[A survey on the implementation of cardiovascular surgery for congenital heart disease in China between 2017 and 2021]

Objective: To investigate the inplementation of cardiovascular surgery for congenital heart disease (CHD) in China. Methods: A cross-sectional study was carried out. The CHD cardiovascular surgery data collected by the Chinese Society of Extracorporeal Circulation from 2017 to 2021 in 31 provinces (autonomous regions/municipalities) of China were retrospectively reviewed, the implementation of CHD cardiovascular surgery in different provinces, regions, general/specialized hospitals, and different age groups (whether≤18 years old) were summarized, and the correlation analysis between the number of surgeries carried out in each province/region and the gross regional product and the number of the regional population was performed. Results: Between 2017 and 2021, the annual volume of CHD cardiovascular surgery was 77 120, 77 634, 81 161, 62 663 and 71 492, respectively, showing a decreasing trend. Meanwhile, the proportion of CHD patients aged≤18 years who underwent cardiovascular surgery also showed a downward trend, from 79.8% (61 557/77 120) in 2017 to 58.6% (41 871/71 492) in 2021 (P=0.027). The number of surgical cases varied greatly among different provinces, including 4 provinces with≥5 000 cases and 9 provinces with 2 000-5 000 cases. In the five years, the number of CHD cardiovascular surgeries in Central and East China was the largest, accounting for 41.1%-45.5% of the total surgical cases. The proportion of CHD surgery cases≤18 years old was the highest in Southwest China (69.7%-87.4%) and the lowest in Northeast China (28.2%-68.9%). Except for 2021, the number of cases carried out by each region between 2017 and 2020 was correlated with the gross regional product (r=0.929, 0.929, 0.893 and 0.964, respectively, all P<0.05) and the population (r=0.821, 0.893, 0.821 and 0.857, respectively, all P<0.05). Hospitals that performed more than 100 operations (20.5%±1.2% of the total number of hospitals) completed 86.2%±1.2% of the total number of operations in China during the 5-year period. In 2017 and 2021, the number of CHD cardiovascular surgeries preformed in children's/women's and children's specialized hospitals accounted for 24.3% (18 772/77 120) and 23.8% (17 012/71 492) of the total number of cases in China, respectively. Conclusions: From 2017 to 2021, the number of cardiovascular surgery for CHD decreases slightly, but the proportion of surgery for adult CHD patients increases significantly.There is a strong correlation between the number of CHD operations in each region and their economic development status. The scale of CHD cardiovascular surgery performed in children's hospitals/women's and children's hospitals accounts for about a quarter of the total volume in China.

Bioreactor Expansion Affects Microbial Succession of Mixotrophic Acidophiles and Bioremediation of Cadmium-Contaminated Soils

Microbial scale-up cultivation is the first step to bioremediating cadmium (Cd)-contaminated soils at the industrial scale. However, the changes in the microbial community as the bioreactor volume expands and their associations with soil Cd removal remain unclear. Herein, a six-stage scale-up cultivation process of mixotrophic acidophiles was conducted, scaling from 0.1 L to 10 m3, to remediate Cd-contaminated soils. The findings showed that bioreactor expansion led to a delay in sulfur and glucose oxidations, resulting in a reduced decline in solution pH and cell density. There were minimal differences observed in bacterial alpha-diversity and community structure as the bioreactor volume increased, except for the 10 m3 scale. However, bioreactor expansion decreased fungal alpha-diversity, changed the community structure, and simplified fungal community compositions. At the family level, Acidithiobacillaceae and Debaryomycetaceae dominated the bacterial and fungal communities throughout the scale-up process, respectively. Correlation analysis indicated that the indirect effect of mixotrophic acidophiles played a significant role in soil Cd removal. Bacterial community shifts, driven by changes in bioreactor volume, decreased the pH value through sulfur oxidation, thereby indirectly enhancing Cd removal efficiency. This study will contribute to the potential industrial application of mixotrophic acidophiles in bioremediating Cd-contaminated soils.

Inherited KDM6AA649T facilitates tumor-immune escape and exacerbates colorectal signet-ring cell carcinoma outcomes

Childhood onset of colorectal signet-ring cell carcinoma (CR-SRCC) is extremely rare and featured as highly malignant with poor prognosis. Here we reported a CR-SRCC case of 11-year-old boy with a novel inherited X-linked KDM6AA694T mutation. The H3K27me3 demethylase KDM6A was frequently mutated in varieties of tumors and acts as a tumor suppressor. In vivo H3K27me3 demethylation assay demonstrated that KDM6AA694T had dampened H3K27me3 demethylase activity. Overexpression of KDM6AA694T in SRCC cell line KATO3 promoted cell proliferation, invasion and migration, which were further confirmed in vivo by constructing orthotopic tumor growth and lung metastasis model. Besides, expression of KDM6AA694T in immune cells suppresses inflammatory macrophage response and effector T cell response. In conclusion, we characterized a novel inherited KDM6AA694T mutant from a childhood-onset SRCC case and demonstrated that the mutant with impaired H3K27me3 demethylase activity could potentiate tumor malignancy and suppress antitumor immunity.

Elimination of virus-like particles reduces protein aggregation and extends replicative lifespan in Saccharomyces cerevisiae

A major consequence of aging and stress, in yeast to humans, is an increased accumulation of protein aggregates at distinct sites within the cells. Using genetic screens, immunoelectron microscopy, and three-dimensional modeling in our efforts to elucidate the importance of aggregate annexation, we found that most aggregates in yeast accumulate near the surface of mitochondria. Further, we show that virus-like particles (VLPs), which are part of the retrotransposition cycle of Ty elements, are markedly enriched in these sites of protein aggregation. RNA interference-mediated silencing of Ty expression perturbed aggregate sequestration to mitochondria, reduced overall protein aggregation, mitigated toxicity of a Huntington's disease model, and expanded the replicative lifespan of yeast in a partially Hsp104-dependent manner. The results are in line with recent data demonstrating that VLPs might act as aging factors in mammals, including humans, and extend these findings by linking VLPs to a toxic accumulation of protein aggregates and raising the possibility that they might negatively influence neurological disease progression.

Atomic-Level Matching Metal-Ion Organic Hybrid Interface to Enhance Energy Storage of Polymer-Based Composite Dielectrics

In this work, a distinctive "metal-ion organic hybrid interface" (MOHI) between polyimide (PI) and calcium niobate (CNO) nanosheets is designed. The metal ions in the MOHI can achieve atomic-level matching not only with the inorganic CNO, but also with the PI chains, forming uniform and strong chemical bonds. These results are demonstrated by experiment and theory calculations. Significantly, the MOHI reduces the free volume and introduces deep traps across the filler-matrix interfacial area, thus suppressing the electric field distortion in PI-based composite dielectrics. Consequently, PI-based dielectric containing the MOHI exhibits excellent energy storage performance. The energy storage densities (Ue) of the composite dielectric reach 9.42 J cm-3 and 4.75 J cm-3 with energy storage efficiency (η) of 90% at 25 °C and 150 °C respectively, which are 2.6 and 11.6 times higher than those of pure PI. This study provides new ideas for polymer-based composite dielectrics in high energy storage.

Serratia marcescens LYGN1 Reforms the Rhizosphere Microbial Community and Promotes Cucumber and Pepper Growth in Plug Seedling Cultivation

The vegetable plug seedling plays an important role in improving vegetable production. The process of plug seedling contributes to high-quality vegetable seedlings. The substrate composition and chemical fertilizer are widely studied to promote seedling growth. However, little is known about the effect of beneficial bacteria in the rhizosphere microbial community and vegetables' growth during plug seedling. The use of beneficial microbes to promote vegetable seedling growth is of great potential. In this study, we showed that the Serratia marcescens strain LYGN1 enhanced the growth of cucumber and pepper seedlings in plug seedling cultivation. The treatment with LYGN1 significantly increased the biomass and the growth-related index of cucumber and pepper, improving the seedling quality index. Specifically, LYGN1 also improved the cucumber and pepper root system architecture and increased the root diameter. We applied high-throughput sequencing to analyze the microbial community of the seedlings' rhizosphere, which showed LYGN1 to significantly change the composition and structure of the cucumber and pepper rhizosphere microbial communities. The correlation analysis showed that the Abditibacteriota and Bdellovibrionota had positive effects on seedling growth. The findings of this study provide evidence for the effects of Serratia marcescens LYGN1 on the cucumber and pepper rhizosphere microbial communities, which also promoted seedling quality in plug seedling cultivation.

Poly (ADP-ribose) Polymerase Inhibitors in Patients with Metastatic Castration-Resistant Prostate Cancer: A Meta-Analysis of Randomized Controlled Trials

Context: Several recent randomized controlled trials (RCTs) have reported on the survival benefits of poly (ADP-ribose) polymerase inhibitors (PARPi) compared to standard-of-care (SOC) treatment (enzalutamide, abiraterone, or docetaxel) in patients with metastatic castration-resistant prostate cancer (mCRPC). However, there is a limited integrated analysis of high-quality evidence comparing the efficacy and safety of PARPi and SOC treatments in this context. Objective: This study aims to comprehensively analyze the survival benefits and adverse events associated with PARPi and SOC treatments through a head-to-head meta-analysis in mCRPC. Evidence acquisition: A systematic review search was conducted in PubMed, Embase, Clinical trials, and the Central Cochrane Registry in July 2023. RCTs were assessed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The systematic review was prospectively registered on PROSPERO (CRD42023441034). Evidence synthesis: A total of 8 studies, encompassing 2341 cases in the PARPi treatment arm and 1810 cases in the controlled arm, were included in the qualitative synthesis. The hazard ratio (HR) for radiographic progression-free survival (rPFS) and overall survival (OS) were 0.74 (95% CI, 0.61-0.90) and 0.89 (95% CI, 0.80-0.99), respectively, in the intention-to-treatment patients. For subgroup analysis, HRs for rPFS and OS in the BRCA-mutated subgroup were 0.39 (95% CI, 0.28-0.55) and 0.62 (95% CI, 0.38-0.99), while in the HRR-mutated subgroup, HR for rPFS was 0.57 (95% CI, 0.48-0.69) and for OS was 0.77 (95% CI, 0.64-0.93). The odds ratio (OR) for all grades of adverse events (AEs) and AEs with severity of at least grade 3 were 3.86 (95% CI, 2.53-5.90) and 2.30 (95% CI, 1.63-3.26), respectively. Conclusions: PARP inhibitors demonstrate greater effectiveness than SOC treatments in HRR/BRCA-positive patients with mCRPC. Further research is required to explore ways to reduce adverse event rates and investigate the efficacy of HRR/BRCA-negative patients.

[Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation]

Objective: To explore the value of the aMAP risk score (age, male, albumin-bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods: This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors. Results: Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group (P=0.001). Conclusions: The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..

The "Hand as Foot" teaching method in calcaneal skeletal traction nursing

OBJECTIVE

To introduce the application of "Hand as Foot" teaching method in calcaneal skeletal traction nursing.

Fatty Acids Support the Fitness and Functionality of Tumor-Resident CD8+ T Cells by Maintaining SCML4 Expression

CD8+ tissue-resident memory T (Trm) cells and tumor-infiltrating lymphocytes (TIL) regulate tumor immunity and immune surveillance. Characterization of Trm cells and TILs could help identify potential strategies to boost antitumor immunity. Here, we found that the transcription factor SCML4 was required for the progression and polyfunctionality of Trm cells and was associated with a better prognosis in patients with cancer. Moreover, SCML4 maintained multiple functions of TILs. Increased expression of SCML4 in CD8+ cells significantly reduced the growth of multiple types of tumors in mice, while deletion of SCML4 reduced antitumor immunity and promoted CD8+ T-cell exhaustion. Mechanistically, SCML4 recruited the HBO1-BRPF2-ING4 complex to reprogram the expression of T cell-specific genes, thereby enhancing the survival and effector functions of Trm cells and TILs. SCML4 expression was promoted by fatty acid metabolism through mTOR-IRF4-PRDM1 signaling, and fatty acid metabolism-induced epigenetic modifications that promoted tissue-resident and multifunctional gene expression in Trm cells and TILs. SCML4 increased the therapeutic effect of anti-PD-1 treatment by elevating the expression of effector molecules in TILs and inhibiting the apoptosis of TILs, which could be further enhanced by adding an inhibitor of H3K14ac deacetylation. These results provide a mechanistic perspective of functional regulation of tumor-localized Trm cells and TILs and identify an important activation target for tumor immunotherapy.

SIGNIFICANCE

SCML4 upregulation in CD8+ Trm cells and tumor-infiltrating lymphocytes induced by fatty acid metabolism enhances antitumor immune responses, providing an immunometabolic axis to target for cancer treatment. See related commentary by Chakraborty et al., p. 3321.

DSE inhibits melanoma progression by regulating tumor immune cell infiltration and VCAN

Dermatan sulfate epimerase (DSE) is a C5 epiminase that plays a key role in converting chondroitin sulfate into dermal sulfate. DSE is often upregulated during carcinogenesis of some types of cancer and can regulate growth factor signaling in cancer cells. However, the expression and function of DSE in human melanoma have not been reported. In this study, we investigated the influence of tumor-derived DSE in melanoma progression and the potential mechanism of their action. First, proteomic analysis of collected melanoma tissues revealed that DSE was significantly down-regulated in melanoma tissues. DSE silenced or overexpressed melanoma cells were constructed to detect the effect of DSE on melanoma cells, and it was found that the up-regulation of DSE significantly inhibited the proliferation, migration and invasion of melanoma cells. Data analysis and flow cytometry were used to evaluate the immune subpopulations in tumors, and it was found that the high expression of DSE was closely related to the invasion of killer immune cells. Mechanistically, DSE promoted the expression of VCAN, which inhibited the biological activity of melanoma cells. Together, these results suggest that DSE is downregulated in melanoma tissues, and that high expression of DSE can promote melanoma progression by inducing immune cell infiltration and VCAN expression.

Effects of Thermal-Strain-Induced Atomic Intermixing on the Interfacial and Photoluminescence Properties of InGaAs/AlGaAs Multiple Quantum Wells

Quantum-well intermixing (QWI) technology is commonly considered as an effective methodology to tune the post-growth bandgap energy of semiconductor composites for electronic applications in diode lasers and photonic integrated devices. However, the specific influencing mechanism of the interfacial strain introduced by the dielectric-layer-modulated multiple quantum well (MQW) structures on the photoluminescence (PL) property and interfacial quality still remains unclear. Therefore, in the present study, different thicknesses of SiO2-layer samples were coated and then annealed under high temperature to introduce interfacial strain and enhance atomic interdiffusion at the barrier-well interfaces. Based on the optical and microstructural experimental test results, it was found that the SiO2 capping thickness played a positive role in driving the blueshift of the PL peak, leading to a widely tunable PL emission for post-growth MQWs. After annealing, the blueshift in the InGaAs/AlGaAs MQW structures was found to increase with increased thickness of the SiO2 layer, and the largest blueshift of 30 eV was obtained in the sample covered with a 600 nm thick SiO2 layer that was annealed at 850 °C for 180 s. Additionally, significant well-width fluctuations were observed at the MQW interface after intermixing, due to the interfacial strain introduced by the thermal mismatch between SiO2 and GaAs, which enhanced the inhomogeneous diffusion rate of interfacial atoms. Thus, it can be demonstrated that the introduction of appropriate interfacial strain in the QWI process is of great significance for the regulation of MQW band structure as well as the control of interfacial quality.

Atomic-scale insights into the interfacial charge transfer in a NiO/CeO2 heterostructure for electrocatalytic hydrogen evolution

To understand the underlying mechanism of the interfacial charge transfer and local chemical state variation in the nonprecious-based hydrogen evolution reaction (HER) electrocatalysts, a model system of the NiO/CeO₂ heterostructure was chosen for investigation using a combination of the advanced electron microscopic characterization and first-principles calculations. The results directly proved that interfacial charge transfer occurs from Ni to Ce, leading to reduction in the valence state of Ce and increased formation of V_O. This would optimize ΔG_H* and facilitate the hydrogen evolution process, resulting in outstanding HER performance in 1 M KOH with a low overpotential of 99 mV at the current density of 10 mA•cm^-2 and a modest Tafel slope of 78.4 mV•dec^-1 for the NiO/CeO₂ heterostructure sample. Therefore, the improved HER performance could be attributed to the synergistic coupling interactions and electron redistribution at the interface of NiO and CeO₂. These results concretely demonstrate the direct determination of the interfacial structure of the heterostructure and provide atomistic insights to unravel the underlying mechanism of interfacial charge transfer induced HER performance improvement.

[Risk factors associated with in-hospital mortality in patients requiring extracorporeal membrane oxygenation in the perioperative period of heart transplantation]

Objective: To explore risk factors associated with in-hospital mortality in patients requiring extracorporeal membrane oxygenation (ECMO) in the perioperative period of heart transplantation. Methods: The data of ECMO cases in the perioperative period of heart transplantation from the Chinese Society of Extracorporeal Life Support (CSECLS) between January 2017 and December 2021 were retrospectively analyzed. These patients were divided into the survival group and non-survival group according to their outcomes at discharge. The demographics, indications and complications of ECMO between the two groups were compared, and the related risk factors of poor prognosis were analyzed. Results: A total of 77 patients were included in the study, including 67 males and 10 females, with a median age [M(Q₁, Q₃)] of 48 (36, 59) years. Sixty-three patients (81.8%) were successfully withdrawn from the ECMO and 46 patients (59.7%) survived to discharge. The median ECMO time was 139 (92, 253) hours. Compared with the survival group, the non-survival group (n=31) had more patients with chronic kidney disease before surgery [22.6% (7/31) vs 4.3% (2/46), P=0.034], and a higher proportion of continuous renal replacement therapy (CRRT) during ECMO [74.2% (23/31) vs 50.0% (23/46), P=0.034]. Moreover, the non-survival group had longer duration of extracorporeal circulation [262 (195, 312) vs 201 (155, 261) min, P=0.056] and higher lactate value in the first 24 hours of ECMO support [2.7 (2.1, 4.7) vs 2.3 (1.4, 3.8) mmol/L, P=0.060], but the differences were not statistically significant. Multivariate logistic regression analysis showed that perioperative application of CRRT was an independent risk factor for poor prognosis in ECMO patients during heart transplantation (OR=19.345, 95%CI: 1.209-309.440, P=0.036). Conclusion: CRRT treatment during ECMO is a risk factor for in-hospital mortality in patients undergoing heart transplantation.

m6A methylation regulates hypoxia-induced pancreatic cancer glycolytic metabolism through ALKBH5-HDAC4-HIF1α positive feedback loop

Pancreatic cancer (PC) is the most hypoxic cancer type among solid tumors. The dynamic changes of RNA N6-methyl-adenosine (m6A) contribute to tumor cells adaption to hypoxic microenvironmental. However, the regulatory mechanisms of hypoxia response in PC remains elusive. Here, we reported that the m6A demethylase ALKBH5 mediated a decrease of total mRNA m6A modification during hypoxia. Subsequently, methylated RNA immunoprecipitation sequencing (MeRIP-seq) combined with RNA sequencing (RNA-seq) revealed transcriptome-wide gene expression alteration and identified histone deacetylase type 4 (HDAC4) as a key target gene of m6A modification under hypoxic conditionds. Mechanistically, m6A methylation recognized by m6A reader-YTHDF2 enhanced the stability of HDAC4, and then promoted glycolytic metabolism and migration of PC cells. Our assays also demonstrated that hypoxia-induced HDAC4 enhanced HIF1a protein stability, and overexpressed HIF1a promoted transcription of ALKBH5 in hypoxic pancreatic cancer cells. Together, these results found a ALKBH5/HDAC4/HIF1α positive feedback loop for cellular response to hypoxia in pancreatic cancer. Our studies uncover the crosstalk between histone acetylation and RNA methylation modification on layer of epigenetic regulation.

Self-Adaptive Electronic Structure of Amphoteric Conjugated Ligand-Modified 3 d Metal-C3 N4 Smart Electrocatalyst by pH Self-Response Realizing Electrocatalytic Self-Adjustment

Constructing pH-responsive smart material provides a new opportunity to address the problem that traditional electrocatalysts cannot achieve both alkaline oxygen evolution reaction (OER) and acidic hydrogen evolution reaction (HER) activities. In this study, amphoteric conjugated ligand (2-aminoterephthalic acid, BDC-NH₂ )-modified 3d metal-anchored graphitic carbon nitride (3d metal-C₃ N₄ ) smart electrocatalysts are constructed, and self-adaptation of the electronic structure is realized by self-response to pH stimulation, which results in self-adjustment of alkaline OER and acidic HER. Specifically, the amino and carboxyl functional groups in BDC-NH₂ undergo protonation and deprotonation respectively under different pH stimulation to adapt to environmental changes. Through DFT calculations, the increase or decrease of electron delocalization range brought by the self-response characteristic is found to lead to redistribution of the Bader charge around the modified active sites. The OER and HER activities are greatly promoted roughly 4.8 and 8.5 times over Co-C₃ N₄ after BDC-NH₂ -induced self-adaptive processes under different environments, arising from the reduced energy barrier of O* to OOH* and ΔG_H* . Impressively, the proposed BDC-NH₂ -induced smart regulation strategy is applicable to a series of 3d metal anchors for C₃ N₄ , including Co, Ni and Fe, providing a general structural upgrading method for constructing smart electrocatalytic systems.

[Treat-all: challenges of partial response and low-level viremia]

The recently updated "Guidelines for the Prevention and Treatment of Chronic Hepatitis B" in China have brought about significant changes. The new treatment indications almost mandate the implementation of a Treat-all strategy for the chronically HBV-infected population in China. While simultaneous negativity for hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) DNA has long been an accepted criterion for treatment discontinuation, there has been controversies over the initiation of treatment criteria starting with HBsAg and HBV DNA positivity. Despite the inconsistent treatment criteria, the academic community has started supporting treat-all strategies in recent years due to the decreasing cost of treatment, prolonged management duration, and growing evidence of poor outcomes in untreated populations. Therefore, this update to the Chinese HBV guidelines represents a new direction that suggests "The greatest truths are the simplest." However, in the process of rolling out the Treat-all strategy, we must remain cautious of possible issues arising from the new strategy. Among them, the problem of partial response or low-level viremia following treatment may become more prominent due to the inclusion of a significant number of patients with normal or low levels of alanine transaminase. As existing evidence suggests that low-level viremia increases the risk of HCC in patients, it is essential to monitor and explore optimal therapeutic options for these patients.

Development and Validation of the Prediction Model of Sepsis in Patients After Percutaneous Nephrolithotomy and Sepsis Progresses to Septic Shock

Background: To study the predictors of sepsis and the progression of sepsis to septic shock in patients after percutaneous nephrolithotomy (PCNL) and to establish and validate predictive models. Methods: The patients were assigned to either the development cohort or the validation cohort depending on their hospital. In the development cohort, univariate and multivariate logistic regression analyses were used to screen independent risk factors for sepsis after PCNL and sepsis progression to septic shock. Nomogram prediction models were established according to the related independent risk factors. Areas under the receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) were used to estimate the discrimination, calibration, and clinical usefulness of the prediction models, respectively. The two sets of models were further validated on the validation cohort. Results: In the development cohort, the risk factors for sepsis after PCNL were diabetes, urine nitrite, staghorn calculi, HU value, albumin-globulin ratio, and high-sensitivity C-reactive protein/albumin ratio. The pre- and postoperative white blood cell counts were risk factors for the progression of sepsis to septic shock. The area under the ROC curve value for predicting sepsis risk was 0.891 and that for predicting septic shock risk was 0.981 in the development cohort; in the validation cohort, these values were 0.893 and 0.996, respectively. In the development cohort, the calibration test p values in the sepsis and septic shock cohorts were 0.946 and 0.634, respectively; in the validation cohort, these values were 0.739 and 0.208, respectively. DCA of the model in the sepsis and septic shock cohorts showed threshold probabilities of 10%-90% in the development cohort; in the validation cohort, these values were 10%-90%. Conclusion: The individualized nomogram prediction models can help improve the early identification of patients who are at higher risk of developing sepsis after PCNL and the progression of sepsis to septic shock to avoid further damage.

Synthesis of Fibrous Phosphorus Micropillar Arrays with Pyro-Phototronic Effects

The bottom-up preparation of two-dimensional material micro-nano structures at scale facilitates the realisation of integrated applications in optoelectronic devices. Fibrous Phosphorus (FP), an allotrope of black phosphorus (BP), is one of the most promising candidate materials in the field of optoelectronics with its unique crystal structure and properties.^[1] However, to date, there are no bottom-up micro-nano structure preparation methods for crystalline phosphorus allotropes.^[1c, 2] Herein, we present the bottom-up preparation of fibrous phosphorus micropillar (FP-MP) arrays via a low-pressure gas-phase transport (LP-CVT) method that controls the directional phase transition from amorphous red phosphorus (ARP) to FP. In addition, self-powered photodetectors (PD) of FP-MP arrays with pyro-phototronic effects achieved detection beyond the band gap limit. Our results provide a new approach for bottom-up preparation of other crystalline allotropes of phosphorus.

USP48 stabilizes gasdermin E to promote pyroptosis in cancer

Pyroptosis is a type of programmed cell death characterized by the activation of inflammatory caspases and the cleavage of gasdermin proteins. Pyroptosis can suppress tumor development and induce anti-tumor immunity, and activating pyroptosis is a potential treatment strategy for cancer. To uncover approaches to harness the anti-cancer effects of pyroptosis, we aimed to identify regulators of pyroptosis in cancer. A CRISPR-Cas9 screen identified that loss of USP48, a deubiquitinating enzyme, significantly inhibited cell pyroptosis. USP48 promoted pyroptosis by stabilizing gasdermin E (GSDME). USP48 bound GSDME and removed K48-linked ubiquitination at positions K120 and K189. Clinical tissue testing confirmed that the expression of USP48 positively correlated with GSDME and pyroptosis-related factors. Single-cell sequencing showed that the functions of T cells and tumor-associated macrophages in the tumor microenvironment were inhibited after USP48 knockout. Finally, overexpression of USP48 enhanced the therapeutic efficacy of PD-1 inhibitors in tumors in mouse models. Together, these findings define a pyroptosis regulation pathway and indicate that pharmacological activation of USP48 may provide an effective strategy to sensitize cancer cells to pyroptosis and improve response to immunotherapy.

Research progress of abnormal lactate metabolism and lactate modification in immunotherapy of hepatocellular carcinoma

Tumors meet their energy, biosynthesis, and redox demands through metabolic reprogramming. This metabolic abnormality results in elevated levels of metabolites, particularly lactate, in the tumor microenvironment. Immune cell reprogramming and cellular plasticity mediated by lactate and lactylation increase immunosuppression in the tumor microenvironment and are emerging as key factors in regulating tumor development, metastasis, and the effectiveness of immunotherapies such as immune checkpoint inhibitors. Reprogramming of glucose metabolism and the "Warburg effect" in hepatocellular carcinoma (HCC) lead to the massive production and accumulation of lactate, so lactate modification in tumor tissue is likely to be abnormal as well. This article reviews the immune regulation of abnormal lactate metabolism and lactate modification in hepatocellular carcinoma and the therapeutic strategy of targeting lactate-immunotherapy, which will help to better guide the medication and treatment of patients with hepatocellular carcinoma.

Atomic-Scale Insights into the Interfacial Polarization Effect in the InGaN/GaN Heterostructure for Solar Cells

The model system of the InGaN/GaN quantum wells (QWs), based on the first principles calculation, was chosen to understand the underlying mechanism of interfacial polarization and its synergic effect with the built-in electric field (B_ef) at the p-n junction in solar cells (SLs). The polarized electric field (P_ef) was generated due to the redistribution of electrons and holes at the interface; moreover, the P_ef of InGaN/GaN heterostructure on the semipolar (01-11) GaN surface was consistent with that of on the N-polar (000-1) surface, which is on the lines of the B_ef and favors the electron-hole separation efficiency in SLs. Furthermore, the growth of high-quality InGaN/GaN QWs on the semipolar (01-11) GaN surface was achieved. Such an atomic-scale investigation provides a fundamental understanding of the polarization charge-induced P_ef and its interaction coupling with B_ef at the p-n junction, which could be generalized to polar material-based SLs.

Mixed-Dimensional van der Waals Heterostructure for High-Performance and Air-Stable Perovskite Nanowire Photodetectors

An organic-inorganic hybrid perovskite nanowire (NW), CH₃NH₃PbI₃, shows great potential for high-performance photodetectors due to its excellent photoresponse. However, the inefficient carrier collection between the one-dimensional (1D) NWs and metallic electrodes, as well as degradation of the perovskite, limits the viability of the CH₃NH₃PbI₃ NWs for commercial production. Here, we demonstrate a photodetector with a mixed-dimensional van der Waals heterostructure of hexagonal boron nitride (hBN)/graphene (Gr)/1D CH₃NH₃PbI₃, which exhibits excellent responsivity and specific detectivity of up to 558 A/W and 2.3 × 10¹² Jones, owing to the improved carrier extraction at the electrical contact between Gr and the NW. As for the atomic encapsulation of hBN, the device is extremely robust and maintains its outstanding performance for more than 2 months when exposed to air. Moreover, benefitting from the 1D geometry of the CH₃NH₃PbI₃ NW, our device is highly sensitive to polarized light. The mixed-dimensional van der Waals heterostructure, hBN/Gr/1D CH₃NH₃PbI₃, would provide a novel idea and protocol for fabricating high-performance and air-stable photoelectronic devices based on organic-inorganic hybrid perovskite NWs.

A model for sepsis prediction after retrograde intrarenal surgery and the use of the preoperative/postoperative white blood cell ratio to predict progression from sepsis to septic shock

OBJECTIVES

To study the predictors of sepsis and progression to septic shock after RIRS; to establish and validate predictive models accordingly.

METHODS

In total, 1220 patients were included in the study during. Eight hundred forty-eight patients were assigned to the development cohort and 372 to the validation cohort according to medical record. Univariate and multivariate logistic regression analyses were used to screen independent risk factors for post-RIRS (Retrograde intrarenal surgery) sepsis and progression to septic shock. Nomogram prediction models were established according to the related independent risk factors. Areas under the receiver operating characteristic curves, calibration plots, and DCA (Decision curve analysis) were used to estimate the discrimination, calibration and clinical usefulness of the prediction model, respectively.

RESULTS

In the development cohort, sepsis occurred in 59 patients, 16 of whom developed septic shock. Multivariate logistic regression analyses showed that the independent risk factors for sepsis after RIRS were preoperative D-J stent implantation, hydronephrosis > 6.25 HU (Hounsfield units), AGR (Albumin/globulin ratio) < 1.95, hs-CRP/Alb (High-sensitivity C-reactive protein/albumin ratio) > 0.060, operating time > 67.5 min, and urinary nitrite positivity. The preoperative/postoperative WBC ratio > 1.5 was an independent risk factor for progression from sepsis to septic shock. In the development cohort, the AUC (Area under curve) for predicting sepsis risk was 0.845, and the AUC for predicting septic shock risk was 0.896; in the validation cohort, the corresponding values were 0.896 and 0.974, respectively. In the development cohort, the calibration test P values in the sepsis and septic shock cohorts, respectively, were 0.921 and 0.817; in the validation cohort, these values were 0.882 and 0.859. DCA of the model in the sepsis and septic shock cohorts showed threshold probabilities of 10-90% in the development cohort and 10-50% and 10-20% in the validation cohort.

CONCLUSION

These individualized nomogram prediction models can improve the early identification of patients at risk for developing sepsis after RIRS or progressing from sepsis to septic shock.

Facile and General Method to Synthesize Pt-Based High-Entropy-Alloy Nanoparticles

Pt-based high-entropy-alloy nanoparticles (HEA-NPs) have excellent physical and chemical properties due to the diversity of composition, complexity of surface structure, high mixing entropy, and properties of nanoscale, and they are used in a wide range of catalytic applications such as catalytic ammoxidation, the electrolysis of water to produce hydrogen, CO₂/CO reduction, and ethanol/methanol oxidation reaction. However, offering a facile, low-cost, and large-scale method for preparing Pt-based HEA-NPs still faces great challenges. In this study, we employed a spray drying technique combined with thermal decomposition reduction (SD-TDR) method to synthesize a single-phase solid solution from binary nanoparticles to denary Pt-based HEA-NPs containing 10 dissimilar elements loaded on carbon supports in an H₂ atmosphere with a moderate heating rate (3 °C/min), thermal decomposition temperature (300-850 °C), duration time (30 min), and low cooling rate (5-10 °C/min). The Pt autocatalytic behavior was found and investigated, confirming that Pt element could decrease the reduction temperature of other metals via autocatalytic behavior. Therefore, using the feature of Pt autocatalytic behavior, we have achieved Pt-based HEA-NPs at a minimum temperature of 300 °C. We not only prepared a series of Pt-based HEA-NPs with targetable ingredient, size, and phase using the SD-TDR method but also proved the expandability of the SD-TDR technique by synthesizing Pt-based HEA-NPs loaded on different supports. Moreover, we investigated methanol oxidation reaction (MOR) on as-synthesized senary PtCoCuRuFeNi HEA-NPs, which presented superior electrocatalytic performance over commercial Pt/C catalyst.

[Application of liquid biopsy in early screening and recurrence prediction of hepatocellular carcinoma]

The incidence and mortality of HCC in China account for approximately 50% of all cases worldwide. Low early diagnosis rate and high postoperative recurrence rate are two major causes for poor 5-year survival rate of HCC patients in China. At present, multiple problems such as low performance and compliance of screening technology and lack of effective markers for predicting postoperative recurrence, remain to be resolved. Due to the simplicity and accuracy, new molecular markers, such as liquid biopsy, are expected to serve as supplementary tools to traditional screening and early warning approaches, thereby realizing early detection and accurate treatment of HCC. In this article, research progress upon the clinical application of liquid biopsy in early screening and prediction of postoperative recurrence of HCC was reviewed, and prospects the future research.

Mechanism research and treatment progress of NAD pathway related molecules in tumor immune microenvironment

Nicotinamide adenine dinucleotide (NAD) is the core of cellular energy metabolism. NAMPT, Sirtuins, PARP, CD38, and other molecules in this classic metabolic pathway affect many key cellular functions and are closely related to the occurrence and development of many diseases. In recent years, several studies have found that these molecules can regulate cell energy metabolism, promote the release of related cytokines, induce the expression of neoantigens, change the tumor immune microenvironment (TIME), and then play an anticancer role. Drugs targeting these molecules are under development or approved for clinical use. Although there are some side effects and drug resistance, the discovery of novel drugs, the development of combination therapies, and the application of new technologies provide solutions to these challenges and improve efficacy. This review presents the mechanisms of action of NAD  pathway-related molecules in tumor immunity, advances in drug research, combination therapies, and some new technology-related therapies.

P-448 Changes in gene transcription induced by cyclophosphamide treatment in an experimental ovarian culture model

Study question

How does cyclophosphamide (CPA) treatment impact at transcriptional level on mouse ovarian tissue?

Summary answer

Cultured murine ovarian tissue with CPA versus control showed up-regulated intrinsic and extrinsic apoptotic signaling pathways, associated with DNA damage, DNA repair and oxidative response.

What is known already

Alkylating chemotherapeutic treatment depletes the ovarian pool and induces infertility in women. The suggested mechanisms behind these adverse effects include apoptosis and/or over-activation of the dormant primordial follicle pool. However, there is a lack of knowledge about the pathways that lead to these outcomes and previous researches have been inconclusive. The investigation of changes in the ovarian transcriptomic profiling following the alkylating drug CPA treatment can be useful to identify new potential targets for fertility preservation in women treated for cancer.

Study design, size, duration

Controlled experimental study using 20 female B6CBA/F1 4-day-old mice. Ovaries were collected and randomly assigned to CPA (4-hydroperoxycyclophosphamide) treated group (n = 20) or control group (n = 20). Five ovaries/group were collected at 8, 12, 24 and 36 h to investigate the dynamic of the changes. RNA extraction and RNA sequencing analysis were carried out.

Participants/materials, setting, methods

Ovaries were cultured on Millicell cell culture inserts floating on 0.25 mL culture medium in a 24-well plate. Freshly prepared 4-hydroperoxycyclophosphamide solution was added to the wells of CPA group (final concentration = 5 µM). Equal amount of solvent was added to the wells of control group. Culture medium was refreshed at 48 h with culture medium only. RNA sequencing data were processed for subsequent differentially expressed genes (DEGs) and gene set enrichment analysis (GSEA).

Main results and the role of chance

At 8 h, CPA treatment induced the up-regulation of biological processes related to hypoxia, cell growth and embryonic organ development. At 12 h, DNA damage and the ovarian cell responses were evidenced by an increased activity of DNA damage response, DNA damage checkpoint, DNA repair (double-strand break, mismatch, single strand binding), stress-activated MAPK cascade, antioxidant activity and intrinsic apoptotic signaling pathway. The representative genes of these processes there were Bbc3, Bax, Trp73, Cdkn1a, Trp53inp1 and Mdm2. A dramatic increase in the number of DEGs was found at 24 h (8 h, n = 209; 12 h, n = 239; 24 h, n = 2013). Also at 24 h DNA repair, intrinsic and extrinsic apoptotic signaling pathways were the most representative processes evidenced by the addition of Rad9a, H2afx, Casp3, Bak1 and Casp8 genes to the above mentioned. Whereas, germ cell related genes Ybx2, Nobox and Ddx4 were all down-regulated. At 36 h, the number of DEGs (n = 3804) still increased, the up-regulated pathways were similar to 24 h, while meiosis and microtubule-based movements pathways were observed in the down-regulated set too.

Limitations, reasons for caution

Although the age of the mice chosen for the experiment ensured a high and representative content of primordial follicles in the ovary, whole ovaries were used for RNA sequencing analysis containing a heterogeneous composition of cells other than follicles.

Wider implications of the findings

Our results provide evidence of dynamic sequential changes in transcriptional level where apoptosis was involved in CPA-induced ovarian follicle depletion. Our research indicates a time frame before the occurrence of DNA definitive damage following CPA-treatment, where application of possible treatments in order to prevent the following apoptosis would be possible.

Trial registration number

Not Applicable

Energy Feature of Air Bubble Detachment from a Low-Rank Coal Surface in the Presence of a Dodecane-Oleic Acid Collector Mixture

It has been generally proved that mixed collectors can enhance the flotation of low-rank coal (LRC). However, the inhibition effect of mixed collectors on the detachment between particles and bubbles is still unclear. In this paper, the energy feature of air bubble detachment from the LRC surface in the presence of dodecane (D), oleic acid (OA), and the mixture of dodecane and oleic acid (OA-D) was studied. The effect of collectors on the LRC surface property was analyzed using contact angle measurement, X-ray photoelectron spectroscopy, and wetting heat measurement. The force and displacement during the detachment process were measured synchronously using microforce balance. The results showed that the collector treatment increased the C-C/C-H content and decreased the content of oxygen-containing groups on the LRC surface. The synergistic effect between OA and D enabled the mixed collector to exhibit higher contact angle and wetting heat. Bubble detachment from the LRC surface can be divided into two stages: bubble stretching and bubble sliding, which corresponded to activation energy and detachment work, respectively. The activation energy and detachment work decreased in the same order of OA-D > OA > D, indicating that the mixed collector OA-D increased the energy of bubble detachment from the LRC surface and enhanced the adhesion strength. The theoretical detachment work was calculated, and the calculated results were in agreement with the measured results. This research provides a new perspective on the mechanism of LRC flotation being improved by mixed collectors.

POS0102 GLOBAL CHARACTERIZATION OF SALIVARY GLANDS IMMUNE MICROENVIRONMENT IN PRIMARY SJÖGREN’S SYNDROME BY SINGLE-CELL SEQUENCING

Background

Primary Sjögren’s syndrome (pSS) is a heterogeneous, chronic, complex systemic autoimmune disease. The hallmark symptom of the disease is exocrinopathy, chiefly salivary and lachrymal glands, which often results in dryness of the mouth and eyes. As of today, although a lot of genetic and epigenetic studies have reveal the complexity of pSS to a certain extent, but the knowledge of existing pSS disease heterogeneity is still limited and the immune mechanisms of salivary glands (SG) injury have been challenging to clarify.

Objectives

Single-cell RNA sequencing (scRNA-seq) is a powerful tool capable of defining cell types and states on the basis of their individual transcriptome in a given sample from health and disease. To characterize the salivary glands immune microenvironment of patients with pSS, we performed droplet-based single cell mRNA sequencing (scRNA-seq) (10X Genomics) to provide a deeper insight into the cellular and molecular characteristics of salivary glands from pSS patients.

Methods

11 patients and 5 non-pSS controls were recruited from the The First Affiliated Hospital of USTC. The non-pSS were subjects who had experienced subjective symptoms of dryness, but no not meet any of the classification criteria of pSS. The clinical characteristics and laboratory findings of enrolled patients were also collected. After resection, salivary glands tissue samples were obtained after labial gland biopsy, rapidly digested to a single-cell suspension and subjected to scRNA-seq using the 10X platform. After rigorous quality control (QC) definition, low-quality cells were filtered. Following gene expression normalization for read depth and mitochondrial read count, we applied principle component analysis on genes variably expressed across all 72,853 cell.

Results

A total of 72,853 cells were obtained from all salivary glands samples. Our results revealed 12 major unique cell populations of salivary glands cell, including T cells, B cells, plasma cells, epithelial cells, myoepithelial cells, endothelial cells, myofibroblast, pericytes, melanocytes, fibroblast, myeloid cells and a cluster of unknown cells. As expected, lymphocytes (T and B cell populations) were significant increase in the salivary glands of patients with pSS. For further subsets analysis, we identify 41 subsets, including novel subpopulations in cell types hitherto considered to be homogeneous, as well as transcription factors underlying their heterogeneity. Strikingly, we found that differentially expressed genes (DEGs) that myoepithelial cells uniquely downregulated in pSS patients were involved in regeneration, stem cell population maintenance, cell division, and epithelial cell proliferation. This indicated an impaired stem cell property and regeneration capacity of myoepithelial cells in the SG of pSS patients which may result in the reduction of normal epithelial cells differentiation and proliferation. Our results identified three distinct endothelial subtypes according to the differentially expressed cell markers. ACKR1+ endothelial cells were expanded in the SG of pSS patients which may enhance Leukocyte transendothelial migration. A clear interferon response was observed in most celltypes. We also found a significantly expand PD-1hiCXCR5–CD4+T peripheral helper (Tph), GZMK+CD8+ T cells and a patient-specific fibroblasts in pSS patients. Cellular interaction analysis of SG revealed a strong interaction between epithelial cells and immune cells from pSS patients through CD74-MIF, MIF-TNFRSF14 and HLA-C-FAM3C receptor/ ligand pairs. Chemokine receptors CXCR4 were broadly expressed in SG immune cells implying a potentially central role in cell trafficking.

Conclusion

This resource provides deeper insights into pSS salivary glands immune microenvironment that will be helpful in understanding of the disease heterogeneity and advancing pSS therapy.

Disclosure of Interests

None declared

Application of mixotrophic acidophiles for the bioremediation of cadmium-contaminated soils elevates cadmium removal, soil nutrient availability, and rice growth

A major challenge in radically alleviating the threats posed by Cd-contaminated paddy fields to human health is to reduce the Cd levels in both soils and rice grains. In this study, the microbial extraction (ME) treatment using a mixotrophic acidophilic consortium was used for the bioremediation of Cd-contaminated soils. The results showed that the ME treatment enhanced the total Cd (40%) and diethylenetriamine pentaacetic acid-soluble Cd (DTPA-Cd, 64%) removal efficiencies in contaminated soils. In addition, ME treatment decreased the levels of Cd acid-soluble and reducible fractions and thereby reduced Cd uptake in rice tissues. Microbial community analysis indicated that the indigenous soil microbial diversity and composition were not changed after the ME treatment, but the relative abundance of functional microbes associated with Cd removal was improved. Notably, soil available nutrient levels were elevated upon inoculation with mixotrophic acidophiles, resulting in an increase in rice growth and grain weight. This study provides a scientific basis for the potential application and evaluation of ME treatment in the field for remediating Cd-contaminated paddy soils.

MiR-590 suppresses the progression of non-small cell lung cancer by regulating YAP1 and Wnt/β-catenin signaling

OBJECTIVE

Accumulating evidence has been revealed that miR-590 is involved in the progression and carcinogenesis of various cancers. However, the molecular mechanism of miR-590 in non-small-cell lung cancer (NSCLC) remains unclear.

METHODS

Quantitative reverse transcription-PCR (qRT-PCR), western blot, MTT, and transwell assay were applied to investigate the functional role of miR-590 in this study. Dual luciferase reporter assay was utilized to investigate the interaction between YAP1 and miR-590 expression. Cells transfected with miR-590 mimic or inhibitor were subjected to western blot to investigate the role of Wnt/β-catenin signaling in NSCLC modulated by miR-590.

RESULTS

MiR-590 was down-regulated in NSCLC tissues and cells. Kaplan-Meier analysis found that the higher expression of miR-590 in NSCLC patients, the more improved survival rate of NSCLC patients. Over-expression of miR-590 inhibited NSCLC cell proliferation, migration, and invasion. Moreover, increasing miR-590 suppressed Yes-associated protein 1 (YAP1) expression and inhibited the Wnt/β-catenin pathway in NSCLC cells. Furthermore, miR-590 was negatively correlated with YAP1 expression.

CONCLUSION

These findings demonstrated that the miR-590/YAP1 axis exerted an important role in the progression of NSCLC, suggesting that miR-590 might be the appealing prognostic marker for NSCLC treatment.

Cluster Nanozymes with Optimized Reactivity and Utilization of Active Sites for Effective Peroxidase (and Oxidase) Mimicking

Single-atom catalysts have attracted attention in the past decade since they maximize the utilization of active sites and facilitate the understanding of product distribution in some catalytic reactions. Recently, this idea has been extended to single-atom nanozymes (SAzymes) for the mimicking of natural enzymes such as horseradish peroxidase (HRP) often used in bioanalytical applications. Herein, it is demonstrated that those SAzymes without constructing the reaction pocket of HRP still undergo the OH radical-mediated pathway like most of the reported nanozymes. Their positively charged single-atom centers resulting from support electronegative oxygen/nitrogen hinder the reductive conversion of H₂ O₂ to OH radicals and hence display low activity per site. In contrast, it is found that this step can be facilitated over their metallic counterparts on cluster nanozymes with much higher site activity and atom efficiency (cf. SAzymes with 100% atom utilization). Besides the mimicking of HRP in glucose detection, cluster nanozymes are also demonstrated as a better oxidase mimetic for glutathione detection.

Heteroauxin-producing bacteria enhance the plant growth and lead uptake of Miscanthus floridulus (Lab.)

Soil lead (Pb) contamination has caused severe environmental threats and is in urgent need of remediation. This study was aimed to explore the feasibility of using the Miscanthus-microbe combination to reduce Pb pollution in the farmland surrounding a lead-zinc mining area. We have screened three heteroauxin (IAA)-producing microbes (Lelliottia jeotgali MR2, Klebsiella michiganensis TS8, and Klebsiella michiganensis ZR1) with high Pb tolerance. The IAA-producing ability of the mixed-species was stronger than that of the single bacterium. In pot experiments, the mixed-species of MR2-ZR1 and MR2-TS8 had better performance in enhancing the weight of Miscanthus grass (increased by 22.2-53.6% compared to the control group without inoculating microbes). The remediation efficiency of Pb was significantly higher in the MR2 (30.79%), MR2-TS8 (24.96%), and TS8-ZR1 (21.10%) groups than that in the control group (6.75%). We speculated that MR2 and mixed species of MR2-TS8 and TS8-ZR1 could promote the percentages of activated Pb fractions in soils and increase the Pb uptake of M. floridulus (Lab.). These results implied that the MR2-TS8 mixed-species might be selected as the effective microbial agent to simultaneously enhance the remediation efficiency of Pb-contaminated soils and the biomass of M. floridulus (Lab.).

Crystallization kinetics of amorphous red phosphorus to black phosphorus by chemical vapor transport

The aRP–P4-HP–BP three-stage phase transition revealed the crystallization kinetics and nucleation mechanism of the high-quality BP crystal synthesized by the CVT reaction in the aRP–Sn–I system.