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Objective: To investigate the incidence of pelvic floor dysfunction (PFD) and electrophysiological indicators in postpartum women at 6–8 weeks and explore the influence of demographic characteristics and obstetric factors.Methods: A survey questionnaire collected information about the conditions of women during their pregnancy and puerperal period and their demographic characteristics; pelvic organ prolapse quantitation (POP-Q) and pelvic floor muscle electrophysiology (EP) examination were conducted in postpartum women at 6–8 weeks.Results: Vaginal delivery was a risk factor for anterior pelvic organ prolapse (POP) (OR 7.850, 95% confidence interval (CI) 5.804–10.617), posterior POP (OR 5.990, 95% CI 3.953–9.077), anterior and posterior stage II POP (OR 6.636, 95% CI 3.662–15.919), and postpartum urinary incontinence (UI) (OR 6.046, 95% CI 3.894–9.387); parity was a risk factor for anterior POP (OR 1.397,95% CI 0.889–2.198) and anterior and posterior stage II POP (OR 4.162, 95% CI 2.125–8.152); age was a risk factor for anterior POP (OR 1.056, 95% CI 1.007–1.108) and postpartum UI (OR 1.066, 95% CI 1.014–1.120); body mass index (BMI) was a risk factor for postpartum UI (OR 1.117, 95% CI 1.060–1.177); fetal birth weight was a risk factor for posterior POP (OR 1.465, 95% CI 1.041–2.062); and the frequency of pregnancy loss was a risk factor for apical POP (OR 1.853, 95% CI 1.060–3.237).Conclusion: Pelvic floor muscle EP is a sensitive index of early pelvic floor injury. The changes in muscle strength and fatigue degree coexist in different types of postpartum PFD, and each has its own characteristics.

ObjectiveWe aimed to investigate the influence of media on college students’ mental health during the COVID-19 pandemic.MethodsAfter the COVID-19 outbreak, we used cross-sectional surveys through online questionnaires to investigate the mental health of college students in lockdown at home. We identified the influencing factors of PTSD symptoms using the Chi-Square test and ordinal logistic regression analysis.ResultsIn 10,989 valid questionnaires, 9,906 college students with no PTSD symptoms, 947 college students with subclinical PTSD symptoms (1–3 items), and 136 college students with four or more PTSD symptoms were screened out. The results showed that media content impacted the mental health of college students in lockdown at home. Positive media content was negatively correlated with PTSD symptoms among college students. PTSD symptoms were not associated with sources of information. Moreover, College students with PTSD symptoms would reduce their willingness to learn and could not complete online learning efficiently.ConclusionPTSD symptoms are related to media exposure and excessive information involvement of COVID-19 in college students, which influences the willingness to attend online classes.

Background To compare all-cause rebleeding rates and mortality after transjugular intrahepatic portosystemic shunt (TIPS) between severe thrombocytopenia (TCP) and non-severe TCP patients admitted for variceal bleeding.Methods Between January 2017 and June 2020, patients with severe TCP (platelets 9/L) who received TIPS procedures for variceal bleeding at three medical centers were included. As controls, non-severe TCP patients were matched (1:1) by age, viral hepatitis, splenectomy, white blood cell, prothrombin time, international normalized ratio, total bilirubin, and acute variceal bleeding. Primary outcome was 6-week all-cause rebleeding. Secondary outcomes included 1-year all-cause rebleeding, 30-day and 1-year all-cause mortality and complications occurred during or after TIPS creation.Results A total of 373 patients were included in the study, with 84 patients in each cohort after matching. All-cause rebleeding rates at 6-week and 1-year post-TIPS were similar in cohorts with severe versus non-severe TCP (6.0% vs 4.8% at 6-week and 10.7% vs 10.7% at 1-year; P = 0.962; HR: 1.023; 95% CI, 0.406–2.577). One-year all-cause mortality was also comparable between the two cohorts (10.7% vs 9.5%, P = 0.754; HR: 1.164; 95% CI, 0.449–3.018). The comparison of 30-day post-TIPS mortality was inconclusive due to the relatively small number of positive outcome events. A trend toward slightly higher major complications was observed in the severe TCP cohort (8.3% vs 2.4%, P = 0.078).Conclusions Compared with non-severe TCP, severe TCP did not increase the risk of early and late rebleeding after TIPS in patients with variceal bleeding.

Background Hepatocellular carcinoma (HCC) is diagnosed at the middle and advanced stages, negating radical treatment. Identifying specific and effective prognostic HCC biomarkers is important and can facilitate the discovery of potential therapeutic targets. N6-methyladenosine (m6A) and long non-coding RNAs (lncRNAs) are associated with the development of multiple tumors. The role of m6A-relevant lncRNAs in the initiation and progression of HCC is unclear. The aim of the present study was to investigate the expression of m6A-relevant lncRNAs in HCC and to identify new prognostic markers of the disease. Methods Gene expression and clinical data were retrieved from The Cancer Genome Atlas database. m6A-relevant lncRNAs were identified by co-expression analysis and were screened by univariate Cox regression analysis. Different HCC patient clusters were established via consensus clustering. Gene set enrichment analysis (GSEA) was used to determine the cluster enrichment pathways. A risk score model was constructed, and Kaplan-Meier analysis of the overall survival (OS) between cluster 1 (high risk) and cluster 2 (low risk) was performed. Relationships between the clusters, risk scores, and clinicopathological characteristics were clarified. Results Of the 1,852 m6A-relevant lncRNAs identified, 68 had prognostic relevance. The pathological grade, American Joint Committee on Cancer stage, and T stage of cluster 1 were significantly more advanced than those of cluster 2. Based on GSEA, mitotic spindle, G2M_CHECKPOINT, glycolysis, the phosphoinositide 3-kinase (PI3K) protein kinase B (AKT) mammalian target of rapamycin (mTOR) pathway, and DNA repair were more enriched in cluster 1. Six key m6A-relevant lncRNAs were selected to build a risk score model predicting the prognosis of HCC. The OS of patients in the high-risk group was shorter than that of patients in the low-risk group. Risk score was an independent prognostic factor of HCC patients. Conclusions The findings indicated that m6A-relevant lncRNAs may be important in the progression of HCC. The risk score model based on the 6 key m6A-relevant lncRNAs can accurately predict the prognosis of patients with HCC.

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Background: This study aimed to evaluate whether a large paraumbilical vein (L-PUV) was independently associated with the occurrence of overt hepatic encephalopathy (OHE) after the implantation of a transjugular intrahepatic portosystemic shunt (TIPS). Methods: This bi-center retrospective study included patients with cirrhotic variceal bleeding treated with a TIPS between December 2015 and June 2021. An L-PUV was defined in line with the following criteria: cross-sectional areas > 83 square millimeters, diameter ≥ 8 mm, or greater than half of the diameter of the main portal vein. The primary outcome was the 2-year OHE rate, and secondary outcomes included the 2-year mortality, all-cause rebleeding rate, and shunt dysfunction rate. Results: After 1:2 propensity score matching, a total of 27 patients with an L-PUV and 54 patients without any SPSS (control group) were included. Patients with an L-PUV had significantly higher 2-year OHE rates compared with the control group (51.9% vs. 25.9%, HR = 2.301, 95%CI 1.094–4.839, p = 0.028) and similar rates of 2-year mortality (14.8% vs. 11.1%, HR = 1.497, 95%CI 0.422–5.314, p = 0.532), as well as variceal rebleeding (11.1% vs. 13.0%, HR = 0.860, 95%CI 0.222–3.327, p = 0.827). Liver function parameters were similar in both groups during the follow-up, with a tendency toward higher shunt patency in the L-PUV group (p = 0.067). Multivariate analysis indicated that having an L-PUV (HR = 2.127, 95%CI 1.050–4.682, p = 0.037) was the only independent risk factor for the incidence of 2-year OHE. Conclusions: Having an L-PUV was associated with an increased risk of OHE after a TIPS. Prophylaxis management should be considered during clinical management.

To better understand the clinicopathological characteristics and molecular alterations in different intratumoral components of colorectal cancer (CRC) with heterogeneity of mismatch repair (MMR) protein expression and microsatellite instability (MSI) status.The histopathological features, MSI status, and other molecular alterations were analyzed in separately microdissected intratumoral regions and matched metastatic lymph nodes in four cases with intratumoral heterogenous MMR expression screened from 500 CRC patients, using PCR-based MSI testing, MLH1 promoter methylation, and targeted next-generation sequencing (NGS).High microsatellite instability (MSI-H) was identified in MLH1/PMS2-deficient regions in Cases 1 to 3 and in MSH2/MSH6-deficient regions in Case 4, while microsatellite stability (MSS) was detected in all the intratumoral regions and metastatic lymph nodes with proficient MMR expression (pMMR). Intratumoral heterogeneity of MLH1 promoter methylation and/or other common driving gene mutations of CRC, such as KRAS and PIK3CA mutations, was identified in all four CRCs. Further, three cases (75%) showed heterogeneous histomorphological features in intratumoral components and metastatic lymph nodes (Cases 1, 2, and 4), and the corresponding metastatic lymph nodes showed moderate differentiation with MSS/pMMR (Cases 2 and 3).Intratumoral heterogeneous MSI status is highly correlated with intratumoral histomorphological heterogeneity, which is also an important clue for the intratumoral heterogeneity of drive gene mutations in CRC. Thus, it is essential to detect MMR protein expression and other gene mutations in metastases before treatment, especially for CRCs with intratumoral heterogenous MMR protein expression or heterogenous histomorphological features.

In the present work, dielectric and ferroelectric characteristics of Ba6−pRpZr2+pTa8−pO30 (p = 1, 2, R = La, Nd, Sm) tungsten bronze ceramics were investigated systematically, and the effects of Zr4+ and Ta4+ occupation upon the polar order were emphasized. X-ray diffraction patterns confirmed the tetragonal tungsten bronze structure with P4/mbm space group at ambient temperature. Relaxor ferroelectric behavior was determined for all compounds, even for those who had order A1- and A2-site occupations, and this was quite different from other tungsten bronze systems. Compared with the Ti- and Nb-based analogue, these Zr- and Ta-based compounds exhibited stronger relaxor nature and obvious polar order disruption. Raman spectra and X-ray photoelectron spectra demonstrated distinct local crystal environment for these compounds with different B-site substitutions. Smaller A-site cation displacement inside the pentagonal channels, frustrating BO6 deformation, and weaker B–O-bond covalency were the main reasons for the severe disruption of ferroelectric polar order in these filled tungsten bronzes.

As the lesions in pulmonary nodules (PNs) are small and the clinical manifestations lack specificity, the etiology of PNs is complex, predisposing them to misdiagnoses missed diagnoses. Thus, the diagnosis and treatment of PNs remains challenging and an important clinical problem.This study prospectively enrolled 156 patients with computed tomography (CT)-diagnosed PNs who underwent circulating genetically abnormal cell (CAC) testing between January 2020 and December 2021. We collected data on clinical features closely related to the nature of PNs, such as age, smoking history, and type of nodule. All internal regions of interest (ROIs) of PNs in this study were segmented. Radiomic feature extraction was performed on the ROIs, and a radiomics model was constructed using least absolute shrinkage and selection operator (LASSO) regression to obtain a radiomics score (Rad-score). A comprehensive model combining clinical features, Rad-score, and liquid biopsy was constructed using logistic regression analysis. The diagnostic performance of the model was evaluated using receiver operating characteristic (ROC) curves.In this study, 5 radiomics features were screened for model construction. The area under the ROC curve (AUC) of the radiomics model was 0.844 [95% confidence interval (CI): 0.766-0.915] in the training set. The Rad-score, clinical features, and CAC were further combined to construct a multidimensional analysis model. The AUC of the synthesized model was 0.943 (95% CI: 0.881-0.978) in the training set.A multidimensional model is an effective tool for the noninvasive diagnosis of malignant PNs. The validation and combination of multiple diagnostic methods is a productive avenue of research trend for the identification of malignant PNs.

BACKGROUND The treatment outcome of transarterial chemoembolization (TACE) in unresectable hepatocellular carcinoma (HCC) varies greatly due to the clinical heterogeneity of the patients. Therefore, several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE (re-TACE). AIM To investigate the correlations between prognostic systems and radiological response, compare the predictive abilities, and integrate them in sequence for outcome prediction. METHODS This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016. The Hepatoma Arterial-embolization Prognostic (HAP) score system and its modified versions (mHAP, mHAP2 and mHAP3), as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival (OS) prediction for first TACE. The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART (assessment for re-treatment with TACE) and ABCR (alpha-fetoprotein, Barcelona Clinic Liver Cancer, Child-Pugh and Response) systems for post re-TACE survival (PRTS). RESULTS All the prognostic systems were correlated with radiological response achieved by first TACE, and the six-and-twelve criteria exhibited the highest correlation (Spearman R = 0.39, P = 0.026) and consistency (Kappa = 0.14, P = 0.019), with optimal performance by area under the receiver operating characteristic curve of 0.71 [95% confidence interval (CI): 0.68-0.74]. With regard to the prediction of OS, the mHAP3 system identified patients with a favorable outcome with the highest concordance (C)-index of 0.60 (95%CI: 0.57-0.62) and the best area under the receiver operating characteristic curve at any time point during follow-up; whereas, PRTS was well-predicted by the ABCR system with a C-index of 0.61 (95%CI: 0.59-0.63), rather than ART. Finally, combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo, compared with non-candidates with a median PRTS of 20.0 mo (log-rank test P < 0.001). CONCLUSION Radiological response to TACE is closely associated with tumor burden, but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.

Introduction: The benefits of combining transarterial chemoembolization (TACE) and sorafenib (TACE-S) over TACE alone for treatment of unresectable hepatocellular carcinoma (HCC) remain controversial. Yet, such populations are heterogeneous in terms of baseline characteristics. Objective: To investigate the predictors of survival benefits from added sorafenib and identify the potential candidates for TACE-S. Methods: This multicenter observational study was conducted in 17 Chinese tertiary hospitals for patients with unresectable, liver-confined HCC. Eligible patients with performance status score of ≤1 and Child-Pugh score of ≤7 were treated with TACE or TACE-S. Interactions between treatment and baseline variables were evaluated to find indicators for survival benefits, based on which the patients were stratified. Multivariate models adjusted for baseline characteristics or propensity score were used to compare overall survival (OS) and time to tumor progression (TTP). Results: From January 2009 to December 2015, 1,719 consecutive patients received TACE (n = 1,406) or TACE-S (n = 313). Although TACE-S compared with TACE improved TTP (adjusted hazard ratio [HR] 0.75, p = 0.008), no difference in OS was observed (adjusted HR 0.87, p = 0.090). Nevertheless, the tumor burden (sum of maximum diameter of largest tumor [cm] and tumor number) and albumin-bilirubin (ALBI) score independently predicted the survival benefits from added sorafenib (interaction p< 0.001). For patients with either moderate tumor burden (7–13) or low ALBI score (no more than –2.8) defined as candidates, TACE-S prolonged OS (adjusted HR 0.73, p = 0.003) and TTP (adjusted HR 0.72, p = 0.014) compared to TACE alone, whereas its superiority disappeared in non-candidates. Conclusions: Not all unresectable HCC patients but those with moderate tumor burden or low ALBI score achieve survival benefits from TACE-S compared with TACE alone. Future randomized controlled trials focusing on the subset are warranted.

To investigate the safety and effectiveness of emergent transjugular intrahepatic portosystemic shunt (TIPS) as first-line therapy in patients with advanced cirrhosis with acute variceal hemorrhage.From July 2016 to June 2019, 76 patients with advanced cirrhosis and acute variceal hemorrhage were included in this retrospective study. All patients underwent emergent TIPS as first-line therapy within 24 hours. Gastroesophageal varices in patients with cirrhosis were diagnosed with contrast-enhanced computed tomography because emergent endoscopy has not been routinely performed in this center. The primary outcomes were the control rate of bleeding and the rate of rebleeding. Secondary outcomes were the technical success rate of procedure, transplantation-free survival, the mean hospitalization time, the time of stay in the intensive care unit, and adverse events.All patients underwent TIPS creation successfully and were transferred to general wards. The median follow-up time was 21.7 months (interquartile range, 12.6-28.1 months). The control rate of bleeding (≤5 days) was 100%. The rates of early (5 days to 6 weeks) and late (6 weeks to 2 years) rebleeding were 6.6% and 1.3%, respectively. The 6-week, 1-year, and 2-year transplantation-free survival rates were 94.7%, 93.4%, and 84.6%, respectively. The incidences of acute liver failure, hepatic encephalopathy, and shunt dysfunction were 5.3%, 25%, and 5.3%, respectively.Emergent TIPS as a first-line therapy in patients with advanced cirrhosis with acute variceal hemorrhage is safe and effective. This study provides an alternative approach for medical centers without emergent endoscopy facility to manage the condition.

Purpose: Chronic glomerulonephritis (CGN) is a disease that occurs in the glomeruli. The mechanism of CGN is thought to be involved in a range of inflammatory responses. MicroRNA-339-5p (miR-339-5p) has been reported to be involved in inflammatory responses in many diseases. However, the role of miR -339-5p in CGN remains unclear. The purpose of this study was to investigate the role of miR-339-5p in lipopolysaccharide (LPS) -induced nephritis injury in vitro. Methods: The RNA expression of miR-339-5p and Syk/Ras/c-Fos pathway was detected by qRT-PCR, the protein expression and localization of Syk/Ras/c-Fos pathway was detected by western blot and immunofluorescence (IF), and the targeted binding of miR-339-5p to Syk was detected by double luciferase. Cell viability and cell cycle were detected by cell counting kit-8 (CCK-8) and flow cytometry. The concentrations of inflammatory cytokines IL-1β, IL-10, IL-6 and TNF-α were detected by enzyme linked immunosorbent assay (ELISA). Results: LPS increased HBZY-1 cell viability, decreased G2 phase, promoted cell proliferation and inflammatory cytokine release. Overexpression of miR-339-5p can inhibit HBZY-1 cell viability, decreased the expression of Syk/Ras/c-Fos signaling pathway, down-regulate the expression level of inflammatory cytokines, increase G2 phase, and inhibit cell proliferation.Conclusion: miR-339-5p inhibits the proliferation and inflammation of rat mesangial cell through Syk/Ras/c-Fos signal pathway.

In this work, the electron-phonon, phonon-phonon, and phonon structure scattering mechanisms and their effect on the thermal and thermoelectric properties of a silver nanowire (AgNW) is investigated in the temperature range of 10 to 300 K. The electron-phonon scattering rate decreases with the increase of temperature. The phonon-phonon scattering rate increases with temperature and becomes greater than the electron-phonon scattering rate when the temperature is higher than the Debye temperature (223 K). The rate of phonon structure scattering is constant. The total phonon scattering rate decreases with temperature when the temperature is lower than about 150 K, and increases when the temperature is higher than 150 K. Correspondingly, the temperature dependent variation trend of the lattice thermal conductivity is opposite diametrically to that of the total phonon scattering rate. The thermoelectric properties of the AgNW are strongly coupled with the thermal conductivity

PurposeTo explore the safety and efficacy of transarterial chemoembolization (TACE) in combination with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) for the treatment of unresectable hepatocellular carcinoma (uHCC).Materials and MethodsFrom August 2019 to July 2020, patients who received TACE combined with ICIs and TKIs were retrospectively analyzed. Treatment-related adverse events (AEs) were recorded. The Kaplan–Meier method was used to estimate time to progression (TTP) and progression-free survival (PFS).ResultsIn total, 31 patients with uHCC were included. Eleven patients were classified as BCLC-C. Nineteen patients had multiple lesions, and the cumulative targeted lesions were 69 mm (range, 21-170 mm) according to mRECIST. Twenty-nine (93%) patients experienced at least one AE during the treatment. Four (12.9%) patients developed AEs of higher grade (grade≥3). The objective response rate (ORR) and disease control rate (DCR) were 64.5% and 77.4%, respectively. The median time to response was 7 weeks (range, 4-30 w), and the duration of response was 17.5 weeks (range, 2-46 w). From the first ICIs, TTP and PFS were 6.5 months (95% CI, 3.5-11) and 8.5 months (95% CI, 3.5-NE), respectively.ConclusionsTACE combined with ICIs and TKIs shows an acceptable safety profile and considerable efficacy in patients with HCC.

In this paper, the cold launch test platform is taken as the research object, theoptimization model of this test platform is established by using topology optimization method. First,the topology optimization goal of the structure is determined, and then the constraints are carriedout. Finally, optimized and non-optimized areas are identified, and the result is processed. Afteroptimization, the quality of the test platform was reduced by 2.9 tons under the conditions of use.

Objectives: To synthesize folate acid conjugated quantum dots (QDs) by a simple and green method and explore endocytosis of the QD-folic acid conjugates (FA-QDs) into hepG2 cells. Methods: CdS QDs were prepared using stearic acid as synthetic medium, and were conjugated with mercaptoacetic acid (MAA) to be water-soluble. Then folic acid moiety was coupled to the surface of the QDs using EDC (1-ethyl-3-(3-dimethylamino propyl)carbodiimide) as a coupling agent. The CdS QDs and FA-QDs were characterized by X-ray spectroscopy (XRD), transmission electron microscopy (TEM), spectro fluorimetry and infrared spectroscopy. Endocytosis of the FA-QDs into hepG2 cells was observed by confocal microscopy and TEM. Results: TEM shows that the CdS QDs and FA-QDs were spherical in shape and had a diameter of 10 nm. Fluorescence spectrum of the QDs also shows their narrow size distribution. Confocal microscopic and TEM results show that FA-QDs were successfully internalized into the hepG2 cells. In addition, confocal results show that when the cells were first be saturated with excess free FA, the endocytosis of the FA-QDs became less, and CdS QDs that were not conjugated with FA were not able to be internalized into the hepG2 cells. Conclusions: The FA-QDs can be synthesized by a simple and green method and be used to successfully target tumor cells: hepG2 cell lines, which was probably mediated by the FA receptor.

Objective To explore the feasibility of using random forest (RF) machine learning algorithm in assessing normal and malignant peripheral pulmonary nodules based on in vivo endobronchial optical coherence tomography (EB-OCT). Methods A total of 31 patients with pulmonary nodules were admitted to Department of Respiratory Medicine, Zhongda Hospital, Southeast University, and underwent chest CT, EB-OCT and biopsy. Attenuation coefficient and up to 56 different image features were extracted from A-line and B-scan of 1703 EB-OCT images. Attenuation coefficient and 29 image features with significant p-values were used to analyze the differences between normal and malignant samples. A RF classifier was trained using 70% images as training set, while 30% images were included in the testing set. The accuracy of the automated classification was validated by clinically proven pathological results. Results Attenuation coefficient and 29 image features were found to present different properties with significant p-values between normal and malignant EB-OCT images. The RF algorithm successfully classified the malignant pulmonary nodules with sensitivity, specificity, and accuracy of 90.41%, 77.87% and 83.51% respectively. Conclusion It is clinically practical to distinguish the nature of pulmonary nodules by integrating EB-OCT imaging with automated machine learning algorithm. Diagnosis of malignant pulmonary nodules by analyzing quantitative features from EB-OCT images could be a potentially powerful way for early detection of lung cancer.

BackgroundThough fine-needle aspiration (FNA) improved the diagnostic methods of thyroid nodules, there are still parts of nodules that cannot be determined according to cytology. In the Bethesda system for reporting thyroid cytopathology, there are two uncertain cytology results. Thanks to the development of next-generation sequencing technology, it is possible to gain the genetic background of pathological tissue efficiently. Therefore, a combination of the cytology and genetic background may enhance the accuracy of diagnosis in thyroid nodules.MethodsDNA from 73 FNA samples of thyroid nodules belonging to different cytology types was extracted and exome sequencing was performed by the ThyroLead panel. Test for BRAF mutation was also performed by ARMS-qPCR. Information including age, sex, preoperative cytology, BRAF mutation status tested by ARMS-qPCR, and surgical pathology was collected in electronic medical record system.ResultsA total of 71 single nucleotide variants, three fusion gene, and two microsatellite instability-high status were detected in 73 FNA samples. BRAF V600E mutation is the most common mutation in these malignant thyroid nodules. After combining the cytology and genetic background detected by next-generation sequencing, the diagnosis sensitivity was increased from 0.582 (95% CI: 0.441–0.711) to 0.855 (95% CI: 0.728–0.930) (P < 0.001) in our group, while the specificity, 1,000 (95% CI: 0.732–1.000) compared to 0.857 (95% CI: 0.562–0.975) (P = 0.25), did not get affected.ConclusionsNext-generation sequencing in thyroid nodules can enhance the preoperative diagnosis sensitivity by fine-needle aspiration alone. It can also provide genetic background for direction of medication. It is possible for clinicians to combine cytology with genetic alterations for a more precise diagnosis strategy of thyroid nodules.

The mutation MYBPC3-E334K is a culprit mutation of hypertrophic cardiomyopathy (HCM). The pathogenicity of MYBPC3-E334K is conflicting in ClinVar because of the limited segregation data and the relatively high frequency in gnomAD (0.03% overall, with 0.3% in East Asians and 0.8% in Japanese). The main aim is to clarify the clinical importance and phenotype-genotype correlations in subjects with or without MYBPC3-E334K alone. The prevalence of MYBPC3-E334K was sequenced in 1017 HCM unrelated probands. The clinical features, morphology phenotypes, and electrical phenotypes were further analyzed according to the phenotype and genotype status in families with single-mutation MYBPC3-E334K. Nine of 1017 (0.88%) unrelated HCM probands were detected harboring MYBPC3-E334K, and three of them harbored a second variant in sarcomere protein gene. Family study and co-segregation analyses indicated that patients with single-mutation MYBPC3-E334K showed autosomal dominant mode of inheritance with incomplete penetrance. The overall disease penetrance was 52.6%, and the disease penetrance was higher in males than in females (100% in men vs 25% in women, p = 0.003). The mean age at diagnosis of males was approximately 25 years younger than females (36.57 ± 18.65 vs 62.33 ± 12.10, p = 0.062). The variant MYBPC3-E334K was classified as a likely pathogenic variant, and a second sarcomere variant did not reveal obvious cumulative effects. The patients harboring single-mutation MYBPC3-E334K had incomplete penetrance, and males demonstrated higher penetrance and early onset HCM than females. A second sarcomere variant did not reveal obvious cumulative effects.

Objectives To develop and validate a deep learning-based overall survival (OS) prediction model in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) plus sorafenib. Methods This retrospective multicenter study consisted of 201 patients with treatment-naive, unresectable HCC who were treated with TACE plus sorafenib. Data from 120 patients were used as the training set for model development. A deep learning signature was constructed using the deep image features from preoperative contrast-enhanced computed tomography images. An integrated nomogram was built using Cox regression by combining the deep learning signature and clinical features. The deep learning signature and nomograms were also externally validated in an independent validation set of 81 patients. C-index was used to evaluate the performance of OS prediction. Results The median OS of the entire set was 19.2 months and no significant difference was found between the training and validation cohort (18.6 months vs. 19.5 months, P = 0.45). The deep learning signature achieved good prediction performance with a C-index of 0.717 in the training set and 0.714 in the validation set. The integrated nomogram showed significantly better prediction performance than the clinical nomogram in the training set (0.739 vs. 0.664, P = 0.002) and validation set (0.730 vs. 0.679, P = 0.023). Conclusion The deep learning signature provided significant added value to clinical features in the development of an integrated nomogram which may act as a potential tool for individual prognosis prediction and identifying HCC patients who may benefit from the combination therapy of TACE plus sorafenib.

Three typical porous solid wastes, including livestock manure, crop straw, and coal mining waste, were used as raw materials to prepare cattle manure charcoal, straw charcoal, and coal gangue charcoal by low-oxygen controlling temperature carbonization and calcination. Batch adsorption experiments of sulfamethazine (SMZ) in water were carried out. Adsorption kinetics and isothermal adsorption equilibrium were used to investigate the adsorption characteristics of SMZ on cattle dung charcoal, straw charcoal, and coal gangue charcoal, and the adsorption mechanism was discussed by means of field-electron scanning electron microscope, Fourier transform infrared spectroscopy, Boehm titration, Brunauer-Emmett-Teller measurement, and zeta potentiometric titration. The results showed that the adsorption of SMZ on the three carbon materials reached equilibrium at 24 h. The adsorption kinetics of SMZ on three kinds of carbon materials agreed with the quasi-second-order kinetics equation.

In this study, an optimal method used to extract

BACKGROUND This study aims to investigate the relationship between serum uric acid (SUA) and the severity of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 2961 patients were enrolled in the present cross-sectional study. The severity of DN was determined by 24-hour urinary albumin excretion (UAE), which was classified as normal (UAE

In this study, an optimal method used to extract Annona squamosa pericarp oil (ASPO) was established according to the response surface model. The yield of ASPO was 1.45%. 8 fatty acids were identified from ASPO by GC-MS. Among them, (9Z)-9-Octadecenoic acid was abundant and accounted for 49.65%. The anti-hepatoma activities of ASPO were investigated against SMMC-7721 cell line in vitro and H22 cell line in vivo. Proteins associated with apoptosis in tumour tissue were quantified by western blot assay. The result revealed that ASPO had significant anti-hepatoma activities with IC50 value of 15.96 μg/mL in vitro and tumour inhibition rate of 54.14% at 50 mg/kg dose in vivo. Protein analysis showed that ASPO activated apoptosis by down-regulating Bcl-2, up-regulating Bax, cleaving caspase 9, cleaving caspase 8 and cleaving caspase 3 proteins. The possible mechanisms of apoptosis induced by ASPO were related to Fas/FasL/caspase-8/caspase-3 and Bcl-2/bax/caspase-9/caspase-3 pathways.

The substitution of rare-earth ions has been recognized as an effective way to modify the multiferroic properties, especially to realize the electric field-controlled magnetism in BiFeO3 ceramics, in which the symmetry modulation of R3 c/ Pna21 and the unlocked ferromagnetism through breaking the cycloidal spin structure are the key issues. Here, the enhancement of ferroelectric polarization and weak ferromagnetism are investigated in Bi1− xLa xFeO3 ceramics together with the magnetoelectric coupling coefficient αME with the development of the Pna21 phase. The expected electric field-controlled magnetism is achieved at the phase boundary through the electric field-induced transition of Pna21/ R3 c, where the variation of magnetization reaches 34.18 emu/mol (58.95%) at x = 0.18 after poling.

Hepatocellular carcinoma (HCC) is one of the most common and deadly malignancies worldwide. Approximately, 80% of patients are initially diagnosed at intermediate or advanced stages, which means that curative therapies are unable to be performed. In most cases, systemic treatment is ineffective, especially when conventional cytotoxic agents are used. Sorafenib has been the only systemic agent proven to be effective in treating advanced HCC for over a decade. The rapid development of immunotherapy has remarkably revolutionized the management of advanced HCC. Besides, the combination of immunotherapy with molecular targeted agents or locoregional treatments is emerging as an effective tool for enhancing immunity. In the review, an overview of immunotherapy and its combination therapies for HCC is presented.

Oxygen-deficient tungsten bronze ceramics with general formula Sr 4 Sm 2 Ti 4+2 x Nb 6–2 x O 30- x are synthesized by standard solid-state reaction. The sintering characteristics, crystal structure and dielectric properties have been investigated. Dense ceramics can be obtained by sintering at 1300 °C for all compositions. The x = 0.25 sample has the highest density > 97%. The sharp dielectric peaks and strong endothermic differential scanning calorimetry (DSC) peaks are observed for x = 0 and 0.1 compositions, which suggest the ferroelectric transition. For x = 0.25, the ferroelectricity is weakened, and the low temperature relaxation enhanced obviously. Therefore, the x = 0.25 composition indicates a high dielectric constant e ~ 200, loss tangent tan δ

Rare earth ion (RE)-substitution has been recognized as an effective way for improving multiferroic properties especially for realizing the electric field-controlled magnetism in BiFeO3 ceramics, where the symmetry modulation of R3c-Pna21-Pbnm and unlocking ferromagnetism by destroying the cycloidal spin structure are the key points. In Lu-substituted BiFeO3 ceramics, however, the Pna21 phase is not involved. In the present work, La/Lu co-substitution was investigated to involve the Pna21 phase in BiFeO3 ceramics. The phase transition from R3c to Pna21 occurred with an increase in x, and the mixed structure of R3c, Pna21, and Pbnm phases was determined in Bi0.82−xLaxLu0.18FeO3 ceramics. The greatly enhanced ferroelectric polarization and the switching from antiferromagnetic to the weak ferromagnetic state through the destruction of the cycloidal spin structure were achieved. Subsequently, the direct magnetoelectric coupling coefficient αME up to 2.02 mV/cm Oe was obtained. The increased effective ionic radius of RE in the present ceramics played a key role in involving Pna21 phase in RE-substituted BiFeO3 ceramics, and the critical value was about 0.104 23(2) nm.