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Xin Tang,1,* Qifu Li,1,* Gaoyangzi Huang,1 Ziwen Chen,2 Ya Huang,1 Xianmei Pei,1 Siwen Zhao,1 Zili Liu,1 Taipin Guo,1 Fanrong Liang2 1School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China; 2College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Taipin Guo, School of Second Clinical Medicine/The Second Affiliated Hospital, Kunming, People’s Republic of China, Email gtphncs@126.com Fanrong Liang, College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China, Email acuresearch@126.comPurpose: Acute lumbar sprain (ALS) is a common clinical disease characterized by persistent intolerable low back pain and limitation of movement, and quick pain relief and restoration of mobility in a short time are the main needs of patients when they visit the clinic. This study aims to evaluate the immediate efficacy of contralateral acupuncture (CAT) on SI3 combined with active exercise in treating ALS.Methods and Analysis: This study is a randomized controlled trial which will recruit 118 eligible participants aged 18 to 55 years with ALS at the Second Affiliated Hospital of Yunnan University of Chinese Medicine between March 2024 and December 2026. Participants will be randomly assigned to the acupuncture group or the sham-acupuncture group in a 1:1 ratio. The acupuncture group will receive a 10-minute acupuncture treatment combined with active exercise, while the sham-acupuncture group will receive a 10-minute sham acupuncture treatment combined with active exercise. Randomization will use a computer-generated sequence with allocation concealed in opaque envelopes. The primary outcome will be the pain visual analogue scale (VAS) scores after 10 minutes of treatment. Secondary outcomes will include the pain VAS scores at other time points (2, 4, 6, and 8 minutes post-treatment), the lumbar range of motion (ROM) scores at various time points, blinded assessment, the treatment effect expectancy scale, and the rescue analgesia rate. The analysis will follow the intention-to-treat principle. The primary outcome will be analyzed using ANCOVA, and secondary outcomes with repeated measures ANOVA. The rescue analgesia rate will be assessed using either the χ2 test or Fisher’s exact test.Discussion: This study is the first randomized controlled trial to assess the immediate efficacy of CAT in combination with active exercise for ALS. This study will provide a simple, rapid, and effective treatment for the clinical management of ALS.Keywords: acute lumbar sprain, immediate efficacy, contralateral acupuncture, active exercise, randomized controlled trial

Chunyan Yang,&ast; Hao Tian,&ast; Guixing Xu, Qin Luo, Mingsheng Sun, Fanrong Liang Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fanrong Liang, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No. 37 Shi’er Qiao Road, Chengdu, Sichuan, 610075, People’s Republic of China, Email acuresearch@126.comPurpose: The effect of acupuncture as adjunctive therapy for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) was controversial. Thus, we aimed to evaluate the effects of acupuncture for treating AECOPD.Methods: Eight databases were searched from database inception to July 30, 2023. All RCTs compared acupuncture plus conventional western medicine with conventional western medicine alone were included. Outcomes were quality of life, lung function, blood oxygen condition, exercise capacity, daily symptoms, duration of hospitalization, and adverse events. The statistical analyses were conducted using Stata 17.0, and methodological quality was measured by the Cochrane bias risk assessment tool. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence.Results: Twelve studies including 915 patients were included. Compared with conventional western medicine alone, acupuncture combined with conventional western therapy significantly improved quality of life (CAT: MD: − 3.25; 95% CI: − 3.73 to − 2.78, P< 0.001) and arterial blood gas (PaCO2: MD: − 1.85; 95% CI: − 2.74 to − 0.95, P< 0.001; PaO2: MD: 5.15; 95% CI: 1.22 to 9.07, P = 0.01). And for lung function, statistical benefits were found in FEV1/FVC (MD: 4.66; 95% CI: 2.21 to 7.12, P< 0.001), but no difference was seen for FEV1% (MD: 1.83; 95% CI: − 0.17 to 3.83, P = 0.073). There was no significant improvement in exercise capacity (6MWD: MD: 96.69; 95% CI: − 0.60 to 193.98, P = 0.051), hospitalization duration (MD: − 5.70; 95% CI: − 11.97 to 0.58, P = 0.075), and dyspnea (mMRC: MD: − 0.19; 95% CI: − 0.61 to 0.63, P = 0.376) between two groups. Overall bias for CAT and mMRC was in “high” risk, FEV1%, FEV1/FVC, PaCO2, and PaO2 was in “some concern” and 1 RCT assessing hospitalization duration was in “low” risk. And the overall assessments were either moderate, low or very low certainty. Seven trials performed safety assessment of acupuncture, and no serious adverse events were reported.Conclusion: Acupuncture might have auxiliary effects on AECOPD. However, the quality of the evidence is limited, and more high-quality RCTs are needed to be performed in the future.Keywords: acute exacerbation of chronic obstructive pulmonary disease, acupuncture, systematic review, meta-analysis

Liyu Yang,1,&ast; Long Zhou,1,&ast; Guanqi Wang,2 Min Qiu,1 Feng Liang,1 Changqing Jia,1 Weibing Xu,3 Qin Fu,1 Liqing Yang,1 Gen Ba1 1Department of Orthopedic, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Rehabilitation Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 3Spinal Surgery, Dalian Central Hospital Affiliated to Dalian Medical University, Dalian, Liaoning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Gen Ba, Department of Orthopedic, Shengjing Hospital of China Medical University, Sanhao Street 36, He Ping District, Shenyang, Liaoning Province, People’s Republic of China, 110004, Tel +86 18940259116, Email bagen1983@163.comObjective: This article aims to discuss a novel surgical strategy, referred to as unilateral bi/multi-portal endoscopy (UME), which used a uniaxial spinal endoscope instead of an arthroscope in the traditional unilateral biportal endoscopy (UBE) surgical procedure in our study of the treatment of complicated lumbar degenerative diseases.Methods: This retrospective study included 42 patients diagnosed with high-migrated lumbar disc herniation and bilateral spinal stenosis who underwent UME surgery from January 2021 to December 2021. Patients included 20 men and 22 women, with an average age of 55.97± 14.92 years. The average follow-up period was 13.19 months. The demographic data, operation time (min), and complications were recorded and analyzed. The visual analogue scale (VAS), Oswestry Disability Index (ODI) scores were used to evaluate the surgical outcomes. Three-dimensional CT scans and MRI were conducted to evaluate the radiographic improvement.Results: A total of 26 patients were diagnosed with lumbar disc herniation and 16 with lumbar spinal stenosis. All 42 patients underwent UME surgery and achieved satisfactory outcomes. The operation time was 154.46± 46.09 min. The average follow-up time was 13.19± 1.33 months. The preoperative back pain (VAS-Back) and the last follow-up VAS-Back were 3.84± 1.00 and 0.70± 0.46, respectively (P < 0.05). The preoperative leg pain (VAS-Leg) and the last follow-up VAS-Leg were 6.46± 1.08 and 1.03± 0.64, respectively (P < 0.05). Significant differences existed between preoperative ODI scores (58.70± 11.22%) and the last follow-up ODI scores (9.24± 3.04%; P< 0.05). All patients achieved significant pain relief and functional improvement after the surgery. No severe complications occurred, except for two cases of postoperative dysesthesia and one case suffered from vertebral compression fractures induced by a postoperative accidental injury. Symptoms of numbness disappeared within one week with treatment using dexamethasone and neurotrophic drugs. The vertebral fracture case recovered with percutaneous kyphoplasty treatment.Conclusion: This study suggests that UME is a promising treatment strategy for high-migrated disc herniation and bilateral spinal stenosis.Keywords: unilateral bi/multi-portal endoscopy, lumbar degenerative diseases, high-migrated disc herniation, bilateral spinal stenosis, ligamentum flavum, spinal endoscope

Yuan Tian,1,&ast; Zilin Wang,2,&ast; Feng Liang,3,&ast; Yi Wang1 1Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China; 2Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China; 3Heart Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yi Wang, Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, NO. 100 Haining Road, Shanghai, 200080, People’s Republic of China, Tel/Fax +86 021 63241377, Email wangyi2016@sjtu.edu.cnPurpose: Myocardial remodeling after myocardial infarction (MI) is a complex repair process following myocardial injury, characterized by the infiltration of multiple types of immune cells. However, the underlying molecular mechanism of myocardial remodeling after MI remains obscure. This study aimed to identify the hub differential expression genes (DEGs) of myocardial remodeling after MI and determine the distribution of immune cells infiltrating the pathology.Methods: We downloaded GSE132143, GSE151834, and GSE176092 data from the GEO database. The GSE132143 dataset was used to identify DEGs, perform functional annotation, and screen hub genes based on protein-protein interaction (PPI) analysis. The GSE151834 dataset was used to validate the expression of hub genes. CIBERSORTx analysis was performed to explore the immune microenvironment in myocardial remodeling after MI. After conducting a literature review, we selected P3H3 to confirm the expression by utilizing immunohistochemistry and qRT-PCR. Finally, the snRNA-seq data in dataset GSE176092 was used for clarifying the expression of these hub genes in various cell clusters.Results: We found 975 DEGs in myocardial remodeling after MI. Four hub genes (P3H3, COL15A1, COL16A1, COL27A1) were identified and were verified in the GSE151834 dataset. According to immune infiltration analysis, CD4+ naive T cells, regulatory T cells, monocytes, M2 macrophages, and neutrophils were involved in the pathological process of myocardial remodeling after MI. Additionally, in vitro experiments verified that P3h3 expression was significantly elevated in myocardial remodeling after MI. The snRNA-seq data analyzed that P3h3, Col15a1, Col16a1, and Col27a1 were highly expressed in fibroblasts of post-MI.Conclusion: This study identified four hub genes P3H3, COL15A1, COL16A1, and COL27A1, particularly P3H3, as potential targets for targeted therapy in MI patients.Keywords: myocardial infarction, myocardial remodeling, hub genes, immune infiltration, bioinformatic analysis

Kui-Xiang Wang,1 Li-Li Zhao,1 Ling-Tao Zheng,2 Li-Bin Meng,1 Liang Jin,3 Long-Jun Zhang,4 Fan-Lei Kong,1 Fang Liang2 1Department of Orthopaedics, Xingtai People’s Hospital of Hebei Medical University, Xingtai, Hebei Province, 054000, People’s Republic of China; 2Department of Endocrinology, Xingtai People’s Hospital of Hebei Medical University, Xingtai, Hebei Province, 054000, People’s Republic of China; 3Department of Hand and Foot Surgery, Xingtai People’s Hospital of Hebei Medical University, Xingtai, Hebei Province, 054000, People’s Republic of China; 4Department of Plastic and Burn, Xingtai People’s Hospital of Hebei Medical University, Xingtai, Hebei Province, 054000, People’s Republic of ChinaCorrespondence: Fang Liang, Email 1628960867@qq.comAim: Addressing both inflammation and epithelialization during the treatment of diabetic foot ulcers is an important step, but current treatment options are limited. MiRNA has important prospects in the treatment of diabetic foot refractory wound ulcers. Previous studies have reported that miR-185-5p reduces hepatic glycogen production and fasting blood glucose levels. We herein hypothesized that miR-185-5p might play an important role in the field of diabetic foot wounds.Materials and Methods: MiR-185-5p in skin tissue samples from patients with diabetic ulcers and diabetic rats were measured using quantitative real-time PCR (qRT-PCR). The streptozotocin-induced diabetes rat model (male Sprague-Dawley rats) for diabetic wound healing was conducted. The therapeutic potential was observed by subcutaneous injection of miR-185-5p mimic into diabetic rat wounds. The anti-inflammation roles of miR-185-5p on human dermal fibroblast cells were analyzed.Results: We found that miR-185-5p is significantly downregulated in diabetic skin (people with DFU and diabetic rats) compared to controls. Further, in vitro upregulation of miR-185-5p decreased the inflammatory factors (IL-6, TNF-α) and intercellular adhesion molecule 1 (ICAM-1) of human skin fibroblasts under advanced glycation end products (AGEs). Meanwhile, the increase of miR-185-5p promoted cell migration. Our results also confirmed that the topical increase of miR-185-5p decreases diabetic wound p-nuclear factor-κB (p-NF-κB), ICAM-1, IL-6, TNF-α, and CD68 expression in diabetic wounds. MiR-185-5p overexpression boosted re-epithelization and expedited wound closure of diabetic rats.Conclusion: MiR-185-5p accelerated wound healing of diabetic rats, reepithelization, and inhibited the inflammation of diabetic wounds in the healing process, a potentially new and valid treatment for refractory diabetic foot ulcers.Keywords: diabetes, miRNA, wound healing, inflammation

Dongfang Yu,1,2,&ast; Jinhua Bai,3,&ast; Yufang Zhao,1,3 Chenzu Yin,4 Fangmei Liang,4 Jun Zhang5 1Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, Peoples Republic of China; 2Reader Service Department, Guangxi University of Finance and Economics, Nanning, Peoples Republic of China; 3Faculty of Psychology, Southwest University, Chongqing, Peoples Republic of China; 4School of Teacher Education, Hechi University, Hechi, Peoples Republic of China; 5College of International Studies, Southwest University, Chongqing, Peoples Republic of China&ast;These authors contributed equally to this workCorrespondence: Yufang Zhao, Faculty of Psychology, Southwest University, Chongqing, 400715, Peoples Republic of China, Email zhaobee@swu.edu.cnPurpose: Previous studies show that intergroup contact, through common ingroup identity, has impact on intergroup processes such as reducing intergroup bias, improving intergroup relations, etc. The effect of intergroup contact on individual psychological process (through common ingroup identity), however, needs further exploration. Based on the positive effect of both intergroup contact and ingroup identification on mental health and well-being, this article proposes and tests a new model of individual loneliness reduction through intergroup contact by promoting common ingroup identity.Methods: A total of 263 majority ethnic members and 275 minority ethnic members from China participated in the survey. Intergroup contact, common ingroup identity and loneliness were measured at three time-points (T1-T3) over an 8-month period. Longitudinal mediation analysis and parallel process Latent Growth Curve Model for mediation are used for the examination of the indirect effect of common ingroup identity.Results: Longitudinal mediation analysis showed that intergroup contact quality at T1 positively predicted common ingroup identity at T2, and common ingroup identity at T2 alleviated loneliness at T3. Intergroup contact quality at T1 was indirectly linked to loneliness at T3 via common ingroup identity at T2. The parallel process latent growth curve model for mediation confirmed the robustness of the indirect effect of common ingroup identity. In addition, the growth rate of the quality of intergroup contact increased the growth rate of common ingroup identity, but reduced the growth rate of loneliness.Conclusion: The current study revealed the protectiveness of intergroup contact and common ingroup identity on loneliness, viz., intergroup contact reduces individual loneliness by promoting common ingroup identity, the implication being that intergroup contact and common ingroup identity should be taken into account in intervening process of loneliness prevention so that an individual’s physical and mental health could be better safeguarded.Keywords: intergroup contact, common ingroup identity, loneliness, group-based intervention

Ling-Zhi Jiang, Ye Shen, Feng Liang, Xiang-Ming Ye, Jing Chen, Yan-Mei Yu Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiang-Ming Ye, Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China, Tel +86-13750814756, Email yexmdr@hotmail.comAbstract: Intracranial infections are the most serious and common postoperative complications with significant mortality and morbidity. Myroides odoratimimus (M. odoratimimus), a Gram-negative environmental species and an opportunistic microorganism, predominantly infects immunocompromised individuals. Limited clinical experiences and documented multidrug resistance have resulted in a scarcity of data on the treatment of M. odoratimimus infections. As far as we know, this is the first reported case of an intracranial M. odoratimimus infection with external ventricular drains (EVD) that was effectively treated with a combination of intravenous and intraventricular tigecycline in an immunocompetent adult host.Keywords: Myroides odoratimimus, M. odoratimimus, intracranial infection, immunocompetent host, tigecycline

Qifu Li,1,&ast; Yi Lu,2,&ast; Xinghe Zhang,1 Ziwen Chen,3 Jialei Feng,4 Xuanxiang Zeng,1 Siwen Zhao,1 Gaoyangzi Huang,1 Li Li,5 Chonghui Xing,6 Fanrong Liang,3 Taipin Guo1 1School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China; 2The Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 3College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Kunming, People’s Republic of China; 4Institute for History of Medicine and Medical Literature, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 5The Third Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China; 6The Sports Trauma Specialist Hospital of Yunnan Province, Kunming, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Taipin Guo, School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China, Email gtphncs@126.com Fanrong Liang, School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China, Email acuresearch@126.comBackground: Acupoint catgut embedding (ACE) has been proven to be effective and safe in the treatment of obesity, but few studies have been conducted involving its central mechanisms. Our previous study has demonstrated the effectiveness of Shu-Mu ACE in the treatment of abdominal obesity (AO). However, the neurological mechanism of Shu-Mu ACE for weight loss has not yet been elucidated. The mechanism of the combination of the Shu and Mu acupoints may be related to the central integrative effects of the brain. This paper aims to explore the potential neural mechanisms of Shu-Mu ACE in female patients with AO.Methods and Analysis: A total of 100 eligible female AO patients and 20 healthy female subjects will be recruited for this study. 100 AO patients will be randomly allocated to five groups: Shu-Mu ACE (Group A), Shu ACE (Group B), Mu ACE (Group C), sham ACE (Group D), and waiting-list (Group E). Treatment will be administrated once every two weeks for 12 weeks. The body mass index (BMI), waist circumference (WC), Visual Analog Scales (VAS) of appetite, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) will be utilized to evaluate the clinical efficacy. Outcomes will be assessed at baseline and at each time point of treatment. Multimodal MRI will be performed at baseline and after 12-week treatment and the results will be used to investigate the neural mechanisms of ACE for obesity. Neurological changes and clinical data will be analysed for correlation.Discussions: This study hypothesized that Shu-Mu ACE therapy has a synergistic effect and may treat AO by modulating the neuropathological alterations in the brain. Our findings will demonstrate the neurological mechanism of AO treated by “Shu-Mu” Acupoint Catgut Embedding and compatibility relation.Trial Registration: This trial is registered at the Chinese Clinical Trial Registration Center (No. ChiCTR2100048920).Keywords: acupoint catgut embedding, female, abdominal obesity, Shu-Mu acupoints, compatibility relation, study protocol, neurological mechanism

Fayang Ling,1,&ast; Wenchuan Qi,1,&ast; Xiao Li,1,&ast; Jun Zhou,1 Jian Xiong,1 Yi Zhao,1 Qianhua Zheng,1 Fanrong Liang2 1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fanrong Liang, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email acuresearch@126.com Qianhua Zheng, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China, Tel +86 189 0870 5127, Fax +86-028-87683962, Email zhengqianhua@cdutcm.edu.cnPurpose: Cancer pain is a common symptom of cancer patients and greatly affects quality of life. Acupuncture has certain curative effects on cancer pain. The aim of this study was to analyze and visualize the current status and research trend of acupuncture treatment for cancer pain over the last 10 years and provide directions for future development.Methods: A search of the Web of Science Core Collection from 2012– 01-01 to 2022– 08-20 was performed to collect studies related to acupuncture therapy for cancer pain. CiteSpace was used to conduct bibliometric analysis and visualization from the perspective of the volume of annual publications, journals, nations, institutions, authors, keywords, and references.Results: A total of 302 studies were included in the analysis. The number of publications increased steadily with some fluctuations over the past decade. Integrative Cancer Therapies was the journal with the most relevant publications, and the Journal of Clinical Oncology was the most frequently cited journal. China had the highest volume of publications, and the USA contributed most to international collaboration. The most prolific institution was Memorial Sloan Kettering Cancer Center. The most productive author was Mao JJ, and the most influential author was Lu WD. “Acupuncture” was the top keyword in frequency and centrality. The references with the highest frequency and centrality were published by HE, Y, and Ting Bao, respectively.Conclusion: A stable development trend has formed in this field. The overall collaborative network needs to be strengthened. Breast cancer and multiple myeloma, electroacupuncture and bee venom acupuncture, postoperative pain, peripheral neuropathic pain syndrome, and aromatase inhibitors-associated arthralgia syndrome are research hotspots in this field. Randomized controlled trials (RCTs), evidence-based evaluations and mechanisms (cancer-induced bone pain) are research trends and frontiers.Keywords: acupuncture analgesia, cancer, pain, bibliometric analysis, CiteSpace

Thermodynamic behavior has been extensively used to evaluate the stability of materials and predict the direction of the chemical reaction at different pH values, temperatures, potentials, and ion concentrations. Although researching efforts on Sn species in an aqueous solution system (Sn/H2O) of acid, alkali, and salt have been reported, scattered data leads to the inefficiency of a thermodynamic method in the practical application. This article provides a brief review on the potentialpH diagram for Sn/H2O system, which reflects the thermodynamic behavior of Sn species in an aqueous solution and extracts thermodynamic data for the practical application of Sn species. Firstly, the relationship of the thermodynamic behavior, potential-pH diagram, and equilibrium relations of Sn species for Sn/H2O system was overviewed. Additionally, the potential-pH diagram of Sn/H2O system at different temperatures (298 K, 373 K, and 550 K), dissolved Sn activities (1, 10−1, 10−3, and 10−6), and the potential-pH diagram of the Sn species in a chloridion aqueous solution (Sn/H2O-Cl) was summarized. Finally, the application prospect of the potential-pH diagram for Sn/H2O system was investigated in the intelligent simulation of Sn metallurgy and the practical application of Sn materials.

Zhuo Zhou,1 Guixing Xu,1 Liuyang Huang,1 Yunjie Shu,1 Hao Tian,1 Fengyuan Huang,1 Yilin Liu,1 Fanrong Liang,2 Mingsheng Sun1 1Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of ChinaCorrespondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-28-87683962, Email acuresearch@126.comIntroduction: Chronic pain is one of the major health problems worldwide in recent years, and acupuncture-related therapies have been reported to have definite analgesic effects. However, it is still unclear which treatment is the most effective. Our systematic review and network meta-analysis protocol aims to summarize the evidence and determine the most effective method to treat the chronic musculoskeletal pain.Methods and Analysis: Our literature search will be performed in five electronic databases—the Cochrane Library, EMBASE, and PubMed, AMED, CINAHL, until May 20, 2022. All randomized controlled trials of acupuncture-related therapies for chronic musculoskeletal pain will be included. The primary outcomes will be common pain-related scales, and the secondary outcomes will include quality of life and incidence of adverse events. Excel 2019 will be used for data extraction, RoB2 will be used for bias risk assessment. R 3.6.2 and WinBUGS V.1.4.3 software will be used for network data synthesis and to produce related plots. During the study, literature selection, data extraction, quality assessment and bias risk assessment will be independently completed by two reviewers, and differences will be judged by the third reviewer. Finally, the risk of bias and sources of heterogeneity in the study will be analyzed and explained in order to obtain reliable results.Results: Our study will evaluate the effectiveness and safety of acupuncture-related therapies for the treatment of chronic musculoskeletal pain, and we will rank all methods to recommend the best appropriate treatment option.Conclusion: This study will provide a good foundation for complementary and alternative medicine to treat chronic musculoskeletal pain. It will be also helpful to promote the clinical practice by providing evidence-based medical evidence.Keywords: systematic review, network meta-analysis, acupuncture-related therapies, chronic musculoskeletal pain

Xinghe Zhang1 &ast;, Qifu Li1 &ast;, Rong Yi,2 Chonghui Xing,3 Yuhao Jin,1 Jiangqiong Meng,1 Siwen Zhao,1 Fanrong Liang,4 Taipin Guo1 1School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China; 2Department of Acupuncture and Moxibustion, Kunming Hospital of Traditional Chinese Medicine, Kunming, People’s Republic of China; 3Department of Acupuncture and Moxibustion, The Sports Trauma Specialist Hospital of Yunnan Province, Kunming, People’s Republic of China; 4School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Taipin Guo, School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, 1076 Yuhua Road, Chenggong District, Kunming City, Yunnan Province, People’s Republic of China, Tel +86 18487272658, Email gtphncs@126.com Fanrong Liang, School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Jinniu District, Chengdu City, Sichuan Province, People’s Republic of China, Email acuresearch@126.comBackground: Abdominal obesity (AO) is not only a health issue, but also a serious impact on women’s work and life. The article of acupoint catgut embedding (ACE) on AO has already been accepted to be published and showed significant effect. However, whether ACE is effective for abdominally obese female with strong appetite is still unclear.Methods: This is a mixed analysis of a multicenter, double-blind, randomized controlled trial.Which was conducted in China between July 2018 and March 2020 (n = 101), while with the supplementary samples (n = 22) between April 2020 and June 2022. According to the appetite and intervention methods, 123 abdominally obese female were divided into ACE group with strong appetite (n = 27) and moderate appetite (n = 31), control (non-acupoint catgut embedding) group with strong appetite (n = 37) and moderate appetite (n = 28). Four subgroups were given a 12-week actual intervention period and a 4-week follow-up. Waist circumference (WC), appetite, body weight and BMI were applied and assessed at baseline and after 6, 12 and 16 weeks.Results: In this study, the mean onset age of abdominal obesity in females was 25.27 (8.19) years old. The longer duration of AO, the lower the appetite in females (p< 0.05). At 12 and 16 weeks, ACE group with strong appetite showed significant decrease in WC and appetite than control group with strong appetite (p< 0.01). However, ACE group with moderate appetite showed no significant decrease than control group with moderate appetite in WC, appetite, body weight and BMI (p> 0.05). At 12 and 16 weeks, there was no significant difference in appetite between the ACE groups (strong and moderate appetite)(p> 0.05), while there was still a difference between the control groups (p< 0.05).Conclusion: Younger abdominally obese female had a stronger appetite. ACE own the remarkable therapeutic effects for younger abdominally obese female and showed the perfect effect on appetite-reduction.Keywords: acupoint catgut embedding, abdominal obesity, obese female, appetite, waist circumference

Yilin Liu,1 Liuyang Huang,1 Guixing Xu,1 Hao Tian,1 Zhuo Zhou,1 Fengyuan Huang,1 Fanrong Liang2 1Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of ChinaCorrespondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email acuresearch@126.comPurpose: The purpose of this study is to analyze and visualize the research trends on acupuncture therapy for postoperative pain over the past 20 years to identify hotspots and frontiers, and provide new research ideas.Methods: A search of the Web of Science database, with a time frame of 2001– 01-01 to 2022– 02-28, was conducted to collect literatures related to acupuncture therapy for postoperative pain. A bibliometric analysis and visualization of results was performed using CiteSpace software for the volume of annual publications, journals, countries, institutions, authors, keywords, and references.Results: A total of 840 literatures were eventually included in the analysis. The number of publications has fluctuated upwards each year over the past 20 years and reached a peak in the latest three years. Evidence-Based Complementary and Alternative Medicine was the journal with the most relevant publications and Pain was the most frequently cited journal. The country with the highest volume of publications was China, and the USA contributed most to the international collaboration. The most prolific and influential authors were Inhyunk Ha and Han JS respectively. The most frequent keyword was “acupuncture”. References with highest frequency or centrality were both systematic evaluations focusing on different acupuncture therapies for postoperative pain relief.Conclusion: The field of acupuncture therapy for postoperative pain is currently in a period of high growth. China and the USA have made the largest contribution to the volume of publications. The most influential institutions and authors are mainly from China and South Korea. The overall collaborative network needs to be strengthened. Electroacupuncture and auricular acupuncture (therapeutic techniques), low back surgery (types of surgery), and “postoperative pain, nausea and vomiting” are research hotspots in this field. Improvement of postoperative life quality, proof of clinical efficacy and evidence-based evaluation are the current research trends and frontiers.Keywords: acupuncture analgesia, pain after surgery, bibliometric analysis, CiteSpace

Purpose: To evaluate the biomechanical profile of subcortical backup fixation (subcortical button [SB]) in anterior cruciate ligament (ACL) reconstruction as compared with a bicortical post and washer (BP) and suture anchor (SA) when used with interference screw (IS) primary fixation and to evaluate the utility of backup fixation for tibial fixation with extramedullary cortical button primary fixation. Methods: Fifty composite tibias with polyester webbing–simulated graft were used to test constructs across 10 methods. Specimens were separated into the following groups (n = 5): 9-mm IS only, BP (with and without graft and IS), SB (with and without graft and IS), SA (with and without graft and IS), extramedullary suture button (with and without graft and IS), and extramedullary suture button with BP as backup fixation. Specimens were tested under cyclic loading and then loaded to failure. Maximal load at failure, displacement, and stiffness were compared. Results: Without a graft, the SB and BP had similar maximal loads (802.46 ± 185.18 N vs 785.67 ± 100.96 N, P = .560), and both were stronger than the SA (368.13 ± 77.26 N, P < .001). With graft and an IS, there was no significant difference in maximal load between the BP (1,461.27 ± 173.75 N), SB (1,362.46 ± 80.47 N), and SA (1,334.52 ± 195.80 N). All backup fixation groups were stronger than the control group with IS fixation only (932.91 ± 99.86 N, P < .001). There was no significant difference in outcome measures between the extramedullary suture button groups with and without the BP (failure loads of 721.39 ± 103.32 N and 718.15 ± 108.61 N, respectively). Conclusions: Subcortical backup fixation in ACL reconstruction has similar biomechanical properties to current methods and is a viable backup fixation alternative. Backup fixation methods work synergistically with IS primary fixation to strengthen the construct. There is no advantage to adding backup fixation to extramedullary button (all-inside) primary fixation when all suture strands are secured to the extramedullary button. Clinical Relevance: This study provides evidence that subcortical backup fixation is a viable alternative for surgeons during ACL reconstruction.

Mengxin Yao,1 Yue Xiao,1 Zhuoqiao Yang,1 Wenxin Ge,1 Fei Liang,1 Haoyue Teng,1 Yingjie Gu,2 Jieyun Yin1 1Department of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, People’s Republic of China; 2Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of ChinaCorrespondence: Jieyun Yin, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, Jiangsu, People’s Republic of China, Tel/Fax +86 0512 6588036, Email jyyin@suda.edu.cnBackground: Preeclampsia (PE) is a significant cause of maternal and neonatal morbidity and mortality worldwide. However, the pathogenesis of PE is unclear and reliable early diagnostic methods are still lacking. The purpose of this review is to summarize potential metabolic biomarkers and pathways of PE, which might facilitate risk prediction and clinical diagnosis, and obtain a better understanding of specific metabolic mechanisms of PE.Methods: This review included human metabolomics studies related to PE in the PubMed, Google Scholar, and Web of Science databases from January 2000 to November 2021. The reported metabolic biomarkers were systematically examined and compared. Pathway analysis was conducted through the online software MetaboAnalyst 5.0.Results: Forty-one human studies were included in this systematic review. Several metabolites, such as creatinine, glycine, L-isoleucine, and glucose and biomarkers with consistent trends (decanoylcarnitine, 3-hydroxyisovaleric acid, and octenoylcarnitine), were frequently reported. In addition, eight amino acid metabolism-related, three carbohydrate metabolism-related, one translation-related and one lipid metabolism-related pathways were identified. These biomarkers and pathways, closely related to renal dysfunction, insulin resistance, lipid metabolism disorder, activated inflammation, and impaired nitric oxide production, were very likely to contribute to the progression of PE.Conclusion: This study summarized several metabolites and metabolic pathways, which may be associated with PE. These high-frequency differential metabolites are promising to be biomarkers of PE for early diagnosis, and the prominent metabolic pathway may provide new insights for the understanding of the pathogenesis of PE.Keywords: gestational hypertension, metabolite, biomarker, prediction

Dongfang Yu,1,2 Yufang Zhao,1,3 Chenzu Yin,4 Fangmei Liang,4 Wenyu Chen5 1Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, People’s Republic of China; 2Reader Service Dept, Guangxi University of Finance and Economics, Nanning, People’s Republic of China; 3Faculty of Psychology, Southwest University, Chongqing, People’s Republic of China; 4School of Teacher Education, Hechi University, Hechi, People’s Republic of China; 5College of Computer and Information Science, Southwest University, Chongqing, People’s Republic of ChinaCorrespondence: Yufang ZhaoFaculty of Psychology, Southwest University, Chongqing, 400715, People’s Republic of ChinaEmail zhaobee@swu.edu.cnPurpose: Intergroup contact is an effective strategy to improve intergroup relationships. Although intergroup relationships have been studied extensively, the individual roles of quantity and quality of contact in relationships with cognition, emotion, and intention of behavior toward other ethnic minority groups are not fully understood. This study explores the situation via network analysis among Zhuang and Yao ethnic minorities in Southwest China.Methods: We investigated the quantity and quality of intergroup contact and cognition, emotion, and intention of behavior among a sample of 543 Zhuang and 490 Yao ethnic group members. Data were analyzed using the R-package. Network structures were analyzed via the Qgraph package, and the accuracy and stability of the network were measured via the Bootnet package; communities were detected via the Igraph package; bridge analyses were conducted via the Networktools package; and the network difference was compared via the Network Comparison Test package.Results: The results indicated perceived intimacy is the central node. Quantity of contact constructed a community with “perceived connection,” “sense of community,” “knowledge about out-group,” and “perceived similarity.” Meanwhile, quality of contact constructed a community with “intergroup attitude” and a “feeling thermometer.” The remainder of the nodes constructed two additional communities. The network global connectivity and structure between the two ethnic groups were highly similar.Conclusion: The study examined the quantity and quality of intergroup contact via network analysis for two ethnic minority groups. It was shown that the two groups’ global network structures of intergroup contact and their effects are highly similar. Specifically, quantity and quality of contact produce different effects on intergroup relations. Quantity of contact has proximal effects, including instant cognitive and emotional response without depth cognition, while quality of contact has proximal effects that may change deep-seated cognition and subsequently improve intergroup relations.Keywords: quantity, quality, community analysis, network global connectivity, ethnic minorities, intergroup relationships

Xiangxiang Meng,1 Niu Chenchen,2 Fu Liang,3 Yao Ocean Liu4 1Bank of Jining, Jining, 272000, People’s Republic of China; 2School of Management, Qilu University of Technology, Jinan, 250014, People’s Republic of China; 3Department of Business Management, Shandong University of Finance and Economics, Jinan, 250353, People’s Republic of China; 4School of Professional Studies, New York University, New York City, NY, USACorrespondence: Niu Chenchen Tel +86-153-7666-3653Email ncc0811@163.comPurpose: According to attribution theory, the purpose of this paper is to examine the relationship between paradoxical leadership and employees’ compulsory organizational citizenship behavior, research the mediating and moderating effects of work pressure perception and leadership member exchange differentiation.Participants and Methods: The data collection work was carried out with 329 employees as the research object, and empirical tests were carried out using confirmatory factor analysis and hierarchical regression analysis methods.Results: The results of the empirical test show that: paradoxical leadership has a significant positive effect on employees’ compulsory organizational citizenship behavior; work pressure perception plays a mediating role between paradoxical leadership and employee’s compulsory organizational citizenship behavior; leadership member exchange differentiation plays a moderating role between paradoxical leadership and work pressure perception. Paradoxical leadership will lead employees to adopt compulsory organizational citizenship behavior. Moreover, organizations should reduce employees’ perception of work pressure and leadership member exchange differentiation.Conclusion: The results of the study provide positive suggestions for reducing the compulsory organizational citizenship behavior of employees by focusing on the behavior of paradoxical leadership, thereby promoting the improvement of corporate performance.Innovations: 1) The research on the influence of paradoxical leadership on compulsory organizational citizenship behavior reveals the “dark side” of the influence of paradoxical leadership on employee behavior. 2) By introducing work pressure perception, this paper reveals the mechanism of action between paradoxical leadership and compulsory organizational citizenship behavior, which provides a new research perspective for understanding the formation mechanism of employees adopting compulsory organizational citizenship behavior. 3) This paper confirms that leadership member exchange differentiation can positively moderate the relationship between paradoxical leadership and work pressure perception.Keywords: attribution theory, paradoxical leadership, compulsory organizational citizenship behavior, work pressure perception, leadership member exchange differentiation

Liuyang Huang,1 Guixing Xu,1 Jiamei He,1 Hao Tian,1 Zhuo Zhou,1 Fengyuan Huang,1 Yilin Liu,1 Mingsheng Sun,1 Fanrong Liang2 1Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 2Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Fanrong LiangAcupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, People’s Republic of ChinaTel +86 136 0805 8216Fax +86-28-87683962Email acuresearch@126.comBackground: Researches on the central mechanisms of acupuncture analgesia have been widely conducted worldwide. However, there is no bibliometric analysis of functional magnetic resonance imaging (fMRI) studies on acupuncture analgesia. This study visualized the current status, hot spots and frontiers of fMRI studies on acupuncture analgesia in the past 20 years to provide a theoretical basis for its clinical application.Methods: All publications were obtained from Science Citation Index-Expanded (SCI-E) of Web of Science (WOS). We used CiteSpace to analyze publications, journals, cited journals, authors, cited authors, institutions, countries, references, and keywords. We also analyzed collaborative network maps and co-occurrence network maps.Results: We retrieved a total of 797 articles. Regarding the volume of publications, the total number of annual publications showed a fluctuating but overall increasing trend. Evidence-based Complementary and Alternative Medicine (21 articles) was the most productive journal, and Pain (225 articles) was the most cited journal. The most productive author was Qin W (16 articles), and the most co-cited author was Hui KKS (111). The most prolific institution and country were Massachusetts General Hospital (34 articles) and USA (212 articles). “Pain” was the top-ranked for keyword frequency and centrality. “Functional connectivity” was the frontier hotspot for 2018– 2021.Conclusion: First, fMRI researches on acupuncture analgesia involved several countries (regions) and institutions, mainly located in the USA, China and Korea, and most of them were universities. In addition, the USA was a major contributor in this field. Second, in terms of disciplinary distribution, the literatures were mainly from clinical neurology, neuroscience, and radiology nuclear medicine medical imaging. Third, the keyword co-occurrence analysis showed that the hot keywords included pain, fMRI, and lower back pain. Fourth, through keyword clustering analysis, the hot disease was found to be lower back pain, and the hot contents were acupuncture specificity and frequency specificity. Fifth, a timeline analysis of the references identified that chronic low back pain and specificity will remain a hot topic for future research.Keywords: acupuncture analgesia, functional magnetic resonance imaging, CiteSpace, bibliometric analysis

Weimin Luan,1,2,&ast; Xiqian Qi,3,&ast; Feng Liang,2 Xiaotao Zhang,2 Ziyang Jin,2 Ligen Shi,2 Benyan Luo,1 Xuejiao Dai1 1Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Neurology, Ningbo Municipal Hospital of T.C.M., Ningbo, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xuejiao Dai; Benyan LuoDepartment of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang, 312000, People’s Republic of ChinaTel/Fax +86-571-87235101Email x.dai@zju.edu.cn; luobenyan@zju.edu.cnPurpose: Age-related increase in myelin loss may be responsible for brain atrophy, and the mechanism is not completely understood. We aim to comprehensively delineate oligodendrocyte heterogeneity in young and aged mice and to reveal the underlying mechanism for myelin loss during aging.Methods: Diffusion tensor imaging and immunofluorescent staining were performed to verify the demyelination in the aged brains of both rodents and human. Further, the single-cell RNA sequencing data of all brain cells from young and aged mice were deeply analyzed to identify the subsets of oligodendrocyte lineage cells. Cell-to-cell interaction analysis was performed to detect the mechanism of observed changes in oligodendrocyte generation.Results: Oligodendrocytes were observed to up-regulate several senescence associated genes in aged brain. Four clusters of oligodendrocyte precursor cells (OPCs) were identified in both young and aged brains. The number of those OPCs in basal state was significantly increased, while the OPCs in the procedure of differentiation were immensely decreased in aged brain. Furthermore, it was identified that activated microglia in the aged brain released inflammatory factors to suppress OPC differentiation. Stat1 might be a potential target to transform senescent microglia into tissue repair type to promote oligodendrocyte generation.Conclusion: These results provided a perspective on how age activated microglia could impede remyelination and might give a new therapeutic target for age-related remyelinating diseases.Keywords: remyelination, oligodendrocyte precursor cells, microglia, oligodendrocytes, single cell RNA sequencing

Fuchao Liang,1,2,&ast; Yueqing Tang,1,3,&ast; Kaipeng Bi,1,2 Xuchen Liu,2 Chao Li,4,5 Si Chen,6 Chao Zhang,4,5 Lei Yan,1 Zhonghua Xu,1 Ning Yang4,5,7 1Department of Urology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China; 2School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 3Department of Andrology, Shandong University, Jinan, People’s Republic of China; 4Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, People’s Republic of China; 5Shandong Key Laboratory of Brain Function Remodeling, Jinan, 250012, People’s Republic of China; 6Department of Neurology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China; 7Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, 250012, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ning YangDepartment of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, People’s Republic of ChinaTel/Fax +86 531-82166631Email yangning@sdu.edu.cnZhonghua XuDepartment of Urology, Qilu Hospital of Shandong University, Jinan, People’s Republic of ChinaTel/Fax +86 531-82166701Email xuzhonghua1963@163.comPurpose: This study aimed to investigate the characteristics of urodynamics in female parkinsonian patients with lower urinary tract symptoms (LUTS) and evaluate the outcomes of deep brain stimulation (DBS) based on overactive bladder (OAB) scores and quality of life (QOL) scores.Patients and Methods: Urodynamic assessment was performed in 20 female parkinsonian patients with LUTS. OAB scores and QOL scores were collected before and 6 months after DBS treatment (The target of DBS is STN). We evaluated the related factors affecting QOL score and also the changes in QOL score after DBS treatment.Results: The mean age of 20 patients was 60.6± 6.3 years, with 65% of patients identified with OAB in urodynamic studies. The mean OAB total score and QOL score at baseline were 7.3± 3.7 and 5.0± 1.1, respectively. Four items in the OAB score were found to be independent factors and they influenced the baseline QOL scores. Six months after DBS treatment, the OAB total score and the QOL score were significantly decreased (3.7± 3.2 (p = 0.002) and 3.4± 1.4 (p < 0.001), respectively). Improvements in OAB item 2 (nocturia) and item 3 (urgency) scores were found to be independent factors, which had an influence on the improvement in QOL scores from multivariate analysis. Improvement of OAB item 2 (nocturia) exhibited the greatest influence on improvement in the QOL score. After DBS treatment, 40% of the patients showed significant improvement in urination symptoms (≥ 2 points reduction in QOL score), 30% of the patients showed mild improvement (1 point reduction in QOL score), and 30% patients showed no improvement (no change in QOL score). No patients exhibited worsening urination symptoms.Conclusion: Most parkinsonian female patients with lower urinary tract symptoms were diagnosed with OAB. DBS treatment improved OAB symptoms. Improvement of nocturia and urgency positively impacts the QOL of female parkinsonian patients.Keywords: Parkinson’s disease, urodynamics, OAB score, QOL score

Feifei Liang,1 Rensheng Wang,1 Qinghua Du,2 Shangyong Zhu3 1Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Radiation Oncology, Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 3Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaCorrespondence: Shangyong ZhuDepartment of Ultrasound, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi, 530021, People’s Republic of ChinaEmail zhushangyong2021@163.comBackground: Epithelial-to-mesenchymal transition (EMT) program plays a critical role in cancer. Thus, we attempted to generate a risk score system according to the expression pattern of different EMT hallmark genes in head and neck squamous-cell carcinoma (HNSC).Methods: Differentially expressed EMT hallmark genes were screened to generate a risk score (RS) on TCGA HNSC dataset. The relative prognostic value of the RS compared to clinicopathological characteristics was explored using multivariable Cox analysis. Functional enrichment analysis was performed to reveal the biological characteristics. An external dataset was applied to validate the prognostic value of the RS.Results: Nine genes constituted the EMT hallmark gene-based RS, which is significantly associated with poor prognosis and could successfully divide patients with HNSC into high- and low-risk groups. The RS was also an independent prognostic indicator compared to routine clinical factors.Conclusion: We proposed and validated a nine-EMT hallmark gene-based risk score system in HNSC.Keywords: head and neck squamous-cell carcinoma, epithelial-to-mesenchymal transition, EMT, risk score system, angiogenesis

Fu Liang, Linlin Cao School of Business Administration, Shandong University of Finance and Economics, Jinan, People’s Republic of ChinaCorrespondence: Linlin Cao Email cll2021@163.comBackground: Environmental uncertainty has become the normal surviving and development environment for organizations. Resilience is the key to manage the crisis and abrupt crush, and the relationship between employee resilience and organizational resilience still needs to be explored in Chinese context. The study is to uncover the black box between employee resilience and organizational resilience.Methods: Based on the conservation of resource theory, this study introduced managerial resilience, problem-focused coping and emotion-focused coping into the relational mechanism between employee resilience and organizational resilience. The study adopted structural equations, bootstrapping methods, and analyzed 329 multi-point employee–manager matching data as the research basis from high-tech industries, service industries, and traditional manufacturing industries.Results: This study demonstrated that employee resilience is positively associated with organizational resilience; The indirect effects of employee resilience on organizational resilience through problem-focused coping and emotion-focused coping were statistically significant; moreover, managerial resilience positively moderated the relation between employee resilience and emotion-focused coping, and it also moderated the indirect effect of employee resilience on organizational resilience through emotion-focused coping.Conclusion: This study adds value to the literature by revealing employee resilience boots problem-focused coping and emotion-focused coping, resulting in more or less organizational resilience in the context of Chinese enterprises. It is suggested that in the daily management of the organization, we should pay more attention to cultivate and develop employee resilience to improve organizational resilience.Keywords: employee resilience, managerial resilience, problem-focused coping, emotion-focused coping, organizational resilience

Yu Liu,1,2,* Wenju Chang,1– 3,* Wentao Tang,1– 3,* Ye Wei,1– 3 Tianyu Liu,1,2 Yijiao Chen,1,2 Meiling Ji,1– 3 Fei Liang,4 Li Ren,1– 3 Jianmin Xu1– 3 1Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive, Shanghai, People’s Republic of China; 4Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianmin XuDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of ChinaTel +86 13501984869Email xujmin@aliyun.comBackground: Rectal gastrointestinal stromal tumors (GISTs) are rare digestive tumors. The treatment methods of rectal GISTs are diverse, while no standardized treatment was recommended. The aim of this study was to report the treatment mode of rectal GISTs in our center.Methods: Patients with pathologically confirmed rectal GISTs who received neoadjuvant therapy and surgical resection were retrospectively collected. Perioperative complications and long-term prognosis were evaluated.Results: From January 2010 to December 2019, 36 patients were pathologically diagnosed with primary rectal GISTs. After excluding patients who were treated with surgery or imatinib alone, 21 patients received neoadjuvant therapy and surgery was enrolled. During neoadjuvant treatment, tumors shrank significantly (6.53cm to 4.68cm, p< 0.001) without toxicities over grade 2. The total postoperative complication rate was 42.9% (all grade). R0 resection was achieved in 76.2% patients. Transanal resection had advantages on anus preservation and postoperative recovery. No patients died during the follow-up period, 4 patients relapsed and the relapse-free survival was 81.0%.Conclusion: The combination of neoadjuvant therapy and surgical resection was a safe and effective treatment for rectal gastrointestinal stromal tumors.Keywords: rectal gastrointestinal stromal tumors, GISTs, neoadjuvant therapy, surgical resection

Jie Shen,1,2,* Yiling Wu,3,* Xiaoshuang Feng,1,2,* Fei Liang,4 Miao Mo,1,2 Binxin Cai,3 Changming Zhou,1,2 Zezhou Wang,1,2 Meiying Zhu,3 Guoxiang Cai,2,5 Ying Zheng1,2 1Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Department of Noninfectious Chronic Disease Control and Prevention, Songjiang District Center for Disease Control and Prevention, Shanghai, People’s Republic of China; 4Department of Biostatistics, Zhongshan Hospital Fudan University, Shanghai, People’s Republic of China; 5Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ying ZhengDepartment of Cancer Prevention, Fudan University Shanghai Cancer Center, No. 270 Dong’An Road, Shanghai, 200032, People’s Republic of ChinaEmail zhengying@fudan.edu.cnObjective: To identify people with high-risk early colorectal neoplasm is highly desirable for pre-selection in colorectal cancer (CRC) screening in low-resource countries. We aim to build and validate a risk-based model so as to improve compliance and increase the benefits of screening.Patients and Methods: Using data from the Shanghai CRC screening cohort, we conducted a population-based nested case–control study to build a risk-based model. Cases of early colorectal neoplasm were extracted as colorectal adenomas and stage 0-I CRC. Each case was matched with five individuals without neoplasm (controls) by the screening site and year of enrollment. Cases and controls were then randomly divided into two groups, with two thirds for building the risk prediction model and the other one third for model validation. Known risk factors were included for risk prediction models using logistic regressions. The area under the receiver operating characteristic curve (AUC) and Hosmer–Lemeshow chi-square statistics were used to evaluate model discrimination and calibration. The predicted individual risk probability was calculated under the risk regression equation.Results: The model incorporating age, sex, family history and lifestyle factors including body mass index (BMI), smoking status, alcohol, regular moderate-to-intensity physical activity showed good calibration and discrimination. When the risk cutoff threshold was defined as 17%, the sensitivity and specificity of the model were 63.99% and 53.82%, respectively. The validation data analysis also showed well discrimination.Conclusion: A risk prediction model combining personal and lifestyle factors was developed and validated for high-risk early colorectal neoplasm among the Chinese population. This risk-based model could improve the pre-selection for screening and contribute a lot to efficient population-based screening in low-resource countries.Keywords: cancer prevention, colorectal cancer, risk model, screening

Peng Xu, Feng Liang The State Key Laboratory of Refractories and Metallurgy, Coal Conversion and New Carbon Materials Hubei Key Laboratory, School of Chemistry and Chemical Engineering, Wuhan University of Science and Technology, Wuhan 430081, People’s Republic of ChinaCorrespondence: Feng Liang Email feng_liang@whu.edu.cnAbstract: In recent years, photothermal therapy (PTT) particularly nanomaterial-based PTT is a promising therapeutic modality and technique for cancer tumor ablation. In addition to killing tumor cells directly through heat, PTT also can induce immunogenic cell death (ICD) to activate the whole-body anti-tumor immune response, including the redistribution and activation of immune effector cells, the expression and secretion of cytokines and the transformation of memory T lymphocytes. When used in combination with immunotherapy, the efficacy of nanomaterial-based PTT can be improved. This article summarized the mechanism of nanomaterial-based PTT against cancer and how nanomaterial-based PTT impacts the tumor microenvironment and induces an immune response. Moreover, we reviewed recent advances of nanomaterial-based photothermal immunotherapy and discussed challenges and future outlook.Keywords: nanomaterials, cell death mechanism of PTT, tumor microenvironment, immunogenic cell death, photothermal immunotherapy

En-Ling Liu,1 Yu-Xiu Zhou,2 Jun Li,1 Dong-Hong Zhang,1 Feng Liang1 1The Department of Obstetrics and Gynecology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, Hebei Province, People’s Republic of China; 2The Department of Immunology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, Hebei Province, People’s Republic of ChinaCorrespondence: En-Ling LiuThe Department of Obstetrics and Gynecology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, No. 27 Wenhua Road, Lubei District, Tangshan, Hebei Province, People’s Republic of ChinaTel +0315-3722602Email tsenling888@163.comBackground: Long-chain non-coding RNA (lncRNA) small nucleolar RNA host gene 3 (SNHG3) is reportedly overexpressed in malignant tumors, but its regulatory role in human ovarian cancer (OC) is not fully understood.Methods: A qRT-PCR assay was carried out to detect the level of SNHG3 in OC tissues, serum and cells, a CCK-8 assay to measure the proliferation of OC cells, a transwell assay to measure the invasion and migration of OC cells, and a flow cytometry to detect the cell cycle distribution and apoptosis rate of OC cells. In addition, in vivo experiment was also conducted to determine the effect of SNHG3 on the growth of OC cells.Results: SNHG3 was overexpressed in OC tissues, serum, and cells, and the overexpression in serum indicated a poor prognosis of patients. It was also found that knockdown of SNHG3 could inhibit the malignant phenotypes of OC cells, cause G1/G0 cell cycle arrest, and intensify apoptosis. Furthermore, in in vitro experiments, the growth ability of OC cells was inhibited under knockdown of SNHG3. Assays for relationship verification showed that SNHG3 regulated the expression of miR-339-5p and the canonical transient receptor potential 3 (TRPC3), and the rescue experiment revealed that co-transfection of si-SNHG3+miR-339-5p-inhibitor or si-SNHG3+pcDNA3.1-TRPC3 could reverse the effects of knockdown of SNHG3 on the biological behavior of OC cells.Conclusion: SNHG3 can be adopted as a marker for diagnosis and prognosis evaluation of OC and it plays a role in the progression of OC by enabling the miR-339-5p sponge to regulate TRPC3 expression.Keywords: long-chain non-coding RNA, small nucleolar RNA host gene 3, miR-339-5p, ovarian cancer, biological behavior

Li-ying Liu,1,* Xiao-ji Li,2,* Wei Wei,1 Xiao-li Guo,1 Li-hua Zhu,3 Fei-fei Gao,4 Fan-rong Liang,1 Si-yi Yu,1 Jie Yang1 1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 2Natural Harmony Clinic, Auckland City, New Zealand; 3Department of Traditional Chinese Medicine, Guangzhou Development District Hospital, Guangzhou, Guangdong, People’s Republic of China; 4Geriatrics Department, Tianjin Integrated Traditional Chinese and Western Medicine Hospital, Tianjin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Yang; Si-yi YuChengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of ChinaEmail jenny_yang_jie@126.com; cdutcmysy@gmail.comPurpose: To investigate the effectiveness of moxibustion at different times of the menstrual cycle for patients with primary dysmenorrhea (PD).Patients and Methods: Participants were 208 patients allocated to three controlled groups: one pre-menstrual treatment group (Group A), one menstrual-onset treatment group (Group B), and one waiting-list group (Group C). Groups A and B received the same intervention of moxibustion on points SP6 and RN4 but at different times. Group C, the waiting-list group, received no treatment throughout the study. Cox Menstrual Symptom Scale (CMSS) score was the primary outcome. Secondary outcomes were visual analog scale (VAS) score of pain intensity, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score. CMSS and VAS scores were obtained at the baseline stage (three cycles), treatment stage (three cycles), and follow-up stage (three cycles), a total of seven evaluations. SAS and SDS scores were obtained on the day of group allocation and the first day of the follow-up stage, a total of two evaluations.Results: Baseline characteristics were comparable across the three groups. Pain duration (CMSS score) was significantly higher in Group C than in the other two groups at each evaluation (P< 0.001). There was also a significant difference in the improvement in pain duration between Group B and Group C (P< 0.001) throughout the trial. There were no significant changes in pain severity (CMSS score) after the 3-month treatment in Group A and Group B (P> 0.05). Secondary outcomes showed that pre-menstrual moxibustion (Group A) was as effective as menstrual-onset moxibustion (Group B) in relieving pain intensity (VAS score) and negative mood (SDS and SAS scores).Conclusion: Moxibustion appears as an effective treatment for PD. Pre-menstrual application is more effective than menstrual-onset application.Trial Registration Chictr.org.cn Identifier: ChiCTR-TRC-14004627.Keywords: primary dysmenorrhea, moxibustion, intervention time, randomized controlled trial, pain relief

Feng Liang,1,* Jianli Wang,1,* Xiangyu Zhu,2,* Zhen Wang,1 Jingwei Zheng,1 Zeyu Sun,1 Shenbin Xu,1 Jianmin Zhang,1,3,4 Jingyi Zhou,1 Ligen Shi1 1Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 4Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ligen Shi 88 Jiefang Road, Hangzhou City, Zhejiang Province 310009, People’s Republic of ChinaTel +86-571-87784715Fax +86-571-87784755Email slg0904@zju.edu.cnJianmin Zhang 88 Jiefang Road, Hangzhou City, Zhejiang Province 310009, People’s Republic of ChinaTel +86-571-87784715Fax +86-571-87784755Email zjm135@zju.edu.cnBackground: This study sought to investigate a novel effect of melatonin in reducing brain injury in an in vivo hyperglycemic intracerebral hemorrhage (ICH) model and further explore the mechanisms of protection.Methods: Hyperglycemia ICH was induced in Sprague-Dawley rats by streptozocin injection followed by autologous blood injection into the striatum. A combined approach including RNA-specific depletion, electron microscopy, magnetic resonance, Western blots, and immunohistological staining was applied to quantify the brain injuries after ICH.Results: Hyperglycemia resulted in enlarged hematoma volume, deteriorated brain edema, and aggravated neuronal mitochondria damage 3 days after ICH. Post-treatment with melatonin 2 hours after ICH dose-dependently improved neurological behavioral performance lasting out to 14 days after ICH. This improved neurological function was associated with enhanced structural and functional integrity of mitochondria. Mechanistic studies revealed that melatonin alleviated mitochondria damage in neurons via activating the PPARδ/PGC-1α pathway. Promisingly, melatonin treatment delayed until 6 hours after ICH still reduced brain edema and improved neurological functions. Melatonin supplementation reduces neuronal damage after hyperglycemic ICH by alleviating mitochondria damage in a PPARδ/PGC-1α-dependent manner.Conclusion: Melatonin may represent a therapeutic strategy with a wide therapeutic window to reduce brain damage and improve long-term recovery after ICH.Keywords: melatonin, intracerebral hemorrhage, hyperglycemia, mitochondria, apoptosis

Jiqiao Yang,1,2 Li Xu,1 Pengcheng Liu,1 Zhenggui Du,1 Jie Chen,1 Faqing Liang,1 Quanyi Long,1 Di Zhang,1,3 Helin Zeng,1 Qing Lv1 1Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Cancer Research Institute, Kanazawa University, Kanazawa, JapanCorrespondence: Qing LvDepartment of Breast Surgery, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, People’s Republic of ChinaTel +86-2885422873Email lvqingwestchina@163.comBackground: Radioisotopes and blue dyes are used as dual tracers in the current gold standard procedure of sentinel lymph node (SLN) biopsy (SLNB) performed for breast cancer. However, the blue dye or the radioisotope as a single tracer is also being applied in some institutes. We aimed to explore the risk factors for the miss-detection of SLNs with the radioisotope and the blue dye and to describe the distribution of SLNs missed by each tracer.Patients and Methods: Patients undergoing SLNB with radioisotope and blue dye as dual mapping agents were enrolled between August 2010 and August 2018. Radioactivity count, blue dye staining status, and size and location of each SLN were prospectively documented.Results: In total, 2382 SLNs from 1010 patients were included for statistical analyses. The sentinel node identification rate was 100% for dual tracers, 99.4% for radioisotope, and 89.1% for blue dye. SLN identification using the blue dye was more likely to fail in patients undergoing breast-conserving surgery (p < 0.001) and mastectomy with reconstruction (p = 0.005). Furthermore, miss-detection was significantly more frequent in smaller and uninvolved nodes. Among all SLNs, 8.2% were located in level II and one was in level III. Notably, single tracer of blue dye tended to fail in the detection of lymph nodes in higher levels (p < 0.001).Conclusion: This study explored the association between features and the incidence of the failure to detect SLNs using radioisotope and blue dye. The locations of the miss-detected SLNs are demonstrated to provide a reference for SLNBs conducted using blue dye or radioisotope as a single tracer.Keywords: breast cancer, sentinel lymph node, radioisotope, blue dye, single tracer

Junqiang Liu,1,2 Paicheng Liu,1 Xue Gong,1 Fengbo Liang1 1School of Government, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Chinese Public Administration Research, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaCorrespondence: Junqiang LiuSchool of Government, Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou, People’s Republic of ChinaTel +86 20-84111433Email liujq26@mail.sysu.edu.cnPaicheng LiuSchool of Government, Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou, People’s Republic of ChinaTel +86 18580008701Email pai_cheng@126.comBackground: We know a great deal about types, causes, and prevention of medical errors, as well as the risks of each medical specialties. Although we know something about medical errors, much remains to be done in this area particularly around effective prevention. However, little is known about whether medical errors are related to medical specialties. Our objective was to categorize and map the distribution of medical errors and analyze their relationships with medical specialties.Methods: First, public cases of medical disputes were searched on “China Judgment Online” according to the key words including medical errors. Second, we set up a database with 5237 medical litigations. After removing unrelated judgment documents, we used systematic random sampling to extract half of these. Then, we hired two frontline physicians with M.D. to review the litigation documents and independently determine the medical errors and the departments in which they took place. A third physician further reviewed the divergent results. After the descriptive statistical analysis and mind map analysis, semi-structured interviews were further conducted with 63 doctors to reveal the relationships mentioned above.Results: More than 97.8% of medical errors occurred in clinical departments. The insufficient implementation of informed consent obligations is the top medical error in all medical departments [internal medical departments (12.86%, N=36), surgical departments (14.57%, N=106), specialist departments (13.16%, N=86)]. The types of medical errors in diverse medical departments might be associated with therapeutic means used by physicians. Errors related to surgical operations were common in surgical departments, errors related to diagnoses were common in internal medicine departments, and errors related to therapy were common in specialist departments. A lack of clinical experience and undesirable work system design have contributed to the occurrence of medical errors. Inadequate human resources and unreasonable shift systems have increased the workload of staff members and this has in turn increased the incidence rate of medical errors.Conclusion: Medical departments are facing medical errors both in humanity and technology. Medical institutions should be alert to the harm caused by medical humanity (mainly including insufficient communication between physicians and patients, insufficient implementation of infringement of informed consent, infringement of patient’s privacy and overtreatment). Improving the clinical skill and vigilance of medical staff is a top priority. Medical institutions should also improve undesirable system designs.Keywords: medical errors, medical specialties, patient safety, medical disputes, China

Wei Shi,1,2 Rui Jiang,1,2 Fei Liang,3 Genhua Yu,4 Jiang Long,2,5 Jiandong Zhao1,21Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Shanghai, People’s Republic of China; 3Clinical Statistic Center, Shanghai Cancer Center and Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 4Department of Radiation Oncology, Zhebei Mingzhou Hospital, Huzhou City, Zhejiang Province, People’s Republic of China; 5Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of ChinaPurpose: The objective of this study was to analyze the safety and efficacy of definitive chemoradiotherapy and salvage chemotherapy in pancreatic cancer (PC) patients with isolated locoregional recurrence after radical resection and assess the factors associated with tumor response.Patients and methods: A retrospective study of isolated locoregional recurrent PC patients who were treated with definitive chemoradiotherapy and salvage chemotherapy at our institution between 2012 and 2017 was conducted. Medium dose of 56.0 Gy (range: 54.0 Gy - 60.2 Gy) in 1.8 Gy to 2.15 Gy daily fractions was prescribed to the PTV-G and 50.4 Gy was prescribed to the PTV-C. Patients received chemotherapy before, at the same time with or after radiotherapy. The overall survival (OS) and freedom from locoregional progression (FFLP) rates were estimated by the Kaplan–Meier method, and the log-rank test was performed to compare survival curves. The Cox regression was used to identify factors affecting response to treatment and survival.Results: Thirty-one patients were included. The median interval from the resection of primary PC to the diagnosis of the locoregional recurrence (DFI) was 7.4 months (range 0.2–44.6). Within a median follow-up from the start of radiotherapy (RT) of 31.7 months (95% CI: 20.0–43.5 months), the medium OS and FFLP rates from the start of RT were 23.6 and 12.0 months, respectively. DFI >6 months was shown to be a significant factor associated with favorable OS. Acute and late toxicity of grade 3 occurred in 3 patients (9.7%) and 1 patient (3.2%) respectively. No grade 4 toxicity or higher occurred.Conclusions: This single-institution retrospective analysis identified definitive chemoradiotherapy and salvage chemotherapy to be a feasible and tolerable treatment strategy for patients with isolated locoregional recurrence after radical resection of primary PC.Keywords: pancreatic cancer, isolated locoregional recurrence, locoregional oligo-recurrence, chemoradiotherapy, radiotherapy

Fengyin Liang,1 Fengjuan Su,1 Xiaoxiao Wang,2 Simei Long,1 Yinglin Zheng,3 Xiaofei He,1 Jiyan Pang,3 Zhong Pei1 1Department of Neurology, Guangdong Provisional Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, People’s Republic of China; 2Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China; 3School of Chemistry, Sun Yat-sen University, Guangzhou 510275, People’s Republic of China Purpose: Mild traumatic brain injury (mTBI), the most common type of TBI, can result in prolonged cognitive impairment, mood disorders, and behavioral problems. Reducing oxidative stress and inflammation can rescue the neurons from mTBI-induced cell death. Xyloketal B, a natural product from mangrove fungus, has shown good antioxidative and neuroprotective effects in several disease models. Here, we investigated the potential protection afforded by a xyloketal derivative, C53N, in a closed-skull mTBI model. Materials and methods: Skulls of mice were thinned to 20–30 µm thickness, following which they were subjected to a slight compression injury to induce mTBI. One hour after TBI, mice were intraperitoneally injected with C53N, which was solubilized in 0.5% dimethyl sulfoxide in saline. In vivo two-photon laser scanning microscopy was used to image cell death in injured parenchyma in each mouse over a 12-hour period (at 1, 3, 6, and 12 hours). Water content and oxidation index, together with pathological analysis of glial reactivity, were assessed at 24 hours to determine the effect of C53N on mTBI. Results: Cell death, oxidative stress, and glial reactivity increased in mTBI mice compared with sham-injured mice. Treatment with 40 or 100 mg/kg C53N 1 hour after mTBI significantly attenuated oxidative stress and glial reactivity and reduced parenchymal cell death at the acute phase after mTBI. Conclusion: The present study highlights the therapeutic potential of the xyloketal derivative C53N for pharmacological intervention in mTBI. Keywords: xyloketal derivative, mTBI, in vivo imaging, antioxidant activity, neuroprotective activity

Kai Jia,1 Xin Tong,1 Fang Liang2 1Department of Nutrition, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; 2Department of Hyperbaric Oxygen, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China Objective: To investigate the effects of sequential nutritional support on nutritional status and immune regulation in patients with early severe traumatic brain injury (STBI). Patients and methods: A total of 62 patients diagnosed with STBI enrolled from Chaoyang Hospital (Beijing, China) from February 2015 to October 2016 were divided into two groups. The observational group (n=34) was given sequential nutritional support and the control group (n=28) was given the standard formula of whole protein enteral preparations. The energy supply for the two groups was 30 kcal/kg/d and protein 1.6 g/kg/d, respectively. The albumin (ALB), total protein (TP), high-sensitivity C-reactive protein (Hs-CRP), neuron-specific enolase (NSE), Glasgow Coma Score (GCS), and regulatory T cells before and after nutritional treatment were measured in both groups. Results: At the 14th day, the levels of ALB (41.7±4.2 g/L) and TP (70.6±4.9 g/L) were significantly higher than those in the control group (33.5±2.3 g/L and 62.3±3.9 g/L) (P

Shi-tong Yu,1,2,* Zhiwei Zhou,1,2,* Qian Cai,1,2 Faya Liang,1,2 Ping Han,1,2 Renhui Chen,1,2 Xiao-ming Huang1,2 1Department of Otolaryngology, Head and Neck Surgery, 2Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China *These authors contributed equally to this work Purpose: The present study was designed to retrospectively evaluate the prognostic value of the C-reactive protein/albumin (CRP/ALB) ratio in laryngeal squamous cell carcinoma (LSCC).Methods: One hundred and twenty-nine newly diagnosed LSCC patients admitted between May 2006 and October 2011 were retrospectively reviewed. Their serum CRP and ALB were quantified preoperatively. The relationship between the CRP/ALB ratio and the clinicopathologic features was analyzed. Receiver operating characteristic curve was used to calculate the prognostic value of the CRP/ALB ratio. Then, the Cox proportional hazards model was used in univariate and multivariate analyses to identify significant prognostic factors associated with disease-free survival and overall survival.Results: The cutoff value for CRP/ALB ratio was 0.047. An elevated CRP/ALB ratio was significantly associated with nodal metastasis, late disease stage, and recurrence. Also, high values of CRP/ALB ratio were significant predictors for poor overall survival and disease-free survival on multivariate analysis.Conclusion: Pretreatment CRP/ALB ratio may be a significant prognostic marker in LSCC. Keywords: C-reactive protein/albumin ratio, laryngeal squamous cell carcinoma, prognosis, survival

Wenping Xiang,1 Hui Xue,2 Baojun Wang,2 Yuechun Li,2 Jun Zhang,2 Changchun Jiang,2 Furu Liang,2 Jiangxia Pang,2 Lehua Yu1 1Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 2Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People’s Republic of China Background: Delayed encephalopathy after acute carbon monoxide (CO) poisoning (DEACMP) commonly occurs after recovering from acute CO poisoning. This study was performed to assess the efficacy of the combined application of dexamethasone and hyperbaric oxygen (HBO) therapy in patients with DEACMP.Patients and methods: A total of 120 patients with DEACMP were recruited and randomly assigned into the experimental group (receiving dexamethasone 5 mg/day or 10 mg/day plus HBO therapy) and control group (HBO therapy as monotherapy). Meanwhile, the conventional treatments were provided for all the patients. We used the Mini-Mental State Examination (MMSE) scale to assess the cognitive function, the National Institutes of Health Stroke Scale (NIHSS) to assess the neurological function and the remission rate (RR) to assess the clinical efficacy. Myelin basic protein (MBP) in the cerebrospinal fluid (CSF) was also measured.Results: After 4 weeks of treatment, compared to the control group, the experimental group had a significantly higher remission rate (P=0.032), a significantly higher average MMSE score (P=0.037) and a significantly lower average NIHSS score (P=0.002). Meanwhile, there was a trend toward better improvement with dexamethasone 10 mg/day, and the level of MBP in the CSF of patients was significantly lower in the experimental group than in the control group (P

Lingyan Wang,1 Shaolei Guo,2 Nu Zhang,2 Yuqian Tao,3 Heng Zhang,1 Tiewei Qi,2 Feng Liang,2 Zhengsong Huang2 1Department of Neurosurgery ICU, 2Department of Neurosurgery, 3Department of Neurology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China Background: Cerebral arteriovenous malformation (AVM) involves the vasculogenesis of cerebral blood vessels and can cause severe intracranial hemorrhage. Stromal cell-derived factor-1 (SDF-1) and its receptor, CXCR4, are believed to exert multiple physiological functions including angiogenesis. Thus, we investigated the role of SDF-1/CXCR4 in the vasculogenesis of cerebral AVM.Methods: Brain AVM lesions from surgical resections were analyzed for the expression of SDF-1, CXCR4, VEGF-A, and HIF-1 by using immunohistochemical staining. Flow cytometry was used to quantify the level of circulating endothelial progenitor cells (EPCs). Further, in an animal study, chronic cerebral hypoperfusion model rats were analyzed for the expression of SDF-1 and HIF-1. CXCR4 antagonist, AMD3100, was also used to detect its effects on cerebral vasculogenesis and SDF-1 expression.Results: Large amounts of CXCR4-positive CD45+ cells were found in brain AVM lesion blood vessel walls, which also have higher SDF-1 expression. Cerebral AVM patients also had higher level of EPCs and SDF-1. In chronic cerebral hypoperfusion rats, SDF-1, HIF-1, and CD45 expressions were elevated. The application of AMD3100 effectively suppressed angiogenesis and infiltration of CXCR4-positive CD45+ cells in hypoperfusion rats compared to controls.Conclusion: The SDF-1/CXCR4 axis plays an important role in the vasculogenesis and migration of inflammatory cells in cerebral AVM lesions, possibly via the recruitment of bone marrow EPCs. Keywords: cerebral arteriovenous malformation, SDF-1/CXCR4, chronic cerebral hypoperfusion, endothelial progenitor cells

This research investigated spatial-temporal variation in benthic bacterial community structure, rates of denitrification and dissimilatory nitrate reduction to ammonium (DNRA) processes and abundances of corresponding genes and transcripts at three sites – the estuary-head, mid-estuary and the estuary mouth along the nitrate gradient of the Colne estuary over an annual cycle. Denitrification rates declined down the estuary, while DNRA rates were higher at the estuary head and middle than the estuary mouth. In four out of the six two-monthly time-points, rates of DNRA were greater than denitrification at each site. Abundance of gene markers for nitrate-reduction (nitrate reductase narG and napA), denitrification (nitrite reductase nirS) and DNRA (DNRA nitrite reductase nrfA) declined along the estuary with significant relationships between denitrification and nirS abundance, and DNRA and nrfA abundance. Spatially, rates of denitrification, DNRA and corresponding functional gene abundances decreased along the estuary. However, temporal correlations between rate processes and functional gene and transcript abundances were not observed.

Denitrification and dissimilatory nitrate reduction to ammonium (DNRA) are processes occurring simultaneously under oxygen-limited or anaerobic conditions, where both compete for nitrate and organic carbon. Despite their ecological importance, there has been little investigation of how denitrification and DNRA potentials and related functional genes vary vertically with sediment depth. Nitrate reduction potentials measured in sediment depth profiles along the Colne estuary were in the upper range of nitrate reduction rates reported from other sediments and showed the existence of strong decreasing trends both with increasing depth and along the estuary. Denitrification potential decreased along the estuary, decreasing more rapidly with depth towards the estuary mouth. In contrast, DNRA potential increased along the estuary. Significant decreases in copy numbers of 16S rRNA and nitrate reducing genes were observed along the estuary and from surface to deeper sediments. Both metabolic potentials and functional genes persisted at sediment depths where porewater nitrate was absent. Transport of nitrate by bioturbation, based on macrofauna distributions, could only account for the upper 10 cm depth of sediment. A several fold higher combined freeze-lysable KCl-extractable nitrate pool compared to porewater nitrate was detected. We hypothesised that his could be attributed to intracellular nitrate pools from nitrate accumulating microorganisms like Thioploca or Beggiatoa. However, pyrosequencing analysis did not detect any such organisms, leaving other bacteria, microbenthic algae, or foraminiferans which have also been shown to accumulate nitrate, as possible candidates. The importance and bioavailability of a KCl-extractable nitrate sediment pool remains to be tested. The significant variation in the vertical pattern and abundance of the various nitrate reducing genes phylotypes reasonably suggests differences in their activity throughout the sediment column. This raises interesting questions as to what the alternative metabolic roles for the various nitrate reductases could be, analogous to the alternative metabolic roles found for nitrite reductases.

Abstract Background Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. Methods Questionnaires were developed, reviewed and validated by experts, and sent to 25 hospitals in Zhejiang province to prospectively collect data of 492 chemical burn patients admitted during one year from Sept. 1, 2008 to Aug. 31, 2009. Questions included victims' characteristics and general condition, injury location, causes of accident, causative chemicals, total body surface area burn, concomitant injuries, employee safety training, and awareness level of protective measures. Surveys were completed for each of burn patients by burn department personnel who interviewed the hospitalized patients. Results In this study, 417 victims (87.61%) got chemical burn at work, of which 355 victims (74.58%) worked in private or individual enterprises. Most frequent chemicals involved were hydrofluoric acid and sulfuric acid. Main causes of chemical injury accidents were inappropriate operation of equipment or handling of chemicals and absence of or failure to use effective individual protection. Conclusions Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns.