Abnormal Brachial Plexus Differentiation from Routine Magnetic Resonance Imaging: An AI-based Approach

Automatic abnormality identification of brachial plexus (BP) from normal magnetic resonance imaging to localize and identify a neurologic injury in clinical practice (MRI) is still a novel topic in brachial plexopathy. This study developed and evaluated an approach to differentiate abnormal BP with artificial intelligence (AI) over three commonly used MRI sequences, i.e. T1, FLUID sensitive and post-gadolinium sequences. A BP dataset was collected by radiological experts and a semi-supervised artificial intelligence method was used to segment the BP (based on nnU-net). Hereafter, a radiomics method was utilized to extract 107 shape and texture features from these ROIs. From various machine learning methods, we selected six widely recognized classifiers for training our Brachial plexus (BP) models and assessing their efficacy. To optimize these models, we introduced a dynamic feature selection approach aimed at discarding redundant and less informative features. Our experimental findings demonstrated that, in the context of identifying abnormal BP cases, shape features displayed heightened sensitivity compared to texture features. Notably, both the Logistic classifier and Bagging classifier outperformed other methods in our study. These evaluations illuminated the exceptional performance of our model trained on FLUID-sensitive sequences, which notably exceeded the results of both T1 and post-gadolinium sequences. Crucially, our analysis highlighted that both its classification accuracies and AUC score (area under the curve of receiver operating characteristics) over FLUID-sensitive sequence exceeded 90%. This outcome served as a robust experimental validation, affirming the substantial potential and strong feasibility of integrating AI into clinical practice.

Suppression of microRNA-320 Induces Cerebral Protection Against Ischemia/Reperfusion Injury by Targeting HMGB1/NF-kappaB Axis

MicroRNAs have been shown to potentially function in cerebral ischemia/reperfusion (IR) injury. This study aimed to examine the expression of microRNA-320 (miR-320) in cerebral IR injury and its involvement in cerebral mitochondrial function, oxidative stress, and inflammatory responses by targeting the HMGB1/NF-kappaB axis. Sprague-Dawley rats were subjected to middle cerebral artery occlusion to simulate cerebral IR injury. The cerebral expression of miR-320 was assessed using qRT-PCR. Neurological function, cerebral infarct volume, mitochondrial function, oxidative stress, and inflammatory cytokines were evaluated using relevant methods, including staining, fluorometry, and ELISA. HMGB1 expression was analyzed through Western blotting. The levels of miR-320, HMGB1, neurological deficits, and cerebral infarction were significantly higher after IR induction. Intracerebral overexpression of miR-320 resulted in substantial neurological deficits, increased infarct volume, elevated levels of 8-isoprostane, NF-kappaBp65, TNF-alpha, IL-1beta, ICAM-1, VCAM-1, and HMGB1 expression. It also promoted the loss of mitochondrial membrane potential and ROS levels while reducing MnSOD and GSH levels. Downregulation of miR-320 and inhibition of HMGB1 activity significantly reversed the outcomes of cerebral IR injury. MiR-320 plays a negative role in regulating cerebral inflammatory/oxidative reactions induced by IR injury by enhancing HMGB1 activity and modulating mitochondrial function.

The tsRNAs (tRFdb-3013a/b) serve as novel biomarkers for colon adenocarcinomas

The tsRNAs (tRNA-derived small RNAs) are a novel class of small non-coding RNAs derived from transfer-RNAs. Colon adenocarcinoma (COAD) is the most malignant intestinal tumor. This study focused on the identification and characterization of tsRNA biomarkers in colon adenocarcinomas. Data processing and bioinformatic analyses were performed with the packages of R and Python software. The cell proliferation, migration and invasion abilities were determined by CCK-8 and transwell assays. Luciferase reporter assay was used to test the binding of tsRNA with its target genes. With computational methods, we identified the tRNA fragments profiles within COAD datasets, and discriminated forty-two differentially expressed tsRNAs between paired colon adenocarcinomas and non-tumor controls. Among the fragments derived from the 3' end of tRNA-His-GUG (a histidyl-transfer-RNA), tRFdb-3013a and tRFdb-3013b (tRFdb-3013a/b) were notably decreased in colon and rectum adenocarcinomas, especially, tRFdb-3013a/b might tend to be down-regulated in patients with lymphatic or vascular invasion present. The clinical survival of colorectal adenocarcinoma patients with low tRFdb-3013a/b expression was significantly worse than that of high expression patients. In colon adenocarcinoma cells, tRFdb-3013a could have inhibited cell proliferations, and reduced cell migration and invasion abilities. The enrichment analyses showed that most of tRFdb-3013a correlated-genes were enriched in the extracellular matrix associated GO terms, phagosome pathway, and a GSEA molecular signature pathway. Additionally, the 3'UTR of ST3GAL1 mRNA was predicted to contain the binding site of tRFdb-3013a/b, tRFdb-3013a/b might directly target and regulate ST3GAL1 expression in colon adenocarcinomas. These results suggested that tRFdb-3013a/b might serve as novel biomarkers for diagnosis and prognosis of colon adenocarcinomas, and act a key player in the progression of colon adenocarcinomas.

[The 504th case: Multiple lymph node enlargement, renal insufficiency, blindness, and white matter lesions of the brain]

A 65-year-old male patient was admitted for recurrent lymph node enlargement for 5 years and elevated creatinine for 6 months. This patient was diagnosed with angioimmunoblastic T-cell lymphoma 5 years ago and underwent multiple lines of anti-tumor therapy, including cytotoxic chemotherapy; epigenetic modifying drugs such as chidamide and azacitidine; the immunomodulator lenalidomide; and targeted therapy such as rituximab, a CD20-targeting antibody, and brentuximab vedotin, which targets CD30. Although the tumor was considered stable, multiple virus activation (including BK virus, JC virus, and cytomegalovirus) accompanied by the corresponding organ damage (polyomavirus nephropathy, cytomegalovirus retinitis, and progressive multifocal leukoencephalopathy) occurred during anti-tumor treatment. Anti-tumor therapy was suspended and ganciclovir was used. The serum viral load decreased and organ functions were stabilized. The purpose of this report was to raise clinicians' awareness of opportunistic virus reactivation during anti-tumor treatment.

Age effect on the shared etiology of glycemic traits and serum lipids: evidence from a Chinese twin study

PURPOSE

Diabetes and dyslipidemia are among the most common chronic diseases with increasing global disease burdens, and they frequently occur together. The study aimed to investigate differences in the heritability of glycemic traits and serum lipid indicators and differences in overlapping genetic and environmental influences between them across age groups.

METHODS

This study included 1189 twin pairs from the Chinese National Twin Registry and divided them into three groups: aged ≤ 40, 41-50, and > 50 years old. Univariate and bivariate structural equation models (SEMs) were conducted on glycemic indicators and serum lipid indicators, including blood glucose (GLU), glycated hemoglobin A1c (HbA1c), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), in the total sample and three age groups.

RESULTS

All phenotypes showed moderate to high heritability (0.37-0.64). The heritability of HbA1c demonstrated a downward trend with age (HbA1c: 0.50-0.79), while others remained relatively stable (GLU: 0.55-0.62, TC: 0.58-0.66, TG: 0.50-0.63, LDL-C: 0.24-0.58, HDL-C: 0.31-0.57). The bivariate SEMs demonstrated that GLU and HbA1c were correlated with each serum lipid indicator (0.10-0.17), except HDL-C. Except for HbA1c and LDL-C, as well as HbA1c and HDL-C, differences in genetic correlations underlying glycemic traits and serum lipids between age groups were observed, with the youngest group showing a significantly higher genetic correlation than the oldest group.

CONCLUSION

Across the whole adulthood, genetic influences were consistently important for GLU, TC, TG, LDL-C and HDL-C, and age may affect the shared genetic influences between glycemic traits and serum lipids. Further studies are needed to elucidate the role of age in the interactions of genes related to glycemic traits and serum lipids.

Structural and functional coupling in cross-linking uracil-DNA glycosylase UDGX

Enzymes in uracil-DNA glycosylase (UDG) superfamily are involved in removal of deaminated nucleobases such as uracil, methylcytosine derivatives such as formylcytosine and carboxylcytosine, and other base damage in DNA repair. UDGX is the latest addition of a new class to the UDG superfamily with a sporadic distribution in bacteria. UDGX type enzymes have a distinct biochemical property of cross-linking itself to the resulting AP site after uracil removal. Built on previous biochemical and structural analyses, this work comprehensively investigated the kinetic and enzymatic properties of Mycobacterium smegmatis UDGX. Kinetics and mutational analyses, coupled with structural information, defined the roles of E52, D56, D59, F65 of motif 1, H178 of motif 2 and N91, K94, R107 and H109 of motif 3 play in uracil excision and cross-linking. More importantly, a series of quantitative analyses underscored the structural coupling through inter-motif and intra-motif interactions and subsequent functional coupling of the uracil excision and cross-linking reactions. A catalytic model is proposed, which underlies this catalytic feature unique to UDGX type enzymes. This study offers new insight on the catalytic mechanism of UDGX and provides a unique example of enzyme evolution.

Retrospective computed tomography assessment of chemotherapy-related pneumonia with severity screening in pediatric acute lymphoblastic leukemia by radiological imaging

Objectives

To evaluate the radiological imaging-guided severity along the pneumonia course and evaluate the chest computed tomography (CT) findings of chemotherapy-related pneumonia in children with acute lymphoblastic leukemia (ALL).

Materials and methods

A retrospective database review of children with ALL was conducted from March 2016 to August 2021 to identify cases with CT images who developed pneumonia during the chemotherapy course. A total of 51 children with ALL developed pneumonia were ultimately included (31 boys and 20 girls, mean age: 6 ± 4 years [standard deviation]). Each child's demographics, medical records, and laboratory results were collected. The CT images were then reviewed and the radiologic severity index (RSI) was calculated based on the regional opacity and implicated volume. A t-test, U test, Pearson's Chi-square test, and Fisher's exact test were performed to compare the clinical or radiologic features between the severe and moderate cases. The linear regression models were employed to analyze the correlation of RSIs with other clinical features.

Results

Eleven children (22 %, 11/51) displayed severe phenotypes associated with respiratory failure. The ground glass opacity (GGO) frequently appeared (65 % of CT images). The baseline RSI was positively associated with the lowest lymphocyte (p = .003), neutrophil (p = .01) counts, and the highest C-reactive protein level (p = .04). The peak RSI may predict severe phenotypes at a cutoff of 4.5 (AUC 0.76 [0.61, 0.91]) with 73 % sensitivity and 63 % specificity.

Conclusion

The chest CT images of children with chemotherapy-related pneumonia displayed clinically related baseline RSI and a peak RSI of >4.5 of 36 predicted severe phenotypes.

Activating two-dimensional semiconductors for photocatalysis: a cross-dimensional strategy

The emerging two-dimensional (2D) semiconductors substantially extend materials bases for versatile applications such as semiconductor photocatalysis demanding semiconductive matrices and large surface areas. The dimensionality, while endowing 2D semiconductors the unique properties to host photocatalytic functionality of pollutant removal and hydrogen evolution, hurdles the activation paths to form heterogenous photocatalysts where the photochemical processes are normally superior over these on the mono-compositional counterparts. In this perspective, we present a cross-dimensional strategy to employ thenD (n= 0-2) clusters or nanomaterials as activation partners to boost the photocatalytic activities of the 2D semiconductors. The formation principles of heterogenous photocatalysts are illustrated specifically for the 2D matrices, followed by selection criteria of them among the vast 2D database. The computer investigations are illustrated in the density functional theory route and machine learning benefitted from the vast samples in the 2D library. Synthetic realizations and characterizations of the 2D heterogenous systems are introduced with an emphasis on chemical methods and advanced techniques to understand materials and mechanistic studies. The perspective outlooks cross-dimensional activation strategies of the 2D materials for other applications such as CO2removal, and materials matrices in other dimensions which may inspire incoming research within these fields.

Selective FRET nano probe based on carbon dots and naphthalimide-isatin for the ratiometric detection of peroxynitrite in drug-induced liver injury

Drug-induced liver injury (DILI) is the most common cause for acute liver failure in the USA and Europe. However, most of DILI cases can recover or be prevented if treatment by the offending drug is discontinued. Recent research indicates that peroxynitrite (ONOO-) can be a potential indicator to diagnose DILI at an early stage. Therefore, the establishment of an assay to detect and track ONOO- in DILI cases is urgently needed. Here, a FRET-based ratiometric nano fluorescent probe CD-N-I was developed to detect ONOO- with high selectivity and excellent sensitivity. This probe consists of carbon dots and a naphthalimide-isatin peroxynitrite sensing system assembled based on electrostatic interactions. Using CD-N-I we were able to detect exogenous ONOO- in live cells and endogenous ONOO- in APAP-induced liver injury of HepG2 cells.

Concurrent remission of lymphoma and Sjögren's disease following anti-CD19 chimeric antigen receptor-T cell therapy for diffuse large B-cell lymphoma: a case report

Anti-CD19 chimeric antigen receptor (CAR)-T cells not only target CD19-positive malignant lymphoma cells but also normal B cells. The utility of CAR-T cell therapy has been reported in rheumatoid arthritis and systemic lupus erythematosus; however, its use in Sjögren's disease (SjD) remains unknown. In this study, we describe the case of a 76-year-old woman with active SjD for 10 years who was diagnosed with diffuse large B-cell lymphoma. After receiving anti-CD19 CAR-T cell therapy, she achieved complete remission (CR) on day 28. Since the onset of her 10-year history with SjD, she was negative for antinuclear antibodies and anti-Ro-52 for the first time on day 90 after CAR-T cell therapy. Six months after CAR-T cell therapy, the CR status was maintained, serum cytokine levels returned to their normal levels, and dry mouth symptoms improved. The EULAR Sjögren's Syndrome Disease Activity Index score decreased from 5 to 2, indicating a partial remission of SjD activity compared with that before CAR-T cell treatment. In the early stage of treatment, she presented with grade 2 cytokine release syndrome and grade 1 neurotoxicity, which were completely controlled after an active intervention. This case highlights the potential application of CAR-T cells in treating autoimmune diseases, such as SjD.

[An investigation on the nutritional status and support of in-patients with common variable immunodeficiency]

The study aimed to reveal for the first time the clinical characteristics, nutritional and metabolic status and support of hospitalized patients with common variant immunodeficiency disease (CVID), and provide reference to improve the long-term nutritional management for such patients. This is a retrospective cross-sectional study. Through searching the electronic medical record system of Peking Union Medical College Hospital, the study included 33 consecutive in-patients with CVID diagnosed in Jan 2016 to Jun 2021, with the male to female ratio of 16∶17. All their medical data, nutritional assessment and intervention retrospectively summarized and analyzed. Data with normal distribution were described using (x¯±s), and analyzed with independent sample t-test. Data with non-normal distribution were compared with non-parametric test. The results showed that the median onset-age of the included patients was 22 (10.0,36.5) years old, and the median duration was 9.0 (2.0,16.0) years. All patients had recurrent infections involving various systems (33/33), with development of autoimmune diseases (8/33) and lymphoproliferative disease or malignancy (9/33) in some cases among them. The nutritional risk screening 2002 (NRS 2002) scores revealed that 85.19% of adults had an NRS 2002≥3 points, and 33.33% of children had a BMI-for-age z score<-2. Weight loss occurred in 66.67% of patients (22/33), while 87.88% (29/33), 69.70% (23/33) and 81.82% (27/33) of patients respectively had anemia, hypoalbuminemia and decreased prealbumin. Among 22 patients with micronutrients status evaluated, 77.27% (17/22), 22.73% (5/22) and 31.82% (7/22) of patients respectively had lowered serum iron, folate deficiency and vitamin B12 insufficiency. Six patients underwent 25-OH-VD3 measurement, and were all testified to have vitamin D deficiency. Among all patients with nutritional risk, 56.00% of them underwent nutritional support: oral nutritional supplements (14 cases), enteral feeding (4 cases) and parenteral nutrition (5 cases). In conclusion, the condition of malnutrition was prevalent in patients with CVID, but was under-recognized and undertreated to some degree.

A promising perovskite primary explosive

A primary explosive is an ideal chemical substance for performing ignition in military and commercial applications. For over 150 years, nearly all of the developed primary explosives have suffered from various issues, such as troublesome syntheses, high toxicity, poor stability or/and weak ignition performance. Now we report an interesting example of a primary explosive with double perovskite framework, {(C6H14N2)2[Na(NH4)(IO4)6]}n (DPPE-1), which was synthesized using a simple green one-pot method in an aqueous solution at room temperature. DPPE-1 is free of heavy metals, toxic organic components, and doesn't involve any explosive precursors. It exhibits good stability towards air, moisture, sunlight, and heat and has acceptable mechanical sensitivities. It affords ignition performance on par with the most powerful primary explosives reported to date. DPPE-1 promises to meet the challenges existing with current primary explosives, and this work could trigger more extensive applications of perovskite.

Treatment Outcomes and Prognostic Factors of Chemotherapy Combined with Radiotherapy for Patients with Stage I-II Nasal-Type Natural Killer/T-Cell Lymphoma

PURPOSE/OBJECTIVE(S)

The purpose of this study was to assess the treatment outcome and the potential prognostic factors for patients with stage I-II nasal ENKTL treated with radiotherapy (RT) combined chemotherapy (CT).

MATERIALS/METHODS

From July, 2005 to January, 2019, 118 eligible patients were retrospective included in the study. Among the 118 patients, 84 were male and 34 were female. The median age was 45 years (range: 14-77 years). According to the Ann Arbor staging system, 66 patients had stage I disease (Primary tumor invasion (PTI) was present in 29 patients), and 52 patients had stage II disease. B symptoms were observed in 61 patients. The Eastern Cooperative Oncology Group (ECOG) performance score was 0 to 1 in 88 patients. Cervical lymph node involvement was observed in 51 patients. The primary lesions were located in the nasal cavity in 92 cases and in the Waldeyer ring in 26 cases. Five patients had received RT followed by CT (RT + CT), 20 patients had received CT followed by RT (CT + RT), 90 patients had received CT followed by RT, again followed by CT (CT+RT+CT), and 3 patients had received concurrent chemoradiotherapy (CRT) (1 patient received CRT + CT, other 2 patients received CT+CRT+CT). Patients were irradiated with a median dose of 50 Gy (range, 24-61.2). All patients received chemotherapy, 91 received non-anthracycline-based chemotherapy, whereas 27 patients received anthracycline-based chemotherapy. The median number of courses of chemotherapy was four (range: 1-10). Patients were scored as having low-risk disease (n = 50), intermediate-risk disease (n = 60) or high-risk disease (n = 8) according to the prognostic index of natural killer cell lymphoma (PINK).

RESULTS

Among the 118 patients, after initial therapy, the complete response (CR) rate was 82.2% (n = 97), and the partial response (PR) rate was 11.0% (n = 13). The stable disease (SD) rate was 2.5% (n = 3), and the progressive disease (PD) rate was 4.2% (n = 5). With a median follow-up of 43 months (range, 4-201) after irradiation, the 3-year PFS and OS were 76.9% and 82.9%, respectively. The 3-year OS rate was 75.0% for RT + CT, 70.0% for CT + RT, 87.1% for CT + RT+ CT, and 50.0% for CRT (P = 0.052). Three-year OS and PFS were 88.6% and 83.4%, respectively, for non-anthracycline-based chemotherapy regimen compared to 61.6% (P = 0.001) and 58.4% (P = 0.003), respectively, for the anthracycline-based chemotherapy regimen. Three-year OS and PFS were 84.0% and 79.0%, respectively, for patients receiving high-dose RT (≥50 Gy, n = 111) compared to 71.4% (P = 0.076) and 71.4% (P = 0.228), respectively, for low-dose RT (<50 Gy, n = 7). In multivariate analysis, adverse factors associated with OS in our study were chemotherapy regimen and response to RT and CT (P = 0.047, <0.001).

CONCLUSION

Radiotherapy combined with chemotherapy reported promising response rate and a favorable survival for patients with stage I-II nasal ENKTL. Anthracycline-based chemotherapy regimen and no remission after RT and CT were adverse factors of OS.

An Identification Method for Irregular Components Related to Terminal Blocks in Equipment Cabinet of Power Substation

Despite the continuous advancement of intelligent power substations, the terminal block components within equipment cabinet inspection work still often require loads of personnel. The repetitive documentary works not only lack efficiency but are also susceptible to inaccuracies introduced by substation personnel. To resolve the problem of lengthy, time-consuming inspections, a terminal block component detection and identification method is presented in this paper. The identification method is a multi-stage system that incorporates a streamlined version of You Only Look Once version 7 (YOLOv7), a fusion of YOLOv7 and differential binarization (DB), and the utilization of PaddleOCR. Firstly, the YOLOv7 Area-Oriented (YOLOv7-AO) model is developed to precisely locate the complete region of terminal blocks within substation scene images. The compact area extraction model rapidly cuts out the valid proportion of the input image. Furthermore, the DB segmentation head is integrated into the YOLOv7 model to effectively handle the densely arranged, irregularly shaped block components. To detect all the components within a target electrical cabinet of substation equipment, the YOLOv7 model with a differential binarization attention head (YOLOv7-DBAH) is proposed, integrating spatial and channel attention mechanisms. Finally, a general OCR algorithm is applied to the cropped-out instances after image distortion to match and record the component's identity information. The experimental results show that the YOLOv7-AO model reaches high detection accuracy with good portability, gaining 4.45 times faster running speed. Moreover, the terminal block component detection results show that the YOLOv7-DBAH model achieves the highest evaluation metrics, increasing the F1-score from 0.83 to 0.89 and boosting the precision to over 0.91. The proposed method achieves the goal of terminal block component identification and can be applied in practical situations.

A single center retrospective study assessing the prognostic significance of pre-treatment neutrophil/lymphocyte ratio in locally advanced nasopharyngeal carcinoma

Background

In light of the growing evidence suggesting the impact of inflammatory parameters on the survival of individuals with cancer, this research assessed the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in individuals diagnosed with locally advanced nasopharyngeal carcinoma (NPC) prior to undergoing intensity-modulated radiation therapy (IMRT).

Methods

A total of 163 individuals diagnosed with locally advanced NPC treated with IMRT at our hospital between January 2012 and December 2017 were included in this research. For each patient, the absolute counts of neutrophils and lymphocytes were recorded, and the NLR was calculated at the first diagnosis. To determine the optimal cut-off values for NLR, receiver operating characteristic (ROC) curve analysis was conducted. The effects of the determined cut-off value on local failure-free survival (LFFS), overall survival (OS), progression-free survival (PFS), and distant failure-free survival (DFFS) were evaluated employing the Cox regression model.

Results

The median follow-up duration for the individuals in this study was 15 months (ranging from 6 to 79 months). According to the determined NLR cut-off value of 3.27, individuals were classified into two groups (high NLR and low NLR). Individuals in the high-NLR group had remarkably poorer 3-year OS (62.8% vs. 91.7%), PFS (51.4% vs. 82.4%), and DFFS (70.7% vs. 89.6%) compared to the low-NLR group. Furthermore, the outcomes of univariate and multivariate survival analyses revealed that NLR served as an independent predictor of DFFS (HR: 2.81, 95% CI: 1.195-6.608, P=0.018), OS (HR: 3.1, 95% CI: 1.211-7.935, P=0.018), and PFS (HR: 2.21, 95% CI: 1.133-4.292, P=0.02).

Conclusions

Elevated NLR exhibited a significant correlation with reduced OS, DFFS, and PFS. These findings suggest that NLR holds promise as a cost-effective and reliable marker for the prediction of clinical outcomes among patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Furthermore, incorporating NLR into clinical decision-making regarding LANPC treatment strategies may contribute to a more targeted approach aimed at reducing the risk of distant failure.

SETD2 variation correlates with tumor mutational burden and MSI along with improved response to immunotherapy

BACKGROUND

SETD2 protects against genomic instability via maintenance of homologous recombination repair (HRR) and mismatch repair (MMR) in neoplastic cells. However, it remains unclear whether SETD2 dysfunction is a complementary or independent factor to microsatellite instability-high (MSI-H) and tumor mutational burden-high (TMB-H) for immunocheckpoint inhibitor (ICI) treatment, and little is known regarding whether this type of dysfunction acts differently in various types of cancer.

METHODS

This cohort study used multidimensional genomic data of 6726 sequencing samples from our cooperative and non-public GenePlus institute from April 1 through April 10, 2020. MSIsensor score, HRD score, RNAseq, mutational data, and corresponding clinical data were obtained from the TCGA and MSKCC cohort for seven solid tumor types.

RESULTS

A total of 1021 genes underwent target panel sequencing reveal that SETD2 mutations were associated with a higher TMB. SETD2 deleterious mutation dysfunction affected ICI treatment prognosis independently of TMB-H (p < 0.01) and had a lower death hazard than TMB-H in pancancer patients (0.511 vs 0.757). Significantly higher MSI and lower homologous recombination deficiency were observed in the SETD2 deleterious mutation group. Improved survival rate was found in the MSKCC-IO cohort (P < 0.0001) and was further confirmed in our Chinese cohort.

CONCLUSION

We found that SETD2 dysfunction affects ICI treatment prognosis independently of TMB-H and has a lower death hazard than TMB-H in pancancer patients. Therefore, SETD2 has the potential to serve as a candidate biomarker for ICI treatment. Additionally, SETD2 should be considered when dMMR is detected by immunohistochemistry.

The Practical Access to Fluoroalkylated Pyrazolo[1,5-c]quinazolines by Fluoroalkyl-Promoted [3 + 2] Cycloaddition Reaction

The efficient synthesis of fluoroalkylated pyrazolo[1,5-c]quinazolines by reactions of 3-diazoindolin-2-ones with methyl β-fluoroalkylpropionates has been achieved. This protocol affords two regioisomers of fluoroalkylated pyrazolo[1,5-c]quinazolines with excellent yields in total. The dipolarophilicity of methyl β-fluoroalkylpropionates enhanced by perfluoroalkyl groups is crucial for the high efficiency of this [3 + 2] cycloaddition reaction.

Pinellia ternata (Thunb.) Breit. Attenuates the allergic airway inflammation of cold asthma via inhibiting the activation of TLR4-medicated NF-kB and NLRP3 signaling pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Pinellia ternata (Thunb.) Breit. (PT) has been demonstrated to be effective against the allergic airway inflammation (AAI) in clinical practices, especially in cold asthma (CA). Until now, the active ingredients, protective effect, and possible mechanism of PT against CA remain unknown.

AIM OF THE STUDY

The aim of this investigation was to examine the therapeutic impact and elucidate the underlying mechanism of PT on the AAI of CA.

METHODS

The compositions of PT water extract were determined via the UPLC-Q-TOF-MS/MS. The ovalbumin (OVA) and cold-water baths were used to induce CA in female mice. Morphological characteristic observations, expectorant effect, bronchial hyperreactivity (BHR), excessive mucus secretion, and inflammatory factors were used to uncover the treatment effect of PT water extract. In addition, the mucin 5AC (MUC5AC) mRNA and protein levels and the aquaporin 5 (AQP5) mRNA and protein levels were detected via qRT-PCR, immunohistochemistry (IHC), and western blotting. Moreover, the protein expressions associated with the TLR4, NF-κB, and NLRP3 signaling pathway were monitored by western blot analysis.

RESULTS

Thirty-eight compounds were identified from PT water extract. PT showed significant therapeutic effects on mice with cold asthma in terms of expectorant activity, histopathological changes, airway inflammation, mucus secretion, and hyperreactivity. PT exhibited good anti-inflammatory effects in vitro and in vivo. The expression levels of MUC5AC mRNA and protein decreased significantly, while AQP5 expression levels increased significantly in the lung tissues of mice after administration with PT as compared to mice induced by CA. Furthermore, the protein expressions of TLR4, p-iκB, p-p65, IL-1β, IL-18, NLRP3, cleaved caspase-1, and ASC were markedly reduced following PT treatment.

CONCLUSIONS

PT attenuated the AAI of CA by modulating Th1- and Th2-type cytokines. PT could inhibit the TLR4-medicated NF-kB signaling pathway and activate the NLRP3 inflammasome to reduce CA. This study provides an alternative therapeutic agent of the AAI of CA after administration with PT.

[Electroencephalographic microstates in vestibular schwannoma patients with tinnitus]

OBJECTIVE

To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology.

METHODS

The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package.

RESULTS

Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031).

CONCLUSION

EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.

Oxidase Heterotetramer Completes 1-Azabicyclo[3.1.0]hexane Formation with the Association of a Nonribosomal Peptide Synthetase

Ficellomycin, azinomycins, and vazabitide A are nonribosomal peptide natural products characterized by an amino acid unit that contains a similar 1-azabicyclo[3.1.0]hexane (ABCH) pharmacophore. This unit is derived from diamino-dihydroxy-heptanic acid (DADH); however, the process through which linear DADH is cyclized to furnish an ABCH ring system remains poorly understood. Based on the reconstitution of the route of the ABCH-containing unit by blending genes/enzymes involved in the biosynthesis of ficellomycin and azinomycins, we report that ABCH formation is completed by an oxidase heterotetramer with the association of a nonribosomal peptide synthetase (NRPS). The DADH precursor was prepared in Escherichia coli to produce a conjugate subjected to in vitro enzymatic hydrolysis for offloading from an amino-group carrier protein. To furnish an aziridine ring, DADH was processed by C7-hydroxyl sulfonation and sulfate elimination-coupled cyclization. Further cyclization leading to an azabicyclic hexane pharmacophore was proved to occur in the NRPS, where the oxidase heterotetramer functions in trans and catalyzes α,β-dehydrogenation to initiate the formation of a fused five-membered nitrogen heterocycle. The identity of ABCH was validated by utilization of the resultant ABCH-containing unit in the total biosynthesis of ficellomycin. Biochemical characterization, crystal structure, and site-specific mutagenesis rationalize the catalytic mechanism of the unusual oxidase heterotetramer.

Selective detection of peroxynitrite using an isatin receptor and a naphthalimide fluorophore

Peroxynitrite is a reactive oxygen and nitrogen species that participates in various biological reactions. Therefore, it is important to readily detect and track peroxynitrite in biological systems. Here, a novel turn-on probe encapsulated in PEG DSPE-PEG/HN-I was used to fluorescently detect ONOO^- rapidly. The encapsulation of HN-I using DSPE-PEG2000 optimizes the sensing performances of the naphthalimide probe and avoids ACQ. Using DSPE-PEG/HN-I to detect changes in the levels of exogenous ONOO^- in HepG2 cells and endogenous ONOO^- induced by LPS in RAW 267.4 cells was demonstrated.

A new polysaccharide from Hawk tea: Structural characterization and immunomodulatory activity associated with regulating gut microbiota

In this study, a novel 28.6 kDa acidic polysaccharide (HTP-1), containing → 4)-GalpA-(1→, →2)-Rhap-(1 → and → 3,6)-Galp-(1 → residues as the backbone, analogous to pectin, was isolated from mature Hawk tea leaves. HTP-1 exhibited significant immunoregulatory activities on CTX-induced immunosuppressed mice in a dose-depend manner by alleviating jejunum injury and improving the levels of immune organ indexes, cytokines and immunoglobulins. Moreover, HTP-1 supplementation boosted the content of SCFAs, altered the intestinalmicrobiota composition, and raised the abundances of beneficial bacteria Muribaculaceae, Lactobacillaceae, Bacteroidaceae, Prevotellaceae and Ruminococcaceae, which showed a strong positive correlation with most immune indicators. The current findings suggested that the immunomodulatory action of HTP-1 might rely on the regulation of the gut microbiota, and these results may also serve as a foundation for the future exploitation of HTP-1 as functional foods.

Mechanism of Qingre Huoxue Fang treatment on inhibiting angiogenesis of rheumatoid arthritis based on network pharmacology and in vitro experiments

This study aimed to explore the mechanism of Qingre Huoxue Fang (QRHXF) treatment on anti-angiogenesis in rheumatoid arthritis (RA) based on network pharmacology and in vitro experiments. We used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Therapeutic Target (TTD) database to extract the active components of QRHXF and potential targets for regulating angiogenesis. First, we used Cytoscape bioinformatics software to construct the network of QRHXF-angiogenesis and screened the potential targets. Then, we performed gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis on the potential core targets. In addition, enzyme-linked immune assay and Western blot were used for in vitro validation and to verify the effects of different concentrations of QRHXF on the expression levels of the vascular endothelial growth factor receptor type 1 (VEGFR-1) and VEGFR-2 cytokines and phosphoinositide 3-kinase (PI3k) and Ak strain transforming (Akt) proteins in human umbilical vein endothelial cells (HUVECs). In results, we screened 179 core QRHXF antiangiogenic targets, including vascular endothelial growth factor (VEGF) cytokines. Enrichment analysis showed that the targets were enriched in 56 core signaling pathways, including PI3k and Akt. In vitro experiments showed that the migration distance and square, adhesion optical density (OD) values, and the number of branch points in tube formation significantly decreased in the QRHXF group compared with the induced group (P<0.01). Notably, the serum levels of VEGFR-1 and VEGFR-2 were lower compared with the induced group (P<0.05 or P<0.01). In addition, the expressions of PI3K and p-Akt proteins were decreased in the middle- and high doses groups (P<0.01). This study's results suggest that the downstream mechanism of QRHXF anti-angiogenesis might inhibit the PI3K-Akt signalling pathway and downregulate VEGF-1 and VEGF-2.

Mechanism of Qingre Huoxue Fang treatment on inhibiting angiogenesis of rheumatoid arthritis based on network pharmacology and in vitro experiments

This study aimed to explore the mechanism of Qingre Huoxue Fang (QRHXF) treatment on anti-angiogenesis in rheumatoid arthritis (RA) based on network pharmacology and in vitro experiments. We used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Therapeutic Target (TTD) database to extract the active components of QRHXF and potential targets for regulating angiogenesis. First, we used Cytoscape bioinformatics software to construct the network of QRHXF-angiogenesis and screened the potential targets. Then, we performed gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis on the potential core targets. In addition, enzyme-linked immune assay and Western blot were used for in vitro validation and to verify the effects of different concentrations of QRHXF on the expression levels of the vascular endothelial growth factor receptor type 1 (VEGFR-1) and VEGFR-2 cytokines and phosphoinositide 3-kinase (PI3k) and Ak strain transforming (Akt) proteins in human umbilical vein endothelial cells (HUVECs). In results, we screened 179 core QRHXF antiangiogenic targets, including vascular endothelial growth factor (VEGF) cytokines. Enrichment analysis showed that the targets were enriched in 56 core signaling pathways, including PI3k and Akt. In vitro experiments showed that the migration distance and square, adhesion optical density (OD) values, and the number of branch points in tube formation significantly decreased in the QRHXF group compared with the induced group (P<0.01). Notably, the serum levels of VEGFR-1 and VEGFR-2 were lower compared with the induced group (P<0.05 or P<0.01). In addition, the expressions of PI3K and p-Akt proteins were decreased in the middle- and high doses groups (P<0.01). This study's results suggest that the downstream mechanism of QRHXF anti-angiogenesis might inhibit the PI3K-Akt signalling pathway and downregulate VEGF-1 and VEGF-2.

Unusual Talaromyces marneffei and Pneumocystis jirovecii coinfection in a child with a STAT1 mutation: A case report and literature review

Talaromyces marneffei and Pneumocystis jirovecii are the common opportunistic pathogens in immunodeficient patients. There have been no reports of T. marneffei and P. jirovecii coinfection in immunodeficient children. Signal transducer and activator of transcription 1 (STAT1) is a key transcription factor in immune responses. STAT1 mutations are predominately associated with chronic mucocutaneous candidiasis and invasive mycosis. We report a 1-year-2-month-old boy diagnosed with severe laryngitis and pneumonia caused by T. marneffei and P. jirovecii coinfection, which was confirmed by smear, culture, polymerase chain reaction and metagenome next-generation sequencing of bronchoalveolar lavage fluid. He has a known STAT1 mutation at amino acid 274 in the coiled-coil domain of STAT1 according to whole exome sequencing. Based on the pathogen results, itraconazole and trimethoprim-sulfamethoxazole were administered. This patient's condition improved, and he was discharged after two weeks of targeted therapy. In the one-year follow-up, the boy remained symptom-free without recurrence.

[Status and related factors on the drinking behavior among primary and secondary students in China rural middle and western regions in 2019]

Objective: To analyze the daily drinking behavior and related factors of primary and middle school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) pilot regions. Methods: Multi-stage stratified random cluster sampling method was used to select one to three national pilot counties in 22 provinces in central and western China where the NIPRCES was implemented in 2019. According to different feeding patterns, two primary schools and two middle schools were selected as key monitoring schools. One or two classes were selected from grade 3 to grade 9. The student questionnaire was used to collect the basic information and daily drinking behavior. Taking whether the drinking water ≥5 cups every day as the dependent variable, multivariate logistic regression model was used to analyze the related factors of drinking behavior among students. Results: A total of 27 374 students were included. On average, primary and middle school students in the regions where NIPRCES was implemented had 3.9 cups of water every day. Logistic regression model showed that boys (OR=1.230, P<0.001), primary school students (OR=1.379, P<0.001), father worked outside the home (OR=1.169, P<0.001), both parents worked outside the home (OR=1.228, P<0.001), non-resident students (OR=1.142, P<0.001), the school in the village (OR=1.638, P<0.001) or township (OR=1.358, P<0.001), school feeding (OR=1.252, P<0.001), the school building with flush toilets (OR=1.384, P<0.001) and the central regions (OR=1.300, P<0.001) students were more likely to drink ≥5 cups water every day. Conclusion: The water consumption of primary and middle school students in the pilot regions of NIPRCES is low, and their drinking behaviors are affected by many factors.

The tRNA-Cys-GCA Derived tsRNAs Suppress Tumor Progression of Gliomas via Regulating VAV2

The tsRNAs (tRNA-derived small RNAs) are new types of small noncoding RNAs derived from tRNAs. Gliomas are well-known malignant brain tumors. The study focused on tsRNA characterizations within gliomas. Datasets processing, bioinformatics analyses, and visualizations were performed with the packages of Python and R. Cell proliferations were demonstrated via CCK8 assays and colony formation assays, and in vivo xenograft experiments. Dual-luciferase reporter assay was performed to confirm the binding of tsRNA with its targets. Via using bioinformatics approaches, the hundreds of tsRNAs with available expression abundance were identified in gliomas dataset, most of them derived from D-loop or T-loop fragments of tRNAs. Among tsRNAs derived from tRNA-Cys-GCA, tRFdb-3003a and tRFdb-3003b (tRFdb-3003a/b) were remarkably down-regulated in gliomas. The survival outcome of gliomas patients with low tRFdb-3003a/b expressions was notably worse than that of high-expression patients. In glioma cells, tRFdb-3003a could suppress cells proliferation and colony formation ability. In vivo, tRFdb-3003a suppressed the tumor growth of xenograft gliomas. Enrichment analyses displayed the tRFdb-3003a-related mRNAs were enriched in the specific GO terms, spliceosome and autophagy pathways, and three GSEA molecular signatures. Mechanically, 3'-UTR regions of VAV2 mRNA were predicted to contain the binding positions of tRFdb-3003a/b, tRFdb-3003a and tRFdb-3003b was effective to reduce the relative luciferase activity of cells with VAV2 wild-type reporter. Overexpression of tRFdb-3003a/b could down-regulated the expression levels of VAV2 protein and mRNA in glioma cells. The tRNA-Cys-GCA derived tRFdb-3003a and tRFdb-3003b might act as key player in tumor progressions of gliomas; tRFdb-3003a/b might directly bind to VAV2 and regulate VAV2 expressions in gliomas.

DR0022 from Deinococcus radiodurans is an acid uracil-DNA glycosylase

Uracil-DNA glycosylase (UDG) initiates base excision repair (BER) by removing damaged or modified nucleobases during DNA repair or mammalian demethylation. The UDG superfamily consists of at least six families with a variety of catalytic specificities and functions. Deinococcus radiodurans, an extreme radiation resistant bacterium, contains multiple members of UDG enzymes within its genome. The present study reveals that the putative protein, DR0022, is a uracil-DNA glycosylase that requires acidic conditions for its glycosylase activity, which is the first case of such an enzyme within the UDG superfamily. The key residues in the catalytic motifs are investigated by biochemical, enzyme kinetics, and de novo structural prediction, as well as molecular modeling analyses. The structural and catalytic roles of several distinct residues are discussed in light of predicted and modeled DR0022 glycosylase structures. The spontaneous mutation rate analysis performed in a dr0022 deficient D. radiodurans strain indicated that the dr0022 gene plays a role in mutation prevention. Furthermore, survival rate analysis in a dr0022 deficient D. radiodurans strain demonstrated its role in stress resistance, including γ-irradiation. Additionally, the novel acid UDG activity in relationship to its in vivo roles is discussed. This work underscores the functional diversity in the UDG superfamily.

[Overweight and obesity status and its associated factors among primary and secondary school students in China rural middle and western regions]

Objective: To analyze the overweight and obesity status of students in the national pilot counties of the Nutrition Improvement Program for Rural Compulsory Education Students in 2019 and its associated factors. Methods: In 2019, a multi-stage cluster random sampling method was used to select about 40 students from each grade in primary and secondary schools in China's central and western regions where the Nutrition Improvement Program for Rural Compulsory Education Students was implemented. The height and weight of the children were measured using height or weight scales. The school questionnaire and county questionnaire were used to investigate the associated factors. A Chi-square test was used for comparison between groups. The logistic regression analysis was used to analyze the associated factors. Results: In 2019, the prevalence of overweight and obesity among rural primary and secondary school students aged 6-15 years in central and western China 2019 was 11.5%. It was higher for boys (13.1%) than that for girls (9.8%), higher in central (14.3%) than that in the west (9.9%) and higher for elementary school students (12.4%) than that for secondary school students (9.5%, all P<0.001). The logistic regression showed that boys (OR=1.388), primary school students (OR=1.271), students without other dietary subsidies(OR=1.037), schools in rural areas (OR=1.133), schools with enterprise-based feeding mode (OR=1.043), schools without the provision of lunch (OR=1.143), schools without the provision of dinner (OR=1.122), and schools without providing drinking water (OR=1.015) were positively associated with overweight and obesity among students (P<0.05). Schools with snack shops (OR=0.952) were negatively associated with overweight and obesity among students (P<0.001). Conclusion: A certain proportion of primary and secondary school students in rural areas of central and western China are overweight and obese. The prevalence is not only related to children's gender, school section and county area but also related to school meals, whether schools provide drinking water and other factors.

[The 498th case: rash, fever and hematuria]

A 50-year-old man was admitted to the Department of Rheumatology at Peking Union Medical College Hospital with rash for 6 months, and fever and hematuria for 5 months. The main clinical manifestations included fever, fatigue, purpura, hematuria and thrombocytopenia. He was positive for antinuclear antibody (ANA), anti-neutrophil cytoplasmic antibodies (ANCA) and rheumatoid factor (RF), and had low complement levels. Initial blood culture, echocardiography and chest CT showed no signs of infection. Diagnosis of connective tissue disease was made initially. His disease improved under treatment with glucocorticoids and immunosuppressive agents, but relapsed when glucocorticoids were tapered. After admission, the diagnosis was reconsidered, and infective endocarditis was finally diagnosed with repeated positive blood cultures and vegetations detected by transesophageal echocardiography. Amoxicillin and clavulanate potassium were initiated, and surgery was performed. His symptoms finally recovered gradually.

[Perspectives on recent monkeypox outbreak in non-endemic areas]

Monkeypox is a rare infectious disease caused by the monkeypox virus, which used to occur endemically in central and western Africa. As of 25th May, a total of 219 recently confirmed cases of monkeypox have been reported from 19 non-endemic countries. This outbreak unusually takes place in non-endemic areas for monkeypox virus and has exhibited features of high risk of human-to-human transmission. Onset of multiple human monkeypox cases may be related to the decreased level of herd cross-immunity after the cessation of smallpox vaccination. Moreover, behavioral patterns in specific populations may account for the human-to-human transmission in this outbreak. Currently, possibility of global epidemic of monkeypox is extremely low, but China should be cautious about risks of importation of monkeypox cases. The key to prevention and control is to establish a surveillance system to identify suspicious cases and close contacts as soon as possible.

Antitumor Potential and Structure Characterization of Polysaccharides From Lagotis brevituba Maxim in the Tibetan Plateau

This study purified two polysaccharides (LBMPs) from Lagotis brevituba Maxim in several steps. The chemical structure of LBMP-2 was determined by HPGPC, FT-IR, IC, ¹H and ¹³C NMR, AFM, SEM, and TEM. The results show that LBMP-2 was mainly composed of GalA, and the Mw of LBMP-2 is 23.799 kDa. In addition, the antioxidant activity, and the antitumor activity in vitro and in vivo were studied. LBMP-2 has excellent antioxidant and antitumor capacity. The inhibition of tumor cell proliferation in vitro may result in the inhibition of aerobic respiration and glycolysis. Tumor growth inhibition in vivo may inhibit the expression of AMPK in tumors and enhance spleen function. Compared with conventional chemotherapy drug cyclophosphamide, LBMP-2 is less harmful to the body and safer. Therefore, LBMP-2 provides a potential source of antitumor drugs.

[Exploration on teaching reform of cancer epidemiology course]

This study aims to explore optimized teaching mode of cancer epidemiology for undergraduates, and provide scientific ideas and basis for improving teaching quality. Non-randomized concurrent control study was used. Undergraduates, enrolled in 2018, from the department of preventive medicine in A and B medical universities were selected as research objects. Traditional teaching mode was used for cancer epidemiology course in A medical university, and innovative teaching mode named "one core, four dimensions" was adopted in B medical university. After the course, questionnaire method was used to investigate self-cognition of students, teaching satisfaction and class preparation time of teachers in B Medical University. The post-class test method was used to compare the students' grades of cancer epidemiology in the two universities. The results indicated that among the 58 students of B medical university, 94.83% (55/58) students were familiar with common types of epidemiological studies and 86.21% (50/58) mastered the evaluation indicators of screening research. Among the nine teaching faculties from B medical university, seven reported that the new teaching plan helped students to learn frontier knowledge of cancer epidemiology, and eight reported the new teaching model was conducive to the interaction between teachers and students. The text score of students in B medical university was 50.34±4.90, significantly higher than that in A medical university (46.21±4.91, t=5.20, P<0.001). The optimized teaching mode of cancer epidemiology is highly praised by students and teachers, which has the potential to improve students' grasp of cancer epidemiology, the ability to combine theory with practice, and the teaching effect of cancer epidemiology.

[Clinical features and influencing factors of long-term prognosis in patients with tuberculous meningitis]

Objective: To investigate the clinical features and influencing factors of long-term prognosis of tuberculous meningitis(TBM), and to provide a recommendation for treatment and early intervention of TBM. Methods: Clinical data of TBM patients were retrospectively collected at Peking Union Medical College Hospital from January 2014 to December 2021. Patients who were followed-up more than one year were divided into two groups according to modified Rankin Scale (mRS). Risk factors associated with long-term prognosis were analyze by conditional logistic stepwise regression. Results: A total of 60 subjects were enrolled including 33 (55%) males and 27 (45%) females with age 15-79 (44.5±19.8) years. There were 30 cases (50%) complicated with encephalitis, 21 cases (35%) with miliary tuberculosis. The diagnosis was microbiologically confirmed in 22 patients (36.7%), including 5 cases (22.7%, 5/22) by acid-fast staining, 8 cases (36.4%, 8/22) by Mycobacterium tuberculosis (MTB) culture, and 20 cases (90.9%, 20/22) by molecular biology. The median follow-up period was 52(43, 66 ) months in 55 cases surviving more than one year. Among them, 40 cases (72.7%) were in favorable group (mRS 0-2) and 15 cases (27.3%) were in unfavorable group (mRS 3-6) with poor prognosis. The mortality rate was 20% (11/55). Elderly (OR=1.06, P=0.048 ) , hyponatremia(OR=0.81,P=0.020), high protein level in cerebrospinal fluid (CSF) (OR=3.32,P=0.033), cerebral infarction(OR=10.50,P=0.040) and hydrocephalus(OR=8.51,P=0.049) were associated with poor prognosis in TBM patients. Conclusions: The mortality rate is high in patients with TBM. Molecular biology tests improves the sensitivity and shorten the diagnosis time of TBM. Elderly, hyponatremia, high protein level in CSF, cerebral infarction and hydrocephalus are independent risk factors of long-term survival in TBM patients.

Vector textures derived from higher order derivative domains for classification of colorectal polyps

Textures have become widely adopted as an essential tool for lesion detection and classification through analysis of the lesion heterogeneities. In this study, higher order derivative images are being employed to combat the challenge of the poor contrast across similar tissue types among certain imaging modalities. To make good use of the derivative information, a novel concept of vector texture is firstly introduced to construct and extract several types of polyp descriptors. Two widely used differential operators, i.e., the gradient operator and Hessian operator, are utilized to generate the first and second order derivative images. These derivative volumetric images are used to produce two angle-based and two vector-based (including both angle and magnitude) textures. Next, a vector-based co-occurrence matrix is proposed to extract texture features which are fed to a random forest classifier to perform polyp classifications. To evaluate the performance of our method, experiments are implemented over a private colorectal polyp dataset obtained from computed tomographic colonography. We compare our method with four existing state-of-the-art methods and find that our method can outperform those competing methods over 4%-13% evaluated by the area under the receiver operating characteristics curves.

Hawk tea prevents high-fat diet-induced obesity in mice by activating the AMPK/ACC/SREBP1c signaling pathways and regulating the gut microbiota

Scope: Hawk tea, a non-Camellia tea, is an ancient tea drink from southwest China and has been proven to exhibit significant hypoglycaemic and lipid-lowering effects. The aim of this study was to evaluate whether Hawk tea extract (HTE) can improve obesity induced by a high-fat diet (HFD) in a mouse model and to determine whether its anti-obesity effects are related to improvements in lipid metabolism and the gut microbiota. Methods and results: We tested the ability of HTE to prevent obesity and regulate gut microbiota in C57BL/6J mice fed with a HFD. We found that HTE significantly reduced body weight, fat deposition, serum triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels, and significantly increased serum levels of high-density lipoprotein cholesterol (HDL-C) induced by HFD. HTE also increased the levels of AMPK and ACC phosphorylation, up-regulated the expression of CPT-1, and downregulated the expression of SREBP1c and FAS. In addition, the administration of HTE significantly altered the composition of the gut microbiota, reduced the ratio of Firmicutes to Bacteroidetes, increased the relative abundance of Akkermansia muciniphila, Bacteroides-vulgatus, and Faecalibaculum_rodentium, and decreased the relative abundance of Desulfovibrionaceae and Lachnospiraceae. Conclusions: Collectively, our data demonstrate that HTE can prevent HFD-induced obesity by regulating the AMPK/ACC/SREBP1c signaling pathways and the gut microbiota.

TFA-Promoted Intermolecular Friedel-Crafts Alkylation of Arenes with 2,2,2-Trifluoroethylaryl Sulfoxides

The classical Pummerer rearrangement of 2,2,2-trifluoroethylaryl sulfoxide with trifluoracetic anhydride (TFAA) affords the S , O -acetal efficiently. In the presence of trifluoracetic acid (TFA) as the co-solvent, the S , O -acetal can regenerate reactive thionium intermediate of Pummerer rearrangement. When employing arenes as nucleophiles, this strategy produces corresponding 1-thiyl-2,2,2-trifluoroethyl arenes with excellent yields under metal-free conditions.

[Anemia prevalence and its influencing factors among students involved in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze anemia prevalence and its influencing factors of students involved in the Nutritional Improvement Program for Rural Compulsory Education Students in 2019. Methods: From the 2019 surveillance system of the Nutrition Improvement Program for Rural Compulsory Education Students, 47 297 primary and middle school students aged 6-17 were included in the study. Hemoglobin level was tested according to the criteria of WHO 2011. Anemia prevalence of different genders, ages, and regions was analyzed. Results: The average hemoglobin level was 135.19 g/L, with the prevalence of anemia as 8.7% in the children aged 6-17. The prevalence of anemia was 10.0% in girls, higher than that in boys (7.4%). The prevalence rates in western and central areas were 9.8% and 7.1%, respectively. From northwest, southwest, central and south, east, north to northeast areas of China, the anemia rate appeared gradually decreasing (10.2%, 9.7%, 8.3%, 7.5%, 5.7% and 3.5%). The anemia prevalence rates were 8.0%, 8.3%, and 10.9% in children from the 6-, 11-, and 14-17 years age groups, respectively. Logistic regression models revealed that students from schools not using catering software (OR=1.482, 95%CI:1.296-1.694,P<0.001), schools not serving lunch (OR=1.241, 95%CI:1.103-1.395,P<0.001), and from relatively low-income families (OR=1.297, 95%CI:1.211-1.389, P<0.001) showed as risk factors for anemia. After supplementing students' dietary factors, the results showed that students who ate meat three or more times a week had a lower risk of anemia (OR=0.907, 95%CI:0.832-0.989, P=0.026). Conclusions: The Nutritional Improvement Program for Rural Compulsory Education Students had an essential impact on improving the anemia prevalence of primary and middle school students. Family income, school location, economic factors, school feeding, and students' diet programs all impacted the prevalence of anemia.

[Growth retardation of children and its influencing factors in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To understand the growth retardation among primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students and its influencing factors to provide evidence for improving the nutrition status of rural students in China. Methods: The multi-stage cluster random sampling method selected 1 550 969 primary and secondary school students aged 6-15 years from China's central and western regions. The ratio of male and female students was balanced. The height was measured, and the growth retardation of students was determined according to the Screening Criteria for School-age Children and Adolescents malnutrition (WS/T 456-2014), from the school and county questionnaire survey related factors. The number of cases and percentages described the growth retardation of students, and the χ² test was used for comparison between groups. Binary logistic regression was used to analyze students' growth retardation factors. Results: In 2019, the growth retardation rate of primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students was 5.7% (88 631/1 550 969), the growth retardation rate in the western part (7.1%, 66 167/927 954) was higher than that in the central part (3.7%,19 511/533 973) with difference statistically significant (P<0.001). The growth retardation rate of the boys (6.3%,50 665/803 851) were higher than that of girls (5.1%, 37 966/747 118), the difference was statistically significant (P<0.001). The growth retardation rate of primary school students in central China was 3.9%(14 914/380 598), higher than that of junior middle school students (3.0%,4 597/153 375, P<0.001). In contrast, the growth retardation rate of the western junior high school students (7.2%, 21 494/297 217) were higher than that of elementary school students (7.1%, 44 673/630 737), with a difference statistically significant (all P=0.009). Multi-factor logistic regression results showed that, in high income area (OR=0.829, 95%CI: 0.816-0.842, P<0.001), parents providing part of the meal cost (OR=0.948, 95%CI: 0.931-0.965, P<0.001), enterprises providing meals (OR=0.845, 95%CI: 0.805-0.887, P<0.001), schools providing milk (OR=0.780, 95%CI: 0.767-0.793, P<0.001), health education courses (OR=0.702, 95%CI: 0.682-0.723, P<0.001) and other local nutrition improvement efforts (OR=0.739, 95%CI: 0.720-0.758, P<0.001) were negatively correlated with the occurrence of growth retardation, The growth retardation rate of the students was lower. Conclusions: There appeared significant regional, gender, and age differences in the growth retardation rate of primary and middle school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students. Appropriate food supply in schools, health education courses, and parental participation in nutritional improvement was related to children's lower growth retardation rate.

[Status and influencing factors on the leftover school meals among students the Nutrition Improvement Program for Rural Compulsory Education Students in 2019]

Objective: To analyze the situation and influencing factors of school meals leftover among primary and secondary school students in the area of the Nutrition Improvement Program for Rural Compulsory Education Students, improve the quality of school meals, develop healthy dietary behavior, and reduce food waste. Methods: In 2019, among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns.This study randomly selected one or two classes from grade 3 to grade 9. Basic information and school meals of 26 778 students were collected by using a student questionnaire. Multivariate logistic regression was used to analyze the influencing factors of leftovers rate. Results: 54.93% (14 709) of students wasted school meals, in which the highest rate was the staple food, with the main reason as "not in favor". 11.87% (1 743) of the students wasted school meals 6-7 days a week, with 54.20% (7 957) of students wasted but in less amount. The leftover rate of staple food was the highest (29.78%), followed by vegetables and meat. The main reason of leftovers was that they didn't like this kind of food (33.52%). The rate of school meal waste was higher for girls (OR=1.19,95%CI:1.13-1.25), junior high school students (OR=1.17, 95%CI: 1.11-1.25), resident students (OR=1.06, 95%CI: 1.00-1.12), lower economic level (OR=1.06, 95%CI: 1.00-1.12), parents working outside their houses (OR=1.22, 95%CI: 1.13-1.30), health education classes (OR=1.70, 95%CI: 1.40-2.06), company-based meals (OR=1.89, 95%CI: 1.71-2.07) and school meals were not as good as home food(OR=1.89, 95%CI: 1.78-2.00)(P<0.05). Conclusions: It is common for poor rural primary and middle school students in central and western China to waste school meals, and the reasons were affected by many factors. Reducing food waste requires the joint efforts of individuals, families, schools and society.

anti-Markovnikov Iodofluorination of Alkenes

The fluorination of alkenes with electrophilic N-F type reagents usually occurs through a Markovnikov-type addition, and the anti-Markovnikov-type addition may require the use of a transition metal catalyst or an expensive catalyst. Herein we describe a convenient anti-Markovnikov iodofluorination of alkenes with Selectfluor/ nBu4NI. A wide substrate scope and good functional group tolerance were observed. The process allows for the construction of various C-F bonds, especially tertiary C-F bonds. The remarkable features make this protocol attractive, including convenient operations, simple reaction conditions, and the installation of an iodine atom which provides possibilities for further transformations.

Restoring trilinearity with the purpose of advanced modeling: towards a more effective analysis of Pericarpium Citri Reticulatae during storage periods

To accurately quantify Pericarpium Citri Reticulatae samples, trilinear structure was restored in the stacked fingerprints for more robust modeling. Initially, liquid chromatography - diode array detector - mass spectrometry (LC-DAD-MS) and head space-solid phase micro extraction coupled to gas chromatography - mass spectrometry (HS-SPME/GC-MS) were utilized to analyze Pericarpium Citri Reticulatae. Faced with the time-shifts in two-dimensional (2D) matrices across different samples, three algorithms were developed to synchronize them. Furthermore, bilinear and trilinear models were used to realize the quantifications with different principles. Through real cases based on LC-DAD, the advantages and disadvantages of trilinear decomposition over multivariate curve resolution-alternating least-squares can be clarified in the quantification of raw or synchronized fingerprints. Also in the data processing, a modification version of multi-scale peak alignment (^mMSPA) was proved to be more suitable for trilinearity restoring than the other two algorithms. Recognizing these facts, restoring trilinearity were developed for more robust modeling in the application of the Pericarpium Citri Reticulatae fingerprints from different storage periods. After effective analysis, the upward/downward trend of 13 flavonoids were drawn accurately; and several flavour components having the highest contribution rate during storage were outlined reasonably. In conclusion, more robust modeling can be realized in trilinear data synchronized by appropriate algorithms, leading to an accurate quantification in herbal quality researches.

[Regulatory effect of Ac-SDKP on phosphorylated heat shock protein 27/SNAI1 pathway in silicotic rats]

Objective: To study the effect of anti-fibrotic tetrapeptide N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) on phosphorylated heat shock protein 27 (P-HSP27) and zinc finger family transcriptional repressor 1 (SNAI1) expression to explore the anti-silicosis fibrosis effect of Ac-SDKP. Methods: In December 2014, the rat silicosis animal model was prepared by one-time bronchial infusion of silicon dioxide (SiO(2)) dust. 80 SPF healthy adult Wistar rats were selected, and the rats were divided into 8 groups according to the random number table method, 10 in each group. Model control group for 4 weeks (feeding for 4 weeks) , model control group for 8 weeks (feeding for 8 weeks) : bronchial perfusion with normal saline 1.0 ml per animal. Silicosis model group for 4 weeks (feeding for 4 weeks) and silicosis model group for 8 weeks (feeding for 8 weeks) : bronchial perfusion of 50 mg/ml SiO(2) suspension 1.0 ml per animal. Ac-SDKP administration group for 4 weeks (feeding for 4 weeks) , Ac-SDKP administration group for 8 weeks (feeding for 8 weeks) : Ac-SDKP 800 μg·kg(-1)·d(-1) was administered by intraperitoneal pump. Ac-SDKP preventive treatment group: 48 h after Ac-SDKP 800 μg·kg(-1)·d(-1) administration, bronchial perfusion of SiO(2) suspension 1.0 ml per animal, raised for 8 weeks. Ac-SDKP anti-fibrosis treatment group: after bronchial perfusion of 1.0 ml of SiO(2) suspension for 4 weeks, Ac-SDKP 800 μg·kg(-1)·d(-1) was administered for 4 weeks. Western blotting was used to detect the expression of P-HSP27, SNAI1, α-smooth muscle actin (α-SMA) , and collage typeⅠ and Ⅲ in each group. The expression of P-HSP27 and SNAI1 was detected by immunohistochemistry, and the co-localized expression of P-HSP27 and α-SMA was detected by laser confocal microscopy. Results: Compared with the model control group, the expressions of P-HSP27, SNAI1, α-SMA, and collage typeⅠ and Ⅲ in the silicosis fibrosis area of the rats in the silicosis model group were enhanced, and the differences were statistically significant (P<0.05) . After Ac-SDKP intervention, compared with silicosis model group for 8 weeks, the expressions of P-HSP27, SNAI1 α-SMA, and collage typeⅠ and Ⅲ in the Ac-SDKP preventive and anti-fibrosis treatment groups were significantly decreased, and the differences were statistically significant (P<0.05) . However, the expressions of P-HSP27 SNAI1, and collage typeⅠ and Ⅲ between the Ac-SDKP administration group and the model control group did not change significantly, and the differences were not statistically significant (P>0.05) . Laser confocal results showed that the positive cells expressing P-HSP27 and α-SMA in the lung tissue of the silicosis model group were more than those in the model control group. Compared with the silicosis model group, the Ac-SDKP prevention and anti-fibrosis treatment groups expressing the positive cells of P-HSP27 and α-SMA decreased. Compared with the model control group for 8 weeks, there were some double-positive cells expressing P-HSP27 and α-SMA in the nodules of the silicosis model group for 8 weeks. Conclusion: Ac-SDKP may play an anti-silicic fibrosis effect by regulating the P-HSP27/SNAI1 pathway.

An Adaptive Learning Model for Multiscale Texture Features in Polyp Classification via Computed Tomographic Colonography

Objective: As an effective lesion heterogeneity depiction, texture information extracted from computed tomography has become increasingly important in polyp classification. However, variation and redundancy among multiple texture descriptors render a challenging task of integrating them into a general characterization. Considering these two problems, this work proposes an adaptive learning model to integrate multi-scale texture features. Methods: To mitigate feature variation, the whole feature set is geometrically split into several independent subsets that are ranked by a learning evaluation measure after preliminary classifications. To reduce feature redundancy, a bottom-up hierarchical learning framework is proposed to ensure monotonic increase of classification performance while integrating these ranked sets selectively. Two types of classifiers, traditional (random forest + support vector machine)- and convolutional neural network (CNN)-based, are employed to perform the polyp classification under the proposed framework with extended Haralick measures and gray-level co-occurrence matrix (GLCM) as inputs, respectively. Experimental results are based on a retrospective dataset of 63 polyp masses (defined as greater than 3 cm in largest diameter), including 32 adenocarcinomas and 31 benign adenomas, from adult patients undergoing first-time computed tomography colonography and who had corresponding histopathology of the detected masses. Results: We evaluate the performance of the proposed models by the area under the curve (AUC) of the receiver operating characteristic curve. The proposed models show encouraging performances of an AUC score of 0.925 with the traditional classification method and an AUC score of 0.902 with CNN. The proposed adaptive learning framework significantly outperforms nine well-established classification methods, including six traditional methods and three deep learning ones with a large margin. Conclusions: The proposed adaptive learning model can combat the challenges of feature variation through a multiscale grouping of feature inputs, and the feature redundancy through a hierarchal sorting of these feature groups. The improved classification performance against comparative models demonstrated the feasibility and utility of this adaptive learning procedure for feature integration.

[China guideline for the screening and early detection of prostate cancer (2022, Beijing)]

Prostate cancer (PC) is one of the malignant tumors of the genitourinary system that occurs more often in elderly men. Screening, early diagnosis, and treatment of the PC high risk population are essential to improve the cure rate of PC. The development of the guideline for PC screening and early detection in line with epidemic characteristics of PC in China will greatly promote the homogeneity and quality of PC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. This guideline strictly followed the World Health Organization Handbook for Guideline Development and combined the most up-to-date evidence of PC screening, China's national conditions, and practical experience in cancer screening. A total of fifteen detailed evidence-based recommendations were provided with respect to the screening population, technology, procedure management, and quality control in the process of PC screening. This guideline aimed to standardize the practice of PC screening and improve the effectiveness and efficiency of PC prevention and control in China.