[Clinical observation on the treatment of ossification of the posterior longitudinal ligament of the cervical spine using 3D printed self-stable zero-profile artificial vertebral body]

Objective: To observe the clinical efficacy of a 3D printed self-stable zero-profile artificial vertebral body for anterior cervical corpectomy decompression and fusion in the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Methods: In this prospective randomized controlled trial, patients diagnosed with OPLL in Luohe Central Hospital from January to July 2022 were divided into a zero-profile group (3D printed self-stable zero-profile artificial vertebral body was used for internal fixation and fusion after anterior cervical subtotal decompression,) and titanium-mesh group (titanium-mesh and titanium plate were used for internal fixation and fusion after anterior cervical subtotal decompression) according to envelope random method. Operation time, intraoperative blood loss, Japanese Orthopaedic Association (JOA) score and improvement rate, incidence of postoperative prosthesis subsidence, and bone graft fusion were recorded and compared between the two groups. Results: Finally, 21 patients in the zero notch group and 20 patients in the titanium mesh group were included in the study and were followed-up. In the zero-profile group, there were 16 males and 5 females, aged (48.0±12.7) years. In the titanium-mesh group, there were 14 males and 6 females, aged (49.8±10.2) years. All the 41 patients successfully completed the operation. In the zero-profile group, the surgical time was (50.04±8.45) minutes, the blood loss was (95.38±26.07) ml and the hospitalization cost was (42.32±6.12) thousand yuan. In the titanium-mesh group, the surgical time was (59.20±11.95) minutes, the blood loss was (93.10±27.86) ml and the hospitalization cost was (42.10±6.71) thousand yuan. The surgical time in the zero-profile group was shorter than that in the titanium-mesh group (P=0.007), and there was no statistically significant difference in blood loss and hospitalization costs between the two groups (both P>0.05). The 41 patients were followed-up for (14.29±1.45) months. Four cases (20.0%) in the titanium mesh group experienced swallowing difficulties and 0 cases in the zero incision group, the difference between the two groups was statistically significant (P=0.048). No intraoperative hematoma, spinal cord nerve recompression, airway crisis, incision infection complications, and no steel plate or screw breakage or displacement occurred after surgery. At the last follow-up, all cases had bone fusion. At the follow-up of 12 months after surgery, the JOA score of the zero incision group increased from preoperative (10.33±1.71) points to (15.47±0.81) points, with an improvement rate of 76.1%±15.7%; the JOA score of the titanium mesh group increased from (10.30±1.75) points to (15.30±0.92) points, with an improvement rate of 73.2%±16.7%; there was no statistically significant difference in improvement rate between the two groups (P=0.580). At the follow-up of 12 months after surgery, 1 case (4.8%) in the zero incision group and 8 cases (40.0%) in the titanium mesh group experienced implant sinking, and the difference between the two groups was statistically significant (P=0.009). Conclusion: Compared with titanium-mesh, 3D printed self-stable zero-profile artificial vertebral body for the treatment of OPLL of the cervical spine can achieve good surgical efficacy, shorter surgical time, lower incidence of postoperative chronic swallowing discomfort, and can provide a better bone material bonding interface and be less prone to prosthesis settlement.

[Efficacy and safety of chimeric antigen receptor T-cell therapy followed by allogeneic hematopoietic stem cell transplantation in 21 patients with Ph-like acute lymphoblastic leukemia]

Objective: To evaluate the efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Ph-like acute lymphoblastic leukemia (Ph-ALL) . Methods: Patients with Ph-ALL who underwent CAR-T therapy followed by allo-HSCT from March 2018 to August 2023 at the First Affiliated Hospital of Soochow University were included, and their clinical data were retrospectively analyzed. Results: Of the 21 patients, 14 were male and 7 were female. The median age at the time of CAR-T therapy was 22 (6-50) years. Seven patients had ABL1-like rearrangements, and 14 had JAK-STAT rearrangements. Prior to CAR-T therapy, 12 patients experienced hematologic relapse; 7 were multiparameter flow cytometry minimal residual disease (MFC-MRD) -positive and 2 were MFC-MRD-negative. CAR-T cells were derived from patients' autologous lymphocytes. Nine patients were treated with CD19 CAR-T cells, and 12 were treated with CD19/CD22 CAR-T cells. After assessment on day 28 after CAR-T therapy, 95.2% of the patients achieved complete remission, with an MRD-negative remission rate of 75%. Nineteen patients developed grade 0-2 cytokine release syndrome (CRS) and 2 patients suffered grade 3 CRS, all cases of which resolved after treatment. All patients underwent allo-HSCT after CAR-T therapy. The median time from CAR-T therapy to allo-HSCT was 63 (38-114) days. Five patients experienced relapse after CAR-T therapy, including four with hematologic relapse and one with molecular relapse. The 3-year overall survival (OS) rates in the ABL1 and JAK-STAT groups were (83.3±15.2) % and (66.6±17.2) %, respectively (P=0.68) . The 3-year relapse-free survival (RFS) rates were (50.0±20.4) % and (55.6±15.4) % in the ABL1 and JAK-STAT groups, respectively. There was no significant difference in 3-year OS or RFS between the two groups. Conclusions: CAR-T therapy followed by allo-HSCT leads to rapid remission in most patients with Ph-ALL and prolongs leukemia-free survival.

Hybrid wavelet/Elman NN model for short term cost prediction utilizing developed deer hunting optimizer

The cost signal of electricity in the competitive electrical energy marketplaces is of special importance for all planning and operation activities. Also, the price of electricity has an uncertain nature and various factors affect it in the short and long term. Factors active in the electricity market need to accurately and effectively forecast the electricity price signal to manage risk in the market. For estimating future electricity prices, this research suggests a combined procedure on the basis of Elman neural network model and the wavelet transform. The proposed Elman neural network/wavelet transform forecasted the next hour's power price based on the past 24 h' pricing. This research uses an optimized Elman neural network using a developed deer hunting optimizer and the total model is named Elman neural network/developed deer hunting optimization-wavelet transform. In this paper, Data of Zone Preliminary Billing is used for establishing the training of model and forecasting of performance. The method is then compared with some other published works and the outcomes demonstrate the offered approach superiority toward those for the electrical cost predicting.

In Situ Construction Channels of Lithium-Ion Fast Transport and Uniform Deposition to Ensure Safe High-Performance Solid Batteries

Solid-state lithium-ion batteries (SLIBs) are the promising development direction for future power sources because of their high energy density and reliable safety. To optimize the ionic conductivity at room temperature (RT) and charge/discharge performance to obtain reusable polymer electrolytes (PEs), polyvinylidene fluoride (PVDF), and poly(vinylidene fluoride-hexafluoro propylene) (P(VDF-HFP)) copolymer combined with polymerized methyl methacrylate (MMA) monomers are used as substrates to prepare PE (LiTFSI/OMMT/PVDF/P(VDF-HFP)/PMMA [LOPPM]). LOPPM has interconnected lithium-ion 3D network channels. The organic-modified montmorillonite (OMMT) is rich in the Lewis acid centers, which promoted lithium salt dissociation. LOPPM PE possessed high ionic conductivity of 1.1 × 10-3 S cm-1 and a lithium-ion transference number of 0.54. The capacity retention of the battery remained 100% after 100 cycles at RT and 0.5 C. The initial capacity of one with the second-recycled LOPPM PE is 123.9 mAh g-1 . This work offered a feasible pathway for developing high-performance and reusable LIBs.

Single-atom Iron Catalyst with Biomimetic Active Center to Accelerate Proton Spillover for Medical-level Electrosynthesis of H2 O2 Disinfectant

Electrosynthesis of H2 O2 has great potential for directly converting O2 into disinfectant, yet it is still a big challenge to develop effective electrocatalysts for medical-level H2 O2 production. Herein, we report the design and fabrication of electrocatalysts with biomimetic active centers, consisting of single atomic iron asymmetrically coordinated with both nitrogen and sulfur, dispersed on hierarchically porous carbon (FeSA -NS/C). The newly-developed FeSA -NS/C catalyst exhibited a high catalytic activity and selectivity for oxygen reduction to produce H2 O2 at a high current of 100 mA cm-2 with a record high H2 O2 selectivity of 90 %. An accumulated H2 O2 concentration of 5.8 wt.% is obtained for the electrocatalysis process, which is sufficient for medical disinfection. Combined theoretical calculations and experimental characterizations verified the rationally-designed catalytic active center with the atomic Fe site stabilized by three-coordinated nitrogen atoms and one-sulfur atom (Fe-N3 S-C). It was further found that the replacement of one N atom with S atom in the classical Fe-N4 -C active center could induce an asymmetric charge distribution over N atoms surrounding the Fe reactive center to accelerate proton spillover for a rapid formation of the OOH* intermediate, thus speeding up the whole reaction kinetics of oxygen reduction for H2 O2 electrosynthesis.

[Structural changes of the frontal cortex in depressed mice are associated with decreased expression of brain-derived neurotrophic factor]

OBJECTIVE

To investigate the changes in gray matter volume in depressive-like mice and explore the possible mechanism.

METHODS

Twenty-four 6-week-old C57 mice were randomized equally into control group and model group, and the mice in the model group were subjected to chronic unpredictable mild stimulation (CUMS) for 35 days. Magnetic resonance imaging was performed to examine structural changes of the grey matter volume in depressive-like mice. The expression of brain-derived neurotrophic factor (BDNF) in the grey matter of the mice was detected using Western blotting and immunofluorescence staining.

RESULTS

Compared with the control mice, the mice with CUMS showed significantly decreased central walking distance in the open field test (P < 0.05) and increased immobile time in forced swimming test (P < 0.05). Magnetic resonance imaging showed that the volume of the frontal cortex was significantly decreased in CUMS mice (P < 0.001, when the mass level was greater than or equal to 10 756, the FDRc was corrected with P=0.05). Western blotting showed that the expression of mature BDNF in the frontal cortex was significantly decreased in CUMS mice (P < 0.05), and its expression began to decrease after the exposure to CUMS as shown by immunofluorescence staining. The volume of different clusters obtained by voxel-based morphometry (VBM) analysis was correlated with the expression level of mature BDNF detected by Western blotting (P < 0.05).

CONCLUSION

The decrease of frontal cortex volume after CUMS is related with the reduction of mature BDNF expression in the frontal cortex.

Comparative Study of the Efficacy of the Ovarian-Adnexa Reporting and Data System Ultrasound Combined With Contrast-Enhanced Ultrasound and the ADNEX MR Scoring System in the Diagnosis of Adnexal Masses

OBJECTIVE

The aims of this study were to develop the Ovarian-Adnexa Reporting and Data System (O-RADS) and O-RADS + contrast-enhanced ultrasound (O-RADS CEUS) scoring system to distinguish adnexal masses (AMs) and to compare the diagnostic efficacy of these systems with that of a magnetic resonance imaging scoring system (ADNEX MR).

METHODS

We retrospectively evaluated 278 ovarian masses from 240 patients between May 2017 and July 2022. Pathology and adequate follow-up were used as reference standards for comparing the validity of O-RADS, O-RADS CEUS and ADNEX MR scoring to diagnose AMs. Area under the curve (AUC), sensitivity and specificity were calculated. The inter-class correlation coefficient (ICC) was calculated to evaluate inter-reader agreement (IRA) between the two sonographers and two radiologists who analyzed the findings with the three modalities.

RESULTS

The AUCs of O-RADS, O-RADS CEUS and ADNEX MR scores were 0.928 (95% confidence interval [CI]: 0.895-0.956), 0.951(95% CI: 0.919-0.973) and 0.964 (95% CI: 0.935-0.983), respectively. Their sensitivities were 95.7%, 94.3 and 91.4%, and their specificities were 81.3%, 92.3% and 97.1%, respectively. The three modalities had accuracies of 84.9%, 92.8% and 95.7%, respectively. O-RADS had the highest sensitivity but significantly lower specificity (p < 0.001), whereas the ADNEX MR scoring had the highest specificity (p < 0.001) but lower sensitivity (p < 0.001). O-RADS CEUS had intermediate sensitivity and specificity (p < 0.001).

CONCLUSION

The addition of CEUS significantly improves the efficacy of O-RADS in diagnosing AMs. The diagnostic efficacy of the combination is comparable to that of the ADNEX MR scoring system.

[Advances in clinical application of electrical impedance tomography to evaluate pulmonary perfusion in critically ill patients]

Lung perfusion monitoring can provide accurate information on changes in pulmonary blood flow in critically ill patients, and thus help guide clinical diagnosis and treatment. However, due to inconveniences such as patient transport, conventional imaging techniques are unable to meet the demand for real-time monitoring of lung perfusion, more convenient and reliable real-time functional imaging techniques should be developed to optimise cardiopulmonary management in critically ill patients. Electrical impedance tomography (EIT) is a non-invasive, radiation-free, bedside functional imaging technique that can be used to assess lung perfusion in patients with acute respiratory distress syndrome, pulmonary embolisms and other conditions, thereby assisting with the diagnosis of disease, the adjustment of treatment protocols, and the assessment of treatment outcomes. In this review, we focused on advances in EIT for lung perfusion monitoring in critically ill patients.

[Analysis of the status of excess heart age and its risk factors among residents aged 35 to 64 years in China]

Objective: To analyze the status of excess heart age and its risk factors among Chinese residents aged 35 to 64 years. Methods: The study subjects were Chinese residents aged 35 to 64 years who completed the heart age assessment by WeChat official account"Heart Strengthening Action"through the internet from January 2018 to April 2021. Information such as age, gender, body mass index (BMI), blood pressure, total cholesterol (TC), smoking history, and diabetes history was collected. The heart age and excess heart age were calculated according to the characteristics of individual cardiovascular risk factors and the heart aging was defined as excess heart age≥5 years and 10 years respectively. The heart age and standardization rate were calculated respectively based on the population standardization of the 7th census in 2021.CA trend test was used to analyze the changing trend of excess heart age rate and population attributable risk (PAR) was used to calculate the contribution of risk factors. Results: The mean age of 429 047 subjects was 49.25±8.66 years. The male accounted for 51.17% (219 558/429 047) and the excess heart age was 7.00 (0.00, 11.00) years. The excess heart age rate defined by excess heart age≥5 years and≥10 years was 57.02% (the standardized rate was 56.83%) and 38.02% (the standardized rate was 37.88%) respectively. With the increase of the age and number of risk factors, the excess heart age rate of the two definitions showed an upward trend according to the result of the trend test analysis (P<0.001). The top two risk factors of the PAR for excess heart age were overweight or obese and smoking. Among them, the male was smoking and overweight or obese, while the female was overweight or obese and having hypercholesterolemia. Conclusion: The excess heart age rate is high in Chinese residents aged 35 to 64 years and the contribution of overweight or obese, smoking and having hypercholesterolemia ranks high.

Accelerated Transfer and Spillover of Carbon Monoxide through Tandem Catalysis for Kinetics-boosted Ethylene Electrosynthesis

Cu-based catalysts have been widely applied in electroreduction of carbon dioxide (CO₂ ER) to produce multicarbon (C₂₊ ) feedstocks (e.g., C₂ H₄ ). However, the high energy barriers for CO₂ activation on the Cu surface is a challenge for a high catalytic efficiency and product selectivity. Herein, we developed an in situ *CO generation and spillover strategy by engineering single Ni atoms on a pyridinic N-enriched carbon support with a sodalite (SOD) topology (Ni-SOD/NC) that acted as a donor to feed adjacent Cu nanoparticles (NPs) with *CO intermediate. As a result, a high C₂ H₄ selectivity of 62.5 % and an industrial-level current density of 160 mA cm^-2 at a low potential of -0.72 V were achieved. Our studies revealed that the isolated NiN₃ active sites with adjacent pyridinic N species facilitated the *CO desorption and the massive *CO intermediate released from Ni-SOD/NC then overflowed to Cu NPs surface to enrich the *CO coverage for improving the selectivity of CO₂ ER to C₂ H₄ .

Direct observation of cation diffusion driven surface reconstruction at van der Waals gaps

Weak interlayer van der Waals (vdW) bonding has significant impact on the surface/interface structure, electronic properties, and transport properties of vdW layered materials. Unraveling the complex atomistic dynamics and structural evolution at vdW surfaces is therefore critical for the design and synthesis of the next-generation vdW layered materials. Here, we show that Ge/Bi cation diffusion along the vdW gap in layered GeBi₂Te₄ (GBT) can be directly observed using in situ heating scanning transmission electron microscopy (STEM). The cation concentration variation during diffusion was correlated with the local Te₆ octahedron distortion based on a quantitative analysis of the atomic column intensity and position in time-elapsed STEM images. The in-plane cation diffusion leads to out-of-plane surface etching through complex structural evolutions involving the formation and propagation of a non-centrosymmetric GeTe₂ triple layer surface reconstruction on fresh vdW surfaces, and GBT subsurface reconstruction from a septuple layer to a quintuple layer. Our results provide atomistic insight into the cation diffusion and surface reconstruction in vdW layered materials.

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.

[Survival rate and quality of life of human papillomaviruse-negative patients with advanced oropharyngeal cancer receiving different treatments]

OBJECTIVE

To analyze the survival rates and quality of life of human papillomaviruse (HPV)-negative patients with advanced oropharyngeal cancer after different combined treatments with chemotherapy, surgery and radiotherapy.

METHODS

We retrospectively analyzed the data of patients with oropharyngeal cancer hospitalized in our hospital from January, 2015 to December, 2020, and after case analysis of the clinical, imaging and pathological data, 405 patients were included in this study and grouped according to the treatments they received. Kaplan-Meier and Log-rank analysis were used to calculate the overall survival rate and the survival rate of patients with different treatments. The self-rated quality of life of the tumor-free survivors was assessed using UW-QOL (4) questionnaire and compared among the patients with different treatments.

RESULTS

Among the 405 patients included in this study, 146 received treatments with chemotherapy+surgery+radiotherapy (CSRT), 138 received surgery+radiotherapy (SRT) and 121 were treated with radiotherapy+chemotherapy (RCT). The overall survival rates of the 3 groups at 1, 3 and 5 years were 85.1%, 67.1% and 56.9%, respectively, and the survival rates of patients receiving CSRT, SRT and RCT did not differ significantly (P > 0.05). A total of 280 UW-QOL (4) questionnaires were distributed and 202 (72.14%) were retrieved. The average total scores decreased in the order of CSRT > SRT > RCT; the scores were significantly higher in CSRT group than in SRT and RCT (P < 0.05), but did not differ significantly between SRT and RCT groups (P > 0.05).

CONCLUSION

CSRT, SRT and RCT are all treatment options for locally advanced oropharyngeal cancer, but CSRT may achieve better quality of life of the patients than SRT and RCT.

Autophagy-Sirtuin1(SIRT1) Alleviated the Coronary Atherosclerosis (AS)in Mice through Regulating the Proliferation and Migration of Endothelial Progenitor Cells (EPCs) via wnt/β-catenin/GSK3β Signaling Pathway

BACKGROUND AND PURPOSE

SIRT1 was associated with AS risk and EPCs were reported to participate in the endothelial repair in Coronary Atherosclerosis (CAS). In this study, we explored the role of SIRT1 in AS mice and also its modulation in EPCs.

METHODS AND MATERIALS

ApoE-/-mice were fed on high-fat and high-glucose diet to establish the AS animal model with the normally-raised C57BL/6 mice as a control group. SIRT1 activator, SRT 2104 was injected intravenously into 5 ApoE-/-mice and its inhibitor Nicotinamide was injected in tail in another 5 ApoE-/-mice. Weight changes were recorded. Blood samples were taken from posterior orbital venous plexus and were detected by automatic biochemical analyzer. HE staining displayed the pathological conditions while Immunohistochemistry (IHC) evaluated the CD34+/VEGFR2+ relative density in the aorta tissues. EPCs were isolated from bone marrow and verified using immunofluorescence staining (IFS). The modulatory mechanism of SIRT1 in EPCs were studied by using RT-PCR, MTT, Western Blot and colony formation, scratch methods.

RESULTS

SIRT1 activator negatively regulated the weight and TC, TG and LDL levels, alleviated the lesion conditions and decreased the CD34+/VEGFR2+ density compared to the AS control. In vitro, SIRT1 activator promoted the proliferation and migration of EPCs and activated wnt/β-catenin/GSK3β signaling pathway. SIRT1 activator also inhibited the autophagy biomarkers ATG1 and LC3II. Furthermore, inhibitor of autophagy promoted SIRT1 expression and induced EPC proliferation, migration and activated wnt/β-catenin/GSK3β pathway. The suppression of the wnt/β-catenin/GSK3β pathway inhibited SIRT1 expression in EPCs, attenuated the proliferation and migration and promoted autophagy of EPCs.

CONCLUSION

SIRT1 activation might be protective in AS mice through autophagy inhibition in EPCs via wnt/β-catenin/GSK3β signaling pathway.

Electronic Localization Derived Excellent Stability of Li Metal Anode with Ultrathin Alloy

Lithium metal is an ideal anode for next-generation high-energy-density batteries. However, lithium dendrite growth has impeded its commercial application. Herein, fabricating Li-based ultrathin alloys with electronic localization and high surface work function via depositing Bi, Al, or Au metals on the surface of copper foil for in situ alloying with lithium is proposed. It is discovered that the electronic localization can induce self-smoothing effect of Li ions, as a result, significantly suppressing the growth of dendritic lithium. Meanwhile, the high surface work function can effectively alleviate side reactions between the electrolyte and lithium. With the as-obtained ultrathin alloys as anodes, excellent cycling performance is achieved. The half cells run stably after more than 120 cycles under high capacity of 4 mAh cm^-2 . The S||Bi/Cu-Li full cell delivers a specific capacity of 736 mAh g^-1 after 200 cycles. This work provides a new strategy for fabricating long-life and high-capacity lithium batteries.

Primary mediastinal seminoma with leiomyosarcoma: a rare case report

Germ cell tumor is the most common malignant tumor of the gonads, sometimes they are found in locations other than the gonads, called Extra-gonadal Germ cell tumours (EGCTs). Primary mediastinal germ cell tumors (PMGCTs) are a kind of rare neoplasm in the anterior mediastinum, including seminoma and non-seminomatous, or appear as a mixture. Primary mediastinal seminoma mixed with sarcoma is an extremely rare clinicopathologic entity. Previous studies have revealed that primary pure mediastinal seminomas are commonly sensitive to chemoradiotherapy and possibly to palliative excision. The treatment options for mixed germ cell tumor composed of seminoma and sarcoma remain unknown. Only one case of primary mediastinal seminoma with rhabdosarcoma has been reported in the literature up to date and the patient benefited from chemotherapy as the neoadjuvant therapy. However, cases of primary mediastinal seminoma with leiomyosarcoma have not been documented. Herein, we report a case of an 18-year-old patient, who presented with dyspnea, orthopnea, and chest pain, the CECT scan of the chest showed a large mass in the anterior mediastinum, which turned out to be seminoma mixed with leiomyosarcoma after partial excision. We investigate the treatment strategy and potential molecular mechanism of this disease. Finally, our study demonstrated that the patient benefited from the treatment of chemotherapy alone, or combined with target therapy after the operation. Meanwhile, the BRAF p.G466V, TP53 mutations, MTOR p.T1977I and exons 2-5 deletion of FLCN may be potential molecular mechanisms and oncogenic drivers of this disease.

The Three Hundred–NIKA2 Sunyaev–Zeldovich Large Program twin samples: Synthetic clusters to support real observations

The simulation database of The Three Hundred Project has been used to pick synthetic clusters of galaxies with properties close to the observational targets of the NIKA2 camera Sunyaev–Zeldovich (SZ) Large Program. Cross–matching of cluster parameters such as mass and redshift of the cluster in the two databases has been implemented to generate the so–called twin samples for the Large Program. This SZ Large Program is observing a selection of galaxy clusters at intermediate and high redshift (0:5 < z < 0:9), covering one order of magnitude in mass. These are SZ–selected clusters from the Planck and Atacama Cosmology Telescope catalogs, wherein the selection is based on their integrated Compton parameter values, Y500: the value of the parameter within the characteristics radius R500.

The Three Hundred hydrodynamical simulations provide us with hundreds of clusters satisfying these redshift, mass, and Y500 requirements. In addition to the standard post-processing analysis of the simulation, mock observational maps are available mimicking X–ray, optical, gravitational lensing, radio, and SZ observations of galaxy clusters. The primary goal of employing the twin samples is to compare different cluster mass proxies from synthetic X–ray, SZ effect and optical maps (via the velocity dispersion of member galaxies and lensing κ-maps) of the clusters. Eventually, scaling laws between different mass proxies and the cluster mass will be cross–correlated to reduce the scatter on the inferred mass and the mass bias will be related to various physical parameters.

The Three Hundred project: Contrasting clusters galaxy density in hydrodynamical and dark matter only simulations

Cluster number count is a major cosmological probe for the next generation of cosmological large scale-structure surveys like the one expected from the Euclid satellite mission. Cosmological constraints will be mainly limited by the understanding of the selection function (SF), which characterize the probability of detecting a cluster of a given mass and redshift. The SF can be estimated by injecting realistic simulated clusters into the survey and re-applying the detection procedure. For this purpose we intend to use The Three Hundreds project, a 324 cluster sample simulated with full-physics hydrodynamical re-simulations. In this paper we concentrate on the study of the distribution of member galaxies in the cluster sample. First, we study possible resolution effects by comparing low and high resolution simulations. Finally, accounting for the latter we derive the density profiles of the member galaxies and discuss their evolution with cluster mass and redshift.

[Identification of serum peptide biomarker for ovarian cancer diagnosis by Clin-TOF-II-MS combined with magnetic beads technology]

Objective: To explore the serum cyclic polypeptide biomarkers for ovarian cancer diagnosis. Methods: A total of 54 patients with epithelial ovarian cancer confirmed by pathology in Cancer Hospital, Chinese Academy of Medical Sciences from March 2018 to September 2018 were selected as the study subjects, and 40 healthy women with normal examination results in the cancer screening center were selected as the control. All of the samples were randomly divided into training set and validation set at the ratio of 1∶1 with a random number. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with magnetic bead technology was used for detecting peptide profiling in serum samples to screen significantly differently expressed peptides between ovarian cancer group and control group of the training set (score>5). Receiver operating characteristic (ROC) curve analysis was used to screen differential peptide peaks with area under curve (AUC) ≥0.8, sensitivity and specificity>90% in the training set and validation set. Liquid chromatography-mass spectrometry (LC-MS/MS) was further used to determine the composition of differentially expressed peptides. Results: By comparing the peptide profiles of the two groups, 102 differential peptide peaks were initially detected in the mass-to-charge ratio range of 1 000 to 10 000. ROC curve analysis showed that there were 42 differential peptide peaks with AUC ≥0.8 in both training set and validation set, 19 of which were highly expressed in ovarian cancer group, and 23 were lowly expressed. There were 15 different peptide peaks in highly expressed ovarian cancer group with sensitivity and specificity over 90%. The mass-to-charge ratios were 7 744.27, 5 913.41, 5 329.87, 4 634.21, 4 202.02, 3 879.26, 3 273.35, 3 253.79, 3 234.34, 2 950.33, 2 664.51, 2 018.38, 1 893.37, 1 498.69 and 1 287.55. There were 15 different peptide peaks in lowly expressed ovarian cancer group with sensitivity and specificity over 90%, the mass-to-charge ratios were 9 288.46, 7 759.77, 5 925.24, 4 652.77, 4 210.42, 3 887.02, 3 279.90, 3 240.82, 2 962.15, 2 932.70, 2 022.42, 1 897.16, 1 501.69, 1 337.38 and 1 290.13. No protein composition was identified in 15 different peptide peaks in lowly expressed ovarian cancer group. The two protein compositions identified in 15 different peptide peaks in highly expressed ovarian cancer group were recombinant serglycin (SRGN) and fibinogen alpha chain (FGA), the mass-to-charge ratios of which were 1 498.696 and 5 913.417, respectively. The sensitivity and specificity of the two proteins for ovarian cancer diagnosis were 100%, 100% and 90.9%, 100%, respectively. Conclusion: SRGN and FGA are highly expressed in the serum of ovarian cancer patients, which may be potential diagnostic markers for ovarian cancer.

[Association of GMF-β expression with Ki-67 and its significance in the prognostic evaluation of astrocytoma]

Objective: To clarify the correlation of the expression of glia maturation factor-β (GMF-β) with Ki-67 in astrocytoma, and to investigate the prognostic implications of combined detection of GMF-β and Ki-67. Methods: One hundred and forty human astrocytoma samples (WHO Ⅱ-Ⅳ grade) were collected at Southwest Hospital, Army Medical University (the Third Military Medical University), China from 2006 to 2009. Clinicopathological information and 3-year follow-up data were collected. Expression of GMF-β and Ki-67 was detected by single and double immunohistochemical staining, then the association of GMF-β expression with Ki-67 and its significance in prognostic evaluation of astrocytoma were statistically analyzed. Results: GMF-β expression in astrocytoma cells was correlated to both tumor grade and Ki-67 (both P<0.05); Kaplan-Meier survival analysis showed that GMF-β and Ki-67 expression were negatively correlated to the 3 year-survival rates, respectively (both P<0.01). Further analysis demonstrated that the two factors were co-influenced on survival, showing a trend of "GMF-β^low Ki-67^low>GMF-β^high Ki-67^low>GMF-β^low Ki-67^high>GMF-β^high Ki-67^high" in 3-year survival rate with significant intergroup differences (P<0.05, P<0.01). Conclusions: GMF-β expression is positively associated with Ki-67 in astrocytoma. Combined detection of GMF-β and Ki-67 can predict prognosis of patients with glioma.

Improving Fast and Safe Transfer of Lithium Ions in Solid-State Lithium Batteries by Porosity and Channel Structure of Polymer Electrolyte

Solid-state lithium batteries using solid polymer electrolytes can improve the safety and energy density of batteries. Smoother lithium-ion channels are necessary for solid polymer electrolytes with high ionic conductivity. The porosity and channel structure of the polymer film affect the transfer of lithium ions. However, their controllable synthesis remains a big challenge. Here, we developed a simple synthesis approach toward wrinkled microporous polymer electrolytes by combining the amphoteric (water solubility and organic solubility) polymer in three polymer blends. The homogeneous blend solution spontaneously wrinkled to vertical fold channels as the solvent evaporated. Two minor polymers, poly(vinyl pyrrolidone) (PVP) and polyetherimide (PEI), formed close stacks, and Janus PVP was dispersed in the poly(vinylidene fluoride) (PVDF) matrix. The interfacial tensions between the three polymers were different, so stress was produced when they solidified. The solvent was evaporated to the top layer of the polymers when the temperature increased. The bottom layer wrinkled owing to the stress during solidification. The evaporation of the solvent generated micropores to form the lithium-ion channel. They helped Li⁺ transference and created a wrinkled microporous PVDF-based polymer electrolyte, which achieved an ionic conductivity of 5.1 × 10^-4 S cm^-1 and a lithium-ion transference number of 0.51 at room temperature. Meanwhile, the good flame retardancy and tensile strength of the polymer electrolyte film can improve the safety of the battery. At 0.5C and room temperature, the batteries with a LiFePO₄ cathode and the wrinkled microporous LiTFSI/PEI/PVP/PVDF electrolyte reached a high discharge specific capacity of 122.1 mAh g^-1 at the 100th cycle with a Coulombic efficiency of above 99%. The results of tensile and self-extinguishing tests show that the polymer electrolyte film has good safety application prospects.

Cell-free DNA from bile outperformed plasma as a potential alternative to tissue biopsy in biliary tract cancer

BACKGROUND

Biliary tract cancers (BTCs) are rare and highly heterogenous malignant neoplasms. Because obtaining BTC tissues is challenging, the purpose of this study was to explore the potential roles of bile as a liquid biopsy medium in patients with BTC.

PATIENTS AND METHODS

Sixty-nine consecutive patients with suspected BTC were prospectively enrolled in this study. Capture-based targeted sequencing was performed on tumor tissues, whole blood cells, plasma, and bile samples using a large panel consisting of 520 cancer-related genes.

RESULTS

Of the 28 patients enrolled in this cohort, tumor tissues were available in eight patients, and plasma and bile were available in 28 patients. Somatic mutations were detected in 100% (8/8), 71.4% (20/28), and 53.6% (15/28) of samples comprising tumor tissue DNA, bile cell-free DNA (cfDNA), and plasma cfDNA, respectively. Bile cfDNA showed a significantly higher maximum allele frequency than plasma cfDNA (P = 0.0032). There were 56.2% of somatic single-nucleotide variant (SNVs)/insertions and deletions (indels) shared between bile and plasma cfDNA. When considering the genetic profiles of tumor tissues as the gold standard, the by-variant sensitivity and positive predictive value for SNVs/indels in bile cfDNA positive for somatic mutations were both 95.5%. The overall concordance for SNVs/indels in bile was significantly higher than that in plasma (99.1% versus 78.3%, P < 0.0001). Moreover, the sensitivity of CA 19-9 combined with bile cfDNA achieved 96.4% in BTC diagnosis.

CONCLUSION

We demonstrated that bile cfDNA was superior to plasma cfDNA in the detection of tumor-related genomic alterations. Bile cfDNA as a minimally invasive liquid biopsy medium might be a supplemental approach to confirm BTC diagnosis.

[Predicting postoperative recurrence of stage Ⅰ-Ⅲ renal clear cell carcinoma based on preoperative CT radiomics feature nomogram]

OBJECTIVE

To explore the preoperative radiomics features (RFs) and construct a nomogram for predicting postoperative recurrence of stage Ⅰ-Ⅲ clear cell renal carcinoma (ccRCC).

METHODS

The clinicopathological data and preoperative enhanced CT images collected from 256 patients with ccRCC were used as the training dataset (175 patients) and test dataset (81 patients). The enhanced CT images of the tumor were segmented using ITK-SNAP software, and the RFs were extracted using the PyRadiomics computing platform. In the training dataset, the RFs were screened based on Lasso-CV algorithm, and the Rad_score was calculated. The Clinic factors were screened by univariate and multivariate logistic regression analysis of the clinical and pathological factors and CT characteristics. The Rad_score, Clinic、Rad_score + Clinic nomograms were constructed and verified using the test dataset. The performance, discrimination power and calibration of the nomograms were compared, and their clinical value was evaluated using decision curve analysis.

RESULTS

Six RFs were retained to calculate the Rad_score. The Clinic factors included Rad_score, KPS score, platelet, calcification and TNM clinical stage. In terms of discrimination, the Rad_score + Clinic nomogram showed better performance (AUC=0.84 for training set; AUC=0.85 for test set) than the Rad_score nomogram (AUC=0.78 for training set, P=0.029; AUC=0.77 for Test set, P=0.025) and Clinic nomogram (AUC=0.77 for training set, P=0.014; AUC=0.77 for test set, P=0.011). In terms of calibration, the P value for goodness of fit test of the Rad_score+Clinic nomogram was 0.065 for the training set and 0.628 for the test set. Decision curve analysis showed a greater clinical value of the Rad_score+Clinic nomogram with Rad_score than the Clinic nomogram without Rad_score.

CONCLUSION

The nomogram based on preoperative CT RFs has a high value for predicting postoperative recurrence of stage Ⅰ-Ⅲ ccRCC to facilitate individualized treatment of RCC.

[Risk factors of occurrence and treatment failure of peritoneal dialysis-associated polymicrobial peritonitis: a multicenter retrospective study]

OBJECTIVE

To determine the risk factors of occurrence and treatment failure of peritoneal dialysis associatedperitonitis (PDAP) due to polymicrobial infections.

METHODS

We retrospectively collected the clinical data of patients with PDAP from the peritoneal dialysis (PD) centers in 4 general hospitals in Jilin Province from 2013 to 2019. The patients were divided, according to the results of peritoneal dialysate culture, into polymicrobial PDAP group and control group for comparison of the clinical data, treatment outcomes, and long-term prognosis. The independent risk factors of the occurrence and treatment failure of polymicrobial PDAP were explored using multivariate regression analysis.

RESULTS

We recruited a total of 625 patients from the 4 PD centers, among whom 1085 episodes of PDAP were recorded. Polymicrobial PDAP accounted for 7.6% of the total PDAP episodes, and this proportion increased from 5.3% in 2013-2016 to 9.4% in 2017-2019 (P= 0.012). Compared with the control group, polymicrobial PDAP group had higher proportions of elderly patients and patients with refractory PDAP, with greater white blood cell counts in the first-day dialysate and longer course of antibiotic treatment (P < 0.05). The risk of catheter removal and treatment failure (catheter removal or PDAP-related death) in polymicrobial PDAP group was 2.972 times (OR=2.972, 95% CI: 1.634-5.407, P < 0.001) and 2.692 times (OR=2.692, 95% CI: 1.578-4.591, P < 0.001) that in the control group, respectively. The risk of withdrawal from PD (technical failure + all-cause death) was 1.5- fold higher in polymicrobial PDAP group than that in the control group (OR=1.500, 95% CI: 1.085-2.074, P=0.014). Elderly patients (>65 years) had a 1.937-fold higher risk of experiencing polymicrobial PDAP than younger patients (OR=1.937, 95% CI: 1.207-3.109, P= 0.006). Diabetes mellitus (OR=5.554, 95% CI: 1.021-30.201, P=0.047), mixed fungal infeciton (OR=343.687, 95% CI: 21.554- 5480.144, P < 0.001), and Pseudomonas aeruginosa infection (OR=11.518, 95% CI: 1.632 to 81.310, P=0.014) were associated with increased risks of treatment failure by 4.554, 342.687 and 10.518 times, respectively.

CONCLUSION

The proportion of polymicrobial PDAP in the total PDAP cases tends to increase in recent years. Polymicrobial infection is an independent risk factor of both treatment failure and poor prognosis in patients with PDAP. An old age is an independent risk factor for polymicrobial PDAP, while diabetes mellitus and infections with mixed fungi or Pseudomonas aeruginosa are independent risk factors for treatment failure.

Dimensional Control of Octahedral Tilt in SrRuO3 via Infinite-Layered Oxides

Manipulation of octahedral distortion at atomic scale is an effective means to tune the ground states of functional oxides. Previous work demonstrates that strain and film thickness are variable parameters to modify the octahedral parameters. However, selective control of bonding geometry by structural propagation from adjacent layers is rarely studied. Here we propose a new route to tune the ferromagnetism in SrRuO₃ (SRO) ultrathin layers by oxygen coordination of adjacent SrCuO₂ (SCO) layers. The infinite-layered CuO₂ exhibits a structural transformation from "planar-type" to "chain-type" with reduced film thickness. Two orientations dramatically modify the polyhedral connectivity at the interface, thus altering the octahedral distortion of SRO. The local structural variation changes the spin state of Ru and orbital hybridization strength, leading to a significant change in the magnetoresistance and anomalous Hall resistivity. These findings could launch investigations into adaptive control of functionalities in quantum oxide heterostructures using oxygen coordination.

[Treatment of lumbar degenerative diseases with recapping laminoplasty and nerve root canal's decompression preserving the continuity of supraspinous ligament]

Objective: To explore the clinical effect of lumbar discectomy and nerve root canal's enlargement preserving the continuity of supraspinous ligament in the treatment of lumbar degenerative disease. Methods: The data of patients with lumbar degenerative disease who underwent operation from 2016 to 2018 were analyzed retrospectively, and the patients were divided into two groups according to the different operation. The treatment group (17 cases) was treated with recapping laminoplasty, lumbar discectomy and nerve root canal's enlargement, and the control group (28 cases) was treated with total laminectomy, nerve root canal's enlargement, lumbar discectomy, interbody fusion and internal fixation (PLIF). All patients were followed up for 12 to 27 months (mean 17.8 months). Japanese Orthopaedic Association Scores(JOA) and visual analogue scale(VAS) of pain were used to evaluate the clinical effect before and after the operation, lumbar dynamical X-ray and Cobb angle were collecting for imaging evaluation, and the adjacent segment degeneration at the last follow-up was recorded. Results: There was no significant difference in preoperative JOA score, VAS score and Lumbar Cobb angle between the two groups (all P>0.05). The operation time in the treatment group was shorter than that in the control group, and the blood loss during operation in the treatment group was lower than that in the control group, the bed rest time of the treatment group after operation was shorter than that in the control group ((79±14) vs (118±17) min, (151±38) vs (324±70) ml and (3.4±0.7) vs (4.3±1.0) d,respectively; t=-8.508, -10.724, -3.244, all P<0.01). In addition, compared with the control group, the volume of postoperative drainage in the treatment group also decreased significantly (t=-5.637, P<0.01). There was no significant difference in JOA score between the two groups 1 year after the operation (P>0.05), but there was significant difference in VAS score between the two groups, the treatment group was better than the control group (P<0.05). Compared with the control group, the lumbar Cobb angle in the treatment group increased significantly one year after the operation (55.3°±3.2° vs 38.4°±6.2°, t=10.391, P<0.05). During the follow-up, no loosening or fracture of the implants was found in all patients. Conclusion: Treatment of lumbar degenerative diseases with recapping laminoplasty and nerve root canal's decompression preserving the continuity of supraspinous ligament by ultrasound osteotome has the same clinical effect as PLIF. It has the advantages of shortening operation time, less bleeding, better maintenance of lumbar lordosis after operation and reduction of adjacent segment degeneration.

Electrochemical activation induced multi-valence variation of (NH4)2V4O9 as a high-performance cathode material for zinc-ion batteries

Electrochemical activation of (NH₄)₂V₄O₉ has been found in the first charging process. After this activation, a high capacity (477 mA h g⁻¹ at 50 mA g⁻¹) and stable cycling life (97.7% retention after 5000 cycles at 15 A g⁻¹) have been achieved.

Strong Ferromagnetism Achieved via Breathing Lattices in Atomically Thin Cobaltites

Low-dimensional quantum materials that remain strongly ferromagnetic down to monolayer thickness are highly desired for spintronic applications. Although oxide materials are important candidates for the next generation of spintronics, ferromagnetism decays severely when the thickness is scaled to the nanometer regime, leading to deterioration of device performance. Here, a methodology is reported for maintaining strong ferromagnetism in insulating LaCoO₃ (LCO) layers down to the thickness of a single unit cell. It is found that the magnetic and electronic states of LCO are linked intimately to the structural parameters of adjacent "breathing lattice" SrCuO₂ (SCO). As the dimensionality of SCO is reduced, the lattice constant elongates over 10% along the growth direction, leading to a significant distortion of the CoO₆ octahedra, and promoting a higher spin state and long-range spin ordering. For atomically thin LCO layers, surprisingly large magnetic moment (0.5 μ_B /Co) and Curie temperature (75 K), values larger than previously reported for any monolayer oxides are observed. The results demonstrate a strategy for creating ultrathin ferromagnetic oxides by exploiting atomic heterointerface engineering, confinement-driven structural transformation, and spin-lattice entanglement in strongly correlated materials.

Structural Analysis of the Regulatory GAF Domains of cGMP Phosphodiesterase Elucidates the Allosteric Communication Pathway

Regulation of photoreceptor phosphodiesterase (PDE6) activity is responsible for the speed, sensitivity, and recovery of the photoresponse during visual signaling in vertebrate photoreceptor cells. It is hypothesized that physiological differences in the light responsiveness of rods and cones may result in part from differences in the structure and regulation of the distinct isoforms of rod and cone PDE6. Although rod and cone PDE6 catalytic subunits share a similar domain organization consisting of tandem GAF domains (GAFa and GAFb) and a catalytic domain, cone PDE6 is a homodimer whereas rod PDE6 consists of two homologous catalytic subunits. Here we provide the x-ray crystal structure of cone GAFab regulatory domain solved at 3.3 Å resolution, in conjunction with chemical cross-linking and mass spectrometric analysis of conformational changes to GAFab induced upon binding of cGMP and the PDE6 inhibitory γ-subunit (Pγ). Ligand-induced changes in cross-linked residues implicate multiple conformational changes in the GAFa and GAFb domains in forming an allosteric communication network. Molecular dynamics simulations of cone GAFab revealed differences in conformational dynamics of the two subunits forming the homodimer and allosteric perturbations on cGMP binding. Cross-linking of Pγ to GAFab in conjunction with solution NMR spectroscopy of isotopically labeled Pγ identified the central polycationic region of Pγ interacting with the GAFb domain. These results provide a mechanistic basis for developing allosteric activators of PDE6 with therapeutic implications for halting the progression of several retinal degenerative diseases.

[A novel trans-muscular approach for microsurgical bilateral decompression via unilateral approach for degenerative lumbar stenosis: a series study]

Objective: To compare clinical outcomes of microsurgical bilateral decompression via unilateral approach (MBDU) between trans longissimus and iliocostalis approach, a novel lateral paraspinal approach(LPA), and classic Wiltseapproach for single level degenerative lumbar stenosis. Methods: LPA approach was researched by imaging measurement and cadaver anatomy. Retrospective analysis of a total 124 cases(male/female 75/49, aged(55±14) years) received single-level MBDU due to degenerative lumbar stenosis from 2016 to 2018 in Beijing Tiantan Hospital. Patients were categorized into two groups according to spinal canal morphology. Group A: trefoil shape (n=48), received MBDU via LPA; Group B: round & oval shape (n=76), received MBDU via Wiltse approach. Clinical parameters, including visual analogue scale (VAS) of pain, OswestryDability Index (ODI), satisfaction rate were assessed before the operation and at the latest follow-up. The internal fixation and intervertebral fusion were evaluated by X-ray and CT.The data were compared with single sample t test between the two groups. Results: The feasibility of trans longissimus and iliocostalis approach was proved by imaging measurement and anatomic study. The tube's maximum tilt angle in LPA group was 65°, and it was 40°in Wiltse group. There was no significantly difference in the operating time, bleeding and drainage volume between the two groups((120±27) min vs (115±32) min, (104±31) ml vs (110±41) ml, (50±15) ml vs (47±18) ml, respectively, t=1.246,-1.917,1.730,all P>0.05). In both groups, VAS and ODI scores significantly improved at the latest follow-up when compared with those before the operation (all P<0.05), but those were all comparable between the two groups(all P>0.05). The excellent rate of subjective satisfaction for the clinical efficacy in group A and B was 89.6%(43/48) and 86.8%(66/76) respectively (χ(2)=0.208,P>0.05). Conclusions: LPA approachfor microsurgical bilateral decompression via unilateral approach (MBDU) in degenerative lumbar stenosis is safe and effective, it has advantages in direct vison of contralateral nerve root canal decompression for trefoil shaped spinal canal.

Single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle: a novel technique for pediatric inguinal hernia

PURPOSE

Laparoscopic high ligation of the internal inguinal ring is an alternative procedure for treatment of pediatric inguinal hernia (PIH), with a major trend toward increasing use of extracorporeal knotting and decreasing use of working ports. We have utilized this laparoscopic technique to treat the entire spectrum of PIH (including incarcerated cases) for more than 17 years, and the technique continues to evolve and improve. We herein report our latest modification of this minimally invasive technique, namely single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle, and evaluate its safety and efficacy.

METHODS

From July 2016 to July 2019, 790 children with indirect PIH were treated by laparoscopic surgery. All patients underwent high ligation surgery with a modified single-site laparoscopic technique mainly performed by extracorporeal suturing with an ordinary closed-eye taper needle (1/2 arc 11 × 34). The clinical data were retrospectively analyzed.

RESULTS

All surgeries were successful without serious complications. A contralateral patent processus vaginalis (CPPV) was found intraoperatively and subsequently repaired in 190 patients (25.4%). The mean operative time was 15 min (8-25 min) for 557 unilateral hernias and 21 min (14-36 min) for 233 bilateral hernias. The mean postoperative stay was 20 h. Minor complications occurred in five patients (0.63%) and were managed properly, with no major impact on the final outcomes. No recurrence was noted in the patients who were followed up for 6-42 months. No obvious scar was present postoperatively.

CONCLUSION

Modified SLPEC of hernia sac high ligation using an ordinary taper needle for repair of indirect PIH is a safe, reliable, and minimally invasive procedure with satisfactory outcome, with no special device being needed. It is easy to learn and perform and is worthy of popularization in the clinical setting.

Construction of a doxycycline inducible lentivirus that expresses stem cell-specific miR-302 cluster

INTRODUCTION

The polycistronic miR-302 cluster encodes five miRNA genes that have an important role in the regulation of embryonic stem cell function. Studies showed that the miR-302 cluster can reprogram both mouse and human fibroblasts to induced pluripotent stem cells (iPSCs) with high efficiency. The aim of this study was to generate an inducible lentivirus that expresses miR-302 cluster in order to further investigate somatic cell reprogramming by these miRNAs.

MATERIALS AND METHODS

The miR-302 cluster was amplified by polymerase chain reaction technique from human genomic DNA and was ligated into pTRIPz, an inducible lentiviral vector.

RESULTS

MRC5 fibroblasts and HEK293 (human embryonic kidney) cells were infected with pTRIPz-302 cluster lentivirus and the family of 302 miRNAs were strongly expressed in HEK293 cells but lowly expressed in MRC5 fibroblasts. When cultured in hESC conditions, MRC5 cells expressed only low levels of DNMT3B, Nanog, Oct4 and Lin28 and failed to show stem cell induction. The red fluorescent expression seen in the majority of MRC5 cells, indicated that the rate of infection by lentivirus was efficient.

DISCUSSION

The efficiency of reprogramming may be improved perhaps by either using a different cell type or a high expression vector with a different type of promoter.

[Clinical safety and efficiency of ultrasonic bone curette used in anterior cervical discectomy and fusion surgery]

Objective: To investigate the safety and efficiency of ultrasonic bone curette used in anterior cervical discectomy and fusion surgery. Methods: As a retrospective study, we collected and analyzed the clinical data of 47 patients receiving anterior cervical discectomy and fusion surgery in Luohe Central Hospital from January 2014 to January 2017, there were 26 males and 21 females with a mean age of (52±9) years. According to the different surgical tools used in the process of decompression by resecting osteophytes or bone like an inverted Chinese character "" located at the posterior margin of the vertebral body, the patients were divided into two groups: ultrasonic bone curette group (group A) and traditional tools group (group B). The operating time, volume of intraoperative blood losing, complications, Japanese Orthopedic Association (JOA) score before and after the operation and improvement rate were recorded in the two groups. The t test was used to compare the data between the two groups. Results: In group A, the operating time was (47±7) min, blood loss was (49±4) ml, 1 case experienced urinary tract infection and there was no cerebrospinal fluid leakage or spinal cord injury. In group B, the operating time was (54±12) min and the blood loss was (117±16) ml, cerebrospinal fluid leakage occurred in 2 patients and the incision healed one-stage by local compression, hoarseness happened in 1 case and it disappeared after 2 weeks, 2 patients had swallowing discomfort and recovered in one month, no spinal cord injury occurred in this group. The operating time and blood loss in group A were lower than those in group B (t=2.691, 20.704, both P<0.05). And the incidence of complications in group A were lower than that in group B (χ(2)=4.157, P=0.041). The JOA score of group A at 3 days after surgery was improved for 39.0% when compared with that before the surgery, and it was improved for 71.6% at one year after the surgery. The JOA score in group B at 3 days after surgery was elevated for 38.7% from that before the surgery, and it increased for 69.4% at one year after the surgery. There was no significant different in JOA score before the surgery, 3 days and one year after the surgery between the two groups (t=0.611, 1.076, 0.061, all P>0.05). Conclusion: In the process of decompression by resecting osteophytes or bone located at the posterior margin of the vertebral body in the anterior cervical discectomy and fusion surgery, ultrasonic bone curette is safe and effective, and it can effectively shorten the operating time, decrease the blood loss and cut down the incidence of complications.

Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator's experience

Microvascular coupler devices have gained wide acceptance as an alternative to the traditional hand-sewn technique in reconstructive surgery. However, no study has directly compared the efficacy of the coupler and hand-sewn techniques in arterial anastomosis during head and neck reconstruction surgery. A total of 123 patients who underwent surgery performed by a single surgeon between 2016 and 2018 were included in this retrospective study. The patients were divided into the coupler group and the hand-sewn group according to the technique of arterial anastomosis used. Patients in the coupler group underwent a special procedure including arterial bifurcation to enlarge the recipient artery diameter. Of the 123 free flap surgeries performed, 56 were done using a coupler and 67 with the standard suture technique. One flap in the coupler group failed due to simultaneous arterial and venous thromboses. One flap in the hand-sewn group was lost due to venous compromise. The overall flap survival rate was 98.4% (n=121). There was a significant decrease in anastomotic time when a coupler was used (P<0.001). The complication and flap loss rates were similar in the coupler and hand-sewn groups. The application of the coupler helped to decrease the anastomotic time and achieved satisfactory vessel patency.

Direct investigation of current transport in cells by conductive atomic force microscopy

Currents play critical roles in neurons. Direct observation of current flows in cells at nanometre dimensions and picoampere current resolution is still a daunting task. In this study, we investigated the current flows in hippocampal neurons, PC12 cells and astrocytes in response to voltages applied to the cell membranes using conductive atomic force microscopy (CAFM). The spines in the hippocampal neurons play crucial roles in nerve signal transfer. When the applied voltage was greater than 7.2 V, PC12 cells even show metallic nanowire-like characteristics. Both the cell body and glial filaments of astrocytes yielded CAFM test results that reflect different electrical conductance. To our best knowledge, the electrical characteristics and current transport through components of cells (especially neurons) in response to an applied external voltage have been revealed for the first time at nanometre dimensions and picoampere current levels. We believe that such studies will pave new ways to study and model the electrical characteristics and physiological behaviours in cells and other biological samples.