L1 (22C3) was marginally associated with DFS and OS of patients (P>0.05). Conclusions: The expression of PD-L1 (22C3) is different from that of PD-L1 (SP142) in TNBC, and the two antibodies can't be interchangeable for each other in clinical tests. PD-L1 (SP142) status is an independent prognostic factor of DFS in TNBC. The DFS is significantly prolonged in patients with positive expression of PD-L1 (SP142).

A Highly Stretchable and Permeable Liquid Metal Micromesh Conductor by Physical Deposition for Epidermal Electronics

Stretchable electronics allow functional devices to integrate with human skin seamlessly in an emerging wearable platform termed epidermal electronics. Compliant conductors represent key building components for functional devices. Among the various candidates, gallium-based liquid metals stand out with metallic conductivity and inherent deformability. Currently, the widespread applications of liquid metals in epidermal electronics are hindered by the low steam permeability and hence unpleasant wearing perceptions. In this study, a facile physical deposition approach is established to create a liquid metal micromesh over an elastomer sponge, which exhibits low sheet resistance (∼0.5 Ω sq^-1), high stretchability (400% strain), and excellent durability. The porous micromesh shows textile-level permeability to achieve long-term wearing comfort. The conformal interaction of the liquid metal micromesh with the skin gives rise to a low contact impedance. An integrated epidermal sensing sleeve is demonstrated as a human-machine interface to distinguish different hand gestures by recording muscle contractions. The reported stretchable and permeable liquid metal conductor shows promising potentials in next-generation epidermal electronics.

[Stereotactic body radiation therapy for patients with lung and liver oligometastases from colorectal cancer: a phase Ⅱ trial]

Objective: To explore the safety and effectiveness of stereotactic body radiation therapy (SBRT) for oligometastases from colorectal cancer (CRC). Methods: This is a prospective, single-arm phase Ⅱ trial. Patients who had histologically proven CRC, 1 to 5 detectable liver or lung metastatic lesions with maximum diameter of any metastases ≤5 cm were eligible. SBRT was delivered to all lesions. The primary endpoint was 3-year local control (LC). The secondary endpoints were treatment-related acute toxicities of grade 3 and above, 1-year and 3-year overall survival (OS) and progression free survival (PFS). Survival analysis was performed using the Kaplan-Meier method and Log rank test. Results: Petients from 2016 to 2019 who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Forty-eight patients with 60 lesions were enrolled, including 37 liver lesions and 23 lung lesions. Forty-six patients had 1 or 2 lesions, with median diameter of 1.3 cm, the median biologically effective dose (BED(10)) was 100.0 Gy. The median follow-up was 19.5 months for all lesions. Twenty-five lesions developed local failure, the median local progression free survival was 15 months. The 1-year LC, OS and PFS was 70.2% (95% CI, 63.7%~76.7%), 89.0% (95% CI, 84.3%~93.7%) and 40.4% (95%CI, 33.0%~47.8%). The univariate analysis revealed that planning target volume (PTV) and total dose were independent prognostic factors of LC (P<0.05). For liver and lung lesions, the 1-year LC, OS and PFS was 58.7% and 89.4% (P=0.015), 89.3% and 86.5% (P=0.732), 30.5% and 65.6% (P=0.024), respectively. No patients developed acute toxicity of grade 3 and above. Conclusion: SBRT is safe and effective treatment method for oligometastases from CRC under precise respiratory motion management and robust quality assurance.

Selective photocatalytic CO2 reduction in aerobic environment by microporous Pd-porphyrin-based polymers coated hollow TiO2

Direct photocatalytic CO₂ reduction from primary sources, such as flue gas and air, into fuels, is highly desired, but the thermodynamically favored O₂ reduction almost completely impedes this process. Herein, we report on the efficacy of a composite photocatalyst prepared by hyper-crosslinking porphyrin-based polymers on hollow TiO₂ surface and subsequent coordinating with Pd(II). Such composite exhibits high resistance against O₂ inhibition, leading to 12% conversion yield of CO₂ from air after 2-h UV-visible light irradiation. In contrast, the CO₂ reduction over Pd/TiO₂ without the polymer is severely inhibited by the presence of O₂ ( ≥ 0.2 %). This study presents a feasible strategy, building Pd(II) sites into CO₂-adsorptive polymers on hollow TiO₂ surface, for realizing CO₂ reduction with H₂O in an aerobic environment by the high CO₂/O₂ adsorption selectivity of polymers and efficient charge separation for CO₂ reduction and H₂O oxidation on Pd(II) sites and hollow TiO₂, respectively.