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Background: Prophylactic central neck dissection (pCND) in well-differentiated primary papillary thyroid carcinoma (PTC) patients have become controversial. Several attempts have been made to predict central compartment lymph node metastasis (CLNM) based on clinical and conventional ultrasonic parameters. This study seeks to develop a decision tree (DT) model for predicting the risk of CLNM in these patients based on clinical and preoperative multimodal ultrasound (US) characteristics.Methods: A total of 148 PTC nodules confirmed by surgical pathology at Beijing Tiantan Hospital were retrospectively analyzed. All nodules underwent multimodal US examinations from January 2020 to September 2021 before surgery. Correlation analysis of CLNM with clinical characteristics, multimodal US parameters of PTC lesions based on grayscale US, color Doppler flow imaging, superb microvascular imaging, contrast-enhanced US and shear wave elastography technology was carried out. Finally, the Chi-squared automatic interaction detector with a ten-fold cross test was used to establish DT models based on multimodal US parameters to predict CLNM. The area under the curve (AUC) was calculated for comparing prediction performance.Results: Univariate analysis indicated that CLNM was positively correlated with Tg level, maximum size, tall than wide, the number of microcalcifications greater than or equal to 5, contact capsule, US reported abnormal cervical lymph nodes, non-centripetal perfusion, delayed clearance, SWV mean and SWV ratio (p<0.05). The multimodal US algorithm based on tall than wide, contact the capsule, US reported abnormal cervical lymph nodes, centripetal enhancement as independent variables showed good discrimination: the sensitivity, specificity, accuracy and AUC were 80.0%, 76.7%, 78.4%, and 0.837 (95% CI: 0.771-0.902). There was a significant difference between multimodal US DT with conventional ultrasound DT (p<0.001). Conclusions: This study implies that the DT model based on preoperative multimodal US characteristics of PTCs has reasonable prediction ability for CLNM, which can be conveniently used for clinical decision-making of individualized treatment in well-differentiated PTC patients.

Development of novel therapeutic antibodies that not only kill tumor cells but modulate the adaptive immune response has the potential to produce long term anti-cancer immunity and a durable clinical response. We previously reported the discovery of an anti-complement factor H (CFH) autoantibody in lung cancer patients that were associated with early stage disease and exceptional outcomes. The human monoclonal antibody GT103, produced from a single CFH autoantibody-expressing B cell of a lung cancer patient, recognizes a conformationally distinct epitope on tumor cells, kills tumor cells, and inhibits tumor growth in animal studies. Recent experiments have shown that GT103 restructures the tumor microenvironment and initiates a robust antitumoral adaptive immune response. The current study further elucidates several mechanisms by which GT103 kills tumor cells and drives the immune program. Here we show GT103 has specificity for tumor cells without binding to native soluble CFH or normal tissues. GT103 causes complement C3 split product deposition on tumor cellsin vitroandin vivo,triggers antibody-dependent cellular phagocytosis, and increases translocation of the danger associated molecular pattern molecule calreticulin to the plasma membrane.We also demonstrate that GT103 causes B cell activation and that GT103 antitumor activityin vivois B cell dependent. The complex mechanism of GT103, a tumor specific antibody that kills tumor cells and stimulates an immune response, supports further development of this human-derived antibody as a novel therapeutic option for patients with lung cancer.

Quercus dentata Thunb., a dominant forest tree species in northern China, has significant ecological and ornamental value due to its adaptability and beautiful autumn coloration, with color changes from green to yellow into red resulting from the autumnal shifts in leaf pigmentation. However, the key genes and molecular regulatory mechanisms for leaf color transition remain to be investigated. First, we presented a high-quality chromosome-scale assembly for Q. dentata. This 893.54 Mb sized genome (contig N50 = 4.21 Mb, scaffold N50 = 75.55 Mb; 2n = 24) harbors 31 584 protein-coding genes. Second, our metabolome analyses uncovered pelargonidin-3-O-glucoside, cyanidin-3-O-arabinoside, and cyanidin-3-O-glucoside as the main pigments involved in leaf color transition. Third, gene co-expression further identified the MYB-bHLH-WD40 (MBW) transcription activation complex as central to anthocyanin biosynthesis regulation. Notably, transcription factor (TF) QdNAC (QD08G038820) was highly co-expressed with this MBW complex and may regulate anthocyanin accumulation and chlorophyll degradation during leaf senescence through direct interaction with another TF, QdMYB (QD01G020890), as revealed by our further protein–protein and DNA–protein interaction assays. Our high-quality genome assembly, metabolome, and transcriptome resources further enrich Quercus genomics and will facilitate upcoming exploration of ornamental values and environmental adaptability in this important genus.

Background: As a first-echelon nodal drainage site of breast cancer, the status of axillary lymph nodes (ALN) and internal mammary lymph nodes (IMLN) is both valuable for regional staging and treatment choice. The internal mammary sentinel lymph node biopsy (IM-SLNB) may provide minimally invasive staging, and guide individual IMLN radiation. Modified technique (periareolar intraparenchymal, high volume and ultrasound guidance) got a high internal mammary sentinel lymph nodes (IM-SLN) visualization rate of 71.1% in single center, and the prospective multicenter study was designed to verify its repeatability (CBCSG026, NCT03541278). High visualization rate and low false negative rate are prerequisites for the widespread of IM-SLNB. The question arises as to whether IM-SLN detected with the modified technique should be considered as “true” IM-SLN. The prospective, multicenter, clinical validation study of IM-SLNB followed by internal mammary lymph node dissection (IM-LND) was designed to verify the accuracy of IM-SLNB in patients with ALN positive breast cancer (CBCSG027, NCT03024463). Methods: While CBCSG026 trial enrolled patients with both axillary negative and positive breast cancer, CBCSG027 trial only enrolled axillary positive patients receiving mastectomy (either biopsy proving cN+ disease or cN0 with positive axillary SLN). The 1st to 3rd intercostal IM-LND was performed immediately after IM-SLNB to verify its accuracy in the CBCSG027 trial. Result: From May 2018 to June 2022, 600 and 264 patients were enrolled in the CBCSG026 and CBCSG027 trial from seven centers in China, respectively. Among the 600 recruited patients in the CBCSG026, the IM-SLN visualization rate was 65.0% (390/600), which was significantly related to patient’s age, body mass index, radiotracer intensity and interval time between injection and IM-SLN identification (all P< 0.05). The IM-SLNB successful rate was 97.4% (380/390), and the complication was 6.9%. The median number of IM-SLN was 1. The overall IM-SLN metastases rate was 18.9% (72/380), with 33.0% (65/195) and 3.8% (7/185) in ALN positive and negative patients, respectively. Multivariate analysis showed that the tumor size (P=0.028), the tumor location (P< 0.001) and the number of positive ALNs (P< 0.001) were independent predictors of IM-SLN metastasis. Those variables were included in a novel nomogram (Table 1), which was significantly better than the probability based on the number of metastatic ALNs alone according to the current guidelines (area under the curve: 0.860 vs. 0.804, P< 0.001). Of the 264 patients enrolled in the CBCSG027 trial, 185 patients (70.1%) had IM-SLN visualization (included 107 with cN+ disease and 78 with positive axillary SLN). The median number of IM-SLN and IM-nSLN was 2 (1~4) and 3 (1~9), respectively. The positive rate of IMLN and IM-SLN was 37.8% (70/185) and 36.8% (68/185), respectively, yielding the false negative rate of IM-SLNB 2.9% (2/70), the accuracy of 98.9% (183/185) and the sensitivity of 97.1% (68/70). The false negative rate of patients with cN+ disease and patients with positive axillary SLN was 4.8% (2/42) and 0, respectively. The positive IM-SLNs were the only positive IMLNs identified in 51.4% (36/70) patients. IM-SLNB can change the pN stages of 37.2% (68/183) patients. IMLN irradiation could be avoided in 72.7% (80/110) patients with axillary pN1 and 46.7% (35/75) with pN2/N3 disease in the study. Conclusions: The modified technique of radiotracer injection (periareolar intraparenchymal, high volume, and ultrasound guidance) can significantly improve the detection rate of IM-SLN with very low false-negative rate with the prospective, multicenter validation results, providing minimally invasive staging and guiding individual IMLN radiation. When there is no IM-SLN visualization, the nomogram can predict the risk of IMLN metastasis and guide IMLN radiation. The nomogram which can predict the risk of IMLN metastasis The nomogram which can predict the risk of IMLN metastasis Citation Format: Yong-Sheng Wang, Qing Lu, Shi-Guang Zhu, Wen-He Zhao, Guang-Lun Yang, Yuan-Xi Huang, Hong Zhong, Xiao Sun, Pengfei Qiu. Prospective, multicenter, clinical validation study of the repeatability and accuracy of internal mammary sentinel lymph node biopsy with modified injection technique (CBCSG026/CBCSG027) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-14-06.

Rubber asphalt is considered to have potential development and application prospects because it not only has good performance but also promotes the resource utilization of waste tires. However, compared with ordinary asphalt, rubber asphalt has greater viscosity and needs to be made at higher temperatures. The resulting harmful fumes and odorous gas seriously threaten human health and cause environmental pollution. This paper reviews the research status of the toxic emissions of rubber asphalt at high temperatures from hazards, emission mechanisms, treatment measures, and analysis methods. Compared with the emissions of ordinary asphalt, the high-temperature emissions of rubber asphalt are more complex. Since they include the emissions of asphalt, the pyrolysis of rubber, and the interaction between them. Most of the existing treatment measures can only reduce the emissions of some parts of the mixing or paving processes. The effective collection of emissions is still a problem, which reduces the accuracy of qualitative and quantitative analyses. Future work on relieving the toxic emissions of rubber asphalt is also recommended: the degradation and desulfurization of rubber, the preparation of compound fume suppressants, and the utilization of multiple analysis methods.

Stroke is closely associated with carotid plaques. The assessment of carotid plaque is still the key issue of stroke prevention in clinical practice. This prospective cross-sectional study included patients with carotid plaque evaluated by ultrasonography (US). The intima-media thickness (IMT), lumen stenosis severity, thickness, and length of carotid plaque were measured by the routine US, and the amplitudes of subharmonics in the upstream shoulder, top, and downstream shoulder of all plaques and corresponding lumens were observed by Subharmonic Aided Pressure Estimation (SHAPE) US examination from the US contrast agent perflubutane microbubbles (Sonazoid), which analyzed the clinical parameters of patients, the subharmonic amplitude characteristics of all plaques and lumens, and the parameter differences between the ischemic stroke (IS) group and control group. From May 2021 to February 2022, 46 carotid plaques of 23 patients were included. For plaques, the subharmonic amplitude in the plaque (-60.52 ± 4.46) was lower than that in the opposing level lumen (-56.82 ± 5.68 dB), the subharmonic gradient across the plaque cap was negatively correlated with plaque thickness (r = -0.51, p 0.001), and with the lumen stenosis severity (r = -0.42, p = 0.003). The median IMT of the IS group was thicker than the control group. The subharmonic gradient of the intraplaque of the IS group was larger than the control group (p = 0.004). In this analysis, we use the receiver operating characteristic (ROC) curve to establish the cutoff value of the difference to predict a new monitoring method for plaque without invasion to predict IS. It still needs a large-scale study with long-term follow-up to validate these findings.

A new approach to treat LLZO particles with salicylic acid (SA) to achieve dual-functionalization. This interfacial modification technique enhances Li+ transport not only at the LLZO/PEO interface, but also throughout the PEO matrix.

Hydrogen is an important energy carrier for the transition to a carbon-neutral society, the CMS membrane exhibited ultrahigh H2/N2 selectivity (117) and H2 permeability, which have bright prospects for hydrogen purification.

Thyroidectomy is the first-line treatment for papillary thyroid microcarcinoma (PTMC), but often involves aggressive overtreatment. Thermal ablation (TA) has been gradually used for the treatment of recurrent PTMC. However, it is not recommended for the treatment of primary PTMC according to the Korean and Italian guidelines. Therefore, this systematic review aimed to analyse the indications, efficacy, and safety of TA in the treatment of PTMC.Systematic review PATIENTS AND MEASUREMENTS: A search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 27 articles were included in this study until January 2022.According to current guidelines and studies, we divided the indications of TA for PTMC into six primary and three secondary indications. Laser ablation (LA) has the advantages of a small needle, accurate output energy, and precision ablation, and it is safe to important organs around the lesion. The patients recover quickly after radiofrequency ablation (RFA), with no major complications, recurrence, or lymph node metastasis. The volume reduction rate after RFA was the highest, followed by microwave ablation and LA, and the improvement in patient quality of life after TA was significantly better than after thyroidectomy.TA is an effective alternative method for surgery in the treatment of low-risk PTMC and has the advantages of being minimally invasive, economical, having less bleeding, and having a high postoperative quality of life. This article is protected by copyright. All rights reserved.

Background Bronchopulmonary dysplasia (BPD) is a common chronic lung disease in extremely preterm neonates. The outcome and clinical burden vary dramatically according to severity. Although some prediction tools for BPD exist, they seldom pay attention to disease severity and are based on populations in developed countries. This study aimed to develop machine learning prediction models for BPD severity based on selected clinical factors in a Chinese population. Methods In this retrospective, single-center study, we included patients with a gestational age Results We ultimately included 471 patients (279 mild, 147 moderate, and 45 severe cases). On ordinal logistic regression, gestational diabetes mellitus, initial fraction of inspiration O2 value, invasive ventilation, acidosis, hypochloremia, C-reactive protein level, patent ductus arteriosus and Gram-negative respiratory culture were independent risk factors for BPD severity. All the XGB, LR and RF models (AUC = 0.85, 0.86 and 0.84, respectively) all had good performance. Conclusions We found risk factors for BPD severity in our population and developed machine learning models based on them. The models have good performance and can be used to aid in predicting BPD severity in the Chinese population.

Synaptic dysfunction is one of the earliest pathological processes that contribute to the development of many neurological disorders, including Alzheimer’s disease and frontotemporal lobar degeneration. However, the synaptic function of many disease-causative genes and their contribution to the pathogenesis of the related diseases remain unclear. In this study, we investigated the synaptic role of fused in sarcoma, an RNA-binding protein linked to frontotemporal lobar degeneration and amyotrophic lateral sclerosis, and its potential pathological role in frontotemporal lobar degeneration using pyramidal neuron-specific conditional knockout mice (FuscKO). We found that FUS regulates the expression of many genes associated with synaptic function in a hippocampal subregion-specific manner, concomitant with the frontotemporal lobar degeneration-linked behavioural disinhibition. Electrophysiological study and molecular pathway analyses further reveal that fused in sarcoma differentially regulates synaptic and neuronal properties in the ventral hippocampus and medial prefrontal cortex, respectively. Moreover, fused in sarcoma selectively modulates the ventral hippocampus–prefrontal cortex projection, which is known to mediate the anxiety-like behaviour. Our findings unveil the brain region- and synapse-specific role of fused in sarcoma, whose impairment might lead to the emotional symptoms associated with frontotemporal lobar degeneration.

Chainlike ZSM-5 was synthesized in a tetrapropylammonium hydroxide (TPAOH) and poly(diallydimethylammonium chloride) (PDDA) dual-template system. The synthesis parameters and formation mechanism of chainlike zeolites were investigated. The optimized composition of the synthesis mixture was as follows: the PDDA/SiO

Recently, a new representation model has been proposed to improve the interpretability and accuracy of Computing with Words (CW) processes, the so-called Extended Comparative Linguistic Expressions with Symbolic Translation (ELICIT). It extends the concept of comparative linguistic expressions based on hesitant fuzzy linguistic term sets into a continuous domain by means of the symbolic translation used in the linguistic 2-tuple model. The aggregation of this kind of information is vital when solving decision making problems, but as the field of ELICIT information is still quite new, not many aggregation operators have been defined for it. Therefore, taking into account the need to deal with the fuzzy representation of ELICIT information for its aggregation, we propose the ELICIT type-1 OWA (ELICIT-t1-OWA) operator based on the equivalent α − level type-1 OWA operator to simplify the CW processes by using ELICIT trapezoidal fuzzy representations. The ELICIT-t1-OWA operator will use interval weights induced by an interval-valued linguistic quantifier to aggregate ELICIT expressions and then its properties will be studied. Additionally, a way to deal with both the weights and arguments of the ELICIT-t1-OWA operator is provided in the form of fuzzy numbers. Finally, a decision making model dealing with ELICIT information that carries out the aggregation by using the proposed ELICIT-t1-OWA operator is developed and a numerical example to show its effectiveness is introduced.

Active ingredients of Chinese medicine (AIFCM) are pharmacological substances taken from traditional Chinese medicine that show promise in treating gastrointestinal cancer. Compared with traditional chemotherapeutic drugs, AIFCM have advantages such as multi-target and multi-level treatment of gastrointestinal cancer. Nanocarriers have the following advantages, better bioavailability, passive or active targeting of tumor sites and responsive release of drugs. The use of nanocarriers for delivery of AIFCM in treatment of gastrointestinal cancer, can overcome the disadvantages of some AIFCM, such as insolubility and low bioavailability. In this review, we first outline the background on gastrointestinal cancer, main curative factors and conventional therapeutic approaches. Then, the mechanisms for AIFCM in gastrointestinal cancer therapy are presented in the following four aspects: gene regulation, immune modulation, cellular pathway transduction, and alteration of intestinal flora. Thirdly, preparation of various nanocarriers and results when combining AIFCM in gastrointestinal cancer are presented. Fourth, application of novel targeted nanocarriers and responsive nanocarriers in gastrointestinal tumors is further introduced. Finally, the application of AIFCM in the treatment of gastrointestinal cancer is summarized and prospected, hoping to shed some light on the nanocarrier-bound AIFCM in the treatment of gastrointestinal cancer.

Multiple stereoisomers can be found when a substance contains chiral carbons in its chemical structure. To obtain the desired stereoisomers, asymmetric synthesis was proposed in the 1970s and developed rapidly at the beginning of this century. Stereodivergent synthesis, an extension of asymmetric synthesis in organic synthesis with the hope to produce all stereoisomers of chiral substances in high conversion and selectivity, enriches the variety of available products and serves as a reference suggestion for the synthesis of their derivatives and other compounds. Since biocatalysis has outstanding advantages of economy, environmental friendliness, high efficiency, and reaction at mild conditions, the biocatalytic reaction is regarded as an efficient strategy to perform stereodivergent synthesis. Thus, in this review, we summarize the stereodivergent synthesis catalyzed by enzymes or chemo-enzymes in cases where a compound contains two or three chiral carbons, i.e., at most four or eight stereoisomers are present. The types of reactions, including reduction of substituent ketones, cyclization reactions, olefin addition, and nonredox transesterification reactions, are also discussed for the understanding of the progress and application of biocatalysis in stereodivergent synthesis.

Citrus plants are sensitive to waterlogging, which can cause yield reduction. Their production heavily depends on the rootstock being used for grafting of scion cultivars, and the rootstock is the first organ to be affected by waterlogging stress. However, the underlying molecular mechanisms of waterlogging stress tolerance remain elusive. In this study we investigated the stress response of two waterlogging-tolerant citrus varieties (Citrus junos Sieb ex Tanaka cv. Pujiang Xiangcheng and Ziyang Xiangcheng), and one waterlogging-sensitive variety (red tangerine) at the morphological, physiological, and genetic levels in leaf and root tissues of partially submerged plants. The results showed that waterlogging stress significantly decreased the SPAD value and root length but did not obviously affect the stem length and new root numbers. The malondialdehyde (MDA) content and the enzyme activities of superoxide dismutase (SOD), guaiacol peroxidase (POD), and catalase (CAT) were enhanced in the roots. The RNA-seq analysis revealed that the differentially expressed genes (DEGs) were mainly linked to ‘cutin, suberine, and wax biosynthesis’, ‘diterpenoid biosynthesis’, and ‘glycerophospholipid metabolism’ in the leaves, whereas were linked to ‘flavonoid biosynthesis’, ‘biosynthesis of secondary metabolites and metabolic pathways’ in the roots. Finally, we developed a working model based on our results to elucidate the molecular basis of waterlogging-responsive in citrus. Therefore, our data obtained in this study provided valuable genetic resources that will facilitate the breeding of citrus varieties with improved waterlogging tolerance.

Background The ‘public versus private healthcare’ debate has never stopped, and the empirical evidence is inconclusive and limited in developing countries. This study tries to examine the impacts of delivery structure on the efficiency of healthcare services as well as whether the impacts vary among markets with different characteristics in China. Methods We use panel data at China’s provincial level from 2010 to 2019, and conduct a DEA-Tobit model to investigate the impacts. More concretely, first we apply a DEA model to calculate the efficiency of healthcare services, then examine the impacts of delivery structure on it with a Tobit model. Results Our results indicate that after considering the factors of service quality in the outputs of healthcare services, the efficiency of healthcare services decreased by 20.47% since 2010 because of the overuse of healthcare services and blind expansion of hospitals. However, the large entry of private hospitals does have a significantly positive impact on the efficiency, because the competition pressure pushes them to reduce costs. Moreover, this effect is more effective in the market of primary care which social capital mainly enter. Conclusions This study provides new and reliable evidence on the positive effects of absorbing private capital into the healthcare market, which provides beneficial implications for China and other developing countries to promote and improve market-oriented reform of healthcare services.