[Multi-omics research progress in early-onset colorectal cancer]

Globally, the incidence of early-onset colorectal cancer (EOCRC) among individuals younger than 50 is escalating. Compared to late-onset colorectal cancer, EOCRC exhibits distinct clinical, pathological, and molecular features, with a higher prevalence in the left colon and rectum. However, the occurrence and development of EOCRC is a multi-factor and multi-stage evolution process, which is the result of the mutual effect of environmental, genetic and biological factors, and involves the multi-level regulation mechanism of other organisms. With the development and improvement of high-throughput sequencing technology, the application of multi-omics analysis has become an important development direction to resolve the pathogenesis of complex diseases and individualized treatment plans. This article aims to review the research progress of EOCRC at the multi-omics level, providing a theoretical foundation for earlier diagnosis and more precise treatment of this diseases.

An Edge Computing System with AMD Xilinx FPGA AI Customer Platform for Advanced Driver Assistance System

The convergence of edge computing systems with Field-Programmable Gate Array (FPGA) technology has shown considerable promise in enhancing real-time applications across various domains. This paper presents an innovative edge computing system design specifically tailored for pavement defect detection within the Advanced Driver-Assistance Systems (ADASs) domain. The system seamlessly integrates the AMD Xilinx AI platform into a customized circuit configuration, capitalizing on its capabilities. Utilizing cameras as input sensors to capture road scenes, the system employs a Deep Learning Processing Unit (DPU) to execute the YOLOv3 model, enabling the identification of three distinct types of pavement defects with high accuracy and efficiency. Following defect detection, the system efficiently transmits detailed information about the type and location of detected defects via the Controller Area Network (CAN) interface. This integration of FPGA-based edge computing not only enhances the speed and accuracy of defect detection, but also facilitates real-time communication between the vehicle's onboard controller and external systems. Moreover, the successful integration of the proposed system transforms ADAS into a sophisticated edge computing device, empowering the vehicle's onboard controller to make informed decisions in real time. These decisions are aimed at enhancing the overall driving experience by improving safety and performance metrics. The synergy between edge computing and FPGA technology not only advances ADAS capabilities, but also paves the way for future innovations in automotive safety and assistance systems.

Determination of Spin-Parity Quantum Numbers of X(2370) as 0^{-+} from J/ψ→γK_{S}^{0}K_{S}^{0}η^{'}

Based on (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, a partial wave analysis of the decay J/ψ→γK_{S}^{0}K_{S}^{0}η^{'} is performed. The mass and width of the X(2370) are measured to be 2395±11(stat)_{-94}^{+26}(syst)  MeV/c^{2} and 188_{-17}^{+18}(stat)_{-33}^{+124}(syst)  MeV, respectively. The corresponding product branching fraction is B[J/ψ→γX(2370)]×B[X(2370)→f_{0}(980)η^{'}]×B[f_{0}(980)→K_{S}^{0}K_{S}^{0}]=(1.31±0.22(stat)_{-0.84}^{+2.85}(syst))×10^{-5}. The statistical significance of the X(2370) is greater than 11.7σ and the spin parity is determined to be 0^{-+} for the first time. The measured mass and spin parity of the X(2370) are consistent with the predictions of the lightest pseudoscalar glueball.

[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.

Observation of Structures in the Processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2}

We present measurements of the Born cross sections for the processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2} at center-of-mass energies sqrt[s] from 4.308 to 4.951 GeV. The measurements are performed with data samples corresponding to an integrated luminosity of 11.0  fb^{-1} collected with the BESIII detector operating at the Beijing Electron Positron Collider storage ring. Assuming the e^{+}e^{-}→ωχ_{c2} signals come from a single resonance, the mass and width are determined to be M=(4413.6±9.0±0.8)  MeV/c^{2} and Γ=(110.5±15.0±2.9)  MeV, respectively, which is consistent with the parameters of the well-established resonance ψ(4415). In addition, we also use one single resonance to describe the e^{+}e^{-}→ωχ_{c1} line shape and determine the mass and width to be M=(4544.2±18.7±1.7)  MeV/c^{2} and Γ=(116.1±33.5±1.7)  MeV, respectively. The structure of this line shape, observed for the first time, requires further understanding.

Observation of the Anomalous Shape of X(1840) in J/ψ→γ3(π^{+}π^{-}) Indicating a Second Resonance Near pp[over ¯] Threshold

Using a sample of (10087±44)×10^{6}  J/ψ events, which is about 45 times larger than that was previously analyzed, a further investigation on the J/ψ→γ3(π^{+}π^{-}) decay is performed. A significant distortion at 1.84  GeV/c^{2} in the line shape of the 3(π^{+}π^{-}) invariant mass spectrum is observed for the first time, which could be resolved by two overlapping resonant structures, X(1840) and X(1880). The new state X(1880) is observed with a statistical significance larger than 10σ. The mass and width of X(1880) are determined to be 1882.1±1.7±0.7  MeV/c^{2} and 30.7±5.5±2.4  MeV, respectively, which indicates the existence of a pp[over ¯] bound state.

Observation of D^{+}→K_{S}^{0}a_{0}(980)^{+} in the Amplitude Analysis of D^{+}→K_{S}^{0}π^{+}η

We perform for the first time an amplitude analysis of the decay D^{+}→K_{S}^{0}π^{+}η and report the observation of the decay D^{+}→K_{S}^{0}a_{0}(980)^{+} using 2.93  fb^{-1} of e^{+}e^{-} collision data taken at a center-of-mass energy of 3.773 GeV with the BESIII detector. As the only W-annihilation-free decay among D to a_{0}(980) pseudoscalar, D^{+}→K_{S}^{0}a_{0}(980)^{+} is the ideal decay in extracting the contributions of the W-emission amplitudes involving a_{0}(980) and to study the final-state interactions. The absolute branching fraction of D^{+}→K_{S}^{0}π^{+}η is measured to be (1.27±0.04_{stat}±0.03_{syst})%. The branching fractions of intermediate processes D^{+}→K_{S}^{0}a_{0}(980)^{+} with a_{0}(980)^{+}→π^{+}η and D^{+}→π^{+}K[over ¯]_{0}^{*}(1430)^{0} with K[over ¯]_{0}^{*}(1430)^{0}→K_{S}^{0}η are measured to be (1.33±0.05_{stat}±0.04_{syst})% and (0.14±0.03_{stat}±0.01_{syst})%, respectively.

Observation of Significant Flavor-SU(3) Breaking in the Kaon Wave Function at 12<Q^{2}<25 GeV^{2} and Discovery of the Charmless Decay ψ(3770)→K_{S}^{0}K_{L}^{0}

We present cross sections for the reaction e^{+}e^{-}→K_{S}^{0}K_{L}^{0} at center-of-mass energies ranging from 3.51 to 4.95 GeV using data samples collected in the BESIII experiment, corresponding to a total integrated luminosity of 26.5  fb^{-1}. The ratio of neutral-to-charged kaon form factors at large momentum transfers (12 Collapse

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Investigation of the ΔI=1/2 Rule and Test of CP Symmetry through the Measurement of Decay Asymmetry Parameters in Ξ^{-} Decays

Using (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, numerous Ξ^{-} and Λ decay asymmetry parameters are simultaneously determined from the process J/ψ→Ξ^{-}Ξ[over ¯]^{+}→Λ(pπ^{-})π^{-}Λ[over ¯](n[over ¯]π^{0})π^{+} and its charge-conjugate channel. The precisions of α_{Λ0} for Λ→nπ^{0} and α[over ¯]_{Λ0} for Λ[over ¯]→n[over ¯]π^{0} compared to world averages are improved by factors of 4 and 1.7, respectively. The ratio of decay asymmetry parameters of Λ→nπ^{0} to that of Λ→pπ^{-}, ⟨α_{Λ0}⟩/⟨α_{Λ-}⟩, is determined to be 0.873±0.012_{-0.010}^{+0.011}, where the first and the second uncertainties are statistical and systematic, respectively. The ratio is smaller than unity more than 5σ, which signifies the existence of the ΔI=3/2 transition in Λ for the first time. Besides, we test for CP symmetry in Ξ^{-}→Λπ^{-} and in Λ→nπ^{0} with the best precision to date.

[Long-term outcomes of intravascular ultrasound-guided drug-eluting stents implantation in patients with acute coronary syndrome: ULTIMATE ACS subgroup]

Objective: To explore the long-term effects of intravascular ultrasound (IVUS) guidance on patients with acute coronary syndrome (ACS) undergoing drug-eluting stents (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. A total of 1 448 all-comer patients were enrolled between 2014 August and 2017 May. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target-vessel-related myocardial infarction, and clinically-driven target vessel revascularization. Results: ACS was present in 1 136 (78.5%) patients, and 3-year clinical follow-up was available in 1 423 patients (98.3%). TVF in the ACS group was 9.6% (109/1 136), which was significantly higher than 4.5% (14/312) in the non-ACS group (log-rank P=0.005). There were 109 TVFs in the ACS patients, with 7.6% (43/569) TVFs in the IVUS group and 11.6% (66/567) TVFs in the angiography group (log-rank P=0.019). Moreover, patients with optimal IVUS guidance were associated with a lower risk of 3-year TVF compared to those with suboptimal IVUS results (5.4% (16/296) vs. 9.9% (27/273),log-rank P=0.041). Conclusions: This ULTIMATE-ACS subgroup analysis showed that ACS patients undergoing DES implantation were associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in patients with ACS, especially in those who had an IVUS-defined optimal procedure.

Radiation Detector Front-End Readout Chip with Nonbinary Successive Approximation Register Analog-to-Digital Converter for Wearable Healthcare Monitoring Applications

A 16-channel front-end readout chip for a radiation detector is designed for portable or wearable healthcare monitoring applications. The proposed chip reads the signal of the radiation detector and converts it into digital serial-out data by using a nonbinary successive approximation register (SAR) analog-to-digital converter (ADC) that has a 1-MS/s sampling rate and 10-b resolution. The minimum-to-maximum differential and integral nonlinearity are measured as -0.32 to 0.33 and -0.43 to 0.37 least significant bits, respectively. The signal-to-noise-and-distortion ratio and effective number of bits are 57.41 dB and 9.24 bits, respectively, for an input frequency of 500 kHz and a sampling rate of 1 MS/s. The SAR ADC has a 38.9-fJ/conversion step figure of merit at the sampling rate of 1 MS/s. The proposed chip can read input signals with peak currents ranging from 20 to 750 μA and convert the analog signal into a 10-bit serial-output digital signal. The input dynamic range is 2-75 pC. The resolution of the peak current is 208.3 nA. The chip, which has an area of 1.444 mm × 10.568 mm, is implemented using CMOS 0.18-μm 1P6M technology, and the power consumption of each channel is 19 mW. This design is suitable for wearable devices, especially biomedical devices.

[Significance of triggering receptor expressed on myeloid cells-2 prognostic evaluation in hepatitis B virus-related acute-on-chronic liver failure]

Objective: To explore the significance of triggering receptor expressed on myeloid cells-2 (TREM-2) prognostic evaluation so as to provide novel biological markers in clinical practice for patients with hepatitis B virus-related acute-on-chronic liver failure ( HBV-ACLF). Methods: The research subjects of this study were divided into an experimental group and a control group. Fifty HBV-ACLF cases admitted to the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from January 1, 2019 to December 31, 2019 were selected as the experimental group. Patients were divided into survival and death groups according to the actual prognosis at discharge (self-discharge and dead patients were considered death groups, and all enrolled patients were hospitalized for more than 28 days). Twenty-five healthy subjects were chosen as the control group. Peripheral venous blood was collected from the experimental group and the control group. Plasma and peripheral blood mononuclear cells (PBMC) were isolated. The concentrations of TREM-2, interleukin (IL)-6, and IL-8 were detected in the plasma. TREM-2 mRNA expression was detected in PBMC. A single blood sample was collected from the control group, whereas five blood samples were dynamically collected from the experimental group on the day of admittance and at 7, 14, 21, and 28 days after treatment commenced. Simultaneously, upon admission, the relevant clinical indicators of HBV-ACLF patients were monitored, including the liver function test: alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, coagulation function test: international normalized ratio, prothrombin time, and other indicators. Measurement data were expressed as mean±standard deviation (x±s). Count data were compared and analyzed using the χ(2) test. The intra-group factor mean was compared using a repeated measures ANOVA. The means were analyzed by t-tests between the two groups. Bivariate correlation analysis was used to analyze the correlation between the two variables. The value of TREM-2 as a diagnostic marker was analyzed using the receiver operating characteristic (ROC) curve. Results: The mRNA expression of TREM-2 in the PBMC of HBV-ACLF patients showed a gradually increasing trend at various time points and was significantly higher in the survival group than that of the control group at 28 days (P < 0.01), while the death group showed a gradually weakening trend at various time points and was significantly lower than the control group at 28 days (P < 0.01). (1) The levels of TREM-2 in the plasma of HBV-ACLF patients generally showed a gradually increasing trend at various time points in the survival group. The levels on the day of admission and 7, 14, 21, and 28 days after the initiation of treatment were (1.49±0.85), (1.62±0.58), (1.95±0.69), (2.33±0.71), and (2.00±0.67) ng/ml, respectively. The expression of TREM-2 in the death group showed a gradually weakening trend at various time points. The levels on the day of admission and 7, 14, 21, and 28 days after initiation of treatment were (1.40±0.73), (1.59±0.79), (1.56±0.80), (1.05±0.49), and (0.81±0.21) ng/ml, respectively. The survival group's various detection time points were higher than those of the death group, and the difference was statistically significant. The plasma level of TREM-2 in the healthy control group was (1.25±0.35) ng/ml. (2) The concentrations of IL-6 and IL-8 in the plasma of HBV-ACLF patients showed a gradually decreasing trend at various time points in the survival group. The levels on the day of admission and 7, 14, 21, and 28 days after initiation of treatment were (46.70±26.31), (33.98±20.28), (19.07±10.24), (14.76±7.84), (9.12±7.65) and (108.29±47.07), (93.85±26.53), (79.27±34.63), (56.72 ±18.30), (37.81±13.88) pg/ml, respectively. However, its concentration in the death group fluctuated within a relatively high range. The levels on the day of admission and 7, 14, 21, and 28 days after the initiation of treatment were (41.94±24.19), (36.99±19.78), (34.30±20.62), (34.14±14.52), (36.64±23.61) and (104.65±50.16), (112.98±45.03), (118.43±45.00), (111.67±40.44), (109.55±27.54) pg/ml, respectively. (3) Bivariate correlation analysis results indicated that the plasma TREM-2 content was negatively correlated with the plasma levels of pro-inflammatory cytokines IL-6 and IL-8 (r = -0.224, P = 0.025; r = - 0.223, P = 0.026). ROC curve analysis showed that the mRNA levels of TREM-2 in PBMCs at various time points for prognostic evaluation of HBV-ACLF patients were 1d=0.667, 7d=0.757, 14d=0.979, 21d=0.986, and 28d= 0.993. The areas under the ROC curve of the TREM-2 content in the plasma at various time points were 1d=0.522, 7d=0.571, 14d=0.658, 21d=0.927, and 28d=0.994. Conclusion: TREM-2 mRNA expression in PBMC and TREM-2 content in plasma have a significant relationship to the prognosis of HBV-ACLF patients and may inhibit the liver inflammatory response by regulating the secretion of pro-inflammatory cytokines IL-6 and IL-8. Dynamic monitoring of TREM-2 expression in peripheral blood is favorable for evaluating the prognostic condition of HBV-ACLF patients.

[Clinical analysis of allogeneic hematopoietic stem cell transplantation for seven cases of acute myeloid leukemia with BCR::ABL1 fusion]

Objective: To explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia (AML) patients with BCR::ABL1 fusion. Methods: The clinical data of seven AML patients with BCR::ABL1 fusion from November 2012 to January 2022 were retrospectively analyzed, and their survival status was followed up. Results: The median age of patients at the time of diagnosis was 35 years. Four cases (57.1%) were diagnosed with high leukocyte counts. All cases were assayed as BCR::ABL1 positive and accompanied by four types of gene mutations (NPM1, RUNX1, ASXL1, PHF6) . Seven patients received tyrosine kinase inhibitor (TKI) combined with induction chemotherapy and bridged to allo-HSCT, and six patients received maintenance therapy with TKI. Before allo-HSCT, six patients achieved complete remission, and four patients achieved complete molecular remission (CMR) . After allo-HSCT, the three remaining cases also achieved CMR. All patients were in remission post-allo-HSCT. One case died of infection, and the remaining cases survived without relapse. The 3-year cumulative overall survival rate was (80.0±17.9) %. Conclusions: TKI combined with traditional chemotherapy could achieve a high response rate in AML patients with BCR::ABL1 fusion. In addition, allo-HSCT could enhance the molecular response rate. Maintenance therapy post-HSCT with TKI could improve prognosis.

[CD103+CD8+T cells combined with neutrophil-to-lymphocyte ratio predict response to neoadjuvant chemoimmunotherapy in advanced oral squamous cell carcinoma]

Objective: To investigate the relationship between the expression of CD103+CD8+T cells in locally advanced oral squamous cell carcinoma (LA-OSCC), and the response to neoadjuvant chemoimmunotherapy (NACI). Methods: Thirty LA-OSCC patients from the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, who underwent NACI from June 2020 to December 2022 were analyzed, including 16 responders and 14 non-responders. Using multiple immunofluorescence technique to stain sections of patients to verify the correlation between the expression of CD103+CD8+T cells and the efficacy of NACI. CD103+CD8+T cell density was counted using Inform and HALO software. The Spearman correlation coefficient in rank correlation is used to describe the correlation between CD103+CD8+T cell and neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII) It's effectiveness as a predictive marker to NACI was analyzed by receiver operator characteristic (ROC) curve analysis and decision curve analysis (DCA). Two-tailed t-test or Mann-Whitney U-test was used to compare data between two groups, and one-way ANOVA was used to compare data between multiple groups. SPSS 22.0 and GraphPad prism 9.0 software were used for statistical analysis and plotting of relevant statistical graphs such as histograms. P<0.05 was considered a statistically significant difference. Results: The density of CD103+CD8+T cells has expanded in advanced OSCC patients who are responsive to NACI. The CD103+CD8+T cell densities in the responsive and nonresponsive groups were 118.30(41.92, 197.80) pcs/mm2 and 21.63(4.91, 71.92) pcs/mm2 respectively, with statistically significant differences(U=52.00, P=0.012). CD103+CD8+T cell abundance was negatively correlated with NLR, dNLR, PLR, and SII (P<0.05). ROC curve analysis showed that the AUC for predicting efficacy of NLR, dNLR, PLR, and SII were 0.781 (P=0.009, 95%CI: 0.5715-0.9910), 0.671 (P=0.105, 95%CI: 0.467-0.881), 0.679 (P=0.020 95%CI: 0.549-0.951), 0.750 (P=0.096, 95%CI: 0.461-0.896), respectively. The AUC for CD103+CD8+T cells alone was 0.861 (P=0.013, 95%CI: 0.585-0.950), and the AUC of combining CD103+CD8+T cells with NLR was 0.896 (P=0.025, 95%CI: 0.454-0.938). Conclusions: The density of CD103+CD8+T cells is expanded in advanced OSCC patients who are responsive to NACI. CD103+CD8+T cells positively predict favorable responses as a strong indicator to NACI in advanced OSCC patients. Co-interpretation of CD103+CD8+T cells and NLR value enhances the predictive accuracy of NACI in advanced OSCC patients.

An Intelligent Water Monitoring IoT System for Ecological Environment and Smart Cities

Global precipitation is becoming increasingly intense due to the extreme climate. Therefore, creating new technology to manage water resources is crucial. To create a sustainable urban and ecological environment, a water level and water quality control system implementing artificial intelligence is presented in this research. The proposed smart monitoring system consists of four sensors (two different liquid level sensors, a turbidity and pH sensor, and a water oxygen sensor), a control module (an MCU, a motor, a pump, and a drain), and a power and communication system (a solar panel, a battery, and a wireless communication module). The system focuses on low-cost Internet of Things (IoT) devices along with low power consumption and high precision. This proposal collects rainfall from the preceding 10 years in the application region as well as the region's meteorological bureau's weekly weather report and uses artificial intelligence to compute the appropriate water level. More importantly, the adoption of dynamic adjustment systems can reserve and modify water resources in the application region more efficiently. Compared to existing technologies, the measurement approach utilized in this study not only achieves cost savings exceeding 60% but also enhances water level measurement accuracy by over 15% through the successful implementation of water level calibration decisions utilizing multiple distinct sensors. Of greater significance, the dynamic adjustment systems proposed in this research offer the potential for conserving water resources by more than 15% in an effective manner. As a result, the adoption of this technology may efficiently reserve and distribute water resources for smart cities as well as reduce substantial losses caused by anomalous water resources, such as floods, droughts, and ecological concerns.

Development of a Microfluidic Chip System with Giant Magnetoresistance Sensor for High-Sensitivity Detection of Magnetic Nanoparticles in Biomedical Applications

Magnetic nanoparticles (MNPs) have been widely utilized in the biomedical field for numerous years, offering several advantages such as exceptional biocompatibility and diverse applications in biology. However, the existing methods for quantifying magnetic labeled sample assays are scarce. This research presents a novel approach by developing a microfluidic chip system embedded with a giant magnetoresistance (GMR) sensor. The system successfully detects low concentrations of MNPs with magnetic particle velocities of 20 mm/s. The stray field generated by the magnetic subject flowing through the microchannel above the GMR sensor causes variations in the signals. The sensor's output signals are appropriately amplified, filtered, and processed to provide valuable indications. The integration of the GMR microfluidic chip system demonstrates notable attributes, including affordability, speed, and user-friendly operation. Moreover, it exhibits a high detection sensitivity of 10 μg/μL for MNPs, achieved through optimizing the vertical magnetic field to 100 Oe and the horizontal magnetic field to 2 Oe. Additionally, the study examines magnetic labeled RAW264.7 cells. This quantitative detection of magnetic nanoparticles can have applications in DNA concentration detection, protein concentration detection, and other promising areas of research.

Deep Learning for Dental Diagnosis: A Novel Approach to Furcation Involvement Detection on Periapical Radiographs

Furcation defects pose a significant challenge in the diagnosis and treatment planning of periodontal diseases. The accurate detection of furcation involvements (FI) on periapical radiographs (PAs) is crucial for the success of periodontal therapy. This research proposes a deep learning-based approach to furcation defect detection using convolutional neural networks (CNN) with an accuracy rate of 95%. This research has undergone a rigorous review by the Institutional Review Board (IRB) and has received accreditation under number 202002030B0C505. A dataset of 300 periapical radiographs of teeth with and without FI were collected and preprocessed to enhance the quality of the images. The efficient and innovative image masking technique used in this research better enhances the contrast between FI symptoms and other areas. Moreover, this technology highlights the region of interest (ROI) for the subsequent CNN models training with a combination of transfer learning and fine-tuning techniques. The proposed segmentation algorithm demonstrates exceptional performance with an overall accuracy up to 94.97%, surpassing other conventional methods. Moreover, in comparison with existing CNN technology for identifying dental problems, this research proposes an improved adaptive threshold preprocessing technique that produces clearer distinctions between teeth and interdental molars. The proposed model achieves impressive results in detecting FI with identification rates ranging from 92.96% to a remarkable 94.97%. These findings suggest that our deep learning approach holds significant potential for improving the accuracy and efficiency of dental diagnosis. Such AI-assisted dental diagnosis has the potential to improve periodontal diagnosis, treatment planning, and patient outcomes. This research demonstrates the feasibility and effectiveness of using deep learning algorithms for furcation defect detection on periapical radiographs and highlights the potential for AI-assisted dental diagnosis. With the improvement of dental abnormality detection, earlier intervention could be enabled and could ultimately lead to improved patient outcomes.

[Interpretation of Asian Pacific Society of Cardiology consensus recommendations on the use of MitraClip for mitral regurgitation]

The Asian Pacific Society of Cardiology proposed an expert consensus on the treatment of mitral regurgitation (MR) using transcatheter edge-to-edge repair technique (the representative product: MitraClip) in 2021. The expert panel reviewed the latest literature to develop consensus recommendations on the use of MitraClip for treating MR. The current article combines the current situation of MR treatment in China and provides a comprehensive interpretation and reflection on the consensus in terms of the concept and classification of MR, and the use of MitraClip for the treatment of degenerative and functional MR, thereby providing valuable reference for the clinical practice of MR treatment in China.

Quantitative elemental analysis of bismuth brass with target-enhanced orthogonal double-pulse LIBS combined with variant one-point calibration

Self-absorption and unknown transition probabilities of the analytical lines hinder the accurate quantitative elemental analysis of bismuth brass with conventional calibration-free laser-induced breakdown spectroscopy (LIBS). In this work, target-enhanced orthogonal double-pulse LIBS combined with a variant one-point calibration method was used to solve this problem and realize quantitative elemental analysis of bismuth brass with a relative error of less than 4%. This approach is able to reduce the influence of self-absorption and capable of using analytical lines with unknown transition probabilities while using a calibration-free algorithm, which is helpful for accurate quantitative elemental analysis of bismuth brass and other samples.

Improving Dental Implant Outcomes: CNN-Based System Accurately Measures Degree of Peri-Implantitis Damage on Periapical Film

As the popularity of dental implants continues to grow at a rate of about 14% per year, so do the risks associated with the procedure. Complications such as sinusitis and nerve damage are not uncommon, and inadequate cleaning can lead to peri-implantitis around the implant, jeopardizing its stability and potentially necessitating retreatment. To address this issue, this research proposes a new system for evaluating the degree of periodontal damage around implants using Periapical film (PA). The system utilizes two Convolutional Neural Networks (CNN) models to accurately detect the location of the implant and assess the extent of damage caused by peri-implantitis. One of the CNN models is designed to determine the location of the implant in the PA with an accuracy of up to 89.31%, while the other model is responsible for assessing the degree of Peri-implantitis damage around the implant, achieving an accuracy of 90.45%. The system combines image cropping based on position information obtained from the first CNN with image enhancement techniques such as Histogram Equalization and Adaptive Histogram Equalization (AHE) to improve the visibility of the implant and gums. The result is a more accurate assessment of whether peri-implantitis has eroded to the first thread, a critical indicator of implant stability. To ensure the ethical and regulatory standards of our research, this proposal has been certified by the Institutional Review Board (IRB) under number 202102023B0C503. With no existing technology to evaluate Peri-implantitis damage around dental implants, this CNN-based system has the potential to revolutionize implant dentistry and improve patient outcomes.

[Associations of all-cause mortality with admission blood pressure variability during multiple hospitalizations in acute decompensated heart failure]

Objective: To investigate whether admission blood pressure (BP) variability during multiple hospitalizations is associated with all-cause mortality independent of baseline BP in acute decompensated heart failure (ADHF). Methods: Patients with ADHF admitted to the Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University from September 2013 to December 2017 were retrospectively enrolled. The risk of all-cause mortality associated with indices of BP variability, including mean admission BPs, standard deviation of BP and coefficient of variation of BP during multiple hospitalizations was assessed, using Cox regression model. Results: A total of 1 006 ADHF patients (mean aged (69.3±13.5) years; 411 (40.8%) female; 670 (66.6%) with preserved ejection fraction) were enrolled. During a median follow-up of 1.54 years, 47.0% of patients died. In all ADHF patients, after adjusting for confounding factors, for every 1-standard deviation (SD) increase in SD and coefficient of variation (CV) of systolic BP, the risk of all-cause mortality increased by 10% and 11%, respectively (SD: HR, 1.10, 95%CI, 1.01-1.21, P=0.029, CV: HR, 1.11, 95%CI, 1.02-1.21, P=0.017); for every 1-SD increase in the mean of diastolic BP, the risk of all cause mortality decreased by 25% (HR, 0.75; 95%CI, 0.65-0.87; P<0.001). In ADHF patients with preserved ejection fraction, after accounted for potential confounders, higher SD and CV of admitted systolic and diastolic BP were significantly associated with higher risk of all-cause mortality, regardless of whether confounding factors were adjusted (P≤0.049); After adjusting for confounding factors, the risk of all-cause mortality increased by 18% and 19% for every 1-SD increase in SD and CV of systolic BP, while the risk of all-cause mortality increased by 11% and 15% for every 1-SD increase in SD and CV of diastolic BP. In ADHF patients with reduced ejection fraction, after adjusting for confounding factors, the higher the mean admission systolic BP during multiple hospitalizations, the lower the risk of total mortality (HR, 0.68; 95%CI, 0.47-1.00; P=0.049). Conclusions: In patients with ADHF, independent of baseline BP, BP variability during multiple hospitalizations was strong predictor of all-cause mortality.

VLSI Design Based on Block Truncation Coding for Real-Time Color Image Compression for IoT

It has always been a major issue for a hospital to acquire real-time information about a patient in emergency situations. Because of this, this research presents a novel high-compression-ratio and real-time-process image compression very-large-scale integration (VLSI) design for image sensors in the Internet of Things (IoT). The design consists of a YEF transform, color sampling, block truncation coding (BTC), threshold optimization, sub-sampling, prediction, quantization, and Golomb-Rice coding. By using machine learning, different BTC parameters are trained to achieve the optimal solution given the parameters. Two optimal reconstruction values and bitmaps for each 4 × 4 block are achieved. An image is divided into 4 × 4 blocks by BTC for numerical conversion and removing inter-pixel redundancy. The sub-sampling, prediction, and quantization steps are performed to reduce redundant information. Finally, the value with a high probability will be coded using Golomb-Rice coding. The proposed algorithm has a higher compression ratio than traditional BTC-based image compression algorithms. Moreover, this research also proposes a real-time image compression chip design based on low-complexity and pipelined architecture by using TSMC 0.18 μm CMOS technology. The operating frequency of the chip can achieve 100 MHz. The core area and the number of logic gates are 598,880 μm² and 56.3 K, respectively. In addition, this design achieves 50 frames per second, which is suitable for real-time CMOS image sensor compression.

A High-Accuracy Detection System: Based on Transfer Learning for Apical Lesions on Periapical Radiograph

Apical Lesions, one of the most common oral diseases, can be effectively detected in daily dental examinations by a periapical radiograph (PA). In the current popular endodontic treatment, most dentists spend a lot of time manually marking the lesion area. In order to reduce the burden on dentists, this paper proposes a convolutional neural network (CNN)-based regional analysis model for spical lesions for periapical radiographs. In this study, the database was provided by dentists with more than three years of practical experience, meeting the criteria for clinical practical application. The contributions of this work are (1) an advanced adaptive threshold preprocessing technique for image segmentation, which can achieve an accuracy rate of more than 96%; (2) a better and more intuitive apical lesions symptom enhancement technique; and (3) a model for apical lesions detection with an accuracy as high as 96.21%. Compared with existing state-of-the-art technology, the proposed model has improved the accuracy by more than 5%. The proposed model has successfully improved the automatic diagnosis of apical lesions. With the help of automation, dentists can focus more on technical and medical diagnoses, such as treatment, tooth cleaning, or medical communication. This proposal has been certified by the Institutional Review Board (IRB) with the certification number 202002030B0.

Fast Control for Backlight Power-Saving Algorithm Using Motion Vectors from the Decoded Video Stream

Backlight power-saving algorithms can reduce the power consumption of the display by adjusting the frame pixels with optimal clipping points under some tradeoff criteria. However, the computation for the selected clipping points can be complex. In this paper, a novel algorithm is created to reduce the computation time of the state-of-the-art backlight power-saving algorithms. If the current frame is similar to the previous frame, it is unnecessary to execute the backlight power-saving algorithm for the optimal clipping points, and the derived clipping point from the previous frame can be used for the current frame automatically. In this paper, the motion vector information was used as the measurement of the similarity between adjacent frames, where the generation of the motion vector information requires no extra complexity since it is generated to reconstruct the decoded frame pixels before the display. The experiments showed that the proposed work can reduce the running time of the state-of-the-art methods by 25.21% to 64.22%, while the performances are maintained; the differences with the state-of-the-art methods in PSNR are only 0.02~1.91 dB, and those in power are only -0.001~0.008 W.

[Effects of plasma lipopolysaccharide changes on platelet release of vascular endothelial growth factor and thromobospondin-1 in patients with cirrhotic portal hypertension after TIPS procedure]

Objective: To investigate the effects of plasma lipopolysaccharide (LPS) concentration changes on platelet release of vascular endothelial growth factor (VEGF) and thrombospondin (TSP)-1 in patients with decompensated cirrhotic portal hypertension after transjugular intrahepatic portosystemic shunt (TIPS) procedure. Methods: 169 cases with cirrhotic portal hypertension were enrolled, of which 81 cases received TIPS treatment. LPS, VEGF, and TSP-1 concentrations with different Child-Pugh class in peripheral blood plasma of patients were measured. After pre-incubation of normal human platelets with different concentrations of LPS and stimulated by collagen in vitro, platelet PAC-1 expression rate, VEGF, and TSP-1 concentrations were detected. PAC-1 expression rate and the concentrations of LPS, VEGF and TSP-1 in peripheral blood plasma of patients before and after TIPS procedure were detected. The relationship between plasma LPS, VEGF and TSP-1 concentrations and Child-Pugh score changes in patients after TIPS procedure was analyzed. Statistical analysis was performed by t-test, one-way ANOVA or Pearson's rho according to different data. Results: Plasma LPS and TSP-1 concentrations were significantly higher in Child-Pugh class C patients than class A and B, but the concentration of plasma VEGF was significantly lower than class A and B (P < 0.01). In vitro experiments showed that concentration of LPS, TSP-1, and platelet PAC-1 expression rate was higher in the supernatant, but the difference in the concentration of VEGF in the supernatant was not statistically significant. Portal vein pressure and platelet activation were significantly decreased (P < 0.01) in patients after TIPS procedure. Portal venous pressure, platelet activation, plasma LPS, and TSP-1 levels were significantly decreased continuously, while VEGF levels were significantly increased continuously after TIPS procedure. Plasma LPS concentration was positively correlated with TSP-1 concentration (r = 0.506, P < 0.001), and negatively correlated with VEGF concentration (r = -0.167, P = 0.010). Child-Pugh score change range was negatively correlated with change range of plasma VEGF concentration (r = -0.297, P = 0.016), and positively correlated with change range of plasma TSP-1 concentration (r = 0.145, P = 0.031) after TIPS. Conclusion: Portal venous pressure gradient, plasma LPS concentration and corresponding platelet activation was decreased in cirrhotic portal hypertension after TIPS procedure, and with TSP-1 reduction and VEGF elevation it is possible to reduce the liver function injury caused by portal venous shunt.

The Uses of a Dual-Band Corrugated Circularly Polarized Horn Antenna for 5G Systems

This paper presents the development of a wide-beam width, dual-band, omnidirectional antenna for the mm-wave band used in 5G communication systems for indoor coverage. The 5G indoor environment includes features of wide space and short range. Additionally, it needs to function well under a variety of circumstances in order to carry out its diverse set of network applications. The waveguide antenna has been designed to be small enough to meet the requirements of mm-wave band and utilizes a corrugated horn to produce a wide beam width. Additionally, it is small enough to integrate with 5G communication products and is easy to manufacture. This design is simple enough to have multi-feature antenna performance and is more useful for the femtocell repeater. The corrugated circularly polarized horn antenna has been designed for two frequency bands; namely, 26.5–30 GHz for the low band and 36–40 GHz for high band. The results of this study show that return-loss is better than 18 dB for both low and high band. The peak gain is 6.1 dBi for the low band and 8.7 dBi for the high band. The beam width is 105 degrees and 77 degrees for the low band and the high band, respectively. The axial ratio is less than 5.2 dB for both low and high band. Generally, traditional circularly polarized antennas cannot meet the requirements for broadband. The designs for the antennas proposed here can meet the requirements of FR2 bandwidths. This feature limits axial ratio performance. The measurement error in the current experiment comes from the high precision control on the size of the ridge.

Detection of Dental Apical Lesions Using CNNs on Periapical Radiograph

Apical lesions, the general term for chronic infectious diseases, are very common dental diseases in modern life, and are caused by various factors. The current prevailing endodontic treatment makes use of X-ray photography taken from patients where the lesion area is marked manually, which is therefore time consuming. Additionally, for some images the significant details might not be recognizable due to the different shooting angles or doses. To make the diagnosis process shorter and efficient, repetitive tasks should be performed automatically to allow the dentists to focus more on the technical and medical diagnosis, such as treatment, tooth cleaning, or medical communication. To realize the automatic diagnosis, this article proposes and establishes a lesion area analysis model based on convolutional neural networks (CNN). For establishing a standardized database for clinical application, the Institutional Review Board (IRB) with application number 202002030B0 has been approved with the database established by dentists who provided the practical clinical data. In this study, the image data is preprocessed by a Gaussian high-pass filter. Then, an iterative thresholding is applied to slice the X-ray image into several individual tooth sample images. The collection of individual tooth images that comprises the image database are used as input into the CNN migration learning model for training. Seventy percent (70%) of the image database is used for training and validating the model while the remaining 30% is used for testing and estimating the accuracy of the model. The practical diagnosis accuracy of the proposed CNN model is 92.5%. The proposed model successfully facilitated the automatic diagnosis of the apical lesion.

[Clinical manifestations and treatment of ulnar club hand]

The medical records of 13 cases (16 limbs) diagnosed with ulnar club hand in Beijing Jishuitan Hospital between 1966 and 2016 were reviewed. The radiological characteristics of upper limb bones, the shape and function of shoulder, elbow, forearm, wrist, and hand were recorded. The surgical options include radial wedge osteotomy, ulnar anlage excision, release of syndactyly or narrowed first web, and release of camptodactyly were performed to correct deformities. The subjective evaluation of patients or their families was recorded. Thirteen patients with 16 affected limbs were identified with ulnar club hand. There were 7 males and 6 females with an average age of 12.4 years (range:1-29 years). Among them, 3 cases were bilateral, and 10 cases were unilateral. Six patients had right-side involvement and 4 patients had left-side involvement. Based on Bayne's classification, there were 4 type Ⅰ, 7 type Ⅱ, 4 type Ⅲ, and 1 type Ⅳ. The affected extremity was shorter than the normal limb. In patients with type Ⅰ deformity, the elbows were stable with normal range of motion, the wrists were stable with almost normal range of motion, and the hands were normal. In patients with type Ⅱ deformity, the stability of elbow was variable, and hand deformities were common. In patients with type Ⅲ deformity, the elbows were unstable, and hand deformities were common. The elbow of the patient with type Ⅳ deformity showed radiohumeral synostosis without hand deformity. Surgical treatment was performed on 9 limbs. Mean follow-up was 22.3 months(range: 8-48 months), the subjective evaluation of patients or their families was satisfactory or relatively satisfactory. The surgical treatments of ulnar club hand usually focus on correction of hand and forearm deformities. The surgical result is good.

[Comparison of autopsy and magnetic resonance imaging of triangular fibrocartilage complex structure]

Objective: To evaluate the reliability and accuracy of magnetic resonance imaging (MRI) on describing the structure of triangular fibrocartilage complex (TFCC) in 7 cadavers with autopsy being the golden standard. Methods: In total, 7 healthy cadavers were included (4 males, 3 females, the average age was 51 years). All cadavers were preserved under -30 ℃ condition and thawed out before the experiment. The autopsy was performed by the same group of hand surgeons immediately after the MRI examination (3.0 tesla, wrist coil,"superman"position). The integrity of triangular fibrocartilage (TFC), proximal component/distal component of distal radioulnar ligament (DRUL), ulnocarpal ligament (UCL) was evaluated, and the thickness of central portion of TFC was measured during the autopsy. The sensitivity, specificity, positive/negative predictive value (PPV/NPV) and positive/negative likelihood ratio (PLR/NLR) of MRI were calculated. The intraclass correlation coefficient (ICC) was calculated between the thickness of central portion of TFC on MRI and autopsy results. Results: With autopsy being the golden standard, the ICC of MRI= 0.838 (95%CI: 0.33-0.97, P<0.01). In evaluating the condition of central portion of TFC by MRI, sensitivity= 1, specificity=1, PLR=+∞, NLR=0. In evaluating the condition of proximal component/distal component of DRUL by MRI, sensitivity=1, specificity=0.83, PLR=6, NLR=0. The sensitivity, specificity, PPV, NPV, PLR, NLR of integrity of UCL in MRI was 0.33, 0.75, 0.50, 0.75, 1.33, 0.89, respectively. Conclusion: The 3.0T MRI can be a useful tool in diagnosis of the injury of TFC and proximal/distal component of DRUL, as it has a good description of TFCC's subtle structure.

A High-Accuracy and Power-Efficient Self-Optimizing Wireless Water Level Monitoring IoT Device for Smart City

In this paper, a novel self-optimizing water level monitoring methodology is proposed for smart city applications. Considering system maintenance, the efficiency of power consumption and accuracy will be important for Internet of Things (IoT) devices and systems. A multi-step measurement mechanism and power self-charging process are proposed in this study for improving the efficiency of a device for water level monitoring applications. The proposed methodology improved accuracy by 0.16-0.39% by moving the sensor to estimate the distance relative to different locations. Additional power is generated by executing a multi-step measurement while the power self-optimizing process used dynamically adjusts the settings to balance the current of charging and discharging. The battery level can efficiently go over 50% in a stable charging simulation. These methodologies were successfully implemented using an embedded control device, an ultrasonic sensor module, a LORA transmission module, and a stepper motor. According to the experimental results, the proposed multi-step methodology has the benefits of high accuracy and efficient power consumption for water level monitoring applications.

[Long-term outcomes of intravascular ultrasound-guided drug-eluting stent implantation in patients with chronic kidney disease: ULTIMATE CKD subgroup analysis]

Objective: To explore the long-term effect of intravascular ultrasound (IVUS) guidance on patients with chronic kidney disease (CKD) undergoing drug-eluting stent (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. From August 2014 to May 2017, 1 448 patients with coronary heart disease undergoing DES implantation were selected from 8 domestic centers and randomly divided into two groups in the ratio of 1∶1 (IVUS or coronary angiography guided stent implantation). A total of 1 443 patients with the baseline serum creatine available were enrolled. The patients were divided into CKD group and non CKD group. CKD was defined as the estimated glomerular filtration rate (eGFR) derived from Cockcroft Gault (CG) formula< 60 ml·min^-1·1.73 m^-2 for at least 3 months. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target vessel myocardial infarction, and clinically-driven target vessel revascularization. Kaplan Meier method was used for survival analysis, and log rank test was used to compare the occurrence of end-point events in each group. Cox proportional hazards model was used to calculate HR and 95%CI, and interaction was tested. Multivariate Cox regression was used to analyze the independent influencing factors of TVF. Results: A total of 1 443 patients with coronary heart disease were enrolled in this study, including 349 (24.2%) patients in CKD group and 1 094 patients in non CKD group. In CKD group, IVUS was used to guide stent implantation in 180 cases and angiography was used in 169 cases; in non CKD group, IVUS was used to guide stent implantation in 543 cases and angiography was used in 551 cases. Three-year clinical follow-up was available in 1 418 patients (98.3%). The incidence of TVF in CKD group was 12.0% (42/349), which was higher than that in non CKD group (7.4% (81/1 094) (P = 0.01). The difference was mainly due to the higher cardiac mortality in CKD group (4.6% (16/349) vs. 1.5% (16/1094), P<0.001). In CKD group, the incidence of TVF in patients who underwent IVUS guided stent implantation was lower than that in angiography guided stent implantation (8.3% (15/180) vs. 16.0% (27/169), P = 0.03). There was no significant difference in the incidence of TVF between IVUS guided stent implantation and angiography guided stent implantation in non CKD group (5.9% (32/543) vs. 8.9% (49/551), P = 0.06), and there was no interaction (P = 0.47). Multivariate Cox regression analysis showed that IVUS guidance (HR = 0.56, 95%CI 0.39-0.81, P = 0.002), CKD (HR = 1.83, 95%CI 1.17-2.87, P = 0.010) and stent length (every 10 mm increase) (HR = 1.11, 95%CI 1.04-1.19, P = 0.002) were independent risk factors for TVF within 3 years after DES implantation. Conclusions: CKD patients undergoing DES implantation are associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in comparison with angiography guidance in patients with CKD.

Integrated optical chip for a high-resolution, single-resonance-mode x-ray monochromator system

An integrated optical chip that minimizes the size of the energy-tuning single-resonance-mode x-ray monochromator system into a 3cm×5cm silicon wafer is proposed. A Fabry-Perot x-ray resonator and two back-reflecting Si mirrors are employed on the wafer as the optical components, where Si(12 4 0) back reflection is used for both Fabry-Perot resonance and re-diffraction of the x-ray beams from the resonator in the incident direction. We can achieve an energy bandwidth of 3.4 meV in single-mode x rays and tune the energy by temperature variation. Such Si chips can be readily employed at the synchrotron beamlines and conventional x-ray laboratories for high-resolution investigations.

Low Cost AIP Design in 5G Flexible Antenna Phase Array System Application

In this paper, a low cost 28 GHz Antenna-in-Package (AIP) for a 5G communication system is designed and investigated. The antenna is implemented on a low-cost FR4 substrate with a phase shift control integrated circuit, AnokiWave phasor integrated circuit (IC). The unit cell where the array antenna and IC are integrated in the same plate constructs a flexible phase array system. Using the AIP unit cell, the desired antenna array can be created, such as 2 × 8, 8 × 8 or 2 × 64 arrays. The study design proposed in this study is a 2 × 2 unit cell structure with dimensions of 18 mm × 14 mm × 0.71 mm. The return loss at a 10 dB bandwidth is 26.5-29.5 GHz while the peak gain of the unit cell achieved 14.4 dBi at 28 GHz.

[Comparison of the curative effect of transjugular intrahepatic portosystemic shunt with expanded polytetrafluoroethylene-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal -gastric variceal bleeding in portal hypertension]

Objective: To compare the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with expanded polytetrafluoroethylene (ePTFE)-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal-gastric variceal bleeding in portal hypertension. Methods: Patients with esophageal-gastric variceal bleeding who received TIPS treatment (ePTFE covered stent) or gastroscopy for the first time as the secondary prevention for portal hypertension at Nanfang Hospital of Southern Medical University through March to July 2017 were selected. One year after the operation, liver function changes, ascites remission rates, incidence of hepatic encephalopathy, re-bleeding rate, average hospitalization frequency and expenses, survival time, as well as the TIPS patency conditions were analyzed in the two groups of patients. 2 test, Kaplan-Meier method and Mann-Whitney U test were used to analyze the data. Results: There were 74 and 66 cases in the TIPS and the drug combined gastroscopy group and the follow-up duration (14.57 ± 0.79) was 12-16 months. One year after surgery, the remission rate of ascites in the TIPS group was higher 57.1% (32/56) than that of the drug combined gastroscopy group (0), and the difference was statistically significant (χ(2) = 2 = 36.73, P < 0.01). The cumulative incidence of hepatic encephalopathy at 1, 3, 6, and 12 months after surgery in the TIPS group was 32.4% (24/74), 37.8% (28/74), 40.5% (30/74), and 40.5% (30/74), respectively. The cumulative incidence of hepatic encephalopathy in the drug combined gastroscopy group was 3.0% (2/66), 3.0% (2/66), 3.0% (2/66), and 6.1% (4/66), respectively. Kaplan-Meier analysis showed that the cumulative incidence of hepatic encephalopathy in the TIPS group was higher than that of the drug combined gastroscopy group (χ(2) = 11.29, P < 0.01). The incidence of severe hepatic encephalopathy ( grade III to IV) at 1, 3, 6, and 12 months after surgery in the TIPS group was 2.7% (2/74), 0, 0, and 0, respectively. The incidence of severe hepatic encephalopathy in drug combined gastroscopy group was 0, and there was no statistically significant difference in development of hepatic encephalopathy between the two groups (P > 0.05). The re-bleeding rates of TIPS group and drug combined gastroscopy group were 0 and 27.3% (18/66), respectively, and the difference was statistically significant (χ(2) = 22.42, P < 0.01). There was no death reported during the follow-up period between both groups. The hospitalization frequency times (1.45 ± 0.80) in TIPS group was lower than that of the drug combined gastroscopy group times (3.24 ± 1.80), and the difference was statistically significant (U = -4.52, P < 0.01). Conclusion: In the prevention of esophageal-gastric variceal bleeding, TIPS (ePTFE-covered stent) treatment has the advantages of reducing re-bleeding rate, high ascites remission rate and hospitalizations frequency. In addition, patients treated with TIPS have a higher incidence of hepatic encephalopathy than that of drugs combined with gastroscopy. However, TIPS did not exacerbate the incidence of hepatic encephalopathy, and there was no significant difference in the 1-year survival rate after TIPS and drugs combined with gastroscopy treatment.

Genomic and transcriptional heterogeneity of multifocal hepatocellular carcinoma

BACKGROUND

Hepatocellular carcinoma (HCC) often presents with multiple nodules within the liver, with limited effective interventions. The high genetic heterogeneity of HCC might be the major cause of treatment failure. We aimed to characterize genomic heterogeneity, infer clonal evolution, investigate RNA expression pattern and explore tumour immune microenvironment profile of multifocal HCC.

PATIENTS AND METHODS

Whole-exome sequencing and RNA sequencing were carried out in 34 tumours and 6 adjacent normal liver tissue samples from 6 multifocal HCC patients. Protein expression of Ki67, AFP, P53, Survivin and CD8 was detected by immunohistochemistry. Fluorescence in situ hybridization was carried out to validate the amplification status of sorafenib-targeted genes.

RESULTS

We deciphered genomic and transcriptional heterogeneity among tumours in each multifocal HCC patient including mutational profiles, copy number alterations, tumour evolutionary trajectory and tumour immune microenvironment profiles. Of note, sorafenib-targeted alterations were identified in the trunk of phylogenetic tree in only one out of the six patients, which may explain the relative low treatment response rate to sorafenib in clinical practice. Moreover, we demonstrated RNA expression patterns and tumour immune microenvironment profiles of all nodules. We found that RNA expression pattern was associated with Edmondson-Steiner grading. Based on the differential expression of 66 reported immune markers, unsupervised hierarchical clustering analysis of 34 nodules identified immune subsets: one low expression cluster with seven nodules and one high expression cluster with 11 nodules. CD8+ T cells were more enriched in nodules of the high expression cluster.

CONCLUSIONS

Our study provided a detailed view of genomic and transcriptional heterogeneity, clonal evolution and immune infiltration of multifocal HCC. The heterogeneity of druggable targets and immune landscape might help interpret the clinical responsiveness to targeted drugs and immunotherapy for multifocal HCC patients.

Effect of Crystal Symmetry on the Spin States of Fe3+ and Vibration Modes in Lead-free Double-Perovskite Cs2AgBi(Fe)Br6

We show by electron spin resonance (ESR) and Raman spectroscopies that the crystal phase transition of the lead-free double-perovskite Cs₂AgBiBr₆ has a profound symmetry-breaking effect on the high spin states of, for example, a transition-metal ion Fe³⁺ and the vibrational modes. It lifts their degeneracy when the crystal undergoes the cubic-tetragonal phase transition, splitting the six-fold degenerate S = 5/2 state of Fe³⁺ to three Kramer doublets and the enharmonic breathing mode T_g of the MBr₆ octahedra (M = Ag, Bi, Fe) into E_g + A_g. The magnitudes of both spin and Raman line splitting are shown to directly correlate with the strength of the tetragonal strain field. This work, in turn, demonstrates the power of the ESR and Raman spectroscopies in probing structural phase transitions and in providing in-depth information on the interplay between the structural, spin, and vibrational properties of lead-free double perovskites, a newly emerging and promising class of materials for low-cost and high-efficiency photovoltaics and optoelectronics.

A Low-Power High-Data-Transmission Multi-Lead ECG Acquisition Sensor System

This study presents a low-power multi-lead wearable electrocardiogram (ECG) signal sensor system design that can simultaneously acquire the electrocardiograms from three leads, I, II, and V1. The sensor system includes two parts, an ECG test clothing with five electrode patches and an acquisition device. Compared with the traditional 12-lead wired ECG detection instrument, which limits patient mobility and needs medical staff assistance to acquire the ECG signal, the proposed vest-type ECG acquisition system is very comfortable and easy to use by patients themselves anytime and anywhere, especially for the elderly. The proposed study incorporates three methods to reduce the power consumption of the system by optimizing the micro control unit (MCU) working mode, adjusting the radio frequency (RF) parameters, and compressing the transmitted data. In addition, Huffman lossless coding is used to compress the transmitted data in order to increase the sampling rate of the acquisition system. It makes the whole system operate continuously for a long period of time and acquire abundant ECG information, which is helpful for clinical diagnosis. Finally, a series of tests were performed on the designed wearable ECG device. The results have demonstrated that the multi-lead wearable ECG device can collect, process, and transmit ECG data through Bluetooth technology. The ECG waveforms collected by the device are clear, complete, and can be displayed in real-time on a mobile phone. The sampling rate of the proposed wearable sensor system is 250 Hz per lead, which is dependent on the lossless compression scheme. The device achieves a compression ratio of 2.31. By implementing a low power design on the device, the resulting overall operational current of the device is reduced by 37.6% to 9.87 mA under a supply voltage of 2.1 V. The proposed vest-type multi-lead ECG acquisition device can be easily employed by medical staff for clinical diagnosis and is a suitable wearable device in monitoring and nursing the off-ward patients.

[Doxycycline inhibits paraquat-induced pulmonary fibrosis via TGF-β1/Smad pathway]

Objective: To investigate the possible mechanism of doxycycline inhibiting paraquat-induced pulmonary fibrosis and provide a theoretical basis for its clinical application. Methods: Human lung fibroblast HFL1 cells were selected as the research object in the cell group. Divided into blank group, paraquat group, paraquat+doxycycline group. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein was detected by ELISA using 40 ml of paraquat 40 umol/L and 3 mg/L of oleic acid 10 mg/L. In the animal group, 120 healthy and clean SD rats were randomly divided into three groups: blank group, paraquat group, paraquat+doxycycline group. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein in lung tissue of mice at 1 day, 3 days, 7 days, 14 days and 21 days was detected by Elisa method. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein in lung tissue of 21-day mice was detected by Western Blotting. The pathological changes of lung tissue were observed by HE staining for 1 day, 3 days, 7 days, 14 days and 21 days. Results: In the cell group experiment, the expression of TGF-β1, a-SMA, Smad3 and Smad2 protein increased gradually with paraquat in the paraquat group, and the expression of TGF-β1, a-SMA, Smad3 and Smad2 protein was significantly higher than that in the blank group. The difference was statistically significant (P<0.05) . The expressions of TGF-β1, a-SMA, Smad3 and Smad2 in the paraquat+doxycycline group were significantly lower than those in the paraquat group, but still higher than the blank group, the difference was statistically significant (P<0.05) . Conclusion: Doxycycline inhibits paraquat-induced pulmonary fibrosis by inhibiting the expression of TGF-β1, a-SMA and Smad3, Smad2 proteins.

A Power-Efficient Multiband Planar USB Dongle Antenna for Wireless Sensor Networks

Wireless Sensor Networks (WSNs) had been applied in Internet of Things (IoT) and in Industry 4.0. Since a WSN system contains multiple wireless sensor nodes, it is necessary to develop a low-power and multiband wireless communication system that satisfies the specifications of the Federal Communications Commission (FCC) and the Certification European (CE). In a WSN system, many devices are of very small size and can be slipped into a Universal Serial Bus (USB), which is capable of connecting to wireless systems and networks, as well as transferring data. These devices are widely known as USB dongles. This paper develops a planar USB dongle antenna for three frequency bands, namely 2.30–2.69 GHz, 3.40–3.70 GHz, and 5.15–5.85 GHz. This study proposes a novel antenna design that uses four loops to develop the multiband USB dongle. The first and second loops construct the low and intermediate frequency ranges. The third loop resonates the high frequency property, while the fourth loop is used to enhance the bandwidth. The performance and power consumption of the proposed multiband planar USB dongle antenna were significantly improved compared to existing multiband designs.

[Clinical outcome of postchemotherapy retroperitoneal lymph node dissection and predicting retroperitoneal histology in advanced nonseminomatous germ cell tumours of the testis]

Objective: To explore the clinical outcome of advanced testicular nonseminomatous germ cell cancer patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND), and to analyze the relevant prognostic factors of lymph node pathological. Methods: A total of 43 consecutive testicular nonseminomatous germ cell cancer patients underwent PC-RPLND between March 2001 and December 2014 in Department of Urology at Sun Yat-sen University Cancer Center were retrospectively reviewed. The average age of the patients was (29.0±11.5) years (ranging from 12 to 58 years). Before PC-RPLND, 22 patients were classified as phase Ⅱ, while 21 were phase Ⅲ. Primary tumor histology revealed seminomatous elements in 19 cases, embryonal cell carcinoma in 22 cases, yolk sac tumor in 13 cases, chorionic carcinoma in 3 cases, mature teratomatous elements in 11 and immature teratomatous elements in 2 cases. Patients were treated with cisplatin-based chemotherapy after orchectomy and then underwent surgical resection of retroperitoneal lymph nodes.After PC-RPLND, all patients underwent a periodic review including the blood routine, biochemistry routine and computed tomography or ultrasonograph of the chest, the abdomen and the pelvis. The association of pathological data with patient's clinic features and the correlations between molecular features detected with each other were assessed by the t test, χ(2) and Fisher's exact test. Multivariate logistic regression were used to assess prognostic factors. Results: The median operative time was 278 minutes (ranging from 50 to 715 minutes). Median blood loss was 425 ml (ranging from 50 to 5 000 ml). Eight patients received blood transfusion intra-operatively, 2 patients underwent adjunctive surgical procedures, 4 patients developed ileus and 4 had an ascites chylosus following PC-RPLND, 1 patient had a postoperative hyperthermia and retrograde ejaculation was present in 10 patients. The transverse diameter of the residual tumor in patients ranged from 0.8 to 18.2 cm. Necrosis, teratoma and viable germ cell tumors were found in 15, 17 and 11 of all patients. The median follow-up time was 46 months (ranging from 6 to 169 months). There were 39 patients had no tumor recurrence, 7 patients were found recurrence after PC-RPLND, 5 died of malignant germ cell tumor. The normal serum lactate dehydrogenase (LDH) level before chemotherapy (HR=25.811, 95%CI: 0.678 to 982.624, P=0.017) and relative changes more than 50% in retroperitoneal lymph node size (HR=0.016, 95%CI: 0 to 0.698, P=0.032) were statistically significant prognostic factors of the presence of necrosis. Conclusions: Since most residual masses are not sensitive to chemotherapy, PC-RPLND is still an essential part of the treatment of metastatic testicular nonseminomatous germ cell cancer. Patients with the normal serum LDH level before chemotherapy and a shrinkage of 50% or more in retroperitoneal mass have a considerably chance of having necrosis in the retroperitoneum resection. This may help to refine the selection of candidates for PC-RPLND.

[Effects of preexisting donor-specific HLA antibodies for graft failure in un-manipulated haploidentical hematopoietic stem cell transplantation]

目的

探讨单倍体相合造血干细胞移植中HLA供者特异性抗体（DSA）对干细胞植入的影响以及处理方法。

方法

采用免疫磁珠液相芯片技术，对2016年6月至2017年5月拟行单倍体相合造血干细胞移植患者进行HLA抗体及DSA的检测，对已完成移植患者进行DSA与植入失败相关性分析，检测移植前后DSA水平，探索针对DSA的处理方法。

结果

共检测了92例拟行单倍体相合造血干细胞移植患者的HLA抗体，其中16例（17.4%）存在HLA抗体，6例（6.5%）DSA阳性。在常规清髓性预处理单倍体相合移植中，26例DSA阴性患者中有24例成功植入，仅有2例发生植入失败，而采用常规预处理的4例DSA阳性患者中仅有1例成功植入，其余3例发生植入失败，二组患者植入率差异有统计学意义[92.3%（24/26）对25.0%（1/4），χ²=8.433，P=0.004]。多因素分析显示，DSA是影响供者干细胞植入的唯一因素[OR=12.0（95% CI 1.39~103.5），P=0.024]。6例DSA阳性的患者中，4例次在移植时采取了针对DSA的措施，均获得供者干细胞顺利植入，其中3例HLA-Ⅰ类DSA阳性患者（首次移植2例、二次移植1例）在输入供者干细胞之前输入供者血小板，另1例HLA-Ⅰ、HLA-Ⅱ类DSA并存患者在二次移植时更换供者并给予全身放疗、利妥昔单抗及供者血小板输注。

结论

DSA是导致单倍体相合造血干细胞植入失败的关键因素，移植前应进行常规检查，DSA阳性患者应选用DSA阴性供者；无合适供者时，应采取适当措施降低DSA水平以促进干细胞植入。

[Clinical significance of exosomal miR-1231 in pancreatic cancer]

Objective: To investigate the expression and clinical significance of exosomal miR-1231 in plasma of pancreatic cancer (PC) patients and pancreatic cancer cells. Methods: A total of 16 patients who were diagnosed with pancreatic cancer in Hunan Cancer Hospital were collected from April 2016 to August 2017. Meanwhile, 16 healthy volunteers were recruited as the healthy control group at the same period. The plasma exosomes were extracted, and the levels of miR-1231 were detected by qRT-PCR in PC and healthy control groups. Moreover, the clinicopathological significance of exosomal miR-1231 expression was analyzed. Furthermore, the expression of exosomal miR-1231 was detected in several pancreatic cancer cells (MIA PaCa-2, PANC-1, SW1990, AsPC-1 and BxPc-3) and two normal pancreatic epithelial cells (HPDE and human primary pancreatic epithelial cell). Results: qRT-PCR results showed that the expression level of miR-1231 in plasma exosomes of pancreatic cancer patients (1.06±0.46) was significantly lower than that in healthy controls (2.30±0.99; P<0.05). The levels of exosomal miR-1231 in patients with stage Ⅰ-Ⅱ (1.515±0.531), no distant metastasis (1.236±0.461) and no lymph node metastasis (1.337±0.522) were significantly higher than those with stage Ⅲ-Ⅳ (0.848±0.224), distant metastasis (0.757±0.278) and lymph node metastasis (0.838±0.261), respectively (P<0.05 for all). In addition, there were no correlation between exosomal miR-1231 expression and age, sex, smoking history, CA19-9 levels and tumor sites (P>0.05). Furthermore, the expression level of exosomal miR-1231 in pancreatic cancer cell lines (0.142±0.135) was significantly lower than that in normal epithelial cells (1.127±0.179; P<0.05). Conclusions: The downregulation of exosomal miR-1231 in plasma of pancreatic cancer patients and pancreatic cancer cells suggests that it is related to the initiation and development of PC. It may be a new diagnostic and prognostic marker for PC.

Three-dimensional analytical poromechanical solutions for an arbitrarily inclined borehole subjected to fluid injection

Hydraulic fracturing is the primary method of stimulation in unconventional reservoirs, playing a significant role in oil and gas production enhancement. A key issue for the analysis of hydraulic fracture initiation is to accurately determine the stress distributions in the vicinity of the borehole caused by the injection of pressurized fluids. This paper develops an exact, three-dimensional, poroelastic coupled analytical solution for such stress analysis of an arbitrarily inclined borehole subjected concurrently to a finite-length fluid discharge and in situ stresses, using Fourier expansion theorem and the Laplace-Fourier integral transform technique. The complicated boundary conditions, which involve the mixed boundary values at the borehole surface and the coupling between the total radial stress and injection-induced pore pressure over the sectioned borehole interval, as well as the fully three-dimensional far field in situ stresses, are addressed in a novel way and deliberately/elegantly decomposed into five fundamental, easier to handle modes. The rigour and definitive nature of the proposed analytical methodology facilitates fundamental understanding of the mechanism underlying the stress responses of the borehole and porous medium. It can be and is used here as a benchmark for the numerical solutions obtained from the finite-element analysis commercial program (ABAQUS).