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Summary Background /Objective: As a new immune-nutritional marker, the controlled nutritional status (CONUT) score has been reported to predict the prognosis of cancer patients. We aimed to elucidate the prognostic value of preoperative CONUT score in pancreatic cancer patients undergoing radical surgery, and to construct a nomogram based on CONUT score to predict individual survival. Methods Preoperative CONUT scores were calculated prospectively in 382 patients with pancreatic cancer who underwent radical surgery. Evaluated the relationship between CONUT score and pancreatic cancer prognosis. Cox proportional hazard models were used to determine predictors of survival and a new nomogram was established to predict pancreatic cancer overall survival (OS). Results The area under curve of CONUT score was higher than other immune-nutritional indexes. The OS of the high-CONUT group were significantly lower than that of low-CONUT group. Multivariate analysis showed that CONUT score, gender, AJCC stage, complications and reoperation were independent prognostic factors for OS. Nomogram based on these variables has better discriminant ability in predicting survival compared with other traditional staging systems. Conclusions Preoperative CONUT score is an effective independent predictor of OS in pancreatic cancer patients undergoing radical surgery. This new CONUT based nomogram provides accurate, individualized survival prediction for pancreatic cancer.

The design of workwear has significant effects on worker performance. However, the current workwear for coal miners in Northern China is poor in fitness and thermal comfort. In this study, new workwear (NEW) for coal miners was developed with the design features providing better cold protection and movement comfort performance, as compared with a commonly worn workwear (CON). To evaluate the effectiveness of NEW, we conducted human trials which were performed using simulated work movements (i.e., sitting, shoveling, squatting, and crawling) in a climate chamber (10°C, 75% RH). Physiological measurements and perceptual responses were obtained. The results demonstrated that the local skin temperatures at chest, scapula, thigh, and calf; mean skin temperatures,; and thermal comfort in NEW were significantly higher than those in CON. NEW also exerted an improvement in enhancing movement comfort. We conclude that NEW could meet well with the cold protective and mobility requirements.

In this communication, we propose a novel feeding scheme to design a wideband filtering patch antenna. The antenna is composed of two substrates: the feeding- and the radiating ones. Two circular patches are etched on the top surface of the radiating substrate as the radiators and a hybrid substrate integrated waveguide (SIW) and spoof localized surface plasmon (SLSP) structure is employed as the feeding scheme. Due to the abundant resonant modes and filtering feature of the hybrid SIW-SLSP structure, the antenna can radiate under the triple-mode resonance with high filtering performance. Moreover, the proposed filtering antenna has an independently adjustable capability of both low-band and high-band radiation nulls. The presented antenna is designed, fabricated and measured. Measured results reveal that the operating bandwidth reaches up to 11.3%, ranging from 7.44 GHz to 8.33 GHz. The peak gain of 10 dBi is obtained in passband with 10 dB gain suppression out of the band. This approach provides a simple way to design wideband filtering patch antenna, which can be easily integrated with planar circuit.

© Copyright 2021 The Author(s). At present, Solid-State Fermentation (SSF) is mainly controlled by artificial experience, and the product quality and yield are not stable. Therefore, predicting the quality and yield of SSF is of great significance for improving the utility of SSF. In this works, we propose a Deep Learning Utility Prediction (DLUP) scheme for the SSF in the Industrial Internet of Things (IIoT), including parameter collection and utility prediction of the SSF process. Furthermore, we propose a novel Edge-rewritable Petri net to model the parameter collection and utility prediction of the SSF process and further verify their soundness. More impor- tantly, DLUP combines the generating ability of Least Squares Generative Adversarial Networks (LSGAN) with the predicting ability of Fully Connected Neural Network (FCNN) to realize the utility prediction (usually use the alcohol concentration) of SSF. Experiments show that the proposed method predicts the alcohol concentration more accurately than the other joint prediction methods. In addition, the method in our paper provides evidences for setting the ratio of raw materials and proper temperature through numerical analysis. Tai Shan Industry Leading Talent Project (Grant Number: tscy20180416); Major Science and Technology Innovation Project of Shandong Province (Grant Number: 2019TSLH0214).

Cancer cells evade immune detection via programmed cell death 1/programmed cell death-ligand 1 (PD-1/PD-L1) interactions that inactivate T cells. PD-1/PD-L1 blockade has become an important therapy in the anti-cancer armamentarium. However, some patients do not benefit from PD-1/PD-L1 blockade despite expressing PD-L1. Here, we screened 101 gastric cancer (GC) patients at diagnosis and 141 healthy control subjects and reported one such subpopulation of GC patients with rs17718883 polymorphism in PD-L1, resulting in a nonsense P146R mutation. We detected rs17718883 in 44% of healthy control subjects, and rs17718883 was associated with a low susceptibility to GC and better prognosis in GC patients. Structural analysis suggests that the mutation weakens the PD-1:PD-L1 interaction. This was supported by co-culture experiments of T cells, with GC cells showing that the P146R substitution results in interferon (IFN)-γ secretion by T cells and enables T cells to suppress GC cell growth. Similar results with animal gastric tumor models were obtained in vivo. PD-1 monoclonal antibody treatment did not enhance the inhibitory effect of T cells on GC cells expressing PD-L1P146R in vitro or in vivo. This study suggests that rs17718883 is common and may be used as a biomarker for exclusion from PD-1/PD-L1 blockade therapy.

Ta-doped Bi3.25La0.75Ti3O12(BLTT)/ZnO films were fabricated on Pt(111)/Ti/SiO2/Si substrates by a magnetron sputtering method. Firstly, ZnO crystal thin films were grown on the substrates by a reactive sputtering method. Then, BLTT thin films were deposited on the ZnO layers at room temperature and post-annealed at 600 °C. The micromorphology, ferroelectric and dielectric properties of BLTT/ZnO films were analyzed. The XRD analysis shows that ZnO buffer layer significantly reduces the crystallization temperature of BLTT thin film. The TEM results show that lamellar BLTT grains are grown on ZnO layer at a certain angle with few elements diffusion at the interface of ZnO phase and Bi4Ti3O12 phase. The ferroelectric properties indicate that BLTT/ZnO films exhibit different remanent polarization and coercive fields under electric field with different directions. The novel mechanism of tailoring ferroelectric properties may open new possibilities for designing special ferroelectric devices.

In this letter, a design of multibeam antenna (MBA) with 2-D beam steerable capability is proposed. The proposed MBA is composed of a circular 44 butler matrix (BM) and a 24 patch antenna array. And the 24 patch antenna array consists of four 2-element subarrays uniformly arranged along E-plane. By introducing the switching diodes in the subarray and controlling the switching diodes on and off, elements of the subarray are excited through the paths with different lengths, and the beam of the subarray is steered subsequently in H-plane. The circular 44 BM is designed as the beamforming network to excite the four subarrays uniformly arranged along E-plane and steer the beam in E-plane. The proposed MBA can generate 12 beams by selecting the excitation port and controlling the on-off state of the switching diodes. To validate the performance of the proposed MBA, a prototype is fabricated and measured. By the design, the dimension of the designed MBA has reduced to 2.9 01.3 0. The designed MBA operates at 5.7 GHz, and the results show that beams of the MBA can cover the range of 36 in E-plane and 22 in H-plane, respectively.

Selenium (Se) plays an important role in human health. Approximately 80% of the world’s population does not consume enough Se which recommended by WHO (World Health Organization). Wheat is an important staple food and Se source for most people in the world. This article summarizes literatures about Se from 1936 to 2020 to investigate Se in wheat farming soil, wheat, and its derived foods. Se fortification and the recommended Se level in wheat were also discussed. Results showed that Se contents in wheat farming soil, grain, and its derived foods around the world were 3.8–552 (mean, 220.99), 0–8,270 (mean, 347.30), and 15–2,372 (mean, 211.86) μg·kg−1, respectively. Adopting suitable agronomic measures could effectively realize Se fortification in wheat. The contents in grain, flour, and its derived foods could be improved from 93.94 to 1,181.92, 73.06 to 1,007.75, and 86.90 to 587.61 μg·kg−1 in average after leaf Se fertilizer application in the field. There was a significant positive correlation between Se content in farming soil and grain, and it was extremely the same between foliar Se fertilizer concentration rate and grain Se increased rate. The recommended Se fortification level in cultivation of wheat in China, India, and Spain was 18.53–23.96, 2.65–3.37, and 3.93–9.88 g·hm−2 respectively. Milling processing and food type could greatly affect Se content of wheat derived food and should be considered seriously to meet people’s Se requirement by wheat.TOC graphic

Age of Information (AoI) is a critical metric for Internet of Things (IoT) real-time applications, where real-time services need fresh data. The AoI is directly affected by the arrival rate of packet in the IoT, yet the optimal arrival rate based on the hard AoI and peak AoI constraints has not been investigated. Knowing the optimal arrival rate can help to design more reliable IoT networks with minimal AoI. In this letter, based on the violation probabilities of AoI and peak AoI, the optimal arrival rate of status update is analyzed in the sight of asymptotical optimality. For loose or tight AoI/peak AoI constraint, it demonstrates that the optimal arrival rate converges to a half of service rate. Numerical results validate the correctness of theoretical analysis.

Background The immunochemical fecal occult blood test (iFOBT) for colorectal cancer (CRC) screening and the serum carcinoembryonic antigen (CEA) assay for disease detection of CRC is associated with a high false-positive rate and a low detection sensitivity, respectively. There is an unmet need to define additional modalities to complement these assays. Different subsets of circulating tumor cells (CTCs) are present in the peripheral blood of cancer patients. Whether or not CTCs testing supplements these clinical assays and is valuable for patients with CRC was investigated. Methods CTCs were enriched from pre-operative patients with CRC (n = 109) and the non-cancerous controls (n = 65). CTCs expressing either epithelial cell adhesion molecule (EpCAM) or podoplanin (PDPN, the marker associated with poor cancer prognosis) were defined by immunofluorescence staining and were analyzed alone or in combination with iFOBT or serum CEA. Results Patients with early or advanced stage of CRC can be clearly identified and differentiated from the non-cancerous controls (p Conclusion CTC testing could supplement iFOBT to improve CRC screening and supplement serum CEA assay for better disease detection of patients with CRC.

BACKGROUND: The Naples prognostic score (NPS) is an effective and objective tool to assess the immune–nutritional status of patients with malignant tumors. The aim of this study was to investigate the clinical significance of preoperative NPS on short- and long-term outcomes after pancreatoduodenectomy (PD) for ampullary carcinoma. METHODS: We retrospectively analyzed 404 consecutive patients with ampullary carcinoma who underwent PD between January 2012 and June 2018. Preoperative NPS was calculated from serum albumin and total cholesterol concentrations, and the neutrophil–lymphocyte ratio and lymphocyte-monocyte ratio (LMR). Patients were then divided into three groups according to their NPS. Clinicopathological variables, postoperative outcomes, and survival data were compared between the three groups. Univariate and multivariate Cox analysis of overall survival (OS) and recurrence-free survival (RFS) were also conducted, and time-dependent receiver operating characteristic (ROC) curves were created to evaluate the discriminatory ability of the prognostic scoring systems. RESULTS: Patients with higher NPS had worse prognosis, and significant OS difference (group 0 vs. 1, P=0.02; group 1 vs. 2, P

SUMMARYThe 2021 Mw7.4 Maduo earthquake occurred on the Jiangcuo fault within the Bayan Har block in eastern Tibet. It is a rather unique event and attests that large earthquakes can occur in the interior of major tectonic blocks within the Tibetan plateau. By processing GPS data observed in the eastern Tibet region, we produce a data set documenting 3-D coseismic displacements of the Maduo earthquake. Using the data set to constrain a coseismic slip model, we find that the earthquake ruptured a nearly vertical fault about 170 km in length, with ∼90% of the moment released in the shallow layer above 20 km depth. The maximum slip of ∼3.6 m occurred near the surface around a bend in the east segment of the fault. The overall seismic moment release is 1.82 × 1020 N m and is equivalent to Mw7.4. Driven by the eastward extrusion of the Tibetan plateau, the deformation field in eastern Tibet is dominated by left-lateral shear, with the strikes of the tectonic faults rotating clockwise from west to east along with the shear stress orientation. This deformation pattern explains the mechanisms of earthquakes along block boundary faults, as well as the ones on faults within the blocks. The Jiangcuo fault is located ∼70 km south of the East Kunlun fault and could be connected to the Kunlun Mountain Pass fault to its WNW that ruptured during the 2001 Kokoxili earthquake, and a seismic gap of ∼240 km long between the two faults is worth special attention for its increased earthquake potential.

Subjective cognitive decline (SCD)-related worries are indicative of an increased risk for developing Alzheimer’s disease (AD) dementia. However, the influence of SCD-related worries on the relationship between amyloid and gray matter (GM) atrophy remains unknown. A total of 93 SCD participants underwent 18F-florbetapir PET and T1-weighted MRI scans. SCD individuals were classified into amyloid-positive or amyloid-negative groups based on global amyloid uptake. Three-step statistical analyses were performed: (1) partial correlation analysis was conducted to determine whether global amyloid relates to GM volume in amyloid-positive and amyloid-negative groups; (2) linear regression analysis was conducted to determine whether the interaction term (worries × global amyloid) predicts GM volume; and (3) post hoc subgroup linear regression analysis was conducted to determine the association between amyloid and GM volume in the subgroups with and without worries. Age, sex, education and total intracranial volume were adjusted in all models. We found a negative relationship between global amyloid load and GM volume in the right hemisphere (r = 0.441, p = 0.012) and right temporal cortex (r = 0.506, p = 0.003) in the amyloid-positive group. Moreover, in the amyloid-positive group, a significant worries × amyloid interaction effect on GM volume was found in the bilateral hemisphere (right: pinteraction=0.037; left: pinteraction=0.036), left temporal cortex (pinteraction=0.044) and bilateral frontal cortex (right: pinteraction=0.010; left: pinteraction=0.011). Subsequent post hoc analysis revealed a significant amyloid-GM association only in the subgroup with worries but not in the subgroup without worries. In preclinical AD cases, SCD-related worries may occur as a symptom in those cases where amyloid affects GM to a greater extent and may thus represent a high-risk population for future cognitive decline.

Acousto-optic (AO) properties of an environmentally friendly Ge20Sb15Se65 chalcogenide glass were investigated, and the results show that Ge20Sb15Se65 glass was a potential material for manufacturing AO modulator (AOM) because its composition possesses excellent performance of high optical quality and transmission in the infrared region spectral, non-toxic, high glass transition temperature, strong mechanical strength, easy to fabricate in large bulk, and isotropic homogeneity. Particularly, its outstanding AO figure of merit (M2 = 407 × 10−15 s3/kg) was approximately 270 times that of fused quartz glass, making it attractive for AO device designs. Herein, the construction of the AOM based on Ge20Sb15Se65 glass as AO material was performed, and we obtained a high diffraction efficiency of 73.4% at a high acoustic frequency of 160 MHz and an extremely low radio-frequency (RF) power of 0.25 W when the laser beam at 1550 nm was controlled. To our best knowledge, the results of initial tests on the AOM prepared from Ge–Sb–Se chalcogenide glass were first reported. Such an AOM design enriches the family of AO devices and exploits the route for the practical application of chalcogenide glass.

Aim: This study aimed to evaluate the levels and functions of miR-101-3p in neonatal sepsis (NS). Materials & methods: Quantitative real-time PCR was conducted to investigate the expression of miR-101-3p and the receiver operating characteristic curve was applied to manifest its diagnostic effects. Results: miR-101-3p was increased in the NS patients and the dysregulation of miR-101-3p was associated with levels of procalcitonin, CRP, IL-8 and TNF-α. The combination of miR-101-3p and procalcitonin could function as a promising indicator in distinguishing NS patients. The silenced miR-101-3p reversed the increased levels of TNF-α and IL-8 caused by lipopolysaccharide in vitro. DUSP1 was identified as a direct target gene of miR-101-3p in NS. Conclusion: The abundance of miR-101-3p facilitated the inflammation in NS by targeting DUSP1.

Yue Guo,1,2,* Ying-Hui Zhou,1,* Xian-Ping Wu,1 Chen-Yi Tang,1 Min Wang,3 Zhao-Hui Mo,4 John A Shepherd,5 Bennett K Ng,5 Bo Fan,5 Hou-De Zhou1 1National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, People’s Republic of China; 2Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People’s Republic of China; 3Department of Endocrinology, Xiangya Hospital of Central South University, Changsha, 410008, People’s Republic of China; 4Department of Endocrinology, The Third Xiangya Hospital of Central South University, Changsha, 410013, People’s Republic of China; 5Department of Radiology & Biomedical Imaging, University of California at San Francisco, San Francisco, CA, 94143, USA*These authors contributed equally to this workCorrespondence: Hou-De ZhouNational Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, People’s Republic of ChinaTel +86-731-85292223Fax +86-731-85533525Email houdezhou@csu.edu.cnPurpose: There are limited clinical studies aimed at solving the problem of the efficiency of conventional treatment with oral phosphate and calcitriol in adults with hypophosphatemic osteomalacia (HO). In addition, there still had no good non-hazardous markers to evaluate the severity of bone loss of osteomalacia before and after treatment. Therefore, the purpose of this study was to assess the efficacy of conventional treatment with a self-blended phosphate supplementation and calcitriol on patients with HO and whether bone mineral density (BMD) can be helpful for monitoring the efficacy.Patients and Methods: A total of 21 HO patients and 105 healthy controls were enrolled. All patients were tested for serum biomarkers and BMD of the lumbar spine (L1–L4), femoral neck, and total left hip. After three years of treatment, 11 of 21 HO patients were recalled for BMD measurement. According to the administration of drugs, HO patients with calcium and calcitriol were divided into three phosphate treatment groups: patients in group A (n = 3) received continuous phosphate supplementation, patients in group B (n = 5) received intermittent phosphate supplementation and patients in group C (n = 3) received no phosphate supplementation.Results: The diagnoses of 21 HO patients were 5 cases of hereditary hypophosphatemic rickets, 4 cases of Fanconi syndrome with the features of renal tubular acidosis and vitamin D deficiency, and 12 cases of hereditary vitamin D abnormality. The average initial serum phosphorus level of the patient group was approximately 50% lower than that of the control group. Lower BMD was significantly observed in the HO group than the control group at the lumbar spine and total hip. Continuous treatment with the phosphate supplement could increase BMD in the lumbar spine and total hip by 33.4– 52.3% and in the femoral neck increased by 43.2– 79.3% compared with baseline, and the effect appears to be continued once treatment is discontinued.Conclusion: These findings suggest that conventional therapy can improve bone mineral defects in patients with HO, especially in the femoral neck. Detection of BMD in HO patients is a good tool to assess the extent of bone defects and the therapeutic effect.Trial Registration: Chinese Clinical Trial Registry, ChiCTR-OOC-16010095. Registered 7 December 2016. Retrospectively registered.Keywords: bone mineral density, conventional treatment, hypophosphatemic osteomalacia

Driven by the development of global Energy Internet and the requirement of energy transition, the sharing economy mode in energy sector has turned into a novel inspiration. This paper aims to explore whether the sharing economy model advance China’s energy transition effectively. We describe the system of Energy with Uber-like mode, and introduce the Uber-like Mode into the PV power sector. By using the Analytic Network Process method, a set of comprehensive benefit evaluation system for the Uber-like mode plus renewables project is put forward from aspects of the technical and economic benefit, the social and environmental benefit, the energy benefit and the safety (reliability) benefit. The Uber-like mode plus PV project, as one specific application, is chosen as a case study to verify the effectiveness of the evaluation model. Based on the evaluation results, SWOT is adopted to discuss the internal conditions and the external environment for Renewables Sharing Economy in China. Finally, this article puts forward a series of suggestions to realize the goal of the proper adjustment of energy structure with respect to the renewables’ sharing economy mode.

Background Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China. Methods A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed. Results 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid. Conclusions Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use.

BACKGROUND Hepatic hemolymphangioma is an extremely rare benign congenital malformation composed of cystically dilated lymphatic and blood vessels, and they have nonspecific clinical symptoms and laboratory results. In this study, hepatic hemolymphangioma with multiple hemangiomas in an elderly woman was initially reported and analyzed. CASE SUMMARY A 61-year-old female patient, with a history of hysterectomy and bilateral adnexectomy, was referred to the hepatobiliary surgery department with the complaint of multiple hepatic hemangiomas that had been diagnosed 2 years prior in a preoperative contrast-enhanced computed tomography (CECT) examination. Upon entering our hospital, no abnormal physical examination and laboratory data were found. The latest CECT revealed a new 7.0 cm × 6.2 cm cystic-solid lesion with multiple internal divisions in segment II of the liver, with delayed CECT enhancement characteristics that presented as solid parts with internal division. On the positron emission tomography (PET)/CT, no significant uptake of 18F-fluorodeoxyglucse was observed. Finally, hepatic hemolymphangioma was confirmed based on the pathological and immunohistochemical results after surgery. At 1-year follow-up, her posthepatectomy evaluation was uneventful, and she had recovered full activity. In addition, no postoperative recurrent or residual lesion was found on CECT imaging. CONCLUSION Hepatic hemolymphangioma with multiple hemangiomas was reported and observed by CECT and PET/CT imaging.

Organic lead halide perovskites have attracted extensive interest for potential use in next‐generation photovoltaic devices due to the demonstrated high power conversion efficiency, low materials cost, and low fabrication cost. Besides, the electromechanical properties have also been explored in detail to expand the application potential. Here, we report the reversible photoelectric modulation (including photoresponse and photoresistance modulation, by near 6%) in methylammonium lead triiodide (MAPbI3) film under an external electric bias (only 0.06 V µm‐1), which stems from the strain response induced by the competition of electrical biasing and light exposure. In addition, accompanied by the use of bias and light, the lattice is found to be deformed in MAPbI3 film. This result does not only shed light on the lattice deformation from external factors but also highlights the dramatic electron/photon‐lattice coupling in perovskite films.

Objectives: This study investigated the efficacy of Korean medical treatment for a headache (suspected CPSP) patient with a history of cerebral infarction.Methods: We treated the patient using Korean medical treatments (herbal medicines-Kamiseokyong-tang, acupuncture, pharmacopuncture, and chuna). The treatments were measured using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) for headache and post neck pain. General health status was evaluated using the European Quality of Life Five Dimensions (EQ-5d) Scale.Results: We observed improvements in the NRS, NDI, and EQ-5d scores after the treatments.Conclusions: This study suggests that Korean medicine may effectively treat headaches (suspected CPSP) with accompanying cerebral infarction.

Objectives: This study investigated the efficacy of Korean medical treatment for reflux esophagitis.Methods: We used Korean medical treatment (herbal medicines, acupuncture, herbal acupuncture, and therapy) to treat a hospitalized patient with reflux esophagitis. To evaluate the treatment, we measured the symptoms using the Reflux Symptom Index (RSI) and the Visual Analogue Scale (VAS) for heartburn, acid reflux, chest pain, foreign body sensations in the throat, chronic cough, hoarseness, and bronchial asthma. The generic health status was evaluated using the European Quality of Life Five-Dimension (EQ-5d) Scale.Results: The RSI and EQ-5d scores improved following treatment, but the VAS scores showed that only heartburn, acid reflux, and chest pain symptoms were relieved.Conclusions: This study suggests that Korean medicine may be effective for treating reflux esophagitis.

This report describes the efficacy of using Yangshimtang-gamibang for a sleep disorder caused by a traffic accident. We treated a patient with Yangshimtang-gamibang for 12 days for sleep disorder caused by a traffic accident. To evaluate the results, we used the Korean Modified Leeds Sleep Evaluation Questionnaire (KMLSEQ) to measure sleep disorder. The degree of sleep disorder was also evaluated using the Numerical Rating Scale (NRS). The generic health status was evaluated using the European Quality of Life-5 Dimensions (EQ-5D) scale. Improvements in the NRS and EQ-5D scale scores were observed after the treatments. The change in the KMLSEQ score indicates that the patient's sleep disorder was relieved. The results of this case study suggest that Yangshimtang-gamibang may be an effective treatment for sleep disorders caused by traffic accident.

Objective Diabetes increases the risk for cancers. However, whether it is associated with hematologic malignancies is not clear. The present study investigated the association between diabetes and acute lymphocytic leukemia (ALL), acute myeloid leukemia (ML), non-Hopkin lymphoma (NHL), and multiple myeloma (MM). Methods Newly diagnosed adult cancer patients were recruited consecutively from our clinical database. Peoples from a local enterprise were recruited to create a small-scale population-based dataset. We compared the diabetes prevalence between the cancer patients and the local people; an increase in diabetes prevalence in the cancer patients suggests an association between diabetes and the cancer(s). Results We found that the prevalence of diabetes was 19.7%, 21.3%, 12.5%, and 12.0% in ALL, AML, NHL, and MM, respectively, which was higher than that (9.1%) in the local people. Despite that there were more male than female cancer patients, there were more female than male diabetic patients. The increase in diabetes prevalence occurred in ALL and NHL patients aged 18 to 39 years old as well as in AML patients over 40. In MM patients, the increase in diabetes prevalence (18.6%) occurred only in females. Approximately 70% of the diabetic patients were undiagnosed before the diagnosis of the blood cancer. Approximately half of the pre-existing diabetic patients had anti-diabetic treatment, with over 70% of them still had poor glycemic control. Conclusions Our results suggest that diabetes is associated with ALL, AML, NHL, and MM, at least in adult patients.

Treatment resistant (TR) psychosis is considered to be a significant cause of disability and functional impairment. Numerous efforts have been made to identify the clinical predictors of TR. However, the exploration of molecular and biological markers is still at an early stage. To understand the TR condition and identify potential molecular and biological markers, we analyzed demographic information, clinical data, structural brain imaging data, and molecular brain imaging data in 7 Tesla magnetic resonance spectroscopy from a first episode psychosis cohort that includes 136 patients. Age, gender, race, smoking status, duration of illness, and antipsychotic dosages were controlled in the analyses. We found that TR patients had a younger age at onset, more hospitalizations, more severe negative symptoms, a reduction in the volumes of the hippocampus (HP) and superior frontal gyrus (SFG), and a reduction in glutathione (GSH) levels in the anterior cingulate cortex (ACC), when compared to non-TR patients. The combination of multiple markers provided a better classification between TR and non-TR patients compared to any individual marker. Our study shows that ACC-GSH, HP and SFG volumes, and age at onset, could potentially be biomarkers for TR diagnosis, while hospitalization and negative symptoms could be used to evaluate the progression of the disease. Multimodal cohorts are essential in obtaining a comprehensive understanding of brain disorders.

Objectives Pre-albumin (PAB) can be used to evaluate the association between nutrition status and in-hospital mortality. However, there is no literature to compare if PAB is the best indicator to predict in-hospital mortality among the nutrition indexes in a study. Methods We operated a retrospective study including 145 patients admitted to our institution’s elderly intensive care unit (ICU) from January, 2017 to December, 2019. Admission laboratory results were collected. Regression analysis and receiver operating curve (ROC) were analyzed to explore the performance of different nutrition indexes. Results The levels of PAB were significantly different between the survivor and non-survivor group (p=0.001). Univariate analysis showed nutrition indexes (lymphocytes, albumin, body mass index [BMI], geriatric nutritional risk index (GNRI), prognostic nutritional index [PNI] and PAB) were associated with in-hospital mortality (all p Conclusions PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly ICU patients.

BACKGROUND Colon cancer is a common malignant disease of the gastrointestinal tract and usually occurs at the junction of the rectum and sigmoid colon. Lymphatic and hematogenous metastases occur frequently in colon cancer and the most common metastatic sites include the liver, lung, peritoneum, bone, and lymph nodes. As a manifestation of advanced tumor spread and metastasis, soft tissue metastasis, especially skeletal muscle metastasis with bone metaplasia caused by colon cancer, is rare, accounting for less than 1% of metastases. CASE SUMMARY A 43-year-old male patient developed skeletal muscle metastasis with bone metaplasia of the right proximal thigh 5 mo after colon cancer was diagnosed. The patient was admitted to the hospital because of pain caused by a local mass on his right thigh. Positron emission tomography-computed tomography showed many enlarged lymph nodes around the abdominal aorta but no signs of lung or liver metastases. Color ultrasound revealed a mass located in the skeletal muscle and the results of histological biopsy revealed a poorly differentiated adenocarcinoma suspected to be distant metastases from colon cancer. Immunohistochemistry showed small woven bone components that were considered to be ossified. CONCLUSION This case reminds us that for patients with advanced colorectal tumors, we should be alert to the possibility of unconventional metastasis.

Energy band structure and interfacial compatibility of heterojunctions are crucial for photocatalysts in promoting photogenerated charge separation and transfer. Here, a combined strategy of vacancy engineering and quantum effect via a facile phosphating process is reported, for the first time, to modulate the energy band structure and the interface of ZnxCd1−xS/CoP quantum dots (ZCSv/CoP QDs) heterojunction. The combined experimental and theoretical investigation revealed that phosphating process transformed CoOx QDs to CoP QDs, and more importantly, generated considerable amount of sulfur vacancies in ZCSv. As a result, a Type II ZCSv/CoP QDs heterojunction with compatible interfaces was constructed via in-situ generated P-Zn, P-Cd and S-Co bonds, which facilitated the separation and transfer of the photogenerated charge and thus resulted in a high ability towards hydrogen evolution under visible light (17.53 mmol g−1 h−1). This work provides an effective and adaptable strategy to modulate band structure and interfacial compatibility of heterojunctions via vacancy engineering and quantum effect.

The medial plantar artery (MPA) is often sacrificed as the vascular pedicle of the medial plantar flap (MPF). However, for patients with ankle soft tissue defect caused by traffic accident, the anterior tibial artery (ATA) could be damaged and the blood supply of the distal foot would only come from the MPA and the lateral plantar artery (LPA). In this case, sacrificing the MPA for the MPF means that the LPA will become the mainly source of blood supply of the distal foot. Whether the blood supply of the distal foot is adequately guaranteed remains to be discussed. A total of seven patients with ankle soft tissue defect and ATA injury were enrolled in the study. The digital subtraction angiography (DSA) was performed to observe the hemodynamics of the ipsilateral foot. The MPF was harvested only when the foot arterial network consisting of the MPA, the LPA, the deep plantar arch, and the deep plantar artery of DPA, and the blood redistribution existed. DSA results showed the blood from the posterior tibial artery was redistributed to the ipsilateral foot and the MPA is not the dominant artery in the foot. Seven MPFs were harvested, and all flaps survived completely. No complications, such as pain, ulcer, and necrosis, occurred in the ipsilateral toes. The DSA could accurately and intuitively evaluate the hemodynamics of foot in patients with ATA injury. The DSA data and clinical practice proved that the ATA injury is not the contraindication of the MPF.

BACKGROUND Indwelling inferior vena cava (IVC) filters might cause various complications, including filter penetration, filter fracture, filter migration, and thrombosis of the IVC. Penetration and migration complications are common, while a caudal migrated double-basket filter with associated infected iliac pseudoaneurysm has seldom been reported. CASE SUMMARY We report a 64-year-old female admitted for sudden onset of severe right abdominal pain after IVC filter placement for 3 mo. The patient had a history of failed endovascular IVC filter retrieval. Computed tomography showed that the retrieval hook of the filter penetrated the right common iliac artery and vein, leading to right iliac artery pseudoaneurysm accompanied by right ureteral obstruction with ipsilateral hydronephrosis, and bilateral iliac veins were occluded. Emergency open repair was performed to remove the IVC filter, the right iliac pseudoaneurysm, and the compromised segments of the iliac veins and IVC with right common iliac artery reconstruction. Staphylococcus aureus was isolated from the tissue culture. The patient was discharged on postoperative day 12 with anticoagulation therapy and antibiotic therapy after discharge. Six-month follow-up computed tomography revealed that the right common iliac artery was patent, and only mild hydronephrosis was detected. CONCLUSION An indwelling IVC filter, even ‘embedded’ within organized thrombus, could still cause life-threatening complications. Open procedures remain the last resort for IVC filters with severe complications.

Smart Driving Vehicles (SDVs) are assisted by Mobile Edge Computing (MEC) to enhance the ability to deal with complex road conditions. Smart network composed of SDVs and MEC. The transmission of low delay is required in intelligent driving tasks. However, High Mobility Edge Computing Service Hand-Off (HMEC-HO) can cause retransmission delays and some security issues. To reduce delay in Smart network, a Hybrid Transmission and Reputation Management (HTRM) system is presented. Based on Fifth Generation Mobile Communications (5G) Vehicle-to-Everything (V2X) technology, an efficient hybrid Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) Scheduling (EH-V2VV2I) algorithm is designed, which uses relay vehicles to help initiating-vehicles for task transmission. To enhance the reliability of V2V connection, an algorithm of Relay Vehicle Selection and Reputation Management (RV-SRM) is proposed for predicting the link survival time, selecting highly reliable relay vehicles, and managing vehicle credibility simultaneously. The simulation results show that HTRM makes the throughput of the tasks of edge server to meet the requirements of vehicles. The experiments show that the delay of our method is reduced by 41\% and the reliability of V2V connection is improved by 31\% than the hard handover method.

BACKGROUND: To explore the specific mechanism of circular RNA (circRNA) in the occurrence and development of hepatocellular carcinoma (HCC), and provide new ideas for its diagnosis and treatment. METHODS: Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was for evaluating the expression of circ_NOTCH3 in liver cancer tissues and matched normal tissues and related cell lines. After overexpression or co-expression of circ_NOTCH3 or microRNA (miRNA) in cells, the changes in cell function were analyzed. Bioinformatics analysis and dual luciferase report analysis were utilized to predict and verify the binding site between circ_NOTCH3 and miRNA. Western blotting was applied to detect gene expression alterations. Additionally, in vivo tumor growth was also utilized to further assess the influence of knocking-down circ_NOTCH3 on the progression of HCC. RESULTS: It was confirmed circ_NOTCH3 was highly expressed in HCC specimens and cells. The proliferation, migration, invasion, and oxaliplatin-resistance potential of HCC could be restrained by silencing circ_NOTCH3 or by ectopic expression of miR-875-5p in vitro. In terms of mechanism, circ_NOTCH3 directly binds to miR-875-5p, regulating its activity by targeting the 3'-UTR of ZNF146. Overexpression of circ_NOTCH3 evidently overturned the diminishing influence of miR-875-5p mimics on HCC cells. CONCLUSIONS: As an oncogene, circ_NOTCH3 can trigger the proliferation, invasion, migration, and oxaliplatin resistance of HCC cells through the miR-875-5p/ZNF146 axis, and may be a promising target for the treatment of HCC.

AJCC TNM stage and WHO grade (G) are two widely used staging systems to guide clinical management for pancreatic neuroendocrine neoplasms (panNENs), based on clinical staging and pathological grading information, respectively. We proposed to integrate TNM stage and G grade into one staging system (TNMG) and to evaluate its clinical application as a prognostic indicator for panNENs. Accordingly, 5254 patients diagnosed with panNENs were used to evaluate and to validate the applicability of TNMG to panNENs. The predictive accuracy of TNMG system was compared with that of each separate staging/grading system. We found that TNM stage and G grade were independent risk factors for survival in both the Surveillance, Epidemiology, and End Result (SEER) and multicenter series. The interaction effect between TNM stage and G grade was significant. Twelve subgroups combining the TNM stage and G grade were proposed in the TNMG stage, which were classified into five stages TNMG. According to the TNMG staging classification in the SEER series, the estimated median survival for stages I, II, III, IV, and V were 203, 174, 112, 61, and 8 months, respectively. The predictive accuracy of TNMG stage was higher than that of TNM stage and G grade used independently. The TNMG stage classification was more accurate in predicting panNEN patient's prognosis than either the TNM stage or G grade.

BACKGROUND AND AIM Pancreatic elastase-1 (PE-1) has been investigated in pancreatic disorders. However, the reference interval (RI) of PE-1 in blood remains unconfirmed. We aimed to establish the blood RI of PE-1 in an adult population. METHODS In this prospective cross-sectional study, we enrolled 400 adults who had received the whole-body physical check-up program between May 1, 2019 and November 20, 2019. The serum and plasma PE-1 levels were measured by latex turbidimetric immunoassay in different storage conditions (fresh, refrigerated, and frozen). The 95% and 99% RI of PE-1 were calculated according to the Clinical & Laboratory Standards Institute guidelines. The correlations between PE-1 and other parameters were analyzed using multivariable regression models. Ultimately, 38 patients with acute pancreatitis were prospectively recruited as the validation cohort. RESULTS The PE-1 levels in fresh serum were highly correlated with those in refrigerated (R2 = 0.998) or frozen (R2 = 0.942) samples; however, plasma should not be suggested in frozen conditions (plasma vs serum: R2 = 0.185). In the RI study population (202 male & 198 female participants), the median age was 52.6 (25-75% interquartile range: 43.1-61.0). The 95% and 99% RIs of PE-1 were 30.0-221.0 and 22.0-359.0 ng/dL, respectively. Triglycerides (β = 0.106, P = 0.033), lipase (β = 0.154, P = 0.007), and CA19-9 (β = 0.130, P = 0.008) were independent factors associated with PE-1. In the pancreatitis validation cohort, with a cut-off value of 359.0 ng/dL, the sensitivity and specificity were 100% and 99.8%, respectively. CONCLUSION The RI of PE-1 established in this study can be used for further applications. Serum is the suggested form for frozen sample storage.

Introduction: The anterosuperior portion of the bulla lamella can extend into the frontal sinus and form the supra bulla frontal cell (SBFC) and supraorbital ethmoid cell (SOEC). This can affect the frontal drainage pathway and make surgery more challenging. Objectives: The aim of the study was to compare the anatomical characteristics of SBFC and SOEC in Chinese chronic rhinosinusitis (CRS) patients and explore the relationship between the cells and frontal sinusitis (FS). The surgical skills in dealing with these cells were also studied. Methods: We prospectively identified SBFC and SOEC in 114 patients with CRS by computed tomography (CT). The sides of the patients were divided into groups A (with FS) and B (without FS). CT scans were analyzed to distinguish the SBFC, SOEC, and the drainage pathway. Statistical analysis was conducted to determine whether the cells were associated with the occurrence of FS. Results: The prevalence of frontal cells was as follows: SBFC: 9.65%, SOEC: 21.93%. There was an association between the presence of SBFC and FS (p < 0.05). The anterior drainage pathway was present in patients with SBFC and SOEC, anterolateral pathway in those with SBFC/SOEC coexisting with the frontal septal cell, and anteromedial pathway in those with SBFC/SOEC coexisting with the supra agger frontal cell. Conclusions: There was an association between the presence of SBFC and the occurrence of FS. Extension of the anterosuperior portion of the bulla lamella into the frontal sinus obstructed the drainage pathway posteriorly. Understanding the anatomy may help surgeons thoroughly dissect the bulla lamella.

BACKGROUND The immune-mediated invasion of IgG4-positive plasma cells in the liver is found in some autoimmune hepatitis. Giant-cell hepatitis (GCH) is a very rare pathological feature in adults, and the clinical characteristics of the simultaneous appearance of the two pathological phenomena are not clear. CASE SUMMARY A 68-year-old woman was hospitalized with fatigue, poor appetite, and yellow urine for 20 d. Liver function tests and immunological indexes were significantly abnormal and accompanied by elevated serum IgG4 levels. Liver pathology revealed severe inflammation of the interface between the portal tract and hepatocytes, portal area inflammation, plasma cell infiltration, formation of rosette cells, IgG4-positive plasma cells > 10/high-power field, IgG4/IgG > 40%, and multinucleated liver cell swelling. IgG4-related autoimmune hepatitis (AIH) combined with GCH was diagnosed, and methylprednisolone was administered at 40 mg/day. Two weeks later, the clinical symptoms disappeared, and the liver function and immunological indicators were significantly improved. Methylprednisolone was reduced at a rate of 4–8 mg per week to 8 mg/day for maintenance. A second liver biopsy 48 wk later indicated that liver inflammation and fibrosis were significantly improved. IgG4-positive plasma cells and GCH were not detected. A literature search was conducted to analyze articles reporting similar pathological phenomena. CONCLUSION AIH with simultaneous IgG4-positive plasma cell infiltration and GCH, liver inflammation, and fibrosis is possibly more severe than typical AIH but sensitive to corticosteroids.

Remote sensing image fusion plays important roles in numerous applications, including monitoring, metrology, and agriculture. Image fusion gathers essential information from several image sources and consolidates them into a single image called a fused image. The fused image involves relevant data, and it is more informative than any other images extracted from one source. This study proposed a pansharpening technique based on image filtering utilising a bilateral filter to generate high‐frequency details from panchromatic image. The various types of side window guided filters are employed to enhance the multispectral band from panchromatic image and then used these filters to adjust spatial data misfortune that happens when images are combined. Experimental results demonstrated that the proposed method provides consistent results concise with reported by the previous research in terms of subjective and objective assessments on remote sensing data.

Introduction There have been no prospective clinical studies investigating adherence and tolerability of HIV post-exposure prophylaxis (PEP) in China. Tolerability, adherence, and transmitted drug resistance are concerns, especially when single-tablet regimen (STR) usage is low. The present study aimed to explore the safety, tolerability, and adherence of regimens containing albuvirtide (ABT) compared with recommended non-STR antiretrovirals for HIV PEP. Methods This was a prospective, open-label, multicenter cohort study. The subjects were stratified into 3 groups based on their preference: ABT + Dolutegravir (DTG) (Group 1), ABT + Tenofovir disoproxil fumarate (TDF) + Lamivudine (3TC) (Group 2), and DTG + TDF + 3TC (Group 3). All enrolled subjects received PEP within 72 h after exposure and continued for 28 days, and were followed-up for 12 weeks. Results A total of 330 participants were enrolled in the three groups. Most participants were male (87.2%). Sexual contact was the most frequent mode of exposure (91.9%). The average time from exposure to treatment was 26.8 ± 19.5 h. There were no statistically significant differences between the three study groups with respect to completion of oral medication at 28 days. The 28-day completion rate was shown to be significantly higher with ABT versus oral (88.9% vs. 64.0%; p

Based on a county-level monthly panel data from four provinces and a province-level monthly panel data from 21 provinces from 2009 to 2015, we use the regression discontinuity method to examine the impacts of the tired pricing reform implemented in July 2012 on residential electricity use in China. The county-level (province-level) estimation shows that the tiered pricing reform has reduced the monthly electricity use per household by 6.5 ​kWh (8.9 ​kWh), accounting for 6.1% (7.1%) of the monthly electricity use per household. Moreover, counties and provinces with a more drastic policy shift have shown a larger decrease in residential electricity use.

Background The discovery of adrenoceptors, which mediate the effects of the sympathetic nervous system neurotransmitter norepinephrine on specific tissues, sparked the development of sympathomimetics that have profound influence on skeletal muscle mass. However, chronic administration has serious side effects that preclude their use for muscle‐wasting conditions such as sarcopenia, the age‐dependent decline in muscle mass, force, and power. Devising interventions that can adjust neurotransmitter release to changing physiological demands will require understanding how the sympathetic nervous system affects muscle motor innervation and muscle mass, which will prevent sarcopenia‐associated impaired mobility, falls, institutionalization, co‐morbidity, and premature death. Here, we tested the hypothesis that prolonged heart and neural crest derivative 2 (Hand2) expression in peripheral sympathetic neurons (SNs) ameliorates sympathetic muscle denervation, motor denervation, and sarcopenia in geriatric mice. Methods We delivered either a viral vector encoding the transcription factor Hand2 or an empty vector (EV) driven to SNs by the PRSx8 promoter by injecting the saphenous vein in 16‐month‐old C57BL/6 mice that were sacrificed 10–11 months later. Studies relied on sympathetic and muscle immunohistochemistry analysed by confocal microscopy, nerve and muscle protein expression assessed by immunoblots, nerve‐evoked and muscle‐evoked maximal muscle contraction force, extensor digitorum longus (EDL) muscle RNA sequencing, SN real‐time PCR, and tests of physical performance using an inverted‐cling grip test and in an open‐arena setting. Results Examining the mice 10–11 months later, we found that inducing Hand2 expression in peripheral SNs preserved (i) the number of neurons (EV: 0.32 ± 0.03/μm2, n = 6; Hand2: 0.92 ± 0.08/μm2, n = 7; P

To substantially prevent electromagnetic threatens, microwave absorbing materials (MAMs) are required to eliminate surplus electromagnetic waves. As a typical MAM, Fe3O4 particles with complex permittivity and permeability have been widely applied due to the coexistence of magnetic loss and dielectric loss. However, the necessary high mass fraction significantly limited its applications, thus Fe3O4 nanostructures have been extensively investigated to overcome this problem. In this work, uniform Fe3O4 nanobelts were prepared by electrospinning and two-step thermal treatment. By controlling the composition and viscosity of the electrospinning precursor solution, Fe3O4 nanobelts with tunable lateral sizes (200 nm–1 μm) were obtained. The samples with low content (only 16.7 wt%) Fe3O4 exhibited wide maximum effective absorbing bandwidths (EAB) over 3 GHz, and Fe3O4 nanobelts with smaller lateral sizes showed a maximum EAB of 4.93 GHz. Meanwhile, Fe3O4 nanobelts with smaller lateral sizes presented superior reflection loss properties, the lowest reflection loss reached −53.93 dB at 10.10 GHz, while the maximum EAB was up to 2.98 GHz. The excellent microwave reflection loss of Fe3O4 nanobelts was contributed to the enhanced synergistic effect of magnetic loss, dielectric loss, and impedance matching, originated from the hierarchically cross-linked networks and shape anisotropies. This study could broaden the practical applications of magnetic absorbers, and provided an approach for the development of shape anisotropic magnetic materials.

Peritoneal dialysis is one of the main renal replacement treatments. However, long-term peritoneal dialysis keeps the peritoneum in contact with the sugar-containing nonphysiological peritoneal fluid, which leads to recurrent peritonitis, peritoneal fibrosis, and failure of ultrafiltration. Transforming growth factor-β1 (TGF-β1), related cytokines, and inflammatory factors are closely related to peritoneal fibrosis. Sulodexide (SLX) is a new type of glycosaminoglycan preparation, which is involved in the formation of an anionic charge barrier and can maintain the selective permeability of vascular endothelial cells. In this study, the innovative analysis of SLX specifically prevents the process of peritoneal dialysis peritoneal fibrosis by downregulating the expression of TGF-β1 and its signaling pathway molecules. We randomly divided 30 rats into three groups. The blank control group received no treatment. The peritoneal dialysis model group was injected with 4.25% peritoneal dialysate (PDF) 20 ml daily, and the SLX group was injected with 4.25% PDF 20 ml + sulodexide (SLX) 20 mg/kg daily. After 8 weeks of dialysis, the rats were sacrificed, and the peritoneal function test was performed to determine the amount of glucose transport and ultrafiltration. The thickness of peritoneal per unit area was observed under high magnification. The level of inflammation in peritoneal tissue and the expression of TGF-β1/Smad were detected. The results showed that SLX can significantly improve peritoneal tissue thickening and inflammation, can downregulate the expression of TGF-β1, Smad2, Smad3, and Smad7 in peritoneal tissue, and improve the progression of peritoneal fibrosis.

Background. Zuojin Pill (ZJP), a classic prescription, has the potential to prevent ulcerative colitis (UC). However, the active components and mechanisms of ZJP are still arcane. This study aimed to use a network pharmacology approach to find the bioactive compounds and potential action mechanisms of ZJP in the treatment of UC. Methods. Firstly, the components and putative targets of ZJP were collected based on herbal medicine target databases, and a network containing the interaction between the targets of ZJP and the potential therapeutic targets of UC was established. Then, topological parameters were calculated to identify the key targets in the network and, in turn, to import them into the David database to perform path enrichment analysis. Results. 14 potential therapeutic components of ZJP and 26 key targets were obtained. These targets were related to signal transduction, MAPK cascade, inflammatory response, immune response, and the apoptotic process of UC. Moreover, the PI3K-Akt signaling pathway, MAPK signaling pathway, toll-like receptor signaling pathway, and Prolactin signaling pathway were predicted to participate in ZJP treating UC. Among them, 14 active components of ZJP directly regulate these pathways. Conclusion. ZJP could alleviate UC through the predicted components and mechanisms. The 14 predicted active components of ZJP may mainly play a therapeutic role for UC through synergistic regulation of the PI3K-Akt signaling pathway and MAPK signaling pathway.

The immunosuppressive function of regulatory T (Treg) cells is dependent on continuous expression of the transcription factor Foxp3. Foxp3 loss of function or induced ablation of Treg cells results in a fatal autoimmune disease featuring all known types of inflammatory responses with every manifestation stemming from Treg cell paucity, highlighting a vital function of Treg cells in preventing fatal autoimmune inflammation. However, a major question remains whether Treg cells can persist and effectively exert their function in a disease state, where a broad spectrum of inflammatory mediators can either inactivate Treg cells or render innate and adaptive pro-inflammatory effector cells insensitive to suppression. By reinstating Foxp3 protein expression and suppressor function in cells expressing a reversible Foxp3 null allele in severely diseased mice, we found that the resulting single pool of rescued Treg cells normalized immune activation, quelled severe tissue inflammation, reversed fatal autoimmune disease and provided long-term protection against them. Thus, Treg cells are functional in settings of established broad-spectrum systemic inflammation and are capable of affording sustained reset of immune homeostasis.

Depression is a common occurrence in patients with Parkinson's disease (PD); however, its pathophysiology is still unclear. This study assessed the association between the integrity of white matter and depressive symptoms in patients with PD. 67 patients with PD were divided into a non-depressed PD group (ndPD, n = 30) and a depressed PD group (dPD, n = 37). The dPD group was further subdivided into a mild-moderately depressed PD (mdPD, n = 22) and a severely depressed PD group (sdPD, n = 15). Tract-Based Spatial Statistics was used to compare fractional anisotropy (FA) between groups. Region-of-interest analysis was used to explore changes in diffusivity indices in the regions showing FA abnormalities. The sdPD patients exhibited significantly reduced FA in the left superior longitudinal fasciculus, uncinate fasciculus, anterior corona radiata, corticospinal tract, and bilateral inferior fronto-occipital fasciculus when compared with the ndPD patients, but the decreased FA was within a smaller area when compared with the mdPD patients. No significant difference in FA was found between the mdPD and ndPD groups. Among the dPD patients, FA values in the left superior longitudinal fasciculus negatively correlated with BDI scores. Impaired white matter integrity in the prefronto-limbic/temporal circuitry, mainly in the left hemisphere, is associated with severe, but not mild-moderate depressive symptoms in patients with PD.

BACKGROUND AND AIM Gastrointestinal stromal tumors (GISTs) are among the most common submucosal tumors in the stomach that require therapeutic intervention. We aim to identify the predictors of technical difficulty during endoscopic resection of gastric GIST and to investigate follow-up outcomes. METHODS Patients with gastric GISTs were reviewed from June 2009 to June 2020 at Zhongshan Hospital. Clinical and pathological features, endoscopic procedure information, and follow-up data were collected and analyzed. A nomogram was developed and validated internally and externally. RESULTS A total of 628 GISTs were finally analyzed. The difficulty was experienced in 66 cases. GISTs size (2-3 cm: OR 2.431 P = 0.018 and > 3 cm: OR 9.765 P

Transcutaneous trigeminal electrical neuromodulation (TTEN) is a new treatment modality that has a potential to improve sleep through the suppression of noradrenergic activity. This study aimed to explore the changes of subjective and objective sleep parameters after 4-weeks of daily session of transcutaneous trigeminal electrical neuromodulation in a group of patients with insomnia. In a group of patients with insomnia, TTEN targeting the ophthalmic division of the trigeminal nerve was utilized to test the effects of transcutaneous trigeminal electrical neuromodulation. Patients went through daily 20-min sessions of TTEN for 4 weeks. Polysomnography parameters, Pittsburgh sleep quality index, insomnia severity index, and Epworth sleepiness scale were obtained pre- and post-intervention. Changes in these parameters were compared and analyzed. Among 13 patients with insomnia there was a statistically significant reduction in Pittsburgh sleep quality index, insomnia severity index, and Epworth sleepiness scale scores after 4-week daily sessions of TTEN. There were no differences in polysomnography parameters pre- and post-intervention. This is the first study to demonstrate the effects of TTEN in a group of insomnia patients. TTEN may improve subjective parameters in patients with insomnia. Further replication studies are needed to support this finding. The data presented in the study are from a study exploring the effect of TTEN on insomnia ( www.clinicaltrials.gov , registration number: NCT04838067, date of registration: April 8, 2021, “retrospectively registered”)

Background and Purpose: Aceruloplasminemia (ACP) is a rare disorder of iron overload resulting from ceruloplasmin (CP) variants. Because of its rarity and heterogeneity, the diagnosis of ACP is often missed or misdiagnosed. Here, we aim to present a clinical spectrum of ACP and raise more attention to the early diagnosis. Methods: Whole exome sequencing (WES) was performed in a Chinese female patient suspected with ACP and her clinical data were collected in detail. The PubMed databases was searched for published ACP patients within the last decade, and we present a systematic review of their clinical features with data extracted from these researches. Results: A novel pathogenic variant (c.2689delC) and a known pathogenic variant (c.606dupA) within ceruloplasmin gene were identified in our patient and confirmed the diagnosis of ACP. Then we reviewed 50 ACP patients including the case we reported here. A possible timeline of symptoms was discovered, anemia appears first (29.7 years old on average), followed by diabetes (37.3 years old) and finally neurological symptoms (52.2 years old). The delay in diagnosis was significantly shortened in patients without neurological symptoms. Biochemical triad including anemia, low to undetectable serum ceruloplasmin, low serum iron and/or hyperferritinemia, showed better sensitivity in diagnosis than clinical triad including diabetes, neurological symptoms and retinal degeneration. Conclusions: Due to the variable symptom spectrum, patients with ACP often visit different departments, which can lead to misdiagnosis. Clinical attention needs to be paid to symptoms and tests that have a warning effect. Prompt diagnosis in the early stage of the disease can be beneficial.