Search

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide. HCC cells possess biological characteristics of high invasion and metastasis. In this respect, to prevent cancer cell invasion and metastasis and early active intervention, we herein screened through the TCGA database for further prognostic analysis including overall survival and disease-free survival . The Kaplan-Meier curve suggested that Cyclin-Dependent Kinase 4 (CDK4) might be an independent prognostic factor for HCC. Moreover, we performed mRNA expression analysis to measure CDK4 levels in normal liver tissues and HCC tissues, and immunohistochemistry analysis to detect protein level of CDK4 in Non-tumor tissue and HCC tissues . Our findings indicated that the expression of CDK4 was significantly higher in tumor tissues compared with Non-tumor tissue in HCC, which increased from HCC stage 1 to 3. Furthermore, the results of transwell-assay indicated that knocking down CDK4 significantly suppresses the invasion and migration of HCC cells, and the results of bioinformatics analysis revealed that genes closely associated with CDK4 are potentially worthy of further investigation. Additionally, the results of Western Blot indicated CDK4 regulates epithelial mesenchymal transition in HCC,and CDK4 appears to regulate EMT and HCC progression via the Wnt/β-catenin pathway. Collectively, this study found the key target gene through bioinformatic analysis and further functional validation through cell experiments. In particular, CDK4 is anticipated to become a crucial hub gene to snipe the metastasis of cancer cells in HCC. Abbreviations: Hepatocellular carcinoma (HCC);Cyclin-Dependent Kinase 4(CDK4);Genomic Data Commons (GDC); genes; EC, Endometrial cancer; GEO, gene expression omnibus; GO, Gene Ontology; GSEA, Gene set enrichment analysis; KEGG, Database; TCGA, The Cancer Genome Atlas; TSGs, tumor suppressor genes;epithelial mesenchymal transition (EMT).

A 3D printed conformal polarization converter, based on a novel dielectric unit cell, is proposed for linear-to-circular polarization conversion. The designed dielectric unit cell comprises a cuboid-shaped dielectric block and a thin square dielectric substrate layer for ease of fabrication with 3D printing technology. Meanwhile, the unit cell can achieve linear-to-circular polarization conversion performance from 14.2 GHz to 20.1 GHz with 3-dB axial ratios (ARs) of 34% and good angular stability within 40°. Then, the unit cell is applied to design the conformal dielectric linear-to-circular polarization converters (LCPCs) for cylindrical and spherical surfaces, respectively. To verify the feasibility, three kinds of dielectric converters including planar, cylindrical, and spherical shapes are fabricated and measured. The measured results demonstrate that the proposed dielectric polarization converters with different shapes can produce almost similar linear-to-circular polarization performances with low loss, high conversion efficiency, and angular stability within 40°.

Objective: Patients with non–small cell lung cancer (NSCLC) respond differently to cytokine-induced killer cell (CIK) treatment. Therefore, potential prognostic markers to identify patients who would benefit from CIK treatment must be elucidated. The current research aimed at identifying predictive prognostic markers for efficient CIK treatment of patients with NSCLC. Methods: Patients histologically diagnosed with NSCLC were enrolled from the Tianjin Medical University Cancer Institute and Hospital. We performed whole-exome sequencing (WES) on the tumor tissues and paired adjacent benign tissues collected from 50 patients with NSCLC, and RNA-seq on tumor tissues of 17 patients with NSCLC before CIK immunotherapy treatment. Multivariate Cox proportional hazard regression analysis was used to analyze the association between clinical parameters and prognostic relevance. WES and RNA-seq data between lung squamous cell carcinoma (SCC) and adenocarcinoma (Aden) were analyzed and compared. Results: The pathology subtype of lung cancer was the most significantly relevant clinical parameter associated with DFS, as analyzed by multivariate Cox proportional hazard regression (P = 0.031). The patients with lung SCC showed better CIK treatment efficacy and extended DFS after CIK treatment. Relatively low expression of HLA class II genes and checkpoint molecules, and less immunosuppressive immune cell infiltration were identified in the patients with lung SCC. Conclusions: Coordinated suppression of the expression of HLA class II genes and checkpoint molecules, as well as less immune suppressive cell infiltration together contributed to the better CIK treatment efficacy in lung SCC than lung Aden.

Objective To explore the effects and value of establishing a multi-target nursing group (MTNG) for facilitating goal-oriented enhanced recovery after surgery (ERAS) using the LEER (“less pain”, “early movement”, “early return to a normal diet” and “reassurance”) model. Methods The clinical data of 198 patients with hepatobiliary and pancreatic malignancies were retrospectively analyzed. The patients were divided into two groups: 91 cases were collected in a traditional group, which adopted traditional perioperative care, and 107 cases were collected in an MTNG group, which adopted MTNG measures. The differences in the clinical data including postoperative recovery, unplanned readmission rate, the implementation rate of nursing measures, the degree of a patient’s understanding of the disease, and patient compliance and satisfaction with nursing care during hospitalization were compared and analyzed between the two groups. Results The MTNG group reflected a lower pain degree and hospitalization expenses (P < 0.05), earlier postoperative flatulence, earlier recommencing of a normal diet, and earlier postoperative ambulation (P < 0.05), together with a shorter postoperative indwelling catheter duration and length of hospital stay (P < 0.05). There were no significant differences in the incidence of postoperative complications and unplanned postoperative readmission rates between the two groups (P > 0.05). The implementation rate of nursing measures and the degree of patients understanding the disease, and patient compliance and satisfaction with nursing care were higher in the MTNG group (P < 0.05). Conclusion The MTNG approach, based on ERAS with the LEER model, was conducive to the safe and rapid postoperative recovery of patients, the precise and efficient implementation of ERAS measures, the improvement of medical treatment satisfaction among patients.

Introduction Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib are approved for advanced non–small-cell lung cancer (NSCLC) with ALK rearrangement. However, the mechanisms of resistance remain largely unclear. Methods This prospective multicenter study analyzed cell-free DNA (cfDNA) and/or cancer tissues of patients with NSCLC after progression on ALK TKI(s), using targeted next-generation sequencing. Patients’ clinicopathologic characteristics and treatment outcomes were analyzed. Results Overall, 88 patients were enrolled; 31 cancer tissues and 90 cfDNA samples were analyzed. Five (16%) ALK mutations (L1196M × 2, I1171T, D1203N, G1269A/F1174L) and 3 possible bypass mutations (NRAS G12V, EGFR R108K, PIK3CA E545K) were found in 32 crizotinib-resistant cancers. Four (22%) ALK mutations (G1128A, G1202R, G1269A, I1171T/E1210K) and 3 possible bypass mutations (KIT D820E, MET E1012∗, EGFR P265_C291del) were found in 18 ceritinib-resistant cancers. Four (17%) ALK mutations (G1202R × 2, W1295C, G1202R/L1196M) and 1 possible bypass mutation (EGFR P753S) were found in 24 alectinib-resistant cancers. Two (11%) ALK mutations (G1202R/G1269A × 2) and 2 possible bypass mutations (BRAF V600E, MET D1246N) were found in 18 lorlatinib-resistant cancers. In patients with simultaneous paired tissue and cfDNA samples (n = 20), mutations were identified in 9 (45%) and 6 (30%) cases, respectively; the concordance rate was 45%. Conclusions The mechanisms of ALK TKI resistance were heterogeneous; ALK mutations were found in less than one-third of patients. Compound ALK mutations, which may confer lorlatinib resistance, may occur in crizotinib, ceritinib, and alectinib-resistant lung cancers.

Chronic obstructive pulmonary disease (COPD) has significant contributions to morbidity and mortality world-wide. Early symptoms of COPD are not readily distinguishable, resulting in a low rate of diagnosis and intervention. Different guidelines and recommendatations for the diagnosis and treatment of COPD exist globally. The first edition of clinical practice guidelines for COPD was published in 2016 by the Ministry of Health and Welfare in Taiwan in collaboration with the Taiwan evidence-based medicine association and Cochrane Taiwan, and was revised in 2019 in order to update recent diagnostic and therapeutic modalities for COPD and its acute exacerbation. This revised guideline covered a range of topics highlighted in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report, including strategies for the diagnosis, assessment, monitoring, and management of stable COPD and exacerbations, with particular focus on evidence from Taiwan. The recommendations included in the revised guideline were formed based on a comprehensive systematic review or meta-analysis of specific clinical issues identified by an expert panel that surveyed relevant scientific evidence in the literature and guidelines published by the clinical communities and organizations nationally and internationally. The guidelines and recommendations are applicable to the clinical settings in Taiwan. We expect this revised guideline to facilitate the diagnosis, treatment and management of patients with COPD by physicians and health care professionals in Taiwan. Adaptations of the materials included herein for educational and training purposes is encouraged.

Background American ginseng (AG) is a valuable medicine widely consumed as a herbal remedy throughout the world. Huge price difference among AG with different growth years leads to intentional adulteration for higher profits. Thus, developing reliable approaches to authenticate the cultivation ages of AG products is of great use in preventing age falsification. Methods A total of 106 batches of AG samples along with their 9 physicochemical features were collected and measured from experiments, which was then split into a training set and two test sets (test set 1 and 2) according to the cultivation regions. Principle component analysis (PCA) was carried out to examine the distribution of the three data sets. Four machine learning (ML) algorithms, namely elastic net, k-nearest neighbors, support vector machine and multi-layer perception (MLP) were employed to construct predictive models using the features as inputs and their growth years as outputs. In addition, a similarity-based applicability domain (AD) was defined for these models to ensure the reliability of the predictive results for AG samples produced in different regions. Results A positive correlation was observed between the several features and the growth years. PCA revealed diverse distributions among different cultivation regions. The most accurate model derived from MLP shows good prediction power for the fivefold cross validation and the test set 1 with mean square error (MSE) of 0.017 and 0.016 respectively, but a higher MSE value of 1.260 for the test set 2. After applying the AD, all models showed much lower prediction errors for the test samples within AD (IDs) than those outside the AD (ODs). MLP remains the best predictive model with an MSE value of 0.030 for the IDs. Conclusion Cultivation years have a close relationship with bioactive components of AG. The constructed models and AD are also able to predict the cultivation years and discriminate samples that have inaccurate prediction results. The AD-equipped models used in this study provide useful tools for determining the age of AG in the market and are freely available at https://github.com/dreadlesss/Panax_age_predictor.

Tianyan Ding1,2 &ast;, Cantong Liu1,2 &ast;, Binliang Huang,1,2 Lingyu Chu,1,2 Laifeng Wei,1,2 Yiwei Lin,1,2 Yun Luo,1,2 Biao Zhang,1,2 Chaoqun Hong,3 Yiwei Xu,1,2 Yuhui Peng1,2 1Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, People’s Republic of China; 2Precision Medicine Research Center, Shantou University Medical College, Shantou, People’s Republic of China; 3Guangdong Provincial Key Laboratory of Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yiwei XuDepartment of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, 515041, Guangdong, People’s Republic of ChinaFax +86-754-8856-0352Email yiwei512@126.comYuhui Peng Email pengyuhui666@163.comBackground: Neoadjuvant chemoradiotherapy (NCRT) followed by surgery is a component of the standard treatment for resectable locally advanced esophageal squamous cell carcinoma (ESCC), and the parameters for survival prediction are not clear yet. Our study aimed to construct a survival prediction nomogram for ESCC with NCRT followed by surgery.Methods: We analyzed hematological parameters and related-derivative indexes from 122 ESCC patients treated with NCRT followed by surgery. Univariate and multivariate Cox survival analyses were performed to identify independent prognostic factors to establish a nomogram and predict overall survival (OS). The predictive value of the nomogram for OS was evaluated by the concordance index (C-index), decision curve analysis (DCA), the clinical impact curve (CIC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).Results: The pretreatment nutritional candidate, prognostic nutrition index, inflammation-related absolute monocyte count and TNM staging were entered into the nomogram for ESCC with NCRT followed by surgery. The C-index of the nomogram for OS was 0.790 (95% CI = 0.688– 0.893), which was higher than that of TNM staging (0.681; 95% CI = 0.565– 0.798, P = 0.026). The DCA, CIC, NRI, and IDI of the nomogram showed moderate improvement in predicting survival. Based on the cut point calculated according to the constructed nomogram, the high-risk group had poorer OS than that of the low-risk group (P < 0.05).Conclusion: A novel nomogram based on nutrition- and inflammation-related indicators might help predict the survival of ESCC treated with NCRT followed by surgery.Keywords: esophageal squamous cell carcinoma, neoadjuvant chemoradiotherapy, surgery, nomogram, survival, prognosis

Cheng-Yu Chang,1,&ast; Chung-Yu Chen,2,3,&ast; Shih-Chieh Chang,4– 6,&ast; Yi-Chun Lai,4,5 Yu-Feng Wei7– 9 1Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 2Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; 3College of Medicine, National Taiwan University, Taipei, Taiwan; 4Division of Chest Medicine, Department of Internal Medicine, National Yang-Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; 5Faculty of Medicine, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan; 6Department of Critical Care Medicine, National Yang-Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; 7School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 8Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan; 9Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan&ast;These authors contributed equally to this workCorrespondence: Yu-Feng WeiDepartment of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan, No. 21, Yida Road, Jiao-su Village, Yan-chao District, Kaohsiung, 824, TaiwanTel +886-7-6150011Fax +886-7-6150927Email yufeng528@gmail.comIntroduction: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are standard first-line treatments for advanced EGFR-mutated non-small-cell lung cancer (NSCLC) patients. The efficacy of EGFR-TKIs in older patients including poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) is seldom investigated.Methods: We enrolled patients 65 years or older with EGFR-mutated Stage IIIB–IV NSCLC and evaluated the efficacy and prognosis of first-line EGFR-TKI treatment. Clinical and demographic characteristics were reviewed and analyzed, including age, sex, PS, smoking history, EGFR mutation type, treatment regimen, progression-free survival (PFS), and overall survival (OS).Results: From January 2015 to December 2019, a total of 237 patients were included, 205 of whom were eligible for efficacy and outcome analyses. Among them, 91 (44.4%) were categorized as poor PS (2– 4). Compared with patients categorized as good PS (0– 1), those with poor PS were older (79 versus 75 years), had a higher proportion of brain metastases (41.8% versus 25.4%), more comorbidities (74.7% versus 54.4%), and more likely to be treated with first-generation TKIs (74.7% versus 57.0%). The PFS and OS were 17.1 and 26.7 months respectively in patients with good PS and 12.7 and 18.2 months in those with poor PS (both p < 0.001). In the multivariate analysis, good PS, < 3 metastatic sites, and first-line treatment with afatinib compared with erlotinib and gefitinib were associated with longer PFS. A relatively younger age, good PS, < 3 metastatic sites, and no brain metastasis at diagnosis were associated with better OS.Conclusion: In older patients with EGFR-mutated NSCLC and receive EGFR-TKI treatment, a good PS and < 3 metastatic sites at diagnosis were associated with a longer PFS and OS. In addition, afatinib as first-line treatment was associated with a longer PFS whereas a relatively younger age and no brain metastasis at diagnosis were associated with better OS.Keywords: older adults, epidermal growth factor receptor tyrosine kinase inhibitor, non-small-cell lung cancer, performance status

In this letter, a novel elliptical cylinder dielectric resonator (ECDR) is proposed. By combining a square substrate and two symmetrical ECDRs, an ECDR element is formed, which can effectively achieve the transformation from the linearly polarized incident wave to the circularly polarized (CP) transmitted wave. By adjusting the height of the element, a linear transmission phase range over 360° can be obtained, which can reduce the fabrication difficulty and cost through a 3-D printed technology significantly. Meanwhile, the ECDR element has a low conductor loss in high frequency. Additionally, a CP 3-D printed dielectric transmitarray antenna at the millimeter-wave band is designed by employing the ECDR elements. It is found that the aperture efficiency is up to 40.3%, the 3 dB axial ratio bandwidth is 17%, and the 1 dB gain bandwidth is 13.3%, respectively. The measured results are in good agreement with the simulated ones. This may be the first time that a CP 3-D printed dielectric transmitarray antenna has been reported.

Objective: The present study aimed to explore the expressions of long noncoding RNA (lncRNA) p53 upregulated regulator of p53 levels (PURPL) in different ovarian tissues, and to evaluate the significance of disregulations of PURPL and microRNA-338-3p (miR-338-3p) in epithelial ovarian cancer (EOC). Methods: The expressions of PURPL in ovarian cancer, the relations between PURPL and the prognosis of ovarian cancer, and the relation between PURPL and miR-338-3p were queried in multiple biomedical databases. Real-time PCR was performed to detect the expressions of PURPL in different ovarian tissues. Logistic regression analysis was used to analyze the risk factors of recurrence and death. Kaplan-Meier analysis was implemented to evaluate the relations between PURPL and miR-338-3p expressions and the survival of ovarian cancer. Results: PURPL could target miR-338-3p, PURPL were upregulated in ovarian cancer tissues, upregulation of PURPL in ovarian cancer was negatively related with the recurrence free survival (RFS) and overall survival (OS), which were indicated by biomedical databases query. Our data showed upregulations of PURPL were noted in ovarian cancer tissues. Higher expressions of PURPL were associated with more advanced FIGO stage and developed lymph node metastasis in epithelial ovarian cancer. Upregulation of PURPL was related with the recurrence (P=0.002, OR=21.482, 95%CI: 3.457~94.251) and death (P=0.004, OR=35.643, 95%CI: 2.453~84.359) of ovarian cancer patient. PURPL expressions were negatively correlated to miR-338-3p expressions in different ovarian tissues (r = -0.968, P

Background Many lymph nodes resected from early-stage non-small cell lung cancer (NSCLC) patients haven’t metastasis. Selective lymph node dissection (SLND) can reduce surgical trauma by retaining non-metastatic lymph nodes, we aimed to investigate whether SLND could reduce immune impairment compared with systematic lymph node dissection. Methods According to the selection criteria, patients with no metastasis in hilar and regional lymph nodes were selected as the research subjects. The patients were randomly divided into 2 groups: the SLND group (Group SD) and the systematic lymph node dissection group (Group CD). At 24 hours before surgery and on the 1st and 3rd postoperative days (POD), fasting venous blood was sampled to detect cytokine indicators [interleukin-6 (IL-6), C-reactive protein (CRP)], cellular immune indicators [lymphocytes, natural killer cells (NK cells), CD4+, CD8+, CD4+/CD8+], and humoral immune indicators (IgG, IgA, IgM). At the same time, clinically indicators of the patients were recorded. All indicators between the 2 groups were compared. Results The comparison of clinical indicators between the two groups showed that SLND is more conducive to patients’ rapid recovery after surgery. CRP and IL-6 levels in Group CD were significantly higher than those in Group SD after surgery (P0.05). The proportions of CD4+ cells and CD4+/CD8+ in Group CD were significantly lower than those in Group SD at POD1 (P0.05). Conclusions Compared with systematic lymph node dissection, SLND has the following advantages: (I) it is more conducive to patients’ rapid recovery after surgery; (II) it can reduce the body’s acute inflammatory response and non-specific immune damage; (III) it can reduce the damage to cellular immune function caused by surgery. Trial registration Chinese Clinical Trial Registry ChiCTR2100045893.

A charge‐trapping memory (CTM) field effect transistor (FET) featured with an Hf1.5Gd2O6 charge trapping layer and thin MoS2 channel are fabricated. Benefit from high defect densities of the Hf1.5Gd2O6 film, large memory windows are achieved under low operating voltages (2.3 V@4 V, 3.1 V@5 V and 3.6 V@6 V), which distinctly outperform previously reported CTMs. In addition, high programming/erase (P/E) speeds, good data retention and endurance characteristics are experimentally demonstrated. The results demonstrate a feasibility of CTM FET with an HfGdO charge trapping layer and thin MoS2 channel for ultra‐low power memory devices application.

PurposeThis study examined the link between abusive supervision and subordinates’ turnover intentions via job dissatisfaction. In addition, this study examined the moderating effect of continuance commitment in this process.Design/methodology/approachThe authors collected three-wave time lagged data (N = 190) from the hospitality industry in China.FindingsThe analysis showed that abusive supervision predicts subordinates’ turnover intentions both directly and indirectly via job dissatisfaction. Moreover, continuance commitment was considered to be a boundary condition such that the mediated link was weaker when higher levels of continuance commitment were present.Practical implicationsThis study explains how and when abusive supervision leads to turnover intentions in the hospitality industry. This study also helps hospitality managers to understand the abusive supervision prevalence and provide interventions that can reduce detrimental effects of abusive supervision in hospitality organizations.Originality/valuePrior research examining the influence of supervisor abuse in hospitality organizations was scant. To bridge this noteworthy gap, this study examined the influence of abusive supervision in Chinese hospitality organizations. This study also discussed the theoretical and practical implications for the hospitality industry.

Surrogate-assisted evolutionary algorithms (SAEAs) have become one popular method to solve complex and computationally expensive optimization problems. However, most existing SAEAs suffer from performance degradation with the dimensionality increasing. To solve this issue, this article proposes a classifier-assisted level-based learning swarm optimizer on the basis of the level-based learning swarm optimizer (LLSO) and the gradient boosting classifier (GBC) to improve the robustness and scalability of SAEAs. Particularly, the level-based learning strategy in LLSO has a tight correspondence with the classification characteristic by setting the number of levels in LLSO to be the same as the number of classes in GBC. Together, the classification results feedback the distribution of promising candidates to accelerate the evolution of the optimizer, while the evolved population helps to improve the accuracy of the classifier. To select informative and valuable candidates for real evaluations, we devise an ${L}1$ -exploitation strategy to extensively exploit promising areas. Then, the candidate selection is conducted between the predicted ${L}1$ offspring and the already real-evaluated ${L}1$ individuals based on their Euclidean distances. Extensive experiments on commonly used benchmark functions demonstrate that the proposed optimizer can achieve competitive or better performance with a very small training dataset compared with three state-of-the-art SAEAs.

A broadband folded reflectarray antenna (FRA) is presented employing a novel single-layer cross-polarization conversion (CPC) subwavelength element in this letter. The proposed element has a very simple structure and consists of only a square ring resonator loaded with two splits, thereby realizing easy fabrication with low cost. By varying the length of the ring and mirroring the element, a 360° phase change range is achieved with low losses at the center frequency. These characteristics make the proposed configuration unique, as most of the reported FRA elements rely on complex and multilayer structures to realize the broadband CPC. Furthermore, an FRA using the proposed elements is designed and measured at 22 GHz. A good agreement between the simulated and measured results is obtained. The measured results demonstrate that the proposed FRA realizes a 1 dB gain bandwidth of 20.9% and a maximum aperture efficiency of 47.8%.

Study Design: Retrospective study. Objectives: Giant cell tumors (GCTs) of the mobile spine can be locally aggressive. This study described and classified the typical and atypical appearance of aggressive spinal GCTs according to imaging findings to help the imaging diagnosis, especially for patients with rapid neurological deficit that may require emergent surgery without biopsy. Methods: Computed tomography (CT) and magnetic resonance imaging (MRI) scans of patients diagnosed with aggressive spinal GCTs at single center were reviewed. Results: Overall, 101 patients with 100 CT images and 94 MR images were examined. All lesions were osteolytic with cortical destruction; 95 lesions showed epidural extension; 90 were centered in the vertebral body; 82 showed pathological fracture and/or collapse of the vertebral body; 78 had pseudotrabeculation on CT; 80 showed low-to-iso signal intensity or heterogeneous high-signal intensity with cystic areas on the T2-weighted images; 9 showed fluid–fluid level on T2-weighted images; and 61 patients showed marked enhancement on contrast-enhanced CT and/or MRI. Forty-one lesions (40.6%) had at least 1 atypical radiographic feature: 19 involved ≥2 segments; 11 were centered in the posterior neural arch; 10 had a paravertebral mass over 2 segments; 16 showed partial margin sclerosis with partial cortical destruction on CT scans; and 3 showed mineralization within the tumor on CT. Eighty-eight patients underwent CT-guided biopsy with a diagnostic accuracy rate of 94.3%. Conclusions: Spinal GCTs might appear more radiologically atypical, and about 40% of the lesions may have at least 1 atypical feature. CT-guided biopsies are recommended for definitive diagnosis.

According to cancer statistics reported in 2020, breast cancer constitutes 30% of new cancer cases diagnosed in American women. Histological markers of breast cancer are expressions of the estrogen receptor (ER), the progesterone receptor (PR), and human epidermal growth factor receptor (HER)-2. Up to 80% of breast cancers are grouped as ER-positive, which implies a crucial role for estrogen in breast cancer development. Therefore, identifying potential therapeutic targets and investigating their downstream pathways and networks are extremely important for drug development in these patients. Through high-throughput technology and bioinformatics screening, we revealed that coiled-coil domain-containing protein 167 (CCDC167) was upregulated in different types of tumors; however, the role of CCDC167 in the development of breast cancer still remains unclear. Integrating many kinds of databases including ONCOMINE, MetaCore, IPA, and Kaplan-Meier Plotter, we found that high expression levels of CCDC167 predicted poor prognoses of breast cancer patients. Knockdown of CCDC167 attenuated aggressive breast cancer growth and proliferation. We also demonstrated that treatment with fluorouracil, carboplatin, paclitaxel, and doxorubicin resulted in decreased expression of CCDC167 and suppressed growth of MCF-7 cells. Collectively, these findings suggest that CCDC167 has high potential as a therapeutic target for breast cancer.

Study design Retrospective observational study. Objective To assess the accuracy and reliability of standing lateral lumbar radiographs for measurements of spinopelvic parameters, compared with whole-spine EOS® images. Summary of background data Lateral lumbar radiographs are commonly used for measurements of spinopelvic parameters. However, variable magnifications by fan-beam x-ray projection at margins may cause measurement errors. Methods Fifty consecutive patients with standing lateral lumbar radiographs and whole-spine EOS® images were retrospectively reviewed from March to July in 2019. Two orthopedic surgeons (observers) independently measured the spinopelvic parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) on the computers. These spinopelvic parameters of each patient were measured twice on both lateral lumbar radiograph and EOS® image by two observers with the usage of Surgimap software. The measurement difference and agreement of each parameter value between lateral lumbar radiographs and EOS® images were analyzed by paired t test and the interclass correlation coefficient (ICC) respectively. Intra- and inter-observer's reliabilities of both imaging methods were assessed by ICC. Results The measurement difference of each spinopelvic parameter on EOS® images and lateral lumbar radiographs was less than 1° on average. Only the measurement difference of PI value revealed statistically significant (P = 0.020) with 0.9° discrepancy (95% confidential interval: 0.2-1.6), which indicated no clinical significance. The ICC values of lateral lumbar radiographs and EOS® images were more than 0.870 (range, 0.872-0.976), thus showed good to excellent measurement agreement between both imaging methods. All the ICC values for evaluating intra- and inter-observer reliability were greater than 0.960 (range, 0.963-0.993), indicating excellent reliability for observer's measurements. Conclusion Measurements of spinopelvic parameters (PI, PT, SS, and LL) on standing lateral lumbar radiographs are accurate and reliable, which are comparable to whole-spine EOS® images.Level of Evidence: 3.

Background Spine osteoblastomas (OBs) are relatively rare. In contrast to osteoid osteoma, radiologic and clinical manifestations of OB can be varied and atypical. Typical radiographic features in spinal OB include peritumoral bone sclerosis, bone marrow edema, and soft tissue edema. Atypical radiographic features include lesions involving ≥3 segments, lesions with extensive (≥3 segments) bone sclerosis, excessive edema (≥3 segments) of soft tissue and bone marrow, no intralesional calcification, and location in the vertebral body only. The aim of this study was to identify typical and atypical features of OB. Methods Pretreatment computed tomography scans and magnetic resonance imaging were reviewed retrospectively. Percutaneous biopsies were performed to confirm pathology in atypical cases. Results A total of 50 images from patients with diagnosed OB were reviewed. Atypical radiographic features were found in 18 cases (36%). Pathologic diagnosis was confirmed as OB in 86.2% (25/29) cases after percutaneous computed tomography–guided biopsy. Conclusions Our results show that >30% of spinal OB cases might have atypical radiographic features. In cases with atypical radiographic features, computed tomography–guided biopsies are recommended.

Temperature is a critical parameter for evaluating battery safety during the process of charging and discharging. However, it is a challenge to monitor it accurately because batteries are used in various compact environments such as energy stations. In this study, β-NaYF4:Er3+/Yb3+@NaYF4 nanoparticles were used to fabricate an optical fiber temperature sensor for battery temperature monitoring. The temperature sensing characteristics of the optical fiber sensor were explored in the range of 293–373 K using fluorescence intensity ratio (FIR) technology which can improve the temperature monitoring accuracy. The maximum relative sensitivity of the optical fiber sensor was 1.62% K−1 at 293 K and the temperature detection limit was within ±0.5 °C. By embedding the prepared sensor in a Li-ion battery, the proof of concept was obtained for monitoring the internal temperature of a battery with upconversion nanoparticles (UCNPs). A larger temperature variation was observed under a higher discharge rate. These results indicate that the prepared optical fiber sensor is an active tool for monitoring the thermal behavior and improving the safety of the battery.

Background: First-line durvalumab plus etoposide with either cisplatin or carboplatin (platinum–etoposide) showed a significant improvement in overall survival versus platinum–etoposide alone in patients with extensive-stage small-cell lung cancer (ES-SCLC) in the CASPIAN study. Here we report updated results, including the primary analysis for overall survival with durvalumab plus tremelimumab plus platinum–etoposide versus platinum–etoposide alone. Methods: CASPIAN is an ongoing, open-label, sponsor-blind, randomised, controlled phase 3 trial at 209 cancer treatment centres in 23 countries worldwide. Eligible patients were aged 18 years or older (20 years in Japan) and had treatment-naive, histologically or cytologically documented ES-SCLC, with a WHO performance status of 0 or 1. Patients were randomly assigned (1:1:1) in blocks of six, stratified by planned platinum, using an interactive voice-response or web-response system to receive intravenous durvalumab plus tremelimumab plus platinum–etoposide, durvalumab plus platinum–etoposide, or platinum–etoposide alone. In all groups, patients received etoposide 80–100 mg/m2 on days 1–3 of each cycle with investigator's choice of either carboplatin area under the curve 5–6 mg/mL/min or cisplatin 75–80 mg/m2 on day 1 of each cycle. Patients in the platinum–etoposide group received up to six cycles of platinum–etoposide every 3 weeks and optional prophylactic cranial irradiation (investigator's discretion). Patients in the immunotherapy groups received four cycles of platinum–etoposide plus durvalumab 1500 mg with or without tremelimumab 75 mg every 3 weeks followed by maintenance durvalumab 1500 mg every 4 weeks. The two primary endpoints were overall survival for durvalumab plus platinum–etoposide versus platinum–etoposide and for durvalumab plus tremelimumab plus platinum–etoposide versus platinum–etoposide in the intention-to-treat population. Safety was assessed in all patients who received at least one dose of study treatment. This study is registered at ClinicalTrials.gov, NCT03043872. Findings: Between March 27, 2017, and May 29, 2018, 972 patients were screened and 805 were randomly assigned (268 to durvalumab plus tremelimumab plus platinum–etoposide, 268 to durvalumab plus platinum–etoposide, and 269 to platinum–etoposide). As of Jan 27, 2020, the median follow-up was 25·1 months (IQR 22·3–27·9). Durvalumab plus tremelimumab plus platinum–etoposide was not associated with a significant improvement in overall survival versus platinum–etoposide (hazard ratio [HR] 0·82 [95% CI 0·68–1·00]; p=0·045); median overall survival was 10·4 months (95% CI 9·6–12·0) versus 10·5 months (9·3–11·2). Durvalumab plus platinum–etoposide showed sustained improvement in overall survival versus platinum–etoposide (HR 0·75 [95% CI 0·62–0·91]; nominal p=0·0032); median overall survival was 12·9 months (95% CI 11·3–14·7) versus 10·5 months (9·3–11·2). The most common any-cause grade 3 or worse adverse events were neutropenia (85 [32%] of 266 patients in the durvalumab plus tremelimumab plus platinum–etoposide group, 64 [24%] of 265 patients in the durvalumab plus platinum–etoposide group, and 88 [33%] of 266 patients in the platinum–etoposide group) and anaemia (34 [13%], 24 [9%], and 48 [18%]). Any-cause serious adverse events were reported in 121 (45%) patients in the durvalumab plus tremelimumab plus platinum–etoposide group, 85 (32%) in the durvalumab plus platinum–etoposide group, and 97 (36%) in the platinum–etoposide group. Treatment-related deaths occurred in 12 (5%) patients in the durvalumab plus tremelimumab plus platinum–etoposide group (death, febrile neutropenia, and pulmonary embolism [n=2 each]; enterocolitis, general physical health deterioration and multiple organ dysfunction syndrome, pneumonia, pneumonitis and hepatitis, respiratory failure, and sudden death [n=1 each]), six (2%) patients in the durvalumab plus platinum–etoposide group (cardiac arrest, dehydration, hepatotoxicity, interstitial lung disease, pancytopenia, and sepsis [n=1 each]), and two (1%) in the platinum–etoposide group (pancytopenia and thrombocytopenia [n=1 each]). Interpretation: First-line durvalumab plus platinum–etoposide showed sustained overall survival improvement versus platinum–etoposide but the addition of tremelimumab to durvalumab plus platinum–etoposide did not significantly improve outcomes versus platinum–etoposide. These results support the use of durvalumab plus platinum–etoposide as a new standard of care for the first-line treatment of ES-SCLC. Funding: AstraZeneca.

Background Adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are increasing considered for the tailored management of resectable non-small cell lung cancer (NSCLC). This study aimed to analyze the survival and toxicity profile of patients with EGFR mutation-positive NSCLC treated with adjuvant icotinib. Methods This was a single-center retrospective study of patients with EGFR mutation-positive NSCLC who underwent R0 (microscopically margin-negative) resection and received adjuvant icotinib between November 2011 and December 2017. The outcomes included 2-year disease-free survival (DFS) rate, 3-year overall survival (OS) rates, DFS, OS, and adverse events (AEs). Results A total of 86 patients receiving adjuvant icotinib were included. Their mean age was 59.7±10.0 years, and 26 (30.2%) patients were male. The 2-year DFS rate was 86.7%, and the 3-year OS rate was 95.3% with adjuvant icotinib. DFS (P=0.044) and OS (P=0.003) are better in stage I/II disease than in stage III disease. There seems no differences in DFS and OS between patients with low or high preoperative CEA levels (cutoff of 5 ng/mL), patients with exon 19 or 21 EGFR mutation or patients with or without smoking history. The most common AEs with adjuvant icotinib were rash (83.7%) and diarrhea (19.8%). One (1.2%) patient-reported grade ≥3 AEs. No treatment-related death occurred. Conclusions For patients with EGFR mutation-positive NSCLC, adjuvant icotinib might be associated with a promising survival benefit, with an acceptable toxicity profile.

A significantly negative reversion in the QuantiFERON-TB Gold In-tube (QFT-GIT) test is reported in patients on dialysis, which makes the results unreliable. The CD4 and CD8 responses of the QFT-Gold plus (QFT-Plus) may have better positive consistency, but this needs to be investigated. We enrolled dialysis patients with baseline positive QFT-GIT0 results and conducted two rounds of follow-up paired QFT-GIT1&2 and QFT-Plus1&2 tests at an interval of 6 months. The positive consistency, concordance, and discordance of the QFT results were analyzed. A total of 236 patients on dialysis were screened, and 73 participants with positive QFT-GIT0 results were enrolled. The baseline QFT-GIT0 response was higher in the 1st QFT-Plus1(+) group than in the QFT-Plus1(−) group, but insignificantly different between the 1st QFT-GIT1(+) and QFT-GIT1(−) groups. The two assays had good correlation when concurrently tested. Fifty-three subjects completed a second round of the QFT-GIT2 and QFT-Plus2. Persistent positivity was higher with the QFT-Plus2 (81.8%) than with the QFT-GIT2 (58.8%, p = 0.040). The QFT-GIT1 and QFT-Plus1 CD4 responses were higher in patients with persistent positivity than in those with negative reversion, whereas the difference of the QFT-Plus TB1 and TB2 data, representative of the CD8 response, were similar between positive persistence and negative reversion. In conclusion, the QFT-Plus provides more reliable positive consistency than does the QFT-GIT. The CD4 interferon-γ response might play a role in maintaining positivity of LTBI.

Two balanced microstrip dual-band bandpass filters (BPFs) based on short stub loaded resonator (SSLR) and open stub loaded resonator (OSLR) are presented in this brief, respectively. The center frequencies of the two differential-mode (DM) passbands can be controlled quasi-independently by adjusting the lengths of resonators. Moreover, a stepped impedance microstrip line etched with an interdigital coupling line is utilized to introduce a coupling between the two resonators, which generates two extra controlled transmission zeros (TZs) to obtain better selectivities. Furthermore, balanced microstrip/ slotline (MS) transition structures are employed as feed networks, which can suppress common-mode (CM) inherently while the DM responses are not affected, thereby the design procedure can be simplified significantly. In order to demonstrate the theoretical design, two balanced dual-band BPFs were designed and fabricated. The simulated responses are compared with the measured ones and a good agreement is obtained.

Early detection strategies and improvements in cancer treatment have dramatically reduced the cancer mortality rate in the United States (US). However, cardiovascular (CV) side effects of cancer therapy are frequent among the 17 million cancer survivors in the US today, and cardiovascular disease (CVD) has become the second leading cause of morbidity and mortality among cancer survivors. Circulating biomarkers are ideal for detecting and monitoring CV side effects of cancer therapy. Here, we summarize the current state of clinical studies on conventional serum and plasma CVD biomarkers to detect and prevent cardiac injury during cancer treatment. We also review how novel exploratory tools such as genetic testing, human stem cell-derived cardiomyocytes, Omics technologies, and artificial intelligence can elucidate underlying molecular and genetic mechanisms of CV injury and to improve predicting cancer therapy-related cardiotoxicity (CTRC). Current regulatory requirements for biomarker qualifications are also addressed. We present generally applicable lessons learned from published studies, particularly on how to improve reproducibility. The combination of conventional circulating biomarkers and novel exploratory tools will pave the way for precision medicine and improve the clinical practice of prediction, detection, and management of CTRC.

The study was designed to investigate the effect of cerebrospinal fluid leakage (CFSL) on the surgical outcomes of thoracic spinal stenosis (TSS). 153 TSS cases were recruited for this study from January 2012 to December 2017. Preoperative duration of symptoms, neurological status, operative parameters, postoperative courses and neurological recovery were collected. Modified Japanese Orthopedic Association (JOA) score for thoracic myelopathy was used to assess neurological status, and recovery rate was calculated, accordingly. Comparison was between postoperative transient neurological deterioration (PTND) group and Non-PTND group. Cases were further grouped into favorable outcome (FO) (JOA recovery rate ≥25%) and unfavorable outcome (UO) (JOA recovery rate

This study aims to determine whether bariatric surgery (BS) decreases the risk of respiratory tract infections (RTIs) in obese patients. This retrospective, population-based, matched cohort study utilized data from the Taiwan National Health Insurance Research Database. All patients 18 to 55 years of age with obesity diagnosed between 2005 and 2010 were enrolled. Patients were separated into two groups based on whether they underwent BS. Two groups were selected using 1:1 propensity score matching according to age, sex, and comorbidities. The general population was also enrolled for comparison. The primary endpoint was the incidence of RTIs, including pneumonia, influenza, and bronchitis. All patients were followed up until the end of 2013, the primary endpoint, or death. Compared to the non-surgery group, the BS group was at significantly lower risk for RTIs (aHR 0.432, 95% CI 0.340–0.549, p

In this work, WO3 films were synthesized by glancing angle deposition (GLAD) and conventional planar deposition respectively. By depositing Pt on WO3 by GLAD, the NO2 sensitivity of WO3 films were significantly improved. The structural characteristics and NO2 sensing properties of the films were investigated in order to establish the enhancement mechanism. The results show WO3 films prepared by GLAD have porous nanorod-like structure, and isolated Pt clusters are distributed on WO3. The nanostructured Pt/WO3 films show high sensitivity to NO2 at 150 °C, detecting as low as 80 ppb NO2 with a response of 1.23. Meanwhile, the films also exhibit high NO2 selectivity against NH3, CO, acetone and ethanol. The excellent NO2 sensing properties of the Pt/WO3 films can be explained due to large specific surface area of nanorod-like WO3, catalysis of Pt and Schottky barriers at interfaces. The reliable Pt/WO3 nanostructure prepared by GLAD could be potentially applied in low-temperature, highly sensitive NO2 sensor for micro-electro-mechanical system (MEMS).

Ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF) are not uncommon independent causes of thoracic myelopathy (TM); however, concomitant OPLL and OLF at the same segment is rare. The ideal surgical strategy remains controversial, and it is difficult for surgeons to balance sufficient neural decompression while simultaneously reducing the occurrence of postoperative neurological defect after circumferential decompression (CD). Aiming to solve this dilemma, we investigated a CD-based surgery using intraoperative ultrasound (IOU) assistance to evaluate spinal decompression sufficiency.The aims of this study are to evaluate the surgical outcomes and identify prognostic factors of one-stage posterior surgery with IOU assistance in patients with concomitant OPLL and OLF.Retrospective study of a single-center TM database with long-term follow-up.Twenty-four patients with TM and concomitant OPLL and OLF.Japanese Orthopaedic Association (JOA) score system for TM, recovery rate (RR), complication rate.Twenty-four patients' data were retrospectively reviewed. All patients initially underwent en bloc excisions of posterior spinal canal elements, and IOU was then used to evaluate spinal decompression sufficiency. If any compression of OPLL was confirmed in IOU, further CD procedure was performed. The JOA score was used to evaluate health-related quality of life. RR was calculated using the Hirabayashi formula. A RR ≥50% was considered favorable, and a RR50% was considered unfavorable. The paired t test was performed to statistically compare the preoperative and postoperative JOA scores. The chi-squared test, rank sum test, and logistic regression analyses were performed to find variants associated with unfavorable surgical outcomes The prognostic factors were analyzed by Spearman correlation and Pearson correlation analyses.The invasive CD procedure were avoided in 9 of 28 segments were avoided, with a mean blood loss of 1,458 mL. Seventeen patients experienced cerebrospinal fluid leakage, and 5 experienced immediate postoperative paralysis. The mean JOA score improved from 4.25±2.2 (preoperative) to 8.16±1.9 (final follow-up). The mean RR was 57.7%±29.4%. There was a significant difference (p.01) between the preoperative and final follow-up JOA score. A comparison between the favorable and the unfavorable groups showed no significant differences in the evaluated factors, but the considerable blood loss was a significant risk factor for poor RR (p=.036, b=-0.43).One-stage CD-based surgery via a posterior approach with IOU assistance for the treatment of concomitant OPLL and OLF led to significant functional improvement in the majority of patients. Under the premise of sufficient decompression, the postoperative paralysis rate reduced compared to that in previous studies. However, there were still high cerebral spinal fluid leakage rates. Considerable blood loss is a risk factor for poor RR.

A broadband balanced-to-single-ended (BTSE) four- way power divider (PD) with out-of-phase is designed in this letter. The proposed four-way PD composed of three-series T-junction PDs, a balanced U-type microstrip–slotline transition structure, and multiple cross-junction microstrip–slotline transitions. The series T-junction PD achieves equal amplitude and out-of-phase power distribution at the output ports over a wide frequency band. Meanwhile, the balanced U-type structure as the feed of the BTSE PD can realize a great broadband common-mode (CM) rejection without affecting the differential-mode (DM) responses. In addition, the proposed BTSE PD is employed with four quasi-Yagi antennas to realize a balanced quasi-Yagi antenna array. The proposed antenna array keeps the merits of wide DM transmission and high CM suppression level and achieves low cross-polarization level and high gain in the endfire direction. Finally, a prototype antenna array is fabricated and measured, and the experimental results show that it exhibits 10 dB return loss bandwidth of 5.7–8.9 GHz, peak gain of 12.5 dBi, and maximum cross-polarization levels of −25.6/−34.6 dB in E -/ H -planes at 5.8 GHz, respectively.

Background: The detection and treatment of latent tuberculosis infection (LTBI) is a key step in eliminating tuberculosis (TB), but information on safety and on treatment interruption in elderly LTBI patients remains limited. Methods: This multicenter prospective observational study included individuals with LTBI who underwent preventive therapy. Incidents of systemic adverse reactions (SARs) and treatment interruption rates in an elderly group (≥60 years old) and a young group (

Purpose The combined small-cell lung cancer (c-SCLC) is rare and has unique clinicopathological futures. The aim of this study is to investigate 18F-FDG PET/CT parameters and clinicopathological factors that influence the prognosis of c-SCLC. Methods Between November 2005 and October 2014, surgical-resected tumor samples from c-SCLC patients who received preoperative 18F-FDG PET/CT examination were retrospectively reviewed. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to evaluate metabolic parameters in primary tumors. The survivals were evaluated with the Kaplan–Meier method. Univariate and multivariate analyses were used to evaluate potential prognostic factors. Results Thirty-one patients were enrolled, with a median age of 62 (range: 35 − 79) years. The most common mixed component was squamous cell carcinoma (SCC, n = 12), followed by large-cell carcinoma (LCC, n = 7), adenocarcinoma (AC, n = 6), spindle cell carcinoma (n = 4), adenosquamous carcinoma (n = 1) and atypical carcinoid (n = 1). The median follow-up period was 53.0 (11.0–142.0) months; the 5-year overall survival (OS) and progression-free survival(PFS) rate were 48.4% and 35.5%, respectively. Univariate survival analysis showed that gender, smoking history, tumor location were associated with PFS (P = 0.036, P = 0.043, P = 0.048), SUVmax and TNM stage were closely related to PFS in both Mixed SCC and non-SCC component groups (P = 0.007, P = 0.048). SUVmax, smoking history, tumor size and mixed SCC component were influencing factors of OS in patients (P = 0.040, P = 0.041, P = 0.046, P = 0.029). Multivariate survival analysis confirmed that TNM stage (HR = 2.885, 95%CI: 1.323–6.289, P = 0.008) was the most significantly influential factor for PFS. High SUVmax value (HR = 9.338, 95%CI: 2.426–35.938, P = 0.001) and mixed SCC component (HR = 0.155, 95%CI: 0.045–0.530, P = 0.003) were poor predictors for OS. Conclusion Surgical-resected c-SCLCs have a relatively good prognosis. TNM stage is the most significant factor influencing disease progression in surgical-resected c-SCLCs. SUVmax and mixed NSCLC components within c-SCLCs had a considerable influence on the survival. Both high SUVmax and mixed SCC component are poor predictors for patients with c-SCLCs.

OBJECTIVE DNA Methylation of the tumour suppressor gene leading to gene silencing plays an important role in thyroid tumour development. The purpose was to determine the DNA methylation status of phosphatase and tensin homolog (PTEN) and death-associated protein kinase (DAPK) in patients with thyroid nodules and to explore whether they can be used as molecular diagnostic tools to differentiate benign and malignant thyroid nodules. DESIGN, PATIENTS AND MEASUREMENTS Thyroid tissue and blood samples were obtained from normal healthy individuals (controls) and patients suffering from clinically diagnosed thyroid nodular disease [papillary thyroid carcinoma (PTC), adenoma and nodular goitre]. DNA methylation level, mRNA expression and protein expression of PTEN and DAPK in the thyroid tissues and peripheral blood were detected using methylation-specific PCR, semi-quantitative reverse transcription PCR and Western blot, respectively. Diagnostic sensitivity, specific and accuracy of detection were evaluated between blood and thyroid tissue. RESULTS There was a significant increase in the level of DNA methylation of PTEN and DAPK in PTC (P

High performance flexible pressure sensors have received tremendous attention due to the potential applications in wearable electronics and humanoid robotics. Herein, a low-cost, time-saving fabrication strategy is reported to efficiently construct highly sensitive and scalable pressure sensors based on graphene-textile. The flexible pressure sensor was prepared through a dip coating approach where the graphene ink was used as the active material and textile with ordered network structure, serves as the flexible support matrix. By increasing the number of layers of the textile, the pressure sensor could achieve a high linear sensitivity value of 0.23 kPa−1, a broad pressure range from 0 to 140 kPa, and a durability over 800 cycles. It was found that the network structure of the graphene-textile contributed to the enhancement of the sensing performance due to the piezoresistive effect resulting from the deformation of conductive graphene-textile. Moreover, by virtue of its exceptional properties, it is demonstrate that the high performance flexible pressure sensor could be further used to detect human physiological signals, such as wrist pulse, finger press detection and walking state monitoring, indicating its promising potential to flexible and wearable electronics.

A recent progress in new emerging two-dimensional (2D) materials has provided promising opportunity for gas sensing in ultra-low detectable concentration. In this work, we have demonstrated a flexible NO2 gas sensor with porous structure graphene on polyethylene terephthalate substrates operating at room temperature. The gas sensor exhibited good performance with response of 1.2% and a fast response time within 30 s after exposure to 50 × 10−9 NO2 gas. As porous structure of graphene increased the surface area, the sensor showed high sensitivity of ppb level for NO2 detection. Au nanoparticles were decorated on the surface of the porous structure graphene skeleton, resulting in an incensement of response compared with pristine graphene. Au nanoparticles-decorated graphene exhibits not only better sensitivity (1.5–1.6 times larger than pristine graphene) for NO2 gas detection, but also fast response. The sensor was found to be robust and sensitive under the cycling bending test, which could also be ascribed to the merits of graphene. This porous structure graphene-based gas sensor is expected to enable a simple and inexpensive flexible gas sensing platform.

In this paper, a tunable balanced-to-balanced in-phase filtering power divider (FPD) is designed, which can realize a two-way equal power division with high selectivity and isolation. A differential-mode (DM) passband with a steep filtering performance is realized by applying microstrip stub-loaded resonators (SLRs). Meanwhile, six varactors are loaded to the SLRs to achieve the center frequency (CF) and bandwidth adjustment, respectively. U-type microstrip lines integrated with stepped impedance slotline resonators are utilized as the differential feedlines, which suppress the common-mode (CM) intrinsically, making the DM responses independent of the CM ones. A tuning center frequency from 3.2 to 3.75 GHz and a fractional bandwidth (12.1–17.6%) with more than 10 dB return loss and less than 2.3 dB insertion loss can be achieved by changing the voltage across the varactors. A good agreement between the simulated and measured results is observed. To the best of authors' knowledge, the proposed balanced-to-balanced tunable FPD is first ever reported.

Pulmonary fibrosis is a progressive chronic inflammatory lung disease whose pathogenesis is complicated. Platelets and neutrophils play important roles in the progression of pulmonary inflammation. We have reported that cangrelor, a non-sepesific GPR17 antagonist, alleviates pulmonary fibrosis partly by inhibiting macrophage inflammation in mice. Cangrelor is also a well-known anti-platelet agent. To test whether cangrelor mitigated pulmonary fibrosis partly through the inhibition of platelets, bleomycin (BLM) was used to induce pulmonary fibrosis in C57BL/6 J mice. We found that cangrelor (10 mg/kg) not only significantly decreased BLM-induced release of inflammatory cytokines (PF4, CD40 L and MPO), but also decreased the increment of platelets, neutrophils and platelet-neutrophil aggregates in the fibrotic lung and in the peripheral blood of BLM-treated mice. In addition, cangrelor decreased the number of CD40 and MPO double positive neutrophils and the expression level of CD40 in BLM-treated mouse lungs. Based on these results we conclude that cangrelor alleviates BLM-induced lung inflammation and pulmonary fibrosis in mice, partly through inhibition of platelet activation, therefore reducing the infiltration of neutrophils due to the adhesion of platelets and neutrophils mediated by CD40 - CD40 L interaction. Cangrelor could be a potential therapeutic medicine for pulmonary fibrosis.

Background: Neoadjuvant chemotherapy is important for advanced laryngeal and hypopharyngeal carcinoma (LHC).Aims/objectives: To determine the efficacy and toxicity of the combination of docetaxel, ...

The pulse current oxidation methods were used to degrade the malachite green (MG) using lead dioxide as anodes. The influences of operating parameters, including pulse frequency, pulse curr...

Background The risk of tuberculosis (TB) in patients with impaired kidney function remains unclear by different stages of renal function impairment. Methods We retrospectively recruited all patients with kidney function in a tertiary-care referral center from January 2008 to December 2013 and followed them till December 2016. We defined the primary outcome as active TB development and analyzed the impact of kidney function impairment. Results During the study period, a total of 289,579 patients were enrolled for analysis, and of them, 1012 patients had active TB events in an average of 4.13 years of follow-up. According to kidney function impairment, the incidence rate of TB was similar in patients with no chronic kidney disease (CKD) or stage 1 and stage 2, and it increased apparently at stage 3a (167.68 per 100,000 person-years) to stage 3b, stage 4 and stage 5 (229.25, 304.95 and 349.29 per 100,000 person-years, respectively). In a Cox proportional hazard regression model, the dose response of TB risk among different stages of kidney function impairment increased significantly from CKD stage 3a to stage 5. Patients with long-term dialysis had a hazard ratio of 2.041 (1.092–3.815, p = 0.0254), which is similar to that of stage 4 CKD but lower than that of stage 5. Conclusion In patients with impaired kidney function, the risk of TB increases from CKD stage 3, and in stage 5, the risk is even higher than that of those receiving dialysis. Further strategies of TB control need to consider this high-risk group.

Study design Retrospective cohort study. Objective To evaluate the effect of time to first ambulation on recurrence after percutaneous endoscopic lumbar discectomy (PELD). Methods From July 2017 to August 2018, 90 patients with lumbar intervertebral disc herniation underwent PELD surgery. According to the initial walking time, i.e., the time until the patient could walk after the operation, the operations were divided into three groups: early stage, middle stage, and late stage. The follow-up period was 3 months, and complete follow-up data were obtained. The visual analog scale (VAS) and Oswestry disability index (ODI) scores before the operation, at first ambulation, 1 month after the operation, and 3 months after the operation and the recurrence and incidence rates of high magnetic resonance imaging (MRI) signal in the vertebral endplate area were recorded after the operation. Results The success rate was 100% for these 90 cases. The VAS and ODI scores at the first ambulation after the operation significantly improved compared with those before the operation, and the difference was statistically significant. The improvements in the lumbar VAS and ODI scores of the middle- and late-stage groups were better than that of the early-stage group at 1 and 3 months after the operation, and the differences were statistically significant; however, there was no significant difference between the middle- and late-stage groups. The postoperative recurrence rate and rate of high MRI signal in the vertebral endplate area were significantly higher in the early-stage group than in the other two groups, and the difference was statistically significant. Conclusion The time to first ambulation after PELD is an important factor affecting the curative effect of the operation. Early ambulation may be one of the factors affecting recurrence after PELD.

Many interesting multifunctional materials are obtained under the application of an external electric field, which arouses extensive interest of experimental and theoretical researchers. In the pre...

As the number of people using the internet has surged over the past few years, more and more people are choosing to share and retrieve information online. There are several decentralized retrieval applications that provide file-sharing platforms for exactly this purpose. However, these applications cannot guarantee churn resilience, trustworthiness, or low cost of retrieval. Therefore, in this paper, we present a system called trustworthy and churn-resilient academic distribution and retrieval system in P2P networks, or TCR, which: (1) ensures that information will not be centralized by central network administrators; (2) utilizes LSH to classify nodes with similar research topics into a local subnetwork, and applies routing algorithms with trust score equations to determine the next trustworthy node to forward the message, thus ensuring each node can accurately and efficiently find its trustworthy nodes within only a few hops; (3) provides a trustworthy management system that itself deals in trustworthiness, ensuring that even when there is a large proportion of malicious nodes, the system can still detect and punish misbehaving nodes; (4) guarantees that nodes can still retrieve the desired files even when in high-churn networks. We finally demonstrate that our TCR entails low message costs, provides high match rates, detects malicious nodes, and ensures churn resilience and search efficiency when compared to other P2P retrieval systems.