Search

Background Lipusu is the first commercialized liposomal formulation of paclitaxel and has demonstrated promising efficacy against locally advanced lung squamous cell carcinoma (LSCC) in a small‐scale study. Here, we conducted a multicenter, randomized, phase 3 study to compare the efficacy and safety of cisplatin plus Lipusu (LP) versus cisplatin plus gemcitabine (GP) as first‐line treatment in locally advanced or metastatic LSCC. Methods Patients enrolled were aged between 18 to 75 years, had locally advanced (clinical stage IIIB, ineligible for concurrent chemoradiation or surgery) or metastatic (Stage IV) LSCC, had no previous systemic chemotherapy and at least one measurable lesion as per the Response Evaluation Criteria in Solid Tumors (version 1.1) before administration of the trial drug. The primary endpoint was progression‐free survival (PFS). The secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety profiles. To explore the possible predictive value of plasma cytokines for LP treatment, plasma samples were collected from the LP group at baseline and first efficacy evaluation time and were then subjected to analysis by 45‐Plex ProcartaPlex Panel 1 to detect the presence of 45 cytokines using the Luminex xMAP technology. The correlation between treatment outcomes and dynamic changes in the levels of cytokines were evaluated in preliminary analyses. Results The median duration of follow‐up was 15.4 months. 237 patients in the LP group and 253 patients in the GP group were included in the per protocol set (PPS). In the PPS, the median PFS was 5.2 months versus 5.5 months in the LP and GP group (hazard ratio [HR]: 1.03, P = 0.742) respectively. The median OS was 14.6 months versus 12.5 months in the LP and GP group (HR: 0.83, P = 0.215). The ORR (41.8% versus 45.9%, P = 0.412) and DCR (90.3% versus 88.1%, P = 0.443) were also similar between the LP and GP group. A significantly lower proportion of patients in the LP group experienced adverse events (AEs) leading to treatment interruptions (10.9% versus 26.4%, P < 0.001) or treatment termination (14.3% versus 23.1%, P = 0.011). The analysis of cytokine levels in the LP group showed that low baseline levels of 27 cytokines were associated with an increased ORR, and 15 cytokines were associated with improved PFS, with 14 cytokines, including TNF‐α, IFN‐γ, IL‐6, and IL‐8, demonstrating an overlapping trend. Conclusion The LP regimen demonstrated similar PFS, OS, ORR and DCR as the GP regimen for patients with locally advanced or metastatic LSCC but had more favorable toxicity profiles. The study also identified a spectrum of different cytokines that could be potentially associated with the clinical benefit in patients who received the LP regimen., Cisplatin plus Lipusu (LP) regimen has comparable efficacy and more favorable toxicity profiles compared with cisplatin plus gemcitabine (GP) regimen for patients with advanced LSCC. The study also demonstrated that LP had a significant impact on the levels of plasma cytokines and a spectrum of cytokines were associated with clinical benefit in patients who received LP. Thus, our results provided a new option for patients with advanced LSCC.

BACKGROUND Acute respiratory distress syndrome (ARDS) is injury of alveolar epithelial cells and capillary endothelial cells caused by various factors, including endogenous and exogenous lung factors, leading to diffuse pulmonary interstitial and alveolar edema, and acute respiratory failure. ARDS involves alveolar epithelial cells and pulmonary interstitial capillary endothelial cells. Circulating endothelial cells (CECs) are the only marker that directly reflects vascular endothelial injury in vivo. There have been few studies on the correlation between peripheral blood CECs and ARDS at home and abroad. The lungs are the organs with the highest capillary density and the most endothelial cells, thus, it is speculated that when ARDS occurs, CECs are stimulated and damaged, and released into the circulatory system. AIM To explore the correlation between CEC level and severity of ARDS in patients postoperatively. METHODS Blood samples were collected from all patients on day 2 (d2) and day 5 (d5) after surgery. The control group comprised 32 healthy volunteers. Number of CECs was measured by flow cytometry, and operation time was recorded. Changes in various indexes of patients were monitored, and diagnosis of ARDS was determined based on ARDS Berlin definition. We comprised d2 CECs in different groups, correlation between operation time and d2 CECs, ARDS of different severity by d2 CECs, and predictive value of d2 CECs for ARDS in postoperative patients. RESULTS The number of d2 CECs in the ARDS group was significantly higher than that in the healthy control group (P < 0.001). The number of d2 CECs in the ARDS group was significantly higher than that in the non-ARDS group (P < 0.001). The number of d2 CECs in the non-ARDS group was significantly higher than that in the healthy control group (P < 0.001). Operation time was positively correlated with number of CECs on d2 (rs = 0.302, P = 0.001). The number of d2 CECs in the deceased group was significantly higher than that in the improved group (P < 0.001). There was no significant difference in number of d2 CECs between patients with mild and moderate ARDS. The number of d2 CECs in patients with severe ARDS was significantly higher than that in patients with mild and moderate ARDS (P = 0.041, P = 0.037). There was no significant difference in number of d5 and d2 CECs in the non-ARDS group after admission to intensive care. The number of d5 CECs was higher than the number of d2 CECs in the ARDS improved group (P < 0.001). The number of d5 CECs was higher than the number of d2 CECs in the ARDS deceased group (P = 0.002). If the number of CECs was > 1351/mL, sensitivity and specificity of predicting ARDS were 80.8% and 78.1%, respectively. CONCLUSION Changes in number of CECs might predict occurrence and adverse outcome of ARDS after surgery, and higher numbers of CECs indicate worse prognosis of ARDS.

Sixth generation (6G) network is a revolutionary technology to satisfy the ever-growing demands from the sustainable development of emerging industrial applications and services. Due to its high flexibility, convenient and rapid deployment, self-organization capability, and outstanding expansibility, network-in-box (NIB) represents a promising approach for future networks. The integration of NIB with 6G can lead to many new applications in geoscience, robotics, and industrial automation. For 6G-enabled NIB, services are deployed directly on the NIB, which increases the fault tolerance and reduces the traffic volume on the backhaul link. As more and more data are processed and shared in industrial applications and services, the security of data aggregation becomes a key challenge for 6G-enabled NIB. To address this challenge, in this article, we propose a blockchain based privacy-aware distributed collection (BPDC) oriented strategy for data aggregation. In BPDC, an improved blockchain with a new block header structure and two different block generation rules are designed and introduced, which restricts the task receivers to search and receive the tasks beyond their levels of security permission. While guaranteeing the data aggregation performance, BPDC can also achieve privacy protection by decomposing sensitive tasks and task receivers into multiple groups. Validation experiments show that the BPDC accomplishes low overhead, high throughput, and privacy preservation in various industrial applications.

Yu Zeng,1,&ast; Nanhong Li,2,&ast; Zhenzhen Zheng,1 Riken Chen,3 Wang Liu,1 Jinru Zhu,1 Mingqing Zeng,4 Junfen Cheng,1 Min Peng,1 Cheng Hong3 1Department of Respiration, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China; 2Department of Pathology and Pathophysiology, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China; 3China State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China; 4First Clinical School of Medicine, Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Cheng Hong; Min Peng Email gyfyyhc@126.com ; pengmin1118@126.comBackground: The role of adenylate cyclase 7 (ADCY7) in cancer is still unclear. This study analyzed the interrelationship between the expression and immune function of ADCY7.Methods: ADCY7 expression in multiple human cancers was analyzed using the databases of Genotype-Tissue Expression Project (GTEx), Cancer Cell Line Encyclopedia (CCLE), and The Cancer Genome Atlas (TCGA). Correlations among ADCY7 gene expression, mismatch repair (MMR) gene expression, and DNA methyltransferase (DNMT) expression were assessed using Spearman correlation analysis. Univariate survival analysis and Kaplan–Meier (KM) curve were used to examine the effect of ADCY7 expression on prognosis. The Tumor Immune Estimation Resource (TIMER) database was used to evaluate the relationship between ADCY7 gene expression and tumor immune invasion or immune checkpoint gene (ICG) expression.Results: ADCY7 was abnormally expressed in multiple human cancers and was correlated with MMR genes and DNMT expression. Univariate survival analysis and KM curve showed that ADCY7 expression influences the overall survival (OS) of six types of cancer, disease-specific survival (DSS) of eight, and progression-free interval (PFI) of three. The high expression of ADCY7 in OS, DSS, and PFI was strongly associated with poor outcomes in patients with breast cancer and lung squamous cell carcinoma. ADCY7 expression was strongly associated with immune cell infiltration and ICG expression.Conclusion: The results of this study indicated that ADCY7 may be a prognostic biomarker of tumorigenesis. The study may also provide a new perspective on the role of ADCY7 in human cancers.Keywords: adenylate cyclase 7, ADCY7, prognosis, immune infiltration, pan-cancer analysis, biomarker

The findings regarding the associations between red meat, fish and poultry consumption, and the metabolic syndrome (Mets) have been inconclusive, and evidence from Chinese populations is scarce. A cross-sectional study was performed to investigate the associations between red meat, fish and poultry consumption, and the prevalence of the Mets and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 4424 participants were eligible for the analysis. A logistic regression model was used to estimate the OR and 95 % CI for the prevalence of the Mets and its components according to red meat, fish and poultry consumption. In addition, the data of our cross-sectional study were meta-analysed under a random effects model along with those of published observational studies to generate the summary relative risks (RR) of the associations between the highest v. lowest categories of red meat, fish and poultry consumption and the Mets and its components. In the cross-sectional study, the multivariable-adjusted OR for the highest v. lowest quartiles of consumption was 1·23 (95 % CI 1·02, 1·48) for red meat, 0·83 (95 % CI 0·72, 0·97) for fish and 0·93 (95 % CI 0·74, 1·18) for poultry. In the meta-analysis, the pooled RR for the highest v. lowest categories of consumption was 1·20 (95 % CI 1·06, 1·35) for red meat, 0·88 (95 % CI 0·81, 0·96) for fish and 0·97 (95 % CI 0·85, 1·10) for poultry. The findings of both cross-sectional studies and meta-analyses indicated that the association between fish consumption and the Mets may be partly driven by the inverse association of fish consumption with elevated TAG and reduced HDL-cholesterol and, to a lesser extent, fasting plasma glucose. No clear pattern of associations was observed between red meat or poultry consumption and the components of the Mets. The current findings add weight to the evidence that the Mets may be positively associated with red meat consumption, inversely associated with fish consumption and neutrally associated with poultry consumption.

The Pulmonary Arterial Hypertension Symptoms and Impact Questionnaire (PAH-SYMPACT) is a PAH-specific patient-reported outcome scale assessing patients' quality of life from four aspects: cardiopulmonary symptoms, cardiovascular symptoms, physical impacts and cognitive/emotional impacts. This study aimed to validate the Chinese version of PAH-SYMPACT and explore its relationship with risk stratification in patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH). In addition, 75 patients with CTD-PAH confirmed by right heart catheterization were invited to complete questionnaires including PAH-SYMPACT, the 36-item Medical Outcomes Study Short Form Survey (SF-36) and EuroQol five dimensions questionnaire (EQ-5D). The demographic, clinical, laboratory and treatment data were collected. The endpoint was treatment goal achievement status in 6-12 months after completing the questionnaires, defined as an integrated outcome. Participants' mean age was 36.4 ± 11.9 years and the mean pulmonary arterial pressure was 38.9 ± 13.67 mmHg. The reliability of the PAH-SYMPACT domains ranged from 0.83 to 0.88. Results of factor analysis basically conformed the original PAH-SYMPACT. The treatment goal achievement (TGA) status in 6-12 months was significantly associated with physical impacts scores (odds ratio: 0.180, 95% confidence interval: 0.036-0.908, P=0.038). The Chinese version of PAH-SYMPACT is a reliable measurement to evaluate quality of life in CTD-PAH patients and is also a potential predictor of patient's condition change in routine clinical practice.

Owing to its benefits such as flexibility, scalability, and interoperability, Software-Defined Networking (SDN) has been incorporated into Internet of Vehicles (IoV) to cope with the increasing demands of vehicular applications. The integration of SDN and IoV, namely SDN-IoV, can enrich many new applications for intelligent transportation such as traffic monitoring, smart navigation, and self-driving. The spatial crowdsourcing technology has been adopted as an effective data collection and processing method that is the premise of various SDN-IoV applications. However, as huge amounts of data are generated in spatial crowdsourcing services, the data privacy and security has become a key challenge for SDN-IoV. To overcome abovementioned challenge, a Deep Reinforcement Learning (DRL) and Blockchain empowered Spatial Crowdsourcing System (DB-SCS) is proposed. In DB-SCS, we design an improved multi-blockchain structure and a blockchain-based hierarchical task management method, which divide the spatial tasks into different categories according to the privacy requirements and the areas of the task and then decompose different categories of tasks and task receivers into sub-blockchains. While guaranteeing the data privacy, DB-SCS can also enhance the spatial crowdsourcing performance by using the proposed DRL-based management strategy to dynamically select the consensus algorithm, block size, and block generation rule. Extensive simulation experiments demonstrate that the DB-SCS can obtain high throughput, low overhead, and data privacy under various SDN-IoV scenarios.

This letter investigates the joint uplink and downlink resource allocation problem, where the non-orthogonal multiple access (NOMA) technology is applied to enhance device-to-device (D2D) communications. In order to maximize the sum data rate of NOMA-enabled D2D groups while guaranteeing the minimum data rate requirements of both cellular users (CUs) and D2D groups, we first design a subcarrier assignment algorithm to assign the downlink and uplink subcarriers for D2D groups, and then transform the problem into a convex optimization to obtain the optimal power allocation. Simulation results demonstrate the remarkable improvement in terms of data rate of D2D groups by using our algorithms.

To evaluate the potential of metagenomic next-generation sequencing (mNGS), compared with that of comprehensive conventional microbiological tests (CMTs), of bronchoalveolar lavage fluid (BALF) as a front-line diagnostic for immunocompromised patients with suspected pneumonia.Sixty critically ill immunocompromised patients undergoing both mNGS of BALF and CMTs for suspected pneumonia were retrospectively analysed. The diagnostic performance was compared between mNGS and CMTs, using the composite diagnosis as the reference standard.Forty-nine patients were diagnosed with microbiologically confirmed pneumonia, with 55% having polymicrobial infections. There was no significant difference in the overall diagnostic accuracy between mNGS and CMTs (61.7% vs 76.7%; P = 0.11). mNGS and CMTs had comparable diagnostic accuracy for bacterial and viral infections. Although mNGS identified more viral pneumonia, it had a much lower diagnostic accuracy for fungal infections (76.7% vs 99.2%; P0.001), mainly due to the low sensitivity for invasive pulmonary aspergillosis (45.5% vs 100%; P0.001).The overall diagnostic performance of BALF mNGS as a first-line diagnostic was similar to that of comprehensive CMTs, except in the case of a lack of consideration of potential pathogens or limited CMTs. The combination of mNGS and CMTs may be the best diagnostic strategy.

Objective To evaluate the clinical effect of electroacupuncture treatment for chloasma in young and middle-aged women. Methods Sixty young and middle-aged female patients with chloasma were divided into treatment group (n = 30) and control group (n = 30) according to random number table. In the treatment group, the electroacupuncture was applied to the facial acupoints and “Vagus” in the cavity of concha in the ear. The selection of facial acupoints was relating to the running course of facial nerve trunk: Yifēng (翳风 TE17), Shangguān (上关 GB3)—Sīzhukōng (丝竹空 TE 23) (Temporal branch), Xiaguān (下关 ST7)—Sibai (四白 ST2) (Zygomatic branch), Qiānzheng (牵正 Extra) —Quanliao (颧髎 SI18) (Zygomatic branch), Jiāchē (颊车 ST6) —Jiāchengjiāng (夹承浆Extra) (Buccal branch), Hegǔ (合谷LI 4). Electro-stimulation was adopted at “Vagus” in the cavity of concha in the ear (two distribution points of the vagus in the cavity of concha of each ear). The control group received conventional acupuncture (surrounding method of needling at the Ashi points in the facial lesion area and 15 acupoints which were selected in the highest frequency in the conventional acupuncture treatment). After 8 weeks of treatment, the clinical effects were compared.The total score of facial skin lesion, score of skin lesion color, score of lesion area, and effective rate of treatment for chloasma were used to evaluate the clinical effect of the two groups before and after treatment. Results After treatment, the effective rate of the treatment group was 95.00%, that of the control group was 67.50%. The effect of the treatment group was better than that of the control group, and the difference was statistically significant (χ2 = 9.928, P = 0.002). Before treatment, there was no difference in the area score, color score, and total score of skin lesions between the two groups (P>0.05). After treatment, the area score, color score, and total score of skin lesions in the treatment group were (1.05±0.64), (1.05±0.64), and (2.10±0.98) points respectively, while those in the control group were (1.38±0.63), (1.28±0.75), and (2.65±1.19) points respectively.The area score, color score, and total score of skin lesions in the treatment group were lower than those in the control group, with statistically significant differences (all P Conclusion electroacupuncture is more effective than conventional acupuncture in treating chloasma in young and middle-aged women.

BACKGROUND As air pollution has increased in severity over recent years, fine particulate matter (PM) (

This letter proposes a novel full-duplex-enabled cooperative relay scheme to reduce the downlink delivery latency in cloud radio access networks (CRAN). Specifically, remote radio heads (RRHs) are deployed with full-duplex capability and work in Amplify-and-Forward mode so that they could receive signals from the baseband signal processing unit (BBU) and forward to the user groups immediately, which can efficiently decrease the waiting and processing delay. Beyond the proposed scheme, we move forward to jointly optimize the transmit/receive beamforming vectors of both BBU and the RRHs with the target of minimizing the maximal delivery latency among all user groups. The formulated problem is a multivariable coupling problem and difficult to solve. To deal with it, we propose an efficient successive convex approximation iterative algorithm. Simulation results show that our proposed scheme could reduce the delivery latency compared with other schemes.

Objective To explore the associations of duration and quality of sleep during pregnancy with preterm birth and small for gestational age (SGA). Methods A prospective study was carried out on 1082 healthy women with singleton pregnancies from Chengdu, China. Self-report questionnaires, including duration and quality of sleep and other information, were administered at 8-12, 24-28, and 32-36 weeks of pregnancy. Data on gestational age and weight and length of the neonates were recorded after delivery. After controlling the potential confounders, a multivariable logistic regression model was performed to evaluate whether duration and quality of sleep were associated with preterm birth and SGA. Results Participants with short duration of sleep during the third trimester were more likely to report preterm birth (odds ratio [OR] 2.16, 95% confidence interval [CI 1.26-4.81) and SGA (OR 2.67, 95% CI 1.18-6.54). Participants with poor quality of sleep during the third trimester were at high risk for preterm birth (OR 2.26, 95% CI 1.29-5.84) and SGA (OR 2.08, 95% CI 1.19-5.38). Conclusion Short duration and poor quality of sleep during pregnancy are associated with an increased risk of preterm birth and SGA. Sleep characteristics should be assessed during prenatal evaluations to decrease adverse maternal and fetal outcomes.

Background Loss to follow-up (LTFU) during post-operative surveillance of breast cancer patients is detrimental. The pattern of LTFU and its risk factors in Chinese breast cancer patients remains unknown. Method Eligible non-metastatic breast cancer patients who underwent surgery at our institution between 2009 and 2012 were included. The clinicopathological features, as well as the LTFU status, were retrieved from the REDCap database. LTFU was defined as the absence of patients for at least 12 months since her last contact. 5-year LTFU was defined as the LTFU status of each patients at 5 years after surgery. The incidence and potential risk factors of LTFU were analyzed. A LTFU-risk score was developed to quantify the risk of LTFU. Results A total of 1536 patients with breast cancer were included, and 411(26.8%) patients were 5-year LTFU. 198 patients were LTFU in the first year. Univariate and multivariate analysis revealed that age (younger and older), a lack of medical insurance, longer distance from residence to the hospital, pathology (DCIS/Paget’s/Phyllodes), lymph node metastasis, the absence of endocrine therapy and fewer than five contact numbers were significantly and independently associated with the risk of LTFU. A LTFU-risk score was developed and was predictive of LTFU. Conclusions A series of risk factors were significantly associated with post-operative LTFU of breast cancer patients. Patients with different risks of LTFU could possibly be identified, and surveillance plans could be individualized for different patients, so as to effectively reduce the overall LTFU rate, and optimize the allocation of medical resources., Highlights • The first research investigating loss to follow-up in patients with breast cancer in China, its patterns and risk factors. • A LTFU (loss to follow-up)-risk score which could be used to predict the risk of LTFUwas developed. • The LTFU-risk score stratified the risk of LTFU, assisting the development of individualized surveillance plans.

Introduction Anti-IgLON5 disease is a rare autoimmune disease of the central nervous system. Different from the previous autoimmune encephalitis, the disease is a chronic progressive disease characterized by abnormal sleep, sleep apnea and motor disorders, which is prone to misdiagnosis and missed diagnosis. Methods We report a unique case of anti-IgLON5 disease in a pediatric patient with Langerhans cell histiocytosis (LCH). He gradually developed increased muscle tone and nystagmus during chemotherapy and showed signs of meningeal enhancement on cranial imaging. Due to insufficient evidence of LCH invasion of the central nervous system, the presence of autoimmune encephalitis-related antibodies was investigated by using cell-based assay (CBA) experiment in indirect immuno-fluorescence assay (IFA). Results Clinical manifestations of sleep disorders and motor disorders, plus the presence of IgLON5 IgG antibodies (1:30) in the serum leading to a confirmed diagnosis of anti-IgLON5 disease. Conclusion Anti-IgLON5 disease is rare and almost no cases of children have been reported. In view of the difficult to recognize symptoms in pediatric patients, especially those with other comorbidities. Clinicians should raise their awareness of this disease and pay attention to the detection of autoimmune antibodies.

Objectives. Immune checkpoint inhibitors (ICI) combined with radiotherapy (RT) have emerged as a breakthrough therapy in the treatment of various cancers. The combination has a strong rationale, but data on their efficacy and safety are still limited. Hence, we comprehensively searched the database and performed this study to elucidate the clinical manifestations of this combined strategy. Methods. We performed a meta-analysis of randomized trials that compared ICI plus RT with placebo plus RT or ICI alone for the treatment of advanced nonsmall-cell lung cancer (NSCLC) and prostate cancer. The outcomes included overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and treatment-related adverse events. A fixed-effects or random-effects model was adopted depending on between-study heterogeneity. Results. Three trials involving 1584 patients were included. ICI plus RT was significantly associated with improvement of OS (hazard ratio [HR] = 0.81, 95% confidence interval [CI] = 0.70–0.94,P=0.004), PFS (HR = 0.64; 95% CI 0.56–0.72,P<0.00001), and DCR (relative risk [RR] = 1.38; 95% CI 1.03–1.84,P=0.03). A significant predictor for PFS with the combination of ICI and RT was age, as a significant improvement in PFS (HR = 0.49; 95% CI 0.37–0.64,P<0.00001) was observed in NSCLC patients aged under 65 years. In safety analyses, patients receiving ICI plus RT had a significantly higher incidence of dyspnea (RR = 2.43; 95% CI 1.16–5.08,P=0.02) and pneumonitis of grade 3 or higher (RR = 2.78; 95% CI 1.32–5.85,P=0.007). Conclusion. The combination of ICI and RT was associated with improved OS, PFS, and DCR. Patients under 65 years will be the dominant beneficiaries. However, the incidence of dyspnea and pneumonia of grade 3 or higher also increased, which deserves our vigilance.

Rationale: Platinum-based chemotherapy is one of treatment mainstay for patients with advanced lung squamous cell carcinoma (LUSC) but it is still a "one-size fits all" approach. Here, we aimed to investigate the predictive and monitoring role of circulating cell-free DNA (cfDNA) profiling for the outcome of first-line chemotherapy in patients with advanced LUSC. Methods: Peripheral blood samples of 155 patients from a phase IV trial and 42 cases from an external real-world cohort were prospectively collected. We generated a copy number variations-based classifier via machine learning algorithm to integrate molecular profiling of cfDNA, named RESPONSE SCORE (RS) to predict the treatment outcome. To monitor the treatment efficacy, cfDNA samples collected at different time points were subjected to an ultra-deep sequencing platform. Results: The results showed that patients with high RS showed substantially higher objective response rate than those with low RS in training set (P < 0.001), validation set (P < 0.001) and real-world cohort (P = 0.019). Furthermore, a significant difference was observed in both progression-free survival (training set, P < 0.001; validation set: P < 0.001; real-world cohort: P = 0.019) and overall survival (training set, P < 0.001; validation set: P = 0.037) between high and low RS group. Notably, variant allele frequency (VAF) calculated from an ultra-deep sequencing platform significantly reduced in patients experienced a complete or partial response after 2 cycles of chemotherapy (P < 0.001), while it significantly increased in these of non-responder (P < 0.001). Moreover, VAF undetectable after 2 cycles of chemotherapy was correlated with markedly better objective response rate (P < 0.001) and progression-free survival (P < 0.001) than those with detectable VAF. Conclusions: These findings indicated that the RS, a circulating cfDNA sequencing-based stratification index, could help to guide first-line chemotherapy in advanced LUSC. The change of VAF is valuable to monitor the treatment response.

Deep neural network is a promising method to recognize motor imagery electroencephalography (MI-EEG), which is often used as the source signal of a rehabilitation system; and the core issues are the data representation and the matched neural networks. MI-EEG images is one of the main expressions, however, all the measured data of a trial are usually integrated into one image, causing information loss, especially in the time dimension; and the neural network architecture might not fully extract the features over the $\alpha $ and $\beta $ frequency bands, which are closely related to MI. In this paper, we propose a key band imaging method (KBIM). A short time Fourier transform is applied to each electrode of the MI-EEG signal to generate a time-frequency image, and the parts corresponding to the $\alpha $ and $\beta $ bands are intercepted, fused, and further arranged into the EEG electrode map by the nearest neighbor interpolation method, forming two key band image sequences. In addition, a hybrid deep neural network named the parallel multimodule convolutional neural network and long short-term memory network (PMMCL) is designed for the extraction and fusion of the spatial-spectral and temporal features of two key band image sequences to realize automatic classification of MI-EEG signals. Extensive experiments are conducted on two public datasets, and the accuracies after 10-fold cross-validation are 97.42% and 77.33%, respectively. Statistical analysis shows the superb discrimination ability for multiclass MI-EEG too. The results demonstrate that KBIM can preserve the integrity of the feature information, and they well match with PMMCL.

The Geriatric Nutritional Risk Index (GNRI) is widely applied as a prognostic factor in different cancers. We aimed to analyze the prognostic value of the GNRI in 257 patients diagnosed with advanced non-small-cell lung cancer (NSCLC). Patients with GNRI98, 92-98, and92 were grouped into normal, low risk and moderate/high risk groups, respectively. There were 45.1% patients at risk for malnutrition. Kaplan-Meier survival curves indicated that patients with lower GNRI scores had a poorer overall survival (OS). Two-year OS for normal, low risk and moderate/high risk groups were 57.4%, 42.3% and 15.8%, respectively. In multivariate survival analysis, GNRI (92), body mass index (BMI, ≥24 kg/m2), combined therapy, hemoglobin and neutrophil-to-lymphocyte ratio (NLR) were independent prognostic factors of OS. Stratifying by age groups, GNRI (92), hemoglobin and NLR were independent prognostic factors of OS in patients aged65 years. GNRI (92), smoking, BMI (≥24 kg/m2) and platelet-to-lymphocyte ratio were independent prognostic factors of OS in patients aged ≥65 years. In conclusion, GNRI was a significant prognostic factor in advanced NSCLC patients regardless of age. A decreased GNRI may be considered as a clinical trigger for nutritional support in advanced NSCLC patients, though additional studies are still required to confirm the best cut-point.

In the rapidly growing era of Internet-of-Things (IoT), healthcare systems have enabled a sea of connections of physical sensors. Data analysis methods (e.g., k-means) are often used to process data collected from wireless sensor networks to provide treatment advices for physicians and patients. However, many methods pose a threat of privacy leakage during the process of data handling. To address privacy issues, we propose a mutual privacy-preserving k-means strategy (M-PPKS) based on homomorphic encryption that neither discloses the participant’s privacy nor leaks the cluster center’s private data. The proposed M-PPKS divides each iteration of a k-means algorithm into two stages: finding the nearest cluster center for each participant, followed by computing a new center for each cluster. In both phases, the cluster center is confidential to participants, and the private information of each participant is not accessible by an analyst. Besides, M-PPKS introduces a third-party cloud platform to reduce the communication complexity of homomorphic encryption. Extensive privacy analysis and performance evaluation results manifest that the proposed M-PPKS strategy can achieve high performance. In addition, it can obtain approximate clustering results efficiently while preserving mutual private data.

Aim: Glycemic index (GI) and glycemic load (GL) influence postprandi al glucose concentrations and insulin responses. This study aims to ascertain the connection between GI, GL, and carotid atherosclerotic stenosis and cardiovascular disease (CVD) risk factors. Methods: A total of 669 patients with ischemic stroke within 7 days were enrolled. GI and GL were assessed with a validated food frequency questionnaire from patients. Computed tomography angiography (CTA) was used for the evaluation of carotid atherosclerotic stenosis. Traditional risk factors such as total cholesterol, triglycerides, LDL-C, HDL-C, C-reactive protein, homocysteine, neutrophil to lymphocyte ratio (NLR), fasting plasma glucose, and hemoglobin A1c were measured. GI/GL and its association with CVD risk factors and carotid stenosis were explored with Spearman analysis and multivariable logistic regression, respectively. Results: The prevalence of carotid stenosis was 63.2% of all 669 participants. The mean value of GI/GL was 49.3/137. Spearman test did not detect significant relationships between GI/GL and CVD risk factors. In multivariable regression models, GI (4th vs. 1st quartile, OR = 2.11; 95% CI, 1.30–3.42) and GL (4th vs. 1st quartile, OR = 1.82; 95% CI, 1.12–2.96) were observed a significant association with carotid stenosis after adjustment for major confounding factors. The association between GL and carotid stenosis became more pronounced among yo ungers (4th vs. 1st quartile, OR = 2.42; 95% CI, 1.13–4.76) and women (4th vs. 1st quartile, OR = 3.81; 95% CI, 1.45–5.05). Conclusion: Higher GI and GL were positively associated with a higher degree of carotid stenosis in these Chinese cerebral infarction patients, especially in younger patients and women.

Background and Purpose: Long-term dietary patterns can influence the intensity of systemic inflammation and, therefore, the development of atherosclerosis. This study aimed to evaluate the association between dietary inflammatory index (DII) and vulnerability characteristics of carotid atherosclerotic plaques in patients with ischemic stroke. Methods: Patients with ischemic stroke within 7 days of onset were enrolled. DII was calculated from 32 food components with the help of a food frequency questionnaire. Vulnerable plaque was defined as presence of artery positive remodeling (remodeling index >1.1) and low CT attenuation plaques ( Results: Of the 398 enrolled patients, 144 (36.2%) were detected with vulnerable plaque. Their DII ranged from −4.58 to 4.18. Patients with vulnerable plaques consumed less nutrients with anti-inflammatory properties, less fruits and vegetables (85.6±64.3 versus 94.6±74.4 g/d, P =0.027), and less nuts (5.66±7.14 versus 8.84±15.9 g/d, P =0.024) than patients without vulnerable plaques. Patients with vulnerable plaque had higher DII than patients without vulnerable plaque (−0.26±1.54 versus −0.64±1.53, P =0.018). Logistic regression analysis revealed that DII was associated with vulnerable plaques after adjusted for major confounding factors (odds ratio=1.307; 95% CI, 1.113–1.533). Conclusions: DII is associated with the vulnerability of carotid plaques in patients with ischemic stroke. Considering a possible causal relationship, the mechanisms underlying the association between diet and atherosclerosis warrant further study.

As one of the fundamental information extraction methods, topic model has been widely used in text clustering, information recommendation and other text analysis tasks. Conventional topic models mainly utilize word co-occurrence information in texts for topic inference. However, it is usually hard to extract a group of words that are semantically coherent and have competent representation ability when the models applied into short texts. It is because the feature space of the short texts is too sparse to provide enough co-occurrence information for topic inference. The continuous development of word embeddings brings new representation of words and more effective measurement of word semantic similarity from concept perspective. In this study, we first mine word co-occurrence patterns (i.e., biterms) from short text corpus and then calculate biterm frequency and semantic similarity between its two words. The result shows that a biterm with higher frequency or semantic similarity usually has more similar words in the corpus. Based on the result, we develop a novel probabilistic topic model, named Noise Biterm Topic Model with Word Embeddings (NBTMWE). NBTMWE extends the Biterm Topic Model (BTM) by introducing a noise topic with prior knowledge of frequency and semantic similarity of biterm. NBTMWE shows the following advantages compared with BTM: (1) It can distinguish meaningful latent topics from a noise topic which consists of some common-used words that appear in many texts of the dataset; (2) It can promote a biterm’s semantically related words to the same topic during the sampling process via generalized $P\acute {o}lya$ Urn (GPU) model. Using auxiliary word embeddings trained from a large scale of corpus, we report the results testing on two short text datasets (i.e., Sina Weibo and Web Snippets). Quantitatively, NBTMWE outperforms the state-of-the-art models in terms of coherence, topic word similarity and classification accuracy. Qualitatively, each of the topics generated by NBTMWE contains more semantically similar words and shows superior intelligibility.

ObjectiveSubjects with a positive faecal immunochemical test (FIT) have a much higher likelihood of advanced neoplasms than the general population. Whether FIT-positive subjects with negative colonoscopy should receive subsequent FIT screening remain unclear.DesignSubjects with a negative colonoscopy after positive FIT in the first screening in the Taiwanese Colorectal Cancer (CRC) Screening Program 2004–2009 were followed until the end of 2014. CRC incidence was compared between those who did and did not receive subsequent FIT screening. Cox regression analysis was conducted, adjusting for major confounders to investigate whether subsequent FIT was associated with lower risk of incident CRC.ResultsThe study cohort was comprised of 9179 subjects who had negative diagnostic colonoscopy after positive FIT in 2004–2009, of whom 6195 received subsequent FIT during the study period. The CRC incidence (per 1000 person years) was 1.34 in those who received subsequent FIT and 2.69 in those who did not, with corresponding adjusted HR (aHR) of 0.47 (95% CI 0.31 to 0.71). Lower adenoma detection rate of diagnostic colonoscopy was associated with higher risk of incident CRC but became non-significant in multivariable analysis after adjustment for subsequent FIT. Higher baseline faecal haemoglobin concentration (FHbC, μg haemoglobin/g faeces) was associated with increased risk of incident CRC (reference: FHbC=20–39; aHR=1.93 (1.04–3.56), 0.95 (0.45–2.00), 2.26 (1.16–4.43) and 2.44 (1.44–4.12) for FHbC=40–59, 60–99, 100–149 and ≥150, respectively).ConclusionSubsequent FIT should be scheduled after negative colonoscopy to detect missed neoplasms and reduce the risk of incident CRC in a national FIT screening programme.

Recently, with the proliferation of communication devices, Internet of Things (IoT) has become an emerging technology which facilitates massive devices to be enabled with connectivity by heterogeneous networks. However, it is usually a technical challenge for traditional networks to handle such a huge number of devices in an efficient manner. Recently, the software-defined network (SDN) technique with its agility and elasticity has been incorporated into IoT to meet the potential scale and flexibility requirements and form a novel IoT architecture also known as SDN-IoT. As the size of SDN-IoT increases, efficient routing protocols with low latency and high security are required, while the default routing protocols of SDN are still vulnerable to dynamic change of flow control rules especially when the network is under attack. To address the above issues, a deep-reinforcement-learning-based quality-of-service (QoS)-aware secure routing protocol (DQSP) is proposed in this article. While guaranteeing the QoS, our method can extract knowledge from history traffic demands by interacting with the underlying network environment, and dynamically optimize the routing policy. Extensive simulation experiments have been conducted with respect to several network performance metrics, demonstrating that our DQSP has good convergence and high effectiveness. Moreover, DQSP outperforms the traditional OSPF routing protocol, at least 10% relative performance gains in most cases.

Highlights • The prevalence of depression was increased (6.21%) in quarantined subjects. • Depressed group were younger, less educated and married than non-depressed group. • Depression was positively correlated with anxiety, poor sleep quality and PTSS. • It is necessary to take strategies to improve the depression of quarantined subjects., Background The COVID-19 outbreak has brought tremendous psychological pressure to the general population, which may lead to depression. Therefore, this study aim to evaluate the prevalence and clinical correlates of depressive symptoms in the general population quarantined during the COVID-19 outbreak in Shenzhen. Methods 2237 quarantined general individuals participated in this cross-sectional study from February 14 to March 4, 2020, during their 14 days quarantine. They completed the Zung's Self-Rating Depression Scale (SDS) for depression, Zung's self-rating anxiety scale (SAS) for anxiety, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the Impact of Events Scale-Revised (IES-R) for post-traumatic stress symptoms (PTSS). Results The prevalence of depressive symptom was 6.21% in quarantined individuals. The depressed group were younger, less married and educated, and had higher SAS, PSQI, IES-R total scores (all p

Previous studies usually used the common tunnel model and paid little attention to the propagation characteristics of fire in the carriage structure with multiple lateral openings. In the current study, experiments were carried out in a reduced-scale (1:5) subway carriage model to study the propagation characteristics of carriage fire. The main focuses were on the temperature contour profiles and distribution laws under the ceiling and at different doors inside the carriage. Results show that although the status of the side door of the carriage does not have a significant effect on the mass loss rate of fuel combustion, the temperature distribution under the ceiling will be affected under the effect of the smoke overflow of the door opening. The effect of door status on the longitudinal ceiling temperature is mainly on the area between the fire source and the adjacent door. For the transverse ceiling temperature above the fire source, the effect of the status of the door is significant with the increase of the fire source. Besides, the temperature contour profile at the door shows regular distribution. In the process of gradually increasing the temperature as the height increases, the isotherm gradually changes from a horizontal straight line to two inverted triangular sides, the temperature at the door has been basically in the ambient temperature from the dimensionless height (normalized by the height of the door) below 0.6. The measured radiation at the upper part of the carriage end is about 5 times higher than that in the middle of the door adjacent to the fire source, and the ratio is not significantly affected by the heat release rate. The results of this study can be of use to the fire-protection community to better understand fire dynamics.

Background This study aimed to investigate whether an immunohistochemical prognostic model (IHC4 score) can predict the prognosis and the chemotherapy benefit in patients with estrogen receptor‐positive (ER+)/human epidermal growth receptor 2–negative (HER2−) metastatic breast cancer (MBC). Materials and Methods We developed a method to calculate the modified IHC4 (mIHC4) scores based on routine pathological reports and compared them with the original IHC4 scores that were much more difficult to calculate. Univariate and multivariate analyses were used to study the prognostic factors of progression‐free survival (PFS) and overall survival (OS). The predictive value of mIHC4 score was also investigated. Results The Sun Yat‐sen Memorial Hospital data set included 315 patients with newly diagnosed ER+ MBC with a median follow‐up of 25.6 months. Univariate and multivariate analysis showed that higher mIHC4 scores in metastatic lesions, but not the ones in primary tumors, were significantly associated with worse PFS and OS. The prognostic value of mIHC4 scores for PFS was validated using an independent Chinese Society of Clinical Oncology‐ Breast Cancer (CSCO‐BC) data set. More importantly, subpopulation treatment effect pattern plot analysis showed that first‐line endocrine therapy achieved better PFS and OS than chemotherapy in low‐risk patients with ER+/HER2− MBC, whereas first‐line chemotherapy was associated with improved PFS and OS compared with endocrine therapy in high‐risk ones. The predictive value of mIHC4 score for PFS in selecting first‐line endocrine therapy versus chemotherapy was also confirmed in the CSCO‐BC data set. Conclusion mIHC4 scores in metastatic lesions are prognostic for the PFS and OS in patients with ER+ MBC. Low or high mIHC4 score may indicate the survival benefit in choosing first‐line endocrine therapy or chemotherapy in patients with ER+/HER2− MBC, respectively. Implications for Practice The modified IHC4 (mIHC4) score is easy to implement and able to predict patients with advanced and/or metastatic breast cancer. In addition, with the help of the mIHC4 score, physicians might be able to recommend chemotherapy or endocrine therapy as the first‐line treatment for patients with high and low risk as predicted by the mIHC4 score., A method to reliably predict prognosis for patients with metastatic breast cancer is needed. This article reports an immunohistochemical prognostic model (IHC4 score) that can predict the prognosis and chemotherapy benefit in patients with ER+/HER2– metastatic breast cancer.

The purpose of this study is to investigate the influence of an outpatient multidisciplinary diagnosis and treatment model on the health economic indices of diabetic foot patients. We included 142 diabetic foot patients who received treatment in 2 target hospitals from January to April 2018 in this prospective cohort study. According to their exposure factors, the patients were divided into a MDT group and a control group, with 71 patients in each group. The patients’ baseline data were collected. The follow-up period was 12 months; all patients were followed up to April 30, 2019. Health economic indicators were collected when the patients were discharged from the hospital. The prognosis of each group was followed every month. If a wound healed, a major amputation occurred, or the patient died within 12 months, the follow-up was stopped. A total of 129 patients were followed, and their baseline data were comparable. During the follow-up period, the healing rate of the 2 groups was significantly different ( P = .034). The healing rate of Wagner grade 4 patients was significantly better than Wagner grade 2 and grade 3 patients ( P = .001). Health economic indicators demonstrated significant differences in bed waiting time ( P = .038), transfer time ( P = .001), surgery waiting time ( P = .003), length of hospital stay ( P = .047), and hospitalization expenses ( P = .011). In conclusion, an outpatient multidisciplinary diagnosis and treatment model for diabetic foot can support cost-effective patient management.

Eosinophilic bronchitis (EB) is a clinical disease characterized by chronic cough, airway eosinophil infiltration, and responsive to steroid therapy but with the absence of airway hyperreactivity (AHR). This study established an EB mouse model with all the above features. First, 42 mice were divided into 7 groups to investigate the optimal time interval between cough and AHR detections. Afterward, 28 mice were divided into the asthma, EB, normal saline (NS), and dexamethasone (DXM) groups. Mice were challenged using nasal drops of 200 µg ovalbumin (OVA), 10 µg OVA, NS, or intraperitoneal injections of 5 mg/kg of DXM one hour prior to 10 µg OVA challenge. Airway reactivity was measured 6 h after cough was observed. The frequency of coughs in the asthma and EB groups increased significantly compared to mice in the NS group. After DXM administration, frequency of coughs was significantly decreased compared to mice in the asthma and EB groups. Lung resistance in the asthma group was significantly higher compared to mice in the NS, EB, and DXM groups. Obvious airway eosinophilic inflammation in BALF and lung tissues were observed in the asthma and EB groups, while DXM administration could attenuate airway inflammatory infiltration. In summary, we developed a mouse EB model with all four clinical features of EB by the administration of 10 µg OVA nasal drops.

As the number of aged population grows, fall detection has attracted considerable research attentions in recent years. Through the data collected by wearable sensors and specific algorithms, fall detection and protection can be performed before the user hits the ground. However, most of existing researches have not considered the direction of falls which can be used for more effective protection. In this paper, to further distinguish the direction of falls and improve the detection accuracy, we propose a multi-sensor-based fall detection system by taking the detection as a multi-class problem. To extract the feature from multi-sensor data more effectively, we also present a Multi-source CNN Ensemble (MCNNE) structure. In the proposed system, data from different sensors are preprocessed and formatted as the training dataset independently, and output features map from different sensors are concatenated to construct a overall feature map. Compared with single CNN structure and various ensemble bi-model structures, MCNNE has better performance. On 800 falls and 1000 activities of daily living, the overall average accuracy of our detection system can reach to 99.30%, and false positive rate (FPR) is lower than 0.69%.

In Wireless Local Area Networks, channel bonding allows several basic channels to constitute a wide channel. The wide channel can increase potential throughput in a single Basic Service Set (BSS). However, channel contention among BSSs is more serious because the number of non-overlapping channels decreases. Therefore, the appropriate channel bandwidth should be chosen to improve the throughput of the whole network. In this paper, to control channel contention and improve throughput, we propose a channel bonding algorithm in which the channel bandwidth is constrained based on the achievable throughput analysis. At first, the channel contention relationship among BSSs is obtained according to the topology of the network. In each possible channel bonding and channel allocation scheme, the achievable throughput can be calculated according to the contention graph and the maximal clique algorithm. Then, the channel bonding scheme with the maximum achievable throughput can be selected. In the selected channel bonding scheme, each BSS uses a specific channel which consists of several basic channels, and these basic channels are candidate channels of constrained channel bonding in this BSS. Finally, constrained channel bonding will be performed in each BSS, and the combined wide channel can only be constituted by some or all of candidate basic channels. In this manner, channel contention among BSSs can be controlled. Simulation results show that the proposed constrained channel bonding achieves better performance than traditional channel bonding.

Objective: To study the effects of Yixintai pills on myocardial cell apoptosis in rats with adriamycin (ADR)-induced heart failure (HF) and the mechanism of action. Methods: Sixty healthy male Wistar rats randomly were divided into Control, Model, Captopril, and Yixintai pill groups. A rat model of ADR-induced HF was constructed by intraperitoneal injection of ADR (2.5 mg/kg). The control group was given an equal volume of normal saline; the Yixintai pill and Captopril groups were given corresponding mediations (5 mg/kg) by lavage. After 4 weeks of treatment, fasting blood was collected to detect the contents of plasma rennin activity (PRA), angiotensin II (AngII), and aldosterone (ALD). B ultrasound was used to detect the heart structure, and the heart weight/body weight (HW/BW) ratio was calculated. The pathology of myocardial tissues was observed by HE staining. The apoptosis of myocardial cells was detected by TUNEL assay. The expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in serum were analyzed by ELISA, and the protein expression levels of protein kinase B (Akt), phosphorylated (p)-Akt, glycogen synthase kinase-3β (GSK-3β) and p-GSK-3β in myocardial tissues were measured by Western blotting. Results: Compared with the Control group, the PRA, AngII, ALD, left ventricular posterior wall thickness at end-systole (LVPWs), left ventricular posterior wall thickness at end-diastole (LVPWd), interventricular septal thickness at end-systole (IVSs), interventricular septal thickness at end-diastole (IVSd), HW/BW, TNF-α and IL-6 of model group increased significantly (P < .05). PRA, AngII, ALD, LVPWs, LVPWd, IVSs, IVSd, HW/BW, TNF-α and IL-6 of the Yixintai pill and Captopril groups were significantly lower than those of the Model group (P < .05). There were no significant differences in the indices between the Yixintai pill and Captopril groups (P > .05). In the Model group, lamellar necrosis, vacuolar degeneration, increased myocardial fibers and lamellar dissolution of myocardial cells were found in myocardial tissues. However, the myocardial cells of the Control group were neatly arranged and clearly structured, and only a few ones underwent fibrosis. There were mild myocardial fibrosis and vacuolar degeneration in the Yixintai pill and Captopril groups, and the degeneration and hyperplasia of myocardial fibers were obviously relieved. Compared with the Control group, the apoptosis index (AI) of the Model group increased significantly (P < .05). The AI values of the Yixintai pill and Captopril groups were significantly lower than those of the Model group (P < .05). Compared with the Control group, the expression levels of p-Akt and p-GSK-3β in the Model group decreased significantly (P < .05). The expression levels of p-Akt and p-GSK-3β in the Yixintai pill and Captopril groups were significantly higher than those of the Model group (P < .05), whereas the former 2 groups had similar results (P > 0.05). Conclusion: Yixintai pills may inhibit myocardial cell apoptosis and ventricular remodeling in rats by up-regulating PI3K/Akt/GSK-3β signal, thus protecting the heart function.

Industrial Internet of Everything (IIoE), as the deep integration of industry 6.0, the Internet of Things (IoT) and 6G mobile communication technology, pave the way for intelligent industry, enabling industrial optimization and automation. To ensure the high quality of services (QoS) in IIoE, tremendous real-time information generated by the pervasive smart things needs to be aggregated and processed quickly and reliably. However, a large-scale disaster could damage the entire communication network and cut off data aggregation such that Qos is compromised. In this paper, an Intelligent NIB based Data Aggregation Strategy, named (IDAS), is proposed for after disaster scenarios in IIoE. Specifically, IDAS first applies both iterative cubature kalman filter and radial basis function neural network to predict the data collection rates of survived infrastructures. Then, an energy efficient task distribution mechanism is design. Next, a deep reinforcement learning method is developed for the car-carrying NIB route design to perform corresponding task. Eventually, all data are aggregated toward the rescue headquarter by NIB deployment based on Fermat tree constructions. The theoretical analysis and simulations indicate that IDAS is not only energy efficient for after disaster scenarios but requires the least NIB consumption while compared with contemporary strategies.

Purpose Circulating tumor cell (CTC) detection methods based on epithelial cell adhesion molecule (EpCAM) have low detection rates in epithelial ovarian cancer (EOC). Meanwhile, folate receptor alpha (FRα) has high expression in EOC cells. We explored the feasibility of combining FRα and EpCAM as CTC capture targets in EOC. Patients and methods EpCAM and FRα antibodies were linked to magnetic nanospheres (MNs) using the principle of carbodiimide chemistry. Blood samples from healthy donor spiked with A2780 ovarian cancer cells were used for detecting the capture rate. Ninety-five blood samples from 30 patients with EOC were used for comparing the positive rate of detection when using anti-EpCAM-MNs alone with that when using combination of anti-EpCAM-MNs and anti-FRα-MNs. Samples from 28 patients initially diagnosed with EOC and 20 patients with ovarian benign disease were used for evaluating the sensitivity and specificity of combination of anti-EpCAM-MNs and anti-FRα-MNs. Results Regression analysis between the number of recovered and that of spiked A2780 cells revealed yEpCAM = 0.535x (R2 = 0.99), yFRα = 0.901x (R2 = 0.99), and yEpCAM+FRα = 0.928x (R2 = 0.99). In mixtures of A2780 and MCF7 cells, the capture rate was 92% using the combination of anti-EpCAM-MNs and anti-FRα-MNs, exceeding the rate when using anti-EpCAM-MNs or anti-FRα-MNs alone by approximately 20% (P < 0.01). The combination of anti-EpCAM-MNs and anti-FRα-MNs showed a significantly increased positive rate of CTC detection in EOC patients compared with anti-EpCAM-MNs alone (χ2 = 14.45, P < 0.001). Sensitivity values were 0.536 and 0.75 and specificity values were 0.9 and 0.85 when using anti-EpCAM-MNs alone and when using the combination of anti-EpCAM-MNs and anti-FRα-MNs, respectively. Conclusion The combination of FRα and EpCAM is feasible as a CTC capture target of CTC detection in patients with EOC.

Background Most neonates with persistent left superior vena cava (PLSVC) have no clinical symptoms or hemodynamic changes, and this anomaly is only found during cardiac catheterization, pacemaker implantation, or central venous catheterization. Electrocardiogram (ECG) localization is helpful for the application of the peripherally inserted central catheter (PICC) technique in neonates with PLSVC. Objective To explore the characteristic waveforms of the P wave when a PICC under ECG localization is applied in neonates with PLSVC. Study Design The observation and management strategies for the P wave changes during catheter insertion (CI) of two neonates with PLSVC admitted to our institution between January and July 2020, who underwent PICC line insertion, were summarized. Results The characteristic P wave changes in two children with a PICC line inserted via the PLSVC were observed. When a wide inverted P wave appeared on ECG, the catheter was immediately withdrawn by 0.5 cm, a bidirectional P wave gradually appeared and then disappeared. After that, the catheter was further withdrawn by 0.5 cm. After catheterization, the optimal position of the PICC was confirmed by X-ray photography and bedside B-ultrasound. The PICC line was removed as scheduled after indwelling for 18 and 29 days, respectively, in the two cases, and no PICC-related complications occurred during indwelling. Conclusion The characteristic P wave changes on ECG during CI provide important clinical reference values for the application of the PICC technique under ECG localization in neonates with PLSVC. Key Points

OBJECTIVE In recent years, many studies have tried to prove whether Helicobacter pylori (H. pylori) can promote the progression of atherosclerosis (AS), but the reported results are conflicting. Carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), or pulse wave velocity (PWV) are the most commonly used indicators to evaluate the progress of AS. So, we collected and evaluated these three indicators to provide evidence-based medicine for the clinic. MATERIALS AND METHODS We included and evaluated studies on H. pylori infection and CIMT, FMD, or PWV from PubMed, Cochrane trials, and Embase databases before September 1, 2021, and language restrictions: English. Research types include cross-sectional studies, cohort studies, and case-control studies. The MINORS scale was used to evaluate the quality of these studies. For all studies, we choose a random-effects model and calculate the weighted mean difference (WMD) for analysis, and all our analyses use STATA software. RESULTS Meta-analysis shows that H. pylori infection can significantly increase CIMT (WMD = 0.059, 95% CI: 0.039, 0.079, p

BackgroundCirculating tumor DNA (ctDNA) levels and blood tumor mutation burden (bTMB) have a significant impact on the prognosis of tumor patients. However, their prognostic role in immune checkpoint inhibitors (ICIs) in cancer patients is still unclear.MethodsWe used the Review Manager software (version 5.3) to perform a meta-analysis based on the published literature to explore the prognostic value of ctDNA and bTMB in patients receiving immunotherapy. We extracted the hazard ratios (HRs) of progression-free survival (PFS) and overall survival (OS) for each included study and their respective 95% confidence intervals (CIs) and p-values for analysis.ResultsThirteen studies were included in the meta-analysis. Higher ctDNA levels were significantly associated with shorter OS (HR = 3.35, 95%CI = 2.49–4.51, p < 0.00001) and PFS (HR = 3.28, 95%CI = 2.47–4.35, p < 0.00001). The results of ctDNA subgroup analysis showed that high posttreatment ctDNA levels significantly correlated with shorter OS in cancer patients receiving ICIs (HR = 5.09, 95%CI = 1.43–18.07, p = 0.01). Moreover, patients with ctDNA clearance had better OS (HR = 4.94, 95%CI = 2.96–8.26, p < 0.00001). Patients with high posttreatment ctDNA levels had shorter PFS (HR = 3.00, 95%CI = 2.02–4.46, p < 0.00001) and those with ctDNA clearance had longer PFS (HR = 4.61, 95%CI = 2.78–7.65, p < 0.00001). However, there was no statistically significant difference in the OS benefits between a high and a low bTMB after ICI therapy (HR = 0.68, 95%CI = 0.33–1.37, p = 0.28).ConclusionsThe host immune system and tumor burden together determine whether cancer patients can benefit from ICI therapy. Our systematic review and meta-analysis revealed for the first time that the levels of pretreatment and posttreatment ctDNA and the clearance of ctDNA can independently be used as prognostic factors for antitumor immunotherapy, while bTMB cannot. In conclusion, ctDNA levels have great potential as an assistant tool for radiological assessments to make clinical therapeutic decisions. The prognostic utility of bTMB still requires further exploration.

Background Social support is an important health determinant and may affect dietary behaviors. The purpose of this study was to examine the relations between perceived social support and the Chinese Diet Balance Index-16 (DBI-16) among ethnic minority groups in Southwest China. Methods This cross-sectional study was conducted between May 2019 and August 2020 among six ethnic minority groups native to Yunnan Province (n = 3564). Perceived social support from family, friends and significant others were measured with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Dietary data were obtained using a 100-item Food Frequency Questionnaire (FFQ) and a lifestyle questionnaire. Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) which represent inadequate, excessive and unbalanced food intake respectively were calculated to measure the compliance with the recommendations of the Dietary Guidelines for Chinese 2016. Results One thousand four hundred ninety-six men and two thousand sixty-eight women were included. 51.2% of the subjects had moderate or high levels of inadequate intake; 21.3% had moderate or high levels of excessive intake; and 74.0% had moderate or high levels of unbalanced dietary intake. With potential confounders adjusted, support from family was negatively associated with inadequate intake, while support from friends was positively associated with inadequate and excessive intake. No significant associations were found between perceived social support from significant others and diet quality indicators. Conclusions An unbalanced diet is common among adults of the ethnic minority groups in Yunnan Province, Southwest China. Social support should be taken into account in designing nutrition interventions rather than focusing solely on individuals.

Objective: To identify factors associated with mortality in SLE patients who were hospitalized for pulmonary infections (PIs).Methods: This single-center retrospective study analyzed the characteristics and risk factors for mortality in 95 SLE patients hospitalized for PIs.Results: Ninety-five SLE patients had 97 episodes of hospitalization for PIs, and 33 of these episodes (34.02%) led to death. Death from PI was associated with a higher neutrophil count (6.30 vs. 4.201 × 109/L, p < 0.01), immunoglobulin G (6.20 vs. 9.82 g/L, p = 0.01), serum creatinine (126.00 vs. 73.00 μmol/L, p = 0.01), proteinuria (2.99 vs. 0.54 g/day, p < 0.01), cardiopulmonary involvement (57.58 vs. 34.38%, p < 0.05), SLE disease activity index (SLEDAI; 11.00 vs. 6.00, p < 0.05), and opportunistic infections (78.79 vs. 45.31%, p < 0.05). Demographic characteristics, antibody/complements, bacterial infection, and primary treatment before infection (including corticosteroid and immunosuppressants) had no effect. Multivariate analysis indicated cardiopulmonary involvement (HR: 2.077; 95%CI: 1.022–4.220; p = 0.043) and opportunistic infection (HR: 2.572; 95%CI: 1.104–5.993; p = 0.029) were independent risk factors for mortality. High-dose steroid pulse therapy (HR: 0.982; 95%CI: 0.410–2.350; p = 0.982) and first-line immunosuppressant therapy (HR: 1.635; 95%CI: 0.755–3.542, p = 0.212) had no effect on mortality.Conclusion: Cardiopulmonary involvement and opportunistic infection were independent risk factors for mortality for SLE patients hospitalized for PIs. Use of high-dose pulse steroids and or immunosuppressants before hospitalization had no significant effects.

Highlights • H3BP targeted ANP32A against AML by competitively disrupting ANP32A and H3 interaction and decreasing H3 acetylation and the expression of lipid metabolism genes. • Expressed H3BP-GFP and synthetic TAT-H3BP peptide impaired H3 acetylation on multiple locus of target genes that reduced proliferation and caused apoptosis of leukemia cells in vitro. • TAT-H3BP exhibits potent efficacy against leukemia in vivo: Intra-tumor injection of TAT-H3BP peptide prominently diminished the volume of subcutaneous tumors in nude mice; AMKL mice engrafted with TAT-H3BP-pretreated 6133/MPL W515L cells displayed dramatically moderated disease burden and prolonged survival time. • TAT-H3BP peptide possess a therapeutic potential in patients with AML for micromole concentration of TAT-H3BP peptide efficiently inhibited the proliferation and CFU of human primary leukemia cells from AML patients. • High ANP32A levels in human primary AML cells correlate with the intervention effect of TAT-H3BP peptide., Clinic therapy of acute myeloid leukemia (AML) remains unsatisfactory that urges for development of novel strategies. Recent studies identified ANP32A as a novel biomarker of unfavorable outcome of leukemia, which promoted leukemogenesis by increasing H3 acetylation and the expression of lipid metabolism genes. It is of great significance to investigate whether targeting ANP32A is a novel strategy for leukemia therapy. To target ANP32A, we identified a peptide that competed with ANP32A to bind to histone 3 (termed as H3-binding peptide, H3BP). Disrupting ANP32A and H3 interaction by the overexpression of H3BP-GFP fusion protein mimicked the effect of ANP32A knockdown, impaired H3 acetylation on multiple locus of target genes, reduced proliferation, and caused apoptosis in leukemia cells. Furthermore, a synthesized membrane-penetrating peptide TAT-H3BP effectively entered into leukemia cells and phenocopied such effect. In vivo, TAT-H3BP showed potent efficacy against leukemia: Intra-tumor injection of TAT-H3BP significantly reduced the volume of subcutaneous tumors in nude mice and recipient mice engrafted with TAT-H3BP-pretreated 6133/MPL W515L cells exhibited ameliorated leukemia burden and prolonged survival. Noticeably, TAT-H3BP efficiently suppressed proliferation and colony-forming unit of human primary AML cells without affecting normal cord blood cells. Our findings demonstrate that intervening the physical interaction of ANP32A with H3 impairs the oncogenicity of ANP32A and may be a promising therapeutic strategy against AML.

Background Obstructive sleep apnea (OSA) is often accompanied by other complications, especially hypertension. Hypothesis The purpose of this study is to compare the application value of six tools in the screening of OSA in patients with hypertension.Compared with other questionnaires, we hypothesized that Berlin performed better in screening hypertensive patients suspected of OSA. Methods Methods In this study, we collected the basic data and polysomnography (PSG) data of patients diagnosed with hypertension who underwent PSG at the Sleep Medicine Center of the First Affiliated Hospital of Guangzhou Medical University from April 2012 to March 2021. The sensitivity, specificity, positive predictive value, negative predictive value, area under the curv (AUC) and diagnostic odds ratio (DOR) of the six screening tools were then calculated, and their correlation with the sleep apnea hypopnea index (AHI) analyzed. Results There were 303 males (303/398, 76.1%) out of 398 hypertension patients suspected of OSA. The area under the curve of the Berlin questionnaire's receiver operating characteristic (ROC) curve reached 0.753 (95%CI: 0.707-0.794). When the AHI was 5, 15 and 30 times/h as the cut-off points, the sensitivity and negative predictive value of Berlin were the highest at 0.947 and 0.630, 0.970 and 0.851, and 0.988 and 0.957 respectively, while the specificity and positive predictive value of the Epworth Sleepiness Scale (ESS) were the highest at 0.696 and 0.729, 0.750 and 0.887, and 0.674 and 0.575 respectively. The DOR value of the Berlin questionnaire could reach 18.333 when the AHI cut-off point was 30 times/h. Berlin had the largest rank correlation coefficient with AHI at 0.466. Conclusion The Berlin questionnaire can be considered a priority for the screening and stratifying of hypertensive patients suspected of OSA.

Background: Given the known lethality of highly frequent ovarian cancer (OC) among females, it is imperative to investigate potential biomarkers of prognostic and therapeutic significance. The objective of this study was to identify significant differentially expressed genes (DEGs) with poor prognosis and to explore their underlying mechanisms. Methods: We acquired three microarray datasets (GSE14407, GSE36668 and GSE18520), available from the public database GEO. We compared a total of 72 cancerous and 26 normal samples originating from ovarian tissues. GEO2R and Venn diagram tools were used to obtain DEGs, followed by the gene ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG) analysis via Database for Annotation, Visualization and Integrated Discovery (DAVID). Subsequently, protein-protein interaction (PPI) network was constructed and visualized in Cytoscape. Results: Among three analyzed datasets, a total of 232 DEGs were common. The upregulated 108 genes were significantly enriched in the cell adhesion, cellular response to interleukin-1, positive regulation of transcription from DNA/RNA, and transcription, extracellular matrix/region, anchored membrane component, cell junction and golgi membrane, sequence-specific DNA binding, transcription factor activity, RNA polymerase II regulatory region, and DNA binding. The PPI network analysis via MCODE plug-in revealed a total of 14 upregulated genes. Kaplan-Meier plotter analysis revealed that 9 genes were associated with significantly worse survival among OC patients while 4 genes exhibited no significant effect. Gene Expression Profiling Interactive Analysis (GEPIA) showed that 13 DEGs had significantly higher expression in the ovarian cancerous tissues compared to the normal ones. Repeated KEGG analysis showed that 11 genes (CDC6, CCNE1, BUB1B, CCNB2, BUB1, SFN, TTK, CDC20, PTTG1, CDK1 and CDKN2A)) were mainly associated with cell cycle while 2 genes (SFN and RRM2) were related to p53 signaling pathway. Conclusion: Our findings identify potential upregulated DEGs of prognostic value among OC patients. This will facilitate to understand the underlying OC mechanisms and to implement targeted therapeutic measures.

ObjectiveThe objective of this systematic review and meta-analysis was to determine the prognostic value of memory CD8(+) T cells in cancer patients with immunotherapy.MethodsEMBASE, MEDLINE (PubMed), and Web of Science databases were searched to identify suitabile articles published before March 2021. Risk of bias on the study level was assessed using the Cochrane Bias Risk Assessment Tool. The hazard ratios (HRs) and 95% confidence intervals (CIs) of pooled progression-free survival (PFS) and overall survival (OS) were calculated using RevMan 5.4 to evaluate the prognostic impact of memory CD8(+) T cells.ResultsIn total, nine studies were included in the final analysis. High levels of memory CD8(+) T cells were significantly closely correlated with better progression-free survival (PFS) and overall survival (OS) of cancer patients with immunotherapy (PFS, HR 0.64, 95% CI 0.53–0.78; OS, HR 0.37, 95% CI 0.21–0.65). Memory CD8(+) T cells still have significant prognostic value in cancer patients given immunotherapy alone after excluding of other interfering factors such as chemotherapy, radiotherapy, and targeted therapy (PFS, HR 0.65, 95% CI 0.48–0.89; OS, HR 0.23, 95% CI 0.13–0.42). However, high memory CD8(+) T cells levels did not correspond to a longer PFS or OS in cancer patients with non-immunotherapy (PFS, HR 1.05, 95% CI 0.63–1.73; OS, HR 1.29, 95% CI 0.48–3.48). Thus, memory CD8(+) T cells might be a promising predictor in cancer patients with immunotherapy.ConclusionsThe host’s overall immune status, and not only the tumor itself, should be considered to predict the efficacy of immunotherapy in cancer patients. This study is the first to show the significant prognostic value of memory CD8(+) T cells in immunotherapy of cancer patients through systematic review and meta-analysis. Thus, the detection of memory CD8(+) T cells has a considerable value in clinical practice in cancer patients with immunotherapy. Memory CD8(+) T cells may be promising immunotherapy targets.

Background This study was performed to analyze the clinical manifestations, imaging features, and prognosis of Takayasu’s arteritis (TA) with pulmonary arteritis (PA). Methods In total, 51 of 815 patients with TA were diagnosed with PA at the Peking Union Medical College Hospital from 1986 to 2015. The patients’ medical records and radiographic data were retrospectively reviewed. Results The patients comprised 39 women and 12 men with a median age of 33 years (range, 14–67 years). The most common symptoms were dyspnea (70.6%), cough (66.7%), hemoptysis (47.1%), and chest pain (45.1%). Computed tomography (CT) pulmonary angiography, pulmonary arteriography, and pulmonary perfusion imaging showed pulmonary artery stenosis or occlusion in 44 patients. A total of 82.4% of patients had lung parenchyma lesions on CT scans, indirectly indicating pulmonary artery involvement. Additionally, 58.8% of patients had pulmonary hypertension (PH) by echocardiography. Compared with the PH group, the non-PH group was characterized by a shorter disease duration; more symptoms such as fever, chest pain, and hemoptysis; an increased erythrocyte sedimentation rate; and a higher incidence of subpleural wedge-shaped shadows on chest CT (P Conclusions The clinical manifestations of TA with PA are nonspecific. PH often complicates PA and is associated with a poor prognosis. Early clinical manifestations such as repeated fever, chest pain, hemoptysis, and recurrence of subpleural wedge-shaped shadows on chest CT should arouse suspicion of PA in patients with TA and prompt further investigations. This may allow PA to be diagnosed before the occurrence of PH. Trial registration ClinicalTrials, NCT03189602. Date of registration: June 16, 2017. Retrospectively registered.

BACKGROUND: Given the growing number of patients suspected of having obstructive sleep apnea-hypopnea syndrome (OSAHS), screening methods have become increasingly important for sleep clinics. We analyzed the clinical value of the No-apnea score which is used to diagnose OSAHS in patients with cerebral infarction, and compared the accuracy of the No-apnea score with the accuracy of the NoSAS score, the STOP-Bang questionnaire (SBQ), the Epworth Sleepiness Scale (ESS), the STOP questionnaire (STOP) and the Berlin questionnaire (BQ). METHODS: Between January 2014 and December 2018, a total of 221 cerebral infarction patients, suspected of having OSAHS, underwent the polysomnography (PSG) for one night at the sleep medical center of Guangdong Medical University Affiliated Second Hospital. The PSG data were collected and analyzed with the NoSAS score, the SBQ, the ESS, the STOP, the BQ, and patients’ demographic information. Based on the apnea-hypopnea index (AHI), the patients were classified into four groups: the normal group (

Oil adsorption sponges have attracted great attention in the field of oil-water mixture treatment, due to their low cost, high porosity, flexible design, and three dimensional skeleton structures. However, the hydrophilic-oleophilic of commercial sponge limits its application for oil-water treatment. To improve the adsorption performance and simplify the oil recovery process, various modification methods have been studied recently. Herein, we discuss the fabrication of hydrophobic/oleophilic sponges and summarize the recently reported modify materials onto sponges. Furthermore, some additional material properties are also presented, which make sponges superior capacity for addressing oil spills under extreme conditions. In addition, some oil collecting devices based on sponges, which are used to facilitate the oil collecting processes, are also shown. Meanwhile, the outlooks and challenges are also offered for future applications of sponges in the remediation of oil spill.