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Accurately evaluating minimal residual disease (MRD) could facilitate early intervention and personalized adjuvant therapies. Here, using ultradeep targeted next-generation sequencing (NGS), we evaluate the clinical utility of circulating tumor DNA (ctDNA) for dynamic recurrence risk and adjuvant chemotherapy (ACT) benefit prediction in resected non-small cell lung cancer (NSCLC). Both postsurgical and post-ACT ctDNA positivity are significantly associated with worse recurrence-free survival. In stage II-III patients, the postsurgical ctDNA positive group benefit from ACT, while ctDNA negative patients have a low risk of relapse regardless of whether or not ACT is administered. During disease surveillance, ctDNA positivity precedes radiological recurrence by a median of 88 days. Using joint modeling of longitudinal ctDNA analysis and time-to-recurrence, we accurately predict patients’ postsurgical 12-month and 15-month recurrence status. Our findings reveal longitudinal ctDNA analysis as a promising tool to detect MRD in NSCLC, and we show pioneering work of using postsurgical ctDNA status to guide ACT and applying joint modeling to dynamically predict recurrence risk, although the results need to be further confirmed in future studies., ctDNA has been shown to identify minimal residual disease (MRD) and is thus dynamically monitored in different types of tumours. Here, the authors show that serial longitudinal ctDNA analysis can be used as a tool to detect MRD, inform the use of adjuvant therapy, and predict recurrence risk in lung cancer.

BACKGROUND: Previous studies have reported on the efficacy and safety of neoadjuvant use of a programmed cell death 1 (PD-1) antibody, sintilimab, in patients with non-small cell lung cancer (NSCLC). This study aimed to further evaluate the difficulty of this surgery and the postoperative complication rates in patients with NSCLC receiving neoadjuvant sintilimab. METHODS: Patients who received neoadjuvant sintilimab (200 mg) in the Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital from March 2018 to March 2019 were enrolled in the neoadjuvant immunotherapy group (NI group). Another two cohorts who did not receive sintilimab were retrospectively selected by propensity score matching (PSM) at a ratio of 1:1 in the upfront surgery (M-US) and neoadjuvant chemotherapy (M-NC) groups. The postoperative complication rate, postoperative days (PODs), and other detailed objective indicators were compared by t-test or χ(2) test. RESULTS: Thirty-seven patients were enrolled in each group. Postoperative complications were greater in the NI group (37.8%) than in the M-US (10.8%; P=0.013) or in the M-NC group (16.2%; P=0.036). The number of PODs (7) was greater in the NI group than in the M-US group (P=0.005). The total number of dissected lymph nodes was lower in the NI group than in the M-US group (P

Two-dimensional van der Waals (vdW) ferromagnetic materials have attached a significant attention for developing miniaturized electronic devices. Fe3GeTe2 (FGT) as two-dimensional vdW materials with intrinsic ferromagnetism has high Curie temperature, which have potential applications in overcoming microwave pollution and radiation. Herein, a single-crystal FGT is synthesized using a self-flux method and then dissociated into nanosheets via the liquid-phase exfoliation technique. Curie temperature of FGT nanosheets powder is approximately 230 K, which is close to room temperature. FGT nanosheets as microwave absorber exhibit low reflection loss (RL) due to poor impedance matching. The microwave absorption properties of FGT nanosheets are improved by introducing graphene nanosheets (GNS). FGT@GNS 1–2 composites exhibit excellent microwave absorption performance. The minimum RL of FGT@GNS 1–2 reach − 44.43 dB at a microwave frequency of 9.9 GHz, when thickness is only 1.45 mm. This meets the requirements of strong RL and thin thickness of microwave absorption materials, indicating that FGT@GNS composites have a potential application for overcoming microwave pollution and radiation.

To compare the efficacy and safety of induction chemotherapy (IC) followed by intensity‐modulated radiotherapy (IMRT) alone versus concurrent CCRT in locoregionally advanced nasopharyngeal carcinoma (LA‐NPC). Patients with newly diagnosed stage III to IVB nasopharyngeal carcinoma (NPC) were randomized to receive IC plus IMRT (IC+RT arm), or concurrent chemotherapy plus IMRT (CCRT arm), using a random number table. Both treatment arms received the same chemotherapy regimen. The primary endpoint was progression‐free survival (PFS). Secondary end points included overall survival (OS), locoregional recurrence‐free survival (LRRFS), distant metastasis‐free survival (DMFS), treatment response, and acute treatment toxicities. From June 2013 to September 2018, a total of 204 patients histologically diagnosed with LA‐NPC were enrolled in the study, with 102 patients randomly assigned to each arm. After a median follow‐up duration of 45 months (range 4 to 84 months), the 3‐year PFS, OS, LRRFS and DMFS were 72.2%, 87.8%, 92.3%, and 82.7% in the IC+RT arm, compared with 82.6%, 92.8%, 94.7%, and 88.2% in the CCRT arm. No statistical difference for PFS, OS, LRRFS, DMFS, or treatment response was observed between the two arms (p > 0.05). The incidences of leukopenia (p = 0.008) and anemia (p = 0.015) were significantly higher in patients in the CCRT arm than those in the IC+RT arm. Compared to CCRT, IC plus IMRT alone provided similarly favorable treatment outcomes in terms of PFS, OS, LRRFS, and DMFS for patients with LA‐NPC, but resulted in fewer incidences of leukopenia and anemia., Concurrent chemoradiotherapy is the standard modality for locoregionally advanced nasopharyngeal carcinoma, accompanied with non‐negligible toxicities and poor compliance. The authors present comparable favorable treatment results in a randomize trial comparing induction chemotherapy plus IMRT versus CCRT. While induction chemotherapy plus IMRT had fewer incidences of leukopenia and anemia. The authors propose that induction chemotherapy plus IMRT is a promising option for locoregionally advanced nasopharyngeal carcinoma and further investigation to identify favorite individuals is warranted.

BACKGROUND: The aim of the study was to explore the outcomes of wedge resection on patients with early-stage lung adenocarcinoma (LUAD) and further identify potential prognostic factors for these patients. METHODS: A retrospective cohort of 190 patients (99 solitary LUAD and 91 multifocal LUAD) undergone wedge resection from October 2014 to September 2015 was established. Cox proportional-hazards model was used to evaluate the significant clinical prognostic factors. Further, data on patients with multifocal adenocarcinoma after segmentectomy were retrieved and propensity score matching was used to compare the outcomes of patients with multiple pulmonary nodules (MPNs) after wedge resection and segmentectomy. RESULTS: The 5-year overall survival (OS), progression-free survival (PFS), and lung cancer specific survival of the 190 patients after wedge resection were 95.5%, 87.9%, and 97.7%, respectively. Multivariable analysis showed that MPN [hazard ratio (HR) 3.07; 95% confidence interval (CI), 1.05–8.98] and solid-dominant lesions (HR 15.87; 95% CI, 2.38–105.84) were independently associated with worse PFS. Further, propensity score matching analysis showed that MPN patients had better PFS after segmentectomy compared with wedge resection (94% vs. 80.9%, P=0.008). MPN patients were more likely to perform systematic mediastinal nodal sampling (95.6% vs. 59.3%, P

In quantitative phase imaging (QPI), it is greatly important to extract the phase from the phase-shifting interferograms. Despite extensive research efforts for decades, how to retrieve the actual ...

Background The detection rate of multiple pulmonary nodules in computed tomography (CT) screening has increased significantly in recent years. In cases with multiple nodules within the same lung lobe or segment, it is often difficult for thoracic surgeons and pathologists to accurately locate all lesions in the surgically resected specimens. Therefore, the objective of our study was to use three-dimensional (3D) reconstruction in conjunction with 3D printing as an auxiliary method for localizing multiple small nodules in specimens after surgery and to evaluate its effectiveness. Methods A single-center prospective cohort study was conducted between September 2019 and September 2020 at the National Cancer Center (Beijing, China). In total, 43 surgical candidates with multiple nodules were recruited to undergo lobectomy or segmentectomy and 40 patients were ultimately enrolled in this study. With the assistance of 3D reconstruction/printing models, the obtained specimens were marked and then identified by a pathologist. The primary outcome was the success rate of nodule localization in the resected specimens, and the secondary outcome was the agreement rate between the pathological results of the samples and CT images. Results In the 40 patients enrolled, 126 nodules were detected by preoperative imaging, of which 124 nodules (positive rate: 98.4%) were successfully located in the resected specimens using 3D reconstruction/printing. For the 124 nodules, the agreement rate of the pathological results of samples and CT images with the assistance of 3D reconstruction/printing models was 100.0%. Conclusions The results show that 3D reconstruction/printing models allow for the rapid and accurate localization of nodules in resected specimens. Also, the pathological results of lesions show good agreement with the results of preoperative CT imaging, which is of great significance for further study into the clinicopathological characteristics and radiomics of multiple pulmonary nodules.

Purpose This paper aims to use a derivative of genetic programming to predict the bond strength of glass fiber-reinforced polymer (GFRP) bars in concrete under the effects of design guidelines. In developing bond strength prediction models, this paper prioritized simplicity and meaningfulness over extreme accuracy. Design/methodology/approach Assessing the bond strength of GFRP bars in concrete is a critical issue in designing and building reinforced concrete structures. Findings Ultimately, the equation of a linear form of a particular design guideline was suggested as the optimal prediction model. Improvements to the current design guidelines suggested by this model include setting a 1.31 magnification and considering the effects of the three significant parameters of bar diameter (db), minimum cover-to-bar diameter (C/db) and development length to bar diameter (l/db) under an acceptable root mean square error accuracy of around 2 MPa. Furthermore, the model suggests that the original influence parameter of concrete compressive strength (fc) may be removed from bond strength calculations. Originality/value The model suggests that the original influence parameter of concrete compressive strength (fc) may be removed from bond strength calculations.

In recent years, a vast number of potential cancer therapeutic targets have emerged. However, developing efficient and effective drugs for the targets is of major concern. Hydrogen sulfide (H2S), one of the three known gasotransmitters, is involved in the regulation of various cellular activities such as autophagy, apoptosis, migration, and proliferation. Low production of H2S has been identified in numerous cancer types. Treating cancer cells with H2S donors is the common experimental technique used to improve H2S levels; however, the outcome depends on the concentration/dose, time, cell type, and sometimes the drug used. Both natural and synthesized donors are available for this purpose, although their effects vary independently ranging from strong cancer suppressors to promoters. Nonetheless, numerous signaling pathways have been reported to be altered following the treatments with H2S donors which suggest their potential in cancer treatment. This review will analyze the potential of H2S donors in cancer therapy by summarizing key cellular processes and mechanisms involved.

Background Compared with immunocompetent patients, immunosuppressed patients have higher morbidity and mortality, a longer duration of viral shedding, more frequent complications, and more antiviral resistance during influenza infections. However, few data on this population in China have been reported. We analysed the clinical characteristics, effects of antiviral therapy, and risk factors for admission to the intensive care unit (ICU) and death in this population after influenza infections and explored the influenza vaccination situation for this population. Methods We analysed 111 immunosuppressed inpatients who were infected with influenza virus during the 2015–2020 influenza seasons. Medical data were collected through the electronic medical record system and analysed. Univariate analysis and multivariate logistics analysis were used to identify risk factors. Results The most common cause of immunosuppression was malignancies being treated with chemotherapy (64.0%, 71/111), followed by haematopoietic stem cell transplantation (HSCT) (23.4%, 26/111). The most common presenting symptoms were fever and cough. Dyspnoea, gastrointestinal symptoms and altered mental status were more common in HSCT patients than in patients with immunosuppression due to other causes. Approximately 14.4% (16/111) of patients were admitted to the ICU, and 9.9% (11/111) of patients died. Combined and double doses of neuraminidase inhibitors did not significantly reduce the risk of admission to the ICU or death. Risk factors for admission to the ICU were dyspnoea, coinfection with other pathogens and no antiviral treatment within 48 h. The presence of dyspnoea and altered mental status were independently associated with death. Only 2.7% (3/111) of patients less than 12 months old had received a seasonal influenza vaccine. Conclusion Fever and other classic symptoms of influenza may be absent in immunosuppressed recipients, especially in HSCT patients. Conducting influenza virus detection at the first presentation seems to be a good choice for early diagnosis. Clinicians should pay extra attention to immunosuppressed patients with dyspnoea, altered mental status, coinfection with other pathogens and no antiviral treatment within 48 h because these patients have a high risk of severe illness. Inactivated influenza vaccines are recommended for immunosuppressed patients.

After a large-scale earthquake, the road is susceptible to get blocked by liquefaction or building collapse, and that results in disaster-relief difficulty. This study adopted two earthquake loss estimation systems in Taiwan, and the risk of road blockage caused by liquefaction or building collapse was calculated separately. A new modeling was proposed, and the comparisons of the results of a single factor and that of the joint factors were made. Four scenarios of peak ground acceleration (PGA) = 250, 400, 550, 750 Gal were tested. The result shows that the probability of road blockage due to liquefaction almost reaches the maximum when PGA hits 400 Gal. On the other hand, the probability of road blockage due to building collapse increases if PGA increases. The joint probability of road blockage due to liquefaction and building collapse can improve the underestimation when using either one factor, and it can evaluate the risk more realistically. At present, there is no risk assessment modeling considering two important factors for disaster-relief road planning in Taiwan. This study provides a simple and comprehensive disaster-relief road risk assessment modeling to make better emergency rescue plans. In addition, it can provide the information for conducting seismic strengthening policy for both sides of the disaster-relief road that can reduce the risk of obstacles to disaster-relief roads.

The green building concept originated from the need and desire for more energy efficient and environmentally friendly construction practices. With a boom in certified green buildings in recent decades, however, various stakeholders have raised concerns about the actual energy performance of such buildings. While studies have shown significant gaps between the expected and actual energy use of green buildings, the methods used in the analyses have been considered inappropriate. A dynamic approach has been suggested to quantify the discrepancy between the expected and actual energy use in green buildings. However, although the concept of the dynamic approach has been discussed in several studies, a process and methods for applying the approach in real applications are not available in the literature. This study introduces a process and methods for practicing the dynamic approach and provides five case studies of using this approach to assess the energy performance gap of green buildings. The analyses show that the dynamic performance gap of the five buildings ranges from 3.0% to 53.5%, with a median of 24.7%, and the average dynamic gap of the HVAC system is nearly two orders of magnitude greater than that of the non-HVAC system. The degraded controls of HVAC systems may be a main cause of the performance gap.

Background Sphingosine-1-phosphate (S1P) is a bioactive metabolite of sphingolipids and produced by sphingosine kinases (SphK1 and SphK2). SphK1/S1P pathway is implicated in the progression of chronic kidney disease. However, the role of SphK1/S1P pathway in renal injury in hypertension has not been reported. This study tested the hypothesis that SphK1/S1P pathway mediates the kidney damage in DOCA-salt hypertensive mice. Methods Male wild type (WT) C57BL6 and SphK1 knockout (KO) mice were subjected to unilateral nephrectomy, subcutaneous implant containing 50 mg of deoxycorticosterone acetate (DOCA) and 1% NaCl drinking water for 7 weeks. At the end of experiments, blood pressure data, 24 h urine and kidney samples were collected. Renal mRNA levels of SphK1 were measured by real-time RT-PCR. Markers for fibrogenesis and immune cell infiltration in kidneys were detected using Western blot and immunohistochemistray analysis, respectively. The glomerular morphological changes were examined in kidney tissue slides stained with Periodic-Acid Schiff. Four groups were studied: wild type control (WT-C), WT-DOCA, KO-C and KO-DOCA. Results The renal SphK1 mRNA expression was significantly upregulated in WT-DOCA mice, whereas this upregulation of renal SphK1 mRNA was blocked in KO-DOCA mice. There was no difference in DOCA-salt-induced hypertension between WT and KO mice. The urinary albumin was increased in both DOCA-salt groups. However, the albuminuria was significantly lower in KO-DOCA than in WT-DOCA group. There were increases in glomerulosclerosis indices in both DOCA-salt groups, whereas the increases were also significantly lower in KO-DOCA than in WT-DOCA mice. Renal protein levels of α-smooth muscle actin were upregulated in both DOCA-salt groups, but the increase was significant lower in KO-DOCA than in WT-DOCA group. The increased staining areas of collagen detected by Sirius Red-staining in kidney tissue sections were also attenuated in KO-DOCA compared with WT-DOCA mice. In contrast, the increased infiltration of CD43+ (a T cell marker) or CD68+ (a macrophage marker) cells in DOCA-salt kidneys showed no significant difference between WT-DOCA and KO-DOCA mice. Conclusions SphK1/S1P signaling pathway mediates kidney damage in DOCA-salt hypertensive mice independent of blood pressure and immune modulation.

OBJECTIVE Equations for predicting body surface area (BSA) produce flawed estimates, especially for individuals with obesity. This study aimed to compare BSA measured by a three-dimensional photonic scanner (3DPS) with BSA predicted by six commonly cited prediction equations and to develop new prediction equations if warranted. METHODS The 3DPS was validated against manual measurements by breadth caliper for body thicknesses measured at three anatomical sites on a mannequin. BSA was derived from 3DPS whole-body scans of 67 males and 201 females, aged 18 to 83 years, with BMI between 17.8 and 77.8 kg/m2 and varied races/ethnicities. RESULTS Width and depth measurements by 3DPS and caliper were within 1%, except for hip, with an error of 1.8%. BSA3DPS differed from BSA predicted by each equation (P

Rural–urban migration is a defining feature of socio‐economic change in contemporary China. It is estimated that internal migrants in China account for 20% of its population of 1.39 billion, providing manpower to the expanding urban industries. Yet internal migrants have long faced barriers to accessing health and other social services in urban destinations, and the migration process may expose them to novel health risks and inequities. Based on the analysis of policy documents and associated material, this article reviews the historical development of health policy in China in relation to internal migrants, identifying elements of continuity and change in the policy agenda and the ways in which migrants have been framed in policy formulations. Against this background, remaining gaps in the current policy framework and implementation challenges are discussed.

Since the end of 2019, a new type of coronavirus pneumonia (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been spreading rapidly throughout the world. Previously, there were two outbreaks of severe coronavirus caused by different coronaviruses worldwide, namely Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). This article introduced the origin, virological characteristics and epidemiological overview of SARS-CoV-2, reviewed the currently known drugs that may prevent and treat coronavirus, explained the characteristics of the new coronavirus and provided novel information for the prevention and treatment of COVID-19.

In recent years, natural disasters occur frequently, and secondary disasters induced by major disasters will also cause huge losses. The diversity of secondary disasters makes humanitarian emergency logistics (HEL) more challenging but often overlooked by researchers. In order to solve the comprehensive HEL problem of major and secondary disasters, a three-stage mixed integer linear optimization (TS-MILO) model is proposed. Among them, the uncertainty of the demand for relief supplies is also extremely difficult to deal with. In order to resist the interference of uncertainty, based on robust optimization, the TS-MILO model is further transformed into a three-stage mixed integer robust optimization (TS-MIRO) model, which are respectively BTS-MIRO (Box set), PTS-MIRO (Polyhedral set), and ETS-MIRO (Ellipsoid set). The experimental results show that the TS-MILO model can provide the lowest cost but cannot solve the uncertainty problem. The improved TS-MIRO model will pay a robust price (increase by at least 10.05%), but maintains supply stability even in the worst-case scenario. Specifically, ETS-MIRO model has strong robustness, and its cost increase only accounts for 44.66% of BTS-MIRO model in the worst case. The service level of the three TS-MIRO models increases with the safety parameters, among which the service level in the ETS-MIRO model increases significantly from 88.53% to 96.44%. The research results can provide a strong support for the decision making of disaster relief management department.

BACKGROUND: Recent studies indicated that thoracoscopic anatomical segmentectomy (TAS) is widely adopted in early non-small cell lung cancer. Considering the slender segmental bronchi and the narrow space around segmental bronchi, it is easier to treat segmental bronchi with powered vascular stapler (PVS), which was designed to have a narrower anvil and a beak like tip. However, the safety and feasibility of PVS in stapling segmental bronchi are not yet clear. METHODS: We retrospectively compared the perioperative features of segmental bronchial closure treated with PVS and powered linier cutter (PLC) in thoracoscopic anatomic segmentectomy performed by a single surgeon and evaluated the safety and feasibility of PVS for the segmental or subsegmental bronchus. RESULTS: Between April 2018 and April 2019, a total of 162 patients who underwent anatomic segmentectomy were analyzed (PVS n=75 and PLC n=87). No bronchopleural fistula (BPF) occurred in 162 patients. Intraoperative blood loss in PVS group (15.2±8.91 mL) was significantly lower than that in PLC group (25.29±24.06 mL) (P0.05). There was no significant difference between the two groups in postoperative drainage and chest tube duration (all P>0.05). In terms of postoperative complications, the incidence of hemoptysis in PVS group was similar to PLC group (P>0.05). Two cases of subcutaneous emphysema occurred in PVS group, one case of pulmonary air leakage (>3 days) and one case of subcutaneous emphysema occurred in PLC group. Besides, all the surgeons (100%) slight agree or strongly agree that PVS is easier to pass through the segmental bronchus. CONCLUSIONS: PVS is a smoother and easier instrument and has the same effectiveness and security as PLC. It leads to reduced operation difficulty and potential intraoperative complications.

Background: Lung cancer is one of the most common malignant tumors in the world and mainly occurs in elderly patients, but rarely in young patients. The purpose of this retrospective study was to examine the clinicopathological features and prognosis of lung cancer patients aged 30 years and younger. Methods: Patients aged 30 years and younger with lung cancer admitted to our center from November 2013 to October 2018 were retrospectively identified. Data included sex, age, smoking history, family history of cancer, high resolution computed tomography results, size and location of tumors, histology of tumors, lymph node status, stage of tumors, treatment methods and prognosis of patients. Results: The patient group included more females (56.3%) than males (43.7%) among lung cancer patients aged 30 and younger. Some patients had a history of tobacco inhalation and family cancer (17.5% and 22.3%, respectively). The most common tumors were in the left lower lobe (27.2%). Nearly half (49.5%) of the patients had pathological adenocarcinomas and 59.3% of the patients were showed early clinical stage and had no lymph node metastasis. All patients received surgical treatment; 47.1% received lobectomy and only 17.9% received adjuvant therapy such as radiotherapy, chemotherapy or targeted therapy after operation. Only seven (7.4%) of the successful follow-up patients died. Local recurrence occurred in two cases and distant metastasis in six cases. Conclusions: The main clinicopathological type of lung cancer in young lung cancer patients aged 30 years and younger is adenocarcinoma, and most cases were at the early stage. Surgical treatment based on lobectomy is still the main treatment method and the prognosis of these patients is very good. Early screening of lung cancer should be actively promoted for young people.

Motivation Analysis of whole-genome sequencing (WGS) for genetics is still a challenge due to the lack of accurate functional annotation of non-coding variants, especially the rare ones. As eQTLs have been extensively implicated in the genetics of human diseases, we hypothesize that rare non-coding variants discovered in WGS play a regulatory role in predisposing disease risk. Results With thousands of tissue- and cell-type-specific epigenomic features, we propose TVAR. This multi-label learning-based deep neural network predicts the functionality of non-coding variants in the genome based on eQTLs across 49 human tissues in the GTEx project. TVAR learns the relationships between high-dimensional epigenomics and eQTLs across tissues, taking the correlation among tissues into account to understand shared and tissue-specific eQTL effects. As a result, TVAR outputs tissue-specific annotations, with an average AUROC of 0.77 across these tissues. We evaluate TVAR’s performance on four complex diseases (coronary artery disease, breast cancer, Type 2 diabetes and Schizophrenia), using TVAR’s tissue-specific annotations, and observe its superior performance in predicting functional variants for both common and rare variants, compared with five existing state-of-the-art tools. We further evaluate TVAR’s G-score, a scoring scheme across all tissues, on ClinVar, fine-mapped GWAS loci, Massive Parallel Reporter Assay (MPRA) validated variants and observe the consistently better performance of TVAR compared with other competing tools. Availability and implementation The TVAR source code and its scores on the ClinVar catalog, fine mapped GWAS Loci, high confidence eQTLs from GTEx dataset, and MPRA validated functional variants are available at https://github.com/haiyang1986/TVAR. Supplementary information Supplementary data are available at Bioinformatics online.

BackgroundAlthough effective vaccines have been developed against COVID-19, the level of neutralizing antibodies (Nabs) induced after vaccination in the real world is still unknown. To evaluate the level and persistence of NAbs induced by two inactivated COVID-19 vaccines in China.Methods and findingsSerum samples were collected from 1,335 people aged 18 and over who were vaccinated with COVID-19 inactivated vaccine in Peking University People’s Hospital from January 19 to June 23, 2021, for detection of COVID-19 antibodies. The WHO standard of SARS-CoV-2 NAbs was detected. The coefficients of variation between the detection results and the true values of the NAbs detected by the WHO standard were all lower than the WHO international standard 3% after the dilution of the original and the dilution of the theoretical concentrations of 500 IU/mL, 250 IU/mL, 125 IU/mL, 72.5 IU/mL, 36.25 IU/mL and 18.125 IU/mL. On day 11-70, the positive rate of NAbs against COVID-19 was 82% to 100%; From day 71 to 332, the positive rate of NAbs decreased to 27%. The level of NAbs was significantly higher at 3-8 Weeks than at 0-3 Weeks. There was a high linear correlation between NAbs and IgG antibodies in 1335 vaccinated patients. NAbs levels were decreased in 31 of 38 people (81.6%) at two time points after the second dose of vaccine. There was no significant difference in age between the group with increased and decreased neutralizing antibody levels (χ2 =-0.034, P>0.05). The positive rate of NAbs in the two-dose vaccine group (77.3%) was significantly higher than that in the one-dose group (18.1%), with statistical difference (χ2=312.590, P60 years old. The positive rates of NAbs in three groups (18-40 years old, 41-60 years old and >60 years old) were 95.14%, 78.43% and 81.8%, respectively. The positive rate of NAbs was significantly higher in 18-40 years old than in 41-60 years old (χ2=12.547, P P χ2=0.222, P >0.05).ConclusionsThe positive rate of NAbs was the highest from 10 to 70 days after the second dose of vaccine, and the positive rate gradually decreased as time went by. There was a high linear correlation between COVID-19 NAbs and IgM/IgG antibodies in vaccinators, suggesting that in cases where NAbs cannot be detected, IgM/IgG antibodies can be detected instead. The level of NAbs produced after vaccination was affected by age, but not by gender. The highest levels of NAbs were produced between shots 21 to 56 days apart, suggesting that 21 to 56 days between shots is suitable for vaccination.Author summaryWhy was this study done?At present, the inactivated vaccines that have been approved to market in China have passed clinical trials to prove their effectiveness and safety. But the level of neutralizing antibodies induced by vaccination in the real world remains unclear.Serological testing for neutralizing antibodies against COVID-19 is important for assessing vaccine and treatment responses and comparing multiple drug candidates. We assessed the levels of neutralizing antibodies produced in populations receiving inactivated vaccines and assessed the persistence of these vaccines in producing COVID-19 neutralizing antibodies in healthy adults.What did the researchers do and find?We collected serum samples from 1,335 people aged 18 and above who had received COVID-19 vaccine in Peking University People’s Hospital, and divided them into two groups according to one dose of inactivated vaccine and two doses of inactivated vaccine.Our study found that the positive rate of NAbs was 66.2% in adults who received one or two doses of inactivated vaccine and 77.3% in adults who received two doses of inactivated vaccine in the real world.From 11 to 70 days after the second dose of vaccine, the positive rate of neutralizing antibodies against COVID-19 was 82-100%; On days 71-332, the positive rate of neutralizing antibodies decreased to 27%.The titer and the positive rate of NAbs in 18-40 years old group were significantly higher than that in 41-60 years old group.What do these findings mean?What is novel is we observed that in the real world, the positive rate of neutralization antibody was the highest at 10 to 70 days after the second vaccination, and with the extension of the vaccination time, the positive rate of antibody gradually decreased. Therefore, we recommend that the third dose of vaccine be administered at day 61 to day 70 for COVID-19 neutralizing antibodies levels.We observed that there was a high linear correlation between COVID-19 neutralization antibodies and COVID-19 IgM/IgG antibodies in vaccinators, suggesting that in cases where NAbs cannot be detected, COVID-19 IgM/IgG antibodies can be detected instead.In our manuscript, we found that the titer and positive rate of neutralizing antibodies in 18-40 years old group were higher than those in 41-60 years old group. The level of neutralizing antibodies produced after vaccination was affected by age, but not by gender.We also observed that the highest levels of NAbs were produced between shots 21 to 35 days apart, suggesting that 21 to 35 days between shots is suitable for vaccination.

Objective To investigate the correlation between acetylcholine receptor antibodies (AChR‐Ab) concentration levels and individualized clinical symptoms in patients with AChR myasthenia gravis (AChR‐MG) in China. Methods ELISA was used to determine the concentration of AChR‐Ab in patients with MG. The Myasthenia Gravis Foundation of America (MGFA) Clinical Classification, Quantitative Myasthenia Gravis (QMG) score, and MG‐specific activities of daily living (MG‐ADL) scoring systems were used to evaluate the clinical status of patients. Spearman correlation analysis was used to determine the correlation between the AChR‐Ab concentration and clinical score. The changes in the antibody concentration and clinical score are shown in MGFA‐antibody concentration–treatment plots. Results Autoantibody detection tests were performed in 67 patients, and their clinical scores were recorded. Forty‐nine patients received immunosuppressive therapy, 17 patients received pyridostigmine only, and 1 patient under thymectomy without any medication. The AChR‐Ab concentration correlated with the MGFA Classification in 5 (29.4%) patients in the pyridostigmine‐only group and 15 (30.6%) patients in the immunosuppressive drug group. The changes in the MGFA Classification preceded the changes in the AChR‐Ab concentration in 4 (23.5%) patients treated with pyridostigmine and 10 (20.4%) patients on immunosuppressive drugs. In patients on oral non‐steroidal immunosuppressants, the AChR‐Ab concentration changed by more than 50%, whereas the MGFA Classification did not increase. The AChR‐Ab concentration decreased in 17/32 (53.1%) patients after thymectomy, and then increased, whereas the AChR‐Ab concentration increased in 15/32 (46.9%) patients and the MGFA Classification decreased in 27/32 (81.8%) patients after thymectomy. The AChR‐Ab concentration presented a slight correlation with the corresponding MGFA, QMG, and MG‐ADL in patients with thymoma. Discussion In the Chinese AChR‐MG population, the Changes in the AChR‐Ab concentration in individuals with AChR‐MG did not consistently correlate with the severity of clinical symptoms., We detected AChR‐Ab concentration at least four times per patient and performed corresponding clinical evaluations on 67 patients, and MGFA‐antibody concentration–treatment plots were drawn for each patient. We found that patients receiving oral glucocorticoid doses greater than 40 mg/d and nonsteroidal immunosuppressive drugs may have increased or decreased AChR‐Ab concentrations, and the clinical symptoms often improved to varying degrees. We did not find a consistent correlation between the changes in individual AChR‐Ab concentrations and the severity of clinical symptoms in patients.

Objective The use of limited anatomic resection for early-stage lung cancer is widely practiced worldwide. However, most studies have focused on standard segmentectomy or subsegmentectomy, and data on the short-term outcomes after anatomic sublobar resection in China are lacking. Methods In 2014, the use of anatomic partial lobectomy (APL), which is defined as lesion-centered resection of anatomical sublobular parts, was proposed by the National Cancer Center in China. We retrospectively evaluated all consecutive patients who underwent APL between November 2013 and October 2019 from our database, and the operative techniques and short-term outcomes were analyzed. Results A total of 3336 patients with a median age of 56 years underwent APL during the study period. Benign lesions were present in 8.5% of all patients and decreased across time. The mean total operation time was 127.3 minutes, the mean overall number of nodal sampling/dissections was 13, and the mean number of stations sampled was 4. Postoperative complications (grade ≥2) developed in 359 patients (10.8%), and no mortality occurred in the 30 days after surgery. Multivariate analysis showed that smoking, surgeon’s early experience, thoracotomy or unplanned conversion to thoracotomy, and complex cases were risk factors for the occurrence of postoperative complications. Conclusion Despite the increasing proportion of complex cases treated with APL, the incidence of postoperative complications decreased as our center accumulated surgical experience. APL procedures are safe and feasible when conducted in a specialized center.

PurposeOur study aimed to establish and validate prognostic nomograms based on gross tumor volume (GTV) and cervical nodal volume (CNV) for nasopharyngeal carcinoma (NPC) patients treated with two cycles of concurrent chemoradiotherapy (CCRT).MethodsFrom 2012 to 2015, 620 eligible patients who received radical treatment at the Cancer Hospital of Shantou University Medical College were recruited for a nomogram study. Variables were determined in a training set of 463 patients from 2012 to 2014 by X-tile analysis, univariate and multivariate Cox proportional hazard analyses, and the least absolute shrinkage and selection operator (LASSO). Another cohort of 157 patients in 2015 was validated with bootstrap resampling. The concordance index (C-index) and calibration curves were applied to assess its predictive discriminative and accuracy ability, while decision curve analysis (DCA), X-tile analysis and Kaplan–Meier curve for clinical application.ResultsIndependent prognostic variables for overall survival (OS) were age, GTV, CNV, cranial nerve, positive cervical lymph node laterality below the caudal border of cricoid cartilage (LNBC), and were selected for the nomogram. Optimal prognostic factors including Karnofsky performance status (KPS), age, GTV, CNV, LNBC were incorporated in the nomogram for progression-free survival (PFS). In the training set, the C-index of our nomograms for OS and PFS were 0.755 (95% CI, 0.704 to 0.807) and 0.698 (95% CI, 0.652 to 0.744). The calibration curve showed good agreement between nomogram-predicted and actual survival. DCA indicated that our nomograms were of clinical benefit.ConclusionOur nomograms are capable of effective prognostic prediction for patients with NPC.

Beibu Gulf is an important shellfish aquaculture area in the northwest of the South China Sea, China. In this study, the toxin profile and spatial-temporal distribution of domoic acid (DA) and 10 lipophilic phycotoxins were systematically analyzed in the bivalve mollusks collected in Beibu Gulf from October 2018 to October 2020. Neurotoxin DA was first detected in the mollusks from the investigative regions with a prevalence of 17.7%, peaking at 401 µg kg−1. Cyclic imines (CIs) including gymnodimine-A (GYM-A, 46.6%) and 13-desmethyl-spirolide-C (SPX1, 15.8%) predominated the lipophilic phycotoxins in shellfish, peaking at 10.1 µg kg−1 and 19.6 µg kg−1, respectively. Gymnodimine-A partially accompanied by SPX1 was detected in all batches of shellfish samples, suggesting that Alexandrium ostenfeldii and Karenia selliformis were possible sources of CIs-group toxins in Beibu Gulf. During the investigative period, relatively higher levels of DA occurred in shellfishes from March to August, while slightly higher contents of CIs in mollusks appeared in October and December. Spatial distribution of the targeted phycotoxins demonstrated that shellfishes tended to accumulate relatively higher contents of toxins in Lianzhou, Qinzhou and Tieshan bays.

Respiratory diseases are leading causes of death and disability around the globe, with a diverse range of health problems. Treatment of respiratory diseases and infections has been verified to be thought-provoking because of the increasing incidence and mortality rate. Hydrogen sulfide (H2S) is one of the recognized gaseous transmitters involved in an extensive range of cellular functions, and physiological and pathological processes in a variety of diseases, including respiratory diseases. Recently, the therapeutic potential of H2S for respiratory diseases has been widely investigated. H2S plays a vital therapeutic role in obstructive respiratory disease, pulmonary fibrosis, emphysema, pancreatic inflammatory/respiratory lung injury, pulmonary inflammation, bronchial asthma and bronchiectasis. Although the therapeutic role of H2S has been extensively studied in various respiratory diseases, a concrete literature review will have an extraordinary impact on future therapeutics. This review provides a comprehensive overview of the effective role of H2S in respiratory diseases. Besides, we also summarized H2S production in the lung and its metabolism processes in respiratory diseases.

Alzheimer’s disease (AD) is a devastating disease of the aging population characterized by the progressive and slow brain decay due to the formation of extracellular plaques in the hippocampus. AD cells encompass tangles of twisted strands of aggregated microtubule binding proteins surrounded by plaques. Delivering corresponding drugs in the brain to deal with these clinical pathologies, we face a naturally built strong, protective barrier between circulating blood and brain cells called the blood–brain barrier (BBB). Nanomedicines provide state-of-the-art alternative approaches to overcome the challenges in drug transport across the BBB. The current review presents the advances in the roles of nanomedicines in both the diagnosis and treatment of AD. We intend to provide an overview of how nanotechnology has revolutionized the approaches used to manage AD and highlight the current key bottlenecks and future perspective in this field. Furthermore, the emerging nanomedicines for managing brain diseases like AD could promote the booming growth of research and their clinical availability.

Hydrogen sulfide (H2S), a colorless gas smelling of rotten egg, has long been recognized as a toxic gas and environment pollutant. However, increasing evidence suggests that H2S acts as a novel gasotransmitter and plays important roles in a variety of physiological and pathological processes in mammals. H2S is involved in many hepatic functions, including the regulation of oxidative stress, glucose and lipid metabolism, vasculature, mitochondrial function, differentiation, and circadian rhythm. In addition, H2S contributes to the pathogenesis and treatment of a number of liver diseases, such as hepatic fibrosis, liver cirrhosis, liver cancer, hepatic ischemia/reperfusion injury, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, hepatotoxicity, and acute liver failure. In this review, the biosynthesis and metabolism of H2S in the liver are summarized and the role and mechanism of H2S in liver health and disease are further discussed.

Background: Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid metabolite involved in various diseases. S1P also plays significant roles in the differentiation of fibroblasts into myofibroblasts, being implicated in fibrotic diseases. S1P is produced by the phosphorylation of sphingosine catalyzed by sphingosine kinases (SphK1 and SphK2). It remains unclear if the activation of endogenous SphK1 contributes to fibrogenesis in kidneys. The present study determined the effect of SphK1 gene knockout (KO) on fibrotic markers in kidneys. Methods: The renal fibrosis was produced using the unilateral ureteral obstruction (UUO) model in wild-type (WT) and SphK1 gene KO mice. Renal mRNA levels of SphK1 and S1P receptors (S1PR) were measured by real-time RT-PCR. Fibrotic and immune cell markers in kidneys were measured by Western blot analysis and immunostaining, respectively. Renal morphological damage was examined by Periodic-Acid Schiff staining. Results: The mRNA levels of SphK1 and S1PRs were dramatically increased in renal tissues of WT-UUO mice, whereas the increase in renal SphK1 mRNA was blocked in KO-UUO mice. Interestingly, the increased levels of fibrotic markers, collagen and α-smooth muscle actin, in kidneys were significantly attenuated in KO-UUO versus WT-UUO mice. Meanwhile, kidney damage indices were remarkably attenuated in KO-UUO mice compared with WT-UUO mice. However, increased numbers of CD43+ and CD48+ cells, markers for T cell and macrophage, respectively, showed no significant difference between ­WT-UUO and KO-UUO kidneys. Conclusion: The activation of the SphK1-S1P pathway may contribute to tubulointerstitial fibrosis in UUO kidneys by affecting fibrotic signaling within renal cells independent of immune modulation.

Taking advantage of the thermal inertia of a building to shift the cooling load during a demand response (DR) period is an important strategy for commercial buildings. However, researchers have consistently ignored the effects of the thermal inertia of air-conditioning systems on the DR potential of buildings. This study focused on the coupling effect of a building and an air-conditioning system. This paper describes the construction of a coupled thermal inertia model of a building and an air-conditioning system, which was validated experimentally; analyzes the accuracy of the thermal inertia of a building solely, as well as the accuracy of both the building and air-conditioning system together by comparing the model and experiment results; and quantifies the DR contributions of the thermal inertia of both the building and the air-conditioning system. A considerable demand reduction effect of the thermal inertia of the air-conditioning system was found, and the results of coupling the thermal inertia of both the building and air-conditioning system showed greater accuracy.

In recent years, the production of fresh agricultural products (FAPs) in our country has been increasing rapidly, but FAPs are badly depleted in circu-lation. Then strengthening the construction of cold chain logistics and im-proving logistics efficiency have become a problem that needs to be solved. This paper studied the decision-making optimization and using the analytical model to the cold chain logistics of FAPs from the perspective of the cost-benefit. Through using numerical analysis, it proves the scientific nature of adopting the Internet of Things technology in practice, which is a cold chain for fresh produce and also provides the fresh agricultural enterprises to provide a theoretical basis for enterprises to invest in Internet technology, which has important application value in improving the efficiency of cold chain logistics of FAPs.

Irinotecan is a key chemotherapeutic agent for the treatment of colorectal (CRC) and pancreatic (PDAC) cancer. Because of a high incidence of bone marrow and gastrointestinal (GI) toxicity, Onivyde® (a liposome) was introduced to provide encapsulated irinotecan (Ir) delivery in PDAC patients. While there is an ongoing clinical trial (NCT02551991) to investigate the use of Onivyde® as a 1(st)-line option to replace irinotecan in FOLFIRINOX, the liposomal formulation is currently prescribed as a 2(nd)-line treatment option (in combination with 5-fluorouracil and leucovorin) for patients with metastatic PDAC who failed gemcitabine therapy. However, the toxicity of Onivyde® remains a concern that needs to be addressed for use in CRC as well. Our goal was to custom design a mesoporous silica nanoparticle (MSNP) carrier for encapsulated irinotecan delivery in a robust CRC model. This was achieved by developing an orthotopic tumor chunk model in immunocompetent mice. With a view to increase the production volume and to expand the disease applications, the carrier design was improved by using an ethanol exchange method for coating of a supported lipid bilayer (LB) that entraps a protonating agent. The encapsulated protonating agent was subsequently used for remote loading of irinotecan. The excellent irinotecan loading capacity and stability of the LB-coated MSNP carrier, also known as a “silicasome”, previously showed improved efficacy and reduced toxicity when compared to an in-house liposomal carrier in a PDAC model. Intravenous injection of the silicasomes in a well-developed orthotopic colon cancer model in mice demonstrated improved pharmacokinetics and tumor drug content over free drug and Onivyde®. Moreover, improved drug delivery was accompanied by substantially improved efficacy, increased survival and reduced bone marrow and GI toxicity compared to the free drug and Onivyde®. We also confirmed that the custom-designed irinotecan silicasomes outperform Onivyde® in an orthotopic PDAC model. In summary, the Ir-silicasome appears to be promising as a treatment option for CRC in humans based on improved efficacy and the carrier’s favorable safety profile.

AIM To develop a novel rat model of heterogeneous hepatic injury. METHODS Seventy male Sprague-Dawley rats were randomly divided into a control group (n = 10) and a colchicine group (n = 60). A 0.25% colchicine solution (0.4 mL/kg) was injected via the splenic vein in the colchicine group to develop a rat model of heterogeneous hepatic injury. An equal volume of normal saline was injected via the splenic vein in the control group. At days 3, 7, and 14 and weeks 4, 8, and 12 after the operation, at least seven rats of the colchicine group were selected randomly for magnetic resonance imaging (MRI) examinations, and then they were euthanized. Ten rats of the control group underwent MRI examinations at the same time points, and then were euthanized at week 12. T2-weighted images (T2WI) and diffusion weighted imaging (DWI) were used to evaluate the heterogeneous hepatic injury. The heterogeneous injury between the left and right hepatic lobes was assessed on liver sections according to the histological scoring criteria, and correlated with the results of MRI study. RESULTS Obvious pathological changes occurred in the hepatic parenchyma in the colchicine group. Hepatic injury scores were significantly different between the left and right lobes at each time point (P < 0.05). There was a significant difference in apparent diffusion coefficient (ADC) of DWI and liver-to-muscle ratio (LMR) of T2WI between the left and right lobes of rats in the colchicine group (P < 0.05) at each time point, and similar results were observed between the colchicine and control groups. Besides, there was a significant correlation between hepatic injury scores and ADC values or LMR (r = -0.682, P = 0.000; r = -0.245, P = 0.018). CONCLUSION Injection with colchicine via the splenic vein can be used to successfully develop a rat model of heterogeneous hepatic injury. DWI and T2WI may help evaluate the heterogeneous injury among liver lobes.

In dual-wavelength interferometry, the key issue is how to efficiently retrieve the phases at each wavelength using the minimum number of wavelength-multiplexed interferograms. To address this problem, a new dual-wavelength interferogram decoupling method with the help of deep learning is proposed in this study. This method requires only three randomly phase-shifted dual-wavelength interferograms. With a well-trained deep neural network, one can obtain three interferograms with arbitrary phase shifts at each wavelength. Using these interferograms, the wrapped phases of a single wavelength can be extracted, respectively, via an iterative phase retrieval algorithm, and then the phases at different synthetic beat wavelengths can be calculated. The feasibility and applicability of the proposed method are demonstrated by simulation experiments of the spherical cap and red blood cell, respectively. This method will provide a solution for the problem of phase retrieval in multiwavelength interferometry.

Nazeer Hussain Khan,1,2 Shao-Feng Duan,3 Dong-Dong Wu,1,4 Xin-Ying Ji1,4,5 1Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, 475004, People’s Republic of China; 2School of Life Sciences, Henan University, Kaifeng, Henan, 475004, People’s Republic of China; 3Institute for Innovative Drug Design and Evaluation, School of Pharmacy, Henan University, Kaifeng, Henan, 475004, People’s Republic of China; 4School of Basic Medical Sciences, Henan University College of Medicine, Kaifeng, Henan, 475004, People’s Republic of China; 5Kaifeng Key Laboratory of Infection and Biological Safety, Henan University College of Medicine, Kaifeng, Henan, 475004, People’s Republic of ChinaCorrespondence: Dong-Dong Wu; Xin-Ying Ji Email ddwubiomed2010@163.com; 10190096@vip.henu.edu.cnAbstract: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths in women globally. In 2018, 2.1 million new cases were reported, with 627,000 deaths. Pakistan has the highest incidence rate of breast cancer among Asian countries: one in every nine women has a lifetime risk of being diagnosed with breast cancer. By reason of many misconceptions about the etiology of the disease and socioeconomic factors, Pakistani women have very low rates of early detection and diagnose breast cancer at advance stages with fewer chances of survival. The key to cure the breast cancer is early diagnosis. The aim of current review is to highlight the factors leading to the delays in early presentation of breast cancer in Pakistani women and to summarize possible recommendations for educating women about early diagnosis along with palliative care facilities for patients suffering from breast cancer. Furthermore, this study appeals to both the general public and government in the belief that better reporting and awareness campaigns may bring more women to clinics for early diagnosis.Keywords: breast cancer, health budget, Pakistani women, better reporting; awareness campaigns

Brain is by far the most complex organ in the body. It is involved in the regulation of cognitive, behavioral, and emotional activities. The organ is also a target for many diseases and disorders ranging from injuries to cancers and neurodegenerative diseases. Brain diseases are the main causes of disability and one of the leading causes of deaths. Several drugs that have shown potential in improving brain structure and functioning in animal models face many challenges including the delivery, specificity, and toxicity. For many years, researchers have been facing challenge of developing drugs that can cross the physical (blood–brain barrier), electrical, and chemical barriers of the brain and target the desired region with few adverse events. In recent years, nanotechnology emerged as an important technique for modifying and manipulating different objects at the molecular level to obtain desired features. The technique has proven to be useful in diagnosis as well as treatments of brain diseases and disorders by facilitating the delivery of drugs and improving their efficacy. As the subject is still hot, and new research findings are emerging, it is clear that nanotechnology could upgrade health care systems by providing easy and highly efficient diagnostic and treatment methods. In this review, we will focus on the application of nanotechnology in the diagnosis and treatment of brain diseases and disorders by illuminating the potential of nanoparticles.

Background Chronic kidney disease (CKD) is associated with Immune deficiency. T lymphocytes are significant components of the adaptive immune system. Previous studies have found dysfunction of T lymphocytes in patients with CKD,but the changing trend of the absolute number of T lymphocytes and the relationship with infection has been still unclear in CKD. Methods We collected 447 patients with CKD, tested the absolute counts of T lymphocyte subsets, explored the relationship between the absolute count of T lymphocytes and renal function, and explored these impacts on infection. Results absolute counts of T lymphocyte gradually decrease as CKD progresses. The patients with infection demonstrated fewer T lymphocyte cells compared with non-infected patients. CD4+ (cluster of differentiation 4) T lymphocytes are closely related to infection and CD4+ T +T absolute count has a specific predictive power for infection in patients with chronic kidney disease. Our results suggest a new feasible strategy for preventing infections in CKD patients.

Background Improvements of population health in China have been unevenly distributed among different sexes and regions. Mortality Registration System provides an opportunity for timely assessments of mortality trend and inequalities. Methods Causes of death were reclassified following the method of Global Burden of Disease Study (GBD). Age-standardized mortality rate (ASMR) and ring-map of the rate by town were used to describe inequalities in changing mortality. Life expectancy (LE) and cause-deleted LE were calculated on the basis of life table technique. Results The burden of death from 2002 to 2018 was dominated by cardiovascular diseases (CVD), neoplasms, chronic respiratory diseases and injuries in Jiading district, accounting for almost 80% of total deaths. The overall ASMR dropped from 407.6/100000 to 227.1/100000, and LE increased from 77.86 years to 82.31 years. Women lived about 3.0–3.5 years longer than men. Besides, a cluster of lower LE was found for CVD in the southeast corner and one cluster for neoplasms in the southern corner of the district. The largest individual contributor to increment in LE was neoplasms, ranged from 2.41 to 3.63 years for males, and from 1.60 to 2.36 years for females. Conclusions Improvement in health was mainly attributed to the decline of deaths caused by CVD and neoplasms, but was distributed with sex and town. This study served as a reflection of health inequality, is conducive to formulate localized health policies and measures.

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in China. Although numerous studies have been conducted to determine the risk factors for COPD mortality such as ambient air pollution, the results are not fully consistent.Methods: This study included mortality analysis and a case-control design by using the data extracted from the Mortality Registration System in Jiading District, Shanghai. Traditional logistic regression, geographically weighted logistic regression (GWLR), and spatial scan statistical analysis were performed to explore the geographic variation of COPD mortality and the possible influencing factors.Results: Traditional logistic regression showed that extreme lower temperature in the month prior to death, shorter distance to highway, lower GDP level were associated with increased COPD mortality. GWRL model further demonstrated obvious geographical discrepancies for the above associations. We additionally identified a significant cluster of low COPD mortality (OR = 0.36, P = 0.002) in the southwest region of Jiading District with a radius of 3.55 km by using the Bernoulli model. The geographical variation in age-standardized mortality rate for COPD in Jiading District was explained to a certain degree by these factors.Conclusion: The risk of COPD mortality in Jiading District showed obvious geographical variation, which were partially explained by the geographical variations in effects of the extreme low temperature in the month prior to death, residential proximity to highway, and GDP level.

Hydrogen sulfide (H2S) has long been considered as a toxic gas, but as research progressed, the idea has been updated and it has now been shown to have potent protective effects at reasonable concentrations. H2S is an endogenous gas signaling molecule in mammals and is produced by specific enzymes in different cell types. An increasing number of studies indicate that H2S plays an important role in cardiovascular homeostasis, and in most cases, H2S has been reported to be downregulated in cardiovascular diseases (CVDs). Similarly, in preclinical studies, H2S has been shown to prevent CVDs and improve heart function after heart failure. Recently, many H2S donors have been synthesized and tested in cellular and animal models. Moreover, numerous molecular mechanisms have been proposed to demonstrate the effects of these donors. In this review, we will provide an update on the role of H2S in cardiovascular activities and its involvement in pathological states, with a special focus on the roles of exogenous H2S in cardiac protection.

Background and Purpose. Allergic asthma, a respiratory disease with high morbidity and mortality, is reported to be related to the airway allergic inflammation and autophagy-induced oxidative stress. Although the therapeutic effects of fermentate prebiotic (YFP) on allergic asthma have been widely claimed, the underlying mechanism is still unclear. This study is aimed at investigating the possible mechanism for the antiasthma property of YFP in a mouse model. Methods. Ovalbumin was used to induce allergic asthma following administration of YFP for one week in mice, to collect the lung tissues, bronchoalveolar lavage fluid (BLFA), and feces. The pathological state, tight-junction proteins, inflammatory and oxidative stress-associated biomarkers, and TLRs/NF-κB signaling pathway of the lung tissues were evaluated by HE staining, immunofluorescence, ELISA, and WB, separately. RT-PCR was used to test oxidative stress-associated genes. Leukocyte counts of BLFA and intestinal microbiota were also analyzed using a hemocytometer and 16S rDNA-sequencing, separately. Result. YFP ameliorated the lung injury of the mouse asthma model by inhibiting peribronchial and perivascular infiltrations of eosinophils and increasing tight-junction protein expression. YFP inhibited the decrease in the number of BALF leukocytes and expression of inflammatory-related genes and reversed OVA-induced TLRs/NF-κB signaling pathway activation. YFP ameliorated the level of oxidative stress in the lung of the mouse asthma model by inhibiting MDA and promoting the protein level of GSH-PX, SOD, CAT, and oxidative-related genes. ATG5, Beclin1, and LC3BII/I were significantly upregulated in asthma mice, which were greatly suppressed by the introduction of YFP, indicating that YFP ameliorated the autophagy in the lung of the mouse asthma model. Lastly, the distribution of bacterial species was slightly changed by YFP in asthma mice, with a significant difference in the relative abundance of 6 major bacterial species between the asthma and YFP groups. Conclusion. Our research showed that YFP might exert antiasthmatic effects by inhibiting airway allergic inflammation and oxidative stress level through suppressing autophagy.

Digital technology has promoted service innovation and provided effective technical support for public service innovation in recent years. Smart healthcare, a key element of smart city development, has gradually become an important issue in government administration. Digital technology is deeply embedded in healthcare services and reshapes value creation through digital transformation. This study combines data-enabled platform business models and value cocreation and adopts a case study approach to develop a business model for a medical information service platform that allows stakeholders to cocreate value through service exchange and resource integration in smart healthcare ecosystems, promotes efficient and coordinated applications of information, and realizes innovative development in the medical industry.

Gastric cancer (GC) is the second leading cause of cancer mortality and the fourth most commonly diagnosed malignant disease, with approximately 951,000 new cases diagnosed and approximately 723,000 cases of mortality each year. The highest mortality rate of GC is in East Asia, and the lowest is in North America. A large number of studies have demonstrated that GC patients are characterized by higher morbidity, metastasis rates, and mortality and lower early diagnosis rates, radical resection rates, and 5-year survival rates. All cases of GC can be divided into two important stages, namely, early- and advanced-stage GC, and the stage mainly determines the treatment strategy for and the therapeutic effect in GC patients. Patients with early-stage GC undergo radical surgery followed by chemotherapy, and the 5-year survival rate can be as high as 90%. However, patients with advanced-stage GC cannot undergo radical surgery because they are at risk for metastasis; therefore, they can choose only radiotherapy or chemotherapy and have a poor prognosis. Based on the lack of specific clinical manifestations and detection methods, most GC patients (>70%) are diagnosed in the advanced stage; therefore, continued efforts toward developing treatments have been focused on advanced-stage GC patients and include molecular targeted therapy, immunotherapy, and small molecular therapy. Nevertheless, in recent years, accumulating evidence has indicated that small molecules, especially long noncoding RNAs (lncRNAs), are involved in the occurrence, development, and progression of GC, and their abundantly dysregulated expression has been identified in GC tissues and cell lines. Therefore, lncRNAs are considered easily detectable molecules and ideal biomarkers or target-specific agents for the future diagnosis or treatment of GC. In this review, we primarily discuss the status of GC, the role of lncRNAs in GC, and the emerging systemic treatments for GC.

In the era of big data, the rapid development of information technology has made the sharing of data and information more free, bringing convenience to the public, but at the same time, the massive amount of data also brings “information anxiety.” In this paper, we use the knowledge of design discipline, combined with psychological cognitive science, statistics, and communication discipline, and analyze a large number of excellent cases to effectively combine “information visualization-visual representation-design.” The purpose of this study is to enable audiences to efficiently access information through visual symbols in a large amount of data and to increase their interest in reading and satisfaction in accessing information. As a carrier of communication between designers and audiences in the process of visual representation of information visualization, visual symbols can effectively convey information content and emotional concepts to audiences. Finally, based on the theoretical support of the previous paper, combined with our own practical experience, we conduct a systematic study on the application of design thinking and the construction of design methods for the design of visual representations of information visualization. A comparative study on the aesthetics of different categories of APP interface design is conducted, and it is believed that different categories of APP can create distinctive and different categories of APP interface aesthetics through the differentiated design of interface layout, content expression, and visual form, which is considered as the ultimate goal that APP interface design must pursue. Visual representation is a method and means to realize information visualization as a representation practice that expresses the meaning of information in the form of visual symbols. The visual representation of information visualization uses visual symbols as a medium, and the audience interprets the visual symbols based on cognitive experience to obtain information, which helps to maximize the dissemination of information.

COVID-19 has spread rapidly worldwide since its outbreak and has now become a major public health problem. More and more evidence indicates that SARS-CoV-2 may not only affect the respiratory system but also cause great harm to the central nervous system. Therefore, it is extremely important to explore in-depth the impact of SARS-CoV-2 infection on the nervous system. In this paper, the possible mechanisms of SARS-CoV-2 invading the central nervous system during COVID-19, and the neurological complications caused by SARS-CoV-2 infection were reviewed.

Hydrogen sulfide (H2S) plays a key role in the regulation of physiological processes in mammals. The decline in H2S level has been reported in numerous renal disorders. In animal models of renal disorders, treatment with H2S donors could restore H2S levels and improve renal functions. H2S donors suppress renal dysfunction by regulating autophagy, apoptosis, oxidative stress, and inflammation through multiple signaling pathways, such as TRL4/NLRP3, AMP-activated protein kinase/mammalian target of rapamycin, transforming growth factor-β1/Smad3, extracellular signal-regulated protein kinases 1/2, mitogen-activated protein kinase, and nuclear factor kappa B. In this review, we summarize recent developments in the effects of H2S donors on the treatment of common renal diseases, including acute/chronic kidney disease, renal fibrosis, unilateral ureteral obstruction, glomerulosclerosis, diabetic nephropathy, hyperhomocysteinemia, drug-induced nephrotoxicity, metal-induced nephrotoxicity, and urolithiasis. Novel H2S donors can be designed and applied in the treatment of common renal diseases.

Brain-computer interface (BCI) based on motor imagery (MI) electroencephalogram (EEG) decoding helps motor-disabled patients to communicate with external devices directly, which can achieve the purpose of human-computer interaction and assisted living. MI EEG decoding has a core problem which is extracting as many multiple types of features as possible from the multi-channel time series of EEG to understand brain activity accurately. Recently, deep learning technology has been widely used in EEG decoding. However, the variability of the simple network framework is insufficient to satisfy the complex task of EEG decoding. A multi-scale fusion convolutional neural network based on the attention mechanism (MS-AMF) is proposed in this paper. The network extracts spatio temporal multi-scale features from multi-brain regions representation signals and is supplemented by a dense fusion strategy to retain the maximum information flow. The attention mechanism we added to the network has improved the sensitivity of the network. The experimental results show that the network has a better classification effect compared with the baseline method in the BCI Competition IV-2a dataset. We conducted visualization analysis in multiple parts of the network, and the results show that the attention mechanism is also convenient for analyzing the underlying information flow of EEG decoding, which verifies the effectiveness of the MS-AMF method.

BACKGROUND: Considering the complexity of vascular or bronchial variations and the difficulty of nodule localization during segmental resection, the three-dimensional (3D) reconstruction and printing model can provide a guarantee for safe operation and, to some extent, can simplify the surgical procedure. We conducted this study to estimate the avail of 3D reconstruction and personalized model in anatomical partial-lobectomy (APL). METHODS: We prospectively collected and retrospectively reviewed the data of 298 cases who underwent APL in our institute from April 2017 to May 2019. The patients were divided into “3D-reconstruction” group (131 patients), “3D model” group (31 patients) and “non-3D” group (136 patients). We adopted the ANOVA analysis and Chi-square test to compare the perioperative data between the three groups. Subjective satisfaction questionnaires for surgeons were provided to evaluate the value of personalized 3D printed model. RESULTS: The proportion of complex segmentectomy in 3D model group (87.1%) was significantly higher than that in the 3D-reconstruction group (60.3%) and non-3D group (55.9%) (P=0.006), and the average operation time of complex segmentectomy in 3D model group (99.56 minutes) was significantly shorter than that of the other group (all P